One night ... there came a ring to my bell, about the hour when a
man gives his first yawn and glances at the clock. I sat up in my
chair.... I groaned for I was newly back from a weary day.
_The Man with the Twisted Lip_
John H. Watson, M.D., was born in England in 1852. He was graduated
from the University of London Medical School in 1878 (_A Study in
Scarlet_), and took his internship at St. Bartholomew’s Hospital.
Since England was then engaged in a war on the Afghan frontier,
Dr. Watson became attached as a military surgeon to the Fifth
Northumberland Fusiliers. The English were badly defeated on July 27,
1880 by a large Afghan force at Maiwand. Dr. Watson received a painful
wound--a Jezail bullet hit him in the shoulder. Later he contracted
typhoid fever in a base hospital at Peshawar. He was eventually
discharged from the army and returned to London with a very modest
disability pension.
Not long after this, he met Sherlock Holmes through a mutual
acquaintance, and they obtained comfortable living quarters at 221B
Baker Street. While living with Holmes, Dr. Watson, as we know,
assisted him in many of his cases and served as his chronicler.
After a time, Dr. Watson married and set up as a general practitioner
in London. Doubtless, many of his experiences in his practice are
reflected in his writing. It is in order to consider some of the
references made to the general practice of medicine in the tales.
In one of Watson’s early stories, _A Scandal in Bohemia_ (written
about seventy years ago), we find Holmes saying to Dr. Watson:
As to your practice, if a gentleman walks into my rooms smelling
of iodoform, with a black mark of nitrate of silver upon his right
forefinger and a bulge on the side of his top-hat to show where he has
secreted his stethoscope, I must be dull indeed, if I do not pronounce
him to be an active member of the medical profession.
As Holmes stated, if an individual smelled of iodoform, had silver
nitrate stains on his fingers, and carried his stethoscope in his hat,
it would not be difficult to pronounce him a medical man. Iodoform,
which was once widely used, is employed but little today, and it would
be poor taste for a physician making professional calls to carry its
odor with him. Silver nitrate is still widely used, but most physicians
make an earnest effort to keep their hands looking neat and free of
stains.
Dr. Watson had an appropriate sense of the fitness of things,
and appreciated the fact that a physician should comport himself
with dignity both in manner and in dress. Dr. Watson writes: “The
rough-and-tumble work in Afghanistan, coming on the top of a natural
Bohemianism of disposition, has made me rather more lax than befits
a medical man” (_The Musgrave Ritual_). In speaking of dress,
Watson states: “His dress was quiet and sober--a black frock coat, dark
trousers, and a touch of color about his necktie” (_The Resident
Patient_).
It is hardly necessary to say that the modern physician no longer
carries his stethoscope in his hat. An interesting reference is found
in the story just mentioned concerning how the general practitioner
carried his instruments. One evening, Holmes and Watson returned from
a walk and found a brougham waiting at their door. Holmes remarked
that it belonged to a general practitioner. Watson writes: “I was
sufficiently conversant with Holmes’ methods to be able to follow his
reasoning, and to see the nature and state of the various medical
instruments in the wicker basket which hung in the lamplight inside the
brougham....”
A fact not generally known in this country is that a red lamp was once
the sign of the general practitioner. Reference is made to this in
_The Adventure of the Six Napoleons_. Watson writes that a bust of
Napoleon, owned by a Dr. Barnicott, was found broken near his red lamp.
A pleasing manner is surely a desirable trait in a physician. There
are doctors whose mere presence in the sickroom makes a patient feel
better. Dr. Watson is depicted as a person not only eager to help his
patients but also as a kind and sympathetic individual--attributes
that are most commendable in all physicians. Once when Dr. Watson was
speaking of a lady who was emotionally upset, he writes: “We soothed
and comforted her by such words as we could find.” Somewhat later, he
states: “I am an old campaigner.... If I can be of any assistance,
either to you or my friend here, I should be indeed happy” (_The Man
with the Twisted Lip_). In _The Adventure of the Sussex Vampire_,
Dr. Watson again states that he would be glad to be of any service.
Later, when he was asked to see a lady who had suffered a great nervous
shock, he explains how he stepped up to the bed on which she was lying
and spoke a few reassuring words to her, while he took her pulse and
temperature.
Dr. Watson, like many practitioners, presumably had patients whom he
felt he was not helping, and who were taking an inordinate amount of
his time and energy. It is likely that he persuaded them to seek the
aid of some other physician. Holmes probably sensed this, for on one
occasion Dr. Watson asked whether a certain individual was Holmes’
client. The detective remarked that he supposed so, since Scotland
Yard had sent this individual to him on the same principle that some
doctors refer their incurable patients to quacks, with the idea that
nothing can be done for them anyway, and that whatever happens they are
no worse off than they were formerly. Dr. Watson made no reply. One
does not like to think that an ethical practitioner would knowingly
send any patient to a quack. Holmes probably was in a facetious mood
when he made this remark, and was simply teasing Watson, who was not
known for his sense of humor.
