The Remedy

by Thomas Goetz

  Conan Doyle, meanwhile, felt in the prime of life. He was too honorable, and too adoring of Touie, to do her insult, but in 1897 he had found another love. Her name was Jean Leckie, and for the next decade she would become the great platonic love of his life. Always in the company of a family chaperone (his sister or mother, most often), Conan Doyle began bringing Jean on various trips across Europe. Touie, apparently, never knew; he was careful to ask his mother and sister to destroy any of his letters mentioning Jean, lest Touie find them. (Thankfully, they were less than diligent about this request, allowing us to read some of the correspondence.)

  But by 1902 he was a man living somewhat publicly with two loves—one an invalid and one unrequited; one who had been his partner in the past and the other, he hoped, in his future. “This is a high & heaven-sent thing, this love of ours,” Conan Doyle wrote to his mother about Jean, in February 1902. “It has kept my soul & my emotions alive.”

  In the wake of Baskervilles and the play, he must have realized that he could never really escape Holmes. The detective may have been his creation, but the whole culture, from America through Europe and most certainly in Britain, had been captivated by this curious character. It wasn’t something Conan Doyle could ignore any longer. Perhaps there was more life in Sherlock Holmes after all.

  The matter was decided in early 1903, a few months after the last installment of Baskervilles. Conan Doyle received a letter from the editor of Collier’s Weekly, a popular American magazine. The editor made an offer that Conan Doyle couldn’t refuse: thirteen stories for forty-five thousand dollars—more than a million dollars in today’s currency. By postcard, Conan Doyle sent his reply: “Very well. A.C.D.”

  • • •

  BY JUNE 1906, TOUIE WAS FARING BADLY. SHE HAD LOST A GOOD deal of weight in recent months and began to suffer fits of delirium, then other symptoms, including paralysis on her left side. Conan Doyle entertained the thought that these “may be a mere passing weakness,” but the physician in him knew the truth. The disease was in its final stages. Touie’s body could no longer stand the ordeal. On July 4, 1906, he telegrammed his family: “She passed in peace.”

  It had been thirteen years since she was first diagnosed with tuberculosis. Then just thirty-six years old, she had made it to forty-nine. Conan Doyle would spend the next year in mourning, much of it in a true depression, as he cared for his two children, now ages seventeen and thirteen. On September 18, 1907, he married Jean Leckie in London.

  Conan Doyle would no longer shy away from Sherlock Holmes. The detective was back in a new Strand series again in 1908. For the next two decades, he would make irregular appearances. The last story featuring him, “The Adventure of Shoscombe Old Place,” was published in 1927, some forty years after A Study in Scarlet.

  The public adored each appearance of the scientific detective, but Conan Doyle himself began to take a curious turn. This man who had spent years championing medical science, in both practice and pen, instead became a devout believer in spiritualism and superstition. In truth, he had had an interest in the occult since his years in Southsea, but after Touie’s death he seemed drawn to séances and mysticism and all sorts of deeply unscientific hokum. By 1918 he was publicly championing spiritualism, a quasi-religion that put great stock in psychics as spirit mediums and in communication with the dead.

  The public more or less politely ignored Conan Doyle’s enthusiasms, happy to have the detective, whatever his creator might be doing. But it was impossible to ignore the spectacle that ensued in 1919, when photographs emerged of two girls from Yorkshire, Elsie Wright and Frances Griffiths, playing with fairies. About eight inches tall with ornate wings, and playing miniature pipes, the fairies appeared to be enjoying their time with the girls. Conan Doyle seized on the pictures and, in an essay published in December 1920 in The Strand, pronounced them real. After examining them with Holmesian techniques—“long and earnestly” with a high-powered lens—he declared that “these people are destined to become just as solid and real as the Eskimos.”

