be aware that hypothyroidism is often encountered in postmenopausal women. Our recommendation therefore also stresses the need for clinical awareness of the early manifestations of hypothyroidism rather than for unselective screening of, for example, "patients over 50 who present to doctors with other problems". Richard B. Goldbloom, MD, FRCPC Professor Department of Pediatrics Dalhousie University Halifax, NS
Doctor bashing atrick Sullivan's recent reF' port on the CMA's second .L Canadian Medical Leadership Conference (Can Med Assoc J 1990; 142: 863, 865) includes a pithy lament, quoted by Dr. Jock Murray, about societal attitudes toward our profession: "You set your hopes on us when you're ill and your dogs on us when you're well." The American humorist Ambrose Bierce unleashed this witticism in 1906. In its original form it read as follows:' "PHYSICIAN, n. One upon whom we set our hopes when ill and our dogs when well." Should we be comforted or saddened by the knowledge that "doctor bashing" was prevalent at the turn of the century? Bierce indulged in the sport himself, as witnessed by his comments on the last rites of medicine.2 A KIND-HEARTED PHYSICIAN sitting at the bedside of a patient afflicted with an incurable and painful disease heard a noise behind him and turning saw a Cat laughing at the feeble efforts of a wounded Mouse to drag itself out of the room.
"You cruel beast!" he cried. "'Why don't you kill it at once, like a lady?" Rising, he kicked the Cat out of the door and picking up the Mouse com260
CAN MED ASSOC J 1990; 143 (4)
passionately put it out of its misery by pulling off its head. Recalled to the bedside by the moans of his patient, the Kind-Hearted Physician administered a stimulant, a tonic, and a nutrient, and went away.
Bierce would almost certainly be contemptuous of our current "high-tech" efforts to cheat the grim reaper. His medieval counterparts probably criticized the art of leeching with equal vigour. Our critics we have always with us. Charles Shamess, MD, CM 703-1081 Carling Ave. Ottawa, Ont.
References 1. Bierce A: The Devil's Dictionary. In
The Collected Writings of Ambrose Bierce, Citadel Pr, Secaucus, NJ, 1979: 325 2. Idem: Fantastic Fables. Ibid: 571
[Dr. Murray responds.] Dr. Shamess is correct. I was flattered to be quoted in the CMAJ report, but in fact I was quoted making a quote from Bierce's The Devil's Dictionary. I went on to quote Bierce's definition of medicine (again from The Devil's Dictionary): "a stone flung down the Bowery to kill a dog in Broadway". T.J. Murray, MD Dean of medicine Dalhousie University Halifax, NS
The future of medical research in Canada
his choice of examples seems to indicate too little support for research away from the university laboratory bench. Those of us studying our patients in rural clinics and hospital wards work against the odds of making astounding discoveries. The systems we choose to investigate are complex, with a great many variables. Networking with colleagues is diflficult. Our busy practices and family lives tend to dilute our research efforts. Our output, to the eyes of bench researchers, often looks drab, incomplete and "fuzzy". A future national strategy for Canadian medical research should find ways of increasing the quality and quantity of output from community researchers. Research into prehospital medical care is a case in point. The people best positioned to carry out this research are up to their armpits in clinical, political and economic work. Providing leadership to do the necessary research is difficult. Yet Canada, with its affluent society, is tied with the United States for having the best prehospital medical care in the world. I think that prehospital medicine is a gold mine of exciting discoveries waiting to be tapped. For decades family physicians have made the same argument in their field, yet support for the complex clinical research required in family medicine is often incomplete. Perhaps Canada's great contribution to medical research in the second millenium could be the development of community research. The first great discoveries were made by clinicians at the bedside. Then laboratory bench research took over. Perhaps it is time to marshall sophisticated new tools and develop community research to its full potential.
D_ r. Martin J. Hollenberg's excellent and timely editorial (Can Med Assoc J 1990; 142: 805-807) is welcome, but there is an important omission: community research. Hollenberg's general comments are cer- James M. Thompson, MD, CCFP (EM) tainly valid for all types of medi- P0 Box 930 cal research in this country, but Sundre, Alta.
