St. Bernard's: The Romance of a Medical Student. Edward Berdoe
and Dulness), over the water. But fancy anybody in Pall Mall or the Row being “so dreadfully in earnest, don’t you know!”
Such being too commonly the case with the Church, what can be expected of medicine? Inaugural addresses and the classic poets notwithstanding, it is rather too much, they say, to expect fellows in the nineteenth century to live up to an ideal guild of St. Luke. Now, by a beautiful instance of the law of compensation ever active in Nature, just as men are voting enthusiasm bad form, women are taking up the work men are too limp and too selfish to perform, and the spectacle is presented to the eye of hundreds of noble, clever, earnest, indefatigable women coming forward to fill the places which men decline, and leaving work more congenial to their habits and tastes, because men lack the energy and sympathy required to effect the necessary reforms. The salt of the earth is now fast becoming a feminine compound.
But the man of our story was a true man, not a nineteenth century sham; he had his enthusiasms and was not ashamed of them, was a sentimentalist if you will, and was proud of the title. He had an idea that no good had ever been wrought in this world except by enthusiasts and sentimentalists. He felt that sentiment was thought sublimed, and enthusiasm the holy fire that exalted it; his prayer was to be classed with the band of workers who had helped their world; and when he decided to enter the portals of a great hospital, it was not to make his account with fame, to exploit the poor and suffering for his own advancement, but just simply to have the satisfaction day by day of having, by even ever so little, diminished the awful sum of human misery. It was a perfectly contemptible ideal, an absurdly insufficient goal to nineteen-twentieths of the men who that day had enrolled their names in the books of the hospitals of the kingdom; but it was just simply his ideal and his goal, and he thought no other profession would help him to attain these like medicine. “The parson,” he used to say, “sees men at their best, the lawyer at their worst, but the doctor as they are. I will be a doctor.” Now of all things which Elsworth was not, least was he a prig; so that he had no idea of the very unusual nature of the impetus that was driving him on a medical career. He thought, in his ingenuous way, that such impulses moved his fellow-aspirants. This sentiment was to be modified.
In what a world he found himself! He had several friends on the staff, and some half-dozen of his fellow-students were more or less known to him; but to what others was he introduced! In a couple of hundred young men one looks for variety, one expects that some will be heedless, vain, indolent, or vicious, while others are earnest, industrious, and true. But who were these men he saw to-day, and how came they to adopt the sacred ministry of healing, the work of the great Physician Himself?
Rough, rowdy, vulgar, and decidedly unintellectual as many of them appeared, with all the characteristics of the fast man about town, the profession they had chosen to follow seemed likely to suffer at their hands, if these men were fair samples. It has long been the habit of society to view with great leniency the peculiarly Bohemian manners and customs of medical students. The very term has become the symbol for rollicking rowdyism that would be tolerated in no other class. Their boisterous mirth, rude violence, and disregard of the ordinary proprieties of civilized existence have become recognised as their appropriate conduct, partly no doubt because their lugubrious occupation at the schools needs relaxation of a pronounced kind, and especially perhaps that as they must when in actual practice become the gravest and most “respectable” of men, it must be permitted to them to compress into their student life the follies, the riotousness, and the highly flavoured pleasures that must suffice for the rest of their mundane existence.
Be this as it may, it is certain that from the patient in the hospital ward to the magistrate on the bench, conduct that would be considered in other men as intolerable and worthy of the severest punishment is in their case lightly passed over. On the part of the public at large, and on behalf of the men themselves, this is a great error, and has its foundation in a wrong conception, both of the work the students have to do and the sort of relaxation it requires. On behalf of the suffering humanity soon to become dependant upon such men for their help in sickness, a revolution in such a false system of education is no less urgently demanded. Unpleasant as the work of the dissecting, post-mortem rooms, and hospital wards, may seem to the outside world, its daily recurrence makes it so familiar to all engaged in it that it very soon ceases to be any more unpleasant than many other occupations. The men who take real interest in their work very speedily forget or do not recognise any of its disagreeables, while those who do not acquire this real interest in their occupation become mere hangers-on at the schools, and grow rowdy for want of better employment. The real students, with their hearts in business, do not seek or take such methods of unbending the bow; for the rest it should not be permitted them to insult their noble calling by behaviour that would disgrace savages in unexplored tracts of equatorial Africa.
The sooner a more common-sense theory of medical student life is adopted by the public, the better for the world and the men themselves.
Young Elsworth, then, was not altogether pleased with what he saw of his future companions, and it took him but a short time after his entry at the schools to see that not more than half of the men by whom he was surrounded would be for him even tolerable class mates.
The opening festival was over, and early in the following week he began the work of dissecting. He had previously bespoke of the College beadle what is known as “a part,” for be it known to the outside world that a well conditioned corpse having no friends to claim it after death in the hospital or workhouse which saw its owner’s last moments, is by the Anatomy Act permitted, under certain legal restrictions, to be used for dissection. To preserve it for the length of time it will require for some six or eight men daily working at it to unravel all its mysteries of muscle, nerve, artery, and vital organs, its blood vessels are injected by an ingenious process by the dissecting room porters with a preservative fluid which, permeating every part of the body, keeps it fairly fresh and arrests decay till the scalpel of the young anatomist has revealed all it has to teach.
Let us enter into the dissecting room of St. Bernard’s, and see how our future doctors learn to deal with the ailments our flesh is heir to. It is a spacious chamber, some fifty feet long by thirty feet wide; its floor is slate, cold, and non-absorbent; its walls half-way up of the same impervious material; it has no windows, but is lighted by a glass roof and many gas jets for dark days. On either side are eight strong tables, on each of which lies a corpse. Round each table are several heavy, well-made stools; they need be heavy. They are often subject to rough usage at the hands of their occupants when not engaged in more scientific work.
On this first of October, all the “subjects,” as they are technically called, are untouched by the knife; in a few days they will scarcely be recognisable as having ever been our brothers and sisters of the mortal life. The busy scalpel of the anatomy student will be engaged on every limb and feature in “getting out,” as it is termed, his “part.” Then the observant eye of a man of science would see how fearfully and wonderfully we are made. The Psalmist could have had but a faint idea how much his beautiful phrase conveyed. Here are displayed for us the exquisite sets of muscles and tendons that enable us to move our hands and arms. This part shows the nerve and blood supply of the leg, and that one the machinery by which we smile, laugh, or express our wonder and surprise. Here is a man at work seeking to unfold the marvellous convolutions of the brain, while at another table one has got down to the articulations of the foot, and is showing the pulleys and joints that enable us to walk. The art of anatomical dissection consists in freeing the muscles, tendons, arteries, veins, and nerves from the surrounding fat and connective tissue which in the living body preserves and covers them.
It is absolutely necessary that the student should not only know from books, but actually see with his own eyes, and for a long period attentively observe the origin and course of every nerve, artery, and vein which in the whole body is capable of being dissected out. He must know the exact position of all the muscles, how they move the bones, how they extend or flex the limbs, what nerves supply them with motive power, and how that nerve takes its course from the brain or spinal cord. The number of complications is so great that nothing but patient tracing out with forceps and scalpel for himself will ever teach a man anatomy.
As an accurate knowledge of this science is the foundation of all medical learning, it is not to be wondered at that the medical schools and examining bodies insist on a very long