Holmes and Watson (4 page)

‘In the year 1878 I took my Degree of Doctor of Medicine of the University of London, and proceeded to Netley to go through the course prescribed for surgeons in the army,’ Watson states in the opening sentence of
A Study in Scarlet
.

It all seems perfectly straightforward. But for the sake of brevity, Watson has telescoped the information, leaving out certain important facts about his medical training. He has said nothing either about his life immediately
preceding his entry to London University as a student. Apart from two oblique references elsewhere in the canon, he hardly touches on this period at all. As they are crucial in establishing Watson’s date of birth, it is necessary to examine them in some detail.

In
The Sign of Four
(1888) Watson remarks, on noticing the heaps of earth dug up by the Sholtos in the grounds of Pondicherry Lodge: ‘I have seen something of the sort in the side of a hill near Ballarat, where the prospectors have been at work.’

This is a reference to the gold-prospecting town of Ballarat in Victoria, south-east Australia. It is quite clear Watson has been there. But when? Some commentators have suggested he was taken to Australia as a child. This, however, is unlikely.

Also in
The Sign of Four
, Watson, who regarded himself as something of a ladies’ man, makes another revealing comment. He states that his ‘experience of women’ extended over ‘three separate continents’, by which he must mean Europe (England), Asia (India) and Australia, the only parts of the world of which at that time, 1888, he had any personal knowledge. It is unlikely he is referring to a childhood experience of women. As the remark is made on his first meeting with Miss Mary Morstan, to whom he was strongly attracted, it is clear from the context that this experience was gained when he was of an age to appreciate the charms of the opposite sex. The only period in his life before 1888 when such a trip to Australia was feasible was in the years between his leaving
school at seventeen or eighteen and enrolling as a medical student. He would then have been old enough to admire a pretty face although, at that stage, his ‘experience’ may not have extended much beyond an adolescent longing or a mild flirtation. Watson was always a little prone to exaggeration.

As we have already seen, Watson had a love of adventure and it was no doubt this urge which prompted him to set off for Australia on leaving school. He may even have been attracted by the possibilities of becoming a gold prospector himself, which would explain why he visited Ballarat. Whether or not this was the case, he may, like many other school-leavers, have wanted to travel abroad before settling down to further studies.

In
The Sign of Four
, Holmes remarks that Watson’s father had been dead for many years. If he died about 1870, the approximate date of this Australian adventure, Watson may have inherited enough money from his father to finance the trip. The time gap of eighteen years accords with Holmes’ remark.

The question of Watson’s date of birth hinges on this visit to Australia. The voyage took about two months by sea: four if one counts the return trip. Watson must therefore have been away for at least a year, possibly two, otherwise the trip was hardly worth the time and expense. If Watson left England at the age of seventeen or eighteen, he was aged between eighteen and twenty when he returned to England and began his medical studies.

As we shall see later in the chapter, Watson spent at
least six years before qualifying as a doctor in 1878. This would place his date of birth between 1852 and 1854, the more likely being either the year 1852 or 1853.
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He gives the impression of being a year or two older than Holmes, although this is an entirely subjective judgement.

We shall assume therefore that Watson entered medical school in 1872 at the age of nineteen or twenty.

The Medical Act of 1858 prohibited anyone from using the title of physician, surgeon, doctor or apothecary without holding a licence from one of the appropriate corporations: the Royal College of Surgeons, the Royal College of Physicians or the Society of Apothecaries. As Watson later practised both as a surgeon and a general practitioner, he must, at the very least, have qualified as a Member of the Royal College of Surgeons (MRCS) and, in order to prescribe medicines for his patients as a GP, must also have passed as a Licentiate of the Society of Apothecaries (LSA), in addition to holding a medical degree (MD). It is less likely that he was also a Member of the Royal College of Physicians (MRCP). Most GPs at that time held only two licences, the minimum required. This agrees with the rather unkind comment Holmes makes in ‘The Adventure of the Dying Detective’ on Watson’s medical qualifications, which he describes as ‘mediocre’.

Watson would have had to sit an entrance examination before being accepted as a student at London University and, having passed, would have registered both with the
university and also with the General Medical Council. Once these formalities were completed, he was then free to attend the medical school of his choice, in his case St Bartholomew’s Hospital.

Bart’s, as it is affectionately known, is one of the oldest hospitals in the world. Founded in 1123 by Rahere, an attendant at the court of Henry I,
*
it still occupies its original site in West Smithfield where it was established as a hospital for the poor. In Watson’s time it retained its charitable status, relying on donations from wealthy sponsors.

Although much has changed since the day when Watson first entered its gates, he would still recognise parts of it – as would Holmes, too, for that matter – in particular the church of St Bartholomew the Less and the square with its trees and central fountain. He could well have strolled here between lectures, enjoying a quiet cigar. But the old chemistry laboratory has gone: so, too, has the original Pathological Museum where Watson studied the anatomical specimens and perhaps shared a table with Holmes.

At that time, the basic course for an MD was four years, ten months of which had to be spent on the wards. In addition, students spent further time preparing for the examinations which would qualify them for membership of the professional medical corporations.

The early career of Frederick Treves, the doctor who
later befriended Joseph Merrick, the Elephant Man,
*
demonstrates this clearly. Although he studied at the London Hospital, his training would have been similar to Watson’s. Having taken his MD in 1873, Treves then sat for the licence of the Society of Apothecaries in 1874 and, in the following year, on passing the examination, became an MRCS. As he practised as a GP as well as a surgeon, we can see how closely his career parallels Watson’s.
†
Like Treves, Watson almost certainly took his MD first, in his case in 1876, before going on to qualify as an LSA and an MRCS, a fact which, in his abbreviated account of his medical training, he has failed to make clear, lumping all his qualifications together under the general title of MD. It was probably in 1878 that he was accepted by the General Medical Council as a fully qualified doctor, licensed to practise.

