What Osler Can Teach Us About Radiology

Sir William Osler (1849–1919) is arguably the most renowned internist of all time, a practitioner whose humanity and teaching style continue to inspire generations of physicians. As such, it may be a surprise that he elected to spend many years of his early career as a pathologist. Osler’s knack for pathology came not from wanting to stray away from the patient, but from an intrinsic curiosity — a thirst for understanding the root cause of disease. Fields like radiology and pathology can be attractive, for similar reasons, to the innately curious.

Osler’s infectious curiosity and expertise in pathology spread throughout the hospital system. He pioneered courses in histology and pathology. He and his pathology students eagerly volunteered to carry out all the autopsies at Montreal General Hospital, culminating in the creation of the first formal pathology position at the institution. Historian of medicine, Michael Bliss, author of Osler’s biography, writes, "Osler's energies, curiosity, and expanding clinical experience took him riding off in all directions." His investigations included “pernicious anemia, Bright's disease, Hodgkin's disease, tubercular meningitis, muscular atrophy, fibroid phthisis, and more."¹ Osler is a prime example of a clinician who cared, even when not facing the patient directly.

A specialty can often translate into an easily internalized identity. Internalizing the gold standard and how others perceive us is intrinsic to human nature. Toni Morrison’s book, The Bluest Eye, reveals the menaces of internalizing what is mainstream.² The story is about Percola Breedlove, a young girl who dreams of having blue eyes in hopes of engendering an identity she perceives as the gold standard. In seeking the bluest eyes, she loses sight of herself. Similarly, in striving to become a radiologist, one might begin to internalize how others perceive the field, even if this culminates in the loss of who we truly are and what we can contribute with our experience.

If a specialty is to become an identity, then radiology’s identity can be defined by the radiologists themselves, away from the current dark-room at a distance perception — far away from the stereotype that radiologists don’t care about patients nor want anything to do with them. Instead, in the beauty of our curiosity and centered in the idea that radiologists are often perceived as philosophers of medicine, we can encourage the clinician to ask unexplored questions and foster inquisitiveness in the medical system.

Osler’s early career as a pathologist is a poignant example for radiology and one that radiology can add to its root identity. Radiology, too, is for the “Oslers” of medicine — those who carry Osler’s humanity, his determination to understand the root cause of disease and who want to be a beacon of systematic change. Radiology is also for the “doctor’s doctor,” whose expertise in all systems is one to be admired, and whose curiosity, too, can be infectious. Finally, our specialty is for the individual whose philosophy can seep into the rest of the medical system to foster large-scale change

ACR^® Resources

• Patient- & Family-Centered Care — An approach to the planning, delivery and evaluation of healthcare that is grounded in mutually beneficial partnerships among healthcare providers, patients and families. It redefines the relationships in healthcare by placing an emphasis on collaborating with people of all ages, at all levels of care and in all healthcare settings. In patient- and family-centered care, patients and families define their “family” and determine how they will participate in care and decision making. A key goal is to promote the health and well-being of individuals and families and to maintain their control.
  
  
• Honor Roll of AIRP® Best Cases — Residents attending the four-week course must submit a case report demonstrating radiologic-pathologic correlation.

References

1. Bloom, Harold. Toni Morrison's The Bluest Eye. Infobase Publishing, 2007.
   
   
2. Bliss, Michael. William Osler: A Life in Medicine. Oxford University Press, 1999.