The Whistle-Blower

Joanna Seldon

• Publisher: University of Buckingham Press
• Year: 2017
• eBook ISBN: 9781789551020
• Topic: Medicine
• Subtopic: Ethics in Medicine

"No doctor, however great his capacity or original his ideas, has the right to choose martyrs for science or for the general good." Human Guinea Pigs: Experimentation on Man.

Whistle-blowers tend not to be very popular. Maurice Pappworth's whistle was in the form of Human Guinea Pigs, the controversial book published in 1967 which examined unethical medical experimentation on humans and identified the researchers and institutions responsible. The ground-breaking text took the medical establishment by storm and provoked questions in Parliament.

Brilliant, Jewish, already an outsider, Pappworth was recognised as the best medical teacher in the country. But convinced that the reason for these experiments being carried out was purely to advance the careers of ambitious practitioners, Pappworth had to speak up.

In the wake of his expose, stricter codes of practice for human experimentation were put into place and the establishment of the research ethics committees was formed, which remains in place today.

Maurice Pappworth's daughter, the late Joanna Seldon, re-assesses the importance of Human Guinea Pigs in her book Whistle-blower: The Life of Maurice Pappworth. She considers her father's text a major milestone in the development of current medical research ethics and demands a re-evaluation of the pioneering medical ethicist who compromised his own career in order to ensure the protection of the patient.

Chapter One

From Lomza to Liverpool: a healer’s hinterland

‘Certainly neither our parents nor we ourselves had any material possessions which could be called luxuries by any stretch of the imagination.’

(from Maurice Pappworth’s tape-recorded memoir)

In the Beginning

Maurice Pappworth was an outsider. He came from a family of outsiders, for whom it took a generation as new immigrants before they could confidently feely they truly belonged. Even then, there was certainly no shortage of occasions when they were reminded of their strangeness. He was a maverick doctor who was unafraid to speak his mind. And it was partly because he felt treated as an outsider that Maurice Pappworth had, apparently, so few qualms about blowing the whistle on the British medical establishment.

His family story begins in the twelfth century, when Jews first settled in the town of Lomza (pronounced ‘Wodja’), north of Warsaw. Expelled in 1556, the Jews were permitted by the Congress of Vienna in 1815 to return to Lomza after an enforced absence of 260 years. From the mid-nineteenth century, Jews played a prominent role in the economic life of Lomza, especially in the wholesale timber and grain trades. They involved themselves in the municipal administration until 1926, when a decree was issued forbidding Jews from this sphere. They were also actively involved in the Polish uprisings of 1830, 1848 and 1863. Once Jews were cut off from work in local administration and found themselves facing an impoverished life, many emigrated. It was also in 1926 that the Lomza Yeshiva (a place of Jewish learning) where Pappworth’s grandfather and-great grandfather studied, was closed down. It is a testament to the Jewish determination to survive, culturally and intellectually, that in the very year of its closure the Lomza Yeshiva reopened in Palestine, in Peta Tikvah.

Lomza has changed hugely since the Second World War. Its twenty-first century approach takes visitors past roadside billboards reminiscent of some town in the American mid-west. Through it flows the River Bug (pronounced ‘Book’), within a wide valley. This river played its part in the story of the Pappworth emigration from Poland. Today, Lomza is a centre of the brewing industry, and the local beer is, apparently, much to be recommended. In the town centre some old buildings remain. Efforts are clearly being made to create a more attractive main square, which is flanked by houses painted in different colours and dotted with trees. It is still possible to walk through what was the Jewish ghetto. On its surprisingly wide main road, Senatorska Street, number 7 marks the old Jewish orphanage, which is still standing. Further down the street is the Jewish hospital, built in 1879 and now a school. A bronze plaque on the wall marks the edge of the ghetto: crowned by a Star of David, its commemoration is in Polish, and a bronze relief shows a group of anonymous faces – those for whom this town was once home.

Between the ghetto and the town square a ceramic relief features a Jewish cantor – known in Hebrew as a ‘chazan’ – and a Catholic pastor (among others), with explanations in Polish and English. The juxtaposition seems to suggest that, for many years, Jews and Christians lived in relative harmony. This was not, however, the experience of Maurice Pappworth’s parents.

Reba Michal Ben Josef-Aron Luckl, a leading cantor in Lomza after 1918, was known for his strong baritone. He composed music for the prayers performed by the choir, which he conducted himself. ‘He was kind to people,’ runs the tribute, ‘and followed God’s word.’ He was killed by the Germans in the Gielezynski Forest during the mass executions that took place in 1941. The Great Synagogue in Lomza, built between 1878 and 1899, included a famous rabbinic higher school run by Rabbi Eliezer Szulawicz. The synagogue was destroyed during the Second World War.

