William Osler

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mjl1717

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It Friday night into Saturday.
Question?

If William Osler was resurrected by Houdini from the dead and you had to update him about the major differences/thought processes in medicine in 1908 versing 2008..What would you say changed?? (major changes)

Ill start:

1)The field is much more litiginous because of greedy people, greedy insurance companies, and greedy lawyers (John Edwards caliber)
 
Hi...

I would tell him that today, more importance is placed on knowledge relating to the generalized disease rather than to the individual patient.
 
I would tell him that his little protege Cushing totally pwned him.
 
I would tell him that his little protege Cushing totally pwned him.

To be honest I will first ask you if there was really a heaven and hell and if so where he ended up. Then based on his experience I will try to repent to the best of my ability... 😛
 
To be honest I will first ask you if there was really a heaven and hell and if so where he ended up. Then based on his experience I will try to repent to the best of my ability... 😛

Agreed. Osler seems to have been a complete saint across the board. But I think if someone told him that so many female doctors have joined the fraternal order, he would die laughing.
 
Also Id tell him if there ever was a scourge placed on mankind.
Human Immunodeficiency Virus would be it.. And its incidence and prevalence recently placed it in the same realm as HTN, Diabetes, COPD and CHF.
 
It Friday night into Saturday.
Question?

If William Osler was resurrected by Houdini from the dead and you had to update him about the major differences/thought processes in medicine in 1908 versing 2008..What would you say changed?? (major changes)

Ill start:

1)The field is much more litiginous because of greedy people, greedy insurance companies, and greedy lawyers (John Edwards caliber)

You forgot greedy doctors.
 
(Cushing became a more accomplished physician, rose to higher social circles, and won a pulitzer by writing Osler's biography).

Osler's contributions affected vastly more people than Cushing. There is no question of who was the greater contributer to medicine, especially bringing the center of gravity of turn of the century medicine towards North Americia.

Osler also singlehandedly advanced Cushing's career at several forks in Harvey's life. Without Osler, Cushing never controls his temper, never visits certain people in Europe, never puts a window on a dog's brain, etc...

Osler is by far a more accomplished physician, in my opinion. Cushing is my personal hero for different reasons.

I'm taking this thread too seriously heh...
 
You forgot greedy doctors.

I'm not sure if I agree with this. Greed is as old as humanity. I'm sure there were just as many physicians "back in the day" who were money-hungry as there are today.

However, I will agree that much of the profession has been adulterated by the new business-centered rather than patient-centered model of care today. I would imagine that paradigm shift would make it seem that physicians are much more focused on money as it is not guaranteed to them (code a patient visit wrong to an insurance company to see what i mean).

Still not sure what I'd tell Osler, though...
 
Osler's contributions affected vastly more people than Cushing. There is no question of who was the greater contributer to medicine, especially bringing the center of gravity of turn of the century medicine towards North Americia.

Osler also singlehandedly advanced Cushing's career at several forks in Harvey's life. Without Osler, Cushing never controls his temper, never visits certain people in Europe, never puts a window on a dog's brain, etc...

Osler is by far a more accomplished physician, in my opinion. Cushing is my personal hero for different reasons.

I'm taking this thread too seriously heh...

I agree.. (I bit my tongue) I did not want to say anything, but had 2nd thoughts about a mere mortal guy discounting Sir William Osler!!
 
I'm not sure if I agree with this. Greed is as old as humanity. I'm sure there were just as many physicians "back in the day" who were money-hungry as there are today.

However, I will agree that much of the profession has been adulterated by the new business-centered rather than patient-centered model of care today. I would imagine that paradigm shift would make it seem that physicians are much more focused on money as it is not guaranteed to them (code a patient visit wrong to an insurance company to see what i mean).

Still not sure what I'd tell Osler, though...

After quickly reflecting about the doctor greed point. True, its not a full slam dunk that doctors are greedy--{I think doctors in general dont go to school for buisness and many have tried to take advantage of this..}
 
It Friday night into Saturday.
Question?

If William Osler was resurrected by Houdini from the dead and you had to update him about the major differences/thought processes in medicine in 1908 versing 2008..What would you say changed?? (major changes)

Ill start:

1)The field is much more litiginous because of greedy people, greedy insurance companies, and greedy lawyers (John Edwards caliber)

How in the world would a dead person resurrect another dead person? Now that is a magic trick I would pay to see.

