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 VALEDICTORY ADDRESS. 
 
 DKMVKREI) TO THE GKADI'ATES IN MEDICINE AT THE ANNTAL 
 
 CONVOCATION OF THE MEDICAL FACULTY OF MiGILL 
 
 UNIVERSITY, APRIL 2ni), 1807. 
 
 KY 
 
 II. S. BIKKKTT, M.I)., 
 
 Professor of Liiryngolo^.V, McGill University; Laiyngologist, Montreal Genernl 
 
 Hospital. 
 
 (Reprinkd from Montreal Medical Juur.ml, May, 1807.) 
 
VALEDICTORY ADDRESS. 
 
 DELIVERED TO THE GRADUATES IN MEDICINE AT THE ANNUAL CON- 
 VOCATION OF THE MEDICAL FACULTY OF McGILL UNIVERSITY. 
 
 APRIL 2nd, 1897. ■• . " 
 
 • BY 
 
 H. S. BiKKETT, M.D., 
 
 Professor of Laryngology, McGill University : Laryngologlst, Montreal General 
 
 Hospital. 
 
 Gentlemen o ? the Graduating Class : 
 
 For the past four years it has been the duty of the Members of the 
 Faculty to lecture to you within the College walls of the University, 
 and in the theatres of the hospitals, but to-day such duties cease, and 
 the relation of pupil and teacher no longer exists ; we are confreres 
 and to me has been delegated the privilege of congratulating you 
 upon your preferment, and of welcoming you to the ranks of an hon- 
 ourable profession. 
 
 Your progress during the past four years has been our earnest care, 
 and no effort has been spared to fit you for the responsibilities which, 
 from this day forth, you are yourselves to assume. You have been 
 brought to the goal of your first ambition, and it now remains for 
 each of j-ou to determine your future career. 
 
 There is much to be borne and much that is wearisome in the cor- 
 ditions of life upon which you are about to enter. The weight of the 
 burden can be lightened by the view you may take of the work. Do 
 not look to your profession as a mere source of pecuniary gain and 
 personal preferment, for it offers you the highest opportunities for the 
 advancement of your intellectual powers, the promotion of social good 
 and the alleviation of physical woes of suffering mankind. By con- 
 centrating every faculty to the careful fulfilment of such work, the 
 
(lull prosaic sido of life will 1k> lightt'iUMl by a consciousness of a noble 
 duty t'fibetually accoinplisluMl, which will throw around your ordinary 
 duties a halo and relievo tiie tedium of your solitary hours. Those 
 men who have entered upon tin; study of medicine from love of it, 
 make the best students and doctors, — the physician to be successful 
 must think his profession the finevit in the world. 
 
 Our profession is an arduous, yet fascinating one. Our responsi- 
 bilities are great. " We are trusted as no other men arc. By the 
 force of circumstances, as well as by the relations of mutual confi- 
 dence which grow up between the patient and his medical adviser, 
 enormous power for good or evil lies within our hands, and on our 
 discretion depends fre<)uently the happiness and well-V»eing of families." 
 You are to become the trusted friend of the family, and whatever is 
 entrusted to your care must be regarded as sacred ; a breach of such 
 trust will mark you as unworthy of the pro^'ession. Therefore do 
 not make the ailments of any patient or their private affairs a topic 
 wherewith to entertain others whilst making your <laily rounds. 
 There is no more objectionable individual than a gossiping doctor. 
 
 The (|uestion at the outset which undoubtedly has occurred to each 
 of you is, " What am I going to do " ? To some of you are open posi- 
 tions as house-surgeons in the ho.spitals, either in this city or else- 
 where, and I would strongly urge the seeking of such positions. 
 Once installed, you will find opportunities unexcelled of more pro- 
 perly fitting you for the great responsibilities of your calling. Here 
 your mind will be trained to be observant, careful and exact in noting 
 the details of cases under your direct charge. 
 
