Arthur Hamilton Crisp
Authors: Caroline Richmond
Journal: BMJ (2007)

We owe our understanding of anorexia nervosa to Arthur Crisp, who earned an international reputation for the meticulous research that enabled him to define its core feature: the fear and avoidance of normal body weight. He defined the factors that contribute to the disorder's development, and these have stood the test of time. His treatment programme was, in its day, considered the gold standard. A mild, unpretentious, generous, and approachable man, he also carried out research (behavioural, psychodynamic, and epidemiological) into sleep disorders, psychological factors in heart attacks, migraine, obesity, and smoking. His humanistic approach was to define each patient's social, biological, and psychological features, and he used a range of pharmacological and psychological therapies. He developed psychiatric services around St George's Hospital in south west London, and incorporated Springfield, the local psychiatric unit, into the teaching hospital framework. He developed a wide range of specialised psychiatric services. 

He edited the Journal of Medical Psychology. He was visiting professor to Harvard and Sydney universities. He was a fellow of three royal colleges: psychiatrists (1971), physicians of London (1975), and physicians of Edinburgh (1972).

As London University's dean of medicine in the 1970s he supervised medical education in 25 undergraduate and postgraduate teaching hospitals, five dental and two pharmacy schools, and a veterinary college. He chaired the advisory committee to the European Community during 1983-5. As chairman of the General Medical Council's education committee he broadened the curriculum to incorporate psychology and sociology. He was an active member of the Royal College of Psychiatrists, including chairing the college's committees set up to respond to the Ashworth inquiry and the Tomlinson report, which looked at neglect of patients in institutions and care standards. He advised the Chinese and Japanese governments, and was an adviser to the World Health Organization until shortly before his death.

Crisp was the son and grandson of an electrical engineer. He shared their devout Christianity. At Watford Grammar School he planned to study engineering at Imperial College, though his mother wanted him to join the civil service. He was captain of rugby and athletics and won a cap as a flanker for the 1948 English schools rugby team. While waiting to join up for national service he suffered an appalling knee injury that hospitalised him for nine months and left him with a permanent left foot drop. Nevertheless, he completed his national service and—on 29 December 1950, when he was 20 and had just finished a medical consultation—he decided he wanted to be a doctor and possibly a missionary. He graduated in 1956 from King's College and Westminster Hospital, winning prizes in medicine, surgery, and social medicine. He did his house jobs at Westminster, and that same year he was invited to provide medical care for Hungarian refugees.

He trained in neurosurgery under Sir Wylie McKissock, best remembered as being keen on lobotomy at Atkinson Morley Hospital; he also started his psychiatry training there. He was then introduced to Sir Denis Hill, head of psychiatry at the Middlesex Hospital, where he worked as lecturer and then senior lecturer. Hill became his mentor, and he turned down an opportunity to work at the Maudsley and Institute of Psychiatry. He shone on ward rounds and at clinical discussions he regularly astounded colleagues with his knowledge of the psychiatric literature. In 1969 he was appointed head of psychiatry (later mental health) at St George's. He remained there for the rest of his career.

He published 330 papers and four books: Nutrition and Mood (with Edward Stonehill) (1976), Anorexia—Let Me Be (1980), When Dieting Becomes Dangerous—A Guide to Understanding and Treating Anorexia and Bulimia (with Deborah Michel and Susan Willard) (2003), and Every Family in the Land: Understanding Prejudice and Discrimination Against People with Mental Illness (2003).

Crisp was a very private person who fought his corner without rancour. He often said his family was the greatest source of fulfilment in his life.

In 2001, in his retirement, he took on the task of director of the “Changing Minds Campaign” for the Royal College of Psychiatrists, looking at ways of dealing with the stigma that psychiatric patients suffer. His recreations were golf and wood carving, for which he won awards. He died at home, of stomach cancer, and is buried at St Mary's Church in Friston, Suffolk, where he had a cottage. He is survived by his wife and three sons.

Arthur Hamilton Crisp, head of psychiatry (later mental health), 1967-95, and dean of medicine, 1976-80, London University (b 1930; q Westminster 1956; MD, DSc, FRCPsych, FRCP Ed, FRCP), died from stomach cancer on 13 October 2006.