Project Gutenberg Australia

Title: Doctors Off Duty
Author: Arthur Gask
* A Project Gutenberg Australia eBook *
eBook No.: 2000891.txt
Language: English
Date first posted:  September 2020
Date last updated:  September 2020

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------------------------------------------------------------------------

DOCTORS OFF DUTY


By Arthur Gask


Published in the Chronicle (Adelaide, SA : 1895 1954), Thursday 7
November 1940.



An important medical congress had been opened that morning in a big
northern city, and, after dinner that night, a little party of medical
men were smoking and talking in the library of a palatial mansion
which was giving them hospitality for the duration of the congress.
Their host, a wealthy manufacturer, had arranged with the organising
committee of the congress to put up a round score of the visiting
members, and, his house and grounds being among the show places of the
district, he had been allotted some of the chairmen of the various
sections. He was now thrilled at entertaining such distinguished
members of the profession under his roof.

"And I suppose," he laughed, "I should be quite safe tonight if I were
to be suddenly attacked with any kind of disease. I mean there must be
a specialist here for almost everything."

"Certainly there is, Sir Herbert," laughed back a merry-looking little
man who, for all his diminutive size, was one of the best known
authorities upon nervous diseases in the Western Hemisphere, "and
among the lot of us I am sure we should be able to manage your decease
somehow. With all the new drugs which have come out lately we should
have a splendid chance."

"And people have the idea," went on Sir Herbert jokingly, "that in no
calling in the world are there so many really good and really bad men
as among you doctors."

"Exactly!" commented the nerve specialist, but now speaking quite
seriously. "The very nature of our work, with all its opportunities,
brings out both the best and worst in us." He nodded. "But I like to
think that, considering our number, there are very few black sheep
among us. Occasional money-grabbers, of course, who trade with their
eyes for ever upon the till and who put in every extra visit they can
and operate wherever they guess there's a bit of cash." He nodded
again. "Still, those are the exceptions and the majority of us are
quite decent men."

"In a district near where I am," growled an old and grizzled general
practitioner, the panel and lodge patients of whose practice ran into
many thousands, "there's a fellow who boasts he takes out an appendix
almost every morning before breakfast." He shrugged his shoulders.
"I don't know where he finds them. I often see a hundred patients a
day, and it's an event when I send a patient into hospital for an
appendicectomy. And it's the same with tonsils. I don't agree with this
wholesale taking of them out."

"But perhaps you're a wee bit old fashioned, Dr. Gregson," smiled a
bright-faced young surgeon, prominent among the ear, nose and throat
men in the West of England. "You general practitioners are not ready
enough to appreciate the beautiful new instruments and appliances which
are being turned out for us by the manufacturers."

"I, certainly, am slow there," said the old G.P. frowningly. He nodded
significantly. "But my patients live just as long without them and they
probably suffer a great deal less."

"I'm quite sure they do, Dr. Gregson," smiled a great Harley street
consulting physician. He went on banteringly. "All these young surgeons
think of is cutting you about. They're crazed to open you somewhere.
It's your blood they want."

Another physician chimed in in the same vein. "Quite right, sir, there
is a false glamor about surgery, and so many in our profession want to
make it the hallmark of cleverness if they can cut you open and you
don't die on the operating table. They'd like the public to think so,
too."

"Yes," nodded a second general practitioner darkly, "and I know several
men who can do a good operation and yet who are rotten doctors, for all
that. With many minor ailments they are perfect duds and can't treat
even an ordinary indigestion properly." He smiled. "It's we common
G.P.'s who are the salt of the profession, and no man becomes a great
surgeon--I don't mean a good operator, for that doesn't necessarily
mean a good surgeon--unless he has first graduated from among us."

"But why," asked their host, looking rather puzzled, "does a good
operator not always mean a good surgeon?"

"Well, he may only have operated because he has made a faulty
diagnosis," replied the G.P. "Suppose you go to him with a hard
swelling in a gland and he tells you you've got a growth there and cuts
the whole gland out. Then he finds the swelling is only a hardened
abscess and all he need have done to put you right was to have lanced
it. Now, although he may have done a perfect operation you wouldn't
call him a good surgeon, would you?" He shook his head. "No, a good
surgeon must be a good physician, first."

A famous surgeon who could command almost any fee for his operations
took up the tale. "You are quite right, Dr. Hensley," he said. He
shrugged his shoulders deprecatingly. "I know that what little success
I have had I owe entirely to the foundation the five gruelling years I
spent as an assistant up North gave me. My employer had a huge practice
among the poorest classes and my work made a good physician of me." He
smiled a grim smile. "A shilling for a consultation, including a bottle
of medicine, and, as with Dr. Gregson here, our visiting list ran into
hundreds a day."

