Felson’s 10 Axioms for a Lifetime of Learning Medicine

Felson’s 10 Axioms for a Lifetime of Learning Medicine

1. You like it, you’ll learn it; so learn to like it.
2. Principles are as important as facts. If you master the principles, you can make up the facts.
3. You learn better when you know your goals. If you don’t know where you’re going, says the Talmud, all roads will take you there. But if you do know, you’ll get there much quicker.
4. Follow your cases. I've learned and remembered more by follow up than any other way. It’s hard work, but as Confucius says, “He learneth most who worketh most.” Or was it Knute Rockne?
5. Like sex, learning is better if you are actively involved. When you read, talk back to the author. Be skeptical. Don’t follow the authorities too closely or you may become a Brown Nose Duck; he can fly as fast as the leader, but can’t stop as quick.
6. Reinforcement is essential for acquiring knowledge. But don’t reinforce by simple repetition; use some other method than the original way you learned it. See a case, look it up; read an article, find a case or ask a question.
7. Reward is important for learning. Show off what you know. Brag a little. Speak up in class. Tell your spouse or sweetheart; tell your colleagues; don’t bother to tell your friends – you won’t have any.
8. Different people learn best by different methods. Figure out your own best method and cater to it, whether it be reading, listening, observing or doing, or a combination of these. Don’t depend on great teachers. They are as rare as great students.
9. Quick retrieval of once-acquired information is crucial. The home comptuer is ideal but other good retrieval methods are available. Create your own presonal modification and keep improving it. Without a recall system you’re a “loser”, an old man with a stuck zipper.
10. Divide your study time into prime time, work time, and sleepy time. Biorhythms vary widely among students, so develop your own study schedule. Don’t watch television during prime time and don’t read medicine during sleepy time.

Taken from Felson, B. Humor in Medicine, 1989; RHA Inc., Cincinnati, Ohio.

Who was Felson?

Dr Benjamin Felson, one of the outstanding diagnostic radiologists of his

time, died suddenly of a heart attack October 22, 1988, while working on a manuscript. At his death he was professor emeritus of radiology at the University of Cincinnati College of Medicine, where he had served as director of the department of radiology for 22 years. He voluntarily relinquished this position, but continued actively as professor of radiology under the aegis of the distinguished colleague he had trained, Dr Jerome H. Wiot. Dr Felson gave the University of Cincinnati 50 years of dedicated service, establishing a department of radiology whose name and fame were recognised everywhere. Dr Felson was born in Newport, Kentucky, on October 21, 1913. The family moved to Cincinnati, and Dr Felson attended public schools there. He matriculated at the University of Cincinnati, both at its College of Liberal Arts and its Medical School, earning his MD degree in 1935. He completed a 1-year internship, a 1-year residency in pathology, and a 3-year residency in radiology at The Cincinnati Genera! Hospital. After a 1- year fellowship in cancer therapy at Indianapolis City Hospital, he entered the U.S. Army Medical Corps in 1942. For 2 years he served as chief of radiology at the 28th General Hospital in Europe. After his discharge with the rank of major in 1945, he accepted a full-time position in radiology at Cincinnati General Hospital and the University of Cincinnati College of Medicine. He rose rapidly in rank, from assistant professor in 1945 to associate professor in 1948 to professor and director of radiology in 1951. From 1973 until his death he continued actively as professor emeritus of radiology. Dr Felson is survived by his devoted wife, Virginia, five children, and eight grandchildren, a unique family constellation of fascinating individuals.

Dr Febson’s curriculum vitae and bibliography reflect the accomplishments of a prodigious worker, with we!! over 150 published articles and seven textbooks, mainly but not exclusively dealing with disorders of the chest. His contributions and achievements in radiology have

been singular. Dr Felson traveled far and wide in his capacity as a teacher. He was invited everywhere in this country and abroad, and the lectures and seminars he presented must have numbered in the hundreds. He gave no less than 32 named lectures, honoring the most prestigious individuals in the history of radiology. He was granted honorary membership in at least 14 U.S. medical societies (mainly radiologic) and in 20 societies in various foreign countries. Just before he died he was accorded honorary membership in the Chinese Radiological Association, a rarely given award for a foreign radiologist. The number and importance of the awards and honors bestowed on him were legion. He was given the highest honors by most of the important radiologic societies. These included Gold Medals from the Radiobogical Society of North America and the American College of Radiology. In addition, a special award for outstanding service and contributions was given him by the American Roentgen Ray Society. He was also

awarded an Honorary Fellowship in the Royal College of Radiologists of Great Britain, a prestigious award granted to only a handful of Americans. One of the most significant reflections of his reputation was his selection as both the Caldwell lecturer of the ARRS and the lecturer of the annual oration of the RSNA. Under the aegis of the ACR, Dr Felson was videotaped several

