Lessons from Osler 002

Have fun and cultivate your sense of humo(u)r

In 1905 William Osler gave his farewell address as he prepared to leave Johns Hopkins for Oxford and England. After speaking to the assembled medical students about the tragic side of medicine he said:

The comedy, too, of life will be spread before you, and nobody laughs more often than the doctor at the pranks Puck plays upon the Titanias and the Bottoms among his patients. The humorous side is really almost as frequently turned towards him as the tragic. Lift up one hand to heaven and thank your stars if they have given you the proper sense to enable you to appreciate the inconceivably droll situations in which we catch our fellow creatures. Unhappily, this is one of the free gifts of the gods, unevenly distributed, not bestowed on all, or on all in equal portions. In undue measure it is not without risk, and in any case in the doctor it is better appreciated by the eye than expressed on the tongue. Hilarity and good humor, a breezy cheerfulness, a nature “sloping toward the southern side,” as Lowell has it, help enormously both in the study and in the practice of medicine. To many of a somber and sour disposition it is hard to maintain good spirits amid the trials and tribulations of the day, and yet it is an unpardonable mistake to go about among patients with a long face.

William Osler ‘The Student Life‘ in Aequanimitas, 1905:405

As a doctor I relish working with colleagues who have fun at work and find enjoyment in their toil. Indeed, as a patient I would hope to see my doctor relishing their work despite the hardships. People really connect with one another when they are having fun. Furthermore, for the doctor, sometimes it is only the buttress of humour that holds at bay the stress and strife of the working day.

Like song that sweetens toil, laughter brightens the road of life, and to be born with the sense of comic is a precious heritage.

William Osler ‘Two Frenchman on Laughter‘, CMAJ 1912(II):152

Unfortunately, not all of us are blessed with an Oslerian capacity for fun (nor for work for that matter). Yet, who among us did not once have the talent for finding fun in the mundane? Consider the child who weaves an imaginary world out of a handful of sticks, or another child that, on receiving a present, is mesmerized by the endless possibilities of playing with the box, having forgotten about the present itself. Is it the burden of age that extinguishes our appetite for fun?

Osler’s talent for fun was evident early; he was a joker from a young age. A favourite story of mine is that of the clergyman who one evening paid a visit to William Osler’s father, Featherstone. William was just a boy at the time. After letting the man in, Willie warned his father that the clergyman was really quite deaf and that he would have to shout so that the visitor could hear. Osler senior was unaware, of course, that young Willie had already given a similar warning to the clergyman about the state of his father’s hearing. It is easy to imagine the boy’s delight as the two men shouted and roared at each other over the course of the evening.

As the adult William Osler progressed in his profession he preserved and cultivated his sense of humour and playfulness. Nowhere was this more evident than with emergence of his alter ego, Egerton Yorick Davis, who we have met before. Osler showed that humour and fun can be instructive: at the bedside, in the lecture hall and in the written word. Yet Osler was human. Sometimes his practical jokes would go too far. Indeed, some have found Egerton Y. Davis so convincing that his legacy – particularly the satirical non-entity of penis captivus – has confounded some in the profession a century later.

Osler’s humour and sense of fun meant that while he was always a sincere doctor, he was only serious when he had to be. It certainly protected him from taking himself too seriously. It also meant that he was loved by all who knew him – patients, students and colleagues alike.

But whatever you do, take neither yourself nor your fellow-creatures too seriously. There is tragedy enough in our daily routine, but there is room too for a keen sense of the absurdities and incongruities of life, and in the shifting panorama no one sees better than the doctor the perennial sameness of men’s ways.

William Osler ‘The Reserves of Life’, St Mary’s Hospital Gazette 1907;13:95-98.

LITFL Further Reading

**Foot note: Men and Books

Men and Books was collated as a 67 page tome in 1959. Articles were taken from the Journal of the Canadian Medical Association Journal between 1911-1914

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the person behind the name

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

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