Ohio State University College of Medicine - Caducean Yearbook (Columbus, OH)

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real medical advance must be dependent on this type of re- search. But we also hear here that you must consider the patient as an individual. You have cut out Mrs. jones' salt entirely and her cardiac status doesn't improve. Are you going to treat heart failure as you think heart failure ought to be treated or are you going to treat Mrs. jones' peculiar physiology with respect as something you don't completely understand? It is evident, then, that often fand the more you know the more often it is evidentj the proper management of your patient depends not only upon diagnosis, prognosis, and general indications, but upon your ability to treat your patients reaction to his disease as an individual research problem in which you must know exactly what responses and adaptations are taking place-how great they are-how stable they are- how they are reacting to your therapeutic measures-and, if possible, why? It would be theoretically possible to cut out the preclinical training-yes, and the premedical sciences also-if you would put in the extra effort to learn by rote the constellations of symptoms and physical signs for a presumptive diagnosis, the interpretations and indications for dehnitive procedures in the diagnostic laboratories, and the indications, contra- indications, and doses of the various therapeutic agents. That way you could recognize and treat any disease-nearly any- according to the accepted best method. Advances in diagnosis of disease and the development of new therapy could be left to the research men. That way you could learn to treat disease. Most of you, however, want to treat patients. When the methods of the research man irk you . . . you may be right that the subject matter in hand is not indispensable for diagnosing and treating disease-but the method is the one you must use if you are going to adapt the treatment to your patient. So it seems to me that Science has two places in medicine. The first is the application of the scientific method to the acquisition of new knowledge, whether so-called Fundamental or applied, and the use of this knowledge in the diagnosis and evaluation and treatment of diseases, syndromes, dis- abilities, and symptoms. This knowlege, once established and confirmed, is available for every physician to use according to his lights. The other place of Science is the use of the scientific method by each physician on each patient to see exactly where this patient Hts in the large group of cases with a given diagnosis, to evaluate how much each organ system and function of the individual is altered by the events of his life and by the particular disease causing his complaints, to take the proper treatment of the disease and to fit its details accurately to the present dynamic state of the individual patient. To achieve this perfectly would need not only the skillful integration of all the knowledge available in the standard texts of preclinical sciences, but also a complete understanding of individual variations in structure, chemistry, and function, and of the methods for evaluating these in- dividual variations of the bedside. You can't afford to waste any more time digging for a degree-there's too much to be learnt in the short lifetime that remains to you! Evidently the perfection of the scientific handling of each patient is, like most perfections, outside our reach. But in proportion as we steep ourselves in scientific method and factual knowledge, and in proportion as we strive to handle each patient scientifically, so does our reach become longer, our effectiveness greater, and our success nearer to the idealized perfection. The two functions of science in medicine, science dealing with disease and science dealing with Mrs. Jones, though com- plimentary, related, and mutually indispensable, are not iden- tical and must not be confused. 'Me Wea:-OM Zfamilzfaa Wai! . . , Hamilton Hall as we have known it in the past is changing -from the basement up. Generally, most of the alterations are located in the northern wing, once occupied by the l Page Ten School of Dentistry. The North Basement will house the Physiological Chemistry laboratories now located in Kinsman hall. One room in this section, however, will be assigned to the Physiology Department for a laboratory for research purposes. The center basement will include the student lounge and the Caducean office. On the first floor, the Physiological Chemistry ofiice will be moved up one floor and these rooms will be occupied by the junior Dean of the College of Medicine. The Store Room is moved to the former College of Dentistry office. The remainder, except the lecture rooms, will house in part the Chemistry laboratories, The Library is to be tremendously enlarged in its present location. It will present an outer desk and Reserve Section separated completely by a glass partition and glass doors from a large reading room. Books, for the most part, will be housed in the two floors immediately below the library and the stacks will be readily accessible to Medical Students. The Physiology Office is to be moved to Room 512, the well-remembered lecture room of old. The southern wing of this second floor, then, will be used by Physiological Chemistry, with the exception, of the lecture rooms. The North Wing of the third floor will be divided between Physiology and Comparative Anatomy. The top floor will be entirely apportioned to the Anatomy Department, includ- ing the rooms added by suspending a dividing Hoof in the former two-story Dental Clinic. Corresponding changes in the hospital are contemplated. The north central section of all fioors will be assigned to the Department of Pathologyg the Lobby will be made into a large classroom, and the Out-Patient Clinics will be en- larged to include the entire A wing.

