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 Front Matter
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 Title Page
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Title: Medicine as a career
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00098579/00001
 Material Information
Title: Medicine as a career
Physical Description: 23 p. : ;
Language: English
Creator: Pusey, William Allen, 1865-1940
Publisher: Press of American Medical Assn.
Place of Publication: Chicago
Publication Date: 1930, c1927
Subject: Medicine -- Vocational guidance   ( lcsh )
Genre: non-fiction   ( marcgt )
General Note: Reprinted from An outline of careers, ed. by E. L. Bernays.
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Bibliographic ID: UF00098579
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 05691078


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Table of Contents
    Front Cover
        Front Cover 1
        Front Cover 2
    Front Matter
        Front Matter 1
        Front Matter 2
        Front Matter 3
        Front Matter 4
    Half Title
        Half Title 1
        Half Title 2
    Title Page
        Title Page 1
        Title Page 2
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
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        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
    Back Matter
        Page 25
        Page 26
        Page 27
        Page 28
    Back Cover
        Page 29
        Page 30
Full Text



Medicine as a


Reprint from Bernays' Outline of Careers


S 'ress cf
Amer:can ;4dical: Aicsctcatioa


.,,.,.,, II '**'i: K~.I.


.\A lt the ci.:l :-: ..,I .le. ilu:. ihe ..,,t important
'-leI:i :.I a ,iuIIn hI:- t'., ,ikC, e in t .li- c .i.l is that of a
I., iles i.n. .-'.iil a I fsi i -i:n i- il.t inarriage in
another irec.ct it often ti i irs t .Ii'ierent from what
it \."s e.:'ecteIj ,.., l.e It It: LnitJrlt ii tcly true that
t..,:ntiiii, ,:" i .n :-. s y a e ch,:e, : i 'I deal upon the
.ati of extri.r' ll-. \1, thl.I t -] fu ll kn.iii ledge of the
Ic : ...l..iiu-'.e u e.llre that a:t l I. Idet character. In the case of medicine the young man
knows the family doctor who has been the reliance in
hi f.i; ninl L. I:- lng as he can remember; or he sees the
:i.:t..it ie 1 and the apparent prosperity of the specialists;
hIe cii.I.... thle iiefulness of all of them; and he decides
thlit ime.li,:ine i- the life for him. I would not imply
tliiht tllic: externals in the life of the physician are not
real anlld thlit Ihey are not factors to be considered in the
(hoic i e :1 tl,.it \jcation. I mean, simply, that they are
nort the ii.:'-t important. Driving about in a comfortable
,tiiim,.nlobile, filling a position of importance in the com-
inrnlit\. ; .Ling people, most of them agreeable, under
Page 1

conditions where the physician is their reliance and his
word is law, are the fruits of successful careers founded
on a long period of hard training and harder later work,
and they are no more the whole life of the doctor than
is occupying the center of the stage upon important
occasions that of the clergyman.
There are, I believe, few young men who have an
irresistible call to, or a peculiar fitness for, any vocation.
Most who think they have are quite likely to be mis-
taken in their judgment; this, because of the inherent
difficulties of fully estimating what a career in any pro-
fession means. Of course, a young man should allow
his predilections for any vocation to have influence with
him in his choice. If he has a real bent, and :-'.t 'i
imaginary one. for some career, he is fortunate and will
probably find himself happy in that occupation. But
most intelligent young men have no compelling ambition
in any one direction. They will be content with any
vocation that leads to material success, that s'-lI!ic-
their intellectual and emotional tastes, and that is u -.' f ul.
The problem that they are trying to decide i- .'ldt
occupation gives them the best prospect of th.-.e
rewards. And, as far as my experience goes, th,.-e

Page 2

I li '1 nILI :1 lir hel top ,1 >-:iln enlt s11nll tlhelr icaLeerl
a: th :slit h i:. in tiie ll't., i't1ie i rI. i-tic'l i;r bn it in :iiHe
lii ectioni f r they aie ,uilie t iL lil.el; t':- iC -tucce .-tful
:iil, aftei nil, t- iCC in a ctic i. i :, ne of II: l iiel"
f : i.'i: i Inl.ia ili-4 it ,ili'i c[.-I I
T Iic' L it. tinl .tcll tlc, I.. i .11 -. 1!',. e-:.l eci ll;' ii, i 1 I lii- >:
W'll e ,-.ts iii-f in ~ ilc lilect pcr'f 'i 11i l .r ice r TO I .til-
SlI '.l tih t [i,. ,i: l. \v.,r .Ii arillitc-i i in lif i% cr r i' i :c.
let til: r'ewar.Js be w]t they iin:y. E-ce'pt lWei e it c-.
i,-_lIsh, I beheld e tl- it unnraturdl andJ, p<.rlhap unin:-
i' ii lrtI\ iii iiikerel service e\ 'ic i' t ill a!ll tiiillitLi il
Co-il( ti -it *:f e;.,filt i ioll, it iOL 11i O'' i r:\ali l .i ll
II ei il Im. % Ill i '1 114 1A 11 L. II lil l i i Il I 1. I r I
m dli y I l ill hill \ uJ. i lit i a.l-, tiles t, d i ,,
*reaiti\ 111 li t e ;ort of i v'.'arJ- tle\ v. .iir .\t -ine
c rcinc i tilt imit *i.'ii.e -I -.-*Ihi .h -iJoa i- nit l..10 :1I
-ll ,- .'=,, ;:il the tlle r i- I *ti1, L ,.vil [_ -_o n ,'l'|llili .lt it ]
I Ilhis i ite ll,- i. ;Il -i r iii r tiH l- o il _-i i nt .tt: ti at s ilci te'

