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The Mysterious Patient

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As I look back through the years of my association with John Thorndyke, I am able to recall a wealth of adventures and strange experiences such as falls to the lot of very few men who pass their lives within hearing of Big Ben. Many of these experiences I have already placed on record; but it now occurs to me that I have hitherto left unrecorded one that is, perhaps, the most astonishing and incredible of the whole series; an adventure, too, that has for me the added interest that it inaugurated my permanent association with my learned and talented friend, and marked the close of a rather unhappy and unprosperous period of my life.

Memory, retracing the journey through the passing years to the starting-point of those strange events, lands me in a shabby little ground-floor room in a house near the Walworth end of Lower Kennington Lane. A couple of framed diplomas on the wall, a card of Snellen's test-types and a stethoscope lying on the writing-table, proclaim it a doctor's consulting-room; and my own position in the round-backed chair at the said table, proclaims me the practitioner in charge.

It was nearly nine o'clock. The noisy little clock on the mantelpiece announced the fact, and, by its frantic ticking, seemed as anxious as I to get the consultation hours over. I glanced wistfully at my mud-splashed boots and wondered if I might yet venture to assume the slippers that peeped coyly from under the shabby sofa. I even allowed my thoughts to wander to the pipe that reposed in my coat pocket. Another minute and I could turn down the surgery gas and shut the outer door. The fussy little clock gave a sort of preliminary cough or hiccup, as if it should say: "Ahem! ladies and gentlemen, I am about to strike." And at that moment, the bottle-boy opened the door and, thrusting in his head, uttered the one word: "Gentleman."

Extreme economy of words is apt to result in ambiguity. But I understood. In Kennington Lane, the race of mere men and women appeared to be extinct. They were all gentlemen—unless they were ladies or children—even as the Liberian army was said to consist entirely of generals. Sweeps, labourers, milkmen, costermongers—all were impartially invested by the democratic bottle-boy with the rank and title of armigeri. The present nobleman appeared to favour the aristocratic recreation of driving a cab or job-master's carriage, and, as he entered the room, he touched his hat, closed the door somewhat carefully, and then, without remark, handed me a note which bore the superscription "Dr. Stillbury."

"You understand," I said, as I prepared to open the envelope, "that I am not Dr. Stillbury. He is away at present and I am looking after his patients."

"It doesn't signify," the man replied. "You'll do as well."

On this, I opened the envelope and read the note, which was quite brief, and, at first sight, in no way remarkable.

"DEAR SIR," it ran, "Would you kindly come and see a friend of mine who is staying with me? The bearer of this will give you further particulars and convey you to the house. Yours truly, H. WEISS."

There was no address on the paper and no date, and the writer was unknown to me.

"This note," I said, "refers to some further particulars. What are they?"

The messenger passed his hand over his hair with a gesture of embarrassment. "It's a ridicklus affair," he said, with a contemptuous laugh. "If I had been Mr. Weiss, I wouldn't have had nothing to do with it. The sick gentleman, Mr. Graves, is one of them people what can't abear doctors. He's been ailing now for a week or two, but nothing would induce him to see a doctor. Mr. Weiss did everything he could to persuade him, but it was no go. He wouldn't. However, it seems Mr. Weiss threatened to send for a medical man on his own account, because, you see, he was getting a bit nervous; and then Mr. Graves gave way. But only on one condition. He said the doctor was to come from a distance and was not to be told who he was or where he lived or anything about him; and he made Mr. Weiss promise to keep to that condition before he'd let him send. So Mr. Weiss promised, and, of course, he's got to keep his word."

"But," I said, with a smile, "you've just told me his name—if his name really is Graves."

"You can form your own opinion on that," said the coachman.

"And," I added, "as to not being told where he lives, I can see that for myself. I'm not blind, you know."

"We'll take the risk of what you see," the man replied. "The question is, will you take the job on?"

Yes; that was the question, and I considered it for some time before replying. We medical men are pretty familiar with the kind of person who "can't abear doctors," and we like to have as little to do with him as possible. He is a thankless and unsatisfactory patient. Intercourse with him is unpleasant, he gives a great deal of trouble and responds badly to treatment. If this had been my own practice, I should have declined the case off-hand. But it was not my practice. I was only a deputy. I could not lightly refuse work which would yield a profit to my principal, unpleasant though it might be.

