Medicine – After Twenty-Five Years Part 3

But what is most important in an introductory lecture remains to be spoken, for dead indeed would I be to the true spirit of this day, were I to deal only with the questions of the curriculum and say nothing to the young men who now begin the serious work of life. Personally, I have never had any sympathy with the oft-repeated sentiment expressed originally by Abernethy, I believe, who, seeing a large class of medical students, exclaimed, “Good God, gentlemen! whatever will become of you?” The profession into which you enter today guarantees to each and every one of you a happy, contented, and useful life. I do not know of any other of which this can be said with greater assurance. Many of you have been influenced in your choice by the example and friendship of the doctor in your family, or some country practitioner in whom you have recognized the highest type of manhood and whose unique position in the community has filled you with a laudable ambition. You will do well to make such an one your exemplar, and I would urge you to start with no higher ambition than to join the noble band of general practitioners. They form the very sinews of the profession—generoushearted men, with well-balanced, cool heads, not scientific always, but learned in the wisdom not of the laboratories but of the sick room. This school can take a greater pride in her graduates scattered throughout the length and breadth of the continent than in her present splendid equipment; they explain in great part the secret of her strength.

I was much interested the other day in reading a letter of John Locke to the Earl of Peterborough who had consulted him about the education of his son. Locke insisted that the main point in education is to get “a relish of knowledge.” “This is putting life into a pupil.” Get early this relish, this clear, keen joyance in work, with which langour disappears and all shadows of annoyance flee away. But do not get too deeply absorbed to the exclusion of all outside interests. Success in life depends as much upon the man as on the physician. Mix with your fellow students, mingle with their sports and their pleasures. You may think the latter rash advice, but now-a-days even the pleasures of a medical student have become respectable, and I have no doubt that the “footing supper,” which in old cote street days was a Bacchanalian orgie, has become a love feast in which even the Principal and the Dean might participate. You are to be members of a polite as well as of a liberal profession and the more you see of life outside the narrow circle of your work the better equipped will you be for the struggle. I often wish that the citizens in our large educational centres would take a little more interest in the social life of the students, many of whom catch but few glimpses of home life during their course.

As to your method of work, I have a single bit of advice, which I give with the earnest conviction of its paramount influence in any success which may have attended my efforts in life—Take no thought for the morrow. Live neither in the past nor in the future, but let each day’s work absorb your entire energies, and satisfy your widest ambition. That was a singular but very wise answer which Cromwell gave to Bellevire—”No one rises so high as he who knows not whither he is going, ” and there is much truth in it. The student who is worrying about his future, anxious over the examinations, doubting his fitness for the profession, is certain not to do so well as the man who cares for nothing but the matter in hand, and who knows not whither he is going !

While medicine is to be your vocation, or calling, see to it that you have also an avocation—some intellectual pasttime which may serve to keep you in touch with the world of art, of science, or of letters. Begin at once the cultivation of some interest other than the purely professional. The difficulty is in a selection and the choice will be different according to your tastes and training. No matter what it is—but have an outside hobby. For the hard working medical student it is perhaps easiest to keep up an interest in literature. Let each subject in your year’s work have a corresponding outside author. When tired of anatomy refresh your mind with Oliver Wendell Holmes; after a worrying subject in physiology, turn to the great idealists, to Shelley or Keats for consolation; when chemistry distresses your soul, seek peace in the great pacifier, Shakespeare; and when the complications of pharmacology are unbearable, ten minutes with Montaigne will lighten the burden. To the writings of one old physician I can urge your closest attention. There have been, and, happily, there are still in our ranks notable illustrations of the intimate relations between medicine and literature, but in the group of literary physicians Sir Thomas Browne stands preeminent. The Religio Medici, one of the great English classics, should be in the hands—in the hearts too—of every medical student. As I am on the confessional today, I may tell you that no book has had so enduring an influence on my life. I was introduced to it by my first teacher, the Rev. W. A. Johnson, Warden and Founder of the Trinity College School, and I can recall the delight with which I first read its quaint and charming pages. It was one of the strong influences which turned my thoughts towards medicine as a profession, and my most treasured copy—the second book I ever bought—has been a constant companion for thirty-one years,—comes viae vitaeque. Trite but true, is the comment of Seneca—”If you are fond of books you will escape the ennui of life, you will neither sigh for evening, disgusted with the occupations of the day—nor will you live dissatisfied with yourself or unprofitable to others.”

And, finally, every medical student should remember that his end is not to be made a chemist or physiologist or anatomist, but to learn how to recognize and treat disease, how to become a practical physician. Twenty years ago during the summer session, I held my first class in clinical medicine at the Montreal General Hospital, and on the title page of a note book I had printed for the students I placed the following sentence, which you will find the alpha and omega of practical medicine, not that it by any means covers the whole field of his education:

“The knowledge which a man can use is the only real knowledge, the only knowledge which has life and growth in it and converts itself into practical power. The rest hangs like dust about the brain or dries like rain drops off the stones.” (Froude.)