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The Elephant Man

And Other Reminiscences

The Elephant Man

and

Other Reminiscences

By

Sir Frederick Treves, Bart.

G.C.V.O., C.B., LL.D.

Serjeant-Surgeon to His Majesty the King.

AiitJwr of ''The Other Side of the Lantern," "The Cradle
of the Deep," "The Country of the Ring and the Book,"
''Highways and Byways of Dorset," "The Riviera of the
Corniche Road,'' "The Lake of Geneva," etc. etc.

CASSELL AND COMPANY, LTD

London, New York, Toronto and Melbourne

1923

First published Februarv 1923
Reprinted February 1923

Printed in Great Britain

Contents

I. The Elephant Man

II. The Old Receiving Room .

III. The Twenty-Krone Piece .

IV. A Cure for Nerves

V. Two Women ....

VI. A Sea Lover ....

VII. A Case of "Heart Failure"

VIII. A Restless Night

IX. In Articulo Mortis

X. The Idol with Hands of Clay

XI. Breaking the News

XII. A Question of Hats .

I

39

59

67

91
III

121
135

155
181

199

213

The Elephant Man

And Other Reminiscences
I

THE ELEPHANT MAN

IN the Mile End Road, opposite to the London
Hospital, there was (and possibly still is) a
line of small shops. Among them was a vacant
greengrocer's which was to let. The whole of
the front of the shop, with the exception of the
door, was hidden by a hanging sheet of canvas
on which was the announcement that the Elephant
Man was to be seen within and that the price of
admission was twopence. Painted on the canvas
in primitive colours w^as a life-size portrait of
the Elephant Man. This very crude production
depicted a frightful creature that could only have
been possible in a nightmare. It was the figure
of a man with the characteristics of an elephant.
The transfiguration was not far advanced. There
was still more of the man than of the beast.
This fact — that it was still human — was the most

2 The Elephant Man

repellent attribute of the creature. There was
nothing about it of the pitiableness of the mis-
shapened or the deformed, nothing of the
grotesqueness of the freak, but merely the loath-
some insinuation of a man being changed into
an animal. Some palm trees in the background
of the picture suggested a jungle and might have
led the imaginative to assume that it was in this
wild that the perverted object had roamed.

When I first became aware of this phenomenon
the exhibition was closed, but a well-informed boy
sought the proprietor in a public house and I was
granted a private view on payment of a shilling.
The shop was empty and grey with dust. Some
old tins and a few shrivelled potatoes occupied
a shelf and some vague vegetable refuse the
window. The light in the place was dim, being
obscured by the painted placard outside. The
far end of the shop — where I expect the late
proprietor sat at a desk — was cut off by a curtain
or rather bj^ a red tablecloth suspended from a
cord by a few rings. The room was cold and
dank, for it was the month of November. The
year, I might say, was 1884.

The showman pulled back the curtain and
revealed a bent figure crouching on a stool and
covered by a brown blanket. In front of it, on

The Elephant Man 3

a tripod, was a large brick heated by a Bunsen
burner. Over this the creature was huddled to
warm itself. It never moved when the curtain
was drawn back. Locked up in an empty shop
and lit by the faint blue light of the gas jet,
this hunched-up figure was the embodiment of
loneliness. It might have been a captive in a
cavern or a wizard watching for unholy mani-
festations in the ghostly flame. Outside the sun
was shining and one could hear the footsteps
of the passers-by, a tune whistled by a boy
and the companionable hum of traflBc in the
road.

The showman — speaking as if to a dog — called
out harshly : " Stand up ! " The thing arose
slowly and let the blanket that covered its head
and back fall to the ground. There stood re-
vealed the most disgusting specimen of humanity
that I have ever seen. In the course of my
profession I had come upon lamentable deformi-
ties of the face due to injury or disease, as well
as mutilations and contortions of the body depend-
ing upon like causes ; but at no time had I met
with such a degraded or perverted version of a
human being as this lone figure displayed. He
was naked to the waist, his -feet were bare, he
wore a pair of threadbare trousers that had

4 The Elephant Man

once belonged to some fat gentleman's dress
suit.

From the intensified painting in the street I
had imagined the Elephant Man to be of gigantic
size. This, however, was a little man below the
average height and made to look shorter by the
bowing of his back. The most striking feature
about him was his enormous and misshapened
head. From the brow there projected a huge
bony mass like a loaf, while from the back of
the head hung a bag of spongy, fungous-looking
skin, the surface of which was comparable to
brown cauliflower. On the top of the skull were
a few long lank hairs. The osseous growth on
the forehead almost occluded one eye. The cir-
cumference of the head was no less than that of
the man's waist. From the upper jaw there
projected another mass of bone. It protruded
from the mouth like a pink stump, turning the
upper lip inside out and making of the mouth a
mere slobbering aperture. This growth from the
jaw had been so exaggerated in the painting as
to appear to be a rudimentary trunk or tusk.
The nose was merely a lump of flesh, only recog-
nizable as a nose from its position. The face iwas
no more capable of expression than a block of
gnarled wood. The back was horrible, because

The Elephant Man 5

from it hung, as far down as the middle of the
thigh, huge, sack-like masses of flesh covered by
the same loathsome cauliflower skin.

The right arm was of enormous size and shape-
less. It suggested the limb of the subject of
elephantiasis. It was overgrown also with pendent
masses of the same cauliflower-like skin. The
hand was large and clumsy — a fin or paddle rather
than a hand. There was no distinction between
the palm and the back. The thumb had the
appearance of a radish, while the fingers might
have been thick, tuberous roots. As a limb it
was almost useless. The other arm was remark-
able by contrast. It was not only normal but
was, moreover, a delicately shaped limb covered
w^ith fine skin and provided with a beautiful hand
which any woman might have envied. From the
chest hung a bag of the same repulsive flesh. It
was like a dewlap suspended from the neck of
a lizard. The lower limbs had the characters of
the deformed arm. They were unwieldy, dropsical
looking and grossly misshapened.

To add a further burden to his trouble the
wretched man, when a boy, developed hip disease,
which had left him permanently lame, so that
he could only walk with a stick. He was thus
denied all means of escape from his tormentors.

6 The Elephant Man

As he told me later, he could never run away.
One other feature must be mentioned to emphasize
his isolation from his kind. Although he was
already repellent enough, there arose from the
fungous skin-growth with which he was almost
covered a very sickening stench which was hard
to tolerate. From the showman I learnt nothing
about the Elephant Man, except that he was
English, that his name was John Merrick and
that he was twenty-one years of age.

As at the time of my discovery of the Elephant
Man I was the Lecturer on Anatomy at the
Medical College opposite, I was anxious to examine
him in detail and to prepare an account of his
abnormalities. I therefore arranged with the
showman that I should interview his strange
exhibit in my room at the college. I became
at once conscious of a difficulty. The Elephant
Man could not show himself in the streets. He
would have been mobbed by the crowd and seized
by the police. He was, in fact, as secluded from
the world as the Man with the Iron Mask. He
had, however, a disguise, although it was almost
as startling as he was himself. It consisted of
a long black cloak which reached to the ground.
Whence the cloak had been obtained I cannot
imagine. I had only seen such a garment on

The Elephant Man 7

the stage wrapped about the figure of a Venetian
bravo. The recluse was provided with a pair of
bag-like slippers in which to hide his deformed
feet. On his head was a cap of a kind that
never before was seen. It was black like the
cloak, had a wide peak, and the general outline
of a yachting cap. As the circumference of
Merrick's head was that of a man's waist, the
size of this headgear may be imagined. From
the attachment of the peak a grey flannel curtain
hung in front of the face. In this mask was
cut a wide horizontal slit through which the
wearer could look out. This costume, worn by
a bent man hobbling along with a stick, is prob-
ably the most remarkable and the most uncanny
that has as yet been designed. I arranged that
Merrick should cross the road in a cab, and to
insure his immediate admission to the college I
gave him my card. This card was destined to
play a critical part in Merrick's life.

I made a careful examination of my visitor
the result of which I embodied in a paper. ^ I
made little of the man himself. He was shy,
confused, not a little frightened and evidently
much cowed. Moreover, his speech was almost
unintelligible. The great bony mass that pro-

i British Medical Journal, Dec, 1886, and April, 1890.

8 The Elephant Man

jected from his mouth blurred his utterance and
made the articulation of certain words impossible.
He returned in a cab to the place of exhibition,
and I assumed that I had seen the last of him,
especially as I found next day that the show had
been forbidden by the police and that the shop
was empty.

I supposed that Merrick was imbecile and had
been imbecile from birth. The fact that his face
was incapable of expression, that his speech was
a mere spluttering and his attitude that of one
whose mind was void of all emotions and concerns
gave grounds for this belief. The conviction was
no doubt encouraged by the hope that his intellect
was the blank I imagined it to be. That he
could appreciate his position was unthinkable.
Here was a man in the heyday of youth who was
so vilely deformed that everyone he met con-
fronted him with a look of horror and disgust.
He was taken about the country to be exhibited
as a monstrosity and an object of loathing. He
was shunned like a leper, housed Hke a wild beast,
and got his only view of the world from a peep-
hole in a showman's cart. He was, moreover,
lame, had but one available arm, and could hardly
make his utterances understood. It was not
until I came to know that Merrick was highly

The Elephant Man 9

intelligent, that he possessed an acute sensibility
and — worse than all — a romantic imagination
that I realized the overwhelming tragedy of
his life.

The episode of the Elephant Man was, I
imagined, closed ; but I was fated to meet him
again — two years later — under more dramatic
conditions. In England the showman and Merrick
had been moved on from place to place by the
police, who considered the exhibition degrading
and among the things that could not be allowed.
It was hoped that in the uncritical retreats of
Mile End a more abiding peace would be found.
But it was not to be. The official mind there,
as elsewhere, very properly decreed that the
public exposure of Merrick and his deformities
transgressed the limits of decency. The show
•must close.

