(Automatic transcript - may present inaccuracies)

>> Good evening, ladies and gentlemen. We welcome you to the last of the laity lectures for this year. We assure you there will be more next year. And we'll look forward to seeing you then. This lecture is called the George R. Seidenberg [assumed spelling] Memorial Lecture. George R. Seidenberg was not a doctor. He was one of the early people who gave money for the advancement of medicine and the teaching of medicine. And it is the custom of the academy to pay tribute to people who do that. So this lecture is called the George R. Seidenberg Memorial Lecture. I wish to call to your attention, the last lecture on February 1st, we had Dr. Raymond W. Firth, who was head of the Department of Anthropology, the London School of Economics and Political Science in the University of London England. We call to your attention now that we've gone to the opposite side of the country. And our speaker tonight will be introduced to you. But I call your attention to the fact that he comes from California. So I wish you to realize the breadth of the ground from which we draw our speakers. It's my pleasure to introduce to you the chairman of the evening our presiding chairman is Dr. Clarence Henry Faust. President of the Fund For the Advancement of Education of the Ford Foundation. Dr. Faust was educated at the University of Chicago, where he acquired his degree of Doctor of Philosophy. He is a former clergyman. An ordained minister of the Evangelical Church in 1924 to 1928. He has taught English at the universities of Arkansas and of Chicago. At Stanford University, he has been Dean of the Library School and of the Graduate Library School. And also Dean of Humanities and Science. For some months in 1949 he was acting president. It's my pleasure to introduce to you Dr. Faust.

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>> Clarence Henry Faust: Thank you Dr. [Inaudible]. I am eager to be understood as intending a great deal more than the usual polite introductory statement when I say that it is a great pleasure and a great privilege to introduce to this audience my old and admired friend, Dr. John Dodds. Dr. Dodds is a graduate of the College of Wooster. Took his Master's and Doctoral degrees at Yale. Taught for some years at the University of Pittsburgh. And then joined the faculty of Stanford University. Where he has been a professor of English. A Dean of the School of Humanities. Director of Special Programs in the Humanities. He's the author of several books. And the editor of anthologies of prose, fiction and plays. His latest volume, "The age of paradox: The History of England from 1841 to 1851," has received a great deal of scholarly attention. What, however, makes this career unusual, almost unique. What gives Dr. Dodds his great distinction is he combines, in not merely a rare but I think in a most extraordinary way, several capacities, interests and competencies. He's a great teacher. But he combines his interest in teaching with a capacity for scholarship. He's a great scholar. But he's not content to deal with questions in the remote and dusty past. But rather to look at the live past insofar as it has bearing upon important and contemporary problems. He is an administrator and educative leader for whom, to whom the faculty at Stanford and educators about the country turn for guidance and advice. I've sometimes thought that John Dodds was almost the modern version of the Renaissance gentleman. The scholar. The gentleman. The statesman. Even the sportsman. He combines that interest in exploiting and developing the full range of man's capacities that the Renaissance gentleman loved to combine. Well, here is a man who, beyond all of the things I've said about him, is also interested in sports. And is a great gadgeteer. I can vouch for his interest, if not for his great success, as a fisherman. And I can tell you that, as a gadgeteer, his interest is unparalleled. I think there's something dramatic about the situation in which I suspect that Dr. Dodds prepared this lecture for you. I suspect he worked in his cabin on the ocean on the very edge of the Pacific Ocean. In a study which is lined with, not merely with books, but with woodwork of his own construction. And at a desk of his own design. It's unusual in our day of specialization to find someone with the breadth and range of interest Dr. John Dodds exhibits. To me the striking quality of all of these aspects of Dr. John's, Dodds' accomplishments and character is the way in which everything is pointed out in his own development to a concern for urgent contemporary problems. So that, as a teacher. As a scholar. As an educational leader. His concern has been to see that man's wisdom is brought to bear upon the solution of man's problems. He's going to address us tonight on the subject "A Humanist Looks At the Doctor." You are to have the opportunity to present questions to him at the end of his lecture. And I think you were provided with the forms on which you may write these out so that they can be collected at the conclusion of the lecture. It gives me then very great pleasure to present to you Dr. John Dodds on the interesting subject "A Humanist Looks At the Doctor."

