LEST WE FORGET: DR. NEIL MACLEOD By Dr. Dennis Pitt and Dr. Alan Bowker (A timely article for Remembrance Day)

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         Alan Bowker              Dennis Pitt

"We lose ourselves in books. We find ourselves there too." Anonymous

Dennis Pitt is a bookworm. He admits it. As a student, he annoyed his teachers by reading books in class. But Dr. J. A. Milliken, a Queen’s medical professor who was his prime role model for entering the field of medicine, was also an avid reader who had a library in his home. This was not a trait widely shared among busy physicians. As a practising surgeon and professor at the University of Ottawa, Dr. Pitt was appalled to find that most of the books in the library of the Royal College of Physicians and Surgeons appeared never to have been opened. He believes books are not just for show. They are to be read, they should have worn bindings, the pages should be dog-eared and pencil-marked. And if they are lent and never returned, so much the better, because it means they are being read by more people.

As a surgeon at the Riverside Hospital, Dr. Pitt probably spent more time in its Donald Scobie Memorial Library – named in honour of its first chief-of-surgery – than most. So when the library closed with hospital amalgamation in 1998, a kindly librarian directed him to boxes of books destined for the recycle bin. Among the treasures he left with that day were the six volumes of Dr. William Osler’s classic 1907 medical text Modern Medicine. He had the bindings repaired and they sit on a special shelf in at his home.

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William Osler’s six volume Modern Medicine on a special bookshelf built by Dr. Pitt

Last April, Dr. Pitt looked in these books to find out what was known about pandemics in those days. There was little reference to viruses (which were theorized but had not been identified) but there was a great deal of information on influenza based on the experience of a pandemic in the 1880s. “Thus the great mass of evidence,” Osler had written, “is in favor of the direct transfer of the disease from person to person.” Not an earth-shattering conclusion by today’s standards, but a big step forward from earlier theories, and a conclusion that would prove important when doctors and public health officials had to confront the Spanish Flu in 1918.

But most interesting was something that fluttered from between the pages of this old volume: a bill from Dr. Neil MacLeod of 36 Charles Street, New Edinburgh, dated 1908, for $5.00 for administering anaesthesia to one Harry Saunders, an employee of the Grand Trunk Railway (which would in the following year begin construction of the Union Station and the Chateau Laurier Hotel in Ottawa). If Dr. MacLeod got paid, it was likely by the railway, as $5 was a week’s wages for a labourer. Who Harry Saunders was or why he was anesthetized will likely never be known. But who was Dr. Neil MacLeod?

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 Dr. MacLeod’s anaesthesia bill, 1908

Knowing that Dr. Alan Bowker (PhD, not MD) has been studying the lives of the soldiers from MacKay United (then Presbyterian) Church who served in World War I, Dr. Pitt asked Bowker if he know anything about Dr. MacLeod and his practice in New Edinburgh. He did indeed. Dr. MacLeod was one of the 140 men and one nursing sister who enlisted in that war, and Bowker did have information on his life and service.

Neil Duncan MacLeod was born on July 4, 1877, the second youngest of five children of Duncan MacLeod and Jessie MacIntosh MacLeod, who had a farm not far from Maxville. The MacLeods were part of the large Scottish Highland community that had settled in Glengarry Township. Their collective legacy is the Highland Games which take place in Maxville every year and are among the largest in the world. Neil MacLeod’s own heritage was revealed during the war when the British press reported him as speaking to wounded Cameron Highlanders in Gaelic, even though he had never set foot in Scotland. MacLeod also inherited a staunch Presbyterianism which he practised all his life.

Another important hallmark of his Scottish background was a respect for knowledge and the pursuit of education. Unusually for a country boy, MacLeod went on to higher education and studied medicine at the University of Toronto, from which he graduated in 1907. He then came to Ottawa as a resident at St. Luke’s Hospital, on Elgin Street between Frank and Gladstone. Opened in 1898 with donations from inter alia the Wright and Booth families, it was a four-storey, state-of-the-art facility designed to serve the protestant community of Ottawa. (St. Luke’s was closed in 1924 after merging with the newly established Civic Hospital. The building was torn down during the depression and part of its site is now a park.) While serving at St. Luke’s, Dr. MacLeod rented a wood frame house at 36 Charles Street, New Edinburgh, and opened a private practice as a physician and surgeon.

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St. Luke’s Hospital

Also in 1907, Dr. MacLeod had joined the No. 2 Field Ambulance of the Canadian militia. He was still serving with the militia when war broke out in August 1914, and MacLeod travelled with the Field Ambulance to Valcartier, Quebec, where he served as a medical officer. (Dr. Pitt’s grandfather was also at Valcartier, as a private.) He then signed up to be part of the Canadian Expeditionary Force which sailed for England in October, 1914. He was 5’ 10 ½” tall, with dark complexion, grey eyes, and brown hair.

Once in England, MacLeod was transferred to the British Army medical services as a Captain. He went to France in February 1915, first with the British, and then with the Canadian First Division, as a Field Ambulance doctor. A Field Ambulance consisted, in addition to the vehicles used to transport wounded soldiers and the men and women who staffed them, of a series of advanced dressing stations at the front line, treating sick and wounded soldiers. It was the first step in a chain of medical treatment facilities that reached back to the Casualty Clearing Stations located outside the range of enemy artillery, then to Stationary or General Hospitals in large rear bases, and finally to England to a range of hospitals and convalescent facilities. At each stage a soldier was triaged, given appropriate treatment, and sent back to the front, sent along the chain of hospitals for further treatment, or buried.


