Richard (Dick) Hornabrook, prominent Wellington neurologist, researcher and naturalist, died after a long illness on June 21st 2012 aged 86

Dick was a gentleman scholar, trained as an academic physician. He was also an accomplished entomologist and a clinical neurologist, renowned for his skill.

Dick was born in Wellington in 1925. His father was a successful stockbroker, his mother the daughter of a businessman. His early education was at Wellesley private school for boys. From an early age he was intensely interested in natural history and kept meticulous records of where and how insects were found. During WWII the family moved to Sydney where he spent 4 years at Knox Grammar. A master recommended a career in medicine which would also allow him the time and the resources to pursue his entomology. He graduated from Otago Medical School, MB ChB in 1949, with distinction in anatomy and was a 6th year student and then house surgeon in Wellington Hospital from 1950 for two years. During that time he published a paper as the sole author on public health issues relating to the poisonous Katipo Spider. He held a post as anatomy demonstrator at Otago Medical School in 1952, at the time as preparation for a career as a neurosurgeon. The anatomical knowledge was useful in research and for future practice of internal medicine. The knowledge he acquired was both very useful and evident in his later practice of neurology. Ian McDonald was one of the students he taught that year. Ian was later to become a professor of neurology at Queen Square, and internationally recognised expert on multiple sclerosis. He remained a life long friend. During the year he joined Jock Caughey’s ward rounds. Caughey persuaded him to work on an M.D. and be his registrar the following year. Caughey encouraged him to undertake an experimental study of the adaptation of rats to cold in the endocrinology research laboratory supervised by Purves and Griesbach. Dick was disappointed that his research project had nothing to do with neurology, but he was grateful for the opportunity to work with Purves and Griesbach from whom he learnt a rigorous academic approach to experimental studies. The project led to two publications and an M.D in 1955.

He also produced two clinical papers, one on pituitary necrosis, the other on subacute thyroiditis with Dr Jock Caughey, the author of an important monograph on myotonic dystrophy. He also qualified as a physician, MRACP in 1954.

While working in Dunedin he met Sir Charles Symonds, the Sir Arthur Sims Commonwealth travelling professor for 1953 and a leading London academic neurologist with important papers on subarachnoid haemorrhage, benign intracranial hypertension and on flying neurosis among airmen in World War II. Dick was asked to entertain Sir Charles bird watching and trout fishing in central Otago, interests they both shared. Sir Charles persuaded Dick that neurosurgery would be “boring beyond endurance” and that neurology would be a more interesting career. He was later to help Dick obtain a neurology training position in London. Dick was a Nuffield Travelling Fellow in medicine in 1955, and obtained a job “on the House” at the National Hospital for Nervous Diseases, Queen Square London. He was house physician for two years and then resident medical officer.

This training, as an undergraduate research fellow and advanced trainee in internal medicine, followed by postdoctoral clinical training at one of the pre-eminent international centres for neurological illness established his credentials as an academic neurologist.

While in England Dick met Fay Marshall, an intensive care nurse at Queen Square from Lincolnshire. Fay followed Dick to New York where they were married.

In London Dick met Dr Fletcher McDowell, a Cornell and Stanford trained neurologist, while Fletcher was at Queen Square for a year in 1955. Fletcher was made chief of the Cornell Neurological Service at Bellevue Hospital in 1956. In 1959 Dick left Queen Square for New York as assistant director of neurology in the Second Cornell Neurological Division Bellevue Hospital New York. Since 1913 Cornell Medical School had appointed the staff in what became known as the Second (Cornell) Division. Bellevue was one of New York's busiest hospitals, and this was a prestigious academic appointment.

Dick returned to New Zealand and was appointed Visiting Neurologist at Wellington Hospital in 1961. Fletcher went on to be one of the founders of the American Heart Association journal Stroke, and its second editor. He ran a large programme of research in treatment of Parkinson's. The two remained close friends. Just how close was made clear when on a visit to New Zealand Fletcher, frustrated at his inability to use email for communication with Dick, bought him one of the new IBM computers and a printer. Though Fay used it to type his reports, Dick never took to the new technology, occasionally giving the computer a joking and gently reproving kick.

Dick never settled to the life of a visiting neurologist in Wellington. He was committed to scientific investigation in neurology, and immediately commenced an epidemiological study of the prevalence of Parkinson's disease with Dr Martin Pollock, neurology registrar. The study was the first to identify significant disability from dementia in a community sample of patients with Parkinson's disease. Armed with the credentials gained from having successfully completed this large study, Martin went on to train in the US and returned to New Zealand to a successful career as an academic neurologist and peripheral nerve expert in Dunedin.

In 1962 Dick received a grant from the MS Society of Canada to attend a course on epidemiology at the CDC in Atlanta.

