Edward Berdoe - St. Bernard's - The Romance of a Medical Student

At a card-party, say, in the house surgeon’s room, her manner was much appreciated. A knock. “Come in!” “Accident sir!” “Oh, bother, Podger, what a fidget you are!” “Well, sir, it wasn’t me as caused it; there’s three of ’em, for the matter of that, and they have been here about half-an-hour, and I thought as you’d like to know.” “Fifteen two, and a pair’s four, and his nob! Now, Podger, wet your whistle, old girl; here, have a toothful, and tell them you have called the doctors, and they are all in the wards over a bad case, but are coming to see them directly.” “Bless you, sir,” says Podger, having bobbed a curtsey, “I told ’em that when they came in. Here’s your very good ’ealth, gentlemen, and long life and plenty of practice for you all.” And she returns to the receiving-room refreshed in spirit and better able to contend with the grumbling of the unhappy victims it contained. She would have dressed their wounds, and sent them all off packing about their business, but it was against the rules, grave scandals having arisen from this “unqualified treatment.” Not but that the work would have been often done quite as well as if the students, to the number of say eight or nine, had all had “a go” at it, and with infinitely less discomfort and even agony to the patient; but it was “agin’ the rules,” as she declared “’cos why? it didn’t seem proper for ‘a nuss’ to set broken limbs; besides, it pervented the boys from gettin’ ‘the experience’ they paid for.” She was very anxious they should avail themselves of every opportunity that arose to improve themselves. No member of the staff was more interested than she in the pass list of the College of Surgeons; she felt it as a reproach against her teaching when any of them failed, and on the eve of a “Pass Exam.” or a “Final College,” she spared the patients in the receiving-room no agony as long as any one of the men “going up,” could extract useful information about fracture, dislocation, or the adjustment of a splint.

“Now, stop that there row, young man; it’s all for your good! The doctors is a-settin’ of your leg, and if you ’oller like that, you’ll make ’em nervous. You may thank yer stars there’s ’orspitals for poor sufferers like yourself to come to, and have so many kind gents to make yer all right agen.” And the old girl would wink at the boys, give them all a good chance with the case, and when everybody had quite done, and had got all their points, the poor suffering wretch was sent into the wards, there to undergo as many further examinations as the pursuit of knowledge demanded. Did he scream, she bade him desist; did he struggle, she called another and a stronger nurse to her assistance; did he rebel yet, a porter or two came in to reduce him to order. Chloroform was not often resorted to, it had an element of risk; and ether was too troublesome to be given unnecessarily. The house surgeons always prided themselves on an air of nonchalance and dignity; they were never in a hurry; it was undignified and unprofessional to be anything but perfectly calm under any circumstances. To speak loftily, in measured tones, and with studied stand-offishness, was no less necessary than the binaural stethoscope they never appeared without, the gold spectacles or eye-glass they usually affected, and the patronising manner they adopted towards the men with whom they had been fellow-students, whose larks and escapades they had shared in with equal relish, but who, not having yet attained the dignity of membership of the College of Surgeons, and the still greater honour of house surgeon to St. Bernard’s, were no longer their companions, nor participants in their enjoyments.

They all comported themselves as became members of the staff of a great hospital; they would not have been of much use in any of the ordinary sicknesses that require the aid of the experienced general practitioner or family doctor, who is so serviceable in our every-day troubles and infirmities: they paid no attention to colds, measles, and the mumps; they aspired to greater things, and occupied themselves with eye diseases, maladies of the brain, or the higher surgery. Attend you in your attack of the gout? Oh, dear no! any fool of a G.P. (slang for general practitioner) could do that, or your nurse might manage the case. But trephine you, resect your knee-joint, or do a gastrotomy upon you, – they were burning with enthusiasm for nothing less. So they all told each other they meant to be operating surgeons, speciality men, consulting physicians; they would all go to live and practise in Saville Row, or the neighbourhood of Cavendish Square. “Work for half-crowns like the miserable family doctors in the high-road outside? Not if they knew it!” They were born to send cases to the Lancet , to read papers at Congresses, to edit the Journal of Psychopathy , or arouse the medical world by their work on “Diseases of the Upper Eyelid.” Poor beggars; in ten years’ time seven-tenths of them would be toiling up rotten staircases, or groping in coal mines, visiting patients at an average of nine-pence-halfpenny a head, or holding parish appointments, and doing Friendly Societies’ work at half that rate; while of the other three-tenths, one would be starving in two gloomy rooms in a West End square, the second might make his fortune by marrying a rich wife, and the other work his way to distinction late in life by an ultimate succession to the permanent staff of his own hospital. Now and then he might be luckier still; he might start a special Hospital for Diseases of the Upper Eyelid, and so work his way to eminence and emolument. Of course all these men were supremely scientific. What was pain (in other people), if science could be advanced? What was suffering (in patients), if anything could be added to the sum of our knowledge as to the causes of their suffering? To cure the disease, to cut short the malady – ah, no, too often that was to extinguish alike the discomfort and the interesting course of phenomena that accompanied it. The true patient, the typical client, was he who – devoured by fever or disfigured by disease – asked for nothing better than to be well watched by observant medical eyes, while the “expectant treatment” ( i. e. , the letting the disease severely alone) did its work. To the objection that a man may die while the expected cure does not arrive, what more obvious than the answer, “But see what a brilliant paper for the Journal is the outcome of it all?” Somehow, Podger vaguely saw all this. Podger recognised that all the “cases” were but “cases.” She knew that Mr. Graves was getting up statistics on broken legs, and was well aware that Mr. Brand was hard at work on a treatise on “Burns and the Cayenne Pepper Treatment.” Now this was in no way objectionable to Podger; she, indeed, could cure burns beautifully with her lint and cotton wool, and soothing unguents; “But, lor bless you! my dear sir,” she would say, “if you likes to pepper ’em on the chance of making a discovery, I ain’t the nuss as ’ud stand in your way of your doing something singular to get yerself a name. So pepper ’em, I say. Thank the Lord it ain’t me nor mine as you are a-operatin’ on. What makes ’em come to the ’orspital at all, I says, if they are a-goin’ to find fault with the treatment?” So Podger co-operated bravely with all the science of the day; she would have flayed the broken-backed bricklayer alive if the staff had ordered it, and said it was scientific treatment. She knew very well the chief object of St. Bernard’s existence, and above all, she knew her place. Oh, but she was an artful and motherly old woman! the true daughter of the receiving-room; the inheritor of all its traditions, and the heiress of a large legacy of hospital tricks. She had such wheedling ways. “You! only an ignorant carpenter, good enough, perhaps, at joists, and flooring, and staircases, what was your opinion against the learned, clever, charitable young surgeon, who wanted to take your leg off, and all for nothing? Shame on you, sir, to suggest ‘practice, practice, all for practice, like making me plane up deals when I was a ’prentice.’ Have it off like a brave Englishman, and don’t make a fuss about a paltry broken leg.” What could a man say under the circumstances? What Podger said to the house surgeon of the day, who had bribed her to get him the operation, was: “It’s all right, Mr. Esmarch; he’s a-goin’ to have it done, so take him while he is in the humour;” and Mr. Esmarch did; and the theatre bell rang to assemble the men for the operation, and Mr. Esmarch rushed off to his books to read up “legs,” and take notes for his first “flap operation.” Oh, Podger could manage it when she gave her mind to it. Was it not truly an invaluable Podger?