Книга - St. Bernard’s: The Romance of a Medical Student

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




Æsculapius Scalpel

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





CHAPTER I.

THE FIRST OF OCTOBER


“Homines ad deos nullâ re proprius accedunt quàm salutem hominibus dando.”


Having selected medicine as a profession, the usual day for a man to enter on a course of study at one of our great medical schools is the first of October. The almanack tells us this is the feast of St. Remigius, the day on which Cambridge term begins and pheasant shooting commences. Neither of these interesting facts, however, explains the opening of the medical schools on the day in question; nor is it explained by the circumstance that this period is the anniversary of the institution of the order of merit for Folly, created at Cleves in the year of our Lord 1381; nor by what good old Thomas Fuller tells us of the holding of Lawless Courts, or Curia de Domino Rege Dicta sine Lege on Kingshill at Rochford in Essex; though some non-medical antiquaries, holding the learned profession of medicine in low esteem, have pretended that a day sacred to folly and lawlessness is peculiarly appropriate for the commencement of the curriculum of a medical student. We will not, like the ancient philosopher of whom Montaigne speaks, seek for learned and obscure explanations when our serving maid can offer us a simple one, but will state at once that the medical schools open at this season of the year because the weather being now cool, corpses set apart for dissection keep well! Thus did scholastic speculation vanish before the timely discovery of the legend, Bill Stumps, his X mark. This day of high festival at all the hospitals to which medical schools are attached is celebrated in various ways. An inaugural address, given by one of the staff, has long been the custom at the most famous of these; and on such occasions the freshman is usually staggered by the picture of the awful responsibilities he has undertaken, and made aware that he has devoted his life and energies to the loftiest, noblest, and worst paid calling he could have possibly selected. He is assured that he will be a benefactor to humanity of the highest type, but must expect neither gratitude, wealth, nor elevation to the peerage; that although he will, if he join the Army Medical Service, be looked down upon as only a superior kind of camp follower; that, as Dr. Abernethy used to say, if he does not claim his fees “while the tears are about,” he stands a good chance of losing them – so prone is an ungrateful country and a forgetful client to ignore the doctor when the danger is over. Notwithstanding all these drawbacks, however, he is assured he will find in the commendation of his own conscience an ever-sufficient reward for his devotion to suffering humanity. All successful professional men talk more or less of this pessimistic cant, like the Chancery judge who addressed a batch of newly admitted barristers-at-law in these terms: “Gentlemen, I cannot congratulate you on the profession which you have chosen. It is one in which very few succeed, and most of those who succeed wish they had failed.” The fact is, with professions and business, as with wives, men get just as much success as they deserve. These sentiments produce on the newly entered pupils their profoundest effect, but they are totally lost on the older ones, who declare them all humbug, and only intended to gull the public who will read them in the daily papers. Many of the seats are always filled by medical men who were educated in the hospital and school attached, who like to hear these time-honoured sentiments, reminding them of the happy period when they entered their Alma Mater with an enthusiasm long since damped by contact with the harsh world without. After the address, the prizes won by the successful students are usually distributed, and the teaching staff dine together, and the students go off to make a night of it, and show their new companions a little life about town.

“The learn’d physician, skilled our wounds to heal,
Is more than armies to the public weal,”

On this particular first of October with which the present history is concerned, Harrowby Elsworth affiliated himself to the old and honoured medical school attached to St. Bernard’s Hospital, London – an hospital of high reputation, with a great and renowned school of medicine. He had distinguished himself at Oxford, and had selected his profession with the determination to do well in it, as he had done with all he had hitherto put his hand to.

He was a tall, slim fellow, standing six feet one in his stockings, so dark in the complexion that he might have passed for a native of Southern Europe. Although rather an Apollo amongst men, his graceful bearing and manly carriage were not the characteristics that gave him a passport at first hand to every one he met. It was the full, deep, earnest, clear, and honest eye, by which you could look into his soul. At a glance you took this in; there was no mistaking that, in the handsome young fellow who confronted you, there dwelt a spirit as brave, strong, and well braced as the frame that held it.

He had long since lost his mother – so long ago that he could but just recall her image as that of a tall, fair, delicate, blue-eyed woman, who had left her heart on his lips on the day she died.

His father was a retired Indian officer, who had seen much service, and had greatly distinguished himself in the Indian Mutiny. He had been severely wounded, and returned to England. Having recruited his health after several years’ stay in Cheltenham, he went back to the scenes of his former victories to occupy himself with investigations concerning the ancient literature of the Hindoos. He soon became so completely engrossed in this work, in which he hoped to cover himself with no less glory than in his campaigns, that he determined not to trouble himself with his native country or its affairs till he was able to announce to the learned societies of Europe the full fruition of his labours. He was a good man, and had been a kind and generous father, but became so enwrapped in his musty literature as to be practically dead to his duties to his only son, who, with all his kinsmen and friends of his fatherland, had become of very much less importance to him than the Sanskrit poem he had just discovered hidden in an image of a cross-legged Buddha serenely contemplating his epigastrium. So it having been finally settled that Harrowby was to be made a doctor, Major Elsworth arranged with his agents in England to pay the necessary fees, and settled on his son a sum of £300 a year for life, so that he might be free to pursue his own calling untroubled by the smaller anxieties of life till his profession should afford him a more ample subsistence. All these matters having been finally concluded, at the expense of much distraction from the Mahâbhârata research, the old gentleman felt disburdened of a long-standing load which had often impeded the even tenor of his work, and once more settled down to the classic heroes of Indian song and the legends of his mythic age. He felt that Harrowby was off his hands, and gave him very plainly to understand that, pending the completion of his great work on the Origin of the Mahâbhârata Poems, he must have no disturbing communications requiring any reply from him. Acting upon these hints, Harrowby very rarely troubled his father with any letters, and still more rarely had any replies to them. He made up his mind that when he had done all the work at the hospital he wanted to do, he would go out to his father, and spend a year or two with him before finally settling down to practice.




CHAPTER II.

THE SCHOOL OF ANATOMY


Foremost in the regal class
Nature has broadly severed from her mass
Of men…

    – Browning.

Elsworth entered the profession of medicine with a large stock of a commodity just now rather out of fashion with our young men. This limp and degenerate age seems unable to supply our youth with backbone enough to make them enthusiasts about anything beyond dress, the Opera Comique, and the quality of their tobacco. They adopt a profession without at all intending it shall absorb them; they consider it a sign of weakness to show a consuming interest in great subjects, and their energies are frittered away on the most trivial concerns. How many men enter the Church, not as though Heaven-sent messengers, but as affording them a pleasant way of getting on in life! As for a message to mankind or a call from God, it would be too much in the way of the Methodists and Salvation Army people to be consistent with their notions of propriety. What they have to offer the world may be taken or left without interfering in the least with their peace of mind. Hence so many empty churches, while our courts and alleys are full of folk perishing for lack of knowledge which nobody is sufficiently interested to impart, except in a perfunctory manner. It may be all very well for good Mr. Spurgeon to be consumed with desire to save souls; that sort of thing may be consistent with life in the “region of the three D’s” (Dirt, Dissent, and Dulness), over the water. But fancy anybody in Pall Mall or the Row being “so dreadfully in earnest, don’t you know!”

Such being too commonly the case with the Church, what can be expected of medicine? Inaugural addresses and the classic poets notwithstanding, it is rather too much, they say, to expect fellows in the nineteenth century to live up to an ideal guild of St. Luke. Now, by a beautiful instance of the law of compensation ever active in Nature, just as men are voting enthusiasm bad form, women are taking up the work men are too limp and too selfish to perform, and the spectacle is presented to the eye of hundreds of noble, clever, earnest, indefatigable women coming forward to fill the places which men decline, and leaving work more congenial to their habits and tastes, because men lack the energy and sympathy required to effect the necessary reforms. The salt of the earth is now fast becoming a feminine compound.

But the man of our story was a true man, not a nineteenth century sham; he had his enthusiasms and was not ashamed of them, was a sentimentalist if you will, and was proud of the title. He had an idea that no good had ever been wrought in this world except by enthusiasts and sentimentalists. He felt that sentiment was thought sublimed, and enthusiasm the holy fire that exalted it; his prayer was to be classed with the band of workers who had helped their world; and when he decided to enter the portals of a great hospital, it was not to make his account with fame, to exploit the poor and suffering for his own advancement, but just simply to have the satisfaction day by day of having, by even ever so little, diminished the awful sum of human misery. It was a perfectly contemptible ideal, an absurdly insufficient goal to nineteen-twentieths of the men who that day had enrolled their names in the books of the hospitals of the kingdom; but it was just simply his ideal and his goal, and he thought no other profession would help him to attain these like medicine. “The parson,” he used to say, “sees men at their best, the lawyer at their worst, but the doctor as they are. I will be a doctor.” Now of all things which Elsworth was not, least was he a prig; so that he had no idea of the very unusual nature of the impetus that was driving him on a medical career. He thought, in his ingenuous way, that such impulses moved his fellow-aspirants. This sentiment was to be modified.

In what a world he found himself! He had several friends on the staff, and some half-dozen of his fellow-students were more or less known to him; but to what others was he introduced! In a couple of hundred young men one looks for variety, one expects that some will be heedless, vain, indolent, or vicious, while others are earnest, industrious, and true. But who were these men he saw to-day, and how came they to adopt the sacred ministry of healing, the work of the great Physician Himself?

Rough, rowdy, vulgar, and decidedly unintellectual as many of them appeared, with all the characteristics of the fast man about town, the profession they had chosen to follow seemed likely to suffer at their hands, if these men were fair samples. It has long been the habit of society to view with great leniency the peculiarly Bohemian manners and customs of medical students. The very term has become the symbol for rollicking rowdyism that would be tolerated in no other class. Their boisterous mirth, rude violence, and disregard of the ordinary proprieties of civilized existence have become recognised as their appropriate conduct, partly no doubt because their lugubrious occupation at the schools needs relaxation of a pronounced kind, and especially perhaps that as they must when in actual practice become the gravest and most “respectable” of men, it must be permitted to them to compress into their student life the follies, the riotousness, and the highly flavoured pleasures that must suffice for the rest of their mundane existence.

Be this as it may, it is certain that from the patient in the hospital ward to the magistrate on the bench, conduct that would be considered in other men as intolerable and worthy of the severest punishment is in their case lightly passed over. On the part of the public at large, and on behalf of the men themselves, this is a great error, and has its foundation in a wrong conception, both of the work the students have to do and the sort of relaxation it requires. On behalf of the suffering humanity soon to become dependant upon such men for their help in sickness, a revolution in such a false system of education is no less urgently demanded. Unpleasant as the work of the dissecting, post-mortem rooms, and hospital wards, may seem to the outside world, its daily recurrence makes it so familiar to all engaged in it that it very soon ceases to be any more unpleasant than many other occupations. The men who take real interest in their work very speedily forget or do not recognise any of its disagreeables, while those who do not acquire this real interest in their occupation become mere hangers-on at the schools, and grow rowdy for want of better employment. The real students, with their hearts in business, do not seek or take such methods of unbending the bow; for the rest it should not be permitted them to insult their noble calling by behaviour that would disgrace savages in unexplored tracts of equatorial Africa.

The sooner a more common-sense theory of medical student life is adopted by the public, the better for the world and the men themselves.

