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

Mildred had found her ideal man. They talked of many things, but most of his hospital down in the city, and the next day they all went to see it, and many other of the charitable agencies of the town.

Of course Mr. Crowe was huffy and upset at the meeting, and at the reception which the ladies gave to the handsome young fellow whom they had discovered. He was jealous, too; for Mildred did not conceal the interest she felt in all that was shown her, and Mr. Crowe could not scoff down the good works of which he had evidence that day, though he tried hard to make game of any attempt to Christianize the gipsies, and protested it was a great pity to waste so many opportunities of investigating cholera germs and inoculations in such a favourable field.

Mildred set him down when he spoke contemptuously of Elsworth’s Gitano friends.

“Now, Mr. Crowe, you surprise me, as a deep student of natural phenomena, to hear you talk so. Don’t you know —

‘No creature’s made so meanBut that, some way, it boasts, could we investigate,Its supreme worth’?”

Mr. Crowe did not think the game was worth the candle; besides, it would spoil the artists’ chances to civilize the gipsies.

Elsworth explained that had he attempted to experiment with the cholera patients, if he had been so inclined, he would have fared no better than the native doctors, who were suspected of propagating the disease for the Government, who wished to deplete the population.

“Yes,” said Aunt Janet, “can we wonder at the poor Neapolitans and Spaniards, in the late cholera epidemics, attacking the doctors with sticks and stones, declaring they were spreading the disease – as, in fact, they were – by these abominable vaccinations?”

“I hear that Pasteur’s hydrophobia cure is entirely discredited by the French experts,” said Mildred.

“It is,” replied Elsworth; “and anybody who believed that God, and not the devil, governs the world, might have predicted its failure from the infernal nature of the process for keeping up the supply of the vaccine. Just fancy, keeping in cages, a lot of dogs inoculated with the virus, to inoculate again a lot of rabbits, ready for use for any patient who might want the treatment!”

“Do you know, Mr. Elsworth,” said Mildred, “I am almost afraid to venture the opinion, yet it is a growing one with me, that what is called scientific medicine is a contradiction in terms. The human stomach is not a test-tube, and till we leave off treating it as a dyer treats his vats, we can’t expect to make any progress. So many things go to make up therapeutic treatment. How often have I heard my father say that he never could do any good unless the patient had full faith in him!”

“I fear you do not estimate very highly either the education you got at St. Bernard’s, or the benefits such institutions confer on the people,” said Mr. Crowe, in a rather sneering tone, when Elsworth had assented to Mildred’s remarks.

Dr. Graves maintained that the hospital education given at St. Bernard’s was second to none in Europe, and doubted if it were possible to improve on its methods, as far as they went. “What do you say, Mr. Elsworth?” he asked.

“I hold,” said Elsworth, “that all hospitals are only necessary evils in an imperfect state of society.”

“I have long held that opinion, too,” replied Mildred; “it seems to me that our poor people are far too ready to get rid of their sick and troublesome relatives.”

“Yes, nursing is rapidly becoming a lost art amongst the working people,” remarked Aunt Janet. “The instant their children, husbands, or wives get sick, they are packed off to one or other of the charities which compete for their favours and they are troubled with them no more till they are cured.”

“You mean till they recover?” said Mildred, with an arch look.

“Oh, we really do make some cures, though our Spanish friends are cruel enough to say, ‘El medico lleva la plata pero Dios es que sana!’ (the doctor takes the fee, but God works the cure.”)

“I fear our noble art is not more highly esteemed here than in England,” said Dr. Graves.

“England is the very Paradise of doctors; though the art of medicine, so far from making progress even there, bids fair to be destroyed by a noisy and arrogant school,” said Elsworth emphatically.

“You mean the ultra-physiological party which goes in for these hideous inoculations?” asked Mildred.

“I do,” he replied. “While I was a student at the hospital, I often remarked the contempt with which many of the physicians spoke of drugs and of the people who believed in them; and found it difficult to reconcile all they said with their practice amongst their private patients who went to their consulting rooms and always returned armed with prescriptions which they were instructed should be dispensed only at the most eminent pharmacies. At the hospital, peppermint water was the great remedy for every complaint, except where some new thing was in hand which wanted testing; but when the guinea-paying public were to be dealt with, they received the most formidable prescriptions, resulting ultimately in rows of medicine bottles.”

