Arthur Conan Doyle’s “His First Operation”: The Short Story as Medical Casebook

As many know, the success of the Sherlock Holmes stories, published in the Strand, prompted Arthur Conan Doyle to abandon his medical career to become a full-time writer. His involvement in the medical sphere appears clearly in his literary work, not only in the character of Dr. Watson but also in Holmes’s deductive methods, which were famously inspired by Conan Doyle’s former professor of surgery, Dr. Joseph Bell.¹ In 1894, the author made medicine a focus of his writing with the publication of a short story collection, Round the Red Lamp: Being Facts and Fancies of Medical Life. Out of fifteen stories, nine were initially published in periodicals, such as Black and White Magazine, The Idler, and Blackwood’s Magazine, before they were gathered and re-edited in Round the Red Lamp.

In a letter to a friend, which was later used as the preface to the collection, Conan Doyle suggests that medicine and fiction could generate similar palliative effects: “A tale which may startle the reader out of his usual grooves of thought, and shocks him into seriousness, plays the part of the alterative and tonic in medicine, bitter to the taste but bracing in the result” (iv). In an interview given to The Idler magazine, also in 1894, Conan Doyle uses another medical metaphor to describe the practice of writing: “To get an idea to penetrate to the masses of the people you must put fiction round it, like sugar round a pill. No statesman and no ecclesiastic will have more influence on public opinion than the novelist of the future will have” (“Chat with Conan Doyle” 348). In these two metafictional statements, the writer’s ability to address contemporary issues through fiction is discussed in a way that situates the story as the vehicle of remedies to social concerns and the act of reading as a potential cure.

Maria Cairney has observed that “[w]ithin the confines of the Strand magazine . . . Conan Doyle’s role was one of diagnosis and assimilation,” thus granting the latter a dual position as writer and social healer (71). For Cairney, the clinical approach exposed in the Holmes stories carries “a curative function” that could efficiently relieve the Strand’s readership from “the multiplicity of moral and social ills that troubled the journal month by month” (67). Cairney goes on to observe that by integrating “increasingly medicalized terms and settings” (70) in the content it published, the Strand provided an illusion of order in a society perceived as increasingly diseased and chaotic (71).

In Round the Red Lamp, writing and medicine explicitly interact on a thematic level: medicine is explored from multiple angles, varying in their degree of realism, seriousness, and technical detail. In fact, Conan Doyle goes as far as to write about writing about medicine with “A Medical Document,” in which an outsider is taking note of a conversation between doctors who are discussing their careers. One of them eventually asks: “What possible interest can the public take in that?” (204). This mise en abyme resonates with Conan Doyle’s own project to combine medicine and writing, and encourages readers to engage with the connections between these practices.

On the level of form and structure, too, Conan Doyle’s stories often insist upon the similarities between the short story and medical practice. The shortness of his tales mirrors the brevity of a medical consultation. Each story is a glimpse into the life of a character: a patient or a doctor. Just as a medical appointment is limited in time and the topics that can be covered are similarly limited, a short story provides only a certain amount of information about its characters. Because we know very little about Conan Doyle’s characters, our curiosity is triggered. We, as readers, have to fill in the gaps to understand a character’s behaviour, just as a doctor has to establish a diagnosis without knowing everything about a patient’s life. Thus, Round the Red Lamp functions like a medical casebook, built upon gaps and composed from fragments of...