Hire some bloody fact-checkers!!

The Better Half and I received a great many video entertainments for Christmas this year.  (We also gave a lot of them to The Critter, which is essentially the same as buying them for ourselves.)  Since we are the parents of two small children, we don’t make it to the movies like we used to, so these were welcome additions to our possible recreational options.

The first one we opened and watched was “Sherlock,” the BBC’s reimagining of Sir Arthur Conan Doyle’s legendary detective.  We love it.  The writing and acting are superb.  (I also think Martin Freeman as Watson is kinda cute.)  As soon as we finished with Season One, I was dispatched to Best Buy for the second one.  We’re hooked.

But damned if those writers didn’t make such an epically stupid medical error that I was forced (as is my wont) to pause the video so I could make The Better Half listen to a diatribe about how wrong they were.

And here is the obligatory SPOILER ALERT.  Below I will mention a spoiler-ish aside about the episode “A Study in Pink,” and will discuss a major spoiler for one (of many) plot point(s) in “The Great Game.”  Consider yourselves alerted.

First, the minor aside.  I was unable to watch the denouement of “A Study in Pink” without thinking of a certain scene in “The Princess Bride” in which death is on the line. It… complicated the dramatic tension.  Still a good scene, but I kept wondering if the cabbie was Sicilian.

But the plot blunder.  Oh, the blunder.  It is a blunderous blunder, which they could have avoided by having anyone with a passing acquaintance with medicine look over the script.  Since they obviously did not, Sherlock’s solution is a steaming pile of wrong.

The case in question involves the demise of a prominent television personality, who purportedly died in her home.  The cause of death was attributed to tetanus, supposedly contracted through a cut on her hand sustained while gardening.  Everyone apparently accepts this explanation for her death without much consternation.  Dropping dead of tetanus is no great shakes in “Sherlock”‘s Britain, it seems.

That right there is just plain nutty.  First of all, vaccination against tetanus is routine in the UK, and has been since 1961.  Is it possible the character was one of those wacky vaccine-refusers, in which case dying of tetanus would be a grimly meet reward for her bad choices?  Sure.  One need look no further than a recent front page comment thread to find evidence that there are plenty of people out there who are.  But it would make her an outlier in a nation where almost everyone is vaccinated, and would have provoked at least a mention from someone.  But no, Holmes and Watson discuss dying of tetanus as though it were as commonplace as croaking from a heart attack.  Wrong.

Not only that, but tetanus is an absolutely awful way to die.  The muscles slowly begin to spasm, eventually causing painfully powerful contractions all over the body, sometimes bad enough to break bones and rupture muscles.  People die when their muscles of respiration seize up, essentially suffocating them in their own ribcage.  Yet we’re meant to believe that this famous person died this way in her home and nobody took her to the hospital, where she might possibly have received life-saving treatment?  It’s a slow enough killer that she could have simply gone herself when her symptoms got bad enough.  But again, her death at home of tetanus is simply accepted as Just One of Those Things.  Wrong.

But that’s not all!  NO!  That would be dumb enough!  Yet the stupid is stronger still in this storyline.  For you see, she didn’t actually die of tetanus.  No, she was poisoned with overlarge doses of Botox, and died of botulism.

This is so dumb it makes my face hurt.  Any medical examiner who thinks a person who died of botulism actually died of tetanus should be sacked immediately and reassigned to a more appropriate job for his intellect, like charting Paris Hilton’s record sales.

Tetanus and botulism kill people in the exact opposite way!  Tetanus causes intractable spasticity, and botulism causes progressive muscle weakness and flaccidity.  While they are both caused by bacteria from the same genus, in terms of clinical presentation they look absolutely nothing alike.  If Holmes was able to solve this one, it’s only because any medical personnel involved in the case beforehand were too grossly incompetent to remain employed.

