For the 1964–1965 academic year, I had the good fortune to be Dr. J. Willis Hurst’s eighth chief resident in medicine at Atlanta’s Grady Memorial Hospital. Willis was bigger than life, an extraordinary physician and teacher, and the year was one of the best of my life. Dr. Hurst had been appointed professor and chairman of the Department of Medicine at Emory University and chief of the medical service at Grady in 1957, at age 36. In 7 years, he had revitalized both institutions. As Dr. Eugene Stead, one of Hurst’s predecessors at Emory, told Dr. Mark Silverman many years later, Hurst “gave his all to Emory in a time of great need. He saved the medical school.” During my year as chief resident, Dr. Hurst taught me many things, and he continued to teach me until his death on October 1, 2011, at the age of 90. Described here are a few of the multitude of things he taught me.
Take nothing for granted
Listen respectfully to the findings and diagnosis of the referring physician, who often is right, but if you accept it all as correct, you will probably arrive at the same diagnosis, correct or not, because most us run diagnostic algorithms the same way. Doing your own history and physical and examining the pertinent studies yourself may provide a new data set, a new algorithm, and a new diagnosis. This trust-but-verify approach is essential for a consultant to be effective.
High-tech is wonderful, but low-tech is often better
Technology has always driven medical advances, and we cannot do without it. Dr. Hurst often said that if Osler were alive today, he would make appropriate use of our myriad high-tech diagnostic and therapeutic modalities. “Appropriate” is the operative word, because high-tech is always expensive, may have significant side effects, and unless used selectively may not provide the desired information or result. Low-tech investigation (i.e., history, physical examination, and a few simple tests) will either yield a diagnosis or point to the appropriate high-tech investigation.
High-tech is wonderful, but low-tech is often better
Technology has always driven medical advances, and we cannot do without it. Dr. Hurst often said that if Osler were alive today, he would make appropriate use of our myriad high-tech diagnostic and therapeutic modalities. “Appropriate” is the operative word, because high-tech is always expensive, may have significant side effects, and unless used selectively may not provide the desired information or result. Low-tech investigation (i.e., history, physical examination, and a few simple tests) will either yield a diagnosis or point to the appropriate high-tech investigation.
Be reckless and spendthrift with your talent
One of Dr. Hurst’s first hires when he took over as chief of medicine at Grady was Elbert Tuttle, Jr., an outstanding nephrologist. His father, Elbert Tuttle, Sr., a judge on the United States Fifth Circuit Court of Appeals, gave a commencement address to the professional and graduate schools of Emory University that was Willis’s favorite speech. This must have been because Judge Tuttle’s description of the ideal professional man or woman was the definition of Willis: “So do not try to set a price on yourselves … . Rather be reckless and spendthrift, pouring out your talent to all to whom it can be of service! … Like love, talent is useful only in its expenditure, and it is never exhausted. Certain it is that man must eat, so set what price you must on your service. But never confuse the performance, which is great, with the compensation, be it money, power or fame, which is trivial.”
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