KILLING A PATIENT.
President Lindsley, late of one of our south western colleges,--a very
shrewd and observing, as well as learned and excellent individual--has
been often heard to say that no half-educated young physician ever
succeeded in obtaining a good run of professional business, and a fair
medical reputation, without despatching prematurely to the other world,
at least as many as half a dozen of his patients.
It is said that most rules have their exceptions; and it is even
affirmed by some, that the exceptions strengthen the rule. If this is
so, perhaps the rule of Pres. L. may stand; though to many it seems at
first exceedingly sweeping. One known exception to its universality may
be worth mentioning, on which the reader may make his own comments, and
from which he may draw his own inferences. I was so fortunate for one,
as to attain to the eminence he mentions, without killing any thing
_like_ half a dozen patients; at least, so far as I know.
And yet, as I verily fear and most honestly confess, I _did_ kill one or
two. Not, of course, with malice aforethought, for they were among my
very best friends; and one in particular was a near and highly valued
neighbor. Let me give you a few details concerning the latter. It may
serve as a lesson of instruction, as well as a confession.
He was about six feet high, with large vital organs; and though by no
means possessed of a strong constitution, yet in virtue of a most rigid
temperance, generally healthy. He was, however, subjected to the
habitual influences of a most miserable cookery. Indeed, I never knew
worse. Seldom, if ever, did he pass a single week--I might even say a
single day--without having his alimentary organs irritated to
subinflammation by more or fewer of what Dr. Dunglison, the
physiologist, would call "rebellious" mixtures. I do not wonder, in
truth, that he occasionally sickened. The wonder with me is, that he did
not sicken and die long before he did. And though the blow that finished
his perilous mortal career, was doubtless inflicted by my own hand, I do
not hesitate to say that his "housekeeper" had nearly half destroyed him
before I was called.
It was a midsummer night, when the messenger came across an intervening
field, and aroused me from my slumbers with the intelligence that Mr. M.
was very sick, and wanted to have me come and see him immediately.
Although it was fully twelve o'clock, and I had been so fully occupied
during the preceding evening, that I had but just crawled into bed and
begun my slumbers, I was instantly on my feet, and in about twelve
minutes at the bedside of the sick man.
He had been affected with a bowel complaint, as it appeared, for several
days, during which his wife, who was one of those conceited women who
know so much, in their own estimation, that nobody can teach them any
thing, had dosed him with various things, such as were supposed to be
good for the blood, or the stomach, among which was brandy and loaf
sugar. Now his bowels, though they were inflamed, might have borne the
sugar; but the brandy was a little too much for them. They had endured
it for a time, it is true, but had at length yielded, and were in a
worse condition than when she began her treatment. And what was worse,
her alcoholic doses, frequently "inflicted," had heated the circulatory
apparatus, and even the whole system, into a burning fever.
It needed no very active imagination, in such circumstances, to make
out, at least in prospect, a very "hard case." And as he who has a giant
foe to contend with, arms himself accordingly, I immediately invoked the
strongholds of the Materia Medica for the strongest doses which it could
furnish, and these in no measured or stinted quantity. In short, I
attacked the disease with the most powerful agents of which I could
avail myself.
I will not trouble the non-professional reader with the names of the
various and powerful drugs which were laid under contribution in this
trying and dangerous case, and which were most assiduously plied. It is
sufficient, perhaps, to say that on looking over my directions--fairly
written out as they were, and laid on a small stand near the
sick-bed--you might have discovered that hardly a half-hour, by night or
day, could pass, in which he was not required to swallow some very
active or in other words poisonous medicinal agent or other. For though
I was even then greatly opposed, in _theory_, to the exhibition of much
medicine in disease, yet in _practice_ I could not free myself wholly
from the idea that my prospects of affording aid, or rather of giving
nature a chance of saving a patient, was nearly in proportion to the
amount I could force into him of opium, calomel, nitrate of silver,
carbonate of ammonia, etc.
It was, in short, enough to kill a Samson or a Hercules; and I repeat
that I verily fear that it did kill in the present instance; not,
however, immediately. For several days and nights we watched over him,
heating his brain, in our over-kindness, to a violent delirium on the
one hand, or to a stupor almost like the sleep of death on the other.
Not satisfied with our own murderous efforts, we at length applied for
medical counsel. My predecessor was not so far off as to be quite beyond
our reach, and was in due time on the spot. He, good man, sanctioned the
deeds already done, and only made through the force of their
prepossessions, an addition to the dark catalogue of demons which
already assailed if they did not actually possess him.
For the first time in my medical career, I suffered, here, from a loss
of the confidence of my employers. A very mean man, who could gain
notoriety in no other way, undertook to insinuate that I did not
understand well my profession; and this story for a short time made an
impression. However, there was soon a reaction in my favor, so that
nothing was lost in the end. More than even this might be said--that I
rose higher, as the result of the report.
Mr. M. at length began to decline. Nature, though strongly entrenched in
her citadel, and loth to "give up the ship," began to succumb to the
powers of disease and the load of medicine; and he gradually descended
to the tomb. His whole sickness was of little more than a week's
duration.
I was present at the funeral, but I could scarcely hold up my head, or
look any person in the face. To my perturbed imagination every one who
was but "three feet high" was ready to point at me the finger of scorn,
and say, "You have killed that man." The heavens themselves seemed
covered with thick darkness, and the green earth with sackcloth and
ashes. "Never again," I said to myself a thousand times, "can I bear up
under such sad and severe responsibilities."
And yet--will the reader believe it?--no one circumstance of my whole
medical life ever did more to establish my reputation than this. True, I
had contended on the battle field, and had been beaten, but then it was
thought I had contended against a powerful foe. Men sometimes think it
honorable even to be beaten. I well remember an instance of this sort. A
very great scoundrel heaped insults upon a worthy justice of the peace,
till the latter seized him and held him down to the ground for a
considerable time. The man was quite respectable afterward, and told the
story to his own praise a thousand times over! He had measured lances
with 'Squire H.! And though the 'Squire was too much for him, he
obtained a town-wide reputation by the contest.
You will see, more and more, as I proceed with these confessions, that
it is not in him that willeth nor in him that runneth, to be acceptable
as a physician, but in certain circumstances, partly within and partly
beyond our control. You will see, however, that the best way in the end
is, boldly and fearlessly to do right, and then trust in Him who loves
right, and whose throne is in the Heavens, for the final issue. We may
not always be popular in doing right--probably we shall _not_ be--but we
shall, in any event, have a clear conscience.