William Osler was offered the Chair of Clinical Medicine at the University of Pennsylvania while vacationing in Europe in the summer of 1884. The choice was a surprising one, as the University had a long history of hiring its own men - either graduates of their medical school, or Philadelphia natives, or both. But after ten years of the practice, study, and teaching of medicine, Osler's reputation had become such that he was a prime candidate.

Once he had arrived in Philadelphia, Osler continued many of the themes he had begun to develop in Montreal - he laid an emphasis on practical demonstrations in teaching, and stressed the importance of pathology in understanding the causes of death and disease. Osler had also begun to emphasize to his students the importance of treating the patient and not the disease.

Osler committed himself only to a consulting practice and not a general practice, like many of his colleagues, leaving himself more time for autopsies and dissections at the Blockley Hospital (which were occasionally attended by students from the Women's Medical College of Pennsylvania, a first for Osler). He was eventually appointed pathologist at Blockley. He counted many eminent Philadelphians among his patients, and several times was called to examine the poet Walt Whitman.

In addition to teaching, treating patients, and doing lab work, Osler was travelling in the United States, Canada, and England, to attend conferences and give lectures as well as to visit friends and family. It was during this period that he became known as a talented writer and speaker. It was also during this period that Osler met his future wife, Grace Revere Gross, whose first husband was Dr. Samuel W. Gross, of a distinguished family of Philadelphia medical men. Gross died in 1889.

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