Swan M. Burnett, MD, Phd: the Forgotten Father of Little Lord

SPECIAL ARTICLE Swan M. Burnett, MD, PhD The Forgotten Father of Little Lord Fauntleroy Daniel M. Albert, MD, MS; Sarah L. Atzen, BA generation after the end of America’s Civil War, a 7-year-old boy in a velvet suit and golden curls captured the fancy of readers around the country. Little Lord Fauntleroy, the literary creation of Frances Hodgson Burnett (Figure 1), sparked a sensation A every bit as potent as that kindled by the Harry Potter series today. Although better known to us now as the associated clinical laboratory in the city of author of a later work, The Secret Garden, Washington, DC, and one of the first in Frances Hodgson Burnett reached the pin- the nation. He also established the first eye nacle of her popularity when Fauntleroy and ear clinic in Washington, DC, and appeared in 1886. The book sold hun- treated all who came there, including in- dreds of thousands of copies, was trans- digent and African American patients. lated into multiple languages, became a Swan was the first professor of oph- household name around the world,1(p110) thalmology in the School of Medicine at influenced fashion for a generation Georgetown University. He conducted (Figure 2), and created a marketing groundbreaking research on the relation- frenzy, which included dolls, candy, play- ship of race with eye diseases, making ing cards, and perfume. (It also embar- original contributions to anthropology as rassed Frances’s son Vivian who was well as medicine. He is still known in the known from then on as the real Little Lord field for his work in refraction. He also Fauntleroy, as he was the inspiration for played an essential role in the understand- the character.2) ing and correction of astigmatism. Harry Potter is a household name to- A leader in the introduction of the day, and many of us know the name of his Crede´ prophylaxis to protect the eyes of creator, J. K. Rowling, but few of us could newborn children from gonorrhea, Swan name the anesthesiologist to whom Rowl- also helped to improve the recently in- ing is married. Likewise, Fauntleroy en- vented ophthalmoscope, improving medi- dures in the American lexicon, and Frances cine itself. Years before the appearance of Hodgson Burnett is still children’s bed- the epochal Flexner Report, he was among time reading in many American homes, but the leading advocates for higher stan- few of us know that the husband of Frances dards in American medical education to and the father of Little Lord Fauntleroy was equal those in Europe. Somehow he also one of the most esteemed ophthalmolo- found time to develop one of the great per- gists of his day. sonal libraries of his era and to achieve rec- That his wife became a Gilded Age ce- ognition as an ardent patron of the arts. lebrity was both a blessing and a curse to In contrast to the steady growth of his Swan M. Burnett, MD, PhD (Figure 3). professional success, Swan’s marriage to Although he was eclipsed in his lifetime Frances began to fail long before she struck and in history by the fame of the larger- literary gold with Little Lord Fauntleroy. than-life Frances, Swan’s achievements are They met as teenagers and he pursued her arguably more enduring. In 1892, he for years before she agreed to marry him. founded and equipped the first hospital- He was by nature somewhat shy; she was anything but.1(p27) She was also ambi- Author Affiliations: Department of Ophthalmology and Visual Sciences, University tious. Frances had supported herself, and of Wisconsin School of Medicine and Public Health, Madison. often her family, with her writing since the (REPRINTED) ARCH OPHTHALMOL / VOL 127 (NO. 12), DEC 2009 WWW.ARCHOPHTHALMOL.COM 1664 ©2009 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 Figure 3. Swan M. Burnett, MD, PhD. Courtesy of Penny Deupree. Figure 1. Frances Hodgson Burnett. Courtesy of Penny Deupree. Figure 2. Elsie Leslie in the play Little Lord Fauntleroy from the late 1880s. Little Lord assumed to be her lover.1(p189) When Fauntleroy suits like the one worn here became Frances learned that Lionel was dy- 1(p31) a common fashion for boys following the book’s age of 18 years. Her income was publication. Courtesy of Penny Deupree. ing, she sailed for America. Remov- crucial in the early years of their mar- ing Lionel from his father and home riage1(p56); but as her popularity grew, cine and building a reputation as a in Washington, DC, she brought him so did the differences between them. noted clinician and scientist, special- first to specialists on the Eastern sea- Most of Frances’s stories were izing in ophthalmology and otology. board