the possible extremes of sensory appreciativeness seen in disease, in
hysteria, and in the hypnotic state, we should have a being of
extraordinary capacities for observation. Taylor, in his "Physical
Theory of Another World," a singular and half-forgotten book, has set
this forth as conceivable of the beings of a world to come, and dwelt
upon it in an ingenious and interesting way. For a long time even the
inhalation of tobacco-smoke from a friend's cigar disturbed my heart,
but one day, and it was, I fear, long before my physician, and he was
wise, thought it prudent, I suddenly fell a prey to our lady Nicotia. I
had been reading listlessly a cruel essay in the _Atlantic_ on the
wickedness of smoking, and was presently seized with a desire to look at
King James's famous "counterblast" against the weed. One is like a
spoiled child at these times, and I sent off at once for the royal
fulmination, which I found dull enough. It led to results the monarch
could not have dreamed of. I got a full-flavored cigar, and had a
half-hour of worshipful incense-product at the shrine of the
brown-cheeked lady,--a thing to remember,--and which I had leisure
enough to repent of in the sleepless night it cost me.
This new keenness of perception, of taste and touch, of smell and sound,
belongs also, in the splendid rally which the body makes toward health,
to the intellectual and imaginative sphere of activities. Something of
the lost gifts of the fairy-land of childhood returns to us in fresh
aptitude for strange, sweet castle-building, as we lie open-eyed, or in
power to see, as the child sees, what we will when the eyes are
closed,--
Pictures of love and hate,
Grim battles where no death is. Tournaments,
Tall castles fair and garden terraces,
Where the stiff peacock mocks the sunset light,
And man and maiden whisper tenderly
A shadowy love where no heart ever breaks,--
Love whose to-morrow shall be as to-day.
With the increase of intellectual clearness, within a certain range,
come, as with the brightened senses, certain drawbacks, arising out of
the fastidiousness which belongs to the changing man just at this time.
Let him, therefore, be careful what novels he chooses, for of all times
this is the one for fiction, when we are away from the contradictions of
the fierce outer world, and are in an atmosphere all sun and flowers,
and pleasant with generous service and thankful joy. Be careful what
Scheherezade you invite to your couch. By an awful rule of this world's
life, in all its phases, the sharper the zest of enjoyment, the keener
the possible disgusts may be. I recommend Dumas's books at this crisis,
but they should be read with acceptance; as stories, their value lying
largely in this, that no matter who is murdered or what horror occurs,
you somehow feel no more particular call upon your compassion than is
made when you read afresh the terrible catastrophes of Jack the
Giant-Killer.
A delightful master of style, Robert Louis Stevenson, in a recent
enumeration of the books which have influenced him in life, mentions, as
among the most charming of characterizations, the older Artagnan of the
Vicomte de Bragelonne. I feel sure that on the sick-bed, of which he
does not hesitate to speak, he must have learned, as I did, to
appreciate this charming book. I made acquaintance then, also, with what
seems to me, however, the most artistic of Dumas's works, and one so
little known that to name it is a benefit, or may be, the Chevalier
d'Harmenthal.
In the long road towards working health, I must have found, as my
note-books show, immense leisure, and equal capacity to absorb a
quantity of fiction, good and bad, and to find in some of it things
about my own art which excited amused comment, and but for that would
long ago have been forgotten. Among the stuff which I more or less
listlessly read was an astonishing book called "Norwood." It set me to
thinking, because in this book are recounted many things concerning sick
or wounded folk, and those astonishing surgeons and nurses who are
supposed to have helped them on to their feet again.
