Nat Blau (1928-2010)

Dad-small

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.