John Hickam
John Bamber Hickam (1914-1970) was an American physician
Hickam was a physician, educator, and medical investigator best known for his leadership in internal medicine and contributions to pulmonary and cardiovascular research. Hickam earned his undergraduate and medical degrees summa cum laude and cum laude respectively from Harvard University. His postgraduate training included residencies at Peter Bent Brigham Hospital and Emory University, followed by service as a U.S. Army physician during World War II.
In 1947, Hickam joined the faculty at Duke University School of Medicine, where his research into pulmonary function in heart and lung disease gained national attention. In 1958, he was appointed Chair of Medicine at Indiana University School of Medicine, a position he held until his death. During this time, he transformed the department into a leading center for cardiovascular research and postgraduate training. He held leadership roles including president of Central Society for Clinical Research; secretary of Association of American Physicians; president of Association of Professors of Medicine; member of NIH Heart Council and AMA committees..
Hickam authored approximately 75 scientific papers, contributed to the Cecil-Loeb Textbook of Medicine, and served on the editorial boards of several major journals. He was a key contributor to the 1964 U.S. Surgeon General’s report on smoking and health. Although widely associated with “Hickam’s dictum”, there is no direct evidence that he coined the phrase himself. Nonetheless, the aphorism reflects his nuanced approach to clinical diagnosis.
Biographical Timeline
- 1914 – Born August 10 in Manila, Philippine Islands; son of Colonel Horace M. Hickam (namesake of Hickam Air Force Base, Hawaii).
- 1936 – Graduated A.B. summa cum laude from Harvard University.
- 1940 – Received MD cum laude from Harvard Medical School.
- 1940–1946 – Internship and residency at Peter Bent Brigham Hospital, Boston; additional residency at Emory University; served in the U.S. Army during World War II.
- 1946 – Brief return to Emory University post-war.
- 1947–1958 – Faculty member, Duke University School of Medicine; led important clinical and research initiatives.
- 1958 – Appointed Professor and Chair, Department of Medicine, Indiana University School of Medicine.
- 1964 – Contributed to the U.S. Surgeon General’s report Smoking and Health.
- 1960s – Directed IU’s Heart Research Center; served as PI for U.S. Air Force cardiopulmonary lab at Wright-Patterson AFB.
- 1960s – Published ~75 scientific articles; contributed chapters to Cecil-Loeb Textbook of Medicine.
- Various Dates – Held leadership roles: president of Central Society for Clinical Research; secretary of Association of American Physicians; president of Association of Professors of Medicine; member of NIH Heart Council and AMA committees.
- 1970 – Died February 9 at age 55.
Medical Eponyms
Hickam’s Dictum
Hickam’s Dictum counters the medical application of Occam’s Razor, reminding clinicians that patients can have multiple simultaneous conditions. Commonly phrased as “patients can have as many diseases as they damn well please”, the dictum advises caution against premature diagnostic closure based on parsimony alone.
While Occam’s Razor emphasises the simplicity of a single unifying diagnosis, Hickam’s Dictum reflects clinical reality, especially in older or comorbid patients, where overlapping or unrelated pathologies may coexist. Together, they form a complementary diagnostic heuristic: begin with simplicity, but remain open to complexity.
A man can have as many diseases as they damn well please
Attributed to Dr. John Hickam
1998 – Wallace T. Miller published “Letter from the Editor” titled Occam versus Hickam in Seminars in Roentgenology, raising the contrast between diagnostic parsimony and multiple co‑morbidities. This appears to be the earliest documented English‑language publication explicitly naming “Hickam’s dictum.”
Major Publications
- Hickam JB, Ross JC. Respiratory acidosis in chronic pulmonary heart disease: pathogenesis, clinical features and management. Prog Cardiovasc Dis. 1959 Feb;1(3):309-25
- Hickam JB, Sieker HO. Pulmonary embolism and infarction. Dis Mon. 1959 Jan:1-36
- Hickam JB, Close WD. Symposium on medical education–No. 3. V. The proposed Indiana family practice program. JAMA. 1961 Jun 17;176:907-9.
- Hickam JB, Deiss WP, Frayser R. Intramural use of extramural examinations. JAMA. 1965 Jun 7;192:828-31
- Hickam JB. Periodic recertification. JAMA. 1970 Sep 7;213(10):1657-8
References
Biography
- Bogdonoff MD. John Bamber Hickam. Arch Intern Med. 1971 Apr;127(4):569-70
- Ross JC. John Bamber Hickam. Physician, educator, investigator. Arch Intern Med. 1971 Apr;127(4):571-3.
- Stead EA Jr. John Bamber Hickam, 1914-1970. Trans Assoc Am Physicians. 1970;83:20-4.
- McIntosh HD. Memorial. John Bamber Hickam, M.D. Trans Am Clin Climatol Assoc. 1971;82:lx-lxii
Eponymous terms
- Miller WT. Occam versus Hickam. Seminars in Roentgenology 1998; 33(3): 213.
- Hilliard AA, Weinberger SE, Tierney LM Jr, Midthun DE, Saint S. Clinical problem-solving. Occam’s razor versus Saint’s Triad. N Engl J Med. 2004 Feb 5;350(6):599-603.
- Mani N, Slevin N, Hudson A. What Three Wise Men have to say about diagnosis. BMJ. 2011 Dec 20;343:d7769
- Levine D, Bleakley A. Maximising medicine through aphorisms. Med Educ. 2012 Feb;46(2):153-62.
- Borden N, Linklater D. Hickam’s Dictum. West J Emerg Med. 2013 Mar;14(2):164.
- Freixa M, Simões AF, Rodrigues JB, Úria S, da Silva GN. Occam’s razor versus Hickam’s dictum: two very rare tumours in one single patient. Oxf Med Case Reports. 2019 May 31;2019(5):omz029.
- Stein H, Lowenstein EJ. Occam’s razor and Hickam’s dictum: a dermatologic perspective. Diagnosis (Berl). 2022 Nov 18;10(2):96-99.
- Blaser S, Schaye V, Hwang J, Cocks P, Kudlowitz D. Hickam’s dictum, Occam’s razor, and Crabtree’s bludgeon: a case of renal failure and a clavicular mass. Diagnosis (Berl). 2021 Aug 5;9(1):133-139.
- Aberegg SK, Poole BR, Locke BW. Hickam’s Dictum: An Analysis of Multiple Diagnoses. J Gen Intern Med. 2024 Oct 28
Eponym
the person behind the name
BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |