Medicine – The Master-Word in Medicine Part 3

Professional work of any sort tends to narrow the mind, to limit the point of view and to put a hallmark on a man of a most unmistakable kind. On the one hand are the intense, ardent natures, absorbed in their studies and quickly losing interest in everything but their profession, while other faculties and interests “fust” unsued. On the other hand are the bovine brethren, who think of nothing but the treadmill and the corn. From very different causes, the one from concentration, the other from apathy, both are apt to neglect those outside studies that widen the sympathies and help a man to get the best there is out of life. Like art, medicine is an exacting mistress, and in the pursuit of one of the scientific branches, sometimes, too, in practice, not a portion of a man’s spirit may be left free for other distractions, but this does not often happen. On account of the intimate personal nature of his work, the medical man, perhaps more than any other man, needs that higher education of which Plato speaks,—”that education in virtue from youth upwards, which enables a man eagerly to pursue the ideal perfection.” It is not for all, nor can all attain to it, but there is comfort and help in the pursuit, even though the end is never reached. For a large majority the daily round and the common task furnish more than enough to satisfy their heart’s desire, and there seems no room left for anything else. Like the good, easy man whom Milton scores in the Areopagitica, whose religion was a “traffic so entangled that of all mysteries he could not skill to keep a stock going upon that trade” and handed it over with all the locks and keys to “a divine of note and estimation,” so it is with many of us in the matter of this higher education. No longer intrinsic, wrought in us and ingrained, it has become, in Milton’s phrase, a “dividual movable,” handed over nowadays to the daily press or to the haphazard instruction of the pulpit, the platform or the magazines. Like a good many, other things, it comes in a better and more enduring form if not too consciously sought. The all-important thing is to get a relish for the good company of the race in a daily intercourse with some of the great minds of all ages. Now, in the spring-time of life, pick your intimates among them, and begin a systematic cultivation of their works. Many of you will need a strong leaven to raise you above the dough in which it will be your lot to labour. Uncongenial surroundings, an ever-present dissonance between the aspirations within and the actualities without, the oppressive discords of human society, the bitter tragedies of life, the lacrymae rerum, beside the hidden springs of which we sit in sad despair—all these tend to foster in some natures a cynicism quite foreign to our vocation, and to which this inner education offers the best antidote. Personal contact with men of high purpose and character will help a man to make a start—to have the desire, at least, but in its fulness this culture—for that word best expresses it—has to be wrought out by each one for himself. Start at once a bed-side library and spend the last half hour of the day in communion with the saints of humanity. There are great lessons to be learned from Job and from David, from Isaiah and St. Paul Taught by Shakespeare you may take your intellectual and moral measure with singular precision. Learn to love Epictetus and Marcus Aurelius. Should you be so fortunate as to be born a Platonist, Jowett will introduce you to the great master through whom alone we can think in certain levels, and whose perpetual modernness startles and delights. Montaigne will teach you moderation in all things, and to be “sealed of his tribe” is a special privilege. We have in the profession only a few great literary heroes of the first rank, the friendship and counsel of two of whom you can-not too earnestly seek. Sir Thomas Browne’s Religio Medici should be your pocket companion, while from the Breakfast Table Series of Oliver Wendell Holmes you can glean a philosophy of life peculiarly suited to the needs of a physician. There are at least a dozen or more works which would be helpful in getting wisdom in life which only comes to those who earnestly seek it.

A conscientious pursuit of Plato’s ideal perfection may teach you the three great lessons of life. You may learn to consume your own smoke. The atmosphere is darkened by the murmurings and whimperings of men and women over the non-essentials, the trifles that are inevitably incident to the hurly burly of the day’s routine. Things cannot always go your way. Learn to accept in silence the minor aggravations, cultivate the gift of taciturnity and consume your own smoke with an extra draught of hard work, so that those about you may not be annoyed with the dust and soot of your complaints. More than any other the practitioner of medicine may illustrate the second great lesson, that we are here not to get all we can out of life for ourselves, but to try to make the lives of others happier. This is the essence of that oft-repeated admonition of Christ, “He that findeth his life shall lose it, and he that loseth his life for my sake shall find it,” on which hard saying if the children of this generation would only lay hold, there would be less misery and discontent in the world. It is not possible for anyone to have better opportunities to live this lesson than you will enjoy. The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish. To you, as the trusted family counsellor, the father will come with his anxieties, the mother with her hidden grief, the daughter with her trials, and the son with his follies. Fully one-third of the work you do. will be entered in other books than yours. Courage and cheerfulness will not only carry you over the rough places of life, but will enable you to bring comfort and help to the weak-hearted and will console you in the sad hours when, like Uncle Toby, you have “to whistle that you may not weep. ”

And the third lesson you may learn is the hardest of all-that the law of the higher life is only fulfilled by love, i.e. charity. Many a physician whose daily work is a daily round of beneficence will say hard things and think hard thoughts of a colleague. No sin will so easily beset you as uncharitableness towards your brother practitioner. So strong is the personal element in the practice of medicine, and so many are the wagging tongues in every parish, that evil-speaking, lying, and slandering find a shining mark in the lapses and mistakes which are inevitable in our work. There is no reason for discord and disagreement, and the only way to avoid trouble is to have two plain rules. From the day you begin practice never under any circumstances listen to a tale told to the detriment of a brother practitioner. And when any dispute or trouble does arise, go frankly, ere sunset, and talk the matter over, in which way you may gain a brother and a friend. Very easy to carry out, you may think! Far from it; there is no harder battle to fight. Theoretically there seems to be no difficulty, but when the concrete wound is rankling, and after Mrs. Jones has rubbed in the cayenne pepper by declaring that Dr. J. told her in confidence of your shocking bungling, your attitude of mind is that you would rather see him in purgatory than make advances towards reconciliation. Wait until the day of your trial comes and then remember my words.

And in closing, may I say a few words to the younger practitioners in the audience whose activities will wax not wane with the growing years of the century which opens so auspiciously for this school, for this city, and for our country. You enter a noble heritage, made so by no efforts of your own, but by the generations of men who have unselfishly sought to do the best they could for suffering man-kind. Much has been done, much remains to do; a way has been opened, and to the possibilities in the scientific development of medicine there seems to be no limit. Except in its application, as general practitioners, you will not have much to do with this. Yours is a higher and more sacred duty. Think not to light a light to shine before men that they may see your good works; contrariwise, you belong to the great army of quiet workers, physicians and priests, sisters and nurses, all over the world, the members of which strive not neither do they cry, nor are their voices heard in the streets, but to them is given the ministry of consolation in sorrow, need, and sickness. Like the ideal wife of whom Plutarch speaks, the best doctor is often the one of whom the public hears the least; but nowadays, in the fierce light that beats upon the hearth, it is increasingly difficult to lead the secluded life in which our best work is done. To you the silent workers of the ranks, in villages and country districts, in the slums of our large cities, in the mining camps and factory towns, in the homes of the rich, and in the hovels of the poor, to you is given the harder task of illustrating with your lives the Hippocratic standards of Learning, of Sagacity, of Humanity, and of Probity. Of learning, that you may apply in your practice the best that is known in our art, and that with the increase in your knowledge there may be an increase in that priceless endowment of sagacity, so that to all, everywhere, skilled succour may come in the hour of need. Of a humanity, that will show in your daily life tenderness and consideration to the weak, infinite pity to the suffering, and broad charity to all. Of a probity, that will make you under all circumstances true to your-selves, true to your high calling, and true to your fellow man.