general idea as to the advance of modern science. He persists in looking
upon it, however, as a huge and rather ludicrous experiment. The germ
theory of disease set him chuckling for a long time, and his favourite
joke in the sick-room was to say, "Shut the door, or the germs will be
getting in." As to the Darwinian theory, it struck him as being the
crowning joke of the century. "The children in the nursery and the
ancestors in the stable," he would cry, and laugh the tears out of his
eyes.
He is so very much behind the day that occasionally, as things move
round in their usual circle, he finds himself, to his own bewilderment,
in the front of the fashion. Dietetic treatment, for example, had been
much in vogue in his youth, and he has more practical knowledge of it
than any one whom I have met. Massage, too, was familiar to him when it
was new to our generation. He had been trained also at a time when
instruments were in a rudimentary state and when men learned to trust
more to their own fingers. He has a model surgical hand, muscular in the
palm, tapering in the fingers, "with an eye at the end of each." I shall
not easily forget how Dr. Patterson and I cut Sir John Sirwell, the
County Member, and were unable to find the stone. It was a horrible
moment. Both our careers were at stake. And then it was that Dr. Winter,
whom we had asked out of courtesy to be present, introduced into the
wound a finger which seemed to our excited senses to be about nine
inches long, and hooked out the stone at the end of it.
"It's always well to bring one in your waistcoat pocket," said he with a
chuckle, "but I suppose you youngsters are above all that."
We made him President of our Branch of the British Medical Association,
but he resigned after the first meeting. "The young men are too much for
me," he said. "I don't understand what they are talking about." Yet his
patients do very well. He has the healing touch--that magnetic thing
which defies explanation or analysis, but which is a very evident fact
none the less. His mere presence leaves the patient with more
hopefulness and vitality. The sight of disease affects him as dust does
a careful housewife. It makes him angry and impatient. "Tut, tut, this
will never do!" he cries, as he takes over a new case. He would shoo
death out of the room as though he were an intrusive hen. But when the
intruder refuses to be dislodged, when the blood moves more slowly and
the eyes grow dimmer, then it is that Dr. Winter is of more avail than
all the drugs in his surgery. Dying folk cling to his hand as if the
presence of his bulk and vigour gives them more courage to face the
change; and that kindly, wind-beaten face has been the last earthly
impression which many a sufferer has carried into the unknown.
When Dr. Patterson and I, both of us young, energetic, and up-to-date,
settled in the district, we were most cordially received by the old
doctor, who would have been only too happy to be relieved of some of his
patients. The patients themselves, however, followed their own
inclinations, which is a reprehensible way that patients have, so that
we remained neglected with our modern instruments and our latest
alkaloids, while he was serving out senna and calomel to all the
country-side. We both of us loved the old fellow, but at the same time,
in the privacy of our own intimate conversations, we could not help
commenting upon this deplorable lack of judgment.
"It is all very well for the poorer people," said Patterson, "but after
all the educated classes have a right to expect that their medical man
will know the difference between a mitral murmur and a bronchitic rale.
It's the judicial frame of mind, not the sympathetic, which is the
essential one."
I thoroughly agreed with Patterson in what he said. It happened,
however, that very shortly afterwards the epidemic of influenza broke
out, and we were all worked to death. One morning I met Patterson on my
round, and found him looking rather pale and fagged out. He made the
same remark about me. I was in fact feeling far from well, and I lay
upon the sofa all afternoon with a splitting headache and pains in every
joint. As evening closed in I could no longer disguise the fact that the
scourge was upon me, and I felt that I should have medical advice
without delay. It was of Patterson naturally that I thought, but somehow
the idea of him had suddenly become repugnant to me. I thought of his
cold, critical attitude, of his endless questions, of his tests and his
tappings. I wanted something more soothing--something more genial.
"Mrs. Hudson," said I to my housekeeper, "would you kindly run along to
old Dr. Winter and tell him that I should be obliged to him if he would
step round."
She was back with an answer presently.
"Dr. Winter will come round in an hour or so, sir, but he has just been
called in to attend Dr. Patterson."
IX
HIS FIRST OPERATION
It was the first day of a winter session, and the third year's man was
walking with the first year's man. Twelve o'clock was just booming out
from the Tron Church.
"Let me see," said the third year's man, "you have never seen an
operation?"
