In his day Dr. Donald Hunter was widely respected and greatly feared. He was respected for his knowledge of occupational medicine and of illnesses caused by noxious agents. He was feared because during membership examinations he was reputed to produce a rock out of his pocket and ask the terrified candidate what it was and to what disease it might lead. He was the author of the classic textbook The Diseases of Occupations; and in 1971 wrote an excellent article about his former chief at the London Hospital, Sir Robert Hutchison.

In that article he tells that Hutchison, born in Scotland, lived from 1871 to 1960, and was the prototype of the generalist attending physicians of his time, learned, experienced, and highly respected. It was in some respects a different world; and anyone working in London even in the 1960s will remember the traditional ward round, in a quiet room with perhaps flowers in the middle, patient notes and x-rays on the bed-tables, beds neatly made up and even their wheels carefully aligned, the ward sister with her book ready to write down new orders, and the house staff trailing behind the chief, who having descended from his Bentley now proceeded from bed to bed, telling patients such encouraging news as “Jones, you have an ulcer and we will take care of it,” to which Jones would later comment that “Dr. So-and-so is such a wonderful man.”

Dr. Hunter goes to great pains to explain that Sir Robert Hutchison, remembered among his many achievements as author of a widely used text-book currently in its 23rd edition, must not be confused with Sir Jonathan Hutchinson (1828-1913), spelled differently and who in 1858 described the notched incisors of congenital syphilis. Among Dr. Hutchison’s sayings, dutifully recorded by his students, is the one about vegetarians being full of two things—wind and righteousness. But the reason for this voyage into the past is Hutchison’s prayer, as relevant now as when “he stood tall and elegant in this frock coat, with one hand on the curtain rail above the patient’s bed” upbraiding his students for percussing a child’s chest as if hammering away to leave behind a trail of broken ribs. We should also mention that in those days, as he remarked, surgeons could afford six weeks’ vacations in fashionable places in Switzerland, whereas even the top physicians had to content themselves with two weeks with their family at some boarding-house in Brighton. So now to the Lord’s Prayer:

“From inability to let well alone; from too much zeal for the new and contempt for what is old; from putting knowledge before wisdom, science before art, and cleverness before common sense; from treating patients as cases, and from making the cure of the disease more grievous than the endurance of the same, Good Lord deliver us”

References

1. Hunter D.  Centenary of the Birth of Robert Hutchison. British Medical Journal 1971; 2:222.