What the Neighbors Think

Abstract

Radiotherapy in malignancy has, happily, long since become respectable. Within the memory of man she was a wayward child, the casual property of the beachcombers of the profession, as well as of its more ethical members, looked down upon from heights of superior virtue by her older and more staid therapeutic sister, Surgery. We, who love her, feel that she has not yet been accorded her proper place in the family circle, and we meet to deplore the fact. Unfortunately the rest of the family does not come to the meetings. At the moment the most important thing in regard to radiotherapy seems to be not so much what it is capable of accomplishing, as what it is to be allowed to accomplish. Just now, the really vital opinion regarding it is not our own, but that of the surgeon, the internist, and the practitioner of general medicine. It is really immaterial whether we can eradicate 5 per cent or 35 per cent of pelvic malignancies, unless we can convince the surgeon that the latter figure is the correct one. It does not make any difference what we can do with early cancer if we are never to be allowed to see one. The answer is, of course, education—of the profession. The plan is simple and goes back to the fundamentals of ethics, both professional and general. A scrupulous regard for the truth, recently recognized as a virtue inherent in all good advertising; moderation, both in word and deed; a niggardly spirit, when it comes to promises and a generous one in performance; and again truth. Deep X-ray therapy is now going through one of those unfortunate phases which seem to be essential in the evolution of any new therapeutic measure, and opinion as to its real value and as to the technique of its employment is sharply and honestly divided. To-day one can obtain from the most interested and best informed, opinions, varying all the way from a flat statement that it is a grave disappointment and will be given up entirely within a few years, to the equally radical statement that it will supplant surgery altogether in the treatment of malignancy. The surgeon, particularly, comes to our mart with reluctant steps, and the more we claim, the more reluctant are his steps. It has been said that a man's value to the community is in direct proportion to his ability to work in harmony with other men. Certainly the radiologist's value to the patient, or at least to the patient as a group, if not as an individual, is directly proportionate to his ability to work in harmony with the surgeon and the internist. And his work is, at the moment, under much more jealous scrutiny than that of the surgeon. No one thinks of discrediting the art of surgery on account of an occasional operative mortality. The blame, if blame there is, is laid at the door of the man, not of the art; of the individual and not of the instrument.