"But what could you do to them," asked his interested host, "when you
were attending to so many?"

"All that was necessary," replied the surgeon. "As with my employer, I
became most expert in making a lightning diagnosis. Some, I could see
with one glance, had nothing much the matter with them, and two minutes
was all they got." He nodded. "Others may have taken up half an hour."
He turned to the old general practitioner. "That's the way you handle
them, too, is it not, Dr. Gregson?"

Dr. Gregson nodded. "And I've been so long at the game that I can tell
with one look at them whether they're heart, lung or kidney cases." His
old shrewd eyes glinted. "Ay, and also whether I'll be getting my money
paid."

There were smiles all round, and then their host, addressing them all,
generally, remarked, "And, of course, being brought in contact with so
many people, you must have had many very interesting experiences."

"We have," replied an old doctor, Dr. Smith, who was not far off eighty
and who had given up active practice for some years, but who in his
time had been noted for his successes in difficult cases of midwifery.
"And it is only natural," he went on, "for the life of a medical man is
one great adventure from start to finish, from beginning to end. We are
present at all the crises of our patients' lives, their births, their
deaths, and all the sicknesses and accidents in between. No, we can't
help seeing and hearing a lot."

"Then tell us one of your adventures, Master," called out a young
doctor. "We all know everything you say is worth listening to."

The others joined in with the request, and the old man was flattered.
"Well," he said slowly. "I'll give you a little bit of romance, and
the moral it points is the absolute trust which most people have in
their medical man. I mean a confidence which they take to themselves
as a matter of course. They are sure that if he knows any secret about
them he will not give them away. There is no need for them to exact any
promise."

He spoke fervently. "Gad, in this particular instance I held a woman's
secret for nearly fifty years, and yet, ignoring there was any secret
to hide and that I knew all about it, during all that time she lived a
happy, smiling, and confident life! She was certain I should never give
her away."

A rustle of interest stirred round the room, and the old man went on.
"What happened was this. When I was quite young, indeed, only just
qualified, I went to look after the practice of a man who had been
ordered away for a long voyage, and who would not be returning to work
for a year."

"I had not been there long when a young woman came in to book me"--he
smiled--"for the forthcoming interesting event so natural with members
of her sex. She had left things rather late, and there were only a
few weeks to go. She was very pretty, and I guessed at once there was
tragedy about the business, because she said she was a stranger to the
town and all upon her own. She asked me to engage the nurse and not get
an expensive one. She told me she was twenty-two, but I was sure she
was younger than that. She said she was Mrs. Brown.

"In due time, after some little anxiety for me, as the case was by
no means an easy one, the baby was born in the house where the girl
had apartments. She was a little daughter, and when delivered was not
pretty to look at, as there was a big naevus covering the whole of one
side of the face and the entire nose as well." He turned to his host.
"I mean, Sir Herbert, she had one of those port wine stain birthmarks
which are so disfiguring for anyone when they grow up, and particularly
so for a girl. This one was so big that it would have been impossible
to do anything for it." He frowned. "There was also a deformity of one
foot. The child was not breathing when she was born.

"I made a lightning decision as to what I should do, and all my life
long I have never regretted what it was. The mother was in a bad way
and needed all the attention I could give her. The child was, so
obviously to me, born out of wedlock, and if she lived, unsightly as
she would grow up, would have to face both the pity as well as the
scorn of the world. So"--he paused a few moments--"if she had come from
heaven I let her return there straightaway. I made no attempt to start
the breathing." He looked round the room. "Now does anyone here say I
did wrong?"

A silence followed, and, no one taking up the challenge, he went
on--"The mother soon got well, and in a fortnight passed out of my
life, as I thought, for ever. I never expected to hear or see anything
more of her. But I was greatly mistaken, for a little over two years
later I met her again.

"I had gone up North and set up in practice in a district where it
was destined I should remain for the rest of my professional life. A
couple of months or so after I arrived I was invited to a dance and
there, to my amazement, was introduced to my one-time patient, the
pretty Mrs. Brown. Her name was now given me as Miss So-and-So, but,
of course, I recognised her at once, realising at the same moment
that she had recognised me, too. Still, only just a quick intake of
breath, a levelling of the beautifully arched eyebrows and a lightning
look of dismay in the soft grey eyes, and that was all the evidence
of recognition she showed. I thought her prettier than ever, for
now the sadness upon her face had passed. She quite fascinated me.
We had several dances together, and I took her into supper, but our
conversation was just the ordinary conventional one, and there was not
the slightest allusion to our having met before.