Young Elsworth, then, was not altogether pleased with what he saw of his future companions, and it took him but a short time after his entry at the schools to see that not more than half of the men by whom he was surrounded would be for him even tolerable class mates.

The opening festival was over, and early in the following week he began the work of dissecting. He had previously bespoke of the College beadle what is known as “a part,” for be it known to the outside world that a well conditioned corpse having no friends to claim it after death in the hospital or workhouse which saw its owner’s last moments, is by the Anatomy Act permitted, under certain legal restrictions, to be used for dissection. To preserve it for the length of time it will require for some six or eight men daily working at it to unravel all its mysteries of muscle, nerve, artery, and vital organs, its blood vessels are injected by an ingenious process by the dissecting room porters with a preservative fluid which, permeating every part of the body, keeps it fairly fresh and arrests decay till the scalpel of the young anatomist has revealed all it has to teach.

Let us enter into the dissecting room of St. Bernard’s, and see how our future doctors learn to deal with the ailments our flesh is heir to. It is a spacious chamber, some fifty feet long by thirty feet wide; its floor is slate, cold, and non-absorbent; its walls half-way up of the same impervious material; it has no windows, but is lighted by a glass roof and many gas jets for dark days. On either side are eight strong tables, on each of which lies a corpse. Round each table are several heavy, well-made stools; they need be heavy. They are often subject to rough usage at the hands of their occupants when not engaged in more scientific work.

On this first of October, all the “subjects,” as they are technically called, are untouched by the knife; in a few days they will scarcely be recognisable as having ever been our brothers and sisters of the mortal life. The busy scalpel of the anatomy student will be engaged on every limb and feature in “getting out,” as it is termed, his “part.” Then the observant eye of a man of science would see how fearfully and wonderfully we are made. The Psalmist could have had but a faint idea how much his beautiful phrase conveyed. Here are displayed for us the exquisite sets of muscles and tendons that enable us to move our hands and arms. This part shows the nerve and blood supply of the leg, and that one the machinery by which we smile, laugh, or express our wonder and surprise. Here is a man at work seeking to unfold the marvellous convolutions of the brain, while at another table one has got down to the articulations of the foot, and is showing the pulleys and joints that enable us to walk. The art of anatomical dissection consists in freeing the muscles, tendons, arteries, veins, and nerves from the surrounding fat and connective tissue which in the living body preserves and covers them.

It is absolutely necessary that the student should not only know from books, but actually see with his own eyes, and for a long period attentively observe the origin and course of every nerve, artery, and vein which in the whole body is capable of being dissected out. He must know the exact position of all the muscles, how they move the bones, how they extend or flex the limbs, what nerves supply them with motive power, and how that nerve takes its course from the brain or spinal cord. The number of complications is so great that nothing but patient tracing out with forceps and scalpel for himself will ever teach a man anatomy.

As an accurate knowledge of this science is the foundation of all medical learning, it is not to be wondered at that the medical schools and examining bodies insist on a very long and careful training in the practical part of this study. So indispensable is it that the schools have never scrupled to obtain subjects for dissection when popular prejudice stinted the supply, by foul means when fair did not avail. No questions were asked in the old days, before the passing of the Anatomy Act, how the “subject” was procured; enough that it was on the table for the uses of science. Whether murder had brought it there, or the visitation of the graveyard by the body-snatcher, nobody concerned in teaching or learning anatomy cared a jot.

In one famous school there was a private trap through which the corpse was pushed into the porter’s room, he passing the money out to the persons who delivered the body, and holding no communication with the body-snatcher, or even seeing his face. Things, however, are different now, and the workhouses are permitted to send the bodies of friendless and unclaimed paupers, whom nobody owns or cares to bury, for the purposes of dissection.

Dissection and the making of a post-mortem examination, though often confounded in the public mind, differ materially. Dissection consists in minutely tracing out all the important structures of the limbs, body, and vital organs, and thus it takes several weeks’ hard work to get through a whole subject; while a post-mortem examination is the labour of an hour or two, and consists in examining and noting the pathological conditions of the internal organs, with a view merely to discovering the cause of death. An adult subject is worth about £5 when properly prepared for research. Each arm and leg, the half of the head, the chest, and the rest of the trunk, was charged to the student requiring it at St. Bernard’s, 12s. 6d., and he was expected to make good use of his opportunity. Every portion removed by his scalpel was carefully gathered up by a porter, and every night and morning placed in a coffin in the vaults below. When a coffin is filled with this minutely divided humanity, it is sent to a cemetery and buried as “our brethren and sisters departed.” The provisions of the Anatomy Act forbid the taking of any portion of the subjects out of the schools; nevertheless more than one ardent student whom we see in the room will finish his work on the hand or the foot at his own lodgings, to the horror and disgust of his landlady if she catches him at it.

Some men never make good dissectors; they can cram up what they want for their examinations without the infinite pains required for a beautiful “preparation” such as is being made at this table on our right for the college museum. It is an arm, and every muscle stands out clean and clear, every artery is seen with its vermilion wax injection running its sharply defined course, and anastomosing with its neighbouring vessels. Here are the nerves like silver threads, becoming, like the blood supply, smaller as they reach the fingers, till they are lost in their terminations at the tips. It requires a man with a special genius, and the gift of an infinite capacity for taking pains, to do work like this, and many take a pride in doing it.

Round this table on the left is a group of junior students, listening to the demonstrator, who is lecturing on the muscles of the chest, or thorax as it is called, and asking each of his auditors in turn some question to test his knowledge, and explain his difficulties if he have any.

The coloured diagrams round the walls, and the illustrations in the text-books used, serve to complete our acquaintance with the matter in hand, and its daily repetition fixes it in the memory. The men do their work in great linen blouses or aprons with sleeves. Most of them smoke, and the dissecting-room certainly is one place from which the most violent anti-tobacco agitator would hardly wish to banish it, if he knew how it mitigates its awful odours. When the morning is over, and the men have taken their lunch (they eat sandwiches at their work without the least fastidiousness), few of them return for any more work in that place unless they chance to be very industrious. There are some few men who, in their first and second year, dissect on every available opportunity; for anatomy cannot be crammed, and can only be mastered by this persistent business of the scalpel. Occasionally a visitor will drop in to look round at the work going on; some general practitioner who has been at the school in his early days, to refresh his memory on some point, or to rekindle for a few moments the lost enthusiasm in such studies. Often they tell good stories of the difficulties they had in the olden time of procuring bodies. One old fellow who had been a demonstrator in that room, told one day how, on one occasion some fifty years before, he had been urging the beadle to provide more subjects.

“Can’t get you a fresh ’un before this day week, sir,” replied the man. “You see, sir, it is my mother-in-law. She only died last night. She will be buried on Thursday. We’ll have her up the same night, and she’ll be ready next morning for you.”

And then he related how the body-snatchers went to Bow Cemetery, then almost out in the country, and “resurrected” the poor woman, stripped her of her shroud (to take which was felony), put her in a light cart, and drove off with her. On either side of the Bow road at that time were fields; it was very dark and lonely. When half-way towards their destination they feared they were closely pursued, and to avoid a capture they cast the body out into the ditch, and made off with all haste. Next morning there was a report of a horrible murder. An inquest followed, and an open verdict was returned, name and cause of death unknown.

Close by the hospital there dwelt an aged man with his daughter in genteel poverty, a learned and serious person, who seemed to have known better days. His conversation was charming, and his society was much sought after, but seldom accorded. He kept himself apart from his neighbours, and held no more intercourse with them than was necessary for the amenities of life. But he was on good terms with the St. Bernard’s staff, often strolled through the dissecting-room and the museum, and was generally present in the operating theatre when anything of special interest was “on the table.”

There was considerable mystery about this man, Dr. Robert Day by name; but the hospital people knew his antecedents, and thought much the more of him on account of them. Indeed, most medical folk considered him a hero and a martyr of science, though nobody took the least trouble to help him in any more substantial way. Many years ago Dr. Robert Day had been professor of anatomy at a great school of medicine. He was an author of celebrity, and his works were text books in the hands of all the students. He had been implicated in the Burke and Hare scandal, had been proved to have availed himself of the services of these murderers to procure him subjects for dissection at his school of anatomy. The murderers having been detected in their horrible business, and having met their fate, the attention of the populace was forcibly directed to Dr. Robert Day and his dealings with the criminals. Had he been caught when the attack was made on his residence, he would have speedily been lynched. As it was, his house was wrecked, his furniture destroyed, his costly library set on fire, and he had to fly the town to escape personal violence. He was long in hiding, a ruined man, subsisting as a medical coach under an assumed name, till after some years, when the storm had passed over, and the new Anatomy Act had set the popular mind at rest, he was able to declare himself amongst his professional brethren, but they were always shy of him, and, though in private they let him see they thought none the worse of him for his complicity in “subject” getting, it was impossible to put him forward, or do him any very material service. They could not be hard on him. They had all profited by his research; all had learned their anatomy more or less from his books. It was little to them how he came by his knowledge. His more fortunate brethren in the kindred sciences now do not scruple to use methods to obtain their objects which, if fully laid bare to the inspection of the lay and ignorant public, would perhaps be considered only slightly less objectionable. But then the lay public is so unreasonable. They demand to be cured instantly of all the ailments that afflict them, and object to give up their mothers, their children, or their friends, and indeed even their cats and dogs, on whose living bodies the necessary experiments can be duly tried. This is naturally irritating to the scientific mind; it feels it is expected to make bricks without straw; and the straw, in the shape of clinical and physiological material, must be had somehow, so they protest.




CHAPTER III.

IN STUDENTS’ LODGINGS


Heroes mischievously gay,
Lords of the street, and terrors of the way,
Flush’d as they are with folly, youth, and wine.

    – Johnson.

Throw physic to the dogs! A pipe – cheroot —
Pilot – and life-preserver —voila tout!
A little lecture now and then to boot,
A school or hospital to bustle thro’,
A few hard terms – on easy terms – to keep,
Then brown stout, billiards, half-slew’d and sleep!

    – Cruikshank’s Almanack.

Lindsay Street, where Elsworth took lodgings, was an old thoroughfare at the back of the hospital grounds, and was largely occupied by lodging-houses, in which those students boarded who desired to be handy for their work, and have their fellow-students near neighbours. It was a dull and a grimy old place, but it had many conveniences, and was quite historic as a residence for young medicos, – indeed, it was always held to be a kind of precinct of the hospital. The landladies were for the most part elderly widows with no encumbrances; those who had husbands kept them out of the way, and the students, if they paid up promptly, did pretty much as they liked in their diggings. It has often been a subject of wonder what becomes of the husbands of lodging-house-keeping ladies in the daytime, so seldom do they show their faces to the lodgers. Perhaps the most plausible suggestion is that they spend their time hearing the trials in the law courts, or the police cases. It must be some such persons who are able to devote so much leisure to these matters.