The showman, in despair, fled with his charge
to the Continent. Whither he roamed at first I
do not know ; but he came finally to BiTissels. His
reception was discouraging. Bnissels was firm ;
the exhibition was banned ; it was brutal, indecent
and immoral, and could not be permitted within
the confines of Belgium. Merrick was thus no
longer of value. He was no longer a source of
profitable entertainment. He .was a burden. He

10 The Elephant Man

must be got rid of. The elimination of Merrick
was a simple matter. He could offer no resist-
ance. He was as docile as a sick sheep. The
impresario, having robbed Merrick of his paltry
savings, gave him a ticket to London, saw him
into the train and no doubt in parting condemned
him to perdition.

His destination was Liverpool Street. The
journey maj'^ be imagined. Merrick was in his
alarming outdoor garb. He would be harried by
an eager mob as he hobbled along the quay. They
would run ahead to get a look at him. They
would lift the hem of his cloak to peep at his
body. He would try to hide in the train or in
some dark corner of the boat, but never could he
be free from that ring of curious eyes or from
those whispers of fright and aversion. He had
but a few shillings in his pocket and nothing
either to eat or drink on the way. A panic-dazed
dog with a label on his collar would have received
some sympathy and possibly some kindness.
Merrick received none.

What was he to do when he reached London?
He had not a friend in the world. He knew no
more of London than he knew of Pekin. How
could he find a lodging, or what lodging-house
keeper would dream of taking him in? All he

The Elephant Man ii

.wanted was to hide. What most he dreaded were
the open street and the gaze of his fellow-men.
If even he crept into a cellar the horrid eyes and
the still more dreaded whispers would follow him
to its depths. Was there ever such a home-
coming !

At Liverpool Street he was rescued from the
crowd by the police and taken into the third-class
waiting-room. Here he sank on the floor in the
darkest corner. The police were at a loss what
to do with him. They had dealt with strange and
mouldy tramps, but never with such an object as
this. He could not explain himself. His speech
was so maimed that he might as well have spoken
in Arabic. He had, however, something with
him which he produced with a ray of hope. It
was my card.

The card simplified matters. It made it evi-
dent that this curious creature had an acquaintance
and that the individual must be sent for. A
messenger was dispatched to the London Hospital
which is comparatively near at hand. Fortunately
I was in the building and returned at once with
the messenger to the station. In the waiting-
room I had some difficulty in making a way
through the crowd, but there, on the floor in the
corner, was Merrick. He looked a mere heap.

12 The Elephant Man

It seemed as if he had been thrown there hke a
bundle. He was so huddled up and so helpless
looking that he might have had both his arms and
his legs broken. He seemed pleased to see me,
but he was nearly done. The journey and want of
food had reduced him to the last stage of exhaus-
tion. The police kindly helped him into a cab,
and I drove him at once to the hospital. He
appeared to be content, for he fell asleep almost
as soon as he was seated and slept to the journey's
end. He never said a word, but seemed to be
satisfied that all was well.

In the attics of the hospital was an isolation
ward with a single bed. It was used for emergency
purposes — for a case of delirium tremens, for a
man who had become suddenly insane or for a
patient with an undetermined fever. Here the
Elephant Man was deposited on a bed, was made
comfortable and was supplied with food. I had
been guilty of an irregularity in admitting such
a case, for the hospital was neither a refuge nor
a home for incurables. Chronic cases were not
accepted, but only those requiring active treat-
ment, and Merrick was not in need of such treat-
ment. I applied to the sympathetic chairman of
the committee, Mr. Carr Gomm, who not only
was good enough to approve my action but who

The Elephant Man 13

agreed with me that Merrick must not again be
turned out into the world.

Mr. Carr Gomm wrote a letter to the Times
detailing the circumstances of the refugee and
asking for money for his support. So generous
is the EngHsh pubUc that in a few days — I think
in a week — enough money was forthcoming to
maintain Merrick for life .without any charge
upon the hospital funds. There chanced to be
two empty rooms at the back of the hospital which
were little used. They were on the ground floor,
were out of the way, and opened upon a large
courtyard called Bedstead Square, because here
the iron beds were marshalled for cleaning and
painting. The front room was converted into a
bed-sitting room and the smaller chamber into a
bathroom. The condition of Merrick's skin ren-
dered a bath at least once a day a necessity, and
I might here mention that with the use of the
bath the unpleasant odour to which I have referred
ceased to be noticeable. Merrick took up his abode
in the hospital in December, 1886.

Merrick had now something he had never
dreamed of, never supposed to be possible — a
home of his own for life. I at once began to
make myself acquainted with him and to endeavour
to understand his mentality. It was a study of

14 The Elephant Man

much interest. I very soon learnt his speech so
that I could talk freely with him. This afforded
him great satisfaction, for, curiously enough, he
had a passion for conversation, yet all his life
had had no one to talk to. I — having then much
leisure — saw him almost every day, and made a
point of spending some two hours with him every
Sunday morning when he would chatter almost
without ceasing. It was unreasonable to expect
one nurse to attend to him continuously, but there
.was no lack of temporary volunteers. As they
did not all acquire his speech it came about that
I had occasionally to act as an interpreter.

I found Merrick, as I have said, remarkably
intelligent. He had learnt to read and had become
a most voracious reader. I think he had been
taught when he was in hospital with his diseased
hip. His range of books was limited. The Bible
and Prayer Book he knew intimately, but he had
subsisted for the most part upon newspapers, or
rather upon such fragments of old journals as he
had chanced to pick up. He had read a few
stories and some elementary lesson books, but
the delight of his life was a romance, especially a
love romance. These tales were very real to him,
as real as any narrative in the Bible, so that he
would tell them to me as incidents in the lives of

The Elephant Man 15

people who had Hved. In his outlook upon the
world he w^as a child, yet a child with some of
the tempestuous feelings of a man. He was an
elemental being, so primitive that he might have
spent the twenty-three years of his life immured
in a cave.

Of his early days I could learn but little. He
was very loath to talk about the past. It was a
nightmare, the shudder of .which was still upon
him. He was born, he believed, in or about
Leicester. Of his father he knew absolutely
nothing. Of his mother he had some memory.
It was very faint and had, I think, been elaborated
in his mind into something definite. Mothers
figured in the tales he had read, and he wanted
his mother to be one of those comfortable lullaby-
singing persons who are so lovable. In his sub-
conscious mind there was apparently a germ of
recollection in which someone figured who had
been kind to him. He clung to this conception
and made it more real by invention, for since the
day when he could toddle no one had been kind
to him. As an infant he must have been repellent,
although his deformities did not become gross
until he had attained his full stature.

It was a favourite belief of his that his mother
was beautiful. The fiction was, I am aware, one

i6 The Elephant Man

of his own making, but it was a great joy to him.
His mother, lovely as she may have been, basely
deserted him .when he was very small, so small
that his earliest clear memories were of the work-
house to which he had been taken. Worthless
and inhuman as this mother ,was, he spoke of her
with pride and even with reverence. Once,
when referring to his own appearance, he said :
"It is very strange, for, you see, mother was so
beautiful."

The rest of Merrick's life up to the time that
I met him at Liverpool Street Station was one
dull record of degradation and squalor. He was
dragged from town to town and from fair to fair
as if he were a strange beast in a cage. A dozen
times a day he would have to expose his nakedness
and his piteous deformities before a gaping crowd
who greeted him with such mutterings as "Oh!
what a horror! What a beast! " He had had
no childhood. He had had no boyhood. He had
never experienced pleasure. He knew nothing of
the joy of Fiving nor of the fun of things. His
sole idea of happiness was to creep into the dark
and hide. Shut up alone in a booth, awaiting the
next exhibition, how mocking must have sounded
the laughter and merriment of the boys and girls
outside who were enjoying the " fun of the fair " !

The Elephant Man 17

He had no past to look back upon and no future
to look forward to. At the age of twenty he
was a creature without hope. There was nothing
in front of him but a vista of caravans creeping
along a road, of rows of glaring show tents and
of circles of staring eyes with, at the end, the
spectacle of a broken man in a poor law infirmary.
Those who are interested in the evolution of
character might speculate as to the effect of this
brutish life upon a sensitive and intelligent man.
It would be reasonable to surmise that he would
become a spiteful and malignant misanthrope,
swollen with venom and filled with hatred of his
fellow-men, or, on the other hand, that he would
degenerate into a despairing melancholic on the
verge of idiocy. Merrick, how^ever, was no such
being. He had passed through the fire and
had come out unscathed. His troubles had en-
nobled him. He showed himself to be a gentle,
affectionate and lovable creature, as amiable as
a happy .woman, free from any trace of cynicism
or resentment, without a grievance and without
an unkind word for anyone. I have never heard
him complain. I have never heard him deplore
his ruined life or resent the treatment he had re-
ceived . at the hands of callous keepers. His
journey through life had been indeed along a via

i8 The Elephant Man

dolorosa, the road had been uphill all the way,
and now, when the night was at its blackest and
the way most steep, he had suddenly found him-
self, as it were, in a friendly inn, bright with light
and warm with welcome. His gratitude to those
about him was pathetic in its sincerity and
eloquent in the childlike simplicity with which it
was expressed.