As I turned the matter over in my mind, I half unconsciously scrutinized my visitor—somewhat to his embarrassment—and I liked his appearance as little as I liked his mission. He kept his station near the door, where the light was dim—for the illumination was concentrated on the table and the patient's chair—but I could see that he had a somewhat sly, unprepossessing face and a greasy, red moustache that seemed out of character with his rather perfunctory livery; though this was mere prejudice. He wore a wig, too—not that there was anything discreditable in that—and the thumb-nail of the hand that held his hat bore disfiguring traces of some injury—which, again, though unsightly, in no wise reflected on his moral character. Lastly, he watched me keenly with a mixture of anxiety and sly complacency that I found distinctly unpleasant. In a general way, he impressed me disagreeably. I did not like the look of him at all; but nevertheless I decided to undertake the case.

"I suppose," I answered, at length, "it is no affair of mine who the patient is or where he lives. But how do you propose to manage the business? Am I to be led to the house blindfolded, like the visitor to the bandit's cave?"

The man grinned slightly and looked very decidedly relieved.

"No, sir," he answered; "we ain't going to blindfold you. I've got a carriage outside. I don't think you'll see much out of that."

"Very well," I rejoined, opening the door to let him out, "I'll be with you in a minute. I suppose you can't give me any idea as to what is the matter with the patient?"

"No, sir, I can't," he replied; and he went out to see to the carriage.

I slipped into a bag an assortment of emergency drugs and a few diagnostic instruments, turned down the gas and passed out through the surgery. The carriage was standing at the kerb, guarded by the coachman and watched with deep interest by the bottle-boy. I viewed it with mingled curiosity and disfavour. It was a kind of large brougham, such as is used by some commercial travellers, the usual glass windows being replaced by wooden shutters intended to conceal the piles of sample-boxes, and the doors capable of being locked from outside with a railway key.

As I emerged from the house, the coachman unlocked the door and held it open.

"How long will the journey take?" I asked, pausing with my foot on the step.

The coachman considered a moment or two and replied:

"It took me, I should say, nigh upon half an hour to get here."

This was pleasant hearing. A half an hour each way and a half an hour at the patient's house. At that rate it would be half-past ten before I was home again, and then it was quite probable that I should find some other untimely messenger waiting on the doorstep. With a muttered anathema on the unknown Mr. Graves and the unrestful life of a locum tenens, I stepped into the uninviting vehicle. Instantly the coachman slammed the door and turned the key, leaving me in total darkness.

One comfort was left to me; my pipe was in my pocket. I made shift to load it in the dark, and, having lit it with a wax match, took the opportunity to inspect the interior of my prison. It was a shabby affair. The moth-eaten state of the blue cloth cushions seemed to suggest that it had been long out of regular use; the oil-cloth floor-covering was worn into holes; ordinary internal fittings there were none. But the appearances suggested that the crazy vehicle had been prepared with considerable forethought for its present use. The inside handles of the doors had apparently been removed; the wooden shutters were permanently fixed in their places; and a paper label, stuck on the transom below each window, had a suspicious appearance of having been put there to cover the painted name and address of the job-master or livery-stable keeper who had originally owned the carriage.

These observations gave me abundant food for reflection. This Mr. Weiss must be an excessively conscientious man if he had considered that his promise to Mr. Graves committed him to such extraordinary precautions. Evidently no mere following of the letter of the law was enough to satisfy his sensitive conscience. Unless he had reasons for sharing Mr. Graves's unreasonable desire for secrecy—for one could not suppose that these measures of concealment had been taken by the patient himself.

The further suggestions that evolved themselves from this consideration were a little disquieting. Whither was I being carried and for what purpose? The idea that I was bound for some den of thieves where I might be robbed and possibly murdered, I dismissed with a smile. Thieves do not make elaborately concerted plans to rob poor devils like me. Poverty has its compensations in that respect. But there were other possibilities. Imagination backed by experience had no difficulty in conjuring up a number of situations in which a medical man might be called upon, with or without coercion, either to witness or actively to participate in the commission of some unlawful act.

