Part 4

Quite mediæval methods were still observed. The first time in my life that I saw the interior of an operating theatre I, in my ignorance, entered by the door which opened directly into the area where the operating table stood. (I should have entered by the students’ gallery.) When I found myself in this amazing place there was a man on the table who was shrieking vehemently. The surgeon, taking me by the arm, said, “You seem to have a strong back; lay hold of that rope and pull.” I laid hold of the rope. There were already two men in front of me and we all three pulled our best. I had no idea what we were pulling for. I was afterwards informed that the operation in progress was the reduction of a dislocated hip by compound pulleys. The hip, however, was not reduced and the man remained lame for life. At the present day a well-instructed schoolgirl could reduce a recent hip dislocation unaided.

In this theatre was a stove which was always kept alight, winter and summer, night and day. The object was to have a fire at all times ready whereat to heat the irons used for the arrest of bleeding as had been the practice since the days of Elizabeth. Antiseptics were not yet in use. Sepsis was the prevailing condition in the wards. Practically all major wounds suppurated. Pus was the most common subject of converse, because it was the most prominent feature in the surgeon’s work. It was classified according to degrees or vileness. “Laudable” pus was considered rather a fine thing, something to be proud of. “Sanious” pus was not only nasty in appearance but regrettable, while “ichorous” pus represented the most malignant depths to which matter could attain.

There was no object in being clean. Indeed, cleanliness was out of place. It was considered to be finicking and affected. An executioner might as well manicure his nails before chopping off a head. The surgeon operated in a slaughter-house-suggesting frock coat of black cloth. It was stiff with the blood and the filth of years. The more sodden it was the more forcibly did it bear evidence to the surgeon’s prowess. I, of course, commenced my surgical career in such a coat, of which I was quite proud. Wounds were dressed with “charpie” soaked in oil. Both oil and dressing were frankly and exultingly septic. Charpie was a species of cotton waste obtained from cast linen. It would probably now be discarded by a motor mechanic as being too dirty for use on a car.

Owing to the suppurating wounds the stench in the wards was of a kind not easily forgotten. I can recall it to this day with unappreciated ease. There was one sponge to a ward. With this putrid article and a basin of once-clear water all the wounds in the ward were washed in turn twice a day. By this ritual any chance that a patient had of recovery was eliminated. I remember a whole ward being decimated by hospital gangrene. The modern student has no knowledge of this disease. He has never seen it and, thank heaven, he never will. People often say how wonderful it was that surgical patients lived in these days. As a matter of fact they did not live, or at least only a few of them. Lord Roberts assured me that on the Ridge at Delhi during the Indian Mutiny no case of amputation recovered. This is an extreme instance, for the conditions under which the surgeons on the Ridge operated were exceptional and hopelessly unfavourable.

The attitude that the public assumed towards hospitals and their works at the time of which I write may be illustrated by the following incident. I was instructed by my surgeon to obtain a woman’s permission for an operation on her daughter. The operation was one of no great magnitude. I interviewed the mother in the Receiving Room. I discussed the procedure with her in great detail and, I trust, in a sympathetic and hopeful manner. After I had finished my discourse I asked her if she would consent to the performance of the operation. She replied: “Oh! it is all very well to talk about consenting, but who is to pay for the funeral?”

III

THE TWENTY-KRONE PIECE

More than once in speaking at public meetings on behalf of hospitals I have alluded to my much valued possession—a twenty-krone piece—and have employed it as an illustration of the gratitude of the hospital patient.

The subject of this incident was a Norwegian sailor about fifty years of age, a tall, good-featured man with the blue eyes of his country and a face tanned by sun and by salt winds to the colour of weathered oak. His hair and his beard were grey, which made him look older than he was. He had been serving for three years as an ordinary seaman on an English sailing ship and spoke English perfectly. During his last voyage he had developed a trouble which prevented him from following his employment. Accordingly he had left his ship and made his way to London in the hope of being cured. Inquiring for the hospital of London he was directed to the London Hospital and, by chance, came into my wards. He had an idea—as I was told later—that the operation he must needs undergo might be fatal, and so had transferred his savings to his wife in Norway.

