Notebook

Sherlock Holmes and Dr. Watson are alike in an intriguing way. Curiosity. An important gene to be possessed by a detective and clinician alike.

I do not dare to compare myself with more than a tiny fraction of Sherlock Holmes. In any case, I merely follow Sherlock Holmes’ way of keeping a notebook to make room for mysterious cases. A doctor's notebook may seem a far cry from that of a detective, but it is the very first building block in our search of knowledge. During all these years of clinical practice, I had no inklings of the truth in countless encounters, which were simply jotted down. Every now and then, the answer might dawn on one of them after months, or years, as I keep on reading.

For reasons not well understood at the time, I met a handful of diabetic patients with exquisitely painful legs few years ago. All of them found their place in the collection of my notebook. One weekend few months later, the answer just dropped into my lap while the words "diabetic muscle infarct" caught my eyes (during my literature search on a completely irrelevant subject). My next patient with diabetic muscle infarct ended up with a quick diagnosis by magnetic resonance imaging, and I ended up with making three publications out of the exhilarating diagnosis.

True wit, however, is rare in real life – at least in the doctor’s life – and a thousand barbed arrows fall at the feet of the archer for every one that flies. I admit that I don’t have much wit, except a notebook to keep score or tally of the missed arrows.