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

“In this instance Mrs. Gamp has a good deal of reason on her side, and it is not unlikely that her explanation may have its foundation in fact. The uneducated mind has often made discoveries by observing and comparing this sort of facts which scientific men have after much scoffing been compelled to admit are correct statements of natural phenomena.

“For instance, in the case of the stigmata of St. Francis of Assisi, all the scientific men for many years put the whole business down to imposture, if they took the trouble to consider it seriously at all. Now they are compelled to recognise that it is a fact that in highly nervous temperaments the concentration of the mind for a length of time on one engrossing idea, such as the wounds of Christ in the hands and feet, will produce just such a condition of the parts in question on the body of the absorbed individual, as is recorded of St. Francis. The influence of the mind upon the body is even yet only very partially understood. Mrs. Gamp, in the case you allude to, has my sympathy. Pray remember that our great Paracelsus, the father of our modern scientific medicine, derived much of his valuable information on treatment from the unlettered peasantry of the countries in which he travelled, and of whom he was not too proud to learn.”

“That is true, and I saw the other day that a layman of Vienna has discovered a method of treatment for the cure of that puzzling and intractable disease, writer’s cramp, which has been recognised by the physicians of Vienna as affording the only really good results they know of. But you are wandering rather wide of our argument. We started from the evidences of design as shown in the human hand, and went on to consider the question of a great First Cause. Paley’s argument from the watch might have been all very well for his time, but is of little force now, because you see where it lands you; it makes your designer – your watchmaker – responsible for all the imperfections as well as the excellencies. I see a watch lying by the road-side, and at once say it must have had a maker. Very well; it is a bad time-keeper – gains one day, loses the next, and is a generally shabby bit of workmanship. So much the worse for the watchmaker. Now, take the human eye. Helmholtz said, as an optical instrument it was so defective, that had such a piece of workmanship been sent to him by any optician, he should have forthwith forfeited his custom. If you persist in using the design argument after Paley, you make your Omnipotent Designer responsible for all the evil, the disease, the misery that is in the world. Here is the hand with all its wonders. ‘Behold the all-wise, all-powerful Creator,’ say you. Good. But there are scarlet fever, lunacy, cancer. How about your all-wise, all-powerful Creator now?

“Oh, if you would but read your Browning! Hear what he says: —

“‘I can believe this dread machineryOf sin and sorrow, would confound me else,Devised, – all pain, at most expenditureOf pain by Who devised pain, – to evolve,By new machinery in counterpart,The moral qualities of man – how else? —To make him love in turn and be beloved,Creative and self-sacrificing too,And thus eventually God-like,  *       *       *       *       *Enable man to wring, from out all pain,All pleasure, for a common heritage,To all eternity.’2

“I am surprised you think the existence of evil militates against the existence of a perfect Creator. A ribald controversialist was once asked how he would have improved the world had he had the making of it. He replied; ‘For one thing I would have made health catching instead of disease. Yours is a similar ad captandum style of argument. You must know as well as I do that our fevers are the result of dirt and neglect of the most elementary sanitary precautions; it is not nature that afflicts us so much as our artificial living and our vicious habits. As for lunacy, it is largely the product of vice, drink, and the race for wealth. With regard to pain, it is frequently conservative. As Theodore Parker points out, if we could put our fingers into the fire without pain, they would soon be destroyed; if dust did not make our eyes smart, their utility would soon be destroyed by rough usage; if we could eat improper food without unpleasant consequences, our digestive functions would soon be unfit for their work, and so forth.”

Linda laughed at the idea of health being catching, and thought the advocate of design was cornered.

“For my part,” said Elsworth, “I think the man was a great fool. Love is catching, as Coventry Patmore says, ‘love that grows from one to all, and love is better than health, isn’t it?’”

“I don’t see,” said the doctor, “that you have in the least affected my argument that evil could never have been permitted by an all-wise, omnipotent, and good Creator. Its existence proves the Creator not to have been all these, at any rate.”

“A great deal of man’s ill may be removed,” said Elsworth; “indeed, amelioration is the dominant note of nature. If you will forgive me quoting my favourite poet Browning again —

“‘Dragons were, and serpents are, and blindworms will be,Ne’er emergedAnd new created python for man’s plagueSince earth was purged,’

you will see what I mean. There is a general onward movement; the prospect brightens for mankind. But there will always be evil, because without it there can be no good. Where would be patience without trials; where sympathy and charity without suffering? Do you think the virtues and nobility of Gordon, of Sakya Muni, of St. Francis, would have been evolved had there been no evil and suffering in the world?”

“In a perfect world there would have been no occasion for them,” said Linda.

“I cannot conceive,” Elsworth replied,“ of a perfect world without love for one’s neighbour, sacrifice of self, devotion to high and noble efforts for the good of others. Fancy the hideous selfishness of a world of wealthy, luxurious aristocrats, such as helped to precipitate the French Revolution; the gratification of their own pleasures and passions the sole object of their existence! Contrast this state of things in your ideal perfect world – where every one would have all he wanted, and would have no occasion to think of others, – no opportunity to exercise charity, pity, long-suffering, or altruism in any form – with the burning love of a St. Paul, who was willing himself to be accursed if he could thereby save others; with Christian heroes who have sold themselves into slavery; have entered lazar-houses from which they could never return; have cheerfully embraced martyrdom, and undertaken every form of danger and suffering, to help their brother men. Or to come to every-day affairs, contrast the selfishness of the rich, and those who are elevated above the grosser cares and difficulties of life, with the charity and devotedness practised by the poor of our great cities towards each other; and say if the existence of pain, sorrow, and suffering is not actually necessary for the evolution of the highest man? And so ‘upon men’s own account must evil stay.’”

“But here we are at your diggings, Elsworth. You will get rid of these cobwebs of the brain before you have done with St. Bernard’s,” laughed Devaux.

And so the friends went home to bed, to dream of a regenerated world, fit for an age of steam, telephones, and physiological research not contemplated by the Apostles, and therefore requiring a new religion of its own.

CHAPTER XII.

“SEND FOR FATHER O’GRADY.”

“What! do they study?”“No, father, but they feel!”“Feel! I comprehend thee not!”Sir. E. B. Lytton.

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

– Bacon.

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

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

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

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

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

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

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

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

“Just so.”

“Is it really necessary, doctor dear?”

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

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

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

“Quite sure.”

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

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

“But I hope it is really necessary.”

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

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

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

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

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

* * * * *

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

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

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

CHAPTER XIII.

“THE SOOTHING IDEA OF GOD.”

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

– Emerson.

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

– Burton.

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

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

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

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

CHAPTER XIV.

THE SACRED WHOLE OF MAN

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

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

– Lavater.

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

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