Edward Leicester Atkinson (1881–1929): Antarctic explorer,scientist and naval surgeon

Introduction

Captain Robert Scott took three doctors with him on his Terra Nova Expedition to the Antarctic (1910–1913). The lives of Drs Edward Wilson (1872–1912) ¹ and Murray Levick (1876–1956) ² have been described previously in this journal and the aim of this paper is to describe the life and career of Dr Edward Leicester Atkinson which was no less remarkable than that of his two colleagues.

Edward Aktinson

Edward Atkinson (Figure 1) was born in the West Indies in 1881 but returned to England and was educated at Forest School in East London where he excelled both academically and at sport. He entered St Thomas's Hospital as a medical student in 1900 and became the United Hospitals light heavyweight boxing champion. He qualified LRCP MRCS in 1906 and afterwards worked in the Brompton Hospital. In 1908 he joined the Royal Navy, winning a prize for his performance in the entrance exam. ³ OPEN IN VIEWER

Antarctic explorer

After service at Royal Naval Hospital (RNH) Haslar and on board the cruiser, HMS Achilles, he was appointed, in 1910, as surgeon to Captain Robert Scott's second (Terra Nova) expedition to the Antarctic (1910–1913). The other doctor in the main party of the expedition was Edward Wilson. Wilson had not practised medicine for a number of years and went primarily as zoologist, artist and chief of scientific staff. He did, however, have previous Antarctic experience on Scott's Discovery expedition (1901–1904) and he selected most of the medical kit and designed the medical cases for the sledging expeditions. Murray Levick, another naval surgeon, was surgeon to what became known as the Northern Party. Atkinson was also appointed as parasitologist to study the parasites of the Antarctic animals, birds and fish, and he prepared for his role by studying at the London School of Hygiene under Robert Thompson Leiper (1881–1969) who has been called the father of British helminthology (and who, incidentally had also cooperated with Dr Wilson on his study of disease in grouse). He also intended to do bacteriology.

There were few medical problems in the first year apart from minor wounds and sprains and mild degrees of frostbite and snow blindness. The most serious problem was Thomas Clissold, the cook, who climbed an iceberg for a photograph and fell, losing consciousness from a head injury and also sustaining a back injury. Other than that, the most significant problems probably were those of Atkinson himself. He developed an infected and painful heel from chafing or frostbite and this had to be lanced by Dr Wilson. Atkinson did not admit to this initially and Scott wrote in his diary ‘Atkinson suffering much pain and mental distress at his condition – for the latter I fear I cannot have much sympathy, as he ought to have reported his trouble long before’. ⁴

On another occasion he went out to obtain meteorological readings in bad weather and got lost. Scott wrote

‘He was badly frostbitten in the hand and less seriously on the face, and though a good deal confused, as men always are on such occasions, he was otherwise well… His tale is confused, but as far as one can gather he did not go more than a quarter of a mile … . The fact that he did not [hit land as he intended], but attempted to wander straight on, is clear evidence of the mental condition caused by that situation. There can be no doubt that in a blizzard a man has not only to safeguard the circulation in his limbs, but must struggle with a sluggishness of brain and an absence of reasoning power which is far more likely to undo him … It is a rambling tale to-night and a half thawed brain. It is impossible to listen to such a tale without appreciating that it has been a close escape or that there would have been no escape had the blizzard continued’. ⁴

This seems to describe hypothermia. Although it was recognised that people could die of exposure, the clinical features of lesser degrees of hypothermia were poorly described and the clinical syndrome of hypothermia was not described in the medical literature at the time. ⁵ However although Scott never described Atkinson's condition as hypothermia (or anything similar), he does appear to have recognised the pattern of behaviour that occurred when a person was cold. Atkinson's frostbitten hand has been immortalised in a famous photograph (Figure 2). OPEN IN VIEWER

Atkinson appears to have been a diplomat as Wilson, writing to his wife, said ‘Atkinson is splendid in the way he has always played the game by me, for he does nothing without telling me and asking if I approve – knowing quite well that he knows a lot more about it all [medicine] than I do’. ⁶