Reflections of this kind occupied me pretty actively if not very agreeably during this strange journey. And the monotony was relieved, too, by other distractions. I was, for example, greatly interested to notice how, when one sense is in abeyance, the other senses rouse into a compensating intensity of perception. I sat smoking my pipe in darkness which was absolute save for the dim glow from the smouldering tobacco in the bowl, and seemed to be cut off from all knowledge of the world without. But yet I was not. The vibrations of the carriage, with its hard springs and iron-tired wheels, registered accurately and plainly the character of the roadway. The harsh rattle of granite setts, the soft bumpiness of macadam, the smooth rumble of wood-pavement, the jarring and swerving of crossed tram-lines; all were easily recognizable and together sketched the general features of the neighbourhood through which I was passing. And the sense of hearing filled in the details. Now the hoot of a tug's whistle told of proximity to the river. A sudden and brief hollow reverberation announced the passage under a railway arch (which, by the way, happened several times during the journey); and, when I heard the familiar whistle of a railway-guard followed by the quick snorts of a skidding locomotive, I had as clear a picture of a heavy passenger-train moving out of a station as if I had seen it in broad daylight.

I had just finished my pipe and knocked out the ashes on the heel of my boot, when the carriage slowed down and entered a covered way—as I could tell by the hollow echoes. Then I distinguished the clang of heavy wooden gates closed behind me, and a moment or two later the carriage door was unlocked and opened. I stepped out blinking into a covered passage paved with cobbles and apparently leading down to a mews; but it was all in darkness, and I had no time to make any detailed observations, as the carriage had drawn up opposite a side door which was open and in which stood a woman holding a lighted candle.

"Is that the doctor?" she asked, speaking with a rather pronounced German accent and shading the candle with her hand as she peered at me.

I answered in the affirmative, and she then exclaimed:

"I am glad you have come. Mr. Weiss will be so relieved. Come in, please."

I followed her across a dark passage into a dark room, where she set the candle down on a chest of drawers and turned to depart. At the door, however, she paused and looked back.

"It is not a very nice room to ask you into," she said. "We are very untidy just now, but you must excuse us. We have had so much anxiety about poor Mr. Graves."

"He has been ill some time, then?"

"Yes. Some little time. At intervals, you know. Sometimes better, sometimes not so well."

As she spoke, she gradually backed out into the passage but did not go away at once. I accordingly pursued my inquiries.

"He has not been seen by any doctor, has he?"

"No," she answered, "he has always refused to see a doctor. That has been a great trouble to us. Mr. Weiss has been very anxious about him. He will be so glad to hear that you have come. I had better go and tell him. Perhaps you will kindly sit down until he is able to come to you," and with this she departed on her mission.

It struck me as a little odd that, considering his anxiety and the apparent urgency of the case, Mr. Weiss should not have been waiting to receive me. And when several minutes elapsed without his appearing, the oddness of the circumstance impressed me still more. Having no desire, after the journey in the carriage, to sit down, I whiled away the time by an inspection of the room. And a very curious room it was; bare, dirty, neglected and, apparently, unused. A faded carpet had been flung untidily on the floor. A small, shabby table stood in the middle of the room; and beyond this, three horsehair-covered chairs and a chest of drawers formed the entire set of furniture. No pictures hung on the mouldy walls, no curtains covered the shuttered windows, and the dark drapery of cobwebs that hung from the ceiling to commemorate a long and illustrious dynasty of spiders hinted at months of neglect and disuse.

The chest of drawers—an incongruous article of furniture for what seemed to be a dining-room—as being the nearest and best lighted object received most of my attention. It was a fine old chest of nearly black mahogany, very battered and in the last stage of decay, but originally a piece of some pretensions. Regretful of its fallen estate, I looked it over with some interest and had just observed on its lower corner a little label bearing the printed inscription "Lot 201" when I heard footsteps descending the stairs. A moment later the door opened and a shadowy figure appeared standing close by the threshold.

"Good evening, doctor," said the stranger, in a deep, quiet voice and with a distinct, though not strong, German accent. "I must apologize for keeping you waiting."

I acknowledged the apology somewhat stiffly and asked: "You are Mr. Weiss, I presume?"