In those days the family name was Papperovitch, meaning ‘the child of Papa’. The Russians had forced Jewish families to use the patronymic form for surnames. Jews create their surnames from their parents’ first names – and these remain as what is known as one’s ‘Hebrew name’, by which one is called up to participate in the synagogue service. So Maurice Henry Pappworth was Moshe Elkanan ben Yitzhak Yaakov ve Miriam Devorah, ‘ben’ meaning ‘son’, ‘ve’ meaning ‘and’.

Samuel Hirsch Papperovitch, Maurice Pappworth’s paternal great-grandfather, lived in Lomza with his wife, whom their great-grandson believed had the almost identical surname of Papparovitch. It is likely that they married in their teens. He was a Kest, meaning he spent more than forty years as a student and later a teacher in the Yeshiva, supported financially by his father-in-law. He was awarded a Biblical diploma, the Zomarha, and also managed to run a part-time timber business and a bakery – the latter organised and supervised by his wife. She died when her husband was in his sixties, at which point – after the mandatory year of mourning – Samuel Hirsch married a widow over thirty years his junior who already had three children. Her name was Esther, but she was always known as Spilker, which in Yiddish means ‘plaything’.

Samuel’s son and Maurice’s paternal grandfather was Yisshur Chayim Papperovitch, born and brought up in Lomza. For several years his father taught him at the local Yeshiva where he studied. Although he had been a Kest, he was a businessman at heart, dealing, like his father, in timber, but also becoming involved in property refurbishment. He died in Poland in the early 1920s, over a hundred years old. In his seventies and possibly eighties he visited England and New York to see his emigrant offspring. Travelling by boat from Poland to Hamburg and then on to New York via Liverpool (where he stayed with his son, Maurice’s father) and London must have been quite an undertaking. But the Papperovitch/Pappworth family have always described themselves as ‘stoical’, so Yisshur Chayim would have taken the journey in his stride.

Yisshur Chayim married Miriam Cohen, with whom he had five children. The eldest of these, Avram Tuvia, at the age of twenty-one, drowned in the local river. While he was swimming, so the family story goes, some Christian boys pelted him with stones and knocked him unconscious. The second child, Rosuria, who had three children, was murdered alongside two of them at a concentration camp in Poland – most probably Auschwitz, as it was to here that the Jews of Lomza were generally deported. Just one, Rachel, survived. In the 1920s she emigrated to the United States.

The third child was Yitzhak Yaakov, father of Maurice, who was followed by Hannah: her husband Elkanan Jepcovitz was conscripted into the Russian army for four years. On his release, he emigrated with Hannah to New York, changing his name to Henry Rosen. The youngest two were Etta, known as Maschitka, who got married in Liverpool but who doesn’t appear to have maintained any contact with the family, and Sam, who developed a large dental practice in Brooklyn. When I visited my father’s New York family in 1973, I met Sam Rosen and his wife Betty, and also their dentist son Bernard, all of whom lived on Long Island. But it was in Brooklyn that I stayed, with the eldest of Hannah and Henry’s five children, Fanny Nagelberg.

Hannah’s daughter, Minnie Dublin, was the one cousin with whom my father kept in regular touch, and she came to my sister Dinah’s wedding in Jerusalem in 1980. She didn’t have far to travel: when her husband died in the late 1960s, she decided to do that which, in her interpretation, is the thing God requires all Jews to do: return to the land of Zion which He gave to us. So this elderly woman said farewell to the life in Brooklyn she had always known, to her daughter Dorothy (a nurse) and son Bobby (a doctor), and to her seven grandchildren, and set off to live in an alien country which she saw as her true home. She settled in Dizengoff Avenue in Tel Aviv, a noisy thoroughfare, in a small flat where she lived until her death.

So we come to Yitzhak Yaakov/Isaac Jacob, the third of Yissur Chayim and Miriam Papperovitch’s children, and Maurice Pappworth’s father. My memories of him, with his full crop of thick straight white hair and white moustache, are of a benevolent old man bearing a strong resemblance to Father Christmas. But in his younger days this man, who was never seen out of doors without his top hat, ruled his family with a rod of iron, and seems to have given his six daughters a particularly hard time. His youngest, Naomi, in her unpublished Chapters of an Autobiography, recalls: ‘My father was a dim presence who went to work early, came home late, had his meal and then sat by the fire smoking his pipe, disregarded except when a fierce outbreak of temper had him throwing himself between his fighting younger sons, lashing out in all directions, accompanied by a fine flow of Yiddish curses (favourites were something about being afflicted by a black year and “hang yourself and drown yourself”) until mother intervened to save her young.’ In her other work of family history, Chronicles of the Papperovitch Family, Naomi does admit that occasionally the atmosphere was relaxed, and her parents would play dominoes or draughts. ‘This was a great treat… Once he sat me on his knee. I was very pleased.’

