Q: How did you come to write The Masters of Medicine?
I started writing this book in 2020 near the outset of the COVID pandemic. It was a time when we didn’t know that much about the virus and doctors like myself were constantly worried about bringing it home from work to our families. So for many weeks I semi-quarantined myself at home. I would enter my home through a side door, take an immediate shower, and live in an extra bedroom. I spent a lot of hours alone in that bedroom, reading books, watching TV, and thinking. During that time, I got inspired to write this book. My goal was simple: to help people better understand the diseases that afflict us all.
After caring for tens of thousands of patients in my career, I’d gotten a pretty good idea of what my patients understand and do not understand about their diseases. I felt a lot of basic knowledge was lacking. I decided the best way for me to explain the complexity of medicine was to take readers on a journey from where we were to where we are today. Telling people a lot of dry facts about pathophysiology is not as gripping as following the ups and downs of real-life heroes who failed, endured, triumphed, and sometimes loathed one another.
I decided to organize the book by the most common and deadly diseases in history: heart disease, diabetes, infection, cancer, trauma, and childbirth. Breakthroughs in these fields were fantastic tales of perseverance, serendipity, rivalry, and mistakes that somehow resulted in the saving of millions of lives. I still shake my head sometimes when I think of them. Audacious doctors who risked their own lives and experimented on themselves. Unsung heroes who labored in obscurity for decades. Patients who willingly let themselves be operated on even though they knew the chances of survival were remote.
It is impossible to not be inspired by the heroes who made these accomplishments. As a surgeon, I sometimes catch myself wondering why I don’t try harder to invent new devices and techniques myself. But then I remember that this is very hard to do and the risks are enormous because we are talking about people’s lives. Failure is very consequential. So for now, I’ve contented myself to write this book in the hope that it might inspire some young person to be that innovator who does cure a disease—and makes humanity better.
Q: What was your inspiration for the title?
“The Masters of Medicine” was not my first title for this book. It was “To Wrest from Nature.” This had personal significance for me because at my medical school, there was a beautiful new building constructed with the following quote from Dr. William Osler* engraved on a wall in the lobby.
“To wrest from nature the secrets which have perplexed philosophers of all ages, to track to their sources the causes of disease, to correlate the vast stores of knowledge, that they may be quickly available for the prevention and cure of disease—these are our ambitions.”
When I read this phrase, from a presentation Osler gave in 1902, I felt it perfectly encapsulated what we aspired to do as young doctors and scientists. Problem was, my publisher rightly realized “To Wrest from Nature” might not be clear enough for readers to understand what my book was about.
Thankfully, in the same Osler speech there was another fantastic quote. He said:
“It helps a man immensely to be a bit of a hero-worshipper, and the stories of the lives of the masters of medicine do much to stimulate our ambition and rouse our sympathies.”
Here was a description that aptly described so many of the amazing biographies in my book. Hence, the title became “The Masters of Medicine.”
* Osler was a founding professor of the Johns Hopkins Hospital and helped establish internal medicine as an academic discipline.
Q: What do you consider the most amazing medical breakthrough in your book?
I found the story of penicillin’s discovery to be incredibly gripping for several reasons. First, there was Alexander Fleming’s lucky observation that a blob of his snot contained a substance that inhibited bacteria on a petri dish. Then, years later, this initial experience primed him to recognize the same phenomenon happening around a wayward mold that had landed on a culture. The serendipitous events surrounding this event almost beggar belief, from the role of the London weather, to the introduction of an incredibly rare mold, to the timely visit of a colleague in the lab at the perfect moment.
And that isn’t even the most compelling part of the story. The best part is how the actual innovators who developed penicillin into a usable treatment were largely ignored by the press and public. They did not receive the credit they were due. The entire saga has all the ups and downs of a blockbuster movie. Many of the discoveries in my book would probably still have been made, eventually, if the actual discoverers had never existed, but this isn’t necessarily so with penicillin. Its discovery is one of the luckiest events in the history of humankind.
Q: In your research, did you identify similarities among the medical discoveries you researched?
There were many commonalities, like the importance of hard work, perseverance, and luck. But the most consistent feature was the character of the maverick. Mavericks are people who think outside the box and believe so strongly in their newfangled ideas that they are able to endure ridicule, labor for years in obscurity, and persist even though others feel they are wasting their time. We see this in figures such as Andreas Gruntzig (cardiac catheterization), Frederick Banting (insulin), George Papanicolaou (Pap smear), Ignaz Semmelweis (puerperal fever), and many others. These medical mavericks changed the world, and we should look for and support the mavericks of today.
Q: What role did rivalry and competition play in medical discoveries?
There are times when negative human characteristics hurt science. Jealousy, pride, and arrogance lead people to do nasty things to get ahead. But one human quality can enhance science because it drives investigators to work harder. I’m talking about competition and rivalry. One good example was the rivalry between Louis Pasteur and Robert Koch, microbe hunters of the nineteenth century who had acrimonious conflicts but whose mutual loathing prompted each to try to out-discover each other. Hence, there are times when humanity seems to benefit from the worst in people.
Another example was the rivalry between Jonas Salk and Albert Sabin in the race for the polio vaccine. The debate and conflict stemming from their two methods of vaccine creation continued well into the twenty-first century and long after each had died. But at the start, the competition between the two hastened the development of highly effective vaccines.
Q: How did military history augment our medical capabilities?
One of my favorite adages is: “The only winner in war is medicine.” This strikes me as so true and there are numerous medical advances that originated with doctors who were confronted by myriad ghastly wounds far more severe than any they had encountered in civilian practice. Such innovators include Harold Gillies, who invented new plastic surgery techniques to help tens of thousands of men with dreadful facial wounds in WWI. Or Dwight Harken, who developed a new way to operate inside beating hearts after learning how to remove shrapnel from the hearts of dying soldiers in WWII. And Archibald McIndoe, who helped modernize burn care and facial reconstruction after treating hideously burned pilots during the Battle of Britain. Even the most basic triage used in emergency rooms today harken back to methods instituted by Napoleon’s chief surgeon, Dominique Jean Larrey, who equipped “flying ambulances” that were aid wagons employed to speed wounded soldiers to the rear—because he’d observed these men were far more likely to survive if treated promptly.
If you have a question, please email me at email@AndrewLamMD.comand I’ll get back to you.
(With regrets, I am not able to give medical advice over email)