This piece was conceived by John Cash, who was president of the College in the period 1994 - 1997. He presented this work to the RCPE in March 2000. Jill Watson carried out the wax modelling and bronze finishing, and the casting was carried out by Powderhall Bronze in Leith.

The bronze figures are cast from wax originals using the lost wax process, each figure is attached to the bronze base with two 4mm countersunk brass bolts. The brass base is attached to black marble, from Galliotti in Pietrasanta, Lucca, Italy, using three 4mm bolts fixed with resin and the feet on the base of the marble block are fixed in the same way.

The piece, a tribute to those who founded the College, depicts a meeting of Edinburgh physicians during the seventeenth century; it was meetings such as this which led to the founding of the College. However, as the title of the piece indicates, these were difficult times as the physicians of Edinburgh were often perceived to be acting against local and national political interest in their attempt to found the RCPE. Thus, the figures are depicted meeting out in the open and one figure appears to be warning the others of the presence of a possible government informer, who walks a little removed from the main group.

As it was a long campaign to establish the College only one of the figures in the main group of physicians, Sir Robert Sibbald, is identifiable from his portrayal in the piece. It was under Sibbald’s leadership that the campaign for the establishment of the RCPE was finally successful in gaining its royal charter in 1681. The other three physicians are unidentifiable as they represent the many Edinburgh physicians who participated in the long campaign for the establishment of the College. The physicians are dressed in the fashions of Leyden, Paris and Padua, the locations of significant universities where many physicians studied in the seventeenth century.

The dog, seen walking near the physicians, symbolises the state of public hygiene and medical conditions in seventeenth century Edinburgh and Scotland. Meanwhile, the four plants which are seen supporting the piece at the base of the marble block, are four herbs mentioned by Sibbald in his writing: Sibbaldia Procumbens, Asplenium Septentrionale, Lychnis Viscaria, and Ligusticum Scoticum.