Abstract
In seeking to apply a diagnosis to speech defects described in classic novels, Sainsbury et al. 1 trespass into the world of literature at their peril. It is not their conclusions I wish to question, rather that these fictional characters are constructs and therefore the interpretation of their symptoms into neat medical diagnoses is meaningless. Such characters will always remain at the mercy of their author's pen and plot. Even an aphasic subject may ‘speak’ through their thoughts depending on the story's narrator.
Conversely, the author's background maybe very relevant. As a fictional doctor, John Watson, M.D., was at perfect liberty to diagnose and treat fictional characters in the Sherlock Holmes novels written by Sir Arthur Conan Doyle who first trained as a doctor. Indeed, these stories list no less than 68 diseases, 32 medical terms, 38 doctors, 22 drugs, 12 medical specialties, six hospitals and even three medical journals. 2 Thomasson 3 makes the case that fictional characters should be treated as such. For example, Sherlock Holmes was not a real consulting detective and neither did he really live at 221B, Baker Street. We cannot meet him as he did not exist. Equally, his immortality as a character long after the author's death, is testament to his popularity and not some rare medical longevity condition. Applying 21st Century medical knowledge to imaginary characters is taking fictional realism a step too far.