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momentum and their insidious forces. For the third time in a short 35 years, and for the second time in the past decade, education in general and scientific education in par- ticular, face a devastating international crisis in a society mobilized for war. During this era of political and economic instability, scientific medicine has come of age, and the social order, which gave it birth, has been permitted to catch just a glimpse of the potential for better mental and physical health, which, after all, are the only ramparts of Peace we, as individuals, may hope to have in today's chaotic world. It is an anachronistic paradox, that inherent in the current rapidly expanding volume of factual knowledge-from the humanities through the physical sciences to atomic Hssion itself-are the tools of Medicine, as well as the instruments of false propaganda and human destruction. In the sudden upsurge of necessity for increasing the destructive potential for national defense, it is essential that as a nation we do not reduce the correspondingly important effort to better con- serve our total manpower at the highest possible levels of mental and physical alertness and efficiency. Always, a democracy in crisis must attempt to focus its collective best thinking on the total national picture, in the perspective of past experience and of projected remote as well as immediate needs. Principles of action are but the best thought of individuals, whose integrity in turn, is the only guarantee we have of effective performance. Our men- tally disciplined and technically trained experts, for the most part are products of our highly developed, universally dis- tributed system of higher education. This Peace-time blessing of unlimited educational opportunity must not be abrogated or lost. Actually the greater any national emergency-becomes, the greater the need for trained disciplined leadership and trained disciplined citizenry for tomorrow's even greater needs. At the very heart of this national structure-currently threatened from within and from without-stands the medical profession, upon whose quality and quantity of specialized service depend all civilian as well as military health guarantees. Are we ready, are we willing, are we capable of meeting today's challenge? Entirely irrespective of any extraordinary requirement peculiar to military mobilization and its attendant exigencies, the phenomenal advances in medical knowledge with the attendant increase in diagnostic accuracy and thera- peutic specificity in the prevention and treatment of disease, have taxed both physicians and hospitals to capacity. Our immediate challenge is the mastery of health, the con- trol of disease. This, when approximately achieved, will give the socio-economic and political problems a greater chance of being successfully solved. The modern University Medical Center will increasingly serve all the needs of all the people, either directly or indirectly, being the only source of new medical manpower, the chief fount of new medical knowledge, and exemplar of the best in modern medical patient care. SCIENCE AND YOUR PATIENT Eric Ogden, M.D. I want to outline my scheme so that you may help to bring it about for the benefit of future classes by using your influence wherever you may. In brief, the proposal is this: At this opening Convocation in October, the University should confer upon each member of the entering medical class the degree of Doctor of Medicine. This procedure would have two great advantagesg first, it would eliminate much anxiety-the anxiety associated with examinations, with this required course, or with that pro- fessor, for with an M.D. you would have nothing to fear and could devote your whole attention to learning those fundamentals on which the effective integration of your later professional experiences must be built. Moreover, among so carefully selected a group as our medical classes, there would be no one so lacking in perception that he would not be awed by the magnitude of the responsibility of having an M.D. degree-and, more important still, an Ohio M.D.- at a stage of his career when he still realizes that he hasn't begun to learn how it should be used! . . . As a matter of fact, this scheme-or a slight modification of it-seems to be in operation at present in Germany. If I seem to emphasize its failures in Germany rather than its successes it is because I believe they are not inherent in the basic idea but are caused by avoidable details. The German student comes out of high school after many more hours of exposure to academic study than the American student. I-Ie then goes directly to medical school. In most schools virtually no selection of medical students is at- tempted. The student sits amid enormous classes in luxurious and wonderfully equipped auditoria to listen to twenty or thirty lectures a week. These lectures are punctuated by demon- strations at frequent intervals and by examinations at rare intervals. The students are much concerned with these examina- tions-particularly with the physikum which corresponds somewhat to the first part of the National Board .... At first the student has a few hours a week of practicum or laboratory work. This is given with much didactic ex- planation and a minimum of equipment .... During his Clinical years the student is expected to attend another million lectures, see many amphitheater clinics and operations, and many more dry clinics. I-le is also re- quired to spend about six weeks in a clerkship, which is usually orderly work, though if he is lucky he may get to help with nurse-work or take histories. The Clerkship is usually served during two of the summer vacations. Finally, he helps with some library or laboratory research, writes a thesis, passes more examinations, and gets his M.D .... Now-azfler receizfiizg hir M.D. degree-he gets busy learn- ing to be a physician, physiologist, surgeon, or what have you .... We see this also in America. In fact, it may be that much Page Nine

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' ' ,Zaa.., , The fzzrtifrrziiofz for .fz rmirferrily is tba! il p1'e.rer1fe.r lbe mfmerliofz b e I 111 e e 71 knowledge and lbe zest of life, by mziling lbe young and lhe old in lbe imagimziive ti07l.l'l!l8I'dfl0I1 nf lenr11i11g. - Wlmiteliead. There mn be no adeqnafe lerbnicnl eclllcalion which ir :mf liberal, and 110 liberal ezlzrmlion wbirla ir noi leebni- crzl: tba! ir, 710 education -which does no! imfmrl bolb 1 . -5 lerbniqzle and inlellecfzml zfiriofl.-Wlmitelmeacl. ig la- A University properly attuned to these changing times airview of the University, are closeups of the Student Union requires frequent additions to its Plant' The many Changes which is to be dedicated this Fall and the Book Tower of which have substantially altered the skyline at Ohio State, most of which we have caught glimpses in our daily routine, are too varied to detail here. Above, in addition to a recent the magnificent newly-enlarged Wlilliam Oxley Thompson Memorial Library, dedicated this june. de Szfadewt rilmezdccm 77Zea!eZm6 ,-4eeac6cu'6an 64 7aaewled . . , Student delegates from 48 medical schools over the country with a total enrollment of 15,855 medical students gathered in Chicago, December 28-29, to approve a constitution for a Student American Medical Association. Its objectives are: The advancement of medicine, contribution to the welfare and education of medical students, familiarization of its members with the purpose and ideals of the medical pro- fession, and the preparation of its members to meet the social, moral and ethical obligations of the profession. The Association is to be comprised of academic societies in approved medical schools. Donald Brugger represented the Ohio State Student body at the organizational meeting and was elected a student Councilor. Local olhcers are Donald Burk, President, joe Mullen, Vice President, Robert Rine- hart, Secretary, and Dale Flickinger, Treasurer. Page Eleven