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Edward Berdoe
St. Bernard's: The Romance of a Medical Student

CHAPTER XII.
“SEND FOR FATHER O’GRADY.”

 
“What! do they study?”
“No, father, but they feel!”
“Feel! I comprehend thee not!”
 

Sir. E. B. Lytton.

Such men, in other men’s calamities, are, as it were, in season, and are ever on the loading part; not so good as the dogs that licked Lazarus’ sores, but like flies that are still buzzing upon anything that is raw.

– Bacon.

As a resident dresser, it often devolved upon our hero to reason with troublesome patients who offered opposition to the methods of treatment proposed to be adopted in their particular case.

One day an ambulance deposited at the door of the hospital, an Irishman, who had just fallen from a high scaffold, and had been carried thither by the police.

Dr. Wilson had carefully examined the poor man, and had determined to amputate one of his legs. Dr. Wilson had what has been aptly termed the “furor operativus” the operative madness. He had a burning desire to do everything that anybody had ever been known to do on the human subject in the way of surgery. He did not want his period of office to expire till he had had an opportunity of adding to his list of cases the most difficult and dangerous operations set down in books. Now the Hibernian subject just brought in would do very well for a trial of a new method of amputating the leg at the thigh; and as the man objected to any such interference with the integrity of his ambulatory apparatus, the strongest pressure was brought to bear upon his obstinacy.

“Send for Father O’Grady, he’ll manage it. I won’t lose my chance if I can help it!” And the newly appointed house-surgeon looked defiantly round on his little band of dressers, who shared his anxiety that so good an operation should not slip through his fingers without a final effort. Pat was determined he would not have his leg off. “What would he be good for with a wooden leg? How would the wife and childher go on if he were maimed like that? Let me be out of this! By the mercy o’ God and His blessed Mother I’ll get well again and kape me leg. Just boind it up, mates, and let me go. God bless ye all, I know ye mane it for me good. Don’t be thinkin’ me a coward: it isn’t that at all. Ye might cut me in little paices, if it wasn’t for the missis and the bits of childher.” And poor Pat began to cry bitterly, not for his pain, which was bad enough, but at the recollection of his dear ones at home, for whom he could do no more work for many a week, perhaps might never climb a ladder again.

The dressers were rough but warm-hearted, and some had difficulty in restraining tears that were undresser-like and derogatory to their authority.

The house surgeon had long ago got over that nonsense. He was there in the interests of science. Sympathy was for women and clergymen. What had he to do with a patient’s calling and his home concerns? He walked up and down the receiving room with his hands in his pockets, musing thus: “Conservative surgery is all very well, but it isn’t brilliant. When a fellow has taken off a dozen or two lower extremities, he can afford to be conservative; but if I let this go, I may complete my term of office without another chance of doing anything half so good. That conceited ass Gayworth, is crowing over me already. He did a better hernia than I ever had the chance to do; but I shall beat him if I get this. Perhaps I could save the poor devil’s leg – at any rate, Laxton thinks so; but, hang it, what’s a fellow to do? I go off next week, and I shall never have anything like this again! Here comes the priest; he will bring him to reason.”

Cheery, bustling, kindly Father O’Grady runs up the hospital steps, and is met in the entrance hall by our ardent young operator. “Sorry to bother you, father, but one of your people here who has a compound fracture of the thigh refuses to undergo the necessary operation to save his life.”

“Won’t have his leg off, I suppose?” said the priest.

“Just so.”

“Is it really necessary, doctor dear?”

“Decidedly, and I wouldn’t answer for his living the week out if it isn’t done at once.”

And the surgeon looked as dogmatic and authoritative as though he were the President of the College of Surgeons himself. The good priest looked at this youth, only just turned twenty-two, and wondered, if he were older and wiser, with the knowledge that comes not from books and lectures, but from experience and meditation, the true correctives for so many medical theories – wondered if he would be as positive as he was now.

“You are sure you couldn’t save his leg anyhow?”

“Quite sure.”

It was not for the good clergyman to argue the case, so he went to the couch on which lay the crushed form of his suffering countryman and co-religionist, bent over him and whispered loving words in his ear, and commanded him in the name of the Church to submit to lose his limb that his life might be saved, as the doctors desired.

