Coexisting failures do not diminish the stature of a giant

I read with interest the recent CMAJ humanities article by Dr. Persaud and colleagues1 but have been left confused as to the authors’ intentions. If the piece was intended to highlight or rediscover the contributions of those who have not yet received their due in the history of medicine, then the authors have my applause and appreciation. On the other hand, if the authors’ intent was to assassinate the character of someone long deceased, then I have to add a note of caution. Dr. Osler may have said some things that are embarrassingly unflattering to his character and certainly unkind to those to whom he referred. Even so, I can only hope that no one in the future ever wastes their time writing about my career, for surely someone will have a recollection of something I said and later regretted (given the opportunity to recant or clarify — something Dr. Osler is unable to do at this point).

Sir Isaac Newton (no hallowed saint himself) once said that “if I have seen further, it is by standing on the shoulders of giants.”2 It is well recognized that Dr. Osler was one such “giant” in that he embraced the concept that medicine and medical education should be based on science; he was the recognized leader of this movement in the late 19th and early 20th century. We would do well to pull out our endocrinology textbooks and recall that giants, for all their vertical advantages, can have many weaknesses as well: severe scoliosis, osteoarthritis, cardiomegaly with heart failure, diabetes, increased rates of cancer, sleep apnea, hypertension, hypopituitarism, etc.3^,4 For a medical practitioner (or the authors of this CMAJ humanities piece) to diagnose hidden, serious problems but omit the coexisting gigantism in which they occur is as medically confused as it is historically inappropriate to use a person’s failings as a pretext to declare that their many contributions were not so helpful after all.

Giants may have problems that need diagnosis and correcting, but we still need to stand on their shoulders to see beyond the barriers that otherwise stand in our way. Discovering and celebrating the best qualities of all those who work for the betterment of medical practice is surely a more charitable and gracious way to inspire others to do likewise while still generally acknowledging that humanity (including each of us) has a long way to go.