"Yes, I am Mr. Weiss. It is very good of you to come so far and so late at night and to make no objection to the absurd conditions that my poor friend has imposed."

"Not at all," I replied. "It is my business to go when and where I am wanted, and it is not my business to inquire into the private affairs of my patients."

"That is very true, sir," he agreed cordially, "and I am much obliged to you for taking that very proper view of the case. I pointed that out to my friend, but he is not a very reasonable man. He is very secretive and rather suspicious by nature."

"So I inferred. And as to his condition; is he seriously ill?"

"Ah," said Mr. Weiss, "that is what I want you to tell me. I am very much puzzled about him."

"But what is the nature of his illness? What does he complain of?"

"He makes very few complaints of any kind although he is obviously ill. But the fact is that he is hardly ever more than half awake. He lies in a kind of dreamy stupor from morning to night."

This struck me as excessively strange and by no means in agreement with the patient's energetic refusal to see a doctor.

"But," I asked, "does he never rouse completely?"

"Oh, yes," Mr. Weiss answered quickly; "he rouses from time to time and is then quite rational, and, as you may have gathered, rather obstinate. That is the peculiar and puzzling feature in the case; this alternation between a state of stupor and an almost normal and healthy condition. But perhaps you had better see him and judge for yourself. He had a rather severe attack just now. Follow me, please. The stairs are rather dark."

The stairs were very dark, and I noticed that they were without any covering of carpet, or even oil-cloth, so that our footsteps resounded dismally as if we were in an empty house. I stumbled up after my guide, feeling my way by the hand-rail, and on the first floor followed him into a room similar in size to the one below and very barely furnished, though less squalid than the other. A single candle at the farther end threw its feeble light on a figure in the bed, leaving the rest of the room in a dim twilight.

As Mr. Weiss tiptoed into the chamber, a woman—the one who had spoken to me below—rose from a chair by the bedside and quietly left the room by a second door. My conductor halted, and looking fixedly at the figure in the bed, called out:

"Philip! Philip! Here is the doctor come to see you."

He paused for a moment or two, and, receiving no answer, said: "He seems to be dozing as usual. Will you go and see what you can make of him?"

I stepped forward to the bedside, leaving Mr. Weiss at the end of the room near the door by which we had entered, where he remained, slowly and noiselessly pacing backwards and forwards in the semi-obscurity. By the light of the candle I saw an elderly man with good features and a refined, intelligent and even attractive face, but dreadfully emaciated, bloodless and sallow. He lay quite motionless except for the scarcely perceptible rise and fall of his chest; his eyes were nearly closed, his features relaxed, and, though he was not actually asleep, he seemed to be in a dreamy, somnolent, lethargic state, as if under the influence of some narcotic.

I watched him for a minute or so, timing his slow breathing by my watch, and then suddenly and sharply addressed him by name; but the only response was a slight lifting of the eyelids, which, after a brief, drowsy glance at me, slowly subsided to their former position.

I now proceeded to make a physical examination. First, I felt his pulse, grasping his wrist with intentional brusqueness in the hope of rousing him from his stupor. The beats were slow, feeble and slightly irregular, giving clear evidence, if any were needed, of his generally lowered vitality. I listened carefully to his heart, the sounds of which were very distinct through the thin walls of his emaciated chest, but found nothing abnormal beyond the feebleness and uncertainty of its action. Then I turned my attention to his eyes, which I examined closely with the aid of the candle and my ophthalmoscope lens, raising the lids somewhat roughly so as to expose the whole of the irises. He submitted without resistance to my rather ungentle handling of these sensitive structures, and showed no signs of discomfort even when I brought the candle-flame to within a couple of inches of his eyes.

But this extraordinary tolerance of light was easily explained by closer examination; for the pupils were contracted to such an extreme degree that only the very minutest point of black was visible at the centre of the grey iris. Nor was this the only abnormal peculiarity of the sick man's eyes. As he lay on his back, the right iris sagged down slightly towards its centre, showing a distinctly concave surface; and, when I contrived to produce a slight but quick movement of the eyeball, a perceptible undulatory movement could be detected. The patient had, in fact, what is known as a tremulous iris, a condition that is seen in cases where the crystalline lens has been extracted for the cure of cataract, or where it has become accidentally displaced, leaving the iris unsupported. In the present case, the complete condition of the iris made it clear that the ordinary extraction operation had not been performed, nor was I able, on the closest inspection with the aid of my lens, to find any trace of the less common "needle operation." The inference was that the patient had suffered from the accident known as "dislocation of the lens"; and this led to the further inference that he was almost or completely blind in the right eye.

