MDAdvisor Spring 2023

Sir William Osler made many contributions to medicine and medical education that earned him the title Father of Modern Medicine. In addition, he was well-read in a broad range of literature and was a compulsive collector of books.¹ The publication of remarks made to new medical students as his farewell address at the University of Pennsylvania in 1889 included what became known as the Bedside Library with a list of books to be read by physicians for half an hour before going to sleep and then again in the morning. The list included ten major literary works and classic writings.* This habit was intended to stimulate interest in human affairs and human nature with an emphasis on compassion for the individual patient.² In 1916, Osler delivered an address entitled “Creators, Transmuters, and Transmitters, as Illustrated by Shakespeare, Bacon, and Burton” in which he categorized the contributions made by great authors.³

With his literary acumen established, in early 1919, Osler was asked to deliver a lecture to an English literature class at Oxford University that was entitled “Walt Whitman: An Anniversary Address with Personal Reminiscences.” However, Osler did not deliver the lecture because of illness, and it remained an unfinished draft at his death on December 29, 1919. Later, the complete draft text became available in published form in a 1995 book by the medical historian and Oslerian biographer Philip W. Leon who was a long-time professor of English at The Citadel, the Military College of South Carolina.⁴ This book, Walt Whitman and Sir William Osler: A Poet and His Physician, gave the world an astounding look at this remarkable physician-patient relationship.

“There are at least three noteworthy intersections of Osler and Whitman in their journeys through life.”

There are at least three noteworthy intersections of Osler and Whitman in their journeys through life. These start with their physician-patient relationship, which was highly valued by each but marked by periodic difficulties. Then, Whitman’s significant life-changing experience and traumas during the Civil War that were later manifested in Osler’s insights and perspectives acquired from events during World War I, which increased his understanding and appreciation for Whitman’s poetry. Lastly, following their respective deaths, each of them underwent a postmortem autopsy that was marked by some unusual circumstances.

The Physician-Patient Relationship

Osler first met Walt Whitman shortly after Osler relocated from McGill University in Canada to the University of Pennsylvania in 1884. Making visits to Camden, New Jersey, he served as one of Whitman’s physicians until he left Philadelphia in 1888 to become Physician in Chief at the Johns Hopkins Hospital in Maryland and one of the co-founders of the Johns Hopkins School of Medicine, serving as Professor of Medicine. In 1905, he was appointed the Regius Professor of Medicine at Oxford University. (This academic chair was established by Henry VIII in 1546.)

In his draft 1919 lecture, Osler noted that soon after his relocation from Canada to Philadelphia, he received a telegram from Dr. Maurice Bucke, a friend and fellow Canadian physician. The telegram read: “Please see Walt and let me know how he is.” Osler replied to this message with the following: “Who is Walt, and where does he live?” The next day he had the response and necessary information: “Mr. Walt Whitman, 328 Mickle Street, Camden.” ⁵

Whitman’s work with the wounded of the Civil War led to his receiving the sobriquet of the “Good Gray Poet” in 1866 with the publication of a biographical pamphlet by William O’Connor.⁶ This biography detailed Whitman’s selfless Civil War service. The Good Gray Poet title stuck.

During the Civil War, Whitman began to have health problems. These were in marked contrast to the idealized notion of the human body presented in his poetry.⁷ After his many years of visiting and providing care to wounded soldiers beginning in December 1862, Whitman remained in Washington, DC after the conclusion of the Civil War.

He was employed as a clerk by several different governmental offices. On January 23, 1873, he was working late in the Treasury Building when he had a devastating stroke with left-sided paralysis.⁸ Soon thereafter in 1873, he moved to live with his brother George and other family, including his mother, in Camden. His mother died shortly after his move, and Whitman eventually had substantial recovery from that stroke. Unfortunately, he would have others. In March 1884, he moved to the Mickle Street address. This was the only house Whitman ever owned. It is now both a New Jersey State Historic Site and a National Historic Landmark⁹ (see Figure 1).