Mr. Crowe looked very cross at this, and would have replied with bitterness had it not been for the ladies. To make matters worse, Aunt Janet capped it.

“Yes, I remember Dr. Lee declaring at a meeting of medical men that drugs were a delusion and a sham; and that nothing but nature and a good nurse were wanted to cure any complaint amenable to treatment.”

“What did the others say?” asked Elsworth.

“Oh, they objected that it was all very well for a Royal Physician, who had reached the top of the ladder to talk like that, but that it would not work well for those who were still climbing.”

Wishing to divert the conversation into another channel, Mildred asked Elsworth if he did not think with her that the great cause of sickness amongst the poor was due to drink – in England, at all events.

He agreed that it was so, but attributed the craze for alcohol partly to the climate, and partly to the gradual degradation of the social conditions of life amongst the poor. The separation between the masses and the classes was more pronounced, he thought, in England than in any other country of which he knew anything.

“I don’t wonder at the poor creatures drinking,” said he; “it is the only way they have of satisfying the natural aspiration of mankind for the ideal!”

“You mean, we are all more or less poets, and alcohol develops the latent genius within us?” said Mildred.

“I do, and I can never tolerate the argument that a man who drinks makes a beast of himself, because the beast can have no desire to minister to a sense which he does not possess.”

“Then you would say, that the universal desire for some sort of intoxication is a proof of the higher and immortal nature of man,” said Mr. Crowe.

“In a certain degree, yes; because all error is a perversion of some truth. A booze of bad beer and a glass of gin do for the lower man what Shakespeare and Keats, Bacon and Macaulay do for the cultured man – lift him for a while from his sordid surroundings, and raise him to a Monte Cristo palace of beautiful imagery. Mind, this is all the more sinful, all the more degrading at last, because it is buying of the devil at the price of your soul what God would have given you in another and a better way, if you had asked Him.”

“Very pretty,” said Crowe, “but I don’t believe it a bit!”

Dr. Graves said he thought that the theory was as clever, yet as improbable, as that of an American friend of his, who held that all children told lies, because by nature their dramatic faculties were in advance of their moral principles. Fibbing children were on this theory all premature poets.

And so the symposium ended, and the little party broke up.

CHAPTER XXXIX.

MILDRED FINDS HER WORK

“This is not our work,” you say, “this is the work of men.” Be it so if you like. Let them be the hands to do it: but who, if not women, are to be the hearts of the redemption of the poor from social wrong?

– Stopford Brooke.Live greatly; so shalt thou acquireUnknown capacities of joy.– Coventry Patmore.

When the ladies reached their own room that night, Mildred began at once with something which was, evidently, uppermost in her mind.

“Aunt Janet, do you believe in special providences?”

“Do I not, dear! you know my life has been full of them.”

“Well, auntie, it seems absurd that every action of our lives should be interesting to Heaven, but I think I was sent to Granada as the great turning-point in my life.”

“Nothing very wonderful in that, if you believe that the hairs of our heads are all numbered, and that a sparrow does not fall to the ground without our Father’s knowledge. But what do you mean? Have you met your fate in the hero of Granada?”

“No, no! Nothing in the least romantic, but I have decided on my mission in life; you know I have been a long time on the look-out for it.”

“I always thought your mission, dear, was to make everyone the happier for having come in contact with you.”

“Ah, but you are an infatuated auntie, you know, and have always spoiled me, as papa did; but aren’t you anxious to know what I am going to be?”

“Something quixotic, Millie, to suit our surroundings. It is the couleur locale which has dazzled you; the romance of the Alhambra is too much for you. Is it a novelist or a poet? Don’t dear; the market is overstocked. Now, domestic service offers a grand field.”

“But I don’t feel it to be my vocation. I shall set to work to revolutionise the system of our great hospitals. I have seen enough to-day to convince me that, as at present constituted, they do as much harm as good.”

