It Takes a Medical Sherlock Holmes to Solve Complex Neurological Mysteries

Article excerpt

Is Sherlock Holmes the neurologist's alter ego?

Yes, according to the co-authors of a delightfully quirky paper published Wednesday in the journal Practical Neurology.

"Successful outcomes in neurological practice often turn on an ability to identify clues," write Dr. Peter Kempster, a neurologist at Monash University in Victoria, Australia, and Andrew Lees, a professor of neurology at University College London. "The skills of observation, inquiry and abductive reasoning that compose a good clinical technique have much in common with the methods used in the detection of crime."

The clinical case histories that neurologists have been publishing in medical journals since the 19th century often read like mystery stories, say the two neurologists.

"Like conventional detective stories, [the case histories] are reassuring, affirming the belief that even obscure neurological maladies can be diagnosed," they write.

Indeed, as the two neurologists point out, the British-American neurologist Oliver Sacks has masterfully turned such case histories into best-selling books.

"In many of [his neurological case histories]," say Kempster and Lees, "Sacks gives himself the role of detective -- observing, gently questioning and sometimes searching out clues in the streets or in the homes of his patients."

Sacks even gives his case histories Sherlock Holmesian titles, such as "The Man Who Mistook His Wife for a Hat," "The Disembodied Lady" and "The Man Who Forgot How to Read."

Neurology's Agatha Christies

Several neurologists have actually turned to writing detective stories, Kempster and Lees point out. One of these was Dr. Harold Klawans (1937-1998), a noted authority on Parkinson's disease, who wrote five crime novels, including "Sins of Commission," which has a neurologist as its detective.

"Klawans developed this idea from a case that he and younger colleagues (who appeared, variously disguised, in the story) had seen in consultation," write Kempster and Lees. "...The main character is clearly the author at the pinnacle of his clinical power, and he is given Sherlock Holmes' capacity to observe details, infer other people's thoughts and perform astonishing feats of abductive thinking from seemingly minor clues."

Another neurologist, Peter Gautier-Smith, has written 31 crime books under the pen name Peter Conway. According to Kempster and Lees, Gautier-Smith started his fiction-writing career after making a bet with a friend that writing a novel would be a lot easier than writing a medical monograph on parasagittal meningioma, which he was struggling to finish at the time. …