The Oslerian impulse ==================== * Lara Hazelton **Osler's “A way of life” and other addresses with commentary and annotations** Shigeaki Hinohara and Hisae Niki, editors Durham & London: Duke University Press; 2001 378 pp. US$29.95 ISBN 0-82232-682-5 ![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/166/5/634/F1.medium.gif) [Figure1](http://www.cmaj.ca/content/166/5/634/F1) Figure. ![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/166/5/634/F2.medium.gif) [Figure2](http://www.cmaj.ca/content/166/5/634/F2) Figure. Photo by: Brödel Archives, Johns Hopkins University, Baltimore, Md. Keeping up with developments in medicine places a constant demand on contemporary physicians. The emphasis on life-long learning that begins in medical school and is reinforced through continuous accreditation programs requires a huge investment of time and effort. Why would today's physician devote precious energy to medical material that is over a century old? I doubt that any answer to this would satisfy the true pragmatist. Fortunately, many of us are sufficiently impractical to allocate time to works such as those of William Osler, the great 19th-century physician–writer. We may argue that the humanistic views Osler expressed in his addresses help us to be more sensitive and thoughtful clinicians. Or that his reflections on the nobility of our calling inspire us to excellence. But, to be honest, these are merely excuses to pursue a literary pleasure. The truth is that reading Osler is an idiosyncratic pastime, not unlike stamp collecting or birdwatching: not for everyone, but extremely enjoyable to the enthusiast. Oslerians, like birdwatchers, can be found world wide, and many join societies to share their interest. It is this passion that inspired Shigeaki Hinohara and Hisae Niki to collect 20 of Osler's best-known addresses, including “Aequanimitas” and “The Student Life,” in a single volume and to spend as many years annotating them. Originally part of a project to translate Osler's essays into Japanese, the editors' annotations and commentaries provide what John McGovern, founder of the American Osler Society, calls “an invaluable resource” that will make the addresses “much more lucid for modern readers.” More lucidity is a good thing. Reading Osler's addresses can be much like exploring the attic of an elderly relative. There is the feeling that you are trespassing in another time, immersed in the musty, unfamiliar ideas and culture of the 19th century. Occasionally a description of something catches you, and you think, “Yes, that's exactly what it's like.” But Osler is not an easy read. His addresses are filled with literary allusions easily lost on the average doctor of the 21st century. Greeks, Romans and a plethora of Biblical figures are quoted with an easy informality that assumes these are old friends with whom the reader is not only familiar but intimate. It is astonishing to think that the medical community of Osler's time was so well acquainted with the works of Plato that he could refer in an offhand manner to “the souls in the tale of Er the Pamphylian” without further explanation. (And it is depressing to think what my generation of physicians would share as references. *Gilligan's Island*? *Survivor*? Today, Osler would be forced to forgo references to Marcus Aurelius and quote Yoda instead.) Unfortunately, the same allusions that enriched the addresses when they were originally written can prove an obstacle to their enjoyment today, as modern readers scratch their heads every few lines over yet another inscrutable reference. In this volume, all of the unfamiliar and perplexing allusions have been annotated and their origins referenced. Er the Pamphylian, it turns out, was a figure in Plato's *Republic* who died in war and then came back to life bearing tales of the world of the dead and the Fates. And it is a great relief to be able to refer to the bottom of the page and realize that you are likely not the only reader in need of clarification that “the father of medicine” Osler refers to is Hippocrates. Each address is preceded by a brief introduction describing the context of the piece — where and when it was delivered and what stage of life Osler had reached — and a bit about its content. Some analysis or criticism might also have been helpful. For example, the introduction to the address called “Nurse and Patient” urges us to “remember that this was 1897” but sidesteps the fact that the essay is sexist in the extreme and offensive to the modern reader. (A female physician I know dismisses Osler as “a man's hobby.”) Similarly, it must have been difficult for the editors to know how much detail to include in the notes. With a few exceptions (Do we really need to have the phrase “sang froid” explained?) they err on the side of reticence. The result is that while some notes are quite instructive, others are disappointingly brief. Often one learns where a quote comes from but is left without a sense of its significance. And while it is true that one might then obtain a copy of *Paradise Lost* and actually read it (as Osler would likely have recommended), this is probably not the course of action most readers will take. But it is possible that lengthier footnotes would not remedy the more fundamental problem of our lack of a common classical education. Where an allusion is familiar, the passage resonates with a meaning that can't be conveyed by the few spare words that make up an annotation. It is at these moments that one realizes what Osler has lost in the translation across time: the subtle richness arising from a wealth of knowledge that comes only by delving into the great works of civilization. The annotations in this book help to open the door to the intellectual world Osler inhabited — to enter it fully is another, more challenging, step.