TY - JOUR T1 - Who cares? The James Mackenzie Lecture 2006 JF - British Journal of General Practice JO - Br J Gen Pract SP - 987 LP - 993 VL - 57 IS - 545 AU - David A Haslam Y1 - 2007/12/01 UR - http://bjgp.org/content/57/545/987.abstract N2 - This lecture has traditionally been on a clinical topic, and few aspects of the clinical activity of GPs are more important than the consultation. James Mackenzie was born in 1853 into a world which could not have been more different than ours. The technological, political, environmental, therapeutic, and medical changes since his time have been absolutely astonishing, although many aspects of humanity have changed less. Indeed, it is very likely that his patients were in many respects very similar to those consulting us today. Shakespeare, after all, was writing over 400 years ago and yet we still recognise with beautiful clarity the universal truths of the human relationships in his writings.So, if James Mackenzie and I were effectively treating the same human beings, what do we have to learn from each other? What have we gained? What have we lost? His parents were hill farmers in Perthshire, and he left school at the age of 15 to become apprentice to a pharmacist in Perth. It seems likely that the rather unsatisfactory nature of some of the medicine and advice that was offered in the pharmacy was the stimulus for his wishing to study medicine.Student debt is nothing new, so after completing medical school he needed to earn some money before he did his house jobs. In those days house jobs were unpaid, and so he became a locum in a practice at Spennymoor, County Durham. I quote from his biography: ‘Mackenzie, fresh from his university training, beheld a daily procession of men and women, few of whom were even slightly unwell, coming to demand medicine.’1 (page 30)The doctor he worked for had invented a special mixture of his own, consisting of burnt sugar and water, with a pinch of ginger added. This enjoyed a great reputation … ER -