Book Review

Physician: The Life of Paul Beeson

N Engl J Med 2001; 345:1858December 20, 2001

Article

Physician: The Life of Paul Beeson
By Richard Rapport. 277 pp., illustrated. Fort Lee, N.J., Barricade Books, 2001. $24.95. ISBN: 1-56980-203-3

Richard Rapport, a neurosurgeon, has written a fascinating and accurate account of the life of Paul Beeson, who rose to the highest levels of academic medicine not only because of his outstanding professional achievements but also because of his humility, compassion, personal charm, and remarkable sense of fairness. In tracing Beeson's life from his boyhood in rural Montana and Alaska to the present, Rapport also describes the revolutionary changes that occurred in the practice of medicine during the 20th century. The story reveals the gradual transformation of Beeson from a moderate conservative to a moderate liberal concerned with medical care for uninsured and elderly persons, medical ethics, and the medical consequences of nuclear warfare.

Rapport describes how Beeson's training at the Rockefeller Institute and Hospital in New York and at Peter Bent Brigham Hospital in Boston changed his plan to enter private practice; instead, he chose a career in academic medicine. After 10 successful years at Emory University School of Medicine, Beeson spent 13 years as chairman of the Department of Medicine at Yale University School of Medicine and 9 years as Nuffield Professor of Medicine at Oxford. Rapport notes that the appointment of an American to one of the most prestigious academic medical positions in England was an almost unheard-of accomplishment and was completely contrary to the flow of the brain drain at that time from England to the United States. While in these demanding academic positions, Beeson managed to edit two outstanding textbooks of internal medicine and publish the results of his research on the mechanism of fever, the cause of transfusion hepatitis, and the role of lymphocytes in the induction of parasite-associated eosinophilia. His seminal observation that an endogenous pyrogen (later shown to be interleukin-1) released from stimulated leukocytes produces fever probably represents the earliest clear demonstration of the induction and release of a cytokine.

After he left Oxford, Beeson settled near Seattle, where he became deeply engaged in teaching at the University of Washington School of Medicine. His interest in geriatrics led him to emphasize that physicians must be healers and not executioners. He advocated death with dignity and rejected aggressive therapy for the hopelessly ill.

There are many interesting quotations in this book, but perhaps none is more apt than the comment by Lewis Landsberg and Thomas Ferris, who say that Beeson has “an ineffable quality: a combination of graciousness, shyness, diligence and the intrinsic desire to always do the best that can possibly be done for another person.” Rapport's book not only honors Beeson but also emphasizes his great personal qualities. His medical residents may have best summarized these qualities in their simple statement at his last grand rounds that “he is the kind of physician all of us aspire to be.” For these reasons, I encourage medical students and physicians, regardless of their age or type of practice, to read this engaging account of Paul Beeson's life.

Stuart C. Finch, M.D.
Cooper Hospital–University Medical Center, Camden, NJ 08103
finch@umdnj.edu