"Never."
"Then this way, please. This is Rutherford's historic bar. A glass of
sherry, please, for this gentleman. You are rather sensitive, are you
not?"
"My nerves are not very strong, I am afraid."
"Hum! Another glass of sherry for this gentleman. We are going to an
operation now, you know."
The novice squared his shoulders and made a gallant attempt to look
unconcerned.
"Nothing very bad--eh?"
"Well, yes--pretty bad."
"An--an amputation?"
"No, it's a bigger affair than that."
"I think--I think they must be expecting me at home."
"There's no sense in funking. If you don't go to-day you must to-morrow.
Better get it over at once. Feel pretty fit?"
"Oh, yes, all right."
The smile was not a success.
"One more glass of sherry, then. Now come on or we shall be late. I want
you to be well in front."
"Surely that is not necessary."
"Oh, it is far better. What a drove of students! There are plenty of new
men among them. You can tell them easily enough, can't you? If they were
going down to be operated upon themselves they could not look whiter."
"I don't think I should look as white."
"Well, I was just the same myself. But the feeling soon wears off. You
see a fellow with a face like plaster, and before the week is out he is
eating his lunch in the dissecting rooms. I'll tell you all about the
case when we get to the theatre."
The students were pouring down the sloping street which led to the
infirmary--each with his little sheaf of note-books in his hand. There
were pale, frightened lads, fresh from the High Schools, and callous old
chronics, whose generation had passed on and left them. They swept in an
unbroken, tumultuous stream from the University gate to the hospital.
The figures and gait of the men were young, but there was little youth
in most of their faces. Some looked as if they ate too little--a few as
if they drank too much. Tall and short, tweed coated and black,
round-shouldered, bespectacled and slim, they crowded with clatter of
feet and rattle of sticks through the hospital gate. Now and again they
thickened into two lines as the carriage of a surgeon of the staff
rolled over the cobblestones between.
"There's going to be a crowd at Archer's," whispered the senior man with
suppressed excitement. "It is grand to see him at work. I've seen him
jab all round the aorta until it made me jumpy to watch him. This way,
and mind the whitewash."
They passed under an archway and down a long, stone-flagged corridor
with drab-coloured doors on either side, each marked with a number. Some
of them were ajar, and the novice glanced into them with tingling
nerves. He was reassured to catch a glimpse of cheery fires, lines of
white-counterpaned beds and a profusion of coloured texts upon the wall.
The corridor opened upon a small hall with a fringe of poorly-clad
people seated all round upon benches. A young man with a pair of
scissors stuck, like a flower, in his button-hole, and a note-book in
his hand, was passing from one to the other, whispering and writing.
"Anything good?" asked the third year's man.
"You should have been here yesterday," said the out-patient clerk,
glancing up. "We had a regular field day. A popliteal aneurism, a
Colles' fracture, a spina bifida, a tropical abscess, and an
elephantiasis. How's that for a single haul?"
"I'm sorry I missed it. But they'll come again, I suppose. What's up
with the old gentleman?"
A broken workman was sitting in the shadow, rocking himself slowly to
and fro and groaning. A woman beside him was trying to console him,
patting his shoulder with a hand which was spotted over with curious
little white blisters.
"It's a fine carbuncle," said the clerk, with the air of a connoisseur
who describes his orchids to one who can appreciate them. "It's on his
back, and the passage is draughty, so we must not look at it, must we,
daddy? Pemphigus," he added carelessly, pointing to the woman's
disfigured hands. "Would you care to stop and take out a metacarpal?"
"No, thank you, we are due at Archer's. Come on;" and they rejoined the
throng, which was hurrying to the theatre of the famous surgeon.
The tiers of horseshoe benches, rising from the floor to the ceiling,
were already packed, and the novice as he entered saw vague, curving
lines of faces in front of him, and heard the deep buzz of a hundred
voices and sounds of laughter from somewhere up above him. His companion
spied an opening on the second bench, and they both squeezed into it.
"This is grand," the senior man whispered; "you'll have a rare view of
it all."
Only a single row of heads intervened between them and the operating
table. It was of unpainted deal, plain, strong and scrupulously clean. A
sheet of brown waterproofing covered half of it, and beneath stood a
large tin tray full of sawdust. On the farther side, in front of the
window, there was a board which was strewed with glittering instruments,
forceps, tenacula, saws, canulas, and trocars. A line of knives, with
long, thin, delicate blades, lay at one side. Two young men lounged in
front of this; one threading needles, the other doing something to a
brass coffee-pot-like thing which hissed out puffs of steam.