thi : Jecidin in t,:,r-_ in the c ii.-ce ,of hiii cri.:er. BLut 1l1
t.ilih i ca c.- L' -iitli t in 'irict i 'l cctitri-ol': The
niin 'v.-ise haplinie. i: derine l fr:in pure aliruni-i i.
ju.i t .as mtIchi gu.t l I .. iy c,-el-iiinter t ini iii, slc-i to:,
Eti .ll hi s [piiiiculir t.ste n.; the n a111 11 hoii'e il le

r.i ', ;

desire is for money. This self-interest i- 1i-.t .,,ili
natural, but it is proper. It is the driving force rliat
makes men do things.
The men who seek the professions are, as a rule,
hoping for more or less satisfaction of all of these
tastes. They necessarily must consider material suc-
cess. They can only be satisfied, if, in addition, their
careers give them some intellectual and emotional satis-
faction. Medicine, as largely as any profession, offers
prospect of a considerable share of satisfaction in all
three of these directions. Its material rewards are
sufficient; it demands exercise of mind and hand and:
it offers possibilities of unlimited intellectual excur-
sions; and no vocation can appear more strongly t.-.
sound altruistic instincts.
Of course, no man should go into medicine with tLh
hope of getting rich; it cannot be done. But all men
properly may, and all intelligent men do, consider tl-.
material rewards of their profession. That is not
simply a characteristic of meaner minds. One could.
for example, hardly find a more courageous intellect or
an abler one or a life more controlled by scientific and
altruistic zeal than Thomas Huxley's. Huxley expressed

Page 4

the -lifillid-- i:.li I y.:.It young men when, as a young man,
S,.. I have no ambition, except as
in.ci:,i. t, in _1'. .-rid that end is the possession of a
uflicint i'n'..ne ti.- marry upon."
,Mi,:- l:1i: ,:..:;. :ne prospect of adequate material
re .,rd. It I; trne that these rewards do not compare
\\nh tli..-'-e .-f uc.:c ful business or with those of suc-
t.:e iful C7.ier- in ..ither professions, such as law and
n:iinccrilng aid iar.hitecture. On the other hand, doc-
tors, I have an idea, realize more largely than any other
familiar profession the Scriptural standard of neither
great riches nor great poverty. Their average of
material prosperity will compare, it seems to me, with
that of any group in the community. Unless they have
some peculiar defect which interferes with selling their
professional wares, and this is uncommon, they, as a
rule, make good livings compared with those of similar
social standing-and that is the best-in the com-
munities where they are located. This was brought
home to me in a rather interesting way a few years
ago. I had the inspiration that the Chicago medical
profession, through its general society, which includes
80 per cent. of the city's practitioners, should make pro-

Page 5

,].* .II i fi *,_,,ii .i: ii i 11 1 tili: i \- x'. l rr:1 i U.Ie,.e

\\,. l'r,,l:a 'i le ,-d its e.xist- :, thl r.: h-.]h lA]: pirifc ss,.._n :
a l ni .:::-e J forwm'i,] : li .i r":tui c:iui,.,, ..if li i.ii ._l.iiir
w 'irt Ilv ii f r .aflrt[ l Ir.tli.rs. :. N ...tlhil, n t''Ii',li. l
PF li \ ," 1 \1.1'.'t ]-,,,-r, Ii'm 1 ll,1 : IC -tit ll,:
\\hl:I'er I"in ',t in thIe UL .wtI W trire- lie 1iin
fli\, ,. ci.'ii:s c,-i'llli-rt:ll.L cn irc nit'tii'nce.l liti ,' li.,e w\' ell:
tlh:ir f-m ilies ha' e ll r1.: :,n l.h_. ,l..inta :. : tlh ir chil-
iJrtn L... t.- C. Iklc l :a ar.. ,..II -tnrtci l ...ff in lif'c ThI
*]c -: rvirI., 1iIl 11 h1, r(:;-,n, l.. l l 1'r ri."l re,,', lr l -_-.'%
lui'2 :m i tI' ire in ac tit-e ir.ictiwC Li-'il li'e i- tih
im pfir ni i t pFr,'-. i-i n : It i i ri' 11eitnsl ii'. ieriTIll, IrLle
11i11 r1h1 y 11 l,e f.le.-ll,"le fr.:, .1 ,:n o-i :l .1.1 o ld i. Tlh -,l
i- iof C Lirse,. inl :I .i i I,:T lli i iutritir l iniipr'.. i.,:ic:
*, i n i f l ill -.'t: :r l.
Thicrt i' -ii inipr;s.'..ii tki't nvcc i:.fnil -peci-ili-.l arc
.*r it i .l 'nt':\ cflieii .] no irw liel., tL' CI r!i.. I 1 ,