This conclusion was, indeed, to some extent negatived by a deep indentation on the bridge of the nose, evidently produced by spectacles, and by marks which I looked for and found behind the ears, corresponding to the hooks or "curl sides" of the glasses. For those spectacles which are fitted with curl sides to hook over the ears are usually intended to be worn habitually, and this agreed with the indentation on the nose; which was deeper than would have been accounted for by the merely occasional use of spectacles for reading. But if only one eye was useful, a single eye-glass would have answered the purpose; not that there was any weight in this objection, for a single eye-glass worn constantly would be much less convenient than a pair of hook-sided spectacles.

As to the nature of the patient's illness, only one opinion seemed possible. It was a clear and typical case of opium or morphine poisoning. To this conclusion all his symptoms seemed to point with absolute certainty. The coated tongue, which he protruded slowly and tremulously in response to a command bawled in his ear; his yellow skin and ghastly expression; his contracted pupils and the stupor from which he could hardly be roused by the roughest handling and which yet did not amount to actual insensibility; all these formed a distinct and coherent group of symptoms, not only pointing plainly to the nature of the drug, but also suggesting a very formidable dose.

But this conclusion in its turn raised a very awkward and difficult question. If a large—a poisonous—dose of the drug had been taken, how, and by whom had that dose been administered? The closest scrutiny of the patient's arms and legs failed to reveal a single mark such as would be made by a hypodermic needle. This man was clearly no common morphinomaniac; and in the absence of the usual sprinkling of needlemarks, there was nothing to show or suggest whether the drug had been taken voluntarily by the patient himself or administered by someone else.

And then there remained the possibility that I might, after all, be mistaken in my diagnosis. I felt pretty confident. But the wise man always holds a doubt in reserve. And, in the present case, having regard to the obviously serious condition of the patient, such a doubt was eminently disturbing. Indeed, as I pocketed my stethoscope and took a last look at the motionless, silent figure, I realized that my position was one of extraordinary difficulty and perplexity. On the one hand my suspicions—aroused, naturally enough, by the very unusual circumstances that surrounded my visit—inclined me to extreme reticence; while, on the other, it was evidently my duty to give any information that might prove serviceable to the patient.

As I turned away from the bed Mr. Weiss stopped his slow pacing to and fro and faced me. The feeble light of the candle now fell on him, and I saw him distinctly for the first time. He did not impress me favourably. He was a thick-set, round-shouldered man, a typical fair German with tow-coloured hair, greased and brushed down smoothly, a large, ragged, sandy beard and coarse, sketchy features. His nose was large and thick with a bulbous end, and inclined to a reddish purple, a tint which extended to the adjacent parts of his face as if the colour had run. His eyebrows were large and beetling, overhanging deep-set eyes, and he wore a pair of spectacles which gave him a somewhat owlish expression. His exterior was unprepossessing, and I was in a state of mind that rendered me easily receptive of an unfavourable impression.

"Well," he said, "what do you make of him?" I hesitated, still perplexed by the conflicting necessities of caution and frankness, but at length replied:

"I think rather badly of him, Mr. Weiss. He is in a very low state."

"Yes, I can see that. But have you come to any decision as to the nature of his illness?"

There was a tone of anxiety and suppressed eagerness in the question which, while it was natural enough in the circumstances, by no means allayed my suspicions, but rather influenced me on the side of caution.

"I cannot give a very definite opinion at present," I replied guardedly. "The symptoms are rather obscure and might very well indicate several different conditions. They might be due to congestion of the brain, and, if no other explanation were possible, I should incline to that view. The alternative is some narcotic poison, such as opium or morphia."

"But that is quite impossible. There is no such drug in the house, and as he never leaves his room now, he could not get any from outside."

"What about the servants?" I asked.