The lack of medical work left him a lot of time to concentrate on his research. Sledging and exploring took up much of the summer and so his research was largely conducted in the winter. To collect parasites, he worked closely with the biologists. Wilson wrote: ‘Atkinson is using the fish trap and got 40 notothenia [an Antarctic fish] today … They are full of parasites, protozoa, nematodes, trematodes and a copopod on the gill covers. We eat them all the same, but I can't say they are nice’. ⁷ He later wrote ‘Atkinson has been doing the parasitology and has examined the animals that were procurable in the winter months including the fish, 3 species of seal … the penguins, and the skua gull. From these he has a collection which includes ectoparasites … .  and endoparasites … as well as protozoa, trypanoplasma, gregarines and two others unrecognised’. ⁷ Collecting fish in the winter meant cutting holes in the ice and handling fishing nets in the darkness at temperatures many degrees below freezing (Figure 3). A number of the dogs died and he discovered that this, too, was due to parasitic disease. In all he described 21 new worms, many of which were named after members of the expedition or those associated with it. (It is possible that Tetrabothius Aichisoni was named either for him or a member of his family but one wonders if Edward Wilson's wife appreciated having a tapeworm – Oriana wilsoni – named after her!) His work as a parasitologist has been described by others.^8,9 OPEN IN VIEWER

He played a full role in other activities of the expedition, taking part in sledging to lay depots in preparation for Scott's Southern journey and he was the best footballer among the expedition personnel. ⁴ He also took part in Scott's march to the South Pole, being in the second last supporting party to turn back and getting to within 300 nautical miles of the Pole.

It was at this stage of the expedition that Atkinson's troubles started. Firstly Lt Edward Evans (later Admiral Lord Mountevans 1881–1957), returning in the last of the supporting parties, developed gastrointestinal bleeding from severe scurvy and collapsed about a day's journey from the base. One man went on alone to get help and Atkinson led the party to rescue him. Evans, who was the second in command, then had to be treated for his scurvy before being invalided home.

The next in seniority was Lt Victor Campbell (1875–1956) but he was in the Northern Party which had been stranded when the ship that was meant to relieve them was unable to reach them because of ice conditions. ² Atkinson, as the only naval officer, had to take command of the whole expedition. His first decision was what to do when Scott and his colleagues failed to return from the South Pole. There was much confusion as to what Scott's instructions were for this eventuality and a shortage of manpower. Atkinson felt he had to stay to nurse Evans and he sent Apsley Cherry-Garrard (1886–1959), who was very inexperienced, with Demitri Gerof (1888–1932) to try to find Scott's party. Cherry-Garrard was told to go to One-Ton Depot and if Scott was not there he was to judge what to do. In the event he went to the Depot but his companion was unwell and he went no further before returning. On his return Cherry Garrard collapsed. Initially this was diagnosed as ‘an overstrained heart’ ¹⁰ but it was undoubtedly an acute stress reaction and he was unwell for much of the winter. For the rest of his life Cherry-Garrard tortured himself with the thought of whether Scott might have survived if he had gone an extra 11 miles. In his journal he said that he had ‘… work[ed] till an inevitable breakdown which has given me such hell this winter as I hope never to suffer again’. ¹¹

After Cherry-Garrard's return Atkinson also tried to find Scott, travelling South with one other person, but it was late in the season and the weather was bad and after five days they gave up (by which time Scott was already dead). Later he made an attempt to reach the Northern Party but the condition of the sea ice would not allow this.

Atkinson then had to maintain morale at the base over the winter knowing that Scott and his companions were dead and not knowing the fate of the six men of the Northern Party. When spring came he had to decide whether to go in search of Scott or Campbell and the Northern Party as they did not have the manpower to do both. The dilemma was, in the words of Cherry-Garrard, ‘… we might go South, fail to find any trace of the Polar party, and while we were fruitlessly travelling all the summer Campbell's men might die for want of help. On the other hand we might go north, to find that Campbell's men were safe, and as a consequence the fate of the Polar Party and the result of their efforts might remain forever unknown. Were we to forsake men who might be alive to look for those we knew were dead?’ ¹²

As a group, they decided to look for Scott and, as described elsewhere, ² the Northern Party spent the winter living in a snow hole and found their own way back.

