Sir George Frederick Still (1868-1941): The constant pediatrician

Joseph deBettencourt
Chicago, Illinois, USA

 

Portrait of George Frederic Still, while he was working at King’s College Hospital in the early 1900’s.
By Gerald Festus Kelly, date unknown, UK Wellcome Collection. licensed under
Creative Commons Attribution 4.0 International license (CC BY 4.0)

Coursing through the heart of Salisbury, a historic cathedral city in Wiltshire, England, are a number of clear and cool rivers.  The water of these rivers runs through layers of chalk bedrock, purifying and alkalizing the water.  These rivers emerge as springs, percolating through the rock and running down the country side.  The water is cool and perfect for trout, which spawn in the fresh water allowing their young to grow protected from predators, and the open ocean.  In these natural nurseries it is not uncommon to find fly-fishermen, knee deep in the water, casting for a meal.  In the 1930’s one such angler was a man named George.  He was a retiree who spent his days on the river or in the local school teaching English language and literature and his evenings writing a book of poetry.1  “’[T]is an easy thing to scoff at any art or recreation;” begins an instructional book on fishing, “a little wit, mixed with ill-nature, confidence, and malice, will do it…”2  George was no typical retiree, he had moved to the countryside after a busy life in London.  Born into a working-class family of twelve children, he went on to become the first physician to hold the title of “chair of paediatrics” in England at King’s College after years of working at the Great Ormond Street Hospital for Sick Children as a house physician.  He had been the personal physician to princesses Elizabeth and Margaret and was knighted for his service.1,3  After years of cultivating the brand new field of pediatrics, he had earned his quiet days on the river.

Sir George Frederic Still was the eldest surviving child in his family and the only son.  When his father passed away, George was only seventeen but he took a leading role in his family.  While working towards his degree in medicine, he also needed to make sure that his younger siblings and mother were taken care of.  This early parental experience likely inspired his life-long love of working with children.  Once he began his formal medical training he found that not only did he enjoy working with children, but that their health needs were unique and had life-long consequences if not treated.  Promptly identifying these issues in children, he found, could prevent disability in adulthood.  Still began his 1909 treatise on common childhood disease with the opening line, “Infancy and childhood differ from all other periods of life in being pre-eminently the time of rapid development both physical and mental.”4 From his writings, one can see that Still, while exceedingly scientific in his writings, cared about the well-being of children beyond treating specific diseases. In his book on childhood disease, he presented not only the description of various diseases but compared them with normal childhood development. “[T]he medical man, especially, who is frequently confronted with parents anxious to know whether their child is up to the normal standard in this respect or that, must needs have some knowledge of the facts and figures…he must be familiar with the normal course of events, as well as with the variations…”4  The book then goes on to outline childhood developmental milestones, showing that Still knew how important it was for pediatricians to be able to speak with parents and help them understand their child’s health.

For Still, caring for children was his life’s work which he devoted himself to entirely, publishing over a hundred papers and five books.  During his working life he characterized a number of conditions, one of which, Still’s Disease, a type of juvenile idiopathic arthritis, bears his name.  He also has been credited as one of the earliest physicians to discuss what we now call ADHD, which he believed to be an issue with moral judgement or control but which did not affect intelligence.5  Besides these, he also explored treatments for juvenile scurvy, congenital syphilis, and congenital pyloric stenosis.  All the while, at home he was still caring for his elderly mother and supporting his younger siblings between days at the hospital and evenings writing.

Still’s contribution to pediatric medicine was much more valuable than simply describing new diseases.  He was one of the very first pioneers in a field that had largely been ignored by medicine.  Along with the doctors at Great Ormond Street Hospital, he created the specialty of pediatrics. With his work he not only cared for children but prepared the ground so that others could push the field further.  “For Medicine there is no abiding in one stay […] we are always seeking after some new thing; but we seek it, not because it is new, but in the hope that it is better…” 4  Still knew that others would carry on his tradition of working with and caring for children.  He had planted the seeds of a new frontier and today we are continually reaping the benefits.

 

For my garden is the garden of children
Cometh naught there but golden hours,
For children are its joys and its sunshine,
And they are its heaven sent flowers.

-Sir George Frederick Still, 19416

 

References

  1. Farrow SJ. Sir George Frederick Still (1868–1941). Rheumatology. 2006;45(6):777-778. doi:10.1093/rheumatology/kei166
  2. Izaak Walton CC. The Compleat Angler. John Lane; 1897. http://archive.org/details/compleatangler00gallgoog. Accessed December 30, 2018.
  3. Dunn PM. Sir Frederic Still (1868–1941): the father of British paediatrics. Arch Dis Child Fetal Neonatal Ed. 2006;91(4):F308-F310. doi:10.1136/adc.2005.074815
  4. Still GF. Common Disorders and Diseases of Childhood. London, Frowde; 1920. http://archive.org/details/commondisordersd00stiluoft. Accessed December 30, 2018.
  5. Still GF, Royal College of Physicians of London. The Goulstonian Lectures on Some Abnormal Psychical Conditions in Children. London : Lancet; 1902. http://archive.org/details/b24976295. Accessed December 30, 2018.
  6. Still GF. Childhood: And Other Poems. London: J. Murray; 1941.

 


 

JOSPEH DEBETTENCOURT is a medical student at Rush Medical College in Chicago, Illinois, with an interest in pediatrics. He attended Northwestern University where he received a BA in Theatre and Pre-Medical Studies. He has worked as a professional actor, designer, and carpenter, as well as a standardized patient, and medical researcher.

 

Winter 2019  |  Hektorama  |  Physicians of Note