Doctor and patient : $b Papers on the relationship of the physician to men and institutionsPeabody, Francis Weld
Science
Doctor and patient : $b Papers on the relationship of the physician to men and institutions
Peabody, Francis Weld
Medicine; Medicine -- Practice; Physicians
It is rather fashionable to say that the modern physician has become
“too scientific.” Now, was it too scientific, with all the stomach
tubes and blood counts and roentgen-ray examinations? Not at all.
Mrs. Brown’s symptoms might have been due to a gastric ulcer or to
gall-stones, and after such a long course it was only proper to use
every method that might help to clear the diagnosis. Was it, perhaps,
not scientific enough? The popular conception of a scientist as a man
who works in a laboratory and who uses instruments of precision is as
inaccurate as it is superficial, for a scientist is known, not by his
technical processes, but by his intellectual processes; and the essence
of the scientific method of thought is that it proceeds in an orderly
manner toward the establishment of a truth. Now the chief criticism to
be made of the way Mrs. Brown’s case was handled is that the staff
was contented with a half-truth. The investigation of the patient was
decidedly unscientific in that it stopped short of even an attempt to
determine the real cause of the symptoms. As soon as organic disease
could be excluded the whole problem was given up, but the symptoms
persisted. Speaking candidly, the case was a medical failure in spite
of the fact that the patient went home with the assurance that there
was “nothing the matter” with her.
A good many “Mrs. Browns,” male and female, come to hospitals, and a
great many more go to private physicians. They are all characterized
by the presence of symptoms that cannot be accounted for by organic
disease, and they are all liable to be told that they have “nothing
the matter” with them. Now my own experience as a hospital physician
has been rather long and varied, and I have always found that, from
my point of view, hospitals are particularly interesting and cheerful
places; but I am fairly certain that, except for a few low-grade morons
and some poor wretches who want to get in out of the cold, there are
not many people who become hospital patients unless there is something
the matter with them. And, by the same token, I doubt whether there
are many people, except those stupid creatures who would rather go to
the physician than go to the theater, who spend their money on visiting
private physicians unless there is something the matter with them. In
hospital and in private practice, however, one finds this same type of
patient, and many physicians whom I have questioned agree in saying
that, excluding cases of acute infection, approximately half of their
patients complained of symptoms for which an adequate organic cause
could not be discovered. Numerically, then, these patients constitute
a large group, and their fees go a long way toward spreading butter
on the doctor’s bread. Medically speaking, they are not serious cases
as regards prospective death, but they are often extremely serious as
regards prospective life. Their symptoms will rarely prove fatal, but
Public-domain text, read in full here on John Shaqi.
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