Arthur Conan Doyle was a man of many parts. He went to the wars. He was a friend of AA Milne and Harry Houdini. He played for the MCC and reportedly took WC Fields’ wicket. He was a committed foe of miscarriage of justice — quite a common failing in his class-ridden society — and once sprang a convict of Indian descent from jail, by forcing his case to be reopened. He was a vocal supporter of spiritualism and was scandalously eager to be taken in by hoaxes about fairies and the paranormal. And, paradoxically, he created the Great Detective and Professor Challenger, men of method and science.
But Doyle’s first avatar, from whose experiences these two men were born, is largely forgotten. He was perhaps the most famous alumnus of one of the world’s oldest medical institutions, the University of Edinburgh Medical School. Alexander Fleming, who won a Nobel for discovering penicillin, and Edinburgh surgical head Joseph Lister, who started the practice of sterilising instruments, are perhaps the only other alumni whose fame spread beyond their profession. Though their innovations changed the fortunes of the human race, they are scarcely as famous as the creator of Sherlock Holmes.
Had Doyle’s medical practice prospered, Holmes may never have been born. Fortunately for the global reader, it languished, even though he tried to better his chances by specialising. Reasoning that almost all of humanity would have to don spectacles as they aged, he decided to learn ophthalmology in Vienna, in order to be able to prescribe glasses.
The move was a disaster. The German baffled him — die Krankenberichten (medical reports) made no sense, so to speak, and he fled back to England in three months. He did set up shop as an eye specialist, but he did not see a single patient.
Doyle began writing short fiction during lulls in his professional life, and a small part of his prolific output drew on his experience in medicine. These are among his least-known stories, and Jerry Pinto has done well to collect them in a handy volume, The Case of Lady Sannox: Medical Mysteries and Other Adventures (Speaking Tiger).
The milieu and atmospherics of medical research and practice, rather than the science of medicine, provide the plots and characters. If James Herriot had had human patients, this is what he may have written. Doyle’s early failures in setting up his first practice in Portsmouth are reflected in A False Start, in which a young doctor spends his lonely days sprucing up his clinic, prominently displaying the tools of the trade which belong in a little black bag, such as scissors, lancets, bistouries, forceps and stethoscope, along with a “large copy of Quain’s Dictionary of Medicine”. Then he fakes up his “ledger-book, day-book and visiting-book”, whose use must perplex modern practitioners. He rubs their covers together and smears them with ink, so that they no longer look new, and he puts in imaginary entries, so that his first patient will not know that he is first. And when he imagines that the first patient has appeared, it turns out to be the gas inspector.
Doyle came to medicine at a time when it had conquered challenges to surgery, like sterile theatres and pain management, but medicine had progressed little beyond the art of apothecaries and herbalists. Doctors knew what worked, but frequently did not know why. As practitioners of an inexact science, they often served as priests and mediums, as in this account of a country doctor: “Dying folk cling to his hand as if the presence of his bulk and vigour gives them more courage to face the change; and that kindly, wind-beaten face has been the last earthly impression which many a sufferer has carried into the unknown.”
This collection is not devoid of the science of medicine, but allusions can be quaint. For instance, a physiologist devotes his life to the study of Vallisneria, the aquatic grass frequently seen in aquariums. There are several allusions to the elements of clinical medicine which are still taught, such as “the difference between a mitral murmur and a bronchitic rales.” Indeed, Doyle was a serious researcher with an interest in toxicology — his first published research paper concerned poisoning by Gelsemium sempervirens, and appeared in the doughty British Medical Journal. Despite health concerns, Gelsemium is still used to control migraines and trigeminal neuralgia, which number among the most terrifying pains that a human may suffer.
There is also a windfall for Holmes fans. A housekeeper named Mrs Hudson appears in the very, very short story Behind the Times. She looks after a country doctor, but we can safely presume that she is preparing to move to a more exciting life at 221B Baker Street.