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Every cloud has a silver lining ... even a failed private practice.

Born in Scotland to an English father and an Irish mother, this man was educated at a Jesuit school before entering Stonyhurst College. His poor finances led him to seek a respectable job. He studied medicine and spent some time in general practice in Aston near Birmingham. While still young he published several short stories. He was not, however, an indoor type. During his studies, he spent time as a ship’s doctor firstly on a Greenland whaler and then on a voyage up the West African coast. He prepared a paper, published in the Lancet, on the diagnosis of leucocythaemia. He then returned to university and completed his doctorate on ‘vasomotor changes in tabes dorsalis’. Having graduated, he joined a practice in Plymouth. But things did not work out and he left to set up his own practice in Portsmouth. He was not successful and had few patients. He used one of his medical teachers at the university, Professor Joseph Bell, to form the basis of his most famous character in short stories. He had worked as ward assistant for Professor Bell and this enabled him to see the man at close quarters. Bell took delight in observing people and said that the walk of a sailor was different than that of a soldier. He was expert at detecting differences in accents and studied the hands to see if there were any calluses or marks which could indicate their job. Bell said ‘all careful teachers have first to show the student how to recognise accurately the case. Recognition depends on accurate and rapid appreciation of small points in which the diseased state differs from the healthy.’ Thus, this eminent professor spent time and effort on determining patients’ occupations and insisted his students did the same. From Portsmouth our subject went to Vienna to study ophthalmology. That was also a fiasco and he returned to private practice in Wimpole Street. The same lack of patients occurred again. In his autobiography, he reported that no patients crossed his doorstep. But fate was about to strike. He suffered influenza and was at death’s door. He emerged realizing that he could not combine medical and literary careers and so opted for the latter. His success as a writer of plays and stories was phenomenal but he managed to see military service and it was for this that he was knighted, helped by the fact that the Monarch was a fan. He drove fast cars, spent his life playing golf, flying hot air balloons and airplanes and was into bodybuilding. Who knows what might have happened if his private practice had been successful. We might have been deprived of Sherlock Holmes and Dr Watson and Arthur Conan Doyle may never have become the household name he is today. Nerys Williams R. HOUSE ET AL.: UPPER EXTREMITY DISABILITY IN HAVS 173