"Later, I was told that she and her people had not long come to live in
the town, and that she had there met and become engaged to a very nice
young fellow. It was to be an excellent match for her, as the boy was
very well-off. I became friendly with her family, and when the marriage
took place was present as an esteemed guest.

"None of her people were then patients of mine, neither were any of
her husband's. So I was very astonished when one day, less than a year
later, her husband called upon me and asked me to attend his wife in a
few months' time. I went to see her professionally, and, in the course
of our conversation, she remarked with a smile, "I thought I would
prefer you to anyone else as you would understand me."

The old doctor slapped his hands together. "And that was the only
remark with any suggestion of reference to my earlier association
with her she ever made. Just think of it! For nearly fifty years I
was an intimate friend of the family, as well as being their medical
attendant, and yet--she never asked me to keep silent about what
I knew. It never entered into her mind that I should betray her
secret. She never so much as said. 'I can trust you, can't I? You'll
never mention about that Mrs. Brown?' No"--his old eyes glowed with
pride--"she took it for granted she could rely upon my honor, without
making any appeal to me."

He went on. "Besides this first child of her happy married life, I
brought four more into the world for her, and lovely children they all
were. Then, as the years rolled on, I was the first to set eyes upon
the little ones of her two daughters, and when a much loved and greatly
respected old lady was carried to her last resting place, shortly
before I gave up practice"--his voice was reverent and solemn--"her
secret was buried with her." He spoke huskily. "That is my little
story, gentlemen."

"A very interesting one, Dr. Smith," commented his host, "and you told
it very nicely, too."

"Well, as I say," said the old doctor, "the only moral I wanted to
point was the unquestioning reliance the ordinary men and women place
upon their medical men, and, I believe, deservedly so."

Another doctor spoke up. "Now I'll tell you a little story and it's a
humorous one. It points no moral and, if it be true, rather reflects
upon us as a profession." He laughed. "We need a little taking-down
sometimes." He drew the eyes of his audience upon him and began.

"Two well-to-do elderly ladies lived in a small country town, and the
younger of them fancied she was not in good health, and always upon
the verge of a complete breakdown. In consequence, she was a reliable
source of income to the local medico, who put in an almost daily visit,
with a becomingly solemn face. The patient didn't get any better,
which was not to be wondered at, when you realise she had nothing the
matter with her. Still, the elder sister began to get worried, and one
day told the doctor she thought a specialist from London ought to be
brought down.

"The doctor considered, and then, remembering an old fellow-student of
his who had risen to eminence, and with whom he thought he would like
to have a yarn, suggested, well, we'll call him, Sir Pompey Flapdoddle.
The sister was quite agreeable, and so Sir Pompey was communicated
with, and he came down.

"Now, this elder lady was most anxious to know from what disease her
sister was really suffering, and, accordingly, made arrangements to
listen in to what the two doctors would say when they came to discuss
the case after the examination in the bedroom had taken place. So she
kept out of the way when the great man arrived, and secreted herself
behind a screen in the room into which they would be shown afterwards,
to talk things over. Sherry and biscuits had been provided.

"The examination over, the two medicos duly came in. The door was shut
carefully, and the sister prepared to listen hard. The old friends at
once began to talk animatedly together. They spoke of their hospital
days and the happy times they had had; of their old fellow-students
and what had become of them; how White had worked up a big practice in
Liverpool, how Black had died of fever on the West Coast of Africa; how
Green had married a rich wife, and now did nothing but play golf. Then
they exchanged a few stories which made the listener behind the screen
hold her breath in horror, while the narrators themselves were muffling
their laughter so that it should not be heard outside. And all the time
not a word had been said about the patient. She had not been referred
to in any way.

"Presently the listener heard the pushing back of chairs and the great
consultant say, 'Well, old chap, it's been very nice to have a chat
with you, and many thanks for having me down.'

"'Not at all, my dear fellow,' said the local medico. 'I shall always
be only pleased to do anything I can.'

"'Then, good-bye, my boy,' went on the consultant, 'and good luck to
you,' and they both walked towards the door.

"'Here, one moment!' exclaimed the other, 'You've not given me your
opinion of the patient. What do you think of her?'

"'Think of her?' laughed the consultant, 'why, I think she's the
ugliest old woman I ever saw.'

"'Ha, ha!' laughed back the local man, 'but you wouldn't say that if
you had seen her sister. She's even uglier still.'"

When the general laughter which the story had evoked had died down, the
famous surgeon stirred in his chair, and began slowly. "But, harking
back to operations which the few unscrupulous men among us perform
when they know perfectly well they are not necessary, although it's in
the nature of a confession, I'll tell you what I once did." He looked
upon everyone with a grim smile, and lowered his voice impressively.
"For the first and only time in my life I myself performed an
operation which, when I did it, I was absolutely convinced was wholly
unnecessary."

