Understanding the thesis - MCAT Critical Analysis and Reasoning Skills

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Adapted from Hall, J. N. "Clayhill Parkhill, Anatomist and Surgeon" in Annals of Surgery (May 1902; 35(5): 674-678)

The surgery of America in those days was still in the masterly grasp of those great surgeons who, in the bloodiest war of modern times, had advanced their profession to an enviable position. In practically every city of the land, the leading surgeon was a man who, after Antietam, Gettysburg, and Cold Harbor, had amputated, perhaps, scores of limbs in a single day. The young man thirsting for a place in surgery, stood no chance in the race with men whose operative work in a single day had exceeded all that he might hope to do in ten years.

As a result, the surgery of the country in 1885 was in the hands of men already getting past middle age, and not easily adaptable to new things; as fine a class of surgeons, nevertheless, as ever honored the profession of any country.

Meanwhile the times had changed. Under the stimulus of the work of Lister, antiseptic surgery had been born. The older men watched the younger ones as they fearlessly invaded field after field upon which they had never dared to tread, and they hesitated in their work. The knowledge of bacteriology had been their undoing. A few of these men, conspicuously Keen, of Philadelphia, and Conner, of Cincinnati, adapted themselves to the new order of things; the great majority of them were crowded out by the younger men.

And had these excellent men, thus crowded out of their field of activity, done nothing for surgery? Let us look briefly at their work. After one of the great battles, perhaps 100 amputations were performed. Experience had taught them that in the serious wounds of the extremities, without amputation, 75 percent died; with immediate amputation, 75 percent lived. In other words, amputation avoided fifty deaths in each 100 cases, chiefly from septicemia, pyxemia, erysipelas, secondary hemorrhage, and hospital gangrene. But the new surgery made unnecessary most of these amputations, practically annihilated all these causes of death, and yet saved most of the limbs. Competition under these circumstances was out of the question.

The older men then stepped aside so far as operative surgery went; but the magnificent knowledge of non-operative surgery which these men had attained, executive ability of the first order, and the power of handling large bodies of men, left them still invaluable to the profession and the world. As an illustration of this point, note that as the great railroads pushed westward, almost every one had as chief surgeon one of these able men. Mercer of the Union Pacific, Livingston of the Burlington, and Bancroft of the Denver and Rio Grande, may serve as examples. During the transition period of which I speak, although the young men carried on their operative work independently, they continually sought the counsel of these older men in broad surgical questions, in their fractures and dislocations, and in many other non-operative parts of the field of surgery for which an incomparable experience had so magnificently fitted them.

Which of the following statements most represents the main idea of the passage?

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Answer

The main purpose of this passage can best be summed up by the statement "while the younger surgeons were well-versed in the latest operative techniques, the experience of the older surgeons was priceless."

To break down the passage, let's look at what each paragraph is saying.

Paragraph 1: The field of surgery was dominated by surgeons who made a name for themselves during the Civil War.

Paragraph 2: The established surgeons were of an older generation who did not incorporate all the newest advances in their field.

Paragraph 3: The recognition of infectious microorganisms and development of techniques to counteract them allowed younger surgeons to advance the field well beyond what the previous generation was able to do.

Paragraph 4: Previous surgeons made their name by saving lives through amputations, but they were no competition for younger surgeons using new techniques to save lives as well as the limb itself.

Paragraph 5: While younger surgeons took over the role of operating, the experience, knowledge, and administrative abilities of previous surgeons was second-to-none and invaluable to the field.

The overall idea of the passage is thus that while younger surgeons were taking over most of the operating due to their incorporating new techniques, the previous generation of surgeons were still highly regarded for their intangible attributes of experience and leadership and thus continued to lead prominent roles.

Incorrect choices:

While paragraphs 2 and 3 tell us that the use of new techniques by young surgeons allowed them to perform operations previously impossible to their predecessors, the suggestion that "older surgeons were stubborn and thus replaced by younger surgeons" is faulty use of the information. Likewise, the statement that "younger surgeons were disdainful of older surgeons and were willing to take risks" is not supported by the passage. There is nothing to suggest that the new generation of surgeons clashed with the older generation, nor can we say that they took risks. Their new work and techniques were permitted by aseptic techniques that was previously unknown to their predecessors.

While paragraph 1 seems to suggest that civil war surgeons were firmly entrenched in their field, paragraph 3 tells us that new techniques brought in a new wave of surgeons that quickly established themselves and became the primary operators (paragraphs 4 and 5).

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