As I learnt more of this primitive creature I
found that there were two anxieties which were
prominent in his mind and which he revealed to
me with diffidence. He was in the occupation of
the rooms assigned to him and had been assured
that he would be cared for to the end of his days.
This, however, he found hard to realize, for he
often asked me timidly to what place he would
next be moved. To understand his attitude it is
necessary to remember that he had been moving
on and moving on all his life. He knew no other
state of existence. To him it was normal. He
had passed from the workhouse to the hospital,
from the hospital back to the workhouse, then from
this town to that town or from one showman's
caravan to another. He had never known a home
nor any semblance of one. He had no possessions.
His sole belongings, besides his clothes and some
books, were the monstrous cap and the cloak. He

The Elephant Man 19

was a wanderer, a pariah and an outcast. That his
quarters at the hospital were his for life he could
not understand. He could not rid his mind of
the anxiety which had pursued him for so many
years — where am I to be taken next?

Another trouble was his dread of his fellow-
men, his fear of people's eyes, the dread of being
always stared at, the lash of the cruel mutterings
of the crowd. In his home in Bedstead Square he
was secluded ; but now and then a thoughtless
porter or a wardmaid would open his door to let
curious friends have a peep at the Elephant Man.
It therefore seemed to him as if the gaze of the
world followed him still.

Influenced by these two obsessions he became,
during his first few weeks at the hospital, curiously
uneasy. At last, with much hesitation, he said
to me one day : " When I am next moved can I
go to a blind asylum or to a lighthouse? " He
had read about blind asylums in the newspapers
and was. attracted by the thought of being among
people who could not see. The lighthouse had
another charm. It meant seclusion from the
curious. There at least no one could open a door
and peep in at him. There he would forget that
he had once been the Elephant Man. There he
would escape the vampire showman. He had never

20 The Elephant Man

seen a lighthouse, but he had come upon a picture
of the Eddystone, and it appeared to him that this
lonely column of stone in the waste of the sea was
such a home as he had longed for.

I had no great difficulty in ridding Merrick's
mind of these ideas. I wanted him to get accus-
tomed to his fellow-men, to become a human being
himself and to be admitted to the communion of
his kind. He appeared day by day less frightened,
less haunted looking, less anxious to hide, less
alarmed when he saw his door being opened. He
got to know most of the people about the place,
to be accustomed to their comings and goings, and
to realize that they took no more than a friendly
notice of him. He could only go out after dark,
and on fine nights ventured to take a walk in
Bedstead Square clad in his black cloak and his
cap. His greatest adventure was on one moonless
evening when he walked alone as far as the hospital
garden and back again.

To secure Merrick's recovery and to bring him,
;as it were, to life once more, it was necessary that
he should make the acquaintance of men and
women who would treat him as a normal and
intelligent young man and not as a monster of
deformity. Women I felt to be more important
than men in bringing about his transformation.

The Elephant Man 21

Women were the more frightened of him, the
more disgusted at his appearance and the more apt
to give way to irrepressible expressions of aversion
when they came into his presence. Moreover,
Merrick had an admiration of women of such a
kind that it attained almost to adoration. This
was not the outcome of his personal experience.
They were not real women but the products of
his imagination. Among them was the beautiful
mother surrounded, at a respectful distance, by
heroines from the many romances he had read.

His first entry to the hospital was attended by
a regrettable incident. He had been placed on
the bed in the little attic, and a nurse had been
instructed to bring him some food. Unfortunately
she had not been fully informed of Merrick's un-
usual appearance. As she entered the room she
saw on the bed, propped up by white pillows, a
monstrous figure as hideous as an Indian idol. She
at once dropped the tray she was carrying and fled,
with a shriek, through the door. Merrick was too
weak to notice much, but the experience, I am
afraid, was not new to him.

He was looked after by volunteer nurses whose
ministrations were somewhat formal and con-
strained. Merrick, no doubt, was conscious that
their service was purely official, that they were

22 The Elephant Man

merely doing what they ,were told to do and that
they were acting rather as automata than as
women. They did not help him to feel that he
was of their kind. On the contrary they, without
knowing it, made him aware that the gulf of
separation was immeasurable.

Feeling this, I asked a friend of mine, a young
and pretty widow, if she thought she could enter
Merrick's room with a smile, wish him good
morning and shake him by the hand. She said
she could and she did. The effect upon poor
Merrick was not quite what I had expected. As
he let go her hand he bent his head on his knees
and sobbed until I thought he would never cease.
The interview was over. He told me afterwards
that this was the first woman who had ever smiled
at him, and the first woman, in the whole of his
life, who had shaken hands with him. From this
day the transformation of Merrick commenced and
he began to change, little by little, from a hunted
thing into a man. It was a wonderful change to
witness and one that never ceased to fascinate me.

Merrick's case attracted much attention in the
papers, with the result that he had a constant
succession of visitors. Everybody wanted to see
him. He must have been visited by almost every
lady of note in the social world. They were all

The Elephant Man 23

good enough to welcome him with a smile and to
shake hands with him. The Merrick whom I had
found shivering behind a rag of a curtain in an
empty shop was now conversant with duchesses and
countesses and other ladies of high degree. They
brought him presents, made his room bright with
ornaments and pictures, and, what pleased him
more than all, supplied him with books. He soon
had a large library and most of his day was spent
in reading. He was not the least spoiled ; not the
least puffed up ; he never asked for anything ; never
presumed upon the kindness meted out to him,
and was always humbly and profoundly grateful.
Above all he lost his shyness. He liked to see his
door pushed open and people to look in. He
became acquainted with most of the frequenters
of Bedstead Square, would chat with them at
his window and show them some of his choicest
presents. He improved in his speech, although to
the end his utterances were not easy for strangers
to understand. He was beginning, moreover, to
be less conscious of his unsightliness, a little
disposed to think it was, after all, not so very
extreme. Possibly this was aided by the circum-
stance that I would not allow a mirror of any
kind in his room.

The height of his social development was

24 The Elephant Man

reached on an eventful day when Queen Alexandra
— then Princess of Wales — came to the hospital
to pay him a special visit. With that kindness
which has marked every act of her life, the Queen
entered Merrick's room smiling and shook him
warmly by the hand. Merrick was transported
with delight. This was beyond even his most
extravagant dream. The Queen has made many
people happy, but I think no gracious act of hers
has ever caused such happiness as she brought into
Merrick's room when she sat by his chair and
talked to him as to a person she was glad to see.
Merrick, I may say, was now one of the most
contented creatures I have chanced to meet. More
than once he said to me : *' I am happy every
hour of the day." This was good to think upon
when I recalled the half-dead heap of miserable
humanity I had seen in the corner of the waiting-
room at Liverpool St set. Most men of Merrick's
age would have expressed their joy and sense of
contentment by singing or whistling when they
were alone. Unfortunately poor Merrick's mouth
was so deformed that he could neither whistle nor
sing. He was satisfied to express himself by
beating time upon the pillow to some tune that
was ringing in his head. I have many times found
him so occupied when I have entered his room

The Elephant Man 25

unexpectedly. One thing that always struck me
as sad about Merrick was the fact that he could
not smile. Whatever his delight might be, his
face remained expressionless. He could weep but
he could not smile.

The Queen paid Merrick many visits and sent
him every year a Christmas card with a message
in her own handwriting. On one occasion she
sent him a signed photograph of herself. Merrick,
quite overcome, regarded it as a sacred object
and would hardly allow me to touch it. Pie cried
over it, and after it was framed had it put up in
his room as a kind of ikon. I told him that he
must write to Her Royal Highness to thank her
for her goodness. This he was pleased to do, as
he was very fond of writing letters, never before
in his life having had anyone to write to. I
allowed the letter to be dispatched unedited. It
began "My dear Princess" and ended "Yours
very sincerely." Unorthodox as it was it was
expressed in terms any courtier would have envied.

Other ladies followed the Queen's gracious
example and sent their photographs to this de-
lighted creature who had been all his life despised
and rejected of men. His mantelpiece and table
became so covered with photographs of handsome
ladies, with dainty knicknacks and pretty trifles

26 The Elephant Man

that they may almost have befitted the apartment
of an Adonis-Uke actor or of a famous tenor.

Through all these bewildering incidents and
through the glamour of this great change Merrick
still remained in man}^ ways a mere child. He
had all the invention of an imaginative boy or girl,
the same love of " make-believe," the same instinct
of "dressing up " and of personating heroic and
impressive characters. This attitude of mind was
illustrated by the following incident. Benevolent
visitors had given me, from time to time, sums of
money to be expended for the comfort of the
ci-devant Elephant Man. When one Christmas
was approaching I asked Merrick what he would
like me to purchase as a Christmas present. He
rather startled me by saying shyly that he would
like a dressing-bag with silver fittings. He had
seen a picture of such an article in an advertise-
ment which he had furtively preserved.

The association of a silver-fitted dressing-bag
with the poor wretch wTapped up in a dirty blanket
in an empty shop was hard to comprehend. I
fathomed the mystery in time, for Merrick made
little secret of the fancies that haunted his boyish
brain. Just as a small girl with a tinsel coronet
and a window curtain for a train will realize the
conception of a countess on her way to court, so

The Elephant Man 27

Merrick loved to imagine himself a dandy and a
young man about town. Mentally, no doubt, he
had frequently "dressed up" for the part. He
could "make-believe" with great effect, but he
wanted something to render his fancied character
more realistic. Hence the jaunty bag which was
to assume the function of the toy coronet and the
window curtain that could transform a mite with
a pigtail into a countess.

As a theatrical "property" the dressing-bag
was ingenious, since there was little else to give
substance to the transformation. Merrick could
not wear the silk hat of the dandy nor, indeed,
any kind of hat. He could not adapt his body
to the trimly cut coat. His deformity was such
that he could wear neither collar nor tie, while
in association with his bulbous feet the young
blood's patent leather shoe was unthinkable.
What was there left to make up the character?
A lady had given him a ring to wear on his
undeformed hand, and a noble lord had presented
him with a very stylish walking-stick. But these
things, helpful as they were, were hardly sufficing.