Mrs. Harper occupied Number 15 in this street of students’ lodgings, and was one of the oldest and best-known inhabitants. She was a widow, her late husband having been for twenty years night porter at St. Bernard’s; and she was sister to the famous Podger. A sharp woman of business, with a keen eye to the pence, she did well at her business, and made an excellent income out of the rooms. Her life had been spent amongst medical men, and not even Podger herself was happier at her work than Mrs. Harper “doing for her gents,” as she always called it. Her rooms were decidedly frowzy, and her furniture, which had been picked up at auctions, and was very mixed, was rather dilapidated. What wonder, considering the treatment it received from those who used it! The front parlour, with bedroom at the back, was just now occupied by Jack Mahoney, a merry little fellow, full of good nature, witty, smart at learning, and mad for sprees. “He was always up to his tricks,” his landlady said, but she didn’t mind ’em, not she, not even when he brought home that steak for his tea, and bade her cook it, and then laughed till his sides must have split, as he told her what it was, and where it came from. “And my new frying-pan spoiled as cost me two-and-ninepence in the Row last week; and as for the plates, and the knives and forks, I sha’n’t use ’em agen, you may keep ’em, and I shall put ’em all down in the bill. I wonder when you’ll ever leave off your tricks; a nice sort of doctor you’ll make! I call it sickening – I do.” But Harper, like her sister Podger at the hospital, could be settled. “Hang it all!” cried Mahoney, as he put his feet on the mantel-board, and roared again, “it’s worth a whole shopful of crockery to have sold Harper like that. O Jane, sister of the immortal Podger, and you to be had by a latissimus dorsi; you, who declared you knew your anatomy as well as we did. O Jane! O Jane! you’ll never pass your ‘final,’ not even in your winding sheet!”

“Go on with your impidence, Mr. Mahoney; it was the new girl as was had, not me; I am too old a bird to be caught a second time. Mr. Redway served me that trick once, and I never forgave him-well, at least, not for some time after.”

All this was great fun for Mahoney and his pal Murphy on the other side of the fireplace, and they laughed consumedly, for they knew the worthy dame had been sold that time. But a glass of whisky, which she would not drink before them, but declared she would take the last thing at night, as a precaution against spasms, soothed her down, and a promise of a brace of pheasants out of the next hamper of game from home, sent her to the kitchen in a good humour. She could not be angry with the boy long together. He paid well, and her sister Podger loved him as her own son. Her first floor was occupied by two students, Rice and Higgins. They were both of Mahoney’s set, lively boys all. Sons of wealthy parents, they had usually money enough to squander; but there were times when funds sank low, and they were reduced to amazing shifts to extract the needful amusement which every succeeding night demanded. The ups and downs of the life they led might serve to prepare them for the vicissitudes of the future, and to accustom them to the readiness of resource which is so characteristic of all medical men. To-night they would be feasting at a West-end restaurant, and drinking costly brands of champagne; to-morrow, as likely as not, would find them supping on a few pennyworth of fried fish, and drinking porter out of a pewter pot. It was all the same to them, even if it were not more congenial to be associated with rowdies in a Whitechapel bar-room, than to be dining with their equals in civilised society.

Mrs. Harper, as we said, was not at all particular in the matter of larks, though she was rather annoyed when she went into Mr. Murphy’s sitting-room one morning to lay the breakfast, and saw, over the fireplace in front of her new looking-glass, a great black board, painted in large white letters, “To be Let or Sold, this desirable semi-detached Villa Residence. For cards to view, apply Buggins & Son, 113 Great Mowbray Street, E.C.”

She knew at once this was one of the trophies of last night’s spree. Knockers and bell-handles, brass plates of moderate size, stolen from milliners’ and dressmakers’ doors – to these there could be no objection; but sign-boards, barbers’ poles, doctors’ lamps (for even the profession was not sacred from the attacks of “the boys”), were “dead agen her rules,” as she was always insisting, because, being so big, they could hardly be got into the house without exciting observation, and perhaps might bring discredit on the hospital.

“Look here, Mr. Murphy, I have told you over and over again, I can’t have them things in my house. You will be caught like Mr. Hodder was when he stole the big gold coffee pot from over the grocer’s door, and a bobby as didn’t know him, and wouldn’t take no bribe, run him into Bow Street, and if he hadn’t been the son of a member of Parliament, and known to the beak, he’d ’a had to ’a gone to jail, he would; for the grocer was mortal angry, as he had had two coffee pots and a bell handle stole the winter before, and he always suspected the students. No! I draws the line at things like this. I have too much respect for you, and the character of my house, to harbour the likes of ’em, so don’t do it.” Not even “a toothful of summat short,” as Murphy phrased it, could appease the good woman. “No, bell-handles and sich is good enough sport,” she persisted, “for anybody. I have nothing to say agen them; you gents must have your larks, and bell-handles and knockers goes in your pockets, but I draws the line at these here; take it away. Stay, I’ll put it in the cellar. Why, the taxes, or the gas, or the water rate might see it, and give information. They’re none of ’em any too fond of you boys, and they are quite equal to it.” And so with much regret, Murphy gave up his “Desirable Villa Residence,” merely extorting a promise that it might appear on the mantel for one night only – the “trophy supper” he was to give at the end of the winter session, when he was to exhibit his museum of stolen curiosities to his companions in the midnight revels.

Murphy was very proud of his museum. He had twenty-nine brass and iron knockers, fifty-seven bell-handles, fourteen brass door-plates, three small and very neat Royal Arms, gilt and coloured, one pretty figure of a Scotchman in Highland costume taking a pinch of snuff, several gilt carved wood letters, which once formed parts of names over shop doors, and this latest acquisition, the “Villa Residence” board. Everything was neatly labelled and numbered, and a register kept, recording in the most methodical manner the story of its capture. Many hair-breadth escapes were recalled by a glance at some of these treasures; and to hear little Jack Murphy tell some of the stories connected with them was a treat that many a freshman yearned for with all his heart. Most of the men would rather have had the honour of which this stolen hardware was the symbol than all the medals and certificates of honour the hospital could bestow. Their friends sent them to earn these latter – that was task-work; their own inclination and Bohemian instincts urged the acquisition of bell-handles and door-knockers – in this was danger, and their love of surmounting it was gratified. They had yet to learn the nobler outlets for sentiments that have made the name of Englishman a proud distinction, especially in the practice of a profession on which they have shed so much glory.




CHAPTER IV.

HIS ’PRENTICE HAND


Knowledge after all, is not the greatest thing in life; it is not the “be-all and the end-all” here. Life is not science. The moral nature of man is more sacred in my eyes than his intellectual nature. Goodness, lovingness, and quiet self-sacrifice are worth all the talents in the world.

    – G. H. Lewes.

The comfort or the misery of many families may probably hang upon the notions that each of you will carry from this place.

    – Sir Thomas Watson.

But Lindsay Street was not wholly inhabited by the idlers. There were many men who led solitary lives at their lodgings, and worked night and day at books or bed side. Some took portions of their subjects home to dissect, and the back gardens at their lodgings were often used as places of sepulture for brains, hands, or as Tom Hood sings, —

“Those little feet that used to look so pretty.
There’s one I know in Bunhill Row, the other’s in the City.”

Maternity cases were attended by the junior students at the homes of the patients within a radius of two miles of the hospital. This served to bring them into direct contact with the poor, and familiarized them with scenes of the most horrible destitution in the filthiest and lowest slums of the metropolis. The young men were usually favourites with the people, who are always taken with the free and easy, the good-humoured and generous behaviour of medical students, anxious to improve their own knowledge of work which will be of the greatest importance to them in their future career, and glad to render their – sometimes very far from skilled – services to uncomplaining poverty, with a view to getting their papers signed for the colleges, which demand a definite amount of this work to be performed while in connection with their medical school. It was hourly enforced upon them that such was their only chance of the free and unrestricted use of human “material” for acquiring this sort of information. Their blunders, their negligences, would not count against them whilst in a state of pupilage. A great city, a poverty-stricken population, a benevolent public, and the custom of their profession, had placed at their disposal an immense amount of raw material, unbounded facilities for picking up knowledge, and the deft use of mysterious and complicated instruments. This skill, this dexterous use of the tools of their art, would shortly enable them to earn a handsome living. Let, then, every moment be devoted to obtaining that knowledge at the cost of ignorant and uncomplaining patients who would only see in their attentions the desire of a charitable young gentleman to help them, just as the visiting lady and the clergyman helped them efficiently. Let, then, every day and every case enable them to use more skilfully, under such clinical conditions, those tools the awkward use of which would inevitably be detected in the higher walks of their art to which they are progressing. Such is the admirable way in which the highest skill and wisdom of medicine is combined with the attempts of the novices to attain it in the practice of the hospitals, that the shortcomings and feeble efforts of the learners are glorified and ennobled by the brilliant successes of the teachers, till the mistakes are lost sight of in the dazzling triumphs of their achievements. It is like the Catholic doctrine of works of supererogation. St. Francis Xavier was so much better than he had any occasion to be, that he had a fund of merit at his disposal for helping the deficiencies of those who fell short in their good works.

A great surgeon achieves a brilliant success in an operation which sends a man away from the wards to his own home restored in health and limbs to his family and his work. It is the hospital which gets the credit, and the credit is sufficient to atone for many of the maimings and other unfortunate terminations of a score of cases, which are looked upon as failures, not of much greater consequence than Beau Brummel’s cravats cast aside on his dressing-table. It will not do to be too hard on the failures. Even Professor Holloway did not publish them. The advertisements of quack and royal surgeon are alike in this respect at least, that they do not go into any such unnecessary details!

But oh, the spoiled cravats! condemned to drag out a wretched existence because they had the misfortune to be not only ignorant, and poor, and powerless, but waste material used by St. Bernard’s in the attempt to make of any person able to pay its fees a competent healer of diseases. Not enough was it that they were born into a hard and cruel world, heavily handicapped by feeble frames and badly developed brains, without education or any of the means of lifting themselves from the slough of their environments, but it was also required of them by our advanced civilization that they should yield up their poor bodies, which were enough like better people’s frames for the purpose, to become “teaching stuff” for classes at a medical school.

It was in Lindsay Street, and with Mrs. Jemima White, that Elsworth went to lodge. He had abundant strength of mind, and it was little to him that his fellow-boarders were a rather noisy set. He had full control of himself, and did not permit them to influence him unduly in the matter of sprees. He settled down steadily to his work, and did not find his friends interfere with him much when they saw his tastes were not quite their own; on the contrary, they rather respected him for his diligence, in which there was not the least element of the prig. As for his religion, – for Elsworth came to St. Bernard’s deeply imbued with the religious spirit, – they smiled at him when he talked of it, which was but seldom, as who should say, “Poor innocent! you will outgrow all that quickly here, and find faith and the scalpel, dogma and the microscope, go ill together!”

Yet they knew very well that several of their best men were earnest, faithful Christian souls, who found high scholarship and the deepest devotion to their profession accord extremely well with the doctrines they professed. Still, the prevailing tone of the place, of students and of teachers alike, was not in accord with religious feeling. The school atmosphere was prejudicial to the cultivation of the Christian sentiment; and whatever godliness was taken in by the first-year’s man had usually left him long before he left St. Bernard’s; for there was a new goddess, whose culture was daily in the ascendant, and St. Bernard’s was one of her sacred places. Here she was wont to be honoured, and the supreme God in the newer worship was forgotten. Her glory so far outshone His that the men never named Him, except in their expletives, nor was He in any of their thoughts. It was not held so much an error to believe in the God of the Bible and the Creator and Sustainer of the world, as an amiable weakness, a mark of defective education, a lay feebleness of mind, excellent in subscribers to and governors of hospitals, good also for patients as helping to teach them submission, not bad at all for sisters and nurses for a similar reason; but for medical men, the true high priests of science, utterly inconsistent with their training and their mental attitude, which was the demand for – facts! ever facts! and still more facts! Christianity in a medical man meant an imperfect medical man; one who had been arrested in his development, – a sort of spina bifida case, or a microcephalic idiot; want of lime in the bones, defective iron and phosphorus; excellent condition for a subscriber, wofully defective in a user. For it was discovered that the completely developed, the men full of lime, iron, and phosphorus, the men of robust intellect and of the full standard, did not, as a rule, subscribe anything to anything, least of all to hospitals. Hospital contributors all went to church, and read their Bibles, and then wrote cheques Q.E.D.; whereas they, the persons for whose benefit chiefly all these cheques were signed, did neither, because they were above such weaknesses, as became Fellows of Royal Colleges and Bachelors of Science.

