Osler: Longevity

Longevity is a vascular question.

A man is as old as his arteries.

Osler: Words

Beware of words - they are dangerous things. They change color like the chameleon, and they return like a boomerang.

Osler, on being scientific

By scientific, I do not mean the acquisition of the bare facts of science, but an understanding of its methods, a realisation of its meaning and an inoculation with its spirit...It is an attitude of mind, a sort of reflex, which at once on the presentation of a problem makes a man burn until its solution is accomplished. until he knows the status of the question among the investigators of the world.

The Reserves of Life. St. Mary's Hospital Gazette 1907;13:95-98.
From Osler by Charles Bryan 1997.

Quote: Knowledge & Wisdom

Knowledge is proud that he has learned so much;
Wisdom is humble that he knows no more!
- Cowper.

..."sense" or "wisdom" is knowledge, ready for use, made effects and bears the same relationship to knowledge itself that bread does to wheat.
(From Osler by Charles Bryant. Oxford Univ. Press. p. 116)

Knowledge comes but wisdom lingers.
- Tennyson

Osler: Art of Medicine

Osler: The whole art of medicine is in observation.

Paraphrased by William Thayer in his book about Osler.

Osler: The way to learn & practice medicine

Paraphrased by William Thayer (Osler's student at Johns Hopkins):

Observe, record, tabulate and communicate.

Use you five senses. The art of the practice of medicine is to be learned only by experience; 'tis not an inheritance; it cannot be revealed.

Live on the ward. Do not waste the hours of daylight in listening to that which you may read by night.

Memory plays strange pranks on facts. The rocks and fissures and gullies of the mountain-side melt quickly into smooth, blue outlines of the distant panorama. Viewed through the perspective of memory, an unrecorded observation, the vital details long since lost, easily changes its countenance and sinks obediently into the frame fashioned by the fancy of the moment.

Always note and record the unusual. Keep and compare your observations. Communicate or publish short notes on anything that is striking or new.

Do not waste your time in compilations, but when your observations are sufficient, do not let them die with you.

Study them, tabulate them, seek the points of contact which may reveal the underlying law.

Somethings can be learned only by statistical analysis. If you have the good fortune to command a large clinic, remember that one of your chief duties is the tabulation and analysis of the carefully recorded experience.

Osler: Reading and General practitioner

It is astonishing with how little reading a doctor can practise medicine, but it is not astonishing how badly he may do it.

Self-centered, self-taught, he leads a solitary life, and unless his every-day experience is controlled by careful reading, or by the attrition of a medical society it soon ceases to be of the slightest value and becomes a mere accretion of isolated facts without correlation.

Books and Men in Aequanimitas 210-211.

Osler: Value of libraries

It is hard for me to speak of the value of libraries in terms which would not seem exaggerated. Books have been my delight these thirty years, and from them I have received incalculable benefits. To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not go to sea at all.

Osler: Medical Teaching

"Teach [the student] how to observe, give him plenty of facts to observe and the lessons will come out of the facts themselves".

Medical News [New York] 1903 (82):49-53

"Eye cannot see what the mind does not know."

"The whole art of medicine is in observaton, as the motto goes, but to educate the eye to see, the ear to hear and the finger to feel takes time, and to makea beginning to start a man on the right path, is all that we can do. We expect too much from the student and we try to teach too much. Give him good methods and a proper point of view, and all the other things will be added, as his experience grows."

"The Hospital as College" Aequanimitas 315-316.

Osler: Instruments of Learning

Observation plus thinking has given us the vast stores of knowledge we now possess of the structure of the bodies of living creatures in health and disease. There have been two inherent difficulties - to get men to see straight and to get men to think clearly; but in spite of the fraility of the instrument, the method has been one of the most powerful ever placed in the hands of man.

Glasgow Medical Journal 1911(76):321-333.

Osler: "Aequanimitas" - Student Life...its really about the teachers.

Successful teachers is no longer on a height, pumping knowledge at high pressure into passive receptacles. The new methods have changed all this. He is no longer Sir Oracle...,but he is a senior student anxious to help his juniors...When a simple, earnest spirit animates a college, there is no appreciable interval between the teacher and the taught - both are in the same class, the one a little more advanced than the other. So animated. the student feels that he has joined a family whose honour, whose welfare is his own, and whose interests should be his first consideration.

From p75. Osler by Charles Bryan (Oxford Univ. Press, 1997)

This is quoted from "Aequanimitas" series by Osler. Title: The Student Life.