Osler crossed the Delaware River between Philadelphia and Camden by ferry and found his way to Whitman’s house on Mickle Street. He showed Dr. Bucke’s telegram to the woman who answered the door and was immediately admitted, indicating that Whitman was feeling better that day and was downstairs. Osler was led into a room on the ground floor. In his draft lecture, Osler commented at some length about the “clutter” that filled the room:

At the far corner, near the window, the head and upper part of the chest of a man were visible—everywhere else, covering the floor, the chairs and the table were, to use his own description, ‘heaps of books, manuscripts, memoranda, scissorings, proof-sheets, pamphlets, newspapers, old and new magazines, mysterious looking literary bundles tied up with short strings.’ The magazines and newspapers piled higher than the desk, covered the floor so completely that I had to kick my way by the two sides of the wall of the room to get to the desk.¹⁰

Notwithstanding the state of the room, Osler found that Whitman at the age of 65 was “a fine figure of a man who had aged beautifully, more properly speaking, majestically.”¹⁰ He described his large frame and well-poised head with kindly, gentle eyes and which was covered with snow-white hair, beard and moustache. Osler did not get much information from Whitman about his health at that visit. But at a second visit a few days later, Osler learned of the 1873 stroke and left-sided paralysis. He noted that Whitman had recovered use of his arm and hand but that his leg remained a little weak. Osler remarked that after careful examination he was able to tell Whitman that “the machine was in fairly good condition considering the length of time it had been on the road.”¹¹

Osler visited Whitman in Camden many more times over the approximate four-year period before moving to Baltimore and makes comments in his lecture about “hav[ing] notes of visits” without details. “A serious illness” began in June 1888. Osler went with Bucke to see Whitman and found him “conscious but mentally confused and with the speech slightly blurred & indistinct.” Osler noted in his draft lecture that Whitman had had attacks of “transient unconsciousness … as we know are not uncommon with sclerosis of the arteries of the brain.” This condition persisted for about a week, and then Whitman recovered without any paralysis or loss of speech.¹² Osler continued his periodic visits to Whitman until the end of 1888 when he left the area to become Physician in Chief at Johns Hopkins Hospital in Maryland.

Osler’s lecture barely describes any reaction by Whitman to his illness or treatment. But it makes reference to “that most extraordinary of all records” that had been maintained by Horace Traubel under the title of With Walt Whitman in Camden. This is a nine-volume biography chronicling nearly daily visits and encounters beginning in June 1888 and continuing through Whitman’s death on March 26, 1892 and into April 1892. In the Preface, Traubel indicates that Whitman did not know he was keeping such a record.¹³

Born in Camden, Traubel was an essayist and publisher who had met Whitman when Whitman moved to Camden to live in his brother’s house in 1873. Traubel was then 15 years old, and, as an adolescent, he was a regular companion to Whitman. He would later become one of the three literary executors of Whitman’s estate.¹⁴

Traubel’s reporting begins on March 28, 1888 and first mentions Osler in June 1888. Osler had been Whitman’s physician for several years before that. For example, in October 1885, Osler took Whitman to be evaluated by an ophthalmologist in Philadelphia. Whitman noted in his daybook that the examination had been satisfactory, and the fear that he was becoming blind was “discountenanced” by Dr. Norris.¹⁵

