The Massachusetts General Hospital opened its doors in 1821. I joined the staff as an intern in 1932 and, for nearly one third of the life of the hospital, have been an observer of the profound changes that have occurred in those 57 years. Many of the lessons learned in those early days still exert a strong influence on present decisions. This brief account may explain the forces exerted on a budding surgeon and may demonstrate some of the changes in the practice of surgery that have transpired since that time.
Students in their final year of study at Harvard Medical School commonly spent a clinical clerkship in the Massachusetts General Hospital. On one occasion, three of us were walking down a corridor in the hospital, laughing about some trivial matter. Suddenly a hand was clapped on a shoulder and the tall, soldierly director of the hospital thundered, "Young man,