Viruses, William Osler and antisemitism

Today the world is a hostage to the COVID-19 pandemic, which has claimed the lives of some 900,000 individuals. All of us are hoping, and waiting, for news of the development of a successful treatment or vaccine, a stark reminder of the extent to which our lives are dependent on advances in medicine. In fact, modern medicine is relatively new. William Osler, referred to as the father of modern medicine, died in 1919 at the age of 70 – just over 100 years ago. Osler, a Canadian, completed a degree in medicine at McGill University in Montreal in 1872. After postgraduate studies in Germany with Rudolf Virchow, a pioneer pathologist, he returned to Montreal to assume a position on the medical faculty at McGill. From 1884 to 1889, Osler was chair of clinical medicine at the University of Pennsylvania, after which he moved to Baltimore, where he was instrumental in the establishment of the school of medicine at The Johns Hopkins University. From 1905 until his death, he was the Regius Professor of Medicine at Oxford University. Osler was, and still is, revered by the medical profession for his contributions to medical education, particularly for introducing the concept of residencies in medical specialties and for his insistence on bedside clinical education to complement didactic instruction. One quote attributed to him is”Listen to your patient, he is telling you the diagnosis”. What is less widely known is that Osler was a philosemite who appreciated the contributions by Jews to medicine, understood the barriers and hurdles Jews faced in every-day life and was aware of the perils they faced as a result of the antisemitism that permeated German society. Osler was born and raised in small towns in what is now Ontario. It is unlikely that he had much if any contact with Jews. In fact, the first Canadian census in 1871 indicated there were only 1,115 Jews in all of Canada. Nevertheless, antisemitism was a common feature of 19th century Ontario society, as described by Speisman in Antisemitism in Canada, 1992,(Davies, ed.), and as portrayed in Sisters in the Wilderness (Gray, 1999),a book about the pioneering lives of Susanna Moodie and Catherine Parr Traill, two popular 19th-century Canadian writers. Osler's views on Jews and antisemitism are known because of two published medical journal articles that he wrote. One of the two was published at an early stage in his career and the other at a later point. The later article, “Israel and Medicine” was published in 1914 in the Journal of the Canadian Medical Association. Beginning with the Hebrew bible and its focus on the importance of hygiene, Osler points to the important role of Jewish physicians of the Middle Ages in preserving and transmitting ancient knowledge, to both the medieval Christian and Islamic worlds; in particular, highlighting the medical contributions of Maimonides. He continues by noting that in spite of persecutions and restrictions, Jewish doctors were held in high regard by European courts, as illustrated by a letter in his own library from Pope Gregory XIII (1581) stating” but that there are still many among Christian persons who desiring the infirmities of their bodies to be cured by illicit means, and especially by the service of Jews and other infidels.” Osler goes on to describe how the removal of many restrictions on Jews in the 19th century resulted in an explosion of Jewish contributions to medical science by such figures as Friedrich Henle, as well as by a number of his contemporaries, such as the American pediatrics pioneer Abraham Jacobi. He concludes by stating “In the medical profession the Jews had a long and honorable record, and among no people is all that is best in our science and art more warmly appreciated.” While this article is impressive as a record of Osler's appreciation for Jewish accomplishments in the face of adversity, it doesn't compare to the empathy and concern for Jewish well-being that he expresses in the earlier publication. In 1884, Osler, 35 years old, spent a sabbatical in Berlin. His impressions were published in the Canada Medical Journal as an eight-page article titled “Letters from Berlin.” The first seven pages are devoted to descriptions of Osler's visits with important Berlin medical figures, such as Virchow and von Frerichs, including descriptions of their lectures, interests and research facilities. Beginning with the words, “The modern 'hep hep hep...' has by no means died out,” the final page is devoted to the antisemitism that was prevalent in Germany. Osler notes “to judge from the tone of several of the papers devoted to the Jewish question there are not wanting some who would gladly revert to the plan adopted on the Nile some thousands of years ago.” As to the Jews in the German Medical Faculties “I know their positions have been won by hard and honorable work; but I fear that… the present agitation will help to make the attainment of university professorships additionally difficult.” Perhaps, as has been suggested, Osler sensed the catastrophe that was to come. He writes “Should another Moses arise and preach a Semitic exodus from Germany... they would leave the land impoverished far more than was ancient Egypt by the loss of... material wealth – enough to buy Palestine over and over again from the Turk.” Where did this sensitivity, understanding and tolerance come from? While there are likely several factors, Osler must have been influenced by George Eliot (pen name for Mary Ann Evans), the celebrated Victorian writer whose last novel, Daniel Deronda, is, in part, an appeal for a Jewish national rebirth in the ancestral Jewish homeland. Further, in 1878, two years after the publication of the novel, Eliot published a series of essays, one of which also deals with a Jewish return to national status in Palestine. The title of the essay is “The Modern Hep, Hep, Hep”, the cry used by anti-Jewish rioters in Bavaria in 1819. Osler must have read it. Growing up in Montreal during the 1950s and 60s, the son of Jewish immigrants from Eastern Europe, I was aware not only of McGill University's lofty academic reputation, but also, ironically for an institution that Osler helped build, its antisemitic reputation. Pierre Anctil in Antisemitism in Canada and Allan Levine in Seeking a Fabled City (2018) note the correlation between an increase in Jewish enrollment at McGill (due to an increase in the number of Jewish immigrants to Canada during the early part of the 20th century) and the imposition of discriminatory admission standards. Whereas in 1913 only 6.8 % of the students were Jewish, by 1924 that number had increased to 25 % of the first year undergraduate class, and 25% of the medical class. The approach used to reduce these numbers was to tacitly impose higher admission standards for Jewish applicants. While rarely made explicit, Anctil quotes from a 1928 letter from Ira Mackay, the Dean of Arts, to the assistant registrar stating “kindly admit all Hebrews with an aggregate over 700 (in matriculation marks) and all non-Hebrews with an aggregate of over 630.” The policy worked. By 1935 Jewish enrollment at McGill had fallen by half. In the case of the faculty of medicine, a quota of 10% was established, although Levine notes that in 1938 only 5% (eight Jewish students of 160) were admitted. When asked about such low numbers the answer given, an example of self fulfilling prophecy, was that Jewish graduates have a difficult time finding hospital internship placements. Restrictions on Jewish admissions extended beyond the end of World War II and possibly into the 1960s. My father's family experienced the medical school quota when twin cousins, both academic superstars, applied in the late 1940s and only one was admitted; the other went to medical school in the United States. McGill was not alone. Anctil notes that other universities in Canada and the US practiced similar policies. They were designed to protect Anglo-Saxon economic interests, but they were rooted in antisemitism. Levine quotes a Dean of Arts at McGill writing in 1926 “The simple obvious truth is that the Jewish people are of no use to us in this country.” A number of writers, Bret Stephens and Rabbi Jonathan Sacks among them, have pointed out that antisemitism is a virus that mutates; anti-Zionism being the latest form of the virus. Will there ever be a vaccine against antisemitism? The writer is a distinguished professor emeritus at the University of Waterloo

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