In the last of the Masters of Medicine series, June Shannon spoke to Prof Peter Bronte Gatenby, Trinity College’s first full-time Professor of Clinical Medicine
"It is difficult at this stage to realise the enormity of the task that Gatenby took on, and the debt of gratitude owed to him by Trinity and its future generations of both under- and postgraduate students.”
The extract above by Prof Donal G Weir in a chapter from the book The Feds, An Account of the Federated Dublin Voluntary Hospitals 1961-2005, summarises Prof Peter Bronte Gatenby’s contribution and commitment to the development of clinical medical education in Ireland.
Prof Gatenby was Ireland’s first full-time professor of clinical medicine and in 1961 he established the first Department of Clinical Medicine at TCD.
This meant that for the very first time in the history of the medical school, accommodation and funding became available for graduates interested in clinical research and a career in clinical medicine.
Born in Dublin in 1923, Prof Gatenby qualified in medicine at TCD in 1946. One of four children, he was the only one to study medicine – a decision, he said, that was inspired by his parents and a genuine interest in people.
Prof Gatenby’s father, Prof James Bronte Gatenby, was born in New Zealand and went on to become Professor of Zoology and Comparative Anatomy at TCD.
Prof James Gatenby’s mother, Catherine Bronte, was by all accounts a very formidable woman. Driven by a ferocious ambition for her son who began to show a keen interest in zoology and natural history, Catherine Bronte put all her efforts into securing a place for him to study at Oxford.
Circa 1911, she travelled with her son James to the UK, leaving her husband behind in New Zealand.
According to Prof Peter Gatenby, his father’s eventual appointment to an Irish university somewhat disappointed his grandmother who, as a dominant force in his life, had somewhat higher hopes for her son.
Prof Peter Bronte Gatenby is related to the famous Bronte sisters on his paternal grandmother’s side, although he said the link is “complicated and a bit exaggerated”.
He explained that the father of the Bronte sisters was a Northern Irish man called Patrick Prunty. Patrick was very bright and went on to study at Cambridge.
However on registration, when asked for his name, his strong Northern Ireland accent led the registrar to mistake ‛Prunty’ for ‛Bronte’.
Prof Gatenby said that he, his brother and two sisters were named Bronte Gatenby, which he said might have been an act by his father to acknowledge his mother’s commitment to his early career.
Peter Gatenby’s mother was part of Trinity’s student drama society.
Unfortunately she became ill and it was her sickness, coupled with an immersion in science through his father’s occupation, that led the young Peter Gatenby to study medicine.
As a Professor of Zoology and Comparative Anatomy at TCD, Peter Gatenby’s father taught biology to Trinity medical students and he remembers his father saying, “If you can’t do biology, you can always go on and do medicine; it is simpler”.
“At that time, because he was an old-fashioned Professor of Zoology, he had a natural history museum which is still in existence … When he was going down to work at the weekends on his motorcycle and sidecar he would bring me down and leave me to walk around the museum while he was working in his office,” Prof Gatenby recalled.
Prof Gatenby remembers his father taking him to Trinity when he was just 17 and introducing him to the Registrar, with a view to securing him a place to study medicine at the college.
“I remember he brought me down to Trinity to the Registrar who he knew and he said, ‛He has my brains and his mother’s manners’ ... I don’t think I had anything like his brains.”
Prof Peter Gatenby graduated in 1946 and following a year working as a house doctor in Baggott Street Hospital, he went to the UK where he worked as a Regional Medical Officer (RMO) in Wimbledon.
After a period of working in a number of hospitals in the UK, including the neurological unit of Middlesex Hospital, Prof Gatenby heard of a vacant post in Dr Steevens’ Hospital in Dublin and decided to return home to take up the position.
“I had passed my London membership [MRCP] and later got my Irish membership [MRCPI] so I thought I knew everything after that,” he smiled.
From 1953 to 1974, Prof Gatenby worked as a consulting physician at Dr Steevens’ Hospital. During this time, he also worked as a consultant general physician at both the Meath and the Rotunda Hospitals in Dublin.
