William Osler

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Introduction

Sir William Osler (1849 – 1919) was a Canadian-born physician, and widely-regarded as one of the icons of modern medicine. Some of his peers have even described him as the Father of Modern Medicine. Born in Bradford-West Gwillimbury (now Bond-Head), Ontario and raised after 1857 in Dundas, Ontario, his parents were Reverend Featherstone Lake Osler and Ellen Free Picton. Osler had two older brothers, Britton Bath Osler (1839-1901) and Edmund Boyd Osler (Ontario politician) (1845-1924).

As a teenager, Osler wanted to follow his father into the Anglican ministry and entered Trinity College in Toronto in 1867. He eventually went to the private Toronto School of Medicine, and not the University of Toronto. However, he eventually transferred to McGill University where he earned his medical degree (MDCM) in 1872. Following post-graduate training in Europe, Osler returned to Montreal as a McGill professor of medicine in 1874. In 1884, Osler was appointed Chair of Clinical Medicine at the University of Pennsylvania. His farewell address Aequanimitas is on the equanimity needed by physicians. He became the first chief of staff at Johns Hopkins Hospital in 1889, and one of the first professors of medicine in 1893. In 1905, he was appointed to the Regius Chair of Medicine at University of Oxford which he held until his death.

Osler was created a baron in 1911 for his contributions to medicine.

Author, book collector, teacher

Osler was a prolific author and a great collector of books and materials in the history of medicine. He willed his library to McGill where it became the core of the Osler Library of the History of Medicine. The printed catalogue is entitled "Bibliotheca Osleriana: a catalogue of books illustrating the history of medicine and science, collected, arranged and annotated by Sir William Osler, Bt. and bequeathed to McGill University". Sir William and Lady Osler's ashes rest in a niche in the Osler Library, surrounded by his books. A strong supporter of libraries, Osler served on library committees at the universities he taught at and was a member of the Board of Curators of Oxford's Bodleian Library. Osler was instrumental in founding the Medical Library Association and served as its second President from 1901-1904. In Britain, he was the first (and only) President of the Medical Library Association of Great Britain.

Contributions to medical education

Perhaps Osler's greatest contribution to medicine was to insist that students learned from seeing and talking to patients. The idea of a medical residency spread and remains in place today in teaching hospitals. Doctors in training make up much of a hospital's medical staff. The success of the residency system depended on its pyramidal structure with interns, assistant residents and a single chief resident. Osler insisted that medical students get to the bedside early in their training; by their third year they were taking patient histories, performing physicals and doing lab tests instead of sitting in lecture halls. He diminished the role of lectures and once said he hoped his tombstone would say "He brought medical students into the wards for bedside teaching."

Osler established the full-time, sleep-in residency system where staff physicians lived in the Administration Building of the Hospital. The residency was open-ended, and long tenure was the rule. Doctors spent seven or eight years as residents, during which they led a restricted life. Osler's contribution to medical education was the idea of clinical clerkships--having third and fourth year students work with patients on 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."

Osler is well-known in gerontology for the speech he gave when leaving Hopkins to become the Regius Professor of Medicine at Oxford. His speech (The Fixed Period) from 1905 included controversial words about old age. Osler was in his mid-fifties when he gave the speech citing Trollope's "The Fixed Period" which had envisaged a College where men retired at 60 and after a contemplative period of a year were 'peacefully extinguished' by chloroform. He said that "effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty" and it was downhill from then on. His speech was covered by the popular press which headlined their reports with "Osler recommends chloroform at sixty". The Fixed Period speech is included in the book of his collected addresses, "Aequanimitas")

He himself 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." He is also remembered for saying, "If you listen carefully to the patient they will tell you the diagnosis" which emphasises the importance of taking a good history.

Renaissance man

Osler was a true Renaissance man -- a physician, clinician, pathologist, teacher, diagnostician, bibliophile, historian, classicist, essayist, conversationalist, organizer, manager and author. He established a tradition at Hopkins that became the goal of those who succeeded him. He once 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." He died, at the age of 70, in 1919, during the Spanish influenza epidemic; his wife, Grace, lived another nine years. In 1925, a biography of Osler was written by Harvey Cushing. A later critical biography by Michael Bliss was published in 1999.