The principles and practice of death: The Oslerian conflicted conception of dying

Abstract

Sir William Osler espoused a particularly idealized medical life that included the patient in the physician's worldview. Disease is not considered a monolith, only a reflection of one's broader health. Death, too, is configured as a part of one's being, not as a thing apart from life. The wholesomeness that characterized Osler's practice is well known—however, his long discussions and thoughts on death have not been sufficiently analyzed. His clinical views have been hinted at and numerous medical historians have noted that Osler's worldview on death was avant-garde for its time, one in which he described finality not as a time of suffering and anguish, but as “singularly free from mental distress.” This essay contends with this simple view. This straightforward understanding becomes complicated when delving into such primary resources as Osler's Study on Dying cards, his writings on other medical conditions, and personal reflections following the personal losses of his sons Edward Revere Osler and Paul Revere Osler. This essay contends that the loss and the death he imagines is not one of peace, but rather, of horror and terror. Furthermore, the primary sources show Osler not as the paragon of flawless clinical acumen and reasoning, but a man of personal beliefs that were in conflict with views he espoused more publicly. The essay therefore reconceptualizes the common understanding of a stoic Osler, determines how death prefigures into Oslerian thought, and challenges the idea of an Oslerian simple death.