Enhancing relational care through expressions of gratitude: insights from a historical case study of almoner-patient correspondence

This paper considers insights for contemporary medical practice from an archival study of gratitude in letters exchanged between almoners at London's Brompton Hospital and patients treated at the Hospital's tuberculosis sanatorium in Frimley. In the era before the National Health Service, almoners were responsible for assessing the entitlement of patients to charitable treatment, but they also took on responsibility for aftercare and advising patients on all aspects of welfare. In addition, a major part of the work of almoners at the Brompton was to record the health and employment status of former sanatorium patients for medical research. Of over 6000 patients treated between 1905 and 1963 that were tracked for the purposes of Medical Research Council cohort studies, fewer than 6% were recorded as 'lost to follow-up'-a remarkable testimony to the success of the almoners' strategies for maintaining long-term patient engagement. A longitudinal narrative case study is presented with illustrative examples of types of gratitude extracted from a corpus of over 1500 correspondents' letters. Patients sent money, gifts and stamps in gratitude for treatment received and for the almoners' ongoing interest in their welfare. Textual analysis of letters from the almoner shows the semantic strategies that position gratitude as central to the personalisation of an institutional relationship. The Brompton letters are conceptualised as a Maussian gift-exchange ritual, in which communal ties are created, consolidated and extended through the performance of gratitude. This study implicates gratitude as central to the willingness of former patients to continue to engage with the Hospital, sometimes for decades after treatment. Suggestions are offered for how contemporary relational healthcare might be informed by this unique collection of patients' and almoners' voices.

Daniel Callahan and the Vocation of Bioethics

Did Dan Callahan know the calling he was displaying in his own work and offering to others in the special intellectual garden of The Hastings Center, which he cocreated, with Will Gaylin, and went on to prune and tend for nearly four decades? I would say, yes, he knew what he was about. Successful people usually have self-confidence and drive in abundance, but in Dan's case, there was something more profound and interesting at work. Having gone through the endnotes of his latest book one day, I asked him how he found time to read so widely. He said he had learned to be an efficient skimmer who could pull out the nuggets he valued from another's work because he had a few magnetic ideas from which he would brook no distraction.

Crossing Boundaries

I met Dan Callahan in 1986-when I came to pitch him. Coming from a sleek office setting near Boston, I was intrigued by The Hastings Center's higgledy-piggledy environment where so many smart people got to work in a relaxed, inviting atmosphere. I had noticed that the Center was producing a great deal of policy work on a wide range of topics but didn't seem to go further than publishing the highly valuable guidance developed under Dan Callahan's leadership. I ended my pitch, "Look, Dan, where Hastings gets bored and wants to go on to the next topic, my group in Boston gets interested." To my great pleasure, and despite his skepticism, Dan accepted the pitch. Beyond his generous responsiveness to unproven young people, Dan had many other virtues. For one, he was a boundary crosser.

A Champion for the Unestablished

As a student in bioethics, I knew that The Hastings Center and its founders were the height of excellence in this field, and therefore I found them both intimidating and intriguing. When I began working there, Dan Callahan was supportive of my endeavors to provide a venue for students and other young writers to express their views on bioethics. I started my own blog called Bioethx under 25 that featured short essays by anyone who wished to submit, generally individuals who had a genuine philosophical interest but were not yet at the level of pursuing a Ph.D. Dan's support of my project culminated in his sponsorship of the Daniel Callahan Young Writer's Prize, an essay contest run through the blog. This was one of the many ways he demonstrated that making theoretical contributions to bioethics should not be limited to a select few.

Medical Ethics in Radiography

The medical field often requires radiologic technologists to make complex decisions that affect patients, employers, and colleagues. Technologists must consider practice standards when making choices, and also must act ethically to protect patients' safety and respect their autonomy. To make the most informed and ethical decisions, technologists should know the history of medical ethics, as well as be familiar with philosophical tools and ethical codes that can guide them in their daily practice.

