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by Sir William Osler
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by Michael Bliss
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Osler’s “A Way of Life” and Other Addresses, with Commentary and Annotations by Sir William Osler |
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Born in a rural community in Ontario, Canada, Osler attended the medical school at McGill University, which was relatively small at that time, and earned his medical degree in 1872. Following the fashion of the day, he traveled to Europe to study in London, Berlin, and Vienna; he was deeply impressed by German clinical medicine and laboratory research. On his return to Canada, he was appointed to a professorship at McGill. His growing reputation led to an appointment in clinical medicine at the University of Pennsylvania in 1884. When Johns Hopkins Hospital opened its doors in 1889, Osler was invited to become one of the six founding members of what was intended to be the country's leading medical school; the school was established four years later. His Principles and Practice of Medicine (New York: Appleton, 1892), which has been called the first great textbook of modern medicine, earned him an international reputation. Active on many fronts, Osler became the best-known physician in America. But he was overworked, and in 1904 he accepted the less-demanding Regius Professorship of Medicine at Oxford University, a largely honorary position that provided a base for his multifarious activities, which he carried on with unmatched vigor until his death.
To write a biography of Osler 80 years after his death is a demanding task. A contemporary biographer might be expected to react to the long tradition of Oslerian hagiography by cutting his subject down to size. A number of present-day historians would welcome the opportunity to deconstruct this figure of the Victorian medical establishment in the interest of defrocking doctors and unmasking medicine as a political enterprise. Fortunately, Bliss eschews an agenda-laden approach. A respected medical historian best known for his biography of Sir Frederick Banting, the codiscoverer of insulin, Bliss poses new questions about such matters as sex, class, and race that would not have interested earlier generations of readers. Did Osler share the racial prejudices of his contemporaries? Was he patronizing in his attitude toward women? Did he make distinctions among his patients on the basis of their social standing? Are there skeletons (particularly sex scandals) in his closet? The answers that Bliss gives may surprise some readers. Osler displayed little of the patronizing attitudes toward blacks, women, and the poor manifested by many of his contemporaries. Nor can Bliss find evidence of scandal: persistent rumors of youthful indiscretions, when investigated, lacked substance. Bliss admits that he found almost nothing that would undercut Osler's enormous reputation. In an era when heroes of the past are often shown to have had feet of clay, it is refreshing to see a medical paragon such as Osler emerge from close scrutiny with his personal integrity not merely intact but enhanced.
Bliss explores several themes that, although not new, illuminate Osler's outlook and intellectual development. The son of an Anglican minister, Osler abandoned his boyhood faith and espoused the Darwinian secular liberalism, with its unquestioned belief in progress, that gained popularity in the late 19th century. But his loss of religious faith left a void that was never quite filled. Unable to profess a belief in life after death, he compensated by finding meaning in work and by memorializing great physicians of the past, regarding memory and influence alone as bestowing immortality. As Osler turned away from Christianity, he found consolation in the writers of Greco-Roman antiquity, especially the Stoic philosophers. A humanist and genial skeptic, he laced his speeches, which were enormously popular in their day, with classical and biblical allusions that contemporary readers may find challenging.
Bliss's biography can hardly be termed revisionist. Although he recounts the well-known features of Osler's life and career that have often been discussed elsewhere, his access to previously unused materials sheds light on a number of points. Perhaps the best chapter is the last: "Osler's Afterlife," in which Bliss traces Osler's reputation since his death. Adored in his lifetime, he was acclaimed after his death as his era's "most famous, most beloved, and most influential physician." His textbook was published in updated versions until 1947. Cushing memorialized his life in his great biography, numerous reminiscences were published, and Osler's essays continued to enjoy a wide readership. The Osler cult was assiduously cultivated by a number of his students and admirers, especially his nephew William W. Francis, who catalogued and guarded his library (and relics) at McGill. By the 1950s, memories of Osler had faded, but he became the subject of renewed interest in the 1960s, as a model of medical humanism in a world in which medicine was increasingly dominated by science and technology. Toward the end of the century, books and articles on Osler appeared regularly. If the Osler mystique has faded somewhat, his image possesses a remarkable longevity, and he continues to be one of the most quoted physicians of all time.
Bliss's biography will of course be compared with that of Cushing. A few readers will miss the luxuriant detail that Bliss has omitted, but most readers will welcome a biography that is both more manageable in scope and more up to date in its assessment not merely of Osler but also of the bustling and creative medical world of the late 19th and early 20th centuries in which he practiced. For a generation of readers whose shared values are so different from Osler's, William Osler: A Life in Medicine is certain to generate a new appreciation of the man and his remarkably diverse achievements.
Reviewed by Gary B. Ferngren, Ph.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
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