Adopting a sharp focus by exploring individual lives of people who lived in past times has the potential to illuminate larger scale questions. This paper, which focuses on the life of Australia's colonial surgeon Patrick Hill illuminates larger historical questions and provides important considerations regarding present-day mental health care. Despite making a substantial contribution to the development of mental health services in colonial Australia, until now the story of Dr Patrick Hill’s (1794-1852) life has been largely overlooked by historians. This paper reviews primary sources including clinical notes, patient lists, letters, government documents and newspaper articles which reveal Dr Hill was a dedicated physician who played a vital role in the development of Australian mental health care. He was held in such esteem that by the time of sudden death in 1852 that he had been elevated to the most senior medical officer in NSW. Patrick Hill’s career serves to exemplify how the local practice of individual colonial doctors helped build the reputation of medicine in the modern era.