Rubbing Elbows and Blowing Smoke: Gender, Class, and Science in the Nineteenth-Century Patent Office

The United States Patent Office of the 1850s offers a rare opportunity to analyze the early gendering of science. In its crowded rooms, would-be scientists shared a workplace with women earning equal pay for equal work. Scientific men worked as patent examiners, claiming this new occupation as scientific in opposition to those seeking to separate science and technology. At the same time, in an unprecedented and ultimately unsuccessful experiment, female clerks were hired to work alongside male clerks. This article examines the controversies surrounding these workers through the lens of manners and deportment. In the unique context of a workplace combining scientific men and working ladies, office behavior revealed the deep assumption that the emerging American scientist was male and middle class.

Pieter Van Foreest: The Physician as Writer on Surgery

The Dutch physician Pieter Van Foreest (1520-97) included nine books of surgical observations among his large series of case-histories. Although he demanded that all physicians should have a knowledge of surgery, his writings show the limitations of his approach as well as the overlap between physicians and surgeons. Certain conditions were treated by both types of practitioner, but Foreest left invasive and manipulative side treatments to surgeons, while claiming the right as a physician to organise the overall treatment of the patient.

Financial Capability in Early Social Work Practice: Lessons for Today

During the profession's first decades, social workers tried to improve their clients’ financial capability (FC). This article describes the methods used by early social workers who attempted to enhance the FC of their clients, based on contemporary descriptions of their practice. Social workers initially emphasized thrift, later adding more sophisticated consideration of the cost of foods, rent, and other necessities. Social work efforts were furthered by home economists, who served as specialists in nutrition, clothing, interior design, and other topics related to homemaking. Early home economists included specialists in nutrition and family budgeting; these specialists worked with social services agencies to provide a financial basis for family budgets and assisted clients with family budgeting. Some agencies engaged home economists as consultants and as direct providers of instruction on home budgets for clients. By the 1930s, however, social work interest in family budget problems focused on the psychological meaning of low income to the client, rather than in measures to increase client FC. Consequently, social workers’ active engagement with family budget issues—engagement that characterized earlier decades—faded. These early efforts can inform contemporary practice as social workers are once again concerned about improving their clients’ FC.

From Pulling Teeth to Promoting Oral Health. Pharmacy and Dentistry 1815-2015

Two hundred years ago the occupational boundaries between different medical practitioners were blurred and unspecified, with many practicing in several fields. However the 1815 Apothecaries Act had a major impact on both the emerging pharmaceutical and dental professions. The 1878 and 1921 Dentists Acts enabled pharmacists who did some dentistry to continue practicing dentistry. Changes proposed by the British Dental Association (BDA) resulted in the formation of a Chemists Dental Association in 1910 to defend the interests of this group, which continued in existence until 1951. This paper explores the changing relationship between chemists and dentists from the early nineteenth century through to the early twenty-first century. Sources used include the published work of both dental and pharmaceutical historians, documentary sources, and quotations from oral history interviews.

The professional identity of the practicante: the case of Aragon, 1857-1936

The objective of this study was to reconstruct the professional identity of the practicante (male assistant in medicine and surgery) by analyzing three professional journals of this collective in Zaragoza (Aragón). The discourse of practicantes on their profession insists that they were the only assistants for physicians with technical qualities. This affirmation constituted a key element in shaping their identity, contributing in turn to establish the moral and social legitimization of practicantes and their professional authority. This was constructed in counterpoint to the profile, qualifications and gender identity of the other professional healthcare assistant, the nurse. Despite achieving a clear discourse on their professional identity and developing certain professional infrastructures through the work of institutions and key figures, practicantes were not able to consolidate a collective project of upward social mobility that would improve their status and enhance social recognition of the profession. This led to the construction of a group identity that was largely characterized by apathy, frustration and disunion, elements that eventually weakened the profession.

Introduction to special issue: Robert Jay Kastenbaum (1932-2013)

The three pieces in this section introduce the Festschrift celebrating the works and influence of Omega: Journal of Death and Dying's founding editor, Robert Kastenbaum. Robert Fulton, an early Associate Editor of the Journal begins with some personal reflections on Kastenbaum. Klass and Doka then describe the nature of the Festschrift. A closing coda by Robert Kastenbaum's wife, Beatrice Kastenbaum, reminds us of the person behind the work.

Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman

The lives of the first women doctors in Britain have been well studied by historians, as have the many debates about the right of women to train and practice as doctors. Yet the relationship between these women and their most obvious comparators and competitors-the newly professionalized hospital nurses-has not been explored. This article makes use of a wide range of sources to explore the ways in which the first lady doctors created "clear water" between themselves and the nurses with whom they worked and trained. In doing so, it reveals an identity that may seem at odds with some of the clichés of Victorian femininity, namely that of the intelligent and ambitious lady doctor.

Good enough for America

Adulterated and counterfeit drugs were pouring into the U.S. Providing poor medicines was a growing business, and the market was growing with the rapid expansion of the country itself. There seemed to be little that could be done to slow or stop it. The sophistication of the adulterations was superior to available tests, standards were lacking, and there were few trained pharmacists or physicians who could apply them. There were no laws that would prohibit the importation of these products nor limit their sale once ashore. This was the situation when a small group of New York pharmacists took it upon themselves to convince other health professionals and legislators that there was a problem and devised a solution that would establish patient safety as the core value of the emerging profession of pharmacy.

[The historical aspects of formation of professional competence of pharmacist in XIX--early XX centuries]

The article considers the main directions of formation of professional competence of pharmacist in XIX--early XX centuries. The study revealed six directions: development of normative documents to determine requirements to different aspects of pharmaceutical activities; establishment of requirements to professional education of pharmacists; organization of public control of activities of pharmaceutical organizations and pharmaceutical personnel, development of system of penalties for established infringements of laws and regulations concerning pharmacies; introduction of conduct listings; development of opinion of pharmaceutical community concerning the necessity of top level of education of pharmaceutical personnel and its public responsibility.

The first lady almoner: the appointment, position, and findings of Miss Mary Stewart at the Royal Free Hospital, 1895-99

This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed "appropriate" received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.

Shepherding a flock of different fleece: a historical and social analysis of the unique attributes of the African American pastoral caregiver

Scholars researching and writing on the roles of pastor-caregivers in predominantly black congregations have done so using models originally designed to examine the roles of pastor-caregivers in primarily white churches. This study offers a revised model based on the historical development and present reality of black churches that more closely matches the historical and present roles of the black pastor who can trace his or her roots back to African spiritual traditions.

Sairey Gamps, feminine nurses and greedy monopolists: discourses of gender and professional identity in the Lancet and the British Medical Journal, 1886-1902

The British debate over midwife registration in the late 19th and early 20th centuries was highly gendered. Focusing on the period between the 1886 Medical Act and the 1902 Midwives Act, this article uses the content from the Lancet and the British Medical Journal, the two main general medical publications of the time, to explore the complex ways that gender works through other categories such as class and race to create professional identity. Specifically this article demonstrates how man-midwives used gendered language to help create identities for themselves, female midwives, and other rivals in order to legitimize their own professional identity and practice and to delegitimize the professional identities of their competition.

Quest for professionalism: a biography of the North American Medical and Surgical Journal (1826-31)

This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.

'Often there is a good deal to be done, but socially rather than medically': the psychiatric social worker as social therapist, 1945-70

Seeking to align psychiatric practice with general medicine following the inauguration of the National Health Service, psychiatric hospitals in post-war Britain deployed new treatments designed to induce somatic change, such as ECT, leucotomy and sedatives. Advocates of these treatments, often grouped together under the term 'physical therapies', expressed relief that the social problems encountered by patients could now be interpreted as symptomatic of underlying biological malfunction rather than as a cause of disorder that required treatment. Drawing on the British Journal of Psychiatric Social Work, this article analyses the critique articulated by psychiatric social workers based within hospitals who sought to facilitate the social reintegration of patients following treatment. It explores the development of 'psychiatric social treatment', an approach devised by psychiatric social workers to meet the needs of people with enduring mental health problems in hospital and community settings that sought to alleviate distress and improve social functioning by changing an individual's social environment and interpersonal relationships. 'Physical' and 'social' models of psychiatric treatment, this article argues, contested not only the aetiology of mental illness but also the nature of care, treatment and cure.

