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There is a form of book publishing that relies mainly on purchases by the author's family and friends. Vanity publishing is the unkind name but `non-commercial' would be fairer. I wish that some of my own relatives had set down their stories, now fading from the collective memory. Four medical autobiographies in this category have lately come to the JRSM, and each has something to offer beyond the author's close circle.
Sir Thomas Symington is a pathologist who became a world authority on adrenal gland disease and spent a tough seven years as director of the Institute of Cancer Research in London. He has a pleasingly direct style and his narrative1 is well spiced with quotations from past conversations (whose authenticity I hesitate to question). At the end is a long `monograph' on the National Health Service—seemingly composed in 1990 or thereabouts. One of his messages is that every hospital needs a medical director. As a commercial publisher's editor I would have advised omission of these 70-plus pages. I was much more impressed by the way the life of this researcher was changed by the loss of a son from testicular cancer, with a switch of interest (under the influence of Cicely Saunders) to terminal care. In retirement he campaigned successfully, against medical opposition, for establishment of the Ayrshire Hospice.
John Walker-Smith is an Australian-born paediatric gastroenterologist whose career took him to Barts at the time of its deconstruction (Tomlinson Report) and a chair at the Royal Free. As far as chapter 14 I reckoned that the book2 was strictly for family and former colleagues. Then, with `MMR, Crohn's Disease and Regressive Autism', it takes off into a truly exciting account of the Wakefield affair and its internal and external politics. This chapter, written with conspicuous passion, should be read by all who seek the full picture of this episode.
Walker-Smith is a committed monarchist. Dr Peter Williams, author of the third book3 on my list, is a sort of imperialist: his autobiography laments the end of the British Empire, with its positive contributions to health and development. After military service Williams worked at the Medical Research Council, with a special interest in tropical medicine, and later joined the Wellcome Trust, of which he was a successful director from 1965 to 1991. Part I of the book is mainly about his father and brother, who became directors of agriculture in Zanzibar and Sarawak, respectively. Part II concerns his own life, and his efforts to sustain medical research in tropical medicine after the end of colonialism; and part III deals with his experiences at the Trust. All this is told in engaging style. Then, at the end, he proposes a return to something akin to empire (US) as a solution to corruption and terrorism. In my opinion, George W Bush should be spared encouragement of this sort.
Finally, I come to John Hofmeyr, whose book4 follows the CV model—beginning with early days and ending with retirement. Born in South Africa, he qualified in England after war service, returned to Africa and then served as a general practitioner in the NHS until 1988. The book is an amiable string of anecdotes, and I was particuarly entertained by the account of the interview with Lord Moran whereby he gained admission to St Mary's; it was mainly about rugger. In the St Mary's Rifle Club, his team-mate was Sir Alexander Fleming, who on one occasion accidentally discharged a rifle next to his ear, bursting an eardrum. The first three books are about how a man affected the world; this one is more about how the world affected a man.