Medicine - After Twenty-Five Years Part 1
( Originally Published 1905 )
FROM two points of view alone have we a wide and satisfactory view of life—one, as, amid the glorious tints of the early morn, ere the dew of youth has been brushed off, we stand at the foot of the hill, eager for the journey; the other, wider, perhaps less satisfactory, as we gaze from the summit, at the lengthening shadows cast by the setting sun. From no point in the ascent have we the same broad outlook, for the steep and broken pathway affords few halting places with an unobscured view. You remember in the ascent of the Mountain of Purgatory, Dante, after a difficult climb, reached a high terrace encircling the hill, and sitting down turned to the East, remarking to his conductor—" all men are delighted to look back." So on this occasion, from the terrace of a quarter of a century, I am delighted to look back, and to be able to tell you of the prospect.
Twenty-five years ago this Faculty, with some hardihood, selected a young and untried man to deliver the lectures on the Institutes of Medicine. With characteristic generosity the men who had claims on the position in virtue of service in the school, recognizing that the times were changing, stepped aside in favour of one who had had the advantage of post-graduate training in the subjects to be taught. The experiment of the Faculty, supplemented on my part by enthusiasm, constitutional energy, and a fondness for the day's work, led to a certain measure of success. I have tried to live over again in memory those happy early days, but by no possible effort can I recall much that I would fain remember. The dust of passing years has blurred the details, even in part the general outlines of the picture. The blessed faculty of forgetting is variously displayed in us. In some, as in our distinguished countryman, John Beattie Crozier, it is absent altogether, and he fills chapter after chapter with delightful reminiscences and descriptions of his experiences and mental states.' At corresponding periods—we are about the same age—my memory hovers like a shade about the magic circle which Ulysses drew in Hades, but finds no Tiresias to lift the veil with which oblivion has covered the past. Shadowy as are these recollections, which, be they what they may
Are yet the fountain light of all our day,
they are doubly precious from their association with men who welcomed me into the Faculty, now, alas, a sadly reduced remnant. To them—to their influence, to their example, to the kindly encouragement I received at their hands—I can never be sufficiently grateful. Faithfulness in the day of small things may be said to have been the distinguishing feature of the work of the Faculty in those days. The lives of the senior members taught us youngsters the lesson of professional responsibility, and the whole tone of the place was stimulating and refreshing. It was an education in itself, particularly in the amenities of faculty and professional life, to come under the supervision of two such Deans as Dr. George Campbell and Dr. Palmer Howard. How delightful it would be to see the chairs which they adorned in the school endowed in their memories and called by their names!
One recollection is not at all shadowy—the contrast in my feelings to-day only serves to sharpen the outlines. My first appearance before the class filled me with a tremulous uneasiness and an overwhelming sense of embarrassment. I had never lectured, and the only paper I had read before a society was with all the possible vaso-motor accompaniment. With a nice consideration my colleagues did not add to my distress by their presence, and once inside the lecture room the friendly greeting of the boys calmed my fluttering heart, and, as so often happens, the ordeal was most severe in anticipation. One permanent impression of the session abides—the awful task of the preparation of about one hundred lectures. After the ten or twelve with which I started were exhausted I was on the treadmill for the remainder of the session. False pride forbade the reading of the excellent lectures of my predecessor, Dr. Drake, which, with his wonted goodness of heart, he had offered. I reached January in an exhausted condition, but relief was at hand. One day the post brought a brand-new work on physiology by a well-known German professor, and it was remarkable with what rapidity my labours of the last half of the session were lightened. An extraordinary improvement in the lectures was noticed; the students benefited, and I gained rapidly in the facility with which I could translate from the German.
Long before the session was over I had learned to appreciate the value of the position entrusted to me, and sought the means to improve the methods of teaching. I had had the advantage of one of the first systematic courses on practical physiology given at University College, London, a good part of which consisted of lessons and demonstrations in histology. In the first session, with but a single micro-scope, I was only able to give the stock display of the circulation of the blood, ciliary action, etc., but a fortunate appointment as physician to the smallpox department of the General Hospital carried with it a salary which enabled me to order a dozen Hartnack microscopes and a few bits of simple apparatus. This is not the only benefit I received from the old smallpox wards, which I remember with gratitude, as from them I wrote my first clinical papers. During the next session I had a series of Saturday demonstrations, and gave a private course in practical histology. One grateful impression remains—the appreciation by the students of these optional and extra hours. For several years I had to work with very scanty accomodation, trespassing in the chemical laboratory in winter, and in summer using the old cloak room downstairs for the histology. In 1880 I felt very proud when the faculty converted one of the lecture rooms into a physiological laboratory and raised a fund to furnish and equip it. Meanwhile I had found time to take my bearings. From the chair of the Institutes of Medicine both physiology and pathology were taught. It had been a time-honoured custom to devote twenty lectures of the course to the latter, and as my colleagues at the Montreal General Hospital had placed the post-mortem room at my disposal I soon found that my chief interest was in the pathological part of the work. In truth, I lacked the proper technique for practical physiology. For me the apparatus never would go right, and I had not a Diener who could prepare even the simplest experiments. Alas! there was money expended (my own usually, I am happy to say, but sometimes my friends', as I was a shocking beggar!) in apparatus that I never could set up, but over which the freshmen firmly believed that I spent sleepless nights in elaborate researches. Still one could always get the blood to circulate, cilia to wave and the fibrin to digest. I do not think that any member of the ten successive classes to which I lectured understood the structure of a lymphatic gland, or of the spleen, or of the placental circulation. To those structures I have to-day an ingrained hatred, and I am always delighted when a new research demonstrates the folly of all preceding views of their formation. Upon no subjects had I harder work to conceal my ignorance. I have learned since to be a better student, and to be ready to say to my fellow students "I do not know." Four years after my college appointment the Governors of the Montreal General Hospital elected me on the visiting staff. What better fortune could a young man desire! I left the same day for London with my dear friend, George Ross, and the happy days we had together working at clinical medicine did much to wean me from my first love. From that date I paid more and more attention to pathology and practical medicine, and added to my courses one in morbid anatomy, another in pathological histology, and a summer class in clinical medicine. I had become a pluralist of the most abandoned sort, and at the end of ten years it was difficult to say what I did profess: I felt like the man in Alcibiades II to whom are applied the words of the poet:
Full many a thing he knew;
Weakened in this way, I could not resist when temptation came to pastures new in the fresh and narrower field of clinical medicine.
After ten years of hard work I left this city a rich man not in this world's goods, for such I have the misfortune—or the good fortune—lightly to esteem, but rich in the goods which neither rust nor moth have been able to corrupt,—in treasures of friendship and good fellowship, and in those treasures of widened experience and a fuller knowledge of men and manners which contact with the bright minds in the profession ensures. My heart, or a good bit of it at least, has stayed with those who bestowed on me these treasures. Many a day I have felt it turn towards this city to the dear friends I left there, my college companions, my teachers, my old chums, the men with whom I lived in closest intimacy, and in parting from whom I felt the chordae tendinee grow tense.