In the spring Atkinson led the party that found the bodies of Scott, Wilson and Bowers and said that they showed no evidence of scurvy. He stuck to this story despite many others (who were not on the expedition) being convinced that Scott had scurvy. Eric Marshall (1875–1963), one of the doctors on Ernest Shackleton's Nimrod expedition (1907–1909), later met Atkinson when they served together in 1919 during the North Russian Campaign and claims that he knows that Scott had scurvy because Atkinson was claiming special knowledge of the disease and he essentially accused Atkinson of lying over this. ¹³ However, Atkinson did have experience of scurvy because he had treated Lt. Evans with the disease. The cause of Scott's death has been discussed elsewhere. ¹⁴

Atkinson described the final year in the book of the expedition ¹⁰ but this is often not printed in modern editions of the book.

Critics have spent much time discussing his (and others') decision-making over the search for Scott ¹⁵ but those who were with him defended his decisions and had nothing but praise for him. Tryggve Gran (1889–1980) said ‘everyone had got respect and admiration for him … his wonderful qualities of leadership soon appeared in the winter hibernation at Cape Evans. He never gave orders – only expressed wishes – and more was not needed’. ¹⁵ Charles Wright (1887–1975) said ‘We were a happy party, once we had faced up to the loss of the Polar Party and had decided what to do next summer. In fact the whole atmosphere was now different. There were no cliques as far as I am aware… To a large extent this was due to Atch. As a naval doctor, he was to our petty officers much more accessible than an executive officer. We all respected him, felt for him, pitch-forked into a difficult situation and more than that, I think I can say we loved him’. ¹⁶

In his bacteriological investigations he isolated a bacterium from snow ⁴ but his main bacteriological research was to be postponed until nearer the time of departure as he wanted to return with cultures and it was impossible to maintain these over a long period without loss of characteristics. ⁷ Needless to say, with other things on his mind, little bacteriology was achieved and his results were not published. He did, however, use his microbiological skills to grow yeast with which to bake bread. ¹⁷

It is interesting to speculate why scurvy occurred on this expedition but not on Shackleton's ‘Furthest South’ journey in 1908–1909 and whether Atkinson's views contributed to this. Neither expedition knew the cause of scurvy but it was known that it could be prevented and cured with fresh food. Eric Marshall wrote ‘In principle, we primed every sledge party on fresh meat – mutton, penguin or seal – for a month before starting. Bacon and all preserved meats were prohibited during this period’. ¹⁸ Wilson also believed in the value of fresh meat from his experience of the Discovery expedition whereas Atkinson believed it was only fresh vegetables (which, of course, were not available) that were effective and there is no suggestion that priming with fresh meat occurred on this expedition. Atkinson also believed in Almroth Wright's theory that scurvy was caused by acidosis and could be treated with lactate. ¹⁹ If his views on scurvy did contribute to Lt Evans suffering from the disease, his use of yeast to bake bread ¹⁷ probably prevented the beriberi that affected so many of the other expeditions of that era. ²⁰

On his return in April 1913, the Navy seconded him to write up his results with Leiper and he represented the Antarctic scientists on the committee to oversee publication of the expedition's scientific results. In February 1914 he was seconded to go to China with Leiper to investigate the transmission of schistosomiasis in view of the importance of the disease to the Navy on the Yangtse River and elsewhere in the Far East. This was not laboratory-based research but involved travel for more than three months and over 1000 miles to find a severely infected host they could study. Human subjects were difficult to find and would not cooperate so the host they studied was a dog. He also investigated other parasitic diseases and dysentery secondary to trichomonas infection (more usually a cause of vaginal discharge). ²¹

They achieved their aim^{22, 23} but he fell out with Leiper to the extent that he wanted to give him a good thrashing. ⁸ However, this problem was solved by his returning to England at the declaration of the First World War.

