Speech deficits as plot devices in novels

P Perkins ¹ appears to have misunderstood the key messages of our paper ‘Neurological speech deficits as plot devices in novels’ ² entirely. We pointed out that, unsurprisingly, characters with stroke commonly appear in novels. In each novel discussed the fact that a key protagonist had suffered a speech deficit, presumably as a result of a stroke, significantly altered the plot of the novel. In discussing the various characters, we suggested some possibilities for the speech disorder but we were not seeking to make precise diagnoses. The influence on the novel's plot and not the diagnosis of the speech deficit was our point of interest.

We disagree with Perkins' apparent suggestion that medical diagnosis and treatment in novels should be confined to fictional doctors or medically qualified authors and fail to see how the number of medical references in Conan Doyle's work has any relevance to our paper. As RS Downie points out, there are a variety of ways in which literature has influenced medicine and vice versa. ³ Literature can also remind us that what is scientifically typical appears in unique forms in individual patients. ³ It would be a dull world indeed if medical matters in literature were confined to doctors, real or fictionary, alone. One of the joys of reading the JRSM over many years has been the wide variety of discussions and interpretations of medicine in literature. Long may that continue.