Lawson Wilkins: portrait of a pioneer

Foreword September 27, 2013 was the 50 anniversary of Lawson Wilkins’ death. After reading the two articles by his daughter, Betsy McMaster, and his devoted protégée, Claude Migeon, we can’t help but wonder what Dr. Wilkins would have thought if he could see how we practice Pediatric Endocrinology today. Lawson Wilkins was born in 1894, and his father (also a physician) would take him along on his rounds in a horse and buggy. After serving in World War I and graduating from Johns Hopkins School of Medicine, Dr. Wilkins completed his pediatric residency at Yale and then settled down in his home town of Baltimore to practice general pediatrics. However, he quickly distinguished himself from other practitioners by his insatiable curiosity and careful attention to measurable physical parameters and the information they provided for diagnosis and clinical management. He became renowned for the meticulous graphs and charts that he hand-prepared as illustrated in the famous portrait. (Figure 1) As he studied growth and development of normal children and contrasted these with patterns in children with hypothyroidism, his interest in endocrinologic disorders increased. He developed a relationship with Dr. Edwards Park, Chief of Pediatrics at Hopkins. Dr. Park was eventually able to recruit Dr. Wilkins to a part time and then a full time faculty position. But much of his early work in hypothyroidism was conducted while he was working diligently in his pediatric practice. After giving up his practice in 1946, he devoted himself full time to endocrinology, resulting, with the help of his fellows and associates, in a rapid expansion of scientifically validated knowledge. No doubt that Dr. Wilkins saw tremendous changes over the course of his medical career, perhaps the most important one being the development of antibiotics, which saved the lives of countless children. But Dr. Wilkins himself was the driver of changes in endocrine practice. In fact, while trying to learn from his predecessors about endocrinology in children, he ended up throwing an existing text of endocrine disease against the wall in frustration and decided to write his own based on his collection of painstakingly-developed case observations. This work eventually led to the first textbook of Pediatric Endocrinology and stimulated interest in the subspecialty around the world. But if he could have travelled forward in time to 2013, what would he think of where we are now? He would certainly have been amazed by the technology. Measurement of hormones in his day relied on relatively primitive time and labor-intensive chromatographic and colorimetric techniques. Radioimmunoassays were perfected after his death, and platform-based immunoassays and tandem mass spectrometry were not even dreams. He might have been jealous of our ability to draw a blood sample and know the 17-hydroxyprogesterone or T4 concentration on the same day! As noted above, much of Dr. Wilkins’ early work in Pediatric Endocrinology was in the area of hypothyroidism, particularly congenital Indiana University School of Medicine, Indianapolis, IN, USA Full list of author information is available at the end of the article Figure 1 Lawson Wilkins portrait. Fuqua and Lee International Journal of Pediatric Endocrinology 2014, 2014(Suppl 1):I1 http://www.ijpeonline.com/content/2014/S1/I1