William Osler: A Life in Medicine

\ \ \ \ \ Chapter One\ English Gentlemen with American Energy\ * * *\ \ \ William Osler was born in a parsonage in backwoods Canada on July 12, 1849. His parents had come out from England to serve the Anglican Church in an obscure corner of British North America. Their parish centered on the hamlet of Bond Head, Canada West, some forty miles north of the little city of Toronto. At the time of Osler's birth, Bond Head was still a frontier station on the edge of a savage wilderness. Thousands of miles across the Atlantic, Victorian Britain was approaching the height of its power, prestige, and cultural refinement.\     Osler was of mainly Celtic descent. Many generations of his forebears had lived in Cornwall in southwestern England. The name Osler is derived from `ostler,' a stableman at an inn, and has a common root with `host' and `hospitality.' The Canadian family pronounces the `o' long as in `host,' not short as in `lost.'\     Four older Oslers were particularly important in shaping a legacy for William. They were his grandfather, Edward Osler, of Falmouth, England; a physician-uncle, Edward Osler, of England and Wales; and, of course, his father and mother, the Reverend Featherstone Lake Osler and Ellen Free Pickton Osler. These relatives' ambitions and adventures, especially the parents' journey from genteel England to raw North America, set the stage for William's life and mission. As well, like most of us, he grew up to resemble and echo the people whose genes he bore.\     Edward Osler, William's grandfather, born in 1758, hadturned his back on his family's seafaring tradition to become a shopkeeper and shipowner in the ancient port city of Falmouth, on the southern Cornish coast. He became moderately prosperous and hoped his nine children, especially his four sons, would rise in the world. If not, they should at least maintain the family's degree of comfort and security. When the eldest son, Edward, decided to become a surgeon, a step up the ladder, the father was willing to bear considerable expense to help with his education.\     Much of this book touches on the making of doctors. In England in the early 1800s the two ancient universities, Oxford and Cambridge, turned out only a handful of physicians, mostly from the upper classes. Most young Britons who wanted to study medicine or surgery served a local apprenticeship, then took courses at hospitals or privately run schools, usually in London, and finally wrote licensing examinations. Future-uncle Edward Osler took this route. He served an apprenticeship with a Falmouth surgeon, then sailed with his father to London to arrange for the rest of his training.\     Medical education had become partially modern in the sense that students, then as now, began to know the body by studying bodies. They learned anatomy and pathology by working on cadavers, human preferably, other animals if necessary. Cutting up or dissecting dead bodies has always been a gruesome business for most lay people and would-be students to contemplate. But the ability to examine diseased, dying, and dead humans with at least outward detachment or calm was and is a sine qua non of practicing medicine.\     On a June day in 1816, a year after the end of the Napoleonic Wars, the Edward Oslers, father and eighteen-year-old son, visited the well-known Blenheim Street anatomy `school' run by Joshua Brookes. It was the only such London institution open in summer; other instructors were inhibited by the problem of corpses decomposing in the heat. When Brookes, once described by a colleague as `the dirtiest professional person I've ever met with ... all and every part of him was dirt,' showed the Oslers his anatomical `museum,' Edward senior recoiled in terror from the stench. He thought the odors themselves might poison him. The experience seemed to him like a descent into Hades.\     The son already had a medical student's apparent equanimity. He also had a lively pen and a gauche desire to shock the folk back in Falmouth. Perhaps also sublimating inner nausea, he described what it was like to work at Brookes's:\ \ \ On the second day of my attendance, I entered the dissecting room for the first time. The first object which met my view was the body of an old man stretched on a shutter in the court, the brain taken out, & the scalp hanging about his ears, whilst his straggling white locks were matted together by his blood. A hungry wolf was snarling at it, & straining to get at it as far as his chain would allow him. A tub full of human flesh was standing near it, some pieces of which I gave the eagles, who devoured it with avidity. On entering the room, the stink was most abominable. About 20 chaps were at work, carving limbs & bodies, in all stages of putrefaction, & of all colors; black, green, yellow, blue, while the pupils carved them apparently, with as much pleasure, as they would carve their dinner.\ \ \ The hometown readers were predictably disgusted. Reveling in their discomfort and enjoying indulging his `scribbling propensity,' Edward supplied more graphic detail:\ \ \ We had a woman brought in three weeks ago, which was drowned in the Regents Canal. She is the fattest carcase I ever saw, so much so, that none of the pupils would take her. Her thigh is larger in circumference than my body. Three or four operations have been performed on her, & the fat is four inches deep in some places. Indeed, she is a ball of grease, & is now lying in the dissecting room untouched, except that one hip, shoulder, & breast, & her skull cap are taken off. She stinks most abominably, and when the sun shines hot, the yellow globules of melted fat run from her upon the floor, like fresh butter, and in the evening it congeals there like little saffron buns. I took a gentleman into the dissecting room last Monday, but he could not stand it a second, nor could I persuade him to enter it again ...\ I am now dissecting part of a female subject. Wonderful to relate, though 28 years of age her hymen was perfect. A handsome woman too. I gave it to Brookes at his request, to place among the rareties of his museum.\ \ \     Edward attended lectures at Brookes's school and at Guy's and St Thomas's hospitals, and he walked the wards of several hospitals to see cases. `The ward smells worse than a dissecting room.' He was most interested in observing surgery. We are several decades before the advent of anesthesia:\ \ \ Mr. Travers castrated an Irishman this forenoon at St Thomas', who roared most lustily. He was to have performed the operation for Hydrocele [a scrotal cyst] on a poor devil of a taylor, but he being frightened I suppose at the terrible outcries of the Irishman, would not get upon the table. Mr. Travers endeavored to persuade him to undergo the operation, but in vain, & he accompanied his refusals with gesticulations, which gave such an effect to his pale, trembling, vacant, sartorial physiognomy, that the whole theatre was kept in a roar of laughter. Another patient was brought, & underwent the same operation without flinching, as might be expected ... The taylor ... slunk downstairs to his ward, amidst the laughter of the pupils, the hootings of the patients, who collected at the doors of the wards to see him pass, & the scolds of the nurses & sisters.\ \ \     British medical students no longer had to procure their own corpses for dissection. Graverobbing had become specialized: the recently dead were raised from their resting places and sold to the medical schools by professional bodysnatchers, nicknamed `resurrection men.' The demand was very high, but so was resistance to the idea of mutilating the dead — widely feared as a kind of final, horrible assault on the person. Families tried to forestall graverobbing with mortuaries and burglar-proof coffins, and sometimes with armed guards. Soon all the United Kingdom would be appalled to learn that some resurrectionists, notably William Burke and William Hare in Edinburgh, had bypassed the middleman, as it were, by murdering (`burking') the living to create bodies for dissection. In 1832 Parliament passed the Anatomy Act, based on French practice, making available the corpses of indigents for dissection. In other countries the search for teaching aids in medicine remained less regulated.\     Edward Osler finished his training, became a licensed surgeon, and secured a promising position as resident surgeon to the Swansea Infirmary, one of the few hospitals in Wales. He hoped to fulfill his father's expectations and rise in Britain's layered society: `I think I can climb a little way ... I cannot help thinking that I shall be somebody one day, if I live.' He concentrated on ophthalmic, or eye surgery, a very early specialty.\     Edward married and began to raise a family. But his young wife's health became precarious and she had to leave Swansea (which also was in decline). Edward resigned his position and indulged in an opportunity to go to sea as a medical officer and student of natural history. His wife died soon after his return, and he moved home to Falmouth. There he practiced little medicine, instead spending most of his time scribbling. He wrote poetry (not nearly as well as his contemporary in medical studies in London, John Keats), also natural history, many hymns, and theology, following in the tradition of his maternal relative Samuel Drew, a prolific author locally famous as `the Cornish Metaphysician.'\     Two of Edward's younger brothers were not having much success as Falmouth storekeepers. One of them, Sam, eventually became the family's black sheep, a drinker and womanizer. By the 1830s the septuagenarian father, Edward senior, was suffering from a bilious disorder. Edward junior prescribed regular purging; but the patient himself, `after many experiments,' concluded that the best medicine for his condition was `beef and good Port Wine.' Edward père worried about his offspring's ability to sustain the family's `respectability of station & character.' His boys' blasting of their good prospects disgusted him, and he was not pleased that young Edward appeared to be so contented to stay at home: `I do sometimes grieve to think that after such an Education, no expense spared, he should have so mispent the best years of his life ... He is a peculiar character and I fear there is little prospect of his becoming independant of his Family ... I do like to see a Man more like a Man.'