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About Sir William Osler, his inspirational words, and the Osler Symposia for physicians
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About Sir William Osler, his inspirational words, and the Osler Symposia for physicians
Sir William Osler, M.D., C.M., 1st Baronet (July 12, 1849 December 29,
1919) was a Canadian physician. (The "o" in "Osler" is pronounced like
the "o" in "go".) He was one of the "Big Four" founding professors
at Johns Hopkins Hospital as the first Professor of Medicine and founder of
the Medical Service there. (The "Big Four" were William Osler, Professor of
Medicine; William Stewart Halsted, Professor of Surgery; Howard A. Kelly,
Professor of Gynecology; and William H. Welch, Professor of Pathology.)
Osler created the first residency program for specialty training of
physicians, and he was the first to bring medical students out of the
lecture hall for bedside clinical training.
He has been called the "Father of modern medicine." Osler was a
pathologist, physician, educator, bibliophile, historian, author, and
renowned practical joker.
Following post-graduate training in Europe, Osler returned to McGill
University as a professor in 1874. It is here that he created the first
formalized journal club. In 1884 he was appointed Chair of Clinical
Medicine at the University of Pennsylvania in Philadelphia. When he left
Philadelphia in 1889, his farewell address Aequanimitas was on the
equanimity necessary for physicians.
In 1889 he accepted the position as the first Physician-in-Chief at the
new Johns Hopkins Hospital in Baltimore, Maryland USA and, in 1893, he
was one of the first professors of medicine at Johns Hopkins University School of Medicine. There he quickly
increased his reputation as clinician, humanitarian and teacher. He presided over a rapidly expanding
domain. In the Hospital's first year of operation, when it had 220 beds, 788 patients were seen for a total
of over 15,000 days of treatment. Sixteen years later, when Osler left for Oxford, over 4,200 patients were
seen for a total of nearly 110,000 days of treatment.
In 1905 he was appointed to the Regius Chair of Medicine at Oxford, which he held until his death. He was
also a Fellow of Christ Church, Oxford. Osler was created a baronet in the Coronation Honours List of 1911
for his many contributions to the field of medicine.
Perhaps Osler's greatest contribution to medicine was to insist that students learned from seeing and
talking to patients and the establishment of the medical residency. This latter idea spread across the
English-speaking world and remains in place today in most teaching hospitals. Through this system, doctors
in training make up much of a hospital's medical staff. The success of his residency system depended, in
large part, on its pyramidal structure with many interns, fewer assistant residents and a single chief
resident, who originally occupied that position for years.
He liked to say, "He who studies medicine without books sails an uncharted sea, but he who studies
medicine without patients does not go to sea at all." His best-known saying was "Listen to your patient, he
is telling you the diagnosis," which emphasizes the importance of taking a good history.
The contribution to medical education of which he was proudest was his idea of clinical clerkship having
third- and fourth-year students work with patients on the wards. He pioneered the practice of bedside
teaching making rounds with a handful of students, demonstrating what one student referred to as his
method of "incomparably thorough physical examination." Soon after arriving in Baltimore Osler insisted
that his medical students attend at bedside early in their training: by their third year they were taking
patient histories, performing physicals and doing lab tests examining secretions, blood and excreta.
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He reduced the role of didactic lectures and once said he hoped his tombstone would say only, "He brought
medical students into the wards for bedside teaching." He also said, "I desire no other epitaph than the
statement that I taught medical students in the wards, as I regard this as by far the most useful and
important work I have been called upon to do." Osler fundamentally changed medical teaching in the North
America, and this influence, helped by a few such as the Dutch internist Dr. P.K. Pel, spread to medical
schools across the globe.
Osler was a prolific author and a great collector of books and other material relevant to the history of
medicine. He willed his library to the Faculty of Medicine of McGill University where it now forms the nucleus
of McGill University's Osler Library of the History of Medicine, which opened in 1929. Osler was a strong
supporter of libraries and served on the library committees at most of the universities at which he taught
and was a member of the Board of Curators of the Bodleian Library in Oxford. He was instrumental in
founding the Medical Library Association in North America and served as its second President from 19011904.
Osler was a prolific author and public speaker and his public speaking and writing were both done in a
clear, lucid style. His most famous work, 'The Principles and Practice of Medicine' quickly became a key text to
students and clinicians alike. It continued to be published in many editions until 2001 and was translated
into many languages. Though his own textbook was a major influence in medicine for many years, Osler
described Avicenna as the 'author of the most famous medical textbook ever written.' He noted that
Avicenna's Canon of Medicine remained a medical bible for a longer time than any other work. Osler's essays
were important guides to physicians. The title of his most famous essay, Aequanimitas, espousing the
importance of imperturbability, is the motto on the Osler family crest and is used on the Osler housestaff tie
and scarf at Hopkins.
An inveterate prankster, he wrote several humorous pieces under the pseudonym "Egerton Yorrick Davis."