“Revolutionise the hospitals! Isn’t that rather ‘a large order?’”

“Weaker women than I have done greater things than this; and then remember, auntie dear, the lines —

‘And none are strong but who confessWith happy skill that they are weak.’

Besides, don’t you think the public is almost ready for a revolution on this question?”

“You know, Mildred, my opinion; but I never could see my way clear to any interference with hospitals. It is a terrible responsibility, don’t you think?”

“Poor papa has often declared to me that the public would one day wake up to the fact that the hospital was one of the great shams of the time.”

“I know, dear. But St. Bernard’s having made your papa’s fame and fortune, isn’t it rather a shame to upset the concern?”

“I have no desire to upset anything. Don’t you remember how we rebuilt our parish church at Welby, without stopping the services for a single day? That is what I want to do in this case.”

“I don’t quite follow you, dear.”

“Well, of course I haven’t formed any complete scheme yet; but I have often thought that what we want in London, for instance, is a sort of Hospital University, with a great number of affiliated colleges of healing. Not a great unwieldy Cathedral of Surgery as they call it, here and there, but a ‘Chapel of Ease’ at every sufferer’s door. Fifty beds should be the limit, I think.”

“Not enough. Don’t you know the examining bodies do not recognise as a teaching hospital one with less than two hundred beds?”

“But I am concerned with healing the sick, not with teaching students.”

“Just so; but where are your future doctors to come from if you cut off their only way of learning their business?”

“Do you really believe the present system is the only way of training medical men and medical women, for I recognise the right and advantage of women students?”

“Your papa has often told me that a doctor can only be liberally educated by being enabled to draw his conclusions from a great number of facts; and, as each case has some peculiar feature, the more cases he sees, even of the same disease, the more the intelligent pupil will learn.”

“I see the force of that,” replied Mildred, “but I think my scheme would meet it. I would make use of the great pauper infirmaries, at present entirely wasted, as schools of medicine.”

“I fear they would prove very imperfect substitutes for the great hospitals. I am told, and I can readily understand it to be the fact, that the cases which gravitate to the parish infirmary are usually chronic diseases, old-standing bronchitic, asthmatic, and rheumatic troubles, with bed cases innumerable; and all of little or no use to the student.”

“But wait, aunt; you have only heard of one side of my plan; it provides for a vast and efficient system of out-door treatment. I strongly object to rushing every troublesome phase of disease away from home, and placing it in a great hospital. My indoor scheme would only embrace such cases as could not wisely be treated in the family. What at present do you take to be the chief passport to a bed in a general hospital?”

“The malady which has the greatest interest for the doctor who has power to admit it.”

“Precisely. But, as it is not the doctors who support the hospitals, don’t you think the intentions of the subscribers are often defeated by this system? Is it not, in fact, getting money under false pretences to ask for funds to help sick folk, and then apply them to even so good a purpose as medical education?”

“I think you put it too strongly, Mildred. The public does understand that in supporting the hospital, they are training their doctors.”

“Then,” said Mildred, “the fraud is on the patients. Lady Ponsonby de Tompkyns gives a big cheque to the hospitals, that she may have confidence that no new remedies may first be used upon her. Like the lady of the Fly papers, who

‘Wouldn’t try ’em on her cat,If she could try ’em on another.’

You see, the public is in this dilemma – either they are deceived as to the way patients are treated, or if not then the poor sufferers are misled to their grievous hurt.”

“I know of terrible things which Sister Agnes has told me,” said Aunt Janet; “and I am afraid more goes on than even she knows. Your father told me of a case of puerperal fever which was clearly one of licensed murder. He protested, but in vain. A poor woman recently confined was suffering from hyperpyrexia, which no drugs would abate. The physician in charge had become enamoured of the iced-water-bath treatment, and the wretched woman was the first victim at St. Bernard’s to the new fad. She was kept for four hours a day in the cold water at her bedside. When she died, her relatives all protested she was murdered.”

“That must have discredited the treatment rather.”