Around this time an epidemic of a new and fatal neurodegenerative disease was being reported among the Fore people in the New Guinea highlands. Kuru or shaking sickness had been brought to the attention of Carleton Gajdusek by Vincent Zigas, an Australian colonial officer. Gajdusek was an American physician, virologist, and exceptional linguist, with intense energy and personal magnetism. Gajdusek was subsequently awarded the Nobel prize for his contribution to unravelling the cause of kuru by demonstrating transmission to chimpanzees by inoculation.

Independently MacFarlane Burnet, the prominent Australian immunologist, chairman of the Papua New Guinea Medical Research Advisory Committee between 1962 and 1969, lobbied the Australian government to establish the Papua New Guinea Institute of Human Biology to investigate kuru. A British trained neurologist was needed as part of the team. In 1963 Dick was invited by Professor Robert Walsh of the Papua New Guinea Medical Advisory Committee to take a two year position to study kuru.

Dick went to New Guinea for the first time from 1964 to 1966. He and other team members went on patrol among the Fore people in the highlands of New Guinea to investigate the epidemiology, signs and symptoms of kuru, and to collect biological including neuropathological material.

The team worked closely with Carleton Gajdusek. The key epidemiological observation was the ritual consumption of brain material from the deceased during funeral rites by women and children. This possible mode of transmission was first suggested by two anthropologists, Shirley and Robert Glasse. The investigative work depended on Dick's ability to identify reliably the affected people from their history and physical signs of neurological illness, and exclude patients with hysteria (the Fore tribe lived in constant fear of the epidemic disease), and conditions with similar signs. Gajdusek, who was quick witted and impatient by nature, often expressed disdain for the meticulous neurological assessments that ultimately enabled their work to succeed. Dr Dick Johnson, neurological infectious diseases expert, stayed with the Hornabrooks at the Okapa Patrol Station. By his account, Gajdusek had described the movement disorder of kuru as resembling Huntington’s disease, but Dick Hornabrook correctly characterised it as a cerebellar ataxia. By that time Dick Hornabrook was convinced that transmission was by cannibalism whereas Gajdusek still rejected cannibalism as the mechanism of transmission of kuru. Dick's natural interests, abilities and training culminated in his significant contribution to the understanding of the disease kuru.

Dick returned to New Guinea to direct the new Papua New Guinea Institute of Human Biology from 1968 to 1975. His family returned to New Zealand in 1973 for secondary schooling. The institute and the opportunities it provided for collaborative research in an extraordinary environment was announced by Dick in an article in the prestigious journal Science.

The years appointing and collaborating in research with biologists and anthropologists were productive and exhilarating. He led a broad investigative programme under the Human Adaptability Project in diverse areas including the demography, sociology, and genetic diversity of the inhabitants of New Guinea.

While in New Guinea he continued his scientific study of beetles publishing a monograph the Handbook of Common New Guinea beetles, with Linsley Gressitt, an ecologist, in 1977.

On his return to New Zealand he continued his interest in epidemiology of chronic neurological disease and to inspire and advance the careers of future neurologists. With Dr David Miller and with Dr Chris Shaw, he carried out successive investigations of the prevalence of multiple sclerosis. Both went on to become highly successful, internationally recognised clinician investigators, David Miller in multiple sclerosis, Chris Shaw in the genetics of motor neuron disease.

Dick had 68 papers listed on MedLine, and at least 8 more in journals from other disciplines. He was the editor of "Essays on kuru", "Topics on Tropical Neurology" and co-editor of "A Bibliography of Medicine and Human Biology of Papua New Guinea".

Dick was a visiting neurologist at Wellington Hospital until retirement in 1990, and continued to see patients in private until 2005.

In his long career as a consulting neurologist he was admired by his neurologist colleagues for his clinical acumen and for the care and respect he showed his patients. Throughout his later practising career Dick took a particular interest in the problems of patients with disabling neuropsychiatric conditions such as chronic fatigue, and often remarked that he wished he knew more psychiatry.

His other life-long interest was entomology. He gathered an extensive collection of beetles, butterflies and moths, as well as a smaller collection of shells. He collected in NZ, New Guinea, Malaysia, Europe and North America. His collection, contained in 20 large cabinets, is the largest private collection in the southern hemisphere. He bequeathed the collection to Te Papa, along with money to be used to maintain it.

Dick is survived by his wife Fay, and children Richard, Charles, and Sarah.

Acknowledgments
Information about Dick's early life and his time in research and clinical work in Dunedin was kindly supplied by Annette Beasley. Dr Neil Anderson has researched Dick's life in detail for his history of neurology in New Zealand and supplied much of the information and corrected many errors.