Opening Address by KENT O. FOLTZ, M. D.
The question of what kind of education the modern doctor should receive has agitated the minds of the medical fraternity for years, but the discussion has been confined almost exclusively to the medical curriculum. The preliminary instruction, for the most part, has been ignored. Yet this is much more important. Without a liberal education before the branches of Medical Science are taken up, only mediocre results can be obtained.
Let us briefly glance at the requirements of some of the medical colleges of our country:
"Applicants for admission to the college must bring certificates of good moral character." This clause we find in all the announcements, and of course we may presume it to be rigidly enforced.
One institution, which if it is not scientific is nothing, as shown by the emphasis on the word "regular" states further: "and must give evidence of at least a good English education, including mathematics and the elementary principles of physics." In my ignorance I supposed mathematics and physics were included in all educational institutions, no matter what language was taught; but it seems these two branches are simply accomplishments, and are usually omitted from the regular course of instruction.
This inference, so far at least as regards the educational attainments of many of our scientific brethren, seems to be correct.
Another circular makes it a little stronger, saying "Applicants are required to give evidence of possessing a good English education."
A very noted school trots up to the mark with the following euphonious announcement: "Some of the States have recently enacted laws, by the requirements of which students not provided with literary degrees, or other certificates of scholarship necessary to the study of medicine, must undergo an examination before a State Board in the subjects of such preliminary study, as a prerequisite for a license to practice medicine within their borders. That the graduates of this college may be spared the trouble incident to compliance with these regulations, all students intending to engage in practice in those States and such others as may desire it, will have the opportunity of undergoing such an examination before a committee of the Faculty, and will receive a certificate therefor."
Another school tacks the foregoing to the following statement: "It is assumed that perceptors sending students to the college have satisfied themselves that their pupils have received proper preliminary education, and the college does not require a matriculating examination."
"A fair English Education" is a common expression and I suppose comprises "the three Rs."
Such requirements would be all very well if they were enforced, but the experience of the most of physicians is, that they only appear in the annual announcement, and beyond a few questions, which any school-boy of ten years should answer, are like many of our statutes, practically dead-letters on the books.
In no vocation is a liberal education so necessary for success as in the medical profession.
By a liberal education I mean all that the term liberal implies; not simply a "fair English education" but a knowledge of the natural sciences, arts, etc.
By success I do not mean simply the acquisition of wealth, although this is usually no objection, but that expertness in curing the sick or warding off disease which we are all striving for.
The practice of medicine does not consist entirely in the giving of physic. In fact this is of minor importance in the majority of cases; for nine out of ten will get well without any medication whatever, and the tenth one will in all probability die easier without medicine than with it.
The physician is supposed to know everything, from the name of the latest discovered bacterium, to that of the eminent medical gentleman who presided at the birth of Abel. To confess ignorance on any subject which may be brought up, would be a step downward in the scale of respect of our self-appointed inquisitor.
A liberal education is an aid in many ways, but is only obtained by hard and diligent study on the part of the individual.
Some poor citizen wishes to know whether his water-supply is potable or not, and being unable to pay a competent chemist; and knowing also the unreliabity of "Boards of Health"—maybe by bitter experience—he goes to his family physician and wants to know of him whether the water is fit for household use—it does not require an expert chemist to determine whether water is potable or not.
A plant is held in high esteem for curing some or all ailments, and is carried to the medical attendant for identification. Here a knowledge of Botany is useful. I might extend the list but it is useless.
A new novel is the rage and the opinion of the doctor is sought, and usually carries considerable influence.
In fact the modern physician should be versed on all the current topics of the day, as well as possess some knowledge of the sciences, manufactures, arts, etc.
A liberal education does not necessarily imply a collegiate course, but it does mean a correlation of the mental faculties with the senses; in other words, cultivation not only of the senses to the highest degree attainable in each person, but also the perceptive and reflective faculties, continuity, without which no one can succeed, and also comparison. These four are essential elements in the success of every one, and should be studiously cultivated, and it is not necessary to attend college for their improvement.
