- Indian Rheumatology association
As rheumatologists, we are well aware of the importance of reaching the correct diagnosis, timely! The plenitude of diseases, with their never-ending symptomatology and myriad of clinical presentations, makes the subject nothing less than enigmatic. Naturally, from the very first day of practice, our endeavour is to imbibe excellent and marvellous intuitive powers, which in turn can enable us to do the appropriate permutations & combinations, mentally, within minutes of presentation of a particular set of symptoms in a patient, and help us reach, not just a set of provisional diagnoses, but definitive diagnosis too. In short, majority of us, if not all, aspire to become “The Sherlock Holmes of Rheumatology.”
So, Sherlock Holmes, the fictional detective, admired and loved by many, was created by Sir Arthur Conan Doyle in 1887. I was rather intrigued to know that his source of inspiration was not some sharp-witted sleuthhound with strong analytical and critical thinking abilities, but a Scottish surgeon and lecturer, Dr Joseph Bell. Doyle met him in 1877 and served as his clerk at the Edinburgh Royal hospital. He was highly impressed by Dr Bell’s keen powers of observation and deduction. He observed him over a period of months and noticed that Dr Bell had an uncanny knack of diagnosing patients. And how had he mastered this skill? Nothing fancy, he just stuck to the basics- PRACTICE! Dr Bell would often pick a stranger, and by observing him and his outlook, would correctly surmise his occupation and recent activities. He also engaged his students by encouraging them to use their powers of close observation and logical reasoning, repeatedly, so that, with practice, the same power could become an extension of their personality.
Another fictional character, famous in the physician fraternity, and analogous to the character of Sherlock Holmes and hence, to Dr Bell, is our very own House MD. In fact, in an episode of the show’s eighth and final season, House briefly comes to believe that Dr Joseph Bell is his great grandfather, and his biological father is a man named Thomas Bell.
Very evidently, on a lighter note, it is clear from our continent, and genes that we do not (even distantly!) belong to the genetic lineage of Dr Joseph Bell but we definitely have the potential to become a part of his “Aptitude” lineage. So, let us channelise and bring into practice our intuitive powers through amalgamation of knowledge and clinical skills and strive to become “Our” best versions of Dr Bell, a.k.a. Sherlock Holmes in the field of Medicine. Because to be honest, Chat GPT can fail us in making diagnoses of complicated cases, but a strong intuition born out of brimming knowledge and bedside skills will not.