“Not at all; they persevered in ‘giving the thing a fair trial.’ The Germans invented it, and said it was very effectual in bringing down high temperatures. At St. Bernard’s, it brought the patients down, and the doctors could not bring them up again: and, as all the cases died, the authorities stopped the experiments; but some of the physicians declare to this day, I believe, that ‘there was something in it, after all.’ Mr. Crowe was very strongly in favour of it; he said it was physiologically right, and therefore must be so medically.”

“But perhaps the patients would all have died, any way,” said Mildred.

“Very likely; but what cruel torture in your last moments to be served like that!”

“Yes, that is the horrible part of the business. At an hospital, you cannot even die in peace; you are in danger of being the subject of some ghastly medical freak while there is a gasp left in you.”

“Yet, as the doctor must necessarily be an autocrat in his treatment, I don’t see how you can interfere with him,” mused Aunt Janet.

“Oh, can’t you! Do you think they would dare do such things in a parish infirmary? What a pretty storm there would be if our Mr. Hilbourne, for instance, heard of such things at St. Mark’s Workhouse! Don’t you think the doctors content themselves with using the best of their already acquired knowledge there?” asked Mildred.

“Yet, the poor think much more highly of hospital than of infirmary treatment.”

“Naturally. It is drummed into them a hundred times a day by everybody in the place, that everything is being done for their benefit. Papa told me of ‘a very pretty knee case’ which had been fourteen months in the wards, merely because it was an object of surgical interest, and was the subject of a monograph.”

“Your scheme, I fear, would not provide for monographs!”

“I fear you think I am very quixotic, aunt.”

“No, dear; you are not tilting at windmills, but at real dragons, which I am afraid are much too strong for you! But we must think it over. Dr. Graves is a good, sensible man, and though of course wrapped up in the conventionalism of his class is still open to reason. You will want more armour, and a sharper sword than Isabella’s for this fight, I am thinking.”

“Yet, I can see,” said the girl, “in my prophetic vision, our Boabdil giving me the key of the fortress, if we go to work properly. Meanwhile, let us build our Santa Fe.”

“Castles in Spain! dear – just the place for them. I can see ghosts of giant physiologists and vampire surgeons guarding the treasures of their vermilion towers, and warning you off their premises.”

“I don’t fear them, aunt. I shall visit Isabella’s tomb again for courage, though.”

“I think we had better sleep over this. Buenas noches, señorita.”

“Con dios.”

When the time came to leave Granada, Aunt Janet noticed that her niece was in rather low spirits. She guessed the cause, for it was manifest she was more than interested in the young doctor; and though it was difficult to say whether her interest was more in his work than in himself, or the contrary, she was glad that something had arisen to rouse the girl from the grief which had weighed upon her since her father’s death. That was the charm of Aunt Janet – she always accepted accomplished facts with equanimity, and perhaps was rather a fatalist. If Mildred was really in love, so much the better – she thought it would replace the lost light which had gone out of her life; and if, still better, she had really found a great philanthropic object in life, why the meeting with young Elsworth was the best thing that could have happened.

“There’s a divinity that shapes our endsRough-hew them how we will.”

Would it not be strange if it should turn out that Elsworth’s exile to Granada, and their visit, should be the centre round which the lives of two noble souls should revolve?

CHAPTER XL.

“SHOD WITH WOOL!”

There is no strange handwriting on the wall,Thro’ all the midnight hum no threatening call,Nor on the marble floor the stealthy fallOf fatal footsteps. All is safe. Thou fool,The avenging deities are shod with wool!– W. Allen Butler.But the sinner who would fainCover murder’s crimson stain,Still shall find his steps pursuedBy inquisitors for blood,Due to the unavenged dead,Our malison devotes his head.– J. Anstice, translated from Æschylus.

The last week in September usually sees all the teachers and staff of the hospitals back at their posts. Mr. Crowe and Dr. Graves were again in harness, and the patients who had been the objects of ’prentice work now came under master hands.

These long vacations are grand times for the junior staff; then they are the lords of the territory, and can try everything without fear of interference from their superiors who do not want any more information on what perhaps interests their juniors keenly.

