Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a Canadianphysician. He has been called one of the greatest icons of modern medicine.
- Common sense in matters medical is rare, and is usually in inverse ratio to the degree of education.
- "Teaching and Thinking" in The Montreal Medical Journal (1895).
- The trained nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest, and not inferior to either in her mission.
- Address at Johns Hopkins Hospital (1897); later published in Aequanimitas, and Other Addresses (1905).
- When schemes are laid in advance, it is surprising how often the circumstances fit in with them.
- "Internal Medicine as a Vocation" Address to the New York Academy of Medicine (1897); later published in Aequanimitas, and Other Addresses (1905).
- We can only instill principles, put the student in the right path, give him method, teach him how to study, and early to discern between essentials and non-essentials.
- "After Twenty Five Years", an address at McGill College, Montreal (1899); later published in Aequanimitas : With other Addresses to Medical Students, Nurses and Practitioners of Medicine (1910), p. 210.
- To study the phenomenon of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.
- "Books and Men" in Boston Medical and Surgical Journal (1901).
- I have had three personal ideals: One to do the day's work well and not to bother about tomorrow. You may say that is not a satisfactory ideal. It is; and there is not one which the student can carry with him into practice with greater effect. To it more than anything else I owe whatever success I have had — to this power of settling down to the day's work and trying to do it well to the best of my ability, and letting the future take care of itself.
The second ideal has been to act the Golden Rule, as far as in me lay, toward my professional brethren and toward the patients committed to my care.
And the third has been to cultivate such a measure of equanimity as would enable me to bear success with humility, the affection of my friends without pride, and to be ready when the day of sorrow and grief came, to meet it with the courage befitting a man.
What the future has in store for me, I cannot tell — you cannot tell. Nor do I care much, so long as I carry with me, as I shall, the memory of the past you have given me. Nothing can take that away.
- Remarks at a farewell dinner address in New York (20 May 1905), later published in Aequanimitas, and Other Addresses (1910 edition), p. 473.
- No human being is constituted to know the truth, the whole truth, and nothing but the truth; and even the best of men must be content with fragments, with partial glimpses, never the full fruition.
- "The Student Life" in The Medical News (30 September 1905).
- Acquire the art of detachment, the virtue of method, and the quality of thoroughness, but above all the grace of humility.
- As quoted in The Book of Unusual Quotations (1957) by Rudolf Franz Flesch, p. 122.
- Medicine is a science of uncertainty and an art of probability.
- As quoted in Computers in biomedical research (1965) by Ralph W. Stacy, p. 320.
- The best preparation for tomorrow is to do today's work superbly well.
- As quoted in Lifetime Speaker's Encyclopedia (1962) by Jacob Morton Braude, p. 575.
- In the history of medicine, there are few instances in which a disease has been more accurately, more graphically or more briefly described.
- In reference to "On Chorea" (1872) by George Huntington on what is now known as Huntington's Disease, as quoted in "Huntington's Chorea" by Irwin A. Brody and Robert H. Wilkins in Archives of Neurology Vol. 17, No. 3 (1967). The acclaim Huntington received for this paper, his first, from Osler and others, he would later refer to as an "unsought, unlooked for honor."
- There are three classes of human beings: men, women and women physicians.
- As quoted in Women in Medicine (1968) by Carol Lopate and Josiah Macy, Jr., p. 178.
- To have striven, to have made the effort, to have been true to certain ideals — this alone is worth the struggle.
- As quoted in Wisdom for the Soul (2006) by Larry Chang, p. 678.
- Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science.
- The Treatment of Disease Can Lancet 1909;42:899-912, As quoted in The Quotable Osler, ACP Press, 2008
- One special advantage of the skeptical attitude of mind is that a man is never vexed to find that after all he has been in the wrong.
- The Treatment of Disease Can Lancet 1909;42:899-912.
- Aequanimitas : Valedictory Address, University of Pennsylvania, (1 May 1889)
- In a true and perfect form, imperturbability is indissolubly associated with wide experience and an intimate knowledge of the varied aspects of disease. With such advantages he is so equipped that no eventuality can disturb the mental equilibrium of the physician; the possibilities are always manifest, and the course of action clear. From its very nature this precious quality is liable to be misinterpreted, and the general accusation of hardness, so often brought against the profession, has here its foundation. Now a certain measure of insensibility is not only an advantage, but a positive necessity in the exercise of a calm judgment, and in carrying out delicate operations. Keen sensibility is doubtless a virtue of high order, when it does not interfere with steadiness of hand or coolness of nerve; but for the practitioner in his working-day world, a callousness which thinks only of the good to be effected, and goes ahead regardless of smaller considerations, is the preferable quality.
Cultivate, then, gentlemen, such a judicious measure of obtuseness as will enable you to meet the exigencies of practice with firmness and courage, without, at the same time, hardening "the human heart by which we live."
