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blame. So he goes on, in the even tenor of his way, performing his duties in good faith, until the expiration of his term of service when he receives due acknowledgment of his labors in the form of a diploma from the Medical Board and from the trustees or from lay governors of the institution, and at length becomes a candidate for the private practice of medicine. The moral lessons, the wise methods, and the good example of his teachers of the medical school and of the hospital will naturally lead him to enter upon his new professional duties with true scientific spirit for the weal of mankind. May he therefore ever bear in mind that virtue, knowledge, health, and activity are the primal sources of felicity of the student and physician; that moral rectitude, untiring industry, natural aptitude, and quick perceptions are the highest attributes of the genuine student and physician; and that the advancement of science, justice tempered with mercy and generosity, fidelity to duty, hope of lasting usefulness, and charity toward humanity are the noblest aspirations of the true physician.
THE YOUNG PRACTISING PHYSICIAN
Requisites to professional success-The early years of medical practice-The acquirement of a clientage-The labors, anxieties, responsibilities of the physician in full practice-The growth of a physician's library-His equipment in medical implements His iatrium-His obligations to the profession -When to begin writing for publication-Avoidance of controversy-The review of medical books-The question of specialism The evil of self-sufficiency-The physician in politics.
BEGINNERS often ask-What are the requisites to professional and pecuniary success?
These requisites may be summed up as follows: superior mental equipment, close observation of human nature, kindness, gentleness, prudence, patience, industry, energy, determination, tact, assiduous attention and devotion to sufferers, ability in diagnosis, skill in treatment, caution in prognostications, economy, the cultivation of goodfellowship in and out of medical circles, and a reasonable time given to social duties.
Among his earliest acts, the young graduate should join the medical society of his county. He would thus come in close contact with his professional brethren and the attrition would surely be salutary. At the first meeting, he should be a silent listener, observer and learner. Later on, when becoming to him to take part in discussions, he
would know then how desirable it is to be brief, clear, and pointed in speech and resist the temptation to wander from the main question, having witnessed how tedious, tiresome, and annoying the ubiquitous garrulous member becomes in his wordy ramblings; occupying so much of the time that would be better filled by others, and consequently being voted a bore; while the pleasing speaker expresses in the fewest well chosen words, the views which he desires to convey to his auditors.
Whether the young graduate have or have not served as hospital-interne, his clients will acknowledge his services strictly in accordance with their character and success. His devotion to the further study of the healing art, his developing skill, his powers of observation, his contributions of lore to medical societies, and his moral principles, will determine his standing in and out of the profession.
His worldly intercourse will exert upon him the greatest influence throughout his career. Therefore he cannot be too solicitous of the habits of his acquaintances or too cautious in forming intimacies, for he will be judged by the character of his close associates. The good people with whom he has official relations, those whose frequentation he cultivates, his early friends, will all be helpful to him in the near and distant future, provided his conduct toward them has been always fair, just, generous, and honorable. His chief guiding principles should be equity and reciprocity, and he should keep in mind these few ancient adages and always act in accord with their teaching:
"In behavior be thou always civil, polite, kind; without show of condescension or patronage."
"Let thy manner be dignified, without pride." "Have no intimate friends not equal to thyself." "Cultivate the friendship of the learned and virtuous.”
"Love all, trust a few, do wrong to none."
'Be able for thine enemy rather in power than use." "Keep thy friend under thy own life's key." "Be check'd for silence, but never tax'd for speech." "Only in the faithful service of God, country, mankind, letters, science and art, wilt thou find true happiness."
He should treasure in his mind, also, that justice inspires respect, mercy begets honor, generosity engenders good will, kindness enkindles friendliness, sincerity assures trust, charity breeds gratitude, and industry prompts. reward.
He should avoid being drawn into the trap so often set, to catch the innocent and confiding garrulous neophyte, by certain gossiping flatterers who will encourage him to speak much of himself and of his deeds, only to repeat and exaggerate such speech to his detriment. He should always be on his guard with those mischief-makers who also by flattery endeavor to lead him to severe criticism of men to whom his words and many additions of their own are to be detailed; and remember that conversations about things are always harmless and less tedious than reflections on persons. At no time or place should he speak of a colleague or lay acquaintance unless he have occasion to do so in praise. Censorship is generally a fruitless and
thankless office. He should not "talk shop" in polite society or even to professional associates out of the sick room or of private medical conference. He should not, on any occasion, speak lightly of a colleague's treatment of patients, particularly in cases of broken bones. A word or a look of disapproval in such instances has proved extremely injurious to the physician in charge and has led to burdensome litigation with much loss of time and reputation besides, too often, the imposition of heavy damages on the innocent, for, as is so well known, non-union or illunion of fractured bones is the fault of the patient in the vast majorities of cases.
As a general rule, during the first few years of his practice, the beginner has an abundance of spare time for study and for the care of poor patients in some dispensary, and thus be in a position to gain the experience needed for his future guidance in private practice, and at length fit him to take the desirable and honorable position of visiting-physician to a hospital. He should give himself no concern as to when or whence might come his first remunerative client so likely to appear when and whence least expected. With laudable pride he would then inscribe that client's number, name, and date of first visit in bold letters in the neatest of note books at the head of a full and carefully written history of the case, and there also record the amount of the fee, and the expressions of gratitude for the service rendered. In the successful management of the case, the devotion, gentleness, and skill of the resourceful young physician doubtless won for him the