"That's Peterson," whispered the senior. "The big, bald man in the front
row. He's the skin-grafting man, you know. And that's Anthony Browne,
who took a larynx out successfully last winter. And there's Murphy the
pathologist, and Stoddart the eye man. You'll come to know them all
soon."
"Who are the two men at the table?"
"Nobody--dressers. One has charge of the instruments and the other of
the puffing Billy. It's Lister's antiseptic spray, you know, and
Archer's one of the carbolic acid men. Hayes is the leader of the
cleanliness-and-cold-water school, and they all hate each other like
poison."
A flutter of interest passed through the closely-packed benches as a
woman in petticoat and bodice was led in by two nurses. A red woollen
shawl was draped over her head and round her neck. The face which looked
out from it was that of a woman in the prime of her years, but drawn
with suffering and of a peculiar bees-wax tint. Her head drooped as she
walked, and one of the nurses, with her arm round her waist, was
whispering consolation in her ear. She gave a quick side glance at the
instrument table as she passed, but the nurses turned her away from it.
"What ails her?" asked the novice.
"Cancer of the parotid. It's the devil of a case, extends right away
back behind the carotids. There's hardly a man but Archer would dare to
follow it. Ah, here he is himself."
As he spoke, a small, brisk, iron-grey man came striding into the room,
rubbing his hands together as he walked. He had a clean-shaven face of
the Naval officer type, with large, bright eyes, and a firm, straight
mouth. Behind him came his big house surgeon with his gleaming pince-nez
and a trail of dressers, who grouped themselves into the corners of the
room.
"Gentlemen," cried the surgeon in a voice as hard and brisk as his
manner. "We have here an interesting case of tumour of the parotid,
originally cartilaginous but now assuming malignant characteristics, and
therefore requiring excision. On to the table, nurse! Thank you!
Chloroform, clerk! Thank you! You can take the shawl off, nurse."
The woman lay back upon the waterproofed pillow and her murderous tumour
lay revealed. In itself it was a pretty thing, ivory white with a mesh
of blue veins, and curving gently from jaw to chest. But the lean,
yellow face, and the stringy throat were in horrible contrast with the
plumpness and sleekness of this monstrous growth. The surgeon placed a
hand on each side of it and pressed it slowly backwards and forwards.
"Adherent at one place, gentlemen," he cried. "The growth involves the
carotids and jugulars, and passes behind the ramus of the jaw, whither
we must be prepared to follow it. It is impossible to say how deep our
dissection may carry us. Carbolic tray, thank you! Dressings of carbolic
gauze, if you please! Push the chloroform, Mr. Johnson. Have the small
saw ready in case it is necessary to remove the jaw."
The patient was moaning gently under the towel which had been placed
over her face. She tried to raise her arms and to draw up her knees but
two dressers restrained her. The heavy air was full of the penetrating
smells of carbolic acid and of chloroform. A muffled cry came from under
the towel and then a snatch of a song, sung in a high, quavering,
monotonous voice.
"He says, says he,
If you fly with me
You'll be mistress of the ice-cream van;
You'll be mistress of the----"
It mumbled off into a drone and stopped. The surgeon came across, still
rubbing his hands, and spoke to an elderly man in front of the novice.
"Narrow squeak for the Government," he said.
"Oh, ten is enough."
"They won't have ten long. They'd do better to resign before they are
driven to it."
"Oh, I should fight it out."
"What's the use. They can't get past the committee, even if they get a
vote in the House. I was talking to----"
"Patient's ready, sir," said the dresser.
"Talking to M'Donald--but I'll tell you about it presently." He walked
back to the patient, who was breathing in long, heavy gasps. "I
propose," said he, passing his hands over the tumour in an almost
caressing fashion, "to make a free incision over the posterior border
and to take another forward at right angles to the lower end of it.
Might I trouble you for a medium knife, Mr. Johnson?"
The novice, with eyes which were dilating with horror, saw the surgeon
pick up the long, gleaming knife, dip it into a tin basin and balance it
in his fingers as an artist might his brush. Then he saw him pinch up
the skin above the tumour with his left hand. At the sight, his nerves,
which had already been tried once or twice that day, gave way utterly.
