About Sir William Osler
by David Michael Martin Rider, M.D.
Osler Student Scholar Alumnus 2006
Sir William Osler
Many biographers have tried in lengthy biographies to give a fair account of all the important events and accomplishments in the life and career of William Osler. No other one person has exercised so much constructive influence on modern medicine, in the development of the system in which medicine is taught, or done so much toward the integration of pathology and pathophysiology into the understanding of disease while integrating patient's symptoms into treatment. Osler was also a man of tremendous charisma, and was gifted with graciousness, charm, integrity and an abiding work ethic which drove him to such achievements that more than 80 years since his death he is nearly deified by those who study the history of medicine.
Osler was born of pioneer stock, the eighth of nine children of Church of England canon Featherstone Lake Osler and his wife, Ellen Pickton, who had emigrated from England to upper Ontario in 1837. William Osler was born on July 12, 1849, and accounts of his early childhood show the young Osler to have been a terrific prankster, precocious but not well regarded by his teachers because of his frequent misbehavior. Apparently, firm moral and religious grounding by his parents had a nurturing influence, for he entered the Trinity College School in Dundas, Ontario in 1864 with the intention of becoming a clergyman like his father. Here he met and was influenced by Father Johnson, a professor, as well as a local physician, Dr. James Bovell. Father Johnson and Dr. Bovell would meet weekends to pursue their common interest in naturalism and microscopy, and a young impressionable Osler joined them as they scoured the surrounding Canadian country-side looking for specimens to be stained and mounted for microscopic study. Just a few years after Rudolf Virchow and his contemporaries began to popularize the understanding that life and disease began and ended with cells, Osler developed a fascination with the world he saw under the microscope in a place and time that the microscope was quite a rare instrument.
This was an important phase in the life of Osler; fired by enthusiasm to understand nature he spent much of his spare time learning of the lower forms of life and of the mysteries of biology. There is little doubt that it was this early experience in biologic science which swayed him to become a physician rather than a clergyman, and that his facility with the microscope and belief that he personally could contribute to others' understanding of life and disease would serve him tremendously throughout his future career. Years later Osler taught his students to "observe, record, tabulate, communicate," and to "go out among your fellows and learn from them." That he practiced his own philosophy at this early age is evidenced by his first publication, "Christmas and the microscope," which he published as a 20 year old medical student in 1869.
Platelets from Tulane
Osler graduated from the Trinity College School in 1868 and obtained a medical degree four years later at McGill University, where he distinguished himself through his interest in pathology, both at autopsy and under the microscope. Later, Osler would be instrumental in establishing North America as a place Europeans would come to learn medicine, but as a recently graduated physician himself, he traveled the other direction, to Europe, where most of the exciting developments in the field medicine were taking place. He visited London, Berlin and Vienna, where he attended lectures by a number of the world's leading medical professors. He spent most of his time in London in the laboratory studying human blood, and in May 1873 after reading a paper before the Royal Microscopic Society was elected to its membership. That same summer he was first to describe the platelets as being normal constituents of circulating blood.
Returning to Canada in 1874, at the age of twenty-five he was appointed lecturer of physiology, histology and pathology at his alma mater, the McGill University medical school. For the next ten years he was pathologist at the Montreal General Hospital, Professor of the Institutes of Medicine, and starting in 1878 a full time attending physician to the Montreal General Hospital. At a time when the post-mortem examination was usually performed by the physician attending the patient at death, Osler's enthusiasm for studying disease in its final stage was so great that the hospital created the position of "pathologist" specifically for him. He personally performed over a thousand autopsies while in Montreal, kept records of his observations regarding the pathologic correlations with the patient's diseases, and published his findings in a great many journals. This research, an exhaustive knowledge of what his contemporaries were writing in medical periodicals from the United States and from Europe, and a dedication to his medical students and to his fellow physicians as a group lead Osler to develop a wide reputation as a great clinician and professor by the time he was 35 years old.
In 1884 he accepted the Chair of Clinical Medicine at the University of Pennsylvania, and produced a flurry of papers detailing interesting patient cases, his work in the basic sciences, as well as disease pathology and pathogenesis. Aside from a few exceptions, the United States at this time was fairly lacking in adequate, much less exceptional medical education. Westward expansion and growth meant a terrific need for new physicians, and medical schools had sprung up all over the country without university connections, usually providing a one or two-year curriculum in which the professors were more or less directly paid by the students for lectures.