Without another word of resistance the man obeyed, and gave the surgeon permission to do as he would with him. The good priest blessed the man, and, with tears in his eyes, turning to the grateful young doctor, said in a whisper, —

“But I hope it is really necessary.”

“Oh, certainly, father, or I wouldn’t think of it.”

His reverence did not seem quite so convinced on that score as he might have been, and left the place with a sigh. A message was immediately sent to the visiting surgeon of the week, who lived close by and who had long promised the young doctor “something good before he went off.” He soon arrived, approved of Wilson’s suggestion, and congratulated him on his “opportunity,” for he was an amiable and benevolent teacher, who liked his pupils “to feel their feet” as he used to say.

Of course it was given out that the great man was to operate (that was a precaution always taken) the teachers never shirked any responsibility, their backs were broad enough for everything, and when the anæsthetic had done its work,“who was to know? That’s the beauty of chloroform,” said Wilson. “Qui facit per alium, facit per se,” added the professor,“that is an axiom in law and that must be right!” So the bell was rung that called the students to assemble in the theatre where the operations took place, and all was ready. Mr. Wilson was not quite easy in his mind; his conscience told him he was sacrificing this Irish labourer’s chance of preserving his injured limb (and that limb meant so much more to him and his than to a rich man) to his own advancement in the surgeon’s art. But that conscience was soon silenced. He had learned how to crush out all feelings of pity that interfered with his “work” long ago in the physiological room. He was tender, kind, and a lover of the lower animals when he began his course there, when he first obeyed the order of his teacher to slice off a piece of a living frog’s eye and rub lunar caustic on the injured organ. He shuddered when the professor said: “It won’t be nice for the frog, but it will be useful to you!” But he shuddered less next time, and when he had conquered his aversion to the torture of living dogs which licked his hands before he began, it was not difficult to do any work in the operating theatre on human beings which science might demand.

 
“So patients must suffer that surgeons may learn,
And women must weep when their husbands return
With their limbs left behind at St. Bernard’s.”
 

And he whistled merrily to think how his capital operation had come in the nick of time.

* * * * *

Poor Pat was quite resigned; he had obeyed the voice of the Church; and Faith bade him reflect that God would look after his family when he went out with a wooden leg and his calling gone in this life. It is not absolutely certain that this mediæval attitude of mind is so very inferior to that of the free and independent Protestant way of looking at things, after all. Patrick Flynn’s day-book and ledger would not make a bad figure when the auditing angel came along, notwithstanding his complete ignorance of any learning save his rosary and the non-possession of the key of his own conscience.

“I could have saved that leg if it had been my case,” said Senior Surgeon Bishop after the operation; “but it would have been hard on Wilson to make him lose his chance.”

It was this same Wilson who so horrified Elsworth by compelling him to tear off the thumb-nail of a patient for whom such an operation was necessary, without the use of any anæsthetic. “If we gave chloroform for every trifling job like that,” he said, “we should have enough to do.” He had become so case-hardened against feeling pain in others that he could only attribute to weakness and incompetence that hesitation to cause a single unnecessary pang in any sentient being which is the unvarying qualification of all the greatest and noblest men and women of whom we know anything. The blood-madness of some of the Dukes of Milan no doubt began early with unrestricted torture of animals. Not all at once do men bring themselves to hunt their prisoners with dogs fed on human flesh. Ecelin had to learn his cruelty as men learn any other business, slowly and by degrees qualifying for the title of “The Cruel” which men gave him. It would doubtless be some satisfaction to flies and other insects tortured by ill-trained children, if they could know that their tormentors would soon exercise their skill on their fellows, and so avenge the innocent world below them. Elsworth had done his best to get the man to consent to his mutilation, but his conscience troubled him for many days afterwards.

CHAPTER XIII.
“THE SOOTHING IDEA OF GOD.”

How dear, how soothing to man, arises the idea of God, peopling the lonely place, effacing the scars of our mistakes and disappointments.

– Emerson.

That grand sin of atheism or impiety, Melancthon calls it monstrosam melancholiam, monstrous melancholy; or venenatam melancholiam, poisoned melancholy.

– Burton.