He paused for a moment to let his words sink in, noting with some
amusement the astounded looks upon the faces of his audience.

He went on--"Yes, it's an extraordinary story, and brings home the
almost inconceivable things which may happen to any of us. I was just
over thirty then, and struggling to get a footing as a surgeon in
London, and with no private means behind me. You will all understand
what that meant, keeping up appearances and half-starving to do it. I
had taken my 'master of surgery,' and by great good luck been appointed
an assistant surgeon at St. Bengers. Of course, that helped me a bit,
but private patients were coming in very slowly, and there were many
days when I sat in my expensive consulting room in Wimpole street and
didn't see a soul."

"At that time my main standby was Sir Benjamin Luke--dear old Ben--the
greatest surgeon of his day. He was very kind to me, and I often picked
up a few guineas from patients he sent me. In fact, but for him I am
sure I should have had to go back to an assistantship with some general
practitioner, as all the money I had saved had been spent in trying to
establish myself where I was. I particularly mention that to make you
all realise under what obligations to him I was at that time.

"Well, one morning he rang me up. He was going away that same afternoon
for a month's holiday, and he was sending me a man called Martin, who
would be coming straight away, and whose appendix he wanted me to
remove as speedily as possible. It was not, however, an acute case, but
one of long-standing inflammation, and the patient was a slippery one
to handle. For months and months he, Sir Benjamin, had been urging him
to have it out, but the man had been shilly-shallying and unable to
make up his mind. Now things had come to such a pass that to delay any
longer would be really dangerous.

"Still, bad as his condition is," went on Sir Benjamin over the phone,
"you'll have to bounce him into it. When you've examined him you must
give him no time to think, but take him on the hop and rush him into
hospital immediately. Operate today as a matter of extreme urgency.
That's the only way you'll get him before it comes to an actual
perforation. Oh, and remember, he's unreliable in everything he says.
To put it plainly, he's a dreadful liar. He may say he has no symptoms
at all, or he may describe ones quite different from those he really
has. He's inclined to be very secretive, too, and likes to make a
mystery of everything. So, if he's in the mood he may not mention me
at all, and say nothing about my having told him to come to you. If he
doesn't choose to tell you that, you act as if you knew nothing, and
just deal with him as a new patient who has been recommended to you,
you don't know by whom. You understand the position. Take no notice of
anything he says, insist that an immediate operation is a matter of
extreme urgency, and don't give him the opportunity to change his mind.
Rush him into hospital I say."

The surgeon went on--"I kept close to my consulting room all that day,
but it was not until towards the end of the afternoon, and just when I
was disappointedly thinking the man was not going to turn up that he
arrived. As I have already told you, patients were not very plentiful
with me, and, in consequence, my nurse came into me with some natural
excitement. 'A new patient, doctor,' she said. 'A Mr. Martin, and he
wants to know if you can see him without an appointment. I told him I
thought I could put him in in a few minutes if he waited.'

"So I kept him waiting a quarter of an hour, prepared, however, to rush
out at any moment if I heard any movement in the hall which suggested
he had got tired of waiting. Ah, you smile! But that's a custom
well-known to the profession and I dare venture we've many of us done
it in our time. To go on. When, at length I had him shown in, I thought
him at once, as Sir Benjamin had intimated to me, a secretive and
uncommunicative man, as he did not mention who had recommended me to
him and, moreover made no reference to any abdominal symptoms. His only
complaint was that for a long time he had been suffering from severe
frontal headaches which quite incapacitated him while they lasted. He
had lately begun to fear he must have a tumor on the brain.

"I paid little attention to what he told me about his head and,
apparently to his great surprise, made him strip, and started to
examine his abdomen. Then, to my amazement, I could not find the very
slightest trace of anything wrong. I pushed and pummelled, but there
was absolutely no tenderness, and the abdomen was that of a normal
healthy man.

"I was in a dreadful quandary! What was I to do? How could I possibly
make out the instant operation was imperative? Yet, was I to pit my
judgment against that of a great surgeon like Sir Benjamin, than whom
no one had a more profound knowledge of the diseases of the abdomen?
Should I send this man away, telling him he had nothing the matter with
him which a holiday and some mild sedative might put right, when all
along for many months the renowned Sir Benjamin Luke had been insisting
he was seriously ill and in grave danger? Then, another consideration,
was I to run the risk of offending my best friend, the one man who had
helped me whenever he could? It was a dreadful position for me to be
in."