The dressing-bag, however, was distinctive, was
explanatory and entirely characteristic. So the
bag was obtained and Merrick the Elephant Man
became, in the seclusion of his chamber, the

28 The Elephant Man

Piccadilly exquisite, the young spark, the gallant,
the "nut." When I purchased the article I
realized that as 'Merrick could never travel he could
hardly want a dressing-bag. He could not use
the silver-backed brushes and the comb because
he had no hair to brush. The ivory-handled razors
were useless because he could not shave. The
deformity of his mouth rendered an ordinary
toothbrush of no avail, and as his monstrous lips
could not hold a cigarette the cigarette-case was a
mockery. The silver shoe-horn would be of no
service in the putting^ on of his ungainly slippers,
while the hat-brush was quite unsuited to the
peaked cap with its visor.

Still the bag was an emblem of the real swell
and of the knockabout Don Juan of whom he had
read. So every day Merrick laid out upon his
table, with proud precision, the silver brushes, the
razors, the shoe-horn and the silver cigarette-case
which I had taken care to fill with cigarettes. The
contemplation of these gave him great pleasure,
and such is the power of self-deception that they
convinced him he was the " real thing."

I think there was just one shadow in Merrick's
life. As I have already said, he had a lively
imagination ; he was romantic ; he cherished an
emotional regard for women and his favourite

The Elephant Man 29

pursuit was the reading of love stories. He fell
in love — in a humble and devotional way — with,
I think, every attractive lady he saw. He, no
doubt, pictured himself the hero of many a
passionate incident. His bodily deformity had
left unmarred the instincts and feehngs of his
years. He was amorous. He would like to have
been a lover, to have walked with the beloved object
in the languorous shades of some beautiful garden
and to have poured into her ear all the glowing
utterances that he had rehearsed in his heart. And
yet — the pity of it ! — imagine the feelings of such
a youth when he saw nothing but a look of horror
creep over the face of every girl whose e5''es met
his. I fancy when he talked of life among the
blind there was a half-formed idea in his mind that
he might be able to win the affection of a woman
if only she were without eyes to see.

As Merrick developed he began to display
certain modest ambitions in the direction of im-
proving his mind and enlarging his knowledge of
the world. He was as curious as a child and as
eager to learn. There were so many things he
wanted to know and to see. In the first place he
was anxious to view the interior of what he called
" a real house," such a house as figured in many
of the tales he knew, a house with a hall, a drawing-

30 The Elephant Man

room where guests were received and a dining-room
with plate on the sideboard and with easy chairs
into which the hero could ' ' fling himself. ' ' The
workhouse, the common lodging-house and a
variety of mean garrets were all the residences he
knew. To satisfy this wish I drove him up to my
small house in Wimpole Street. He was absurdly
interested, and examined everything in detail and
with untiring curiosity. I could not show him the
pampered menials and the powdered footmen of
whom he had read, nor could I produce the white
marble staircase of the mansion of romance nor
the gilded mirrors and the brocaded divans which
belong to that style of residence. I explained
that the house was a modest dwelling of the Jane
Austen type, and as he had read "Emma" he
was content.

A more burning ambition of his was to go to
the theatre. It was a project very difficult to
satisfy. A popular pantomime was then in pro-
gress at Drury Lane Theatre, but the problem
was how so conspicuous a being as the Elephant
Man could be got there, and how he was to see
the performance without attracting the notice of
the audience and causing a panic or, at least, an
unpleasant diversion. The whole matter was most
ingeniously carried through by that kindest of

The Elephant Man 31

women and most able of actresses — Mrs. Kendal.
She made the necessary arrangements with the
lessee of the theatre. A box was obtained.
Merrick was brought up in a carriage with drawn
blinds and was allowed to make use of the royal
entrance so as to reach the box by a private stair.
I had begged three of the hospital sisters to don
evening dress and to sit in the front row in order
to " dress " the box, on the one hand, and to form
a screen for Merrick on the other. Merrick and
I occupied the back of the box which was
kept in shadow. All went well, and no one
saw a figure, more monstrous than any on
the stage, mount the staircase or cross the
corridor.

One has often witnessed the unconstrained
delight of a child at its first i)antomime, but
Merrick's rapture was much more intense as well
as much more solemn. Here was a being with the
brain of a man, the fancies of a youth and the
imagination of a child. His attitude was not so
much that of delight as of wonder and amazement.
He was awed. He was enthralled. The spectacle
left him speechless, so that if he were spoken to
he took no heed. He often seemed to be panting
for breath. I could not help comparing him with
a man of his own age in the stalls. This satiated

32 The Elephant Man

individual was bored to distraction, would look
wearily at the stage from time to time and then
yawn as if he had not slept for nights ; while at
the same time Merrick was thrilled by a vision that
was almost beyond his comprehension. Merrick
talked of this pantomime for weeks and weeks.
To him, as to a child with the faculty of make-
believe, everything was real ; the palace was the
home of kings, the princess was of royal blood,
the fairies were as undoubted as the children in the
street, while the dishes at the banquet were of
unquestionable gold. lie did not like to discuss it
as a play but rather as a vision of some actual
world. When this mood possessed him he would
say : "I wonder what the prince did after we
left," or " Do you think that poor man is still
in the dungeon? " and so on and so on.

The splendour and display impressed him, but,
I think, the ladies of the ballet took a still greater
hold upon his fancy. He did not like the ogres
and the giants, while the funny men impressed him
as irreverent. Having no experience as a boy of
romping and ragging, of practical jokes or of
"larks," he had little sympathy with the doings
of the clown, but, I think (moved by some mis-
chievous instinct in his subconscious mind), he
was pleased when the policeman was smacked in

The Elephant Man 33

the face, knocked down and generally rendered
undignified.

Later on another longing stirred the depths
of Merrick's mind. It was a desire to see the
country, a desire to live in some green secluded
spot and there learn something about flowers and
the ways of animals and birds. The country as
viewed from a w^agon on a dusty high road was
all the country he knew. He had never wandered
among the fields nor followed the windings of a
wood. He had never climbed to the brow of a
breezy down. He had never gathered flowers in
a meadow. Since so much of his reading dealt
with country life he was possessed by the wish
to see the wonders of that life himself.

This involved a difficulty greater than that pre-
sented by a visit to the theatre. The project was,
however, made possible on this occasion also by
the kindness and generosity of a lady — Lady
Knightley — who offered Merrick a holiday home
in a cottage on her estate. Merrick was conveyed
to the railway station in the usual way, but as he
could hardly venture to appear on the platform
the railway authorities w^re good enough to run
a second-class carriage into a distant siding. To
this point Merrick was driven and was placed in
the carriage unobserved. The carriage, with the

34 The Elephant Man

curtains drawn, was then attached to the main-
Hne train.

He duly arrived at the cottage, but the house-
wife (hke the nurse at the hospital) had not been
made clearly aware of the unfortunate man's
appearance. Thus it happened that when Merrick
presented himself his hostess, throwing her apron
over her head, fled, gasping, to the fields. She
affirmed that such a guest was beyond her powers
of endurance, for, when she saw him, she was
*' that took" as to be in danger of being per-
manently '* all of a tremble."

Merrick was then conveyed to a gamekeeper's
cottage which was hidden from view and was close
to the margin of a wood. The man and his wife
were able to tolerate his presence. They treated
him with the greatest kindness, and with them he
spent the one supreme holiday of his life. He
could roam where he pleased. He met no one on
his wanderings, for the wood was preserved and
denied to all but the gamekeeper and the forester.

There is no doubt that Merrick passed in this
retreat the happiest time he had as yet experienced.
He was alone in a land of wonders. The breath
of the country passed over him like a healing
wind. Into the silence of the wood the fearsome
voice of the showman could never penetrate. No

The Elephant Man 35

cruel eyes could peep at him through the friendly
undergrowth. It seemed as if in this place of
peace all stain had been wiped away from his
sullied past. The Merrick who had once crouched
terrified in the filthy shadows of a Mile End shop
was now sitting in the sun, in a clearing among
the trees, arranging a bunch of violets he had
gathered.

His letters to me were the letters of a delighted
and enthusiastic child. He gave an account of his
trivial adventures, of the amazing things he had
seen, and of the beautiful sounds he had heard.
He had met with strange birds, had startled a
hare from her form, had made friends with a fierce
dog, and had watched the trout darting in a stream.
He sent me some of the wild flowers he had picked.
They were of the commonest and most familiar
kind, but they were evidently regarded by him
as rare and precious specimens.

He came back to London, to his quarters in
Bedstead Square, much improved in health, pleased
to be " home ' ' again and to be once more among
his books, his treasures and his many friends.

Some six months after Merrick's return from
the country he was found dead in bed. This was
in April, 1890. He was lying on his back as if
asleep, and had evidently died suddenly and with-

36 The Elephant Man

out a struggle, since not even the coverlet of the
bed was disturbed. The method of his death was
peculiar. So large and so heavy was his head that
he could not sleep lying down. When he assumed
the recumbent position the massive skull was
inclined to drop backwards, with the result that
he experienced no little distress. The attitude he
was compelled to assume when he slept was very
strange. He sat up in bed with his back supported
by pillows, his knees were drawn up, and his arms
clasped round his legs, while his head rested on
the points of his bent knees.

He often said to me that he wished he could
lie down to sleep "like other people." I think
on this last night he must, with some determina-
tion, have made the experiment. The pillow was
soft, and the head, when placed on it, must have
fallen backwards and caused a dislocation of the
neck. Thus it came about that his death was due
to the desire that had dominated his life — the
pathetic but hopeless desire to be " like other
people."

As a specimen of humanity, Merrick was
ignoble and repulsive ; but the spirit of Merrick,
if it could be seen in the form of the living, would
assume the figure of an upstanding and heroic man,

The Elephant Man 37

smooth browed and clean of limb, and with eyes
that flashed undaunted courage.