In response to your question, I would tell him about two things:

1. DNA
2. Computers

Both have revolutionized every facet of medicine.
 
How in the world would a dead person resurrect another dead person? Now that is a magic trick I would pay to see.

In response to your question, I would tell him about two things:

1. DNA
2. Computers

Both have revolutionized every facet of medicine.

Remember I tried to set a tone in that it was Friday night when I wrote that.
But Houdini is the only one I know of who spoke of comming back from the dead if he could..

Good!, I noticed that DNA recieved a big boast when it was in the public spotlight during the Simpson case...
 
You'd say:

Do you prefer Sir Osler or Dr.Osler??

1)compared to William Roentegen (who gave his wife hand cancer with his crude X-Ray machine) we have somewhat improved on imaging..) We now have PET, MRI, CT Ultrasound and VARIOUS radioisotope imaging which allow us decent visualization of disease and occasionally treatment..

2) Cataract surgery (the surgery itself) is done in less then 30 minutes and is something we can do well.... Hip replacement takes about one and one half hours can last a lifetime and is something we do a decent job with.. [just to name a couple]

We can grow hair with Minoxiidil or Propecia or possibly give you a hair transplant Dr. Osler..You see Dr Osler we can antagonize the culprit dihydrotestosterone..

3) In case where there is a biochemical defect or affect we occassionally can synthetically produce or antagonize that biochemical..

4)In females we can decrease mortality and morbidity with Pap smears, mammograms and colonoscopy..\

5)Also Dr. Osler we probably could have cured the pleurisy and pneumonia that you succumbed to with rapid pleurocentesis and current and appropiate IV antibiotic treatment

5) You see Dr. Osler in 100 years we did "sumthing", (this is said with some embarrasment) but I really dont think we did alot because basic disease HTN, Diabetes, Heart disease etc. still haunts us BIG time!!😱

6)Also Dr. Osler, mid levels and nurses are imitating doctors
 
Structure elucidation of molecules revolutionized everything.
We don't give [insert gland] extracts anymore.
We have better ways to enhance x-ray contrast than injecting air into CSF circulation 😱
We can operate on the heart!
Europeans want to come here for their "finishing" education.
There are 7 billion people in the world.
 
If Osler came back to life today wouldn't he be scratching at the top of his coffin?
 
Osler's contributions affected vastly more people than Cushing. There is no question of who was the greater contributer to medicine, especially bringing the center of gravity of turn of the century medicine towards North Americia.

Osler also singlehandedly advanced Cushing's career at several forks in Harvey's life. Without Osler, Cushing never controls his temper, never visits certain people in Europe, never puts a window on a dog's brain, etc...

Osler is by far a more accomplished physician, in my opinion. Cushing is my personal hero for different reasons.

I'm taking this thread too seriously heh...

Agreed. No way, no how is Cushing the more respected physician. More famous in the lay public, sure, but I feel certain that even Dr-resurrected-Cushing himself would disavow the idea that he is a more competent or accomplished clinician than Dr-resurrected-Osler.

I think the biggest disappointment Osler would have with today's medicine is--as noted in other posts--the general "greed" (although that's a pretty pejorative word--let's say, "concern over compensation") of today's physicians. I think the young physicians/students of today don't realize that doctors really didn't make a great living until after WWII, when government assistance programs, ripe for billing abuse, provided enormous paydays for procedural specialties, thus paving the way for $multi-million cardiac surgeons, back surgeons, etc. Even today, I would be willing to bet that a major, if not the primary, unspoken reason that most students (AMG's, anyway) shy away from primary care (i.e., the kind of medicine practiced by Dr Osler and his colleagues) is the inferior compensation as compared with Ortho, Optho, ENT, Plastics, interventional Cards, etc etc; i.e., the pay-heavy procedural fields. And if you've ever gotten an Ortho turf for "diabetes management", you know that no one in Ortho is interested in practicing medicine the way Dr Osler did. This is largely because of the compensation, I would argue, although I'm sure 95% of the people in those fields would deny it up and down (and I'm sure many of them would be correct--but not all). (NB: I myself was considering ENT for quite a while, but in the end I've decided on IM because I'm just not ready to narrow the scope of my medical knowledge so early in my training (NB NB: Cards/GI is not for me either)) Obviously we need Orthos, ENTs, and so on, but in the time since Osler's day, the surgical/procedural subspecialties have mushroomed into being overserved in basically every city of any size, while general Internists appear to be a doomed species. I don't think Dr Osler would be very happy with that development.