Does ownership matter for the provision of professionalized services? Hip operations at publicly and privately owned clinics in Denmark

In terms of clinical procedures (to take the example used in this article, hip operations), both public and private organizations provide highly professionalized services. For this service type, our knowledge about ownership differences is sparse. To begin to fill this gap, we investigate how the ownership of hip clinics affects professional behaviour, treatment quality and patient satisfaction. The comparison of private and public hip clinics is based on data from the Danish Hip Arthroplasty Register and the Danish Central Patient Register combined with 20 semi-structured interviews. We find that private clinics employ stronger individual financial incentives and try harder to increase the income/costs ratio than do public clinics. Private clinics optimize non-clinical factors such as waiting time much more than public clinics and have fewer complication-prone patients than public clinics. However, the clinical procedures are very similar in the two types of clinics. Private clinics do not achieve better clinical results, but patient satisfaction is nevertheless higher with private clinics. The implication is that ownership matters for highly professionalized services, but professionalism neutralizes some – but not all – ownership differences.

Amateur knowledge: public art and citizen science

The science studies literatures on amateurs and citizen science have remained largely unconnected despite similarities between the two categories. The essay connects amateur knowledge and citizen science through examples from public art. Through an analysis of the use of the term "amateur" by contemporary artists working to engage the public in critiques of science, connections in the ideals of democratic knowledge making by amateurs and citizen scientists are further explored.

A Lipskian analysis of child protection failures from Victoria Climbié to "Baby P": a street-level re-evaluation of joined-up governance

This paper explores the issue of joined-up governance by considering child protection failures, firstly, the case of Victoria Climbié who was killed by her guardians despite being known as an at risk child by various public agencies. The seeming inability of the child protection system to prevent Victoria Climbié's death resulted in a public inquiry under the chairmanship of Lord Laming. The Laming report of 2003 looked, in part, to the lack of joined-up working between agencies to explain this failure to intervene and made a number of recommendations to improve joined-up governance. Using evidence from detailed testimonies given by key personnel during the Laming Inquiry, the argument of this paper is that we cannot focus exclusively on formal structures or decision-making processes but must also consider the normal, daily and informal routines of professional workers. These very same routines may inadvertently culminate in the sort of systemic failures that lead to child protection tragedies. Analysis of the micro-world inhabited by professional workers would benefit most, it is argued here, from the policy-based concept of street-level bureaucracy developed by Michael Lipsky some 30 years ago. The latter half of the paper considers child protection failures that emerged after the Laming-inspired reforms. In particular, the case of ‘Baby P’ highlights, once again, how the working practices of street-level professionals, rather than a lack of joined-up systems, may possibly complement an analysis of, and help us to explain, failures in the child protection system. A Lipskian analysis generally offers, although there are some caveats, only pessimistic conclusions about the prospects of governing authorities being able to avoid future child protection disasters. These conclusions are not wholeheartedly accepted. There exists a glimmer of optimism because street-level bureaucrats still remain accountable, but not necessarily in terms of top-down relations of authority rather, in terms of interpersonal forms of accountability – accountability to professionals and citizen consumers of services.

The role of hospital heterogeneity in measuring marginal returns to medical care: a reply to Barreca, Guldi, Lindo, and Waddell

In Almond et al. (2010), we describe how marginal returns to medical care can be estimated by comparing patients on either side of diagnostic thresholds. Our application examines at-risk newborns near the very low birth weight threshold at 1500 g. We estimate large discontinuities in medical care and mortality at this threshold, with effects concentrated at “low-quality” hospitals. Although our preferred estimates retain newborns near the threshold, when they are excluded the estimated marginal returns decline, although they remain large. In low-quality hospitals, our estimates are similar in magnitude regardless of whether these newborns are included or excluded.

