1909
It is not the fault of our doctors that the medical service of the
community, as at present provided for, is a murderous absurdity. That
any sane nation, having observed that you could provide for the supply
of bread by giving bakers a pecuniary interest in baking for you, should
go on to give a surgeon a pecuniary interest in cutting off your leg, is
enough to make one despair of political humanity. But that is precisely
what we have done. And the more appalling the mutilation, the more the
mutilator is paid. He who corrects the ingrowing toe-nail receives a
few shillings: he who cuts your inside out receives hundreds of guineas,
except when he does it to a poor person for practice.
Scandalized voices murmur that these operations are necessary. They
may be. It may also be necessary to hang a man or pull down a house.
But we take good care not to make the hangman and the housebreaker the
judges of that. If we did, no man's neck would be safe and no man's
house stable. But we do make the doctor the judge, and fine him anything
from sixpence to several hundred guineas if he decides in our favor.
I cannot knock my shins severely without forcing on some surgeon the
difficult question, "Could I not make a better use of a pocketful
of guineas than this man is making of his leg? Could he not write as
well--or even better--on one leg than on two? And the guineas would
make all the difference in the world to me just now. My wife--my pretty
ones--the leg may mortify--it is always safer to operate--he will be
well in a fortnight--artificial legs are now so well made that they
are really better than natural ones--evolution is towards motors and
leglessness, etc., etc., etc."
Now there is no calculation that an engineer can make as to the behavior
of a girder under a strain, or an astronomer as to the recurrence of a
comet, more certain than the calculation that under such circumstances
we shall be dismembered unnecessarily in all directions by surgeons
who believe the operations to be necessary solely because they want to
perform them. The process metaphorically called bleeding the rich man
is performed not only metaphorically but literally every day by surgeons
who are quite as honest as most of us. After all, what harm is there
in it? The surgeon need not take off the rich man's (or woman's) leg or
arm: he can remove the appendix or the uvula, and leave the patient none
the worse after a fortnight or so in bed, whilst the nurse, the general
practitioner, the apothecary, and the surgeon will be the better.