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The strange case of Dr William Gowers and Mr Sherlock Holmes

Andrew J. Lees
DOI: http://dx.doi.org/10.1093/brain/awv144 2103-2108 First published online: 3 June 2015

Not long after I had embarked on my neurological career at University College Hospital, William Gooddy’s advice to me at the end of a teaching round on Ward 5.2 came straight from William Osler. To study the phenomena of neurological disease without books was to sail an uncharted sea, but to study books without patients was not to go to sea at all. Only his book recommendations were unusual. He advised me to read The Complete Works of Sherlock Holmes, described later by its author Arthur Conan Doyle as ‘the fairy kingdom of romance’, and Marcel Proust’s À la Recherche du Temps Perdu. Much later I realized it had been his clever way of introducing a young man beginning the long apprenticeship of neurology to William Gowers, his predecessor (Frances Walshe separated the two of them) at University College Hospital.

The Baker Street sleuth’s method of crime detection soon proved of far greater value than anything I had read in Brain’s Diseases of the Nervous System. Each time I took the clinical history from a patient I remembered Holmes’s words to John Openshaw in The Five Orange Pips, ‘Pray give us the essential facts from the commencement and I can afterwards question you as to those details which seem to me to be most important’. I came to see detective work as a metaphor for diagnostic acumen.

In a 10-minute 1927 cinematographic recording Arthur Conan Doyle explains, ‘I thought I would try my hand at writing a story where the hero would treat crime as Dr Bell treated disease’. Joseph Bell, a surgeon at the Edinburgh Royal Infirmary, was able to divine the origins, occupation and past history of his patients from their attire, appearance and demeanour. This left a great impression on the young medical student.

In …

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