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>> John W. Dodds: Dr. [Inaudible], Mr. Faust, ladies and gentlemen, I don't know who's supposed to give this lecture tonight. But clearly on the basis of the introduction, it's somebody else. I feel that I ought really to begin tonight with an apology. Fearful that you may have been lured here under false pretenses. And, therefore, to give each of you a chance to slip out quietly now if you so choose. Through some miscalculation, the subject of my talk this evening was earlier announced as "Whither Mankind." It was changed, happily for me, to its present form, "The Humanist Looks At the Doctor." Whatever else I may or may not be, and at the moment I'm a little uncertain as to what I may be. I'm no prophet. And I haven't the slightest idea whither mankind is going. There's some people I know who think our society is going very rapidly in a handcart to a place which for purposes of this lecture shall be nameless. Others detect very hopeful symptoms in the midst of present world psychosis. And like each of you, I have fears and hopes. But no inside information at all. There are some heartless people I suppose who might complain that, of course, neither have I any right to survey the medical profession. And that the proper title for tonight's dissertation would be a sort of composite one. If the humanist can look at the doctor, whither mankind. But as in the case of religion, of course, anyone knows what ought to be done about medicine. But, of course, the two, religion and medicine, aren't so very far apart. When one faces death's door, the old slanderous story goes, it's always a doctor who pulls him through. And after all, this is one of a series of lectures to the laity. Certainly this time, by one of the laity. It might be well at the beginning to establish my description of the humanities. It's been a term so variously interpreted. Has been attached to so many schools of thought. That one is inclined I think to be rather sympathetic with the man on the street who identifies the humanities vaguely with humanitarianism in general. And equates the study of paradise lost with flood relief, let's say. When we established a school of the humanities at Stanford University some years ago, one of the first letters we got was from the Society For the Prevention of Cruelty to Animals. And another letter came from a woman in San Francisco who said she knew we'd be very sympathetically interested in her cause. She ran a lonely hearts bureau. Now, although nothing human, I suppose, is really alien to the humanities. They do mean, I think, a little more than that. The university curricula, where labels tend to stick. They're usually identified with the creative or speculative side of man's activity. The literatures. The arts. Music. Philosophy. Drama and the like. History here plays a dual role. It partakes the nature of both of the social sciences and the humanities. Although, if what the dean of English historians, George Macaulay Trevelyan, says is true. That history is an informed guess at the most likely generalization. Then I suppose the scientific value of history becomes a little less evident. But in general, the humanities deal with the creative, imaginative side of man's nature. As revealed in history in the great works of literature and art. And in the Greek philosophies. But as I understand the term, they mean more than that. [Inaudible] they are or ought to be concerned with man's social as well as his spiritual environment. They differ from the sciences and from the social sciences as usually practiced in their effort to find some kind of unity and significance in the phenomena of human life. They're concerned with everything, in other words, that endows life with meaning. They deal primarily, therefore, with values. And their job, their real job is to interpret and to evaluate the patterns of our existence. Not so much in terms of conflicting ideologies. Or metaphysical systems. Or Aristotelian. Or Kantian. Or Lockean. Or Marxian. As in a much more personal and individual frame of reference. They're concerned with man. Man, living, breathing, acting. Pounding out on the anvil of his little existence between two [inaudible]. The ideals and the moral imperatives. And the ecstasies and the disappointments. The victories and the defeats which torment and bless him. Not to pin this down specifically. These are nice words, but what do they mean? What, for example, does a major literary work do for us? What does it really do for us? To begin with, it deals with universals. With human destiny. With man's loves and hopes and aspirations. As well as his doubts and his despairs. And so we learn about the common nature of men. And our sense of identification with other people is heightened. A great book or a great play does this, not in terms of abstractions, but by revealing character and action. It's not jealousy, it's Othello. It's not indecision, it's Hamlet. And such is the nature of the artist insights that we discover the Othello and the Hamlet in ourselves. We're lead toward self-understanding.

