It may be more than a coincidence that Sir Arthur Conan Doyle, the creator of Sherlock Holmes, was a physician. The observant eye and deductive logic of the detective prototype are also hallmarks of the astute physician who seeks clues to diagnosis or who traces the source of an epidemic. Kinship between the two callings becomes even closer when a pathologist aids in solving a crime or a clinician uses his skill to detect deception on the part of a patient.
Deception by patients takes many forms. It may be deliberate in malingering, subconsciously motivated in hysteria, shamefully concealed in child abuse, and self-destructive in the Munchausen syndrome. More commonly, deception manifests itself as noncompliance with physicians' orders.
Physicians are well aware of noncompliance. They suspect it whenever a patient does not respond as expected to prescribed therapy, be it exercise, medication, or a restricted diet. Justly or unjustly, they