The strange case of the Freudian case history: the role of long case histories in the development of psychoanalysis

Sigmund Freud's five long case histories have been the focus of seemingly endless fascination and criticism. This article examines how the long case-history genre developed and its impact on the professionalization of psychoanalysis. It argues that the long case histories, using a distinctive form that highlighted the peculiarities of psychoanalytic theory, served as exemplars in the discipline. In doing so, the article extends John Forrester's work on "thinking in cases" to show the practical implications of that style of reasoning. The article illustrates how the form disappeared once the theoretical basis of the movement was set. The genre never became institutionalized, although the content of the five long case histories did, because of Freud's accepted role as theoretician of psychoanalysis.

The role of governmentality in the establishment, maintenance and demise of professional jurisdictions: the case of geriatric medicine

This paper examines the professionalising of geriatric medicine in the UK roughly between the 1940s and the 1970s and locates it in terms of the broader context of the relationship between the professions and the state. It looks at how this relationship shaped geriatric medicine's professional jurisdiction, including the discourses of expertise on the one hand and the constituting of the 'subjects' of such expertise on the other. In contrast to other sociological approaches to the professions, which highlight the negative impact of state encroachment on professional territory, this paper contends that without the backing of the Ministry of Health the specialty may never have established itself in the face of prolonged opposition from rival specialists. However, such support was predicated on the specialty's highlighting particular legitimating discourses and practices at the expense of others, and in framing this in terms of specific policy concerns around an ageing population. Whilst this imprinted the profession with the stamp of governmentality, it also contributed to the broader problematising of old age in the twentieth century. The paper concludes by considering the legacy of this context of professionalisation for the profession today.

Students as resurrectionists--A multimodal humanities project in anatomy putting ethics and professionalism in historical context

Because medical students have many different learning styles, the authors, medical students at Mayo Clinic, College of Medicine researched the history of anatomical specimen procurement, reviewing topic-related film, academic literature, and novels, to write, direct, and perform a dramatization based on Robert Louis Stevenson's The Body-Snatcher. Into this performance, they incorporated dance, painting, instrumental and vocal performance, and creative writing. In preparation for the performance, each actor researched an aspect of the history of anatomy. These micro-research projects were presented in a lecture before the play. Not intended to be a research study, this descriptive article discusses how student research and ethics discussions became a theatrical production. This addition to classroom and laboratory learning addresses the deep emotional response experienced by some students and provides an avenue to understand and express these feelings. This enhanced multimodal approach to"holistic learning" could be applied to any topic in the medical school curriculum, thoroughly adding to the didactics with history, humanities, and team dynamics.

The "cradle of glass": incubators for infants in late nineteenth-century France

This article examines the development of the incubator for premature infants in fin-de-siècle France. During a period of widespread anxiety in France regarding infant mortality and its implications for population growth, physicians in Paris developed and widely promoted the lifesaving technology. This article explores the ways in which the incubator reflected new scientific and symbolic approaches to creating hygienic spaces as well as how it reflected new scientific and symbolic approaches to the traditionally feminine project of infant care. By creating such an isolating and protective milieu around premature infants—an entirely new population of patients—the incubator, I argue, heralded a renegotiation of the boundary between motherhood and medical authority.

Eyes on the prize: reflections on the impact of the evolving digital ecology on the librarian as expert intermediary and knowledge coach, 1969-2009

OBJECTIVE

The 2009 Janet Doe Lecture reflects on the continuing value and increasing return on investment of librarian-mediated services in the constantly evolving digital ecology and complex knowledge environment of the health sciences.

SETTING

The interrelationship of knowledge, decision making based on knowledge, technology used to access and retrieve knowledge, and the important linkage roles of expert librarian intermediaries is examined.

METHODOLOGY

Professional experiences from 1969 to 2009, occurring during a time of unprecedented changes in the digital ecology of librarianship, are the base on which the evolving role and value of librarians as knowledge coaches and expert intermediaries are examined.

CONCLUSION

Librarian-mediated services linking knowledge and critical decision making in health care have become more valuable than ever as technology continues to reshape an increasingly complex knowledge environment.

[Scientific training and professional practice in Vicente Cervantes Mendo's Spain.]