  The essay was a sensation, but the public was less than convinced. “Is Conan Doyle Mad?” asked the Daily Express, dismissing the author’s evangelism as “the ravings of a madman.” Cartoons appeared mocking the author as a bewitched old man. But Conan Doyle stood firm: “I have learned never to ridicule any man’s opinion,” he responded, “however strange it may seem.” Though fairy skeptics outweighed believers, it would be more than sixty years before the truth came out: The pictures were a hoax, the fairies mere cutouts from a children’s book that the children gazed at while Elsie’s father took photographs. “I thought it was a joke,” Frances explained, “but everyone else kept it going.”

  Conan Doyle was once a great champion of science, one who had, through his great invention of Sherlock Holmes, helped convince so many millions of readers that science was a powerful force for good. And now he had been caught up in the most specious of fairy tales. His was an unfortunate delusion.

  By Conan Doyle’s later years, Sherlock Holmes was fast becoming the multimedia superhero that we know him to be today. Having already made the leap from books to theater, Holmes transcended another popular entertainment in 1929 when the first Sherlock Holmes talking motion picture, Return of Sherlock Holmes, came to London. In the audience was Arthur Conan Doyle, no doubt fascinated and tremendously impressed that this man he had cooked up half a century before in Southsea still held the public’s attention. Conan Doyle died the next year, on July 7, 1930, of angina.

  Late in his life, Conan Doyle gave an address to the medical students at St. Mary’s Hospital Medical School. Reflecting upon his career in medicine, such as it was, he offered what he considered medicine’s greatest triumph. It was not any one discovery, Conan Doyle said, but rather the process of discovery itself.

  In every literary or dramatic romance, you will observe that from the time that the villain is unmasked he is innocuous. It is the undiscovered villain who is formidable. So it has been in this wonderful romance of medicine. All this work of late years has been in the direction of exposing the villain. When once this is done, be he micrococcus or microbe, and be his accomplice a mosquito or a rat-flea, the forces of law and order can be turned upon him and he can be broken in to that human system which he has so long defied.

  For Conan Doyle, the world of medicine and microbes was closely aligned to the world of law and order. Order out of chaos. Life out of death. Discovery out of obscurity. “And this part of the discovery,” he suggested to the students, “lies with Koch.” The address took place in September 1910, just a few months after Koch’s death. Nearly twenty years after Conan Doyle exposed Koch’s remedy as a false one, he still took time to admire the man’s genius and to honor his legacy.

  • • •

  THE FIRST SHERLOCK HOLMES TALKIE THAT CONAN DOYLE ENJOYED IN 1929 WOULD STAND ON THE THRESHOLD OF A NEW ERA OF enthusiasm for the detective. In the 1930s alone, more than a dozen movies featured him, including 1939’s Hound of the Baskervilles. That film was the first to star Basil Rathbone, an actor who would go on to become associated with the character of Sherlock Holmes as strongly as William Gillette had been four decades earlier. (In all, since the first film in 1900, the character of Sherlock Holmes has appeared in more than 250 movies.)

  In 1934 a group of devoted fans created the Baker Street Irregulars, a society that remains dedicated to the idea that Sherlock Holmes and Dr. Watson were real people and that, at most, Conan Doyle was a mere stenographer. Today, more than four hundred such societies are active worldwide, from Tokyo to Fort Meyers, Florida, to London. Indeed, Sherlockians were the original fanboys, embracing the characters and writing their own mysteries with them as early as the 1890s. Today, Conan Doyle’s corpus of 56 Holmes stories and four novels pales next to the more than 3,400 stories in a dozen different languages that admirers have written and posted at fanfiction.net, an online bulletin board. (Conan Doyle’s versions are bette
r.) Though less than the number of fan-written Harry Potter stories, that’s twice the number of Vampire Diaries stories. In London especially (though not surprisingly), the character is very much alive, with walking tours and pubs and monuments dedicated to him.

  Some of this has devolved into kitsch, but the enthusiasm for Holmes—most of it, at least—remains true to the character that Conan Doyle created more than 130 years ago. In Holmes, we can watch science in action, not just for esoteric purposes but for the thrilling pursuit of criminals and mysteries. No matter what course Conan Doyle may have taken in his later years, in Holmes he created something that resonated with his age and all the years since.

