‘Hearts Unto Wisdom’: William Osler, Physician and Philosopher

Always the family man, William Osler valued the time he spent with his wife and surviving son, Revere. Revere's death in World War I was a blow from which he never emotionally recovered. (Fæ/CC BY-SA 4.0)

“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 that I have been called upon to do.”

The physician who wrote those words got his wish. Sir William Osler (1849–1919) is honored today as the “Father of Modern Medicine” in large part because of his emphasis on teaching and learning medicine from hospital wards, surgeries, and morgues rather than from lectures and textbooks. “Medicine is learned by the bedside and not in the classroom,“ he said. ”Let not your conceptions of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.”

William Osler was a formative figure in the development of Western medical education. (Materialscientist/CC BY-SA 4.0)

Moreover, Osler (pronounced Oh-sler) and three colleagues—physicians William Halsted, William Welch, and Howard Kelly—helped found the Johns Hopkins University School of Medicine, which quickly became one of the finest institutions of its kind. There Osler and Halsted instituted a formal program of residencies in which newly graduated doctors received several additional years of training in a specialty. That practice took hold and is now standard in medical training.

Profile of a Life Well-Lived

Born in Bond Head, Ontario, Osler received an excellent early education and intended to follow his father into the ministry. Encouraged by a teacher to pursue science and medicine, he instead earned a medical degree from Canada’s McGill University and then spent several years overseas studying European medical practices firsthand.

For the rest of his life, Osler would combine the roles of professor, physician, and writer. He taught medicine at prestigious universities—McGill, the University of Pennsylvania, and Johns Hopkins—and in 1905 became Regius Professor of Medicine at Oxford. In 1892, while winning renown at Johns Hopkins, he published “Principles and Practice of Medicine,” a textbook that spread his ideas regarding a hands-on approach to medical training across North America, Great Britain, and Europe.

Osler was born around the same time as the invention of the binaural stethoscope and lived to see the invention of insulin, advances in germ theory, and sanitation regimens that transformed the average American's life. (Fæ/CC BY-SA 4.0)

Known for his love of practical jokes,  Osler was happily married to Grace Revere, a descendent of the American Revolutionary War hero, Paul Revere. He adored children, an admiration that was reciprocated, and he and Grace had two sons, one of whom died in infancy. In 1917, their other son, Revere, was killed in action during the First World War, a death that imbued the few remaining years of Osler’s life with a tremendous sadness.

Osler died of complications of the lungs during the Spanish Flu epidemic. He was greatly admired by his associates and the public at large, and his funeral in Christ Church Cathedral in Oxford “overflowed with mourners.” Today his remains and those of his wife rest in a special niche in McGill’s Osler Library.

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Among the many books and essays that Osler left behind are two student addresses. Their messages gained him a wide audience and continue to attract readers today.

Ways of Living

In 1889, Osler spoke to the graduating class of the medical college at the University of Pennsylvania. He titled this farewell to the graduates “Aequanimitas,” Latin for “Equanimity.” In giving advice to these new doctors on how to successfully practice medicine, Osler stressed the importance of imperturbability and equanimity when dealing with the sick, a “coolness and presence of mind under all circumstances, calmness and storm, clearness of judgment in moments of grave peril.” By using  this technique, he noted, a physician can pass on confidence to the patient and the friends and relatives at the bedside.

In this same oration, Osler remarked that to be a good doctor, “a callousness which thinks only of the good to be effected, and goes ahead regardless of smaller considerations, is the preferable quality.” That remark may still provoke debate among doctors, but if we consider it in the context of his speech, we realize that he is not recommending that physicians be cold to their patients, but that they need to keep a cool head as to offer the best treatment.

Twenty-four years later, Osler delivered another lecture, “A Way of Life,” to students at Yale University. Here he suggested a structure and philosophy for living, “a handle to fit your life tools.” He then noted: “The way of life I preach is a habit to be acquired gradually by long and steady repetition. It is the practice of living for the day only, and for the day’s work, Life in day-tight compartments.” He offered his audience broad advice, telling them, for example, “to shut off the future as tightly as the past,” as well as specifics such as keeping a close check on “careless habits of eating,” avoiding an excess of alcohol, and engaging in morning devotions and prayer.

As we might expect, these brief guides to living share commonalities of style and substance. Osler was a Victorian and expressed himself as such, with the same graceful rotundity in his sentences that we find in writers like Thomas Carlyle, whom Osler admired, and Winston Churchill. His sense of morality is as ancient as the quotations and examples he employs from Scripture and the Greco-Roman classics, and these citations, then the mark of a university education, were doubtless familiar to the students in his audience.

Osler also exhibited a humble fellowship with those in his audience. In “A Way of Life,” for example, he opens with the words “Fellow students,” acknowledging that he is one with them, a student, a lifelong learner. At the close of this same address, he remarks: “Perhaps this slight word of mine may help some of you so to number your days that you may apply your hearts unto wisdom.”

William Osler (front, C) worked in medical education throughout his life. (Fæ/CC BY-SA 4.0)

Osler for the Rest of Us

“Aequanimitas” continues to inspire physicians today. In his 2022 article “Does Osler’s ‘Aequanimitas’ Inform Our Contemporary Pursuit of Stillness?” Dr. James B. Young answers that question in the affirmative, remarking that “health care professionals have shared their experiences of travail and how the stillness born of equanimity leads to redemption.” In his book “Kipling’s ‘If’ Meets Osler’s ‘Aequanimitas’: Nineteenth Century Virtues for the Modern Day Physician,” Dr. John Clay McHugh favorably compares Rudyard Kipling’s poem “If” to Osler’s essay. The two men were friends, contemporaries, and their work largely illustrates their complementary values.

Yet both of Osler’s essays, particularly “A Way of Life,” spoke to broader audiences than doctors and nurses. In her 1937 copy of “A Way of Life,” my grandmother bracketed in pencil several sentences and paragraphs that held special meaning for her. Like so many other readers, she saw that Osler wasn’t just speaking to medical professionals but to everyone. In “Aequanimitas,” for instance, if we slightly revised Osler’s words, we could direct them at parents, teachers, executives, and many others, all of whom might benefit by the practice of a balanced, calm approach to their work and lives. In “A Way of Life,” we can easily discern that Osler addresses not only the students at Yale but readers everywhere, speaking to them as one human being to another.

“Keep calm and carry on” and mindfulness to the day and the business at hand are two popular ideas of our time. If you want to learn more about them and other virtues, read some William Osler and see what he has to say.

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