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“Depend upon it a lucky guess is never merely luck – there is always some talent in it.” —Miss Austen, in Emma.

PRESENCE OF MIND, AND HAPPY GUESSING

Dr. Chalmers used to say that in the dynamics of human affairs, two qualities were essential to greatness – Power and Promptitude. One man might have both, another power without promptitude, another promptitude without power. We must all feel the common sense of this, and can readily see how it applies to a general in the field, to a pilot in a storm, to a sportsman, to a fencer, to a debater. It is the same with an operating surgeon at all times, and may be at any time with the practitioner of the art of healing. He must be ready for what are called emergencies – cases which rise up at your feet, and must be dealt with on the instant, – he must have power and promptitude.

It is a curious condition of mind that this requires: it is like sleeping with your pistol under your pillow, and it on full cock; a moment lost and all may be lost. There is the very nick of time. This is what we mean by presence of mind; by a man having such a subject at his finger ends; that part of the mind lying nearest the outer world, and having to act on it through the bodily organs, through the will – the outposts must be always awake. It is of course, so to speak, only a portion of the mind that is thus needed and thus available; if the whole mind were forever at the advanced posts, it would soon lose itself in this endeavor to keep it. Now, though the thing needed to be done may be simple enough, what goes to the doing of it, and to the being at once ready and able to do it, involves much: the wedge would not be a wedge, or do a wedge’s work, without the width behind as well as the edge in front. Your men of promptitude without genius or power, including knowledge and will, are those who present the wedge the wrong way. Thus your extremely prompt people are often doing the wrong thing, which is almost always worse than nothing. Our vague friend who bit “Yarrow’s” tail instead of “the Chicken’s,” was full of promptitude; as was also that other man, probably a relative, who barred the door with a boiled carrot; each knew what was needed – the biting the tail, the barring the door; both erred as to the means – the one by want of presence of mind, the other by lack of mind itself. We must have just enough of the right knowledge and no more; we must have the habit of using this; we must have self-reliance, and the consentaneousness of the entire mind; and what our hand finds to do, we must do with our might as well as with it. Therefore it is that this master act of the man, under some sudden and great unexpected crisis, is in a great measure performed unconsciously as to its mental means. The man is so totus in illo, that there is no bit of the mind left to watch and record the acts of the rest; therefore men, when they have done some signal feat of presence of mind, if asked how they did it, generally don’t very well know – they just did it; it was, in fact, done and then thought of, not thought of and then done, in which case it would likely never have been done. Not that the act was uncaused by mind; it is one of the highest powers of mind thus to act; but it is done, if I may use the phrase, by an acquired instinct. You will find all this in that wonderful old Greek who was Alexander the Great’s and the old world’s schoolmaster, and ours if we were wise, – whose truthfulness and clear insight one wonders at the longer he lives. He seems to have seen the human mind as a bird or an engineer does the earth – he knew the plan of it. We now-a-days see it as one sees a country, athwart and in perspective, and from the side; he saw it from above and from below. There are therefore no shadows, no foreshortenings, no clear-obscure, indeed no disturbing medium; it is as if he examined everything in vacuo. I refer my readers to what he says on Ἀγχίνοια and Εὐστοχία.8

My object in what I have now written and am going to write, is to impress upon medical students the value of power and promptitude in combination, for their professional purposes; the uses to them of nearness of the Νοῦς, and of happy guessing; and how you may see the sense, and neatness, and pith of that excellent thinker, as well as best of all story-tellers, Miss Austen, when she says in Emma, “Depend upon it, a lucky guess is never merely luck, there is always some talent in it.” Talent here denoting intelligence and will in action. In all sciences except those called exact, this happy guessing plays a large part, and in none more than in medicine, which is truly a tentative art, founded upon likelihood, and is therefore what we call contingent. Instead of this view of the healing art discouraging us from making our ultimate principles as precise, as we should make our observations, it should urge us the more to this; for, depend upon it, that guess as we may often have to do, he will guess best, most happily for himself and his patient, who has the greatest amount of true knowledge, and the most serviceable amount of what we may call mental cash, ready money, and ready weapons.