The ghastly amusement which came to me out of the young lady in this
volume, who amputates a man's leg, made me reflect a little about the
mode in which writers of fiction have dealt with sick people and
doctors. I lay half awake, and thought over this in no unkindly critical
mood,
"With now and then a merry thought,
And now and then a sad one,"
until I built myself a great literary hospital, such as would delight
Miss Nightingale. For in it I had a Scott ward, and a Dickens ward, and
a Bulwer ward, and a Thackeray ward, with a very jolly lot of doctors,
such as Drs. Goodenough and Firmin, with the Little Sister (out of
Philip) and Miss Evangeline to take care of the patients, besides cells
for Charles Reade's heroes and heroines, and the apothecary (out of
Romeo and Juliet) to mix more honest doses than he gave to luckless
Romeo.
Should you wander with a critical doctor through those ghostly wards,
you would see some queerer results of battle and fray than ever the
doctors observe nowadays,--cases I should like to report, it might be:
poisonings that would have bewildered Orfila, heart-diseases that would
have astounded Corvisart, and those wonderful instances of consumption
which render that most painful of diseases so delightful to die of--in
novels. I have no present intention to weary my readers with a clinic in
those crowded wards, but it will ease my soul a little if I may say my
say in a general fashion about the utter absurdities of most of these
pictures of disease and death-beds. In older times the sickness of a
novel was merely a feint to gain time in the story or account for a
non-appearance, and the doctor made very brief show upon the stage.
Since, however, the growth of realism in literary art, the temptation to
delineate exactly the absolute facts of disease has led authors to dwell
too freely on the details of sickness. So long as they dealt in
generalities their way was clear enough. Of old a man was poisoned and
done for. Today we deal in symptoms, and follow science closely in our
use of poisons. Mr. Trollope's "Gemma" is an instance in point, where
every one will feel that the spectacle of the heroine going seasick to
death, owing to the administration of tartar emetic, is as disgusting
and inartistic a method as fiction presents. Why not have made it croton
oil? More and worse of this hideous realism is to be found in About's
books, such, for instance, as "Germaine"; but from which censure I like
to exclude the rollicking fun of "Le Nez d'un Notaire." As to the recent
realistic atrocities of Zola, and even of Tolstoi, a more rare sinner,
if we exclude his disgusting drama of peasant life, I prefer to say
little.
As to blunders in the science of poisons I say little. The novelist is a
free lance, and chooses his own weapons; but I cannot help remarking
that, if recent investigators are to be trusted, one unlucky female, at
least, must be still alive, for a novelist relates that she was done to
death by the internal taking of a dose of rattlesnake venom. I hope when
I am to be poisoned this mode may be employed. She might as well have
drunk a glass of milk. That book was a queer one to me after this
catastrophe: the woman ought to be dead and could not be.
The difficulty of the modern novelist in giving symptoms and preserving
the entire decorum of his pages has amused me a little. Depend upon it,
he had best fight shy of these chronic illnesses: they make queer
reading to a doctor who knows what sick people are; and above all does
this advice apply to death-beds. As a rule, folks get very horrible at
such times, and are a long while in dying, with few of their wits about
them at the last. But in novels people die marvellously possessed of
their faculties; or, if they are shot, always jump into the air exactly
as men never do in fact.
Just here, concerning wounds, a question occurs to me: The heroes who
have to lose a limb--a common thing in novels since the war--always come
back with one arm, and never with a lost leg. Is it more romantic to get
rid of one than of the other?--considering also that a one-armed embrace
of the weeping waiting lady-love must be so utterly unsatisfactory.
But enough of the patients. Among them I think I like Pendennis the
best, and consider little Dombey and Nell the most delightfully absurd.
And as to the doctors. Some of them have absolutely had the high
promotion to be the heroes of a whole book. Had not one, nay, two, a
novel to themselves? There is delightful Dr. Antonio, not enough of a
doctor to call down on him my professional wrath. As to Dr. Goodenough,
he has been in our family a long while,--on the shelf (God bless
him!),--and attended, we remember, our friend Colonel Newcome in that
death-bed matchless in art since Falstaff babbled life away. Yet, after
all, he is not a doctor so much as a man charmingly drawn.
