New York Medical College - Fleuroscope Yearbook (Valhalla, NY)

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UNFINISHED sYMPHoNY BY WILLIAM L. EINHORN FOREW ORD YOU doctors of such vast experience would do well to reflect back upon the visit to your first patient. Perhaps then you will realize that, on the whole, your actions were quite' similar to those of this particular student . . . entirely excusable and attributable to a high degree of exhaltation associated with the realization of a goal within reach .... , Exactly seven days had passed since this student had completed the di- dactic part of his course in Physical Diagnosis . . . Seven-thirty, A. M. finds him freezing in the waiting room of the Municipal Ferry . . . decides it would be rather unprofessional to visit his first patient that early, so endeavors to make himself comfortable . . . He realizes that for the first time in some twenty-odd years, he has no books about his person. CED.-NOTE-Uribe lievablel which fact tends to make him disregard the hard bench . . . Glancing down at his overcoat pocket he notices the bright glare of stethoscope ear- pieces, so carefully fixed that but a wee bit protrudes, but enough, mind you, so that there can be no mistake as to the contents of that pocket. This fact ten-ds to make him disregard the cold . . . Carefully, he pulls his jacket to one side in order to make certain that thermometer and flashlight are well to the mesial side of his upper right vest pocket .... He rises, places his hand into his trouser pocket, and being assured that this maneuver will positively reveal the T and F, he buttons his coat and sits down ..,. by this time he closely ap- proximates satisfaction ....' N 'ow he decides to quickly scan over the ques- tions he was told to ask his patient CED.-NOTE-what's the use, he'll never re- member theml .... Finishing this, he has about three or four cigarettes, and then boards the ferry .... Arriving at the Island he takes a few deliberate steps towards the nearest building but stops short, removes his hat, an-d scatch- es his head, for it has just dawned upon him that the particular destination he had decided upon was only one of many buildings of a similiar kind .... Pushing the stethoscope way down and out of sight, he turns up his coat collar and walks back to the ticket collector KNOTE-he's playing the part of an or- dinary visitor now-how embarrassingl, and inquires as to the whereabouts of the ward he had been assigned to .... Having been satisfactorily directed, he turns down the collar of his coat, brings up the stethoscope and continues on his way .... If you are interested-any third year student is qualified to further en- lighten you. One hundred ninety-eight

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model of how much good a group of women can accomplish in helping a less fortunate group of people. Not only have they given of their money but more important, their time. This brilliant, intelligent and sympathetic group of wo- men have given aid not only for the small necessities which are so necessary for the comfort of the patient, but have taken part in the development of the technical necessities, X-ray and bacteriological laboratories, and most import- ant, a social service department whose work, in my opinion, is better than in any other municipal hospital. This same group of women un-derstand the im- portance of education and have helped equally in the educational program of both nurses and physicians. The Department of Tuberculosis was certainly most fortunate in having this wonderful group of women to stimulate the staff to better and better work. Soon after the organization of the Department of Tuberculosis the medical staff was invited to teach tuberculosis to the undergraduate third and fourth year students of the New York Medical College and Flower Hospital. This association with the College has contributed much to the service. Nothing im' proves a medical service more than teaching. Students stimulate the teach- ers to keep abreast of advances in medicine. The staff becomes keener and the patients derive the benefit of the increased knowledge of medicine. The medical staff of the West Pavilion have been proud of the men who have passed through their department. They appreciate the interest and ef- forts of the students. Students rarely are aware of the sense of satisfaction the instructors have when they hear how well the boys and girls have served at other hospitals. The students of Flower have contributed more to the reputa- tion of the Department of Tuberculosis than any other source. They have brought and demonstrated the experience of the staff to hundreds of other medi- cal institutions. The medical staff is appreciative of their service in spreading the good reputation of the West Pavillion throughout the country. This West Pavilion has contributed much to the modern knowledge of tuberculosis. Year after year treatises on tuberculosis have come from this service and it is my opinion that the West Pavilion has been responsible for more stimulating discussions on pulmonary tuberculosis than any other similir institution. West Pavilion is really the mother of Sea View Hospital, for only five years ago the Commissioner of Hospitals persuaded and commissioned the medical staff to undertake the reorganization of what is probably the largest tuberculosis service in the United States. The success of Sea View Hospital is the success of the West Pavilion. You students now graduating I am sure will all have fond memories of the West Pavilion, the pavilion of the stethoscope. I am sure you will always re- member breath sounds. Pitch-yes, pitch-you will never forget. You will remember the chronic diseases the staff discussed with you. Some of these concepts may change, and the staff hopes you will always keep abreast of the modern concepts of disease. Most important, the staff hopes you will have a liberal attitude and an open mind in medicine, and that you will remember that horse sense has more to do with making a good -doctor than any other qual- ity. The staff bids you goodbye with good wishes for a happy and successful career in medicine. Always look upon the beloved West Pavilion as a healer and teacher. The West Pavilion will always be happy to have you visit her again. 'Now the Chronic Research Hospital One hundred ninety seven

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HEAALTI-IY SKEPTICISM BY JOHN ABAJIAN, 112. THE purpose of this paper is to consider briefly some technical difficulties which are inherent in investigations pertaining to medicine and its allied sciences. One is profoundly impressed with the deluge of literature concern- ing scientific investigations in all branches of medicine. On closer examina- tion of various articles in different journals, apparently diametrically opposed results and conclusons, pertaining to the same subject, often leaves one in Wonderment as to the accuracy of these different papers and conclusions. Therefore, in order that one may avoid the acceptance of scientifically unsound results and theories in his ordinary routine of medical reading, it is necessary to acquaint oneself with some of the loopholes and fundamental Weaknesses which are present in a goodly proportion of the medical writings of today. It is essential to realize that we can seldom attain the simplification of rela- tions which is possible to the physicist or the pure chemist, who has his ma- terial so well under control that he can carry out a crucial experiment so that with proper care his particular results can be repeated at the next trial either by himself or by some other Worker. However, in the fields of experimental physiology, biochemistry, infection immunity and the like such precision is be- yond our reach: and the only hope of immediate progress is to realize the limitations under which our investigations are carried out, and to make due allowances for the various sources of error. The first of these technical difficulties to be discussed is the consideration of just exactly how quantitative our methods of quantitative analysis of blood, urine, body metabolism etc. are? In consideration of this point one must realize that the personnel of the average hospital laboratory is made up of technicians who are forced to do not only all descriptions of Work, from serology to fine micro-analytical determinations, but also work on a basis of mass pro- duction. With all due respect to the excellent and conscientious laboratory technicians, they are as a rule without training in the purely theoretical as- pects of quantitative chemistry, which of course makes them more susceptible to the pitfalls of quantitative analysis. Another point to consider is the usual type or method of analysis, this being the colorimetric method which is more of- ten not specific in the chemical sense and open to greater limits of error. The above points are sufficient for thought, to say nothing of the much too frequent absence of routine duplicate analysis. The Writer recalls one instance in which the same specimen of blood was sent to three different hospitals labora- tories as a check on present day methods of routine cholesterol determinations and was only mildly surprised to find as much as 25 to 5O'hv differences in the reports. Another glaring error in this field is the usage of B. M. R. reports based on methods which utilize only oxygen consumption, and the assump- tion of a normal respiratory quotient of .82 for all patients. This may account for the many discrepancies between the clinical pictures and the B. M. R. One hundred ninety nine