For if there be first a willing mind, it is accepted according to that a man hath, and not according to that he hath not.
(2 Corinthians 8:12, KJV)
We all found out way to the medical ward at Riverside General Hospital in Riverside, California. We were second-year students, feeling both proud and awkward in our barely used white coats. Nurses directed us to a small conference room containing a blackboard, an x-ray view box, chairs, and a slight old man with a thin mustache and a carefully pressed, but not new, suit.
He greeted us, speaking carefully and softly. “I’m Dr. Macpherson,” he said; but his name held little significance to us then, since he was long retired. “Today,” he said, “we will be learning to examine the chest. God has given us special senses and powers of observation and intelligence to interpret the information that we acquire through a careful examination. Let us pray that He guides us in learning and applying these skills.”
He then led us from the conference room to a patient’s bedside. He quietly introduced us to the patient, who, it soon became obvious, he had previously befriended. He then took a stethoscope from his coat pocket and carefully auscultated the chest—demonstrating to us the proper techniques of listening, using the bell and diaphragm. Having obtained the patient’s permission, he asked each of us to listen and then describe what we had heard: rales. He then inquired if we heard sounds in all parts of the chest. Most of us were so focused on listening for sounds that we missed their absence.
He redirected us to a lung base so that we could listen again for absent sounds. With percussion, he outlined the area of dullness and then outlined it with colored marker. He percussed the contralateral chest and marked the diaphragm for comparison. He asked us to remember these markings, then thanked the patient for his kind assistance in teaching the young doctors, and led us back to the conference room. Have he pulled chest x-rays from their folder, placed them on the view box, and then pointed out to us the patient’s basilar effusion and pulmonary congestion.
That afternoon, we discovered our professor had carefully selected and befriended several patients with different pathologies, reviewed each chart, examined each x-ray, and examined each patient in preparation for our instruction and his direction and refinement of our clumsy first attempts at chest examination. Dr. Macpherson allowed us each to feel that we were becoming skilled in physical diagnosis. Now, after many years as a medical school professor, I can appreciate the hours he spent preparing the patients, and organizing the medical records and the x-ray studies for this most memorable moment of instruction.
Walter E. Macpherson, LLUSM class of 1924, demonstrated that God has given us His gifts for helping our patients. He exemplified the highest ideals of medical education in their most elegant form. I often remember that particular day when I’m teaching medical students and house staff, and I pray that I can teach them as clearly and as well as Dr. Macpherson.
-George T.Simpson, LLUSM class of 1973-A