Читать книгу The Corner of Harley Street - Sir H. H. Bashford - Страница 6

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91b Harley Street, W.,

March 11, 1910.

My dear Horace,

Casting a remorseful eye at the date upon your letter, I perceive that it is already almost a week since I resolved to sit down, and answer it immediately; and the postscript that follows "your aff. son H." gazes at me with a rebuking stare, as if to remind me how very far I have been from bucking up, as you so tactfully suggested, and flooring the problem with which you have presented me. And yet you mustn't suppose that I have been altogether too careless or too busy to deal with it as you wished. On the other hand, I have been dodging it round the ring of everyday happenings ever since I first beheld it eyeing me beneath the Trinity crest. For the fact of the matter is, my dear Horace, that your revered Daddy has all along been more than doubtful about his ability to stretch the fellow on the carpet. And now, at the end of a week's somewhat cowardly—footwork, shall we call it?—he has decided to crawl under the ropes, and make room for a lustier substitute.

Shall you become a doctor? Well, I'm afraid, after all, that you must tackle the question for yourself. As an American patient, with a doubtful liver, observed to me this morning, the problem is right up against you; and nobody else can defeat it in your stead. The thought of this has cheered me so amazingly that from now onwards you may safely imagine, I think, an almost contented physician, sitting plumply in a front stall, smiling at the fight over contemplative finger-tips, and merely tendering, between the rounds, some well-worn pieces of ring-side advice.

And so the peaks are challenging you, eh? The wig, the gaiters, the gold pince-nez, and the bedside manner, they have risen up to bid you choose your future path. For twenty-two years, you tell me, you haven't greatly disturbed yourself about these things. You have accepted parental orders: you have taken, in consequence, a respectable, if not distinguished, degree in classics; you have mastered enough science to rob your "first medical" of most of its fears; and you have obtained, by the way, a Rugger "blue," of which you are, no doubt, a great deal more proud. And now that all this has been accomplished you turn to your former guide, and say to him, "Whither away?" And like Gilbert's poor wit, I feel inclined to retort very truthfully that I do indeed wither away. Behold, I have vanished. The mountain range is before you. Choose your summit.

As if to point a moral, I have been here interrupted by a pitiful voice over the telephone. Indeed for a week past, I have been its victim at varying intervals. For Mrs. Cholmondeley, let us call her, cannot make up her mind between the rival hygienic attractions of Cannes and Torquay. As a matter of fact Camberwell or Camden Town would be equally, probably more, effectual. Organically she is perfectly sound. For the rest she is merely over-fed and under-occupied. She has deleted very nearly every healthful activity from her list of physical employments. And now those of her will are to be similarly abandoned; delegated to paid assistants like myself.

Cannes or Torquay? Well, I have refused the responsibility of deciding. In league with her long-suffering family physician, I am endeavouring to force her faculties to make this little effort by themselves. For I doubt if the sorrowful gates of illness behold anything more entirely pitiable than the spectacle of a will on crutches.

Well then, having, as you see, completely foisted the ultimate issue upon your own shoulders, it seems to me that there are three main standpoints from which you must regard our profession before finally deciding to embark upon it. To take the least important of these first, you must bear in mind, I think, that while you should undoubtedly be able to pay your way, and to make an honest living, yet the financial rewards that medicine has to offer are scarcely worth considering. Given an equal amount of capital, both in brain-power and pounds sterling, your hours of work, your expenditure of energy, your capacity for diagnosis and research, your readiness at the reading of human nature, would bring you a far greater return of this world's goods in almost any other occupation that you care to name—incomparably so in commerce. At the same time I don't think that this point of view will detain you very long; because, however little fathers may really know of their own sons (and the sum of parental ignorance under this heading must be something rather stupendous), I am quite sure that the financial laurel, per se, has no overwhelming attraction for you.

Having deigned then to consider the problem from this lowest and most sordid standpoint, you should shift your ground, I think, and reflect upon it from the midmost of my three Pisgahs, the scientific one. If I haven't led you to this first, it is because you have probably scrambled up it already, and paid no attention at all to the one that I have just recommended to you. And in a sense your instinct will perhaps have taken you by a straighter route to the heart of this matter than that which your more prudent parent has indicated. Because ultimately it is from this point that you will have to make your final decision. You must ask yourself, with all the earnestness of a novice at his altar-vigil, "Am I prepared to know?"

For the long day of the charlatan and the quack is drawing at last to its close, and their sun is even now setting in a blaze of patent-medicine advertisements. Modern Europe has almost ceased to be possible for the would-be Paracelsus; even America will not contain him, I think, for very much longer. And through a dissolving mist of white spats and atrocious Latin the eyes of humanity are turning slowly, but very surely, towards the man who knows. Are you prepared to become such a man?

I fancy that I can see your forehead wrinkling a little here; so let me explain myself in a parable. There is an old story, familiar in the hospitals, of a bygone practitioner whose simple habit it was to tie a piece of string about the waist of his patient. He would then ask the sufferer to locate the pain. If this were above the string he administered an emetic, if below a purgative; while if the pain and the string coincided, the unhappy victim would receive both. Now it is melancholy to reflect that this gentleman has never been without disciples. And yet how difficult at times may it become to avoid such a fate. Are you prepared to avoid it?

