Book Review

The Caring Physician: The Life of Dr. Francis W. Peabody

N Engl J Med 1993; 328:817-818March 18, 1993

Article

The Caring Physician: The Life of Dr. Francis W. Peabody
By Oglesby Paul. 220 pp., illustrated. Boston, Francis A. Countway Library of Medicine, 1991. $24.95. (Distributed by Harvard University Press, Cambridge, Mass.) ISBN: 0-674-09738-6

“. . . For the secret of the care of the patient is in caring for the patient.”

These words, burned indelibly into the minds of generations of medical students, closed a lecture given by Francis W. Peabody to Harvard students on October 21, 1925, and the words have lasted well. The lecture, entitled “The Care of the Patient,” is reprinted in this book and deserves reading, particularly today, when medical technology focuses more on the disease than on the patient.

Who was Francis Peabody? Fortunately, Harvard Medical School professor Oglesby Paul has delved deeply and put together a scholarly and fascinating biography of the man and his times, from his birth in 1881 to his premature death in 1927. Peabody was a member of a prominent New England family and trained at Harvard. His influence as a physician, researcher, teacher, and person was subsequently felt far and wide. He attended Harvard Medical School and interned at the Massachusetts General Hospital. Subsequently, at Johns Hopkins, he fell under the influence of the many “greats” there, especially Dr. William S. Thayer. He then spent time at the newly opened Rockefeller and Peter Bent Brigham Hospitals. Interspersed were trips abroad: to Emil Fischer's laboratory in Berlin, to Peking Union Medical school in China, and to Russia during the Bolshevik revolution. These and other adventures are related in interesting detail by Dr. Paul, and throughout we learn of Peabody's growth as a clinical investigator, outstanding bedside teacher, and leader. These qualities prompted Harvard's Medical School dean and the Trustees of the Boston City Hospital to appoint Peabody director of the Harvard Medical Service and of the new Thorndike Memorial Laboratory in 1921.

Harvard students had been at “the City” since its founding in 1864, but Peabody's appointment brought greatly enhanced bedside care and clinical research. The latter was centered in the new Thorndike building, where a ward became available for the intensive study of patients, the first such ward in a municipal hospital. Paul refers to this chapter in Peabody's life as “the crowning glory,” borrowing words from Mayor James Michael Curley, who, at the dedication of the Thorndike, referred to “its establishment . . . as the crowning glory of the long and honorable life of the Boston City Hospital.” And it continued to be a crowning glory for 53 years, until Harvard's activities there ceased in 1974. Unfortunately, Peabody spent only six years at Boston City -- he died of sarcoma in 1927 -- but what he started flourished.

The extraordinary story of the teaching and research begun by Peabody has been recorded in the monumental work by Dr. Maxwell Finland (The Harvard Medical Unit at Boston City Hospital. Boston: Countway Library, 1982).

Among the early residents appointed by Peabody at the Thorndike were Herrman Blumgart, William B. Castle, Joseph T. Wearn, and Soma Weiss, as well as others who became leaders in medicine in the United States and abroad.

Harvard has established a fellowship and, more recently, a faculty professorship in Peabody's name, of which Castle was the first incumbent. The tradition of caring for the patient is also exemplified by the establishment at Harvard Medical School of the Francis W. Peabody Society with Dr. Ronald Arky as master. This society is one of four such societies, with each student belonging to one.

The vision and influence of one man, Francis W. Peabody, has lived on and has been multiplied many times. How this happened is elegantly unfolded by Dr. Paul, who demonstrates that medicine under Peabody was not a business, as it often seems to be today, but a caring profession.

Charles S. Davidson, M.D.
Harvard Medical School, Boston, MA 02115

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