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We learn that character counts. And if an author creates a man or a woman with a certain moral [inaudible], then the actions in which that person engages will have certain inevitable consequences. There's a law of cause and effect in human nature as well as an external nature. Moreover, a great book always raises problems that reach beyond itself. What is the relation between man's freedom and his responsibility? Now, our basic democratic assumption is that man, however much his career may seem to be determined by heredity and environment, has freedom of choice. It's that which gives him dignity and importance. Science may prove that man is relatively weak and insignificant. That what seems to him his freedom is so limited that even equality of opportunity becomes a sterile fiction. Great literature, on the other hand, demands a recognition of the worth of every human being. However much he may appear to be hemmed in by circumstance. However much he may seem to be the victim of his own genes. Thus literature supports by insights those axioms of our democracy, which are also at bottom, matters of insight. The dignity of man is not susceptible of measure. A great work of art then teaches us that responsible choices are important. Teaches us how to live. Teaches us morality, in Matthew Arnold's broad sense, the application of ideas to light. It doesn't do this didactically. It operates by example rather than by precept. Shakespeare doesn't say anywhere in Macbeth, as I remember it, that too much ambition leads to horrible results. Or in King Lear that truly old men are likely to get into trouble. But the meaning is clear nevertheless. And then there's one thing more that a major work of literature can do for us. It can give us, I think, courage to face life as it is, not as we should wish it to be. And thus teach us to think more compassionately and more hopefully of our fellow men. And more courageously of ourselves. It isn't that a hero in a Shakespearian tragedy, for example, is successful in any ordinary sense of the word. Buffeted by fortune. Confounded by the dark recesses of his own nature. Sinking at last in the maelstrom horrors which overwhelm him. He goes down at last in seemingly catastrophic defeat. Yet it's not all defeat. In the midst of tragedy, the measure of man is not his final capitulation to the forces that annihilate him. It's the temper rather in which he meets those forces. And it's the glory of literature to affirm spiritual victory in the midst of physical defeat. To enable us to sense, even as all seems lost in the fifth act, the triumphant invincibility of the human spirit which can surmount disaster. Thus we're made able to understand that men in their potential are one equal temper of heroic hearts made weak by time and fate. But strong in will to strive, to seek, to find and not to yield. Now, your literature can do this for us. I often wonder why it should be treated as a luxury. And science as the only necessity. Now, it's perhaps in their creative aspects that the humanities best express these very tough and stubborn [inaudible] that I've been trying to describe. But to limit the humanities thus severely is to distort them. Nothing is more artificial, for example, than the distinction between the humanities and the social sciences. Except perhaps in the case of the human mathematicians who [inaudible] currently, I think, [inaudible] which will pin down in a series of X's and Y's all social and artistic human achievement. When this happens, we might as well let UNIVAC take over. But in general, the social sciences and the humanities are in each other's laps. As soon as you begin to interpret as well as to collect statistical data, you're in the mainstream of humanity. There's a humanistic way of looking at science. Just as there can be a very un-humanistic way of teaching Shakespeare, for example. And in general, sympathy and understanding are the goals of the humanists. Understanding of the rich texture of man's personality and his achievement. And the compassion and appreciation of the subtle but very profound complexities of his lonesome career. If I were to lead you in advance, therefore, to my conclusion tonight, it would be that every medical man should be, indeed must be a humanist. But how do we get to that point? It will take a little doing. The practice of medicine is still pretty much of a mystery to most people. Although, not as much so perhaps as it was before the newspapers and the magazines began telling us what we ought to ask the doctor to prescribe. But at the very least there's always a kind of morbid fascination about a subject which the frailties of human flesh may make us subject to at any hour of the day or night. Few novels, incidentally, few novels written on medical subjects have failed. Did you know that? The doctor is, he's still something of a magician. He's a medicine man in a primitive sense. Witness how much credibility the mere donning of a white jacket gives to any TV announcer whose duty it is to declare the biological merits of a new toothpaste. Puts on the white jacket and all are convinced. And because of this mysterious lure, I think the word mysterious is the only accurate one to use here. And because to [inaudible] responsible and the influential place the position holds in modern society, the status of the doctor today is higher than at any time in our history. Surveys show that if you ask parents what profession they would like their children to enter, the medical profession leads all the rest. As a friend of mine has pointed out to me, this was not always so. The same friend, incidentally, who was good enough to introduce me this evening. If you had asked a parent in the 18th century in this country what he would most like his boy to become, he might well have said, a minister. There was no more socially desirable profession. Later on in the century, after the Revolution and the construction of the new United States, it would have been the law. In the 19th century, when the Industrial Revolution was really being felt. And the legal profession seemed to many people what it seemed to Thomas Carlyle, a shapeless mass of absurdity and chicane. The parent would then have wished his child to be an entrepreneur in big business, a captain of industry. Later on the banker came into his own. He manipulated the fortunes which the businessman accumulated. The ideal of every Alger hero was to be a banker. But everyone knows what happened to the bankers in the 1930's. And today the man of medicine sits on top of the heap. I'm not drawing any parallels from this earlier cyclic history of the professions. Except to point out that statuses have sometimes changed. Now, along with this emerging prestige of the doctor has come the absolutely phenomenal advance of medical knowledge in our generation. Sometime ago I was interested in exploring the decade of the 1840's in England. An age which seems only yesterday in the long perspective. And it was appalling to realize how primitive medical science was merely a hundred years ago. Ether anesthesia, as you know, was first introduced in 1846. In 1849 a devastating scourge of Asiatic cholera hit England. And the only remedies available to the medical profession ranged from the use of calomel and [inaudible] to packing the patient in the wet sheets and feeding him three small cups of olive oil. And the best authorities, the best authorities favored the so-called zymotic theory of the disease. That cholera arose from the swamps. Was carried by an atmosphere impregnated with what they termed a pestilential miasmata. At the same time it seemed to worry very few people that all the London sewers, 60 of them, emptied into the Thames. Whence 6 of the 9 companies drew their supplies of water for the metropolis. Two thirds of those companies had no system of filtration. This was a situation well into the reign of Queen Victoria. And the wonder is not that so many died, but that anybody lived. Medical histories point out that, as a whole, the treatment of disease in the early 19 century was hardly more advanced than in Hippocratic day. Certainly, the recent advance in medicine has been fantastically rapid. Even though today all the skill of the profession could do nothing about a disease which attacked me the last time I visited New York City. Doctors could tell me that it was caused by one of the smaller viruses about 60 millimicrons across. For which there was no treatment but aspirin and taking to one's bed. I refer, of course, to the common cold. We know so much, and we know so little. Now, what has been medicine's historic connection with the humanities? Much more in the past I venture to say than in the present. Hippocrates, who seems to have been a pretty hardheaded clinician always speaks of the art of medicine. And the Pythagoreans used music as well as medicine to cure the ill. Now, art to Hippocrates may have included what we call science. But today one speaks only of medical science. And the change I think is both significant and symptomatic. In its early days, medicine was closely associated with what we know now as philosophy. The words for ancient medicine perhaps. The medical theory of the four humors. Of the Hippocratic physicians. And of Galen, whose theory, which dominated the Middle Ages, was a philosophical theory of disease. The imbalance in the humors generated the disease.

