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made uniform by fog and mud. Edinburgh, in the time of Conan Doyle’s childhood, consisted of two distinct cities, the Old Town and the New. The old medieval center of Edinburgh, “this accursed, stinking, reeky mass of stones and lime and dung,” as Thomas Carlyle called it, was notorious throughout Europe for its foulness. Beginning at the end of the eighteenth century it had, like Charles Doyle, been supplanted, though not fully replaced, by a stately city of gray stone, erected on a ridge to the north of the old burgh.
    This partly successful act of deliberate moral self-improvement by a city proud of its recent intellectual and commercial accomplishments, and anxious to shed the stigma of its grim parochial past, produced a city with a secret sharer, a striving, rationalistic city whose grid of streets concealed an anxious memory of the bloody old Scots abyss. It also reflected the predicament, and the achievement, of Conan Doyle himself, who lived his dreary and anxious childhood among failure, genteel poverty, and the unimaginable oblivion of his father, on the one hand, and therelative fame and splendor of his successful, artistic Doyle grandfather and uncles in far-off London; between the ever-present specter of ruin and disgrace and the glittering future he dreamed of (and later achieved); between the weird, Irish-Catholic world of his mother’s hearth tales and the overtly empirical, Protestant narrative of urban Victorian Scotland.
    In medical school at the University of Edinburgh, in the grim Gormenghast heart of the Old Town, Conan Doyle got a decisive demonstration of how his father’s way of reading the world for messages could be combined with his mother’s gift for making a story. In the fall of 1876, he began attending lectures and working as a clerk in the Royal Infirmary, presided over by Dr. Joseph Bell, FRCS, an ingenious practitioner of what might be called narrative diagnostics. We might also call it prose fiction, or the science of detection.
    Joe Bell was a legend at the medical school. His favorite trick—he relished, like the character he would one day inspire, the coup de théâtre—was to diagnose patients in the waiting room of the infirmary without even speaking to them or directly examining them. As Dr. Harold Emery Jones recorded it in a memoir, The Original of Sherlock Holmes:
Gentlemen, a fisherman! You will notice that, though this is a very hot summer’s day, the patient is wearing top-boots. When he sat on the chair they were plainly visible. No one but a sailor would wear top-boots at this season of the year … He is concealing a quid of tobacco in the furthest corner of his mouth and manages it very adroitly indeed, gentlemen … Further, to prove the correctness of these deductions, I notice several fish-scales adhering to his clothes and hands, while the odor of fishannounced his arrival in a most marked and striking manner.
    The principle behind these feats of inspired guessing, of taking the sum of a set of physical facts, many of them not apparent to the untrained eye, and checking them against an internal reservoir of knowledge based on prior observation—the point of Bell’s showmanship—was to awaken the young doctor to the wealth of signs, symptoms, and shortcuts a patient provided. The patient came in spouting and strewing great fiery gouts of information; he or she was a petri dish of facts that it required only patience and a highly trained eye to read and diagnose.
    But such observational and interpretational skills were not the whole of the doctoring game, any more than they are for writers or detectives. To succeed as a narrative diagnostician, or a novelist, or a detective, you also needed the art that, if you were Arthur Conan Doyle, you learned from your mother: you needed the feeling for story, both for the “history” to be inferred from the signs and symptoms and for the way that story could be reconstructed, in therapeutic terms, for the benefit of