Religio Medici

This will be my final editorial before I hand over the reins of the journal to the capable David Armstrong. Regular readers of these editorials will have noticed a tendency to approach the world of medicine from a particular philosophical, even theological angle and I wish to conclude in a similar vein.

Without doubt Sir William Osler was one of the giants of 20^th century medicine. With a formidable reputation as clinician, researcher and educator, Osler was professor of medicine, first at McGill University, then the University of Pennsylvania, before being invited to the chair of medicine at the newly established Johns Hopkins School of Medicine, and subsequently holding the title of Regius Professor of Medicine at Oxford.¹ In addition to his medical genius, Osler was an avid reader and collector of books. One book which had a profound influence on him was Sir Thomas Browne’s Religio Medici.² It was said that Osler always kept a copy near him, and would put it in his bag when travelling. It was by his side during his final illness, and, when his funeral was held, a copy was laid on his coffin.³ A more recent admirer of this book is the American physician and author Abraham Verghese. Verghese is Professor for the Theory and Practice of Medicine at Stanford University Medical School. In his forward to When Breath becomes Air, Paul Kalanithi’s moving account of his battle with terminal cancer, Verghese reflects on his passion for Browne’s work and notes how Kalanithi’s writing reminds him of Browne.⁴

Who was Thomas Browne and what was so significant about this book? Browne was a 17^th century English physician who, after studying medicine in Padua, Montpellier, and Leiden, practised in Norwich. Browne is noted to have been a compassionate and conscientious physician continuing to provide care throughout the Great Plague of 1655-56, when many others abandoned their patients. Browne was a natural philosopher and prolific writer – often coining new words and expressions. We can thank Browne for words such as “ambidextrous”, “coma”, “ferocious”, “exhaustion”, literary”, “medical”, and “therapeutic”.⁵

Browne states that he initially wrote his book for his own “private exercise and satisfaction”. However, a copy of the manuscript he had given to a friend was itself copied and recopied, consequently the work entered general circulation. In light of the popularity of this “bootleg” edition, Browne subsequently revised his work, and a corrected, authorised version was published in 1643. It was a hit: The book became an international best seller and was reprinted in 1645, 1648, 1656, and 1649.⁶ The impact of the book in literary circles has continued, influencing writers such as Edgar Allen Poe, Herman Melville, Jorge Luis Borges and Virginia Woolf.⁷

But what is it about? Religio Medici is simply Latin for “the religion of a doctor” and Browne’s religious profession is that of a Christian. He goes on to make clear that this is not because of his baptism as child, his upbringing, or the culture of his country. Instead, he states “having in my riper years and confirmed judgement, seene and examined all, I find myself obliged by the principles of grace and the law of mine own reason, to embrace no other name but this.” Browne’s faith is carefully thought through. Writing in the period of the English Reformation as a member of the Church of England, Browne does not follow trends blindly, but is an independent thinker:

“I observe according to the rules of my private reason… neither believing this because Luther affirmed it, nor disapproving that because Calvin hath disavouched it. I condemne not all things in the Council of Trentⁱ, nor approve all in the Synod of Dort ⁱⁱ.”

In matters of faith, he seeks the guidance from the Bible and the church.

“In brief, where Scripture is silent, the Church is my text; where it speaks, ‘tis but my Comment.”

Browne discusses several matters of religion - the doctrine of the Trinity, the Fall of man, the Incarnation and Resurrection of Jesus Christ. Whilst happy to voice his opinion and to call out error where he sees it, Browne advocates tolerance and charity to those with whom he disagrees.

Browne was also a man of science. In 2017 his collection of specimens of interest formed the basis of an exhibition at the Royal College of Physicians in London. He was an early adopter of William Harvey’s anatomical account of the motion of the heart and blood. As a natural philosopher, he saw no conflict between his scientific and religious beliefs, rather they were parts of a complete worldview.

Another theme Browne deals with is the character of the doctor. Compassion is key: “For by compassion we make others’ misery our own and so, by relieving them we relieve ourselves also.” He did not practise simply for profit. “I desire to cure his infirmities than my own necessities. Where I do him no good, methinks it is scarce honest gain.”

Religio Medici takes careful reading. Browne’s writings demonstrate that he was extremely well read. He cites Plato and Aristotle, Tacitus, and Cicero. He is familiar with works of history and literature. He sprinkles his writing with quotes in Latin and Greek. (The glossary and endnotes in my copy are indispensable!)

For all their enthusiasm for Browne’s book, I am not sure that either Osler or Verghese have really “got it”. Verghese admits that as a young physician, “obsessed with that book”, he struggled to understand it but found “it remained opaque”. Raised in Ethiopia, Varghese’s parents were Syriac Christians originally from the Indian state of Kerala.⁸ Verghese acknowledges their deep devotional life.⁹ However, he does not appear to share their faith. In one essay he describes a spectacular sunset in El Paso as the closest thing he has had to a religious experience. ¹⁰

So too, with Osler, whilst he was deeply impacted by the book, he did not share Browne’s religious outlook. Although he was the son of a clergyman, Osler remained sceptical of religion. As his biographer Michael Bliss writes “As a young man Osler was caught up in the nineteenth century’s crisis of faith in traditional religion as a path to salvation.” He was “A minister’s son who rejected the supernatural for the natural world.... For his Christian parents, life went on forever. Once Osler had abandoned faith in immortality, he knew the terrible brevity of the period fixed by the capacities of the human body.”¹¹ I think that makes all the difference.

For my part, like Browne, I am happy to make the profession of being a Christian. I hope that my editorials have provoked some thought in my readers. The apostle Paul when on trial was asked “Do you think that in such a short time you can persuade me to be a Christian?” I can only echo his reply “Short time or long—I pray to God that not only you but all who are listening to me today may become what I am.”¹²