RECIPROCAL RESPONSIBILITIES. 
AN ADDRKSS 
DELIVERED ON THE PART OF THE FACULTY AT THE FORTY- 
FIRST COMMENCEMENT EXERCISES OF THE MEDICAL DEPART- 
MENT OF GEORGETOWN UNIVERSITY, AT LINCOLN HALL, ON 
MAY 5, 1890, 
BY 
ff 
SWAN M. BURNETT, M. D., PH. D., 
» 
Professor of Ophthalmology and Otology in the University; Ophthalmic and Aural Surgeon to 
Providence Hospital and to the Garfield Hospital; Director of the Eye and Ear 
Clinic at the Central Dispensary and Emergency Hospital; President 
of the Medical Society of the District of Columbia. 
WASHINGTON: 
PUBLISHED BY THE FACULTY. 
1890. Reciprocal Responsibilities. 
Ladies and Gentlemen: We, of the faculty, feel that 
we are here on sufferance. This is not our night. We have 
had ours for seven months for each of the last three years, 
but this night is peculiarly that of these young gentlemen 
who have just received their certificates of admission to 
the ranks of a learned and liberal profession. This is 
their night, their hour, the goal towards which they have 
for three years—often in weariness of mind and body, but 
with steadfast purpose—kept the eye of their ambition and 
hope. We are now only auxiliary to the occasion—mere 
spectators of their triumphs—the delighted witnesses of 
their well-earned success. 
From time immemorial almost, however, it has been the 
custom among medical colleges to have one of the faculty 
utter a few words of farewell to the outgoing class and bid 
them Godspeed in the uncertain journey upon which they 4 
we share these feelings in common with you, mothers and 
sweethearts! For these many months past they have been 
our “boys” too. Their faces have looked down upon us 
from the amphitheater of the lecture-room in earnest at- 
tention, night after night, with minds alert and open for 
the reception of whatever knowledge we were there to im- 
part. And, though each year we have to give up to the 
great world outside a portion of our*family, we can never 
forget that these mother’s sons are, in a sense, our sons too, 
and we shall watch over them, in the great work of their 
lives, with all the interest of alma mater. 
But in giving them back to you it seems not out of 
place to review briefly, for our mutual benefit, let us hope, 
the relations between these young men and the community 
among which they will exercise their newly-acquired skill. 
There are many circumstances which make the relation 
of the doctor to society in general one of peculiar interest. 
It is both public and personal in a way that is not given 
to any other body of men. 
In matters of hygiene and public health, in the protec- 
tion of the community against epidemics and the spread of 
disease, and in the dissemination of instruction in regard 
to the proper mode of living and working, both b}r indi- 
viduals and in large bodies; in fact, in regard to all ques- 
tions which affect the bodily well-being of mankind in the 
mass, he deals with matters second in importance to none 
with which organized society has to do. 5 
That plagues and pestilences do not sweep over the land 
to the extent they did in former times is due to the knowl- 
edge obtained by the researches and discoveries of medical 
science, and mostly by men engaged actively in the prac- 
tice of their art; and it is claimed, and there are figures 
to support the assertion, that at least ten years have been 
added to the average length of human life by these discov- 
eries within the last fifty years. It is not my purpose nor 
is this the occasion to catalogue all the triumphs medicine 
has achieved during the last few decades. It would be 
straining too much the quality of modesty, which is one 
of the distinguishing traits of the individual members 
of that unassuming profession. 
