Dr. Osler and Janet


I scurried in from the cold, tamped the snow from my boots and hung my coat on the rack over the plastic mat to let the melting ice drain off.  Since Lapius had become addicted to Marcus Welby I had decided to go to the lecture alone.  He snapped off the TV as I entered.


“Good meeting, Harry?”


“Interesting.  Fletcher spoke about the responsibility of the doctor to the dying patient.”




“Who said anything about euthanasia?”


“Well originally euthanasia referred to the proper way of comforting the dying patient.  That’s what it means literally, the good death.  Now, of course it is synonymous with mercy killing.”


“Fletcher didn’t touch on that, but rather on the new science of caring for the dying, of developing a dialog with them and helping to allay their fears.”


“Interesting.  It has been my experience that the healthy have more fear of dying than those face to face with death.  Patients seem to undergo a gradual detachment that enables them to die peacefully.”


“Fletcher read a letter from a young woman who was dying.  She wanted to be comforted, and told the doctors that to them death might be old hat, but to her dying was a new experience.”


“Well, I think it’s going to be hard to teach.  Not all of us are equipped to shepherd the flock for the spiritual experience of dying.”


“How was Welby tonight?  Another short course in medicine you so sorely need, no doubt.”


“Don’t be a snob, Harry.  Welby was great, as usual.  I’ve been trying to figure out what attracts me to him.  After all there have been other programs dealing with the dramatics of life and death in medical practice, both in and out of hospitals.  But there is something particularly sensitive about Welby, and therein, for me at least, lies his appeal.  It’s that the program doesn’t really focus on whether the patient will live or die, but that, regardless of the outcome, the patient is in competent hands of someone who cares.  The patient is not alone.  Welby is concerned about his patient as a person.  This is what comes through, Kiley tries to be but isn’t yet mature enough to project it.  Welby has already faced death himself, he had a heart attack and is not well.  I think this is vital to the characterization.  And luckily they were able to get Robert Young to play the part.  He was an alcoholic for many years, and his struggles with that disease probably enabled him to develop the mellow warmth he projects on the screen.”


“Fletcher said that doctors are getting a bad press from their seriously ill patients.”


“I think that’s an exaggeration.  Some doctors to be sure may be abrupt with the dying, and if they are it is because they themselves are afraid.  But in my experience most doctors eventually come to terms with death, regard it almost as a friend after having seen it rescue people from useless suffering.  We used to call pneumonia the old man’s friend.  I find that most doctors are kind and considerate to the dying.  But never mind that.  Here’s a mother’s account of the great William Osler’s approach to her dying daughter.”  Lapius plucked Harvey Cushing’s biography of Osler from his shelves opened it to a marked page, and proceeded to read.


“He visited our little Janet twice every day from the middle of October until her death, a month later, and these visits she looked forward to with pathetic eagerness and joy.  Instantly the sick room was turned into a fairyland, and in fairy language he would talk about the flowers, the birds, and the dolls-.  In the course of this he would find out all he wanted to about the little patient.”


“The most exquisite moment came on old raw November morning, when the end was near, and he brought out from his pocket a beautiful red rose, carefully wrapped in paper, and told how he had watched this last rose of summer growing in his garden and how the rose had called out to him as he passed by, that she wished to go along with him to see his ‘little lassie’.  That evening we all had a fairy tea party at a tiny table by the bed, Sir William talking to the rose, his little lassie and her mother in a most exquisite way – and the little girl understood that neither fairies nor people could always have the color of a red rose in their cheeks, or stay as long as they wanted in one place, but that they nevertheless would be happy in another home and must not let people they left behind, particularly their parents, feel badly about it; and the little girl understood and was not unhappy.”


“Great,” I said, “but who has time for fairy tea parties?”


“Harry,” Lapius said soberly, but not without a twinkle in his eye, “If I should find myself in your care when I am dying, promise me you’ll call in an older man.”