The human brain’s a curious organ, eh

I’ve written that ‘Though no medical genius, I am methodical and obsessional. I adhere to the aphorism that in medicine more is missed by not looking than not knowing’ [1]. In my consulting room, I try to pay attention. To listen to what’s said and how it’s said. And to observe non-verbal cues. I used to think it’s possible to pay attention to – to perceive – everything that’s there to be perceived. In this my role model’s Dr Joseph Bell – who inspired the creation of Sherlock Holmes. But now I’m older and wiser, I think even Sherlock didn’t perceive everything. But rather he knew what was worth perceiving and what wasn’t. An item in the 17 September episode of Science Friday confirmed my conviction that it’s impossible to pay attention to everything – even in the small space of a consulting room. This is due to various confounding factors including preconception and multitasking; and also the science of attention itself. For example, the more we focus on one aspect of what we’re observing, the more prone we are to overlook notable observations. This link’s to a webpage with two YouTube clips on it [2]. Watch these now: ‘The Selective Attention Test’ then ‘The Monkey Business Illusion’. Well, what do your reckon? The human brain’s a curious organ, eh [3]. Makes you wonder how many people’ve been convicted of crimes, and even executed, due to invalid or unreliable accounts of eyewitnesses, More than a few, I’d suggest. Ho hum.

farmdoc's blog post number 325

In our Mole Creek orchard are 13 young fruit trees. On 2 March I noticed, to my dismay and disappointment, one of them – an apple tree – was snapped off where the trunk divided into branches. Reflexively I focussed my forensic skills, which beyond Medicine are barely mediocre, on the cause of this unhappy event. Invoking the galloping-horses-not-zebras aphorism, and observing the floppy-top fence intact and the gates snibbed, I set aside low probability causes – human, sheep, goat, wombat, lightning – in favour of three likely causes – possum, bird, wind. Wind’s unlikely because the broken tree was as equally exposed to wind as the other trees which, though several are flimsier and more prone to wind damage, are fine. I doubt a bird cause because, unlike some of the other trees, the affected tree had no fruit on it. And a possum attack’s unlikely, because the floppy-top fence had never been breached before, and though the tree broke about a metre above the ground there are no claw marks on its trunk. So I don’t know the cause. And now, nine days later during which no other trees have come to grief, I doubt I ever will. But there’s no doubt I must order a new apple tree for planting in the winter. As for my detective skills? Where are you when I need you, Sherlock Holmes?

farmdoc's blog post number 35

Because in the 19th century there were no MRI scanners, reaching diagnoses relied more on interview and physical examination findings than is so today. Joseph Bell (1837-1911), a Scottish surgeon and Edinburgh University lecturer, prided himself on using all his senses to diagnose the seemingly undiagnosable. In 1878 Bell’s clerk was a medical student then named Arthur Doyle (the Conan came later) whom Bell selected as his assistant. Doyle, after presenting his case findings to Bell, was astounded by Bell’s deductions even before Bell had questioned or examined the patient. And so, history records, Bell was the inspiration for the most famous detective ever – Sherlock Holmes – who first appeared in 1887 in A Study in Scarlet. Since I can’t remember when, I have been a Holmes devotee. I am the proud owner of a modest collection of Sherlockiana comprising books, a deerstalker hat, and an authentic brick from 221B Baker Street which was demolished in 1980. And for a time I was a member of the Sherlock Holmes Society of London. Since 1987 my doctoring work has had forensic undertones. Though no medical genius, I am methodical and obsessional. I adhere to the aphorism that in medicine more is missed by not looking than not knowing. Therefore I look. Holmes, Doyle and Bell have taught me well.