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AEQUANIMITAS

Thou must be like a promontory of the sea, against which, though the waves beat continually, yet it both itself stands, and about it are those swelling waves stilled and quieted.

                                                                    Marcus Aurelius.

I say: Fear not! Life still
Leaves human effort scope.
But, since life teems with ill,
Nurse no extravagant hope:
Because thou must not dream, thou need'st not then despair

                                             Matthew Arnold, Empedocles on Etna.

["Aequanimitas," Aequanimitas, p. 3]

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AEQUANIMITAS¹

TO many the frost of custom has made even these imposing annual ceremonies cold and lifeless. To you, at least of those present, they should have the solemnity of an ordinance—called as you are this day to a high dignity and to so weighty an office and charge. You have chosen your Genius, have passed beneath the Throne of Necessity, and with the voices of the fatal sisters still in your ears, will soon enter the plain of Forgetfulness and drink of the waters of its river. Ere you are driven all manner of ways, like the souls in the tale of Er the Pamphylian,² it is my duty to say a few words of encouragement and to bid you, in the name of the Faculty, God-speed on your journey.

I could have the heart to spare you, poor, careworn survivors of a hard struggle, so "lean and pale and leaden-eyed with study;" and my tender mercy constrains me to consider but two of the score of elements which may make or mar your lives—which may contribute to your success, or help you in the days of failure.

In the first place, in the physician or surgeon no quality takes rank with imperturbability, and I propose for a few minutes to direct your attention to this essential bodily virtue. Perhaps I may be able to give those of you, in

¹Valedictory Address, University of Pennsylvania, May 1, 1889

²‘The Republic, Book X.

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["Aequanimitas," Aequanimitas, p. 4]

AEQUANIMITAS

whom it has not developed during the critical scenes of the past month, a hint or two of its importance, possibly a suggestion for its attainment. Imperturbability means coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril, immobility, impassiveness, or, to use an old and expressive word, phlegm. It is the quality which is most appreciated by the laity though often misunderstood by them; and the physician who has the misfortune to be without it, who betrays indecision and worry, and who shows that he is flustered and flurried in ordinary emergencies, loses rapidly the confidence of his patients.

In full development, as we see it in some of our older colleagues, it has the nature of a divine gift, a blessing to the possessor, a comfort to all who come in contact with him. You should know it well, for there have been before you for years several striking illustrations, whose example has, I trust, made a deep impression. As imperturbability is largely a bodily endowment, I regret to say that there are those amongst you, who, owing to congenital defects, may never be able to acquire it. Education, however, will do much; and with practice and experience the majority of you may expect to attain to a fair measure. The first essential is to have your nerves well in hand. Even under the most serious circumstances, the physician or surgeon who allows "his outward action to demonstrate the native act and figure of his heart in complement extern," who shows in his face the slightest alteration, expressive of anxiety or fear, has not his medullary centres under the highest control, and is liable to disaster at any moment. I have spoken of this to you on many occasions,

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["Aequanimitas," Aequanimitas, p. 5]