There are in novels many good portraits of lawyers, from Pleydell to
Tulkinghorn. Whether fair or unjust as pictures, I am scarce able to
judge, although I believe that some of them have been recognized by our
legal brethren as sufficiently exact. While, however, we have plenty of
characters which for his purpose the novelist labels M.D., there seems
to have been some insuperable difficulty in evolving for artistic use a
doctor who shall seem at home, as such, among the other characters of
the novel,--one, at least, who shall appear to any reasonable degree
like a doctor to those who really know the genus doctor thoroughly. Save
Lydgate, no doctor in fiction answers this critical demand, or seems
anything to me but a very stiff lay figure from the moment he is called
upon to bring his art into the story, or to figure, except as an
unprofessional personage.
Nor does this arise from poverty of types in the tribe of physicians.
The training of a doctor's life produces the most varied effects for
good or evil, as may chance, upon the human natures submitted to its
discipline, so that I think any thoughtful medical man will tell you
that there is a more notable individuality among his brethren in middle
life than among most of the people he encounters. As for the novelist's
effort--an inartistic one, it seems to me--to bring on his stage
representations of some especial kind of doctor, I have only a grim
smile to give, remembering Mr. Reade's grewsome medico in "Hard
Cash,"--a personation meant, I suppose, to present to the public a
certain irregular London doctor, but which, to the minds of most
physicians, reads like an elaborate advertisement of the man in
question.
Sir Bulwer Lytton's renderings of a homoeopath and a water-cure
specialist are open to the same charge, and could only have been
successful in the hands of a master.
There are at least two doctors in Balzac's novels. Rastignac, man of
fashion and science, is drawn with the master's usual skill, but he is
not a doctor. His art has no prominence. It is not shown how his
peculiarities influenced his work, nor how his art, and its use, altered
or modified the man. "The Country Doctor," by the same strong hand, is
far more near my ideal of what this portraiture should be than any other
known to me in French literature. The humorous aspects of a medical life
in the provinces of France are nicely handled in Jules Sandeau's "Doctor
Herbeau," but the study, however neat and pleasing, is slight.
Wander where you may, in the drama or the novel, you will still find, I
think, that the character of the physician awaits in its interesting
varieties competent portrayal.
Shakespeare has left us no finished portrait of a doctor. Molière
caricatured him. Thackeray failed to draw him, and generally in novels
he is merely a man who is labelled "Doctor." The sole exception known to
me is the marvellous delineation of Lydgate in "Middlemarch." He is all
over the physician, his manner, his sentiments, his modes of thought,
but he stands alone in fiction. How did that great mistress of her art
learn all of physicians which enabled her to leave us this amazingly
truthful picture? Her life gives us no clue, and when I asked her
husband, George Lewes, to explain the matter, he said that he did not
know, and that she knew no more of this than of how she had acquired her
strangely complete knowledge of the low turf people she has drawn in the
same book, and with an almost equal skill and truth to nature.
It were easy, I fancy, to point out how the doctor's life and training
differ from those of all the other professions, and how this must act on
peculiar individualities for the deepening of some lines and the erasure
of others; but this were too elaborate a study for my present gossiping
essay, and may await another day and a less lazy mood.
If any one should be curious to see what are the modifying circumstances
in a physician's life which strongly tend to weaken or to reinforce
character, I recommend a delightful little address, quite too brief, by
Dr. Emerson, the son of the great essayist. It is unluckily out of print
and difficult to obtain. If you would see in real lives what sturdy
forms of personal distinctness the doctor may assume, there is no better
way than to glance over some half-dozen medical biographies. Read, for
instance, delightful John Brown's sketch of Sydenham and of his own
father, or George Wilson's life of John Reid, the physiologist, whom
community of suffering must have made dear to that gentle intelligence,
and whose days ended in tragic horror such as sensational fiction may
scarcely match; or, for an individuality as well defined and more
pleasing, read Pichot's life of Sir Charles Bell, or one of the most
remarkable of biographies, Mr. Morley's life of Jerome Cardan.