He was a quiet and reserved man, but so pleasant in his manner that he became a favourite with the nurses. He told them quaintly-worded tales of his adventures and showed them how to make strange knots with bandages. The operation—which was a very ordinary one—was successful, and in four or five weeks he was discharged as capable of resuming his work as a seaman. His ship had, however, long since started on another voyage.

One morning, three weeks after he had left the hospital, he appeared at my house in Wimpole Street. My name he would have acquired from the board above his bed, but I wondered how he had obtained my address. I assumed that he had called to ask for money or for help of some kind. As he came into my room I was sorry to see how thin and ill he looked, for when he left the wards he was well and hearty.

He proceeded to thank me for what I had done, little as it was. He had an exaggerated idea of the magnitude of the operation, which idea he would not allow me to correct. I have listened to many votes of thanks, to the effulgent language, the gush and the pompous flattery which have marked them; but the little speech of this sailor man was not of that kind. It was eloquent by reason of its boyish simplicity, its warmth and its rugged earnestness.

As he was speaking he drew from his pocket a gold coin, a twenty-krone piece, and placed it on the table at which I sat. “I beg you, sir,” he said, “to accept this coin. I know it is of no value to you. It is only worth, I think, fifteen shillings. It would be an insult to offer it as a return for what you have done for me. That service can never be repaid. But I hope you will accept it as a token of what I feel, of something that I cannot say in words but that this coin can tell of. When I left my home in Norway three years ago my wife sewed this twenty-krone piece in the band of my trousers and made me promise never to touch it until I was starving. A seaman’s life is uncertain; he may be ill, he may be long out of a job; and so for three years this coin has been between me and the risk of starvation. When I was in the hospital I had a wish to give it to you if it so happened that I got well. Here I am, and I do hope, sir, you will accept it.”

I thanked him as warmly as I could for his kindness, for his thought in coming to see me and for his touching offer, but added that I could not possibly take the gold piece and begged him to put it back into his pocket again and present it to his wife when he reached home. At this he was very much upset. Pushing the coin along the table towards me with his forefinger, he said: “Please, sir, do take the money, not for what it is worth but for what it has been to me. I am proud to say that since I left the hospital I _have_ been starving. I have been looking for a ship. I have not slept in a bed since you saw me in the wards. Now, at last, I have got a ship and, thank God, I have kept the coin unbroken so that you might have it. I implore you to accept it.”

I took it; but what could I say that would be adequate for such a gift as this? My attempt at thanks was as stumbling and as feeble as his had been outright; for I am not ashamed to confess that I was much upset.

I have received many presents from kindly patients—silver bowls, diamond scarf-pins, gold cigarette cases and the like, but how little is their value compared with this one small coin? As I picked it up from the table I thought of what it had cost. I thought of the tired man haunting the docks in search of a ship, often aching with hunger and at night sleeping in a shed, and yet all the time with a piece of gold in his pocket which he would not change in order that I might have it.

A coin is an emblem of wealth, but this gold piece is an emblem of a rarer currency, of that wealth which is—in a peculiar sense—“beyond the dream of avarice,” a something that no money could buy, for what sum could express the bounty or the sentiment of this generous heart?

It would be described, by those ignorant of its history, as a gold coin from Norway; but I prefer to think that it belongs to that “land of Havilah where there is gold” and of which it is truly said “and the gold of that land is good.”

IV

A CURE FOR NERVES

In the account of the case which follows it is better that I allow the patient to speak for herself.

I am a neurotic woman. In that capacity I have been the subject of much criticism and much counsel. I have been both talked to and talked at. On the other hand I have detailed my unhappy symptoms to many in the hope of securing consolation, but with indefinite success. I am afraid I have often been a bore; for a bore, I am told, is a person who will talk of herself when you want to talk of yourself.