The first part of Watson’s course at Bart’s consisted of lectures given by the hospital’s physicians and surgeons, and anatomy demonstrations in the dissecting room. As we have seen, Holmes may well have attended some of these classes, which was when their paths could have first crossed.

Once the introductory courses were completed, the student then went on to study medicine and surgery,
observing operations and accompanying the consultants on their rounds of the hospital wards.

Students were required to pass an interim examination in anatomy, physiology, botany and
materia medica
.
*
The final examination in their fourth year covered advanced studies in these subjects as well as the principles and practice of medicine and surgery.

In order to qualify as an LSA and an MRCS, students had then to take further courses in chemistry, including practical chemistry, forensic medicine, the theory and practice of medicine and surgery, midwifery and hospital practice. Holmes may also have enrolled for some of these classes, in particular those on chemistry and anatomy, subjects in which he had a special interest.

Like Holmes, Watson’s time was not spent entirely on study. There were diversions; in Watson’s case, rugby. Although it is not known in which position he played, he was good enough at the game to be accepted by Blackheath Football Club, the oldest open rugby club in the world. In Watson’s time, the club had no ground of its own and matches were played on the heath, with the spectators occasionally encroaching on the field. Watson almost certainly played under the captaincy of Lennard Stokes, considered by some the best drop-kick in rugby football. Stokes, who won twelve international caps, was studying medicine at Guy’s Hospital and several other players were, like Watson, medical students.

Watson’s physique suited him for the game. According to a subsequent description, unwittingly passed on by Inspector Lestrade when Watson was mistaken for an escaping burglar, he was a ‘middle-sized, strongly-built man’ with a ‘square jaw’ and a ‘thick neck’. At the time of this description, he also sported a small moustache, although this may be a later addition to his appearance.

Watson may have had lodgings at Blackheath. If so, it would explain an otherwise puzzling remark he makes in
The Sign of Four
regarding his own ‘limited knowledge of London’. Considering that at the time he had spent at least seven years in London at Bart’s Hospital, the admission seems strange unless he had lived somewhere on the outskirts and travelled into town every day. This was perfectly possible even from as far away as Blackheath. There was a regular train service from there to London Bridge station, from where he could have caught a dark green Bayswater omnibus which ran close to Bart’s.

In his last year as a medical student, Watson was required to serve at least three months as a dresser to one of the hospital surgeons, treating patients on the wards under the consultant’s supervision.

Watson’s career at Bart’s seems to have been average. He apparently won none of the prizes offered to the more promising students, unlike Dr Percy Trevelyan (‘The Adventure of the Resident Patient’), also a former London University man, who was awarded the Bruce Pinkerton medal for his monograph on nervous lesions while at King’s College Hospital’s medical school. Nevertheless,
Watson passed his examinations and was offered a post as house surgeon at Bart’s. House surgeons usually served for a year only, six months as a junior, six as a senior. Again, Watson makes no reference to this part of his career but the fact that he had his own dresser, Stamford, puts it beyond doubt.

The post of house surgeon was a lowly one with long hours and poor pay. Dr James Mortimer (
The Hound of the Baskervilles
), himself a ‘humble MRCS’, as he terms it, had served as a house surgeon at Charing Cross Hospital and as such was ‘little more than a senior student’, to use Holmes’ rather dismissive comment.

At the end of his year’s service as house surgeon, Watson was faced with a crucial decision about his future career: what should he do next? In order to set up in private practice, he needed capital which he did not possess, a dilemma also faced by Dr Percy Trevelyan, although he was lucky enough to find a wealthy backer.

On the other hand, he could remain in hospital service, although this had its own disadvantages. Hospitals then employed only four consulting surgeons and, as a consequence, promotion was slow. Watson might have to wait until he was in his forties before a senior post became vacant. He would also be required to qualify as a Fellow of the Royal College of Surgeons (FRCS). Watson may have realised that, as he was no academic high-flyer, he had better turn his sights elsewhere.

To a medical man, a military career offered several advantages. An army assistant surgeon earned £200 a
year, with his keep and living quarters provided. After ten years’ service, he could retire on half pay with enough money saved to set himself up in private practice. As C. B. Keetley pointed out in
The Students’ and Practitioners’ Guide to the Medical Profession
(1885), the army offered ‘a serviceable if not brilliant career’ for a man of ‘fairly good abilities’ but ‘with no chance of doing great things as a town practitioner or consultant’. The advice might have been written with Watson in mind.

Above all, though, from Watson’s point of view, the army, unlike the surgical wards at Bart’s, held out the promise of travel and adventure as well as better opportunities for promotion. After all, he was still young, only twenty-five or twenty-six. Consequently, he decided to sit for the entrance examination to the Army Medical School at Netley in Hampshire.

The school, later called the Royal Army Medical School, was first established at Fort Pitt, Chatham, in 1860 and was moved to Netley three years later when the military hospital, the Royal Victoria, was opened. One of the wards was converted into a classroom while laboratories as well as quarters and mess facilities for the students were housed in separate buildings behind the main hospital block.

The site of the Royal Victoria Hospital was superb.
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Set in 210 acres of parkland, it overlooked Southampton
Water, where a special jetty was later built to receive casualties from the Boer War and First World War who were brought there by boat. It was a vast building, with beds for 1,400 patients in wards which opened off corridors a quarter of a mile in length. Florence Nightingale, who advocated the pavilion-style hospital with smaller units, was horrified when she was shown the plans. But it was too late; the foundations were already begun. Nevertheless, she played an active part in the setting up of the Army Medical School, helping to draw up the regulations and to nominate the teaching staff.