I remember as a small child being addressed by ‘Grandad’ (who was then in his eighties) as ‘Wilder Chayah’: an interesting Yiddish mixture of German and Hebrew meaning ‘Wild Creature’ (not a very appropriate moniker for the little girl I was). My sister Dinah was ‘Chutzpah-Diknik’. In her Chronicles, Naomi observes that her father’s education had been confined to the Hebrew Prayer Book. ‘He could read only Hebrew characters. He never learned to write in any language. I once tried to teach him how to write his name, but he was an extremely bad, impatient pupil. As a result, when his signature was required we had to resort to forgery.’

When Naomi won a state scholarship to university, a form had to be signed by the parent and witnessed by a magistrate. Her eldest brother, Avram, obligingly forged their father’s signature. ‘I then took the document to one JP after another, all of whom said “I have not witnessed your father’s signature, so I cannot sign.” Finally, late at night, desperate that I would have to forgo my scholarship, I arrived at the house of the Mayor of Birkenhead. When he too refused his signature, I burst into hysterical sobs and he relented.’

Yitzhak had left Poland in search of a new life during the early 1880s. Maurice claimed that, among several reasons for his wanting to emigrate, one was his sadness at the tragic death by drowning of his elder brother Avram Tuvia. In a tape-recorded family history and autobiography, Maurice described Avram as his father’s ‘great and constant companion.’ That this death was as a direct result of aggressive anti-Semitism will have provided Yitzhak with an additional incentive to turn his back on Poland forever.

There was also a strong probability that he would be conscripted into the Polish or Russian army for anything from four (like his brother-in-law Elkanan) to twenty-five years. According to Naomi, Yitzhak was in fact conscripted into the Tsar’s army, hastening his decision to leave. He disliked the forced use of the patronymic Russian surname, and had no objection when in 1932 his eldest son, Avram David, changed his name by deed poll when called to the Bar. The whole family followed suit, their surname changing from Papperovitch to Pappworth. Maurice changed his by deed poll in 1933, when he embarked on his medical career. Why Avram David (A.D.) chose the double ‘p’ in the middle is unclear; indeed, Leah and Naomi, the two youngest daughters, always spelled it with just one ‘p’.

So Yitzhak Yaakov Papperovitch put himself in the hands of an agent (possibly illegal, almost certainly charging extortionate rates) for the long boat trip to a better life. According to Naomi’s Chronicles, Yitzhak did at one point before the First World War go off to America, leaving his wife behind in England with a brood of children. His niece Minnie, with whom Naomi kept in close touch, remembered him turning up at her mother’s house in Brooklyn without warning, carrying a suitcase full of samples of English cloth with which he hoped to make his fortune. He later told Naomi that he had got as far west as St Louis, Missouri, before deciding that England would suit him better.

Certainly his initial emigration was straight to England, via Hamburg. He had in fact expected to sail to ‘the Goldener Medina’ of America, but instead found himself landing in east London. Here he was helped by a Jewish charity which met the boats at the docks and tried to find lodgings and jobs for the new immigrants. Yitzhak must have arrived hungry, exhausted and dishevelled. The boats did not contain bunks, so he would have brought his own bedding and slept on the floor of the deck. He would also have brought his own kosher food.

This may have been prepared for him by his new wife, Miriam Devorah from Ostrolenka. She was the daughter of Moshe Baruch Poplowicz, who was a Rebbe – someone who taught the rudiments of Hebrew prayer-reading to boys preparing for their barmitzvah. For this, according to Naomi, he was ‘paid a pittance by their parents, who could hardly spare the few kopeks to pay him’. Miriam’s mother had died young, at which point her thirteen-year-old daughter took over the running of the household. When her father re-married, Miriam grew to detest her stepmother, who treated her unkindly. As Ostrolenka and Lomza were more than twenty miles apart, it is likely that Yitzhak and Miriam’s marriage was arranged by a broker – known as a Shadchan.

Miriam’s new husband promised to make arrangements for her to join him in England once he was established. This took some time. He stayed in London for less than a year, working in a tailoring workshop in what amounted to sweat-shop conditions. In Lomza, surrounded by extensive woodland, he had like his father and grandfather worked in timber. He probably became a tailor on his arrival in London chiefly because it seemed the most reliable means to employment.