\     Edward fils finally left home again, marrying a second and eventually a third time. He became mainly a writer and an editor, based in Truro, Cornwall. He was deeply conservative in both religion and politics. He practiced a little medicine among the poor and became especially interested in the healing effect of anointing patients with olive and other oils, a practice dating from at least biblical times. Edward was a dreamy, impractical soul, far more interested in verses and books than in practicing physic. Once asked to treat a lady in a great house, he wandered into the library while waiting for his patient and became oblivious to time and the purpose of his visit. But although Edward Osler never enjoyed the success his father hoped for, he was not in any way a disgrace. Given his brothers' problems and his sisters' apparent inability to make advantageous marriages, a doctor and a prolific author was a bit of an ornament in the Osler family. Some of his hymns are still sung in Anglican churches. His descendants touched the life of his nephew, William Osler, in many ways.\ \ \ * * *\ \ \ Edward Osler senior hoped that his fourth son, Featherstone Lake (William's father), born December 14, 1805, would do better than the others. An adventuresome lad who loved the sea, `Fed' shipped aboard a relative's schooner at age fifteen, survived the vessel's dismasting in a terrible storm, and joined the Royal Navy as a cadet. `He is a fine spirited lad & I have no doubt will fight his way through this rascally World as well as any person I know,' his first master wrote of him.\     As a naval officer in the late 1820s, young Featherstone survived other shipwrecks, as well as outbreaks of yellow fever and battles with privateers and slave traders. He served briefly on the late Horatio Nelson's ship, HMS Victory, spent several years on South American patrol, and saw much of the rest of the world. His father made it a habit to cultivate people in high places; as a result the family knew several families with influence in naval affairs who could be counted on to advance Featherstone's interest when it came to promotion. Edward senior hoped for the best: `You are my fourth Son and I do yet hope to see one who will be my pride, who will be respectable on his own merits, conduct, and situation, independent or without his Father.'\     A shortish, full-faced man, whose hairline was already receding in his twenties, Featherstone did his work with calm competence and a strong sense of duty — and, like brother Edward, with an urge to write. His journals and letters are in straightforward pleasing prose, less cluttered than Edward's. They portray a sober career-oriented officer, who could be resplendent in full uniform with his cocked hat and sword, and enjoyed galloping across the Argentine pampas, flirting with the better class of young ladies in port, and always having fresh flowers in his cabin. An agreeable fellow, seldom reflective, secure in the belief that family friends and patrons would look after him in the influence-riddled world of the as yet unreformed navy.\     Featherstone's personal philosophy was cheerfully fatalist: `"What is to be will be, and all we can do will not prevent it" ... I found "it was folly to fret."' His superiors were entirely satisfied with him. One of his captains reported that Featherstone was `everything he could wish him to be as an Officer and a Man.'\     Having endured shipwreck and pestilence and encounters with cannibals and slavers, Featherstone came close to death in port in 1828 at the hands of naval surgeons. He was accidentally struck on the head with a crowbar and a few days later was diagnosed as having inflamed lungs. To draw off the inflammation, the doctors opened a vein and bled him, eventually draining away one hundred ounces (almost three liters). Literally exhausted or exsanguinated, Featherstone was taken to a naval hospital to die. `There,' he remembered many years later, `the nurse, to save herself the trouble of giving me the medicine, threw away all I should have taken, and after a month's illness, I so far recovered that I was able to rejoin my ship.' When a chest problem recurred, Featherstone told his father that `low diet, plenty of exercise and drinking nothing but water will soon put me to right better than any doctor.'\     As his tour of duty expired in 1831, Featherstone wrote frankly to his father about his prospects: `I could easily get a larger ship as I could make rather strong interests in the Petticoat way. Lady Northesk will do anything in her power and I can have Lady Grey's (sister in law of the Earl Grey) by asking thru' my very good friend Mr. Lake. Every thing that has yet been done for me has been done unasked by me and I shall ask nothing till I really want it. I think I am secure of the Admiral's interests should any thing occur on the station. So my prospects are not bad on the whole and if they will but continue I shall be well contented.' Just as he was leaving South America for home, he received an offer to join a ship on the outward passage that needed a replacement for a surgeon/naturalist who was departing in a huff. The historical might-have-beens if Featherstone Osler had taken the opportunity to join the Beagle as Charles Darwin's co-worker are incalculable.\     While at sea, Featherstone received many letters of advice from his godfather, the Reverend Edward Lake, after whom he had been named. Lake was a well-placed clergyman, a member of the evangelical wing of the Church of England, who took his duties as Featherstone's surrogate father with characteristic earnestness. He made it his business to advance his godson's prospects in the navy. At the same time, he urged upon Featherstone a far more important duty — to consider the prospect of his immortal soul. `The longest life is short when compared with Eternity,' Lake warned.