What detective stories taught me about medicine — and life

Or, Sherlock Holmes…medical doctor?

I loved detective stories when I was growing up.

From the Famous Five, Secret Seven and Nancy Drew as a child, to Miss Marple, Hercule Poirot and Sherlock Holmes in my teens, I was fascinated by these brilliant boys and girls, men and women, enough that I fancied growing up to be a detective myself. (At least before I came to terms with the reality of the kind of country I was growing up in.)

And there were many things I loved about these stories, many of which had to do with the detectives themselves. Their resourcefulness ingenuity. Their keen attention to detail. Their quick minds and repositories of knowledge.

But my best part had to do with the actual stories: I loved how they always ended.

I don’t mean the part when you finally find out whodunnit. Nah, I found that part simply par for the course. I’m talking about the part after that, when the detective highlights the clues everyone else missed (it was always fun when you got those right yourself), explains the hidden motives behind the dastardly act, and ties up all the loose ends.

The moment of resolution.

A whodunnit, you see, is basically a story that starts with a question and ends with an answer. And by answer I don’t just mean the small answer of who did it, but the whole, larger, answer of exactly how they did it, and why.

Detective stories are all about the answer.

And me, I loved answers. Questions can be scary, after all: in the detective stories, the question of who did it is scariest because it could be anyone, and, you know, what if they did it again? Answers are comforting.

And so, in search of answers, I didn’t completely give up on my dreams of becoming a detective as I suggested earlier: I redirected it. Right from my clinical days in medical school, it did not escape my attention that medicine is in many ways, like detective work.

The only difference is, instead of crime, the doctor-detective goes after disease. But just like the detective, we…

  • listen to the account of the crime (symptoms)…
  • observe the “crime scene” (the patient’s body), looking for clues (or as we prefer to say in medicine, “signs”)…
  • ask questions of witnesses (via lab tests)…
  • make a list of possible suspects…
  • and finally, diagnose the culprit (who will then be sentenced to appropriate treatment).

And yet, right there in medical school, something happened.

You see, in the middle of learning to be a “medical detective,” I came to see something I never quite saw the entire time I was reading my childhood and teen stories. It was, like the greatest truths, the kind of thing that seems obvious when you finally realise it—but of course, if it was so obvious, you’d have seen it earlier.

Anyway, it slowly dawned on me that I’d been very wrong to believe that best doctors—and detectives—were great because of their knowledge of the right answers.

Their great skill was in asking the right questions.

Funny thing is, once the right question has been asked, pretty much anyone can answer it correctly. After all, being able to give the right answers requires nothing more than knowledge.

Asking great questions requires wisdom.


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