But these facts are more than an open secret—they are a 
part of the history of the progress of the Age, and they are 
alluded to only to show that in the great advances of mod- 
ern civilization the profession which these young men 
from to-night represent has at least kept pace with the rest, 
and has been no laggard in the hand to hand contest 
humanity is waging against its own weaknesses, death and 
disease. In this public capacity the profession has come 
to hold, in recent times, a position of responsibility, honor, 
and respect, of which it has never shown itself undeserv- 
ing, and discussions of questions in sanitation and hygiene 
have become almost as popular as those in theology, poli- 
tics, or sociology in general. But sanitation and hygiene 
could have no existence on a scientific basis but for the 6 
experiments that have been carried on, and are still being 
carried on, in the laboratories of our medical colleges and 
hospitals, on the physiology of living beings, and investi- 
gation into the various causes which pervert the normal 
functions into pathological conditions and actions. For 
whatever has been accomplished in the prevention and 
limitation in the spread of disease must be placed to the 
credit of the profession which these young men have en- 
tered to-night, and moreover, we guarantee to you, through 
the diplomas which we have conferred upon them here in 
your presence, that they have been instructed in the best 
methods of investigation and are armed and equipped with 
the preliminary knowledge for a further and proper study 
of all the questions which relate to public health, the pre- 
vention of disease, and its cure or alleviation when already 
established. Further than this we cannot go; further than 
this it is not possible for any collegiate instruction to go. 
We have tried to make our experience their knowledge, 
and, quite as important still, we have endeavored to find, 
with them, the limits of our actual acquirements, to teach 
them that the most important knowledge is the knowledge 
of our ignorance. Till we know what we don’t know we 
can never properly know what we do know. Did it ever 
occur to you that the doctor is pre-eminently a searcher 
after truth? Most other men have some bias, either of 
dogma, of interest, or of opinion, but the physician’s con- 
stant aim is to see things in the pure white light of abso- 7 
lute verity. His whole professional life is spent in unrav- 
eling the tangled threads in the skein of evidence presented 
by deranged functions, and in giving to each manifestation 
its value, and its proper and only value in its relation to 
the others. In no other avocation in life is the judicial 
frame of mind called more constantly into requisition 
than in the daily practice of the conscientious physician. 
We have, among other things, tried to teach these young 
men not only what is the actual value of drugs in the 
management of disease, but also the limits of their useful- 
ness and the dangers of over-medication. We have en- 
deavored to induct them into the study of the natural 
history of disease, and the powers of nature to throw off, 
unaided by drugs, the burden of morbific influences when 
they are given a proper opportunity to exercise their func- 
tions. When, therefore, any one of these men comes to 
minister to your relief when you are ill, and does not at 
once fill your stomach with all the contents of an apothe- 
cary-shop, do not consider, for a moment, that it is from 
any lack of knowledge of drug-action, but because he 
knows not only when to give medicine, but when not to. 
lie is only carrying out the truth that we have tried to 
teach him, that any fool can go to the medicine-chest and 
dose out drugs, but he is the wise man who knows when 
to abstain, and that the chief office of the medical attend- 
ant is to tell people what not to do or take. 8 
And when we come to consider, further, the physician 
in what may be termed his private capacity, in his per- 
sonal relations with individual mail and woman, his posi- 
tion becomes one which, in confidence and trust, is ex- 
ceeded by no other. What man is more relied upon than 
the doctor? In whom do you confide as you do in your 
physician? You tell him things you would tell no other 
human being, and it is a trust that is so seldom betrayed 
that an instance of its breach is always a cause of righte- 
ous indignation and surprise. We look for trustworthi- 
ness in a physician with the same certainty as w’e expect 
virtue in woman. And so far has this become a fixed 
belief among men that that merciless critic and mirror of 
life—the stage—has seldom given us a doctor for a villain. 
His ministrations are not confined to the diseased body, 
but, perhaps, quite as important still, extend to the pur- 
turbed spirit, to the disordered mind when it becomes 
“like sweet bells jangled—out of tune.” Few of you but 
have experienced the mental relief which the sound of his 
longed-for footsteps brings, and but know the comfort that 
radiates from his thoughtful yet often cheerful face. His 
eyes are the first to look upon us on our entrance into the 
turmoil of an earthly existence, and among the last to 
gaze upon us when we come to lay the weary burden 
down and enter upon an eternal rest. 
