In the post-war era the husband-father role has been enlarged to encompass active participation in family life. However, occupational commitments may inhibit active involvement in family life, particularly in the middle classes where work has traditionally been defined as salient. This article reports on an investigation of the consequences of heavy work commitments for father role performance and child development. This investigation, using the case study method, focussed on hospital medicine and the early child-rearing stage of the family life cycle. It was found that fathers felt themselves to be shadowy figures in the background of their children's lives and that mothers experienced single-handed responsibility for child-rearing as burdensome. Children have little experience of a father's companionship, and discipline and work pressures may be transmitted to them. A few children exhibited behaviour difficulties. Suggestions for further study are made.