Really though, it doesn't even have to be laid directly at the feet of the highly compensated specialties. Most pre-meds coming into medical school, I think, are expecting a life of high social status and reliably generous compensation, and that simply was not the case in 1800/early 1900's America. Dr Osler achieved an enormous degree of respect and the social graces of Baltimore, but this was because he was literally the tippity-top of medicine at that time, and dedicated his entire life to getting there. Most of the contemporary docs slogging it out in the small-to-medium size towns of the country were not in it for the cash, that's for certain.
 
Agreed. No way, no how is Cushing the more respected physician. More famous in the lay public, sure, but I feel certain that even Dr-resurrected-Cushing himself would disavow the idea that he is a more competent or accomplished clinician than Dr-resurrected-Osler.

I think the biggest disappointment Osler would have with today's medicine is--as noted in other posts--the general "greed" (although that's a pretty pejorative word--let's say, "concern over compensation") of today's physicians. I think the young physicians/students of today don't realize that doctors really didn't make a great living until after WWII, when government assistance programs, ripe for billing abuse, provided enormous paydays for procedural specialties, thus paving the way for $multi-million cardiac surgeons, back surgeons, etc. Even today, I would be willing to bet that a major, if not the primary, unspoken reason that most students (AMG's, anyway) shy away from primary care (i.e., the kind of medicine practiced by Dr Osler and his colleagues) is the inferior compensation as compared with Ortho, Optho, ENT, Plastics, interventional Cards, etc etc; i.e., the pay-heavy procedural fields. And if you've ever gotten an Ortho turf for "diabetes management", you know that no one in Ortho is interested in practicing medicine the way Dr Osler did. This is largely because of the compensation, I would argue, although I'm sure 95% of the people in those fields would deny it up and down (and I'm sure many of them would be correct--but not all). (NB: I myself was considering ENT for quite a while, but in the end I've decided on IM because I'm just not ready to narrow the scope of my medical knowledge so early in my training (NB NB: Cards/GI is not for me either)) Obviously we need Orthos, ENTs, and so on, but in the time since Osler's day, the surgical/procedural subspecialties have mushroomed into being overserved in basically every city of any size, while general Internists appear to be a doomed species. I don't think Dr Osler would be very happy with that development.

Really though, it doesn't even have to be laid directly at the feet of the highly compensated specialties. Most pre-meds coming into medical school, I think, are expecting a life of high social status and reliably generous compensation, and that simply was not the case in 1800/early 1900's America. Dr Osler achieved an enormous degree of respect and the social graces of Baltimore, but this was because he was literally the tippity-top of medicine at that time, and dedicated his entire life to getting there. Most of the contemporary docs slogging it out in the small-to-medium size towns of the country were not in it for the cash, that's for certain.


That really sums it up quite nicely...
A few points..

1) As said above Osler spent his entire life getting to the top. Married late in life(went thru the trauma of losing both of his children) but did the ultimate in doing a full pathology residency and I.M. residency.. To get any where near this level I still maintain one needs to have "as much passion for medicine as one would have for a spouse.".

2) And as Barabara Fadem the "StanleyKaplan psychiatrist" has said and this is true as hinted at above "you dont go into medicine for money but if you happen to make some along the way its OK"..

3)I think Osler was fortunate to have well to do brothers in the buisness field who gave him a gift for graduation. This gift was sending him to Europe to study medicine which was the forerunner in Medicine at the time..

4)I would have loved to ask him .. "Sir Osler what is your study technique"?

5)Excuse the ignorance what does NB stand for? [National boards?]

6)I think the most significant issue about this thread is that the Internist and Primary care provider practices the best medicine.. He treats the entire patient not just ONE disease.. And he maybe a doomed species..

