By Mark Kemball

It’s awards season in two of our schools’ alumni associations, and the Alumni Office is knee-deep in nomination forms, research papers and curriculae vitae. The physical evidence of so many peer-recognized achievements and contributions makes us reflect with pride on the impacts of our graduates locally, nationally and internationally.

However, the recent passing of Sherlock Holmes’ birthday (Jan. 6, in case you missed it) makes we wonder what an award for achievement not within one school but across all of OHSU’s mission areas might look like. And I can’t help thinking that a case could be made for Sherlock Holmes as a worthy recipient – if only he were indeed an alum of OHSU rather than of St. Bartholomew’s Hospital in London.

Holmes the researcher

Let’s make the easiest case first: researcher. As Holmes and Watson meet in a chemistry lab at St. Barts, Holmes is putting the finishing touches to a novel and presumptive test for the presence of hemoglobin, even in highly-diluted states. Cheap and fast, the test is now known as the Kastle-Meyer test and used in forensic science today. One might also cast Holmes as the first proponent of evidence-based outcomes. “There is nothing like first hand evidence,” he says in A Study in Scarlet and throughout the canon he upbraids Watson for obfuscating the facts with a distracting aura of romance.

Holmes the dentist

How about dentist? Formed in 1880, the British Dental Association was making major inroads into the illegal practice of dentistry in Holmes’ time but it was not until 1921 that the dental profession became fully regulated in the United Kingdom. Nevertheless, we can be sure that Holmes was fully conscious of the importance of oral health to the deductive sciences. In The Stockbroker’s Clerk Watson, speaking for them both, states, “I saw with a thrill that his second tooth upon the left-hand side had been very badly stuffed with gold.” Holmes also chooses to secure his simulation of being at death’s door in The Dying Detective with the application of “crusts of beeswax around (his) lips.” And who can doubt that Holmes’ “trifling monograph” on the subject of tobacco ash would not have carried some mention from the great observer of the impact of tobacco on the appearance of the mouth, if not sounding the first alarm about the destructive pathological effects of tobacco use?

Holmes the nurse

Recognizing Holmes as a nurse may seem a stretch at first. His wild fluctuations in temperament, his manipulation of Watson and his apparent indifference to the feelings of others are multiple leagues away from the qualities exemplified by nurses. Consider, however, his immediate embrace of Watson as a roommate, newly-returned as he was from the Second Anglo-Afghan War with physical and psychological wounds that would endure for many years in a society devoid of rehabilitative services. In doing so, Holmes must have realized that he was assuming the role of counselor and supporter—hardly a compatible role for someone truly single-minded and indifferent to the situation and needs of others.

In her recent Puhaty Lecture at OHSU, Dr. Patricia Benner emphasized the critical importance of awareness by health care providers of a patient’s lifeworld. She cited an example where a nurse was able to play the Marine Hymn to ease the traumatic transition of an injured marine from coma to consciousness only because the nurse had herself served as a marine and was uniquely aware of the hymn’s emotional relevance to her patient. Could it be that Holmes, clumsily and imperfectly ahead of his time but recognizing Watson’s desire for adventure and the needs of returning veterans, adopted him into his world, intentionally assuming an indifference to support his physical and mental rehabilitation?

Holmes the physician

Finally, Holmes as physician. Aside from his genesis in the medical studies of Sir Arthur Conan Doyle and specific medical knowledge absorbed through crime scenes and his relationship with Dr. Watson, it is clear that the medical profession and public health exerted a strong influence on Holmes. Why, we can ask, do we first encounter him at a chemistry lab at St. Barts? Science was an evolving profession in the 1870s, and bore little resemblance to most scientific careers today. Surely Holmes attended St. Barts as a medical student.

Properly, Holmes leaves specific medical advice to Watson but his interviews are master classes in holistic communication and the uncovering of underlying issues behind a client’s presentation. He understands that, far from being bucolic oases, rural areas present complex challenges to the delivery of adequate community health care. He also leads the reader past an initial revulsion to the outward appearance of physical and psychological disease to an empathy with the patient and his or her condition (The Yellow Face), often shining an educated light on many of the contemporary social conditions that contributed to poor public health.

Sadly, OHSU does not recognize alumni for achievements across all of OHSU’s mission areas – at least, not yet. Even sadder, Sherlock Holmes would probably not make it through the initial screening even of an imaginary process. However, in an emerging era of team-based education it is alluring to have the world’s greatest detective stand as an initial placeholder for a speculative award and exciting to think about who might eventually replace him should it ever become reality.

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Mark Kemball and the alumni relations team are proud to count almost 34,000 dentists, nurses, physicians, researchers, technicians and other health professionals as OHSU alumni. The team strives to keep them all connected with the university, with its students and with each other.

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