Do we really need medical students learning about birth from mute robots? Really?
Canada's full-bore pursuit of gold at the Olympics the country is hosting in Vancouver, B.C., has attracted much comment, mostly about how out-of-character overt ambition supposedly is for Canadians.
Writing in the New York Times last week, Charles McGrath quoted the Canadian writer George Woodcock on the subject: “Canadians do not like heroes, and so they do not have them. They do not even have great men in the accepted sense of the word.”
Here's one for the books, then -- William Osler, the so-called "father of modern medicine," a great man if ever there was one, born in Bond Head, Ont., in 1849.
Osler received his medical degree from McGill University in Montreal in 1872 but, critically, then went abroad to study in London, Berlin and Vienna before returning to join the McGill faculty. By 1883, he was one of two Canadian fellows of the British Royal College of Physicians. The next year, he accepted a post as professor of clinical medicine at the University of Pennsylvania in Philadelphia.
It was as a founding faculty member of Johns Hopkins School of Medicine in Baltimore, where he went in 1888, that Osler had the opportunity to put the innovations he had seen in Europe to work.
Osler insisted that the patient could teach medical students nearly everything they needed to know -- that the study of medicine was properly conducted at the bedside -- and that hands-on laboratory research must also be part of medical training. He also introduced the German model of post-graduate training, a one-year internship followed by several years of full-time residency.
These innovations began a profound change in American medical education, which up to this point had been largely a matter of learning from lectures.
Osler was able to implement his ideas because he was an excellent doctor. In 1905 he moved to England to take up a prestigious post as professor of medicine at the University of Oxford. His book, The Principles and Practice of Medicine, was a major work in medicine for nearly half a century.
Osler died in England in 1919, of the Spanish flu.
Canadians might say that Osler's absconding to the United States and England rules him out as a national hero, but it says something when a boy from Bond Head can hit the heights of world medicine.
While a very young man, Kelly was hiking around in rural Pennsylvania when he stopped at a house to ask for a glass of water. Thinking he looked hungry, the young woman who answered the door gave him a glass of milk instead.
Fast forward many years. The woman went to a hospital in the city to seek help with a serious gynecological condition. The great Dr. Kelly, as he now was, treated her successfully.
When it came time for the bill, the woman discovered that the invoice read, "Paid in full with one glass of milk."
Like many top doctors of his day, Dr. Kelly, who lived from 1858 to 1943, charged enormous fees. However, Audrey Davis, a friend and biographer, wrote that he often treated people for free. (Remember, people didn't have health insurance in those days.) For every patient Dr. Kelly charged for his services, he treated three for free, Davis reported.
So Dr. Kelly's generosity to the woman who had shown a young man a kindness was an everyday thing for him.
Still, it's a great story.
In 1888, nine years after Robert Felkin brought back his amazing story from Uganda, Dr. Howard A. Kelly of Philadelphia, a brilliant young obstetrician who would go on to help found the medical school at Johns Hopkins University in Baltimore, announced at a convention of the fledgling American Gynecological Society that he had performed the first successful Caesarean section in Philadelphia in 51 years—that is, the mother had survived the operation.
Very few members of the audience he was addressing that day had ever attempted even one Caesarean section because, at the time, the procedure virtually always ended in the mother's death.