Mr. Mole had been working away patiently and secretly. He had a vast accumulation of notes of facts, symptoms, and tests on the action of Lorchelin and Bulbosin on man and animals; and what was of equal importance, no one had apparently even suspected his secret. No one except Dr. Sones, and from him he kept nothing, requesting only that outside the walls of his laboratory no word of the business was to pass.

All Dr. Sones’ efforts to find chemical tests for the poisons which could be absolutely relied upon had been fruitless. Mr. Mole was, however, so satisfied with his physiological tests that he declared himself ready to detect the deadly alkaloids under whatever circumstances they might be administered. Suspecting Mr. Crowe of entertaining a very limited amount of affection for his wife, and knowing how he must estimate the burden of her long-continued illness, he imparted his suspicions to Janet Spriggs, and bade her tell him everything fresh that happened. But there was little to tell. A caution was given to her that should her mistress suddenly die, two or three handkerchiefs were to be dropped as by accident in the remains of the last food of which she had partaken, and especially in anything that might be vomited. These handkerchiefs were then to be given to him.

The winter session had commenced about a month; the lecturers had all returned to their posts and patients, and the work at St. Bernard’s was again in full swing. In all the wards you heard little hints, jokes, and anecdotes of the holiday tours and adventures of the doctors – very impressive to the students, very suggestive of the good things in store for them when they had made their mark and could take expensive trips. The poor assistant surgeons and physicians had been compelled to stick to their work all through the vacation, and heard with rather mitigated relish the stories told by their chiefs of Norway, Switzerland, Italy, or Spain.

Mr. Crowe was full of the latter country, and the backward condition of everything there. He found nothing doing of importance for research but some Pasteur inoculations. He had visited many of the Spanish hospitals and schools of medicine, but everything was backward in comparison with France or Germany. Tho Spaniards, he thought, were unwilling to embrace the new theories which were helping the world forward. He had only met three physiologists who lived up to the true ideal of a modern scientist. One at Salamanca, who, having discovered the bacillus of phthisis in the sputa of a patient, had inoculated with the germs one of his own children several times, with a view to watching the rise and progress of the disease. Another at Valladolid had carried out a long series of experiments in brain localisation on a mule-driver who had fallen over a precipice, and was taken to the hospital with a portion of his brain exposed so conveniently that it could be galvanised as readily as one of Professor Ferrier’s monkeys, and was consequently a most valuable means of confirming that gentleman’s theories. The third he met at Madrid, and he had done wonders at his hospital by ordering a number of his patients, who were either cooks or butchers, to eat daily a portion of raw beef (persons of these professions are usually quite ready to do this), for the purpose of introducing into their systems the parasite Tænia mediocanellata.

As epilepsy, hysteria, convulsions, and even insanity have been known to follow the introduction of this interesting parasite into the human body, it must be admitted that Professor Montijo was one of the heroic school, and merited all Mr. Crowe’s eulogiums. Some of the alumni who listened to these accounts of continental practice thought that the first man was the only true hero of the lot. He, Abraham-like, had been willing to sacrifice his own son “for the good of humanity.” As for the mule-driver and his exposed brain, they had done quite as good things at St. Bernard’s more than once; while in regard to the hydatid and tape-worm germs in beef and pork, that was an every-day business down in the out-patient department, and a very meek sort of experiment for a St. Bernard’s man.

Dr. Stanforth told his class a good thing from Milan, where a tremendous experiment, involving risk to the lives of several women, had been tried by a friend of his at the Maternity Hospital. He admitted it was rather hard on the women, who had sought the comforts of the hospital for quite other reasons; but it was a point which needed clearing up, and the learned professor, with the unwitting assistance of eight patients (and eight other lives especially protected by the laws of God and man, he forgot to add), had settled the question on behalf of therapeutics for ever.

“This is the heroic work we need so much in England. They are not nearly so timid in other countries as we are. We must have a policy of ‘thorough,’ or we shall be left behind.” And he set his lips firmly, and looked as though henceforth his patients were going to have “a bad time.”

Mr. Mole was doing all his little best to bring about this scientific millennium, but just then was not able to produce the results of his work, as the time was not ripe for his revelations.