\     In Featherstone's final months at sea, he fretted about being `the wanderer' in the family, thought more often about getting married, and began to have second thoughts about his lifelong nonchalance towards religion. He thought of Lake as his `other father' and began to see in him something of what today we call a role model. `Since corresponding with Mr. Lake,' Featherstone wrote to a sister, `I have sometimes thought differently to what I did before, and would freely give up all my prospects to be like him. Should I ever be religious I think I should not be lukewarm.'\     Featherstone had to set a future course in 1832, a year of crisis in his country's life and in his own. Britain was experiencing economic and social turmoil as agitation for political reform shook the kingdom to its constitutional foundations and threatened to erupt in serious violence. At the same time, a ghastly new plague, Asiatic cholera, carried off tens of thousands of victims. Godfather Lake interpreted these public events as God's judgment upon sinners: `Our poor native country is in a most alarming state — The general cry is for Reform, indeed the mistaken [view is] that this will be a remedy for every evil — riots are taking place throughout the land — and the burning of farmers [property] is vastly on the increase — Trade is in a dreadful state — and many of the working people are in a starving state — Added to all this the cholera has broken out — and we may expect it will spread — May the rod of God which is thus lifted up help us as a people to repentence and may He in mercy withhold the scourge. Alas sin abounds — it has increased.' Featherstone began attending prayer meetings and was soon convinced that the cholera epidemic was `God's judgment on the Earth and well we deserve it.'\     To his dismay, Featherstone lost his power to influence the navy's judgment of his just deserts. He passed his final examinations to qualify as a permanent officer only to find that the advent of the Whigs to government in Britain had undermined his Tory patrons. England was awash in qualified naval officers. Those with pull got ships; those without, including Featherstone Osler, found themselves on the shelf. Now what was he to do with his life?\     Featherstone's wrestling with fundamental questions led to something of a conversion experience late in 1832. He described it to one of his sisters:\ \ \ You feel distress of mind, you find that your heart is so deceitful that you cannot trust it, sometimes you feel a something like hope, and then again all is dark, and you think you must be a hypocrite that you are not sincere. You look all around for comfort but comfort is not to be found in the world whilst a `still small voice' rather whispers `the end of these things is death.' You try to look to Jesus but no answer appears given to your prayers and you are ready to say there is no hope for me — Are these anything like your feelings? They have been mine ... You are seeking a Saviour and every obstacle that Satan and your own evil heart can find in your way you will find ... but when the Holy Spirit visits the soul as a [baptism] of fire and the Soul feels its wretchedness and evil condition ... the heartfelt cry is uttered `Lord save or I Perish.'\ \ \     The fact that his father was dying may have added to Featherstone's agony. It certainly contributed to his reflections on life after death, which would always be a vital element of his faith. `The greatest consolation I have experienced under our late affliction,' he told his mother after Edward Osler's death,\ \ \ has been and is the hope that in a very little while we shall be where there is no partings. I could not bear to think of the dear departed as dead but as living perhaps watching over us, soothing our wounded minds and whilst we are mourning he is inexpressably happy. Dearest Mother how thankful we ought to feel for the hope that we shall meet in Heaven an unbroken family. Our Father having provided for us on earth is now gone to Heaven to be the first to welcome us there — We have one tie less to the earth — one more serious warning to give earnest heed to make our calling and election sure.\ \ \     By 1833 Featherstone had decided to become a minister of the Church of England. He boned up on Greek and Latin privately and then enrolled at St Catharine's Hall, Cambridge, to take a degree prior to ordination. As a clergyman he would not only be living his faith but would have solved his career dilemma. After all the years wandering the seas, he looked forward to settling down as a country parson, working quietly and usefully in some beautiful corner of England; he might enjoy a comfortable living, as most successful Anglican clergymen did in that time, perhaps under the wing of a noble patron. He continued to have faith in the utility of being well connected: `My prospects of advancement were very good, as I had friends of high power in the Church.'\     Featherstone had a strong constitution and was never afraid of hard work. He went to Cambridge in his late twenties as a man who had seen the world and opted for the unworldly. With his future clear before him, he concentrated on his studies so earnestly that he almost drove himself to a breakdown.