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Through the Magnifying Glass of Sherlock Holmes | Jeremy McKay, MD | TEDxYouth@ClintonSquare

I want to first start by telling you a
little bit about my childhood he told
you I’m a military brat moved around
quite a bit when I was a kid my parents
formed a strong foundation but honestly
my parents are extremely cheap all right
hi mom hi dad
I think the best thing to say is they’re
frugal okay both of them grew up
extremely poor
they knew the worth of the dollar so
they weren’t going to really spend it on
something that they thought was
frivolous I I don’t want you to think
that you know I we were struggling no we
had a roof over our heads I food on the
table I had clothes on my back but those
clothes weren’t name brand clothes all
right no cable TV definitely no J’s no
video game systems but there was one
thing that they would spend their life
last dime on and that was books if it
had to do with anything with education
they would get that for us now you
should know I’m a physician and I love
what I do but I actually wasn’t that
good at school I I just didn’t really
fit in I was actually a pretty bad
student so bad that my parents would
give my teachers their phone number at
the at the beginning of school year I
would get home and my parents would know
the stupid stuff I had already done in
class right that that’s how bad I was
I’ve been suspended I’ve been kicked out
of school before right so for some of
you who are going through that you still
got time you still got time but I also
still loved read books and one of my
favorite books to read was anything
dealing with Sherlock Holmes which it’s
it’s interesting because why would a
black kid from the south
latch on to this 18 19th century white
detective from Britain but he was a lot
of things that I wanted to be he was
intelligent he was smart he was brash he
was eccentric those kind of things that
I really latched on to as a kid there
was two things that I wanted to do when
I was a five-year-old I wanted to be a
Navy fighter pilot
and I wanted to be a doctor I’ve worn
glasses since I was four so Navy fighter
pilot was not going to happen right and
when I found out I was devastated so I
picked myself up and say okay let me
just be a doctor then I can do this
now Sherlock Holmes is actually modeled
after a doctor and I didn’t realize this
when I started reading him but as I got
a little older I started reading about
the history of Sherlock Holmes the
author of Charlotte Holmes is Arthur
Conan Doyle he actually was a physician
– he was a doctor he went to medical
school and one of his professors who had
this brilliant keen observational skill
set is who he modeled Sherlock Holmes
after his professor could just look at a
patient walk into the room and he could
tell you just by looking at him smiling
using all this since senses he could
tell you what was ailing the patient
where that patient was from and all
kinds of just interesting facts that he
could just tell by just by looking at
him and that was amazing to me and I
actually used a lot of things that I
learned from Sherlock Holmes to teach my
med students and my residents residents
are students who graduated from med
school they’re doctors but they still
have to take a couple years to get and
are like an apprenticeship to train to
get to full fledged doctors even though
most people still think you’re a doctor
so you can still pick up girls but
anyway so what do I teach them I teach
them that the exam starts as soon as you
walk into the room it doesn’t just start
when you’re interviewing the patient no
it starts when you walk into the room
what does the room feel like that’s
called transference what does the
patient look like patient hunched over
looking like they’re an acute pain who’s
with the patient what does the patient
wearing what does it room smell like all
these things are very important right
because being a physician is a lot like
being a detective you’re looking for
clues you look you’re using lab work
that you’ve got from the lab you’re
you’re interviewing the patient you’re
trying to ask certain questions to get
the information that you need to
formulate your differential diagnosis
differential diagnosis is a list of
things that you might be causing the
patient’s element because you need to
have a correct differential diagnosis
before you can prescribe the correct
treatment right so one quote that you
see a couple times throughout these
Holmes mysteries is it is a capital
mistake to theorize before having any
evidence it biases the judgment so what
does that mean for me in medicine case
in point I was a medical student in
Boston a couple years ago I was in the
emergency room a young male came in
complaining of excruciating back pain I
went in as the med student to do a full
history and physical swim about 20-25
minutes and I came out to present to my
chief resident I started as follows
patients a 28 year old black male
presenting with excruciating back pain
he cut me off
my chief resident said stop he’s just
here looking for drugs get him out of my
er and I said well oh you haven’t even
let me given you give you the facts he
said I don’t care about the facts get
him out of my er he’s a drug seeker it
started getting heated the patient had
heard overheard this conversation too
luckily at that time another resident
who had sent this patient and to get
pain medicine came in and we were able
to it he was able to talk to my chief
resident and we appropriately treated
this patient now some of you have
probably seen this in medicine and to
write was family members or even
people getting stereotyped people not
getting the treatment that they deserve
the right treatment people look at them
maybe that they’re a hypochondriac or
because of their their race or their
social status or they aren’t treated
correctly but this happens in real life
too right we all like to put people into
boxes without knowing the facts of who
they are or what they are their stories
their struggle and unfortunately it’s
going to happen to you if it hasn’t
already I know what’s happened to me I
know I was told by some teachers that I
couldn’t be a doctor so what are you
gonna do about it cuz it’s gonna happen
right this is gonna happen unfortunately
well but what are you gonna do about it
I’m gonna leave you with two things
number one I want you to internalize
what that feels like when someone
stereotypes you when someone judges you
without having the fat
because the faculty matter is we’ve done
it to other people too I know I have so
you need to remember what that feels
like so you don’t do it to others but
number two I’m going to need you to
fight against those people who try to
create your story who try to put you
into a box without knowing your facts
your truth because each and every one of
you is a unique individual and I know
that sounds sappy we always talk a
little your little snowflakes no no no
you really are you know why I know this
because I’m an anesthesiologist right my
job is to put you into a medical coma so
someone can do surgery on you I don’t I
just don’t put your information and
press a button and everybody gets the
same thing what I give you is going to
be different when I from what I give you
even though you might be the same height
same age same weight no allergies listed
you know why because each and every one
of you is physiologically different I
give you medicines and it might take you
12 hours to wake up that’s called it’s
delayed emergence your mom’s gonna be
like my baby why is it that wake up like
she’s fine it’s not alright you might be
like what you gave me something so each
and every one of you is totally unique
each and every one of you has dreams in
your heart that you know are real some
dreams you might not even have told
other people but people are going to
challenge you people are gonna try to
put you in a box people are going to try
to bend their facts to make judgments
about you so remember what Sherlock
Holmes said it’s a capital mistake to
theorize without having any evidence so
what are you gonna do number one before
you make decisions you’re gonna get the
facts right that person might be a jerk
let them be a jerk well it build those
facts up and then you can get away from
them but don’t don’t stereotype do you
know how many how many relationships
have we already lost out on because we
put them into a box we judge them with
for finding our facts but remember
number two never be afraid of fighting
against people who are trying to try to
tell your story who are ignoring your
story even always fight never be afraid
to show them your strength your
knowledge your courage your dreams what
is in your heart because someone in this
room might be the doctor that takes care
of me
someday in my family and that makes my
heart glad because you fought against
this society trying to tell your story
and judge you without knowing the facts
that lie within your heart thank you
very much [Applause]
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