DoctorsBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a922 (Published 23 July 2008) Cite this as: BMJ 2008;337:a922
- Sanjay Pai, consultant pathologist, Columbia Asia Referral Hospital, Bangalore, India
In Doctors Sherwin Nuland, a surgeon and medical historian, explores the lives, thoughts, and the making of those physicians who he thinks have contributed most to the state of medicine today. These doctors are generally associated with the greatest conceptual advances in their respective fields. They include Hippocrates, Galen, and Vesalius; Ambroise Pare, for making surgery humane; William Harvey, for his use of the experimental method in medical research; Giovanni Morgagni, for showing the relation between clinical symptoms and the pathology of organs; John Hunter, who made surgery into a science; René Laennec, for inventing the stethoscope; and Ignac Semmelweis, for the germ theory.
The 20th century is represented by William Halstead (surgery and education in the United States), Helen Taussig (paediatric cardiology), and those who contributed to the field of transplantation. Thus, one sees a transition from a European (Italian, French, and British, and finally German) to an American hegemony in medical research.
Nuland is scholarly yet immensely readable. In Doctors he recreates the contemporary sociopolitical currents and puts the medical beliefs of the times in perspective. He is sympathetic to Halstead and the procedure he developed for breast cancer, the radical mastectomy, which has now been abandoned. He offers compelling evidence that much of the tragedy of Semmelweis—who failed to convince the medical world that puerperal fever could be prevented if medical students and doctors washed their hands—was of his own doing. If I have any reservation about Nuland’s choice of pioneers, it is that places are not found for Robert Koch, as founder of bacteriology (but that may be a pathologist’s bias, whereas Nuland’s selection has a bias to surgeons), and Edward Jenner, founder of vaccination and immunology.
What links the doctors in these pages? More than anything else it is their self belief. All of the great physicians and scientists have questioned accepted dogma and often been reviled but have nevertheless stuck to their beliefs and principles to prove their points. All had inquiring minds, even if this was not recognised. John Hunter, for instance, was considered a dullard in his youth—but was inquisitive enough to inquire, as a child, why “the leaves changed colour in autumn.”
Readers will learn not only much about the history of those who have changed our lives for the better but also nuggets such as Auenbrugger’s advice to writers (not to be ambitious of ornament in mode or style of writing but to be content if one were understood) and what Harvey Cushing learnt from Halstead (never do anything to a patient without understanding the why and wherefore).
Cite this as: BMJ 2008;337:a922
First published 1988