Monday, December 16, 2013

Sir William Osler

Willy Osler, as he was known to all his friends, was the most gifted of Canadian physicians, the Father of Canadian Medicine, born in rural Ontario in the mid 19th century and died in 1919. After the University of Toronto he graduated from McGill and practiced in Montreal, Baltimore at Johns Hopkins where he was a founding member and at Oxford. He founded and refined the method of bedside teaching; taught that history and physical examination, listening to and examining patients, was the hallmark of teaching diagnosis and treatment. Osler was a compound; composite particles ground together by life's mortar and pestle, where reason, body and soul were blended in. One could say about Osler, that it is one thing to practice an exemplary form of medicine; it is another thing entirely, to teach a thousand medical students to practice an exemplary form of medicine.  
At the time of Osler's dying, he kept, at his bedside, a single one  of his favorite books. Sir William Osler had a deep understanding of both the body and spirit of medicine. It is no accident that the compound nature of Osler embraced the book, Religio Medici, (The Religion of the Doctor), written by Sir Thomas Browne shortly after his medical graduation in 1643. I believe the quotation I draw from it now, in turn, embraces Osler. “--thus there are two books from which I collect my divinity: besides that written one of God, another of his servant Nature, that universal and publick manuscript that lies expansed unto the eyes of all: those that never saw him in the one, have discovered him in the other." It was my privilege to give the Annual Osler Lecture to the Vancouver Medical Society this year. 

Sunday, December 15, 2013

Bag of Skin

Me, Myself, and I are contained in a bag of skin called Jim. We talk to one another regularly about the direction the bag is going, and generally, what it's all about and what's best for it. We know the bag hears us because it often mouths our dialogue and we hear ourselves being repeated, though not always accurately. We are democratic in this bag and this Trinity of ours never tries to dominate or take over from one another and simply laugh off the escaped little foibles that we see from time to time that drive the bag go off in somewhat hapless directions. Jim, who is easily mystified says, "Who are these entities that claim to be me, or that claim to direct me in my life?  Are they Angels or Demons or just Gods or Muses? Do they arise from an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of an underdone potato, as Scrooge apparently said to the ghost of Jacob Marley?"---- We reflected that the three of us are becoming more obvious as Jim gets older and the bag has to listen more closely to the inner life, since in addition, Me, Myself and I are probably stirring up the bag more often?.--- Jim finally asked, "Who are you guys anyway? "-- We, as the Trinity answered in unison. We have rehearsed this answer many times as we have always been there in the bag of skin called Jim and have waited for the question which has finally come.--- "Jim, We are much older than you and have been here many years before you. You, for your information, are a new bag and always will be, since the  cellular replacement of all your current cells arrives from earth's supplies every few weeks as you reconstruct your old skin and renew its cellular contents with new materials. For that reason, though your template remains old and getting older, you become a new cellular entity each week or so, as earth recycles its materials to and fro. Every cell your bag contains undergoes complete renewal;  even your wet bones rise again, renewed, though much more slowly, but the paradox of new cells in an old bag template remains.  We just are. You however, are of earth. Relax! You are no more mad than everyone else;  not more, not less. You're just listening to us more carefully and somewhat more urgently now!"