- Let me recall to your minds an incident related of that best of men and wisest of rulers, Antoninus Pius, who, as he lay dying, in his home at Loriam in Etruria, summed up the philosophy of life in the watchword, Aequanimitas. … Natural temperament has much to do with its development, but a clear knowledge of our relation to our fellow-creatures and to the work of life is also indispensable. One of the first essentials in securing a good-natured equanimity is not to expect too much of the people amongst whom you dwell.
Chauvinism in Medicine (1902)
- Address to the Canadian Medical Association, Montreal (17 September 1902); published in The Montreal Medical Journal Vol. XXXI (1902)
- The critical sense and sceptical attitude of the Hippocratic school laid the foundations of modern medicine on broad lines, and we owe to it: first, the emancipation of medicine from the shackles of priestcraft and of caste; secondly, the conception of medicine as an art based on accurate observation, and as a science, an integral part of the science of man and of nature; thirdly, the high moral ideals, expressed in that most "memorable of human documents" (Gomperz), the Hippocratic oath; and fourthly, the conception and realization of medicine as the profession of a cultivated gentleman.
- We may indeed be justly proud of our apostolic succession. Schools and systems have flourished and gone, schools which have swayed for generations the thought of our guild, and systems that have died before their founders; the philosophies of one age have become the absurdities of the next, and the foolishness of yesterday has become the wisdom of to-morrow; through long ages which were slowly learning what we are hurrying to forget — amid all the changes and chances of twenty-five centuries, the profession has never lacked men who have lived up to these Greek ideals.
- There seems to be no limit to the possibilities of scientific medicine, and while philanthropists are turning to it as to the hope of humanity, philosophers see, as in some far-off vision, a science from which may come in the prophetic words of the Son of Sirach, "Peace over all the earth."
- Nationalism has been the great curse of humanity. In no other shape has the Demon of Ignorance assumed more hideous proportions; to no other obsession do we yield ourselves more readily. For whom do the hosannas ring higher than for the successful butcher of tens of thousands of poor fellows who have been made to pass through the fire to this Moloch of nationalism ? A vice of the blood, of the plasm rather, it runs riot in the race, and rages today as of yore in spite of the precepts of religion and the practice of democracy. Nor is there any hope of change; the pulpit is dumb, the press fans the flames, literature panders to it and the people love to have it so. Not that all aspects of nationalism are bad. Breathes there a man with soul so dead that it does not glow at the thought of what the men of his blood have done and suffered to make his country what it is ? There is room, plenty of room, for proper pride of land and birth. What I inveigh against is a cursed spirit of intolerance, conceived in distrust and bred in ignorance, that makes the mental attitude perennially antagonistic, even bitterly antagonistic to everything foreign, that subordinates everywhere the race to the nation, forgetting the higher claims of human brotherhood.
- The greater the ignorance the greater the dogmatism.
On the Educational Value of the Medical Society (1903)
- Address to the New Haven Medical Association (6 January 1903), published as "On the Educational Value of the Medical Society" in Yale Medical Journal, Vol. IX, No. 10 (April 1903), p. 325
- Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.
- Surrounded by people who demand certainty, — and not philosopher enough to agree with Locke that "Probability supplies the defect of our knowledge and guides us when that fails, and is always conversant about things of which we have no certainty," the practitioner too often gets into a habit of mind which resents the thought that opinion, not full knowledge, must be his stay and prop. There is no discredit, though there is at times much discomfort, in this everlasting perhaps with which we have to preface so much connected with the practice of our art. It is, as I said, inherent in the subject.
- There is no more difficult art to acquire than the art of observation, and for some men it is quite as difficult to record an observation in brief and plain language.
The Master-Word In Medicine (1903)
- Montreal Medical Journal (1903)
- Though a little one, the master-word looms large in meaning. It is the open sesame to every portal, the great equalizer in the world, the true philosopher's stone, which transmutes all the base metal of humanity into gold. The stupid man among you it will make bright, the bright man brilliant, and the, brilliant student steady. With the magic word in your heart all things are possible, and without it all study is vanity and vexation. The miracles of life are with it; the blind see by touch, the deaf hear with eyes, the dumb speak with fingers. To the youth it brings hope, to the middle-aged confidence, to the aged repose. True balm of hurt minds, in its presence the heart of the sorrowful is lightened and consoled. It is directly responsible for all advances in medicine during the past twenty-five centuries. Laying hold upon it Hippocrates made observation and science the warp and woof of our art. Galen so read its meaning that fifteen centuries stopped thinking, and slept until awakened by the De Fabrica, of Vesalius, which is the very incarnation of the master-word. With its inspiration Harvey gave an impulse to a larger circulation than he wot of, an impulse which we feel to-day. Hunter sounded all its heights and depths, and stands out in our history as one of the great exemplars of its virtues With it Virchow smote the rock, and the waters of progress gushed out while in the hands of Pasteur it proved a very talisman to open to us a new heaven in medicine and a new earth in surgery. Not only has it been the touchstone of progress, but it is the measure of success in every-day life. Not a man before you but is beholden to it for his position here, while he who addresses you has that honor directly in consequence of having had it graven on his heart when he was as you are to-day. And the master-word is Work, a little one, as I have said, but fraught with momentous sequences if you can but write it on the tablets of your hearts and bind it upon your foreheads. But there is a serious difficulty in getting you to understand the paramount importance of the work-habit as part of your organization. You are not far from the Tom Sawyer stage with its philosophy "that work consists of whatever a body is obliged to do, and that play consists of whatever a body is not obliged to do."