It required, therefore, no small amount of courage for a St. Bernard’s man to profess Christianity there. He might don a philosophical religion of Humanity, profess an eclectic faith compounded of Buddhism and George Eliot, with a dash at Renan, because downright Bradlaugh and Besantism was vulgar and slightly fusty; but he must denounce priestcraft and other worldism, as became all true followers of medicine, and emancipated souls baptized into the spirit of the age.

Elsworth took lodgings in Lindsay Street, just opposite Mrs. Harper’s house. He soon became attached to little Murphy for his genial disposition and cheerful heart, and it was not long before he found some attraction in the lively company surrounding him. His own landlady was serious and prim, and rigorously excluded the fast set of men at the hospital. “What suited Mrs. Harper wouldn’t suit her,” she used to say; “and if medical students couldn’t behave themselves like other folk, she wouldn’t have anything to do with ’em.” So it was only quiet men who went to live at Mrs. White’s – men who kept good hours, and didn’t kick up rows in their rooms; “she wouldn’t have it at no price.” She went to the little Baptist chapel in Bethesda Court, hard by, and was a good, worthy woman, who made all about her the better for the faith she professed; and though her grammar was defective, and her notions crude, her religion made, as Rowland Hill remarked, “even her cat the better for it,” for her feline companion never drank her lodgers’ brandy, nor smoked their cigars, “nor took aught that wasn’t his’n.” She kept her rooms, as became a good Baptist, beautifully clean; and a man who wanted to read hard, and be quiet at his work, found it a privilege to be cared for by Mrs. White. Here, when not at the schools, Elsworth was almost always to be found; and human bones were scattered grimly about the room. A valuable microscope, with a large cabinet of preparations and sections, and a well-stocked bookcase of works of anatomy and physiology, gave the sitting-room a learned aspect, which of itself seemed to repress the rising desire of any young visitor to invite the occupant to “a shindy.”




CHAPTER V.

THE BEADLE AND THE THEATRE


’Tis part of my proud fate
To lecture to as many thick-skulled youths
As please, each day, to throng the theatre.

    – Browning (“Paracelsus”).

O Youth and Joy, your airy tread
Too lightly springs by Sorrow’s bed;
Your keen eye-glances are too bright,
Too restless for a sick man’s sight.

    – Keble.

Old Jeremiah Horne was the beadle of the medical school at St. Bernard’s. He had held the post now for nearly thirty years, and his father held it before him. He and his family lived on the premises, and the post was generally understood to be a lucrative one. His motto was, “Nothing for nothing, and very little for a halfpenny.” He was a portly man, very dignified in his manner towards the younger students, who were kept at arm’s-length by him for purposes they well understood. He was not hard on them for their mischief, their breach of rules, their neglect of work, or any of their shortcomings, only they had to understand, if they wanted his aid, they must tip him well and tip him often. And this they did, and so Jerry Horne “waxed fat and kicked;” and even the professors themselves somehow came to recognise that the beadle was a not less important factor in the school than one of themselves. He could restore order when they individually or collectively repeatedly failed. A word from him would reduce the most refractory to his senses, when the threats and the preaching of the teachers fell on deaf ears. His business was to see that the theatres and class-rooms were duly arranged for lectures. He had to provide a proper supply of subjects for dissection, to prepare them and allot them in due order. But his most important duty, and the one which gave him the whip hand over all the men, was to register their attendance at lectures, and so make or mar their prospects of being duly “signed up” at the end of the session. By the rules of the examining bodies at “the Hall” or the Colleges of Physicians and Surgeons, a student must attend a certain proportion of all the lectures delivered in his school before his papers can be received and himself duly entered as a candidate for the necessary legal examinations which he must pass before he can get his diploma or certificate to practice. Mr. Horne’s conscience was elastic; and if a sufficient number of half-crowns and shillings were flying about, he could always see and register the presence of a man in the theatre at lecture who was probably at home in bed half a mile away. As everybody voted lectures a great bore, especially those which began at 8 or 9 o’clock on a winter’s morning, this was a great convenience. The lecturers poured forth their wisdom to a scant attendance at such times, and Mr. Horne’s half-crowns grew and multiplied.

At all the lectures it was the duty of the beadle and his assistant to occupy a convenient post, in view of the whole auditory, so that he could mark the individual attendance and detect those engaged in larking during the progress of the lecture. Under such circumstances it was a task to the ingenuity of the boys to let off crackers without detection, or shy potatoes and cabbages at the botany lecturer for purposes of classification. The pundits themselves usually took the interruptions in a good-humoured way, doubtless reflecting that medical science has, from immemorial time, been imparted – in the British Isles, at least – under similar difficult conditions; so these being recognised as conditions, they had to yield to the inevitable with the best grace they might. But as they looked to the beadle to keep order by means they knew him to possess, it was incumbent on Mr. Horne, now and then, to “espy” somebody, usually one out of favour with him temporarily, either from being deep in his debt or from having wounded his dignity. When a scape-goat or two had been thus caught, they had to pass an unpleasant quarter of an hour in the private room of the warden, and give assurances of better behaviour under threats of expulsion or suspension of schedules. The patience of the lecturers was admirable; they bore most interruptions with exemplary meekness, but they always resented pea-shooting as disturbing to the exact thinking and speaking necessary in treating scientific subjects. The botany lecturer, indeed, was a pattern of amiability. Not even a potato plump against his snowy shirt front, or a cabbage flop on his manuscript, disturbed him much or drove him into strong language. “Ah, thanks! yes, my young friend, that tuber is the Solanum tuberosum; it is a good specimen, but a little out of order. We have not yet reached the Solanaceæ. Will the young gentleman who has thus rather roughly drawn my attention to his specimen kindly tell me the characteristics of that order, and name the principal medicinal plants belonging to it? You, sir, I think it was, who forwarded me the example; Mr. – , Mr. – , your name escapes me for the moment. I mean the gentleman with an ecchymosis under his left eye.” The gentleman with the ecchymosis knew as much about the order in question as his bull terrier knew of astronomy; and amid the uproarious laughter of his class-mates, ever ready for a diversion of interest, on being pressed by the lecturer to exhibit his knowledge of the potato tribe, was fain to confess that he knew little more about the species than he saw of them on the dinner-table. He began to wish he had not thrown that tuber, and the laugh was well turned against him as the lecturer scored several neat points in dealing with him. This was one of the recognised and old-established methods of defence adopted by the persecuted teachers, and a good example of the survival of the fittest theory. The chair could really only be held by development of such defence, and the ingenuity of the students in organizing new systems of attack had to be met by improvement in their repulse. It was armour-plating versus guns, and the armour-plating generally saved the ship. Professor Letts would have been a lost man one morning at the chemistry lecture had he not caught the man who threw the lighted squib on the lecture table, where it fizzed and bobbed amongst his neatly fixed-up apparatus for an hour with the gases. “You, sir!” he cried, in his determined, assertive manner that always commanded and secured respect; “you, sir, you squib-thrower, come forward to the black-board! You are going up for your preliminary science; give me the chemical formula for that explosive. We are considering nitrogen this morning; you shall give the audience the benefit of your, doubtless, complete knowledge of your favourite gas. Nitrogen is your favourite gas, is it not, Mr. Albery?” Now poor Albery had to maintain a reputation for chemistry on a very slender basis, and withal was a nervous man; and being all the while unmercifully twitted by Mr. Letts, his symbols got mixed, and he returned to his seat feeling that the squib itself was not more completely “bust up” than he. One of the best retorts was made by the professor of anatomy, who, entering the theatre for lecture one afternoon, found that the skeleton, which always hung on a stand near the lecturer’s table, had been removed from its frame and placed on one of the benches in the auditorium, and was seated in a free and easy manner, with a long clay pipe in its ghastly jaws, and a pewter pot in its left hand. Dr. Hawkes took in the situation at a glance, and said, “Gentlemen, I miss our old friend the skeleton from its accustomed place, and perceive it in a new character seated amongst you. We shall, this afternoon, go on with our remarks on the vertebral column, and I have no doubt my address will be as useful to its empty cranium as it will be to those by which it is surrounded.”

It was many a long day before that trick was played again.

The worst attacks were always made on poor young Dr. Harburne, who held the chair of Materia Medica. He was not equal to dealing with them, and took the matter to heart so much that he soon retired. He was a most able physician, and the more studious of the men did their utmost to repress the disturbances, which were so frequent as to make it impossible for anybody to learn anything or to gain the least benefit from the very valuable course of lectures on this important subject. He often left the theatre, finding it impossible with his meek and gentle manner, and his lack of any power of retort or ability to make reprisals, to continue his address. “Come back, papa,” they would cry; “we are good now!” He knew the ringleaders, but he was too amiable and patient to expose them. “Ah, gentlemen,” he said one day in the lull of a storm of interruption, “the day will come when you will be standing helpless by the bedside of some loved one whom you would give your own lives perhaps to save, and will be powerless by reason of opportunities you are wasting now! I do not envy your reflections then. I pardon you now; your punishment will come later!” Poor fellow! he died in harness, a victim to his long years of hard work in toxicology. In a fit of depression he swallowed prussic acid, just after leaving the profession an exhaustive treatise on its uses!

Such were the lectures at St. Bernard’s, and so passed the time which should have been spent in acquiring information for which the prescribed four years’ course was all too short to gather. No wonder that so many men hold hospital lectures to be almost useless, and attend them no more frequently than they are obliged, when they are generally only occasions of childish amusement. It was not the idle and dissipated who neglected these opportunities – too often these mustered in force for the sake of the fun. It was the best men, who felt that their own rooms and their books could better assist their progress.

Jerry Horne was an accomplished photographer, and used to do many strange and interesting things with his camera. He would get a collection of skeletons from the museum, and arrange them in novel and curious attitudes. One scene was a ball-room, all the dancers being skeletons; another was an inquest, with coroner, witnesses, and jurymen, all skeletons; another an operating theatre, with a skeleton surgeon and assistants, a skeleton patient and spectators. But the favourite subject with the students was the skeleton lecturer, with a skeleton audience larking and otherwise neglecting the business for which they had assembled. The boys bought all these drolleries, and horrified and even appalled their mammas and sisters when they went home, by exhibiting them in a gay and easy manner, thus manifesting their indifference to and contempt of death and the ultimate destiny of man.

Elsworth often thought of the lines Louis XIV. was fond of quoting from Racine: —

“Mon Dieu, quelle guerre cruelle!
Je trouve deux hommes en moi.”

