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Osler and the doctor-patient relationship

Leonard Wang
Education
December 22, 2021
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I first heard about Sir William Osler (1849-1919) through my primary care physician. His biography stated: “I practice family medicine because every day I get to meet new people from all over the world. I get to hear their stories, meet their families, and help them heal. In some cases, I get to see them again and again, building trust and respect while forming meaningful relationships. To me, there is nothing more rewarding. My practice philosophy is best summarized in the words of William Osler: ‘It is much more important to know what sort of patient has a disease than what sort of disease a patient has.’” I didn’t fully understand this philosophy until I received care from physicians who lacked Osler’s principles.

The first time was an unusual Clostridioides difficile infection lasting several weeks that caused me to lose 15 pounds. I felt that the doctors cared more about my atypical case of C. diff than me. Being solely viewed as an “interesting presentation of the disease” was invalidating to my experience in the sick role. I felt more like a diseased patient than a patient with a disease. For infectious disease physicians, my disease was more important than me.

The second time was an occupational exposure at a local student-run clinic that sent me to the emergency room. During both periods of illness, I felt the uncertainty, vulnerability, and alienation associated with being sick. Yet reflecting on these events allowed me to realize the importance of clinical empathy and compassionate care. I learned what kind of physician I want to be: one that prioritizes his patients’ humanity in all doctor-patient relationships. At the same time, I recognize that some clinical situations are more conducive to Osler’s ideals. For example, compared to primary care, emergency medicine can be a more difficult environment to display empathy. How does an emergency medicine physician balance empathy with the need to rapidly treat patients suffering from urgent life-threatening conditions?

Osler’s enduring legacy is at the personal level. His ability to touch people inspired compassionate patient-centered care in subsequent generations. Osler remains the epitome of clinical medicine, emphasizing the importance of learning medicine at the bedside. I’m grateful to attend medical school at an institution that provides opportunities for bedside teaching starting from the first day. Working at our student-run clinic has allowed me to provide care for the underserved and form meaningful relationships. Supporting my didactic education with clinical learning showed me the intangible in medicine. Being present to bear witness to an individual’s experience within the sick role can heal in powerful ways. Empathetic listening provides moments of shared understanding, opening a therapeutic space for people who are suffering.

Osler continues to inspire me to reflect on the human condition, study our own mortality, and find meaning in my connections. My personal periods of illness have taught me how nurturing doctor-patient relationships is critical to improving patient outcomes and experiences. I encourage all health care professionals to study Osler and consider their own experiences as a patient.

Leonard Wang is a medical student.

Image credit: Shutterstock.com

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Osler and the doctor-patient relationship
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