William Osler

• Born: July 12, 1849
• Birthplace: Bond Head, Canada West (now Ontario), Canada
• Died: December 29, 1919
• Place of death: Oxford, England

Canadian physician

Osler published the original Principles and Practice of Medicine, a classic text for many years, and transformed medical education by extending it beyond the classroom to the patient’s bedside.

Area of achievement Medicine

Early Life

Any reading of the life of Sir William Osler (OHS-ler) quickly reveals an individual of widely varied interests and great vitality. He cared deeply for people and was loved in return by young and old alike. He had a special fondness for the young. Born in Ontario, near Lake Simcoe, he was the youngest of nine children of an Anglican clergyman. Life on the frontier of Canada during the mid-nineteenth century was far from easy, and the earnings of a clergyman not great, yet what was lacking in material comfort was made up in the closeness and love of the family. A nurturing of intellect and an abundance of books instilled in the children the desire for education, and somehow from the meager funds available, Featherstone and Ellen Osler saw several sons through university and into professions.

Endowed with a fine mind as well as a small but wiry and healthy body, Osler excelled at both scholarship and sports. A sprightly sense of humor embroiled him in high jinks, a characteristic that would mark him throughout life. While at Weston School, one such prank ended with Osler, along with his fellows, in the Toronto jail. The Matron of Weston failed to appreciate their humor, of which she was the butt, and charged them with assault and battery.

Nevertheless, Osler pursued his studies with diligence. In this, he had the rare good fortune to cross the paths of not one, but two gentlemen who became his mentors and friends. They were friends to one another as well, and the available correspondence is indicative of the warm affection that the three shared. The first of these was the Reverend W. A. Johnson, who had opened Weston, the boarding school to which Osler was sent in preparation for university study. There, he came under Johnson’s influence, and this good man became affectionately known as “Father” Johnson, not so much for his priestly calling as for his genuine caring for the students, especially Osler.

Father Johnson had a passion for botany, and young Osler became his companion and collaborator in this pursuit, an activity that helped to prepare him for the course he was to follow. The sharing of specimens and information went on for years, along with microscopic examination of specimens gathered on numerous forays into the woods and waters of the area.

The second individual to have significant impact upon the course of Osler’s life was the physician Dr. William Bovell, in whose home Osler lived when he attended Toronto University. As a young man, Osler began preparation for the ministry, following his father’s steps. Shortly, however, exposed to Bovell’s remarkable mind as well as his vast library, Osler became interested in medicine.(Ironically, Bovell began theological studies and eventually took a charge in the West Indies, but the friendship continued.)

Transferring to McGill College, Osler completed his clinical study there in 1872. The faculty, upon his graduation, conferred a special award, remarking on the “originality and research” of his thesis that was illustrated with “33 microscopic and other preparations of morbid structure.”

Life’s Work

It was the custom of the time for young medical graduates to make a tour of medical facilities and schools in Europe. As his parents were not in a position to support such a venture financially, an older brother, himself bound for Scotland and pleased to have the company of his lively young brother, paid the cost of transportation. Osler continued his study in Vienna, in Berlin, and in London, allowing himself to expand his knowledge and experience.

Osler continued his microscopic studies, and a notation in his laboratory notebook records that on the fourteenth of June, 1873, he began studies of his own and others’ blood as well as that of various animals, and there appear drawings of what he observed. Here was the beginning of his study of the circulatory system and the identification of platelets as a component of the blood. So passed two frugal but rewarding years. Then, in 1874, a request came for Osler to return to McGill as a lecturer in the medical school. Acceptance of this offer inaugurated Osler’s long and distinguished career as professor, clinician, scholar, and humanitarian.

Osler is said to have humanized the whole of medical practice. He was unusual not only for the respect he showed his students but also for the new collegial relationship that he established among physicians. More important still, the patient-physician relationship was revolutionized. Medical education was extended beyond the confines of the classroom and into the hospital, where patients rather than disease became the focus. If the situation appears to have changed during the late twentieth century, it may be that Osler’s wisdom has been forgotten. “Don’t ask the doctor; ask the patient” is a Yiddish proverb, but it could stand well as the motto of Osler’s life and practice.

Another particular concern of Osler was his insistence that learning must be an ongoing process. Addressing young graduates in 1875, he exhorted them to “be students always” and to keep up their reading (as he himself never failed to do). In 1913, a few short years before his death, he greeted students at Yale as “fellow students.” On another occasion, he urged the student body at McGill to seek as much truth as possible, stating:

No human being is constituted to know… the whole truth.… The truth is the best you can get with your best endeavor [and] an earnest desire for an ever larger portion.

Looking at another facet of this exceptional human being, it appears that Osler never met a stranger. Harvey Cushing, in his superlative biography of the man, records one especially poignant yet characteristic event that illustrates this. In the autumn of 1875, Osler chanced to meet an English businessperson in Montreal. The young man contracted smallpox and died. While attending the patient, Osler learned the address of his parents, and so he wrote to them, describing the illness and death of their son and conveying his sympathy. Many years later, he provided to the man’s sister a photograph of the grave.