  Isaac Asimov wrote that Holmes was “the most successful fictional character of all time” because he represents the triumph of the “gifted amateur who could see clearly through a fog.” Conan Doyle took what medical scientists a generation older than he—Joseph Bell, Lord Lister, and Robert Koch—had accomplished and mythologized their methods, turning their innovations into popular entertainment based on the singular principle that little observations can build into larger conclusions. Through Holmes, Conan Doyle helped people see how from a thousand small observations can come a profound and lasting change.

  • • •

  COMPARED TO ARTHUR CONAN DOYLE’S VIVID PRESENCE IN London, Robert Koch’s legacy is rather inconspicuous in his adopted home of Berlin. He is a curious sort of artifact, one of those historical figures whose names appear on street signs and engraved onto building facades but are largely absent from public knowledge. There is, of course, the Robert Koch Institute, the great brick building on the banks of the Berlin-Spandau Ship Canal. Visitors there are greeted by an alabaster bust of the man, looking stern and tired, off to the side of the foyer. Down the hall, a small, well-kept museum is dedicated to his memory. There one can visit (by appointment) and see the microscope from Wöllstein, the stove Koch would incinerate his mice in after dissection, slides of his original tuberculosis cultures, and his handwritten notes for his first lecture on TB, from March 24, 1882. There is also a vial of liquid, translucent but dark brown, labeled “Tuberculin.” At the end of the hall is Koch’s mausoleum, an austere chamber, its walls lined with black-and-tan marble. On the checkered floor, beneath a profile of Koch etched into white marble, stands an urn filled with his ashes.

  Curiously, there is a second Robert Koch museum in Berlin, this one located in the old Physiology Institute building, which was subsequently renamed the Robert Koch Forum. Here, in a small room down the hall from the library where Koch unveiled his discovery of the tubercle bacilli, are more microscopes, more bottles of tuberculin, and Koch’s Nobel Prize and certificate. Visitors are infrequent, and with piles of papers stacked haphazardly in corners, it’s as much storage room as museum. Near the Humboldt University of Berlin, where Koch once worked, there is also a Robert Koch Platz, a lonely square of grass with a massive granite sculpture of Koch wearing a long robe and looking off to his right. A small fence keeps anybody from stepping on the grass or getting too near the statue. The effect is oddly suited to Koch: The edifice looms large but the park doesn’t have much purpose and is easily ignored.

  That, aside from a plaque or two around Germany or Poland, or a lonely microscope displayed in the German Historical Museum, is Robert Koch’s physical legacy. Where the names of Pasteur and Lister remain in circulation—Pasteur has his pasteurization and Lister has the mouthwash—Koch’s name is most associated with the postulates, those abstruse dictates for how to pursue science.

  As legacies go, the Koch postulates are rather abstract and out of date. The infectious process as Koch explained it became obsolete with the discovery of viruses, the mechanisms of which escape the net of his dictates. But the basic imperative behind the rules remains sound: never B until A. These postulates, and the process they speak to, are perhaps more enduring and beneficial to humanity than any one cure for any one disease might have been. That process is not a singular vaccine that can be injected or a pill to be swallowed; it is a now-pervasive concept, an enduring shift in the way people think. Koch perfected a method by which we could pursue science for the glory of discovery, for the purposes of knowledge, and for the betterment of us all.

  It seems a perfect sort of poetry, then, that this man’s greatest triumphs came because of his principles and that his most wretched failures came when he abandoned those principles. Before Koch, there was no succinct method by which to demonstrate causality, nor a recognized method to examine a treatment. In his postulates, he provided the former, and in his tuberculin trials, he provided the harsh inspiration for the latter.

  Koch’s contribution to science may not have been the cure he so badly yearned for, the remedy that tempted him into hubris. But he did create something. He convinced the world that germs existed and, in so doing, convinced the world that they could be defeated—if not by him, then by those who would follow.

