In memoriam: Jack Sinclair

In memoriam: Jack Sinclair

Jack Sinclair

John Collinson Sinclair MD Neonatologist 27 September 1933 - 2 May 2014

John C Sinclair, Jack to friends and colleagues around the world, died peacefully in Toronto on 2 May 2014 with Suzanne his wife of 55 years and family by his side. Jack died from cancer for which, after reviewing all the best evidence, he decided palliative care was in his particular case the better option.

Jack’s interest in evidence-based medicine was obvious from the beginning of his career. Under the tutelage of Bill Silverman at Columbia University in the nineteen-sixties, Jack conducted some of the first randomized trials in neonatology. He studied the effect of oxygen breathing and assisted ventilation to correct hypoxemia and managing respiratory distress in a respirator. He brought early attention to the importance of experimental design in studying newborn babies. While on sabbatical in Oxford in 1986, he accepted an invitation from Iain Chalmers to prepare a text using systematic reviews based on the neonatal trials collected in the Oxford Database of Perinatal Trials. In 1992 this was published as “Effective Care of the Newborn Infant” which is now recognized as one of the formative texts in the evidence-based medicine paradigm. In 1993 Jack became the first co-ordinating editor of the Cochrane Neonatal Review Group, the third clinical specialty group to join The Cochrane Collaboration, which to date has published more than 300 systematic reviews in neonatology. Many of these reviews have demonstrably improved clinical practice in neonatology across the globe and Jack is quite properly considered to be one of the fathers of evidence-based neonatology, which became a model for evidence-based practice throughout all of medicine.

Jack exemplified the three cornerstones of an outstanding academic clinician: caring physician, enlightened teacher, and meticulous researcher. Indeed, he was the professor’s professor; an email from Jack with a gentle inquiry would lead to a new way of looking at data, or of the world. His gentle critique of a systematic review became a minor treatise on evidence-based reporting.

Recruited from Columbia to McMaster University in 1970 to establish one of the first Canadian neonatal specialist centres, Jack influenced the way doctors thought about the evidence supporting the manner in which these small patients are treated. He retired from McMaster in 1999 but, still at the top of his academic powers, continued teaching at Yale University and the University of Texas at Houston. Even after retiring from these posts, Jack continued until he died to mentor junior colleagues.

Jack was honored by his profession, receiving the Ross Award from the Canadian Pediatric Society, the Rosén von Rosenstein Medal from the Swedish Pediatric Society and both the Neonatal Education and Virginia Apgar Awards from the American Academy of Pediatrics. In a rare academic distinction, Jack was honored by McMaster University with an Endowed Chair in Neonatology in his name. For all his professional laurels, Jack was a humble man, dedicated to his vegetable patch, untangling the knots from his fishing line, and enjoying telling and retelling an amusing story from a seemingly endless collection of anecdotes. He was a natural raconteur and it only took a decent meal and a good bottle of wine to uncork the stories. Jack was proud of his country of birth but was late in acquiring the ubiquitous summer cottage. Nonetheless, his Canadian DNA resulted in a rapid adoption of the lifestyle and provided a perfect backdrop for his sociability and the gathering of his adored family.

Jack Sinclair’s legacy to the evidence-based medicine movement, The Cochrane Collaboration, and to neonatology will endure. To his family and friends, this gentle man will never be forgotten.