Doctoring the Novel: Medicine and Quackery from Shelley to Doyle

Chapter Five: The Quackery of Arthur Conan Doyle

122 Chapter Five The Quackery of Arthur Conan Doyle The science of medicine and surgery is continually advancing . The successive learners of one generation become the advanced teachers of the next. . . . The open book of nature is ever before us, and we gladly welcome all science, all knowledge, and all truth. —C. S. Hall, “Abstract of an Address,” 1885 A distressing feature in the life which you are about to enter, a feature which will press hardly upon the finer spirits among you and ruffle their equanimity, is the uncertainty which pertains not alone to our science and art, but to the very hopes and fears which make us men. In seeking absolute truth we aim at the unattainable, and must be content with finding broken portions. —William Osler, “Aequanimitas,” 1904 Indeed, this state of ignorance and uncertainty, of questions without final answers, remains quite characteristic of the practice of medicine despite an intensive publicrelations campaign to invest the physician with the cloak of certitude more correctly worn by the laboratory sciences. —Pasquale Accardo, Diagnosis and Detection, 1987 At first glance, William Osler’s advice to medical students in “Aequanimitas” seems very practical. Although medicine lauds truth as an ideal, practitioners make decisions every day based 123 R The Quackery of Arthur Conan Doyle on incomplete or ambiguous information, and Osler recognized that cultivating equanimity was one way of maintaining stability in emotionally distressing circumstances. At the same time, this advice opens up a vexed question about truth and illusion in medical practice. Pretending certainty in uncertain circumstances seems to bestow upon medicine a scientific certitude and to downplay medicine’s day-to-day compromises and guesswork. For example, C. S. Hall powerfully deployed the language of progress and discovery to claim prestige and power by aligning medicine with the laboratory sciences through words such as science, knowledge, truth, and advance, which connote precision and certitude . Pasquale Accardo identifies the financial and cultural benefits of wearing the “cloak of certitude.” For Accardo, the appearance of equanimity in the face of uncertainty gestures toward pretense, a “public relations campaign” that connotes at best salesmanship and at worst deception for personal gain. In this respect, Accardo reverses the connotations of Osler’s word, equanimity, by transforming it from a mark of professionalism into a mark of quackery, a confidence trick. The dates of the three epigraphs may at first glance imply increasing skepticism toward illusion in medical practice, as if Hall’s confidence gave way over time to Accardo’s skepticism; however, the question of illusion’s scope and nature in medical practice was explored thoroughly by Victorian physician and writer Arthur Conan Doyle. Critics have long connected Doyle’s best-known character, Sherlock Holmes, to Doyle’s own medical training and practice during the 1870s and 1880s; for example, Ely Liebow argues that Doyle modeled Holmes on Professor Joseph Bell, a medical doctor, and that this resemblance was obvious to mutual acquaintances.1 Susan Cannon Harris views Holmes in a medical context and argues that Holmes’s medicine allows him to save the day by transforming exotic poisons into beneficial medicines.2 For example, in “The Devil’s Foot,” Harris argues, “Holmes is invested with the authority of science, however, he is not a savage ‘medicine-man’ but a civilized jurist.”3 Harris acknowledges that this may not be the case in “The Blanched Soldier,” where Holmes uses medicine as “an illusion,” but she suggests that this story is an anomaly in the Holmes canon.4 Alternately, Paula J. Reiter places the Holmes stories in the context of contemporary physician-poisoner Dr. Thomas Neill Cream and argues that Holmes “encapsulated both a model of expertise and an implicit critique of men not fulfilling this model.”5 Reiter contrasts the incompetent , selfish, and irresponsible professionals of the Cream trial with 124 R Doctoring the Novel Holmes, saying, “Perhaps most crucially, Doyle characterized Holmes as a man worthy of trust.”6 Reiter concludes that Holmes defends the professional class because he is “above petty profit” and because of his “individual achievement,” which combines “expert, specialized knowledge ” with “chivalric service and pleasure.”7 In addition, Maria Cairney explores the “slippage” between criminal and patient, doctor and detective in the Holmes stories and finds Doyle “positing medical solutions to moral and social problems.”8 Cairney argues that Holmes allows the healing of society by purging the infected or criminal element. In these readings...