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Lessons for Physicians from Huck Finn and Tom Sawyer

Neil Baum, MD


May 8, 2025


Healthcare Administration Leadership & Management Journal


Volume 3, Issue 3, Pages 154-155


https://doi.org/10.55834/halmj.1769038613


Abstract

Mark Twain, born Samuel Langhorne Clemens in 1871 in Florida, Missouri, was called the “greatest American humorist of his age.” He wrote the classic novels The Adventures of Huckleberry Finn and The Adventures of Tom Sawyer. This article presents several pieces of advice from the writings of Mark Twain that are applicable to the modern healthcare professional.




Mark Twain was a funny, witty, and wise guy. He was no stranger to success in publishing in his own time, either. He was a peerless self-promoter. The Adventures of Huckleberry Finn was a triumph, both critically and in terms of sales. He also published a biography of General U.S. Grant, directed its distribution, and made large profits for the Grant family and himself.

The following sections offer advice from Mark Twain and discuss how you can apply it to your medical practice.

Twenty years from now, you will be more disappointed by the things you didn’t do than by the ones you did. So, throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.

As physicians, we are risk averse when it comes to our clinical practice. We honor the dictum of Hippocrates, “Do no harm.” However, many physicians are hesitant to be early adopters or to reach out of their comfort zone and try something new. Once we find a treatment that works, we seldom deviate from that option when offered a new and improved method of accomplishing the same thing. We want safety. We want to be secure, but the best life experiences come when we drop those notions and go after what we truly want, whether it feels safe or not. There have been times when I have avoided doing something new because it felt unsafe. I worried about the future, but we can’t know with certainty what the future will bring. Mark Twain suggested setting sail, trying a new adventure, looking for a new path, trying a new technology, looking for new avenues of medical practice, reaching out of conventional medicine, and taking the road less traveled. You will be richer for it.

The secret of getting ahead is getting started. The secret of getting started is breaking your complex overwhelming tasks into small manageable ones and starting on the first.

Going after your dreams can feel like an overwhelming task, but that’s because you’re trying to visualize something in your head that cannot be visualized. Mark Twain suggests that things should be broken into small pieces. Today, we call it “chunking.” It works because you can hold an image in your head of what the result looks like. Instead of thinking, “I think I need to be on the first page of Google,” a better approach would be “I need to start a blog.” If you want to go down that route, from obscurity on the Internet to the first page of Google, break things down, and simplify!

As physicians, we often are maxed-out by the clinical responsibilities of our practices. Like most physicians, I usually find it easier to procrastinate and can easily talk myself out of initiating projects. However, I have found that I can accomplish most activities by just getting started and doing small amounts daily, including writing books, blogging, and making videos for my practice. It is possible to make good use of time between surgical cases. I bring my computer to the surgery area and work on projects during the 30 to 45 minutes between patients instead of drinking coffee in the surgical lounge. Traveling by air is another opportunity for uninterrupted time. I request a window seat and have work ready to do upon reaching 10,000 feet, when it is permitted to turn on the computer.

When angry, count to four. When very angry, swear.

This advice sends the message that you should not make decisions when you’re angry. People are foolish when they are angry. They snap at others and only create more trouble in their life.

Next time you’re angry, count to four, or better yet — count to 10. The best advice my mother ever gave me was to never make a quick response when you are angry. She said it is always a good plan of action to sleep on your thoughts and your response. I can assure you if you try this, you will find that what was bothering you the night before is considerably less aggravating upon awakening in the morning. Your response will be tempered, or you may even decide you don’t have to respond and later be sorry for what you said in the heat of anger.

The take-home message is that speaking when angry will be the biggest speech you wish you had not made!

I have been through some terrible things in my life, some of which actually happened.

We walk around all our lives thinking about things that will never happen. We worry, dread, and fear what hasn’t happened and probably never will. Our minds and imaginations can play tricks and havoc on our psyche. Our heads are filled with negative thoughts. Eliminating bad thoughts is possible; you can replace those negative thoughts with positive thoughts and actions.

I keep several scrapbooks containing dozens of complimentary letters I have received during nearly 35 years of practice. With the patients’ permission, I place their notes in scrapbooks, which are kept on a table in the reception area. They are the most viewed books or magazines in my reception area. When patients ask me how they can get into a scrapbook, I tell them to just send me a note. With the patients’ permission, these notes also are posted as testimonials on my website (http://neilbaum.com/reviews). So how does this apply to feeling bad and having negative feelings? Whenever I have those thoughts or feelings, I go to the reception area, take one of the scrapbooks, and read all the lovely comments and compliments I have received. It almost always makes those negative thoughts vanish.

Courage is resistance to fear, mastery of fear — not absence of fear.

Successful people aren’t fearless; no one is. It’s easy to believe that everything would be fine if you got rid of your fears, but that’s just an excuse for not getting started.

You will always have a smidgen of fear when diving into the unknown.

Physicians who are public speakers or media mavens know about the jitters of giving a speech or appearing on the radio or TV. I have had the opportunity to make several hundred speeches over the past 35 years. Although my comfort level is much greater than when I either memorized my speech or read it, I still get nervous trying to make the butterflies fly in formation when I’m introduced to give a speech to colleagues or even to lay audiences.

Every surgeon or doctor who performs invasive procedures on patients knows about butterflies flitting around randomly before the scalpel touches the patient or the needle is inserted into the subclavian vein to monitor the central venous pressure. However, with experience, the fear is reduced, and even the most seasoned doctor has an element of anxiety prior to performing a procedure on a patient. But don’t let the fear stop you; instead, use it as fuel to keep going.

I can live for two months on a good compliment.

Mark Twain understood the importance of encouragement. We need to offer patients an encouraging word or compliment to encourage them to be compliant. Of course, these compliments need to be sincere to be taken seriously. The same holds true for our staff. We need to compliment them when they go above and beyond what is written in the employee manual. When they provide a positive patient experience, doctors must offer recognition and appreciation. When employees are given a compliment, the behavior is reinforced and is likely to be repeated. Napoleon said, “I could have conquered the world if I just had enough red ribbon.” Let the truth be told; a compliment or word of encouragement is probably more effective than a medal or piece of red ribbon.

Bottom line: I would like to conclude with one final piece of advice from Mark Twain: “Let us endeavor so to live that when we come to die, even the undertaker will be sorry.” Most physicians enjoy a remarkable career and have few or no regrets about entering the medical profession. Although it is unlikely that there will be gnashing of teeth when a doctor takes down his shingle, there will likely be hundreds of our patients who will be sorry when we have left. Let that be a message from Mark Twain and serve as our legacy.

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