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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 July 14; 335(7610): 101.
PMCID: PMC1914509
Between the Lines

Talking with crowds, walking with kings

Theodore Dalrymple, writer and retired doctor

Why is so much of the commentariat—the monstrous regiment of newspaper columnists, television presenters, and literati—so hostile to our great and wholly beneficent profession?

There are two reasons, I think. The first is that we like those who have higher ethical standards than our own no more than we like those who have lower ethical standards. The second is that many critics of our profession wanted to be doctors but didn't quite make it.

Not every frustrated doctor, however, turns against the profession. Rudyard Kipling, for example, wanted to be a doctor but always held the profession in the highest regard, despite never having entered it himself. Indeed, some of his best friends were doctors, including William Gowers and John Bland-Sutton (no mean writer himself and author of Man and Beast in Eastern Ethiopia). The poem If was inspired by “Dr Jim,” Leander Starr Jameson, of the famous (or infamous) Jameson raid against the Boers.

In 1908 Kipling was asked to address the students of the Middlesex Hospital. His address was published in a little booklet called Doctors, and perhaps it will not surprise you to learn that even in those halcyon days hospital managers were verbose—the introductory remarks of Reginald Lucas, member of the board of management, being at least twice as long as those of Kipling himself. In the course of his rambling introductory address Mr Lucas managed to pour scorn on the idea that “amongst provocative causes of [cancer], the habit of ‘smoking tobacco' and the profession of sweeping chimneys were . . . most frequent.” This idea he put on a par with a belief in the curative powers of Wiltshire Holt water, “which came from a spring near Bradford-on-Avon.”

Luckily, a house surgeon, running out of the special water, filled a bottle with ordinary tap water and found it had the same effect. Since then “the composition of all remedies must be disclosed to the Cancer Investigation Committee,” a kind of proto-NICE.

Unlike the rambling Mr Lucas, Kipling was concise. He said that people could be divided into two classes: patients and doctors. Doctors were in constant struggle with a senior practitioner called Death, who always won in the end but whose victories could be postponed.

Doctors were highly privileged. “You and kings,” said Kipling, “are about the only people whose explanations the police will accept if you exceed the legal limit in your car.” There was more: “On presentation of your visiting card you can pass through the most turbulent crowd unmolested; even with applause . . . If you choose to fly a Red Cross flag over a desert you can turn it into a centre of population towards which men will crawl on their hands and knees . . . You can order houses, streets, whole quarters of a city to be pulled down or burnt up, and you can count on the co-operation of the nearest armed troops, to see that your prescriptions are properly carried out.”

Really! I must try it some time (I'd lay waste to two thirds of Britain in a trice). But of course, with powers came responsibilities: “In all times of flood, fire, famine, plague, pestilence, battle, murder, or sudden death, it will be required of you that you remain on duty until your strength fails you . . . Have you heard of any Bill for an eight hours' day for doctors?”

Well, yes, actually I have, although admittedly a century later. “But that,” as Mrs Hawksbee of Plain Tales from the Hills would say, “is another story.”

Doctors were highly privileged. “You and kings,” said Kipling, “are about the only people whose explanations the police will accept if you exceed the legal limit in your car.”

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