One of these two men within him was doomed to perish, which should it be? The wild follies of his companions had a strange fascination for him, and daily he seemed getting spiritually harder and more engrossed with unworthy pursuits. He was full of fun, and there seemed such drollery to be got out of upsetting policemen, leaping closed toll-gates without paying, and such-like pranks, that the lofty purposes with which he entered seemed like the blossoms in spring, which yield to the first frosty night after their appearance. Of course he could have held on his way had he been firmer, but the majority of the better-hearted men were so given to these sprees that he seemed to be merely finding his natural level in joining with them.

Dr. Day often invited Elsworth to spend an evening with him at his lodgings. The great anatomist was not a man of one book, but of world-wide reading and information. Nothing was too small for him to notice, no subject too deep for him to study: he lived to know. There was a charm about the old man, and the calm philosophic way he bore his reverses commanded the respect of all who knew his story. There was one subject on which he was impervious to argument: he would never admit that it concerned him in the least how the subjects for dissection had come into his hands. “If people like to use dynamite and the knife to advance their political projects, what has that to do with the leaders of the party who profit by their actions? Is it not an infamous calumny to accuse them of being the associates of murderers? My work was to teach anatomy. I did not kill people, I did not employ those who did. If the greed of money prompted men to do improper things, how could I be held responsible for them simply because I paid liberally and asked no questions?”

He cared nothing for the healing art; his speciality was the dead subject. The only true use in living, he seemed to think, was to provide the anatomist with good subjects for his table. The man had not lived in vain who had served Robert Day with his frame. He was an atheist, a dogmatic atheist, interested not merely in denying the God of the Bible, but in proving the impossibility of the existence of any Supreme Being at all. Hence the melancholy of the man. His daughter shared his views, for she worshipped her father, and he had taken care she should learn nothing of religion from her infancy. They took pains to imbue Elsworth with their opinions; not that they vulgarly scoffed at his faith, but as propagandists of “the religion of Man” they declared it their duty to wage war against that of God. The learning of the old man and his daughter tempted our student to many a discussion with them; he thought if his faith would not stand a little argument it was not worth much. An orange tree grows and bears fruit in the open air in the South, but soon sickens and dies in an English garden. It was rash of Elsworth to subject his faith to such a test. He was doing what has proved fatal to many a youthful mind.




CHAPTER VI.

JACK MURPHY’S PARTY


Wine and youth are fire upon fire.

    – Fielding.

Idleness, the cushion upon which the devil chiefly reposes.

    – Burton.

Firmly screwed upon the door
Doth the lion-knocker frown.
To-night its reign of noise is o’er;
Courage, boys, we’ll have it down!
Long its strength defied
Every dodge we tried;
But its nuts no more shall bear it,
From the hinge to-night we’ll tear it.

    – Cruikshank’s Almanack.

Jack Murphy gave his party. The winter session was nearly over, and in a few days the students would be all dispersed to the bosoms of their families. For several days past their spirits had been rising, and their fun even at lecture and in the wards was scarcely restrained within moderate bounds. Work was kept up with difficulty, and many of the men were leaving daily. Eight of the choicest spirits of the school turned up on the appointed night. There was not one of them who had not borne the brunt of battle, and won his spurs on a contested field. There was big, heavy Tom Lennard. He was the hero of the smash-up at the Chelsea Alcazar, a not very reputable, but much patronized, place of entertainment, with an open-air dancing platform. There was a fête one summer night there, and an attack on the place was organized by the young medicos of the hospital. The police knew nothing of the proposed attempt, and their numbers were too few to interfere much with their destructive sport. After satisfying their vengeance for some affront they had previously suffered at the hands of the proprietors, they marched through the town in the small hours of the morning, shouting, bellowing, and singing at the top of their alcoholized voices, and upsetting everybody and everything that came in their way. At the houses on either side of their path they threw stones, half bricks, and other missiles, to the terror and alarm of the peaceful inhabitants, and the danger of any sick person who might be in them. A large brickbat, hurled by the powerful hand of Tom Lennard, fell plump on the bed of an old gentleman who lay dying, and his friends were naturally very angry with the perpetrators of such dastardly violence. The destroying army of young gentlemen roughs passed on, leaving behind them very distinct traces of the wreck they had wrought. There were loud outcries against the police, and the whole business made a great stir in the press. Somehow, Tom Lennard’s conduct was discovered by the authorities of his hospital; he was then at St. Luke’s, but was expelled with the loss of all his fees. It was felt that he had somewhat exceeded the natural hilarity of an embryo surgeon, and he was advised to migrate. He migrated to St. Bernard’s, where he had reason to hope the tone of the governing body was less severe. This exploit, and the fact that he was at least a confessor, if not a martyr, in the cause of student life, made him immensely popular with his fellows, and he was always in request when anything was “on.” Tom was a splendid specimen of the muscular student, if student it were correct to term him. He was never known to study anything, con amore, but practical jokes, billiards, football, and midnight revelry. He did fairly well at the examinations by coaches and hard cramming. He was magnificent at “tips” for remembering needful points. All the nerves, arteries, origin and insertion of muscles; infectious diseases, their symptoms and treatment; everything medical and surgical that any examiner had been ever known to ask a question about was by this ingenious fellow reduced to a simple formula of catch words, constituting an original system of artificial memory. Everybody who wanted a good tip for anatomical or other difficulties went to Lennard, and came away with a cabalistic arrangement of ludicrous words, that to most men were more difficult to remember than the facts they were intended to represent. To himself, however, they must have been amazingly useful, as he certainly did pass his exams, and it is no less certain that he seldom did any work, and never really understood what he did manage to get through. He was full of good nature, and always ready to “help any lame dog over a stile,” as he called it; so the needy men went to him when they wanted to borrow; and the helpless idiots who could not learn in the ordinary way, but resorted to royal roads and short cuts, got his tips, and made so mixed and bungling a use of them, that this patent method frequently completed the downfall of those who essayed to bend Ulysses’ bow.

There was Tim Finnigan, “a broth of a bhoy,” from the wilds of Galway, all fun and frolic, but good at learning, and witty as ever trod a bog or broke a head. It was he who led the raid on the Statuary Exhibition near Queen’s College one Saturday night, and carried the great nude gods and goddesses into the adjoining churchyard; so that when the good folk went to early mass, they were confronted by Venuses and Apollos, impudently airing themselves under the trees by the pathway, “mit nodings on.” The maiden lady, whose parlour window overlooked the churchyard, was horrified when she came down to breakfast that Sunday morning, to see a dreadful great plaster man unblushingly staring at her in the undraped similitude of a Greek athlete. The church was served by an order of French religious, and the agony of the poor fathers at the shocking display, rivalling the groves of Blarney, outside their monastic church was painful to behold. Tim Finnigan was present when they discovered the exhibition on their premises, and he declared he never afterwards could believe that a Frenchman had any sense of humour. Poor Tim was discovered to have been the hero of this freak, and that was why he left Queen’s College and turned up at St. Bernard’s. The maiden lady who had caught the vision of the athlete thought expulsion a punishment all too light for him.

There was “Darkey” Dobbs; he was not christened Darkey, his swarthy complexion was the cause of his nickname. He had great mechanical ability, which he brought to bear on his practical jokes. His rapid knack of getting brass plates off doors and railings, his skill at wrenching knockers and bell-handles without alarming the owners, made him an indispensable companion of a night’s fun. It was Darkey who invented the celebrated coffee-stall joke. Four fellows hired a “growler” early one winter’s morning in the main road by the hospital. Three of them got out of the cab and called for coffee, and treated cabby; and while the attention of the stall-keeper was arrested in serving his new customers, the fourth occupant of the vehicle quietly got out, and, unperceived by anybody, tied a long cord to one of the posts of the stall and connected it with the shafts. Cabby remounted, his fares discharged him and decamped, and he drove off dragging the stall behind the vehicle, upsetting all the cups and platters, and wrecking the whole concern. It was said that the stall-keeper’s language was “not of a kind to adorn any Sunday-school book;” when the rope was cut, and the damage calculated, he found to his great grief that a pound would not cover it. It was a good deal for the poor fellow to lose, but the amusement to the perpetrators of the joke was immense, and “the greatest good of the greatest number” was one of the articles of a creed they firmly held.

Then there was “Camel” Campbell, called “Camel” on account of his humpy shoulders, though he was christened Horace. He was the hero of a droll adventure in Great Titchfield Street. Passing through that thoroughfare early one Sunday morning with four or five stalwart fellows of the same kidney, they found a groggy old gentleman who could not gain admittance to his house because his wife had bolted the door, and his latch-key did not avail him. What did Camel and his mates do but in a moment pick him up, and, swinging him backwards and forwards two or three times to get a good impetus, shoot him feet foremost like a bolt from a catapult, smash through the parlour window, where he landed on the table amidst the crash of broken glass, and the disintegrated bust of Psyche that erstwhile beamed upon the street from under a handsome shade. Not one of them was caught; they dispersed by different routes, and got clear away before the leaden feet of the policeman had brought him on the scene.

It must not for a moment be supposed that all, or even the majority, of the men were as much devoted to boisterous amusements as those we have been describing. The quiet, hard workers found means to keep themselves aloof from such revelling, though even they, under the charm of the influence the leading spirits exercised over the generous, light-hearted youths who compose the majority of medical students, sometimes abandoned themselves to the spirit of devilry which often broke loose when the day’s work was over.

Very hard workers, who went in for the greater prizes and scholarships, were obliged to live at a distance from the place, that they might be under the less temptation to this sort of thing.

The assembled guests were in high spirits to-night. Though they had done very little of the work they were supposed to have got through, and had attended scarcely half of the lectures they ought to have heard, they had succeeded in getting their papers signed; and, with but two exceptions, they had as much credit given them on their schedules for honest work as if they had been the most assiduous and conscientious of students. So they sang their songs and retold their stories, drank their beer, smoked their tobacco, played nap, and laughed and talked as only youngsters full of life and spirits can who lead the Bohemian life of a medico.

Lennard was inclined to be sentimental and romantic. “What adventures,” said he, “we should hear if the corpses in that dissecting-room over yonder could tell their histories! Unclaimed all of them! Think what that means. How low one must sink when nobody comes forward to ask the parish to bury you at its own expense! Let me conjure up a history for you of the seven subjects on the tables where we have been at work to-day. I will begin at my own, where I am ‘doing my leg.’”

“Ah! I am glad you said ‘doing.’ I should have demurred to ‘dissecting,’ had you said that,” threw in Murphy.

Disregarding the interruption, Lennard went on: “This old man – not so very old, about sixty I should say – has good features and toil-worn hands; was, let us say, an unfrocked parson: fell into bad ways, family disowned him; left his old associates, or they left him; gradually sank lower and lower; sold little things in the street; lived at threepenny lodging-houses; got ill; taken into the parish infirmary; died, and came here. Think of all he must have gone through! How he would remember his happy youth at school, at Oxford, his ordination, his good aspirations, the society he mixed in, and the remorse that embittered his life. This sort of thing is common enough. That woman on the next table, with the spinal fracture, a tight-rope dancer in her early days; used to delight the habitués of Old Vauxhall; one night fell and broke her back. Folk soon got tired of helping her. Her husband made her happy, and was good to her; till, in old age, he died, and she was left bedridden and without means. Even the church folk got tired of the case. She went into the workhouse, died, and so came here. All this as likely as not. Think of those long years of suffering! From the last dazzling lights and gaiety of Vauxhall, to the gradually beworsening room where she lay a cripple for so many years, while her husband did his best to cheer her, and make her as easy as he could. Behind her is a coloured woman not more than forty. How came she here? A stranger from beyond the seas, knowing nothing of our language, brought here by friends who held out hopes of gain and pleasure, and then left her sick and dying in St. George’s Workhouse, down by the London Docks.”