  EPILOGUE

  The Cure

  Test tubes and flasks of the antibiotic streptomycin fromthe Waksman Laboratory, circa 1945

  It wasn’t until the nadir of the Second World War—forty years after Robert Koch’s death, fifty years after his supposed remedy, and fully sixty years after his initial discovery of Mycobacterium tuberculosis—when a true, real cure for tuberculosis would reveal itself, in the form of antibiotics.

  This first agent to prove effective against TB was streptomycin, isolated by Albert Schatz, a graduate student at Rutgers University’s College of Agriculture, in 1943. Under the direction of Selman Waksman, Schatz was exploring soil for microbes that might be turned into allies against other microbes. Though it seems odd to look in dirt for a germicide, on its face, there is logic to it. Just one gram of ordinary soil can contain billions of bacteria, many of which produce substances to ward off one another for competitive advantage. The great discovery of antibiotics was the realization that, by harnessing these inherent properties, bacteria could be turned into allies of humanity.

  The approach had been validated years earlier, in 1928, when Alexander Fleming observed that a fungus, Penicillium, would naturally kill many kinds of bacteria. It would take more than a decade, not until 1942, before penicillin was purified into a dependable treatment for infectious diseases (among them staph, strep, gonorrhea, and syphilis). But with that proof established, the race was on to beat bacteria at their own game and recover chemical agents from soil that might serve as instruments to defend human health.

  Penicillin and the other first antibiotics were a true godsend, arriving in time to be put to widespread use in World War II. But they weren’t a cure-all; many microbe-borne diseases were unsusceptible to this early generation of antibiotics—most disappointingly, tuberculosis.

  Schatz’s new agent, however, had more success in disabling and killing the tuberculosis microbe. It slipped between the microbe’s thick lipid walls and disabled the bacteria (precisely why it works is still not fully understood today). Waksman recognized the significance of Schatz’s discovery immediately; he himself had been researching possible antibiotic agents for the previous decade. Within eighteen months, he’d recruited the Mayo Clinic to conduct clinical trials of streptomycin and arranged with the Merck Company to manufacture the drug. By 1945, it seemed promising that, at long last, there now existed an agent that could take on this most ruthless of killers.

  But even as the laboratory evidence mounted, the researchers were wary of being too quick to claim victory. They were mindful of Koch’s mistake and of those who had since exulted before they’d proven their case. They also realized that these previous disappointments meant the burden of proof was higher. “We feared that disbelief of the results would be expressed because of the many previous false hopes raised by other ‘cures’ throughout all previous medical history,” said Horton Hinshaw, who was conducting the trials at Mayo. Nonetheless, the promise of the drug soon proved impossible to contain. The February 4, 1946,
issue of Life magazine ran a lavish story devoted to the work of Waksman’s laboratory, hailing streptomycin as “a new drug which is very much like penicillin but which cures diseases penicillin cannot.” Life suggested that the drug’s “greatest hope” would be in killing TB, which it noted worked in the lab but not yet in real trials. In most coverage, though, such subtleties were lost, and demand for the drug soon overwhelmed the Mayo team and anyone else involved with streptomycin.

  Thankfully, this time the remedy did indeed work. On June 12, 1946, Hinshaw sent Waksman a telegram informing him of the completion of the first human clinical trials. “Our streptomycin studies . . . were fully confirmed experimentally and clinically, establishing this as first effective chemotherapeutic remedy for tuberculosis. Hearty congratulations.” In 1952, Waksman would be awarded the Nobel Prize for the discovery of streptomycin; Schatz, unfortunately, would be deprived the glory of his discovery, as he was a mere student in Waksman’s lab.

  • • •

  ALMOST IMMEDIATELY, IT WAS EVIDENT THAT THESE NEW “WONDER DRUGS” weren’t without complications. Even in the first Mayo trials, some patients treated with streptomycin apparently recovered, only for the bacterium to return somehow, in a new form less vulnerable to the drug. This resistance was soon a regular problem with streptomycin, as it had been with penicillin, most gravely with staph infections.