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The great Renaissance physician Paracelsus demolished witheringly the theory of the humors and turned chemistry loose on the analysis of disease. But he himself was highly speculated. And fed upon a kind of fantastical mysticism. Even after the time of Harvey, medical theorists tried to establish complete systems which were more metaphysical than scientific. And in our own generation, Freud's detailed and systematic observations became for him the basis of elaborate set of speculative theories. Which not all his followers were able to tolerate. Doctors, of course, no longer exercise demons. But philosophy, or superstition, if philosophy you happen not to believe in. Has always been the handmaid of medicine. When Apollonius was called to treat a woman in the throws of a difficult labor, difficult because of her narrow pelvis. He told the anxious husband to take a live rabbit and walk around the woman with it. This single example of his medical activity, writes one medical historian, is sufficient to characterize Apollonius as a charlatan of the most contemptible class. I wonder? I don't know what Apollonius could have done about the narrow pelvis. And I suspect that the therapy did no harm. It might even have quieted the husband and thus have given some sort of comfort to the wife. Among the primitive tribes, as Dr. [Inaudible] told you in an earlier lecture. Medicine is all mixed up with sorcery and witchcraft. Depending upon amulets, charms, taboos and noxious potions. Their particular appeasement of the demonic forces. But sound therapy, evolved through who knows what ages of trial and error, sometimes went hand in hand with pure superstition. Modern medicine discovered important drugs in common use by savages. Such as the cinchona of the Peruvian Indians and the curare of the Amazon. Primitive peoples from the Papuans, to the Africans, to the Indians of the United States have always used steam and vapor baths for rheumatic pain. Massage was a standard therapy in Melanesia. Intended, of course, to drive the malicious spirits from the body. But whatever the theory of the disease might be, the results are exactly the same as in modern physiotherapy. Perhaps the best known of the doctor-philosopher-humanists in the whole range of English letter is the incomparable Sir Thomas Browne. Who quietly practiced his medicine during the lifetime of William Harvey. But is known today for his beautiful statements of his philosophical principles in his books "Religio Medici" written in 1643. Or his curious study of vulgar errors in a book entitled "Pseudodoxia Epidemica," where he examines the natural history of the unicorn and blow worms. And for his "Hydriotaphia, or Urn Burial, a Discourse of the Sepulchral Urns Lately Found in Norfolk." Sir Thomas Browne's really beautiful majestic prose has made him one of the enduringly great English stylists. Listen to him, for example, speaking in "Urn Burial" about the fickleness of self-perpetuation. "What song the Syrens sang," he says. "Or what name Achilles assumed when he hid himself among women, though puzzling questions are not beyond all conjecture. "What time the persons of these" urns or "ossuaries entered the famous nations of the dead, and slept with princes and counsellours, might admit a wide solution. But who were the proprietaries of these bones, or what bodies these ashes made up, were a question above Antiquarism. Not to be resolved by man, nor easily perhaps by spirits. Except as we consult the provincial guardians or tutelary observators. Had they made as good provision for their names, as they have done for their relicks, they had not so grossly erred in the art of perpetuation. But to subsist in bones, and be but pyramidally extant, is a fallacy in duration. Vain ashes which in the oblivion of names, persons, times and sexes have found unto themselves a fruitless continuation. And only arise unto late posterity, as emblems of mortal vanities, antidotes against pride, vain-glory, and maddening vices." "But the iniquity of oblivion blindly scattereth her poppy, and deals with the memory of men without distinction to merit of perpetuity. Who can but pity the founder of the pyramids? Herostratus lives that burnt the temple of Diana, he is almost lost that built it. Time hath spared the epitaph of Adrian's horse, confounded that of himself. In vain we compute our felicities by the advantages of our good names. Since bad have equal durations and Thersites is like to live as long as Agamemnon." "Who knows whether the best of men be known, or whether there be not more remarkable persons forgot, than any that stand remembered in the known account of time?" Dr. Sir Thomas Browne. And listen for just a moment Sir Thomas declaring his physician's creed. This is important. "Let me be sick myself," he says, "if sometimes the malady of my patient be not a disease unto me. I desire rather to cure his infirmities than my own necessities. Where I do him no good, methinks it is scarce honest gain. Though I confess, 'tis but the worthy salary of our well-intended endeavors. I am not only ashamed, but heartily sorry, that, besides death, there are diseases incurable. Yet not for my own sake, or that they be beyond my art, but for the general cause and sake of humanity, whose common cause I apprehend as mine own." Is Hippocratic oath any better than that? Incidentally, I reread the Hippocratic oath the other day. And I was impressed, again, by the nobility of its ethical statements. But I was also impressed by something that nobody ever seems to point out. That is, how large proportionately was the space given to the responsibilities of the physician to his fellow craftsmen in the guild of medicine rather than to the patient. And I noticed, incidentally, that the sentence "with purity and with holiness I will pass my life and practice my art" is omitted from the abridged form as given to modern graduates in medicine.

