Nat Blau (1928-2010)


Joseph Norman ‘Nat’ Blau

My dad died five years ago today. He was a brilliant doctor, empathising closely with his patients and making thousands of lives better. He was a neurologist specialising in headache and migraine, and co-founded the City of London Migraine Clinic, which gave free consultations to all migraine sufferers. In 1962 he beat Roger Bannister to the post of consultant neurologist at the National Hospital for Nervous Diseases, at Queen Square in London. He used to joke that it was the only time anyone ran faster than Roger Bannister.

Queen's Square consultants, Oct 1974. Dad is second from left in the middle row.

Queen Square consultants, Oct 1974. Dad is second from left in the middle row.

My dad teaching my brother about migraine

My dad teaching my brother about migraine

He published over 100 papers in scientific journals, not only on migraine but also on such things as ponytail headache (from tying ponytails too tightly) and sleep-lack headache. He edited a respected textbook on migraine, and his Headache and Migraine Handbook (1986) was written in a straightforward style for ordinary people. He was a superbly clear and concise writer: many of the tips I pass on to my own students came from him.

Mum and Dad's wedding

Mum and Dad’s wedding

He was married to my mother, Jill, for 41 years. He was a caring father to me, my brother Justin and my sister Rosie. He put a lot of emphasis on our education, and inculcated a questioning attitude in us. One of his sayings I still quote is: “If a theory explains all the facts, the theory must be wrong, because some of the facts are wrong.” He disliked the phrase “we now know”, because in his view, some of what we “know” is actually incorrect. His papers would sometimes mention what we don’t know or what his hypothesis could not explain – partly out of honesty, partly as a spur to further research.

He used to refer to “Blau’s Law of 10%”, which was his rule of thumb that only 10% of people have “got it”. He would sometimes follow this up with another comment: “If you’ve got it, you’ve got it. If you haven’t got it, you’ve had it!”

Meeting Princess Diana

With Princess Diana

His preferred version of IQ was the “Insight Quotient”; no one could get to 100% on this scale. He also invented an SQ – a “Sleep Quotient” – referring to the number of people in the audience who were asleep in talks and lectures. His own SQ was almost always zero, I suspect – he was an exceptionally engaging lecturer. He would never get stuck behind the lectern or talk at an audience.

Maida Vale Hospital staff, Nov 1968

Maida Vale Hospital staff, Nov 1968. Dad is in the middle of the front row.

He was by all accounts a superb teacher. He taught until he was 80, when his cancer excessively affected his mobility. His students had great admiration and affection for him. He disliked the way that medical students were expected to soak up knowledge without also developing critical faculties.

He was very funny. If we complained of some pain or ache, his answer was always “Talking too much”. In my case, this was usually true.

Dad age 75

J.N. Blau, at 75

Around the age of 75, he started work on a book called Wrong Ideas and No Ideas in Medicine, which he never finished. He had always been fascinated by wrong ideas which held back progress. He published a seering critique of the neurologist Harold Wolff (Cephalalgia 24:3, 2004) which attacked him for “a high degree of obsession, a desire to be on top and to win, and from an intellectual point of view, his dogmatism and ultra-focus on the vascular theory of migraine …. Wolff retarded progress in the understanding of migraine by at least 30 years”. That sums up several things Dad regarded as key sins. He used to say “Listen to the patient: he is telling you the diagnosis.” Wolff’s descriptions of migraine clashed with what Dad heard from the vast majority of his own patients. The one thing worse than a theory which explained all of the evidence was a theory which didn’t even match much of the evidence in the first place!

A black-tie event at Queen's Square, Feb 1965

A black-tie event at Queen Square, Feb 1965

In his day, most medical students came from wealthy backgrounds. He had next to nothing, and if he hadn’t worked hard at school he couldn’t have won the scholarship that allowed him to study medicine. I’m incredibly proud of what he achieved.

I think of him most when I’m very sad or very happy. When I’m sad I wish he was here, and when I’m happy I want to share good things with him. When I won a teaching award in 2013, I had a brief moment of joy and then started crying, because he wasn’t around to hear about this. My brother won a teaching award in the same year and I think my dad would have been prouder about these two prizes than the promotions my brother and I also got that year. Teaching mattered more to my dad than academic standing. When I asked why he wasn’t a Professor, he said: “I don’t profess to know anything.”

I love and miss him very much.

