We recently featured Two Scottish Tales of Medical Compassion as our June Book of the Month, and the editor of this book, John Raffensperger, MD, who re-discovered two classic stories, "Rab and His Friends," by John Brown, and "A Doctor of the Old School," by Ian MacLaren, offered his comments explaining the humanity of medicine as it was supposed to be and lessons for those who are now determining the future of US healthcare:
In this day of commercialized, impersonal medical care that is fraught with political meddling I had hoped that these stories of Scottish medicine in the 19th century might have an impact on the medical profession and the delivery of health care. Each story was popular at a time when the world was more literate. "Rab and His Friends", written in 1861 is at first glance a dog story. When I re-read it after becoming a surgeon, I realized that it is about an operation for breast cancer performed prior to those two medical blessings, anesthesia that banished the pain of surgery and antisepsis that prevents bacterial infections in surgical wounds. The surgeon in the story was James Syme, the father in law of Joseph Lister who discovered antisepsis. Dr. John Brown, the author of "Rab" was a beloved Edinburgh physician and author. When Samuel Clemens visited Edinburgh, Dr. Brown was his wife's physician. The story also influenced William Osler who became Regius Professor of Medicine at Oxford to become a physician.
Dr. MacLure, in "A Doctor of the Old School" was a doctor for every organ as well as an accoucheur and surgeon in the highlands of Scotland. This is the story of how a 19th century physician brought gruff but compassionate care to his patients with little more than his bare hands, a few instruments and basic drugs, that included whiskey. At the good doctor's death, his friend, Lord Kilspindie said, " I pray that doctors everywhere may share his spirit."
Each of these stories reflects the Scottish system of medical education that combined science, bedside teaching and the humanities during the 19th century. Every doctor, indeed all those who are now determining how medical care will be delivered should pause, read these stories and reflect on how distant we now are from the ideals of medicine.
John Brown, M.D. (1810-1882) was a well-known Scottish doctor and writer from Edinburgh. He attended the medical school at the University of Edinburgh before becoming apprentice to James Syme at the Minto House Hospital. His experiences at the hospital influenced his writing, including "Rab and his Friends," the short stories in his book Horae Subsecivae, and others.
Ian Maclaren (1850-1907) was the pen name of Highland-born John Watson. Watson studied for the ministry at the University of Edinburgh and at Tubingen in Germany. In addition to serving at the Parish of Logielmond in Perthshire and the Sefton Park Church in Liverpool, he was well known as a writer and speaker, culminating in several speaking tours in the United States. His works include "A Doctor of the Old School," Beside the Bonnie Briar Bush, and The Days of Auld Lang Syne.
John Raffensperger, M.D. was a surgeon-in-chief at the Children's Memorial Hospital in Chicago and a professor of surgery at Northwestern University. He has authored surgical textbooks, a history of the Cook County Hospital, a collection of short stories, and a "surgical thriller." He currently lives in Sanibel Island, Florida.