4. Serious discussions between the British and Americans began on December 23
On December 23, 1941, the last of the US Marine garrison on Wake Island, far away from a White House festooned with Christmas decorations, surrendered to the Japanese. A contingent of civilian construction workers surrendered as well. Eventually the Japanese murdered almost 100 of them. That same day, Churchill, Roosevelt, and their respective senior military aides and commanders met to discuss the conduct of the war. Despite the continuing bad news from the Pacific, Germany first was quickly agreed to by all concerned. The question was how to strike at Germany. FDR wanted an invasion across the channel, supported by land based air and the British fleet. The British favored attacking the German forces in North Africa, creating a link to the Soviet Union through Iran, and keeping the vital Suez Canal out of German hands.
Eventually, the British point of view won out, and FDR reluctantly agreed to commit to an invasion of North Africa in 1942. From North Africa, Churchill favored attacks through the Caucasus, an option he also favored in the First World War. The Americans supported the idea of attacks on Sicily and Italy, knocking the Italians out of the war. North Africa also offered a staging area for attacks in Southern France. Roosevelt’s reluctance was, in part, based on his knowledge of Joseph Stalin demanding a second front against the Germans in Europe at the earliest possible date. Churchill argued that killing Germans was killing Germans, whether it happened in North Africa or on French soil. The conference also agreed the British would provide bases in Britain for American heavy bombers, and fighters, for a strategic bombing campaign against Germany in 1942.
5. Churchill addressed the American people via radio on Christmas Eve
In 1941, the National Christmas Tree was on the South lawn of the White House. In those days the President lighted the tree on Christmas Eve to celebrate the holiday, rather than in mid-November to initiate the shopping season. Churchill accompanied the President for the ceremony, which was attended by approximately 20,000 guests who braved the cold to crowd onto the White House lawns. With the President and First Lady, as well as invited guests including Princess Marthe of Norway, Churchill listened to an invocation given by the rector of Catholic University, Joseph Corrigan. Then Roosevelt gave some brief remarks before introducing his guest, the British Prime Minister. Churchill, whose stirring speeches from London had long been well received in America, did not disappoint.
“Here in the midst of war, raging and roaring over all the lands and seas, creeping nearer to our hearts and our homes, here, amid all the tumult, we have tonight the peace of the spirit in each cottage home and in each generous heart”, he said. “â¦Let the children have their night of fun and laughter. Let the gifts of Father Christmas delight their play”. Churchill’s brief remarks ended the ceremony and the crowd dispersed from the White House lawns in silence. Churchill then returned to the residence, where with his secretaries he had established an office in the Lincoln study, just off what is now known as the Lincoln bedroom. There he resumed work on a speech to be delivered to a joint session of Congress on the day after Christmas, no doubt fueled by a large dose of his favorite whiskey.
6. Churchill was surprised at the plenty he found in Washington
Great Britain had endured two long years of war by the time Churchill traveled to Washington in 1941. With the war, and the U-boat sinkings in the Atlantic, came privation in Britain, and strictly regulated rationing of nearly all consumer goods and foods. Sugar was rationed, as were milk and eggs in Great Britain. One day Churchill was having a late breakfast with the Roosevelts, and as was his custom, he requested something hot and something cold. He was served two eggs in their shells, soft-boiled. Turning to his hostess, Eleanor Roosevelt, he commented that two eggs was a rare luxury. In Britain, rationing limited eggs to one per person, per week. Although rationing began in America in 1942, it never reached the levels that it did in Britain. Churchill enjoyed the luxury of American eggs for the rest of his visit.
He also did not restrict his visit to Washington to the White House. He traveled to Ottawa to address the Canadian government in January, and traveled by train to Florida for a badly needed few days of rest. Roosevelt escorted him to George Washington’s home at Mount Vernon, where the Prime Minister of Great Britain laid a wreath at the tomb of America’s Revolutionary leader. He and Roosevelt found they had much in common, a mutual love of ships, trains, stamp collecting, and tobacco, though Roosevelt preferred cigarettes to Churchill’s cigars. The two leaders genuinely liked each other and enjoyed each other’s company. Later in the war, during another visit, Roosevelt left the White House for Hyde Park. He left Churchill to use the Executive Mansion at his discretion. Thus, for a brief period, the British Government was led through the White House another British government had once burned.
