Sir Robert Hutchison, Bart.

Sir Robert Hutchison, Bart.

PEDIATRIC PROFILES Sir Robert Hutchison, Bart. (1871-196o) M Y F I R S T c o n t a c t with Robert Hutchison was when I became his resident at The H...

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PEDIATRIC PROFILES

Sir Robert Hutchison, Bart. (1871-196o)

M Y F I R S T c o n t a c t with Robert Hutchison was when I became his resident at The Hospital for Sick Children, Great O r m o n d Street, on Jan. 1, 1925. H e was then approaching his middle fifties, absolutely in his prime, and I find it difficult to believe that I a m older now than he was then. H e was a tall, rather gaunt person, with baldness already well advanced, dressed usually in a long gray "morning coat" style. He arrived at the Hospital on the stroke of 10 A.M. on Mondays and Thursdays, and together we went round his ward of thirtyodd beds, along with the only medical registrar (senior resident who did not reside!) and about ten to fifteen students, either girls from the Royal Free Hospital or visiting postgraduates. T h e child in the first bed presented him with a pink carnation. Histories had to be succinctly given and then he would examine the essential part of the child, comment on the diagnosis, and speak about treatment. His speech still carried a Scottish accent even after m a n y years in London and he spoke beautifully with a terse, often scathing style. Although he had married a woman doctor he never quite approved of women medical students, and his whole training and experience had been so essentially based on clinical examination with a minimum of essential laboratory support that at that time, 35 years ago, he did not approve of x-ray examinations

either and pictures had to be hidden! The design of the ward was such that he approached every patient from the right side, and for this reason his palpation of the pyloric region for a possible tumor in a baby was not very satisfactory. "A tumour that you can only feel from one side of the bed is not a tumour at all," was one of his remarks when I faintly remonstrated. However, I then tried turning the babies round with the head at the foot of the bed and after this he took the hint! Looking back I realize that I was more privileged than m a n y because of m y Scottish name and ancestry. The morning round would end about 11:30 A.M. and then his excellent and tolerant ward-sister and I would seek a place to sit down and discuss the gross errors we seemed to have committed. I learned so m u c h from him in the 6 months of the post; he was always m y favorite among my chiefs and teachers. He was born in 1871 in the Midlothian county in Scotland, the scene of Walter Scott's novels, and although his parents were not poor his early life was far from pampered (a word he freely applied to certain children in later years). H e graduated from the famous Edinburgh University Medical School with the highest honors in 1893. After resident appointments there, including a resident post at the Sick Children's Hospital, and visits to Strasburg and 137

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Sir Robert Hutchison

Paris, he was appointed to a junior position in the department of chemical pathology at Edinburgh. T h e n he descended on London --like m a n y Scots before and since-=-'and there he stayed for the rest of his active life. H e became a junior resident at The Hospital for Sick Children, Great Ormond Street, and after a further period as a physiologist at the London Hospital Medical School he was appointed to the visiting staff at Great Ormond Street in 1900. The same year he was also elected to the staff of the London Hospital as a physician, where he looked after "adults as well as children. H e already had publishedi his first book, Clinical Methods, and the same year that he secured his permanent hospital posts he produced his famous Food and the Principles of Dietetics. His popular Lectures on Diseases o[ Children followed in 1904. There had also already been several scientific papers. It was clear then, as it remained throughout his career, that he had the gift of writing as well as of speaking, and if a

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teacher is born, not made, then Hutchison had this lucky gene. H e was a prolific writer. A hand list of his publications compiled in 1951 for a celebratory number of the Archives of Disease in Childhood on the occasion of his eightieth birthday by Dr. A. White Franklin gave 276 references to books, articles, lectures, and letters in the medical press. He was a great simplifier and this explains his attitude on infant feeding, which he spoke about with abundant common sense and clarity. H e was an early advocate of codliver oiI as a suppIement for bottle-fed babies. Langley Porter has recorded in the same birthday number referred to that when Hutchison's experiences with this substance were reported to the American Pediatric Society they were received "politely but dubiously." Two years later, when Heiman and Grulee presented to the same Society a paper on cod-liver oil in the prevention of rickets, it is recorded that John Howland rose in wrath to protest at such "nonsense," but it drove him to test the theory. Later his work with McCollum and Simmonds led to the isolation of fat-soluble vitamins. I mention this episode to illustrate how far and wide Hutchison's influence ranged. I think among his pupils he is the most quoted authority, and seldom a teaching session passes without my using one of his helpful remarks. A busy consulting practice, his hospital work, lectures to learned medical societies, books to be revised (and more to be written) comprised a full life for Hutchison. H e married in 1905 and there were three sons and one d a u g h t e r . One of the sons was studying medicine at Oxford when he succumbed to a dissecting-room infection. I was working at Great Ormond Street at the time and I greatly admired the way he took this blow. H e was h a p p y in his family and in his family holidays. I do not know what sort of father he w a s when his children were young. H e always denounced overfussy and adoring parents. When his daughter had her first son I remember a visit to Robert in retirement: I had to listen

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to a long exposition of this wonderful baby's virtues! So he was h u m a n after all! Indeed, behind a stern appearance and a caustic tongue there were a w a r m heart and great kindness. Distinctions naturally came his way. H e received honorary degrees at Edinburgh, Oxford, and Melbourne. H e held office at the Royal College of Physicians of London and was President from 1938 to 1941. This was naturally a restricted period in the activities of the College and m a n y of us regretted that he had not had a time of peace in which to make his wisdom and guidance better felt. I think he lived too long to be entirely happy at the way things were going in the

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pediatric world. Despite his early interest in chemistry he was scornful of "all this p H stuff." He had little use for preventive medicine in general terms, although as indicated above he realized how a proper diet might prevent specific diseases. At my last visit a few years ago he was worried about the influence of the United States upon British medicine! H e thought we were becoming too dependent. "Too m a n y American books are being reviewed in British journals." But I am glad he lived so long, and I shall miss his talk, especially the warning introduction " M y dear-r-r" with rolling r's that presaged my name before the criticism came after a suitable pause. He did very much indeed for pediatrics. A L A N 1V~ONCRIEFF