by Josh Stripling, MD

Dr. Tinsley Harrison left an important mark on our residency program and established what the legacy of what UAB medicine has come to be. His biography, written by the late Dr. James Pittman, Tinsley R. Harrison M.D.: Teacher of Medicine, was recently published by NewSouth Books. The book is a well-edited, finer version of Dr. Pittman's "collections" that he was unable to complete before his death in January 2014.

The following selection comes from his earlier manuscripts and represents the unedited words of Dr. Pittman and his reflections on Dr. Harrison:

Tinsley Harrison, MD: Teacher of Medicine"This book starts with a patient and ends with a patient, an individual patient. In the first instance, it begins abruptly, just as a patient often discovers illness suddenly and unexpectedly. Medicine is about patients and curing, managing, or ameliorating their diseases, disabilities, pain, suffering and in the last analysis that is all it is about. Obviously, the various aspects of prevention – vaccinations, prevention of epidemics, provisions of clean and pure water, food, air, policies concerning the macro-allocation of public resources – all of these are necessary and historically have usually been introduced and supported (though sometimes opposed) by physicians, who best understood the problems. But the more these community concerns take first priority, the more the effort becomes public health and the less it is the practice of medicine. Present day discussions trying to emphasize 'patient-centered medicine' only demonstrate how far we have strayed from that fundamental concept.

Which is a more true and accurate description of a mountain in the sunset, that of the team of an engineer, a geographer, a biologist, and a geologist or that of a poet? The team of scientists write a very accurate description of the mountain, with its exact location and geographic relations using tables, graphs, maps and a GPS fix, the mountain's dimensions, maximum height of its peak, mass, quantification of it geological constituents, the types and distributions of foliage and fauna, perhaps the economic value of the timber and mineral resources, the amount of light reaching its various parts of the mountain at sunset, and so on. The poet on the other hand, might emphasize the massive size and increasing darkness of the mountain, its rocky outline against the sky, the clouds over it, the song of the water in the brook along its side, the whisper of the wind in its trees, the evening murmurs of birds in the lower branches, the lengthening shadows as the sun sets, the crepuscular rays from the sun and the fading tints of colors, the apparently increasing rapid rate of descent of the sun as it nears the horizon. Whose description is the more accurate, that of the team of scientists or that of the poet? Which is really True? Both are, but they appeal to different senses or perspectives. One may be more detailed, but the other more intense, therefore more immediately real to the observer. Clinometric is great for history, but is not necessarily more true than the poet's descriptions . . . Medicine is first of all an interaction between warm blooded, breathing, feeling, living people, which we forget at our peril. It is at least half poetry rather than technology, and as life progresses towards its inevitable end the poetry must increase and the technology decrease.

Sir George Pickering said that Tinsley Harrison's chief characteristic was passion. He was rarely neutral on any topic, and he was most intense on medical topics. Dr. Ivan Bennett of Emory, Johns Hopkins and New York University said, "His motto seemed to be that anything worth doing was worth doing in excess." The Editors of the ninth edition of the book – his book, The Principles of Internal Medicine – in press when he died in 1978, remarked as they dedicated the book to his memory, 'From time to time a personality scintillates across the medical firmament that dazzles all beholders. Tinsley Harrison was such a person. A delightful vivacious, passionate physician, he stimulated everyone with whom he came in contact, and he placed an indelible stamp on the medical events of today.'

Tinsley Harrison was unique to medicine. At a time when medicine in the United States was changing from the worst to the best in the world and erupting into the middle of the social scene, he was a major participant in that development. He was probably the only physician in America to become the first 'full time' regular chairman of three separate medical school departments of internal medicine, at Bowman Gray in North Carolina, Southwestern Medical School in Dallas and UAB in Birmingham, Alabama. His crowning achievement was the origination of The Principles of Internal Medicine, which became probably the best selling textbook of internal medicine in all of history. His peak years as a clinician were around the age of 40-60. After his medical activities declined he seemed to sense this and he resigned his post of Chairman of the Department of Medicine in Birmingham at the age of 57 to become a Distinguished Professor. He stayed active with students and writing until his last few years and died a bitter critic of the mindless overuse of medical technology he himself had helped develop and of what he considered the disoriented universities and their even more disoriented medical schools.

I once accused Tinsley Harrison of being a nineteenth century physician. He empathically disagreed: 'No!', he said, 'I am an eighteenth century doctor!' But really, though he said he was anti-Victorian because of the hypocrisy then, he probably would have been more at home in the late nineteenth century or early twentieth century than any other time.

In meeting the modern challenges, Tinsley Harrison probably, without thinking much about his own compensation or perhaps even the legal problems he might precipitate, would have attempted to subvert the system for the benefit of his individual patient."

If you would like a copy of the published book, Tinsley Harrison, M.D.: Teacher of Medicine, it is available for purchase here.