Hamilton Bailey: A Surgeon's Life (review)

Adrian Marston. Hamilton Bailey: A Surgeon's Life. London: Greenwich Medical Media, 1999. x + 157 pp. Ill. $67.50. (Distributed by Oxford University Press.)

This is the lively biography of Hamilton Bailey, an eminent, phenomenally widely published British surgeon who flourished in the middle third of the twentieth century. Written by another distinguished British surgeon, Adrian Marston, this short, pithy work is the wrenching story of a great surgical teacher dogged by immense personal tragedy.

Marston's biography acknowledges his debt to the 1973 book, The Life of Hamilton Bailey by S. V. Humphries, whose surgical education during a lifetime of work in African mission hospitals was largely derived from the surgical teaching texts of Bailey (whom he never met). Humphries's biography was greatly facilitated by the cooperation of Bailey's dynamic widow, Vera (who chose to be called Veta). By the same token, Humphries's respect for Bailey and his deference to Veta softened the frankness with which he might have portrayed the tragic aspects of Bailey's life.

Bailey was born in 1894, the first surviving child of James Bailey, a successful Scottish medical practitioner who went from a difficult practice in a missionary hospital in Palestine to various Scottish and English towns before settling in the seaside resort of Brighton. Hamilton Bailey's alcoholic mother and a schizophrenic younger sister contributed to the withdrawn and loveless attitude adopted by his father as emotional armor to facilitate his professional life. Thus, the son grew up in the shadow of mental illness with a brooding concern that he himself might someday "go mad"; three years of institutional care for what is loosely characterized as manic paranoia fulfilled the realization of that foreboding at the start of his final decade in 1951.

His amazing partial recovery after treatment with the relatively new lithium therapy allowed Bailey some return to his massive editorial labors, under the firm guidance of the indomitable Veta. But his characteristically cantankerous and dominating personality overwhelmed both his own good judgment and that of his attending physicians in the retirement community of Málaga in Spain. The aphorism that the physician who acts as his own doctor has a fool for a patient was tragically borne out in his death from a leaking colonic anastomosis, the conventional, decompressive colostomy having been interdicted by the patient himself. Had the conservative advice in his own textbooks been followed, his malignant bowel obstruction might well have been successfully managed.

Marston's book concisely portrays the personalities and politics surrounding Bailey's practice in the Royal Northern Hospital, an institution founded in 1857 by a brilliant, contentiously independent surgeon, Mr. S. F. Statham, who had been dismissed from University College Hospital for undignified behavior. In many ways Bailey resembled Statham: his uncompromising, cavalier style with patients and colleagues kept him off the ladder of success that customarily led to an honorific position in one of the great London teaching hospitals. Instead, he flourished in the Royal Northern, which took reciprocal benefit from his sizable practice among the local poor, subsidized by the ultimately immense income from his many textbooks. Bailey's operating style was rough and often startlingly rapid. Visitors attracted from around the world by such superb surgical texts as Physical Signs in Clinical Surgery (1930) and The Surgery of Modern Warfare (1941) were often disappointed by the reality of his operative performance. His book A Short Practice of Surgery went through more than twenty editions. Amazingly, R. McNeill Love, his coauthor in much of his vast literary output, never became a close friend, and on their rare personal meetings they addressed each other by their surnames.

The biography's wealth of anecdotal material, charmingly presented by Marston, touches on the evolution of British medicine during this century, the famous hospitals and surgical players in the drama, and the spirit of Britain in war, from the 1916 naval battle of Jutland to...