Book: William Osler: A Life in Medicine
Authors: Steve Sturdy
Journal: BMJ (2000)

Michael Bliss


Oxford University Press, £27.50, pp 581 




ISBN 0 19 512346 8

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Rating: ★★★★

When Sir William Osler died in 1919 he was widely judged to have been among the greatest physicians of all time. It is hard to imagine any present day doctor attracting such near universal adulation. Osler's life thus presents the historian with a fascinating problem: what was it that enabled a single figure to loom so large in the professional self consciousness of early 20th century medicine?

In his handsome new biography Michael Bliss portrays Osler as the living embodiment of the ideal 19th century physician. He was vastly knowledgeable in the natural history of disease, and his clinical acumen was informed by an encyclopaedic experience of postmortem pathology and tempered by a humanistic appreciation of the patient as much as the disease. But he was also sympathetic to the younger tradition of laboratory based experimental medicine and welcomed especially the sceptical rigour it brought to the evaluation of therapeutic practice. Osler looked forward from the 19th to the 20th century, and his teaching and practice combined what many regarded as the best of both epochs.

In this respect Bliss echoes the views of Harvey Cushing, whose Pulitzer prizewinning two volume Life of Sir William Osler was published in 1925. Of the two books, Bliss's is the more accessible for the modern general reader. Where Bliss goes beyond Cushing is in his dissection of Osler's personality. Osler had an astonishing ability to inspire affection and often devotion in practically everyone with whom he had dealings, be they patients, colleagues, or friends. Cushing rather took this for granted, and, as a result, his biography has sometimes been criticised as conventional professional hagiography. Bliss, by contrast, deliberately subjects Osler's personal life and attitudes to more searching scrutiny. To his own surprise, he finds no blot or stain on his subject's character. Osler, it seems, simply was the nearest thing a doctor can be to a saint.

But saints are canonised for the way they make manifest the values of an age, and Osler's exemplary virtue surely needs to be understood in its historical context. What stands out in Bliss's accounts of Osler's personal interactions, from the briefest consultation to the longest friendship, is how thoroughly medicalised they were. The devotion he inspired was a response to a specifically medical persona. Consequently, if we are to understand how Osler became a secular saint, we need to know much more about how he interacted with his patients—particularly at a time when, as he himself knew, physicians had only a very limited range of effective treatments to draw on.

There is an important story to be told here about the therapeutic nature of the doctor-patient relationship and its role in the professional identity of the late Victorian physician. Osler's singular stature in the eyes of his contemporaries was due above all to his remarkable ability to consummate that relationship. Sadly, we are given little insight—if indeed insight is possible—into quite what that consummation involved or how Osler was able to achieve it with such facility.