. 'ti, z i .CC fuil I' .rui ,, l- .r. in ,l -ci ic i- :i aven

li, .'.- lthe li I.'e i.' c :l r e en..l j-, lit tllhe. do not
Iimil. l:a' r-'e -in ,t iles i Thue llc c,:e sisil 1111: 1 i :' l i1U l
ti'li:,''u in li '.. .i Ii Ilie rit s. :irlite l tire ,r Il..i.uli:' --

l'lle rf l i, t i, l l I rI.i I rli t- ,i t, tllr : ilz t t' -l i-,l l t' ,
S i:r1 111 l I [h i Ir li. 1111 l (:'ll 'i: I i t lil .:I 'f l' i i
" Ii n u ill I ti\ i.li ,.I.r' ti O- i I l I tI. i il : ] Sli: t I'i.t ,'r:' li. t llit
C 'it i cl i 111 i 'it ii ,'' .i i i titr ill l -, tl mi *'
l ieg dree-- ,:,c:,:,r.l _, t,: t l l.il- I, ,;,ii:l t t,;, P' lint

theo i'irLi'' ni l thf.. ,: .:f m] :n in : l ,.-_r |lol, r s :il,

I .ie c ciii oi I. I l i u. I .I thl l r II l I t 1- 1 'I lciin t 1.
I III o rt r tct ,Ic -, i t r I r t'',a 't i-a. .\ t r i it 1." i 111 .:,f
pir,,,ei i ci" t et i great Fort of Ion :ll. v,;io u tll
:of =-r.i. ll 1 .orthv i ,,:,-|1 ,. \\1,:, .di ,l ', to lI inim bitt lihe
;lI v ide ,l ,: ll erienc e -lll the 4.1, 1 ] l ,.] ]l,:lli' elt
itlhih m :il.:ke hni Im l: l, i l-:_-,: il. It i. p'rolp.r |hat hI,
1h,:,ilIJ :h.i r-,< ( '-:,1 for thi.- _i'i h -. I.h n; tihe: m in
, I0 i ,. ,l ll h l 1-, I- ir t ,',i, it T hi i- InJO L in
c',,m pren nte lImil .f.:oli: l, l':Ir thl ,r iC '-; li h r- ..i ek n
i.:- i | Ii:, c ,;,I" nilalI n ic,. ii- f.-,i ;nii .: 11 ,r c. m -l z 't oi,- Il I, n
fi: thi il [ i m,: l m ni ,r ,-, led ,, ,_h I ', 1 i,.. ,, I .. i Zr, l

I II k. ..: r I %11 C
IW ll : ',<` 1 .; : I |I i .l I in i im d t l, ,l,'l, ,lel t
p r."'i't ,.. I i l i.lt .:h,, :. ,h ihl, i. ih,: n -n i l ,::,-(r >:, r. [i1
r eii; ll 'y.:-: thler. n li. l_ cel :i l en i' n ,'- nii nl>] t I'll tho:
c.irL '- 'li.> 1,-, l ic'il iC I IL ii T hlr rL- :ir,. in l' >:t, iin -

.. .

dencies to the exploitation of the doctor 1., ,:'..rp'..'ii[.l'.i
organized to furnish medical service and c'. li. I.. l,-,-
pitals, that I believe are dangerous to the \iclfatc of the
profession. There are also many careers open to them
in the proper medical work of corporations, in sanita-
tion and other public health activities, in governmental
positions, federal as well as municipal. There is a large
increase in the opportunities for medical men to go into
purely scientific and academic careers. These fields
offer smaller material rewards than are obtainable by
men of similar competency in independent practice, but
they have many compensations, and they are attracting
an increasing number of our graduates.
The intellectual rewards and opportunities of me.i-
cine would seem to be fairly obvious. The practice ,-,f
medicine is an art based upon science. It theref,.-ce
makes a double call upon a man: First, to know; anl.
second, to do. The knowledge of physics and chemistry
and the biological sciences, which are fundamental t,-.
medicine, and of medicine itself, is so enormous that it
presents a field of intellectual activity large enougl- t.-
tax the capacities of any mind. The man who goes itll'
medicine may be perfectly sure that he will find opp-. -

Page 8

ILiit\ 1 : r all the intellectual exercise of which he is
capable. And there are certain conditions surrounding
one's mental activities in medicine which seem to me
particularly stimulating. In the ordinary everyday
practice of medicine the physician is carrying respon-
sibilities of life and death. He is the reliance in the
most important emergencies of his people's lives. No
man with the proper sense of responsibility can fail to
be stimulated to his best by such situations.
The purely scientific side of medicine-investigation,
research, discovery-is a field in which genius can find
all the intellectual and other satisfaction that even it
can hope for. The problems are as intricate as any
that concern men. The rare man who is suited to a
life devoted to them need have no fear of ever reaching
the point where he has no more interesting problem to
occupy him. The solutions of these problems offer
rewards in service to mankind that are among the great-
est that altruism can wish.
Fortunately the possibilities of investigation and of
discovery are not confined to the few great men. Every
patient is more or less a problem. In medicine, more
than in any other vocation that I know, the rank and