We must not only have wisdom, which is knowledge assimilated and made our own, but we must, as the Lancashire men say and do, have wit to use it. We may carry a nugget of gold in our pocket, or a £100 bank-note, but unless we can get it changed, it is of little use, and we must moreover have the coin of the country we are in. This want of presence of mind, and having your wits about you, is as fatal to a surgeon as to a general.

That wise little man, Dr. Henry Marshall, little in body but not little in mind, in brain, and in worth, used to give an instance of this. A young, well-educated surgeon, attached to a regiment quartered at Musselburgh, went out professionally with two officers who were in search of “satisfaction.” One fell shot in the thigh, and in half an hour after he was found dead, the surgeon kneeling pale and grim over him, with his two thumbs sunk in his thigh below the wound, the grass steeped in blood. If he had put them two inches higher, or extemporized a tourniquet with his sash and the pistol’s ramrod and a stone, he might have saved his friend’s life and his own – for he shot himself that night.

Here is another. Robbie Watson, whom I now see walking mildly about the streets – having taken to coal – was driver of the Dumfries coach by Biggar. One day he had changed horses, and was starting down a steep hill, with an acute turn at the foot, when he found his wheelers, two new horses, utterly ignorant of backing. They got furious, and we outside got alarmed. Robbie made an attempt to pull up, and then with an odd smile took his whip, gathered up his reins, and lashed the entire four into a gallop. If we had not seen his face we would have thought him a maniac; he kept them well together, and shot down like an arrow, as far as we could see to certain destruction. Right in front at the turn was a stout gate into a field, shut; he drove them straight at that, and through we went, the gate broken into shivers, and we finding ourselves safe, and the very horses enjoying the joke. I remember we emptied our pockets into Robbie’s hat, which he had taken off to wipe his head. Now, in a few seconds all this must have passed through his head – “that horse is not a wheeler, nor that one either; we’ll come to mischief; there’s the gate; yes, I’ll do it.” And he did it; but then he had to do it with his might; he had to make it impossible for his four horses to do anything but toss the gate before them.

Here is another case. Dr. Reid of Peebles, long famous in the end of last and beginning of this century, as the Doctor of Tweeddale; a man of great force of character, and a true Philip, a lover of horses, saw one Fair day a black horse, entire, thoroughbred. The groom asked a low price, and would answer no questions. At the close of the fair the doctor bought him, amid the derision of his friends. Next morning he rode him up Tweed, came home after a long round, and had never been better carried. This went on for some weeks; the fine creature was without a fault. One Sunday morning, he was posting up by Neidpath at a great pace, the country people trooping into the town to church. Opposite the fine old castle, the thorough-bred stood stock still, and it needed all the doctor’s horsemanship to counteract the law of projectiles; he did, and sat still, and not only gave no sign of urging the horse, but rather intimated that it was his particular desire that he should stop. He sat there a full hour, his friends making an excellent joke of it, and he declining, of course, all interference. At the end of the hour, the Black Duke, as he was called, turned one ear forward, then another, looked aside, shook himself, and moved on, his master intimating that this was exactly what he wished; and from that day till his death, some fifteen years after, never did these two friends allude to this little circumstance, and it was never repeated; though it turned out that he had killed his two men previously. The doctor must have, when he got him, said to himself, “if he is not stolen there is a reason for his paltry price,” and he would go over all the possibilities. So that when he stood still, he would say, “Ah, this is it;” but then he saw this at once, and lost no time, and did nothing. Had he given the horse one dig with his spurs, or one cut with his whip, or an impatient jerk with his bit, the case would have failed. When a colt it had been brutally used, and being nervous, it lost its judgment, poor thing, and lost its presence of mind.

One more instance of nearness of the Νοῦς. A lady was in front of her lawn with her children, when a mad dog made his appearance, pursued by the peasants. What did she do? What would you have done? Shut your eyes and think. She went straight to the dog, received its head in her thick stuff gown, between her knees, and muffling it up, held it with all her might till the men came up. No one was hurt. Of course, she fainted after it was all right.