His tortured journey had come to an end.
All the way he, like another, had borne on his
back a burden almost too grievous to bear. He
had been plunged into the Slough of Despond,
but with manly steps had gained the farther shore.
He had been made " a spectacle to all men " in
the heartless streets of Vanity Fair. He had been
ill-treated and reviled and bespattered with the
mud of Disdain. He had escaped the clutches of
the Giant Despair, and at last had reached the
"Place of Deliverance," where "his burden
loosed from off his shoulders and fell from off his
back, so that he saw it no more.'

jj

THE OLD RECEIVING ROOM

II

THE OLD RECEIVING ROOM

A HOUSE surgeon at a great accident
hospital in the east of London happens
upon strange scenes, some pathetic, some merely
sordid, together with fragments of tragedy in
which the most elemental passions and emotions
of humanity are displayed. The chief place in
w'hich this experience is gained is the Receiving
Room. I speak of a hospital not as it is now, but
as it was some fifty years ago. The Receiving
Room is a bare hall, painted stone colour. It
contains as furniture rows of deal benches and as
wall decoration a printed notice, framed and
glazed, detailing vivid measures for restoring the
apparently drowned. Below this helpful document
is fixed an iron-bound money-box. There is,
moreover, a long desk in the hall where entries
are made and certificates and other papers issued.
As a room for the reception of the sick and
suffering it is a cold, harsh place, with about it
an air of cynical indifference.

This hall serves as a waiting-room, and there
D 41

42 The Old Receiving Room

are nearly always some people waiting in it. It
may be a sniffing woman who has called for her
dead husband's clothes. It may be a still breath-
less messenger with a " midwifery card " in her
hand, or a girl waiting for a dose of emergency
medicine. There may be some minor accident
cases also, such as a torn finger, a black eye like
a bursting plum, a child who has swallowed a
halfpenny, and a woman who has been " knocked
about cruel," but has little to show for it except
a noisy desire to have her husband "locked up."
In certain days of stress, as on Saturday nights,
when the air is heavy with alcohol, or on the
occasion of a "big" dock accident, the waiting-
room is crowded with excited folk, with patients
waiting their turn to be dressed, with policemen,
busybodies, reporters and friends of the injured.

On each side of the waiting-hall is a dressing-
room — one for women, one for men. Into these
rooms the accident cases are taken one after the
other. Here the house surgeon and his dressers
are engaged, and here the many-sided drama of
the Receiving Room reaches its culminating point.
It is an uninviting room, very plain, and, like the
outer hall, bears an 'aspect of callous unconcern.
By the window is a suspiciously large sink, and on
the ledge above it a number of pewter porringers.

The Old Receiving Room 43

One side of the room is occupied by a mysterious
cupboard containing dressings, gags, manacles,
emetics and other unattractive things. In the
centre are a common table and two hard chairs.

The most repellent thing in the room is a low
sofa. It is wide and is covered with very thick
leather which is suspiciously shiny and black. It
suggests no more comfort than a rack. Its
associations are unpleasant. It has been smothered
with blood and with every kind of imaginable
filth, and has been cleaned up so often that it is
no wonder that the deeply stained leather is
shiny. It is on this grim black couch that " the
case " just carried into the hospital is placed. It
may be a man ridden over in the street, with the
red bone-ends of his broken legs sticking through
his trousers. It may be a machine accident, where
strips of cotton shirt have become tangled up
with torn flesh and a trail of black grease. It
may be a man picked up in a lane with his throat
cut, or a woman, dripping foul mud, who has
been dragged out of a river. Sometimes the
occupant of the sofa is a snoring lump of humanity
so drunk as to be nearly dead, or it may be a
panting woman who has taken poison and
regretted it. In both cases the stomach pump is
used with nauseating incidents. Now and then

44 The Old Receiving Room

the sofa is occupied by a purple-faced maniac, who
is pinned down by sturdy dressers while a strait-
jacket is being applied to him. This is not the
whole of its history nor of its services, for the
Receiving Room nurse, who is rather proud of
it, likes to record that many a man and many a
woman have breathed their last on this horrible
divan.

The so-called dressing room is at its best a
" messy " place, as two mops kept in the corner
seem to suggest. It is also at times a noisy place,
since the yells and screams that escape from it
may be heard in the street and may cause passers-
by to stop and look up at the window.

Among the sick and the maimed who are
** received " in this unsympathetic hall, the most
pathetic are the wondering babies and the
children. Many are brought in burnt and v/rapped
up in blankets, with only their singed hair show-
ing out of the bundle. Others have been scalded,
so that tissue-paper-like sheets of skin come off
when their dressings are applied. Not a few, in
old days, were scalded in the throat from drinking
out of kettles. Then there are the children who
have swallowed things, and v/ho have added to the
astounding collection of articles — from buttons to
prayer-book clasps — which have found their way,

The Old Receiving Room 45

at one time or another, into the infant interior,
as well as children who have needles embedded in
parts of their bodies or have been bitten by dogs
or cats or even by rats.

I remember one bloated, half-dressed woman
who ran screaming into the Receiving Room with
a dead baby in her arms. She had gone to bed
drunk, and had awakened in the morning in a
tremulous state to find a dead infant by her side.
This particular experience was not unusual in
Whitechapel. Then there was another woman
who rushed in drawing attention to a thing like a
tiny bead of glass sticking to her baby's cheek.
The child had acute inflammation of the eyeball,
which the mother had treated with cold tea. The
eye had long been closed, but when the mother
made a clumsy attempt to open the swollen lids
something had popped out, some fluid and this
thing like glass. She was afraid to touch it. She
viewed it with horror as a strange thing that had
come out of the eye. Hugging the child, she had
run a mile or so with the dread object still adher-
ing to the skin of the cheek. This glistening
thing was the crystalline lens. The globe had
been burst, and the child was, of course, blind.
Happily, such a case could hardly be met with at
the present day.

46 The Old Receiving Room

On the subject of children and domestic
surgery as revealed in the Receiving Room, I
recall the case of a boy aged about four who had
pushed a dry pea into his ear. The mother
attempted to remove it with that common surgical
implement of the home, a hairpin. She not only
failed, but succeeded in pushing the pea farther
down into the bony part of the canal. Being a
determined woman, she borrowed a squirt, and
proceeded to syringe out the foreign body with
hot water. The result was that the pea swelled,
and, being encased in bone, caused so intense and
terrible a pain that the boy became unconscious
from shock.

Possibly the most dramatic spectacle in con-
nexion with Receiving Room life in pre-ambulance
days was the approach to the hospital gate of a
party carrying a wounded woman or man. Look-
ing out of the Receiving Room window on such
occasion a silent crowd would be seen coming
down the street. It is a closely packed crowd
which moves like a clot, which occupies the whole
pavement and oozes over into the road. In the
centre of the mass is an obscure object towards
which all eyes are directed. In the procession are
many women, mostly with tousled heads, men,
mostly without caps, a butcher, a barber's

The Old Receiving Room 47

assistant, a trim postman, a whitewasher, a man
in a tall hat, and a pattering fringe of ragged
boys. The boys, being small, cannot see much,
so they race ahead in relays to glimpse the
fascinating object from the front or climb up rail-
ings or mount upon steps to get a view of it as it
passes by. Possibly towering above the throng
would be two pohcemen, presenting an air of
assumed calm ; but policemen were not so common
in those days as they are now.

The object carried would be indistinct, being
hidden from view as is the queen bee by a clump
of fussing bees. Very often the injured person is
merely carried along by hand, like a parcel that
is coming to pieces. There would be a man to
each leg and to each arm, while men on either
side would hang on to the coat. Possibly some
Samaritan, walking backwards, would hold up
the dangling head. It was a much prized distinc-
tion to clutch even a fragment of the sufferer or
to carry his hat or the tools he had dropped.

At this period the present-day stretcher was
unknown in civil life. A stretcher provided by
the docks was a huge structure with high sides.
It was painted green, and was solid enough to
carry a horse. A common means of conveyance
for the helpless was a shutter, but with the

48 The Old Receiving Room

appearance of the modern ambulance the shutter
has become as out of date as the sedan chair.
Still, at this time, when anyone was knocked down
in the street some bright, resourceful bystander
would be sure to call out " Send for a shutter! "

The conveying of a drunken man with a cut
head to the hospital by the police (in the ancient
fashion) was a more hilarious ceremonial. The
" patient " would be hooked up on either side by
an official arm. His body would sag between
these two supports so that his shoulders would be
above his ears. His clothes would be worked up
in folds about his neck, and he would appear to
be in danger of slipping earthwards out of them.
As it was, there would be a display of shirt and
braces very evident below his coat. His legs
w^ould dangle below him like roots, while his feet,
as they dragged along the pavement, would be
twisted now in one direction and now in another
like the feet of a badly stuffed lay figure. He
would probably be singing as he passed along, to
the delight of the people.

Of the many Receiving Room processions that
I have witnessed the most moving, the most
savage and the most rich in colour, noise and
language was on an occasion when two "ladies"
who had been badly lacerated in a fight were being

The Old Receiving Room 49

dragged, carried or pushed towards the hospital
for treatment. They were large, copious women
who were both in an advanced stage of intoxica-
tion. They had been fighting with gin bottles in
some stagnant court which had become, for the
moment, an uproarious cockpit. The technique
of such a duel is punctilious. The round, smooth
bottoms of the bottles are knocked off, and the
combatants, grasping the weapons by the neck,
proceed to jab one another in the face with the
jagged circles of broken glass.

