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A side of logic

“We are at the mercy of our wills more than our intellect in the formation of beliefs, which we adopt in a lazy, haphazard way without taking much trouble to enquire into their foundation.”

~Sir William Osler in Lancet 1909;42:899-912.

When at the AOA convention in San Francisco, I bought a few books. At every medical convention, the textbook companies have vendor booths in the exhibit hall. Squished between the sales people hawking ionized water filtration systems, laser wrinkle removal and custom formulated vitamin supplements to recommend for our patients to take (and obstensibly buy from us) as part of their medical treatment,  there are the two larger book dealers. It is a jam packed booth every time. My copy of Harrison’s Internal Medicine is my original copy. Some things about medicine have changed or at least been expanded and maybe I should buy a new copy of Harrison’s. Likewise my Robbin’s pathology is also the same I highlighted and studied from in medical school. Add my not-so-secret love of books in general and I am enraptured. Instead of buying the new 5-Minute Consult (don’t laugh it is a really cool book), I bought two books on Sir William Osler, a great physician and an even greater thinker. And I start with The Quotable Osler and I am impressed with the fact that his “quotes” are almost never single sentences. These aren’t quotes….these are thoughts and observations and critical opinions. To be critical does not necessarily mean to be judgmental or negative. Criticism is a thoughtful observation that may otherwise have not been made, a connection of things previously unconnected or unobserved. And unlike our modern experience, his quotes couldn’t make a news reporter’s soundbite. Sir Osler maintained a great faith in one thing: the assumption that doctors wanted to think deeper and ponder the mysteries of the human condition. He expected intellectual endeavor to include intelligence. His audience was not for the literacy level of 5th graders. His expectation was that you had read Shakespeare, Plutarch, Emerson, Keats, Voltaire, the personal and political writings of Ben Franklin and Henrik Ibsen. I started thinking about my contemporaries. Who among the intellectuals of today is working in their field of study AND writing critical essays? Who in science or medicine splits their energies between the actual practice of medicine and the contemplation of the human experience. Who? Our “great thinkers” aren’t great thinkers at all. Our “great thinkers” are lobbying Capital Hill or sitting on boards for conglomerates. These are not the great thinkers. They are business men and policy wonks. I fear that in today’s age, Sir William Osler would be a physician working in an obscure corner of America (or Canada) at a public health clinic; he would be invisible and unheard. He would toil away trying to make a difference in the human condition and he would be buried by a system that has lost it true purpose: the ART and SCIENCE of medicine. It is not, nor was it ever meant to be about patents, profit margins, shareholders or risk management. It was about how we might….through compassion and collaborative thinking… improve the human condition. How can we ease suffering? How can we prevent epidemics? How can we protect our lives so we aren’t maimed? How can we keep our babies and mothers from dying in childbirth?  How do we prevent the spread of disease, meaning contagious disease? How do we assist in making a life productive and content? We were curious about why people die and especially interested if we were accidentally causing our own demise inadvertently. But never, ever were we looking to escape death or find immortality. Never was this profession meant to be a way to accumulate wealth or make a fortune. Fortunes were for the captains of industry and the inventors. Sir William could never have testified before a Senate subcommittee today; he was too logical and asked people to THINK logically, to step back and see the bigger picture. He searched for truth. And as I read these books…I appreciate a fine mind that asks me to be my smartest and to have faith that thinking at my full capacity is for what I should strive every day, every moment. And that by feeding my mind the most nutritious thoughts, to give it a diet of high quality works, I will be mentally and intellectually healthier.

We stuff our mouths with crap food. We fill our brains with crap TV instead of reading or listening to music. We have flip top heads into which we let other people pour goo. And then we wonder why we feel sluggish, dull, slow, fatigued, fat and uncoordinated. Is it any wonder considering the “diet” we give ourselves? Not only do I want to eat right, healthy, live, vital food. I also want to improve the quality of what I put in my head. I will feel better and I will THINK better. What goes in determines what comes out. And there is my modern, Twitter ready quotable. It is inelegant and crass, but true to Sir Osler. Structure determines function. The fuel you put into an engine determines how the engine runs. While any fuel will make it run, isn’t it best to give it the best fuel so it runs clean and efficiently and at its peak performance. We just need to figure out how to better identify the carpetbaggers of our day, the gimmicks and gurus and con-men who hawk they tinctures and tonics and quick remedies. I will put my money on Sir William Osler any day over Dr. Oz. And I will read Shakespeare and eat a salad before I swallow fish oil capsules and rub herbal preparations of plant derived estrogens in my skin. Save me…save us… from the carpetbaggers. Can we just have some common sense and logic….please?

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