Julian Thomas Spenser (“Tomi”) was born in Vienna in 1927. The family moved to Prague in 1935. He was evacuated to England in 1939 on a Kindertransport . His mother perished in Auschwitz, and his father, the renowned poet Sonka, survived only to be killed in post-war Czechoslovakia. Tomi lived in England from his evacuation; he entered medical school in St Andrews in 1945.
After graduation he served as a gynaecologist in the British Army. Not long after discharge Tomi married Dr Sheine Schwartzberg (Trinity College, Dublin), whom he met while doing a house job in London. In 1955 they moved to Lancashire to join Sheine's father's practice. For the next 10 years while generating their own nuclear family, Sheine and Tomi became part of a growing family practice in Leigh, Lancashire. During that time Tomi established a second clinic at “Higher Folds,” a nearby coal mining community neighborhood. It is no coincidence that he chose to create a change for a hard working mining community. His quest for social justice in provision of services characterised his initiatives from the start of his career. In addition, he was concerned about the structure of the medical service. He was persuaded to write Ailments and Remedies, a successful book for the Consumers' Association. During the following 10 years four children arrived: Jonathan, Esther, Miriam, and Benjamin. In 1966 the Spensers moved to Israel, to the northern border kibbutz Sasa.
Tomi and Sheine plunged into the rural GP life in Israel. Tomi became active in the young movement that later became the Israel Association of Family Medicine. He helped to create the nascent vocational training, a syllabus, and an elaborate examination system. He was one of the founders of the Department of Community and Family Health in the new medical school in the Technion, Haifa, in 1975 and created its first rotation in family medicine. From 1981 to 1983 he chaired the Israel Family Medicine Association and remained a central member until he retired in 1996. He helped to found the now flourishing Israeli Balint Society in the late '80s.
Tomi's practice was unique. Besides being available 24 hours, seven days a week, he introduced many innovations into his practice first and many of these became subsequently the nation's norm. Foremost was his keen interest in the medical record. He became the champion of the problem oriented medical record, and eventually the record he designed became the one used throughout the Clalit Sick Fund, which was the provider for 80% of the country's population at the time. Tomi felt that this was his third major professional achievement (besides his practice and his contribution to the specialty of family medicine). He was proud of his 30 years of practice with Sheine in an Arab-Jewish group of nearby rural clinics which had contributed much to co-existence.
Tomi was active in family planning (and insertion of intrauterine devices), did the kibbutzim newborn circumcisions, was involved in emergency care of terrorist casualties on the border (he invested much in equipment and preparedness), had a special bent for well child care, modelled shared community and specialist care in diverse fields—for example, cancer and mental health—and promoted and exemplified interprofessional communication. (Eventually his former trainees cared for Sheine and him in their own terminal illnesses).
He was a thorough researcher and a meticulous writer who always kept up with the medical literature. He authored scores of professional articles, wrote a chapter in the first textbook of family medicine (edited by Jack Medalie, who also died this year). Tomi became an active Quality protagonist, introduced Israel to clinical guidelines, and served in the EQUIP working party of WONCA-Europe. He convened the International Family Physicians Orchestra that played at the opening of the world WONCA Jerusalem conference in 1989, an experience none of the listeners will forget. He retired in 1996, resumed his painting (which he had long ago considered as an alternative vocation), spent more time with the grandchildren (15 by now), and looked after the nine goldfish ponds in Sasa. He established the new programme for the study of the Holocaust and medicine in the Rappaport Faculty of Medicine in Haifa. His efforts brought the programme 10 years down the road to become a firm, viable presence in the medical school with courses, study days, conferences, displays, research, publications, and extensive national and international networking. His notable achievements in this period include the exhibition of artwork by and about physicians from Teresin, a paper on Dr Karl Fleishman (the physician-artist from the same camp), and the collected papers that appeared in the Israel Medical Association journals from 1945 to 2005 which he sent to the printers in its final form just before he died. He was a director of Hospice Upper Galilee (HUG) and a volunteer consultant. Eventually and ironically HUG took care of both Sheine and Tomi at the end of each of their lives.
Tomi is the grandfather of family medicine in northern Israel. He personally trained close to 100 family residents and has mentored almost every teacher of family medicine in the region. Former students who rotated with Tomi and are now deans and distinguished professors in numerous specialties recall their time with him as an experience not to be forgotten. He maintained his teaching role model almost to the end. A few weeks before he died he told one of us (SR): “I was approached by a tutor who wanted to send two pre-med students to interview me in the oncology service, to which of course I agreed. The students came in and began to interview me. At one point I found myself in a rather vulnerable state of mind. I began to cry. When I saw how upset they became, I immediately remembered my teacher's role and started to talk to them about how to approach a crying patient.”
Tomi will be remembered by the many that came to love him as an exemplary rural family physician, a legendary teacher, an innovator, a leader, a dear friend, a person who cared a lot about his patients, his student, and his vocation. He was an outstanding Mensch and maintained an additional network of distant cousins, nieces, and friends whom he visited and hosted in Israel. His children and grandchildren were devoted to him as he was to them. He will also be remembered as a renaissance man, a painter, a musician, and an intellectual. He will be remembered as a family man, whose children and grandchildren were around him and Sheine to the end. He was the Kindertransport refugee who overcame the plight of his family to rise to the highest the human spirit can attain.