\ \ \ * * *\ \ \ Ellen Free Pickton, the future Ellen Osler, was born near London on December 14, 1806, into a merchant family, which also was probably of Cornish origin. Her mother was not well and was sent into the country and ordered to take the `cow-house vapours' by sitting in a farmyard inhaling the breath of cows as they were milked. The treatment did not help. Little Ellen was petite all her very long life with a dark complexion, black hair, and black eyes that made her seem vaguely un-English (Canadians later wondered if she had Indian blood). She was first given to a servant for nursing and then adopted at age five by a childless aunt and uncle, the Brittons of Falmouth.\     Like Featherstone, Ellen was a child of Regency England, growing up before the full impact of the Industrial Revolution, before the age of social reform, before the heyday of the doctrine of progress. She remembered seeing the bodies of criminals displayed in chains near the scene of their crimes; and she remembered the time when Captain Britton, one day on the highroad, took up a poor woman's offer to sell them her baby for a guinea. (The woman had second thoughts and reclaimed the infant that night.) During the celebrations in Falmouth after the Battle of Waterloo, Ellen wore a white sash with `Peace and Plenty' emblazoned in gold lettering. Two years later, she and all her schoolmates dressed in black to mourn the 1817 death of Princess Charlotte. Men, too, wore black armbands, and even poor beggars displayed wisps of black crepe as England grieved the passing of a royal.\     The Brittons were a shipowning, churchgoing family of moderate means. `Little Pick' grew up to be fond of nature and the heavens, was educated in a boarding school for young ladies, and was known as a spirited girl, pretty, and sometimes quick-tongued, but religious and loyal to friends. In her teens she once ventured into the disreputable Fish Hill area of Falmouth late at night to bring news of the safe return of a missing ship to a worried mother. She spent many days helping nurse a dear friend who was suffering from the terrible skin disease, pemphigus. When the doctor said each day that he thought the girl was better, Ellen finally exclaimed, `Oh, doctor, how many "betters" does it take to make a person well?' The patient died.\     Ellen had many admirers among the young men who frequented the Britton household. Some of the Oslers thought she would be an ideal match for the seafaring Featherstone. `I wish you would reserve yourself for my brother, who is coming home next week,' one of the Osler boys told Ellen, to her intense annoyance. But when Featherstone came home, he was attracted to her and won her over. They corresponded during his last voyage and became engaged about 1832. They were to be married after Featherstone completed his training for the ministry.\     Featherstone had always trusted his patrons. It was not their fault that control of naval patronage had changed hands. His friends' influence in the church seemed more secure, and it did not occur to the theolog that his plans could again be upset. He failed to reckon with his promoters' belief in Christianity's mission to spread the Gospel and save souls. Instead of holding the easy-going, latitudinarian views common enough in the Anglican Church at most times, Featherstone's friends had been caught up in an evangelical revival, which competed in intensity and many of its doctrines with Methodist, Quaker, and Baptist sects, and other forms of Dissent. The Anglican Evangelicals were in deep earnest, and when persuaded of the need to do their duty or follow the Lord's calling, would not be dissuaded by wordly considerations.\     One Sunday at the end of his last college long vacation, Featherstone received a letter from the newly formed Upper Canada Clergy Society. It had been founded by the very group of aristocratic evangelicals to whom he looked for advancement. They were responding to word of a desperate shortage of ministers for the settlers in far-off Canada. Looking for men to send out in answer to the Canadian call, the society chose Featherstone as one whose travels around the world had presumably fitted him for overseas service. St Paul had always favored evangelists without attachments. The good folk asked Featherstone if it was not his duty to take up this work on their behalf.\     By all accounts, especially his own, Featherstone was appalled at the prospect of going to Canada. The thought of going abroad had no appeal to Ellen or her friends either. Britain's North American colonies were not popular with the Falmouth people. They were cold, poor places to which you sailed at great peril. Special peril: a number of the autumn mail packets that had set out from Falmouth for Nova Scotia had never been heard from again. To `go to Halifax' had become local slang for going to your death.\     `I put the letter in my mother's hands,' Featherstone remembered, `and while tears streamed down her cheeks, she returned it with the remark, "If it is God's will, go, and God bless you." ... I felt I could not refuse the appeal ... duty had evidently called me and I could not refuse.' `If I were still in the navy,' he reasoned to Ellen, `and I were ordered east, west, north, or south, in the service of my king, I could not refuse to go, and shall I be less obedient to the call to go abroad to serve my Heavenly King?'\     Featherstone Osler and Ellen Pickton were married on February 6, 1837. In March the Archbishop of Canterbury ordained Featherstone a deacon of the church under special provision `for the cure of souls in His Majesty's Foreign Possessions.' The pious couple sailed from Falmouth for Canada on April 6 on the barque Bragila. `The pain, I may say the anguish, of parting I will not attempt to describe,' Featherstone wrote to a friend. During the voyage Ellen realized that she was pregnant.