The Value of a Hopeful Prognosis

     Those who may feel inclined to criticise the surgical conduct of [499][500] President McKinley’s case, should recall clearly the fact that if any error was made it was simply one of prognosis. Such an error is always on the right side of the balance, and is more to the credit than to the discredit of the human nature that is prone to show itself in a medical man when he is brought suddenly face to face with a great crisis. In the case of the President, the favorable prognosis did not and could not affect the result unfavorably. The work of the surgeons had already been done.
     We take it as a well established fact in practice that a hopeful prognosis is better than despair in any case and under any circumstances whatever. There is a real and genuine asset to be derived from hope, and the individual who comes in for the biggest share of this asset is the patient. The tristful or lugubrious doctor who cannot see some silver lining to the cloud in an essentially doubtful case, should retire. He is not in the psychological mood to avail himself of all his opportunities. One of Philadelphia’s ablest clinicians (now dead) once lectured on a case presenting doubtful symptoms of cancer of the stomach, and told his students that if he were the patient in such a case and his physician should make the positive diagnosis of gastric cancer, he would instantly discharge him. And this was said with reason; for of what use can a doctor be when he has abandoned hope?
     In President McKinley’s case the progress from the third to the fifth day fully justified a hopeful prognosis. Any other would have recklessly thrown the public into a panic, and this would have reacted disastrously upon the case itself. If these hopes were somewhat too buoyantly expressed, this was due to nothing more than the natural rebound from the frightful shock and anxiety of the first three days.