A Labrador Doctor. Sir Wilfred Thomason Grenfell
and twenty beds each) he was examining a lung case, while a huge class of fifty young doctors stood around.
"What about the sputum, Mr. Jones?" he asked. "What have you observed coming from these lungs?"
"There is not much quantity, sir. It is greenish in colour."
"But what about the microscope, Mr. Jones? What does that show?"
"No examination has been made, sir."
"Gentlemen," he said, "I will now go to the other ward, and you shall choose a specimen of the sputum of some of these cases. When I return we will examine it and see what we can learn."
When he returned, four specimens awaited him, the history and diagnoses of the cases being known only to the class. The class never forgot how by dissolving and boiling, and with the microscope, he told us almost more from his examination of each case than we knew from all our other information. His was real teaching, and reminds one of the Glasgow professor who, in order to emphasize the same point of the value of observation, prepared a little cupful of kerosene, mustard, and castor oil, and calling the attention of his class to it, dipped a finger into the atrocious compound and then sucked his finger. He then passed the mixture around to the students who all did the same with most dire results. When the cup returned and he observed the faces of his students, he remarked: "Gentlemen, I am afraid you did not use your powers of obsairvation. The finger that I put into the cup was no the same one that I stuck in my mouth afterwards."
Sir Stephen Mackenzie, who operated on the Emperor Frederick, was another excellent teacher under whom we had the good fortune to study. Indeed, whatever could be said against the teaching of our college, in this much more important field of learning, the London Hospital was most signally fortunate, and, moreover, was famed not only in London, but all the world over. Our "walking class" used to number men from the United States to Australia, insomuch that the crowds became so large that the teachers could not get room to pass along. It was this fact which led to the practice, now almost universal, of carrying the patient in his bed with a nurse in attendance into the theatre for observation as more comfortable and profitable for all concerned.
On changing over to the surgical side in the hospital, we were employed in a very similar manner, only we were called "dressers," and under the house surgeon had all the care of a number of surgical patients. My good fortune now brought me under the chieftaincy of Sir Frederick Treves, the doyen of teachers. His great message was self-reliance. He taught dogmatically as one having authority, and always insisted that we should make up our minds, have a clear idea of what we were doing, and then do it. His ritual was always thought out, no detail being omitted, and each person had exactly his share of work and his share of responsibility. It used greatly to impress patients, and he never underestimated the psychical value of having their complete confidence. Thus, on one occasion asking a dresser for his diagnosis, the student replied:
"It might be a fracture, sir, or it might be only sprained."
"The patient is not interested to know that it might be measles, or it might be toothache. The patient wants to know what is the matter, and it is your business to tell it to him or he will go to a quack who will inform him at once."
All his teachings were, like Mark Twain's, enhanced by such over-emphasis or exaggeration. He could make an article in the "British Medical Journal" on Cholecystenterostomy amusing to a general reader, and make an ordinary remark as cutting as an amputation knife. He never permitted laxity of any kind in personal appearance or dress, or any imposing on the patients. His habit of saying openly exactly what he meant made many people fear, as much as they respected, him. However, he was always, in spite of it, the most popular of all the chiefs because he was so worth while.
One incident recurs to my mind which I must recount as an example when psychology failed. A Whitechapel "lady," suffering with a very violent form of delirium tremens, was lying screeching in a strait-jacket on the cushioned floor of the padded room. With the usual huge queue of students following, he had gone in to see her, as I had been unable to get the results desired with a reasonable quantity of sedatives and soporifics. It was a very rare occasion, for cases which did not involve active surgery he left strictly alone. After giving a talk on psychical influence he had the jacket removed as "a relic of barbarism," and in a very impressive way looking into her glaring eyes and shaking his forefinger at her, he said: "Now, you are comfortable, my good woman, and will sleep. You will make no more disturbance whatever." There was an unusual silence. The woman remained absolutely passive, and we all turned to follow the chief out. Suddenly the "lady" called out, "Hi, hi,"—and some perverse spirit induced Sir Frederick to return. Looking back with defiant eyes she screamed out, "You! You with a faice! You do think yerself———— clever, don't yer?" The strange situation was only relieved by his bursting into a genuine fit of laughter.
Among other celebrated men who were admired and revered was Mr. Harry Fenwick on the surgical side, for whom I had the honour of illustrating in colours his prize Jacksonian essay. Any talent for sketching, especially in colours, is of great value to the student of medicine. Once you have sketched a case from nature, with the object of showing the peculiarity of the abnormality, it remains permanently in your mind. Besides this, it forces you to note small differences; in other words, it teaches you to "obsairve." Thus, in the skin department I was sent to reproduce a case of anthrax of the neck, a rare disease in England, though all men handling raw hides are liable to contract it. The area had to be immediately excised; yet one never could forget the picture on one's mind. On another occasion a case of genuine leprosy was brought in, with all the dreadful signs of the disease. The macula rash was entirely unique so far as I knew, but a sketch greatly helped to fix it on one's memory. The poor patient proved to be one of the men who was handling the meat in London's greatest market at Smithfield. A tremendous hue and cry spread over London when somehow the news got into the paper, and vegetarianism received a temporary boost which in my opinion it still badly needs for the benefit of the popular welfare.
Among the prophets of that day certainly should be numbered another of our teachers, Dr. Sutton, an author, and very much of a personality. For while being one of the consulting physicians of the largest of London hospitals, he was naturally scientific and strictly professional. He was very far, however, from being the conventionalist of those days, and the younger students used to look greatly askance at him. His message always was: "Drugs are very little use whatever. Nature is the source of healing. Give her a chance." Thus, a careful history would be read over to him; all the certain signs of typhoid would be noted—and his comment almost always was: "This case won't benefit by drugs. We will have the bed wheeled out into the sunshine." The next case would be acute lobar pneumonia and the same treatment would be adopted. "This patient needs air, gentlemen. We must wheel him out into the sunshine"—and so on. How near we are coming to his teaching in these days is already impressing itself upon our minds. Unfortunately the fact that the doctors realize that medicines are not so potent as our forbears thought has not left the public with the increased confidence in the profession which the infinitely more rational treatment of to-day justifies, and valuable time is wasted and fatal delays incurred, by a return of the more impressionable public to quacks with high-sounding titles, or to cults where faith is almost credulity.
Truly one has lived through wonderful days in the history of the healing art. The first operations which I saw performed at our hospitals were before Lord Lister's teaching was practised; though even in my boyhood I remember getting leave to run up from Marlborough to London to see my brother, on whom Sir Joseph Lister had operated for osteomyelitis of the leg. Our most famous surgeon in 1880 was Sir Walter Rivington; and to-day there rises in memory the picture of him removing a leg at the thigh, clad in a blood-stained, black velvet coat, and without any attempt at or idea of asepsis. The main thing was speed, although the patient was under ether, and in quickly turning round the tip of the sword-like amputation knife, he made a gash in the patient's other leg. The whole thing seemed horrible enough to us students, but the surgeon smiled, saying, "Fortunately it is of no importance, gentlemen. The man will not live."
The day came when every one worked under clouds of carbolic steam which fizzed and spouted from large brass boilers over everything; and then the time when every one was criticizing the new, young surgeon, Treves, who was daring to discard it, and getting