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William Osler – the everlasting ‘perhaps’

August 20, 2014

“Variability is the law of life. As no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease. This is the fundamental difficulty in the education of the physician, and one which he may never grasp, or he takes it so tenderly that it hurts, instead of boldly accepting the axiom of Bishop Butler, more true of medicine than of any other profession: ‘Probability is the guide of life.’ Surrounded by people who demand certainty, and not philosopher enough to agree with Locke, that ‘probability supplies the defect of our knowledge and guides us when that fails, and is always conversant about things of which we have no knowledge,’ the practitioner too often gets into a habit of mind which resents the thought that opinion, not full knowledge, must be his stay and prop. There is no discredit, though there is at times much discomfort, in this everlasting perhaps with which we have to preface so much connected with the practice of our art. It is, as I said, inherent in the subject.”

(from ‘On the Educational Value of the Medical Society,’ Aequanimitas, with other addresses to medical students, nurses and practitioners of medicines [1932 (1905)])

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