Page 9

file are constantly stimul.it,:d L. thliir L::. li ;rin-. t,.
suggest new ideas and alni:.-it L .I ..lI,.-t-r :.:.: i:'.-.:. n !l
makes some new obser ti-n .-.r d. lcv\.-l.s :piime. ii:':'l
idea in practice.
Another attraction of me.lici; e ii du.I ~ i li, t th. t
it is not only a science 1 : i '- art r lrat *J:lii:.s nl- rn1:11. al
dexterity and trained skill i, thie u-e .-i 1it 4ence.. Tli
doctor must have trained li-ii.- i- .ell ,- ai tr'miiic.I
mind. He is in this respect in tile am intu:i.-n i: tlh
pianist or painter or hii.llM titi'id rtii- .i \nld tl,:
necessity for high manu.il I.ill in the pr-icti.ce .-i ;Ii,
profession is a feature *-i ttr'cticin t:. Tie dct.-r
not only has the stimulu.i t-, attain thte :.reite--t I:;!ti.\l-
edge, but the highest skill. livie is i thi- :i I iat
relief from monotony. Tilis wi-as icll hi.-iz,;J fol: ii,.:
several years ago by a :', -i..:- i.i 'i i la m -i', \\-.\
in the wholesale grocery 1.'UilliC: I-IL :'iJ: "[ w.unild
give anything if my busine-- h-,' c-imiellc,-i imi: tc- -et
skill in doing something with i i"' an.l: I can:ii c' ci
watch a shoemaker and enti I\ h hi- sl:ill." i :.-.ur:e.
there are other vocations :i lii:lhei intellectuil -ii lul'.
which demand similar skill :for ilitir i:ra3tic. h.it their
arc many others which d,,'.iinld r.o:ithit,. tIxc:plt tile use

Paoe 10

I. (i, ii i '111. ;III I I ilii Ile [lit re i .1 iI i'a:, 1lo :i: J;,' 10 [li c
wliich wU e'cIap-IL.

T he enr,,'ti,-,n]:Il. |-':rirlt:ucl:inlV thi .n rml r ni I "\ 'i l' -....f
lt e ipr ic c': ':[ i -,l i uii : if finli'..I rIia lltl :I tlu i.c-

I'.ili Th': ,uni II',[ l u.t ilth *'li IUC 'r' t ? t Il 'i l 1
.'tientl- i- c.ii-iiLIi1it0 lie ni relief e -illeri ig; I
CTli i ''. l 'r i'ilt c'Jeteci [-. lie C an ll rii ll IIen .i11 1 ,Iol lieil
i :cl t. I.W l.'pi '- : .Ili] ult I tf. l l.t- : liC c:n, .:. i:ll in thl

li',I t -il. l it, : lilli st f c l '., II ,.li lie i 'e <:j]
sawu life. Siiici.nt e& lW cCiillii di ill,' oif titc, trlIiiL-.
b,'r o:un (A '1 l1 h i ic l:ir" W th el\ 1iI Iii V 1'r. ('i
ci .'ir ., :: ii -ille iII-ii ill th e [ Ir'.iL ic ---f I iL. li lit ':., [L.
i,.' ti. ( -llI- 11 -'.A i' r, ti lila i Il i ii I ii ', i' "
hi.cte O;,l. t Ce i i ite ill ; iot:\ ei \

l tlj.,e i lli- t I- l ll ei 'l l i ltJ: I l IJ I ll. it 1i li ': ll. C l. t i \ci\
r l : .ili -,tlC '.- I ,,1' i iled luln,. ei itef, [l t eil:'tii:'i [ 1 -
go 1 C ,lll '-r .- li f l l lie I[ll n't e ,._ Ii : |iji i tni \ '.

ili Cr if iCl i -ll -- '_-, l ,. 1 It il iii,,-i ,,t If lI'ti. lil : lt '.
IlllU .L Ilec. -It \w.'here %C c ire nw,-.;:, ll:evl\ to:- (critici-c
*.*,i. l ',' lrdJ io l Ic '. ,II:' i _l.I A. l II 1 lll Wlkllj -\\

r ... II

are usually bolstered up by the spirit of gratltii-1: ,.t .. ur
patients. But the amount of criticism an I i:...ii.l.: it
that we get in no way balances the appr,...i.itl.n IIan
gratitude. It is hard to think of any more -ati-t--'t.-.I.,
or agreeable relation in life than that between m'nr,, ,-,1.
patients and the doctor on whom they li'- e rrliel
through a lifetime.
This, in outline, indicates, I should say, the major
rewards of a medical career. What are its difficulties
and objections?
It is an arduous and exacting life. Its minimum p: --
liminary training is longer and more expensive than thl-t
of any other familiar calling. The doctor never g-tl
through preparing himself. That has its advantag..:.
for it means that his profession is constantly intere.t-
ing; but it also has its disadvantages, for it likew-v.
means that the doctor must incessantly work to keep ii,
step with the progress of knowledge in his profession
Of course, many of us have not the intellectual ener-.
to make the adequate effort to do this, but the call rest-
on us nevertheless.
The peculiarly exacting demand of medicine is that
made upon the time of the doctor. The demands for 1.i:

Page 12

,-1 i.:.; .i ,.: r.-lation to regular hours or seasons.
HI, uli 'r. t.:. '.:.e degree, be on call all the time. My
n ..r.._-',:. 1- ii- I 1.I this hardship is more imaginary than
I .l. f.ir nii.il.-t.- .-.t work are largely a matter of habit,
.I1,I thi .l <:t.r-i- t inay not be so with his family-gets
v-. I t:. Ii.: i e.ul', hours with little sense of their hard-
ship. The successful doctor can sometimes escape the
unnecessary demands on him at unusual hours by simply
insisting that patients conform reasonably to his con-
venience rather than to their own.
Of course, the doctor, like every man whose service
is personal, has to stay on the job, or his income ceases.
But I think this sort of exaction is much smaller today.
Successful men in medicine, as a rule, take adequate
vacations; many of them, after they get well in the
saddle, take very generous vacations. This does little
more than interfere with income while away; for the
man who has attained success has a pull on his work
h'.lich is effective as soon as he returns to it.
There are also features in the practice of medicine
ilit are physically disagreeable-contact with pain and
:u llering, the performance of duties in examination and
.,:.l.tment that are in themselves disgusting or revolt-

Page 13

ing TI i. T :[im ].C t..i r Q..t .ill tl .-e tl in k. l i n. I h
neces ,i f thi ;r .1-1i l flril. i:c Tale th.: iaittic:r of
sullei i:. t' ., ..:': 1-i1n .l ., : .1,l I let ni e *, i "- pl- r i.. 11.:l
ex).*ri>.in i "mi ,i| nrhI iI '.Iiriii- frni the ;,ight
of o ett rira : I .I.:. i .I i ]| : x -rewlin: unitch .i
p ri i.l i .!i r <'.l: I ; ,i I-il l .:l l .i::l1 i n.. : I' i't, l .:i
see nilli hinrt. cit tilur i i ii ..in .1' tki I' -li, whTen
in ,::l] .' f,.,r jl.ilt:nit I ;iI!, ,i .; :,.- ,, v. Il i t '.v In rl"
A r id it i[ .... ii, [pi,'i tice =e n 'l l, \ the[ ii 'tl le t i li In i ,.:-
occui l it, ,iii ,,lii.,t. r c-. iiirplerel etn. s l es .* -Ii r:ee-
awle .-i p litmie .
i t -r,: thi ,iti 'L.: n c.:': r .. mn k- .1.-', ,1
doci.'i : l '.. t thle ti ,li in-g lhe nin t l:im e?
'Ili po sis l .in! il e ih t .. .. I ':ke Ie ph.. i:-nn
arc ir tlli.in'i,;ce. c:lhar o:Ier .nI n. ,in ,[ \ ir e vnh...I 1, i,-
peO W l 1 n i rimi .ituri. A.!' tl.i l,,j,,,i .AiMlUR t, tIlt t a :e
call ,: ,,in n e 1 i ;, T I .ra:ti'. i i;'.. m ,li,.in f' i. f r v j-
possl.le in the rre, en t -r:t: ,t. ,- o in i. i v.m I .-.. i L..; ,..,I]
u p :., i l, i it ll1-e r j.[.l tii j tll., I't." rt ,, I' l-f -ii- l
anm l l,,,.i, -: ;l oL.,en e [i i:lls .r :i ,cI"r:.te aC. cii -i
of ..-n re;-.:. n: i it c ma IIe I r ',itii l I,. r.r.:, .1 M iic;:l
in '.. i l..iii is I :,eli l .'V l i in .-ciitl' r_'.,,,iiIiQ ,
p r in .,,ll..l ,iil :. i.,:l.i ,-i I. l ,ri. .r l *rt ir...n i he

Pag I,

,Ii".l i-i :% lil i .n -. I I il -lhJ. .- i l I ]Z I I I 1 i I -I- I[n I l1 i l,
r ,+ tn 1 ,] Im lul r ml llll _- l ,.||i |, .J 3 .1.0l. ,'.. It .111:,

only to:, :, lin-iit-Il ext, It l Il:,-. l [,,-, 1 i n iarlilliatical
lI;l,\vle.ll i. .,ll, tlh tl l'.'|15 l l S W n ,5 .;i, lil i,: rii,- t,: I, "I
, .' ] ., -l' i ,[a 2,:. l Th -e rt: ;i ,. i 1"t.i- i .it :I.-,.'t. li5 : i
,*ii: l> r' tlll, itii ll. r i i' l :.i l III n fi i 1:.\; ii l.,'l ilnl \ Ili,:h 1iv'..i
C : 1",' :IILII j:[ l , ." i "11 0li i. ," ; i:it 111, r 1 ,-ii l '" ,. ;,l i; I \

ii, t lif i : III, -' r li ,lnk rll 1 1 .II -.- i 1 1,t i lll. e r l ,'

Iki]lliletI, [lir % tin ir f -[ : 11 :' :li].:-\ ti '. %Ihil1 1 : eCi i ie i l :.I
!II.r i jll .J \wr.:ir, fr .-m l i;I\v, ,.\ l, i ,n Il e lan I:IIy:l:t1 I i
-Cl elli:,i. C'A : V.1 11"0. ot i .l -.l ,,-,I 1 li,-,t te ll ,., h,-,t