Some of Traubel’s entries are quite brief, such as, “Osler over today”; “Osler not here today”; and “Osler was over today.” But the chronicle includes more pointed comments by Whitman. On July 6, 1888, Osler had been in for a visit. He reported that Whitman was “as well as usual,” which Traubel took to mean that Whitman was no more sick than usual. Whitman thought Osler’s statement was “significantly meaningless.”¹⁶ For the entry of September 26, 1888, Traubel reports a conversation with Whitman after a visit by Osler earlier in the day: “Something helped me today—I don’t know what. Osler made light of my condition. I don’t like his pooh-poohs: the professional air of the doctor grates on me.”¹⁷ On October 5, 1888, Whitman received a letter from Dr. Bucke commenting on a favorable report he received from Osler. Traubel quotes Whitman’s response: “I confess I do not wholly like or credit what he says—I do not fancy the jaunty way in which he seems inclined to dismiss the troubles.” He continued with comments about Osler’s cheerful manner and stated, “I know my own condition—don’t need him to tell me about that—can’t be fooled.” Traubel’s rejoinder challenged Whitman to acknowledge the encouraging information even if exaggerated and reminded Whitman of his earlier comments about not fighting the battle with the worst end in view. Whitman smiled and responded: “I must have said something like that—it sounds like me.”¹⁸ This is reminiscent of Whitman the hospital volunteer and wound-dresser of injured and dying soldiers. In a letter to his mother from January 1863, he described his practice while visiting the wards of wounded to have “a passing word of friendliness” and his practice of noting when “the whole ward needs cheering up.”¹⁹

In objecting to Osler’s approach, on several instances Whitman used the metaphor of a shoe that pinches in referring to the results of medical evaluations. On October 3, 1888, Whitman discussed an encouraging report, which he questioned. “The shoe-maker tells his customer that shoe just fits but the customer feels the pinch: the fellow who wears the shoe always knows most about the pinch.”²⁰ This is seen again in Traubel’s entry of Whitman’s words on October 6, 1888:

As I have said before, the fellow who wears the shoe knows best whether it pinches or not. Osler’s cheer, instituted of malice prepense, has a place, is not to be sneezed away; but I, too, know when the wind blows north. For some time I have succeeded in maintaining myself on a low level of comfort: now the enemy is at work again. I feel myself going down hill.²¹

Whitman repeated the metaphor the year he died, as recorded in the entry for February 18, 1892 of an exchange between Traubel and Whitman: “They tell me you are better today.” “So? I believe they do say that. Meanwhile the shoe pinches.”²²

But Whitman also had several recurring positive comments about Osler. For example, Traubel recorded an encouraging remark that Osler had made to set aside a gloomy view of Whitman’s condition. Traubel then noted Whitman’s comment about Osler: “He’s a fine fellow and a wise one, I guess, wise I am sure—he has the air of assurance. Doctor Bucke was to select a man—selected Osler: said Osler was the head of the band.”²³ Then on December 26, 1888, Traubel noted this comment by Whitman:

As for Osler: he is a great man—one of the rare men: I should be much surprised if he didn’t soar way up—get very famous at his trade—some day: he has the air of the thing about him—of achievement.²⁴

Although Osler was one of about a half-dozen physicians who provided Whitman with medical care while he was in Camden,²⁵ he certainly was the most prominent.

The Evolving Appreciation of Whitman’s Poetry

In his Oxford lecture, Osler acknowledged that when he received the “Walt” telegram from Dr. Bucke, he did not recognize Walt Whitman as the acclaimed author of Leaves of Grass, and, as of the initial meeting, he had not read any of his poems. But after beginning to care for Whitman as a physician, he acquired a copy of Leaves of Grass. It is unclear what edition he read. The initial edition from 1856 had 12 poems. In the final version published between 1891 and 1892, there were 389 poems. But Osler reacted negatively to his first reading. He stated: “Whether the meat was too strong, or whether it was the style of cooking—‘twas not for my pampered palate, accustomed to Plato and Shakespeare and Shelly and Keats.”²⁶ This stance would change. An Osler biographer has stated that after many years “Whitman’s poetry gained on Osler” and before Osler died “Whitman’s poems were beginning to grow on him.”²⁷

In 1910, Osler delivered a lecture at Yale University in which he quoted Whitman for an embodiment of what he considered to be an appropriate philosophy of life:

Ah, the glory of the day’s work, whether by hand or brain! I have tried
To exalt the present and the real,
To teach the average man the glory of his daily work or trade.²⁸

The last two lines of this passage are from the poem “Song of the Exposition,” which Whitman composed in 1871 and appeared in the 1872 version of Leaves of Grass. Osler reiterated this viewpoint in June 1919 in his last published essay entitled “Walt Whitman’s Message: The Glory of the Day’s Work.”²⁹

But Osler’s embrace of Whitman’s words and point of view in the next decade intensified with the onset of World War I. In the original 1855 Leaves of Grass, Whitman had presented an effusive celebration of life. That voice changed during the war because of daily exposure to the wounded and dying in the hospitals resulting in the transformation seen in the 1865 publication of Drum-Taps, which was later incorporated into Leaves of Grass. He recognized and utilized empathy and compassion in the healing of damaged and hurting human beings.