Prof Gatenby said he was very fond of Dr Steevens’ Hospital as it was a profoundly interesting and historical place.
“It is now the headquarters of the HSE and when I see a picture of it in the paper I get a sort of chill because I remember it as a very active hospital. Steevens’ was a lovely place and the patients were most co-operative.
“Irish patients are the most co-operative about teaching of anywhere in the world; they seem to understand and were always on the side of the students, hoping that they would pass their exams.”
He remembered that in the early ’50s, Dr Steevens’ Hospital had approximately 200 beds, most of them surgical and an out-patient department famous for the treatment of malarial and venereal diseases.
“At that time, penicillin hadn’t come in and there were scores of patients attending the VD clinic. A lot of the medical cases were the late effects of syphilis, GPI and so on; that fitted in with my experience in London so I did a lot of teaching in that.”
During this time, Prof Gatenby was also working at the Rotunda and he remembered it as a time of great poverty and very high birth rates.
“The Rotunda was in the middle of the poor part of Dublin. There were a lot of medical problems in women having babies; either they had TB or heart trouble or various things and they were having a baby every year – there was no contraception.”
Through his clinical experience at the Rotunda, Prof Gatenby, together with consultant obstetrician Dr Eddie Lillie, published original work on the pathogenesis, epidemiology and management of megaloblastic anaemia of pregnancy.
Coupled with his contribution to the teaching of clinical medicine in Ireland, Prof Gatenby also made a significant contribution to and was instrumental in the development of the Federated Voluntary Dublin Hospitals – which resulted in the seven small Dublin hospitals being grouped together under the control of one central council.
Writing in The Feds in a chapter on the beginning of the Federated Dublin Voluntary Hospitals, Prof Gatenby noted that in the 1950s a series of inspections of medical teaching in Ireland were carried out.
The first of these was by the American Medical Association (AMA) which, on the invitation of the Irish Medical Association, came to assess the comparability of Irish medical teaching to that in the US.
Following their visit, the AMA issued a very adverse and critical report, which mainly criticised the lack of laboratory facilities. This resulted in a period of time where no Irish medical qualification was recognised or accepted in large parts of America.
“A further inspection in 1955 jointly by the General Medical Council of the UK and the Medical Registration Council of Ireland supported the American criticism and remarked specifically on the lack of integration between the medical schools and hospitals. These reports emphasised the need for reform, especially of the small hospital buildings founded in the 18th and the beginning of the 19th Centuries, which were mainly associated with Trinity College,” Prof Gatenby wrote.
“I remember showing people around Dr Steevens’ Hospital from the GMC … they were very polite about the hospital … but when they saw the laboratory they roared with laughter … the thing was way out of date,” he said.
In 1957, Prof Gatenby was one of four junior clinical teachers in the TCD School of Medicine who met informally and agreed that there was an urgent need to amalgamate the resources of the small old hospitals associated with Trinity, to develop laboratory facilities and facilitate the growing specialisation of medicine in Ireland.
Following a long and protracted period of discussion, negotiation and debate, the Hospitals Federation and Amalgamation Act finally became law on July 8th 1961.
This resulted in all seven of the smaller hospitals – the Adelaide (established in 1839); Dr Steevens’ (1720); the Meath (1753); Mercer’s (1734); the National Children’s Hospital, Harcourt Street (1821); Baggott St Hospital (1832) and Sir Patrick Dun’s (1810) coming together under the management of one central council.
Prof Gatenby served for a time as Vice-Chair of the Council, which was made up of five representatives from each hospital, three lay and two medical, and five representatives from the Dublin Health Authority.
An additional two members were appointed to represent the medical schools. The council was charged with controlling expenditure and appointing staff throughout the federation. From 1961 onwards, all consultant appointments were made to the hospital group, with doctors being appointed to work in one or more of the seven hospitals.