Osler: Mentor-Protege relationship

From Osler by Charles Bryant (Oxford Univ. Press, 1997) p. 59 & 62

Origin of Mentor: (Greek legend) Ulysses, king of Ithaca went to Trojan war - leaving behind his wife Penelope and Telemachus under Mentor's care. Telemachus learned practical wisdom from Mentor, that can not be learnt from books.

Mentor-protege relationship can not be forced. The would-be mentor should have competence, character and patience. The would-be protege must show ability, enthusiasm and a willingness to help.

Their personalities should be compatible.

A shared sense of humor is highly desirable, since relationship should be fun.

In general, the story of Mentor-Protege relationship is as follows: The eager young man expresses interest in another's work, formed a bond, and received guidance, focus and affection.

Quote: Osler - Importance of medical societies

p.50

The daily round of a busy practitioner tends to develop an egoism of a most intense kind, to which there is no antidote. The few set-backs are forgotten. The mistakes are often buried, and ten years of successful work tends to make a man touchy, dogmatic, intolerant of correction and abominably self-centered. To this mental attitude the medical society is the best corrective, and a man misses a good part of his education who does not get knocked about a bit by his colleagues in discussions and criticisms.

From Osler by Charles Bryan, Oxford Univ. Press, Oxford. 1997.

Quote: Osler - Find a calling, Stages of life

From Osler by Charles Bryan (Oxford Univ Press 1997)

p.32

Age specific developmental tasks:

(According to Carl Jung,...later by Erik Erikson)

21-35: Stage of identity

35-55: Stage of generativity

>55: Stage of consolidation

p.33

Osler to gradulating nursing students 1891:

...And happy life shall be yours, because busy and useful; having been initiated into the great secret - that happiness lies in the absorption in some vocation which satisfies the soul;that we are here to add what we can to, not to get what we can from, life.

Osler: Kalidasa's poem

Osler requested addition of Kalidasa's poem (from 400 AD) to his essay.

The following is the partial English translation.

Listen to the Exhortation of the Dawn!

Look to this Day!

For it is Life, the very Life of Life.

...

Yesterday is but a Dream

Tomorrow is only a vision;

But Today well lived makes

Every Yesterday a Dream of Happiness

And, every Tomorrow a Vision of Hope.

Look well therefore to this Day!

Such is the salutation of the Dawn!

(From p30. Osler by Charles S. Bryan 1997 Oxford Univ. Press)

Osler: Time Management & Advice to students

From Osler (by Charles Bryan) 1997

p.18

Four qualities requisite for success in medicine:

The Art of Detachment, the Virtue of Method, and the Quality of Thoroughness may make you students, in the true sense of the word, successful practitioners, or even great investigators; but your characters may still lack that which can alone give permanence to powers - the Grace of Humility.

Charles Hobbs: Show me a person with high self-esteem and humility, and you will show me an effective manager of time, a tremendously powerful individual.

Thoroughness is the most difficult habit to acquire, but it is the pearl of great price, worth all the worry and trouble of the search. The dilettante lives an easy, butterfly life, knowing nothing of the toil and labour with which treasures of knowledge are dug out of the past, or wrung by patient research in the laboratories.

p.20

Realize how much time there is, how long the day is. Realize that you have sixteen wakeful hours, three or four of which at least should be devoted to making a silent conquest of your mental machinery.

Control the mind as a working machine, in it of habit, so that action becomes almost an automatic as walking, is the end of education - and yet how rarely reached! It can be accomplished with deliberation and repose, never with hurry and worry.

p.19

Value of experience is not in seeing much, but in seeing wisely.

Osler: Fruit of labor

Excerpts from "Osler - Inspirations from a Great Physician" by Charles Bryan. Oxford Univ. Press 1997


p11. "To few is given the tenacity of will which enables a man to pursue a cherished purpose through a quarter of a century...to fewer still is the fruition granted. Too oftern the reaper is not the sower. Too often the fate of those who labour at some object for the public good is to see their work pass into other hands". (Reportedly, taken from "Books and Men" in Aequanimitas. 145.)


"We must set our goals carefully because we may reach them!"


p. 12. Thucydides [Greek Historian] it was who said of the Greeks tha they possessed "the power of thinking before they acted, and of acting too". That same is true in a high degree of the English race. To know just what has to be done, then do it, comprises the whole philosophy of practical life.
("British Medicine in Greater Britain" in Aequanimitas)