Vicente Cervantes Mendo (Ledrada, Salamanca, 1758 - México, 1829) was a famous Spanish Mexican scientists; he is today heritage of Spain and Mexico. As a continuation of two recent articles on his life at Spain, the present study deals with his scientific formation at madrid, as pharmacist and as botanist, as well as on his professional activity. Two documents of Casimiro Gómez Ortega, principal professor of the Real Jardín Botánico de Madrid, dated in 1786 and related with the "Real Expedición Botánica a Nueva España (1787-1803)," have served to establish conclusions which clarify the subjects studied and correct mistakes.

[The professionalization of nursing in Argentina: political and institutional disputes during Peronism.]

This paper discusses the professionalization of nurses in Argentina during Peron's administration (1946-1955). We will focus on two nursing schools during such period: Escuela de Engermas de la Secretaría de Salud Pública (1947) and Escuela de Enfermeras "7 de mayo" member of Fundación Eva Perón (1950). We will analyze the institutional disputes over budgetary positions in the context of greater government intervention in public health issues.

The professional and the scientist in nineteenth-century America

In nineteenth-century America, there was no such person as a "professional scientist". There were professionals and there were scientists, but they were very different. Professionals were men of science who engaged in commercial relations with private enterprises and took fees for their services. Scientists were men of science who rejected such commercial work and feared the corrupting influences of cash and capitalism. Professionals portrayed themselves as active and useful members of an entrepreneurial polity, while scientists styled themselves as crusading reformers, promoters of a purer science and a more research-oriented university. It was this new ideology, embodied in these new institutions, that spurred these reformers to adopt a special name for themselves--"scientists". One object of this essay, then, is to explain the peculiar Gilded Age, American origins of that ubiquitous term. A larger goal is to explore the different social roles of the professional and the scientist. By attending to the particular vocabulary employed at the time, this essay tries to make clear why a "professional scientist" would have been a contradiction in terms for both the professional and the scientist in nineteenth-century America.

[In the heart of Brazil, a healthy capital--the participation of doctors and sanitarists in the construction of Brasília (1956-1960)]

Projected as an expression of the daring and modernity of an age, Brasília could not overlook planning that considered the conditions where it would be located in the interior of Brazil. Constructed in a region historically associated with isolation, poverty and diseases, the new capital required the participation of doctors and sanitarists from the very beginning of construction to ensure healthy conditions. Seeing the opportunity to expand their sphere of action, until then restricted to the interior, doctors from Goiás stood out in this process, highlighted by concerns of the profession manifested in the periodical published by its association and their extensive mobility and modern practice, contradicting the common conceptions regarding doctors in the interior.

Cookery, diet and district nursing in late nineteenth-century London

While health education in late nineteenth-century Britain could be beneficial for every household, it was particularly so where district nurses understood family circumstances and adapted knowledge to individual needs. During this period sick room cookery training and lectures on hygiene and dietetics became standard for nurses--especially following the reforms of Matron Eva Lückes at the London Hospital. Because understanding about health was not widespread in society, due to the living conditions and poverty of so many patients, and because doctors had few opportunities to convey such knowledge, the active support of nurses in the community proved to be essential for translating professional knowledge into words commonly understood. By demonstrating cooking and other health-related skills in the homes of the poor, nurses played an important part in improving the nation's health.

[Masters of Ireneusz Wierzejewski]

Authors described the figures of outstanding German orthopaedists and the influence they exerted on the development of Polish orthopaedics. Their biggest achievements for the European and global orthopaedic are clarified. The particular attention was devoted to these luminaries of German orthopaedics at whom Ireneusz Wierzejewski, author of modern Polish orthopaedics, began studies, undertook the clinical practice as well as developed his professional interests.

[Famous figures of the Poznań orthopaedics of the period of the occupation and post-war years. Coryphees of Polish orthopaedics]

In this article author presents, from a perspective of own memories is portraying persons which he met in his professional activity. They participated in forming the orthopaedics in Poznań and different nooks of Poland. He resembles their, often very dramatic, fates and the influence they had on Polish medicine reviving after the II world war. With the special attention he is reminding one of most well-known and valued celebrities of the Polish orthopaedics professor Wiktor Dega.