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Arthur Conan Doyle: The Power of Observation

Students in every medical school hear the same stories heard in every other medical school, but they usually believe that these stories happened to their own professors at their own school. Here is a story that I heard when I was in medical school in the 1950s.

DR HOFF’S STORY: Dr. Hebel Hoff was chairman of the Department of Physiology in my medical school. At his first lecture on our first day in medical school, he told us the story of HIS professor at Harvard who told his students that they should feel privileged to have laboratory tests available to help them make diagnoses that he did not have when he was a student. He said that in the old days, they did not have readily-available laboratory tests to tell them when a patient had diabetes. He took out a jar of yellow fluid, stuck his finger in it, and then put the finger in his mouth and made the most horrible face you ever saw. He looked as if it was the most foul-tasting fluid he had ever tasted in his life.

Then he turned to the class and stated that he would pass the jar with the yellow fluid around to the class and after each one tasted the liquid, he would ask them if this was urine from a diabetic or non-diabetic. The jar went from student to student, with each one sticking a finger in the yellow fluid, each one making horrible facial expressions, some vomiting, and some refusing to take the test.

After all the students had either tasted the urine or refused to do so, the jar came back to the professor who held the jar high over his head and said that it was important to listen to what a professor SAYS, but it is even more important to observe what a professor DOES. He told the class that he would repeat his demonstration. First he stuck his index finger into the jar and then he stuck his third finger into his mouth.

For more than forty years I have been telling anyone who would listen about Hebel Hoff, the professor at my medical school, who told us the story about the need for doctors to be observers.

MY AWAKENING: Forty years later, I picked up a copy of a book about one of my heroes, Sir Arthur Conan Doyle, the doctor who became a great writer of the stories about Sherlock Holmes. The biography is called “Teller of Tales: The Life of Arthur Conan Doyle” by Daniel Stashower.

Sir Arthur Conan Doyle attended medical school at Edinburgh University. He wrote about a physician named Dr. Watson who traveled with the great detective, Sherlock Holmes (“Elementary, my dear Watson”).

Arthur Conan Doyle patterned Dr. Watson after his own physiology professor at the University of Edinburgh, Dr Joseph Bell. Sir Arthur was impressed with Dr. Bell’s uncanny ability to prevent a patient from offering lots of worthless history points by forcing him or her to tell him only what was pertinent to making a diagnosis.

On page 19, the book reports that when Dr. Arthur Conan Doyle was a medical student, Dr. Bell gave the following lecture. Here it is word-for-word from Sir Arthur Conan Doyle. Notice how much better he writes than I do.

“Bell cleared his throat and began to speak. ‘This vial, gentlemen, contains a most potent drug,’ he said, holding the glass vial aloft. ‘It is extremely bitter to the taste. Now, I wish to see how many of you have developed the powers of observation that God granted you.’ He folded his arms and surveyed the room. ‘But sir, you will say, It can be analyzed chemically … Aye, aye, but I want you to taste it — by smell and taste. As I don’t ask anything of my students which I wouldn’t do alone with myself, I will taste it before passing it around.’ He brought his hand to his mouth and sucked his finger. Evidently the potion had a remarkably vile taste; Bell’s features contorted as though he had sampled poison. [The vial is passed, everyone tastes it and is repulsed.] When the vial had completed its rounds, Bell looked out over the rows of students and gave a sad shake of his head. ‘Gentlemen,’ he said, ‘I am deeply grieved to find that not one of you has developed his power of perception, the faculty of observation which I speak so much of, for if you had truly observed me, you would have seen that, while I placed my index finger in the awful brew, it was my middle finger — aye — which somehow found its way into my mouth.’”

Doyle served as a doctor in a military hospital in South Africa during the Boer War in 1900. He was knighted in 1902, to become Sir Arthur Conan Doyle, for writing a book defending Britain’s treatment of their enemies.

And so I found the origin of a story I heard in medical school more than 50 years ago, that I thought was unique to my professor and me.

December 16th, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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