Arrowsmith

through before he fell asleep at his rickety study-table.
Memorizing of gynecology, of ophthalmology, till his mind was burnt raw.
Droning afternoons of hospital demonstrations, among stumbling students barked at by tired clinical professors.
The competitive exactions of surgery on dogs, in which Angus Duer lorded it with impatient perfection.
Martin admired the professor of internal medicine,  T. J. H. Silva, known as “Dad” Silva, who was also dean of the medical faculty. He was a round little man with a little crescent of mustache. Silva’s god was Sir William Osler, his religion was the art of sympathetic healing, and his patriotism was accurate physical diagnosis. He was a Doc Vickerson of Elk Mills, grown wiser and soberer and more sure. But Martin’s reverence for Dean Silva was counterbalanced by his detestation for  Dr. Roscoe Geake, professor of otolaryngology.
Roscoe Geake was a peddler. He would have done well with oil stock. As an otolaryngologist he believed that tonsils had been placed in the human organism for the purpose of providing specialists with closed motors. A physician who left the tonsils in any patient was, he felt, foully and ignorantly overlooking his future health and comfort⁠—the physician’s future health and comfort. His earnest feeling regarding the nasal septum was that it never hurt any patient to have part of it removed, and if the most hopeful examination could find nothing the matter with the patient’s nose and throat except that he was smoking too much, still, in any case, the enforced rest after an operation was good for him. Geake denounced this cant about Letting Nature Alone. Why, the average well-to-do man appreciated attention! He really didn’t think much of his specialists unless he was operated on now and then⁠—just a little and not very painfully. Geake had one classic annual address in which, winging far above otolaryngology, he evaluated all medicine, and explained to grateful healers like Irving Watters the method of getting suitable fees:
“Knowledge is the greatest thing in the medical world but it’s no good whatever unless you can sell it, and to do this you must first impress your personality on the people who have the dollars. Whether a patient is a new or an old friend, you must always use salesmanship on him. Explain to him, also to his stricken and anxious family, the hard work and thought you are giving to his case, and so make him feel that the good you have done him, or intend to do him, is even greater than the fee you plan to charge. Then, when he gets your bill, he will not misunderstand or kick.”

II
There was, as yet, no vision in Martin of serene spaciousness of the mind. Beyond doubt he was a bustling young man, and rather shrill. He had no uplifted moments when he saw himself in relation to the whole world⁠—if indeed he realized that there was a deal of the world besides himself. His friend Clif was boorish, his beloved Leora was rustic, however gallant she might be, and he himself wasted energy in hectic busyness and in astonishment at dullness. But if he had not ripened, yet he was close to earth, he did hate pretentiousness, he did use his hands, and he did seek iron actualities with a curiosity inextinguishable.
And at infrequent times he perceived the comedy of life; relaxed for a gorgeous hour from the intensity wearing to his admirers. Such was the hour before Christmas vacation when Roscoe Geake rose to glory.
It was announced in the Winnemac Daily News that  Dr. Geake had been called from the chair of otolaryngology to the vice-presidency of the puissant New Idea Medical Instrument and Furniture Company of Jersey City. In celebration he gave a final address to the entire medical school on “The Art and Science of Furnishing the Doctor’s Office.”
He was a neatly finished person, Geake, eye-glassed and enthusiastic and fond of people. He beamed on his loving students and cried:
“Gentlemen, the trouble with too many doctors, even those splendid old pioneer warhorses who through mud and storm, through winter’s chill blast and August’s untempered heat, go bringing cheer and surcease from pain to the world’s humblest, yet even these old Nestors not so infrequently settle down in a rut and never shake themselves loose. Now that I am leaving this field where I have labored so long and happily, I want to ask every man jack of you to read, before you begin to practice medicine, not merely your Rosenau and Howell and Gray, but also, as a preparation for being that which all good citizens must be, namely, practical men, a most valuable little manual of modern psychology, How to Put Pep in Salesmanship, by Grosvenor  A. Bibby. For don’t forget, gentlemen, and this is my last message to you, the man worth while is not merely the man who takes things with a smile but also the man who’s trained in philosophy, practical philosophy, so that instead of daydreaming and spending all his time talking about ‘ethics,’ splendid though they are, and ‘charity,’ glorious virtue though that be, yet he never forgets that unfortunately the world judges a man by the amount of good hard cash he can lay away. The graduates of the University of Hard Knocks judge a physician as they judge a business man, not merely by his alleged ‘high ideals’ but by the horsepower he puts into carrying them out⁠—and making them pay! And from a scientific standpoint, don’t overlook the fact that the impression of properly remunerated competence which you make on a patient is of just as much importance, in these days of the new psychology, as the drugs you get into him or the operations he lets you get away with. The minute he begins to see that other folks appreciate and reward your skill, that minute he must begin to feel your power and so to get well.
“Nothing is more important in inspiring him than to have such an