I C.if i.'lll II Ii l ilill i: i l ll, I'ilp -1 c l i 4 1[
T 1 1i i. 1 1 il'. i i, I t .!ii f [ .Ic -:.'l li' I ;.I, i I ;,: -1 l 1 .. I 5
, lir l ii. l ',.l ,1- i, l -c, i l ,rc it i ..i l ii lr;I r ,lil' r cr l-i :,?
l, t ',e' ; l) t ill, i : tin l [l ,:, ,:- -.,i .lr ll~ .' ,Ir illli- ],illi t.V:, l

.\ lfi ir. ,i 1i' i:,i ,. l, iIo:li tli i.-.la -,i in ti. i iil .d i -
<- i ,.- l lii ;4 l .'ri ,ire .[ t il i ,ii .l li[',,:,ii ,,ll 'i i1 ,,,'. ,]i ,-,I "
o l, ,.l s.i,-, .lll I i, 'l".l\ rl :i -Ml ll i I:oll < :r:ii Ili il-t
i ;t: ,' G -l c i'' ll. _.l r rI ',ii -l,. '-c I Ih Iiin .-I Li<- Il ,'_l ',,n lhi il
I, ,l.;i i f .r I',, it It l ii I, l ,.- I il I W. -l: 1 --. ,- lie- i I -

P ., %. I,

well as ready to interpret them and act iip:rn hi-,i ...in-
clusions. Observation is a quality that ca- 1... 1J. .Ih.,p.l
in any intelligent man by training. In :., bri-.i thi:
amount of facts that the doctor must learn I[.ll- "in i ::.r-
mous tax upon his memory; but this als.i- i. Iir1.i'.\:.I
by use.
All of these qualities are those commonly t... int.I.llh-.ir
men. We have, of course, brilliant men in Iili.:ini-
with an especial gift for its pursuit-oncLe In ..i -il. 11
genius-but probably most of these men .....il. h.,v,
succeeded equally in almost any vocation ilc I ntl'it
have pursued.
I lay the greatest emphasis, as essential I..r pli, -
sician, upon those qualities that go to r, al.e up*. ;.lihat
we call character. The physician is tru-te,- tr;ii tii:
responsibilities of life and death; he is usu;.irll rl t: ;.-i
and uncontrolled reliance; and certainly, tIn: h r-i .:ii-ilr.
that the layman should look for is unquesnl..1i11 IC chli.r-
acter. Fortunately for mankind, truste..hil:p. in .ll
except the meanest individuals, stimulate tih: 'ciic; .'f
responsibility; and physicians, like other ii:i-i t.f 1.i!,
class, rarely fail to try to live up to their tir.it;
As for responsiveness, tenderness, pit. :,inl thl.-,-
qualities that go to make up the sympatl-ti,; i..:'' .

Page 16

lhm111 k: i .ilJ'l t lilen 1,i r .'l t .ii,1,1 %]i -1 I' lii I. th -_l
III ':uliI i f6ut l Ci : |qiij i[i i. wVilth.I.uti 1'.'i r', nr l..:.Iit ill i.i i
Ct 1_ l i l i I I .L ,, I-. .-1 i , '., ll I T I L l I I.dL

;I ,IJ11 l ] I I1,. i1, I' I ,lI .L I t I l ) .,- i' lll I 1 1 t d i,.A

\'. l, .:-- t.:.- I inll tr ".le i, -,- |. m ;.:]tl ,. t !e ,-,,ti ,,' I. ,
putters busily in efforts of sympathy is usually a weak
one, and I have never seen any one going into medicine
on the basis of his highly sympathetic disposition whom
I considered particularly adapted to it.
General intelligence, I think, covers that intangible
and much discussed quality of personality, so far as it
concerns the physician. The physician should, of
course, be gracious and have poise and sufficient self-
assurance ; but intelligent men, who know wlat they are
doing, usually suffer from no difficulties of this sort.
The ingratiating qualities that are supposed to make
up an agreeable personality, illustrated in the extreme
I,[ the imaginary type of the smooth go-getter after
Il inress in general, have, in my experience, nothing to
J.. '.ith success in the practice of medicine. I know
ihein are shams in medical practice who fool people
'ii,:l make some money (I have never seen such a one

Paoc 17

who seemed satisfied va. it i iii cai reer l.ttI I:.'i Il. thlier
hand, it is amazing hc... a. : iiil':. I the public -u::cee.1
in getting at the truly} .rth-.li il. .l.ct.:.ri Tlihe :nl
quality that seems to ir,: t-:i chiarai':ter .ie he me that i
make worth-while succe-e-' in mi i lii: I tliu r aLilit,
to deliver the goods. Tl- ;\ A i ., Ii, .- r lick -.i
graces. Some of thenrm rti carieriul ii thicii ilemeano:ii.
In dress most of them arre emic,a'I.H i l'it i:r..:nt. Thli
are responsive and the', ar:' bi t r.lu i ct Iih.:, .i ,.
less considerate of th.:-' tliinii. tanii thli:, -lh.i u.iil l ~
Certainly, the man goitn- init. thi p-i '.:ti.:c .-.f mni.liciLic.
judging from my expelir ice f -ucceiL'ul i:tn it.
can feel that he has to maikc :. i: c:inpi.)m n: :,_e. it l'i-
self-respect in cultivaii. :, p :r-:na:ll v hi hli i- ni.t
genuine. He ought to I'e I g'iitlcni:iii niicnaiiiii Li thlit
term one who is honest -in.l Iar. i, r -c.. .i. ll.ra;ti:ll fir- .
others; that is all the Il~i -.:.i tlh tihnt is i c;-es lr\.
Of course, industry j- e-sn:iitil t..i -uicc,-s i in elicine.
as in every other vocal-. It i tii ,: .ive pI.c..vi .-.f
the human machine; ail C c i., iiiachin:, n.1 ii 'tt:i It.ih\','
brilliant or competent in :,crion. i; ..'idIl iarittr r 'hcri n-.t
energized. And mediciri mnk.st- nm:ie th.-ani .r-liiiar-
demands upon indusii .i.lth ph sicil ,ii.l mental