Let me put the question in yet another shape. Some day a patient will come to you—you may be quite certain that he will—at the end of a long round or an exhausting afternoon at hospital; will complain to you of his lamentable depression of spirits, his entire loss of appetite, his slight but continual headache; and will show you, in confirmation of these symptoms, nothing graver, let us say, than a dull eye and a yellowish tongue. You will be tired; you will see at a glance that his subjective troubles are altogether disproportionate to the objective gravity of his complaint, and perhaps justifiably you will send him away happy, or at any rate contented, in the belief that he is a bit "liverish." But are you going to allow "liverish" to satisfy yourself? "Of course not," you reply; and yet, believe me, my son, it will be a very real temptation. Why bother, at a long day's end, to worry your tired faculties into presenting to your mind as exact a mental picture of the man's actual condition as they can draw? Nevertheless, unless you do this, you will be treating him with less respect than your old bicycle in the coach-house; as though, if it should creak or wheeze or begin to run less smoothly, you would merely tell yourself that it was "wheelish," and drop oil at random into its most convenient aperture. Do you begin to see what I am driving at?

And then you will probably turn upon me and say, "But to cultivate this habit of forming proper mental pictures, I shall have to be at least a chemist, a physicist, a pathologist, a bacteriologist, to say nothing of a philosopher; and how can a single human being, however industrious, contain as many persons as these?" And of course he cannot. Upon no more than one branch of the tree of Healing will it be given to you to climb out a little farther than your fellows; but, at any rate, you can keep your eye upon the others. It is in this way alone that you can become a scientific physician in the best and broadest sense. And you can take my word for it that it will never be worth your while to become any other sort of a sawbones—an exacting prospect? I agree with you. And many an hour will come to you with the easy question, "Why lavish all this time and trouble in gathering up some very trifling grain of extra knowledge—knowledge that, in all probability, will never become of the least importance in your hands?"

And then, perhaps, a moment will flash into your life when this very grain shall shape a million destinies. Are you prepared to live for that moment?

I am almost tempted to finish my letter at this question mark; and the more so because the great public, or such of it as has been led away by a certain school of literary sentimentalists, has plastered my final mound of observation—shall we call it the human one?—with such a viscid layer of adulation that it has become a little hard for a self-respecting physician to take his stand there even for two and a half moments. Has ever, I wonder, a doctor figured in fiction or drama who, being neither a clown nor a fool, was not described as noble? Have we not tracked him on his rounds through unconscionable horrors, and wept big tears at his preposterous death-bed? No wonder such a fellow finds it hard to get his bills paid. To offer him mere money would seem little less than sacrilege.

And yet, I think, you will agree with me that here is an aspect of medicine worth consideration. To the seeing eye and the tender hand there is no easier door into the warm heart of humanity. There is no other profession that will lead you quite so close to reality. And by this I don't mean realism in the modern sense, wherein, as it seems to me, the altogether ugly looms so disproportionately large. For after thirty years of tolerably wide opportunity I have still failed to find the altogether ugly. And though of course you will meet ugliness in plenty—a cancer that will find you shocked and, alas, largely impotent—yet, if you look long enough, and carefully enough, how often will you discover it to be but the shadow of some clearly shining spiritual beauty. No, you need not fear, I think, to tread behind the veil.

And now let me round off my epistle with a brief reminiscence. In my early twenties, just after I had qualified, I travelled down to a small fishing-village in Cornwall to act there as locum tenens for a practitioner who had finally broken down in health. The practice, mostly among a poor population, was a scattered one, and I was kept fairly busy; so busy, in fact, that beyond a hazy impression of buffeting across estuaries in big-bottomed ferryboats, and driving, upon a wild night or two, along as rough a coast-line as one could desire to see, I remember very little of that month's experiences.

One remains with me. And you must imagine a rather tumble-down, twopenny-halfpenny cottage, half-way down a cobbled street, with its front door opening directly into a tiny living-room. A youthful-looking Hippocrates is backing out of it rather more awkwardly than usual. And in front of him, still holding one of his hands, is a willowy, comely Cornish lass, mother of three, with the most disturbingly moist-looking eyes. In the background there would be, I think, a very old and rugged woman, crooning over her youngest grandchild, just recovered, happily, and rather miraculously, from a very tough attack of pneumonia. The young man had been telling them, this simple family, that he was going away now, back to London and the big hospital. And hence—dare I write it?—hence these tears.

"Ah, doctor," says the lassie, "'tis wisht you've made us. An' whatever'll us do now if the little uns take bad?"

"Oh, rot," says the blushing physician, jolted for the moment out of a rather elaborate bedside manner—"nonsense, I mean. You'll get along all right. There's another man coming. And I didn't do anything, you know, really."

"Didn't do nothen? D'you hear that, mother?" And the old woman looks up, with her wrinkled cheeks and cavernous, sea-blue eyes. "D'you think us don't know very well as you've saved the poor lamb's life?"

And so, as Pepys would say, into the wet, bright street, and up the hill to the surgery. She was under a misapprehension, of course. Presently, if you take up medicine, you will learn that a doctor's part in the treatment of pneumonia consists chiefly of a masterly inactivity. But a boy of twenty-four can't hear words like that spoken to him, and remain quite the same person; even if next week he is busy bashing hats in at a Hospital Cup-tie. By the way, I got mine rather badly damaged last Wednesday when Guy's won the cup again. And, I think, now you have read this letter, that I can almost hear you murmuring, "No wonder."

Your affect. father,

P. H.