скачать книгу бесплатно
Round The Red Lamp
Arthur Conan Doyle
"Round the Red Lamp" features realistic stories and episodes of medical life, sketches of old-fashioned doctors, medical students and their pranks.
Round the Red Lamp
by Sir Arthur Conan Doyle
I. Behind the times
My first interview with Dr. James Winter was under dramatic circumstances. It occurred at two in the morning in the bedroom of an old country house. I kicked him twice on the white waistcoat and knocked off his gold spectacles, while he with the aid of a female accomplice stifled my angry cries in a flannel petticoat and thrust me into a warm bath. I am told that one of my parents, who happened to be present, remarked in a whisper that there was nothing the matter with my lungs. I cannot recall how Dr. Winter looked at the time, for I had other things to think of, but his description of my own appearance is far from flattering. A fluffy head, a body like a trussed goose, very bandy legs, and feet with the soles turned inwards – those are the main items which he can remember.
From this time onwards the epochs of my life were the periodical assaults which Dr. Winter made upon me. He vaccinated me; he cut me for an abscess; he blistered me for mumps. It was a world of peace and he the one dark cloud that threatened. But at last there came a time of real illness – a time when I lay for months together inside my wickerwork-basket bed, and then it was that I learned that that hard face could relax, that those country-made creaking boots could steal very gently to a bedside, and that that rough voice could thin into a whisper when it spoke to a sick child.
And now the child is himself a medical man, and yet Dr. Winter is the same as ever. I can see no change since first I can remember him, save that perhaps the brindled hair is a trifle whiter, and the huge shoulders a little more bowed. He is a very tall man, though he loses a couple of inches from his stoop. That big back of his has curved itself over sick beds until it has set in that shape. His face is of a walnut brown, and tells of long winter drives over bleak country roads, with the wind and the rain in his teeth. It looks smooth at a little distance, but as you approach him you see that it is shot with innumerable fine wrinkles like a last year's apple. They are hardly to be seen when he is in repose; but when he laughs his face breaks like a starred glass, and you realise then that though he looks old, he must be older than he looks.
How old that is I could never discover. I have often tried to find out, and have struck his stream as high up as George IV and even the Regency, but without ever getting quite to the source. His mind must have been open to impressions very early, but it must also have closed early, for the politics of the day have little interest for him, while he is fiercely excited about questions which are entirely prehistoric. He shakes his head when he speaks of the first Reform Bill and expresses grave doubts as to its wisdom, and I have heard him, when he was warmed by a glass of wine, say bitter things about Robert Peel and his abandoning of the Corn Laws. The death of that statesman brought the history of England to a definite close, and Dr. Winter refers to everything which had happened since then as to an insignificant anticlimax.
But it was only when I had myself become a medical man that I was able to appreciate how entirely he is a survival of a past generation. He had learned his medicine under that obsolete and forgotten system by which a youth was apprenticed to a surgeon, in the days when the study of anatomy was often approached through a violated grave. His views upon his own profession are even more reactionary than in politics. Fifty years have brought him little and deprived him of less. Vaccination was well within the teaching of his youth, though I think he has a secret preference for inoculation. Bleeding he would practise freely but for public opinion. Chloroform he regards as a dangerous innovation, and he always clicks with his tongue when it is mentioned. He has even been known to say vain things about Laennec, and to refer to the stethoscope as "a new-fangled French toy." He carries one in his hat out of deference to the expectations of his patients, but he is very hard of hearing, so that it makes little difference whether he uses it or not.
He reads, as a duty, his weekly medical paper, so that he has a general idea as to the advance of modern science. He always persists in looking upon it as a huge and rather ludicrous experiment. The germ theory of disease set him chuckling for a long time, and his favourite joke in the sick room was to say, "Shut the door or the germs will be getting in." As to the Darwinian theory, it struck him as being the crowning joke of the century. "The children in the nursery and the ancestors in the stable," he would cry, and laugh the tears out of his eyes.
