Wednesday 17 January 2018

Artistic legacy: how a doctor didn't need anaesthetic to stitch inebriated Francis Bacon

Irish patients lead the world in generosity to family doctors, writes Maurice Gueret, who finds plenty of Brass in Bacon

Francis Bacon's studio
Francis Bacon's studio
Dr Maurice Gueret

You learn in medicine to be careful about what you say in front of sick people. A patient once overheard a colleague of mine dictating a letter about starting chemotherapy for his tuberculosis. The doctor merely meant 'treatment with drugs', but the patient took chemotherapy to mean that he also had cancer and that the doctor was afraid to tell him about it. Another patient was told she needed phlebotomy. She went home to tell her husband that they were going to take part of her brain out. That particular doctor learned to say 'blood test' in future.

Last week, I saw an advertisement for phlebotomy training in a local newspaper. "Train as a phlebotomist in two days," said the advert - no experience or qualifications needed. For about €400, a UK-based operation offers small classes, limited places and awards a certificate in phlebotomy. I thought that was a bit quick until I considered that the two days training is two days more than some doctors received at medical school. In the USA, training times vary from State to State, but the usual stipulation is that between 30 and 80 hours training is required.

There is a Phlebotomists Association of Ireland. For 20 years they have been calling for a recognised training system, accreditation and registration in this state. Phlebotomy is an important job. There are all sorts of issues and skills around infection control, laboratory testing, anatomy, physiology, patient resuscitation and confidentiality that need to be imparted to these healthcare professionals. Is a two-day course for a certificate good enough? Perhaps a needle with a wider bore needs to be stuck firmly into the rear of the Department of Health.

The word hypochondria is an interesting one. It derives from the Greek 'hypo', signifying below, and 'khrondros', meaning the sternum or rib cartilage. The area in question is the soft upper part of the tummy, just under the breastbone. Hypochondria was once considered quite an acceptable diagnosis. Men would be told that the root of their symptoms lay in the upper belly and that they had hypochondria. On the other hand, doctors might fob off their wives' complaints with the story that the womb was the likely source of their worries. They were frequently diagnosed with hysteria. The meanings and usage of these diagnoses has changed over the years, and both would be exceedingly rare in modern case notes.

We were looking at some famous Irish hypochondriacs last week, namely Charles Stewart Parnell, John Charles McQuaid and Edward Carson. Two more for our list are the author George Bernard Shaw and one-time leader of the Irish Parliamentary Party, John Dillon. We might examine Shaw and his obsessions next week, but Dillon's preoccupation with personal health matters was the stuff of legend. He was a medical doctor by training, but went straight into Land League and Home Rule politics, serving almost four decades as a Westminster MP. It was said that he was in possession of a double disadvantage, as his life was filled with actual ill health coupled with rabid hypochondria.

His condition was so eminent in his life that it took medical historian Professor FSL Lyons to write his biography. His attendance at parliament was often affected by bouts of ill health, yet he survived to the age of 76 when he met his end at the sharp edge of a surgeon's knife. Dillon had travelled to London to liaise with a specialist in gall-bladder disease. What we now consider an everyday cholecystectomy was a very risky procedure in 1927, and Dillon passed away in the Alfred House Nursing Home on Portland Place, run by the Countess of Carnarvon. The facility specialised in diseases of the rich and famous and treated many European royal families. The countess had no nursing qualifications but liked to gown up and assist her surgeon, usually Lord Moynihan of Leeds, in the counting up and hanging of his bloody swabs.

Irish patients can be very generous to their doctors. BBC2's Newsnight recently interviewed an old-style London GP about a very famous Irishman that he treated. Dr Paul Brass, and his father before him, were family doctors and friends to the artist Francis Bacon. There were frequent house calls to the artist's studio, and Dr Brass described one visit when his patient sustained a nasty laceration. The doctor recommended seeing a specialist plastic surgeon, but Bacon was having none of it. He lay up on the studio table to have stitches put in. Dr Brass said his patient was so inebriated that there was no need for a local anaesthetic.

Bacon had once written to the elder Dr Brass, complaining that he was not getting any medical bills. He demanded invoices for all treatments, or he would have to find a new doctor. Dr Brass recalled that Bacon always paid by return post and was always 15 minutes early for his appointments. Francis Bacon offered the younger Dr Brass a choice between two paintings as a gift. The doctor picked Jet of Water, but Bacon cautioned that it was merely spilled paint on a canvas. So Dr Brass took the other painting, of a rather tortured-looking English cricketer. Bacon told Dr Brass that his paintings would be worthless when he died. Almost 20 years after Bacon's death, the good doctor put the painting up for auction with Sotheby's of New York. It fetched US$14m. There's money in Bacon and Brass.

Dr Maurice Gueret is editor of the Irish Medical Directory

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