Osler: of reputation and the man
CMAJ 1999;161:781
Readers who observe the space we have devoted in this issue to commemorate the sesquicentennial of Sir William Osler's birth will likely experience one of two reactions: intrigue or ennui. In putting together this issue, our interest in learning more about Osler has been balanced by a measure of skepticism about any reputation so enduring as his. Was this man truly a great physician, or did the times he lived in need someone in medicine to be made great? Was he physician or politician, master or magician? Why do so many treasure his life and words, savouring tidbits, at times to an extent bordering on the syrupy and sentimental?
Certainly, Osler had a way with words. A casual read of his standard-setting textbook, The Principles and Practice of Medicine, reveals a superb command of the English language. His prose is of a quality rarely achieved by us physicians and his public addresses have inspired admiration from generations. That being said, the substance of his advice is sometimes dated, if not a little disturbing, to us post-Victorians. How should we interpret, for example, his exhortations to young male students to leave their feelings for the opposite sex in abeyance during the course of their medical training?
One would have to admit that Osler's horizons were limited by his time. To take one example: in embracing the Johns Hopkins model, Osler seems not to have acknowledged that medical practice has an intellectual basis that cannot be accounted for by resorting to science alone. Reformist thinking in medical education in Osler's time, which culminated in the publication of Abraham Flexner's Reports in 1910, emphasized the importance of a foundation in laboratory science and served to rid the profession of many of its charlatans. On the other hand, it failed to provide for the development of the conceptual basis of medical practice, which includes our notions of health, illness, diagnosis, prognosis and intervention, to name a salient few. By way of illustration, Osler's textbook begins with typhoid, with no introduction, as there is in modern texts, to the fundamentals of practice.
Osler the man is perhaps even more of a puzzle. It is very difficult, now, to go behind the public persona to meet the person. In rummaging through biographical closets, historian Michael Bliss has found no skeletons. Yet we might wonder how Lady Osler, the unfailing hostess, felt about the endless stream of young medical men visiting her home, or speculate about Osler's stilted relationship with his own son, which found some sort of positive exchange only late in Revere's short life, over their mutual enjoyment of renaissance literature about fishing. These questions are difficult to square with the image projected by so many friends and authors.
It seems that true greatness survives the challenge of time and investigation, whereas that which is false is ultimately exposed. Eighty years and two eminent biographies later, Osler is still remembered with a fondness beyond explanation. Let us celebrate a great physician and preserve what we know of him to be of lasting value.
 |
Send a letter to the editor Envoyez une lettre à la rédaction |
© 1999 Canadian Medical Association or its licensors