He is so very much behind the day that occasionally, as things move round in their usual circle, he finds himself, to his bewilderment, in the front of the fashion. Dietetic treatment, for example, had been much in vogue in his youth, and he has more practical knowledge of it than any one whom I have met. Massage, too, was familiar to him when it was new to our generation. He had been trained also at a time when instruments were in a rudimentary state, and when men learned to trust more to their own fingers. He has a model surgical hand, muscular in the palm, tapering in the fingers, "with an eye at the end of each." I shall not easily forget how Dr. Patterson and I cut Sir John Sirwell, the County Member, and were unable to find the stone. It was a horrible moment. Both our careers were at stake. And then it was that Dr. Winter, whom we had asked out of courtesy to be present, introduced into the wound a finger which seemed to our excited senses to be about nine inches long, and hooked out the stone at the end of it. "It's always well to bring one in your waistcoat-pocket," said he with a chuckle, "but I suppose you youngsters are above all that."
We made him president of our branch of the British Medical Association, but he resigned after the first meeting. "The young men are too much for me," he said. "I don't understand what they are talking about." Yet his patients do very well. He has the healing touch – that magnetic thing which defies explanation or analysis, but which is a very evident fact none the less. His mere presence leaves the patient with more hopefulness and vitality. The sight of disease affects him as dust does a careful housewife. It makes him angry and impatient. "Tut, tut, this will never do!" he cries, as he takes over a new case. He would shoo Death out of the room as though he were an intrusive hen. But when the intruder refuses to be dislodged, when the blood moves more slowly and the eyes grow dimmer, then it is that Dr. Winter is of more avail than all the drugs in his surgery. Dying folk cling to his hand as if the presence of his bulk and vigour gives them more courage to face the change; and that kindly, windbeaten face has been the last earthly impression which many a sufferer has carried into the unknown.
When Dr. Patterson and I – both of us young, energetic, and up-to-date – settled in the district, we were most cordially received by the old doctor, who would have been only too happy to be relieved of some of his patients. The patients themselves, however, followed their own inclinations – which is a reprehensible way that patients have – so that we remained neglected, with our modern instruments and our latest alkaloids, while he was serving out senna and calomel to all the countryside. We both of us loved the old fellow, but at the same time, in the privacy of our own intimate conversations, we could not help commenting upon this deplorable lack of judgment. "It's all very well for the poorer people," said Patterson. "But after all the educated classes have a right to expect that their medical man will know the difference between a mitral murmur and a bronchitic rale. It's the judicial frame of mind, not the sympathetic, which is the essential one."
I thoroughly agreed with Patterson in what he said. It happened, however, that very shortly afterwards the epidemic of influenza broke out, and we were all worked to death. One morning I met Patterson on my round, and found him looking rather pale and fagged out. He made the same remark about me. I was, in fact, feeling far from well, and I lay upon the sofa all the afternoon with a splitting headache and pains in every joint. As evening closed in, I could no longer disguise the fact that the scourge was upon me, and I felt that I should have medical advice without delay. It was of Patterson, naturally, that I thought, but somehow the idea of him had suddenly become repugnant to me. I thought of his cold, critical attitude, of his endless questions, of his tests and his tappings. I wanted something more soothing – something more genial.
"Mrs. Hudson," said I to my housekeeper, would you kindly run along to old Dr. Winter and tell him that I should be obliged to him if he would step round?"
She was back with an answer presently. "Dr. Winter will come round in an hour or so, sir; but he has just been called in to attend Dr. Patterson."
II. His first operation
It was the first day of the winter session, and the third year's man was walking with the first year's man. Twelve o'clock was just booming out from the Tron Church.
"Let me see," said the third year's man. "You have never seen an operation?"
"Never."
"Then this way, please. This is Rutherford's historic bar. A glass of sherry, please, for this gentleman. You are rather sensitive, are you not?"
"My nerves are not very strong, I am afraid."
"Hum! Another glass of sherry for this gentleman. We are going to an operation now, you know."
The novice squared his shoulders and made a gallant attempt to look unconcerned.
"Nothing very bad – eh?"
"Well, yes – pretty bad."
"An – an amputation?"
"No; it's a bigger affair than that."
"I think – I think they must be expecting me at home."
"There's no sense in funking. If you don't go to-day, you must to-morrow. Better get it over at once. Feel pretty fit?"
"Oh, yes; all right!" The smile was not a success.
"One more glass of sherry, then. Now come on or we shall be late. I want you to be well in front."
"Surely that is not necessary."
"Oh, it is far better! What a drove of students! There are plenty of new men among them. You can tell them easily enough, can't you? If they were going down to be operated upon themselves, they could not look whiter."