The wounds in this instance were terrific.
The faces of the two, hideously distorted, w^ere
streaming with blood, while their ample bodies
seemed to have been drenched with the same.
Their hair, soaked in blood, was plastered to their
heads like claret-coloured seaweed on a rock. The
two heroines were borne along by their women
friends. The police kept wisely in the background,
for their time was not yet. The crowd around
the two bleeding figures was so compressed that
the whole mass moved as one. It was a wild
crowd, a writhing knot of viragoes who roared
and screamed and rent the air with curses and
yells of vengeance, for they were partisans in the
fight, the Montagues and Capulets of a ferocious
feud.

50 The Old Receiving Room

The crowd as it came along rocked to and fro,
heaved and kirched as if propelled by some uneasy
sea. The very pavement seemed unsteady. Borne
on the crest of this ill-smelling wave were the two
horrible women. One still shrieked threats and
defiance in a voice as husky as that of a beast,
while now and then she lifted aloft a blood-
streaked arm in the hand of which was clutched
a tuft of hair torn from her opponent's head.
Every display of this trophy called forth a shout
of pride from her admirers.

The other woman w^as in a state of drunken
hysteria. Throwing back her head until the sun
illumined her awful features, she gave vent to
bursts of maniacal laughter which were made
peculiarly hideous by the fact that her nose was
nearly severed from her face, while her grinning
lips were hacked in two. At another m.oment,
burying her head against the back of the woman
in front of her, she w^ould break out into sobs and
groans which were even more unearthly than her
laughter.

The whole affair suggested some fearful
Bacchanalian orgy, associated with bloodshed, in
which all concerned were the subjects of demoniacal
possession. There is, happily, much less drunken-
ness nowadays and less savagery, while the police

The Old Receiving Room 51

control of these ' ' street scenes " is so efficient and
the public ambulance so secretive that such a
spectacle as I now recall belongs for ever to the
past.

When a crowd, bearing a '* casualty," reaches
the hospital gates its progress is stayed. It rolls
up against the iron barrier. It stops and recoils
like a muddy wave against a bank. The porter
is strict. Only the principals, their supporters
and the police are allowed to filter through. The
members of the crowd remain in the street, where
they look through the raiUngs, to which they
cling, and indulge in fragments of narrative, in
comments on the affair, and on the prospects of
the parties injured. If a scream should escape
from the Receiving Room the watchers feel that
they are well rewarded for long waiting, while
any member of the privileged party who may
leave the building is subjected to very earnest
questioning.

It is needless to say that the Receiving Room
is not always tragical, not always the scene of
alarms and disorders, not always filled with wild-
eyed folk nor echoing the scuffle of heavy feet and
the moans of the suffering. It may be as quiet
as a room in a convent. I have seen it so many a
time, and particularly on a Sunday morning in

52 The Old Receiving Room

the heyday of summer. Then the sun, streaming
through the windows, may illumine the figure of
the nurse as she sits on the awful sofa. She has
her spectacles on, and is busy with some white
needlework. Her attitude is so placid that she
might be sitting at a cottage door listening to a
blackbird in a wicker cage. Yet this quiet-
looking woman, although she has not fought
with wild beasts at Ephesus, has fought with
raving drunkards and men delirious from their
hurts, and has heard more foul language and
more blasphemy in a week than would have
enlivened a pirate ship in a year.

The Receiving Room nurse was, in old days,
without exception the most remarkable woman in
the hospital. She appeared as a short, fat, com-
fortable person of middle age, with a ruddy face
and a decided look of assurance. She was without
education, and yet her experience of casualties
of all kinds — from a bee-sting to sudden death —
was vast and indeed unique. She was entirely
self-taught, for there were no trained nurses in
those days. She was of the school of Mrs. Gamp,
was a woman of courage and of infinite resource,
an expert in the treatment of the violent and in
the crushing of anyone who gave her what she
called "lip." She was possessed of much humour.

The Old Receiving Room 53

was coarse in her language, abrupt, yet not un-
kindly in her manner, very indulgent towards the
drunkard and very skilled in handling him. She
was apt to boast that there was no man living she
would not " stand up to." She called every male
over fifty "Daddy" and every one under that
age " My Son." She would tackle a shrieking
woman as a terrier tackles a rat, while the woman
who " sauced " her she soon reduced to a condition
of palsy. She objected to the display of emotion
or of feeling in any form, and was apt to speak
of members of her sex as a " watery-headed lot."
She had, like most nurses of her time, a lean-
ing towards gin, but was efficient even in her cups.
She had wide powers, for she undertook — on her
own responsibility — the treatment of petty casual-
ties. The dressers regarded her with respect. Her
knowledge and skill amazed them, while from her
they acquired the elements of minor surgery and
first aid. The house surgeons were a little
frightened of her, yet they admired her ready
craft and were duly grateful for her unswerving
loyalty and her eagerness to save them trouble.
Her diagnosis of an injury was probably correct,
so sound was her observation and wide her experi-
ence. She was a brilliant bandager, and was
accepted by the students as the standard of style

54 The Old Receiving Room

and finish in the applying of a dressing. She was
on duty from early in the morning until late at
night, and knew little of " hours off " and " half-
days." In the personnel of the hospital of half
a century ago she was an outstanding figure, yet
now she is as extinct as the dodo.

The hospital in the days of which I speak was
anathema. The poor people hated it. They
dreaded it. They looked upon it primarily as a
place where people died. It ^vas a matter of
difficulty to induce a patient to enter the wards.
They feared an operation, and with good cause,
for an operation then was a very dubious matter.
There were stories afloat of things that happened
in the hospital, and it could not be gainsaid that
certain of those stories were true.

Treatment was very rough. The surgeon was
rough. He had inherited that attitude from the
days when operations were carried through with-
out anaesthetics, and when he had need to be
rough, strong and quick, as well as very indifferent
to pain. Pain was with him a thing that had to
be. It was a regrettable feature of disease. It
had to be submitted to. At the present day pain
is a thing that has not to be. It has to be relieved
and not to be merely endured.

Many common measures of treatment involved

The Old Receiving Room 55

great suffering. Bleeding was still a frequent
procedure, and to the timid the sight of the red
stream trickling into the bowl was a spectacle of
terror. There were two still more common
measures in use — the seton and the issue. The
modern student knows nothing of these ancient
and uncleanly practices. He must inform him-
self by consulting a dictionary. Without touching
upon details, I may say that in my early days, as
a junior dresser, one special duty was to run round
the ward before the surgeon ai*rived in order to
draw a fresh strand of thread through each seton
and to see that a fresh pea was forced into the
slough of every issue.

Quite mediaeval 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

56 The Old Receiving Room

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 iEire 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 ol:
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 repre-
sented 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

The Old Receiving Room 57

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 e^cultingly septic.
Charpie was a species of cotton waste obtained
from cast linen. It would probably now be dis-
carded 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.

58 The Old Receiving Room

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 w^as 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.^

>?

THE TWENTY-KRONE PIECE

Ill

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 Hos-
pital and, by chance, came into my wards. He

6i

62 The Twenty-Krone Piece

had an idea — as I was told later — that the opera-
tion 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 Twenty-Krone Piece 63

the gush and the pompous flattery which have
marked them ; but the Httle 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
yalue 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

64 The Twenty-Krone Piece

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 con-
fess 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

The Twenty-Krone Piece 65

all the time .with a piece of gold in his pocket
which he >vould 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."

A CURE FOR NERVES

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
isymptoms to many in the hope of securing con-
solation, 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

69

70 A Cure for Nerves

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

A Cure for Nerves 71

(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 —
guch 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 symp-
toms, 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 them-
selves. 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

72 A Cure for Nerves

never gone to the extreme of wishing to die
for the mere sake of convincing my husband of
obstinate stupidity. I should Hke to go into a
death-hke 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 w^hen-
ever 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 con-
demned 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 clutch-
ing 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

A Cure for Nerves 73

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 comfort-
able 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 Pra9o de Dom Pedro

74 A Cure for Nerves

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

A Cure for Nerves 75

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

76 A Cure for Nerves

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 1 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

A Cure for Nerves 77

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 con-
fidence, 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 Hked 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.

78 A Cure for Nerves

Something happened to prevent me from leav-
ing England, but six months later I came across
the letter and, feeling it was no longer of use,
opened it. It began, '* My dear Harry," and
contained a great deal about their respective
handicaps at golf and their plans for the summer.
The kind doctor ended in this wise in a postscript :

"The lady who brings this is Mrs. . She

is a terrible woman, a deplorable neurotic. I need
say no more about her, but I hope you won't mind
my burdening you with her, for she is the kind
of tedious person who bores me to death. How-
ever she pays her fees." My husband sent the
letter back to the doctor who wrote it, because he
thought the memoranda about the golf handicaps
would be interesting for him to keep.

As I made no progress and as my friends were
getting as tired of me as I was of myself, it was
resolved that I should be taken " seriously in
hand." I was therefore sent to a nursing home to
undergo the rest cure. I had to lie in bed, be
stuffed with food and be massaged daily. I was
cut off from all communion with the familiar world
and was allowed to receive neither letters nor
newspapers.

The idea underlying this measure is, I think,
a little silly. It is in the main an attempt to cure

A Cure for Nerves 79

a patient by enforced boredom. The inducement
offered is crudely this : ' ' You can go home as
soon as you think fit to be well." I did not mind
the quiet nor the lying in bed. The excessive
feeding merely made me uncomfortable. The
massage was a form of torture that I viewed with
great loathing. The absence of news from home
kept me in a state of unrest and apprehension.
It was the continued speculation as to what was
going on in my household which prevented me
from sleeping at night.

The withdrawal of all newspapers was evidently
a punishment devised by a man. It was no punish-
ment to me nor w^ould it be to the average w^oman.
The nurse, of course, kept me informed of current
events as she was extremely fond of talking and
thereby rendered a newspaper unnecessary. She
told me of the occasions when my husband called
to inquire and always said that he looked very well
and remarkably cheerful. She walked past my
house once and came back with the information
that the drawing-room blinds w^re up and that
the sun was streaming into the room. This worried
me a great deal as I don't like faded carpets and
silks and am very fond of my furniture.