7. Hundreds of people participated in working sessions over the holidays
Winston Churchill brought with him to Washington a working staff of 86 people, including admirals, generals, valets, security agents (he called them detectives), stenographers, clerks and valets and other servants. Each day some, if not all, of the working members attended work sessions held in the White House. There they developed the means to accomplish what their leaders agreed to, as well as recorded the agreements. The Americans countered with a group of equal size, led by George Marshall from the Army, and Admiral Ernest King from the US Navy. Representatives from other nations also attended some of the sessions, including the Soviet Union, Netherlands’ government in exile, China, Mexico, and others. They referred to themselves as the Associated Nations during their working sessions. Neither Churchill nor FDR were pleased with the name.
One morning, FDR was at work when the name “United Nations” popped into his head. Liking the name, he rolled his wheelchair into Churchill’s quarters to share it, where the Prime Minister had just risen from his bath. An apocryphal tale relates that the naked Churchill told FDR, “See, Mr. President. I have nothing to hide”. Neither Churchill nor Roosevelt ever related the story, though in his report to the King upon his return to England, Churchill confided he was probably the only Prime Minister in history to have been visited while naked by a head of state. When the agreement from the sessions was reduced to paper and signed by 24 Allied nations, they recorded themselves as the United Nations, and used that term for the rest of the war. The name was later transferred to today’s United Nations in 1945.
8. Christmas Day included another work session following the celebrations
On Christmas Day Churchill eschewed his usual morning routine to join the President, Eleanor Roosevelt, and other guests including Admiral Dudley Pound of the Royal Navy at church. The President’s children and grandchildren were not present; all of his sons were in the military, and his daughter had remained at home in Seattle, Washington. The President and his entourage went to Foundry Methodist Church on 16th Street in Northwest Washington, just a couple of blocks from the White House, the Prime Minister and President sitting side-by-side. It was one of the occasions when the President walked, using a stick for support as well as the strong arm of an aide as he struggled up the aisle to his seat in the fourth row. Whenever he appeared in public, Roosevelt either remained in whatever vehicle conveyed him or walked, keeping his wheelchair hidden from the public.
Christmas Dinner at the White House was a lengthy affair, attended by Churchill and other houseguests. It included several courses, though the reputation of the White House kitchens was poor at the time. Visitors often commented on the blandness of the food they prepared. Churchill did not, no doubt ruefully impressed at the plenty spread out before him. Between church and dinner another work session took place, with discussions about the Japanese attacks on Singapore. After dinner, the guests were invited to watch the film Oliver Twist. Churchill sat through the first reel before excusing himself, returning to his rooms to work on the speech he was to give the following day before a joint session of Congress. No sitting Prime Minister of Great Britain had ever addressed the Congress, a fact which Churchill noted in the text he prepared.
9. Churchill’s speech before Congress impressed even the most jaded of the politicians
President Roosevelt remained in the White House when Churchill journeyed to Capitol Hill on January 26, where he addressed Congress in the Senate Chamber. Extra seating in the galleries was all taken before the Prime Minister arrived. He first raised a laugh when he referred to his own American heritage (his mother had been an American) as well as what he called, “â¦my life which is already long and has not been entirely uneventful”. As it was Christmas, and many of the Congress were out of town for the holiday, the smaller Senate Chamber easily accommodated those in attendance and the speech was filmed by motion picture crews. The Justices of the Supreme Court were in attendance, as were most of the President’s Cabinet, minus the Secretary of War and Secretary of State. The wives of the Congressmen had precedence for gallery seats.
In reference to the Germans, Churchill said, “With proper weapons and proper organization, we can beat the life out of the savage Nazi”. Of the Japanese: “What kind of a people do they think we are? Is it possible that they do not realize that we shall never cease to persevere against them until they have been taught a lesson which they and the world will never forget?”. He predicted many months of travail before the Allies would be able to reverse the tide of the war, and warned that “â¦many disappointments and unpleasant surprises await us”. Despite being generally well-received by his audience, a smattering of boos were heard when he referred to American pre-war isolationism. As he spoke, Japanese forces continued their drive down the Malay Peninsula toward Singapore. Churchill returned to the White House to read in newspapers praise for his speech from most reporters.