My husband says that there is nothing the matter with me, that my ailments are all imaginary and unreasonable. He becomes very cross when I talk of my wretched state and considers my ill-health as a grievance personal to himself. He says—when he is very irritated—that he is sick of my moanings, that I look well, eat well, sleep well, and so must be as sound as a woman can be. If I have a headache and cannot go out he is more annoyed than if he had the headache himself, which seems to me irrational. He is often very sarcastic about my symptoms, and this makes me worse. Once or twice he has been sympathetic and I have felt better, but he says that sympathy will do me harm and cause me to give way more. I suppose he knows because he is always so certain. He says all I have to do is to cheer up, to rouse myself, to pull myself together. He slaps himself on the chest and, in a voice that makes my head crack, says, “Look at me! I am not nervous, why should you be?” I don’t know why I am nervous and so I never try to answer the question. From the way my husband talks I feel that he must regard me as an impostor. If we have a few friends to dinner he is sure to say something about “the deplorable flabbiness of the minds of some women.” I know he is addressing himself to me and so do the others, but I can only smile and feel uncomfortable.

I have no wish to be nervous. It is miserable enough, heaven knows. I would give worlds to be free of all my miseries and be quite sound again. If I wished to adopt a complaint I should choose one less hideously distressing than “nerves.” I have often thought I would sooner be blind than nervous, and that then my husband would be really sorry for me; but I should be terribly frightened to be always in the dark.

I get a good deal of comfort from many of my women friends. They at least are sympathetic; they believe in me, know that my complaints are real and that what I say is true. Unfortunately, when I have described certain of my symptoms—such as one of my gasping attacks—they say that they have just such attacks themselves, only worse. They are so sorry for me; but then they will go on and tell me the exact circumstances under which they have had their last bouts. I am anxious to tell them of my other curious symptoms, but they say that it does them so much good to pour out their hearts to someone, and I, being very meek, let them go on, only wishing that they would listen to me as I listen to them.

I notice that their husbands have for the most part just the same erroneous views about nerves that mine has. Some of them say that they would like to make their menfolk suffer as they do themselves. One lady I know always ends with the reflection: “Ah, well! I shall not be long here, and when I am dead and under the daisies he will be sorry he was not more appreciative. He will then know, when it is too late, that my symptoms were genuine enough.” I must say that I have never gone to the extreme of wishing to die for the mere sake of convincing my husband of obstinate stupidity. I should like to go into a death-like trance and frighten him, for then I should be able to hear what he said when he thought I was gone and remind him of it afterwards whenever he became cynical.

It is in the morning that I feel so bad. I am really ghastly then. I wake up with the awful presentiment that something dreadful is going to happen. I don’t know what it is, yet I feel I could sink through the bed. I imagine the waking moments of the poor wretch who has been condemned to death and who is said to have “slept well” on the night before his execution. He will probably awake slowly and will feel at first hazily happy and content, will yawn and smile, until there creeps up the horrible recollection of the judge and the sentence, of the gallows and the hanging by the neck. I know the cold sweat that breaks over the whole body and the sickly clutching about the heart that attend such an awakening, but doubt if any emerging from sleep can be really worse than many I have experienced.

I can do so little in the day-time. I soon get exhausted and so utterly done up that I can only lie still in a dark room. When I am like that the least noise worries me and even tortures me almost out of my mind. If someone starts strumming the piano, or if a servant persistently walks about with creaky boots, or if my husband bursts in and tries to be hearty, I feel compelled to scream, it is so unbearable.

It is on such an occasion as this that my husband is apt to beg me “to pull myself together.” He quite maddens me when he says this. I feel as full of terror, awfulness and distress as a drowning man, and how silly it would be to lean over a harbour wall and tell a drowning man in comfortable tones that he should “pull himself together.” Yet that is what my husband says to me, with the irritating conviction that he is being intelligent and practical.

I cannot walk out alone. If I attempt it I am soon panic-stricken. I become hot all over, very faint, and so giddy that I reel and have to keep to the railings of the houses. I am seized with the hideous feeling that I can neither get on nor get back. I am not disturbed by the mere possibility of falling down on the pavement, but by the paralysing nightmare that I cannot take another step.

