23 March 2015

The Detective Doctor

"You see, doctors are detectives, are they not, Rra? You look for clues. I do too.”
--Mma Ramotswe, proprietrix of the No 1 Ladies' Detective Agency. "Doctors, detectives, and common sense," by Alexander McCall Smith

Mystery readers are clever, so you may have deduced that your newest SleuthSayer (moi) is also an emergency physician. I consider this great training for my detective alter ego, Dr. Hope Sze, because medicine trains you to…

1. Talk to people.

On a vacation in Hawaii, I met a 29-year-old who’d been retired for a year. Who does that? I set about quizzing him. How did he do it? Why was he so eager to make bank? I could tell he wasn’t crazy about answering me, so I explained, “I’m an emergency doctor! My job is to extract the most amount of information in the least amount of time.”

Granted, a detective may be more tactful than me. But we both have to learn how to ask intelligent questions, listen to the answers, and throw out the B.S.

Ancient Hawaiian justice system: if you broke a kapu (sacred law),
your only hope was to swim to a sacred place of refuge
like this one at Puuhonua o Honaunau National Historical Park.

2. Learn patience.

You know how long doctors slog in school? I spent 25 years of my life from kindergarten until my emergency fellowship. And I’m not, say, a vascular surgeon with seven years of residency under my belt. Plus they estimate that doctors spend 50 percent of their time doing paperwork. You never see ER, Nurse Jackie,and Grey’s Anatomy spending half their waking hours on forms.

As for detectives, the New York Times recently published the provocatively-titiled essay, The Boring Life of a Private Investigator.

For both of us, TV cuts out the dull bits and maximizes the drama. Wise move.

3. Use your powers of observation as well as technology.

Once my senior resident told me, “The more I practice, the more I realize that the history and physical exam don’t matter. It’s all the tests you order, like the ultrasound or CT.”

Within the hour, the attending staff asked me, “Did you see bed 4?”


“Did you notice anything unusual on the physical exam?”

“I noticed a systolic murmur.”

“That senior resident [a year above you] missed a grade III aortic stenosis murmur. You could feel the delayed upstroke during systole.”

Which may sound like jibber-jabber to people outside the trade, but what it means is, even in the age of technology, you should use your brain at all times. The imaging and other technology will help you, so you may end up doing the right thing, but you can look like an idiot.

Or, to quote Sherlock Holmes in The Hound of the Baskervilles, “The world is full of obvious things which nobody by any chance ever observes."

At the moment, I’m enjoying both medicine and writing. As Dorothy L. Sayers’ detective said in Whose Body?: “It is full of variety and it forces one to keep up to the mark and not get slack. And there's a future to it. Yes, I like it. Why?"

So if you’d like to follow how my fictional medical resident became a detective in her spare time, take a gander at Dr. Hope Sze.

Or if you can take medical stories straight up, for the next week, I’ll also post a free excerpt from my book, Fifty Shades of Grey’s Anatomy.

What do you think? Does medicine train you for detective work? Or is another profession better? Let me know in the comments.

And tune in on April 6th, when I plan to talk about book trailers.


  1. A good piece and of course, Sherlock Holmes was inspired by a real life medical detective

  2. As a former hospital administrative director, I was smiling all through your post, Melissa! Yes, diagnosis by clues is so much of health care. Perfect training, one might say :)
    Good post, and I'm picking up your book.

  3. Absolutely! Doctors make great detectives because that's part of what they do! And I, too, would have questioned that 29 year old a lot.

  4. Melissa, about the senior resident who said, “The more I practice, the more I realize that the history and physical exam don’t matter ... ” just before he missed a diagnosis, I'm sure he relies a lot less on CT scans, tests, etc. nowadays.

    I'm a medical transcriptionist/editor & I've noticed that a person's past medical history & family history are everything.

  5. You're right, Melissa: Doctors are detectives. I also enjoyed the practicality of the article you linked to.

  6. Yup! Doctor Joseph Bell's "eerie knack for detail" was a model for Doyle in writing Holmes. And the only medical show I remember going on about medical paperwork was MASH!

  7. Hey, I was working yesterday and missed all this good stuff.
    @Janice, I had to look it up. I didn't realize that they now think Jerome Caminada was the inspiration for Sherlock Holmes. Very cool.

  8. @Melodie, it's an honour to make the funny girl smile. Thanks for picking up my book!

  9. @Eve, I like to say that part of the reason I became a doctor is because I'm nosy. Guess that's why I'm a writer too. :)

  10. @elizabeth, could be. Sometimes people become more entrenched in their ways. It's easier to point to a test than to think, Oh, I'd better spend more time with the patient. Neat that you're a medical transcriptionist!

  11. @Leigh, you mean the boring detectives one as opposed to the McCall Smith story, right? ;)

  12. @Jeff, looks like you found a different Holmes inspiration. Interesting.
    I never watched MASH, but I like the theme song and I do occasionally joke, "Me love you long time."


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