Page 18

it i i-ll \\ l t i l r i ii ie,1i': i ,n1' '. l .i ill i,: li,;I-
- Icil] tlint \'.'i k- ilui',. iiL:i ':li':il .,'1 1 .l.i-- t 'II:i_ i *c'- ..I1I
E:Iii m '.el I l it I -. 1it, '1 Itt I 1 .1 ''lidlem it II c r..
,J .3i III Il-ividit lle. i- it '].'e- i, (I F1 ]it i! hield :.1 I

:n '"e.t'\ ,I'. l, I I l-li,'Jd tl',i[. I :ll'J 111' iiil I i t(lli. I' i,. ill'[

lil C i l\ l> '. [liit [ e lili] ,_,.:- ii t 1i 1 il hlln it :i _:l,. 1t[

blu1t ll 1' Iii ll -i ll l iiid l nu .It.d I1 llil l .ll ll.:I]
th ; al.l ll I ir l: ill i l I ei -'i II' t 11 ll -II- 1 i I
I'1. (11 1 I; iii i .j( l'i, lii I Jll .Ji ; '.ll l ili t I Il ii -1
i- ., I il'' .C d J : ltI. i.. lt ',.,i i::e.:- It _-
I lchl Il 1 ." l | lli t|Io_ l t f j t' l li ll [r 1 ;] .: 1-. 1 [1 l IM I I 1 1. i.-I
tl ,:- !'|,i ,- | t:l li o. l.,tl l ,ll ,t \\ l- [ th t : t .'- l,.l i),.-,li :,l

tr th:n I it _t ._ in i tli cr I., <. ll i .

T h : t ,ir in.. ', :,r . ],' ,,-:tii:,r ...l i" l e l i', e i, I,, :i .1
I 1it. d r. T h,. l- in li ri'tilli le i nIr elil.tit. 1- l) .IIIt f. I
leIlI IL L P, I l io- I., All I lf ll if I.-[ I- p [ _.i ,-! lI
T Ii. hlti .,crn, I l -tal I rd,,r,.] o I" l, Cti c lier I ltIIl:k ;It
it., i ','_ \ 1-.' r.s 0 f I r 1ie-m e,.l0 : ll .,, Ii ,C:I|lle.*e : l':o' r
.,ir- : l i ,l ili,:,:'l : .c, irl. t ili, a't lc.ii ,,i ic : i r
:, I I.- 'l .I l I'.-,1 t ,illin .. I h a t i. --.., '. L I ll ilti,, : ,

I '.. ')

high school instruction. I am stron-1.- -:i 'L.. ...n. ic-
tion that this training is excessive in tl.. .I:;miinJ- in
time and money upon the student antd ih..I "niii.-.'nit -
instruction that it gives him. But the I',r renin'- thit
the young man going into medicine nov niiii r -rl li...r
requirements. The one part of this iroiin '1i 111:,ti .i
possibly be escaped is the hospital y.ar .nil. thlIt I- il,.
part of all others that should not be in i-..l In Ii'i:.
one year is not enough; it ought to i 1. -, .c i-
and-a-half, and two years to two-and- -li .. c .r:r- is n:i
too much for the ambitious man. Fo: ii.iniii'.1. II1
hospital training can be obtained at li il. .-A Ii....-I"j" -
beyond the required time, for hospit'il !iit! i-l- ij.l:i
care of the board and lodging of the iiUr.-lii :ii-. -it ilir
present time, are frequently paying smll i., 'l.l 1i
is in the hospital, or as an assistant to: i .:.. es.ri,. Ii,' i
a student learns the practice of n...!cin.. .I:ill i
practice-and that means also ease iii .r i.:i~c--'rL .
dependent upon training in practi.:- lihir..lih .:l._
apprenticeship. It can no more be d.- ir;-.I 'frt.m I,-..,I;
and lectures than can violin pla ii- .-'. Il.lli:.-iii
Benjamin Franklin said: "If you wainl I:,. lieirn :. I i'-c
apprentice yourself to a master." Th-i i- :I -::1 '11 'l