He comes when we call, he shares our joys, and bears 
with us the burdens of our sorrows, and that, too, as a rule, 9 
without ostentation or complaint, and with no assumption 
of undue importance. To him life is more serious and 
earnest and grander and nobler than to most men. He has 
opportunities that are accorded to few to know how much of 
unselfishness and love and ennobling patience and courage 
belong to our frail humanity. And I will confess to you— 
and the confession must not be accepted as egotistical as 
it sounds, since I am only a piece of a doctor—not a whole 
one—one of those specialists, as they are called, who found 
that he wasn’t capable of taking in the whole of the body, 
but must be content with doing the best he could with a 
study of a small part of it—I must confess, I say, that I 
have often wondered how men and women can lie down 
in their beds and sleep peacefully night after night with- 
out the consciousness that they have contributed to the 
relief of any human suffering. The doctor has that ano- 
dyne every day of his life—that is, when he hasn’t such a 
big a dose of it as to keep him awake the whole of the 
night—and it goes far to make up to him for the great 
draughts constantly made upon his bodily and mental 
strength. In fact, there is nothing in his professional life 
to develop anything but the best that is in him. There 
is no sort of an excuse for the doctor being a mean or dis- 
honorable man, and if he turns out to be a scoundrel it is 
because there was more bad than good in him to begin 
with, and even the medical profession couldn’t save him. 
Depend upon it, he would have been much worse if he 
had been anything else. 10 
These apparently most egotistical utterances are made 
not for the purpose of “ magnifying our office/’ but to call 
to your minds and those of these young physicians not 
only the responsibilities of the profession, but the ideal 
that has been raised for them to live up to. 
But responsibilities in life are never unilateral. The 
universal law which seeks for proper adjustment and bal- 
ance is applicable here as else wife re, and for a few moments 
I desire to call your earnest attention to some of your 
duties as citizens and members of the community. You 
must bear in mind that you, yourselves, are, in a largo 
measure, responsible for tbe kind of doctors you have. 
While, as I have said, the career of a physician is calcu- 
lated to call forth only that which is best in him, it is 
evident that, if you want mental and moral qualities of 
the first rank in the profession, you must give some sort 
of guarantee that these qualities shall have at least the 
same recognition here as are accorded to them elsewhere. 
If you want the best doctors you must encourage the best 
material to enter the profession. 
It is not, I know, a safe thing to make general statements, 
but I think the intelligence and culture of a community can 
be very well judged by its doctors. Many of you may re- 
member that old story of the Methodist circuit-rider who, at 
the end of his year’s hard labor, found his cash assets to 
amount to two dollars and fifty cents. Going up to Confer- 
ence in the autumn lie was interrogated by his Bishop as to 11 
the religious interests of his late circuit, and as to the kind 
of man they would probably want to succeed him. “ Well,” 
said the preacher, “my experience would lead me to say 
that the requirements of the Bald Knob circuit would be 
properly met by a $2.50 preacher, if you have one.” Now, 
it is not too much to say that it rests largely with you as 
to whether you will have two-dollar-and-half doctors or 
those of the other kind. As ye are, so, also, shall., your 
doctors be. 
In reply to this laying on of responsibility, }rou may say 
that it is not the province of the community to educate 
physicians, that this is the professed duty of the medical 
colleges and hospitals which we represent. That is per- 
fectly true, and we have no desire to shirk any of the duty 
thus imposed, but what we have a right to demand, and 
what we do demand at your hands, is a fair chance and 
full opportunity of furnishing you with what we know to 
be the best, and the power to exclude the unworthy. It 
is mainly because we are hampered by too much free- 
dom—if we may use a paradox—that we have not ap- 
proached more nearly to our own ideal in this country. 
The responsibility of medical practice is made, by law, too 
easy of acquirement, and thus pretention, arrogance, ignor- 
ance, and assumption have equal chances in the race with 
ability, modesty, and scientific acquirement. So long as 
the laws made by your representatives render it a possi- 
bility for an M. D. to be manufactured after twro short 12 
courses of lectures, and often very poor ones at that, and 
so long as it is not illegal for any presumptuous ignoramus 
to assume, unchallenged, the title of doctor, and can ply 
his arts and artifices in opposition to the properly-qualified 
physician and surgeon, so long must the community be 
responsible for an opprobrium which rests upon the medi- 
cal profession, as a mass, in this country, as it does in no 
other civilized nation on earth. 