 The benefit of this cannot be overestimated, and it will stand you 
 in good stead when out in general practice. Many a prominent phy- 
 sician and surgeon of the day owes his position to the proper use 
 made of the opportunities afforded him in his capacity as house- 
 physician and surgeon. 
 
 (Jthers of you mu.st be satisfied with the opportunities afforded of 
 starting into general practice at once ; unless under exceptional cir- 
 cumstances, it will be impossible for .such to be fully occupied from 
 the start. In this way the time at your disposal will at first be con- 
 siderable, and you will form habits during this critical period which 
 will leave their iihpress on your future life. Indolent and careless 
 habits .so ea.sily grow upon one, that they have marred many a prom- 
 ising career, while habits of research and thoroughness, coupled with 
 a love of the profession, are sure not only to lead to success but tc 
 gieatly facilitate your future work. If you have few cases, let them 
 
'7. 
 
 8 
 
 bo carofiilly Htudiod, and do not put away your text liooks with the 
 parchiiiont you liavo received to-day. 
 
 SoMK! of you may anticipates a trip abroad to visit thct various hos- 
 pitals of (Jreat Britain and the Continent. Just a word on this sul)- 
 ject. You are as yet ine.xperienced, the advantages of such a trip 
 cannot at pre.sent lie fully appreciatiMl, as you are not in a position to 
 sift the chaH' from the wheat. The result is a lot of valuable time 
 wasted and money spent to no advantaj^e. 
 
 After four or five years work in general practice, or after holding 
 a hospital appointment as resident for a year or so, you are thc^n in 
 a position from the e.vperience ac(|uiri'd to spend a couple of years 
 very protitaldy abroad. 
 
 Unfortunately however there are cases amongst the graduating 
 class of each year which necessitate some to cross the Atlatitic and 
 obtain further degrees to enable them to become registered pi-acti- 
 tioners of certain Prf)vinces of the Dominion. This state of things is 
 a deploi'able one, and let us hope the day is not far di.stant when one 
 license will give the profe.ssion the privilege of practising any where in 
 Her Majesty's Dominions. 
 
 That any one should cro.ss the Atlantic simply with tlie idea that 
 having acquired further degrees he is therefore entitled to be more 
 deserving of practice is a delusion ; the laity looks to the personal 
 ability of the practitioner and not to any additional degrees he may 
 have secured. 
 
 A danger which confronts u.s in the present time is the ambition of 
 the recent graduate in medicine t(* take up a. speciality, and how often 
 one is asked by the newly created M.D., "What speciality might I 
 take up ? " 
 
 Specialism is not a branch of medicine separated by a definite line 
 of demarcation, independent of and (piite distinct from the field of 
 general practice, but should l)e regarded as supplemi'utaiy to thi.s. 
 A field open to the general practitioner who, in his riper experience, 
 will add to his store of knowledge by such further researches in the 
 region of science as will enable him to deal in a skilful manner with 
 diseases of certain organs which i-efpiire specific treatment. The 
 specialist is thus a co-workei- with the general practitioner, not an 
 antagonist striving for his own .selfi.sh aims, l»ut working harmoniously 
 to their mutual advantage. The recent graduate who imagines that 
 all that is necessary to ([ualifyas a specialist is to spend a few months 
 abroad, or, as some do, a few weeks, attending the clinics of hospitals 
 not far from home, makes as ad mistake. To the.se short-term special- 
 ists is attributable much of the harm done tospecialis.u. Tluv briiiir 
 