The Federation was also to prove crucial for the development of specialisation
in Ireland, as it allowed for certain specialties to be assigned to particular hospitals. This also avoided the duplication of staff and equipment.
In 1960, Prof Peter Gatenby was appointed as Trinity College’s first full-time Professor of Clinical Medicine.
For the next decade, he worked to develop the first department of clinical medicine in Ireland and he also established the first clinical professorial unit at the Meath Hospital.
“I liked teaching very much. It sounds a bit lordly but I was interested it in. I had to learn myself and I thought medicine was very important and that teaching people was a privilege.
“In the medical school there was anatomy, physiology, chemistry, physics, pathology … obstetrics and gynaecology [but] there was no geographical department of medicine, there was no department of surgery; that was the situation in the ’50s.”
Writing in The Feds on the development of Prof Gatenby’s new department of clinical medicine, Prof Donal Weir recalled: “At first his department consisted of a secretary and the use of ENT outpatient rooms at the Meath for three afternoons a week.
"These rooms had been initially constructed for Oliver St John Gogarty who, apart from being an ENT surgeon of repute, was a well-known writer and Dublin celebrity of the last century.
"However appropriate the rooms had been for Gogarty, they were totally inadequate for a modern department of clinical medicine. Indeed, when representatives of the UK General Medical Council visited the School of Physic [Medicine] in 1961, the group asked to inspect the department and concluded that Gatenby was the most fortunate of men because whatever he did, it could only be an improvement!
“From such meagre origins, however, great things can evolve. The first development was the appointment of research fellows to the department, usually medical graduates who had often already worked as registrars in the Federated Hospitals, had obtained their MRCPI from the RCPI and wished to obtain their MD from their relevant medical school.
“The second development was the construction of a wooden hut at the rear of the Meath to house the Department of Clinical Medicine. The facilities this building housed were minimal, including two offices, space for a secretary and a very modest-sized laboratory. The first lecturer was appointed in 1963,” Prof Weir wrote.
Prof Gatenby recalled buying his wooden hut, which was to house his fledgling department, for £4,000. According to Prof Weir, the research fellows who emerged from Prof Gatenby’s department, of which he was the first, became known as the “wooden hut graduates”.
“One of my students became the Dean and Professor of the West Indies Medical School in Jamaica … some of them did very well from my hut,” Prof Gatenby stated.
In 1974, Prof Gatenby applied for a position as Medical Director for the UN – a job that took him all over the world and one which he said he thoroughly enjoyed.
Prof Gatenby was to spend the next 13 years from 1974 to 1987 with the UN, eight of which were spent in New York and five in Rome.
A prolific author, Prof Gatenby has published a number of research papers and as well as contributing The Feds, he has also written a history of the TCD Medical School.
Prof Gatenby returned to Ireland in 1987 for family reasons and retired from medical practice that same year.
Unsurprisingly, he remained very active in retirement and became involved in a number of charitable and voluntary groups, such as the Sick and Indigent Room Keepers Society (established in 1790) and the Multiple Sclerosis (MS) Society of Ireland.
According to Prof Gatenby there isn’t one single thing that makes a good doctor as it very much dependent on the type of doctor they are.
However for clinical doctors who engage with patients, he said it was important to “understand the ups and downs of life and to be able to sympathise”.
He also recommends that doctors retain a separate interest outside of medicine and marry a non-medical wife, “Because there are other things in life besides medicine”.
Asked how he would like to be remembered, Prof Gatenby said as “a good teacher” and someone who helped people get a good start in medical life.
In 2002, the School of Medicine at TCD established the Peter Gatenby Prize in recognition of Prof Gatenby’s “selfless commitment and contribution to the School of Medicine”.
Interestingly, there is also a prize in Prof Gatenby’s father’s name in the TCD Department of Zoology.
Prof Peter Gatenby’s wit and sharp intellect very much belie his 87 years, and his humble and unassuming gentle nature is proof that he does in fact have both his mother’s manners and his father’s brains.
He has proved to be both a true master and one of few remaining gentlemen of Irish medicine.