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I began this section by speaking of the transformation of medical arts into medical science. I wonder, however, if medicine at its best will not always be something of an art. Certainly, a good diagnostician is an artist. What any artist does is to select from the whole broad stream of human experience what seems to him its significant aspect or moments. To recombine those and diffuse them under the fire of his own imagination into a new synthesis of some kind. Which represents his particular vision of reality. Now, what does a doctor do except that? Analyzing symptoms. Weighing appearances. Combining them. Fitting them into a pattern. And arriving, sometimes logically and sometimes with a burst of near intuition, at an understanding of the typical or the atypical. And thus forming his diagnosis. Here's an act I submitted, creative imagination of the highest order. However, more and more the healing art, and I use the quotation there because it's a fantastically quaint word now. The healing art has become medical science. Until medicine sometimes I think is on the verge of becoming a technology. The multiple millions of dollars poured into medical research have resulted in profound benefits for suffering humanity. But the inevitable corollary to that is an emphasis upon the various specialties. The human frame and its illnesses has been charted and divided and subdivided. The increase in medical knowledge is such that no one man today can pretend to comprehend the whole. And the result of all that is the obsolescence, to speak again in technological terms. The obsolescence of the general practitioner. What the young medical student today wants to devote his life to is not the routine care of ordinary illnesses. Why should he do that when all sorts of fascinating specializations with correspondingly increased prestige and financial return lie before him for the choosing? Listen to the list of some of them, a few of them alphabetically. Anesthesiology. Dermatology. Internal medicine. Neurological surgery. Obstetrics and gynecology. Ophthalmology. Orthopedic surgery. Otolaryngology. Pathology. Pediatrics. Plastic surgery. Psychiatry. And neurology. Radiology. And urology. Not to take up the Z's. And more and more today the patient I think tends to bypass the general practitioner and seek out the specialist who, according to the patient's own self-diagnosis, is equipped to treat his illness. And such is the nature of the doctor who is, let us face it, a human being. That as a final report of the commission on medical education of the Association of American Medical Colleges put it. And I quote. "Because his efforts are often confined to a single phase of medicine, the specialist looks too frequently upon the problem of the patient solely from the aspect of his specialty. Rather than from the needs of the patient as a whole." End of quotation. But the quandaries a real one. Medical knowledge is so gigantic that the doctor is forced to a division of labor. We have paid a price for our knowledge therefore. Impersonality does very well in electrical engineering, but how about human engineering? Whatever pains I may have, I'm still a whole human being in terms of a total personality. And is it too much to ask a doctor to treat me as a human being? To find the person in the patient? I know, I know that disease is a biological process. But to myself at least, I seem like more than a bundle of biological responses. And as such, the prospect of push button medicine, if that's what you want to call it, frightens me. If a laymen like myself, very much of a laymen here tonight, were to construct a nightmare. It would be set in a long marble hall, down which I passed with my particular ache on a moving belt. As I went by, machines would appear from nowhere to diagnosis me. I would be palpated by an artificial hand. At various stations I would be x-rayed. Ophthalmoscoped. Stethoscoped. And electrocardiographed. Basally metabolized. Mechanically operated syringes would draw blood from me. A thermometer would be popped automatically into my mouth. And if I were to cry out with Macbeth, "Canst thou not minister to a mind diseased. Pluck from the memory a rooted sorrow. Raze out the written troubles of the brain." I would be presented with a flash card reading, prefrontal lobotomy indicated. As I got off that moving platform, I would wait until the electric calculating machine finished flashing and flicking. And at last I would pick out of a slot my prescription. Accompanied by a blank check. Now, this is a completely frivolous conception, of course. A proper nightmare wouldn't allow for the introduction of some sort of standardize bedside manner. Now, this problem of over specialization is, of course, by no means peculiar to medicine. It's one of the saddle sores of our age. Nothing is clearer than that our technology has outrun our sociology. Ever since steam was harnessed up to machines. Ever since the Industrial Revolution really got underway. Man's ability to control his physical environment has outstripped his ability to control himself.

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With the 20th century, the acceleration has become phenomenal. And the gap has gotten steadily wider. We ride the skies today in supersonic splendor. We create marvels of technological ingenuity. We discover antibiotics so that we can make more people live longer. So that they can be run down by faster and faster automobiles. We extract the basic secrets of the atom so that we can explode ourselves into eternity by the millions rather than by the hundreds. We're the masters of the universe. And spiritually and emotionally and ethically and sociologically we're still, comparatively speaking, crawling around in the primeval slime. If I don't watch out, I shall be lecturing on whither mankind. Now, medicine shares in all this technological glory. And though its conception is still the physical salvation of mankind, medicine also has traps waiting for it. The final report of the Commission on Medical Education supports me also at this point. I quote. "Efforts to standardize procedures in medical services are based in many instances upon the fundamental fallacy that the human being, who is a unit of medical service, can be regarded as a uniform standardized organism. Sound medical practice requires careful study of the health needs of each individual. Physical, psychic and social. Another tendency in medical practice is the emphasis placed upon mechanical devices. The laboratory findings are valuable only insofar as they are correlated with the medical problem of a given patient." End of quotation from the report of the commission. In other words, what, not merely what bacillus is invading me, but am I happy with my wife? Is my job getting me down? Am I worried about my debts? Why do I accept invitations to give public lectures? A lot of things that no laboratory can ever give an answer to. And if the modern doctor is going to fulfill his obligation to his patient, therefore, he'll have to approach him with more than penicillin. With an understanding of the profound importance and influence of social, economic and psychological factors. As they contribute to the causation, the treatment and prevention of disease in the individual. The doctor has to know a lot more than medicine. He must be broadly cultured. Able to understand life in all its phases. To the qualities of honesty and integrity, he must add literacy. An awareness of the relation of men to their social and spiritual environment. A sensitiveness to man's imaginative accomplishments and some knowledge of those accomplishments. He must be aware of the place of medicine in the total spectrum of man's knowledge. He must have the qualities of a good general practitioner. He must be a superb specialist. And in addition, he must be an educated man in the broad rather than in the narrow sense. Now, this pretty clearly is a pall for paragons. Paragons are a little hard to come by nowadays. It's only one's profound respect of the medical profession. And his awareness of the responsibilities of modern medicine that give him courage to insist upon such Renaissance men. At the very least to treat the whole man, the doctor must be a whole man himself.

