AMERICAN OSlER SOCIETY November 2007 Volume 8, Issue 3 The Oslerian A Message from the President Osler's Bedside Library: A Survey and a Proposal Greetings, Fellow Oslerisns Table 1. Osler's Bedside Library for Medical Students Inside this issue: In one of his final acts as presi- dent of the American Osler I. Old and New Testaments VI. Epictetus Society, Chester Bums asked Minutes, Board of Gover- 3 II. Shakespeare VII. ReJigio Medici nors, American Osler Soci- that I form a small committee ety, 30 April 2007 to look at revising and updating Ill. Montaigne VIII. Don Quixote Osler's "Bedside Library for IV. Plutarch's Lives IX. Emerson Minutes, Annual Meeting of 4 Medical Students." Robert American Osler Society, 2 Rakel and Herb Swick joined V. Marcus Aurelius X. Oliver Wendell Holmes- May 2007 me on that committee, and we Breakfast- Table Series soon decided that "improving" Local Arrangements for the 6 Osler was beyond our meager 2008 Annual Meeting, abilities. We carried out an It seems to me that Chester This brief survey implies that Boston, May 4-7 informal survey of American was quite correct in his impli- even dedicated (and not young) Osler Society members, asking cation that the original list is Oslerians ignore the master's Dates and Locations for 6 them to give us their personal unlikely to appeal to twenty- advice when it comes to read- 2009 and 2010 Annual list of ten book titles that they first-century medical students ing to prepare for a life in Meetings would recommend to medical in part because of the ponder- medicine. students (I think for our pur- ous prose style of some of (Continued onpage 2) poses we can consider all sen- Osler's authors (plutarch and tient doctors as students, not Brown, for example). This sen- just the tyro students of an or- timent is borne out by the re- Table 2. Indications of 19 ganized medical school). We sponses of our survey partici- respondents as to whether also asked respondents to tell pants, who were asked to note they'd read items in Table 1 us how many of Osler's ten whether they had read little-to- books they had themselves read none or much-to-all of the en- Shakespeare 95% and to comment on what they tries on Osler's list. Their re- saw as Osler's purpose in mak- sponses are shown in Table 2, Old and New Testa- 84% ing the original list (Table 1). where "0%" means that little or manents none of the item was read by We got 19 responses from 18 Don Quixote 68% Oslerians (one sent the ques- any of our respondents and tionnaire twice-and, interest- "100%" would mean that Oliver Wendell ingly, the two responses were much or all was read by the Holmes 53% not identical, which tells us respondents. If this were a re- ReJigio Medici 42% something about the will-o'- port card, Shakespwere would the-wisp nature of the task get an "A" and the Old and Emerson 42% Chester set for us). Those 19 New Testament a "B"; Don Marcus Aurelius 37% responses form the basis of this Quixote would have a "D+ and Plutarch's Lives report and have led to a pro- all the other entries would flunk 32% Frank A. Neelon posal that I think would satisfy (poor old Epictetus doesn't Montaigne 21% Chester's original charge. even get on the radar screen). Epictetus 0% The Oslerian Volume 8, Issue 3 Page 2 President's Letter (continued) Table 3. Suggestions for a Twenty-First Century Bedside. Library for Medical Students (number of citations) Respondents were asked to submit their own candidates of Works of Shakespeare 8 books for a twenty-first century reading list. A total of 124 book titles were provided (the final tally does not include entries such as Old and New Testaments 6 "internet access" or" The Times Literary Supplement"). Seventy- Don Quixote (Cervantes) 4 eight titles appeared only once; these ranged from the Q'ursn and other non-Biblical holy books and The Gospel According to Pea- Poems in English (various anthologies) 4 nuts, to the New Fowler's Modem English, Toynbee's A Study of The Doctor StOlies(William Carlos Williams) 4 History, Orwell's 1984, and Rushdie's Midnight's Children. I William Osler: A Life in Memcine (BIss) 4 could discern no pattern in the sum of responses except to assume that they represent each respondent's list of personal favorites at Religio Media (Brown) 3 the moment. No one made clear the reasons for their choices. Life of Johnson (Boswell) 2 Thirteen of the cited works were listed by multiple respondents. Man's Search for Meaning (Frankel) 2 Interestingly, Osler's original list fares pretty well in the sense that contemporary respondents