"There are no servants excepting my housekeeper, and she is absolutely trustworthy."

"He might have some store of the drug that you are not aware of. Is he left alone much?"

"Very seldom indeed. I spend as much time with him as I can, and when I am not able to be in the room, Mrs Schallibaum, my housekeeper, sits with him."

"Is he often as drowsy as he is now?"

"Oh, very often; in fact, I should say that is his usual condition. He rouses up now and again, and then he is quite lucid and natural for, perhaps, an hour or so; but presently he becomes drowsy again and doses off, and remains asleep, or half asleep, for hours on end. Do you know of any disease that takes people in that way?"

"No," I answered. "The symptoms are not exactly like those of any disease that is known to me. But they are much very like those of opium poisoning."

"But, my dear sir," Mr. Weiss retorted impatiently, "since it is clearly impossible that it can be opium poisoning, it must be something else. Now, what else can it be? You were speaking of congestion of the brain."

"Yes. But the objection to that is the very complete recovery that seems to take place in the intervals."

"I would not say very complete," said Mr. Weiss. "The recovery is rather comparative. He is lucid and fairly natural in his manner, but he is still dull and lethargic. He does not, for instance, show any desire to go out, or even to leave his room."

I pondered uncomfortably on these rather contradictory statements. Clearly Mr. Weiss did not mean to entertain the theory of opium poisoning; which was natural enough if he had no knowledge of the drug having been used. But still—

"I suppose," said Mr. Weiss, "you have experience of sleeping sickness?"

The suggestion startled me. I had not. Very few people had. At that time practically nothing was known about the disease. It was a mere pathological curiosity, almost unheard of excepting by a few practitioners in remote parts of Africa, and hardly referred to in the text-books. Its connection with the trypanosome-bearing insects was as yet unsuspected, and, to me, its symptoms were absolutely unknown.

"No, I have not," I replied. "The disease is nothing more than a name to me. But why do you ask? Has Mr. Graves been abroad?"

"Yes. He has been travelling for the last three or four years, and I know that he spent some time recently in West Africa, where this disease occurs. In fact, it was from him that I first heard about it."

This was a new fact. It shook my confidence in my diagnosis very considerably, and inclined me to reconsider my suspicions. If Mr. Weiss was lying to me, he now had me at a decided disadvantage.

"What do you think?" he asked. "Is it possible that this can be sleeping sickness?"

"I should not like to say that it is impossible," I replied. "The disease is practically unknown to me. I have never practised out of England and have had no occasion to study it. Until I have looked the subject up, I should not be in a position to give an opinion. Of course, if I could see Mr. Graves in one of what we may call his 'lucid intervals' I should be able to form a better idea. Do you think that could be managed?"

"It might. I see the importance of it and will certainly do my best; but he is a difficult man; a very difficult man. I sincerely hope it is not sleeping sickness."

"Why?"

"Because—as I understood from him—that disease is invariably fatal, sooner or later. There seem to be no cure. Do you think you will be able to decide when you see him again?"

"I hope so," I replied. "I shall look up the authorities and see exactly what the symptoms are—that is, so far as they are known; but my impression is that there is very little information available."

"And in the meantime?"

"We will give him some medicine and attend to his general condition, and you had better let me see him again as soon as possible." I was about to say that the effect of the medicine itself might throw some light on the patient's condition, but, as I proposed to treat him for morphine poisoning, I thought it wiser to keep this item of information to myself. Accordingly, I confined myself to a few general directions as to the care of the patient, to which Mr. Weiss listened attentively. "And," I concluded, "we must not lose sight of the opium question. You had better search the room carefully and keep a close watch on the patient, especially during his intervals of wakefulness."

"Very well, doctor," Mr. Weiss replied, "I will do all that you tell me and I will send for you again as soon as possible, if you do not object to poor Graves's ridiculous conditions. And now, if you will allow me to pay your fee, I will go and order the carriage while you are writing the prescription."

"There is no need for a prescription," I said. "I will make up some medicine and give it to the coachman."

Mr. Weiss seemed inclined to demur to this arrangement, but I had my own reasons for insisting on it. Modern prescriptions are not difficult to read, and I did not wish Mr. Weiss to know what treatment the patient was having.

