P&S Journal: Fall 1997, Vol.17, No.3
Dana Winslow Atchley
1892 - 1982
By Nicholas P. Christy'51
This series, Faculty Remembered, features profiles of former faculty members at P&S. The author of the series is a 1951 P&S graduate and former professor of medicine. He is now special lecturer in medicine and writer-in-residence at P&S.This late in the 20th century, with scientific medicine in the ascendancy, it is easy to forget that many living P&S graduates attended the college before science had won out over entrenched empiricism. Dana W. Atchley, whose association with P&S and Presbyterian comprised nearly 60 years, 1916-1976, especially deserves to be remembered as one of the country's first generation of physician-scientist-practitioners far ahead of their time. His contribution as physician-in-charge of teaching internal medicine for decades was unique, arguably exerting, in the 1920s to 1950s, P&S's greatest influence on the formation of young doctors.
Like many P&S faculty members of his era, Atchley came from a background of small towns and little money, a combination that produces strong people. His mother a New Englander, his father a Southern pastor called to make frequent moves during Atchley's childhood, his first years were spent in Chester, Conn.; Bath, Maine; and Knoxville, Tenn. Money was so short in Knoxville that the young man helped out by selling encyclopedias on horseback in the Tennessee countryside, often to farmers who could neither read nor write. Summers, he drove taxis in Butte, Mont. He got a scholarship to the University of Chicago, there met his future wife, and graduated in 1911. Taking his M.D. from Johns Hopkins in 1915 he did his house staff training at Hopkins and Presbyterian, and for the next five years, with scientifically oriented mentors--Janeway, Longcope, and Palmer--he studied the physical chemistry of blood plasma. In 1921, with Robert Loeb, Franklin Hanger, and A.R. Dochez, he moved from Hopkins to P&S when Palmer was appointed Bard Professor of Medicine. With Loeb, Benedict, E. Gutman, Richards, Driscoll, et al., he began studies of electrolyte imbalance in human disease, especially diabetic ketoacidosis, which made the group world-famous during the years 1930-1940. By now the Atchleys had a growing family--three sons--and Dr. Atchley could not survive on a meager academic salary. He continued to work in the laboratory but had to devote less and less time to science, and so entered upon the private practice of internal medicine as a "geographic full timer," that is, with a small office in the old Harkness Pavilion.
Valuable as Atchley's scientific work was, and is, this next phase of his career--from the 1940s on--had still more import for the teaching of P&S students, making an impact that spread beyond the walls of the medical center. During those years he developed the legendary "Atchley History" form still in use, a comprehensive, systematic outline designed to elicit all relevant information from patients about their personal and family histories, prior health and illnesses, and the present illness. Going over these records with students Dr. Atchley was a merciless taskmaster. He had an eagle eye for the smallest omitted detail. In the account of the current illness he insisted that the material be organized systematically, either chronologically or thematically. In his incisive bedside analyses he had a great talent for making connections--relationships that the student had failed to notice. More important--and this was Atchley's greatest strength--he urged students to think critically, that is, to weigh evidence, to distinguish fact from fiction in what patients said. Teaching the power to discriminate is difficult; discrimination is largely innate. But at least students can be led in right directions, can learn, up to a point, to distinguish wheat from chaff. This kind of rigorous teaching did not make Atchley popular. He made no attempt at bedside wizardry, hitting upon ostentatious snap diagnoses. Rather, he painstakingly got at the truth by the minute dissection and ordering of facts.
Appointed professor of clinical medicine in 1942, he acted as the major support for Robert Loeb, chairman of medicine. Atchley's private practice was enormous and devoted; he was a master at communicating with patients, many of them minent people who donated generously to Presbyterian. Making no pretense to all medical knowledge, he very often called on younger doctors to consult on special problems. He was an astute adviser--much in demand--to young physicians.
Dana Atchley earned many honors: membership in prestigious societies, honorary degrees (Columbia, Strasbourg), consultantship to the Rockefeller Foundation, the Kober Medal of the Association of American Physicians, among others. In 1968 the medical center named after him the Atchley Pavilion, appropriately, a unit for the private practice of medicine in an on-site academic setting. A careful, clear, and vivid writer, he produced more than 50 articles spanning 1915 to 1960, including three in general literary magazines: the Saturday Review, the Atlantic Monthly, and the New Yorker. His many papers on medical education, original and cogent, had wide influence in the United States and abroad.
As he often said, Presbyterian Hospital was his life. Practicing in Harkness until five years before his death at 89, Dana Atchley left an indelible imprint on generations of P&S students by doing the almost impossible: He taught us how to think.