All the mental faculties, however, are important factors in the struggle for eminence and are the distinguishing marks which makes man a reasoning animal.
The doctor who is orthodox in medicine is also bigoted in all his views, consequently is unfit for his high calling.
Boards of Health and laws regulating the practice of medicine are annually being called for; ostensibly for the protection of the "dear people." Is this the true reason for the clamor ?
Who is it that raises the hue and cry? Not the "dear people" by any means. Nor is it for their welfare that the demand is made, but for the protection of our very regular brethren who lack the energy and often the ability to progress.
The priesthood for ages would not allow the people to be educated. Why? Because their positions as dictators depended upon the ignorance and superstition of the masses.
The sectarian physician as he sees his following lessening, and the cemeteries growing plethoric through his mal-practice, sends up a howl for protection; in a manner similar to the priesthood, when they denounced the printing press as an invention of the devil.
The regular doctor talks learnedly of bacilli, zymes and phytes, and proclaims to the world: "I am the only scientific doctor."
The art of printing has lessened the power of the priesthood, and every one has the chance of investigating for himself. The feudal days are past when the man on horseback ruled the country. The invention of gunpowder and the printing press put his henchman on the same footing, and the feudal lord had to come down.
The Dark Ages of Medicine, when incantations, sorcery, blood-letting and poisonous doses of nauseous drugs prevailed, have about disappeared and a brighter era is dawning.
Liberally educated physicians are using drugs in medicinal doses, for direct effects, and the terrors of medication as a result are lessened.
Of this class of doctors the Irishman's soliloquy no longer holds true "Be gorra! after a short sickness it took me six weeks to get well of the medicine I took."
When the physician has received his diploma, he must not think that his medical education is completed, for he has only as yet learned the alphabet. The future is before him, and it rests with him whether it shall prove a benefit or a curse to the community in which he makes his residence.
The doctor must not, and the liberally-educated will not, think that he can get along by simply reading his text-books and the occasional "sample copy" of a medical journal sent him. He should take, and carefully read, not only the best medical journals but also one or two good literary and scientific periodicals.
When I say carefully read, I mean understandingly. It does not require a man of brains to read Darwin, Haeckel, Gray, Carpenter, Howe, Scudder, Goss or John King, but it does require study, and intelligent study at that, to understand and be able to use the knowledge therein contained.
It is a common occurrence to hear a physician say: "If I had had the chance that Brown had, I would have been equally as successful." I deny it. In this country of free schools, free libraries and cheap literature one person's advantages are as good as anothers, and the use made of them lies entirely with the individual.
If he sits down and builds air-castles, or wishes he knew as much as Smith, or was as rich as Jones, what can you expect? Nothing above mediocrity at the best. However if he says: "I am not going to allow any man of equal ability to surpass me;"—employing his leisure moments usefully, the chances are, that he will attain a higher eminence than those of more brilliant mental powers who have not the same incentive.
The race is not always won by the fleetest. Those who study understandingly are on the vantage-ground in the struggle for superiority, and here is where a liberal education places the physician in the front ranks, not only of his profession, but also of the community in which he lives.
The way to elevate the standard of the profession is not by legislative measures, but by the efforts of individual physicians.
Let each doctor, when an applicant for medical instruction presents himself, ask the question mentally: Is the applicant the kind of a person I would wish my family or friends to employ? Am I willing to have it known that he is a student of mine? If both questions can be answered in the affirmative, then careful enquiries as to the person's fitness for the profession should be made, and also whether the arduous duties pertaining to the calling are fully understood. If the answers are not satisfactory the best rule would be, always to discourage the aspirant at once from entering the profession.
The life of the physician is not composed of sunshine and roses without thorns, and many persons enter the field with very vague ideas of the bitter struggle that is before them. They are dazzled by the handsome turn-out of some successful M. D., but do not think of the years of earnest, persevering labor, that have been passed through before such results were obtained.
The demand everywhere is for intelligent physicians, and for such a wide field of usefullness is open, but it must be remembered that intelligent men are what they are, through earnest and close application.
