A FRESH BLUE plaque discreetly adorns the front of the Whitla Hall at Queen’s University in Belfast. It commemorates the benefactor after whom the hall is named, Sir William Whitla, and is the 100th such plaque erected at appropriate locations by the Ulster History Circle to honour men and women who have “distinguished themselves . . . and contributed to [the province’s] history”.
It describes Sir William (1851-1933) as “physician and philanthropist”, but it is undoubtedly his philanthropy rather than his medicine that earned him his plaque. He donated millions, at today’s values, to Queen’s (for example, he funded the Hall that bears his name), to Methodist College, to the Ulster Medical Society and other bodies. Yet his medical achievements were greater and more lasting, and perhaps more worthy of commemoration.
He was one of a very small number of medical men, or women, among the 100 honoured by the Ulster History Circle, and the others, even more so than Sir William, are there not because of their medicine – Dr William Drennan, the United Irishman and poet, for instance – but for their other exploits.
When Whitla was appointed Professor of Materia Medica at Queen’s in 1890, the science and practice of medication were unsystematic and based largely on received faith in the efficacy of various ingredients, both common and bizarre, many of which were useless or even harmful. Through two ground-breaking, block-busting books, one in 1882 (which went through 14 editions in 61 years) and the other in 1890 (nine editions in 47 years), and which were translated into many languages including Chinese, Whitla helped to guide the subject into scientific, systematised channels making it well prepared for the great drug discoveries of the 20th century and so helped to build the modern core specialities of therapeutics and clinical pharmacology to the benefit of untold millions worldwide.
Whitla’s generosity has helped him to escape the frequent inequity of being an unsung medical worthy, one of the many escaping the radar and the footlights, unlike the profession’s luminaries of whom Ireland can proudly boast quite a number. The likes of Colles, Stokes, Adams, Corrigan, Graves and Cusack lead any roll-call of former medical and surgical greats, and they have their modern counterparts.
But consider the doctors at the cutting edge, the great majority of the profession, during the Great Famine for instance, daily exposed to the accompanying contagious diseases.
Calculations by two of their contemporary luminaries (Stokes and Cusack) showed that at least 130 doctors died in the peak year, 1847, due to fever "contracted for the most part in discharge of their public duties". And no wonder: as the Dublin Medical Pressin 1847 noted, "The mud walls of an old cottage eked out with boarding and covered with straw formed Dr Dunne's 'fever hospital' in which nearly 60 patients were under his treatment at the time he contracted the fever of which he died after a few days"; while William Wilde, Oscar's father, wrote in the Dublin Journal of Medical Sciencein 1849, "During the years 1847 and 1848 four medical men died between Clifden and Galway; three between Oranmore and Athenry, a distance of about seven miles [and] four more between Anadown and Kilmain, making in all 11 [in this area]". Only the names of the medical victims, like the unfortunate Dr Dunne, made the press; the survivors remained impeccably anonymous.
Those who say that that was then and this is now should consult a recent important book, Irish Surgeons and Surgery in the Twentieth Century(Gill MacMillan, 2008). It was sponsored by the Royal College of Surgeons in Ireland, and the editor, who in fact wrote all or most of 17 of the 23 chapters and conceived, organised and conducted the study, is the doyen of Irish paediatric surgery, Prof Barry O'Donnell, a former president of the college.
He calls the book “a celebration of Irish surgery”, with emphasis on the surgeons as living people. It is based on pen-portraits of nearly 600 surgeons who practised in Ireland in the last century, and these are shrewd, often enlivened with the telling anecdote, and always fair-minded.
He reminds us that beyond the gilded world of the teaching hospitals and the university and collegiate elite, which are frequent subjects for authors’ attention, there lies the different and less familiar world of the county surgeon: “we salute them . . . surely a breed apart”.
The county surgeon’s problems are no longer those of the 19th-century rural doctor whether among the 600 plus dispensary doctors, those in some 100 district and county fever hospitals or the some 40 county infirmaries, which were simply how to stay alive, or at least healthy, and make a reasonable living while diligently practising his (it was never at that time “her”) profession.
The 20th-century county surgeon, especially in the first half of the century, faced problems of professional isolation. He plied his trade in often outdated facilities, on more or less permanent call, lacking the means of transport and communication now taken for granted and with little chance of serious time off for professional “up-date” sessions even if they readily existed.
He was, perforce, a self-sufficient generalist without colleagues’ shoulders to lean on or their opinions to seek, and with few, if any, white-coated surrogates to do his bidding. He and his family enjoyed the compensation of a high standing in the local community and the amiable pursuits of the countryside, but then they were expected to contribute to its wider life.
Positions were not always filled: Co Fermanagh had only four such surgeons during the entire century; Co Mayo was hardly better. Yet most of the county surgeons supplied a specialist service in the best traditions and many would not have wished to have changed places with their gilded colleagues.
Literature has largely passed-by this “breed apart”. Now Prof O’Donnell’s survey has done much to identify it. Ireland can be proud of its medical and surgical heritage, its current health services, and the standard of its practitioners. It can also be thankful that it has respected senior practitioners willing to work altruistically in the interests of their profession, and professional colleges willing to support them.