Introduction to the Writing I am Forced to Undertake

Have you ever noticed that all medical doctors in North America adopt no more than three basic facial expressions? These expressions bring to mind the automatic transmission of an early Pontiac. The most common, seen round the clock in hospitals and offices across the continent is when their faces shift to neutral. It brings peace to patients, and indeed in many cases, submission. In neutral, we are assured that millions of synapses are not only collecting data, but processing it in such a way that a salutary result is guaranteed. Next one may observe the forward gear: intent on a course of physick that will bring a “hail fellow, well met” from all acquaintances in no time. It is a terror for nurses, orderlies, and first year residents, but a great comfort to the afflicted. Finally there is reverse. It is rare, and almost always accompanied by something akin to a somatic expression of guilt. It is fleeting. None is an expression of joy; none of agony, though surely they must feel these emotions from time to time.

Sir William Osler, that great physician and philosopher, will soon take his place with the rest of those forgotten. Not chief among his works, but salient nonetheless, is a commencement address he gave to his students (and colleagues!) entitled “Aequanimitas”. The great irony is that a portion of this wonderful speech (including the title misspelled!) that points to the importance of library research, is routinely and mistakenly attributed to the author Samuel Butler.

It’s not tabloids making this mistake. It’s not People magazine, or Psychology Today, or even the Times-Picayune. Readers may make a quick search of medical college websites from Brooklyn to Montana and find that Osler’s exhortations are given away with this false citation as introductions by medical scholastics on topics ranging from evidenced-based medicine to medical informatics.

This makes me very, very angry.

The souls who should be protecting the ideas of the most important western medical thinker of our times ignore the truth with abandon. It was Osler who got the students out of the lecture halls and into the wards! He painted the perfect portrait of medical decorum and intellect. But who can blame them?

When I was a student at The University of the South (and much more on this later!) studying under the tutelage of a white-haired and gowned savant who perpetually clenched a pipe in his teeth while lecturing, I read these words: “Truth in history is not necessarily what happened, but what men believed happened.” I learned that this concept was penned by someone named Professor William A. Dunning, quoted in a history book by John Samuel Ezell. I have never forgotten this lesson.

It also makes me very, very angry.

But I’m glad of that. What would happen if it didn’t make me angry? If it didn’t, then I wouldn’t write. I would, like the famous inventor in Thoreau’s Mosquito Coast, “go back to bed.”

Now it has come to pass that my family insists that I write something. They have cajoled, begged, and otherwise used well-placed guilt to stimulate this work. Thus, with anger as the fuel, I will begin a long piece. Much of it will probably be a rant. Some of it will be funny. It will all be humorous in the real sense of humor, and it will be true. Professor Dunning’s assertion might cause one to believe that, if everything is not outright fiction, then it is at least idiosyncratic fallacy. I refute him. Begone! Vade retro Satanas!

Here, then, is the truth. It is the truth of my family. But to find the truth about Sir William Osler, don’t bother looking anywhere other than the deposit of faith at Johns Hopkins in Baltimore. It is perhaps only there that you can read Aequanimitas properly cited. Within, you will discover that among his other great legacies the doctor carefully, beautifully, and elegantly explains to young doctors how to keep their faces in neutral.

Henry G. Selby
Bluffton, South Carolina
September, 2007