CONTINUED
Imagination in the Infirmary
by Robert S. Katz
Dr. Hardcastle, in the story under evaluation here, is presented as devoid of imagination. This is yet another of ACD’s overstatements as the protagonist is rather a clever fellow after all.
What, then, is the role of imagination in medicine and what does Conan Doyle know about it and tell us about it? We must never forget that Conan Doyle was taught by a great diagnostician, Dr. Joseph Bell. Many sources attest to the near-wizardry of Bell’s powers of observation and reasoning. Diagnosis in medicine is not a science. It is an art, based on study and experience. But it is also a gift. The great diagnostician has a unique ability to connect dots (clues, observations, measurements, laboratory data). Sometimes it is rather easy to get from A to B and be done. But sometimes, the ability to connect seemingly non-connected dots requires that gift of diagnostic ability. That gift entails imagination — the ability to discern relationships between data points that others miss. The daring that’s needed, as the vernacular goes, to think out of the box and not just plod along standard lines of thought. Joseph Bell had that gift and Conan Doyle never forgot it.
We know he never forgot about imagination as he imparted it to his two greatest creations. Sherlock Holmes was a great detective because he was a diagnostician at heart. He observed, he read and studied, he acquired vast knowledge. But then his gift of imagination kicked in and he solved a crime. Aren’t so many of his deductions just imaginative diagnoses?
And what of Watson? Conan Doyle gives us the impression that he’s a rather bluff and perhaps stolid fellow. Holmes tells us that he is not brilliant and, at best, a conductor of light. Nevertheless, John Watson has a gift of his own. He can write. He writes the Canon. He recounts his remarkable adventures with Sherlock Holmes. In telling those tales, he provides the most vivid of descriptions and the most memorable of lines. That requires imagination, the ability to create indelible mental pictures out of mere words. After all, Watson brings a physician’s perspective and education to his writing. Holmes may have the greater gift of deduction and diagnosis. Watson has the gift of making those events exciting and immortal.
Beyond Holmes, Conan Doyle wrote science fiction, imaging situations and worlds beyond our imagination but within his gift of storytelling. His tales of terror certainly required him to see beyond the mundane and exercise an imaginative ability of considerable degree.
Some physicians are just average. But a few have that rare skill — the ability to identify connections that seem unconnected, to recall facts and information that seem irrelevant but are nonetheless crucial. Bell had it. Holmes had it. Watson had it. And Conan Doyle had it. It might have manifested itself in different ways in different situations and in different forms. But all of it was imagination. None of us would care about Hardcastle or Holmes if that spark had not permeated Conan Doyle’s legacy to us.
WHO IS ROBERT?
Robert S. Katz, MD, BSI (“Dr. Ainstree”) is a retired Pathologist. He is an alumnus of Haverford College and The Albert Einstein College of Medicine, and is currently the President of the Board of Health of Morris Township, NJ, where he resides. He serves as the Cartwright of The Baker Street Irregulars and is also Co-Publisher of BSI Press, with his writings having appeared in various publications. He’s been a Sherlockian for longer than his memory yet serves.