Of Human Bondage (77 page)

  Most of them were under the impression that the
hospital was an institution of the state, for which they paid out
of the rates, and took the attendance they received as a right they
could claim. They imagined the physician who gave them his time was
heavily paid.

  Dr. Tyrell gave each of his clerks a case to
examine. The clerk took the patient into one of the inner rooms;
they were smaller, and each had a couch in it covered with black
horse-hair: he asked his patient a variety of questions, examined
his lungs, his heart, and his liver, made notes of fact on the
hospital letter, formed in his own mind some idea of the diagnosis,
and then waited for Dr. Tyrell to come in. This he did, followed by
a small crowd of students, when he had finished the men, and the
clerk read out what he had learned. The physician asked him one or
two questions, and examined the patient himself. If there was
anything interesting to hear students applied their stethoscope:
you would see a man with two or three to the chest, and two perhaps
to his back, while others waited impatiently to listen. The patient
stood among them a little embarrassed, but not altogether
displeased to find himself the centre of attention: he listened
confusedly while Dr. Tyrell discoursed glibly on the case. Two or
three students listened again to recognise the murmur or the
crepitation which the physician described, and then the man was
told to put on his clothes.

  When the various cases had been examined Dr. Tyrell
went back into the large room and sat down again at his desk. He
asked any student who happened to be standing near him what he
would prescribe for a patient he had just seen. The student
mentioned one or two drugs.

  "Would you?" said Dr. Tyrell. "Well, that's original
at all events. I don't think we'll be rash."

  This always made the students laugh, and with a
twinkle of amusement at his own bright humour the physician
prescribed some other drug than that which the student had
suggested. When there were two cases of exactly the same sort and
the student proposed the treatment which the physician had ordered
for the first, Dr. Tyrell exercised considerable ingenuity in
thinking of something else. Sometimes, knowing that in the
dispensary they were worked off their legs and preferred to give
the medicines which they had all ready, the good hospital mixtures
which had been found by the experience of years to answer their
purpose so well, he amused himself by writing an elaborate
prescription.

  "We'll give the dispenser something to do. If we go
on prescribing mist: alb: he'll lose his cunning."

  The students laughed, and the doctor gave them a
circular glance of enjoyment in his joke. Then he touched the bell
and, when the porter poked his head in, said:

  "Old women, please."

  He leaned back in his chair, chatting with the H.P.
while the porter herded along the old patients. They came in,
strings of anaemic girls, with large fringes and pallid lips, who
could not digest their bad, insufficient food; old ladies, fat and
thin, aged prematurely by frequent confinements, with winter
coughs; women with this, that, and the other, the matter with them.
Dr. Tyrell and his house-physician got through them quickly. Time
was getting on, and the air in the small room was growing more
sickly. The physician looked at his watch.

  "Are there many new women today?" he asked.

  "A good few, I think," said the H.P.

  "We'd better have them in. You can go on with the
old ones."

  They entered. With the men the most common ailments
were due to the excessive use of alcohol, but with the women they
were due to defective nourishment. By about six o'clock they were
finished. Philip, exhausted by standing all the time, by the bad
air, and by the attention he had given, strolled over with his
fellow-clerks to the Medical School to have tea. He found the work
of absorbing interest. There was humanity there in the rough, the
materials the artist worked on; and Philip felt a curious thrill
when it occurred to him that he was in the position of the artist
and the patients were like clay in his hands. He remembered with an
amused shrug of the shoulders his life in Paris, absorbed in
colour, tone, values, Heaven knows what, with the aim of producing
beautiful things: the directness of contact with men and women gave
a thrill of power which he had never known. He found an endless
excitement in looking at their faces and hearing them speak; they
came in each with his peculiarity, some shuffling uncouthly, some
with a little trip, others with heavy, slow tread, some shyly.
Often you could guess their trades by the look of them. You learnt
in what way to put your questions so that they should be
understood, you discovered on what subjects nearly all lied, and by
what inquiries you could extort the truth notwithstanding. You saw
the different way people took the same things. The diagnosis of
dangerous illness would be accepted by one with a laugh and a joke,
by another with dumb despair. Philip found that he was less shy
with these people than he had ever been with others; he felt not
exactly sympathy, for sympathy suggests condescension; but he felt
at home with them. He found that he was able to put them at their
ease, and, when he had been given a case to find out what he could
about it, it seemed to him that the patient delivered himself into
his hands with a peculiar confidence.

  "Perhaps," he thought to himself, with a smile,
"perhaps I'm cut out to be a doctor. It would be rather a lark if
I'd hit upon the one thing I'm fit for."