A great many hard things may be said of the work-habit. For most of us it means a hard battle; the few take to it naturally; the many prefer idleness and never learn to love labor.
- Every one of you will have to face the ordeal of every student in this generation who sooner or later tries to mix the waters of science with the oil of faith. You can have a good deal of both if you only keep them separate. The worry comes from the attempt at mixture.
Science and Immortality (1904)
- The search of science for the spirits has been neither long nor earnest; nor is it a matter of surprise that it has not been undertaken earlier by men whose training had fitted them for the work.
It is no clear, vasty deep, but a muddy, Acheronian pool in which our modern spirits dwell, with Circe as the presiding deity and the Witch of Endor as her high priestess. Commingling with the solemn incantations of the devotees who throng the banks, one can hear the mocking laughter of Puck and of Ariel, as they play among the sedges and sing the monotonous refrain, "What fools these mortals be!" Sadly besmirched, and more fitted for a sojourn in Ancyra than in Athens, has been the condition of those who have returned from the quest, and we cannot wonder that scientific men have hesitated to stir the pool and risk a touch from Circe's wand. All the more honour to those who have with honest effort striven to pierce the veil and explore the mysteries which lie behind it.
- Though his philosophy finds nothing to support it, at least from the standpoint of Terence the scientific student should be ready to acknowledge the value of a belief in a hereafter as an asset in human life. In the presence of so many mysteries which have been unveiled, in the presence of so many yet unsolved, he cannot be dogmatic and deny the possibility of a future state; and however distressing such a negative attitude of mind to the Teresian, like Pyrrho, he will ask to be left, reserving his judgement, but still inquiring. He will recognize that amid the turbid ebb and flow of human misery, a belief in the resurrection of the dead and the life of the world to come is the rock of safety to which many of the noblest of his fellows have clung; he will gratefully accept the incalculable comfort of such a belief to those sorrowing for precious friends hid in death's dateless night; he will acknowledge with gratitude and reverence the service to humanity of the great souls who have departed this life in a sure and certain hope but this is all. Whether across death's threshold we step from life to life, or whether we go whence we shall not return, even to the land of darkness, as darkness itself, he cannot tell.
The Faith that Heals (1910)
- "The Faith That Heals" British Medical Journal (18 June 1910) p. 1470
- Nothing in life is more wonderful than faith — the one great moving force which we can neither weigh in the balance nor test in the crucible. Intangible as the ether, ineluctable as gravitation, the radium of the moral and mental spheres, mysterious, indefinable, known only by its effects, faith pours out an unfailing stream of energy while abating nor jot nor tittle of its potency. Well indeed did St. Paul break out into the well-known glorious panegyric, but even this scarcely does justice to the Hertha of the psychical world, distributing force as from a great storage battery without money and without price to the children of men.
Three of its relations concern us here. The most active manifestations are in the countless affiliations which man in his evolution has worked out with the unseen, with the invisible powers, whether of light or of darkness, to which from time immemorial he has erected altars and shrines. To each one of the religions, past or present, faith has been the Jacob's ladder. Creeds pass, an inexhaustible supply of faith remains, with which man proceeds to rebuild temples, churches, chapels and shrines.
- A man must have faith in himself to be of any use in the world. There may be very little on which to base it — no matter, but faith in one's powers, in one's mission is essential to success. Confidence once won, the rest follows naturally; and with strong faith in himself a man becomes a local center for its radiation. St. Francis, St. Theresa, Ignatius Loyola, Florence Nightingale, the originator of every cult or sect or profession has possessed this infective faith. And in the ordinary everyday work of the doctor confidence, assurance (in the proper sense of the word) is an asset without which it is very difficult to succeed.
- Faith is indeed one of the miracles of human nature which science is as ready to accept as it is to study its marvellous effects. When we realise what a vast asset it has been in history, the part which it has played in the healing art seems insignificant, and yet there is no department of knowledge more favourable to an impartial study of its effects, and this brings me to my subject — the faith that heals.