"I don't think I should look as white."
"Well, I was just the same myself. But the feeling soon wears off. You see a fellow with a face like plaster, and before the week is out he is eating his lunch in the dissecting rooms. I'll tell you all about the case when we get to the theatre."
The students were pouring down the sloping street which led to the infirmary – each with his little sheaf of note-books in his hand. There were pale, frightened lads, fresh from the high schools, and callous old chronics, whose generation had passed on and left them. They swept in an unbroken, tumultuous stream from the university gate to the hospital. The figures and gait of the men were young, but there was little youth in most of their faces. Some looked as if they ate too little – a few as if they drank too much. Tall and short, tweed– coated and black, round-shouldered, bespectacled, and slim, they crowded with clatter of feet and rattle of sticks through the hospital gate. Now and again they thickened into two lines, as the carriage of a surgeon of the staff rolled over the cobblestones between.
"There's going to be a crowd at Archer's," whispered the senior man with suppressed excitement. "It is grand to see him at work. I've seen him jab all round the aorta until it made me jumpy to watch him. This way, and mind the whitewash."
They passed under an archway and down a long, stone-flagged corridor, with drab-coloured doors on either side, each marked with a number. Some of them were ajar, and the novice glanced into them with tingling nerves. He was reassured to catch a glimpse of cheery fires, lines of white-counterpaned beds, and a profusion of coloured texts upon the wall. The corridor opened upon a small hall, with a fringe of poorly clad people seated all round upon benches. A young man, with a pair of scissors stuck like a flower in his buttonhole and a note-book in his hand, was passing from one to the other, whispering and writing.
"Anything good?" asked the third year's man.
"You should have been here yesterday," said the out-patient clerk, glancing up. "We had a regular field day. A popliteal aneurism, a Colles' fracture, a spina bifida, a tropical abscess, and an elephantiasis. How's that for a single haul?"
"I'm sorry I missed it. But they'll come again, I suppose. What's up with the old gentleman?"
A broken workman was sitting in the shadow, rocking himself slowly to and fro, and groaning. A woman beside him was trying to console him, patting his shoulder with a hand which was spotted over with curious little white blisters.
"It's a fine carbuncle," said the clerk, with the air of a connoisseur who describes his orchids to one who can appreciate them. "It's on his back and the passage is draughty, so we must not look at it, must we, daddy? Pemphigus," he added carelessly, pointing to the woman's disfigured hands. "Would you care to stop and take out a metacarpal?"
"No, thank you. We are due at Archer's. Come on!" and they rejoined the throng which was hurrying to the theatre of the famous surgeon.
The tiers of horseshoe benches rising from the floor to the ceiling were already packed, and the novice as he entered saw vague curving lines of faces in front of him, and heard the deep buzz of a hundred voices, and sounds of laughter from somewhere up above him. His companion spied an opening on the second bench, and they both squeezed into it.
"This is grand!" the senior man whispered. "You'll have a rare view of it all."
Only a single row of heads intervened between them and the operating table. It was of unpainted deal, plain, strong, and scrupulously clean. A sheet of brown water-proofing covered half of it, and beneath stood a large tin tray full of sawdust. On the further side, in front of the window, there was a board which was strewed with glittering instruments – forceps, tenacula, saws, canulas, and trocars. A line of knives, with long, thin, delicate blades, lay at one side. Two young men lounged in front of this, one threading needles, the other doing something to a brass coffee-pot-like thing which hissed out puffs of steam.
"That's Peterson," whispered the senior, "the big, bald man in the front row. He's the skin– grafting man, you know. And that's Anthony Browne, who took a larynx out successfully last winter. And there's Murphy, the pathologist, and Stoddart, the eye-man. You'll come to know them all soon."
"Who are the two men at the table?"
"Nobody – dressers. One has charge of the instruments and the other of the puffing Billy. It's Lister's antiseptic spray, you know, and Archer's one of the carbolic-acid men. Hayes is the leader of the cleanliness-and-cold-water school, and they all hate each other like poison."