Osler’s flair for jest, which belies his sober, even severe, countenance in surviving photographs, caused him to assume the pseudonym of “Egerton Y. Davis, M.D.” for purposes of satire and humor, addressing numerous issues in essays and letters. (Years later, he occasionally and affectionately referred to his son as “Egerton, Jr.”) The byline surfaced from time to time over a number of years, gaining considerable attention.

In 1884, while in Leipzig, Osler was offered the Chair of Clinical Medicine at the University of Pennsylvania, which he is said to have accepted based on the flip of a coin. McGill’s loss became Pennsylvania’s gain. While in Philadelphia, Osler made significant contributions: He revived a faltering professional organization and founded and supported a student club, both of which he valued as a means of professional sharing and mutual support.

Johns Hopkins University was developing a medical school, and in 1891, officials at the university invited Osler to Baltimore. While awaiting the opening of the school, he prepared his Principles and Practice of Medicine (1892), which became a standard text for many years. By 1930, in its eleventh edition, the book had been translated into at least four other languages. Later revisions, edited by others, never quite captured the style and flow of the original. Osler became, too, a part of the brilliant medical staff at Johns Hopkins, which was known as the “Big Four.”

Osler returned to Philadelphia briefly in 1892 to marry Grace Revere Gross, the widow of a colleague and great-granddaughter of Paul Revere. Years later, in Oxford, their home was familiarly referred to as the “Open Arms.” One of their children died in infancy, and their son, Revere, grew to adulthood only to die in the trenches of France in 1917. It was a grief that Osler took to his own grave.

A request to accept the chair as Regius Professor of Medicine at Oxford took the Oslers to England in 1904. There William Osler was to spend his remaining years, serving with great distinction. On the occasion of the coronation of King George V in 1911, a baronetcy was bestowed, and Osler became Sir William—“much to the embarrassment of my democratic simplicity,” he reported to a friend in a letter.

For some years Osler had been subject to episodes of bronchitis, and, in October of 1919, a severe cold developed into bronchitis and bronchopneumonia. Osler was unable to fend off this final illness, and he died on December 29, 1919.

Significance

When Sir William Osler died, he was widely known and admired in his profession and beyond. He brought freshness and humanity to the practice of medicine and humor to those around him. His example remains today and is acclaimed in his profession as unique. This fact was made apparent when, in 1951, a committee of his fellows republished those speeches and essays deemed to be his best in order to give medical students “a taste of Osler.” These works show that his wide interests were not separate from medicine.

Osler believed profoundly, and proclaimed repeatedly to his students, that history, the classics, and an understanding of human behavior were essential to the holistic practice of medicine. An individual in need of medical care, he was convinced, seeks the attention and comfort of a fellow human being before drugs and treatment. Such wisdom is timeless, as fresh in the twenty-first century as in Osler’s own time.

Bibliography

Bliss, Michael. William Osler: A Life in Medicine. New York: Oxford University Press, 1999. The first definitive biography since Cushing’s book (see below). Bliss portrays Osler as a brilliant, compassionate, and influential physician and teacher.

Bryan, Charles S. Osler: Inspirations from a Great Physician. New York: Oxford University Press, 1997. A collection of Osler’s writings providing advice on everyday living.

Cushing, Harvey. The Life of Sir William Osler. 2 vols. Oxford, England: Clarendon Press, 1925. This is the exhaustive biography from which the bulk of the information for this essay was drawn. It was written by one who knew medicine and surgery at first hand and who himself taught surgery at Johns Hopkins University, where Osler had served on the first faculty. This work won the Pulitzer Prize.

Foucault, Michel. The Birth of the Clinic. Translated by A. M. Sheridan Smith. New York: Vintage Books, 1973. Foucault describes this as “an archeology of medical perception.” It examines the development of medical knowledge and practice, confirming that the modern entity of the teaching hospital was brought into being only in the nineteenth century. It was this forum that Osler introduced to the United States and in which he practiced as professor of medicine at Oxford.

Journal of the American Medical Association 210, no. 12 (1969). The entire issue is devoted to Osler. Published fifty years after his death.

Osler, William. The Principles and Practice of Medicine. New York: D. Appleton, 1892. 18th ed. Edited by Abner McGehee Harvey. New York: Appleton-Century-Crofts, 1972. This is a later edition of the textbook originally compiled by William Osler. It continues to be revised and updated by the faculty of Johns Hopkins University for use as a text in the medical school.

‗‗‗‗‗‗‗. Science and Immortality. Boston: Houghton Mifflin, 1904. Publication of the lectures Osler delivered at Harvard University in 1904.

‗‗‗‗‗‗‗. Selected Writings of Sir William Osler. New York: Dover, 1951. Collection of Osler’s essays and addresses spanning the adult years of his life. These writings demonstrate the breadth of his knowledge and interests as well as his fluency with the English language.

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