Strive High

Email received today on 6 September 2008

Sir William Osler came from a very rural background, what we will consider the "Ulus"...

He studied medicine at McGill University in Canada and at that time the quality of the education that he received, is by later standards, highly inadequate. But he was very determined to be a good doctor and travelled to Britain and Germany to learn from the 'masters' after graduation. He was on a shoestring budget as you can imagine. His exposure there provided the foundation of studying from autopsies, the basics of physiology research, meticulous clinical skills, and meeting giants like Prof Virchow expanded his thinking.

When he returned to McGill, he was appointed Professor of medicine in his 20's!! With his exposure and experience, he introduced many changes to medical education. More importantly he correlated clinical history and signs to autopsy findings; remember there was NO investigations in those days other than a basic microscope, the autopsy findings taught him much that will lead him to fame as a doctor and educator. He PERSONALLY conducted more than a thousand autopsies at Montreal General alone, and in the course of his career, CLINICAL-PATHOLOGICAL correlation remained the way of learning and teaching. His patho specimens can still be seen today at McGill. By such hard work, he became a great clinician and pathologist.

His devoted students from McGill, then Philadelphia, then John Hopkins and finally Oxford will follow him on his ward rounds to the autopsy room, learning from the Master. His words must be one of the most documented in medical history for his students recorded them down and till today we have records of what he said at this ward round and that autopsy!

He revolutionised the teaching of medicine by teaching his Medical students at the BEDSIDE instead of didactic lectures which was the norm then. He presented his findings at medical meetings almost non stop; when we study medicine we find his footprint everywhere from platelets, malaria, parasitology, endocarditis, neurology, appendicitis, smallpox, typhoid, etc.

The lesson here is that a small kampung boy can make good and be the best, if only he has the capability and he wants to.

Osler was famous for his discipline and devotion to medicine, for its advancement he was willing to pay any price. A famous incident records a patient he saw with the clinical diagnosis of Addison's disease. There was no serum corticol levels to measure, no CT of the adrenals then; when the patient died, the family refused an autopsy. Osler infamously apparently greased his arm, went in the still of the night to the mortuary and pushed his arm PR, perforated the colon and removed the kidney! Please remember that all the autopsies and this unusual "post mortem" examination was in the era BEFORE gloves and protective wear! He had tuberculous infection of his hands as a result of repeated post mortum contact. Osler's life as a doctor, clinician, teacher and researcher has inspired generations of students and doctors.

Most importantly he was a humanist, a kind doctor at a time when treatment of diseases was near non existent, a time when it was the compassion and humaneness of the doctor that WAS the treatment. His numerous addresses to medical students starting or finishing medical studies is well recorded and you should read them when free.

So dream high, work HARD and remember that THE sole reason for your presence in medical school is to be a good doctor!