- Literature is full of examples of remarkable cures through the influence of the imagination, which is only an active phase of faith.
- While in general use for centuries, one good result of the recent development of mental healing has been to call attention to its great value as a measure to be carefully and scientifically applied in suitable cases. My experience has been that of the unconscious rather than the deliberate faith healer. Phenomenal, even what could be called miraculous, cures are not very uncommon. Like others, I have had cases any one of which, under suitable conditions, could have been worthy of a shrine or made the germ of a pilgrimage.
The Life of Sir William Osler (1925)
- Quotes of Osler from The Life of Sir William Osler (1925) by Harvey Cushing
- We are here to add what we can to, not to get what we can from, Life.
- Humanity has but three great enemies: fever, famine, and war; of these by far the greatest, by far the most terrible, is fever.
- Take the sum of human achievement in action, in science, in art, in literature—subtract the work of the men above forty, and while we should miss great treasures, even priceless treasures, we would practically be where we are today … The effective, moving, vitalizing work of the world is done between the ages of twenty-five and forty.
- Vol. I, Ch. 24 : "The Fixed Period'".
- My second fixed idea is the uselessness of men above sixty years of age, and the incalculable benefit it would be in commercial, political, and in professional life, if as a matter of course, men stopped work at this age.
- Vol. I, Ch. 24 : "The Fixed Period".
- The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.
Sir William Osler : Aphorisms (1961)
- Sir William Osler : Aphorisms from His Bedside Teachings and Writings. (1961) edited by Robert Bennett Bean
- A physician who treats himself has a fool for a patient.
- One of the first duties of the physician is to educate the masses not to take medicine.
- Soap and water and common sense are the best disinfectants.
I have long held the dangerous belief that William Osler's essays, judiciously used, could render teachers of medical ethics redundant. Virtually all the medical student needs for ethical behaviour is contained within them.
One of Osler's most famous essays, Aequanimitas, was first delivered to newly minted doctors in 1889 as a valedictory address at the Pennsylvania School of Medicine. Osler urges his young audience to “consider but two of the score of elements which may make or mar your lives.” The first is imperturbability, which refers to “calmness amid storm, clearness of judgment in moments of grave peril.” This poker faced composure, he claims, is essential to instil confidence in impressionable or frightened patients. Imperturbability is in part acquired through experience and a thorough knowledge of medicine. With these in hand, “no eventuality can disturb the mental equilibrium of the physician.”
The second, related element—equanimity—has been the subject of some debate among Osler scholars. While some have interpreted it as apathy—the absence of emotions—others have read it as “metriopatheia,” measured or moderated emotions. To acquire the virtue of equanimity, Osler recommends a tolerant, somewhat non-judgmental attitude towards our fellow humans. “The more closely we study their little foibles of one sort and another in the inner life which we see,” he remarks, “the more surely is the conviction borne in upon us of the likeness of their weaknesses to our own.” Osler continues: “The similarity would be intolerable, if a happy egotism did not often render us forgetful of it.” Osler also advises us not to seek certainty when it cannot be found but to be satisfied with fragments of the truth and to be ready for the inevitable struggles and disappointments ahead. (Did he foretell MTAS?) When they arrive, “stand up bravely” and “wrestle on” with due persistence; and, should defeat come, cultivating a cheerful equanimity will make the pain easier to bear. When matters of principle or justice are in play, then “cling to your ideal,” Osler urges, even in the face of evident failure.
The final part of the essay is of lesser interest to the modern reader, dealing with eminent alumni of his university and Osler's sadness at leaving.
Osler's essay is a classic for several reasons. Firstly, he tackles head-on a timeless question: what makes a good doctor? The ideals he proposes do not fade with passing years. Like Flaubert before him and Richard Selzer after, his writing is meticulously crafted—each phrase, word, sound, and intonation deftly chosen, at times blurring the line between prose and poetry. Rich in cultural and literary allusions, from Plato to Matthew Arnold, the essay can be enjoyed by the teenage reader and erudite professor alike. What is rare is that Osler's scholarship is not tainted by pretentiousness: “You remember in the Egyptian story, how Typhon with his conspirators dealt with good Osiris”—well, no, I remember no such thing, but this ignorance engenders curiosity rather than shame. Although the essay was written almost 120 years ago, there is a connection between author and reader. Even when discussing sombre matters Osler comes across as a benevolent presence, a calming hand on our shoulder: “It is sad to think, that for some of you, there is in store disappointment, perhaps failure.”
Whatever your position on the value of imperturbability and equanimity in 21st century medicine, Osler's Aequanimitas, with its subtle wit, masterful writing, richness of allusion, unpretentious wisdom, and warmth and charm, is not only a classic of medicine but a classic of the essay genre.