If anyone were to put me down in the middle of a great square, like the Praço de Dom Pedro at Lisbon, and leave me there alone, I think I should die or lose my reason. I know I should be unable to get out. I should fall in a heap, shut my eyes and try to crawl to the edge on my hands and knees, filled all the time with a panting terror. A man who finds himself compelled to cross a glassy ice slope which, twenty feet below, drops over a precipice, could not feel worse than I do if left adrift, nor pray more fervently to be clear of the abhorred space and safe. My husband says that this is all nonsense. I suppose it is, but it is such nonsense as would be sense if the jester were Death.

The knowledge that I have to go to a dinner party fills me with unutterable alarm. By the time I am dressed and ready to start I am chilled, shaking all over and gasping for breath. The drive to the house is almost as full of horror as the drive of the tumbril to the guillotine. By the time I arrive I am so ill I can hardly speak and am convinced that I shall fall down, or be sick, or shall have to cry out. More than once I have insisted upon being driven home again, and my husband has gone to the dinner alone after much outpouring of language.

Possibly my most direful experiments have been at the theatre, to which I have been taken on the ground that my mind needed change and that a cheerful play would “take me out of myself.” My worst terrors have come upon me when I have chanced to sit in the centre of the stalls with people packed in all around me. I have then felt as if I was imprisoned and have been filled by one intense overwhelming desire—the passion to get out. I have passed through all the horrors of suffocation, have felt that I must stand up, must lift up my arms and gasp. I have looked at the door only to feel that escape was as impossible as it would be to an entrapped miner about whom the walls of a shaft had fallen.

It is useless for my husband to nudge me and tell me not to make a fool of myself. If I did want to make a fool of myself I should select some more agreeable way of doing it. It is useless, moreover, to argue. No argument can dispel the ever-present sense of panic, of being buried alive, or relieve the hopeless feeling of inability to escape. I have sat out a play undergoing tortures beyond expression, until I have become collapsed and until my lip had been almost bitten through in the effort not to scream. No one would believe that I—a healthy-looking woman in a new Paris dress, sitting among a company of smiling folk—could be enduring as much agony as if I were lodged in an iron cell the walls of which were gradually closing in around me.

I am very fond of my clothes when I am well, but there are certain frocks I have come to loathe because they recall times when I have nearly gasped out my life in them.

I have taken much medicine but with no apparent good. I envy the woman who believes in her nerve tonic, since such faith must be a great comfort to her. I knew a poor girl who became for a time a mental wreck, owing to her engagement having been broken off. She refused food and lived for a week—so she told me—on her mother’s nerve tonic. She declared that it saved her reason. I tried it, but it only brought me out in spots. I have seen a good many doctors, but although they are all very kind, they seem to be dense and to have but the one idea of treating the neurotic woman as they would treat a frightened child or a lost dog.

I was taken to one doctor because he had the reputation of being very sensible and outspoken. My husband said there was no nonsense about him. He certainly made no effort to be entertaining. After he had examined me he said that all my organs were perfectly sound. He then began to address me as “My dear lady,” and at once I knew what was coming. It was to tell me that I wanted rousing and that all I had to do was to get out of myself. He said I was not to think about myself at all, which is very good advice to a person who feels on the point of dissolution. He told my husband afterwards, in strict confidence, that if I was a poor woman and had to work for my living I should be well directly. He went farther and said that what would cure me would be a week at the washing tub—at a laundry, I suppose. My husband imparted these confidences to me as we drove home from the doctor’s and said what a shrewd, common-sense man he was. My husband quite liked him.

Another doctor I went to was very sympathetic. He patted my hand and was so kind that he almost made me cry. He said he understood how real and intense my sufferings were. He knew I must have gone through tortures. He gave me a great many particulars as to how I was to live and said I was never to do anything I did not like. I wanted to come and see him again, but he insisted that I must go abroad at once to break with my sad associations and afford my shattered nerves a complete rest. He gave me a letter to a doctor abroad which he said contained a very full and particular account of my case.