Medical writings: stories from another time
Author: James A Best
Published online: 1 December 2008

Certainly not in the 1890s, or at least, not with any sense of realism. Better known for his Sherlock Holmes series, Conan Doyle shocked Victorian England with his collection of short stories about medical matters, with its graphic descriptions of diseases and medical disasters, and a somewhat jaundiced view of his own medical profession. This was a view that did not sit well with the romanticised image of doctors at the time.
From a modern physician’s perspective, this collection offers some intriguing insights: a wide range of physician and surgeon capabilities and personalities remain unchanged. Further, our view of our colleagues of 110 years ago may well be close to Conan Doyle’s. I found fascinating their knowledge, or lack thereof, of aetiology, diagnosis and management of diseases. Medicine practised day to day was notable, such as the preponderance of home visit-based practice, surgery as a spectator sport, and the lack of regulation or accountability (yes, quackery was even more widespread then than it is now!).
The stories themselves vary quite a deal in subject, length and quality. The better of them draw complex characters (both doctors and patients), discuss difficult social and medical issues, and do not pull punches. Others are overly sentimental and simplistic, venturing back to the more traditional territory of medical fiction of that century.
This patchiness would draw me to conclude this collection is more fascinating as a piece of medical history than as a work of great fiction. Yet there are some very entertaining stories that will resonate long after they are read, and may well cause a medical reader to reflect on what is the true role of the doctor. Who knows, I might start doing more home visits!
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