7)Thank you everyone..
 
6)I think the most significant issue about this thread is that the Internist and Primary care provider practices the best medicine.. He treats the entire patient not just ONE disease..
Debatable.
 
I would tell him that everything he learned over his entire life was covered in the first three months of my medical school education.
 

In closing

As drfunacular said Osler devoted his entire life to medicine. But people appear amazed when I mention that it seems that to be at the top of your field one should probably have as much passion for medicine as one might have for a spouse..{apparently many are not willing to make that sacrifice..}

Second, if Osler was somehow resurrected Id mention that the quantity of info appears to have increased at least 100 fold ..

Thank you-I rest my case..
 
But people appear amazed when I mention that it seems that to be at the top of your field one should probably have as much passion for medicine as one might have for a spouse..{apparently many are not willing to make that sacrifice..}

I don't think this is actually true. It isn't my love for the field of medicine that makes me come back to work to follow up on something I forgot after I've left or that gets me up at 4:45am every day to come to work. It is my obligation to my patients that does that. To be a great physician, you have to honor that obligation. What ends up sacrificed is your family and personal time.

If one wants to be an academic giant, his/her family will again be sacrificed, but the passion does not need to be for medicine. A person with a passion for plaques and certificates can just as easily be a top academic physician while having little to no passion for medicine.
 
How are you a socialist and an objectivist at the same time?
 
lol good comeback.

I only asked cause of the capital O in Objectivist, (like Rand Objectivism) which to my limited knowledge seems to be very anti-socialism. Serious question, I wasn't trying to be funny.
 
lol good comeback.

I only asked cause of the capital O in Objectivist, (like Rand Objectivism) which to my limited knowledge seems to be very anti-socialism. Serious question, I wasn't trying to be funny.

I understand. I'm not a socialist; it was a name taken a long time ago in an effort to make a dramatic point to a user who couldn't see anyone's side but his own. I am more of an objectivist, but not purely that, either, because it has its weaknesses, too.
 
I don't think this is actually true. It isn't my love for the field of medicine that makes me come back to work to follow up on something I forgot after I've left or that gets me up at 4:45am every day to come to work. It is my obligation to my patients that does that. To be a great physician, you have to honor that obligation. What ends up sacrificed is your family and personal time.

If one wants to be an academic giant, his/her family will again be sacrificed, but the passion does not need to be for medicine. A person with a passion for plaques and certificates can just as easily be a top academic physician while having little to no passion for medicine.

Acknowledged..
 
No one's mentioned antibiotics.....
 
No one's mentioned antibiotics.....

Saturday night..

1)So true!!..Oslers own death due to bronchopnuemonia, empyema and pleurisy could have possibly been prevented with proper C/S and correct ANTIBIOTIC treatment!! (what, Pennicillin came out in the 1950's?)

{by the way the pleurocentesis was done right at his bedside and Osler was disappointed hat he could not be present at his own autopsy.}

2)Also Osler felt that after age 40 man was not good for any thing..But nowadays many pro atheletes play pro sports way after age 40..

3)This is an aside: This person known as "Father of American Medicine" and "Father of Psychosomatic Medicine" is very correct in treating the patient physiologically and psychologically.

4) Also-The name Osler Vasquez disease was changed to Polycythemia Vera. But the name Osler Rendu Weber disease and Oslers nodes has remained to this day.👍
 
No one's mentioned antibiotics.....

Saturday night..

1)So true!!..Oslers own death due to bronchopnuemonia, empyema and pleurisy could have possibly been prevented with proper C/S and correct ANTIBIOTIC treatment!! (what, Pennicillin came out in the 1950's??
{by the way the pleurocentesis was done right at his bedside and Osler was disappointed that he could not be present at his own autopsy.}

2)Also Osler felt that after age 40 man was not good for any thing..But nowadays many pro atheletes play pro sports way after age 40..

3)This is an aside: This person known as "Father of American Medicine" and "Father of Psychosomatic Medicine" is very correct in treating the patient physiologically and psychologically.

4) Also-The name Osler Vasquez disease was changed to Polycythemia Vera. But the names Osler Rendu Weber disease and Oslers nodes have remained to this day.👍
 
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