This business handicap is so self-evident that it is hardly necessary to touch on it. We raise the standard of medical education year by year, yet the mushroom colleges do not go—they are here to stay. If one-half the colleges were wiped out of existence there would still be more than enough to supply the demand for physicians. We have done the best we could to breed competition by manufacturing doctors, and we are doing all we can to make that competition first class—a queer business proposition in force of the oversupply of doctors. We are unjust, too, to the men we educate, by offering them inducements to enter an already overcrowded profession—but so long as human nature is as it is I see no way out of the dilemma.
There was once a time when it appeared a goodly thing for the chosen few to get together like the “three tailors of Tooley street,” and, after establishing to their own satisfaction the fact that they were indeed “the people,” formulated rules for the guidance of the many. These rules were called “ethics.” And the profession has been wrestling with its ethics ever since, trying to determine what it was all about anyhow. The ethical garment of half a century ago no longer fits—it is frayed and fringed, and baggy at the knees; full many a patch has been sewed on it, in individual attempts to make it fit from year to year, until it is now, like the Irishman’s hat, respectable by age and sentimental association only. And the public, the ever practical and heartless public, has also wondered what ’twas all about, and exhibits little sympathy for a profession which, while driveling of ethics, has “strained at gnats and swallowed camels.”
Who does not remember when all the wiseacres with number eighteen collars and number five hats seriously discussed the relative propriety of “Specialty” vs. “Practice Limited,” on professional cards? How times have changed. And then came the discussion by a learned society, of the ethical relations of “Oculist and Aurist” to “Practice Limited to Diseases of the Eye and Ear.” And it was decided that men who had the former on their cards were not ethical and could not enter that society. Ye Gods! Is the fool-killer always on a vacation? Must we always see those long ears waving over the top of the ethical fence, built by the fat hogs to keep all the little pigs out of the clover patch? What is the public to think of a profession that winks its other eye at the man who prints on his cards, “Diseases of Women Only,” but rolls up it eyes like a dying rabbit at the sight of a card reading, “Diseases of Men Only?” What has raised the woman with leucorrhea to a more exalted plane than that occupied by a man with prostatorrhea, does not appear. Why so many inconsistencies, and why such hypocrisy!
Sir Astley Cooper had his own private “hours for the poor.” Our European brethren print their college and hospital positions and all their titles on their cards. Are they less ethical than we? Homeopathy is a dead duck over there, and quackery has a hard row to hoe in Europe—queer, isn’t it?
Our system of ethics has not only been hypocritic, but somewhat confusing. The young man on the threshold of medicine doesn’t know “where he is at.” He is confronted by the unwritten law that only celebrated men and quacks may advertise. Small fry, who haven’t the ear of the newspapers nor a chance for a college position, are tacitly ordered to keep their hands off. And the young fellow watches the career of the big man, who hides every other man’s light under his own bushel, and marvels much. Especially does he marvel at the accurate photographs, life histories and clinical reports of his more fortunate confrères that appear in the newspapers without their knowledge.
Experiences differ. I haven’t yet got around to newspaper clinical reports, but it has been my fortune to be “written up” on several occasions. I do not recall that the newspapers drew on their imaginations for my photograph. I wish I might think so, and that their imaginations were distorted—the result was so uncomplimentary.
So far as I can learn, nobody protests against being legitimately represented in the newspapers. Why not be honest about it? The hypocrisy of some men is sickening. Paying clandestinely for newspaper write-ups is despicable, yet some of the very men who protest that they “really don’t see how that could have gotten into the papers,” have paid for the advertising in good “coin of the realm.” It is queer that the newspapers should write up the most minute details of the wonderful exploits of some poor fellows, together with their family histories, and publish their photographs, without their knowledge or consent—especially queer when we read in conclusion that “Professor John Doe is the greatest surgeon that ever lived.” Why not come out and acknowledge that these are paid for? This would give an equal chance to all, and especially to young fellows who have money enough to pay for similar things. He who has not the price should not find fault with the fellow who has, for, “business is business.” Meanwhile, my young friends, remember that “big mountains may do what little mountains may not do.”
When Koch’s tuberculin was yet new, soon after it escaped, half-fledged from the laboratory, only to be captured and made to perform like a trick monkey for the benefit of the laity, there came a ring at the phone of a prominent daily paper: “Hello, is this the Daily Bazoo?” “Huh, huh, it are.” “Well, I’m Dr. Squirtem Galls. I wish you would send a reporter over here at once. I want to be interviewed on Koch’s tuberculin.” It is said that $25 changed hands, but I don’t believe it. The gentleman would never advertise—at that rate—“no sir-ree.” My informant was once the sporting editor of the War Cry, and hence unworthy of credence.
And what wonderful contributions the newspaper-great-men are making to science! The daily paper is the place to study appendicitis and things. It is not long since I learned from a distinguished surgeon friend of mine, via a daily paper, that evidence of a blow having been received on the head is an imperative indication for craniectomy, whether symptoms are present or not.
In preference to the clandestine methods now in vogue, would it not be better for men in authority to write signed articles for the newspapers and intelligently present medical matter to the public? But that wouldn’t be ethical, would it? Such topics as “Advice to Young Men,” “Letters to Young Wives” and “How to Keep Healthy,” must be left to the quacks. We will confine ourselves to the surreptitious blowing of surgical horns and never mind the false notes.