The condition of medical education and medicine itself in the United States would be fundamentally changed by the will of a Baltimore, Maryland merchant, Johns Hopkins. At his death in 1873 Johns Hopkins willed $7,000,000 to be divided evenly between a projected university and hospital, both to bear his name. According to his will, the hospital was to be affiliated with the university, and the resulting medical school was to become an institution which rivaled the great institutions of Europe in producing the best physicians in the world. The evolution of the university, the hospital, and the medical school is a story in itself, and by 1889 a remarkable array of talent had been attracted to Baltimore to direct the hospital's departments and to teach future medical students. Osler was invited to fill the position of physician-in-chief over the hospital and medical school and to develop a curriculum unique to Johns Hopkins. It is fair to say that Osler's arrival in Baltimore marked a turning point in the trend of medical education in the United States and in the invigoration of American medicine as a whole.
After accepting the position at Johns Hopkins and moving to Baltimore, but before the first students matriculated at the medical school nearly four years later, Osler applied himself to the care of patients, to the pursuit of medical science and the organization of medical societies. However perhaps most importantly, with the help of his capable residents, Osler had time to dedicate to the authorship of what would become the seminal textbook of his age on the subject of medicine, the "Principles and Practice of Medicine," published in 1892. This textbook and its subsequent editions as well as his work at Johns Hopkins medical school served to elevate Osler's public reputation to heights previously unheard of for a physician.
Mrs. Grace Osler
Upon completing the first edition of his textbook, Osler was married to the widow Mrs. Grace Revere Goss, a direct descendent of Paul Revere. They had two sons, one of whom died shortly after birth. The other, Edward Revere Osler, was mortally wounded in combat in World War I at the age of 21. According to one biographer, Osler was emotionally crushed by the loss. The Osler's home in Baltimore became known by Osler's students and residents as a welcoming and wonderful place to visit and learn. Osler gave latchkeys to several of his junior house staff (including Harvey Cushing) so they could have access to his home library in Baltimore. The favored house staff became known as the “latch-keyers.”
Just where Osler found the time for all his activities has always been a mystery even to those who were close to him in life. In one of his many famous speeches, Osler relates to the 1913 graduating class at Yale "A Way of Life" by which they might find time to accomplish great things, much in the way that he has. He advises the graduates to live "life in day-tight compartments," referring to the watertight compartments on ships. "Our main business," he says, "is not to see what lies dimly at a distance, but to do what lies clearly at hand," because "the load of tomorrow, added to that of yesterday, carried today makes the strongest falter." He states in his essay that it is this ability, and not any profound mental prowess which has enabled him to achieve so much in his own life. By all accounts, his energy throughout each day was boundless, and in addition to all of his patient care, student teaching, public speaking, and physician advocacy activities he wrote 1,158 medical publications and 182 literary papers and essays.
Post-Graduate Class of 1897
After sixteen years at Johns Hopkins the relentless drive was beginning to tell on Osler, and when he was offered the Chair of Regius Professor of Medicine at Oxford in England, he accepted, intending to find a more tranquil atmosphere. However, according to habit he instantly became an integral part of the civic and professional community he found in Oxford, and in no time at all had become involved in a dizzying range of activities: his name appears in nearly every committee of the time concerned with medical and scientific matters in England, he threw all his weight into the adequate development of the basic medical sciences which were taught at the school, he conducted clinics at the county hospital, he taught the course in the History of Medicine, he was frequently consulted as part of busy private practice, he continued to write and deliver addresses, and was fundamental in the establishment of the Quarterly Journal of Medicine, the official publication of the Association of Physicians of Great Britain and Ireland.
Countless honors were bestowed upon Osler in the course of his career. He was elected to the Royal Society in 1898, received honorary degrees from a score of universities and in 1911 at the coronation of King George V was made a baron.
Osler in military uniform
The Oslers were in England at the time that World War I began, and though now Sir William wrote that the war "seems so unnecessary," he and Lady Osler devoted themselves to support their new country, specifically the organization and administration of the Army Medical Department. Revere Osler, who volunteered for military service in the war, was wounded on August 27, 1917 and died later that day despite the efforts of Dr. Harvey Cushing, a great pioneer in the field of surgery and one of his father's close friends and eventual biographers. Cushing later wrote of Revere Osler's funeral, "A strange scene–the great-great-grandson of Paul Revere under a British flag, and awaiting him a group of six or eight American Army medical officers–saddened with thoughts of his father."
It is said that Osler never recovered from the heartbreak of his son's death. He continued his work with the Army Medical Department through the end of the war, however, and on July 12, 1919 on his seventieth birthday he was recognized through an unprecedented outpouring of affection and tribute in articles published in medical journals and other magazines and newspapers on both sides of the Atlantic. In December of the same year he contracted bronchopneumonia and died on December 29, 1919.