would retain four of Osler's choices Osler's Collected Essays 2 and the rank order of these four mirrors their positions in Table 2. The Prince (Machiavelli) 2 Still, none of the works was listed on even half of the responses, which really brings us to the crux of the problem of "updating" The Story of Civilization (Durant) 2 Osler's selections-it seems unlikely that we will ever get a con- Works of Winston Churchill 2 sensus, and certainly not often. At least five other authors 1-5 have looked at Osler's recom- mended Bedside Library and offered comments and suggestions. puters can, I propose that the American Osler Society sponsor a web- The papers by Reynolds, Rake!, and Pai and Gurashani provide based catalogue of recommended books. This would include more new lists based on surveys carried out by the authors, while than just recommended titles, though. We would need a brief but Massey and Goldman mediate on Osler's original list, but don't cogent paragraph outlining the nominator's reasons for suggesting give us new ones. The paper by Hallberg'Tists books the author the work and why it is of value for "medical students" (that is, all of and some colleagues consider worth reading, but it does not men- us). We could attach "reviews" of each entry by anyone who wants tion or allude to Osler's list. To my eye, the single most striking to respond. We could keep submitted titles on a probationary list; if thing about these newer lists is the lack of any common thread that no seconding comments are received, they would be deleted after six links the choices. At best, the authors give brief comments about months; if there is at least one positive seconding comment, those their books and why they are worth reading or try to ferret out the items (and the accompanying comments) would be moved to the motives lying behind the choices. "permanent" list where further commentaries would be solicited and Perhaps the wild diversity of recommended books (Table 3) stored. If the list becomes so large as to be unwieldy, items that do reflects the absence of any stated criteria for choice. It is not even not stand the test oftime (based on received comments) would be clear what were Osler's motives in proposing his ten works. I sus- removed. The list would doubtlessly be longer than 10 items, but we pect that behind all the array of nominated readings is the sense could organize it into sections with common themes. that medical practice, despite its reliance on and celebration of 1would very much like to hear what Oslerians think ofthis idea biological science, remains a somewhat mysterious enterprise, full and whether we should move forward with it. of "snarled problems and pratfalls"-the moral and ethical and spiritual dimensions of practice that are not illuminated by scien- Francis A. Neelon tific inquiry. Medical doctors, asked to describe what they do that [email protected] is helpful to the sick, give only superficial and unsatisfactory an- swers (in the words of Michael Polanyi, we "know more than we REFERENCES can tell"). This inability to describe the doctor's job in simple, 1. Goldman N. Literary prescription. Med J Aust 1982; 1: 41-42. declarative phrases, leads us to recommend that students read books that seemed to have helped us mold strongly-held, if diffi- 2. Massey RU. Reflections on medicine: Osler's bedside library. cult to articulate, ideas about what constitutes doctoring. This is Conn Med1986; 50: 51. akin to the idea of Carl Rogers that little that is of value can be 3. Pai SA, Gursahani RD. Osler's bedside library revisited-books taught, but that much that is of value can be learned. Given the for the 21st century. BMJ 2005; 331: 1482. shifting sands on which the various reading lists are constructed, it 4. Rakel RE. Modern version of Osler's bedside library. Perspect is not surprising that they should be so diverse. BioI Med1988; 31: 577-585. Chester Bums's exercise has brought me to the conclusion that 5. Reynolds RC. Osler's bedside library revisited. Pharos 1965; the world does not need another print version of an "updated" Osler's list. Print is too rigid for this purpose. What we need is a 48(2): 34-36. living document, capable of change and revision as times and re- 6. Hallberg J. 11 books that made a difference. Minn Med2005 spondents' moods change. Because print can't do this but com- (July): 24-28. PI The Oslerian Volume 8, Issue 3 Page 3 Minutes, Board of Governors, American Osler Society, 30 April 2007 1. Members of the Board of Governors of the American Osler the medical humanities.