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  1. tynecastle

     /  May 25, 2016

    I was a porter at Maida Vale for some years and remember your dad well.
    He always gave a good impression to us and taught me a little during a short conversation about migraine. Not all consultants would lower themselves to talk to us!
    A good man!

  2. Bill Laughey

     /  September 13, 2016

    That’s a fabulous description of your dad. I found it searching for his picture to use in a teaching session tomorrow, because I am mentioning him as a role model for excellent teaching and lecturing: particularly the way he involved his audience by asking for volunteers and inviting discussion. I was lucky enough to be a junior doctor in the migraine clinic. His insight and kindness and his brilliant way with patients and his memorable teaching and lectures: all of these I share with colleagues and students. And, yes, he had a great sense of humour!

  3. Esther Marcus (Blau)

     /  January 21, 2018

    Thanks for sharing. Remember your dad well. Our dad was so proud and fond of him!

  4. Joseph Koppel

     /  March 13, 2018

    Your father treated me at the City of London Migraine clinic between 2000 and 2005 for cluster headache. I liked him immensely and was sorry to learn from a member of OUCH UK that he was no longer with us. The last time I saw him was at a Cluster Headache meeting in 2006, and with a meeting planned this weekend I googled Dr Blau. I was amazed to read some of his history. My dad also fled the Nazis. He came to the UK in 1938 from Vienna where he’d been a pianist. He went on to teach music at the Royal College and at Guildhall. I really wish I’d known this when I was a patient of his. He even asked where my father had come from but never once mentioned his own story. I just felt compelled to write something here.

  5. Virginia Ironside

     /  April 3, 2019

    I saw your father only once, probably over forty years ago, and he prescribed the pills for migraine that I still use today. I always remember him as one of the few doctors who was kind, exceptionally intuitive, so knowledgeable and I trusted him completely. He would never have remembered me in a million years but I’m so grateful to him. There are very few doctors today with the same qualities.

  6. H. Macit Selekler

     /  July 17, 2020

    Dr. Nat Blau was the most exceptional headache clinician. I learned the Headaches from his articles. I was a “Fan” of Dr. Blau, and still, I do. We personally know each other from the headache congress, and I was proud of that.
    We first met in Spain during a Headache Congress. He was talking to Dr. Kruitzky at the bar. I waited for Dr. Kruitzky to leave. After he left, I went beside him and introduced myself. I told him that I did a study inspiring from his article “A note on migraineurs’ postures during attacks.” (published in 1993 in the “Headache” journal). He asked me what I found. I told him that I found both similar and different things (my study published in the Journal of Headache and Pain, 2003). He looked my eyes and ordered, “sit down!”. He listened to my results, and we talk about headaches, generally. He offered me -as a friend- to look around in the congress center. We met Dr. N.M. They started to discuss Chronic Migraine. Dr. N.M. alleging chronic migraine is a different entity, and Dr. Blau said, “migraine is the migraine.” In the end, Dr. Blau told Dr. N.M. that “your wife got older, but she is still your wife, isn’t she?”

  7. George Kaim

     /  August 5, 2020

    I have just come across this blog site and can I say, I was sorry to learn of the passing of your father. I knew him over several years as I ran the AV unit at Queen Square for 23 years (retiring in 2008). He was a most interesting man, I found him very amiable with a good sense of humour. We had some fascinating conversations. He would even tell me on which side I slept most of each night by looking at the bags under my eyes. He sometimes requested some unusual photographs to be taken to illustrate his talks on headache and migraine. I even took one of a talc powdered face of a staff member with an iron weight suspended over her head to simulate a pale complexion and the pain of pressure from above. These were the days before computer graphics and I hasten to add no people were hurt in the taking of the photograph! It was always a joy to see him. These memories live on.

  8. nads

     /  December 13, 2020

    I have just come across this blog site i was one of his patients at Clementine Churchill Hospital very engaging and simple to the core i was trying to gt hold of him for advice on a neurological matter alas

  9. Peter Tyson

     /  October 18, 2021

    Like others, I have only just come across this site.Your father treated me for suspected migraine, and related neurological problems at the Migraine Clinic. I thought him a wonderful man; I particularly found interesting his comment that it isn’t so much that things in the nervous system go wrong, but given its complexity it is more to be wondered at that MORE things don’t go wrong. I live near Ely, and he told me a little of his childhood in Haddenham, if I remember rightly. A lovely man.

    • Thank you for these very kind words! I’m so glad you remember my father fondly and I hope he helped your neurological issues.


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