A flutter of interest passed through the closely packed benches as a woman in petticoat and bodice was led in by two nurses. A red woolen shawl was draped over her head and round her neck. The face which looked out from it was that of a woman in the prime of her years, but drawn with suffering, and of a peculiar beeswax tint. Her head drooped as she walked, and one of the nurses, with her arm round her waist, was whispering consolation in her ear. She gave a quick side-glance at the instrument table as she passed, but the nurses turned her away from it.
"What ails her?" asked the novice.
"Cancer of the parotid. It's the devil of a case; extends right away back behind the carotids. There's hardly a man but Archer would dare to follow it. Ah, here he is himself!"
As he spoke, a small, brisk, iron-grey man came striding into the room, rubbing his hands together as he walked. He had a clean-shaven face, of the naval officer type, with large, bright eyes, and a firm, straight mouth. Behind him came his big house– surgeon, with his gleaming pince-nez, and a trail of dressers, who grouped themselves into the corners of the room.
"Gentlemen," cried the surgeon in a voice as hard and brisk as his manner, "we have here an interesting case of tumour of the parotid, originally cartilaginous but now assuming malignant characteristics, and therefore requiring excision. On to the table, nurse! Thank you! Chloroform, clerk! Thank you! You can take the shawl off, nurse."
The woman lay back upon the water-proofed pillow, and her murderous tumour lay revealed. In itself it was a pretty thing – ivory white, with a mesh of blue veins, and curving gently from jaw to chest. But the lean, yellow face and the stringy throat were in horrible contrast with the plumpness and sleekness of this monstrous growth. The surgeon placed a hand on each side of it and pressed it slowly backwards and forwards.
"Adherent at one place, gentlemen," he cried. "The growth involves the carotids and jugulars, and passes behind the ramus of the jaw, whither we must be prepared to follow it. It is impossible to say how deep our dissection may carry us. Carbolic tray. Thank you! Dressings of carbolic gauze, if you please! Push the chloroform, Mr. Johnson. Have the small saw ready in case it is necessary to remove the jaw."
The patient was moaning gently under the towel which had been placed over her face. She tried to raise her arms and to draw up her knees, but two dressers restrained her. The heavy air was full of the penetrating smells of carbolic acid and of chloroform. A muffled cry came from under the towel, and then a snatch of a song, sung in a high, quavering, monotonous voice:
"He says, says he,
If you fly with me
You'll be mistress of the ice-cream van.
You'll be mistress of the – "
It mumbled off into a drone and stopped. The surgeon came across, still rubbing his hands, and spoke to an elderly man in front of the novice.
"Narrow squeak for the Government," he said.
"Oh, ten is enough."
"They won't have ten long. They'd do better to resign before they are driven to it."
"Oh, I should fight it out."
"What's the use. They can't get past the committee even if they got a vote in the House. I was talking to – "
"Patient's ready, sir," said the dresser.
"Talking to McDonald – but I'll tell you about it presently." He walked back to the patient, who was breathing in long, heavy gasps. "I propose," said he, passing his hand over the tumour in an almost caressing fashion, "to make a free incision over the posterior border, and to take another forward at right angles to the lower end of it. Might I trouble you for a medium knife, Mr. Johnson?"
The novice, with eyes which were dilating with horror, saw the surgeon pick up the long, gleaming knife, dip it into a tin basin, and balance it in his fingers as an artist might his brush. Then he saw him pinch up the skin above the tumour with his left hand. At the sight his nerves, which had already been tried once or twice that day, gave way utterly. His head swain round, and he felt that in another instant he might faint. He dared not look at the patient. He dug his thumbs into his ears lest some scream should come to haunt him, and he fixed his eyes rigidly upon the wooden ledge in front of him. One glance, one cry, would, he knew, break down the shred of self-possession which he still retained. He tried to think of cricket, of green fields and rippling water, of his sisters at home – of anything rather than of what was going on so near him.
And yet somehow, even with his ears stopped up, sounds seemed to penetrate to him and to carry their own tale. He heard, or thought that he heard, the long hissing of the carbolic engine. Then he was conscious of some movement among the dressers. Were there groans, too, breaking in upon him, and some other sound, some fluid sound, which was more dreadfully suggestive still? His mind would keep building up every step of the operation, and fancy made it more ghastly than fact could have been. His nerves tingled and quivered. Minute by minute the giddiness grew more marked, the numb, sickly feeling at his heart more distressing. And then suddenly, with a groan, his head pitching forward, and his brow cracking sharply upon the narrow wooden shelf in front of him, he lay in a dead faint.