I know I’ve ranted about this kind of thing before, and also that ranting about it is the kind of thing that probably nobody finds interesting.  Fair enough.  But it annoys the living daylights out of me when a show or movie invests so much in all of its aspects of production but doesn’t bother to check some very elementary (see what I did there?) fact, which (unchecked) makes its story collapse into nonsense.  Surely they can scrape a few quid together to hire someone with medical expertise to check a few basic bits of information.  If you’re reading, “Sherlock” people, I’ll do it free!  Just let me pose for a couple of pictures with the cast and we’ll call it even.

Does this make me like the show less?  Not really.  It was a relatively minor point in an otherwise fantastic program.  But it is a silly and careless error in a show that (as far as I can tell) avoids them relatively well otherwise.  And surely Sherlock Holmes would never approve of such silly carelessness.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Would Botox cause botulism for reals? I thought it was a different strain or something like that.

    • I believe Botox is your standard “improper canning” variety of botulinum toxin. It’s just injected in such tiny doses that its effects are limited to the immediate area in which it is used.

  2. I’m on a real Martin Freeman kick myself: Sherlock, the British version of The Office, and The Hobbit. He’s superb in all of them. I have to keep resisting the urge to rewatch the dreadful Hitchhiker’s Guide film. (Not that I think he’s cute, mind you. Though the one that plays Mycroft’s assistant, who ignores him so brutally: wow.) And I suspect the Princess Bride reference was deliberate.

    • I must be the only person in the universe who liked that movie.

      • For a second, I thought you were referring to “The Princess Bride” and I was trying to figure out if you were being ironic, since it may be the most universally loved movie I can think of.

        Then I realized you were referring to the “Hitchhiker’s Guide” movie. Which, sorry… I didn’t like it.

        • I gotta say I’m not a big fan of Princess Bride. I know it’s well liked and that I *should* like it, especially because it’s not dissimilar from my kind of humor. But I just don’t.

          To each their own, of course.

          • “I gotta say I’m not a big fan of Princess Bride.”


          • For me, the ones that I “should but don’t” are Arrested Development, and Kids in the Hall. Both are aimed squarely at the type of humor I generally enjoy, but both just miss the mark for me.

            Even “The Big Lebowski” – I *love* the Coens and Daniels/Goodman etc., and generally like that type of movie – but I think it mostly falls flat except for a few scenes, and this is really rare in their oeuvre for me.

            Maybe when Rose puts up her “Comedy” post (hint, hint) we’ll get back into all this.

          • I love “Arrested Development” but found “The Kids in the Hall” too outre much of the time.

            And I need to watch “The Big Lebowski” again. I was, IIRC, inebriated the first time I watched it (and I think I was also in the company of an ex-boyfriend I had come to dislike intensely), so my opinions are highly unreliable on the subject.

          • The Princess Bride is one of my favorite movies. But the book is even better.

          • I loved Kids in the Hall when I saw it in high school, and I still have a bit of affection for it. But a few months ago I netflixed a few episodes and it really wasn’t as good as I remembered it (or more likely, I changed, and not necessarily for the better).

            I never really got into “Arrested Development,” so I can’t comment on it.

        • Heh. I introduced my two boys to the whole “I’m crushing your head” thing at the dinner table Saturday night. Of course, since I’m a good father I also taught them how to block it as well!

    • I adore his assistant. I’m going to have to work that kind of indifference into a character soon.

  3. I’m sure everyone would find endlessly fascinating the section of the chapter in my dissertation on why we can accept it as fictional that we live in a world such that we can accept it as fictional that the guy we all know is really Benedict Cumberbatch is Sherlock Holmes. Which means there also was no Sir Arthur Conan Doyle, etc., but the world was otherwise very like this one. And the guy that we all know is really Martin Freeman, we accept as fictionally true that he is Watson. Which means that there exists no British version of the Office or Hitchhiker’s Guide in this world. And we accept that Mycroft Holmes has, shall we say, a position in government with powers that I don’t think are granted to any one person in the actual world. But we cannot accept as fictional that “tetanus” does something different in a fictional world. You would find this fascinating, wouldn’t you? Admit it. You are dying for this information. I suspect of flaccidity, not spasticity, but that’s neither here nor there.

