Dr. Gheist, an autobiography from the Midlands

Preface

A book without a preface may, under certain circumstances, take the position of a document in cipher, without the key to unfold its hidden meaning. When this prefatory explanation is furnished, a plea of justification, or apology, for publication may still be craved for by the reader. Autobiography, to be readable, ought to have certain characteristics. It must be the history of a life, either rich in startling incident, or of a life standing boldly out in the van of literature, science, society, or politics. Or it may simply be the portraiture of life-motive, an analysis of the emotions, a photograph of mind, a picture of manners. To which of these categories can the autobiography of an obscure village doctor belong ? The reader is invited to find this out for himself. Some of my friends have hinted at the unseemliness of a doctor making use of his patients in the way of " pointing a moral or adorning a tale."

PREFACE.

VI But I tell my friends, as I now do my readers, that this objection has little weight in my case, as it is now some years since I retired from the active practice of my profession, and most of the characters I have made use of, are either long since dead, or have drifted far into the misty and undefined regions of imagination. I am now a very old man ; and if the story of my life does not turn out readable, it will, I hope, afford matters of interest (matters on which my age gives me a right to speak), if not food for reflection, to the patients and the doctors of the rising generation. To the fair sex I might apologise for the harsh tints in which I have painted the " female doctor of the period." But age has its convictions all set like a plaster of Paris splint, and one conviction of mine more firmly fixed than all my other beliefs is, that were an apology needed, it is certainly not in that direction that it is necessary.

DAVID GHEIST, M.D. The Midlands, CONTENTS CHAP. PAGE I. My Start in Life 1 II. I begin to get Patients, and make some Friends . . 7 III. Being an account of my Arabs 13 IV. Something about Grooms, but not much ... 17 V. My Difficulties begin 20 VI. A Sermon on Health 27 VII. Mabel Faxton, a fair and interesting Patient . . . 37 VIII. Captain Lane's Head and Heart get out of Order . . 45 IX. My Dispenser dreads his Landlady, and takes to Opium-eating 53 X. Dr George comes to the Front, and Discourses of Bacon 63 XI. Dr George objects to Clubs, and Mrs Marsh ... 70 XII. The Mental State of the Dying 83 XIII. Dr Mary Molliere, the Medical Woman of the Period, takes entire charge of Bobbie Sime .... 93 XIV. Dr Mary as a Consultant 105 XV. Dr Mary's views of Woman's Mission .... 121 XVI. Dr George's views of Dr Mary's Mission . . . 129 XVII.

My own views of Education — not those of Dr Mary — beiDg a somewhat long and prosy chapter . . . 133 XVIII. A Garden Party at the Dean's, where Mr Pike sneezes . 156 XIX. The B. M. Association Meeting at Bath, where I meet another Medical Woman ...... 172 XX. Where Dr Mary takes advantage of my absence to make love to my Patients . - 184 XXI. Dr George takes advantage of his visit to Bath by falling in love with Dr Clifton CONTENTS VIII CHAP. rAOF XXII. Dr Nolan, my Irish Assistant 193 XXIII. Green's Case 202 XXIV. Ladders on the Brain 201 XXV. Some unkindly thoughts on my own sex . . . 212 XXVI. Mr Williams in a Duplicate State of Existence . . 215 XXVII. " Doctor, she is Dying " 226 XXVIII. My Groom's opinion of Irish Horses and Irish Assistants 224 XXIX. Mr Ebenezer Bray objects to his Bill . . . .229 XXX.

Dr and Mrs George, Mr and Mrs Pike, and Cousin Sam, dine with me ....... 235 XXXI. The Dead March in Saul 243 XXXII. John the Local's Views on Corruption, Redemption, and Damnation 251 XXXIII. On Moral Epidemics 256 XXXIV. My Cousin Jeanie, or June and November . . 261 XXXV. My Assistant, Dr Nolan, buys a Practice, takes a Wife, and rather does me ...... 271 XXXVI. My Views of Social Ethics 278 XXXVII. I get old and pass/!, take a Partner, and Flirt with my Partner's Wife

Chapter I

"^V*. !| WAS neither born of bumble parents in a ■ Hi remote part of England, nor am I the son of a clergyman, but it is enough to say that after studying medicine and taking my degree in Edinburgh, I found myself with very little money in my pockets, and no means of turning my newly-acquired medical lore to practical account. Like many of my fellow students my profession was all I had to trust to, nor had I even the means to buy a share in a practice. I might, it is true, have settled down in one of the Scotch towns, and taken my chance of getting into practice by degrees ; but my old uncle, who was a retired Naval surgeon, had educated me into the belief, that to five, a doctor should go south of the Tweed, and the farther south the better. Scotland, he used to say, was a good place to die in, but a shocking bad place to get a living in, and my own observation had confirmed me in this idea — I used to wonder at the amount of heroworship displayed by Scotsmen for men who had risen to eminence, and have long noted the fact that this did not show itself till the poor celebrity was in his grave; — as I did not wish to defer this desirable adulation to so remote a period, I cast about for something to do in Merry England.

