Thursday, March 31, 2011

Osler: The way to learn & practice medicine

Paraphrased by William Thayer (Osler's student at Johns Hopkins):

Observe, record, tabulate and communicate.

Use you five senses. The art of the practice of medicine is to be learned only by experience; 'tis not an inheritance; it cannot be revealed.

Live on the ward. Do not waste the hours of daylight in listening to that which you may read by night.

Memory plays strange pranks on facts. The rocks and fissures and gullies of the mountain-side melt quickly into smooth, blue outlines of the distant panorama. Viewed through the perspective of memory, an unrecorded observation, the vital details long since lost, easily changes its countenance and sinks obediently into the frame fashioned by the fancy of the moment.

Always note and record the unusual. Keep and compare your observations. Communicate or publish short notes on anything that is striking or new.

Do not waste your time in compilations, but when your observations are sufficient, do not let them die with you.

Study them, tabulate them, seek the points of contact which may reveal the underlying law.

Somethings can be learned only by statistical analysis. If you have the good fortune to command a large clinic, remember that one of your chief duties is the tabulation and analysis of the carefully recorded experience.

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