It would be very far from the truth to say that when people cast off their orthodox creeds they turn their morals out of doors. Some of the noblest and most beautiful souls maintain their pure and lovely lives in spite of their having long ceased to be Christians – that is, as far as they can tell – for sure it is that many such follow Christ and know it not, perhaps follow Him very much closer than more orthodox believers. Still, it must be confessed from an impartial view of the question, that these cases are quite exceptional, that they cannot be claimed as the fruits of atheism. For one such opponent of Christian teaching who lives an exemplary life in spite of his want of faith, a thousand quiet, self-sacrificing men and women could be found. Of course, philosophy and high culture will do something for mankind. It did something for the pagan world, it does much for the Buddhist and Confucian peoples. But the note of all these philosophers is Melancholy, and the note of all true Christian folk is Cheerfulness. “Christianity alone stands between the human intellect and madness.”

Elsworth could not but notice the despair which at times and in moments of confidence was so manifest in Dr. Day and his daughter, and Linda and her brother; they were “without hope and without God in the world.” They often lamented that they could not believe, and enjoy the peace of God that passes all understanding. How often in the wards of the hospital or at the bedsides of out-door patients had he been moved by the contrast offered by the simple, sublime faith of some poor suffering Christian man or woman, whose sick-room was illumined by a light that never sprang from the human intellect, but rayed forth from the face of God Himself. Peace that yet was not indifference, cheerfulness that was not stoicism, made the chambers and the couches of these men and women unspeakably different from those of their unbelieving neighbours. Prayer, “the window that opens towards the infinite,” as a great writer has beautifully expressed it, brought light and warmth and joy to these poor souls; and his atheist friends would not have made proselytes of them on any account. They said that for these folk their religion was philosophy made easy, and thought this accounted for the matter satisfactorily.

The chaplain of a general hospital should be a man of liberal ideas and wide sympathies; he should be capable of taking an interest in the daily life of his charges, and try to see the things that interest them as much as possible from their own points of view. Here he will meet with people who have perhaps had no instruction in religion whatever, and whose sole knowledge of its working has been gathered from the misrepresentations of a street infidel orator or the ignorant distortions of an atheist journal. To such he cannot be too human and unecclesiastical. He must not talk “Church” to them, but the simplest, most loving human words. One of the St. Bernard chaplains made a great mistake when he asked everybody “if they had said their prayers.” He never got to their hearts, and no wonder. The new chaplain, Mr. Anderson, was a man of very different stamp; he was of Charles Kingsley’s school, and seemed familiar with every calling and phase of the life of his people. He was a devoted son of the Church, but you did not find it out by any symbols or tone. The fact that no patient, whether heathen, Christian, or “unattached,” left the hospital without being the better for knowing him, proved his fitness for his work.

He taught many an indifferent one the true spirit and method of prayer, and many thanked God for the accident or malady which had brought them under his happy influence. In him they had secured at least one friend for life, for discharge from the wards was not the usual termination of the friendship of Mr. Anderson. Before he came the chapel was seldom attended by the resident students; their pews were conspicuous by their emptiness, but he won even them, and helped many out of difficulties with the authorities. Mr. Horsley, the late chaplain of Clerkenwell prison, tells us he learned thieves’ slang, the better to acquaint himself with his flock. Mr. Anderson had some very curious specimens of humanity to deal with who required almost as much skill on his part, for many men injured in unlawful proceedings are taken to hospitals and watched by the police till their recovery permits their removal. He neglected not even these.

CHAPTER XIV.
THE SACRED WHOLE OF MAN

 
So ignorant of man’s whole,
Of bodily organs plain to see —
So sage and certain, frank and free,
About what’s under lock and key —
Man’s soul!
 

– Browning.

He alone is an acute observer who can observe minutely without being observed.

– Lavater.

