We easily forget our faults when they are known only to ourselves.—La Rochefoucauld. Doctor. Is it not natural to die? Then if a dozen or two of my patients have died under my hands, is not that natural? Lisette. Very natural, indeed.—Mrs. Inchbald. And if you die, Why then you lie Stretched on the bed of honour.—Dibdin. Early the following morning, Elsworth presented himself to young Dr. Wilson, the house surgeon in charge of the wards under the chief care of the surgeons, to whom he was appointed dresser. Hitherto he had done no practical work in the wards at all. It was against the regulations for any student to be a dresser in the surgical wards till he had passed his primary or first professional examination, at the end of his second winter session. He had opportunities of learning the countless little details of minor surgery in the out-patient departments day by day, but now he was to be introduced to a very different kind of work. He would have some forty or fifty patients to study and report upon, to watch the progress of their maladies, or the processes of their cure, to dress the wounds, bandage, apply the remedies ordered by the house surgeon, or the surgeon-in-chief, and himself perform such operations as in their discretion he might be entrusted with. Everybody must have a beginning, and upon whom can one begin surgery so well as an hospital “I say, young man,” said a poor carpenter to an hospital novice, after the fifth attempt to lug out his grinder had been fruitlessly made. “Do they pay you here by time or by the job?” Even your hair-dresser must have cut somebody’s hair for the first time. You may be sure it was not a duke’s. “We allus begins on children’s at the Workhus schools,” was the answer of a master barber to an inquiry as to the method of learning the art. Here, then, were fifty live subjects, all human, at the mercy of our new dresser. That young blacksmith with the broken rib thinks he is here simply to get it mended. He will think so in a fortnight’s time, but the officials know better; the mended rib is a mere contingency. The butcher lad in the corner bed has compression of the brain. He shall be cured, if possible. Meanwhile, he shall make himself useful to those who want to investigate the latest theory of “localisation of brain functions.” He shall be trephined—that is to say, a round hole shall be neatly cut in his cranium, and the brain exposed at the injured part; and while the organ of the mind is open to the view, are there not many pretty ideas to be discoursed of, and various experiments awaiting trial? Are there not galvanic batteries at hand? Is not the man at their mercy? He has ether or The house surgeon “went round” with our new dresser, and explained the nature of each case in very brief terms, and in a perfunctory manner. It was his duty to instruct his dressers, and he did it after a fashion; but he was not paid to do anything of the sort, and, with the young and partially-educated, there is often a sort of contempt for those who know just a little less than they do. The scorn felt and expressed by the Board School child who knows decimals, for his companion just beginning vulgar fractions, is nothing to the sense of superiority assumed by a house surgeon appointed a few weeks since, and aged twenty-three, towards his unqualified dressers, who cannot go up for examination for another six months. And the dresser, in his turn, looks down from his exalted post on those late companions of his who failed at the primary, and have not yet achieved the right to handle cases in the wards. Elsworth was shown a number of beds, of the occupants of which he was required to write complete family histories, going into the minutest details, as practice in note-taking. He was called on to carry out, with the assistance of the nurses, daily, all the directions as to the dressings and bandaging required by the nature of the case; and was encouraged to avail himself, while doing so, of any and every means that would assist him in the acquisition of his art, so far as it was consistent with the regular treatment of the patient, and was not calculated to alarm him or make him think it was not actually connected with his cure. Our house surgeon was Let us go round the wards with Dr. Wilson and our hero, his new assistant. Here is a middle-aged woman, evidently having but a short time to live, yet this afternoon Dr. Wilson says his chief proposes to perform upon her a capital operation. He has not the least hope it can save her life, but the chance of performing such an operation arises but seldom; and it is but just and kind to the house surgeon, who wants all the practical work he can get, to let him assist. So the woman and her friends “Might he warn the patient of her imminent danger?” “On no account! It might cause her to revoke her consent; might, at any rate, depress her, and hasten the catastrophe.” In the next bed is an elderly woman with a contused side. That is a slight matter. It was not for that she was taken in, but in her examination in the out-patients’ department it was discovered that she had a peculiarly interesting bony growth on her leg that would make a very neat and pretty operation. So a bed was found for her, and daily and increasing pressure put upon her to have this queer growth removed. It was no inconvenience or annoyance to her at all. She was past middle life, and she had been told by her family doctor there was not the slightest occasion for operative interference; but everybody at St. Bernard’s wanted just such a case to try a new method of treatment recently invented in Vienna, and the chief surgeon was eager to do the operation, and all concerned were charged, as they loved him, not to let it slip. That also was to come off this afternoon. The next bed is occupied by a girl, the subject of a rare and very interesting skin affection. No active treatment has yet “That woman, you will perceive,” said the surgeon, “has a squint. She came in with a fracture of the arm, but with a little more pressure she will let us operate on the ocular deformity. I like doing squints. By the way, there is a woman dying in the next ward who has a perfectly charming optic neuritis. You ought to see that. Don’t examine it very often, as it hurts her dreadfully, and she can’t live much longer; but the case is perfectly typical. I am going to sketch it this evening. One don’t like to hurt folks if it can be avoided, but this is much too good to miss. She grumbles a bit at being disturbed, and I fear suspects all this is no part of her treatment; but I order her a glass of wine before I begin, and she likes that.” They next enter one of the male wards, and Dr. Wilson draws Elsworth’s attention to a man in articulo mortis. “He can scarcely live till the next morning,” says he; “but if you are interested in phthisis, take your stethoscope and have a quarter of an hour overhauling his posterior thorax. There are some sounds to be heard that with careful auscultation are quite typical, and one very rarely gets them so distinct. Don’t be too long at him, as turning him over on his face exhausts him so much, and we have examined him a good deal lately, poor devil!” Elsworth was obliged to assume a look of eager interest in the proposed investigation, for the sake of pleasing “Come into this room, Elsworth. See here is a case on which I am trying a rather singular experiment. I have kept this man for the past seventy hours sitting up to his waist in a bath of cold water, as you see. He has all his meals in this position, and sleeps and reads without removal from his tub.” “Does he like it?” “Well, I can’t say he does; but the experiment is a very interesting one, and I am getting up a good paper on it. I shall not keep him in much longer, for I have nearly completed my investigations. This is the best case on which I have tried the treatment. I have lost three others, but I think this one will do well.” And thus the days went by. To a man who loved his work as our hero loved it, there was hourly something fresh to interest and excite speculation. But the atmosphere of the place was beginning to tell upon him. The utterly reckless, matter-of-course way in which experiments were tried upon the occupants of the beds; tried by everybody concerned, from the chief to the dresser; tried by the performance of operations of terrible gravity on those who, at longest, had but a few weeks to live; down to the snipping off little mites of skin from the arms of one person to “graft” on the wounds of another, had tended to blunt Elsworth’s fine sense of humanity and lower his ideal. Not that anybody about the place ever suggested that all this was wrong; nobody, except now and then a patient or his friends, expressed any objection to a course so fraught with information and dexterity of hand. It all seemed the most natural thing possible, and the hospital “How is a medical man to learn his business if he does not pick it up at the hospital?” asked a noble lord of a friend the other day. The reply was a sensible one. “I don’t know, but I fancy these confounded Socialist fellows will put a stop to all this sort of thing before the world is much older.” Quite so. The mob did not like Marie Antoinette’s carriages to run over them in the streets of Paris just because they were only canaille. Our Radical friends have not found out just yet how we run over them scientifically. When they do, be sure they will find their remedy. |