Famous Rheumatologist Quotes – Part I Save

A famous quote from Verna Wright, MD, states, “Clinicians may all too easily spend years writing“doing well” in the notes of a patient who has become progressively crippled before their eyes".

It’s a hard pill to swallow when physicians find out they are not quite as good as they think they are. This incisive quote carries several messages, including the major warning not to miss the subtle and progressive damage that rheumatoid arthritis can bring – thus, the need for metrics and a treat-to-target approach. The origins of this quote was not easily found and often mis-referenced. It actually appears in a BMJ article from 1983 wherein the editor of the BMJ recalls what Dr. Wright said in a meeting.

Mentors, leaders and teachers create wisdom and reuse the brilliance of others for the right effect. Those who trained (like me) at The University of Texas Southwestern Medical School are easily conversant in the brilliance of Chairman Dr. Morris Ziff (1913-2005), who was the ACR’s first gold medal award recipient in 1988 for his career of outstanding achievements in Rheumatology. Many of these teachings and quotes were often referred to as “Ziffisms”.

There are many great quotes we use when teaching or making important points with colleagues or trainees. Each of us has a few, but there are many out there. Recognizing the potential value of these, I canvased many of our colleagues in search of quotes they felt were either often used or highly impactful. You may have a quote or few that stand out; either your own or those from your mentors or colleagues. We are looking to collect those that reflects your beliefs or those of great teaching value.

Below are several great quotes from several great rheumatologists.

Allan Gibofsky, MD, JD – Hospital for Special Surgery, NYC

"No drug is totally useless until it has been tried in Scleroderma."

• I've heard this multiple times, in various Rheumatology meetings, attributed to the late Gerald Rodnan, but can't find a source for it (although I did hear him say it at an HSS Grand Rounds in the early 80s).

"Nothing is more sadistic than giving a man who can’t walk the runs!"

• Said to during my Fellowship by a Cornell/HSS Professor, Dr. William Kammerer, when teaching me what will usually happen when using colchicine in acute gout "to tolerance."

"The saddest thing in life is reaching the top of the ladder and realizing that you're leaning against the wrong wall."

• Also said to me by Dr. Kammerer, when I told him I'd joined the Cornell Faculty as an Assistant Professor.

Hani El-Gabalawy, MD – University of Manitoba
"You need a clear hypothesis after taking a history from a patient; everything else...physical exam, labs, imaging...serve to test that hypothesis."

• This is one I like to say to my students, especially Med students.

Sterling West, MD – University of Colorado, Denver

"Repetition is the key to good pedagogy. Read it again.

• Said by Thomas Brewer, MD (Senior resident who supervised me during my first month of internship in July 1976)

"A physician is judged by the three A’s: ability, availability, and affability"

• From Paul Reznikoff, MD (1896-1984)

Marc Hochberg, MD – University of Maryland School of Medicine, Baltimore
"It's the best thing since sliced bread."

• From Dr. Mary Betty Steven, Professor of Medicine and Head, Connective Tissue Division, The Johns Hopkins Hospital and School of Medicine. Dr. Stevens was a mentor to a generation of clinical educators and physician scientists and was a Second Vice-President of the American Rheumatism Association.

John D. Reveille, MD – University of Texas, Houston
"If it ain't broke, don't fix it"
"If you're not prepared to deal with the answer, don't ask the question"

• Two things I tell all my patients

Joel Kremer, MD –Albany Medical College, The Center for Rheumatology, Albany, NY
"Listen to the patient"

• If there's one quote that I use all the time with the fellows it's "listen to the patient". I believe it was Sir William Osler who first said “Listen to the patient, he is telling you the diagnosis”. I've found it to be a really valuable piece of advice.

"Your house is on fire and there are flames coming out of the upstairs windows. The firemen are already at the curb with their hoses and want to turn on the water, but you say ' " No, no, you'll ruin my curtains!"

• This is a little story I made up for patients who are reluctant to take a medication that I know they need because they are frightened about possible side effects. They look at me a second, but they get it.

John Esdaile, MD – Arthritis Research Center of Canada, The University of British Columbia
"What the results giveth, the methods taketh away”.

• From F. Dudley Hart. I no longer know where I read it. He wrote a textbook and it may have been in that. It is rather self-explanatory.

“The master work of medicine is work”.

• Sir William Osler. In the medical library at the Montreal General Hospital where he held his first job.

Kathryn Dao, MD – Baylor Research Institute, Dallas, TX
"Hippocrates may say, 'First, do no harm' but if you ain't doing nothing, you're doing no good"

• Attributed to J. Cush, MD. I heard this during my fellowship when Cush was my attending. It was in the scenario of a very sick SLE patient who developed toxic epidermal necrolysis, acute renal failure, high fevers, in septic shock. Her lupus was active. Everyone was afraid to give her aggressive immunosuppression in her current state. She was deteriorating quickly. This quote stuck with me. We went for it: IV Cytoxan and IV steroids. She got better. Fear paralyzes us from doing what should be done. Sometimes, we need to hear that voice that nudges us.

Edward Keystone, MD – Mt. Sinai Hospital, Toronto "

"What you tell me may not determine what will happen to you [in terms of long term damage] but what I see at the bedside [swollen joints] is what is likely going to happen to you”.

“If you aren’t sure as to what decision to make, always err on the side of the patient”.

Jeffrey Curtis, MD MS MPH - University of Alabama at Birmingham 

“The plural of anecdote is not ‘data’”

• One of my favorites.

William Shergy, MD
“Those who live by the Sed Rate Die by the Sed Rate”

• For me this really means trust your exam. The labs may be false, high or low.

“All Med Lists are wrong”

• Meaning, don't believe the list given to you. Always cover the key meds for your clinical situation whether they are on the list or not. Don't forget OTC drugs.  These are my two favorites for day to day encounters.

Jack Cush, MD - RheumNow.com

"Medicine is a science of uncertainty and an art of probability" - Sir William Osler​

"The greater the ignorance the greater the dogmatism" - Sir William Osler​

"60-40-20" -  This is Dr. Ed Keystones great teaching rule on the expected ACR20/50/70 respons rates with a good agent.

"It's suppose to be hard, if it wasn't hard everyone would do it. Hard is what makes it great!" - Tom Hanks in  the movie, "League of their own"

"I need the courage to start, the wisdom to say good and the religion to make it a habit​" - Dr. Ronan Kavanagh of Galway

"The more it costs, the less it works"  - Cush Rule #6 (on homeopathy)

"Ask five Rheumatologists and you'll get five different answers, six if one went to Harvard" - a quote modified from Edgar Fiedler 

DO YOU HAVE A QUOTE?

Please send me your quote - one that you have often; or your favorite; or one that has impact on patient care, physicians practice, medical education or the wisdom/art behind medicine.

Send by posting a comment below (please register to do so - you'll be doing me a great favor and its easy) or send me your "famous rheumatology quote" via email to:  jackcush@rheumnow.com.  Be sure to include short sentence addressing its impact on you or others and also where you work or your affiliation.  I can't promise that I'll publish what you send; but if its good, it will be published!