(liscnidit upon thomselvoa and court the (lispleasuro of the general prac- 
 titioner. With no foundation of general practice, rtnd a Itrazened know- 
 ledge of the speciality they profess to have studied, they launch out, 
 and I can hardly tind words forcilihi enough to denounce their ndseiahle 
 attempts at treatment in which they more often fail than s\icceed. 
 Men of one idea, and that too often warped l»y inte»est, they jvscrihc 
 to causes for which their speciality has the remedies, all the ills that 
 human Hesh is heir to. Then follow the usual results, diagnosis 
 wrongly formed, treatment ini.sdirected, damage irreparably done and 
 the lives of many rendered miserable; hut "When thoroughly 
 grounded in the principles and practice of your profession, and having 
 acquired experience from some years of practical work, it will then 
 he time enough to turn particular attention to some one branch of it. 
 I do not wish to discoui'age you, if your taste and talent sf) incline 
 you, from acquiring knowledge and skill in one particular line, for 
 the range of work has become so enlarged that it is impossible foi- one 
 to perfect himself in all its various branches. So, if in time you find 
 you po.ssess a particular skill in .some certain line of work, and your 
 skill receives such acknowledgment from your fellows as to justify 
 3'ou in relin(|uishing general work for a specific line of action, then I 
 consider you woulil be (piite justified in confining yourself to that 
 special work." (Dr. H. Kelly.) 
 
 Determined then to practice some special branch of medicine, let it 
 be after con,siderable experience in general practice, and after at least 
 two years abroad, studying hanl and honestly in special hospitals. 
 No one can acquire a solid foundation in any speciality in less time, 
 for if the foundation be weak the whole super structure must neces- 
 sarily be defective. 
 
 Enter your new field with a broad mind, detei*mined to investigate 
 and treat local trouble as generally dependent upon a manifestation 
 of disorganisation of the whole system, and not as sjnnptoms to be 
 viewed and treated only through the means of the speculum, laryngo- 
 scope and ophthalmoscope. Then when fully and properly qualified, 
 you will be esteemed by your brother specialists and win the confi- 
 dence of the general practitioner. 
 
 As a practitioner either in the country or the city, let your moments 
 of leisure be occupied in reading as much as possible the current 
 medical literature, in attending meetings of the medical socieMes, and 
 indulging in some form of profitable recreation. Contribute your 
 share, however small in the advancement of medicine and surgery, by 
 reporting your cases, either before the medical .societies, or in reput- 
 
 I 
 
 i 
 
I 
 
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 t: 
 
 able in«flical jonrnala Your work may be criticised, but do not let 
 that <liscouri.,'^o you, but rather incite you Ui better things. 
 
 Seek oppor , unities to visit your Ahna Mater, and the various hos- 
 pitals where you will, and to conit; in contact with men of experience 
 in the professional wf)rld. The interchange! of idejus will tend to 
 broaden your mind and will keep you from falling into a hum-drum 
 way of doing your work. Medicine is a pn)gressive science, and to 
 be successful practition(!rs, you must kcictp abreast of the times. To 
 those of your confvf'reH who are in good standing, be ever rt^ady to 
 extend the hand of good fellowship. PJe considerate of their errors of 
 diagnosis, and do not seek to make capital out of it to suit your own 
 ends. Wlien attending cases which present unusual symptoms, and 
 which batHe your skill, do not hesitate to .seek further advice, it will 
 les.sen your responsibility and will be of b(!iietit to the patient. This 
 will not in anyway depreciate your standing in his eyes, but will 
 rather strengthen your position. 
 
 In all your actions bo manly and straightforward. 
 
 " To thine own wlf he true, 
 
 " And it niu.st follow ns tlie niglit tli*; day 
 
 " Tiiou ean'.st not tlieii l)e false to any man." 
 
 Let not those of you who are the first in the class think that your 
 qualifications are greater than those who have been less fortunate, or 
 that your gifts entitle you to greater success in after life than the 
 rest. It is not always the most brilliant student wlio makes the most 
 successful practitioner. The so-called " plodding " and slow student 
 often has qualities hidden through the pressure of studies during his 
 college course, which will shine only when opportunities present 
 themselves, and often enable him to outstrip his more brilliant college 
 friend. But whatever has been the success of each of you, let me 
 caution you against making an improper use of such qualifications. 
 
 Do not think that with the closing of to-day's functions our interest 
 in your welfare ceases ; it goes forth with you as you leave this hall, 
 and ever will continue through your career. 
 