Being passionately fond of horses, and, indeed, of all animals, I determined, if possible, to settle down in the A country, and with that end in view, looked out for an assistantship in one of the hunting districts in the Midlands. Not long after I found in the Lancet exactly what suited me. "Wanted a qualified Assistant in a Market Town in the Midlands ; must be a light-weight, and a member of the Church of England." Wondering very much to myself why a light-weight, and why a member of the Church were so essential, I rushed off to a neighbouring mill and had my weight taken. I found I was just under ten stone, and being able to give a satisfactory answer as to my religion, I wrote off, and had the luck to secure the appointment at once. I found my principal a jolly, stout, good-natured country doctor of the old school, with a good middle class practice, situated in one of the grass counties, not far from Market Harborough.

The market-town, not a large one, was chiefly remarkable for its prevailing smell of burning leather, and for its working population being all shoemakers. Large quantities of army shoes were made all over the district, and it was this very neighbourhood from which, during the Franco-Prussian war, a lot of shoes were sent to the poor French which had brown paper soles, instead of leather, and which, of course, parted company with the uppers, and let the poor soldiers down in the snow. Though the doctor was considered a successful practi tioner, I must say I was not very highly impressed by his ability. I have no doubt, like most youno medicals, I was too highly impressed by my own theoretical knowledge to credit the value of the old doctor's experience. Be this as it may, I came to like the genial old gentleman, and must confess to picking up a good many practical hints from him, which stood me in good stead in after years.

Theory, I came to find, is all very well as a basis, but it is only after years of observation and experience that a medical man is fit to cope with the sudden and everyday emergencies of a large practice. The chief cause of his success I found was in having a kindly manner with the sick, giving them great atten tion, and making them feel that their case was upper most in his mind, and — shall I mention it ? — giving them no end of medicine. When I went, an old lady patient had just died, and he told me, with a chuckle, that she had had a composing draught every night for three or four years. " And what, Dr Gheist, do you think the draught was composed of? Why, gooseberry wine, sir ! Why, I was driven to my wits' end with this lady. She could not sleep, and all the usual remedies made her worse.

A friend had just sent me a present of eighteen gallons of this wine, and one night, in desperation, I gave her a draught of it. She slept like a top, sir, that night, and she liked it so much, and thought that it did her so much good, that she took the whole eighteen gallon barrel in one ounce draughts." I was rather shocked at this story, and hinted to him that it was scarcely fair to his patient or honourable in a professional point of view, and savoured somewhat of quackery. " Not at all, Dr Gheist, not at all ; when you have practised as long as I have, you will find cases where the mind has to be considered as much, if not more, than the body. Now, just take the case of Mrs Bolton (the lady in question) ; there was not any bodily ailment to speak of, but she was always fancying something or other was the matter.

She had visited most of the watering places, and consulted all the celebrated physi cians in Britain, in search of health, but had not found it, and when in taking the gooseberry wine draught, she cried Eureka, and had a fair amount of bodily and mental comfort in it, I would have been morally wrong not to have kept up the delusion." This I knew was sophistry, but though young in ethics, I was old enough to have found that it is difficult to convince one of the absurdity of a course which suits his interest. On coming to England, I was disgusted to find that it wTas the custom for all general practitioners in the country to dispense their own medicine. It was not that I objected so much to the mere drudgery of putting up the medicine.nor of course to the large bills resultingfrom such a system, but I soon found to my sorrow that even in cases of high scientific interest, the gooseberry-wine system would crop up, and medicine was often poured into the poor patients when they would have been decidedly better without it.

To alter this system was out of the question, for apart from the fact that I was merely the assistant, a custom founded, as this is, on self-interest, I knew to be difficult to change. At best it is an unholy alliance, and to me it always seemed to bring a certain amount of degradation on an otherwise noble profession. The most sensible argument in favour of the village doctor dispensing his own medicine, was undoubtedly that urged so pertinaciously by the doctor when discussing this question. " It is no use," he used to say; " it is the custom of the country, and, I have no doubt, originated in the urgent necessity felt by both patient and doctor, of having the prescribed medicine made up in an honest way, and of the best material. There are many chemists of repute and respectability in large towns, with whom a medical man would feel perfectly safe, but it is far otherwise in the country.

