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The New Zealand Medical Journal

 Journal of the New Zealand Medical Association, 31-March-2006, Vol 119 No 1231

Peter Grahame Snow
Peter Snow was a leading medical researcher who helped identify chronic fatigue syndrome (or "Tapanui flu") while working as a dedicated country doctor who served his West Otago community for more than 30 years.
Peter Grahame Snow Dr Snow died suddenly at his Lake Hayes home on February 28, aged 71.
He had a strong social conscience, which led him to not only provide medical expertise at the general practitioner level, but also ensure a contribution to health administration and medical research.
His unquenchable thirst for knowledge stimulated his mind and directed him towards a variety of interests.
He was a family man, a country doctor, a researcher, a photographer, a deer farmer, an entrepreneur, and a man of the community whose impressive and wide knowledge was often called on by various sectors.
Locally, he was at the forefront of efforts to keep open the doors of Tapanui Hospital in the face of Wellington's demands for centralised health services, and, like most rural doctors, he was virtually on call in the West Otago area 24 hours a day, seven days a week for more than half his working life.
Nationally and internationally, he led the research effort to identify and suggest the means of alleviating the effects of chronic fatigue syndrome.
Peter Grahame Snow was born in Auckland to Claude (a policeman) and Cecile Snow. His mother died when he was 5. He attended Auckland Grammar School and on leaving became a trainee medical technologist at Christchurch Hospital. After the five-year course, he moved to the West Coast, where he worked at Westport Hospital. Here he met his future wife, Helen, who worked as a physiotherapist.
Westport was also the place where he met one of the most influential people in his life, Dr Len Kitson, who urged him to pursue a medical degree, and in 1959, Dr Snow arrived in Dunedin to enrol at the Otago Medical School. During his second year of study, he and Helen married.
He never regretted either decision. Although funds were very short and the couple had to become disciplined in their spending, Dr Snow began to really enjoy his studies, the people with whom he worked, and the knowledge he was gaining.
His second year as a house surgeon was spent at Gore, while the third saw him working over a wider rural area, based in Gore. It was during this time he was approached by a group of West Otago community leaders and invited to set up a practice in Tapanui, where the small town's GP, Mike Soper, was moving on, and the hospital had been closed.
The group hoped the hospital could be re-opened under a new doctor and in 1969, the Snows moved to Tapanui. Dr Snow was excited about the challenges of working in a rural community and believed it was an opportunity he had been long been seeking. He had always wanted to work and live in the country—he disliked city life—and felt Tapanui gave him what he wanted, and much more.
In a 1992 interview, he said the life of a country GP was never dull or boring. "In West Otago, there's always something happening to keep the adrenalin pumping. Being a GP has its own rewards, especially if you are part of the district. In time, the country doctor has the privilege of becoming a confidant of the community—on hand at births, deaths and all the life in between.
"It's hard to put a price on the satisfaction of watching someone you helped deliver into the world grow up, reach adulthood and have families of their own."
Perhaps his greatest claim to fame was his key role in identifying chronic fatigue syndrome, or what the media termed "Tapanui flu". In the early 1980s, farm stock in West Otago were suffering various selenium deficiency characteristics, and he noticed some of his patients seemed to have a similar syndrome. He and two University of Otago academics studied the outbreak—of what came to be called chronic fatigue syndrome—and their research conclusions, published in the New Zealand Medical Journal, attracted international attention.
Dr Snow had been concerned about the intense media interest in the syndrome at the time, fearing it would make light of the issue. But, on reflection, he believed that interest had actually been positive because it revealed the extent of the problem, both locally and globally. The media had also uncovered the medical profession's initial disbelief in the existence of chronic fatigue syndrome, as well as the widespread dissatisfaction among sufferers of the debilitating condition with the profession's lack of understanding.
Since then, much research has been carried out, including an unpublished study by Dr Snow and his University of Otago colleagues that revealed chronic fatigue had multiple causes.
Dr Snow was also nationally influential in raising safety awareness about the use of farm bikes, after several West Otago farmers suffered severe injuries from accidents on their farms. (He was himself a deer farmer for many years on a property near Tapanui.)
He sat on the Otago Hospital Board and, later, the Otago Area Health Board, where he was a passionate advocate of providing health services to all, whether they lived in the heart of a city or in the backblocks: he was regarded as a champion of rural health services.
His contribution to the profession was significant and his death left a gaping hole, according to the New Zealand College of General Practitioners, which described him in a tribute as one of their most illustrious and respected colleagues. He was a president of the college in 1998 and 1999 and was awarded its highest honour, a Distinguished Fellowship, in 2001.
But Dr Snow's pioneering of rural GP education should also be particularly remembered, according to the current president, Dr Jonathan Fox.
"Possibly, he will be remembered as the classic country doctor, looking after the people of Tapanui for over 30 years," he said.
Dr Snow was a man of wit and intelligence—one who always relished the stimulation of quick minds—and hosted many New Zealand and overseas student doctors in his practice. Dr Fox said he had maintained a lifelong interest in seeking knowledge and he was at the forefront of general practice research.
It was noted in his citation for the fellowship that he had "the farmer's ability to perceive the connections between what to others might seem unrelated things".
Dr and Mrs Snow moved permanently to their Lake Hayes home after selling the West Otago practice to the West Otago Health Trust three years ago. The couple had initially planned to operate Venetian-style gondolas on Lakes Hayes and Wakatipu, but decided to shelve the idea due, Dr Snow claimed, to stifling by "red tape".
Peter Snow is survived by his wife and their three sons.
This obituary entitled Country doctor made mark at every level was written and published by the Otago Daily Times on Saturday 11 March 2006. We are grateful to the Royal NZ College of GPs for providing the photograph as well as Diane Campbell (ODT) and Shani Naylor (NZMA) for their assistance.
     
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