Book Review

Taking Care: The legacy of Soma Weiss, Eugene Stead, and Paul Beeson

N Engl J Med 1995; 332:1242-1243May 4, 1995

Article

Taking Care: The legacy of Soma Weiss, Eugene Stead, and Paul Beeson
By William Hollingsworth. 331 pp. Chapel Hill, N.C., Professional Press, 1994. No price available. ISBN: 1-57087-038-1

This book is a personal, thoughtful, and eminently readable account of three extraordinary physicians who exemplify responsible leadership in academic medicine: Soma Weiss, Eugene Stead, and Paul beeson — the last two close associates and friends of the author.

Weiss was a brilliant young émigré from Hungary who had a meteoric career, first at the Thorndike Memorial Laboratory and later as professor and chief of medicine at the Brigham Hospital and Harvard Medical School. He was an inspiring teacher and a remarkable clinical investigator with a gift for linking the symptoms of patients with clinical research. His career was tragically cut short in 1941 by a cerebral hemorrhage after the rupture of an aneurysm at the base of the brain, a diagnosis he made himself at the age of 43 years. In his two and a half years at the Brigham, however, Weiss profoundly influenced many who were to be outstanding leaders of the next generation of academic physicians, including Stead and Beeson, both of whom trained under him and are now in their 80s.

An informative chapter reviews the changes in medicine from its primitive state at the time of the Civil War to the transformation of medical education and health care that took place with the growth of laboratory science at the end of the 19th and beginning of the 20th century. By this time, several of the great medical schools, such as those at Johns Hopkins and Harvard, were establishing educational standards and curricula that became the models recommended by the Flexner report in 1910.

Hollingsworth discusses the backgrounds, careers, and personal styles of these three remarkable leaders. The especially interesting chapter on Weiss vividly recreates his life and unique influence on a whole community of physicians in Boston, and thus provides the setting for the succeeding chapters on Stead and Beeson, who were together at Emory University, from which Stead went to Duke and Beeson to Yale.

The chapters on Stead and Beeson assess the personal qualities of these two men, their commitment to teaching and patient care, and their vital roles as chairmen and administrators of distinguished departments of medicine during the rapid growth of subspecialties, helped by funding from the National Institutes of Health, in the 1950s and 1960s.

In evaluating the legacy of Stead and Beeson, Hollingsworth portrays them as humane physicians who taught at the bedside and as creative clinical investigators. Both men not only won medicine's two highest honors, the Kober Medal and the Flexner Award, but also won the admiration and affection of the physicians who were privileged to work with them, many of whom have since become leaders in academic medicine.

The author's lively and informal discussion is studded with specific and memorable examples of the way in which these men taught and thought. Other aspects of their careers as leaders are discussed, such as Stead's success in integration and his innovative changes in the medical curriculum and initiation of the physician's associate program at Duke and Beeson's modification of the British system of medical education in his years as Nuffield Professor at Oxford University.

This book makes it clear that all three of these physicians were, in the language of social psychology, “inner-directed” men who loved their work, gave freely of their time to others, and exerted an immense influence on their associates and, through them, on succeeding generations of physicians. Although their styles differed, all were independently minded, strong leaders who taught by example — an example that has remained at the center of the lives of their colleagues and students, as evidenced by a number of moving tributes.

At a time when medicine has come under increasing pressure to generate or compete for funds, when “throughput” in many health maintenance organizations seems to be overshadowing the quality of care, this book is a compelling reminder of medicine's ancient and honorable traditions.

Elisha Atkins, M.D.
Yale University, New Haven, CT 06510