The System And Method
of Medicine
Introduction
Sir William Osler

Medicine is the study of the manifestations of disease in its sufferers (patients) so that one may attempt to diagnose, attempt to treat but always to care. No two patients with the same disease will give identical manifestations. The narratives of what they feel (symptoms) will differ, and what is found on examination (signs) will vary. This great variation can be learned only from the one true teacher of disease that the student of medicine encounters – the patient. And it is a lifetime’s work.

Because of the great number of diseases and their myriad manifestations, some system and method must be brought to bear. Only then will medicine become an exciting adventure in experience. As Sir William Osler would have it “ the system under which we work asks too much of the student in a limited time. To cover the vast field of medicine in four years is an impossible task. We can only instill principles, put the student on the right path, give him [or her] methods, teach him [or her] how to study, and early to discern between essential and non-essential. The rest comes with experience.”

The systems and methods described in this website were developed by the senior author and students over three decades of teaching. Didacus Stella, an obscure Roman politician (circa 50BC) is famously quoted as saying “the dwarf standing on the shoulders of a giant sees farther than the giant himself.” The authors (and especially the senior author for reasons of senescence) freely acknowledge their dwarf status and their attempts to perch upon the shoulders of giants. The broadest of giant shoulders in recent times are those of Sir William Osler, whose image and philosophy haunts this site.

Baronet Sir William Osler (1849-1919)

Osler, perhaps more than any other, epitomised the qualities of the great physician. Growing up in Canada, youngest of nine, he originally intended to follow his father into the church. Instead he took his degree in medicine, which he came to love, spending his life passionately studying and teaching the Art, in the laboratory, at autopsy and especially at the bedside.
Osler had both outstanding literary and medical skills and his textbook of medicine became the benchmark for modern texts and an established classic. His contributions transformed the teaching of medical education, calling for students to learn more at the bedside of patients. A man of immense personal charm, Osler’s strength lay in his ability to influence and inspire his students and colleagues. Many of his essays are classics, and together with the numerous books written about him, they continue to inspire the lives of medical students and practitioners today.
Osler’s son and only child, Revere, died in the arms of Harvey Cushing (pupil and great friend of Osler), after sustaining injuries in an artillery barrage in one of the battles of Ypres during World War I. It is said Osler never recovered after the death of his cherished son, and he died a saddened man in 1919. Widely regarded as the most exemplary physician in modern history, he humbly suggested his epitaph simply read: “I taught medical students in the wards”.
It is said that the degree to which we live up to his legacy, is the extent to which our profession will prosper.

“His errand in life … not only concerned the bodies of men and women, but their spirits. He lived in constant contact with all manner of people, giving out incessantly the kindness and wisdom that were in him… He was always directing human life, and wherever he touched it, it seemed to go lighter and more blithely.” (Contemporary obituary)

Gregory O’Grady, Jonathan Koea and Timothy Koelmeyer, 2006.
Artwork by Gina O’Grady

The student of medicine must acquire:
The virtue of method
The quality of thoroughness
The art of detachment
But above all, the grace of humility