Medical Casebook of Doctor Arthur Conan Doyle (review)

164 BOOK REVIEWS It was as if, absent its familiar feeling and function, the leg had become an unrecognizable member of the body commonwealth. Sacks decided to explore this experience of alienation in all its detail, or rather to peer into the hole in his personal reality where once there had been a leg to stand on. Medically, his condition continued to improve. Anatomically, healing was occurring predictably. But spiritually —personally, existentially—the leg was lifeless and alien. This much he now knew: "It was not a problem but a mystery which I faced." Mendelssohn's Violin Concerto provided an early clue to fathoming the mystery. Music promised renewal and indeed seemed "the very score of life." Attempts at rehabilitation advanced falteringly and the mystery remained. Eventually, "with the return of my own personal melody which was somehow elicited by, and attuned to, the Mendelssohnian melody," Sacks remembered how to walk—not by calculation or deliberation but by recollection. The mystery, though not dispelled, was displaced by grace, "the prerequisite and essence of all doing." Now convalescence was possible—putting behind the moral infancy of patienthood, returning to fluency of motion, and celebrating the sacrament of thanksgiving. One of the two great merits of this book (the other being that it is an engaging story, well told and felicitously written) is that it richly reintioduces the patient and his experience of ailing into the drama of injury and recovery in a way that prompts a reconsideration of the diagnostic art. Confronted with an experience of severence, of absence, analysis is of limited use. Needed in addition to the dissecting, disconnecting activities of analysis are painstaking attentiveness to the detail and pattern of experience, appreciation for nuance in that experience , and constructive imagination, even in the face of the uncanny. A Leg to Stand On is a masterly crafted case study in such a phenomenological neurology. —Ronald A. Carson Institute for the Medical Humanities University of Texas Medical Branch Alvin E. Rodin, M.D., and Jack D. Key, Medical Casebook of Doctor Arthur Conan Doyle. Malabar, Florida: Robert E. Krieger Publishing Co., 1984. xxi + 473 pp. $28.50. Probably no fictional doctor is better known, at least by name, than John H. Watson, M.D., who shares and narrates most of the Book Reviews 165 adventures of Sherlock Holmes. The author of the Holmes stories, Dr. Sir Arthur Conan Doyle, is almost certainly less famous than Holmes and Watson. Furthermore, despite careers as an ophthalmologist, historian, novelist, poet, and spiritualist, Doyle is remembered today almost entirely as the man who created Sherlock Holmes. "The reputation of Conan Doyle," say the authors of this study, "has not merely languished—it has suffered greatly because of the success of his creation." Rodin and Key, both of whom are associated with medical schools in the Midwest, set out to rescue Doyle from Holmes's adulators. In this large, informative, but somewhat repetitious volume , they emphasize Doyle's contributions as a physician, a medical writer, and a novelist whose works exemplify many of the strengths and weaknesses of late-Victorian medicine in England. There are already several biographies of Doyle (the best is by Pierre Nordon), but Rodin and Key emphasize the medical aspects and background of his career in a way that has not been done before. They have done an immense amount of research. Doyle took his M.B. (the standard British medical degree) in 1881, at the age of twentytwo . As a graduate of the medically prestigious University of Edinburgh , he was well prepared for a successful career. But as Rodin and Key remind us, "A medical license in the last half of the 19th century was not a passport into guaranteed prestige and wealth. In fact, medicine was then considered a marginal profession because of its technical education and because many of its members came from the lower middle class." After various adventures on the fringes of the profession, Doyle set up practice in the seaside resort of Southsea in 1882. There he practiced general medicine with indifferent success for over eight years. In 1885 he wrote a thesis on Tabes Dorsalis and received the M.D. degree from Edinburgh. Although...