Challenges, conflict and change

Growing up in a medical household with a father who was a consultant physician, the idea of becoming a doctor was with me as early as I can remember. As a teenager, however, deeper thinking about life led me away and then back to medicine. I was fascinated by the wide diversity of human personality, and was an avid reader of biographies. One that influenced me greatly was that of Sir James Mackenzie1 (pictured, Figure 1). He was an Edinburgh graduate who became a general practitioner in Burnley, Lancashire in the second half of the 19th century. From clinical experience, he became keenly interested in the way the heart behaved in arrhythmia. He developed the application of the smoked drum polygraph to interpret the venous waves in his patients’ necks and their relationship to various forms of arrhythmia. As his findings eventually became recognised, he moved into the limelight. He moved to London, practised in Harley Street, headed a new cardiac department at The London Hospital (Figure 2), was knighted, and became the father of clinical cardiology. He was never as happy as he had been as a country family doctor, a role to which he finally returned in Scotland. I was fascinated by the story of how he applied science to resolve problems in a very human context.