Dr Andrew Flapan FRCPE

Dr Andrew Flapan was one of a kind.  A complex individual, even to those who knew him well, driven by loyalty, kindness and an undying commitment to practicing the art of medicine with care and consideration. While often resistant to change, he was committed to improving the service to patients. In taking a dispassionate view on subjects others took more seriously, he instilled his sense of humour into many clinical situations leading to calm and a sense of purpose in those around him

Born to Polish immigrants escaping the war, he grew up in North London with his parents and elder sister. His father, a physician, died aged 56. He was educated at Epsom Collage and trained at the London Hospital Medical School, qualifying in 1981. His career took him through junior posts in Brighton, Hereford, Norwich and Truro, attracting curiosity in the latter for wearing a large army greatcoat when attending emergencies out of hours. He passed MRCP(UK) in 1986, and obtained a research registrar post at the Western General Hospital in Edinburgh in 1987, the start of a long relationship with the hospital over his professional life. His research on the renin-angiotensin system led to his MD in 1993. 

He worked as a cardiology registrar and senior registrar at the two Edinburgh teaching hospitals, becoming adept at cardiac catheterisation, and was appointed to a consultant post at the Royal Infirmary in 1994. After his appointment as Clinical Director for Cardiology, he had two notable achievements. His responsibility for cardiology across both teaching hospital sites in Edinburgh led him and others to realise that siting all invasive and interventional services on the one site where cardiac surgery was provided would be the only sensible means to preserve the necessary standard of care and provide unity of purpose. Because of the implications to the cardiology service at the Western General Hospital, there was a significant resistance to this change. However, he believed that this was the only workable solution and he took on considerable challenges from colleagues, sometimes personal, to achieve this goal. He protected other younger colleagues on both sites from this backlash but achieved a successful outcome with the creation of the Edinburgh Heart Centre, encompassing both the (new) Royal Infirmary and the Western General Hospital.

Concordant with this city-wide redesign, he recognised the need to have a robust arrangement for providing a primary percutaneous coronary intervention service for acute myocardial infarction for South-East Scotland. He succeeded in driving this strategy, despite the consequent physical stress on cardiologists having to work days after nights on call, something more recent medical graduates were not used to. If asked now, they would say it was worth it. He spoke truth to power, which few have the courage to do and which gave him a rare ability to affect change for the better, particularly when working in the higher echelons of NHS Lothian as he took on more management roles.

Extremely loyal, he would never forget a significant interaction and always held many strong views and opinions which did not alter over the years. He supported his junior colleagues with vigour, although many never knew quite how to take him, often a source of great amusement.  His ability to convince the unsuspecting with a prank letter or phone call was legendary, both to new initiates on the ward as well as to his colleagues, who were often taken in.  He took his role as a mentor to younger cardiologists seriously and made a real effort to support then through the changes they had to endure through medical reorganisation over the years, both nationally and locally through the whole hospital-at-night experience. He defended Cardiology to the letter.  He threw his efforts into areas others were less inclined to do so, and it served us all well.

He was appointed to the role of the Queen’s Physician in Scotland in 2008, a matter of immense pride. It was a role cloaked in absolute discretion but was an inspired choice; no doubt he would have added to the colour of the many occasions he served in this role.

Most importantly, and to his great happiness, in 1991 he married Christiane to whom he was devoted. Their two sons, Jacob and Reuben, are very much cut from the same cloth as their father but with the additional benefit of their mother’s insight, charm and diplomacy. She once said at a Cardiology Department Christmas party, when her husband was in full flow, that he did not come with a volume control.  We were all beneficiaries of that. 

He will be missed greatly but never forgotten by his colleagues and patients. He made a real difference, and there are few of whom one can say that.

Neal Uren