November 3, 1964 – April 20, 2015
WITH the death of Martin Fisher on April 20 2015, the world of HIV lost one of its brightest stars.
Although he is mourned globally, his loss is of course felt most keenly by his partner Adrian and his family, as well as friends, colleagues and patients here in Brighton and Hove.
Martin was born in Cyprus, where his Dad was serving with the Royal Air Force, and on returning to England he was educated in Taunton, Somerset, before going on to study Medicine at Guy’s Hospital Medical School. After his general medical training he specialised in genitourinary medicine (GUM) and the relatively new specialty of HIV, first at the old Westminster Hospital (forerunner of the shiny new Chelsea and Westminster!) and then at St Mary’s in Paddington.
In May 1995, aged 30, and not quite seven years since graduating from Guy’s, Martin applied for two Consultant posts: at Kings College Hospital in London and Brighton Health Care (as the Trust was then called). The rest, as they say, is history.
After a short sabbatical in San Francisco, Martin started work in Brighton on October 2, just a few days after the results of the DELTA trial were presented at the European Aids Conference in Copenhagen. This was a defining moment in HIV medicine: after the disappointing results of the CONCORDE study (that showed AZT alone was no better than placebo), DELTA demonstrated that a combination of two drugs was superior to monotherapy, resulting in improvements in quality and length of life. He couldn’t have arrived at a better time!
Considering the size of the local HIV population (one of the largest outside London) services were underdeveloped, though not for the want of campaigning by local activists (mainly from the LGBT community) and from within the NHS. Most inpatients were cared for by the nurses and respiratory physicians in a specialist ward at Hove General Hospital (now Tennyson Court on Sackville Road), whilst outpatients were mainly seen by the GUM doctors at the recently opened Lawson Unit. Consequently, many local people who wanted to access the latest treatment went to London for their care.
These were the days before viral load and resistance testing were available, when there were only 3 licensed antiretrovirals, and when fewer than 15% of people attending the Lawson Unit were on treatment. The 6-bedded ward was always full, and there were usually 6-12 additional patients on other wards, all with HIV-related conditions. Over a third of people who were diagnosed with HIV already had advanced disease and in Brighton there were about two HIV-related deaths each month (13 per 100 patient years).
Now there are over 20 antivirals and more than 90% of Lawson patients are on treatment. People who are on treatment are rarely admitted to hospital for an HIV-related problem, and their life expectancy is similar to those without the virus. Many factors have contributed to this seismic shift, and Martin played a part in most of them, locally and globally: from the development of new medicines and supporting people taking them, to reducing the number with undiagnosed HIV, and strengthening partnerships with GPs and other specialities.
Martin worked tirelessly and fearlessly to transform the service, arguing his case eloquently and persistently with Trust managers and Commissioners. He was a strong supporter of the whole multidisciplinary team and never scorned a suggestion made by a junior colleague. He enjoyed healthy discussion (though it wasn’t easy to persuade him to change his mind!) and he valued and encouraged the contributions of anyone who shared his vision and passion to provide the very best care. He was a great advocate of patient involvement, championing the establishment of Patient Representatives in the clinic, and respected and valued the insights patients had into their own care and the development of the service.
Martin had a deep affection for both the people he cared for and those he worked with, and continually strove to help them ‘be the best that they could be‘. His enthusiasm was infectious and his ‘can-do’ attitude empowering, and this ethos ensured that, as the team grew, it attracted high calibre professionals who also wanted to make Brighton the leading HIV centre.
There isn’t space to list his many achievements, but one local example is the enormous contribution he made to improving how and where services were provided. This began when Hove General closed in 1997, and he successfully lobbied the Elton John Aids Foundation to contribute generously towards the refurbishment and running costs of the new inpatient, day care and research unit at Brighton General. At the same time his support was also crucial in enabling the Sussex Eye Hospital Pharmacy to be re-opened and used for dispensing Lawson Unit and Claude Nicol Centre prescriptions, rather than patients having to trek over to the pharmacy in the tower block.
Martin was a brilliant clinician, a prodigious researcher and a naturally gifted and engaging lecturer, so it’s no surprise that he was much in demand to speak at conferences, workshops and training courses worldwide. For many years he was an active member of the British HIV Association (BHIVA) and the British Association of Sexual Health and HIV (BASHH), serving on committees, writing guidelines and organising conferences. He was highly influential at a national and international level, and we in Brighton were fortunate to be represented by him.
In February 2013 he was appointed to the Chair of HIV Medicine at Brighton and Sussex Medical School, and a few months later he was presented with a Golden Handbags Lifetime Achievement Award, for developing Brighton’s services for people with HIV. Characteristically, the award was a complete surprise to him: just one illustration that, despite his high profile professional role, Martin was very humble.
Apart from his incredibly successful career Martin had a wide range of interests, including cooking, DJing, piano playing and sailing. For many years he was an Arsenal Season Ticket holder, and on the rare occasions that his clinic finished on time it was usually because he was heading to North London for a match.
So many wonderful tributes have been paid to Martin: from the HIV community in Sussex, from his patients and from colleagues around the world, reflecting the extraordinary contribution he made to HIV medicine, locally, nationally and internationally. He was many things to different people: to me he was an inspiration, a mentor, colleague and friend. The world is just that little bit dimmer without him, but his legacy will live on for generations through the lives he touched.
Heather Leake Date
You must be logged in to post a comment.