10. Churchill may have suffered a mild heart attack while in the White House
On the evening of December 26, following his triumph before Congress and only 4 days after arriving at the White House, Winston Churchill felt ill. He had watched the film with Roosevelt and Canadian Prime Minister MacKenzie King. After returning to his rooms Churchill felt what he later described as “a dull pain over my heart” as he attempted to open a window. The following day he reported to his personal physician, who examined him but did not diagnose him at the time as having had a heart attack. The doctor, Sir Charles Wilson (later known as Lord Moran) mildly suggested his patient slow down his dizzying pace. He may have suggested fewer cigars and brandies, though he had long been Churchill’s physician and likely knew the futility of such a suggestion.
In his diary though, which became public following Churchill’s death, Wilson noted his diagnosis of Churchill suffering a mild heart attack. When Dr. Wilson returned to London he sought out the opinion of a specialist, Dr. John Parkinson. Dr. Parkinson reviewed Wilson’s notes and did not concur with his colleague, saying Churchill had not suffered a heart attack on December 26. During the trip to Ottawa (Churchill journeyed by train to and from Canada) Dr. Wilson accompanied him, and later reported several instances when the Prime Minister reported shortness of breath. Churchill returned to Washington around noon on New Year’s Day, where he was whisked to Alexandria and George Washington’s pew at Christ Church. There he and Roosevelt joined in the singing of patriotic songs in celebration of the day. Roosevelt had previously designated New Year’s Day as a National Day of Prayer.
11. The scowl was real in one of the most famous photographs of Winston Churchill
On December 30, 1941, Winston Churchill arrived by train in Ottawa, Canada, to address the Canadian Parliament. During that speech he referred to a comment made by French Marshal Philippe Petain in 1940, to the effect that England would “have her neck wrung like a chicken” if it continued to fight following the French surrender. Petain at the time headed the collaborationist French government at Vichy. “Some chicken. Some neck”, Churchill scoffed before the Parliament to laughter, cheers, and applause. He spoke for nearly forty minutes, his delivery lengthened by numerous interruptions for applause. Following the speech he enjoyed a whiskey and soda with Canadian Prime Minister Mackenzie King, though King chose tea over alcohol. Churchill then learned of a plan for a portrait photograph, something he had not planned. He agreed only grudgingly.
When the photographer posed Churchill, he wanted the Prime Minister to place one hand, his right, on a chair back and the left on his hip, angled to the camera with his head turned toward the lens. Churchill had just lighted another of his numerous daily cigars. The photographer asked him to remove it. Churchill refused. Pretending to move forward to adjust the lighting the photographer plucked the cigar from his mouth and returned to his camera. Upon facing his subject he saw an outraged Churchill glowering at him, a deep scowl on his face. He quickly snapped the picture. The photographer later noted, “By the time I got back to the camera he looked so belligerent he could have devoured me”. Churchill never commented on the resulting photograph, nor did he express an opinion of the photographer, at least not in writing.
12. The Allies signed the agreement they had worked out on New Year’s Day, 1942
Back in Washington, at the White House, Churchill, Roosevelt, and representatives from the Soviet Union and China signed a document entitled A Declaration by the United Nations. Twenty-two other nations signed the same document later. It established the necessity of total victory in the ongoing war. The allies claimed total victory, that is, unconditional surrender, was “â¦essential to defend life, liberty, independence, and religious freedom.” Over the next couple of days war talks between the British and Americans continued. Churchill later claimed in his memoirs that several of the Americans told him he looked fatigued. Edward Stettinius, a Special Assistant to the President offered Churchill the use of his small bungalow near Palm Beach, Florida, for a few days rest. Whether FDR urged him to do so remains uncertain.
By then Churchill had accomplished his two main goals on the American trip. The Allies had agreed on focusing on the destruction of Germany first. He had won over the US Congress, and a considerable portion of the American press. General George Marshall offered the Prime Minister the use of his personal Army aircraft for the trip. On January 5, 1942, Churchill flew from Washington to West Palm Beach, from whence he was conveyed to Pompano Beach and the seaside bungalow. Dr. Wilson accompanied his charge, as did a few officers of the British delegation. Churchill later described the respite as “â¦five daysâ¦lying about in the shade or the sun, bathing in the pleasant wavesâ¦” He also described spotting a large shark. When informed that it was merely a ground shark Churchill noted, “â¦it is as bad to be eaten by a ground shark as by any other”.
