Egerton Y. Davis

In a previous post I reproduced a letter reporting a striking case of “penis captivus”… you may or may not have recognised the letter’s author.

Egerton Yorick Davis was a frequent author of letters to medical societies, although only rarely would his penmanship be published. He was a retired US Army surgeon from Quebec who drowned in the Lachine Rapids in 1884 – his body was never recovered. Adding to his notoriety was a famously suppressed paper, never formally published, on the obstetrical habits of certain Indigenous American tribes. Strangely, Davis was known to sometimes attend conferences in the company of the wife of William Osler and sometimes signed hotel registers on William Osler’s behalf. Indeed, Davis bore a remarkable physical resemblance to Osler and confusing episodes of mistaken identity were prone to occur.

He was, in fact, Sir William Osler’s mischievous alter ego.

Alas, poor Yorick! I knew him, Horatio: a fellow of infinite jest, of most excellent fancy – Hamlet

The “penis captivus” fraud entrenched itself in the medical literature to such an extent that the paper by Davis/ Osler has been cited as truth in textbooks nearly a century later. The letter itself was designed to embarrass Osler’s colleague Theophilus Parvin, the author of a questionable report of “vaginismus” published some weeks prior in the Philadelphia Medical News. However, the satire was too subtle for some.

Osler is unquestionably the great hero of modern bedside medicine. His greatness, according to Professor Michael O’Rourke, stemmed from:

…hard work; he referred to work as the “master word” in introductory student classes. He urged mature students to cultivate a number of qualities: the art of equanimity, of detachment from personal feelings and distractions that could interfere with an issue at hand; the virtue of using a systematic method for organizing work; the quality of thoroughness in assessing symptoms, signs, data and opinions; the grace of humility and a reverence for responsibility. He believed the two most important characteristics a teacher should possess were enthusiasm (“that deep love of a subject”) and knowledge (“a full personal knowledge of the branch taught — not secondhand information derived from books, but the living experience derived from experimental work”).

How does one reconcile Osler’s trouble-making alter ego with his hallowed reputation?

It seems that the revered Osler was “an imp of the perverse” from a young age. As a teenager Osler was the leader of “Barrie’s Bad Boys”. Later, at Weston’s Trinity College, he was charged with assault and a spent at least a night in jail following a “school scrape”. Osler instigated the barricading of a loathed school matron in her sitting room. Osler and his friends fumigated the room with “sulfur and molasses”, and then pelted the matron with various projectiles (including snowballs). The charges against him were later mysteriously dropped (one of the Osler brothers happened to be a defense attorney…).

Later in life, Osler would tag his favorite students with pet names and he remained an inexhaustible practical joker. Sometimes he went too far, as noted by Michael Bliss:

The head matron of the new neurological hospital in Philadelphia prided herself in keeping everything in immaculate condition. She also worshiped Osler. One day he confronted her with a skewer containing a cobweb he had found in a far corner of the basement, and with a straight face questioned her house-keeping. Other doctors had to convince the crying woman that it had been a joke.

One of my favorite anecdotes (though somewhat indefensible!) concerned the death of a patient with Addison’s disease. Not even Osler could convince the man’s family to allow an autopsy. Yet Osler was determined to get his hands on the man’s diseased adrenals. He ghosted into the Morgue during the quiet hours of the night to find the dead man’s corpse. After greasing his own arm and adequately dilating the appropriate lifeless sphincter muscles he was able to grasp the sought-after organs by triumphantly breaching the wall of the deceased’s bowel. Afterward, the body appeared untouched. The next morning, to Osler’s surprise (and probable amusement), he was called upon by the dead man’s Priest. The Priest told Osler the man’s family had changed their minds: Osler had permission to perform the autopsy – with one condition – that the Priest be there to witness the procedure…

Osler’s sense of fun seems, at first, to be at odds with his hallowed reputation. On the contrary, I would argue that it is integral to why he is still so loved and remembered by physicians, and reminds us that although he was a truly great medical hero, he was also human.

References

  • Burrow GN. The trial and tribulation of Egerton Yorrick Davis. West J Med. 1991 Jul; 155(1): 80–82 [PMC1002929]
  • Nation EF. Osler’s alter ego. Dis Chest 1969; 56:531-537
  • Tiggert WD. An annotated life of Egerton Yorrick Davis, MD, an intimate of Sir William Osler. Journal of the History of Medicine and Allied Sciences, 1983;38;3:259–297
  • O’Rourke MF. William Osler: a model for the 21st century? Med. J Aust 1999; 171: 577-579
  • Nickson C. Penis Captivus. LITFL
  • UCEM PR Supervisor Promoted

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

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