My parents’ surgery was in an extension of our home. As children, we answered the phone, gave out prescriptions at the front door when the surgery was closed, and often helped with filing letters or doing other paperwork during school holidays. Growing up, we came to know the patients of the practice and saw how health and sickness weaved through generations.
So, when I first read Family Medicine: The Medical Life History of Families by Frans Huygen, I almost recognised these patients, though from a different country and a very different culture. Describing his patients in a way that we probably could not do now, he shared their personal lives, the family dynamics, how illness repeated in mothers and daughters, the impact of caring for patients at home, and the relationships that are so much a part of family medicine. However, it was his charts and diagrams recording sickness through families that were groundbreaking in a time long before electronic records; his deep understanding of psychological pathology predated our insights into depression; and his drawings illustrating the book, and a further sketchbook Herinneringen aan Lent, capture the burden of illness more acutely than any textbook.
Frans was the grandfather of scholarly general practice in the Netherlands who inspired generations of academics, a founder member of the Dutch College of General Practice (Nederlands Huisartsen Genootschap), Founding Chair of General Practice in Nijmegen, and an immensely influential figure worldwide but, at that time, I had only a vague understanding of his stature and a mental picture of him through his insights as a GP. Some years later, when visiting Nijmegen, I naïvely asked Chris van Weel if I could meet Frans.
By now long retired he first seemed quite reserved, almost severe and a little distant — unsurprising when I look back. There were 40 years between us — he was an academic colossus and I was an upstart.
Frans took me on a tour of the practice in Lent, and we stopped outside the homes of patients in the book. He showed me where he did the drawings, introduced me to some of the families featuring in the narrative, visited the flower growers in the area, and he showed me where he practised. We stopped the car and viewed the bridge at Nijmegen from many different angles and had lunch overlooking the bridge, where he recounted its importance during the war and its personal significance to him. We spent the evening in the garden of his home in Lent beside the pond and its water lilies that he often painted, and we sat chatting in his study where he wrote so much of his work, while he reflected on his life and achievements.
Many of his paintings hang in our home and remind me of the privilege of that friendship and his subsequent visit to Ireland. His landscapes almost all feature Nijmegen bridge, even in the far distance, and are a constant reminder of a war that stayed in his lifetime memory. When my eye is drawn to a particular painting of his study, I can still feel the warm evening air flowing through the open door to his garden at the end of that wonderful day when he brought the book to life.
I sometimes take the book down off the bookshelf and, when browsing through his patients’ stories and his illustrations of their lives, I am reminded that one of the most influential of our general practice academic pioneers was a true family doctor who was familiar with every line etched on the faces of his patients.
- © British Journal of General Practice 2016