The definitive change in Osler’s perception of Whitman occurred during World War I when he was exposed, similarly, to the suffering and deaths of many young soldiers. This eventually included his only son Revere.³⁰ There are parallels to Whitman’s experience and poems.

After the British army mobilized in 1914 and the fighting ensued, Osler began to care for casualties of the war by coordinating medical and nursing personnel and readying Oxford University buildings to be converted to military hospitals. Given his knowledge of infectious diseases, he strongly advocated for the compulsory vaccination of troops against typhoid.³¹ He provided comfort and shelter at his home to wounded soldiers and their families, earning the nickname of “Consoler-General.”³⁰

Osler’s son Revere was beginning his first year at Christ Church College, Oxford when war broke out. He dropped out in January 1915 and joined the Canadian Expeditionary Force in February. Initially assigned to work in a Canadian hospital unit, he obtained transfer to a field ambulance. In 1916, he was commissioned as a Second Lieutenant with a Royal Artillery stationed in Belgium.

Whitman had written a poem entitled “The Artilleryman’s Vision”³² as part of Drum-Taps, which included this passage:

There in the room as I wake from sleep this vision presses upon me;
The engagement opens there and then in fantasy unreal,
The skirmishers begin, they crawl cautiously ahead, I hear the irregular snap! snap!
I hear the sounds of the different missiles, the short t-h-t! t-h-t! of the rifle-balls,
I see the shells exploding leaving small white clouds, I hear the great shells shrieking as they pass…

The parallels to a letter to Osler from Revere written from the Battle of the Somme in 1916 are striking:

At dawn I watched our barrage of shrapnel put up on the German trenches; then a pause, a re-elevation and rush; and then the prisoners began to come, and were herded in a big trench to my right. They looked at first supremely happy but were soon frightened with the shells from their own lines which were dropping all about.³⁰

The resonance of Whitman’s poetry and Osler’s life increased in intensity with the events of August 29–30, 1917. Revere Osler’s artillery unit was part of the offensive known as the Third Battle of Ypres. Revere received severe shrapnel wounds to his abdomen, chest and thigh from a German shell. He was taken to the nearest aid station, which was staffed by Americans. The staff summoned family friend Dr. Harvey Cushing, the pioneering neurosurgeon, who was serving at a nearby hospital. Cushing came and along with three other American surgeons attended to the young man. Osler received a telegram from Cushing informing him of Revere’s injuries: “Revere dangerously wounded, comfortable and conscious, condition not hopeless.” A few hours later Revere died.³⁰

“Come Up From the Fields Father”³³ was another of the poems in Drum-Taps. Whitman’s words included this passage:

Come up from the fields father, here’s a letter from our Pete,
And come to the front door mother, here’s a letter from thy dear son.
…
Open the envelope quickly,
O this is not our son’s writing, yet his name is sign’d,
O a strange hand writes for our dear son, O stricken mother’s soul!
All swims before her eyes, flashes with black, she catches the main words only,
Sentences broken, gunshot wound in the breast, cavalry skirmish, taken to hospital,
At present low, but will soon be better.
…
While they stand at home at the door, he is dead already;
The only son is dead.
…

In January 1919, Dr. Cushing visited Oxford and stayed with the Oslers. By his bedside that night, Osler had left a book for Cushing to read. It consisted of Whitman’s journal entries and notes collected in Memoranda During the War. Commenting in his diary that these had “a very modern sound,” Cushing quoted this passage from Memoranda: “The marrow of the tragedy is concentrated in the hospitals … unnamed, unknown, remained and still remain, the bravest soldiers.”³⁴ Cushing later included this Whitman passage as the epigraph to his From a Surgeon’s Journal: 1915-1918 published in 1936. In 1925, he was awarded the Pulitzer Prize for Biography for his book entitled The Life of Sir William Osler.

