Eczema: The Confident Doctor by Sir William Osler

Sir William delivered the below extemporaneous remarks to a group of medical students over 100 years ago; yet they still resonate with us a century later.

“There is a strong feeling abroad among people that we doctors are given over nowadays to science; that we care much more for the disease and its scientific aspects than for the individual. I don’t believe it, but at any rate, whether the tendency exists or not, I would urge upon you in your own practice, to care more particularly for the individual patients than for the special features of the disease.

Every sickness is a musical problem; every cure a musical solution.

Novalis

Dealing as we do with poor suffering humanity, we see the man unmasked, exposed to all the frailties and weaknesses, and you have to keep your heart soft and tender lest you have too great a contempt for your fellow creatures. The best way is to keep a looking-glass in your own heart, and the more carefully you scan your own frailties the more tender you are for those of your fellow creatures.

More than any other, the practitioner of medicine may illustrate the … great lesson, that we are here not to get all we can out of life for ourselves, but to try to make the lives of others happier. The practice of medicine is an art, not a trade: a calling not a business; a calling in which your heart will be exercised equally with your head.

Often the best part of your work will have nothing to do with powders or potions, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, the wise upon the foolish … Courage and Cheerfulness will not only carry you over the rough places of life, but will enable you to bring comfort and help to the weak-hearted, and will console you in the sad hours when, like Uncle Toby, you have “to whistle that you may not weep.”

About the Author: Dr Marvin Rapaport, MD

In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.