24139: The death of Dr P J Macleod, O.B.E.

Written by Sir Andrew Davidson for the "Lancet", 1951.

The hospital services of Scotland – and, indeed, Scottish medicine itself- has suffered a serious, if not irreparable loss in the passing of Dr P. J. Macleod, Medical Superintendent of Bridge of Earn Hospital, Perthshire. "P. J."as he was affectionately known to a wide circle of friends and acquaintances in this country and elsewhere, had carved out a special niche for himself, his hospital at Bridge of Earn being unique in some respects. It had been built for the purposes of World War II, yet, in less than ten years, it had established a high reputation locally and nationally for the valuable and high standard of services provided there. In addition to general surgery and general medicine the hospital contains an orthopaedic unit directed by the University lecturer in that speciality; also, there is a first class unit for the treatment of turberculosis; for some time the out-patient department has been expanding rapidly although the hospital is situated four miles from Perth and in the country; and the Fitness Centre, offering surgical and medical rehabilitation for those in the wards and those resident in a special unit for that purpose, is well known. Here, in fact, is a new conception of a hospital, rehabilitation could now be commenced in the earliest stages of disability – or sickness – and, if necessary, carried through after active treatment in the same hospital.

"P. J." was the inspiration behind this idea but only after some original doubt and mental reservation had been dispelled by an experimental period of careful recording and assessment of results. When he was convinced of the value of the work, he threw all the weight of his enthusiasm and experience into its development. Many visitors from other countries were attracted to Bridge of Earn Hospital and favourably impressed by what they saw of the rehabilitation work of "P. J." and his team. But the highlight of the Fitness Centre’s history was the visit of Their Majesties the King and Queen in 1943. It was with justifiable pride that "P. J." conducted them over the unit when at Gleneagles and before the transfer to Bridge of Earn. Moreover, the hospital became a training ground for Disablement Resettlement Officers of the Ministry of Labour, of whose Advisory Committee on Rehabilitation Macleod was a valuable member. That the work done there was highly appreciated throughout Scotland by doctors and patients alike is well reflected in the numerous glowing references to "P.J." and his work in the national and local press.

The success of that unique hospital can be attributed largely to the personality and ability of its late Medical Superintendent. First and foremost, P.J. Macleod was a general practitioner. He had all the qualities of the good family doctor -understanding, patience, sympathy, personal interest and a highly developed clinical sense. To see him sit at the bedside of a sick person, to listen to his simple but significant questions and to observe the growing confidence of the new patient was a lesson in true social medicine.He gave no mere lip-service to the saying that the patient comes first; with "PJ." the patient did come first in his thoughts. "If he is able, let the patient do the speaking" he would say. Too often, he thought, the patient is directed for this or that a special examination without a proper case history having been taken. He regretted the over mechanisation of medical diagnosis. Even in his last illness, which he bore with magnificent fortitude, and whose obscurity demanded many investigations, he remarked in a characteristic way. "I didn’t think that I didn’t have so many diseases".

Regretfully, "PJ.", because of the high standard he set himself and an innate modesty, seldom ventured into the print. Studies in rehabilitation, in pneumoconiosis and in the familiar factor in tuberculosis are still unpublished. But his contribution to a symposium on Medical Education – from a general practitioner’s point of view – in the University Quarterly (August 1949) is well worth the attention of those interested in that subjected. Here he makes a plea for a realistic approach to the training of a doctor for general practice; for one year’s apprenticeship in general practice after graduation; and the introduction into the curriculum of a class in general practice during the fourth and fifth years. His views on medical education did not arise spontaneously; they were well considered against a background of wide experience and critical observation, and had been discussed freely with colleagues in many branches of Medicine. Moreover, he had personal experience of lecturing to medical students at Aberdeen University and at one time, had been external examiner there.

"PJ." ‘s work at Gleneagles and at Bridge of Earn had a wide background to it. Born in the Island of Bernera, Lewis, 54 years ago, he was one of those youngsters who, after serving overseas in World War 1, returned to study medicine. He qualified at Glasgow University in 1924. A native Gaelic speaker with an irrepressible love of the Scottish Highlands especially the Hebrides, he chose to enter practice in the Highlands and Islands Medical Service; in isolated Applecross, Ross-shire, he made, like many of his contemporaries, a substantial contribution to the success of that scheme. Later he answered the call of the Outer Hebrides and moved to general practice at Stornoway in his native Lewis. There he was recognised by his ain folk and by his medical colleagues as a good family doctor, the ideal he had set for himself. But, even his perfervid love of Lewis could not restrain his urge to be in World War II when it came. He left his practice in the hands of locums and his colleagues, sailed for the mainland and took a job at Gleneagles E.M.S. Hospital. But that was not for "P. J.". He packed up there and joined the R. A.M.C. Soon his enquiring mind and his philosophic approach to the most abstruse problems came to the notice of the medical authorities at the War Office; and he was posted for duty to the Directorate of Biological Research, for which department he undertook some interesting research.

After the decision had been taken to start civilian rehabilitation work for miners at Gleneagles Hospital, it became necessary to find the right man to conduct what was an important and interesting experiment. "P. J." was just the man for the job; but he was in the Army. The writer remembers well his approach, in 1942, to the D.G.A.M.S. for "P. J."’s release. "Forty-six years of age; A-l; and we need such people said Sir Alexander Hood, who, however, realising the importance of the new project, finally agreed to the release. But no one had reckoned with "P. J." who had no desire to return to civil life while there was a war to be fought. Still, after much pressure and persuasion, he also agreed, with excellent results in the field of rehabilitation.

His outstanding work in that field tends to obscure his success in other directions. "P. J." had, undoubtedly, the quality of leadership in good measure and his popularity with his staff and patients had no reservations; his success in these directions was based on his humanism and on personal contact with all grades. To his friends outside the hospital and to the many visitors from other countries "P. J." was the highland gentleman in his attention to them and in his hospitality.

He was widely read in a variety of subjects and could discuss economic, religious and social topics with the same alterness of mind and with as much knowledge as be brought to bear in his medical work. This served him in good stead when, with a Rockefeller Travelling Fellowship, he visited Canada and the U.S.A. in 1949. He was in great demand in these countries for discussion groups on a wide range of subjects; incidentally, he gave an outstanding broadcast bringing him a large fan mail.

When "P. J." died in the Dundee Royal Infirmary on 15th February 1951, a depression descended over his beloved hospital at Bridge of Earn, for patients and staff loved and respected him as their friend and leader. The depression, however, spread much further than the hospital walls. His passing, at so early and age and before the fruition of his labours, came as a shock to a very wide circle of friends. To them, the gap made his departure will never satisfactorily be filled but his memory will abide, finding its outward expression in Bridge of Earn Hospital and the organisation which he built there.

Those who knew "P.J." well are aware of how much he owed to his wife’s encouragement and to her critical help and advice in his work; our sympathy goes out to her in her great loss.

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