Intersecting Lines After Death

Although he never considered himself a neurologist, Osler’s contributions in his Principles and Practice of Medicine textbook place him among the leading neurologists of the time.³⁵ His interests in the brain led to membership in the American Anthropometric Society, an organization founded in Philadelphia. Its members studied and measured the brains of prominent people, seeking to discover brain types, whether genius-type or criminal-type. The Wistar Institute in Philadelphia became the repository for the brains studied by the Anthropometric Society.

In accordance with Osler’s instructions, following his death in 1919 from the Spanish flu, an autopsy was performed, and his brain was removed and packed in formaldehyde-soaked cotton. Then in 1920, it was sent to the Wistar Institute. After examination and measurements, no special features were found in Osler’s brain.⁴

There is some symmetry to this postmortem examination in the life and actions of Walt Whitman. Whitman had had an interest in phrenology—the study of the shape and size of the cranium with bumps on the skull being interpreted as reflecting personality and character—and in 1849 presented himself for his bumps to be “read” at the Phrenological Museum of Orson Fowler and Horatio Welles in New York.³⁶ In addition to being phrenologists, Fowler and Wells operated a publishing company that published an edition of Leaves of Grass.⁴ In the Preface to Leaves of Grass, Whitman included the phrenologist among “the lawgivers of poets.”³⁷ There are quite a few references to phrenology in Whitman’s poem, but he gradually distanced himself from what had become recognized as pseudo-science.³⁸ In contrast, Osler was never a phrenologist and did not publish anything on that topic.⁴¹

On March 27, 1892, the day after Whitman died, his friend the artist Thomas Eakins came to the house on Mickle Street and made a death mask of Whitman’s face.³⁹ An autopsy was then performed at the house in Camden. Whitman’s brother George objected to the postmortem examination, but Whitman had consented to it before his death in December 1891. The brain was extracted by Dr. Henry Cattell of the American Anthropometric Society, who “put it into his gupsack” in the presence of several persons, including Horace Traubel.⁴⁰

There is confusion as to what ultimately happened with Whitman’s brain. In a paper published in 1906, Dr. Spitzka of the Jefferson Medical College stated that Whitman’s brain was destroyed when the jar containing the brain was dropped by an unidentified lab assistant at the Wistar Institute.⁴¹ This story persisted for many years, but the explanation has been called “historical fiction to protect the reputation of the guilty party.” The true story was exposed after Cattrell’s unpublished diaries containing the details of his role in the incident were sold in an eBay auction out of New Jersey in 2012.⁴²

While the intended study of the two brains failed to identify any special features, there is little doubt that these were the brains of two special people who were exceptionally accomplished human beings. Much has been written about the work and lives of each of these individuals. Each has a prodigious body of work to evaluate. Approximately 400 poems and prose works were written by Whitman during his lifetime. In just the time after moving to Camden in the midst of the persistent deterioration of his health, he published two new editions of Leaves of Grass (1876, 1881–1882), the prose works Memoranda During the War (1875), Two Rivulets (1878), Specimen Days and Collect (1882–1883) and November Boughs (1888), along with the new poems in Good-Bye My Fancy (1891) and the deathbed edition of Leaves of Grass (1891–1892), as well as The Complete Prose Works (1892).

In his lifetime, Osler published more than 1,300 articles and his Principles and Practice of Medicine textbook. More significantly, the evolution of Osler’s view of the Good Gray Poet’s writing from dislike to an intense appreciation is an embodiment of the Father of Modern Medicine’s admonition that physicians should pursue lifelong learning with change and continual growth. Both Walt Whitman and William Osler continue to be sources of influence through their written work and through the values they championed.