Davis, a prolific writer of letters to medical societies, was purported to be a retired US Army surgeon living
in Caughnawauga, Quebec, author of a controversial paper on the obstetrical habits of Native
American tribes which was suppressed and unpublished. Osler would enhance Davis' myth by signing Davis'
name to hotel registers and medical conference attendance lists; Davis was eventually reported drowned
in the Lachine Rapids in 1884.
Sir William Osler died, at the age of 70, in 1919, during the Spanish influenza epidemic; his wife, Grace,
lived another nine years but succumbed to a series of strokes. Sir William and Lady Osler's ashes now rest
in a niche within the Osler Library at McGill University. They had two sons, one of whom died shortly after
birth. The other, Edward Revere Osler, was mortally wounded in combat in World War I at the age of 21,
during the 3rd battle of Ypres. According to one biographer, Dr. Osler was crushed emotionally by the loss.
In 1925 a monumental biography of William Osler was written by Harvey Cushing. For this work, Cushing
received the 1926 Pulitzer Prize for biography. A later and somewhat more balanced biography by Michael
Bliss was published in 1999.
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Osler Inspirations from a Great Physician was written by Charles S. Bryan and published by
Oxford University Press in 1997. The chapter and section titles themselves are an outline for a balanced
and honorable life
1. Manage Time Well: Day- Tight Com partm ents Have Unifying Principles Have Definite Goals Plan
the Day Be Methodical Take the Long View Study Time Management
2. Find a Calling: Being True to Certain Ideals Explore the Possibilities Be an Idealist See the Big
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(used to hold in place EPCs Four Pillars that frame the symposium)
Education
More clearly than any other the physician should illustrate the truth of Platos saying that education is a
life-long process.
A lover of good books is almost always a good [person] and usually a good citizen but not always.
Fifteen or twenty minutes day by day will give you fellowship with the great minds of the race, and little by
little as the years pass you extend your friendship with the immortal dead. They will give you faith in your
own day.
It is a good many years since I sat on the benches, but I am happy to say that I am still a medical student,
and still feel that I have much to learn.
Exercise
Within the past quarter of a century the value of exercise in the education of the young has become
recognized. The increase in the means of taking wholesome out-of-door exercise is remarkable, and should
show in a few years an influence in the reduction of the nervous troubles in young persons. The
prophylactic benefit of systematic exercise, taken in moderation by persons of middle age, is very great.
Patients should have rest, food, fresh air, and exercise the quadrangle of health.
Community
The young doctor should look about early for an avocation, a pastime, that will take him away from
patients, pills, and potions . . . No [person] is really happy or safe without one, and it makes precious little
difference what the outside interest may be botany, beetles or butterflies, roses, tulips, or irises, fishing
mountaineering or antiquities anything will do so long as he straddles a hobby and rides it hard.
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Linked together by the strong bonds of community of interests, the profession of medicine forms a
remarkable world-unit in the progressive evolution of which there is a fuller hope for humanity than in any
other direction.
I propose to consider another aspect of our work of equal importance, neither scientific nor educational,
but what may be called humanistic, as it deals with our mutual relations and with the public. Nothing in life
is more glaring than the contrast between possibilities and actualities, between the ideal and the real.
The desire for unity, the wish for peace, the longing for concord, deeply implanted in the human heart, have
stirred the most powerful emotions of the race, and have been responsible for some of its noblest actions.
It is but a sentiment, you may say: but is not the world ruled by feeling and by passion?
But do not get too deeply absorbed [in your work] to the exclusion of all outside interests. Success in life
depends as much upon the [person] as on the physician. Mix with your fellow students, mingle with their
sports and their pleasures. You are to be members of a polite as well as of a liberal profession and the
more you see of life outside the narrow circle of your work the better equipped you will be for the struggle.
Service
You are in this profession as a calling, not a business; as a calling which exacts from you at every turn selfsacrifice, devotion, love and tenderness to your fellow-men. Once you get down to a purely business level,
your influence is gone and the true light of your life is dimmed. You must work in the missionary spirit, with
a breadth of charity that raises you far above the petty jealousies of life.
We can best oppose any tendency to melancholy by an active life of unselfish devotion to others.
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I have an enduring faith in the men who do the routine work of our profession. Hard though the conditions
may be, approached in the right spirit the spirit which has animated us from the days of Hippocrates
the practice of medicine affords scope for the exercise of the best faculties of the mind and heart.
We doctors do not take stock often enough.
In no relationship is the physician more often derelict than in his duty to himself.
Hilarity and good humour, a breezy cheerfulness. . . help enormously both in the study and in the practice
of medicine.
Start at once a bed-side library and spend the last half hour of the day in communion with the saints of
humanity.
Begin at once the cultivation of some interest other than the purely professional.
The practice of medicine is an art, not a trade, a calling not a business, a calling in which your heart will be
exercised equally with your head.
I have had three personal ideals. One is to do the days work well and not to bother about tomorrow.
The second ideal has been to act the Golden Rule, as far as in me lay, towards my professional brethren
and towards the patients committed to my care. And the third has been to cultivate such a measure of
equanimity as would enable me to bear success with humility, the affections of my friends without pride
and to be ready when the day of sorrow and grief came to meet it with the courage befitting a man.
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