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summed up concisely by the one word
"hurry," and not unjustly so, for it is
Vol. X No. 9
EDITORIAL
773
exemplified by our speed mania with re-
gard to autoing, the craze for get-rich-
quick investments, and even the steadily-
growing popularity of the quick lunch
counter. Not alone do we find speed
playing a prominent part in our daily
life, but in many instances it has actually
obsessed the minds of the surgical pro-
fession.
In every community there are those
who owe much of their patronage to a
reputation for speed in the operating
room. And the reason is obvious, for
the more rapidly an operation is per-
formed, the more the convalescent and his
friends marvel over the "skill" displayed
by the surgeon and the more critical do
they become of the efforts of those who
do not seek to break a I'ecord.
What surgeon has not had the near rel-
atives of a patient just befoi'e operation
address him imploringly : "Doctor, please
do the very best you know how!" But
never does he hear them say : "Doctor,
please do the very quickest work How Much Does Tamoxifen Cost you know
how!" However, afterward the same pa-
tient and family will compare notes with
other convalescents and their friends and
boast of the small number Tamoxifen Citrate Uk of minutes
utilized in an appendectomy, hysterec-
tomy or thyroidectomy, for example,
never stopping for one moment to ask:
"Was Tamoxifen Citrate Tablets the appendix, the uterus, or the thy-
roid the main offender?" or, "Might not
a gastric or duodenal ulcer, gall stones,
or a Meckel's diverticulum have been the
true cause of the symptoms?" Likewise
they little realize that a few minutes more
here and there in closing over, say, the
raw surfaces of the broad ligaments or
the mesoappendix might have saved years
of future discomfort and pain from adhe-
sions.
Who is the better surgeon in this partic-
ular instance, the man who for an admit-
tedly diseased appendix does an appen-
dectomy in twelve minutes through a Mc-
Burney incision or the unspectacular
though more obsei-vant man who, having
detected the chronic appendicitis, like-
wise recognized a badly adherent tube,
and a retroversion of the uterus asso-
ciated with a relaxed perineum, and who
thus being able to see a few inches beyond
his nose, employs an infraumbilical mid- Tamoxifen 20 Mg Side Effects
line incision, removes the tube and ap-
pendix, suspends the uterus, and then re-
constructs the perineal Buy Nolvadex Tamoxifen Citrate floor, taking per-
haps from an hour to an hour and a half,
or even more? The fortunate patient of
the latter will have no remarkable tales
to recount to her visitors, and her conva-
lescence may even be somewhat pro-
longed, but she will be in a much better
position to regain her normal health than
will the woman in whom the lesions were
only one-half or one-third corrected.
A patient very rarely goes to the sur-
geon saying: "Doctor, I have gall stones
which I wish you to remove." But what
he does say is: "Doctor, I am in bad
health and suffer with such and such
symptoms, and hope you can cure me."
It is, therefore, the duty of the surgeon
to seek one and all of the causes of his ill
health.
As the immortal John B. Murphy was
wont to remark, "A surgeon should first
of all have a conscience." We would like
to add that he should remember that care-
ful attention to details is the sine qua non
of all work that is really worth while, no
matter what its nature may be; and that
in surgery an inordinate desire for a rep-
utation for speed seeks an undeserved
credit from an uninformed laity, and un-
justly reflects discredit upon the work of
conscientious, painstaking surgeons, who
undertake a surgical operation for the
purpose of removing the cause of a pa-
tient's trouble and not with a precon-
ceived and set determination to make cer-
774
SOUTHERN MEDICAL JOURNAL
September 1917
tain mechanical changes, regardless of
the operative findings, in order that little
time be consumed.
We do not endorse needless waste of
time during operations, but consider it
most fortunate to be able Tamoxifen Citrate 20 Mg to do things
thoroughly and with dispatch. However,
we do decry the increasing and wild de-
sire to speed up regardless of conse-
quences .iust as we do the ever-present
dread of one's mortality rate when the
best interests of the patient demand a
desperate fight for his life at any cost.
THE BIBLE AND BUBONIC PLAGUE
And the men that died not were smitten with the
enurods: and the cry of the city went up to

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