Thursday, February 21, 2013

John Watson: Too Dumb to be a Doctor

It strains credibility beyond endurance for us to believe Dr. Watson is a medical doctor, much less a "very good" one, considering his appalling lack of medical knowledge or instinct.  There are numerous examples of him dropping the medical ball, this blog looks at two in some detail.

S1E3: The Great Game 

Watson was only an Army doctor in a combat zone, why would he know a thing about wounds?

Here's the victim, Connie Prince, on a metal autopsy table in the morgue.  She hasn't had a full autopsy, she shows no Y incision, but her body has been prepared: stripped and obviously washed down, by the state of her hair.

Sherlock gives us the police finding on her death:
"So, dead two days.  According to one of her staff, Raoul DeSantos, she cut her hand on a rusty nail in the garden. Nasty wound, (which John leans over to take a look at) tetanus bacteria enters the bloodstream - goodnight, Vienna."

Sherlock then looks at the right arm and face of the victim and starts to question Watson:

HOLMES: The cut on her hand, it's deep, it would have bled a lot, right?

WATSON: Yeah.

HOLMES: But the wound's clean.  Very clean and fresh. ....  How long would the bacteria have been incubating inside her?

WATSON: Eight, ten days.

Sherlock smiles knowingly.   The dull fellow with the medical degree who can't manage to figure out that this woman couldn't possibly have died of tetantus without many days of increasingly serious and obvious symptoms, who was in combat but cannot recognize a fresh post-mortem wound, finally manages to work that out:
WATSON: The cut was made later.

LESTRAUDE: After she was dead?

HOLMES: Must have been.

 SERIOUSLY?!!? 


Here is just some of the information (from Mayoclinic.com) that Dr. Watson, combat doctor, seems to have forgotten:

Signs and symptoms of tetanus may appear anytime from a few days to several weeks after tetanus bacteria enter your body through a wound. The average incubation period is seven to eight days.
Common signs and symptoms of tetanus, in order of appearance, are:

  • Spasms and stiffness in your jaw muscles
  • Stiffness of your neck muscles
  • Difficulty swallowing
  • Stiffness of your abdominal muscles
  • Painful body spasms, lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light
Other signs and symptoms may include:

  • Fever
  • Sweating
  • Elevated blood pressure
  • Rapid heart rate

Painting by Sir Charles Bell, 1809: tetanus spasm
Tetanus infection only kills about 11% of it's victims in industrialized countries. It takes a while.  Symptoms can start to appear within a few days, but usually it's about a week, up to three. Untreated, the spasms from this infection can bow the body and the muscle contractions are strong enough to break bones. (See Wikipedia entry for description and picture.)

No one could have found this woman simply lying dead one day with no warning signs. The cut on her hand would have been clean from the washing of the body and not re-bled, obviously, but Watson would have seen immediately that the cut was not a few days old.

We learn later that Sherlock, naturally, figured it all out from the injection sites on her forehead which instantly suggest botox to most casual viewers.  

S2E1: A Scandal in Belgravia

When the elderly woman is attacked, the doctor gives her a hug. 

Here he is: Army Captain, medical man, combat veteran.  When told the woman obviously her 70s has been attacked, he rushes to her side, put his arm around her shoulders asking if a she is "all right" and looks to Sherlock for instruction.

He does not: take a pulse, look for pupillary reflex, or even note if they are the same size or note injuries to her face, feel her zygomatic arch for fracture, and then ... he lets the old lady walk down stairs unaccompanied  while he hangs back to ask what's going on.

A woman of this age, or a man but especially a woman with a more delicate bone structure, can suffer brain damage, similar to an infant, from any strong blow to the head which creates a whiplash effect.   Our guy has her walk downstairs alone (remember, she has a bad hip) after some sort of attack still a mystery to him and apparent shock and serious emotional reaction.  (Perhaps Sherlock should have put a blanket on her as a sign to the doctor.)

SERE - EEE - ESS - LEE?

Where's the doctor?  The one who, when there is a patient in front of them takes charge, because the welfare of the patient is paramount?  They couldn't spare a few seconds for him to do even a cursory check?   What "very good" medical man of military experience does not become Alpha Male Extraordinaire with a patient in front of him?  A patient he has a personal affection for?

Note to writers:  You have Martin Freeman.  It's bad enough an actor as talented as this is burdened by his character's medical duncery. Please stop inflicting it on your viewers.  If you don't want to pay for a full-time medical adviser, Google is your friend. There is room on this show for more than one clever hero.  You knew that in the first episode. Sherlock wanted John because he is "very good."

Sherlock was wrong.  He never needed an assistant.  He needed a partner.   Give us a Dr. Watson for the 21st century.

4 comments:

  1. Amen!!! It would appear that the only "medicine" Dr. Watson is capable of practicing consists of sponging abrasions and falling asleep on the job. Goodness knows how Martin Freeman manages to make the character not only believable but memorable.

    Allowing John to demonstrate his intelligence and his medical knowledge would not at all diminish Sherlock, who is, after all, in charge of the quirky insights and rapid strings of deduction. But please let John supply some of the pieces.

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  2. And a big AMEN to your amen! Let's j hope Series 3 does him better!

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  3. As a medical doctor myself nothing John Watson does seem that out of place IN REAL LIFE circumstances.

    Tetanus infection can be much closer if the wound is closer to the head vs the lower extremities where it'd take longer for the bacteria to travel up the nerve axons.

    Regarding checking vitals on an elderly distressed lady.... Instead of trying to comfort her provided lack of any signs or complaints warranting a physical exam is the right thing to do.

    I deduce you watch too much television. The most singular event that has occurred in your post is that nothing logical has occurred.

    Perhaps you should apply to Scotland Yard. They are in need of few of likes like yourself.

    Let's go Watson. We must not be late how.

    Mrs. Hudson......

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    1. i think your aptitude matches with that of John Watson's in this show. Even if he is not a good doctor, there are moments where the character doesn't seem to observe the facts and his surroundings at all. For example when he walks in a silent room in s02e03 and starts going off "where is mycroft holmes, can you not hear me , am i invisible , can you not see me."
      who does that even if you are not in silent room.
      For a guy who is trained to shoot like the shot he took in first episode (at taxi driver, with a pistol no less). reflexes and combat skills aren't good enough.
      John (in this show) has been purposefully made to look dumb and ignorant. just so Sherlock can be the only genius. which is not fair. The movies have proper character of John Watson.

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