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UNIVERSITY OF VANDERBILT SCHOOL OF MEDICINE

UNIVERSITY OF VANDERBILT SCHOOL OF MEDICINE. A PHILOSOPHY OF MEDICINE : LESSONS WE AND OUR PATIENTS HAVE RECEIVED WITH GRATITUDE H. Cecil Coghlan, MD,FACC. Professor of Medicine University of Alabama at Birmingham. Medical History. First Edition of Principles of Internal Medicine

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UNIVERSITY OF VANDERBILT SCHOOL OF MEDICINE

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  1. UNIVERSITY OF VANDERBILTSCHOOL OF MEDICINE A PHILOSOPHY OF MEDICINE : LESSONS WE AND OUR PATIENTS HAVE RECEIVED WITH GRATITUDE H. Cecil Coghlan, MD,FACC. Professor of Medicine University of Alabama at Birmingham

  2. MedicalHistory First Edition of Principles of Internal Medicine 1951 T. R. Harrison Paul B. Beeson William H. Resnick George W. Thorn M. M. Wintrobe

  3. IntroductionApproach to the Patient No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician. In the care of the suffering he needs technical skill, scientific knowledge, and human understanding. He who uses these with courage, with humility, and with wisdom will provide a unique service for his fellow man, and build an enduring edifice of character within himself. The physician should ask of his destiny no more than this; he should be content with no less. T. R. Harrison, Principles of Internal Medicine, 1951

  4. APPROACH TO THE PATIENT • In the practice of medicine the physician employs a discipline which seeks to utilize scientific methods and principles in the solution of its problems, but it is one which, in the end, remains an art, in the sense that rarely, if ever, is it possible to exclude judgment and experience from the interpretation of the patient’s reactions. T. R. Harrison, Principles of Internal Medicine

  5. Words of Wisdomfrom “ The Chief “ RE- SEARCH : “ cooking the scraps of other’s fare “ Versus PRE- SEARCH : “ blazing new trails for the human mind” T. R. Harrison, 1974

  6. Left Ventricular Function.O. Frank., Z. Biol., 1895; 32: 370 Response of the frog ventricle To increased filling pressure

  7. Professor Tinsley Randolph Harrison 1900-1978

  8. PHILOSOPHY OF EDUCATIONEDUCATIONAL EQUATIONSTINSLEY R. HARRISON , M.D. • “ Such modest abilities as I may have as a teacher are the consequence of an educational philosophy arrived at by the fortunate combination in William Osler of a clear head and a warm heart. The training of a pupil may be compared to the rearing of a child. The best assurance that a teacher has of achieving his objective is to attempt to be the kind of person he wishes his pupil to become “

  9. EDUCATIONAL PHILOSOPHYTinsley R. Harrison • The training of a physician is both similar to and different from the training of an engineer. For both, the precise thinking derived from quantitative measurements and from scientific principles is essential. But because the physician does not deal with inert raw materials and only secondarily with machines but rather with people, impaired by disease, afflicted by suffering, and hampered by fear, even the finest and clearest scientific thinking is not enough. Like the minister, the priest or the rabbi, the physician needs a deep and pervading humanity. It does not seem an insuperable task for our medical schools to train physicians that can think like engineers and feel like ministers

  10. Educational equations inspired by Albert Einstein • E = h H2 • E= education, h = teacher’s head, H = teacher’s HEART • E = mc2 • E = education, m = mental interaction between teacher and pupil, c = mutual, partial cardiac transplantation. • “ If a teacher leaves behind him pupils and pupil’s pupils whose hearts are warm, whose minds are fertile and whose goals are high, he has not lived in vain”

  11. “Support “ • “ Never forget that we physicians can cure sometimes, but must comfort always “ ( T. R. Harrison ) • The patient said softly: “ My doctor’s love is as important to me as his chemotherapy “. For a long time, I had carried the belief that, as a physician, my love didn’t matter and the only thing of value I had to offer was my knowledge and skill. I now realized that medicine is as close to love as it is to science, and its relationships matter even at the edge of life itself. ( R. N. Remen, Kitchen Table Wisdom , 1996 )

  12. A Spanish Proverb • Make sure you never forget that the “ devil “ knows so much, not because he is a devil, but because he has been around for so long.

  13. Albert Einstein in his study in Princeton 1939 “ The important thing is to never stop asking questions “

  14. THE PRACTICE OF MEDICINET. R. Harrison, Principles of Internal Medicine • Tact, sympathy and understanding are expected of the physician, for the patient is no mere collection of symptoms, signs, disordered functions, damaged organs, and disturbed emotions. He is human, fearful, and hopeful, seeking relief, help and reassurance.

  15. THE PRACTICE OF MEDICINE: PHILOSOPHY UPDATE 2006 • Patients serve as a unique scientific resource. They report what is wrong, we have to make sense of what they teach. They tell us the truth; we have to avoid dismissiveness as a defense of our own ignorance. They seek our help; we have to commiserate with their unintended, unwanted metamorphosis from independent, private, integrated personhood to dependent, exposed, disintegrated patienthood. David S. Goldstein, M.D., Ph. D., Adrenaline and the Inner World. An introduction to Scientific Integrative Medicine. The Johns Hopkins University Press, 2006.

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