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MOREY STETTNER

William Osler Set A Higher Standard For Today's Doctors

In 1948, Dale Carnegie wrote "How to Stop Worrying and Start Living." He urged readers to avoid fretting about the past or dwelling on an uncertain future. But William Osler gave that same advice years earlier.

Thirty-five years prior — in 1913 — Osler gave a speech at Yale University. Osler (1849-1919), a founding professor of Johns Hopkins Hospital, revolutionized medical education around the world.

Osler told his Yale audience to set aside worries about the past and future in favor of focusing on the present. He quoted philosopher Thomas Carlyle, "Our main business is not to see what lies dimly in the distance but to do what lies clearly at hand."

Over the last century, business titans such as Charlie Munger have become fans of Osler's life and work. Munger, who built Berkshire Hathaway into a colossus along with Warren Buffett, highlighted the role of master plans in creating a successful organization — and lauded Osler for his ability to turn his vision into reality.

Revolutionize An Industry Like William Osler

Often called the father of modern medicine, Osler's limitless curiosity drove his success. Born in Canada, he spent his early career as a respected physician with a compassionate bedside manner.

His devotion to patients led him to conduct research and teach medical students to excel as clinicians. At 39, he became the first physician-in-chief at Johns Hopkins Hospital in Baltimore and helped launch its medical school four years later.

Before Osler, medical schools taught students about diseases in dry, academic terms. He sought to create what he called "a new style in medical education in the United States" based on a residency program and an emphasis on patient care.

"For clinical teaching, he took medical students to the bedside to speak with patients," said David Cranston, emeritus associate professor of surgery at University of Oxford. "He was an excellent teacher. Students loved him."

Osler: Retain What You Read

As a young man, Osler would read for 30 minutes in bed before turning off the light. This became a lifelong habit, and he encouraged others to do the same — choosing books on a range of topics.

A self-described notebook man, Osler read with pen and paper nearby. He'd scribble notes on his pad so that he'd retain interesting facts or insightful quotes for ready reference later.

Osler's love of reading enhanced his writing skills. Early in his 16-year tenure at Johns Hopkins, he wrote a textbook that solidified his reputation as a leading figure in medical education. "The Principles and Practice Of Medicine" (1892) became "the most influential general medical text for the next 40 years," writes Cranston in his book, "William Osler and His Legacy to Medicine."

Keep The Human Touch

Yet Osler never lost sight of the human side of medicine. In his mid-20s as a Montreal doctor, he lost one of his patients to smallpox and wrote a letter to the young man's parents who lived abroad.

About 30 years later, soon after he moved to England to become a Regius Professor at Oxford, he met a woman who was struck by his last name. She said her brother died from smallpox while in Montreal and a Dr. Osler had written a kind letter to her parents.

"He replied, 'Yes, that was me,'" Cranston said. "The lady's mother was still alive, so Osler wound up visiting her in Cornwall, giving her a photo of the boy's grave," which he obtained ahead of meeting her.

Osler also experienced the pain of losing a child. His first child with his wife, Grace Revere Osler, died within a week of his birth in 1893. Another son, Edward Revere Osler, died in combat in World War I in 1917 at age 21.

Osler: Balance Solitude With Socializing

Osler wielded charisma. A practical joker who bonded easily with everyone from youngsters to seniors, he enjoyed people and saw the best in them.

"When he walked into a room, he was noticed," said Charles S. Bryan, MD, a distinguished professor emeritus of internal medicine at University of South Carolina School of Medicine. "But he also loved solitude" and sought to balance time spent alone with socializing.

An expansive thinker, Osler didn't limit his interests to medicine. "He was also an essayist and lecturer who addressed areas of concern like human mortality, science and war and the future of humankind," said Bryan, author of several books on Osler.

Like many great teachers, Osler led by example. He wanted students to learn from their mistakes, not cover them up. So he modeled that behavior.

In one class, he led students to a patient's bedside and diagnosed pneumonia. The patient died soon after, and Osler's postmortem determined the cause of death as pleural effusion.

He told his class about his mistake, how it happened and how to avoid it in the future.

Keep A Legacy Of Memorable Quotes

Articulate and clever, Osler was eminently quotable. Examples include, "Throw away all ambition beyond that of doing the day's work well" and "A physician who treats himself has a fool for a patient."

J. Mario Molina, MD, grew up with a father who was a doctor. "He would spout Osler's aphorisms," recalled Molina, past president of the American Osler Society. "One of his favorites was, 'Listen to your patient; he is telling you the diagnosis.'"

Former chief executive of Molina Healthcare, Molina says that Osler's writings influenced him from a young age. Today, he holds a vast collection of books that Osler owned.

"Many are inscribed by Osler," Molina said. "He was very generous and liked to give away his books" to people who might enjoy them. After he met someone who liked Percy Shelley's poems, for instance, he gave her his volume of Shelley's works with a friendly inscription.

Giving away his books, especially as Christmas gifts, flowed from his fondness for cultivating relationships. He mixed well with others and retained biographical tidbits of what they told him. "He had a real interest in people," Molina said. "Even if he only talked to you for 10 minutes, he made you feel very important and very special."

Support Others' Goals

If someone mentioned they were pursuing a goal, such as writing an academic paper, Osler didn't just nod his encouragement. He'd follow up with a short letter.

"He dashed off brief notes all the time," Molina said. "If you told him you were working on a book, he'd goad you to finish it and say how much he looked forward to reading it."

Michael Bliss, a prominent Canadian historian, wrote a well-received biography of Osler in 1999. Struck by the universal admiration surrounding Osler, Bliss started out a skeptic. "Bliss thought there must be skeletons in Osler's closet," Molina said.

But after years of research, Bliss was a believer. "I talked to Bliss and he told me, 'Yeah, I've read everything on Osler, all his day books (journals) and a huge volume of correspondence,'" Molina said.

Bliss concluded, "Osler is everything he seems to be."

William Osler's Keys:

  • Hailed as the father of modern medicine and a pioneer in revolutionizing how doctors are trained to treat patients.
  • Overcame: The death of two sons, one within a week of birth and another at age 21 in World War I combat.
  • Lesson: "Throw away all ambition beyond that of doing the day's work well."
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