Here you have to deal with ignorant incompetency, and the grubbing dishonesty of a small shop-keeper who, by the way, may be more of a grocer than a chemist." I confess it is rather hard on both patient and doctor when a chemist withholds a certain percentage of a drug, simply because he wants a large profit on the prescription. I remember some years ago, a commission, which had been appointed to inquire into this subject, sent round to various chemists in one of our large towns, a prescription containing a large amount of quinine, and when the returned bottles were quantitatively ana lysed, only three out of the ten had the prescribed quantity. Keeping all these things in my mind, I accepted my fate, and worked with a will, not only amongst my patients, but at home in the surgery. Our patients were chiefly shoemakers, who were all in benefit clubs, tradesmen of the town, and farmers.

But besides these we had a fair sprinkling of county people, and hunting men, who lived in the neighbourhood during the season. The doctor, some of the patients said, was not the man he used to be, and others even hinted that his practice was gradually leaving him, on account of his habits, which, I must confess, were decidedly convivial. A doctor, of all professions, should be absolutely tem perate in all his habits. At any moment he may be called upon to exercise his skill, in a case requiring not only coolness, but clear discerning judgment, and when he goes to such a bed-side, perhaps from a convivial dinner table, flushed with wine, and his reasoning faculties in a state of undue excitement, no wonder that he is sometimes unequal to the occasion. I do not know that I am peculiar in holding such views, but I started in life with the determination to avoid, as much as possible, all dinner and dancing par ties, and I have not yet seen cause to regret such a course.

Apart from all other considerations, I believe that if a medical man is faithful to his profession, his time will be fully occupied in keeping abreast of his art, which, I need not add, is advancing with rapid strides. But to proceed with my story. I had not been assistant above six months, when one night some one knocked at my door with a quick nervous tap. It was old Joe, the groom, with a face the very picture of terror. " Dr Gheist, for God's sake, come quickly to Foxes Lane ; the Doctor has had a fit and fallen out of his gig, and I believe is dead." I hurried on my clothes, and, following Joe, was soon at the side of my prostrate master. Fallen he had, in a fit of apoplexy, and he died that night.

Chapter II

_f'Tl_P^ principal being dead, I was, in a sense, master of the situation ; and visions of having a house of my own flitted before my mind. But the poor doctor's wife had to be considered, and I determined to be guided by her wishes. I have not attempted to describe Mrs Wymont, for the simple reason that she was rather a sketchy kind of little woman ; and though she was everything that was womanly and gentle in manner, she had no salient point of character to take hold of. After the funeral we came to terms, and formed a kind of mixed partnership, according to which I was to conduct the practice for her for so many years, at the end of which time it was to be my own. Not long after the doctor's death, and when I was beginning to make headway amongst the better-class patients, I was having a gallop with the Pytchley hounds, which were running, strange to say, straight to a village where I was going, when I saw an old gentleman on a splendid, long-bodied, short-legged hunter, which seemed very hot and inclined to bolt with him.

I had no sooner run my eye over the horse, and envied him to my heart's content, than I saw him charge a bullock-fence, at a rate which plainly told me its rider had lost all control over it. Down both went, and on riding up I found the old gentleman, General Archer by name, had broken his leg. I at once introduced myself, and did all I could to place him in a position the most favourable for the injured limb. As luck would have it, I found near at hand some pretty stiff bark ; and placing splints of it outside his riding boots, and binding them on with strips of my handker chief, had him conveyed to his residence in a carriage, kindly lent by some ladies who had been out seeing the meet. General Archer was about seventy years of age, though he looked very much younger. He behaved, as I have noticed most hunting men do under similar circumstances, with a stoical indifference, and did not seem to feel or care for suffering.

This power of bearing pain has often set me specu lating as to its source. I at one time was under the impression it depended, to a great extent, on a low type of nervous organisation ; for I had again and again seen working men come into my surgery, and suffer amputation of one or two fingers without chloro form, and without uttering a groan. This phase of stoicism must undoubtedly be duetto a want of sensi tiveness, as they often confessed it did not hurt. But, on the other hand, I have^seen^men, and women too, of the highest nervous and mental development, who, approaching a surgical operation with terror depicted on their faces, have nevertheless so nerved themselves as to be able to go through the torture without a groan. I remember, in the days before chloroform, assisting a surgeon in applying the actual cautery (a red-hot iron) to a young lady's elbow-joint.

