William Osler Taught the Art of Bedside Medicine to New Doctors

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Sir William Osler

The skills of touching, viewing or speaking with a live patient were not required modules in medical student training in early Canada. A licence to practice medicine, even surgery, was gained through theory in the lecture room, not in the hospital. Canadian physician William Osler changed procedures, giving his students a solid education at the ward bedside. The teaching techniques ensured better, humanistic patient care.

Medical Students Trained in Hands-On Care

“I desire no other epitaph… than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do,” Osler was quoted by Charles G. Roland in “Osler, Sir William,” in Dictionary of Canadian Biography Online. The practice of placing patients in students’ hands was not new in the world – it was done in Europe. But it was new in North America. Under Osler’s influence, hands-on care became a North American standard for training physicians.

As a young man, William Osler planned to be an Anglican minister like his father. Featherstone Lake Osler and his family immigrated to Upper Canada in 1837, the senior Osler charged with building parishes throughout southern Ontario in the mid-1800s. Born in 1849 in Bond Head, Ontario, William was the eighth of the nine children raised by Featherstone and his wife Ellen. In 1857, the Oslers moved to Dundas, Ontario for better educational prospects for their children. A happy, curious and mischievous boy, William Osler was a good student who loved books and reading.

William Osler Inspired by Sciences

Completing his early schooling, Osler enrolled at Toronto’s Trinity College in 1867 in preparation to join the church. Absorbing a wide range of subjects for a year, he found he was instead fascinated with the sciences. Osler switched to medicine. Training at the Toronto School of Medicine, Osler transferred to McGill University in 1870. He graduated as a doctor two years later, with the “realization that greater knowledge was to be acquired by the study of advanced medical practices in Europe…,” said Canada Post Corporation in the 1969 press release for the commemorative stamp, “Sir William Osler, 1849-1919, The System of Medicine.”

The young man sailed to Europe, gathering new medical skills and ideas in London, Vienna and Berlin. Thinking he would concentrate on ophthalmology, Osler altered his focus to general medicine and pathology.

McGill University Lecturer and Professor

Ready to care for patients when he returned from overseas, Osler opened a medical office in Dundas in 1874. In short order, McGill University offered him an appointment to lecture medical students. Only 24 years old, Osler achieved full professorship the next year. Becoming proficient in teaching medicine, Dr. Osler also worked at the Montreal General Hospital as small pox pathologist. He also “performed almost 1,000 autopsies, and made numerous preparations of important specimens for museums,” said Roland, and “published extensively in clinical medicine, pathology, and veterinary medicine.”

In 1884, Osler was selected by the University of Pennsylvania as Professor of Clinical Medicine. Moving to Philadelphia, Osler taught at the university for nearly five years, expanding his own knowledge at the same time. His next appointment took him to the brand-new Johns Hopkins Hospital in Baltimore, Maryland in May 1889. It was at Johns Hopkins that Osler developed his bedside method of teaching, taking his students out of the lecture hall and onto the wards to examine the sick.

Osler’s System of Bedside Medical Training

Osler’s students learned to touch the patients, thoroughly examine them, take their medical histories and listen to their words. Osler was often quoted, “Listen to the patient. He is telling you the diagnosis.” Osler’s techniques were like a gust of fresh air in North America, and soon spread to other schools. Also developing a scheme of hospital interns, residents and head residents, Osler’s system of medical training was one of his most memorable feats.

A skilled diagnostician, Osler was an authority on ailments due to his expertise in the sciences of pathology and biology. Writing “The Principles and Practices of Medicine” in 1892, Osler became a renowned author; the small but comprehensive book reprinted many times over as a medical textbook for decades to come. Updated and enhanced with modern techniques, “The Principles and Practices of Medicine was published in several languages.

Books were one of Osler’s passions. He collected thousands of books, especially medical history books. Calling his collection Bibliotheca Osleriana, Osler willed his books to McGill Library. The 8,000-book collection became the nucleus of McGill’s vast Osler Library of the History of Medicine on the death of Osler.

Marriage and Family in Philadelphia

While in Philadelphia, Osler met and married the widow Grace Revere Gross in 1892. The Oslers had two sons, but sadly, one did not survive early infancy. Edward Revere Osler was born in 1895, the apple of his parents’ eyes.

Tiring of the heavy workloads, Osler accepted a position at England’s University of Oxford in 1905, and remained at the post for 14 years. The Osler family “acquired a beautiful home near the Bodleian Library, said Roland, the house filled with visitors. “Students, visiting colleagues, nurses, friends of friends, all were welcomed.” William Osler was a charming man, filled with cheerfulness and joy. He delighted in children immensely, playing with them as if he, too, were still a child.

Among many awards and honours received in his lifetime, Osler was given an unusual tribute in 1911. He was named a Baronet in England and with it, the title of Sir William Osler; his wife became Lady Osler. (A Baronet is lower in British ranking than a Baron but higher than a Knighthood.) It was a good life for Osler, but dark clouds were stirring in the distance. His son, Revere Osler, joined the military during World War One, taking part in battles. In August 1917, the young Osler was killed. William Osler was heartbroken.

Two years later at age 70, Osler was struck down by disease, the very thing that was his medical specialty. The good doctor succumbed to pneumonia on December 29, 1919. The spirit of Sir William Osler lives on, the Canadian viewed as a “Father of Modern Medicine.”

Sources:

  1. Roland, Charles G., “Osler, Sir William,” Dictionary of Canadian Biography Online
  2. “Sir William Osler, 1849-1919, The System of Medicine,” Canadian Postal Archives, Collections Canada
  3. “The Doctor’s Doctor: Sir William Osler,” Canadian Medicine: Doctors and Discoveries, Mount Allison University
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