Johns Hopkins Magazine -- April 2000
Johns Hopkins 
     Magazine Home

APRIL 2000


For American medical students, teaching at the bedside began with William Osler.
Opening photo:
At Hopkins, Osler eagerly introduced the learning-by-doing method of medical training so popular in Europe.
APRIL 2000
Pioneers of Scholarship

· · · · · · · · · · · ·
Physician, Writer,
Philosopher, Sage

By Melissa Hendricks

Perhaps the most famous and beloved early-20th-century physician, William Osler was a professor of medicine at four universities, in three countries, and on two continents. But the 16 years he spent at Johns Hopkins Hospital (1889-1905) represent his longest stay and the period of some of his most influential work.

One of Hopkins's four original medical faculty and physician-in-chief of the Hopkins Hospital, the Canadian-born Osler was 44 when he joined Hopkins, and he was eager to introduce the learning-by-doing method of medical training practiced in Europe. He encouraged teaching at the patient's bedside--a radical departure from the lecture-intensive medical training that was being taught in the United States. He demanded that students learn science--microscopy, bacteriology, and other disciplines--in the laboratory, in addition to lessons from lectures and textbooks. Medicine begins and ends with the patient, and books and lectures are "tools" to that end, he declared. Osler also introduced Hopkins and American medical education to the system of residency training.

Early in his tenure at Hopkins, Osler retreated to a room in the second floor of the hospital's Administration Building to draft a medical textbook. In 1892, D. Appleton & Co. published his Principles and Practice of Medicine. The tome covered the most up-to-date information about disease diagnosis and treatment, and remained the authoritative medical textbook for 40 years. According to a new biography by Michael Bliss (William Osler: A Life in Medicine, Oxford University Press, 1999), Osler's textbook was instrumental in convincing John D. Rockefeller of the need to underwrite medical research, leading to the establishment of the Rockefeller Institute. Hopkins is currently converting the room where Osler drafted Principles into a small museum of Osleriana.

Osler was a skilled diagnostician, a generalist who believed physicians should be knowledgeable in the gamut of medical specialties. He did seminal work in hematology and described a bleeding disorder called hereditary telangiectasia. He wrote numerous literary medical essays and speeches. Physicians still speak his name with reverence.

Perhaps Osler's most lasting legacy was his vision of how a physician ought to be: skillful and competent, yet approachable and compassionate. In "Aequanimitas," a speech he delivered in 1889 at the University of Pennsylvania, Osler declared: "In the physician or surgeon no quality takes rank with imperturbability...coolness and presence of mind under all circumstances, calmness amid storm, clearness of judgment in moments of grave peril."