Churchill’s workload did not lessen while he rested at Pompano. Papers requiring his attention were flown to him from Washington, and returned in the same manner when he was through with them. He rewrote several papers on the future conduct of the war effort, based on decisions made in Washington and on changing events. He wrote a paper on the necessity of developing new and better designs for landing craft, to deliver troops and equipment to the future beachheads. On January 10 the party departed Florida, returning to Washington by train. They arrived at Washington’s Union Station that day. Churchill and Roosevelt continued a series of meetings over the next four days, along with the British/American Combined Chiefs of Staff. Churchill’s return travel plans were also formalized over the next few days.
HMS Duke of York had been assigned to carry the Prime Minister back to Britain. However, after three weeks in America the rest of the world knew where the Prime Minister was. Duke of York would be a target for every U-boat in the German fleet, and its departure from Norfolk, or any other American port, duly noted by the German submarines operating off the American coastline. Bermuda offered air cover, and it was determined Duke of York would rendezvous with Churchill’s party there. A small contingent would accompany Churchill in a Boeing Flying Boat, which would convey the Prime Minister to Bermuda. At first, Dr. Wilson was not assigned to Churchill’s party. Appalled at the plan, the doctor interrupted a meeting of the Combined Chiefs to argue his case for accompanying the Prime Minister. He won his argument, and Churchill prepared to depart the United States.
The entire White House staff gathered to bid Winston Churchill farewell on January 14. So did the President and a no doubt heavily relieved Eleanor Roosevelt. After three weeks of Churchillian behavior she did not share her husband’s good opinion of the British Prime Minister. He hadn’t been gone a week when FDR had a cloak room in the White House basement converted into a Map Room and communications center, along the lines of Churchill’s. The White House Map Room was a restricted area. Not even the Secret Service were allowed in. It was staffed by officers of the US Army and Navy, and the President visited it whenever he felt the whim to do so. He did so frequently. His long career as a stamp collector had made him a lover of maps, and he enjoyed the privacy of the room.
For the rest of the war, all communications between the White House and Churchill, Stalin, and Chiang Kai-Shek were filed in Roosevelt’s Map Room. It was staffed 24 hours per day. Situated near the elevator used by Roosevelt to move between the residence and his office, it was convenient for the President. It became his habit to visit the Map Room twice a day, in the morning on his way to work and in the evening before retiring. It was a habit he learned from Churchill, and adopted wholeheartedly. During major military operations he could visit the Map Room several times as the day unfolded, following the progress on maps provided to the President by the National Geographic Society. Meanwhile, Eleanor regained the use of the Monroe Room, and the rooms occupied by Churchill were aired out and thoroughly cleaned of the evidence of his ever-present cigars.
Churchill traveled by train to Norfolk, where he boarded the Flying Boat, the Royal Mail Aircraft (RMA) Berwick. A Boeing 314 Flying Boat, it offered commodious spaces to a limited number of passengers. It also served good food. During his journey, Churchill and his party consumed shrimp, ham, chicken, pears, beets, and other cold buffet items, as well as tea and coffee. The record is silent on whether Churchill had access to brandy or another alcoholic libation during the flight. Accompanying Churchill in the aircraft were Dr. Wilson, Sir Dudley Pound, First Sea Lord of the Admiralty, the Minister for Aircraft Production, Lord Beaverbrook, and Air Chief Marshall Charles Portal. Churchill and party departed from Norfolk, arriving in Bermuda late in the day. During the flight the Prime Minister spent a considerable amount of time with the pilot, Captain John Kelly-Rogers.
Kelly-Rogers was a well-known and highly skilled pilot, and Churchill found him knowledgeable and affable. During the flight to Bermuda, where he was to board Duke of York, Churchill learned that with a full load of fuel, Berwick could easily reach Britain from the island. At that time, no national leader had flown across the Atlantic, a distinction which tickled Churchill’s fancy. Arguing that flying to England from Bermuda would save several days of the Prime Minister’s valuable time, and that Duke of York would be freed for duties more in line with the reason it had been built, he suggested flying home to his companions. They agreed, provided the aircraft approached the British coast outside the range of the German Luftwaffe. Upon arrival in Bermuda, the aircraft was refueled, the flight plan filed, and Churchill set off on the last leg of his trip to and from the White House.
