BMJ 1995; 311 doi: (Published 30 September 1995) Cite this as: BMJ 1995;311:852
  1. C S Breathnach
  1. works in the Department of Human Anatomy and Physiology, University College Dublin

    Teaching by subterfuge

    Born in Arklow in August 1897, John Duffy graduated from University College Dublin in 1922. He early fell victim to tuberculosis and spent periods in Swiss and Scandinavian sanatoriums. Thereafter he devoted his life, until his unexpected death on 2 September 1957, to the scientific study of tuberculosis and to the lay and professional antituberculosis campaigns necessary to shake the authorities out of their lethargy and indifference.

    Rialto Chest Hospital in Dublin became part of the municipal Tuberculosis Service in 1943, with Dr Duffy as resident medical superintendent. Within a few years despite its Poor Law past, Rialto developed a reputation as the most progressive tuberculosis hospital in the country, a status unequivocally confirmed when an elaborate surgical unit was added in 1949. In those days six months' experience in a chest hospital was a desirable item in a curriculum vitae; fortunately for me sanatoriums in sylvan surroundings were far more attractive to prospective house physicians, so that in 1951 I went to work in the old work house wards. Dr Duffy taught by subterfuge, and a resident did not realise that he was learning a way of life rather than the minutiae of a restricted medical specialty.

    The day began with a staff meeting in his office, but he was always available thereafter to give advice on any problem that arose on ward rounds. One afternoon when I sought his help he was lying, or rather standing, in ambush. His tuberculosis was healed but he was now racked by rheumatoid arthritis; he could not walk without the aid of crutches, and when he sat it was only on a high stool or on the edge of his desk. After discussing my patient's problem Dr Duffy took a book from the desk, opened it at a bookmark, and read from Osler's incomparable essay on the master-word in medicine: “Though a little one, the master-word looms large in meaning. It is the open sesame to every portal….With the master-word in your heart all things are possible, and without it all study is vanity and vexation….It is directly responsible for all advances in medicine during the past twenty-five centuries…Hippocrates…Galen…Vesalius… Harvey…Hunter…Virchow…Pasteur. Not only has it been the touchstone of progress, but it is the measure of success in everyday life….And the master-word is Work, a little one as I have said, but fraught with momentous sequences if you can but write it on the tablets of your heart and bind it on your forehead….”

    Perhaps I was smitten by the lofty sentiments of the passage and realised that he was quietly undermining my ennui, but it was gradually that I came under the spell not so much of Osler's eloquence as of his gentle admirer, barely able to support Aequanimitas on his gnarled hands and yet prepared to salvage an idler gaily going along the road to nowhere. Subsequently Dr Duffy, with unrelenting encouragement, cajoled me into using the hospital library and five years later he forced me to leave the chest service to go into basic science. And ever since I have cheerfully been riding my favourite hobby horse.

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