As soon as I was left alone, I returned to the bedside and once more looked down at the impassive figure. And as I looked, my suspicions revived. It was very like morphine poisoning; and, if it was morphine, it was no common, medicinal dose that had been given. I opened my bag and took out my hypodermic case from which I extracted a little tube of atropine tabloids. Shaking out into my hand a couple of the tiny discs, I drew down the patient's under-lip and slipped the little tablets under his tongue. Then I quickly replaced the tube and dropped the case into my bag; and I had hardly done so when the door opened softly and the housekeeper entered the room.

"How do you find Mr. Graves?" she asked in what I thought a very unnecessarily low tone, considering the patient's lethargic state.

"He seems to be very ill," I answered.

"So!" she rejoined, and added: "I am sorry to hear that. We have been anxious about him."

She seated herself on the chair by the bedside, and, shading the candle from the patient's face—and her own, too—produced from a bag that hung from her waist a half-finished stocking and began to knit silently and with the skill characteristic of the German housewife. I looked at her attentively (though she was so much in the shadow that I could see her but indistinctly) and somehow her appearance prepossessed me as little as did that of the other members of the household. Yet she was not an ill-looking woman. She had an excellent figure, and the air of a person of good social position; her features were good enough and her colouring, although a little unusual, was not unpleasant. Like Mr. Weiss, she had very fair hair, greased, parted in the middle and brushed down as smoothly as the painted hair of a Dutch doll. She appeared to have no eyebrows at all—owing, no doubt, to the light colour of the hair—and the doll-like character was emphasized by her eyes, which were either brown or dark grey, I could not see which. A further peculiarity consisted in a "habit spasm," such as one often sees in nervous children; a periodical quick jerk of the head, as if a cap-string or dangling lock were being shaken off the cheek. Her age I judged to be about thirty-five.

The carriage, which one might have expected to be waiting, seemed to take some time in getting ready. I sat, with growing impatience, listening to the sick man's soft breathing and the click of the housekeeper's knitting-needles. I wanted to get home, not only for my own sake; the patient's condition made it highly desirable that the remedies should be given as quickly as possible. But the minutes dragged on, and I was on the point of expostulating when a bell rang on the landing.

"The carriage is ready," said Mrs. Schallibaum. "Let me light you down the stairs."

She rose, and, taking the candle, preceded me to the head of the stairs, where she stood holding the light over the baluster-rail as I descended and crossed the passage to the open side door. The carriage was drawn up in the covered way as I could see by the faint glimmer of the distant candle; which also enabled me dimly to discern the coachman standing close by in the shadow. I looked round, rather expecting to see Mr. Weiss, but, as he made no appearance, I entered the carriage. The door was immediately banged to and locked, and I then heard the heavy bolts of the gates withdrawn and the loud creaking of hinges. The carriage moved out slowly and stopped; the gates slammed to behind me; I felt the lurch as the coachman climbed to his seat and we started forward.

My reflections during the return journey were the reverse of agreeable. I could not rid myself of the conviction that I was being involved in some very suspicious proceedings. It was possible, of course, that this feeling was due to the strange secrecy that surrounded my connection with this case; that, had I made my visit under ordinary conditions, I might have found in the patient's symptoms nothing to excite suspicion or alarm. It might be so, but that consideration did not comfort me.

Then, my diagnosis might be wrong. It might be that this was, in reality, a case of some brain affection accompanied by compression, such as slow haemorrhage, abscess, tumour or simple congestion. These cases were very difficult at times. But the appearances in this one did not consistently agree with the symptoms accompanying any of these conditions. As to sleeping sickness, it was, perhaps a more hopeful suggestion, but I could not decide for or against it until I had more knowledge; and against this view was the weighty fact that the symptoms did exactly agree with the theory of morphine poisoning.

But even so, there was no conclusive evidence of any criminal act. The patient might be a confirmed opium-eater, and the symptoms heightened by deliberate deception. The cunning of these unfortunates is proverbial and is only equalled by their secretiveness and mendacity. It would be quite possible for this man to feign profound stupor so long as he was watched, and then, when left alone for a few minutes, to nip out of bed and help himself from some secret store of the drug. This would be quite in character with his objection to seeing a doctor and his desire for secrecy. But still, I did not believe it to be the true explanation. In spite of all the various alternative possibilities, my suspicions came back to Mr. Weiss and the strange, taciturn woman, and refused to budge.

