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William Osler wrote more than a dozen books and over 750 articles in his lifetime, but one book and one article are by far the best known. ‘Principles and Practice of Medicine’ was published in 1892 and was a huge success. It went through 17 editions and established a model for textbooks of general medicine to the present day. The enduring fame of his short piece entitled ‘Aequanimitas’,1 composed 3 years earlier, might have surprised him more. It was the transcript of an address he gave to new medical graduates at the University of Pennsylvania. It also served as his farewell lecture before he departed to become chief of staff at Johns Hopkins Hospital.
Reading it now, it seems in some ways very much from a bygone age. Osler assumes, for example, that every member of his audience will have a comfortable familiarity with classical literature, the Bible and Shakespeare. The first paragraph alone contains at least five references to the classics, including the tale of Er the Pamphylian from Plato’s Republic. Later, he reminds his audience that the word ‘aequanimitas’ (‘equanimity’) was used by the benign Roman emperor Antoninus Pius on his deathbed, as his choice of the day’s military password. He would have taken it for granted that all his students knew the word meant ‘calmness of soul’, from the Latin words ‘aequus’ and ‘animus’. It is not a style that would appeal to many new medical graduates today.
The first three pages do not mention equanimity at all but cover a related quality, imperturbability. His approach is striking because of his insistence that imperturbability is largely a physical endowment, or in other words genetic. According to Osler, you either have it or you do not. …
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