Success in any calling is only attained through thorough and hard work. It has been said that "there is no royal road to wealth;" it can be more truly said that there is no easy road to distinction.
Remember, in our profession as in all other vocations, the bottom-rungs of the ladder are crowded—overflowing in fact; but at the top there is plenty of room, and those who get there do so only by being liberally educated, liberal in all their views as necessarily they must be, and above all, liberal in their medical opinions, which position alone can place them on the broad platform of Eclecticism.
Why Physicians Should Be Liberally Educated.
BY DR. HENRIETTA K. MORRIS.
What does Liberal Education really mean? Hardly free in the sense of being abundant, unrestricted, independent, or possibly heterodox, as we may have learned the definition. It is taken from the word liber, in the idea of being free by virtue of intelligence. The truth makes free; knowledge is power. A liberal education is a book-education, instruction in literature and the liberal arts, a training in those pursuits which place mental improvement in the foreground. Such considerations as the getting of a subsistence by means of such learning place it on the plane of a trade, mercantile pursuit or handicraft; divesting it of intellectual character and sinking it into a vulgar materialism. A liberal education is therefore a broad culture, as well as thorough instruction.
A physician ought certainly to be and know all which that means. He or she can afford to be ignorant of nothing. The fault, too often found with the medical profession, is that many of its members know books and literature too little for purposes of social and professional culture. Yet I would consider this matter itself with no exclusive sentiment, but broadly and intelligently. A physician who has little knowledge or familiarity with books and culture is certainly not as liberally educated as he ought to be; nevertheless, the one who has little conception of knowledge except which he derives from books is far less educated. There is a knowing of the world around us, a capacity of dealing with things as we find them, an intelligent appreciating of every person and experience at the proper value, that infinitely surpasses any measured, conventional, or prescriptive attainment in the mode of learning.
To be educated is to be developed, cultured, perfected. So, to be liberally educated is to be enlarged in scope of mental vision, to be broadened, elevated and made complete and thorough in what the individual should be. Whether this ought to be the case with the physician is hardly a question to argue. It proves itself. If the members of our own School of Medicine would give more attention to these matters, and less to the shortcomings of their rivals, we would have less difficulty to attain our rank and place. The learned, refined and cultured exalt those who are allied to them, whereas the unlettered, the coarse and low-minded are clogs and weights to drag their betters down.
To my sisters in the medical profession, let me add a word: Discipline yourselves thoroughly to be womanly; be practical, self-reliant and self-possessed. If, then, any narrow, exclusive, half-educated, ill-cultured person, being a male, does not extend to you respectful courtesy and the right hand of fellowship, you will be by virtue of your breadth and liberality of your education above and beyond any disquiet. You will leave the slight unnoticed, and go on your own way intrepidly. If you are thoroughly educated, you must be liberal, and so broad enough to realise that all physicians, and all schools of physicians, have intrinsically equal rights to treat the sick and bind up the maimed. So far from resenting a slight, you will be exalted sublimely above the consciousness that any has been offered.
A broad, abundant and liberal education implies culture and refinement on a higher altitude. A classical education is a valuable auxiliary to the attainment, and a physician cannot afford to be without it. He always carries weight and encounters obstacles that the others escape. The higher the culture the greater the capacity to be useful, and to win as well as deserve confidence.
DR. HOWE.—There is no limit to our education. All can have a liberal education. What standard is there? As I went along I ran against many obstacles, and either climbed over, went under, through or around them. I would advise all young men to do the same. Medical lexicons, however, do not contain all the words that we meet in medical parlance. However, flee to your lexicons, your Latin and Greek ones, and master everything that you butt against, and do all the good that you can. In order to get an education, begin to be a student, and at once to study. What I learned thirty years ago helps me now. At the close he will have a liberal education. The more Latin and Greek he knows, the sooner he will learn medicine.
Transactions of the National Eclectic Medical Association, Vol. XVI, 1888-89, edited by Alexander Wilder.