When I was a house officer in the 1970s, my friends and I would often talk about the age of the giants, speaking of them with mixture of amusement, envy, and reverence. Who were the giants? They were our forebears in medicine, physician heroes of the previous generations. In the age of the giants, the house staff lived in the hospital, worked every other night for pennies, and fought mightily against illness with the most meager of weapons.
The giants, even if their legends hid a different reality, were nevertheless great men. Indeed, they were almost all men because this was the era before women entered medicine in any number, the feeling being that “the weaker sex” did not have the strength or gumption for such an arduous career. Despite the unbalanced roster, the giants created scientific medicine as we know it and forged a drive for excellence that underpins academia today.
Compared with them, one of my co-interns once said laughingly, “We are munchkins.”
Some training experiences were not enjoyable, but I look at them with a certain appreciation and gratitude because I was learning my craft from people of knowledge and unyielding standards.
Giants of Rheumatology
At the top of the pantheon of giants were the department chairmen. These were people endowed with fierce intelligence, great vision, and strong leadership. Given the state of medicine then, many were clinicians or clinical investigators who studied human disease and often gave their name to syndromes that they described. They were not gene jockeys like today. They were genuine doctors.
Each of the top medicine departments had one of these men—Osler, Thorn, Hurst. The textbooks still carry their names, such as Harrison and Cecil and Loeb. At my institution, Stead ruled a department for over 25 years and “Stead-trained” was a sign of smarts and fortitude that augured well for future success.
Medicine does not use the term coach, but these men were head coaches. They were the “Bear” Bryants, Bobby Knights, and Dean Smiths but their temperaments and personalities were different than the coaching legends of sports. The giants of medicine were brilliant, elegant, and austere. Reserved and often distant people, they did not shout, but could communicate their feelings with a quick glance over their reading glasses or the slightest tensing of their face.
The chairs of the old era were imposing and intimidating and, like their counterparts on the gridiron or hardwoods, they demanded excellence and inspired loyalty. The expectations for work were outlandish, and complaining was simply not done.