We all know (but why should we not know again?) the story of the Grecian mother who saw her child sporting on the edge of the bridge. She knew that a cry would startle it over into the raging stream – she came gently near, and opening her bosom allured the little scapegrace.

I once saw a great surgeon, after settling a particular procedure as to a life-and-death operation, as a general settles his order of battle. He began his work, and at the second cut altered the entire conduct of the operation. No one not in the secret could have told this: not a moment’s pause, not a quiver of the face, not a look of doubt. This is the same master power in man, which makes the difference between Sir John Moore and Sir John Cope.

Mrs. Major Robertson, a woman of slight make, great beauty, and remarkable energy, courage, and sense (she told me the story herself), on going up to her bedroom at night – there being no one in the house but a servant girl, in the ground floor – saw a portion of a man’s foot projecting from under the bed. She gave no cry of alarm, but shut the door as usual, set down her candle, and began as if to undress, when she said aloud to herself, with an impatient tone and gesture, “I’ve forgotten that key again, I declare;” and leaving the candle burning, and the door open, she went down-stairs, got the watchman, and secured the proprietor of the foot, which had not moved an inch. How many women or men could have done, or rather been all this!

8

As I am now, to my sorrow and shame, too much of a mediate Grecian, I give a Balliol friend’s note on these two words: – “What you have called ‘presence of mind’ and ‘happy guessing’ may, I think, be identified respectively with Aristotle’s ἀγχίνοια and εὐστοχία. The latter of these, εὐστοχία, Aristotle mentions incidentally when treating of εὐβουλία, or good deliberation. Eth. Nic. bk. vi. ch. 9. Good deliberation, he says, is not εὐστοχία, for the former is a slow process, whereas the latter is not guided by reason, and is rapid. In the same passage he tells us that ἀγχίνοια is a sort of εὐστοχία. But he speaks of ἀγχίνοια more fully in Ana. Post. i. 34: – ‘Άγχίνοια is a sort of happy guessing at the intermediate, when there is not time for consideration: as when a man, seeing that the bright side of the moon is always turned towards the sun, comprehends that her light is borrowed from the sun; or concludes, from seeing one conversing with a capitalist that he wants to borrow money; or infers that people are friends from the fact of their having common enemies.’” And then he goes on to make these simple observations confused and perplexing by reducing them to his logical formula.

“The derivation of the words will confirm this view. Εὐστοχία is a hitting the mark successfully, a reaching to the end, the rapid and, as it were, intuitive perception of the truth. This is what Whewell means by saying, ‘all induction is a happy conjecture.’ But when Aristotle says that this faculty is not guided by reason (ἄνευ τε γὰρ λογου), he does not mean to imply that it grows up altogether independent of reason, any more than Whewell means to say that all the discoveries in the inductive sciences have been made by men taking ‘shots’ at them, as boys at school do at hard passages in their Latin lessons. On the contrary, no faculty is so absolutely the child of reason as this faculty of happy guessing. It only attains to perfection after the reason has been long and painfully trained in the sphere in which the guesses are to be made. What Aristotle does mean is, that when it has attained perfection, we are not conscious of the share which reason has in its operation – it is so rapid that by no analysis can we detect the presence of reason in its action. Sir Isaac Newton seeing the apple fall, and thence ‘guessing’ at the law of gravitation, is a good instance of εὐστοχία.

“Άγχίνοια, on the other hand, is a nearness of mind; not a reaching to the end, but an apprehension of the best means; not a perception of the truth, but a perception of how the truth is to be supported. It is sometimes translated ‘sagacity,’ but readiness or presence of mind is better, as sagacity rather involves the idea of consideration. In matters purely intellectual it is ready wit. It is a sort of shorter or more limited εὐστοχία. It is more of a natural gift than εὐστοχία, because the latter is a far higher and nobler faculty, and therefore more dependent for its perfection on cultivation, as all our highest faculties are. Εὐστοχία is more akin to genius, ἀγχίνοια to practical common sense.”