    And, as I have informed Russell by a very important text message, I find Martin Freeman inexplicably attractive, too. Except in Love, Actually. Where I do not accept as fictionally true that any porn director would let him near his movie.

    • The only other problem I’ve had with believability in “Sherlock” was [SPOILER] the notion that Holmes would be uninterested to the point of ignorance that we have a heliocentric solar system, but that he would be familiar enough with some incredibly obscure astronomic phenomenon that seeing it incorrectly painted into a faux Vermeer (I think) would allow him to spot it as a phony.

      Certain “rules” have to be in place for something to be plausible/enjoyable. If tetanus in “Sherlock”-world doesn’t behave like real tetanus, then the fun of seeing Holmes induce a correct solution falls apart. They may as well just recalibrate the dilithium crystals or have eagles show up at the end and rescue him from certain doom.

      I find Martin Freeman inexplicably attractive, too. Except in Love, Actually. Where I do not accept as fictionally true that any porn director would let him near his movie.

      Good heavens, no. I can’t imagine anyone wanting to watch that skin flick. Certainly not me.

      And I have a whole ‘nother rant about what ruins Love, Actually for me.

      • Aha, yes, but which rules? Which rules, damn it?!?! It is for figuring out such answers crucial to human existence, and for confusing undergraduates, that the taxpayers of my fine state (inter alia) pay my salary. I am certain that not one of them doubts the value of this.

        • I struggle with this as well. It is why I got so frustrated with Harry Potter. WHY THE FISH DIDN’T THEY USE THE TIME TURNER AFTER BOOK 2?!?!?! Also, you have frickin’ magic and magical hospitals and magical doctors… did they even TRY to cure cancer? If they have the ability to cure cancer and don’t because it would mean revealing their magical world to the Muggles, they are moral monsters deserving of zero regard.

          What I always think about (and I think Ocean’s 12 or 13 actually explored this) is that in movies, the celebrities themselves don’t exist. What I mean is that, in Christopher Nolan’s “Batman” universe, for instance, there is no Christian Bale. Otherwise, everyone would look at Bruce Wayne and be like, “Holy crap! That guy looks just like Christian Bale!” But they don’t. Because Christian Bale does not exist in that world.

          • I also hate it when people with magical/supernatural powers that include levitation end up falling. Darth Vader, for example, throws the Emporer–the number one Sith lord!–down a hole. Are you fishing kiddin’ me?

          • Darth Vader, for example, throws the Emporer–the number one Sith lord!–down a hole.

            He does?!??! Thanks for the spoiler alert, Hanley!

      • Holmes would be uninterested to the point of ignorance that we have a heliocentric solar system

        It’s a trick.

        Read the chapter of A Study in Scarlet where Holmes and Watson first get to know each other. Holmes denies ever having heard of Thomas Carlyle. Then, a few paragraphs later, he quotes “Genius is an infinite capacity for taking pains”, one of the best-known apothegms of (you guessed it) Thomas Carlyle. He’s having Watson on.

        • I kinda figured that was it. But he seems so irritably insistent about the pointlessness of knowing the earth orbits the sun that it made me wonder.

          • “irritably insistent” is one of Holmes’ signature traits. One thing that “Sherlock” gets right is that Holmes’ singular abilities and approach also make him sort of a d**k, and give him certain blind spots (he always assumes the worst of people, for one, and that makes him miss the correct solution at least once).

          • He was so horrid to the nice forensic pathologist who has the hots for him that I had to hide my eyes during the scene where she gives him a Christmas present.

          • FYI, information about the nova was (IIRC) actually being narrated during the fight scene in the planitarium.

            The logical deductions are pretty straightforward: There was an astronomical issue with the painting (ie: something was off with the night sky) because the murdered guard (amateur astronomer) and the second murder target (the lady at the planaterium) were both, you know, connected by astronomy and the night sky.

            Given the narration about the nova was ongoing during the fight scene, I always felt he’d flat out put it together right there, taking (luckily) straight from the narration mentioning the year of the supernova.

            As to being irritably insistent — it fits his character AND his point: A lot of what most people consider important is irrelevant to him, and vice versa.