The American nation, as a people, are responsible for 
the conditions which make it possible for German medical 
institutions to refuse to recognize the diplomas from any 
medical college in the United States. Not that some of 
these are not as good and efficient as are to be found any: 
where, but because the laws of the land recognize and 
authorize the innumerable diploma mills all over the 
country, which turn out wholesale, and with total disre- 
gard of qualification, any and all sorts of the genus Doctor. 
It is your duty to change all that. It is your duty, through 
your representatives in Legislatures and in Congress, to 
protect yourselves and a liberal and cultured profession 
against charlatanry, ignorance, and imposture. This pro- 
tection is certainly a legitimate province of Government, 
if it have one. Before a man is allowed to assume the 
functions of a physician or surgeon, let him be compelled 
to furnish the evidence of his qualification by a successful 
examination before a board of competent men, selected by 
the governing powers, and who have no interest, personal 13 
or pecuniary, in the result of that examination. No repu- 
table medical college in the country is opposed to this, and 
we, of Georgetown College, are not afraid to meet such a 
test of our teaching. With a bill embodying these features 
now before Congress, it is your evident duty as good citi- 
zens, for your own protection and ours, to see that it is 
passed—and passed promptly and enforced. 
See to it that the study of Anatomy—the foundation of 
surgery and the handmaid of medical practice—is made 
possible in this District without the possibility of the 
stigma of crime being attached to it. Give us an anatomy 
Act—such as is in force, I believe, in every State in the 
Union, and certainly in every one where medical teaching 
is carried on to any extent—which shall give a sense of 
security to the community as to the undisturbed repose of 
their lost loved ones, and make the pursuit of necessary 
knowledge not liable to punishment by fine and imprison- 
ment. The absence of such a law on the statute-books of 
this District you should see rectified at once, and for your 
own sakes; for, depend upon it, the doctor has no interests 
which are not shared by the community in which he lives 
and labors. 
These, among others, are responsibilities which rest 
upon you, and which should be assumed by you in simple 
justice to a class of intelligent, hard-working, liberal- 
minded citizens who have consecrated their lives to the 
preservation of your health and the lengthening of your 14 
days in comfort here upon earth. If these are fulfilled 
as they should be, and.as we have every reason to believe 
they will be, on your part, I, in behalf of my colleagues 
and these young gentlemen who have to-day enrolled 
themselves in the grand army which fights, under the 
black flag, against death and disease, will guarantee the 
fulfillment, on their part, of this compact made by them 
to-night, and which your presence here, with music and 
flowers, is intended to ratify and confirm. Let us all live 
up to it in the highest and noblest interpretation of its 
spirit. 
To you, newly-fledged doctors, there remains little to 
be said by us. If we have not taught you how to become 
physicians during these w£ary months now ended, a few 
words at parting can certainly not make up the fault. 
You have had enough of us for the present, I fancy, and 
are glad to be relieved from the thralldom of the class- 
room, and are eager to assume your new responsibilities. 
I wish it were in my power to advise you with certain 
wisdom, but my observation is that advice to novices is of 
but little use, and that not altogether from the fact that 
they are not willing to take it. No man can give another 
a sure receipt for success, because no two men ever achieve 
success in exactly the same way. But there are one or 
two suggestions which I would throw out to you at part- 
ing, like the traditional old slipper, for luck, and which I 
hope you may not altogether forget, for the sake of your 15 
own manhood. Always be yourself. Never be an imita- 
tion of some one else, and never strive for success by the 
apparently successful methods of another which are not 
in perfect harmony with that which is best and noblest in 
you. Better be a failure in the eyes of the world than a 
miserable disappointment to this best self. After all, we are 
men with Divine aspirations and Immortal Individualities 
before we are doctors, or lawyers, or priests, or merchants. 
Be true, therefore, to that Divinity which is within you— 
listen often to her low, sweet voice—and, whatever betide 
you, your life is a success. “What thy hand findeth to 
do, do it with thy might.” Let no ambition be too exalted 
for your aim. “Hitch your wagon to a star.” 
W. H. Moore & Co., Printers, 511 Eleventh Street, N. W.