For prescribing information see page 339
Doctor bashing atrick Sullivan's recent reF' port on the CMA's second .L Canadian Medical Leadership Conference (Can Med Assoc J 1990; 142: 863, 865) includes a pithy lament, quoted by Dr. Jock Murray, about societal attitudes toward our profession: "You set your hopes on us when you're ill and your dogs on us when you're well." The American humorist Ambrose Bierce unleashed this witticism in 1906. In its original form it read as follows:' "PHYSICIAN, n. One upon whom we set our hopes when ill and our dogs when well." Should we be comforted or saddened by the knowledge that "doctor bashing" was prevalent at the turn of the century? Bierce indulged in the sport himself, as witnessed by his comments on the last rites of medicine.2 A KIND-HEARTED PHYSICIAN sitting at the bedside of a patient afflicted with an incurable and painful disease heard a noise behind him and turning saw a Cat laughing at the feeble efforts of a wounded Mouse to drag itself out of the room.
"You cruel beast!" he cried. "'Why don't you kill it at once, like a lady?" Rising, he kicked the Cat out of the door and picking up the Mouse com260
CAN MED ASSOC J 1990; 143 (4)
passionately put it out of its misery by pulling off its head. Recalled to the bedside by the moans of his patient, the Kind-Hearted Physician administered a stimulant, a tonic, and a nutrient, and went away.
Bierce would almost certainly be contemptuous of our current "high-tech" efforts to cheat the grim reaper. His medieval counterparts probably criticized the art of leeching with equal vigour. Our critics we have always with us. Charles Shamess, MD, CM 703-1081 Carling Ave. Ottawa, Ont.
References 1. Bierce A: The Devil's Dictionary. In
The Collected Writings of Ambrose Bierce, Citadel Pr, Secaucus, NJ, 1979: 325 2. Idem: Fantastic Fables. Ibid: 571
[Dr. Murray responds.] Dr. Shamess is correct. I was flattered to be quoted in the CMAJ report, but in fact I was quoted making a quote from Bierce's The Devil's Dictionary. I went on to quote Bierce's definition of medicine (again from The Devil's Dictionary): "a stone flung down the Bowery to kill a dog in Broadway". T.J. Murray, MD Dean of medicine Dalhousie University Halifax, NS
The future of medical research in Canada
his choice of examples seems to indicate too little support for research away from the university laboratory bench. Those of us studying our patients in rural clinics and hospital wards work against the odds of making astounding discoveries. The systems we choose to investigate are complex, with a great many variables. Networking with colleagues is diflficult. Our busy practices and family lives tend to dilute our research efforts. Our output, to the eyes of bench researchers, often looks drab, incomplete and "fuzzy". A future national strategy for Canadian medical research should find ways of increasing the quality and quantity of output from community researchers. Research into prehospital medical care is a case in point. The people best positioned to carry out this research are up to their armpits in clinical, political and economic work. Providing leadership to do the necessary research is difficult. Yet Canada, with its affluent society, is tied with the United States for having the best prehospital medical care in the world. I think that prehospital medicine is a gold mine of exciting discoveries waiting to be tapped. For decades family physicians have made the same argument in their field, yet support for the complex clinical research required in family medicine is often incomplete. Perhaps Canada's great contribution to medical research in the second millenium could be the development of community research. The first great discoveries were made by clinicians at the bedside. Then laboratory bench research took over. Perhaps it is time to marshall sophisticated new tools and develop community research to its full potential.
D_ r. Martin J. Hollenberg's excellent and timely editorial (Can Med Assoc J 1990; 142: 805-807) is welcome, but there is an important omission: community research. Hollenberg's general comments are cer- James M. Thompson, MD, CCFP (EM) tainly valid for all types of medi- P0 Box 930 cal research in this country, but Sundre, Alta.
For prescribing information see page 339