    • Also this:

      Admit it. You are dying for this information. I suspect of flaccidity, not spasticity, but that’s neither here nor there.

      may be the best thing I have ever read in my life.

    • Of course there was a Sir Arthur Conan Doyle. He was John Watson’s literary agent.

  4. Allow me to add two things: I have a special fondness for Benedict Cumberbatch not only because of his name, but because I think my middle son just slightly resembles him (Cumberbatch would not look entirely out of place at a Ridiculously Rare syndrome conference and they both have very nice blue eyes). And this is possibly the single best list of tag words on a post EVER.

    • It amused me to assemble those tags, it’s true.

      And Mr. Cumberbatch is one of those guys who at first I thought was funny-looking, and then…

  5. *howls*
    I appreciate you warning me of this stupidity, so that I may brace myself against it when I get to that episode eventually.

    I swooned over the inestimable Cumberbatch at first sight, when he was playing William Pitt in the extremely well-acted but rather historically dubious biopic _Amazing Grace_. I wasn’t quite sure whether it was Cumberbatch or Pitt I was swooning over, and I still am not.

    (Can you tell I just pulled an all-nighter to finish coding a game for class? BECAUSE I TOTALLY DID.)

    • Happy to greet you on the other side, m’love.

      There is actually even a little bit more wrong in that episode as pertains to botulism, but I thought as I wrote this post that it was already too ranty. Suffice it to say, the writers of “Sherlock” should eschew biological pathogens as murder agents until they’ve taken a medical microbiology course.

  6. I wonder if you got enough people with different expertise, you’d find that everything Sherlock says is bulls**t. I really enjoy the show, and I love the fun of watching the character quickly deduce the myriad of tiny details in a few seconds and construct a coherent pattern out of them. But I have to confess, I have to actively tell myself to shut up, enjoy the show, and suspend disbelief as I watch it.

    For me, there are two parts of these deductions that force me to actively hold back from wincing:

    The first is that they seem to me to indicate a profound lack of creativity in Sherlock’s character. He see’s a smudge of dirt on someone’s sleeve and thinks, “That smudge must have been caused by X.” He says this, and I find myself thinking, “Yeah? Cause I just thought of a couple dozen other stories that could explain that smudge as I was sitting here watching you.”

    The other difficulty is that I note we’re simultaneously asked to believe that he lacks the social awareness to understand what anyone in his life is motivated by, and yet can construct complex strings of motivations of people he has just met from their hair being parted the wrong way or some such.

    And yet I still love the show.

    • I had a converse complaint with the episode we just watched the other day, “A Scandal in Belgravia.” (Can I dispense with spoiler alerts now?)

      Irene Adler (a character I adored) enters the room where Holmes and Watson are sitting, stark naked, and because of this Holmes is utterly unable to discern any clues about her person. I find this completely nutso. He can look at a man’s pant cuff and figure out that he works at Buckingham Palace, but not at her body and figure out anything??!?! “Likes pilates.” “Usually wears high heels.” “Needs to get that mole checked out.” Nothing? Nada? Yet despite this lack of insight, he still gets an accurate enough picture to know her measurements and use them to open her safe?

      Silly. But we loved the episode anyway.

      • I had assumed the reason he came up blank was because he was smitten for the first time ever, and didn’t know how to process that.

        • But she hadn’t proven herself brilliant and beguiling yet, merely (and quite stunningly) gorgeous. Given his presumed cold-blooded immunity to pulchritude alone, why was he so dazzled by her as to be incapable of noticing any clues about her?

          • Because it WAS an indication of her brilliance. She knew who she was dealing with when he walked in, and how to throw him off his game. He’s used to examining people as though he has X-Ray vision – she did an end-run around that, and showed him her “all”.

            Showing him her body like that, showed him her mind (and ironically, helps her hide everything she needs to hide via misdirection).

      • I’m glad I’m not the only one who did a complete double take on the whole tetanus/botulism thing.

