DOCTOR WATSON, GENERAL PRACTITIONER
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.