\ \ \ * * *\ \ \ The Oslers' seven-week crossing of the North Atlantic to the New World in the spring of 1837 was relatively uneventful. Even so, Featherstone kept a detailed journal and wrote long letters, whether or not he was in `a writing humour': `Inclination says "Put it by for another day," but resolution replies "No, begin at once," and ... resolution shall have the mastery.' The ocean weather was unseasonably warm, there were the usual squalls and gales and passing bouts of seasickness, but the newlyweds were not affected. They had a good supply of fresh food, including oranges, and Featherstone was so attentive to his pregnant bride that Ellen feared she might develop idle habits. Featherstone led morning prayers and Sunday service for their little party and the ship's company, `striving ever to bear in mind,' he wrote, `that I am a dying man speaking to dying men.' Christian joke: Why won't fish off the Grand Banks take the salt pork bait offered from the Bragila? Answer: The cod must be Jewish.\     Their first sight of land was the bleak, snow-swept coast of Newfoundland. Entering the St Lawrence River, they narrowly avoided being shipwrecked on Egg Island. The immense forest dominated the landscape as they sailed upriver. A few solitary houses appeared, then a fur-trading post, and occasional clearings where fire had ravaged the woods and `the black, scorched pine stumps seemed mourning the desolation which reigned on every side.'\     Then Featherstone noticed the sunlight, the glittering snow, the birds and seals and beluga whales, and the farmhouses and fields of cultivated land by the great river, and his mood changed. He concluded that all nature was singing the praises of the Creator. The Ile d'Orléans, just below Quebec, was beautifully pastoral, and the passengers amused themselves by pointing out prototypes of the houses they might have in Upper Canada. Rounding Point Lévis, they marveled as Quebec City burst into view, high above the river, its tin roofs sparkling in the sun. At the Albion Hotel the Oslers found accommodation far better than Featherstone had expected: `Everything is conducted as far as possible in the English style; fare good, waiters civil, and we have our own private room.'\     While her husband went to see the Anglican bishop of Quebec, Ellen looked carefully at their tiny square room in the Albion — at the sheets that had been slept in, the dirty pillow on the bed, the badly mended handle on the water jug. She sat down on the floor, laid her head in her arms on a chair, and wept. Moments later she said to herself, `Come, this will never do,' and washed her face. When Featherstone returned she was perfectly composed. The next morning, when she looked out the window, her heart sank again at the sight of raw wood strewn everywhere in the hotel yard. `I can't say I enjoy my solitude at the inn,' she wrote to a sister, `but I bear it patiently as I can ... Beseech the Lord for me, my dear Lizzy, that I may be fitted for all there is before me to do and bear.'\     The bishop raised Featherstone to priest's orders and gave him details of his missionary posting. He was to take up residence in the townships of Tecumseth and West Gwillimbury, just north of Toronto, the Lake Ontario town that served as provincial capital of Upper Canada. During the Seven Years' War, which had ended in 1763, Great Britain had conquered the land known as New France or Canada or Quebec. In the following decade Britain's northern possessions — which also included Newfoundland, Nova Scotia, and the Hudson's Bay Company's vast fur-trading domain — had not joined in the American rebellion, thereby staying in the Empire as British North America. In 1791 the mother country had divided the old Province of Quebec into Upper and Lower Canada (corresponding roughly to today's Canadian provinces of Ontario and Quebec).\     Lower Canada was dominated by its long-settled French and Roman Catholic majority. Upper Canada, which contained millions of acres of fertile, forested land in the triangle formed by Lakes Ontario, Erie, and Huron, was in its pioneering, settlement phase. Tens of thousands of emigrants from Great Britain arrived in Upper Canada every year in the 1830s, swelling a population originally seeded from the south by United Empire Loyalist refugees and land-hungry Yankee frontiersmen. When their St Lawrence steamer reached Upper Canada, the Osler party congratulated themselves `on being in our own country.' They had a pleasant spring voyage up Lake Ontario — their stops and rambles in the forest spoiled only by mosquitoes reveling in fresh Old Country blood — and disembarked in Toronto.\     It was only a few miles, less than an hour's drive today, from the church spires and semi-refined society taking shape in muddy Toronto to the backwoods townships where the Oslers were to live and preach. In 1837 the journey took two days by stage and then wagon, with the roads and probably the travelers' spirits deterioriating as they penetrated the dense, primeval forest. Ellen and Featherstone finally arrived at their obscure Canadian station on June 19, 1837. One day later, back in London, eighteen-year-old Victoria Hanover ascended to the throne of Great Britain and its empire.\ (Continues...)

