Jefferson Medical College - Clinic Yearbook (Philadelphia, PA)

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But through the efforts of Medical Science the mortality, in childhood, has been enormously reduced. A generation ago, in the particular class of cases on which 'I have been working nearly ninety per cent of the children died. Of course, we all know that a full one hundred per cent of recovery from any kind of serious illness is an impossibilityg that also is an abstract truth, nevertheless I have always striven for that one hundred per cent. It has not been attainedg but we have for many years past, been up to ninety-eight per cent, in our department. But I am still carrying a Banner with the strange device, save 100 per cent of the Kiddiesf' The field in which I am working is a very narrow one. If in this narrow field, Philadelphia has come to be regarded as the leading center in the world, it is due, not to any direct effort of mine to make it so, but fundamentally, to that thoroughness in which as Mr. Bok has truly said, we as a nation, fall short. But now I am becoming pharisaicalg I am even beginning to boast. It is time for me to stop speaking lest I become bombastic. Mere words are inadequate to express my appreciation of this award. To the Honorable Vice President of the United States, To His Honor Mayor Kendrick, To the Ladies and Gentlemen who have honored us all by attendance tonight. To the Philadelphians who probably have suggested my name for con- sideration bythe Board of Trustees, To the members of the Board who have deemed me worthy and especially, to the Founder of this great Institution, -to all of these I can only say, I thank you. Page Ninely

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if only I could have nad him to work beside me in my experimental shop, what wonders we could have accomplished together! To him I owe another thing, As a cabin boy Captain Fairbanks gave him the key to the locker where the liquor was kept, because he did not drink. That worthiness of trust because of abstinence. from liquor sank ineradicably into my youthful mind, and fired me with an ambition for trustworthiness. In after life, hundreds of times, yes thousands of times, when a mother has laid her child on the operating table in absolute trust in me, it has been a great consolation to me to feel that what- ever else I might lack, I could at least command the clear eye and the steady hand that total abstinence can give. Another who would agree with the Board of trustees, if she were here, would be my Mother. No one will ever know the sacrifices she made for me. To her fondness for Medical Science I owe an incentive that has never wavered. Still another would have been my father, long since dead. To his oft-repeated advice, Educate the eye and the fingers I owe the manual training that has been an essential. To his advice: Educate the 'lame duck,' I owe such degree of ambidexterity as I possess. News of this award has come upon me so suddenly that I have not had time to analyze the matter sufficiently to tell you just how it happened. I have given you the hereditary background. It seems to me, however, that what little I have been able to accomplish affords one more example of the cardinal truth enunciated by Mr. Bok, about Thoroughness as a factor in success. Possibly I inherited my thoroughness from my Knickerbocker grandmother. As I did that initial yelling thoroughly, just so I have since done everything as thoroughly as I could do it. As with Mr. Bok, himself, merely good enough was never good enough for meg though I had never formulated the thought as he has formulated it, in his forceful way. Throughout my whole adult life, every' moment of my time, every spark of energy that I could command, or commandeer, has been devoted to saving chil- dren whose lives were imperiled in such a peculiar way that to save them re- quired the recognition and solution of an interminable succession of new and difficult problems. It so happened that by heredity and unknowingly, by early training, I was to an unusual degree, equipped for devising means for the safe solution of these life-saving problems. No high order of intellect was required, the problems were fundamentally mechanical. What was needed above all things was painstaking thoroughness in the working out of innumerable, minute, mechanical details. It has taken twenty-two years to master the safety-ping and I am so constituted that I am not yet satisfied that the mastery is complete. Physicians realize, as an abstract truth, that it is perfectly natural to die. Page Eigbly-nine

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The Psychology of the Sick Man PRESIDENTIAL ADDRESS, AMERICAN SURGICAL ASSOCIATION, MAY 24, 19264: By JOHN H. GIBBON, M.D. or PHILADELPHIA, PA. N CI-IOOSING for my subject the Psychology of the Sick Man, I propose to avail myself of one of the privileges of the ofiice and indulge in broad philosophical wanderings over the realm of medicine as some of my predecessors have done, and I think to advantage. I should first like to offer as a proposition that the advancement of the art of surgery will not come with the invasion of new anatomic fIelds nor with the further perfection of technic, except in the field of anaesthesia, but will come with increased knowledge of the cause and prevention of disease, with the improvement in diagnostic methods, with the exercise of better surgical judgment and with a broader knowledge of general medicine. This may prove a poor prophesy, but you will agree that the sources from which I have indicated advancement might come, certainly represent fields in which we particularly need to work. , ' It is a trite statement that the more a surgeon knows of general medicine the wiser surgeon he is, but with our present-day methods of education and the arrangement of our interne services and apprenticeships, the foundation on which the young surgeon has to build, is too narrow. It would be far better for the young man if he could forget during this preparatory period that he is to become a surgeon and devote himself to the acquire- ment of as broad a knowledge of medicine as possible. It must be understood at the outset that I am looking on surgery as an art and the man who practices it as one upon whom his fellow-man can call in time of need and expect to find a practical man possess- ing not only knowledge but wisdom. Who of us if sick would choose as his physician a scientist? Who would not choose the man best versed in the art of medicine, one who utilizes all that science can give him and who is capable of applying his knowledge in a practical way and who has had a broad experience in the practice of his art? I would not be understood to decry scientific research since modern surgery owes to it its being, but the scientist is a poor physician largely because cf his limited field of vision and experience. It is of the psychology of the patient, however, that I want to speak at some length, as I believe it is a matter to which the average surgeon pays little attention and this little subconsciously. It is not exactly a neglected subject, for instance, much of the good to be derived from Crile's anoci-association is due to the consideration given to the mental state of the patient. Every surgeon needs to consider the patient's attitude toward his ailment, and should be able to distinguish to a certain extent the imaginary from the real symptoms. He should know how to help the patient rid himself of those which are not real and also how to avoid inspiring or augmenting them. The layman today likes to think he knows something about disease and its treat- ment and is very apt to think he is in a position to decide the type of treatment which 'l' Reprint from Annalx of Surgery, August, 1926. Page Ninely-one