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Now, what should medical education do to produce such men? Certainly, it should help the student to sense the social dimensions of the profession he is entering. If medicine is a form of public service, he must be aware that the public will be interested in the kind of service it is getting. And unless it is given adequate leadership from the profession, it will itself try to move in and call the turns. Perhaps unfortunately so. More and more it's becoming evident to most people that civilized countries cannot afford to neglect the health and well-being of large portions of their entire population. That effective medical services must reach everybody. Now, the $64,000 question, to which, as nearly as I know, no shoemaker knows the answer. The big question is how is this to be done? And at this point I fear that the medical profession has spent a good deal of its organized time throwing roadblocks in the path of progress. I'm not referring now to that nasty idea of socialized medicine, quotation, which I hope Americans will never have to endure. I'm referring rather to the program of organized medicine to brand as socialized the efforts public and private to create types of voluntary methods to distribute the spread of medical services and costs. A good friend of mine who is a doctor declares that, if true state medicine were ever to come to America through the demands of a public frustrated in its groping for adequate medical care. The medical profession itself should be held mainly responsible. A few years ago, Dr. Raymond B. Allen wrote for this very academy which I am now addressing. A book called "Medical Education and the Changing Order." And let me quote him on this point. "Physicians of the future," he writes, "must be capable of viewing the problem of medical service dispassionately. Unless they recognize the right of every person to adequate medical service, the medical profession will degenerate to the level of a trade. Has the medical profession up to this time shown the necessary social vision to cooperate with the community at large? And to both volunteer in public hospices in conceiving and carrying out programs for the improved distribution of medical services? In the spear of the economics and sociology of medical care. Looking toward a wider distribution of high-quality service. The profession, as it expresses itself through its regular organizations, has failed to meet some of its responsibilities to society. Medical education shares in the responsibility of the failure of the medical program to exhibit social insight and aggressive leadership in the problem of adequate medical care for all the people." And Dr. Allen then goes on to point out that the organized profession, "opposed to establishing satisfactory workmen's compensation laws. It opposed prepayment insurance plan for hospital care. It opposed prepayment insurance plans for professional services. It did not show, he said, vigorous imaginative leadership or social insight in its approaches to these problems. Rather it tended to hold back until public pressure was such that it had to go along." End of quotation. Dr. Allen was writing in 1946. I wonder, I wonder what progress has been made in the last ten years on this front of educating the doctor? Knowing academic institutions and professional societies pretty well and their resistance to change. I wonder what kind of education the medical student is getting today in these areas of public as well as professional concern? Is he merely being given more sand to stick his head into? Now, there's another kind of social medicine, not socialized, social medicine. Which a medical student I think ought to be instructed in. If it is true that the study of medicine involves life and all its aspects. Psychological and social as well as physical. Then the emotional and mental life of the patient together with his environmental life becomes a matter for medical concern. Not to understand these stressors is to misunderstand the patient and to offer him partial and incomplete therapy. It involves preventive medicine in its most important frame of reference. Not immunology. For to keep me well, the doctor needs more knowledge than how to use the X rays or toxoids of preventive medicine. It involves a knowledge of me in relation to my total environment. And as Dr. Galdston so well points out in his book, "The Meaning of Social Medicine." It is not just immunology or public health or geriatrics. It is a consideration of total man in his total [inaudible]. And should interpenetrate all branches of medicine, not merely in terms of health and disease. But in terms of life to sustain and improve well-being. Dr. Galdston calls it eubiotic medicine. That is, medicine dedicated to help the individual to achieve the best that he is capable of in his experience in living. Now, here's a tremendous challenge for medical education. Which I suspect it, but dimly perceive at present. To be educated then for this kind of service, a student needs much more than the conventional anatomies. Histologies. Physiologies. Bacteriology. Diagnostics. Therapies. And so forth which have been his traditional curriculum. He needs these too, but he needs more. I'm never surprised at the courses which medical schools prescribe for their students. But I'm always surprised at what they fail to prescribe. Either as part of the medical or the premedical curriculum. Psychiatry has at last crept in as an essential. But how about such a subject as cultural anthropology, the basis of the current lecture. This synthesizing science dealing with the cultures of mankind and the many varieties of phenomena as a concerned man would seem to be very important to medical students. Psychology, particularly, social psychology and sociology. These furnish an invaluable basis to the understanding of modern man. To the extent that medicine is a social science, the premedical student must be brought in contact with these important disciplines. Present premedical curricula largely ignore them. Or at least do not stipulate them. And in general, it seems to me that there is an imperative need for the liberalization of the premedical and the medical curriculum. I've heard medical educators agree in conference and in conversation. They'll always do it in the lobby. That the broadly cultured person makes the best medical student. But when it comes time to set up the requirements for interns to schools of medicine, all this seems to be forgotten. One medical school of which I am familiar. Quite a distance from here. Lists 53 units of requirements in chemistry, physics and biology for its minimum admission requirement. It specifies no other courses except for your freshman English composition. The announcement points out that such premedical requirements leave plenty of time for liberal electives. In the fine print, however, it, quote, "recommends," end quote, that students applying for admission should complete 21 additional units in biology and chemistry. In the competition for entrance to medical school, the students read the fine print. Which would the student choose do you suppose? Courses in anthropology and philosophy? Or more work in chemistry? And if fledgling doctors need more, some sophistication in the social sciences, what about studies in the things that I was describing earlier as a traditional humanity? Don't doctors need history to enable them to see the present in the perspective of the past? Don't they need some minimum of philosophy of logic? To know how man conceives of himself and the universe? Don't they need to be brought face-to-face with the riches of literature and art? So they can enter deeply into the imaginative experiences of other people, to extend the scope of their own sympathetic understanding. It's here that they learn to value their own humanity and that of their fellow human beings. It's here that they get the wisdom which the best minds have spoken through all the ages. Tennyson wrote "Knowledge comes, but wisdom lingers."