For all the circumstances of the case were suspicious. The elaborate preparations implied by the state of the carriage in which I was travelling; the make-shift appearance of the house; the absence of ordinary domestic servants, although a coachman was kept; the evident desire of Mr. Weiss and the woman to avoid thorough inspection of their persons; and, above all, the fact that the former had told me a deliberate lie. For he had lied, beyond all doubt. His statement as to the almost continuous stupor was absolutely irreconcilable with his other statement as to the patient's wilfulness and obstinacy and even more irreconcilable with the deep and comparatively fresh marks of the spectacles on the patient's nose. That man had certainly worn spectacles within twenty-four hours, which he would hardly have done if he had been in a state bordering on coma.

My reflections were interrupted by the stopping of the carriage. The door was unlocked and thrown open, and I emerged from my dark and stuffy prison opposite my own house.

"I will let you have the medicine in a minute or two," I said to the coachman; and, as I let myself in with my latch-key, my mind came back swiftly from the general circumstances of the case to the very critical condition of the patient. Already I was regretting that I had not taken more energetic measures to rouse him and restore his flagging vitality; for it would be a terrible thing if he should take a turn for the worse and die before the coachman returned with the remedies. Spurred on by this alarming thought, I made up the medicines quickly and carried the hastily wrapped bottles out to the man, whom I found standing by the horse's head.

"Get back as quickly as you can," I said, "and tell Mr. Weiss to lose no time in giving the patient the draught in the small bottle. The directions are on the labels."

The coachman took the packages from me without reply, climbed to his seat, touched the horse with his whip and drove off at a rapid pace towards Newington Butts.

The little clock in the consulting-room showed that it was close on eleven; time for a tired G.P. to be thinking of bed. But I was not sleepy. Over my frugal supper I found myself taking up anew the thread of my meditations, and afterwards, as I smoked my last pipe by the expiring surgery fire, the strange and sinister features of the case continued to obtrude themselves on my notice. I looked up Stillbury's little reference library for information on the subject of sleeping sickness, but learned no more than that it was "a rare and obscure disease of which very little was known at present." I read up morphine poisoning and was only further confirmed in the belief that my diagnosis was correct; which would have been more satisfactory if the circumstances had been different.

For the interest of the case was not merely academic. I was in a position of great difficulty and responsibility and had to decide on a course of action. What ought I to do? Should I maintain the professional secrecy to which I was tacitly committed, or ought I to convey a hint to the police?

Suddenly, and with a singular feeling of relief, I bethought myself of my old friend and fellow-student, John Thorndyke, now an eminent authority on Medical Jurisprudence. I had been associated with him temporarily in one case as his assistant, and had then been deeply impressed by his versatile learning, his acuteness and his marvellous resourcefulness. Thorndyke was a barrister in extensive practice, and so would be able to tell me at once what was my duty from a legal point of view; and, as he was also a doctor of medicine, he would understand the exigencies of medical practice. If I could find time to call at the Temple and lay the case before him, all my doubts and difficulties would be resolved.

Anxiously, I opened my visiting-list to see what kind of day's work was in store for me on the morrow. It was not a heavy day, even allowing for one or two extra calls in the morning, but yet I was doubtful whether it would allow of my going so far from my district, until my eye caught, near the foot of the page, the name of Burton. Now Mr. Burton lived in one of the old houses on the east side of Bouverie Street, less than five minutes' walk from Thorndyke's chambers in King's Bench Walk; and he was, moreover, a "chronic" who could safely be left for the last. When I had done with Mr. Burton I could look in on my friend with a very good chance of catching him on his return from the hospital. I could allow myself time for quite a long chat with him, and, by taking a hansom, still get back in good time for the evening's work.

This was a great comfort. At the prospect of sharing my responsibilities with a friend on whose judgment I could so entirely rely, my embarrassments seemed to drop from me in a moment. Having entered the engagement in my visiting-list, I rose, in greatly improved spirits, and knocked out my pipe just as the little clock banged out impatiently the hour of midnight.

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