Ashley Davidoff
thecommonvein.net
Art of Radiology
Title: Applying the Art and Practice of the Deductive Reasoning of Sherlock Holmes to Radiology
Authors: Serena Pham, MD a and Ashley Davidoff, MD a
Affiliation: a Department of Radiology, Boston Medical Center, 820 Harrison Avenue, FGH Building, 4th Floor, Boston, MA 02118
Corresponding author: Email: Serena.Pham@bmc.org
Objective: Radiology requires a combination of gathering visual cues, deductive reasoning, and applying logic and knowledge of anatomy, physiology, and disease process to render a thoughtful and evidence-based working diagnosis. This article will provide a framework for those skills by employing detective techniques, derived from the well-known Sherlock Holmes series, written by British author Sir Arthur Conan Doyle, which highlight similar skills that are cultivated in radiology practice.
Description:
Sherlock Holmes is a fictional detective, whose impressive detective skills reflect many aspects of radiology, noticing subtle but important details, recognizing vital facts from incidental facts, and analysis of findings using logic and reference to one’s knowledge and experience.
We identified 11 quotes from the short stories of Sherlock Holmes and we will use these quotes to exemplify their application to radiological education, case examples, and some, just to life experience. As a practice of observation and deduction, in the educational setting, we often approach the reading of a CT with a Sherlock Holmes method. “We approached the case, you remember with an absolutely blank mind, which is always an advantage. We had formed no theories. We were simply there to observe and to draw inferences from our observations.” The art and science of detective work, allow us to look at each radiologic study as an unsolved or partially solved mystery. What are the aberrant findings? How can a sum of the aberrant findings, lead to a cohesive diagnosis? How are these findings relevant to the patient’s prior history, current presentation and prognosis in the future? These techniques push us, as physicians, to improve our skills of detection, observation, perception, and use of logic, similar to any discipline of detective work. “Not invisible but unnoticed… You did not know where to look so you missed all that was important.” This latter quote has profound relevance to our field, and is among many of the other inspiring quotes extracted from the short stories of Sherlock Holmes .