I am reminded as I write how rare are the really good medical
biographies. The autobiographies are better. Ambrose Paré's sketches of
his own life, which was both eventful and varied, are scattered through
his treatise on surgery, and he does not gain added interest in the
hands of Malgaigne. Our own Sims's book about himself is worth reading,
but is too realistic for the library table, yet what a strangely
valuable story it is of the struggle of genius up to eminent success.
But these are the heroes of a not unheroic profession, and I had almost
forgotten to set among them, as a study of character, the life of the
tranquil, high-minded Jenner, the country doctor who swept the scars of
smallpox from the faces of the world of men, and beside him John Hunter,
his friend, impulsive, quick of temper, enthusiastic, an intensely
practical man of science. These are illustrations of men of the most
varied types, whose works show their characteristics, and who would, in
the end, I fancy, have been very different had fate set them other tasks
in life, for if the sculptor makes the statue, we may rest quite sure
that the statue he makes influences the man who made it.
These, I have said, are our heroes, but I still think there remains to
be written the simple, honest, dutiful story of an intelligent,
thoughtful, every-day doctor, such as will pleasantly and fitly open to
laymen some true conception of the life he leads, its cares, its trials,
its influences on himself and others and its varied rewards. John Brown
got closest to it in that sketch of his father, and in her
delicately-drawn "Country Doctor" Miss Jewett has done us gentle
service. But my doctor would differ somewhat in all lands, because
nationality and social conventions have their influence on us as on
other men, as any one may observe who compares the clergymen of the
Episcopal Church in America with those of England.
The man who deals with the physician in fiction would have to consider
this class of facts, for social conventions have assigned to the
physician in England, at least, a very different position from that
which he holds with us, where he has no social superior, and is usually
in all small communities, and in some larger ones, the most eminent
personage and the man of largest influence.
In the rage for novel characters the lady doctor has of late assumed her
place in fiction. Lots of wives have been picked up among hospital
nurses, especially since the Crimean war, and since other women than
Sisters of Charity got into the business, and so made to seem probable
this pleasing termination of an illness. There was a case well known to
me where a young officer simulated delirium tremens in order to get near
to a Sister of Charity. If ever you had seen the lady, you would not
have wondered at his madness; and should any author desire to utilize
this incident, let him comprehend that the order of Sisters of Charity
admits of its members leaving the ranks by marriage, theirs being a
secular order; so that here are the chances for a story of the freshest
kind. As for the lady doctor in fiction, her advantages would be awful
to contemplate in sickness, when we are weak and fevered, and absurdly
grateful for a newly-beaten pillow or a morsel of ice. But imagine the
awful temptation of having your heart auscultated. Let us dismiss the
subject while the vision of Béranger's Ange Gardienne flits before us as
De Grandville drew her.
I have not now beside me Howells's "Doctor Breen's Practice." It is a
remarkable attempt to do justice to a very difficult subject, for there
are two physicians to handle, male and female, not, I think, after their
kind. "Doctor Zay," by Miss Phelps, makes absurd a book which is
otherwise very attractive. This young woman doctor, a homoeopath, sets a
young man's leg, and falls in love with him after a therapeutic
courtship, in which he wooes and she prescribes.
The woman doctor is, I suspect, still available as material for the
ambitious novelist, but let him beware how he deals with her.
PAIN AND ITS CONSEQUENCES.
As I look from my window, on the lawn below are girls at play,--gay,
vigorous, wholesome; they laugh, they run, and are never weary. How far
from them and their abounding health seem the possibilities of such
torment as nature somewhere in life reserves for most of us. As women,
their lives are likely, nay, certain, to bring them a variety of
physical discomforts, and perhaps pain in its gravest forms. For man,
pain is accidental, and depends much on the chances of life. Certainly,
many men go through existence here with but little pain. With women it
is incidental, and a far more probable possibility. The most healthy
will have least of it. Vigor of body is its foe. Thin blood is its ally.