The beautiful young creature stood in the middle of the room, and without assistance held up the diseased arm till the hissing iron had seared both sides of the joint. With a kind of shuddering awe I watched her face, expecting every moment to hear a shriek of agony; but she gave no token of what she must have been endur ing, and but for one large tear, which rolled slowly over her deathly-pallid cheek, might fitly have repre sented a statue of suffering resignation. The General's fracture was a bad one, and as I was young and a stranger to him, I suggested consultation either with his usual medical attendant or some hospital surgeon of repute. This both the General and Mrs Archer objected to ; in the one case because, having lately themselves come into the neighbourhood, they had not a family doctor ; and in the other, they did not wish to incur any needless expense.

Mrs Archer was very decided on this point, and gave me to understand that, if I wras sure I could manage by myself, she did not see the necessity nor wish for further advice. " I know pretty well what consultations are, Dr Gheist ; and I don't see why we should pay a ten-guinea fee simply to please the world, or confirm your opinion. I leave my husband in your hands, and if you feel equal to the management of the case, what more can be gained by having another doctor V Of course I " felt equal to the occasion," but yet what a responsibility for a young man to undertake ! I had heard enough of Mrs Archer, within the last few days, to know that if the case went on as it ought to do, my local reputation was assured ; but, at the same time, should it not, — and I was dealing with very uncertain elements, — she was the very person to turn round and do all she could to injure me in every way.

A young doctor starting in a strange neighbourhood is very much to be pitied ; for though he be ever so talented and competent, cases will occur which, in spite of his most enlightened skill, will go wrong, and irre trievably ruin his chance of success. His profession, above all others, depends on his success ; and, as a rule, the world does not take the trouble to inquire whether his failure is owing to untoward circumstances over which he could have no control. Under the circum stances, then, I did not hesitate to do what was neces sary, though greatly feeling the responsibility I was incurring. I was very much impressed by the cool way in which Mrs Archer assisted me in reducing the displaced bones, and applying the splints and bandages to the limb. She seemed to take quite a scientific interest in the operation, and kept up an incessant rattle about the various accidents she had seen in the hunting-field.

I found out afterwards that she was quite a character in her way, and was known all over the district as one of the boldest riders in the hunt. She was an immense favourite with everybody, and it was said she knew all the horses and grooms for miles round. In her dress she was quite peculiar, and affected rather a masculine style, but in her drawing-room the refined woman showed in every minute detail. Every one acknow ledged that her knowledge of horse-flesh was extensive, and nothing seemed to delight her more than to be consulted as to the ailments of some of her neighbours' horses. She was certainly a strange mixture, and was a rare example of a woman who, though horsey in her tastes, was yet charming in her womanly behaviour. General Archer, though an old man, had a good physique, and was, besides, in splendid health, and his fracture went on beautifully.

He took his confinement to bed, as he did ever}Tthing, in a most philosophical way, and was always contented and happy. Every afternoon he had hosts of visitors, both ladies and gentlemen. These he received in state in his bedroom, while Mrs Archer did the honours of the house, and attended to the four o'clock " drum." During his ill ness I was introduced to some of the elite of the county, all more or less given to hunting, all in splen did health, all pleasant and debonnaire in manner, and bearing in their faces that fresh bloom which be tokens life in the open air. As a student of psychology, I was much interested in noticing that amongst these hunting men certain mental characteristics were always associated with certain types of constitution. Thus I remarked that those who had obtained a name for bold riding, and for being, in fact, " first-flight men," were men of nervo-phlegmatic temperament — men of untiring physical and mental energy, of bold, warm impulses, and remarkable for bringing to bear upon the ordinary affairs of life a judgment pre-eminent for its force and clearness.

They had more or less of the Norman type of face, black or brown hair, and a grey complexion. These men, when elderly, became soon grey, and had that peculiar thorough-bred look so characteristic of many of our old county families. This may be considered an entirely fanciful picture, and, I know, does not coincide with the general idea. " A fox-hunting squire " has often been used as a term of reproach ; but, like many of the wise sayings which are accepted and pass as current coin, is more remarkable for its ignorant absurdity than for being a true representation of actual facts. To be a bold rider in the hunting-field, a peculiar force of character, both mental and physical, is undoubtedly required. Some men, from want of physique, never ride well ; and others, again, however strong physically, lack that mental something in their characters without which no man is safe across country.