 Do not let the knowledge you hove acquired within the prescribed 
 time of the college course lead you to imagine that you have exhausted 
 the science of medicine. There is no greater stumbling block on the 
 road to learning than self-satisfaction. Strive therefore to increase 
 the store of knowledge you now have, by continuous study and prac- 
 tical work, and your labour will not be in vain. 
 
 You may congratulate yourselves upon graduating at this present 
 period in the history of medicine and surgery, for no era has been 
 marked by greater progress and advancement. Look into the field of 
 
stiiyrry, an«l «oo what l)rilliaiit rt-Hiilts have been accoinpIinluMl hy the 
 Hkilt'ul .suix»'«>»i how through hin cMorts many ((hscurc disoaHcs of the 
 hiflilfu orpins of thf Inxly liavi^ hccti inadt^ clear and operations suc- 
 cessfully perforniefj whicili liave lieeii the means of saving' many lives, 
 in cases, which only a few years ago, wouKI have be«'n re^jartled us 
 hopeh^ss. 
 
 Consider th(> physician of the present «lay and how infinitely super- 
 ior are his metho<ls of diajj^nosinj^ and treatinj^ diseases than those 
 formerly accepte*!. Think what opportunities liave heeii afforded you 
 hy the more recent advances of medicine, such as th(( ci^rtainty of 
 rec«»}^nisinif tuberculosis in its incipient sta<;(\ of treatin;^ malaria more 
 intellij^ently, and of havinj^ methods (so recently elaborated by one 
 (>f your teachers) at your disposal, of diajjjtiosinf,' typhoid ftiver in its 
 earliest staphs. It is owin^' to the untiring; work of the bacterioloj^ist 
 that we have placed in our hands such means of so successfully treat- 
 
 u\'^ our cases. 
 
 What (grander work of the last two years has Ijeen accomplished 
 than that of tlu! l)acteriolo<,'ist in givinj,' to us a means whentwith to 
 battle more effectually than ever aj^ainst a disease so dreaded iiiid so 
 awful in its results as diphtheria. The introduction of antitoxin 
 therefore makes another mark in the progress of medicine. 
 
 It is our privilege and yours to reap the benefit of and to carry on 
 the grand work accomplished by the many faithful workers in the 
 field of medicine and surgery, and to apply thefr results, now no 
 longer on their trial, but proved and accepted, to the welfare of 
 patients entrusted to our care. Be not contented to rest here upon 
 the labour of others ; strive by your own endeavours to further the 
 advance of .science, and in dijing so pursue your researches, in that 
 field for which by your inclinations and (|ualifications you are best 
 suited. 
 
 In conclusion, (ientlemen, I would ask you to remember always 
 the nobility of your profe,s.sion and let your just appreciation of its 
 high standard be demonstrated in the honesty and faithfulness of 
 your work. Consider the benevolence of its aim, the elevating char- 
 acter of its studies, in the pursuit of which all the best faculties of 
 our nature are called into action. Let it be your ambition to excel in 
 it, fearlessly encountering the difficulties it presents. Strengthen 
 yourselves both mentally and morally' by the di.scipline it aff(M'ds in 
 patient and sustained laboui", and press forward in your new career 
 with all dil iice, not with a vain-glorious spirit, aspiring to out-d(j 
 your fellow.^, but rather with a desire to bring honour upon your 
 profession. ' 
 
Let your 'vork be honest and it cannot escape reward. Knowled^*' 
 is power. Tlieret'ore (finlmice every opportunity of enlarj^inj^ your 
 iiiiml, not only to gratify your own literary or .scientific ta,Hte.s, liut to 
 IteneHt iiiuiikind. 
 
 Let iiiu on behalf of your covfrh't's and in the naiiic of the Univor- 
 sity. wish you a happy and prosperous career, and may health wait 
 on you in carrying out tlie duties with which you have this day bcien 
 entrustf(l.