[ Background Sounds ]

And if we ever needed wise people, we need them today as doctors. The humanities deal with life and hope and the fulfillment, life made rich and worthwhile. And it is life which it is the doctors task to conserve. Not only the biological process, but the fullness of living. I was pleased recently to come across the presidential address of Dr. Daniel C. Elkin to the American Surgical Association. It was called "A Case for the Study of the Humanities in the Making of a Doctor." And you can see, therefore, why I was pleased to come across it. He quoted Allen Gregg who said that, the fruit of man's preoccupation with nature must give way to humanism to flower a man's experience with man." "If we concentrate our energies, our thinking and our values only on atoms and hormones," went on Dr. Elkin, "then we have, indeed, left ourselves vulnerable to destruction by the very thing we seem to worship and seek to conquer." He goes on to urge the elimination of the word premedical from the curriculum. If premedical meant a sound and inspiring education in scientific and humanitarian thinking. And the acquaintance with cultural achievements so combined and so offered that the student is inspired to recognition of his own potentiality. Then there would be no lost time and cross purpose for the students who do not get into medical school. And those who do would have acquired a proper background of education. "But," concludes Dr. Elkin, "I have just described what does not exist." Now, the impractical, professional humanist, living supposedly with his head in the clouds. Sentimentally aware of the beauty in life. But innocent of any sense of its demanding practicality would be grateful for statements like these from quarters beyond suspicion. I am then with the conclusion, which I stated long ago in advance, every doctor should be, indeed, must be a humanist. And if I wish so much for the medical profession, concerning which I may have sometimes seemed to be severe. It's because I admire it so greatly and share with most people today a keen sense of its dignity and importance. Wish for it nothing but the best in the new society, which is always in the making. Thank you.

[ Applause ]

>> Clarence Henry Faust: I'm sure from observing the play of expression on your faces as you listened to Dr. Dodds. And from this applause, that you have some questions you would like him to answer. I suggest that at this point you write them out so that they may be collected along the aisles. And we will take care of as many as time permits. Meanwhile, there may be one or two that could be asked orally while these are being done. Yes.

>>

[ Inaudible ]

the background or the basis upon which a professional practitioner could do. But with all that supposed background, I imagine the man would have to become almost a geriatric before he starts to practice his medicine, would he not, in order to fulfill those requirements?

>> Clarence Henry Faust: Dr. Dodds, do you wish to respond to that question? Which I take it has that, to do what Dr. Dodds has required of the future physician would take so long that before he was ready to practice medicine his life would be over. Unless we should find some way of extending to the limits of Methuselah the time of life open to him.

[ Inaudible Comment ]

>> John W. Dodds: I have no doubt that there's much truth in what you say. And it's pretty clear that I was painting an ideal picture. You'd know more about this than I probably. But my medical friends tell me, however, that there is an awful lot of water that could be squeezed out of the premedical curriculum particularly. I wouldn't know so much about the medical curriculum. But they start a little earlier, there would be somewhat more time to at least give a kind of, what would you call it. Therapeutic shot in the arm at least to some of the premedical students in the areas that I was describing.

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>> Clarence Henry Faust: Let me ask if you'd reply to this question, Dr. Dodds. In view of the doctors narrow education. Narrow here is put in quotation marks. And in view of his busy schedule, which confines him to the practice of medicine and to the reading of medical journals. Do you feel that doctors are at all qualified to comment on proposals to extend medical services to all, which doctors have classified as socialized medicine?

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>> John W. Dodds: Well, if I understand the question correctly. I would have to say that doctors, however busy they may be. And everybody's pretty busy today. Not as busy as doctors, but they're busy. They still live in society. They vote. They're a part of the commonwealth. And it seems to me, you would have to assume the responsibilities in connection with the commonwealth in relation to their profession that anybody else in any other profession would have to assume. In other words, I don't think the doctor can abdicate simply because he happens to be a busy man.

>> Clarence Henry Faust: Why don't you just remain here since there are half a dozen interesting questions. And the wish to respond to.

>> John W. Dodds: I promise to answer them.

>> Clarence Henry Faust: This question asks whether you feel that the premedical student would benefit more from the Bachelor of Science or the Bachelor of Arts degree?

