Medicine is a jealous mistress, demanding to the extreme, and he who strays too far from her is often regarded with suspicion by colleagues and patients. How can he be a good doctor if he spends so much time writing books, singing, playing football, or politics? But how much more awful if after embracing medicine he then dumps her for another occupation. Is he not a truant, “a person who shirks his or her duty,” or “who stays away without permission?” Most definitely so in the eyes of Lord Moynihan of Leeds, one of Britain’s greatest surgeons, who devoted his entire life to that jealous mistress and wrote a book called Truants that bore the subtitle “the story of some who deserted medicine yet triumphed.”1
Born in Malta in 1865, Berkeley Moynihan went to school and studied medicine in Leeds. Joining the staff of the General Leeds Infirmary in 1894, he then also became professor of surgery at the University. He developed a successful practice and became one of the most prominent surgeons in the realm. For his achievements he was knighted in 1912, became a baronet in 1922, and was called to the House of Lords in 1928. His impact on the craft of abdominal surgery was enormous. Between 1896 and 1913 he made 134 contributions to the surgical literature. He published groundbreaking papers on peptic ulcers, cancer of the stomach, treatment of hernias, of gunshot-wounds, of surgery of the pancreas, gall-bladder, spleen, and of many other surgical conditions.2 In 1913 he founded the British Journal of Surgery. Writing his biography in 1965, Sir Geoffrey Keynes describes him as a highly capable, hard-working man with a prodigious memory.3 “He forgot nothing.” As a student he worked 14 hours a day. He never failed an examination. He said he had never been tired in his life – and if had he been he would not have admitted it! “He was not handicapped by possessing any trace of modesty.”3 He was regarded as a good teacher “for those who wanted to learn, but was not popular among those whose chief aim was to pass examinations.” In accordance with the old dictum, “those who can, do, those who can't, teach,” he expected his students to learn from him by example. He was a powerful orator; his speeches were true orations, one such characterized in an American journal as an intellectual treat of a very high order.3
His surgical technique was unexceptional. He said, “The perfect surgeon must have the heart of a lion and the hands of a lady, not the claws of a lion and the heart of a sheep.”3 He believed in scrupulous care, “light handling and purposeful, effective, quiet movements which are no more than a caress if an operation is to be the work of an artist and not merely of a hewer of flesh.”3 He saw himself as virtually the high priest at a sacrament, his assistants his acolytes, his audience his congregation. He washed his hands in sterile water before operating; kept the sterile soap in antiseptic fluid. He had his hands manicured once or twice a week and wore cotton gloves when not operating. He was so proud of his hands that he had them cast in bronze. “He put surgery above all other activities in his life and regulated all his habits in the interest of his vocation.”3 He was the “compleat surgeon.”
Lord Moynihan died in 1936 from a cerebral hemorrhage, shortly after delivering his famous lecture on Truants. The book, also published in 1936, was well received; The BMJ and JAMA had laudatory reviews.4, 5 To this day it remains a classic. It lists many who achieved a limited degree of immortality in their time but are now largely forgotten; but also many who remain household names, though in some cases the contact with medicine may have been tenuous or even doubtful. The list commences with Copernicus (graduating from Cracow), Galileo (from Pisa), Galvani (from Bologna), John Locke (from Oxford), and Robert Boyle. Chemists are represented by William Wollaston (from Cambridge) and Berzelius (from Stockholm). Also from Sweden came Linnaeus, who had studied at Uppsala University and classified plants. Among those who “strayed to politics” were several prime ministers and judges; also Jean Marat, who practiced medicine in England before returning to the horrors of the French revolution; Joseph Guillotin, who invented a humane method of execution; Clemenceau, prime minister of France and “savior of his country” in World War I; and the first president of the Chinese Republic, Sun Yat-sen, who studied in Hong Kong and practiced there and in Macao.
In the world of literature we find François Rabelais, of Gargantua and Pantagruel fame, who first became a monk but later studied medicine at Montpelier and Sir Thomas Browne, who believed in witches and wrote some of the most gorgeous prose in the English language, practiced in Norwich and received a knighthood from Charles II. Oliver Goldsmith may also have studied medicine, as did Tobias Smollett, who wrote Humphry Clinker; Friedrich Schiller, the great German poet; John Keats, the romantic poet who studied medicine at Guys hospital and later died of tuberculosis; Peter Michael Roget, physician at the Manchester Infirmary and famous for his Thesaurus; Somerset Maugham; AC Cronin, who wrote The Citadel; and Conan Doyle, who studied medicine in Edinburgh and created Sherlock Holmes.
Lord Moynihan also mentions Ronald Ross (St. Bartholomew's Hospital) who discovered the transmission of malaria by the mosquito and also found time and mental energy to be a poet, playwright, writer and painter; Oliver Wendell Holmes; Silas Weir Mitchell; Mungo Park, who explored the course of the river Niger; and David Livingstone, who attended medical classes at Anderson college before losing his way in Africa. Finally, he apologizes for not mentioning actors and sportsmen, among the latter successful cricketers, football players, and tennis winners at Wimbledon in the last decade of the 19th century.
- Truants. The story of some who deserted medicine yet triumphed. Based on the Linacre Lecture delivered at Cambridge, 6 May 1936 by Lord Moynihan, KCGM,CB of Leeds. University Cambridge Press, 1936
- Biographical Entry. Moynihan, Sir Berkeley George Andrew, Lord Moynihan of Leeds (1865-1936). RCS Plarr’s Lives of the Fellows on Line
- Sir Geoffrey Keynes. Moynihan of Leeds. Lecture delivered at the Royal College of Surgeons of England, 13th October 1965.
- Editorial: Medical Truants. Journal of the American Medical Association. 1936; 107:1134 (Oct 3).
- Medical “Truants” Lord Moynihan’s Linacre Lecture. British Medical Journal 1936; 1:943 (May 9).
George Dunea, MD, Editor-in-Chief