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OBITUARIES

Stephen Hough, 1947 - 2014

Stephen Hough and I collided for the first time when we were research fellows in the USA. That encounter in 1980 sowed in me the seed that was to become one of my closest friendships, although at the very beginning I had my doubts. Stephen had hit St Louis about a year before I did and we were to share an office. The potential difficulty lay in putting a slightly 'left of centre' Brit in with a South African, and an Afrikaans one at that. This was 1980. Tricky. Stephen's opening salvo snuffed out my concerns in a flash - big smile, big handshake, a comment along the lines of 'welcome to the madhouse', and a first blast of that window-rattling laugh that was never far from the surface. The politics was not a problem, though it was discussed at length over the years, often facilitated by too little sleep and a certain amount of whisky. Also subject to scrutiny were, in no particular order, the rollercoasters of personalities, sport, academia, clinical medicine, medical politics, food and drink. Stephen loved talking.

The Bone and Mineral Fellowship Programme at Washington University in St Louis was quite exceptional at that time, with an enthusiastic group of largely international fellows under the direction of an extraordinarily potent faculty - Avioli, Haddad, Teitelbaum, Whyte, Slatopolsky, Peck, to name a few. This was a seminal period for Stephen, and one that could easily have ended with him remaining in the USA permanently. There was no shortage of well-supported faculty positions on offer as his reputation grew, and he and I had many a long conversation about the pros and cons of throwing his lot in with the Americans, in many respects an attractive option. Ultimately his sense of duty to family, colleagues, his parent institution and his country trumped all the inducements that were being thrown at him, and it was clear that, with no hint of underlying arrogance, he believed that he should not be a part of the haemorrhage of talent that South Africa was experiencing at the time. In retrospect one can see that the decision was never in doubt.

My family's experience was common to many of Stephen's friends. We all thought the world of Stephen - and brightened at the mere mention of his name. My trips to Cape Town have always been immensely enjoyable, largely because of the amount of laughing that always seemed to go on in Stephen's company, often about very silly things. Stephen really was unquenchable in that respect. One of the most endearing things about him was the fact that this supremely intelligent and able man, even when no longer in the first flush of youth, had a side that was still a boy, and furthermore a boy showing little sign of growing up.

Stephen's achievements were built on a combination of three A's - ability, affability and availability. The ability was there for all to see - bright, inquisitive, competitive. The affability was his hallmark - charm, humour, joie de vivre all served him well, professionally and personally. Availability, so often missing in successful careers, meant that his patients, colleagues and protégés would be very aware of his commitment to them. There was, however, a hard edge as well. He hated posturing and pomposity and was intolerant of anything he perceived as scientific chicanery. He expected from others the high standards that he imposed on himself - Stephen was a man who consistently chose the difficult right path over the easy wrong one.

Although the final grim twist in his story was not anticipated, he tackled it in the way he approached everything, with the tenacity that was his hallmark. He knew that he had led a charmed life, enjoying the luxury of a loving family, wonderful friends scattered across the world, and innumerable adventures. That he handled his last illness in the way he did comes as no surprise - a mix of bravery and determination, with a fair sprinkling of obstinacy thrown in for good measure. As the storm clouds gathered he would still toss in the odd gem of dark humour. Even when ill he was determined to live his life as fully as possible. Of course he was always a terrific optimist and remained so virtually to the end - Stephen didn't do self-pity.

Prof. Sir John Cunningham
Professor of Nephrology, Centre for Nephrology, UCL Division of Medicine, School of Life and Medical Sciences, University College London, UK drjohncunningham@gmail.com

Stephen Hough was one of the finest clinician-scientists to have emanated from South Africa. In his early thirties and already an established researcher with several degrees in medicine and science, he was earmarked by his mentors for advanced training in the USA. From 1979 to 1981 he worked at Washington University in St Louis, Missouri, while on a 2-year research fellowship in endocrinology and metabolism. This centre was famed for its work in metabolic bone disease and jump-started Stephen's lifelong passion for this field, osteoporosis in particular.

On his return to the Department of Medicine at Stellenbosch University's Faculty of Health Sciences, Stephen became head of the newly developed Metabolic Unit (later the Division of Endocrinology) based at Tygerberg Hospital. Over the next 30 years (until retirement) he was pre-eminently responsible for this unit being one of the top training and referral centres in endocrinology in South Africa, as well as the leader in osteoporosis. In 1993 he founded the National Osteoporosis Foundation of South Africa, of which he was President until his death.

From 2001 to 2006 Stephen served as Chairman of the Department of Medicine at Stellenbosch. He retired at the end of 2012, but was too active and enthusiastic not to stay involved. Besides opening a private practice, as Emeritus Professor he committed one full day a week to his alma mater, which included teaching as well as mentoring five new doctoral candidates.

Not only did Stephen receive numerous local accolades over the past 40 years, but he also held senior positions in the Society for Endocrinology, Metabolism and Diabetes of South Africa (Chairman 1992 - 1994), the Colleges of Medicine of South Africa, the South African Diabetes Association and the South African Medical Research Council, to name a few. Internationally he held high office in many societies, including serving on the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF), the International Advisory Panel of the American Paget Foundation and the Membership Committee of the International Bone and Mineral Society. He was also elected to represent Africa on the IOF Board of Governance. He was the founder editor of the Journal of Endocrinology, Metabolism and Diabetes of South Africa and a reviewer for several prestigious international journals.

I knew Stephen Hough for nearly three decades, at first as a revered elder in our field, later as colleague and good friend. Stephen was always warm to everyone, and was not bothered by ego. He was never pretentious, and never acted superior to even his most junior colleagues. There were no hidden agendas, and he was as honest as the day is long. If he strongly disagreed with 'authority' he was not afraid to tackle it head on. He never harboured prejudice and he abhorred racism, even in an era when it was frequently the norm.

We pay homage to a loving husband and father, a true friend, a national and international icon in his field, a giant of a man, full of gusto, humility and passion. We will never again hear that booming baritone voice filling any room, but we are all so much richer for having known Stephen.

Prof. Brynne Ascott-Evans
Head: Division of Diabetes and Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa bae@sun.ac.za