and then to spas in Europe in written in sentimental, romantic In May 1890, the 17th year of his mar- the hope of finding a cure. There was prose, excessive by current stan- riage to Frances, he delivered the none. Lionel died in Paris that De- dards, but they featured strong fe- commencement address to the gradu- cember at age 16 years; Swan re- male characters and touched on ating class of the Georgetown Uni- ceived the news from Frances by modern subjects: marital abuse and versity School of Medicine. Among his cable.1(p147) The heartbroken father infidelity, illegitimate births, un- comments were these: managed his grief by doing what he happy marriages, and independent always did when faced with adver- 1(pxiv) No man can give another a sure receipt women who crossed class lines. for success, because no 2 men ever sity: immersing himself in his work She wrote relentlessly, often to the achieve success in exactly the same way. and in what semblance of a family 1(p69) point of exhaustion, and rarely . Always be yourself. Never be an imi- life remained. revised her work, attributing her tation of someone else, and never strive From newspaper archives, biog- writing ability to a mysterious spiri- for success by the apparently success- raphies of Frances, obituaries, and tual force.1(pxiii) ful methods of another which are not in other sources, Swan emerges as a re- Frances’s enormous commercial perfect harmony with that which is best spected and admired physician and success and unconventional, at times and noblest in you. Better be a failure in scientist. He became known for his the eyes of the world than a miserable even notorious, behavior had from the 3 devotion to his profession and to the early years of their marriage greatly disappointment to this best self. poor and needy patients of Washing- overshadowed Swan’s medical Whether he ever had cause to be dis- ton, DC. He was a cultured and much- achievements. Frances chain- appointed in his own best self, his sought-after presence at Washing- smoked1(p20) and left her children with personal life certainly gave him cause ton soirees, weddings, and important Swan or paid companions for months for misery. There was already the dinners, with his attendance duly and sometimes years at a time as she pain of a marriage in shambles; now noted in the newspapers. traveled for business and pleasure (she there was news that his teenage son crossed the Atlantic 33 times).1(ppxiii-xv) Lionel was dying of tuberculosis. Li- EARLY LIFE She worked, socialized, and traveled onel was his first-born child and he with men without a chaperone. It is would be dead before the year’s end. Swan M. Burnett’s forebears were a likely that she had affairs with That spring found Frances in Eu- poor branch of a distinguished fam- many.1(pxiv) She bought homes in rope, developing her literary projects ily who traced their descent from America, England, and Bermuda1(p10) with her “artistic assistant,” Ste- Huguenots who had emigrated from and spent extravagant sums on the phen Townesend, MD. Townesend France to South Carolina in the 17th feminine fashions she adored.1(p134) was 10 years her junior1(p131) and century. He was the third of 7 chil- Swan meanwhile remained in eventually would become an actor dren, born on March 16, 1847. Washington, DC, practicing medi- in Frances’s plays.1(p153) He was also Swan’s father, Dr John M. Burnett, (REPRINTED) ARCH OPHTHALMOL / VOL 127 (NO. 12), DEC 2009 WWW.ARCHOPHTHALMOL.COM 1665 ©2009 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 was a local general practitioner in beard growing from his lower lip. He the leading ophthalmic specialists on New Market, Tennessee. Dr Bur- had an extremely pleasant voice and the continent and in England.6 From nett traveled the district on 1 of the always dressed well.5 He was of av- Paris, Frances wrote to her sister family’s 2 white mules with saddle- erage height and had a pronounced about this time, during which she bags packed with medicines and in- limp; as a boy, he accidentally mainly stayed in their 2-bedroom struments. His patients were often stabbed himself in the knee with a furnished flat and churned out sto- charity cases who paid with goods penknife and the wound became in- ries to finance their stay and her hus- or food.1(p27) fected, which left the knee perma- band’s studies: 4(p35) Swan’s mother, Lydia Ann Peck nently bent. He was healthy, but When I am the wife of the greatest oph- Burnett, was from a distinguished not physically active or robust, cer- thalmologist in 2 hemispheres, I shall and prosperous southern family.

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