“Oh! hang it all, Lennard!” cried Mahoney; “you are preaching like a teetotal orator. Confound it, we can’t stand the whole seven of ’em. That’s enough! Why, what could the old parson want more than to give a medical school like ours his ‘body of divinity’? He has preached a better sermon in the hands of Professor Sturge than he ever did at church, and his illustrations are much more telling, I dare say; and he makes no reservations now. I can imagine nothing more honourable than to devote one’s body to a dissecting-room out of mere gratitude to a science that has helped us in life. But this is a dismal strain we are in. Give us your song, Williams; dear old Albert Smith’s ‘Student’s Alphabet.’”

Williams laid aside his pipe, and took a pull at the tankard of ale on the mantel board, and began: —


THE STUDENT’S ALPHABET

Oh, A was an Artery, filled with injection;
And B was a Brick, never caught at dissection.
C were some Chemicals – Lithium and Borax;
And D was the Diaphragm, flooring the thorax.


Chorus

Fol de rol lol,
Fol de rol lay,
Fol de rol, tol de rol, tol de rol lay.
E was an Embryo in a glass case;
And F a Foramen that pierced the skull’s base.
G was a Grinder who sharpen’d the tools;
And H means the Half-and-half drunk at the schools.


Fol de rol lol, etc

I was some Iodine, made of sea-weed;
J was a Jolly Cock, not used to read.
K was some Kreosote, much over-rated;
And L were the Lies which about it were stated.


Fol de rol lol, etc

M was a Muscle – cold, flabby, and red;
And N was a Nerve, like a bit of white thread.
O was some Opium a fool chose to take;
And P were the Pins used to keep him awake.


Fol de rol lol, etc

Q were the Quacks, who cure stammer and squint;
R was a Raw from a burn, wrapped in lint.
S was a Scalpel, to eat bread and cheese;
And T was a Tourniquet, vessels to squeeze.


Fol de rol lol, etc

U was the Unciform bone of the wrist;
V was the Vein which a blunt lancet missed.
W was Wax, from a syringe that flowed;
X was the ’Xaminers, who may be blowed!


Fol de rol lol, etc

Y stands for You all, with best wishes sincere;
And Z for the Zanies who never touch beer.
So we’ve got to the end, not forgetting a letter;
And those who don’t like it may grind up a better.


Fol de rol lol, etc

One of the party, a Mr. Randall, a second year’s man, was very groggy, and it was rather unlucky that he was called out to a maternity case in the midst of all this enjoyment. Not that he took it to heart much, indeed he went with alacrity. He had to prove attendance on fifty cases before he could compete for the Obstetric prize, and as this would bring his number up to forty-three, it was important not to miss it; so he left the company with many ribald jokes aimed at him, and was soon in attendance on the unfortunate woman whose life, and that of her babe, were entrusted to his care. The young man meant well, but he would have been less scandalous to the assembled matrons had he been sober. It seemed, however, so natural for a hospital student to be slightly elevated, and the class of medical men who sent their boozy unqualified assistants to look after their poorer clients had so familiarized them with vinous doctors, that he got a better reception than he deserved. Sometimes very terrible accidents arose in this way, but nothing ever came of the investigations that followed. The staff of the hospital, with their great names and solemn opinions, were always at the service of the students to extricate them from a difficulty; and had they amputated a patient’s head while serving their hospital, there were plenty of good men with a string of letters to their names, who would have been found to swear at the inquest that the treatment was justified on high medical authority under the circumstances. This is called medical esprit de corps, and it is born, bred, and educated in our great medical schools.

Under the ægis of this protection there is very little that a student cannot do with a live or a dead human subject. Nice for the subject, especially if a live one! The interesting object of Mr. Randall’s attendance on the evening in question recovered her health, and ultimately died a natural death.

After Randall had started, Dobbs was called upon to tell a story. He was good at this sort of thing; had written several capital tales for the press, and was generally suspected of being engaged upon a medical novel.

“Well, lads,” said he, after mixing himself a whisky and soda, “I will tell you a true story to-night. I don’t think any of you know it, save perhaps one or two. I don’t always feel in the vein for telling it, but to-night I do. So here goes.

“It was one day towards the end of November, four years ago, when the great fog lasted three whole days and nights without lifting. London was in total darkness, save for the feeble ghostly glimmer the gaslights gave here and there. There were few men about the place, but I was working hard for a prize and could not leave town – every spare moment was passed in the dissecting-room. On the afternoon of the day I refer to, two or three fellows came bothering me to go and play billiards with them. They were half screwed, and I was occupied with my work and didn’t want their company. So as soon as I got rid of them I took my ‘part’ down to the vaults below, where the coffins are kept waiting for the weekly visit of the undertaker. I lit the gas, and soon got absorbed in my work. It must have been about four o’clock when I went below, because the fellows who had been bothering me had just left the Anatomy Lecture, and nobody knew of my having done so at all. When one gets interested in the brachial plexus, the flight of the hours isn’t noticed, and I was first recalled to the fact that it was closing time at the schools by hearing the heavy slam of the great iron door at the top of the steps leading down to the vaults. Dropping my scalpel with a rush, I made for the staircase, and in real terror of being locked in for the night, shouted to be let out. No answer came; all I could hear was the banging of more doors, fainter and fainter, as they were more distant; and then, hearing the thud of the great outer door, knew I was imprisoned for the night, with no chance of escape. When I returned to my vault, of course the gas was turned off – the porters had seen to that – and I was in total darkness. I had a box of vestas in my pocket I had fortunately bought of an urchin as I came in, and luckily had plenty of tobacco. Lighting a match, I began to explore the place more carefully than I had done. I did not look for any means of getting out, as I knew there were none; but I was very anxious not to spend the night in darkness. On a shelf over the door there were a lot of bottles and jars, containing the various fluids used in preserving the subjects. To my great delight there was a big bottle of oil, and then I knew I was all right for a light. This was something, at all events. Knocking a large glass bottle to bits, I managed to make the bottom of it into a fairish sort of lamp; and then, with a few slices of cork and some of my wax matches, I rigged up two very decent floating wicks, and set them alight. The glimmer was faint, and served rather to increase the gloominess of the place, and exhibited my sleeping apartment in a rather unpleasant aspect.”

“Why didn’t you burn the door?” asked Elsworth. “They always did that in Dumas’ tales.”

“How could he when it’s iron, you donkey? Shut up; it seems you never do any quiet dissections,” said a young house surgeon.

“There was the body of a newly imported subject, that had just been got ready for use upstairs, lying in ghastly whiteness on a coffin lid in the middle of the place. I noticed that its right arm was attached to a rope and pulley in the ceiling, and had been left in that position when the beadle had injected his preservative fluid into the arteries. The weight which acted as counterpoise was lying on a heap of old rags on the edge of the table. I did not like the look of the raised arm; it seemed pointing at me in a nasty ghostly sort of way, and I pulled it down. Then exploring further, I came upon a great store of tow and old sacking, and with these I made up a tidy sort of bed on a wide shelf, and determined when bedtime came to try and get some sleep. I was downright mad when I thought of my jolly little fire at my diggings, and the kidneys and stout I had ordered for supper. I wasn’t in much of a humour for reading, and had nothing to read with me except my Gray’s Anatomy. I hadn’t light enough to dissect, or would have kept at it all night. I could hear the clock of St. Andrew’s tolling out the lazy hours – how long they seemed! At nine I couldn’t stand it any more, and lay down on my shelf, and covering myself with the sacks tried to go to sleep. It was past ten before I dropped off; my bed was most uncomfortable, and my pillow too low – a low pillow always makes me dream so. I rested badly, and soon awoke. As I lay thinking and praying for morning, I became aware of a peculiar low moaning noise, as of some creature in great pain in a distant corner, as it seemed. Listening with the intensified sense that such circumstances arouse, I heard, in addition to the moans, a regular clank of some machine working like a bellows, and then I remembered that on the day before I had been trying some experiments on two dogs in the next vault. To one I had given curare, and had to keep his respiration going by Paul Bert’s beautiful little machine, invented for the purpose; the other dog had been horribly mangled by Crowe, and ought to have been killed, but there was a question of the bile duct on which I hadn’t completely satisfied myself, and he told me to take the animal below, and I am ashamed to say I had forgotten the poor little beggar.”

“Was that the rough little terrier which followed Dr. Arnold in the Laboratory when he was starving? I have heard him laugh at the misplaced confidence of the brute,” said Elsworth.

“The very animal,” replied the story-teller.

“But, I say, you had no licence, you know!” said Wilks, a shy, curate-looking freshman, who belonged to several humanitarian societies, and thought all this very dreadful.

The roar of laughter with which the delicious joke was received made poor Wilks blush to the roots of his hair, as one of the audience cried:

“Licence be hanged! Do you think we care for the fanatics who impede our work? Let them show themselves at St. Bernard’s! Crowe has one, because it looks well to the public; but don’t you preach, Wilks, or you’ll do for yourself. Go on.”

“Now when I was at work on the physiology part of the business, I never thought of the cruelty, but now it all came upon me horribly. My position was bad enough, but these poor dogs – animals, like ourselves – they were in cruel agony without food or water. I was only not on a feather bed, that was all; they were dying in awful torment. I thought my imprisonment was all arranged by a higher Power, to let me know what I was doing; and God knows I suffered shame and mental distress that night. I fell asleep at last, though the moans and the clockwork worked themselves into my dreams. All at once a loud noise aroused me. I started up, and to my unutterable horror, saw the arm of the corpse on the coffin lid slowly rising, and pointing its rigid hand at me in the dim light. I am no coward, as you know; but my heart was in my mouth as I stared with starting eyeballs at the ghastly object, and then I saw what had happened. The counterpoise of the pulley had slipped down, and dragged up the right arm of the corpse. It was the falling of the weight on the floor of the vault that awoke me. Just then the clock struck three, and I left the arm pointing its stiff fingers at me and went to sleep again – ‘to sleep, to dream.’ I dreamt that two awful-looking burkers had brought a subject in, had taken their gold from the place where it lay ready for them, and had caught sight of me. ‘Why, Bill,’ said one, ‘here’s a chance; let us smother this bloke, and he’ll be worth another five-pun-note to us!’ ‘Right you are, Tom!’ said the other. And they proceeded to carry out their diabolical plans, when I awoke. Horrible night-mare! I shudder now when I think of it.”

“Rather creepy, I must say,” said little Murphy.

“Well, I could not sleep any more after that, and lay a-meditating. After all, I thought, why shouldn’t I have been murdered and given up to science, as I had done with those wretched dogs in the next room? Did not the same Power frame their bodies as mine? Were not the processes Nature so lovingly and carefully carried on in their sensitive little frames just as beautiful and well adapted as those which went on in me? I repented, my lads, that night, and I have never spoken to Crowe since, and have done with that sort of work.”

“Ah! you are a sentimentalist,” they cried; “but tell us how you got out.”

