On Reading Harrison’s Principles of Internal Medicine for the Last Time – Chapter 1

My medical career started in 1973 and wow its now 2022. I recall reading Harrison’s for the first time over forty years ago and had to use Dorland’s medical dictionary every few words. Words like leukocytosis, uremia, salpingo oophorectomy, made me laugh at my ignorance. Eventually I learned their meaning and continue to relate and deal with their significance.

So now I start on page one, “The Enduring Values of the Physician.”

“That Sympathy and understanding are expected of the physician“

I’ve always tried to live up to that expectation. I recall the old baseball manager Sparky Anderson’s admonition that being nice doesn’t cost a dime.” I never forgot the 1984 Detroit Tigers or Sparky Anderson’s advice.

Early in my career I read of doctors who did things that violated Sparky’s advice. Some billed dead patients for profit. A local doctor gave chemotherapy to patients that did not have cancer. And then there was the doctor who molested the female gymnasts and shook the profession.

But I still believe in and want to emulate the ideals of doctors like Arrowsmith and the brave doctor Rieux in Camus’ “The Plague,” Albert Schweitzer, and Dr. Best who discovered insulin and saved many lives and sold the patent for one dollar. (Imagine big-pharma doing that today)

Recall Francis Peabody’s “The Care of the Patient,” a lecture delivered while he was dying of cancer. It wasn’t about him, it was about the patient. “The care of the patient is in caring for the patient.”

Physical Examination page 2

“The patient must be examined from head to toe.”

We will talk about that later.