Co-existing heart failure does not diminish the stature of a giant
References
Nav Persaud, Heather Butts, Philip Berger. William Osler: saint in a “White man’s dominion”. CMAJ 2020;192:E1414-E1416.
Chan C. On the shoulders of giants. In: Mapping Scientific Frontiers: The Quest for Knowledge Visualization. Springer, London. https://doi.org/10.1007/978-1-4471-0051-5_5
Rostomyan L, Daly AF, Petrossians P, Nachev E, Lila AR, Lecoq AL, Lecumberri B, Trivellin G, Salvatori R, Moraitis AG, Holdaway I. Clinical and genetic characterization of pituitary gigantism: an international collaborative study in 208 patients. Endocrin
Beckers A, Petrossians P, Hanson J, Daly AF. The causes and consequences of pituitary gigantism. Nature Reviews Endocrinology. 2018 Dec;14(12):705-20.
I read with interest the recent humanities piece by Drs. Persaud et al. but have been left with confusion as to the authors’ intents. If the piece was intended to highlight or re-discover 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 a person already long deceased, then I have to add a note of caution. Apparently, Dr. Osler may have said or thought some things that are embarrassingly unflattering to his character and certainly unkind to those to whom he referred. If so, I can only hope that no one ever wastes their time in the future writing about my career for surely someone somewhere will have a recollection of something I have said that I might regret at a later date (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.” 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 upon science; he was the recognized leader of this movement in the late 19th and early 20th century. However, 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. For a medical practitioner (or the authors this CMAJ humanities piece) to diagnose a host of hidden but serious problems but omit the co-existing gigantism in which it occurs is as medically confused as it is historically inappropriate to use a person’s failings and weaknesses as a pretext to declare that their widely-appreciated help wasn’t so helpful after all. Giants can have problems that need diagnosis and correcting. But we still need to stand upon 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.