Blog | Friday, April 3, 2020

Can Sherlock Holmes teach today's doctors?

“To Sherlock Holmes, she is always THE woman.” Thus begins Sir Arthur Conan Doyle's “A Scandal in Bohemia,” published in 1891. In this gripping tale, Holmes is bested by a woman who proves to be the detective's equal in intelligence and deception.

For reasons I cannot explain, I restrict my exposure to Holmes and Dr. Watson to podcast listening when I am airborne. Years ago, I did love watching the classic movies starring Basil Rathbone and Nigel Bruce who defined the roles for me.

Conan Doyle, a physician, was a superb story teller, who wove his tales with texture, plot and humanity. I think he wields words with surgical precision. I admire his skill.

I wonder to what extent Conan Doyle's medical training influenced his writing. Certainly, the stories often discuss arcane medical conditions that provide the detective with important clues. In “The Adventure of the Blanched Soldier,” Holmes suspects that the protagonist is suffering from leprosy, a diagnosis that is revised after Holmes arranges for a consulting dermatologist to examine the soldier.

Beyond these medical intricacies that the author includes, I suggest that Conan Doyle has a more direct connection to the world's most famous sleuth. Physicians operate as detectives. We gather facts and evidence in real time. We have suspicions which may be strengthened or refuted as additional data emerges. There may be competing theories that torture us. At times, we are forced to make judgments and recommendations when our knowledge base in incomplete. And some of our patients' dilemmas remain unsolved, similar to crime solvers' cold cases.

In “The Sign of the Four,” Holmes remarks to Watson, ”How often have I said to you that when you have eliminated the impossible, whatever remains, however improbable, must be the truth.” Holmes would have been a superb physician.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.