Dr. Watson clearly recognized a doctor’s responsibility to his patient,
because in _The Sign of the Four_ he writes: “Remember that I speak
not only as one comrade to another but as a medical man to one for
whose constitution he is to some extent answerable.” In _The Dying
Detective_, Holmes twitted Watson by reminding him that he was after
all only a general practitioner with rather mediocre qualifications.
This hurt Dr. Watson, and his comment was that Holmes might be his
master elsewhere, but not in the sickroom. Here undeniably Watson was
his master.
Like other general practitioners, Dr. Watson undoubtedly had hard days,
but presumably he answered night calls. The following occurs in _The
Man with the Twisted Lip_:
One night ... there came a ring to my bell, about the hour when a man
gives his first yawn and glances at the clock. I sat up in my chair,
and my wife ... made a little face of disappointment.... I groaned,
for I was newly back from a weary day.
Obviously, Dr. Watson had never had a lucrative practice, for he
states: “Everyone was out of town, and I yearned for the glades of the
New Forest or the shingle of Southsea. A depleted bank account had
caused me to postpone my holiday....” (_The Resident Patient_). In a
similar vein, “I have nothing to do today. My practice is never very
absorbing” (_The Red-Haired League_). In _A Scandal in Bohemia_ occurs
a reference which further indicates that Dr. Watson was not a busy
practitioner: “At three o’clock precisely I was at Baker Street, but
Holmes had not yet returned.... I sat down beside the fire, however,
with the intention of awaiting him however long he might be.” This
shows that Dr. Watson was not loath to be absent from his practice in
the middle of the day for an indeterminate length of time. Apparently,
he thought nothing of this, but sat down calmly out of reach of his
patients to wait for his friend.
We must not infer, however, that his practice was always dull, for on
one occasion he explains that he had pressing professional business of
his own, and it was not possible for him to accompany Holmes (_The
Adventure of the Illustrious Client_). And again: “A professional
case of great gravity was engaging my attention at the time, and the
whole of next day I was busy at the bedside of the sufferer” (_The
Red-Haired League_). Also, once when Holmes suggested that he and
Watson go out of town, the latter writes that although it was easy for
Holmes to go almost any time, he (Watson) had to do a certain amount
of planning and hurrying because his practice was not inconsiderable.
Holmes was cognizant of the fact that Watson had definite obligations,
for once Holmes told a client that not only was he a busy man but
that Dr. Watson had his patients to consider (_The Adventure of the
Creeping Man_).
Apparently, at the time Watson wrote, it was common for physicians
to buy and sell their practice. Several references are made to this
custom. Watson describes how he had purchased his practice:
I had bought a connection.... Old Mr. ... from whom I purchased it,
had at one time an excellent practice, but his age, and an affliction
... had very much thinned it.... Until when I purchased it from him
it had sunk from twelve hundred to a little more than three hundred a
year.
_The Stock Broker’s Clerk_
It must be remembered that at that time the English pound was worth
almost five dollars; so the practice described by Dr. Watson had been
bringing in about $6,000 per year, but had sunk to $1,500. In those
days, of course, money went much further than it does now, and $6,000 a
year was a splendid income.
On another occasion, Watson relates that, at the request of Holmes, who
wanted Watson to come to live with him at Baker Street, he sold his
small Kensington practice at a rather good figure to a young doctor. A
few years later, he found that the purchaser was a distant relative of
Holmes, and it was the latter who actually had put up the money (_The
Adventure of the Norwood Builder_).
Dr. Watson takes sly digs at specialists. Once he remarks that a
certain individual was an excellent antagonist, and that he was as
cool as ice, silky voiced and soothing as a fashionable consultant
(_The Adventure of the Illustrious Client_). And another time, he
states that he read in his friend’s eye the arrogance which a learned
specialist might experience who had been called to see a case only to
find the patient had measles (_The Adventure of the Abbey Grange_).
As to the drugs used in Watson’s day, only about a dozen are mentioned.
Among them were ammonia, amyl nitrite, brandy, caffeine, ether,
chloroform, iodoform, carbolic acid, curare, and silver nitrate. A
survey made in England in the early part of this century showed that
physicians considered from twenty to twenty-five drugs necessary to
practice medicine satisfactorily. If a survey were made today, it is
likely that more would be listed, because during the past few years
potent antibiotic agents have been discovered and great strides
have been made in chemotherapy. Oliver Wendell Holmes, the famous
poet-physician, if living today, could not write as he did in the last
century: “If the whole materia medica (excepting opium and ether) as
now used could be sunk to the bottom of the sea it would be all the
better for mankind--and all the worse for the fishes.”
We may think of the faithful Dr. Watson answering a call, perhaps late
at night, his stethoscope concealed in his hat, and his trusty medical
bag filled with the acceptable drugs. We can picture him further,
riding along in his hansom--the lights of which shine dimly through
the fog--rattling over the cobblestones of the old London streets,
carrying on the tradition of his noble profession. And we pray that
this priceless tradition will continue as long as mankind suffers from
illnesses of the mind or body.