The famous surgeon sighed heavily. "Gentlemen, I gave in. I stifled my
conscience with the feeble excuse that, after all, I was only obeying
the orders of one much older and wiser than I. So I told the patient
all Sir Benjamin had bidden me. Oh, yes, I frightened him right enough,
and, patting myself upon the back for succeeding where Sir Benjamin had
failed, made him enter a hospital within the hour, arranging that I
would operate at nine o'clock that night.

"Everything seemed to be promising well until I got a 'phone call from
a medical man in a town about forty miles from London. He said he was
a cousin of this Mr. Martin and, having just heard of the operation,
would like to be present. He asked when it was going to take place, and
I had to tell him.

"I was aghast! The last thing I wanted was a shrewd G.P.--and most of
you G.P.'s are shrewd enough, in all conscience--seeing the healthy
appendix I was going to take out. So, plunging even deeper into the
mire, without letting this cousin know anything about it and under an
excuse of urgency, I advanced the time of the operation an hour, and it
was all over and I was well away from the hospital and not to be got at
again that night by the time he had arrived in town. I heard next day
that, when he had asked to see the offending appendix, he had been most
disappointed to learn I had taken it off with me.

"The next morning the patient said he was feeling fine. The wife was
by the bedside when I appeared, and she thanked me most gratefully for
having made her husband have the operation performed so quickly, thus
giving him such a little time to think about it beforehand. I tell
you I felt horrible, but tried hard to console myself, as I had done
before, that I had only been obeying orders, and had acted exactly as
Sir Benjamin would have done had his services been available."

The surgeon paused here to light a cigarette, and then continued. "Now,
for the perfectly astounding sequel. That same afternoon I was seated
once more in my consulting room, as usual disengaged, when in came
my nurse, looking, as she had done the previous day, quite excited.
"There's another new patient here, doctor," she said, "of the same name
as the one who came yesterday, another Mr. Martin, and he says he's
been sent you by Sir Benjamin Luke."

"What!" I exclaimed incredulously, with a cold shiver running up my
spine. "Another patient of the name of Martin, and he says he's been
sent by Sir Benjamin!"

"Yes, doctor, and he wants to see you as quickly as possible. He says
he's in pain and thinks he ought to be operated upon immediately."

"God, I felt sick with horror! What a ghastly mistake! I've operated
upon the wrong man!

"I ordered him to be shown in instantly, and at once the urgency of the
matter was beyond any possibility of doubt. The man was in a very grave
condition, and not a moment must be lost. Indeed, things looked so bad
that I wouldn't let him even return home, but drove him straight to the
hospital, where the other Martin was. Fortunately, he had had nothing
to eat that day, and the moment I could get the anaesthetist round, in
not much over an hour, he was being put under the anaesthetic. Heavens,
I was only just in time! The abscess would have burst in a matter of
only minutes!"

He leant back in his chair and looked round smilingly. "Well, the two
Martins were soon convalescent and reclining upon the balcony together,
no doubt discussing the coincidence of the similarity of their names
and complaints, and the wonderful doctor who was attending to them. He
nodded emphatically. "But wasn't it a marvellous thing that, when I
was expecting one Martin, two of the same name should appear one after
the other. Of course, I know Martin is not a rare name, but it's by no
means a common one."

"And did you get a big fee from the first Martin?" asked one of the
other doctors banteringly.

The surgeon shook his head smilingly. "No, only a very moderate one,
and I sent it as an anonymous donation to my hospital." He laughed.
"But the patient expressed his willingness to pay double or treble the
amount, as he had benefited so greatly from the operation. You see,
from the day I took out his appendix he never had a single one of those
headaches which had been his curse for years and years. That was an
extraordinary happening, too."

"But not so extraordinary as you perhaps think, doctor," broke in
his host immediately, "as I happen to know just such a case in my
own family. My poor father, who is dead now, was cured of dreadful
headaches in exactly the same way, when he was quite a young man. A
surgeon in London, I don't remember his name, took out his appendix,
it must be nearly thirty years ago, for precisely the same reason." He
laughed merrily. "Why, if you hadn't told us your patient was called
Martin, you might be the very doctor who operated upon my father, for
ours, too, is a name which might easily have had a double. There are
plenty of people about called Hunter." He rose from his chair and made
a movement towards the door. "But come on, now. We'll go and join the
ladies. They are going to give us some music."

"Whew, but what a narrow escape that was!" murmured the great surgeon
under his breath. He swallowed hard. "What a mercy I didn't give the
right name! Fancy after all these years meeting the man's son! Gad, as
old Smith has just told me, we medical men do see life!"


THE END.

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