Henry Barnett, Robarts founder, dies at 94

Famed medical researcher Dr. Henry Barnett, co-founder of the Robarts Research Institute, who served as its first scientific director, died peacefully in the company of family on October 20, 2016. He was 94.

Tributes to the famed physician have been flowing in since the news became public.

“For those of us who were trained by Barney, it is a legacy that will stay with us forever. He instilled in all of us a sense that nothing less than excellence was acceptable, that we had a responsibility to practise medicine at the highest level using all available evidence and when it was not available, to work toward creating it,” said Dr. Michael J. Strong, Dean, Schulich School of Medicine & Dentistry.  

“He pushed each of us to our limits of our clinical skills, and then, pushed us beyond.  Being ill-prepared when presenting a case was really not an option.  Meandering in a case presentation usually meant an abrupt ending to the presentation - a skill that many of us still treasure to this day.  But beyond this, he was the consummate gentleman who taught us the value of family and of dedication to the environment. While we perhaps use the term too often, his passing truly marks the loss of an icon in our clinical world. He will be greatly missed,” he added.

Barnett is best known for directing many of the most important large multi-centered clinical trials in stroke, including the first randomized trial to show that aspirin prevents stroke. Supported by the National Institutes of Health (NIH) in the United States, Barnett showed that a then widely used surgical treatment for stroke patients involving carotid artery bypass was less effective than good medical treatment.

Born in Newcastle upon Tyne in England, he moved with his parents to Canada as a child. He entered medicine at the University of Toronto where he graduated in 1944. He did his junior rotating internship at the Toronto General Hospital and later completed training in neurology in Toronto in 1950. After two years at Queen Square in London, UK, and later a research assistant in Oxford, he obtained a fellowship from the Royal College of Physicians and Surgeons of Canada. He was neurologist at the Toronto General Hospital from 1952-67 and Chief of the Division of Neurology at Sunnybrook Medical Centre from 1966-69.

In 1969, he was invited to become the Chief of the Division of Neurology at Western University and Victoria Hospital. From 1974-84, he served as Chairman of the Department of Clinical Neurological Sciences. In 1986, he co-founded the Robarts Research Institute and was named its first Scientific Director.

Barnett is most famous for the North American Symptomatic Carotid Endarterectomy Trial (NASCET), which evaluated whether or not clearing a clogged neck artery in the hopes of averting stroke actually reduced a patient’s risk of stroke or dying.

“No one knew who needed surgery and who didn’t,” Barnett said in a 2012 interview. “So the director of the (U.S.) National Institute of Neurological Disease and Stroke at the time said: ‘Barney, why don’t you evaluate it?’” The rest, as they say, is medical history.

NASCET showed the invasive surgical procedure significantly reduced the risk of stroke in patients who had a carotid artery that was more than 70 per cent blocked – otherwise, the operation yielded only a moderate reduction in the risk of stroke in patients with moderate blockages (50 to 69 per cent) and did not at all benefit patients who had an artery that was less than 50 per cent blocked.

“That got us a reputation for knowing something about stroke,” he said. Before the NASCET study, Barnett was leading another extensive trial, with quite a different outcome. In North America, and some other medical centres in the world, clinics were established to perform extracranial-intracranial (EC-IC) bypass surgery, in patients with total occlusion of one of the major supplies to the brain, the internal carotid artery. Through an opening of the skull bone, arteries on the outside of the skull were connected with those on the surface of the brain.

The EC-IC bypass study showed that these operations did not benefit patients and in the mid-1980s, these operations were almost totally stopped. Today, we know that before any conclusions can be made on the severity of an occluded carotid artery, an evaluation of alternative (collateral) blood flow supply to the brain is essential.
Even earlier, in 1970, Barnett was leading the Canadian Aspirin Trial which established, for the first time, that any antiplatelet drug could prevent diseases (in this case stroke) due to arterial thrombosis.

A worldwide figure in neurology, Barnett really wanted to be a naturalist. The medical schools he chose for his multi-centre international clinical trials also happened to be close to bird sanctuaries. A child of the manse, he skipped Sunday school to frequent sewage lagoons with his binoculars. He was a leader in conservation with much of the preservation of primary forest in the King Township, Ont., due to his years of persuasion. He was able to get the Prime Minister of Canada into his living room and wring $250 million out of him for the Nature Conservancy of areas needed by threatened plant and animal species.

Barnett was named an Officer of the Order of Canada in 1984, and then promoted to Companion in 2003. He was inducted into the Canadian medical Hall of Fame in 1995, awarded an honorary doctor of laws degree from Western in 2001 and an honorary doctor of science degree from the University of Oxford in 2012. Barnett was the first non-European to receive the prestigious Karolinska Stroke Award for Excellence in Stroke Research in 2008. The Karolinska Institute also awards the Nobel Prize annually.

He is survived by his brother Doug and sister Mary Ranger, and his children Ann and David Love, Will and Frances (Brickenden) Barnett, Jane and Jim Drake, and Ian and Judy (Snowden) Barnett, as well as by his grandchildren and great grandchildren.

For more information about visitation you can view the obituary online.