“Oh, I got through the night somehow – an end comes to everything sooner or later; but the scoundrelly porters were later than usual that morning before they opened the place. Jim, the sweeper, was in a beastly funk, and implored me not to tell anybody, because it was his place to look round the vaults before closing; but he says the fog had got into him, and the other porter had asked him to go and have some hot spiced ale with him, and he was anxious he should not change his mind.”

It was getting late, and Mrs. Harper knocked at the door with “Time! gentlemen; time!” Of course she was asked in and invited to have a toothful.

“As my spasms was just a-comin’ on, strange to say, gentlemen, as up the stairs I came, I don’t mind if I do. Just a thimbleful; no, Mr. Murphy! not a drop beyond the pretty part, and cold I’ll have it to-night. It does me most good when the liquor is strong. Here’s your very good ’ealth, gentlemen, and may you all have lots of practice when you’ve done with the ’orspital; and what’s more, lots of fees, and good ’uns.”

“Well done, missus,” said all the men; “you could not have wished us anything better.”

“And now, gentlemen, I thank you for your kindness, but shut up my house I must; so I hope you will pardon me if I ask you to clear out. Oh! lawks, Mr. Murphy; I ’opes to goodness the perlice won’t see this blessed board, nor these knockers and things. I chops up that there ‘Similar – attached Willa Residence’ to-morrow for the fires. I said you should have it for your party, but no more of it – not if I knows it. Now, gents! Good-night! good-night!” And she got rid of them, and they went rollicking home.




CHAPTER VII.

NURSE PODGER


A gentleman who in a duel was rather scratched than wounded, sent for a chirurgeon, who, having opened the wound, charged his man with all speed to fetch such a salve from such a place in his study.

“Why?” said the gentleman, “is the hurt so dangerous?”

“Oh, yes,” answered the chirurgeon; “if he returns not in poste haste, the wound will cure itself.”

    – Thos. Fuller.

Now being from Paris but recently,
This fine young man would show his skill;
And so they gave him, his hand to try,
A hospital patient extremely ill.

    – Oliver Wendell Holmes.

Mrs. Sarah Podger was receiving-room nurse at St. Bernard’s, and one of the most important officials of the charity. The receiving-room is immediately within the main door of the hospital, and when an accident or other case of emergency is brought in, the patient is taken straight to this waiting hall. He first encounters Mrs. Podger, who is on the alert, having been summoned by the bell the gate porter rings when the case passes his lodge.

Mrs. Podger is at least fifty years old, is short, stout, and good-tempered. Her face is florid; she is not a convert to Blue Ribbonism; to use her own expression, she “leaves all that there rot to the sisters and fine ladies who play at nussin’.” She is of the good old school, “before all these fads and fooleries was got up;” she “don’t hold with none of ’em” “and don’t you go for to tell me,” she used to say, when questioned, “as nussin’ can be properly done on milk and water. Milk-and-water nussin’ is all very well for them as ain’t got nothin’ the matter with ’em, but folks as has to be treated at St. Bernard’s is too serious bad to get on with teetotal notions. Teetotal is all very well for the mumps; but lor’ bless yer, my dear, how are yer goin’ to nuss a capital hoperation on tea, leastways not without a drop of somethin’ in it?”

Mrs. Podger is first of all the obsequious and humble servant of the house governor, the resident staff, and the doctors attached to the charity. To these she is a very dragon of virtue and propriety. To them she protests against all larks on the part of the young students, and is never seen to smile at them in their presence. The hospital and the good of the patients is her sole love and desire. Not Jerusalem was holier to the Jew than St. Bernard’s to Mrs. Podger, when any of these were in her presence. But her heart was with the boys, and her pockets in that lavender print gown found its account in keeping well in with them. “The boys,” as she used to call the students, who were always lounging about the receiving-room, waiting for somebody to fall off a scaffold, or get run over, boasted that Podger could teach them more than all the staff put together. Where was the man who had not learned his practical surgery at Podger’s hands? Did he shine in his bandaging, it was Podger who had taught him to make those neat, smooth turns. How would that “foreign body in the eye,” as was designated the bit of coke dust in the governor’s organ of vision, have been extracted just now by the house surgeon of the day, if Podger had not given him that gentle nudge and that knowing look and told him exactly what to do, and let him have all the credit of doing it? If Podger liked the students, they on their part found Podger indispensable to them. Without her the receiving-room was the house without the mistress – the whole business went wrong. Now Podger was capital for the students, and well deserved all her tips and all her drops of gin and whisky; but you would not have appreciated Podger at her proper value had you tumbled off an omnibus, and been carried to her place of business, say at five o’clock, when the staff was dining, or at ten, when the house surgeon of the week had his little card party in his rooms. Well, yes, it would have been all right if the friend who went with you had “exhibited,” say, half an ounce of silver coinage for application to the palm of Podger’s hand, right or left; otherwise you would have been placed on that black leather couch in the corner there under the shelf of lint and tow, and you would have been weary waiting in that receiving-room, counting the various form of splints hanging round it, and listening to the groans of other sufferers waiting till dinner was over, or the game of cribbage finished, for your wounds and bruises to be attended to.

At a card-party, say, in the house surgeon’s room, her manner was much appreciated. A knock. “Come in!” “Accident sir!” “Oh, bother, Podger, what a fidget you are!” “Well, sir, it wasn’t me as caused it; there’s three of ’em, for the matter of that, and they have been here about half-an-hour, and I thought as you’d like to know.” “Fifteen two, and a pair’s four, and his nob! Now, Podger, wet your whistle, old girl; here, have a toothful, and tell them you have called the doctors, and they are all in the wards over a bad case, but are coming to see them directly.” “Bless you, sir,” says Podger, having bobbed a curtsey, “I told ’em that when they came in. Here’s your very good ’ealth, gentlemen, and long life and plenty of practice for you all.” And she returns to the receiving-room refreshed in spirit and better able to contend with the grumbling of the unhappy victims it contained. She would have dressed their wounds, and sent them all off packing about their business, but it was against the rules, grave scandals having arisen from this “unqualified treatment.” Not but that the work would have been often done quite as well as if the students, to the number of say eight or nine, had all had “a go” at it, and with infinitely less discomfort and even agony to the patient; but it was “agin’ the rules,” as she declared “’cos why? it didn’t seem proper for ‘a nuss’ to set broken limbs; besides, it pervented the boys from gettin’ ‘the experience’ they paid for.” She was very anxious they should avail themselves of every opportunity that arose to improve themselves. No member of the staff was more interested than she in the pass list of the College of Surgeons; she felt it as a reproach against her teaching when any of them failed, and on the eve of a “Pass Exam.” or a “Final College,” she spared the patients in the receiving-room no agony as long as any one of the men “going up,” could extract useful information about fracture, dislocation, or the adjustment of a splint.

“Now, stop that there row, young man; it’s all for your good! The doctors is a-settin’ of your leg, and if you ’oller like that, you’ll make ’em nervous. You may thank yer stars there’s ’orspitals for poor sufferers like yourself to come to, and have so many kind gents to make yer all right agen.” And the old girl would wink at the boys, give them all a good chance with the case, and when everybody had quite done, and had got all their points, the poor suffering wretch was sent into the wards, there to undergo as many further examinations as the pursuit of knowledge demanded. Did he scream, she bade him desist; did he struggle, she called another and a stronger nurse to her assistance; did he rebel yet, a porter or two came in to reduce him to order. Chloroform was not often resorted to, it had an element of risk; and ether was too troublesome to be given unnecessarily. The house surgeons always prided themselves on an air of nonchalance and dignity; they were never in a hurry; it was undignified and unprofessional to be anything but perfectly calm under any circumstances. To speak loftily, in measured tones, and with studied stand-offishness, was no less necessary than the binaural stethoscope they never appeared without, the gold spectacles or eye-glass they usually affected, and the patronising manner they adopted towards the men with whom they had been fellow-students, whose larks and escapades they had shared in with equal relish, but who, not having yet attained the dignity of membership of the College of Surgeons, and the still greater honour of house surgeon to St. Bernard’s, were no longer their companions, nor participants in their enjoyments.

They all comported themselves as became members of the staff of a great hospital; they would not have been of much use in any of the ordinary sicknesses that require the aid of the experienced general practitioner or family doctor, who is so serviceable in our every-day troubles and infirmities: they paid no attention to colds, measles, and the mumps; they aspired to greater things, and occupied themselves with eye diseases, maladies of the brain, or the higher surgery. Attend you in your attack of the gout? Oh, dear no! any fool of a G.P. (slang for general practitioner) could do that, or your nurse might manage the case. But trephine you, resect your knee-joint, or do a gastrotomy upon you, – they were burning with enthusiasm for nothing less. So they all told each other they meant to be operating surgeons, speciality men, consulting physicians; they would all go to live and practise in Saville Row, or the neighbourhood of Cavendish Square. “Work for half-crowns like the miserable family doctors in the high-road outside? Not if they knew it!” They were born to send cases to the Lancet, to read papers at Congresses, to edit the Journal of Psychopathy, or arouse the medical world by their work on “Diseases of the Upper Eyelid.” Poor beggars; in ten years’ time seven-tenths of them would be toiling up rotten staircases, or groping in coal mines, visiting patients at an average of nine-pence-halfpenny a head, or holding parish appointments, and doing Friendly Societies’ work at half that rate; while of the other three-tenths, one would be starving in two gloomy rooms in a West End square, the second might make his fortune by marrying a rich wife, and the other work his way to distinction late in life by an ultimate succession to the permanent staff of his own hospital. Now and then he might be luckier still; he might start a special Hospital for Diseases of the Upper Eyelid, and so work his way to eminence and emolument. Of course all these men were supremely scientific. What was pain (in other people), if science could be advanced? What was suffering (in patients), if anything could be added to the sum of our knowledge as to the causes of their suffering? To cure the disease, to cut short the malady – ah, no, too often that was to extinguish alike the discomfort and the interesting course of phenomena that accompanied it. The true patient, the typical client, was he who – devoured by fever or disfigured by disease – asked for nothing better than to be well watched by observant medical eyes, while the “expectant treatment” (i. e., the letting the disease severely alone) did its work. To the objection that a man may die while the expected cure does not arrive, what more obvious than the answer, “But see what a brilliant paper for the Journal is the outcome of it all?” Somehow, Podger vaguely saw all this. Podger recognised that all the “cases” were but “cases.” She knew that Mr. Graves was getting up statistics on broken legs, and was well aware that Mr. Brand was hard at work on a treatise on “Burns and the Cayenne Pepper Treatment.” Now this was in no way objectionable to Podger; she, indeed, could cure burns beautifully with her lint and cotton wool, and soothing unguents; “But, lor bless you! my dear sir,” she would say, “if you likes to pepper ’em on the chance of making a discovery, I ain’t the nuss as ’ud stand in your way of your doing something singular to get yerself a name. So pepper ’em, I say. Thank the Lord it ain’t me nor mine as you are a-operatin’ on. What makes ’em come to the ’orspital at all, I says, if they are a-goin’ to find fault with the treatment?” So Podger co-operated bravely with all the science of the day; she would have flayed the broken-backed bricklayer alive if the staff had ordered it, and said it was scientific treatment. She knew very well the chief object of St. Bernard’s existence, and above all, she knew her place. Oh, but she was an artful and motherly old woman! the true daughter of the receiving-room; the inheritor of all its traditions, and the heiress of a large legacy of hospital tricks. She had such wheedling ways. “You! only an ignorant carpenter, good enough, perhaps, at joists, and flooring, and staircases, what was your opinion against the learned, clever, charitable young surgeon, who wanted to take your leg off, and all for nothing? Shame on you, sir, to suggest ‘practice, practice, all for practice, like making me plane up deals when I was a ’prentice.’ Have it off like a brave Englishman, and don’t make a fuss about a paltry broken leg.” What could a man say under the circumstances? What Podger said to the house surgeon of the day, who had bribed her to get him the operation, was: “It’s all right, Mr. Esmarch; he’s a-goin’ to have it done, so take him while he is in the humour;” and Mr. Esmarch did; and the theatre bell rang to assemble the men for the operation, and Mr. Esmarch rushed off to his books to read up “legs,” and take notes for his first “flap operation.” Oh, Podger could manage it when she gave her mind to it. Was it not truly an invaluable Podger?