16. Both the Luftwaffe and the Royal Air Force scrambled to intercept Churchill’s airplane
During the flight from Bermuda, Kelly-Rogers’s navigation left something to be desired. Or perhaps it was Churchill’s piloting. For approximately twenty minutes of the return flight, Churchill took the controls of the airplane. At least, that is what he later claimed. A photograph exists which shows Churchill seated in the left-hand pilot’s seat, cigar clenched in his mouth, the wheel clenched in his hands. Churchill himself later declared the decision to return home by air, rather than aboard Duke of York, to have been rash. Considering the others of his party, he wrote, “I thought perhaps I had done a rash thing in that there were too many eggs in one basket”. As the plane drew closer to England, it appeared on German radar at the port of Brest, where an important submarine base and naval installation stood.
German Luftwaffe fighters were scrambled to intercept the airplane, though the Germans had no idea it was carrying Winston Churchill and several highly-ranked British officials. Regardless, the fighters failed to find the airplane before running short of fuel and returning to base. The aircraft flew on, maintaining radio silence. Churchill later wrote that in addition to the Germans, six Royal Air Force Hurricane fighters also scrambled to intercept the flying boat, and they too failed to spot the large aircraft. Given the state of the British radar and command and control system, which had contributed so much to the success of the RAF in the Battle of Britain, this seems unlikely. Shortly before ten o’clock in the morning of January 17, 1942 and after an eighteen-hour flight, Berwick landed in Plymouth. Winston Churchill’s American adventure had come to an end. He would have more as the war went on.
17. Churchill was re-examined by physicians after his return to London
When Churchill returned to London Dr. John Parkinson examined the 67-year old Prime Minister, giving him a full battery of the then available tests, in the presence of Dr. Wilson. His findings did not support the diagnosis than Churchill had a cardiopulmonary event in the White House. Nor did his findings support a diagnosis of angina. So, what had happened the night of December 26 in the White House? Several possibilities have been proposed in the years since, but Churchill never had another such attack. He came to believe he had strained a muscle overexerting himself in an attempt to open the window. Dr. Wilson remained firmly of the opinion he had suffered a mild heart attack, and he did not record Dr. Parkinson’s findings in the medical diary he kept regarding his patient. After Churchill’s death the “fact” he had suffered a heart attack in 1941 emerged.
Churchill’s doctors did advise him to slow down. Shortly after his return to London he began planning several other trips; to India to meet with Chiang Kai-Shek, and to Cairo, to address the situation regarding the British troops in the Middle East. In March he confided to Anthony Eden that he was considering a trip to Teheran, as it was then spelled, in order to meet with Joseph Stalin. He mentioned that he may consider going all the way to Moscow should Stalin hesitate to leave Russia during the critical counterstrikes that Spring against the German Army. Far from slowing down, Churchill increased his workload, entering into the detailed planning for the proposed invasion of North Africa, designated Operation Torch by the Combined Chiefs of Staff. And he maintained his extensive correspondence with FDR in Washington.
18. Churchill returned to the United States in June, 1942
On June 17, 1942, Winston Churchill departed Stanraer, Scotland in another flying boat, operated by BOAC pilots under military orders. He arrived in the United States at Baltimore, and departed by train for Franklin Roosevelt’s home on the Hudson at Hyde Park, New York. While there Churchill observed the mothballed fleet in the Hudson River, and hit upon the idea of sinking some of the vessels to protect the landing sites of invasion troops. FDR like the idea, and turned it over to the Navy for consideration. The Navy was not particularly enamored with the idea, but it eventually led to the development of the Mulberry Harbors used in the D-Day invasion two years later. Roosevelt and Churchill remained at Hyde Park for two days, before moving to Washington for the Second Washington Conference. The hastily arranged meeting planned the invasion of North Africa known as Operation Torch.
Even at that late stage, FDR still supported the idea of an invasion across the Channel into France. He received continuous messages from Joseph Stalin demanding a second front in Europe, and the Russian had made clear he did not consider an attack on French North Africa a second front. At the end of the conference, FDR made a decision which had a tremendous impact on the rest of the war in Europe. Dwight Eisenhower was named to command all American forces in the European Theater of Operations. Later, Ike would be elevated to Supreme Commander of Allied Forces in Europe, placing the Free French under deGaulle and the British Army, Navy, and Air Forces under his command. Churchill concurred with the idea, to the dismay of some of his own generals, including Montgomery.
