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Medicine And Books

Sir Thomas Lewis: Pioneer Cardiologist and Clinical Scientist

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7096.1773 (Published 14 June 1997) Cite this as: BMJ 1997;314:1773
  1. Graham Jackson, consultant cardiologist
  1. Guy's Hospital, London

    Arthur Hollman Springer, £39.50, pp 300 ISBN 3 540 76049 0

    The direction and style of this book are outlined by Dr Hollman in the preface: “In some quarters there is now a strong tendency to play down the personal contributions of individuals and to emphasise instead the general events of their lifetime. In other words to demonstrate the importance of what is called social history. But I have not felt the urge to join this movement.”

    Encouraged by this, I set aside my lack of enthusiasm for medical history but first I had to overcome an important hurdle–the book's layout reminded me of those 1950s textbooks with relatively small print and text-heavy pages that were an inspiration to no one. I could so easily have been put off if I wasn't reviewing the book, and this would have been a tragedy for I found the book fascinating, well written, and rewarding.

    Lewis comes across as the most dedicated of research workers, whose contribution not just to cardiology but to experimental science was enlightened. He clearly did not suffer foolish conversation well, but he inspired great loyalty and respect. He founded the journal now known as Heart while working principally on arrhythmias, with his classic papers on atrial fibrillation being cardiac landmarks. He forged friendships with and earned the respect of Levine, Dudley White, and Mackenzie, and his lectures were enthusiastically received in the United States. He was stubborn–for example, he repeatedly refused to believe that he was incorrect in his explanation of left bundle branch block, and he was also wrong in his understanding of the effects of mitral stenosis. He was, however, quite extraordinarily inspired in his thought, and this is reflected in his overall achievements.

    Above all else, he had an approach to research that we should all reflect on, and his letter to the Morning Post on 25 April 1914 entitled “Research in Medicine–Its Position and Needs,” reproduced in Appendix 4, should be compulsory reading for those involved in medical research and those who believe they know how it should be organised.

    Arthur Hollman's book is comprehensively researched, with key notes of explanation at the end of each chapter as well as 537 references. He builds a picture of a man who at times was a “loner” with disconcertingly piercing eyes but who also had a happy family life–he rightly wonders why Lewis failed to get the Nobel Prize. Though Lewis questioned the use of digoxin in sinus rhythm and heart failure, it is interesting that he took it with benefit on the advice of Parkinson as his coronary disease gradually overcame him–as Hollman points out, the controversy is not new but probably better marketed.

    This is the first biography of Sir Thomas Lewis and it is an important book. I learned a lot at a simple factual level, but Lewis's philosophy of medicine and research comes across clearly and it unsettled me for it highlighted my weaknesses and those of our current approach to research. You may think that historical books have little relevance, but Arthur Hollman's biography should change your mind as it did mine. I admit I began with indifference but I ended with enthusiasm, and I was glad I'd been given the opportunity to step outside my normal reading. Dr Hollman hopes his “family and friends will give their approval to this book”: to these can be added the approval of this reviewer.

    Rating: ***

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