1. Jonathan McFarland
27th January 2014

2. “ it is good to hark back to the olden days and gratefully to
recall the men whose labours in the past have made the
present possible.” ( Sir William Osler -AEQUANIMITAS )

3. 
I could talk about:

4. Alexander Fleming
Andreas Vesalius

5. Robert Koch
Galen

6. John Hunter
Rene Laennec

8. 
“We are here to add what we can to life, not to get what
we can from life”

9. Featherstone Osler, the father – (1805-1895)
Interestingly enough, in 1831 Featherstone Osler was invited to serve on HMS
Beagle as the science officer on Charles Darwin’s historic voyage to the Galapagos'
Islands, but he turned it down because his father was dying

10. 
William Osler was born in Bond Head Canada
West (now Ontario) on July 12, 1849.

He entered Trinity College, Toronto (now part of
the University of Toronto) in the autumn of 1867.

His chief interest proved to be medicine and,
forsaking his original intention, he enrolled in the
Toronto School of Medicine.

Osler left the Toronto School of Medicine after
being accepted to the MDCM program at McGill
University Medicine Faculty in Montreal.
He received his Medical Degree in 1872


11. 
In 1874 Osler became a professor at McGill
University Faculty of Medicine

He created his first journal club.

In 1884, he was appointed Chair of Clinical
Medicine at the University of
Pennsylvania in Philadelphia

In 1885, was one of the seven founding members
of the Association of American Physicians, a
society dedicated to "the advancement of
scientific and practical medicine."

12. 
In 1889, he accepted the position as the
first Physician-in-Chief of the new Johns
Hopkins Hospital in Baltimore, Maryland.

In 1893, Osler was instrumental in the
creation of the John Hopkins School of
Medicine and became one of the school's
first professors of medicine.

Osler quickly increased his reputation as
a clinician, humanitarian, and teacher.

13. The Four Doctors by John Singer Sargent, 1905, depicts the
four physicians who founded Johns Hopkins Hospital . From
left to right: William Henry Welch, William Stewart Halsted,
Osler, Howard Kelly

14. 
In 1905, he was appointed to the Regius Chair of
Medicine at Oxford, which he held until his death.
He was also a Fellow of Christ Church, Oxford.

In 1911, he initiated the Postgraduate Medical
Association, of which he was the first President.

He died at the age of 70, on December 29, 1919
in Oxford, during the Spanish Influenza epidemic

Osler was a founding donor of the American
Anthropometric Association, a group of
academics who pledged to donate their brains for
scientific study. Osler's brain was taken to the
Wistar Institute in Philadelphia to join the Wistar
Brain Collection.

16. 

In 1925, a biography of William Osler was
written by Harvey Cushing* who
received the 1926 Pullitzer prize for the
work. A later biography by Michael Bliss
was published in 1999.
In 1994 Osler was inducted into
the Canadian Medical Hall of Fame
* Often called the “Father of
Neurosurgery”

17. 
He has frequently been described as the "Father of Modern
Medicine"
With his wife and son

19. 
Perhaps Osler's greatest contribution to
medicine was to insist that students learn
from seeing and talking to patients and the
establishment of the medical residency. The
latter idea spread across the Englishspeaking world and remains in place today
in most teaching hospitals.

While at Hopkins, Osler established the
full-time, sleep-in residency system
whereby staff physicians lived in the
administration building of the hospital.

22. 

Perhaps Osler's greatest contribution to
medicine was to insist that students
learned from seeing and talking to
patients
The contribution to medical education of
which he was proudest was his idea of
clinical clerkship – having third- and
fourth-year students work with patients
on the wards.

23. 
He pioneered the practice of bedside
teaching, making rounds with a handful of
students, demonstrating what one student
referred to as his method of "incomparably
thorough physical examination."

He reduced the role of didactic lectures and
once said he hoped his tombstone would
say only,
"He brought medical students into the
wards for bedside teaching."


24. 
“The four points of a
medical student’s compass
are: Inspection, Palpation,
Percussion, and
Auscultation.”
Series of four photographs of Sir William Osler at patient's
bedside, in the stages of observation, palpation, auscultation
and contemplation

25. Baltimore Period (1889-1905)

26. "Ciencia y caridad" (1897). Pablo Picasso
The Doctor, Luke Fildes 1891

27. 
“Listen to the patient, he is telling you the
diagnosis. “

“Every patient you see is a lesson in much
more than the malady from which he
suffers.”

“The kindly word, the cheerful greeting, the
sympathetic look, trivial they may seem,
help to brighten the paths of the poor
sufferers”

28. 
Osler fundamentally changed medical
teaching in the North America, and this
influence, helped by a few such as the
Dutch internist Dr. P.K. Pel, spread to
medical schools across the globe.

29. 
Osler was a prolific author and public
speaker and his public speaking and writing
were both done in a clear, lucid style. His
most famous work, ”The Principles and
Practice of Medicine” quickly became a key
text to students and clinicians alike. It
continued to be published in many editions
until 2001 and was translated into many
languages.

32. 
Osler's essays were important guides to physicians.
The title of his most famous essay, "Aequanimitas",
espousing the importance of imperturbability.

33. 
Osler’s nodes are raised tender nodules on the pulps of
fingertips or toes, an autoimmune vasculitis that is
suggestive of sub acute bacterial endocarditis. They are
usually painful

Osler-Libman Sacks syndrome is an atypical, verrucous,
nonbacterial, valvular and mural endocarditis.

Osler's syndrome is a syndrome of recurrent episodes of
colic pain, with typical radiation to back, cold shiverings and
fever; due to the presence in Vater’s diverticulum of a freemoving gallstone which is larger than the orifice
Osler's triad: association of pneumonia, endocarditis,
and meningitis.


34. 




A speech called "The Fixed Period", given on
February 22, 1905, included some controversial
words about old age..
He envisaged a college where men retired at 67
and after a contemplative period of a year were
"peacefully extinguished" by chloroform.
He claimed that, "the effective, moving, vitalizing
work of the world is done between the ages of
twenty-five and forty" and it was downhill from
then on.
This caused a strong controversy with the
tabloids stating
“ Osler recommends chloroform at sixty!!”

35. 



In the conclusion
“The French have a saying, plus ca change, plus c'est la
meme chose—the more things change, the more things
stay the same”
William Osler was not just a great man of his times but
speaks to us today in the dilemmas that we face about a
way of practice and life
Despite having no modern diagnostics and relying only
upon his eyes, his stethoscope, and a microscope, his
approach to diagnosis and of dealing with patients
remains fresh and energizing to anyone who would open
his volumes and read his writings.
*Proc (Bayl Univ Med Cent). 2011 July; 24(3): 227–235

36. 

To understand what Osler has to say to us today, 100 years
later, is to listen to his own “way of life”:
“I have three personal ideals. One, to do the day's work well
and not to bother about tomorrow…. The second has been to
act the Golden Rule, as far as in my lay, towards my
professional brethren and towards the patients committed to
my care … and the 3rd 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.”

37. Osler wrote his own epitaph,
“that I taught medical students in the ward”

38. 
The answer is YES.

And perhaps, even more so

In the days when a complementary test is
sometimes preferred to a good history
then Osler can still teach us A LOT.

39. 



Back to the basics:
A good clinical history
A good physical examination
A good bedside manner

41. Mcfarland.jonathan@gmail.com