19. Eleanor Roosevelt’s opinion of Churchill evolved over time
In March, 1965, two months after Churchill’s death following a series of strokes, Eleanor Roosevelt published an article in Vanity Fair discussing her relationship with the famed Englishman. It was decidedly mixed. In it she made several comments of a less than complimentary nature. “I have to confess I was frightened of Mr. Churchill”, she wrote. “I was solicitous for his comfort, but I was always glad when he departedâ¦” She referred to his working hours late at night as “unconscionable”. The article also revealed the fact that Churchill had long expected and planned for a visit to Britain by FDR. Eleanor was on a trip to that country when Churchill showed her the rooms, modified to accommodate Roosevelt’s wheelchair, in Number 10 Downing Street. Further modifications were made at his country residence, Chartwell.
Though Eleanor made several trips to Great Britain during the war, FDR never did. He traveled to Casablanca, Teheran, and Yalta, to meet with Churchill and Stalin, but for British trips he preferred to send his trusted aide Harry Hopkins, or another aide, to represent him. He also made lengthy trips to the Pacific to meet with Admiral Nimitz and General MacArthur. But though Churchill invited him several times, and suggested they meet in Great Britain, FDR never accommodated him. He preferred their meetings to occur in the White House, or on neutral territory, as at Casablanca, in then American controlled Morocco. The reason was political, FDR reasoned there could only be one head man, and that was he, as far as the Allies were concerned. Churchill and Stalin’s war efforts were dependent on American aid, not the other way around.
20. Churchill’s 1941 trip to Washington altered the course of the war
When Churchill arrived in Washington just before Christmas, 1941, America was a long way from being on a war footing. Coastal cities opposed the idea of a blackout, rationing had not yet begun, and the extent of the disaster at Pearl Harbor remained hidden from the public. Jingoism over the fate of Japan drowned out harsh reality. Churchill’s visit changed much of that. Though he exhorted America and Britain to work for the ultimate victory, he also frankly acknowledged it would present a long, hard, and frequently discouraging war. His soaring oratory and frank assessments endeared him to the American people, even those who just three weeks before had opposed American aid to Britain. After Churchill’s visit, the Anglo-American partnership never wavered through the course of the war. That had been his most important goal.
Churchill and Roosevelt met several more times during the war, and maintained a lengthy correspondence in letters, notes, telegrams, and official documentation. As the war went on he visited Roosevelt’s Hyde Park home, the Presidential retreat at Shangri-La, later known as Camp David, and several other sites in the United States. Yet none of these communications and visits carried the importance of his December, 1941, journey, across a stormy Atlantic crawling with German U-boats. It was that visit which established the United States and its Allies would concentrate on the complete destruction of the Nazi’s power and ability to make war, to the detriment of the Pacific effort. That war began in earnest in 1942, with American bombers striking targets in Europe, and Allied troops landing in French North Africa in November, the first step on their journey to the Rhine.
Where do we find this stuff? Here are our sources:
“Christmas at the White House with Winston Churchill”. Meredith Hindley, HUMANITIES. Fall, 2016.
“Churchill’s Character: A Rigid Daily Schedule”. Cole Feix, The Churchill Project, Hillsdale College. February 6, 2019. Online
“Mr. Churchill in the White House”. Robert Schmuhl, White House Historical Association. Online
“Battle of Wake Island”. Article, History Net. Online
“Operation Torch: Invasion of North Africa, 8 – 16 November, 1942”. Article. Naval History and Heritage Command. Online
“1941-1953 National Christmas Trees”. Article, President’s Park. National Park Service. Online\
“Allied visits to Mount Vernon during the Second World War”. Article, George Washington’s Mount Vernon. Online
“Winston and Washington: Remembering Churchill’s romance with wartime Washington DC”. Michael E, Ruane, The Washington Post. October 27, 2016. Online
“‘My Day, 12-27-1941′”. Column, Eleanor Roosevelt. Reprinted at the White House Historical Association. Online
“Churchill Addresses Congress”. Article, Art and History, US Senate.gov. Online
“Did Winston Churchill suffer a myocardial infarction in the White House at Christmas 1941?” J. Allister Vale, John W. Scadding, Journal of the Royal Society of Medicine. 2017. Online