Reviews Personal views

Osler's bedside library revisited—books for the 21st century

BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7530.1482 (Published 15 December 2005) Cite this as: BMJ 2005;331:1482
  1. Sanjay A Pai, consultant pathologist (s_pai{at}vsnl.com)1,
  2. Roop D Gursahani, consultant neurologist2
  1. 1 Manipal Hospital, Bangalore, India
  2. 2 P D Hinduja Hospital, Mumbai

    Medical education is, in many ways, incomplete. Although we are taught about the science of medicine, most medical school curriculums lack formal teaching on the humanity of medicine. Ethics, history, and philosophy are not taught formally in many schools. William Osler was one of the earliest to realise this, and in 1904 he proposed a bedside library for medical students that consisted of the Old and New Testaments, Shakespeare, Montaigne, Plutarch's Lives, Marcus Aurelius, Epictetus, Thomas Browne's Religio Medici, Don Quixote, Ralph Waldo Emerson, and Oliver Wendell Holmes's “breakfast table” series.

    The reading tastes of people have changed over the years. From time to time other people, all from the West, have attempted to renew the list. We contacted 44 doctors (25 from India and 19 from North America and Europe) for their views on which books were essential reading to make doctors humane and complete. The doctors, who represented different specialties, included some with university attachments and some in private practice, Oslerphiles and others, and some renowned authors or editors. Thirty eight responded positively, and their lists contained from one to 38 books, giving a total of 442 books.

    One respondent did not agree with Osler's list and thought it “largely irrelevant to this age and our society” but added that “the concept of doing some general reading every day should be presented to every professional.” Another found “medical students… as diverse as all humanity, and what excites, or bores, one will have the opposite effect on another.” Four said that their lists were likely to be affected by mood and time and that were the exercise to be repeated the list would be entirely different.

    The respondents chose their books in various ways. Some included only those from their own area of interest (disease and illness in literature), others only edifying literature or only autobiographies. One approach was to choose popular novels and biographies that “would [not] necessarily make a student more humane—but what a slice of life the reader would get.” One chose only books “which every thinking person should read and reread: books on ecology, technology, etc, so as to change the world.”

    We learnt that one person would mourn the loss of her copy of Alice in Wonderland, that Les Miserables changed one respondent's life, and that The Citadel influenced at least two people to become doctors. One respondent believed that “all books changed cognition, in greater or lesser degree.” To our delight, six of the lists included a book written by one of the other respondents.

    We agree with C P Snow, who believed that “there ought to be a literary component throughout… medical education”

    Books that appeared three times in the respondents' lists were Moby Dick, Middle-march, Pride and Prejudice, Don Quixote, Meditations by Marcus Aurelius, The Adventures of Sherlock Holmes, The Final Diagnosis by Arthur Hailey, Richard Feynmann's Surely You are Joking, Mr Feynmann, and (only among the submissions from India) the Ramayana and Mahabharata. Other authors who appeared three times were George Orwell, Peter Medawar, Richard Asher, and Edward De Bono.

    The figure shows our revised bedside library, which is based on the books or authors that appeared most often in the respondents' lists. (A fuller version of the list, including the number of lists in which books or authors appeared and some alternative titles, is on bmj.com, along with our own choices.)



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    A 21st century version of Osler's bedside library?

    We agree with C P Snow, who believed that “there ought to be a literary component throughout the course of medical education,” because doctors “would have been wiser with the elements of a humanist education.”

    Acknowledgments

    We thank all the respondents. We also thank Mugdha Thakur and Anand Date for sending relevant literature.

    Footnotes

    • Embedded Image The full list of books, including rankings, is on bmj.com

      We welcome submissions for the personal view section. These should be no more than 850 words and should be sent electronically via our website. For information on how to submit a personal view online, see http://bmj.com/cgi/content/full/325/7360/DC1/1