Page 20

ini -eIl. ii 1.. I I,, 'i : ,l ti.iinhi Iii m .. .'l:inc. The better
ithi Ii:.-'I t.iI or. : i r:'rt r : ii,1 il. l..J.lit I the practitioner
dii~cr .' hIi.in .nc .,:l i ret :hniuI:,I tr'ning, the sounder
In.I m l Ie i..:lli Il,. ll I. th : *:linl.::il -kill.
1 Ie Fir'i .-liui,-'i l raii n. in n,-'lcini, e should be, as far
,1 I".' ,-ill-. .a .n'i,.- r il trir ilv Inot training directed to
..'n e .i:it I n: i- ... in t... 1'l.e up a specialty,
ii.: .. ..rt lir .- ,. "a I I?!liII I .ir'. tr:i iit ri of at least tw o
,':ar- in ;e el,"l i- i eI ''li.:ioie The beginner will
]ir.:.lil.\ I,, .'-e i c I l1 en i thiIre m ore years in
eiIer:il [r:.ri.: either .i lIi x... n :ount or in asso-
-'rIn i a i..l ,'::ir in :i;:1i] practice. If he is
,..in il ii iiti\. I.: .,iillI n.i1t -.pend more than
tI hr t I",; e I'ar: :if hi- '..:ireei in, -ei.,ral w ork.
I'li.:re I. ,i1 co:,ll :I tr n- i tiri.. clir ,y at present for
it t .. *- i ., I *eIci: lle The reciilr i- that competition
ill thi '- l ".:irtIn.. i : 1..1. 1 I.r.: is. on the other
lh-', r *.i t 'e.Il i':ii iIt l ,I -.,iieral practitioners. It
i ; I1.J] v l l I .. %.: l ili :o -l ,. I.::l: into favor. It
:I'l'r iii: i1 ; :i ...n i ] l rat p, ::sibilities for the
., l I; 1 -.i h ... .i n-i iii.nLel I l.r.'il. experiencedd use-
inil pi, .. c :ir- 'It i- -ii..ra ill, ..: tiri e..l that the trained
i'Ir:: ii i I'-,er :' ', I .ll Po -i- it I .,.r cent. of practice.

Page 21

H e can do this i:itl-,ii. t ci-.l.ri'.r.i111i nIi ; *- _ii lf -
respect in his insi-tei .:r: ipI.-i.i l Il :iiin ..ur, .I.i cxccd-
lence in his work.
If one is go i iiu- ,1 .:-llli l cr:- in..-. 1', i 1
opinion, two satiFs fct.: r, \i'.- 1 :.i ...I: it: im. i -
obtaining an interniihil. ii the dlci lr-.dl .c. irl -: i ....
either in a general l-']..i., '.i i-.ir a i. :1l ir:i l
devoted to this p,.rti,: l.ln I[r" 11, ti, :itlin 1 is t:, W .i- :.i>- C
associated with a ri:.'iter I, tliit el;.1 :11 in,: *.: TI,.
best m ethod of pirelI r I- : -] ,.:,.il, iv i:i i 'l.,., l
these forms of tr'um;tr'
One compensatrii fi:,.-t t.. offr'-t rth. c.:;ricliir c-f tih
long period of pr'.Iniiiii ir i tr iiil:, iIn iir.ne h: i_ irit
there is not now an-iuIll\v the li: i I time o:f x.'11nIi.; li:.
practice which vx. f':1rn ,:rl s -'. : hlW.iti iii.,.:. .,ai
active dem and e: .i:t, f... IIt ;lli.<.int y.-.:.l I.li -i..i.i n
who have had a ,...--..I i.- it; I tr:ii n: Ti-,. i 'i .-.t
go immediately int.-. -.il -.tin ii'in:. I:iit ira' tice
but even here wo l i. .,n ii.- in -ic : quic lil, tlian ii i:r rl,-li
to the young mani '.J i, c i.'iIhl ifn :inri l P.rrictce.
A nd there is a greit .:le:'iii. f,.r:ni rli n:.i.i-e> i..i it. li:r
well-trained youn. [.h: -i'.iii: ., 8.i: iit., t.:t[ il i ':l'en-
eral practitioners w.] t.: .-i ld:it& 1t i r,.-,li 'oimi

Page 22

Ilk.n ian, lu.l 1,, Ili.i .l' -- ii.. tin, positions that offer
:i'lln:ortii[ty fo:r ei-n.fla:i their experience and that
are *.lJrectl ,i1 in i: r th. ..ke.cLijpinent of independent
c.i'el .\: I lhai'c al' :i I. l lidicted, these assistant-
zhip-, in iy opinion,. :lt' thl: Ihct opportunities for
ronLlinI lnll t lii' Ir;liiiii .1i- ell as being the best
.*''i.1lu c ii ,llllr.'in C 1- .1 .i i; .

I in-;:.inc :uli '*.- I-..1I alc,-i ii.-l the foregoing that
I i.:ar.i in.,ln.ni: a; I -,: d .:jr..r. I do. I think it
1- .:rrth the ei :lrli re'iiine.I I the long period of

i.:lriir : in f:.it i .iii ilnclin.l to: paraphrase Sidney
Sin'li'- renmarl; .ilii. thle -r',vr.lic ly, to the effect that
I.untl l;- I.ir-,1 nii-liTl lak:.'i i;l better man than a
'., .l Ic .-.1 : i1t 1 1i i,:i iiii : lie it r c i- did.

'o ,

:. ,
..' ,. o'

P'aqe 23



1~ 111


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Due Returned

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3 1262 00140 7245




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