years ago as a “living legend” in radiology, a truly appropriate award. He was also one of the first recipients of the Daniel Drake Medal given at the University of Cincinnati for “major contributions to medical science.” In 1987 the University of Cincinnati announced the formation of the Benjamin Felson Chair in Radiology, the first instance in the United States of an academic chair in radiology being established for a living recipient. His unique reputation outside radiologic circles was acknowledged in his being awarded an Honorary Doctorate in Science by the University of Cincinnati in spring 1988, again, the first such honor at this university for one of its own graduates. In addition to the many honors, Dr Felson held office in many prestigious medical organizations, the list of which is too long to do more than mention a few. He was consultant to the U.S. Aim Force, the Walter Reed Army Medical Center, the Armed Forces Institute of Pathology, the Panel of Consultants in Radiology to the National Institute for Occupational Safety and Health; first vice-president of the RSNA; chairman of the Commission on Education and member of the Board of Chancellors of the ACR; president of the Fleischnem Society for the Study of Disorders of the Chest; and member of the James Picker Foundation of the National Academy of Science. He also held a number of editorial positions. For Dr Felson the most important of all these was for the Seminars in Roentgenology, a very popular journal which he founded and edited from 1966 until his death. Dr Felson’s talents as an innovative clinical radiologist were unique. He was adept in all areas of diagnostic radiology, as well as radiology of the chest, in which he was preeminent. He played a fundamental role in formulating a working international classification for the diagnosis of various pneumoconioses and other occupational disorders affecting the chest. Ben Felson took a major interest in the development of radiology in Israel. He was an active member of several organizations in the United States that gave unstintingly to Israel, both financially and scientifically. As a special tribute to Dr Felson, an annual Felson Lectureship was established in Israel several years ago at the University of Tel Aviv, Petach Tikva. As a fitting tribute, Dr Felson was asked to give the first lecture in this ongoing series. The enumeration of his many accomplishments fails to bring into focus the full flavor of the man. His extraondinary talents as a diagnostic radiologist could be appreciated best by observing one of his many performances on a traditional film-reading panel. Here his consummate mastery in producing the answer to an obscure problem was totally akin to legerdemain. He had an extraordinary impact on teaching at all levels: medical students, residents, and even highly competent radiologists. Thus, he was given the Golden Apple award by his medical college no less than eight times for his inspired teaching of medical students. He introduced many innovative concepts in teaching, bringing it to a level unsurpassed in radiology in his time. He generated enormous enthusiasm and excitement in all his students. To listen to and see Ben Felson in one of his teaching sessions was a memorable experience, never to be forgotten. Of singular interest was his peripatetic spirit in the cause of teaching. He lectured

throughout the world in all types and sizes of teaching and non-teaching hospitals. He carried a limitless bag of teaching tools-lectures, film-reading sessions, instructional courses, symposia, and whatever else his fertile mind would concoct. His charisma and talent brought him countless invitations again and again from literally everywhere in the world. Uniquely, each place he visited wanted him back, not once but many times. He had a special interest in teaching in disadvantaged countries, where he believed he could help in their radiologic problems. Dr Felson truly earned the appellation of the “American ambassador-at-large for radiology.” Some measure of Dr Febson’s personal characteristics are relevant in attempting to define his extraordinary

success. The parameters that established him as a great clinician and teacher included an extraordinary level of intelligence; a high degree of innovativeness and imagination; a dogged persistence, determination, and self discipline; and a capacity for never-ending work in

his field-all constituting a number of intrinsic talents that made him so extraordinary. Of equal importance was his unique charisma and his obvious love for people reflected in his every endeavour. The aura of unbounded enthusiasm he created in everything he did influenced all those he taught and with whom he worked. He laughed easily, displaying a sense of humor that was overwhelmingly infectious, and demonstrated unusual ability as a delightful raconteur. It might be appropriately said of him that he carried a perpetually charged generator that supplied its own excitement at every level and at every minute. Added to this dynamism was a quality best described by Malraux: “He is constantly in movement, crowding every waking hour of his life with highly charged interplay between the action and the passion for work. He is ever-challenged by the impossible. He truly lives life to the fullest.” No more appropriate description of Ben Felson could be written. The qualities just described are more than sufficient to label Ben Felson as a giant of our time. Yet he had other attributes that enhanced him as a man, qualities whose presence (or absence) are important in evaluating the accomplishments of an individual whose “meritorious services to the science and art of medicine” are freely acknowledged. Ben was ever human and ever humane. He combined unalterable integrity, great moral courage, and a sense of justice with a deep understanding and compassion for those less fortunate, no matter the circumstances. He treated royalty in the same way that he related to subordinates at every level. He never knowingly harmed anyone. He had a sense of fairness that was ever present. These attributes constituted his distinct hallmark in life. Lacking these, no matter what the accomplishments, success would be a mirage and achievements necessarily degraded. Dr Felson’s humanism was self-evident. He was truly “a man for all seasons.”

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