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A field ambulance in France

MacLeod was in the Ypres Sector, and although we do not know in which part (a field ambulance could serve any unit in the British army, as needed), he would have experienced many terrible battles, including gas attacks, during 1915. The Ypres Sector was a horrible place to be. Rain, frost, mud, filth, the stench of rotting bodies, and the constant threat of death from snipers, shells, trench raids, and attacks, were an indelible memory for those who served there. Men cracked under the stress and fear. They got trench foot – a form of frostbite resulting from being constantly in cold water, which could lead to the amputation of toes. They got hacking coughs from the cold and damp, as well as lung injuries from the gas that often lingered in the trenches and the soil. They got infections that in the era before antibiotics could be fatal. It is a tribute to the advances in medicine before the war that in spite of millions of men being crammed into these appalling conditions, wastage from disease – which had been the fate of most armies up to that time – was relatively low.

Besides dealing with these health issues, and a daily parade of men wounded by snipers or artillery, Dr. MacLeod and his Field Ambulance would have faced a sudden deluge of casualties brought by stretcher straight from the battlefield – bodies mangled by bullets and shrapnel or lungs seared by gas – whenever there was an attack or a major artillery barrage. Doctors might have to perform emergency surgery.

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1916: a soldier being operated on at a field ambulance within an hour of being wounded)

This was dangerous, high pressure work, under constant artillery and small arms fire, or worse if there were a major battle. MacLeod served at the front for a year – far longer than he should have – until in early 1916 he contracted emphysema and severe bronchitis – perhaps from gas, but likely also from stress and overwork in damp conditions – and was assigned to a general hospital. But he also served as the medical officer for the 15th battalion for a month, and he was serving as MO to the 7th Battalion in June 1916 when it all caught up with him.

Besides his lung problems, he was now suffering from difficulty sleeping, extreme nervousness and severe debility, and he was sent to hospital in England. There doctors recognized his condition as “shell-shock” or battle fatigue. Battle fatigue – what happened when a soldier’s nerves could no longer stand the tension, noise, stress, and fear of the front – was something military doctors had been slow to recognize and reluctant to diagnose. It might manifest as physical disease – pyrexia of unknown origin, disordered action of the heart, alveolar haemorrhaging – or as uncontrolled palsy, hallucinations, screaming, loss of memory, and mental collapse. Sometimes men cracked only after long periods in the trenches or near-death experience. Sometimes they exhibited symptoms after only a short time at the front. Many generals, and some doctors, saw battle fatigue as lack of moral fibre, effeminacy, mental weakness, even cowardice – to excuse a soldier from duty on these grounds was to encourage malingering and betray his sturdier comrades.

As they began to understand the reality of battle fatigue – what we would today call PTSD – and that it was something that needed to be accepted and treated, doctors used the term “shell-shock” – properly speaking, injury to the brain and nervous system from the concussion of an exploding shell – to cover battle fatigue as well. This avoided stigma and allowed for proper treatment. By the end of the war shell-shock was one of the most frequent causes of hospital treatment in the Canadian Corps.

Macleod was an officer, and a doctor. His condition was diagnosed for what it was, and he was given what was considered the best treatment at the time: complete rest, and utter quiet. But after a month in hospital, he was clearly unfit to return to the front. A medical board recommended “long rest” and a “change of air to Canada”. He was “granted leave” to Canada in September 1916, which was later “extended” to January 31, 1917. He came back to Ottawa for medical treatment and home duty, and once again lived at 36 Charles Street.

“Capt. MacLeod,” read the report of a medical board which examined him soon after his arrival in Ottawa, “has been at the front without any leave for the past eighteen months. He has been under fire most of that time. His condition is one of nervousness, and he is generally run down. He is still unable to sleep properly, and cannot concentrate his mind on his work.” By December 1916, his condition was improving but he still slept badly at night, had a poor appetite and had lost weight, suffered a slight tremor of the hands and at times severe headaches. He continued to suffer symptoms of nervousness into early 1917 as well as continuing bronchial irritation.

Nonetheless, in February 1917, 39-year-old Captain MacLeod married Alice MacGrady, 31, a Roman Catholic civil servant. (He remained an active member of the Presbyterian Church.) In March 1917, he was appointed president of the Standing Medical Board at the Base Recruiting Office in Ottawa and resumed military duties with the rank of Major. In March 1919, he assumed similar duties in Kingston. In May he was discharged with a pensionable disability, because while the Board concluded that while his general physical condition would improve, his chest condition was probably permanent.

Following his discharge Dr. MacLeod resumed his medical practice in a house he had built at 121 Cartier Street. He and his wife had a daughter in 1918. The family settled down to two decades as a general physician. But during the Second World War he once again joined the war effort to serve on numerous medical boards and later with the Department of Veterans’ Affairs. He then returned to private practice until 1948 when he was forced to retire due to ill health. He died in 1958 at the age of 81 and is buried in Beechwood Cemetery.

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 Dr. MacLeod’s gravestone in Beechwood cemetery)

And so, the discovery of a long-forgotten bill in a classic medical text salvaged by a bookworm doctor, and his partnership with a retired diplomat and historian, has brought to light once again the story of a courageous doctor who served his country and his patients with devotion and sacrifice.

Lest we forget.

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