Monday, March 20, 2023

'The Periganglionic Spaces of His Grey Cortex'

“With half an hour’s reading in bed every night as a steady practice, the busiest man can get a fair education before the plasma sets in the periganglionic spaces of his grey cortex.” 

I don’t associate reading with self-improvement and have never subscribed to the eat-your-broccoli-it’s-good-for-you school of thought when it comes to books. Reading, especially serious reading of worthwhile books, is its own reward. If you want to ensure your kids remain lifelong aliterates, order them to read, turn it into an obligation and leach all the pleasure from what ought to be one of life’s chief consolations.


The sentence quoted at the top is spoken by Dr. William Osler (1849-1919) in Dr. Harvey Cushing’s biography of his former teacher, The Life of Sir William Osler (Oxford University Press, 1925). The thought is preceded by this context provided by Cushing, an eminent neurosurgeon:


“He emphasized the importance of reading as a part of post-graduate study. . . . The average non-reading doctor might play a good game of golf or of bridge, but professionally he was a lost soul. The driven or tired practitioner might plead that he could not find the time to read.”


Osler (1849-1919) is one of those fascinating men who turned a non-literary profession into literature, and was himself an inveterate reader, antiquarian and bibliophile. Among his favorite writers were Montaigne, Shakespeare, Robert Burton, Sir Thomas Browne, Sterne, Swift, Coleridge, Keats and Lamb. He wrote nearly as often about books as medicine. I’m not qualified to judge whether this statement by Osler, also from Cushing’s book, is true:


“Books are tools, doctors are craftsmen, and so truly as one can measure the development of any particular handicraft by the variety and complexity of its tools, so have we no better means of judging the intelligence of a profession than by its general collection of books. A physician who does not use books and journals, who does not need a library, who does not read one or two of the best weeklies and monthlies, soon sinks to the level of the cross-counter prescriber, and not alone in practice, but in those mercenary feelings and habits which characterize a trade.”


I once had a Syrian-born cardiologist who enjoyed talking about Shakespeare's work, including Othello’s final speech: “that in Aleppo once . . .”


The Canadian historian Michael Bliss in his William Osler: A Life in Medicine (1999) tells us Osler treated William and Henry James, Walt Whitman, and James Murray, the founding editor of the Oxford English Dictionary. He socialized with Mark Twain and Rudyard Kipling, was partly responsible for getting Gertrude Stein kicked out of Johns Hopkins University (bless him), and even shows up in Finnegans Wake: “The ogry Osler will oxmaul us all.”


In 1892, Osler published The Principles and Practice of Medicine, a 1,050-page medical textbook he wrote single-handedly. It remained the standard text for more than 40 years and stayed in print until 2001. Even in a textbook his bibliomania was evident. Bliss writes: “He mentioned historical figures ranging from Hippocrates, Mephibosheth, and Sir Thomas Browne, through Montaigne, Oliver Wendell Holmes, Coleridge, and Swift.”


Osler adored Tristram Shandy and in a paper devoted to birth injuries he included a footnote that “directed readers to the ravages of Dr Slop’s forceps . .  .” In addition, Bliss reports: “At times he admitted to whistling that he might not weep, like Uncle Toby in Tristram Shandy.” The biographer quotes this from one of Osler’s letters: “How I should have liked to get drunk with Charles Lamb.”


About that quote at the top: Osler refers to the brain and the motor neurons of the autonomic nervous system, located in the spinal cord and brainstem. He’s talking about loss of brain function, dementia, what used to be called senility.

[A reader in the comment section refer to Dr. Richard Selzer, whom I wrote about here.]


Richard Zuelch said...

Osler, as you know, is considered the father of modern surgery. A local library around here has Cushing's 2-volume biography of the great man. I should consider reading it. Terrific first paragraph after the quote, by the way.

Speaking of biographies, I resisted and resisted, and then gave in and bought the 2-volume biography of Thomas Henry Huxley, written by his son and published in 1901, at one of my favorite used bookshop haunts.

Faze said...

Through my work, I've gotten to know hundreds of doctors. They included two of the world's leading heart surgeons, both close to the same age. One of them said that he'd never read a novel in his life (he was dyslexic), the other told me, a propos P.G. Wodehouse, "I think I've read everything he wrote - certainly all of Jeeves and Bertie. Maybe twice."

There was one renowned old surgeon who was vociferous atheist, yet quoted the Bible almost as often as a preacher. When I asked him why he was so familiar with scripture, he said, "I believe you should know your enemy". (He would quote Shakespeare and country western songs as well.)

Many of the more literate docs held "Death of Ivan Ilyich" in a kind of reverent awe. Ohio's Hiram College used to have a department of Literature and Medicine. And every so often book groups of a more or less serious nature spring up among health cafe professionals.

I once attended a medical lecture by the surgeon and short story writer Dr. Richard Seltzer (whom I was thrilled to meet, being a fan of his work). During the lecture, a man in the audience passed out and fell from his seat. Nobody in this room full of doctors paid any attention. Seltzer stopped his talk and asked, "Isn't anybody going to help this man? By God, I will ..." and came down from the podium to minister to the fallen figure.

Medicine was a more humanistic profession in the days of Osler and Cushing (who is buried in Cleveland's Lakeview Cemetery). There were fewer professional journals to follow, and a knowledge of literature was thought to deepen a doctor's knowledge of human nature, and so enhance the ability to diagnose and treat.

Of course, doctors did as much harm as good in those days, and it might have been some comfort to a doctor to take a broad and liberal view of the human condition. As medicine has gotten more scientific, the humanities have diminished in importance outside of the occasional cross-disciplinary seminar. Medicine has become "healthcare" and the rage now is for "empathy" rather than understanding.

slr in tx said...


Your second paragraph has an extra 'l' in it. (Probably that damned spellcheck.)

Cushing and Osler still loom large in medicine.