Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

Page 27 text:

DR. PICKRELL DR. GLExN DR. Onoxt emergency, and his powers of diagnosis and of decision may be blunted. These facts of life distinguish a surgeon from his medical colleagues. Indeed, in some localities, the lament is how to get the surgeon into the laboratory and how to get the internist back with the patient! The surgeon must keep one foot in the laboratory, for he alone can apply the discoveries in the biologic sciences in practical form to a surgical problem which the basic scientist has difhculty in understanding. It is this ability of the surgeon to seize upon the advances in the natural sciences and take them into his own labora- tory to test and apply to his own problems that has re- sulted in the phenomenal advances in surgery in recent years. Students must accept these facts. Learning to become a surgeon takes time. It requires thorough knowledge of the basic sciences, and understanding of the natural history of disease processes, and an ability to apply all of the newer knowledge in the natural sciences to surgical problems. It also requires knowledge of opera- tive procedures and manual dexterity and technical skill. The latter, though important, is subordinate to the former, and is learned during the period of postgraduate training. The former takes the longest to learn, indeed, its learning is a lifetime process. CLARENCE E. GARDNER, IR. Chairman of thc' Department DR, GREGG DR. STEPIIEN DR. AxnERsox tufenzy-zf11'fc'

Page 26 text:

SURGERY Surgery applies the basic knowledge of the biologic sciences to the art of healing through an operative pro- cedure. The proper performance of the operation, with gentleness and dispatch and with strict attention to the principles of wound healing and to the altered physiology of the structures repaired, is essential. But the surgeon must first be a basic scientist and a physician. Ambrose Pare was one of the first to emphasize that knowledge other than of the technique of the operation was necessary for the surgeon, when, in closing his case reports, he frequently stated, 'Al dressed him but God healed him. Probably one of Iohn Hunter's greatest contributions to Surgery was his observation that the surgeon has no power to repair directly any injury and he must in all humility acknowledge that it is the pre- rogative of Nature to repair the waste of any structure. He must thus realize that it is his chief duty to under- stand and remove the impediments which thwart the efforts of Nature and thus, enable her to restore the parts to their normal condition. Advances in our understanding of the laws of Na- ture have been tremendous in recent years. It has been properly said that more has been added to the fund of human knowledge in the natural sciences in the past generation than had been amassed before in the whole history of mankind. This being the case, a surgeon must be constantly on the alert, as Lister was when he seized on Pasteur's discoveries, to apply this newer knowledge to his profession. Surgery is a very personal branch of the healing Art. The surgeon must establish a close relationship with the patient as he develops his diagnosis and prepares his V DR. GARDNER patient for the ordeal of surgery. He performs the opera- tion himself-and this consumes time and energy. After- wards, it is his responsibility to watch closely over the reparatory processes. This demands a continuing respon- sibility and a close association between doctor and patient which does not allow the surgeon to retire into his lab- oratory for long periods of uninterrupted study. If he does, he loses his operative dexterity or his zeal to leave a warm bed in the middle of the night to minister to an DR. BAKER DR. HUDSON DR. SEALY ZbUEHly'IWO

Page 28 text:

PEDIATRICS Pediatrics has been dehned as the study of the growth and development of the child from the moment of con- ception through adolescence, and the science and art of the prevention, diagnosis, and treatment of all diseases from the moment of birth through adolescence, whether these disturbances be on a physical, emotional, or mental basis. It is a profound concern with, and an abiding in- terest in everything that goes to make the final product -the healthy adult ready to assume his position in lifef' This definition indicates the broadened horizons of this specialty which, when it was founded about the turn of the century, was designed primarily to help children through the hazards of acute diseases such as dysentery which claimed so many young lives. Mere survival through infancy and childhood at that time was, in itself, a sufficient achievement. However, as these acute prob- lems were met and solved fat least in the developed countriesj the scope of pediatrics has expanded. New and fascinating areas of study have been explored and applied to our central focus,-the growing child. These trends have added to 'Lgeneral pediatrics, a number of pediatric subspecialties such as cardiology, hematology, endocrinology, allergy, infectious disease, and a host of others. Many of these are already represented within our own Department of Pediatrics and more of them will be added in the years to come with the natural growth and expansion of the Department. In addition, these broad- ening goals of Pediatrics have encouraged pediatricians into interdisciplinary cooperation with a number of other helds of human endeavor. Thus pediatrics, already in- volved in biochemistry and preventive medicine for ex- ample, must join forces with genetics, for this governs the directions and potentialities of development, with DR. H.ARRIS obstetrics, in a cooperative endeavor to understand the effect of prenatal events on the nature and later course of the infant, and with psychiatry, better to understand the psychological development of the child. The need to develop areas within pediatrics and with other dis- ciplines in order to achieve pediatric goals has led this past year to a new joint endeavor between the Depart- ments of Pediatrics and Psychiatry in a training program to enable pediatricians and medical students to function more effectively in recognizing, planning for, and deal- ing with the emotional aspects of childhood growth and development, the emotional impact of childhood illness on the family, and the emotional crises of children which have psychopathological significance. To this end, a team of pediatric psychiatrists Qqualified both in pedi- atrics and psychiatryj, a psychologist interested in mental and emotional development, and a social worker sim- fC0nzinued on page 1342 DR. SIDBURY DR. DEES DR. STEIXIPFEL twenty-four