Speaking now, not of the physiological pain, which few escape, but of
the torments of neuralgia and the like, Romberg says, "Pain is the
prayer of the nerves for healthy blood." As the woman is normally less
full-blooded than the man, she is relatively in more danger of becoming
thin-blooded than he.
Moreover, the disturbances which come from the nature of her
physiological processes subject her to larger risks of lessened blood
than man, and hence, for all reasons, she is more likely than he to
become anæmic, and out of this to evolve pain in some shape.
If we see that our girls are not overtasked at the age of sexual
evolution, that the brain is not overtrained at bitter cost of other
developments as essential, we escape a part of this peril. To discuss
the question here is not my intention. To secure in our artificial life
what is desirable is difficult. It involves matters of dress, exercise,
proportion of lessons, diet, and other matters, of which I shall yet say
something, and as to which I have elsewhere said a good deal.
But no matter how careful we may be, how thoughtful as to the true needs
of these young lives, we may be sure that our daughters will be more
likely to have to face at some time the grim question of pain than the
lads who grow up beside them.
For both there are always the little ailments of childhood,--the hurts,
the accidents, and the disorders or the diseases of youthful years. All
come in for a share. Let us be careful how we deal with them. I have
often watched with interest a mother beside the girl or boy in temporary
pain. As a rule, she assumes from the beginning that the hurt boy is to
be taught silent, patient endurance. What! you, a boy, to cry! Be a man!
Among his comrades he is a "cry-baby" if he whimpers, "a regular girl,"
"a girl-boy." He is taught early that from him endurance is expected;
the self-conquest of restrained emotion is his constant lesson.
If it be a girl who suffers, she is assumed to be weak, and it is felt
that for her tears are natural and not to be sternly repressed; nor are
her little aches and complaints dismissed as lightly as are her
brother's. She is trained to expect sympathy, and learns that to weep is
her prerogative. The first gush of tears after a hurt of body or mind is
in some mysterious way a relief, and not rudely to be chidden; but, on
the whole, it is wise and right to teach patience and unemotional
endurance to the sex which in life is sure to have the larger share of
suffering. To be of use, this education must begin reasonably early, and
we may leave to the mother to make sure that it is not too severe.
As a girl grows older, we ask and expect some measure of restraint in
emotional expression as regards any of the physical or moral troubles
which call out tears in the child; for the woman who is wise understands
that unrestrained emotion and outward expressions of pain or distress
are the beginnings of that loss of self-rule which leads to habitual
unrestraint, and this to more and more enfeeblement of endurance, and
this, again, to worse things, of which more in the future.
We are dealing now with pain. My simple practical thesis is that pain
comes to all soon or late, that the indirect consequences are most to be
feared, and that endurance in the adult, rational endurance, must be won
by a gradual education, which can hardly begin too early. But of what
use are these stern lessonings in the bearing of what none can quite
escape? Do they enable us to diminish pain or to feel it less?
Indirectly, yes. One woman cries out for instant easement if in pain or
distress, unschooled to endure. She claims immediate relief. Another,
more resolute, submits with patience, does not give way, as we put it,
tries to distract her attention, knowing that even as distinct suffering
as toothache may be less felt in the presence of something which
interests the mind and secures the attention. Nothing, indeed, is more
instructive than to watch how women bear pain,--the tremendous calamity
it is to one, the far slighter thing in life it is to another. I speak
now of transient torments. When we come to consider those years of
torture which cruel nature holds in store for some, no one blames the
sight of the moral wreck it is apt to make of the sufferer. On the other
hand, there is nothing I ever see in my profession so splendid as the
way in which a few, a rare few, triumph over pain, which we know must
often rise to the grade of anguish, and from which scarce a day is ever
free.