When the students enter the wards of the hospitals for regular work with the staff, they have to devote a considerable portion of their time to the business of minutely recording the family history, physical signs and symptoms, and the treatment of each patient allotted to them. These records are valuable for reference, and still more so for the education of the pupils. They accustom the student to habits of careful observation; and as clinical work is by far the most important factor in his training, the man who does most of this stands the best chance of thoroughly learning his business. Elsworth found his account in sticking to the bedside, and often learned from conversing with his patients many things which helped him to understand how they came to be patients at all. Indeed, he found so much imprudence and ignorance in the habits of the people, that he wondered how it was they were ever free from disease. All the industrious men were great note-takers in the wards; they found that to understand the disease one must understand the subject of it. The practice introduced them to the habits of the working classes as nothing else could have done so perfectly. The expert note-taker learned more of human nature in thus recording these histories than he could have acquired from reading any number of books. Some startling revelations as to the amount of drink the British workman can absorb were often made in this way. There were several great breweries in the neighbourhood, and the men employed assured the doctors they usually drank about two gallons of beer a day. These men were always awkward persons to treat; their flesh healed badly, and they were liable to many complications which abstemious persons would escape. Many artisans, whose weekly wages would average twenty-eight to thirty shillings, owned to spending ten shillings on their own liquor – a sum which, given to their wives, would have often made all the difference between poverty and decent comfort. Many of the accidents that were brought in could be traced to unsteadiness of brain caused by alcohol. When men are working in dangerous situations, it is perilous in the extreme for them to indulge in stimulants. It was not surprising that men who drank two gallons of strong beer a day should fall into the vats or down trap-doors; the wonder was they could walk at all.

One man confessed to having taken on an average forty two-pennyworths of rum a day. He was a Jew dealer in metals, and made a good deal of money at times; but his liver could not stand the alcohol, and he was the subject of a good pathological address on cirrhosis when he died.

This drink-madness was often found to be hereditary, as were many other maladies. Very often the taking of the family history involved the collection of very curious facts from the patients’ relatives when they came to visit their sick friends. Idiosyncrasies were often traced several generations back, odd deformities and bodily peculiarities persisted in families as explained by Darwin, and illustrated the fact that a man thinks and reasons in certain grooves wherein have run the wheels of thought of hosts of his ancestors. A descendant of a Huguenot refugee remarked lately that his nerves had not yet got rid of the terror infused into them by the hair-breadth escapes his progenitors endured hundreds of years ago. It is said the whole world feels the effect of the stamp of one’s foot on the ground; not less is it true that our habits and work will influence the minds of untold generations of our successors.

True psychological medicine is less understood in the present age of science by our doctors than it was in the East thousands of years since. It will scarcely be credited that the great, the overwhelming majority of medical men can and do obtain their diplomas to practise, and attain to all the honours of their profession, without ever having heard a lecture on mental diseases, seen the inside of a lunatic asylum, or examined a person of unsound mind, except in connection with some physical signs indicating bodily disease, as in the delirium of fevers. In connection with some medical schools facilities are offered to the students to visit a neighbouring asylum for clinical observation, but it is extremely rare for them to avail themselves of the privilege. One may pass half a score of examinations at the various boards which have the power of licensing the practitioner who is to be charged with the duty of aiding by his counsel the families amongst which he will practise in a hundred forms of mental affliction, without having ever been asked a single question bearing upon psychological medicine. The student will be required to state with the minutest accuracy the stages of great operations which there are ten thousand chances to one he will never have the chance of performing, and a still remoter probability that he would have either the knowledge or the nerve to perform if he had the opportunity. He will be minutely cross-examined over obscure and rare complaints which it is extremely likely he will never see in his own practice if he live to Methuselah’s age; yet he will not be required to diagnose the difference between melancholia and hysteria. At the same time it is quite true, if he be an industrious man, he may learn a good deal about these mental maladies if he attend the lectures of the physicians who make them their speciality, but this is optional; he does not get any credit for it in his schedules; he will not be advancing his chances of a “pass” by so doing, and there is much temptation if, amongst so many things which a student of medicine must know, he holds in light esteem some things about which he may or may not trouble himself at his discretion. The study of mental phenomena occupies the attention, then, of but few, and those only the most cultivated and thoughtful of the students. To the Sawbones it is like cuneiform inscriptions or the domestic economy of the Hittites. Is not this a scandalous blot on our system of medical education? Yet every half-educated, idle, and beer-boozing young man who can get one foot on the medical register, and write L.S.A. after his name (implying that he has the licence of the Apothecaries’ Society, Blackfriars), has the legal power to sign a lunacy certificate which may consign anyone of us to the walls of a mad-house! Would this be tolerated were it understood? It is recorded of Garibaldi that in the war against the Austrians in Lombardy, he was seized with the marsh fever in the midst of one of his campaigns. The malady soon turned to typhus, and he was given over by his physicians. Lying at Lerino at the point of death, he heard the wild shout – “The Austrians!” The enemy had suddenly come down upon the little town, and the slaughter of his followers had begun. Springing from his bed with an infusion of new life in his veins, he buckled on his sword, and led his troops, inspired by his own wonderful personality, to conflict and victory. What was the influence of the mind in effecting this cure? Ah! that is no part of a medical curriculum. Mesmerists, spiritualists, theologians may deal with that as best they may – it is beneath the notice of the colleges.

