When preparing to write on Medical Investigation, following our previous essays on Medical Misinformation and Information, the great detective Sherlock Holmes and his creator Arthur Conan Doyle came to mind. So, we did some review of The Medical Casebook of Arthur Conan Doyle. Then, we decided that it might be useful and even enjoyable for followers to look at the life of one of the world’s most read authors – and later consider that renowned sleuth, Sherlock Holmes, and obvious medical skills.

Sir Arthur Conan Doyle (1859-1930) was a British subject of varied career and huge talent, wide experience and keen insights on medicine and illness, life and the world at large. Doyle entered adult life as a medical student at the University of Edinburgh. He completed his studies in 1881 when he was barely 22 years of age. Becoming a doctor at such early age was quite common in his era.

Doyle remembered his training as being “one long weary grind of botany, chemistry, anatomy, physiology, and a whole list of compulsory subjects, many of which have a very indirect bearing upon the art of curing. The whole system of teaching, as I look back upon it, seems far too oblique and not nearly practical enough for the purpose in view.” 

Like this writer, he thought his instructors did “… expend undue attention upon rare diseases, and take the common ones for granted.” We wonder what Dr. Doyle might think of the current medical teaching system. Has it really changed all that much in 140 years?

In later years, Doyle wrote mostly about his first six months in practice, and much less on the rest of his ten years in active medical work. Although he had a brief career in medicine, Doyle considered his medical training to be a most valuable possession. “A great place to begin observing humans, their ills as well as their potentials,” one might say.

Interestingly, Doyle seemed to think “the work too hard,” on the one hand. On the other, he fought tedium for long periods waiting for patients to appear at his office.

Fortunately his interests widened, as they continued to do for most of his life. While waiting for patients, he remarked that his mind turned to writing, oculism (ophthalmology), and occultism – as well as the sport of cricket.

Turning from his insuccess in general medicine, Doyle thought for a time that, “There’s a fortune in the eye,” and turned to Europe to study that new medical specialty. But Dr. Doyle’s affair with the eye was short lived.

Writing gradually engulfed his life as Conan Doyle became involved in writing the Sherlock Holmes tales. But, he was even more taken with writings on history and related novels, poetry, drama, and psychism.

Amidst his varied careers, Arthur Conan Doyle was known to patients and public for his compassion and humor. He was well respected and knowledgeable in wide ranges of medicine of the day. Despite his brief tour in medical practice, Doyle was said to possess “a genuine sense of vocation.”

When the Boer War erupted, in 1899 Doyle took off for duty in South Africa. He was there noted to be “a cheery doctor who carried the sunshine with him wherever he went.” Stories were told of his attachment, interest and keen care of the sick, injured, and dying soldiers.
 
All the same considering the broad scope of illness and healing, Doyle concluded that much of so-called medical progress was quite illusory. While Abraham Flexner was preparing his Report in America in 1910 which led to hospital and laboratory based medicine, Conan Doyle held views which clashed with the rising tide. Doyle was concerned with the state of “undue materialism and intellectual priggishness (arrogance)” which beset medical circles.  

He believed that medical science to a large degree was “a huge and ludicrous experiment.” At the same time, he perceived medical practice was turning more and more toward technical knowledge and terminology over rapport and bedside manner. Doyle complained about the overemphasis on disease over patients. He was a great champion of the value of sympathy and personality in dealing with humans and their ills.

We can confidently say that he addressed the keys to sound Medical Information listed in our previous essay:

• Spirit – Doyle recognized the presence of spirit and spirits in our midst. They were and are fundamental to health and the healing process. In his latter years, Conan Doyle dedicated himself to the study of Spiritualism and wrote a number of books on the subject.

• Consciousness – Doctor Doyle was quite aware of the powers of soul/mind in patients and in physicians. He wrote on the Great Keinplatz Experiment which proved to him that “soul or mind can be mesmerized to separate from the body.”

• Essence – On a wider scale Doyle was confident that the universe was based on order, thus it must be directed by mind. Order may be considered as one of the universal essences or archetypes.

• Substance – Doyle recognized vitality (called prana in the East) as fundamental to health and recovery from illness and injury. As noted above, he was familiar to a degree with mesmeric influences when he noted that Dr. Winter had “the healing touch – that magnetic thing which defies explanation or analysis … His mere presence leaves the patient with more hopefulness and vitality.”

• Story – Arthur Conan Doyle was storyteller par excellence. He could write stories because he understood the importance of story in human existence and human illness. This part of Doyle was key to his creation of Sherlock Holmes whose own story will be highlighted further on.

• Nature – Doctor Doyle was keen to recognize the “wisdom which runs through nature.”  One of his favorite poems was that of another Holmes – the American physician Oliver Wendell Holmes. An excerpt from his The Morning Visit follows.

• Wholeness – Conan Doyle was himself a true holistic doctor, long before the word came into popular parlance. He knew that the inmost essence of the man does not lie in his physical body – not “in the bony framework which is the rack over which nature hangs her veil of flesh – but there lurks that impalpable seed, to which the rest of our frame is but the pod.”

He recognized a human being much like a book – the body being its cover, the essence or life substance and spirit existing in its pages.

Doyle was ahead of his times in many ways. But as far as most people are concerned, Arthur Conan Doyle’s greatest contribution to society was his creation of the investigative genius he named Sherlock Holmes. The fictional Holmes was a huge success, even while in a few years Doyle got bored with his detective and tried to “do him in.” The public wouldn’t allow that, and Sherlock had to be resurrected several years after his supposed death.

From a present perspective, we have to believe that Holmes’s popularity was due to personal magnetism of his true ego: his creator, Doctor Doyle. Doyle imbued life, intelligence, and wisdom into Sherlock Holmes to the degree that was developing within himself. And the public was enthralled with the “consulting detective” to the tune of 56 short stories and four novels.

Holmes in print was a paragon of Medical Investigation drawn into the larger world of criminal and civil life. It was no accident that Sherlock’s silent partner was Dr. Watson. Between the two of them, they mirrored Doyle’s wide expertise. While his gifts had gone relatively unnoticed by his medical clientele, they were writ boldly in the form of Mr. Holmes for a vast, long and addictive reading public – some of whom believed the fictional hero to a real individual.

Doyle eventually told that Holmes was partially modeled on his medical school teacher Joseph Bell. In 1892, Doyle wrote to Bell saying, “It is most certainly to you that I owe Sherlock Holmes.... Around the centre of deduction and inference and observation which I have heard you inculcate, I have tried to build up a man.”

Bell may have been the model, but Doyle was the detective’s creator, sustainer and vital energizer. Investigator Holmes displayed all manner of medical skills to meet demands of stories and readers. He was and is still known for his proficiency with observation, deduction, forensic science and logical reasoning that borders on the fantastic.

He aimed to create “an exact science” in his detective work, becoming cold and even unemotional at times. All the same, Holmes was said to practice what is now called mindfulness, concentrating on one thing at a time. He generally refrained from “multitasking.”

Like the greatest physicians, Holmes was a master at observation – keen to pick up every possible visible and tangible clue. Holmes was called a “spectacular diagnostician” noted for drawing broad conclusions from minute observations.

Even more inexplicable to readers and followers, Sherlock Holmes was somehow able to reach “certain” inferences in many of his cases.

Like Bell, Doyle and Holmes, all of us have at least in potential similar capabilities to diagnose clearly, come to certain inferences, and to ultimately know ourselves. Along the way, we can surely become outstanding Medical Investigators in likes of Conan Doyle and Sherlock Holmes.

So, our next and final essay will focus on You and Me as Medical Investigators.