Preface: On Doing an Osler Autopsyix1 English Gentlemen with American Energy32 Learning to See: Student Years363 The Baby Professor804 The Best Men: Philadelphia1225 Starting at Johns Hopkins1686 We All Worship Him2087 The Great American Doctor2598 Leaving America3089 A Delightful Life and Place33210 Sir William36911 All the Youth and Glory of the Country40212 Never Use a Crutch44113 Osler's Afterlife477Notes and Sources505Acknowledgments557Illustration Credits561Index563Illustrations follow pages 210 and 434

\ From the Publisher"A dutiful social historian, Bliss inquires into Osler's sensitivity to issues of ethnicity, class, and gender." -- Ronald L. Numbers, Science\ "A well-told, enjoyable, enlightening--and much needed-- biography of a giant of medical practice and education...A first-rate biography of a towering medical figure." --Kirkus Reviews (starred review)\ "Medical historian Bliss has written the authoritative modern biography of the 19-century Canadian physician William Osler...This volume replaces Harvey Cushing's two volume tribute, The Life of William Osler (1956) as the definitive text in the field. Highly recommended...essential."--Library Journal (starred review)\ "An excellent, readable biography written by a true scholar of medical history who knows his man and his material intimately."--Journal of the American Medical Association\ \ \ \ \ \ New England Journal of Medicine...certain to generate a new appreciation of the man and his remarkably diverse achievements.\ \ \ Journal of the American Medical Association[W]ith the publication of this new book by Professor Michael Bliss of the University of Toronto, [Osler] now has an excellent, readable biography written by a true scholar of medical history who knows his man and material intimately.\ \ \ \ \ Library JournalMedical historian Bliss (The Discovery of Insulin) has written the authoritative modern biography of 19th-century Canadian physician William Osler. Idolized by many as one of the greatest of all modern physicians, Osler emerges from this critical text as a brilliant, influential physician and teacher, full of compassion for his profession and patients. Bliss offers a glimpse of the rise of modern medicine and medical education as it unfolded around Osler and provides a view of the time as well as of the man. This volume replaces Harvey Cushing's two-volume tribute, The Life of Sir William Osler (1956), as the definitive text in the field. Highly recommended for history collections in all academic libraries and essential for medical collections.--Eric D. Albright, Duke Medical Ctr. Lib., Durham, NC Copyright 1999 Cahners Business Information.\ \ \ \ \ BooknewsBliss tells the story of Osler (1849-1919) who was born in backwoods Canada, taught and wrote about medicine at McGill University, Johns Hopkins University in the US, and at Oxford in Britain. He was a scholar of the natural history of disease and revolutionized the bedside practice of medicine. He was also a noted humanist. Annotation c. Book News, Inc., Portland, OR (booknews.com)\ \ \ \ \ William GavinMedical historian Michael Bliss' William Osler is a big, sturdy, readable account of Osler's life and the medical advances that were made in his lifetime, a period the author calls "the age of bacteriology"....Mr. Bliss tells his story remarkably well, varying his style with little ventures into present-tense storytelling. The author has a firm grasp of medical esoteria, and possesses a sly wit.\ —Washington Times\ \ \ \ \ Kirkus ReviewsA well-told, enjoyable, enlightening—and much needed—biography of a giant of medical practice and education.\ \