John McCrae History Of Pathology Symposium 45 John George Adami International Academy of Pathology Montreal pathologists 20 September 2006 Oslerianmedical educators Montreal, Quebec British imperialists Canadians in the Great War Frederick A. Meier, MD, CM From Colony to Dominion The “Scotch”of Ontario Strathcona’sMcGill Edwardian Montreal Canadian Army Grandson of the Great Immigration [1849-1850] Thomas McCrae –Entrepreneur John Eckfield–School Superintendent 1 Son and Brother David McCrae Thomas McCrae (1845-1930) (1870-1936) • Mill owner • Osler’s 3rdresident • Livestock breeder • Text/Systemsuccessor • Soldier • Prof. of Medicine JMC McCrae of the Gunners Academic Education “Best drilled” Highland Cadets age-14 • Guelph Collegiate Institute/William Tytler Bugler to 1stLt Wellington Field 15-23 Company Captain Varsity Co, QOR 16-19 • University of Toronto/Robert Ramsay Wright Lt commanding D Battery, RCA 27-28 * BA Natural Science 1894 Served to Major 16thBatt. RCA 29-32 * Summer MBL, Woods Hole, MA 1894 Lt.Col, 2nd-in-com. 1stBrig. RCA 41-42 * Fellow in Zoology 1894-97 Asthma and Temperament • Asthma initially associated with farm • Exacerbations during Toronto years • Barking cough persisted through active life • Sanguine faces: mobile features, amiable • Choleric complexion: ruddy, irritable • Sanguinary temperament ascendant in Montreal • Choleric temperament dominant after Ypres 2 Sentimental Education Imaginative Writing I • Published from adolescence • Death of Alice McRae (Spring 1890) • Most produced when medical student • Teaching at OAC (1892-1893) • Influenced by Boys’Own, Carlyle,Tennyson • Remarkably consistent themes and imagery Imaginative Writing II • Fiction: Imperial adventure • Non-Fiction: Vivid descriptions of animals Interweaving of comic/tragic • Poetry: Preoccupation with death Desire for oblivion Affirmation of immortality Medical Education • University of Toronto (1896-1897) * Apprenticing with Henry Howitt, Guelph * Externingat Robert Garrett Hospital, MD • Toronto General Hospital (1898-1899) * Summer on Osler’s JHH service (1899) • McGill University (1899) * Governor’s Fellowship in Pathology * Delayed by Boer War service 3 McCrae In Africa (1900) • Fellow battery commander, EWB Morrison, to be brigade commander in France • Visited Kipling: “high priest of it all” • KenhardtColumn marched across Karoo • Delagoa Bay Railway Campaign- Balmoral, Belfast, Lydenburg McCrae’s Pathology Department (1901-1904) J.G. Adami Chair; RVH Wyatt Johnson Osler’s old assistant; MGH Maude Abbott Curator, Medical Museum Osler Klotz Other Fellow (from ’02) McCrae’s Pathology Practice McCrae’s Teaching Positions • 1901-1902 417 autopsies • Lecturer in Pathology, McGill 1902-14 • 1902-1903 succeeds Johnson at MGH • ‘Railroad’Professor of Path.,UVM 1903-12 • 1903-1909 combines with Klotz • Lecturer in Medicine, McGill 1909-14 • 1910-1914 works for L. Rhea (MGH) 4 The Saturday Demonstrations McCrae’s Teaching Style • McCrae and Klotz presented • Logical, brief exposition • Adami commented • Effective, copious use of specimens • ‘The simple exposition of the • Merging lecture with demonstration pathology of disease’ • Rhetoric of memorable, grotesque contrasts McCrae’s Medical Practice • Sat FRCP (London) in 1904 • Associate in Medicine at RVH • More patient contact, night calls • Insistence on accurate records ‘I have never refused any work that was given to me to do’ Medical Pathological Outdoor clinics Laboratory supervision Ward attending/ Post mortems/ clinical teaching demonstrations House calls Meetings/papers Editing (for TMcC) Reviewing (for Klotz) 5 The Krausmanian Club J. McCrae E. Archibald O. Klotz C. Palmer Howard W.T. Turner W.W. Francis “Dr. McCrae of This Club” The Pen and Pencil Imperialists Andrew MacPhail Neuropathologist/ • Military Institute litterateur • Pen and Pencil Stephen Leacock Economist/humourist • Shakespearean • University John MacNaughton Classicist/courtier Tea and Tundra: With Earl Gray to Hudson’s Bay (1910) • From Norway House (L.Winnipeg) to Churchill (via York Factory) • Leo Amery of the Timesreporting • J.McCexpedition physician and story teller 6 McCrae’s Medical Writing Interest in Infectious Diseases • Tuberculosis and typhoid • Writing for Osler/McCrae System 1907-11 • Scarlet fever and other childhood infections • Condensing Adami’sPathology 1909-11 • Zoonoses e.g. glanders • Reviewing for Klotz’s AmJMedSci 1911-14 Nona: Life Imitating Art of Henry James • McCrae brothers visit XVII International Medical Congress (London, 1913) • Nona Gwyn, Tom’s sister-in-law, WO’s niece, staying with Oslers • Lord Strathcona(act 93) hosts 1300 • Shooting in Scotland with Cushings • Lady Osler later writes that JMcChad proposed to Nona there and was refused McCrae’s War Begins • Embarked October 1914 • Winter on Salisbury Plain • Poor pay, cramped quarters, no alcohol • Into the Line March 1, 1914 7 In Flanders Fields - I • March 10-12 NeuveChapelle(Haig) • April 6: moved to Oudezele(Smith-Dorrein) • April 20: moved to NE Ypres salient • April 22: first gas attack [on North Africans] Canadian counter attack fails [50% casualties] • April 24: second gas attack breaches Cdnline; McCrae’s Battery prevents breakthrough In Flanders Field - II • April 25: Canadian casualties 6,000/10,000 • May 2: Lt Alexis Helmerkilled by a direct hit; fragments of Helmer’sbody collected; Major McCrae conducts service In Flanders Fields - III • McCrae’s 2 May journal entry: “Lt H. was killed at the guns. His diary’s last words were: ‘It has quieted a little I shall try to get a good sleep’. I said the Committal service over him.” • Cosgrave (officer) and Allinson(gunner) agree: InFlandersFieldwritten after Helmer’sdeath- 2 or 3 May 1915 • May 9: McCrae’s Battery withdrawn from lines 8 Lt. Col. In Charge of Medicine Number 3 Canadian General Hospital(McGill) • Durbar tents/ ruins of Jesuit College • Dannes-Camiers/Boulogne • From June 17 1915: 30-40 consults/day • Debredement, drainage, saline lavage • Trench food, bronchitis, trench fever • War nephritis, shell shock, soldier heart Illness and Anger Bitterness and Disillusion Autumn 1917: Oct 1916: cough forces change in quarters • Passed over for Hospital command Nov1916: hospitalized:bronchitis/pleurisy • Irritated by integration of Portuguese intoCanadianHospital Apr 1917: obsessed by Germans, politicians January 1918: Dec 1917: extended vituperation to • ‘Silent , asthmatic, moody’ French Canadians and RC’s • Received appt.as Consultant day of onset of fatal illness Pneumococcal Pneumonia and Meningitis Jan 24 - Gram stain-positive sputum Jan 26 –Meningeal signs Jan 28 –Death, age 45 9 Pursuit of a Victorian Ideal: Versatile Excellence • Soldierly duty and adventure • Medical service and skill • Defeated by mechanized, mass war A Man Among Men: An Accurate Epitaph Pathologist Poet Physician Soldier An Exotic Lancashire Man: John George Adami ‘The Englishman Italianate’ 12 January 1862 –29 August 1926 Father Mother Also JGA Sarah Leech Cambridge Born in France Sister of Mayor of Manchester Montreal Polyglot hotelier Mother of 5 sons, 4 daughters Medical ancestors Sister of Professor of Materia Wartime London Medicaat Manchester Liverpool 10