Canadian physician Sir William Osler (1849-1919), sometimes called ‘the father of modern medicine’, urged doctors to maintain a lifetime habit of reading. In an address delivered at the opening of the Boston Medical Library in 1901, he said:
To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”
But, important though it was to keep up-to-date with the latest scientific findings, he did not want clinicians to limit themselves to reading medical texts. Osler advocated also reading broadly and deeply in the humanities and literature. He believed that “for physicians to be properly educated to practice their art, knowledge of the science of medicine … must be supplemented by familiarity with the humanities.”
He regarded the humanities as “the leaven in the dough of caring, compassion and empathy”, and believed that reading was vital for maintaining equanimity and perspective, and a rich source of learning about human character. He saw science and the humanities as “twin berries on the same stem”, and noted that “grievous damage” to both resulted from seeing them “in any other light than complemental.”
“Start at once a bed-side library,” he wrote, “and spend the last half hour of the day in communion with the saints of humanity.”
Osler’s advice must have been much easier to put into practise in 1901, when bio-science was yet a tiny part of medicine, when home radio broadcasts, film, television and the internet did not exist, and when students entered medical schools with sound educations in both science and the humanities. A century on, practitioners are undoubtedly better equipped to diagnose and treat disease, but their inner resources for understanding and responding to human suffering – a store replenished every time we read a novel or a biography or a history book – may be empty. Just keeping abreast of science, technology and workloads makes it very hard to maintain a reading habit outside of these requirements. Added to this is the fact that most students enter medicine already several years’ out of practise in reading and responding to long-form literary prose. Reading is a horse that’s hard to get back on once you’ve fallen off.
Yet medical practice remains both an applied science and a relational art. It has been called a ‘narrative activity’, whereby stories about ill health are shared, and their meanings interpreted. Rita Charon, Professor of Clinical Medicine at Columbia University, has highlighted the need for twenty-first century doctors and other health professionals to develop and practice ‘narrative competence’.
Narrative competence strengthens a practitioner’s ability to cope with the reality of clinical practice, where science meets the actual flow of life. It nourishes the ability to understand another person’s position, and to more deeply understand one’s own responses and motivations. It supports tolerance of suffering in others and in oneself. It provides a way to ‘hold’ and ‘handle’ aspects of people’s stories that won’t neatly fit the cookie-cutter textbook version. It allows practitioners to recognise that there are always at least two stories underway in a patient’s body – the story of the pathological disease and the story of the sufferer’s unique and complex experience of illness. These stories overlap and intertwine, the facts of the situation taking their place in a more nuanced narrative affected by factors like ambiguity, paradox, doubt, fear and shame. Osler, for example, recognised uncertainty as a “distressing feature” of the reality of medical care, and knew that reading literature was a way to help the practitioner “be content with finding broken parts.”
Osler’s thoughts on the value of reading are as pertinent as ever – start at once that bedside library.
Sue Wootton is co-editor of Corpus.
- William Osler, A Way of Life” and Other Address, with Commentary and Annotations, (Durham: Duke UP, 2001).
- Kathryn Montgomery Hunter, Doctors’ Stories: The Narrative Structure of Medical Knowledge, (Princeton: Princeton UP, 1991).
- Rita Charon, Narrative Medicine, (Oxford: Oxford UP, 2008).