First World War

He had a very distinguished war. He initially served in HMS St Vincent, a battleship and in 1915 was sent to Gallipoli to try to solve the problem of the flies that were multiplying in the manure and dead animal and human bodies of the battlefield. His work included gruesome experiments with the body of a dead mule and a dead Turkish soldier though the experimental conditions were not perfect as the body was within sight of enemy snipers. ²⁴ He had to be repatriated as a result of illness and worked at RNH Haslar. From May 1916 to June 1918 he served as a senior medical officer with the Royal Naval Division in France, seeing service at the Somme, Arras and Ypres. He was wounded twice, returning to work very quickly and for his service was mentioned in dispatches and awarded a DSO. In the words of the citation this was

‘In recognition of his services as Senior Medical Officer of the R.M.A. [Royal Marines Artillery] Howitzer Brigade since the 26th May, 1916. He has carried out his duties with the greatest zeal and energy, and has shown an excellent example by his fearlessness and devotion to duty. He has been twice wounded, and would have been relieved but for his strong desire to remain at his post.’ ²⁵

In September 1918 he was serving in HMS Glatton which was in Dover Harbour when a fire in a shell magazine led to a severe explosion in which 60 men were killed and 124 injured. One of the injured was Atkinson. For his work in rescuing other injured sailors he was awarded the Albert Medal (the equivalent of the George Cross). In the words of the citation

‘At the time of the explosion Surgeon Lieut. - Commander Atkinson was at work in his cabin. The first explosion rendered him unconscious. Recovering shortly, he found the flat outside his cabin filled with dense smoke and fumes. He made his way to the quarter deck by means of the ladder in the Warrant Officers flat, the only one still intact. During this time he brought two unconscious men on to the upper deck, he himself being uninjured.

He returned to the flat, and was bringing a third man up, when a smaller explosion occurred whilst he was on the ladder. This explosion blinded him, and, at the same time, a piece of metal was driven into his left leg in such, a manner that he was unable to move until he had himself extracted it. Placing the third man on the upper deck, he proceeded forward through the shelter deck. By feel, being totally unable to see, he here found two more unconscious men, both of whom he brought out.

He was found later on the upper deck in an almost unconscious condition, so wounded and burnt that his life was despaired of for some time’. ²⁶

After the war

In 1919 he was sent to Russia on HM Hospital Ship Lord Morton, a converted paddle steamer, to provide a medical service to the North Russia Expeditionary Force. A number of members of Scott's and Shackleton's expeditions including Drs Marshall and Alexander Macklin (1889–1967), another of Shackleton's doctors, were sent to Russia as it was felt that their Antarctic experience would have prepared them for the Arctic weather. In 1920 he was awarded the Chadwick Naval Prize (worth £100) and Gold Medal, awarded once every five years to an officer of the Naval Medical Services for promoting the health of men in the navy. ²⁷

After the war he served in various naval ships, hospitals and establishments, including service in the Royal Hellenic Navy from 1921 to 1922 as part of the Naval Mission to Greece which started in 1911 to assist the Greek Navy in training and organisation and which continued (with some interruptions) until the late 1920s. He also continued with writing up the scientific reports of the Terra Nova expedition and he described the equipment and stores taken. ²⁸ He also required further surgery to remove shrapnel from his face.

He contributed much to the Journal of the Royal Naval Medical Service on a variety of topics including Antarctic exploration and bacteriology.^29–31 Amazingly for somebody who had lost an eye, one of his postings was as a specialist in ophthalmology at RNH Haslar and he wrote numerous case reports, mostly on ophthalmological topics, but he also described an interesting appendicectomy at sea: he was the surgeon but the anaesthetic was not going smoothly and so he and the anaesthetist swapped positions for him to give the anaesthetic while the Surgeon Lieutenant successfully removed the appendix. ³²

He married in 1915 but his wife died in early 1928. In the same year he was promoted Surgeon Captain, at 46, the youngest in the Navy, but his injuries had taken a major physical and probably psychological toll and he was retired on the grounds of ill-health.

After retiring from the Navy he remarried in November 1928 and went to sea again as ship's doctor on the SS City of Sparta which was making a trip to India but he died suddenly at sea in February 1929 on the return journey. This was diagnosed by the ship's captain as heart failure. He was buried at sea in the Mediterranean. He had no children.