CHAPTER VIII.

AMONGST THE OUT-PATIENTS


Some persons will tell you, with an air of the miraculous, that they recovered although they were given over; whereas they might with more reason have said, they recovered because they were given over.

    – Lacon.

Mosca. And then, they do it by experiment,
For which the law not only doth absolve them,
But gives them great reward, and he is loath
To hire his death so.
Corbaccio. It is true, they kill
With as much license as a judge.

    – Ben Jonson.

While engaged during their first year at the medical school dissecting, learning their bones, and listening to lectures on physiology, the students were encouraged to attend the out-patient department of the hospital. Hundreds of poor suffering folk attend at noon daily to consult the physicians and surgeons on the staff. Very arduous is the work these gentlemen perform. Many hours a week are given by them gratuitously for this purpose, and half their lives may be said to be passed here or in the wards. Such of them as in addition are lecturers at the school receive fair but not very liberal fees, but the purely hospital work is without monetary reward. Yet the appointments are eagerly sought for by medical men, because of the publicity and private practice which are sure to follow a successful hospital practitioner; and above all, on account of the great number of rare and interesting cases which occur in hospitals, giving great scope for the trying of new remedies, new apparatus and modes of treatment, new operations and new methods of dealing with obscure forms of disease. Every inducement is held out for sick folk to attend the out-patient department of a large hospital. The great majority of the cases may present no new feature, but there will certainly be a fair proportion of strange and curious maladies, inviting the attention of the penetrative skill of some member of the staff. You see, you are sick of some grievous disorder which your family doctor fails to cure. You demand to see some specialist who has had larger experience of your class of case. He sends for such a one who has passed half his life hunting up this malady in its every phase; it is reasonable he should know more about it than the man who has to attend to everything that comes in his way. It is, therefore, very well worth the while of the aspirant to “consulting practice” to spend every spare moment where he can see most cases. This is the way the hospital pays him for his services. He attends a hundred cases which cannot interest him, because of their frequency; the hundred and first is a variant of the peculiar complaint on which he is writing his great monograph. And there are ways by which every one of the hundred others may be made to contribute their quota of information. If you have not suffered from the complaint forming the subject of the monograph, you will be lucky if you escape exhibiting the genesis of the disease or one of its stages for clinical purposes.

The out-patient departments of the great general hospitals stand more in need of reform than perhaps any of the charitable institutions of our time. To the contributors and subscribers they appear, doubtless, to be the one great means of affording poor persons the highest medical and surgical advice, and the best medicines and appliances free of charge. The poor believe this, the well-to-do middle classes, and even the rich believe it. The out-patient department day after day is thronged by several hundreds of men, women, and children, who go there at noon and wait hour after hour, often till five o’clock in the evening, for an interview with the physician or surgeon who, between the hours of two and four, will probably see one hundred cases. Well-dressed women and men, whose aspect proves them to be at least above the necessity of obtaining medical assistance gratuitously, occupy the time of the staff, and deplete the resources of the hospital in respect of valuable drugs to the extent of many thousands of pounds’ worth annually in London alone. Vast numbers of patients attend who are suffering from trifling ailments which need but the simplest home remedies for their cure. On the other hand, children and adults of both sexes go week after week to the out-patient department, when every time they leave their room for the purpose, the exposure, the necessary fatigue, the long waiting in draughty and over ventilated rooms, does them more harm than any medical treatment they can receive, under such circumstance, can do good. All this happens within the perfect knowledge of the staff, who, so far from discountenancing the system, encourage the patients to attend regularly, and seldom dissuade them till the last days of the poor creatures’ existence. The reasons for such policy, held to be paramount are these:

First; the greater the number of patients who seek the aid of the charity, the greater claim the committee can make on the purses of the charitable.

Again; the greater the number of the cases in hand day after day, the more chance there is of getting hold of rare and interesting complaints for their own notes and statistics; and for clinical teaching for their students, who attend the out-patient department with great assiduity. But even the simplest and least complicated case has its uses for demonstration to the students. Here is a case of commencing phthisis; there is one still more advanced; another is in the last stage; and all afford good opportunities for demonstrating a multitude of points useful for the tyros in medicine to know. A half-dead woman, with lungs far advanced in the destructive changes of pulmonary consumption, applies for treatment. She is examined with care and kindness by the physician, who, having satisfied himself as to the nature and progress of the disease, makes the requisite notes of her case, and hands her over to his class for perhaps a dozen more fatiguing examinations. She has been waiting probably two or three hours for the interview, for another hour or more she must be stethoscoped, percussed, pounded and pummelled, while the students are picking up from her emaciated and wasting frame the elements of their profession. Nobody at the hospital supposes for a moment they can do her any good, but she offers herself in her ignorance, day after day, a sacrifice on the altar of science, that her abnormal breathing sounds, and other phenomena of disease may teach young men how to earn a respectable living. Then, again, there are a vast number of minor operations, for the performance of which, by novices, the out-patient departments afford peculiar facilities. How much it adds to the terror, nervous apprehension, shame and mental distress of the patients, who cannot but feel often how greatly their trouble and risks are increased by their performances as school experiments, can be readily imagined. No doubt medical men do as much work for nothing as other professional men, but certainly not more – not nearly so much as clergymen, for instance. Yet, the hospitals do not pay their staff for all the time and labour devoted to its work. How, then, are they paid? In the first place, their students are constantly going into practice on their own account; they will require well-known and trusted consultants and operators to assist them in difficult cases occurring in well-to-do and affluent families; they will introduce them in this way to lucrative practice, ever increasing if they are skilful men. Every one of their students, therefore, becomes an agent for their success. Even the patients who have received benefit will often be able to recommend to richer relatives or friends, masters or mistresses – as in the case of workpeople or servants – the doctor who has helped them to a cure. It is in this way the great practices of the greatest men attached to the hospitals have all been founded and maintained. That they should devote themselves to the interests of their pupils is, then, of the first importance, as, in a few years, the kindnesses shown to them will be coming back in a steady flow of guineas.

At the close of the second winter session, the men are expected to be ready for the first professional examination at the College of Surgeons, in anatomy and physiology. It is the desire of both teachers and the hospital itself, that as large a proportion as possible of the students shall present themselves for examination at the regular time, as the credit of the school depends on the proportion of passes. Every effort is made to urge the men on, and the teaching staff take the utmost pains to perfect the knowledge of their pupils, and thoroughly instruct them in the subjects they will be required to know. They hold test examinations, and send the men up in batches; those of most promise go up first, while the backward ones are detained till the last efforts have been put forth to fit them for the day of trial. Elsworth was sent up in the first batch, and passed creditably. Having thus proved that he had a sufficient knowledge of the rudiments of his work, he was at once permitted to act as a dresser or surgeon’s assistant in the wards of the hospital proper. This is the first bit of promotion which the successful student obtains. The nurses could do pretty well all the work he has to do, as far as the dressing goes; but this is purposely left to him, that he may pick up instruction and experience.




CHAPTER IX.

“WALKING THE HOSPITAL.”


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 patient? Your dentist began upon somebody; he did not acquire without practice that nice skill, that rapidity, almost amounting to sleight of hand, by which he jerks out your offending molar, before you are half aware he has begun. To be sure, he had a long course on sheeps’ heads from the butchers, and then at the hospital or dispensary, he tugged away at the mouths of poor children, or men and women of low degree, who could not afford the chemist’s shilling, or the still cheaper barber’s fee, and who, getting the job done for nothing, could not reasonably complain of the several bungling attempts with the wrong instruments applied in the wrong way, and often to the wrong tooth.

“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 chloroform, and able men of science about him; and, if they don’t cure him, they will doubtless get information that will enable them to cure some much more important personage! It is not enough to have done all this on a monkey; it needs a man before you can be quite sure. Ultimately they will do it with safety to a gentleman, a duke, a royal prince, and the successful operation will make somebody’s fortune. So as every rising surgeon carries a royal surgeon’s baton in his instrument bag, have at the butcher!

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 going in for ophthalmology, and he never missed an opportunity of dropping belladonna into every patient’s eyes, and taking stock of his retina with the ophthalmoscope. Whether you had cracked your skull or broken your leg, fractured a rib or sprained your ankle, your eyes must be examined minutely, on the chance of something pretty turning up to show the professor of ophthalmology. Dr. Wilson was such an enthusiast on eyes that one day, happening to pass through one of the out-patient wards, he caught sight of a working man in whose visual organs he instantly detected something of interest. Immediately he had him under a lamp, and set to work making sketches of the morbid appearances in the retina, explaining to the other students the beautiful things to be seen therein. Now the patient had not come about his eyes, but being troubled with indigestion, wanted a bottle of medicine to cure it; and he was naturally surprised that for three mortal hours eighteen young gentlemen should be examining his eyes, which wanted no treatment but the sight of a little more weekly pay; and marvelled that no questions should be asked him about the ailment which caused him discomfort. He was still more amazed when, as evening drew on, one after another went away, and nobody prescribed anything for him at all! However, one of the resident staff saw him before the place was closed, and he had a bottle of “house mixture,” and went away more satisfied; but still wondering at the singular ways of doctors.

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 are duly pressed to consent that this – “the only means of saving her life” – shall forthwith be done. To this end all the nurses are instructed to urge her. At last she submits. She will be carried to the operating theatre, and this chance of instruction will fall to Dr. Wilson’s hands; for, as soon as the chloroform has effected its work, he will take the place of the chief, and “do his first strangulated hernia.” Dr. Wilson is jubilant – slightly nervous, for it is very grave work. It is utterly unjustifiable work, Elsworth thinks, but dare hardly express his thoughts except by a timid question or two. He knows he must steel himself to plenty of such matters, that his turn will come and that he would not like to leave St. Bernard’s without doing just as much himself. But his heart, for all that, misgives him.

“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 been suggested, as it is much too pretty to spoil by any attempt at cure just yet. Several surgeons are expected from other hospitals to see it, so she has an ounce of peppermint water three times a day and full diet, and the cure is postponed till a sufficient number of interested people have seen it. Drawings must be made; the artist to the hospital could not attend for a week to come; then there were photographs to be taken, and it would never do to spoil anything so effective by commencing a cure. So “repeat the mixture,” till science has done with the first part of the case, and therapeutics can step in.

“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 his instructor, but he resolved that the auscultation, as far as he was concerned, should at least not distress the poor sufferer. How any human being could find it in his heart to disturb the last moments of his patient with investigations of “cavernous breathing,” “râles,” and “pectoriloquy” puzzled our hero; – but then, this was his first day in his new office; he had much to learn yet.





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