The doctor as polymath

Dr Seamus O’Mahony

True polymaths are rare, but there are some notable examples in the medical profession

Jonathan Miller (doctor, theatre and opera director, documentary maker, broadcaster, abstract sculptor, and photographer), who died in November 2019, was often called a “renaissance man” or a “polymath”. He hated these judgements, regarding them as vulgar and glib. He was right. True polymaths are vanishingly rare. Most so-called polymaths are dabblers.

“Polymath activities”, wrote the biochemist and author Carl Djerassi, “must pass a certain level of quality control that is expected within each field by the competition. If they accept you at their level, you have reached that stage rather than just dabbling.” In other words, a polymath must be the equal of the monomaths in each field of his or her activity. Using this strict criterion, Miller was an opera director who happened to have a medical degree. Oliver St John Gogarty (surgeon, poet, athlete, and senator) was often called a polymath, but wasn’t much respected by the medical monomaths. After taking 10 years to qualify as a doctor, he went on to become a fashionable ear, nose, and throat surgeon, whose entire contribution to the scientific literature was a single case report in the British Medical Journal. Gogarty was the ultimate dabbler.

Wilfred Trotter (1872-1939) is a rare example of a true medical polymath; in his own words, one of “the small and sporadic crop of the heroically gifted”. Wilfred who? Trotter was, by common consent, the finest British surgeon of the inter-war years. In 1928, he operated on George V for empyema, saving his life. He carried out the operation in Buckingham Palace, travelling there by bus. For this service, he was offered a knighthood, which he (rather stylishly) refused.

Trotter was a pioneer in several branches of surgery, including neurosurgery and head and neck surgery. His contemporaries at University College Hospital (UCH) London regarded him with awe: “No gentler hands were ever given to a surgeon,” wrote his pupil, the neurosurgeon Julian Taylor. The surgeon Robin Pilcher described him as “the perfect example of the good doctor”.

Trotter’s claim to polymath status rests mainly on his 1915 book Instincts of the Herd in Peace and War. This was a major contribution to social psychology and coined the phrase “the herd instinct”. The book influenced many, particularly Edward Bernays (nephew of Sigmund Freud), who almost single-handedly invented the profession of public relations. Although Trotter is most remembered for Instincts, his later essays (gathered in The Collected Papers of Wilfred Trotter) on what might broadly be called the philosophy of science, constitute his best work.

He was a prose stylist: “He used the English language as he used his hands,” said a colleague, “with a delicate precision born of constant striving after perfect control.” Trotter constantly questioned received opinion.

Addressing a class of students commencing their clinical training at UCH in 1932, he urged them to think for themselves (an unusual exhortation to medical students): “Uniformity of thought is an increasingly apparent goal and demand of civilisation. Still, there burns on in most of us a small wild spark. I advise you to nourish it as a precious possession.

Really, to think for oneself is as strange, difficult, and dangerous as any adventure.” Reviewing Trotter’s Collected Papers for JAMA in 1957, the American neurologist Charles Aring wrote: “He was a philosopher in a profession where there are none.”

Are there any polymaths lurking in contemporary medicine? Raymond Tallis (born 1946) is both an Emeritus Professor of Geriatrics (at the University of Manchester) and a distinguished philosopher and public intellectual, not to mention Kirsty Young’s favourite ever castaway during her tenure on Desert Island Discs. He fulfils Carl Djerassi’s definition of the true polymath: He is respected and admired in both medicine and academic philosophy. Moreover, he does not regard these activities as competing or antithetical: “I am a humanist and see my work as a doctor and a philosopher as respectively an expression of, and setting out a case for, my humanist convictions.”

Tallis has written that his many books “offer a critique of many current predominant intellectual trends and an alternative understanding of human consciousness, the nature of language and what it is to be a human being”. He has been described as the most respected philosopher never to have held an academic position in the subject.

As a geriatrician, he authored two major textbooks and over 200 original scientific papers, mainly on the neurology of old age. He has been a passionate defender of the Bevanite foundation principles of the NHS; his 2004 book Hippocratic Oaths is, in my opinion, the best of the many books written about that great, but troubled institution.

Being a polymath is hard work. Throughout his medical career, Tallis did his philosophical work between 5 and 7am, before setting off to start his day as a doctor. To be a polymath, you need to be not only “heroically gifted”, but also an early riser.