The truly scientific mind is altogether unafraid of the new, and while having no mercy for ideas which have served their turn or shown their uselessness, it will not grudge to any unfamiliar conception its moment of full and friendly attention, hoping to expand rather than to minimize what small core of usefulness it may happen to contain.
The mind likes a strange idea as little as the body likes a strange protein and resists it with similar energy. It would not perhaps be too fanciful to say that a new idea is the most quickly acting antigen known to science.
If we watch ourselves honestly we shall often find that we have begun to argue against a new idea even before it has been completely stated.
It is necessary to guard ourselves from thinking that the practice of the scientific method enlarges the powers of the human mind. Nothing is more flatly contradicted by experience than the belief that a man distinguished in one or even more departments of science, is more likely to think sensibly about ordinary affairs than anyone else.
The dispassionate intellect, the open mind, the unprejudiced observer, exist in an exact sense only in a sort of intellectualist folk-lore; states even approaching them cannot be reached without a moral and emotional effort most of us cannot or will not make.
It was not noisy prejudice that caused the work of Mendel to lie dead for thirty years, but the sheer inability of contemporary opinion to distinguish between a new idea and nonsense.
The second thing to be striven for is intuition. This sounds an impossibility, for who can control that small quiet monitor? But intuition is only interference from experience stored and not actively recalled.
If mankind is to profit freely from the small and sporadic crop of the heroically gifted it produces, it will have to cultivate the delicate art of handling ideas. Psychology is now able to tell us with reasonable assurance that the most influential obstacle to freedom of thought and to new ideas is fear; and fear which can with inimitable art disguise itself as caution, or sanity, or reasoned skepticism, or on occasion even as courage.
The ordinary patient goes to his doctor because he is in pain or some other discomfort and wants to be comfortable again; he is not in pursuit of the ideal of health in any direct sense. The doctor on the other hand wants to discover the pathological condition and control it if he can. The two are thus to some degree at cross purposes from the first, and unless the affair is brought to an early and happy conclusion this diversion of aims is likely to become more and more serious as the case goes on.
The fundamental activity of medical science is to determine the ultimate causation of disease.
Disease often tells its secrets in a casual parenthesis.
The various systems of doctrine that have held dominion over man have been demonstrated to be true beyond all question by rationalists of such power-to name only a few-as Aquinas and Calvin and Hegel and Marx. Guided by these master hands the intellect has shown itself more deadly than cholera or bubonic plague and far more cruel. The incompatibility with one another of all the great systems of doctrine might surely be have expected to provoke some curiosity about their nature.
An event experienced is an event perceived, digested, and assimilated into the substance of our being, and the ratio between the number of cases seen and the number of cases assimilated is the measure of experience.
The first [quality] to be named must always be the power of attention, of giving one's whole mind to the patient without the interposition of anything of oneself. It sounds simple but only the very greatest doctors ever fully attain it. ... The second thing to be striven for is intuition. This sounds an impossibility, for who can control that small quiet monitor? But intuition is only interference from experience stored and not actively recalled. ... The last aptitude I shall mention that must be attained by the good physician is that of handling the sick man's mind.
The air of caricature never fails to show itself in the products of reason applied relentlessly and without correction. The observation of clinical facts would seem to be a pursuit of the physician as harmless as it is indispensable. [But] it seemed irresistibly rational to certain minds that diseases should be as fully classifiable as are beetles and butterflies. This doctrine ... bore perhaps its richest fruit in the hands of Boissier de Sauvauges. In his Nosologia Methodica published in 1768 ... this Linnaeus of the bedside grouped diseases into ten classes, 295 genera, and 2400 species.
It is sometimes asserted that a surgical operation is or should be a work of art ... fit to rank with those of the painter or sculptor. ... That proposition does not admit of discussion. It is a product of the intellectual innocence which I think we surgeons may fairly claim to possess, and which is happily not inconsistent with a quite adequate worldly wisdom.