His head swam round and he felt that in another instant he might faint.
He dared not look at the patient. He dug his thumbs into his ears lest
some scream should come to haunt him, and he fixed his eyes rigidly upon
the wooden ledge in front of him. One glance, one cry, would, he knew,
break down the shred of self-possession which he still retained. He
tried to think of cricket, of green fields and rippling water, of his
sisters at home--of anything rather than of what was going on so near
him.
And yet, somehow, even with his ears stopped up, sounds seemed to
penetrate to him and to carry their own tale. He heard, or thought that
he heard, the long hissing of the carbolic engine. Then he was conscious
of some movement among the dressers. Were there groans too breaking in
upon him, and some other sound, some fluid sound, which was more
dreadfully suggestive still? His mind would keep building up every step
of the operation, and fancy made it more ghastly than fact could have
been. His nerves tingled and quivered. Minute by minute the giddiness
grew more marked, the numb, sickly feeling at his heart more
distressing. And then suddenly, with a groan, his head pitching forward
and his brow cracking sharply upon the narrow, wooden shelf in front of
him, he lay in a dead faint.
* * * * *
When he came to himself he was lying in the empty theatre with his
collar and shirt undone. The third year's man was dabbing a wet sponge
over his face, and a couple of grinning dressers were looking on.
"All right," cried the novice, sitting up and rubbing his eyes; "I'm
sorry to have made an ass of myself."
"Well, so I should think," said his companion. "What on earth did you
faint about?"
"I couldn't help it. It was that operation."
"What operation?"
"Why, that cancer."
There was a pause, and then the three students burst out laughing.
"Why, you juggins," cried the senior man, "there never was an operation
at all. They found the patient didn't stand the chloroform well, and so
the whole thing was off. Archer has been giving us one of his racy
lectures, and you fainted just in the middle of his favourite story."
X
THE THIRD GENERATION
Scudamore Lane, sloping down riverwards from just behind the Monument,
lies at night in the shadow of two black and monstrous walls which loom
high above the glimmer of the scattered gas-lamps. The footpaths are
narrow, and the causeway is paved with rounded cobblestones so that the
endless drays roar along it like so many breaking waves. A few
old-fashioned houses lie scattered among the business premises, and in
one of these--half-way down on the left-hand side--Dr. Horace Selby
conducts his large practice. It is a singular street for so big a man,
but a specialist who has a European reputation can afford to live where
he likes. In his particular branch, too, patients do not always consider
seclusion to be a disadvantage.
It was only ten o'clock. The dull roar of the traffic which converged
all day upon London Bridge had died away now to a mere confused murmur.
It was raining heavily, and the gas shone dimly through the streaked and
dripping glass, throwing little yellow circles upon the glistening
cobblestones. The air was full of the sounds of rain, the thin swish of
its fall, the heavier drip from the eaves, and the swirl and gurgle down
the two steep gutters and through the sewer grating. There was only one
figure in the whole length of Scudamore Lane. It was that of a man, and
it stood outside the door of Dr. Horace Selby.
He had just rung and was waiting for an answer. The fanlight beat full
upon the gleaming shoulders of his waterproof and upon his upturned
features. It was a wan, sensitive, clear-cut face, with some subtle,
nameless peculiarity in its expression--something of the startled horse
in the white-rimmed eye, something, too, of the helpless child in the
drawn cheek and the weakening of the lower lip. The man-servant knew the
stranger as a patient at a bare glance at those frightened eyes. Such a
look had been seen at that door before.
"Is the doctor in?"
The man hesitated.
"He has had a few friends to dinner, sir. He does not like to be
disturbed outside his usual hours, sir."
"Tell him that I _must_ see him. Tell him that it is of the very first
importance. Here is my card." He fumbled with his trembling fingers in
trying to draw one from the case. "Sir Francis Norton is the name. Tell
him that Sir Francis Norton of Deane Park must see him at once."
"Yes, sir." The butler closed his fingers upon the card and the
half-sovereign which accompanied it. "Better hang your coat up here in
the hall. It is very wet. Now, if you will wait here in the
consulting-room I have no doubt that I shall be able to send the doctor
in to you."