        Oooo, don’t get me started on that bit in “Scandal.” In normal life, many women I know can recognize brands of lipstick by their color, stone settings in jewelry (high-end brands especially are quite distinctive), makeup and how it’s applied, etc., all of which in the Sherlock world would tell something about Ms. Alder. And that doesn’t get into what someone can tell from your naked body – the calluses on your feet and hands, scars, how you hold yourself, etc. My first meeting with a trainer at the gym noticed a long-ago repetitive stress injury in my shoulder just by the way I was standing.

        I will say, though, I like the fact that Sherlock actually takes off his gloves at a crime scene before reaching for his phone or shaking someone’s hand.

        Like Rose, I also find Martin Freeman quite attractive as Watson….

        • Well, that makes three of us re: Mr. Freeman.

          And I’m happy to reassure you that no, you are not the only one who found the whole tetanus/botulism thing totally bonkers. Or that even a sexually stupefied Holmes should have noticed something about Ms. Adler that gave him insight into her character.

    • It’s the same thing with House. You have to believe that everyone with disease X has exactly the same set of symptoms, and reacts exactly the same way to all possible courses of treatment. When they diagnose X and give Y to treat it, causing horrible reaction Z, the answer is never simply “He’s allergic to Y”.

      • I cannot watch “House” for all manner of reasons. You get a more accurate picture of real medical practice from watching Mummenschanz.

        • My big problem with House is that I can’t really participate in the mystery. In Law&Order, even with incomplete information, I can make a reasonable guess that it was the boyfriend or the ex-husband or the son. Rarely is the culprit someone you haven’t even seen in the show. But on House, it often seems that the ailment is something I’ve never heard of and would never guess; sometimes I suspect they even make up the disease entirely.

          • sometimes I suspect they even make up the disease entirely.

            Because I am unable to watch the show without getting very shouty very fast, I’m not familiar enough with it to say for sure. (I did once figure out the correct diagnosis from the episode promo alone, which made me hypocritically pleased with myself.) But it wouldn’t surprise me in the least if they did invent diseases.

          • Only ever saw one episode. It had cats.
            (magic kitties who could tell which person was going to die.)

          • House prided itself on finding a new obscure disease for each episode. How much actual medical knowledge their researchers have, I don’t know.

    • You’d be very fond of Samuel Vimes, of the Ankh-Morpork City Watch.

      His views on Sherlock Holmes (well, the method) is that it is an insult to the varied nature of the human experience.

      • There’s one book (I don’t recall which), where he rejects all the ridiculously improbable solutions and concludes it must be the impossible one. Which makes more sense when there are gods and magic around.

  7. Interestingly, my father, a lawyer, loves any and all crappy lawyer shows. L.A. Law, Perry Mason, whatever. Could not care less about, “Objection! The lawyer is deeply in love with the witness!”

    • “Although I am in the middle of my closing argument, I would like to call a surprise witness.”

      • My favorite howler along those lines comes at the end of the movie “Fracture,” in which we see [once again, SPOILER] that Ryan Gosling’s character is once again prosecuting Anthony Hopkins, despite now being a key witness.

        • Is the key witness Gosling or Hopkins? (Not that it matter, really.)

          • Gosling is the key witness. He prosecutes Hopkins once, then hears him confess to a crime for which he has been found innocent (double jeopardy, you know), but through a technicality another case is brought… for which he again serves as prosecutor. Had I not been in a theater at the time, I would have screamed “You can’t prosecute a case and also be a material witness!!

          • Love, love, love when Futurama did a courtroom drama episode, and no matter inanity occurred, the judge just said, “I’m going to allow this.”

          • “Even though this is a celebrity murder case that’s already attracted more tabloid press than a royal wedding, I’m going to allow TV cameras into my courtroom to make sure it’s a complete circus.”

            Hold on, that was real life.

  8. Have you not done a Stupid Tuesday on stuff you’re suposed to like, but don’t?

    • I think I’ve done the converse a couple of times, some variation on “I know this is loathsome, but I like it anyway.” I don’t think I’ve done one on stuff I’m supposed to like, but don’t.

      Which gives me an easy idea for next week.

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