Outsiders in Birkenhead

By the time Miriam emigrated from Poland to join her young husband, he had moved to Liverpool. They lived initially in the city’s almost exclusively Jewish quarter, centred on the axis of Brownlow Hill, which comes up from Lime Street to the area now occupied by University buildings and the Roman Catholic Cathedral. The whole area was demolished during the Second World War. Now that he is in England, let us refer to Yitzhak as Isaac. He used his second name – Jacob – as the ‘surname’ of his business, opening a tailor’s workshop where Miriam and later their eldest daughter, Hetty, worked. On the outbreak of the First World War in 1914, he won a contract to make khaki trousers for the army. His illiteracy did not seem to impede Isaac’s conduct of business or everyday affairs. Naomi’s theory was that ‘he must have been very observant and had an excellent memory’ – qualities inherited by both her and Maurice.

Within a few months of the outbreak of war, Isaac, Miriam and their now completed family of nine children moved to Birkenhead. There was in fact a tenth child, the second eldest. He died when still a small baby. Naomi noted in her Chronicles that ‘He was never spoken of.’ My father never mentioned to me the unknown older brother. Naomi maintains that the children were never told anything about their parents’ harsh experiences. They occasionally spoke of “der haim” (the home), always in a tone of affection. To them, home was Russia, to which their part of Poland belonged, the country having been partitioned during the late eighteenth century between Russia, Prussia and Austria. The Papperovitches’ hatred of anti-Semitic Poles meant that they did not communicate with their non-Jewish neighbours. They knew no Polish, except for a few words. Yiddish was their language.

‘My mother’s babies arrived at two-year intervals,’ observes Naomi in her Autobiography, ‘until Sidney was born only seventeen months after Maurice.’ Born in June, Sidney was the only Papperovitch child who wasn’t a winter baby. The family consisted of Hetty (born in 1896), Fanny, Rebecca (known always by Maurice as ‘Rivkah’ – her Hebrew name, and by Naomi as ‘Becky’), Avram David (referred to by his siblings as ‘A.D.’ or ‘Aby’, Esther, Leah, Maurice (born on 9 January 1910), Sidney (1911) and Naomi – who broke the two-yearly pattern by being born in December 1915. ‘I heard my mother tell someone,’ she recalls, ‘that she had expected Sidney to be her last.’ She cannot recall her parents sharing a bed.

As Naomi remembers it, her mother slept with Fanny after the latter became ill, her father with Sidney, Becky with Leah, Aby with Maurice and she herself with Esther. There was also always a cat attached to the family. ‘Then one day,’ Naomi tells us, ‘Dad brought home a tiny black and white mongrel terrier puppy and gave him to me. I called him Jacky and lavished all my affection on him.’ She used to sing to him, ‘I will buy a licence for you if no-one else will pay. Jacky, oh Jacky, please do stay.’ A licence then cost 7/6d a year. It reveals much about the emotional limitations of the Papperovitch family that Naomi found in her love for her dog an outlet for pent-up affections that could be channelled nowhere else. Jacky died at about sixteen, ‘never having been taken to the vet and fed mainly on scraps, including all the bones from hens and fish which are now believed to be so harmful’.

On his father’s decision to move the family across the Mersey from Liverpool, Maurice comments in the autobiography that he tape-recorded in the 1980s: ‘Why he chose Birkenhead, which was then a town of only twenty to twenty-five Jewish families and has in fact never had more than that, I do not know. Perhaps the authenticated vandalism and harassment of foreigners, especially in the Jewish neighbourhood of Liverpool, was a determining factor.’ Naomi was similarly puzzled, especially by their father’s choice of neighbour-hood within Birkenhead: ‘It was far away from the shopping centre of the town and, there being no Jews within miles, it was, in my mother’s words, “Farvarfen from Menschen”’ – far away from people. According to Naomi, ‘we were known in the neighbourhood as “the Jews.” This was in no way pejorative. They were not anti-Semitic. We were the only Jews for miles around, so it was simply a statement of fact.’

The family settled at first into number 15 Greenway Road, but within less than a year moved to number 5, a combined house and shop. In Naomi’s Chronicles of the Papperovitch Family number 5 ‘was the villain of the family story. I was sure that it had a malevolent influence on our lives… It was a horrible house… Greenway Road ran along the top of a low ridge, where had once stood the...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Foreword by Professor Martin Gore
• Preface by Sir Anthony Seldon
• Preface by Joanna Seldon
• Introduction: When doctors become torturers: why the whistle had to blow
• Chapter One: From Lomza to Liverpool: a healer’s hinterland
• Chapter Two: Roots and branches: a family in search of home
• Chapter Three: Prejudice and pride: a doctor at war and peace
• Chapter Four: Guru and showman: a great teacher at work
• Chapter Five: Breaking the silence: a rebel and his cause
• Chapter Six: The whistle blows: the book and the storm
• Chapter Seven: The patient’s champion, the doctor’s conscience: a career in controversy
• Chapter Eight: Gratitude and solitude: a prophet honoured and a man alone
• Conclusion: The Pappworth legacy: compassion, courage, attention
• Afterword: Our father, Maurice Pappworth
• Index