When he came to himself, he was lying in the empty theatre, with his collar and shirt undone. The third year's man was dabbing a wet sponge over his face, and a couple of grinning dressers were looking on.
"All right," cried the novice, sitting up and rubbing his eyes. "I'm sorry to have made an ass of myself."
"Well, so I should think," said his companion.
"What on earth did you faint about?"
"I couldn't help it. It was that operation."
"What operation?"
"Why, that cancer."
There was a pause, and then the three students burst out laughing. "Why, you juggins!" cried the senior man, "there never was an operation at all! They found the patient didn't stand the chloroform well, and so the whole thing was off. Archer has been giving us one of his racy lectures, and you fainted just in the middle of his favourite story."
III. A straggler of '15
It was a dull October morning, and heavy, rolling fog-wreaths lay low over the wet grey roofs of the Woolwich houses. Down in the long, brick-lined streets all was sodden and greasy and cheerless. From the high dark buildings of the arsenal came the whirr of many wheels, the thudding of weights, and the buzz and babel of human toil. Beyond, the dwellings of the workingmen, smoke-stained and unlovely, radiated away in a lessening perspective of narrowing road and dwindling wall.
There were few folk in the streets, for the toilers had all been absorbed since break of day by the huge smoke-spouting monster, which sucked in the manhood of the town, to belch it forth weary and work-stained every night. Little groups of children straggled to school, or loitered to peep through the single, front windows at the big, gilt-edged Bibles, balanced upon small, three-legged tables, which were their usual adornment. Stout women, with thick, red arms and dirty aprons, stood upon the whitened doorsteps, leaning upon their brooms, and shrieking their morning greetings across the road. One stouter, redder, and dirtier than the rest, had gathered a small knot of cronies around her and was talking energetically, with little shrill titters from her audience to punctuate her remarks.
"Old enough to know better!" she cried, in answer to an exclamation from one of the listeners. "If he hain't no sense now, I 'specs he won't learn much on this side o'Jordan. Why, 'ow old is he at all? Blessed if I could ever make out."
"Well, it ain't so hard to reckon," said a sharp– featured pale-faced woman with watery blue eyes. "He's been at the battle o' Waterloo, and has the pension and medal to prove it."
"That were a ter'ble long time agone," remarked a third. "It were afore I were born."
"It were fifteen year after the beginnin' of the century," cried a younger woman, who had stood leaning against the wall, with a smile of superior knowledge upon her face. "My Bill was a-saying so last Sabbath, when I spoke to him o' old Daddy Brewster, here."
"And suppose he spoke truth, Missus Simpson, 'ow long agone do that make it?"
"It's eighty-one now," said the original speaker, checking off the years upon her coarse red fingers, "and that were fifteen. Ten and ten, and ten, and ten, and ten – why, it's only sixty-and-six year, so he ain't so old after all."
"But he weren't a newborn babe at the battle, silly!" cried the young woman with a chuckle. "S'pose he were only twenty, then he couldn't be less than six-and-eighty now, at the lowest."
"Aye, he's that – every day of it," cried several.
"I've had 'bout enough of it," remarked the large woman gloomily. "Unless his young niece, or grandniece, or whatever she is, come to-day, I'm off, and he can find some one else to do his work. Your own 'ome first, says I."
"Ain't he quiet, then, Missus Simpson?" asked the youngest of the group.
"Listen to him now," she answered, with her hand half raised and her head turned slantwise towards the open door. From the upper floor there came a shuffling, sliding sound with a sharp tapping of a stick. "There he go back and forrards, doing what he call his sentry go. 'Arf the night through he's at that game, the silly old juggins. At six o'clock this very mornin there he was beatin' with a stick at my door. 'Turn out, guard!' he cried, and a lot more jargon that I could make nothing of. Then what with his coughin' and 'awkin' and spittin', there ain't no gettin' a wink o' sleep. Hark to him now!"
"Missus Simpson, Missus Simpson!" cried a cracked and querulous voice from above.
"That's him!" she cried, nodding her head with an air of triumph. "He do go on somethin' scandalous. Yes, Mr. Brewster, sir."
"I want my morning ration, Missus Simpson."
"It's just ready, Mr. Brewster, sir."
