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How to be a Doctor

Certainly the progress of science is a wonderful thing.
One can't help feeling proud of it. I must admit that I
do. Whenever I get talking to anyone--that is, to anyone
who knows even less about it than I do--about the marvellous
development of electricity, for instance, I feel as if
I had been personally responsible for it. As for the
linotype and the aeroplane and the vacuum house-cleaner,
well, I am not sure that I didn't invent them myself. I
believe that all generous-hearted men feel just the same
way about it.

However, that is not the point I am intending to discuss.
What I want to speak about is the progress of medicine.
There, if you like, is something wonderful. Any lover of
humanity (or of either sex of it) who looks back on the
achievements of medical science must feel his heart glow
and his right ventricle expand with the pericardiac
stimulus of a permissible pride.

Just think of it. A hundred years ago there were no
bacilli, no ptomaine poisoning, no diphtheria, and no
appendicitis. Rabies was but little known, and only
imperfectly developed. All of these we owe to medical
science. Even such things as psoriasis and parotitis and
trypanosomiasis, which are now household names, were
known only to the few, and were quite beyond the reach
of the great mass of the people.

Or consider the advance of the science on its practical
side. A hundred years ago it used to be supposed that
fever could be cured by the letting of blood; now we know
positively that it cannot. Even seventy years ago it was
thought that fever was curable by the administration of
sedative drugs; now we know that it isn't. For the matter
of that, as recently as thirty years ago, doctors thought
that they could heal a fever by means of low diet and
the application of ice; now they are absolutely certain
that they cannot. This instance shows the steady progress
made in the treatment of fever. But there has been the
same cheering advance all along the line. Take rheumatism.
A few generations ago people with rheumatism used to have
to carry round potatoes in their pockets as a means of
cure. Now the doctors allow them to carry absolutely
anything they like. They may go round with their pockets
full of water-melons if they wish to. It makes no
difference. Or take the treatment of epilepsy. It used
to be supposed that the first thing to do in sudden
attacks of this kind was to unfasten the patient's collar
and let him breathe; at present, on the contrary, many
doctors consider it better to button up the patient's
collar and let him choke.

In only one respect has there been a decided lack of
progress in the domain of medicine, that is in the time
it takes to become a qualified practitioner. In the good
old days a man was turned out thoroughly equipped after
putting in two winter sessions at a college and spending
his summers in running logs for a sawmill. Some of the
students were turned out even sooner. Nowadays it takes
anywhere from five to eight years to become a doctor. Of
course, one is willing to grant that our young men are
growing stupider and lazier every year. This fact will
be corroborated at once by any man over fifty years of
age. But even when this is said it seems odd that a man
should study eight years now to learn what he used to
acquire in eight months.

However, let that go. The point I want to develop is that
the modern doctor's business is an extremely simple one,
which could be acquired in about two weeks. This is the
way it is done.

The patient enters the consulting-room. "Doctor," he
says, "I have a bad pain." "Where is it?" "Here." "Stand
up," says the doctor, "and put your arms up above your
head." Then the doctor goes behind the patient and strikes
him a powerful blow in the back. "Do you feel that," he
says. "I do," says the patient. Then the doctor turns
suddenly and lets him have a left hook under the heart.
"Can you feel that," he says viciously, as the patient
falls over on the sofa in a heap. "Get up," says the
doctor, and counts ten. The patient rises. The doctor
looks him over very carefully without speaking, and then
suddenly fetches him a blow in the stomach that doubles
him up speechless. The doctor walks over to the window
and reads the morning paper for a while. Presently he
turns and begins to mutter more to himself than the
patient. "Hum!" he says, "there's a slight anaesthesia
of the tympanum." "Is that so?" says the patient, in an
agony of fear. "What can I do about it, doctor?" "Well,"
says the doctor, "I want you to keep very quiet; you'll
have to go to bed and stay there and keep quiet." In
reality, of course, the doctor hasn't the least idea what
is wrong with the man; but he DOES know that if he will
go to bed and keep quiet, awfully quiet, he'll either
get quietly well again or else die a quiet death. Meantime,
if the doctor calls every morning and thumps and beats
him, he can keep the patient submissive and perhaps force
him to confess what is wrong with him.

"What about diet, doctor?" says the patient, completely
cowed.

The answer to this question varies very much. It depends
on how the doctor is feeling and whether it is long since
he had a meal himself. If it is late in the morning and
the doctor is ravenously hungry, he says: "Oh, eat plenty,
don't be afraid of it; eat meat, vegetables, starch,
glue, cement, anything you like." But if the doctor has
just had lunch and if his breathing is short-circuited
with huckleberry-pie, he says very firmly: "No, I don't
want you to eat anything at all: absolutely not a bite;
it won't hurt you, a little self-denial in the matter of
eating is the best thing in the world."

"And what about drinking?" Again the doctor's answer
varies. He may say: "Oh, yes, you might drink a glass of
lager now and then, or, if you prefer it, a gin and soda
or a whisky and Apollinaris, and I think before going to
bed I'd take a hot Scotch with a couple of lumps of white
sugar and bit of lemon-peel in it and a good grating of
nutmeg on the top." The doctor says this with real feeling,
and his eye glistens with the pure love of his profession.
But if, on the other hand, the doctor has spent the night
before at a little gathering of medical friends, he is
very apt to forbid the patient to touch alcohol in any
shape, and to dismiss the subject with great severity.

Of course, this treatment in and of itself would appear
too transparent, and would fail to inspire the patient
with a proper confidence. But nowadays this element is
supplied by the work of the analytical laboratory. Whatever
is wrong with the patient, the doctor insists on snipping
off parts and pieces and extracts of him and sending them
mysteriously away to be analysed. He cuts off a lock of
the patient's hair, marks it, "Mr. Smith's Hair, October,
1910." Then he clips off the lower part of the ear, and
wraps it in paper, and labels it, "Part of Mr. Smith's
Ear, October, 1910." Then he looks the patient up and
down, with the scissors in his hand, and if he sees any
likely part of him he clips it off and wraps it up. Now
this, oddly enough, is the very thing that fills the
patient up with that sense of personal importance which
is worth paying for. "Yes," says the bandaged patient,
later in the day to a group of friends much impressed,
"the doctor thinks there may be a slight anaesthesia of
the prognosis, but he's sent my ear to New York and my
appendix to Baltimore and a lock of my hair to the editors
of all the medical journals, and meantime I am to keep
very quiet and not exert myself beyond drinking a hot
Scotch with lemon and nutmeg every half-hour." With that
he sinks back faintly on his cushions, luxuriously happy.

And yet, isn't it funny?

You and I and the rest of us--even if we know all this--as
soon as we have a pain within us, rush for a doctor as
fast as a hack can take us. Yes, personally, I even prefer
an ambulance with a bell on it. It's more soothing.

Stephen Leacock