A fact like this is surprising only to those medical men who have never studied psychological medicine.

The miracles of Lourdes and of hundreds of other Catholic shrines need not be denied altogether as unworthy of credence. There is abundant evidence that some cases of cure do really occur in connection with faith healing. Those who have made a study of mesmerism have adduced instances of healing by its means which it would be foolish to deny. So much charlatanism and fraud have always been mixed up with these things that it is not perhaps matter of much surprise that they are held in low esteem by men of science. Still, as there are undoubted phenomena in connection with them worthy of patient examination, it is surprising that so prominent a field of inquiry should be so completely neglected by our doctors, while it is considered necessary to know precisely how long a dog covered with varnish would live, and how many degrees of heat a rabbit can tolerate before succumbing to its agony. A young lady of hysterical temperament, who had been humoured to the top of her bent by her medical man, had, after a few months of gynæcological treatment, become so enfeebled in mind that she imagined she had lost the use of her lower extremities, and even succeeded in inducing her doctor to believe that she really was unable to walk. She was advised to consult a well-known hospital physician, who was chiefly celebrated as a true mind doctor. When he took his seat by the couch of the invalid he soon diagnosed her malady, and, finding she was of high intellectual culture, asked permission to read to her. The doctor was an admirable reader, and his rendering of a long and soul-stirring passage from one of the great poets made the girl forget her ailment so completely that she sprang from her couch with energy as he paced the room declaiming the poem, and exclaimed, “Is not that magnificent?” At that moment the deluded woman found the complete use of her limbs, and a few more readings cured her without other medicine. They don’t teach this sort of things in hospitals, – not the curative part, at least. Examiners at the colleges would “plough” the man who ventured to propose readings from Shakespeare three times a week with dramatic action as a remedy for hysteria. What they want is —

R. Tinct. Valer. Am. dr. j; Potass. Brom. gr. x.

Aq. Dest. oz. j; ter die sumend.

You see, it has been discovered by physiologists that if a solution of the bromide of potassium is applied locally to a rabbit’s heart, it produces instantly marked lessening of its action,³ and if applied to the muscle of the frog it throws it into tetanic spasm.⁴ On the nerve trunks it acts as a paralyzing poison;⁵ in fact, if you inject it in the vicinity of a living dog’s heart, “cardiac arrest always occurs.” So that you see how easily the physiologist can demonstrate how bromide of potassium quiets the excited nervous system of the hysterical ladies. You do not quite follow the reasoning? Well, do not tell the examiners that, because they declare it is quite plain to them, and helps to prove the value of experiment. Now, as there are no instances given in any books of physiology known to us, detailing any effects produced on the hearts or brains of any mammals by the dramatic reading of poetry, it would be manifestly unscientific to treat lady patients by any such method. Moreover, as it is of no use to cure anybody if you cannot demonstrate precisely how you cure him, it is better to let him alone.

The mind specialist who effected these remarkable results was answered by his colleagues who went in for the rabbit and dog theories that in the first place the patient wasn’t ill at all; secondly, that consequently she was not cured; and thirdly, that she was still as ill as ever. But the good physician still holds on his course, speaks with growing disrespect of the Pharmacopœia, studies Nature, but does not “put her to the question,” and takes hints from old women, birds, trees and flowers; and like another Paracelsus, is ridiculed by his professional brethren in proportion to his success in unorthodox methods.