William Osler: A Life in Medicine

Abstract

As is the case with many famous persons, Dr. William Osler was a man at the right place at the right time. He came to medicine in an era when the epicenter of medicine was shifting from Europe (a place where medicine was practiced more as a tradition) to North America (a place where medicine was becoming practiced more as a science). This unique crossroads in medical culture gave rise to one of the most respected, well-known clinicians in the history of the medical profession. Michael Bliss does an excellent job of telling Dr. Osler's story from his birth in rural, backwoods Canada, through his meteoric rise to the top of his field, to his death from pneumonia, “the old man's friend” (a phrase Osler coined). His research is thorough and his footnotes informative. He has done his job so exhaustively that some parts of the book become a little burdensome to read, as he becomes bogged down in the many small details that his research uncovered. These overly detailed parts, however, are few and far between, and this biography flows smoothly overall. William Osler's rise to the pinnacle of medicine was due mainly to his strong desire to learn. He was obsessed with knowing. Although famous as a clinician, he started in medicine as a pathologist. He took every chance he could during his early years in medicine to do an autopsy. His boundless enthusiasm for this means of discovery even led to rumors of grave robbing to get “good” cases. As he learned how disease had ravaged the bodies of the dead, he turned his interests to treating the living. At a time when most physicians were fairly snobbish and would diagnose patients from across the room, Dr. Osler advocated and taught his students the art of laying hands on the patient and was a pioneer in physical examination. At a time when most physicians were content to pursue “traditional” medicine such as mustard plasters and leeches, Dr. Osler advocated the use of evidence-based medicine and was one of the first to advocate the use of morphine. If treatments did not work, he abandoned them. If a treatment might work, he was willing to try something new. He was a true pioneer and a world-renowned expert in the treatment of not 1 or 2 diseases, but almost every major disease of his time. Bliss does a superb job of detailing Osler's contributions to his field. Obsessive-compulsive almost to a fault, Osler was not a perfect physician, and in fairness Bliss also details Osler's imperfections. A workaholic, Osler endangered his own health on several occasions. Dr. Osler was not a perfect clinician either. Like every doctor before and since, he made mistakes. One interesting story tells of a patient whom Osler examined, felt the tumor in the patient's abdomen, and declared the patient would be dead within weeks. A surgeon rounding on the same patient later that day inserted a catheter into the patient's bladder, the “tumor” vanished, and the patient was discharged. William Osler: A Life in Medicine is filled with amusing anecdotes and speeches and tells of Osler's contributions not only to medicine but to the teaching of medicine. This quintessential primary care practitioner and “Father of Internal Medicine” had a full and interesting life, and this well-written book is worthwhile reading not only for doctors, but also for anyone who enjoys good biography.