>> John W. Dodds: That's a technical question. It's impossible to swear because it depends entirely upon what the requirement for either degree may be. And requirements for those two degrees differ a great deal in various institutions. I happen to direct currently at Stanford a thing called an Honors Program in Humanities. And the thing that interests me is the way the really intelligent young premedical students try to fight their way into that program to major in it. They have hard work getting in because they have to fulfill these other premedical requirements. But we do everything we can to get them in. And when we do get them in, we're very happy about it. I don't think the degree's of much importance. The important thing is to see that whatever the degree is, somewhere along the line the student gets a chance for exposure to some of these things.

>> Clarence Henry Faust: Well, I wonder what I could follow that question up with, Dr. Dodd. Isn't it true that in the fields that would be described as the humanities. That is, literature. The arts. Anthropology. Sociology. You have the same kind of specialization taking place that you were describing in medicine. That is, the humanities are broken up into French and German and Spanish languages and literatures. The department of English that deals with literature will be broken up into subfields of the Middle Ages. The Renaissance. The 18th century. Linguistics. Criticism. If then the future doctor is to have the humanities, how is he in this vast proliferation of the humanities to find what you're talking about? That is, the kind of insight into human nature and society on what is offered in the specialized courses?

>> John W. Dodds: Well, certainly he needs guidance. I suspect that any good university has amid all these specialized courses a few geared to the general student which might do him good. At the same time I wouldn't attempt in any way to evade what, an implied indictment on your part. Sometime next year, if we gather together again, I'll tell you what's wrong with the humanities this time.

>> Clarence Henry Faust: Another question here is what is the best current method by which an aspirant may qualify to undertake the study of medicine so that he may succeed as he should? I think what the questioner intends to ask is what the best road into medicine is? Whether by way of other general studies and then medical training. Or beginning of medical training fairly quickly.

>> John W. Dodds: I'm sorry, I don't have really any professional opinion on that. The important thing is that somewhere along the line he gets exposure. Now whether it should come earlier later, it's a matter of technique that I'm not really competent to talk about, I think. Clarence, do have any opinions on that?

>> Clarence Henry Faust: No. I would tend to suppose that the broad general base would be desirable in view of the fact that medicine is rapidly changing. If medicine were fixed, then I would suppose one could quite early get the whole of it conveyed. But if what the doctor needs to do is to keep up with a rapidly changing science. Then use the imagination what a broader base would give him. Now, here's a question that comes after the problem from a rather different angle. At the top of the page is written a thanks that I hereby convey to the committee [inaudible] these lectures. It reads thank you for the series. But question is whether or not it isn't too bad that the Academy of Medicine does not extend its influence into general education for some of us who are so steeped in academic and cultural fields?

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>> John W. Dodds: That I would attempt no answer to. It seems to me the Academy's doing a very beautiful thing with perhaps the exception of the speaker tonight in constructing these annual lectures for the laity. Which is certainly a venture in public education I would say, if not general education.

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>> Clarence Henry Faust: May we have your question.

[ Inaudible Question ]

>> John W. Dodds: Will you write a letter to the director.

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>> Clarence Henry Faust: Here's a question you may not wish to comment on. Though I think it involves a reference to something you said in the lecture that you may wish to expand. Do we have anything to learn, this questioner asks, from the native systems of medicine of India and Pakistan and from primitive cultures?

>> John W. Dodds: I do not wish to comment on that.

>> Clarence Henry Faust: Hard to expand your earlier reference. Well, I think I've caught the main gist of these questions. Unless there's a question from the floor at this point. And I pause for it. Yes.

[ Inaudible Question ]

May I venture to say for the lecturer that he was asked to speak on a subject to whoever happened to be here.

[ Inaudible Comment ]

Well, I may say from knowing something of Dr. Dodds' activities, that he has often spoken to those who have a good deal to do with premedical and medical training. I'm sure that I can on behalf of all of you thank Professor Dodds for this very interesting, very illuminating and very stimulating address.

[ Applause ]

The hour is late. There are many more interesting things to be said. One asked if we had any knowledge from India? One of the most interesting things we have from India in the last two or three years is the Indian root raudextin [phonetic] for high blood pressure. And it was ignored for years until we now have discovered it's of tremendous value. They wanted to know why we didn't educate our young men better. Most universities very wisely now have a course in what they call contemporary education. And the young instructors go to college and try to understand how they shall teach contemporary education to the students. And fortunately, it is a compulsory course in most institutions. The doctor very truly talked about the need of greater education for the doctors. I remember casually strolling into my father's study many years ago. And casually saying, Dad, I think I'd like to study medicine. He looked at me a long while until it was almost embarrassing even with my own father. He said, young man, he said, do you realize that if you're going to study medicine, that you've got to study all your life? And I said, no, I didn't realize that. But if you say so, then it's so. So now I, oh, I beg your pardon. There is one announcement. Remember we made some talk about the word ecology here two or three lectures ago. And somebody in the audience tonight by the name of Percy Whiting [assumed spelling] has sent me a note which says. About ecology, I did better than the dictionary. I found, quote, "Elements of Ecology" by George C. Clark, a Harvard individual. That must be good. I feel like the small boy I was when we used to go to Sunday school. And when Sunday school was over, do you remember we all stood up and we said, our Sunday school is over, we are going home. Let every, be all good and kind. I haven't got it right, but that's the gist of it. This Sunday school is over for the rest of this year. Thank you.

[ Applause ]