It was a large and lofty room in which the young baronet found himself.
The carpet was so soft and thick that his feet made no sound as he
walked across it. The two gas-jets were turned only half-way up, and the
dim light with the faint aromatic smell which filled the air had a
vaguely religious suggestion. He sat down in a shining leather arm-chair
by the smouldering fire and looked gloomily about him. Two sides of the
room were taken up with books, fat and sombre, with broad gold lettering
upon their backs. Beside him was the high, old-fashioned mantelpiece of
white marble, the top of it strewed with cotton wadding and bandages,
graduated measures and little bottles. There was one with a broad neck,
just above him, containing bluestone, and another narrower one with what
looked like the ruins of a broken pipe stem, and "Caustic" outside upon
a red label. Thermometers, hypodermic syringes, bistouries and spatulas
were scattered thickly about, both on the mantelpiece and on the central
table on either side of the sloping desk. On the same table to the right
stood copies of the five books which Dr. Horace Selby had written upon
the subject with which his name is peculiarly associated, while on the
left, on the top of a red medical directory, lay a huge glass model of a
human eye, the size of a turnip, which opened down the centre to expose
the lens and double chamber within.
Sir Francis Norton had never been remarkable for his powers of
observation, and yet he found himself watching these trifles with the
keenest attention. Even the corrosion of the cork of an acid bottle
caught his eye and he wondered that the doctor did not use glass
stoppers. Tiny scratches where the light glinted off from the table,
little stains upon the leather of the desk, chemical formulae scribbled
upon the labels of some of the phials--nothing was too slight to arrest
his attention. And his sense of hearing was equally alert. The heavy
ticking of the solemn black clock above the fireplace struck quite
painfully upon his ears. Yet, in spite of it, and in spite also of the
thick, old-fashioned, wooden partition walls, he could hear the voices
of men talking in the next room and could even catch scraps of their
conversation. "Second hand was bound to take it." "Why, you drew the
last of them yourself." "How could I play the queen when I knew the ace
was against me?" The phrases came in little spurts, falling back into
the dull murmur of conversation. And then suddenly he heard a creaking
of a door, and a step in the hall, and knew with a tingling mixture of
impatience and horror that the crisis of his life was at hand.
Dr. Horace Selby was a large, portly man, with an imposing presence. His
nose and chin were bold and pronounced, yet his features were puffy--a
combination which would blend more freely with the wig and cravat of the
early Georges, than with the close-cropped hair and black frockcoat of
the end of the nineteenth century. He was clean shaven, for his mouth
was too good to cover, large, flexible and sensitive, with a kindly
human softening at either corner, which, with his brown, sympathetic
eyes, had drawn out many a shame-struck sinner's secret. Two masterful
little bushy side whiskers bristled out from under his ears, spindling
away upwards to merge in the thick curves of his brindled hair. To his
patients there was something reassuring in the mere bulk and dignity of
the man. A high and easy bearing in medicine, as in war, bears with it a
hint of victories in the past, and a promise of others to come. Dr.
Horace Selby's face was a consolation, and so, too, were the large,
white, soothing hands, one of which he held out to his visitor.
"I am sorry to have kept you waiting. It is a conflict of duties, you
perceive. A host to his guests and an adviser to his patient. But now I
am entirely at your disposal, Sir Francis. But, dear me, you are very
cold."
"Yes, I am cold."
"And you are trembling all over. Tut, tut, this will never do. This
miserable night has chilled you. Perhaps some little stimulant----"
"No, thank you. I would really rather not. And it is not the night which
has chilled me. I am frightened, doctor."
The doctor half turned in his chair and patted the arch of the young
man's knee as he might the neck of a restless horse.
"What, then?" he asked, looking over his shoulder at the pale face with
the startled eyes.
Twice the young man parted his lips. Then he stooped with a sudden
gesture and turning up the right leg of his trousers he pulled down his
sock and thrust forward his shin. The doctor made a clicking noise with
his tongue as he glanced at it.
"Both legs?"
"No, only one."
"Suddenly?"
"This morning."
"Hum!" The doctor pouted his lips, and drew his finger and thumb down
the line of his chin. "Can you account for it?" he said briskly.
"No."
A trace of sternness came into the large, brown eyes.
"I need not point out to you that unless the most absolute
frankness----"
The patient sprang from his chair.