The Portland daily press., 1897-09-23
HOSPITAL SURGEONS.
Positions Hard to Get, and it Isn't
Easy to Fill Them.

Visiting Surgeon Secs Thousands of
Cases a Year = The Ambulance Doctor
Defended-Merit Wins, but Iittls Pull
Is Not Bad Thing.
Every graduate of the New York med
bal schools would be glad to hold for the
first IS months of his professional life
post on the staff of metropolitan hospi-
tai. Perhaps one graduate in 80 obtains
such an appointment. So valuable to
physician or surgeon is hospital practice
in New York that graduates in medicine
from all the region round flock to the an
nual examinations of the hospitals If the
staff vacancies are to be filled, 20, 80, so
young men present themselves for exami-
nation. Graduates of the Harvard Medical
school come over to these examinations,
partly because there is wider experience
to be had here than in Boston, partly per-
maps because young man going upon the
stall OF Boston hospital must come not
as graduate in medicine with the diplo-
ma OF M. D., but as a sort of house pupil
or apprentice in medicine.
Ali physicians and surgeons to the New
York hospitals, save the pathologists, serve
without pay. Newly graduated doctors,
men from 23 to near 80 years of age, have
appointments for about Is months. Con-
sulting surgeons, always skilled and often
highly distinguished, are glad to serve
without pay for two years together, be-
cause it is here that experience is gained
and regulations are made. A visiting
surgeon may see 10000 or $4,000 cases in
a single year, such number as not the
ht1ci 49,
during a like season.
Junior, senior, house-that Is the orxier
of promotion in the hospital service for
both physicians and surgeons. The young
graduate has in the natural order of things
six months in each place. Every hospital
has from to 20 doctors on its house staff.
Tho house surgeon proper has general
charge Of all surgical cases after they have
been seen by the visiting surgeon. The
same is true OF the house physician. The
junior OF senior, as the case may be, must
go out with the ambulance when call
comes In. Tho police or private persons
now and then complain that a man has
lain 40 OF 80 minutes, perhaps two hours,
awaiting an ambulance after the call has
been sent out. Most of the time the am
bulance surgeon has an entirely sound cx-
cuse for the delay. Sometimes be is off in
another direction ON ambulance duty.
More often perhaps the call finds him aid
Ing at a surgical operation, and he must
reach stopping place in that duty and
change his clothing before he can go out
IN response to a CALL
The hospital surgeon and his friends
have multitude of answers to the charge
of brutality now and then brought
against the former. Should you see me
at my hospital work, - said the visiting
surgeon of afalnous hospital, "you d think
me rude and perhaps brutal. I have in
two hours to see from go to 90 patients
with all sorts Of injuries from crushed
finger to broken thigh. I must diagnose
rapidly, and should I listen to demands
for anasthetics or heed the hundred and
one other pleas of the patients I should
never finish MY work. 1t is SO with the
young ambulance surgeon kneeling beside
the injured man on the sidewalk. He
must do what he has to do with all speed
without stopping to heed the advice or
comments of a sympathetic crowd"
Tender the hospital surgeon should be,
but sympathetic he must not be. Tho
sympathetic Junior is marked out for fail-
ure just as the sympathetic nurse is
marked out for dismissal. A surgeon
never performs an important operation
upon a member of his own family. He
distrusts his own skill as affected by SYM
pathy.
Hospital surgeons are among the hard
est worked men of their profession. They
have no fixed hours of duty and may be
called upon f5r service at any hour of the
day or night. When hospital has large
staff of medical men, it is possible for the
members of the staff to arrange among
themselves for days and hours off, but the
doctors of a small hospital are often on
duty night and day, and it is lucky
night when the busy Junior has seven
hours of unbroken sleep. The house sur
geon and the senior of small hospital
must never be absent at the same time,
and an absent house physician must never
be many hours away without leaving word
where he may be found.
But if the service of the New York hos
pitfalls is hard it furnishes the very best
practical school in medicine, and especially
in surgery, to be found anywhere in
America. At the end of IS months serv-
ice the young hospital surgeon has seen per-
formed, AMI perhaps has helped to perform,
nearly every operation that falls to the
duty of an ordinary surgeon in lifetime,
and some of such operations he has seen
and taken part in many times over. The
cosmopolitan character of the city and its
immense floating population make it the
temporary home of more strange diseases
than any other city of the continent, SO
that the hospital physician has beneath his
eyes the ailments of the world.
Considering the great opportunities open
to the hospital surgeon, laymen often
wonder whether influence has aught to do
with appointments to hospital staffs. 1t
has and it has not. Examinations are
rigid and fairly conducted, yet the man
that passes the best technical examination
is not always the man that gets the ap-
pointmeDt Yet, on the other hand, an
incapable man is seldom or never appoint
ed The personal equation always helps
to determine All appointment. A candi-
dates appearance, manner, speech and
general record at school are taken into oon-
alteration. The examiners are often the
same men who have instructed the candi-
Al, 10. -, 4bo ,,,adira1 schools and an aY-