Dr. Joseph Bell
More Than Just a Model for Sherlock Holmes
In 1877 Arthur Conan Doyle, a young medical student, began a three year career at Edinburgh Royal Infirmary. Studying to become a doctor, he worked as an outpatient clerk for a man who would become the inspiration for his world-wide fame, and the creation of the Great Detective. That man was Dr. Joseph Bell, to whom Doyle wrote in 1892, It is most certainly to you that I owe Sherlock Holmes.
Doyle gained a close insight into the surgeon’s unique qualities. He was mesmerised by Dr. Bell’s powers of deduction and swift faultless diagnosis. He witnessed firsthand his analytical methods, humanity, teaching methods, and surgical prowess.
The Power of Deduction
Before carrying out an examination Dr. Bell could deduce whether a patient was a sailor or soldier by his gait, detect from his dialect precisely where he hailed from, and reveal his occupation from observing the position of calluses on his hands. In awe of his mentor, Doyle kept copious notes during ward rounds. These records were later to play an important part in the construction of the character Sherlock Holmes.
He taught the Method — a process of deduction based on careful observation of small details about a patient. On one occasion a patient gave a false name. He surprised him by addressing him by his correct name, having observed a laundry label inside the collar of his shirt. Another time he amazed his students by declaring to an elderly lady patient that she smoked a short-stemmed clay pipe. Confirming his diagnosis she produced the pipe from her bag. He pointed out that he observed a small ulcer on her lip and a tell tale reddened cheek on the same side of her face.
Dr. Bell studied dialects, putting that knowledge to use in the diagnosis of his patients. Astonishingly, he suggested that one patient was a bell ringer, lived near the Tweed, and rang the bells on Sunday. To Dr. Bell’s ear, the man’s accent placed him in Northumberland. The man had expressed a need to leave the Infirmary by Saturday latest, and the position of calluses on his hands, caused by the ropes, completed the picture.
To impress on his students the need for keen observation, the professor would employ his wry sense of humour. Dipping a finger into a container of foul tasting liquid, he would lick his finger, pull a face, and pass the offending substance round. Each student in turn would reluctantly follow his example, expecting to be examined on the contents. When everyone had completed the task he would then ask who had noticed that he had dipped his index finger into the liquid, but had put his middle finger into his mouth.
No Fictional Doctor
However, Dr. Joseph Bell, or Joe, as he chose to be known, deserves to be recognised for more than just the inspiration for the character of Sherlock Holmes. The similarity with the detective ends at his amazing powers of deduction. The physical features of the two men were described as similar, but unlike Holmes, who was brusque and opinionated, Joe had a much gentler nature.
As a surgeon he had a progressive attitude, and was a leading exponent of hospital hygiene and cleanliness. In Victorian theatres surgeons would carry out operations wearing the same clothing all day. Joe advocated a change of overalls after each surgical procedure, suggesting that gangrene was being created by the transmission of infection to patients. As early as 1887 he was suggesting using steam to sterilise instruments, and hands-free washing facilities for surgeons. When Joseph Lister introduced a carbonic spray into operating rooms, he was one of the first to employ its use.
He was a compassionate surgeon, particularly with children. During an outbreak of diphtheria at the Royal Hospital for Sick Children, he developed an instrument to assist a child’s ability to breathe, which necessitated close contact with his patient. Its use was to put him at considerably risk. As a result he contracted the disease which laid him up for four months. Consequently, it left him with a distinctive limp and an altered pitch to his voice.
While at the hospital those powers of observation revealed something remarkable. He noticed and recorded a few instances of children with diarrhea having an unusual hankering for mouldy cheese, an unknown source of penicillin at the time. But it was to be a few decades before Alexander Fleming’s research was to take it further, resulting in the introduction of the life-saving antibiotic.
Going to university in 1854 gave Joe his first sight of poverty in the city. Although coming from a background of successful doctors and surgeons, Joe showed compassion for the poor of Edinburgh. There are many accounts of him continuing treatment and making calls without charging. He also regularly gave free time to three Edinburgh hospitals. As a teacher he was popular with his students who were intrigued by his reputation, unique training methods, and encouraging support.
He led a varied and active life, would walk up to ten miles a day, play cricket, tennis, shoot, write poetry, and became the editor of the Edinburgh Medical Journal for 23 years. In later years he became a forensic expert for the Crown. Both he and Arthur Conan Doyle were called upon by Scotland Yard to study the Ripper murders and suggest a likely suspect. Not surprisingly perhaps, they both came to the same conclusion in their reports, which have never been revealed.
Joe married Edith Murray, the love of his life in 1865. Sadly they only enjoyed nine years together. Edith died in 1874 of puerperal peritonitis. Such was the shock that within weeks Joe’s black hair turned grey. Although devastated by his loss he returned to lecturing the week following her death.
Raising the Profile of Nursing
Joe recognised how little training nurses were given. Following the Crimean war Florence Nightingale had set up a training programme for nurses in London. Joe wrote to her, and she encouraged him to organise training for nurses in Edinburgh. At the time nursing had no professional standing. Joe fought for women to be admitted to medical school. He gave lectures to nurses, demonstrated medical and surgical procedures, and went on to produce nursing manuals, which he was still producing following his retirement in 1896. Correspondence continued between him and Florence Nightingale during which she praised him for his contributions to nursing.
Dr. Joseph Bell died on 4th. October 1911. During his lifetime he brushed away any credit accorded to him for his part in the creation of Sherlock Holmes. The contribution he made to the people of Edinburgh as a respected surgeon deserves to be acknowledged as greater than any gift he made to literature.