With good physique, there must be self-reliance and complete absence of " funk ;" and these qualities must be of such intensity as to be communicable and kept alive in the rider's horse. The moment a man becomes nervous, the horse feels the influence, and, though bold-tempered, partakes of the vacillating fears of the rider. To me this subtile psychical union between horse and rider has always appeared most mysterious. What is its true nature, and how is it communicated and kept up ? Is it merely the result of increased muscular vigour in the rider's limbs, or is there really such a thing as psychic force, which, partly physical and partly mental, flows in electrical currents from the rider to the will of the horse ? Every one accustomed to horses must have noticed how easy it is to influence the action and temper of the animal he rides, by the will alone.

When there is an intimate understanding between horse and rider, how easy it is to make him stop, by simply willing him to do so ! In a canter how easy to start him into a gallop ! And with a horse of bad manners and uncertain temper, how often do we find that he takes advantage when he finds the rider not in good form for riding ? I have had this again and again exemplified in the case of one of my own horses. He is a high-tempered, impulsive, half-bred Arab, and likes to have more of his own way than is good for either him or me. When from over-work or want of sleep (for, of course, as a doctor I am often in that con dition), my nerves become somewhat relaxed and un steady, this mercurial hack tries all he knows to get the better of me. When, on the other hand, I am all right and in good form, he is quiet as a Quaker and is a most perfect hack.

Chapter III

§plt?| COUNTRY doctor, it need not be remarked, sWrl'.i depends very much on his horses — to have a ' " comfortable saddle " is indeed one of the first considerations to him. Having long journeys to take at a moment's notice, and often when he is tired and wearied from want of sleep or previous work, a horse that can take him over the ground easily and without much muscular fatigue on his part, is a possession almost beyond price. Living in one of the crack hunt in g districts, I for the most part ride, and seldom drive, except in the heat of summer. After many years' experience, I am convinced that riding is the least fatiguing to the medical man. The mere exercise is decidedly exhilarating, and as one can take many short cuts by bridle paths and over fields, and besides go at a greater speed than on wheels, so the doctor, by riding, not only saves time, but gains in bodily health.

A country doctor's life is decidedly one of hardship, and entails much more physical fatigue than life in one of our large cities ; and though " our sentence is to labour from the cradle to the grave," — still recom mend me to the country. What so glorious or exhila rating as a gallop across some of our deep-green swelling pastures on a bright April morning? or a canter through the bursting avenued woods so com mon in our dear Pytchley country ? Why, mounted on one of my thorough-bred hacks, with the life-giving breeze in my face, I cannot imagine anything so glorious : one is then at peace with the world and with himself; one can feel nothing but joy, a joy born of the gods. Away then with care and anxiety, your horse feels the influence of the movement and neighs with perfect delight ! " By Gad, doctor !" an old broken down farmer said to me, on extolling a gallop across country, " I get quite out of myself ; I feel, sir, I feel as if I were out of debt."

What more need be said ? If a gallop is capable of making a man feel this, truly its influence must be great. A village doctor never makes money ; but who does now-a-days ? One of my patients, a fast living huntino man, once made the remark, that " it must be a devilish strange sensation to have a five pound note in one's pocket, all one's own." I suspect few doctors, except those amongst the upper ten, ever realise this blessed sensation, but surely our mission is not that of the money grubber. I should, for one, be sorry to think so, and I trust I am not singular in looking upon our noble profession as having other and higher aims. Look at many of our poor clergymen, men of talent, education, and high mental culture, voluntarily settling down in some obscure country village, their only aim and work being the spiritual welfare of their parish ioners — they are the physicians of the soul, as we are the physicians of the body, and from the very nature of the work done, our lives, to a great extent, must be that of denial and self-sacrifice.

Nor, setting aside the high consideration of duty, is the fife of the village doctor one of the least desirable. If he is devoted to his profession, as he ought to be, and fond of horses and country life, his career, though blustering and stormy, is not, by any means, to be despised. I cannot imagine, on the other hand, a man taking to this kind of work who has been city-bred, or who has a hankering after society and the common pleasures 0f life—the sooner such a one sells out and seeks his proper habitat the better, for his life will be a burden to himself and certainly not profitable to his patients. But to return to my horses— I have to keep three, or, as a facetious friend said, two and a-half, that is, two hacks and a miniature cob for night work. This small gentleman is quite a character in horse-flesh.