  It seemed to Philip that he alone of the clerks saw
the dramatic interest of those afternoons. To the others men and
women were only cases, good if they were complicated, tiresome if
obvious; they heard murmurs and were astonished at abnormal livers;
an unexpected sound in the lungs gave them something to talk about.
But to Philip there was much more. He found an interest in just
looking at them, in the shape of their heads and their hands, in
the look of their eyes and the length of their noses. You saw in
that room human nature taken by surprise, and often the mask of
custom was torn off rudely, showing you the soul all raw. Sometimes
you saw an untaught stoicism which was profoundly moving. Once
Philip saw a man, rough and illiterate, told his case was hopeless;
and, self-controlled himself, he wondered at the splendid instinct
which forced the fellow to keep a stiff upper-lip before strangers.
But was it possible for him to be brave when he was by himself,
face to face with his soul, or would he then surrender to despair?
Sometimes there was tragedy. Once a young woman brought her sister
to be examined, a girl of eighteen, with delicate features and
large blue eyes, fair hair that sparkled with gold when a ray of
autumn sunshine touched it for a moment, and a skin of amazing
beauty. The students' eyes went to her with little smiles. They did
not often see a pretty girl in these dingy rooms. The elder woman
gave the family history, father and mother had died of phthisis, a
brother and a sister, these two were the only ones left. The girl
had been coughing lately and losing weight. She took off her blouse
and the skin of her neck was like milk. Dr. Tyrell examined her
quietly, with his usual rapid method; he told two or three of his
clerks to apply their stethoscopes to a place he indicated with his
finger; and then she was allowed to dress. The sister was standing
a little apart and she spoke to him in a low voice, so that the
girl should not hear. Her voice trembled with fear.

  "She hasn't got it, doctor, has she?"

  "I'm afraid there's no doubt about it."

  "She was the last one. When she goes I shan't have
anybody."

  She began to cry, while the doctor looked at her
gravely; he thought she too had the type; she would not make old
bones either. The girl turned round and saw her sister's tears. She
understood what they meant. The colour fled from her lovely face
and tears fell down her cheeks. The two stood for a minute or two,
crying silently, and then the older, forgetting the indifferent
crowd that watched them, went up to her, took her in her arms, and
rocked her gently to and fro as if she were a baby.

  When they were gone a student asked:

  "How long d'you think she'll last, sir?"

  Dr. Tyrell shrugged his shoulders.

  "Her brother and sister died within three months of
the first symptoms. She'll do the same. If they were rich one might
do something. You can't tell these people to go to St. Moritz.
Nothing can be done for them."

  Once a man who was strong and in all the power of
his manhood came because a persistent aching troubled him and his
club-doctor did not seem to do him any good; and the verdict for
him too was death, not the inevitable death that horrified and yet
was tolerable because science was helpless before it, but the death
which was inevitable because the man was a little wheel in the
great machine of a complex civilisation, and had as little power of
changing the circumstances as an automaton. Complete rest was his
only chance. The physician did not ask impossibilities.

  "You ought to get some very much lighter job."

  "There ain't no light jobs in my business."

  "Well, if you go on like this you'll kill yourself.
You're very ill."

  "D'you mean to say I'm going to die?"

  "I shouldn't like to say that, but you're certainly
unfit for hard work."

  "If I don't work who's to keep the wife and the
kids?"

  Dr. Tyrell shrugged his shoulders. The dilemma had
been presented to him a hundred times. Time was pressing and there
were many patients to be seen.

  "Well, I'll give you some medicine and you can come
back in a week and tell me how you're getting on."

  The man took his letter with the useless
prescription written upon it and walked out. The doctor might say
what he liked. He did not feel so bad that he could not go on
working. He had a good job and he could not afford to throw it
away.

  "I give him a year," said Dr. Tyrell.

  Sometimes there was comedy. Now and then came a
flash of cockney humour, now and then some old lady, a character
such as Charles Dickens might have drawn, would amuse them by her
garrulous oddities. Once a woman came who was a member of the
ballet at a famous music-hall. She looked fifty, but gave her age
as twenty-eight. She was outrageously painted and ogled the
students impudently with large black eyes; her smiles were grossly
alluring. She had abundant self-confidence and treated Dr. Tyrell,
vastly amused, with the easy familiarity with which she might have
used an intoxicated admirer. She had chronic bronchitis, and told
him it hindered her in the exercise of her profession.

  "I don't know why I should 'ave such a thing, upon
my word I don't. I've never 'ad a day's illness in my life. You've
only got to look at me to know that."

  She rolled her eyes round the young men, with a long
sweep of her painted eyelashes, and flashed her yellow teeth at
them. She spoke with a cockney accent, but with an affectation of
refinement which made every word a feast of fun.

  "It's what they call a winter cough," answered Dr.
Tyrell gravely. "A great many middle-aged women have it."

  "Well, I never! That is a nice thing to say to a
lady. No one ever called me middle-aged before."

  She opened her eyes very wide and cocked her head on
one side, looking at him with indescribable archness.

  "That is the disadvantage of our profession," said
he. "It forces us sometimes to be ungallant."

  She took the prescription and gave him one last,
luscious smile.

  "You will come and see me dance, dearie, won't
you?"

  "I will indeed."

  He rang the bell for the next case.

  "I am glad you gentlemen were here to protect
me."

  But on the whole the impression was neither of
tragedy nor of comedy. There was no describing it. It was manifold
and various; there were tears and laughter, happiness and woe; it
was tedious and interesting and indifferent; it was as you saw it:
it was tumultuous and passionate; it was grave; it was sad and
comic; it was trivial; it was simple and complex; joy was there and
despair; the love of mothers for their children, and of men for
women; lust trailed itself through the rooms with leaden feet,
punishing the guilty and the innocent, helpless wives and wretched
children; drink seized men and women and cost its inevitable price;
death sighed in these rooms; and the beginning of life, filling
some poor girl with terror and shame, was diagnosed there. There
was neither good nor bad there. There were just facts. It was
life.