Makers of Modern Medicine

by James J. Walsh

During the years after the death of the doctor's wife, intimate friends found out what an effort of Christian fortitude it was for him to keep up his spirits and his work. Though he was one of the busiest of professional men, in very active practice, not a week passed but he found time to go to her grave and put flowers thereon. Just after her death he was as a man stricken by some dazing mental affection. Yet his sense of duty was so great that on his return from her funeral, being informed that a little child suffering from diphtheria needed his services for the performance of intubation, he at once made haste to comply with the untimely demand on him, and had given the little patient relief within the quarter of an hour after he had alighted from the funeral carriage.

Personally, Dr. O'Dwyer was of cold exterior, nor had he many close friends. Those who knew him well understood that beneath the layer of ice there was a warm, considerate, tender heart for those whom he admitted to the penetralia of his intimacy. On the other hand, few men have ever had friends more devoted than were O'Dwyer's. He was, however, of an extremely sensitive disposition. His conclusions in medicine had always been worked out with [{352}] the greatest care, and were the results of personal observations. To have them criticised then by those who had much less experience, or who had never thought along the same lines, was always intolerable to him, and generally kept him out of medical discussions. Those who knew him best realized that his opinions were of the greatest value, nor ever failed to contain a germ of original thought, the result of his personal experience. After his long years of work at intubation, many of his medical brethren refused at first to accept his new method of treatment, claiming that it did not reduce the mortality, even though it did for a moment relieve the sufferings of the patient. This position was a source of the keenest disappointment and depression to O'Dwyer.

After the method of treatment by intubation had been for some time before the medical profession of the country, a thorough discussion of it was held at one of the meetings of the Academy of Medicine of New York. Authorities in children's diseases from several of the large Eastern cities were invited to be present to give their opinions of intubation. Most of them were agreed that O'Dwyer's invention was of very little service. It was not a novelty in the history of medicine to have a really great and helpful discovery thus at first rejected by those who were later to be its ardent advocates. To O'Dwyer, however, who was present and took part in the discussion, the criticism of his method of treatment was a source of veritable torment. He did not show at the meeting how deeply wounded was his spirit, but for three days afterward he practically shut himself up in his room and refused to see anyone.

Naturally he was of a rather melancholic tendency, prone to dwell on the sadder side of things, and was constantly interested in sad stories and songs. He liked sad music, [{353}] and usually refused to listen to the livelier airs that others, especially of his race, were apt to find so refreshing. Something of this sterner side of his character entered into all his relations with others, and even with his own family. Though deeply affectionate, he very seldom permitted them to see and appreciate that fact. He was rather apt to be stern than otherwise, fearful lest his affection should in any way spoil them. To the very young children, in whose regard he did not consider this objection to hold, he was almost demonstratively affectionate, and those who knew his love for little children appreciated the sacrifice he made in denying himself demonstrations of affection to his own.

With all his sadness there was, as might be expected from his racial descent, a vein of dry humor, not infrequently manifest, though only to very near friends. He appreciated a good story, though the slightest tendency to vulgarity was extremely displeasing to him. He is said to be the originator of the humorous expression that has since been used often enough. While one day calling at a friend's house, in the absence of the friend, the servant asked him to leave his name, but was met with the reply (from the doctor) that "he preferred not to, as he thought he might have use for it before he got home."

The religious side of O'Dwyer's character is intensely interesting, because it represents a successful professional man--the maker of an important discovery in medicine; a logical, scientific thinker, whose opinion was valued by all his professional brethren--as one of the simplest of believers, tenderly pious and faithful. The sexton of the church near which he lived tells (since his death) of frequently seeing him steal in during the day to say his prayers at the foot of the altar. He was one of the most faithful attendants at the communions and retreats of the Xavier Alumni Sodality [{354}] of New York City, of which he was an enthusiastic member. His deep piety can, perhaps, be best appreciated from a characteristic incident, which illustrates his faith in prayer--his confidence in Providence. He had asked for something with regard to one of his children over and over again, and finally thought that his prayer had been heard. Later on he had reason to regret the fact that his wish had been granted, and to a friend, to whom he told the circumstances, he said:

"All that we can do is to say with resignation, 'Thy will be done,' and then we shall be sure that whatever happens will be for the best."

The story of O'Dwyer's death serves to illustrate some of the weaker points of modern medicine. During the nearly ten years after his wife's death he had never been quite the same man, but had succeeded in doing a large amount of work and had continued to care for a very large practice. In December, 1897, he began to develop some anomalous symptoms, pointing to a serious pathological condition within the skull. He seemed to have had what are known as "Ménière's symptoms," that is, a tendency to vertigo, some ringing in the ears and other unpleasant feelings. Toward the end of that month some hemiplegia, or at least some weakness of one side of his body, developed. He was rather neglectful of his personal health, as most physicians are, and until this time had paid very little attention to his symptoms. Most of the prominent New York consultants and nervous specialists were called in, but there was a marked disaccord as to the cause of the symptoms.

After some days in bed, comatose symptoms began to manifest themselves, and on January the seventh following, after having been lethargic for some days, Dr. O'Dwyer died. The antemortem diagnosis of his case was dubious, lying amid the possibilities of tubercular meningitis, [{355}] secondary infection after otitis media, and secondary infection from some external cause. During the previous December, O'Dwyer had been treating a patient with carbuncle, and developed himself a small carbuncle on his chin. By some it is thought that infectious material from this lesion had been carried by emissary veins or their accompanying lymphatics to the inside of the skull, affecting the meninges, and perhaps portions of the brain-substance itself.

The postmortem examination did not entirely clear up the doubts of diagnosis. The lateral sinus was found thrombosed, while there were some suspicious signs in the middle ear, but no distinct inflammatory condition. Just how the infection took place, then, is not clear, but O'Dwyer's condition of lowered resistive vitality was evidently at fault, to an important degree, in permitting infection to take place and in not throwing it off afterward.