After I had been in the home a few days I
discovered that the institution was not wholly

8o A Cure for Nerves

devoted to rest-cure cases, but that it was also a
surgical home where many operations were per-
formed. This frightened me terribly because I
began to wonder whether an operation had been
an item of the programme when I was taken
seriously in hand. I arrived at the conclusion that
I was being " prepared for operation," that I was
being "built up," with the result that I was
prostrated by alarm. I felt that at any moment
a man with a black bag might enter the room and
proceed to chloroform me. There came upon me
a conviction that I was being imprisoned, that I
had been duped and trapped. Above all was the
awful feeling, which nearly suffocated me, that I
was powerless to escape. I thought my husband
had been most base to desert me like this and
hand me over, as it were, to unknown executioners.
I have a dread of operations which is beyond
expression. The mere thinking of the process of
being chloroformed makes me sick and faint. You
are held down on a table, I believe, and then
deliberately suffocated. It must be as if a man
knelt upon your chest and strangled you by grip-
ping your throat with his hands. When I was
a small girl I saw a cook dispose of a live mouse
by sinking the mouse-trap in which it was im-
prisoned in a bucket of water. I remember that

A Cure for Nerves 8i

the struggles of the mouse, as seen under water,
were horrible to witness. When I grew up and
was told about people being chloroformed for
operation I always imagined that their feelings
would be as hideous as those of the drowning
mouse in a trap.

I told all my suspicions and alarms to the nurse,
who laughed at me contemptuously. She said :
"You are merely a nerve case." ("Merely,"
thought I.) " No surgeon ever thinks of operating
on a nerve case. The greater number of the
patients here come for very serious operations.
They are real patients." As she conversed further
I must confess that my pride began to be touched.
I had supposed that my case was the most im-
portant and most interesting in the establishment.
I had the largest room in the house while the
fussing over me had been considerable. I now
began to learn that there were others who were
in worse plight than myself. I, on the one hand,
had merely to lie in bed and sleep. They, on the
other, came to the home ,with their lives in their
hands to confront an appalling ordeal. I was
haunted by indefinite alarms ; they had to submit
to the tangible steel of the surgeon's knife. I
began to be a little ashamed of myself and of the
trouble I had occasioned. Compared with me

82 A Cure for Nerves

these women were heroines. They had something
to fuss about, for they had to walk alone into the
Valley of the Shadow of Death. I had many times
said that I wished I was dead, but a little reflec-
tion on the modes of dying made me keep that
wish ever after unexpressed.

My nurse deplored that she was not a surgical
nurse. " To nurse an operation case is real
nursing," she said. " There is something satis-
factory in work like that. I am only a mental
nurse, you see " — a confession which humbled me
still further.

It was in September that I entered the home,
and as the leading surgeons were still out of
London there were no operations. When October
came the gruesome work was resumed. The
house was set vibrating with excitement. In
this I shared as soon as I discovered that the
operating theatre was immediately over my bed-
room. Almost the first operation happened to
be a particularly momentous one, concerned with
which was none other than the great surgeon of
the day. His coming was anticipated with a buzz
of interest by the nurses, an interest which was
even shared by the mental nurse in whose charge
I .was.

I could learn very little about this great case

A Cure for Nerves 83

save that it was desperate and the victim a woman.
I know that she entered the home the night before,
for my nurse planned to meet her on her way to
her room. I know also that just before the hour
of closing the house I heard sobbing on the stair-
case as two people slowly made their way down.
I came to know afterwards that one was the hus-
band, the other the daughter.

The operation was to be at nine in the morn-
ing. By 6 A.M. the whole house was astir. There
was much running up and down stairs. Every-
body was occupied. My morning toilet and
breakfast were hurried through with little cere-
mony. The nurse was excited, absent-minded
and disinclined to answer questions. After my
breakfast was cleared away she vanished — it
was supposed that I was never to be left alone
— and did not appear again until noon. When
she did come back she found me an altered woman.

I lay in bed in the soHtary room with my eyes
fixed upon the white ceiling over my head. I was
terrified beyond all reason. There was everywhere
the sense of an overstrung activity, hushed and
ominous, which was leading on to tragedy. I
knew that in the room above me was about to be
enacted a drama in which one of the actors was
Death.

84 A Cure for Nerves

There was considerable bustle in the room in
question. They were moving something very
heavy into the middle of the floor. It was, I am
sure, the operation table. Other tables were
dragged about and adjusted with precision. Above
the ceaseless patter of feet I could hear the pour-
ing of water into basins.

I knew when the surgeon and his assistants
arrived, for I heard his voice on the stair. It
was clear and unconcerned, the one strong and
confident thing among all these portentous pre-
parations. Heavy bags were carried up from the
hall to be deposited on the floor above. I could
hear the surgeon's firm foot overhead and noticed
a further moving of tables. There came now a
clatter of steel in metal dishes which made me
shiver.

I looked at the clock on my table. It was
three minutes to nine.

What of the poor soul who was waiting ? She
also would be looking at the clock. Three minutes
more and she would be led in her nightdress into
this chamber of horrors. The very idea paralysed
tme. If I were in her place I should scream until
I roused the street. I should struggle with every
fibre of my body. I should cling to the door
until my arms were pulled out of their sockets.

A Cure for Nerves 85

A barrel-organ in the road was playing a trivial
waltz, a boy was going by whistling, the world
was cheerfully indifferent, while the loneliness of
the stricken woman was horrible beyond words.

As the church clock struck nine I knew that
the patient was entering the room. I fancied I
could hear the shuffle of her slippers and the
closing of the door — the last hope of escape —
behind her. A chair was moved into position.
She was stepping on to the table.

Then came an absolute silence. I knew they
were chloroforming her. I fancied that the vapour
of that sickly drug was oozing through the ceiling
into my room. I was suffocated. I gasped until
I thought my chest would burst. The silence was
awful. I dared not scream. I would have rung
my bell but the thought of the noise it would
make held me back.

I lay glaring at the ceiling, my forehead
covered with drops of cold sweat. I wrung my
fingers together lest all sensation should go out
of them.

In a while there came three awful moans from
the room above and then once more the moving,
of feet was to be heard, whereby I felt that the
operation had begun. I could picture the knife,
the great cut, the cold callousness of it all. For

86 A Cure for Nerves

.what seemed to me to be interminable hours I
gazed at the ceihng. How long was this murder-
ing to go on ! How could the poor moaning
soul be tortured all this while and endure another
minute !

Suddenly there was a great commotion in the
room above. The table was dragged round rapidty.
There were footsteps everywhere. Was the opera-
tion over? No. Something had gone wrong. A
man dashed downstairs calling for a cab. In a
moment I could hear the wheels tear along the
street and then return. He had gone to fetch
something and rushed upstairs with it.

This made me wonder for a moment what had
happened to the husband and daughter who were
waiting in a room off the hall. Had they died
of the suspense? Why did they not burst into
the room and drag her away while there was yet
time? The lower part of the house was practic-
ally empty and I was conscious that two or three
times the trembling couple had crept up the stairs
to the level of my room to listen. I could hear
the daughter say, "What shall we do! What
shall we do ! " And then the two would stumble
down the stairs again to the empty room.

I still glared at the ceiling like one in a trance.
I had forgotten about myself, although there was

A Cure for Nerves 87

such a sinking at my heart that I could only
breathe in gasps. The loathsome bustle in the
room above continued.

Now, as I gazed upwards, I noticed to my
expressionless horror a small round patch of red
appear on the white ceiling. I knew it was blood.
The spot was as large as a five-shilling piece. It
grew until it had become the size of a plate.

It burnt into my vision as if it had been a
red-hot disk. It became a deeper crimson until
at last one awful drop fell upon the white coverlet
of my bed. It came down with the weight of
lead. The impact went through me like an
electric shock. I could hardly breathe. I was
bathed with perspiration and was as wet and as
cold as if I had been dragged out of a winter's
river.

Another drop fell with a thud like a stone. I
would have hidden my head under the bedclothes
but I dared not stir. As each drop fell on the
bed the interval came quicker until there was a
scarlet patch on the white quilt that grew and grew
and grew. I felt that the evil stain would come
through the coverings, hot and wet, to my clenched
hands which were just beneath, but I was unable
to move them. My sight was now almost gone.
There was nothing but a red haze filling the room.

88 A Cure for Nerves

a beating sound in my ears and the drop recurring
like the ticking of some awful clock.

I must have become unconscious for I cannot
remember the nurse entering the room. When I
realized once more where I was I found that the
bedclothes had been changed. There was still the
round red mark on the ceiling but it was now dry.

As soon as I could speak I asked, " Is she
dead? " The nurse answered "No." '' Will she
live? " " Yes, I hope she will, but it has been
a fearful business. The operation lasted two and
a quarter hours, and when the great blood vessel
gave way they thought it was all over." "Was
she frightened? " I asked. " No ; she walked into
the room, erect and smiling, and said in a jesting
voice, ' I hope I have not kept you waiting,
gentlemen, as I know you cannot begin without
me.' "

In a week I returned home cured. My
" nerves" were gone. It was absurd to say that
I could not walk in the street when that brave
woman had walked, smiling, into that place of
gags and steel. When I thought of the trouble I
had made about going to the play I recalled what
had passed in that upper room. I began to
think less of my " case " when I thought of hers.

The doctor was extremely pleased with my

A Cure for Nerves 89

recovery ; while his belief in the efficacy of the rest
cure became unbounded. I did not trouble to tell
him that I owed my recovery not to his tiresome
physic and ridiculous massage but to that red
patch on the ceiling.

The lady of the upper room got well. Through
the instrumentality of the nurse I was able to
catch sight of her when she was taking her first
walk abroad after the operation. I expected to
see a goddess. I saw only a plain little woman
with gentle eyes and a very white face. I knew
that those eyes had peered into eternity.

Some years have now passed by, but still when-
ever I falter the recollection of that face makes
me strong.

TWO WOMEN

y

TWO WOMEN

IN the course of his experience the medical man
acquires probably a more intimate knowledge
of human nature than is attained by most. He
gains an undistorted insight into character. He
witnesses the display of elemental passions and
emotions. He sees his subject, as it were, un-
clothed and in the state of a primitive being.
There is no camouflage of feeling, no assumption
of a part, no finesse. There is merely a man or
a woman faced by simple, rudimentary conditions.
He notes how they act under strain and stress,
under the threat of danger or when menaced by
death. He observes their behaviour both during
suffering and after relief from pain, the manner
in which they bear losses and alarms and how they
express the consciousness of joy. These are the
common emotional experiences of life, common
alike to the caveman and the man of the twentieth
century. Among the matters of interest in this
purview is the comparative bearing of men and of
women when subject to the hand of the surgeon.

93

94 Two Women

As to which of the two makes the better patient
is a question that cannot be answered in a word.
Speaking generally women bear pain better than
men. They endure a long illness better, both
physically and morally. They are more patient
and submissive, less defiant of fate and, I think I
may add, more logical. There are exceptions, of
course, but then there are exceptions in all things.

Perhaps what the critic of gold calls the " acid
test " is provided by the test of an operation.
Here is something very definite to be faced. A
man is usually credited with more courage than a
woman. This is no doubt a just estimate in situa-
tions of panic and violence where less is expected
of a woman ; but in the cold, deliberate presence
of an operation she stands out well.

A display of courage in a man is instinctive,
a feature of his upbringing, a matter of tradition.
With women is associated a rather attractive ele-
ment of timidity. It is considered to be a not
indecorous attribute of her sex. It is apt to be
exaggerated and to become often somewhat of a
pose. A woman may be terrified at a mouse in her
bedroom and yet will view the entrance into that
room of two white-clad inquisitors — the anaesthetist
and the surgeon — with composure. A woman will
frankly allow, under certain conditions, that she

Two Women 95

is '' frightened to death " ; the man will not permit
himself that expression, although he is none the
less alarmed. A woman seldom displays bravado ;
a man often does. To sum up the matter — a
woman before the tribunal of the operating theatre
is, in my experience, as courageous as a man,
although she may show less resolve in concealing
her emotions.

In the determination to live, which plays no
little part in the success of a grave operation, a
woman is, I think, the more resolute. Her powers
of endurance are often amazing. Life may hang
by a thread, but to that thread she will cling as
if it were a straining rope. I recall the case of a
lady who had undergone an operation of unusual
duration and severity. She was a small, fragile
w^oman, pale and delicate-looking. The blow she
had received would have felled a giant. I stood
by her bedside some hours after the operation.
She was a mere grey shadow of a woman in whom
the signs of life seemed to be growing fainter and
fainter. The heat of the body was maintained by
artificial means. She was still pulseless and her
breathing but a succession of low sighs. She evi-
dently read anxiety and alarm in the faces of
those around her, for, by a movement of her lips,
she indicated that she wished to speak to me. I

0 Two Women

bent down and heard in the faintest whisper the
words, " I am not going to die." She did not
die; yet her recovery was a thing incredible.
Although twenty-eight years have elapsed since
that memorable occasion, I am happy to say that
she is still alive and well.

There are other traits in women that the
surgeon comes upon which, if not actually peculiar
to their sex, are at least displayed by them in
the highest degree of perfection. Two of these
characteristics — or it may be that the two are one
— are illustrated by the incidents which follow.

The first episode may appear to be trivial,
although an eminent novelist to whom I told the
story thought otherwise and included it, much
modified, in one of his books.

The subject was a woman nearing forty. She
was plain to look at, commonplace and totally
uninteresting. Her husband was of the same
pattern and type, a type that embraces the
majority of the people in these islands. He was
engaged in some humdrum business in the city of
London. His means were small and his life as
monotonous as a downpour of rain. The couple
lived in a small red-brick house in the suburbs.
The house was one of twenty in a row. The twenty
were all exactly alike. Each was marked by a

Two Women 97

pathetic pretence to be "a place in the country " ;
each was occupied by a family of a uniform and
wearying respectability. These houses were like
a row of chubby inmates from an institution, all
wearing white cotton gloves and all dressed alike
in their best.

The street in which the houses stood was called
*' The Avenue," and the house occupied by the
couple in question was named " The Limes." It
was difficult to imagine that anything of real
interest could ever occur in "The Avenue." It
was impossible to associate that decorous road with
a murder or even a burglary, much less with an
elopement. The only event that had disturbed its
peace for long was an occasion when the husband
of one of the respected residents had returned home
at night in a state of noisy intoxication. For
months afterwards the dwellers in " The Avenue,"
as they passed that house, looked at it askance.
It may be said, in brief, that all the villas were
"genteel" and that all those who lived in them
were " worthy."

The plain lady of whom I am speaking had no
children. She had been happy in a stagnant,
unambitious way. Everything went well with
her and her household, until one horrifying day
when it was discovered that she had developed a

9^ Two Women

malignant tumour of the breast. The growth was
operated upon by a competent surgeon, and for
a while the spectre was banished. The event, of
course, greatly troubled her; but it caused even
more anxiety to her husband. The two were very
deeply attached. Having few outside interests
or diversions, their pleasure in life was bound up
with themselves and their small home.

The husband was a nervous and imaginative
man. He brooded over the calamity that had
befallen his cherished mate. He was haunted by
the dread that the horrid thing would come back
again. When he was busy at his office he forgot
it, and when he was at home and with a wife who
seemed in such beaming health it left his mind.
In his leisure moments, however, in his journeyings
to London and back and in sleepless hours of the
night, the terror would come upon him again.
It followed him like a shadow.

Time passed; the overhanging cloud became
less black and a hope arose that it would fade
away altogether. This, however, was not to be.
The patient began to be aware of changes at
the site of the operation. Unpleasant nodules
appeared. They grew and grew and every day
looked angrier and more vicious. She had little
doubt that " it " — the awful unmentionable thing

Two Women 99

— had come back. She dared not tell her husband.
He was happy again ; the look of anxiety had left
his face and everything was as it had been. To
save him from distress she kept the dread secret
and, although the loathsome thing was gnawing
at her vitals, she smiled and maintained her wonted
cheerfulness when he and she were together.

She kept the secret too long. In time she
began to look ill, to become pallid and feeble and
very thin. She struggled on and laughed and joked
as in the old days. Her husband was soon aware
that something was amiss. Although he dared
not express the thought, a presentiment arose in
his mind that the thing of terror was coming back.
He suggested that she should see her surgeon
again, but she pooh-poohed the idea. *'Why
should a healthy woman see a surgeon? " At
last her husband, gravely alarmed, insisted, and
she did as he wished.

The surgeon, of course, saw the position at a
glance. The disease had returned, and during the
long weeks of concealment had made such progress
that any operation or indeed any curative measure
was entirely out of the question. Should he tell
her ? If he told her what would be gained thereby ?
Nothing could be done to hinder the progress of
the malady. To tell her would be to plunge her

\

100 Two Women

and her husband into the direst distress. The
worry that would be occasioned could only do her
harm. Her days were numbered ; why not make
what remained of her life as free from unhappiness
as possible ? It was sheer cruelty to tell her. In-
fluenced by these humane arguments he assured
her it was all right, patted her on the back and
told her to run away home.

For a while both she and her husband were
content. She was ready to believe that she had
deceived herself and regretted the anxiety she had
occasioned; but the unfortunate man did not
remain long at ease. His wife was getting weaker
and weaker. He wondered why. The surgeon
said she was all right ; she herself maintained that
she was well, but why was she changing so quickly.?*
The doubt and the uncertainty troubled both of
them ; so it was resolved that a second opinion
should be obtained, with the result that she came
to see me in London.

A mere glimpse was enough to reveal the condi-
tion of affairs. The case was absolutely hopeless
as her surgeon, in a letter, had already told me.
I was wondering how I should put the matter to
her but she made the decision herself. She begged
me to tell her the absolute truth. She was not
afraid to hear it. She had plans to make. She

Two Women loi

had already more than a suspicion in her mind and
for every reason she must know, honestly and
openly, the real state of affairs. I felt that matters
were too far gone to justify any further conceal-
ment. I told her. She asked if any treatment was
possible. I was obliged to answer " No." She
asked if she would live six months and again I was
compelled to answer " No."

What happened when she left my house I
learned later. It was on a Saturday morning in
June that she came to see me. For her husband
Saturday was a half-holiday and a day that he
looked forward to with eager anticipation. So
anxious was he as to my verdict that he had not
gone to his business on this particular day. He
had not the courage to accompany his wife to
X<ondon and, indeed, she had begged him not to-
be present at the consultation. He had seen his
wife into the train and spent the rest of the morn-
ing wandering listlessly about, traversing every
street, road and lane in the neighbourhood in a
condition of misery and apprehension.

He knew by what train she would return, but
he had not the courage to meet it. He would
know the verdict as she stepped out of the carriage
and as he caught a glimpse of her face. The plat-
form would be crowded with City friends of his,

102 Two Women

and whatever the news— good or bad— he felt that
he .would be unable to control himself.

He resolved to wait for her at the top of " The
Avenue," a quiet and secluded road. He could
not, however, stand still. He continued to roam
about aimlessly. He tried to distract his thoughts.
He counted the railings on one side of a street,
assuring himself that if the last railing proved
to be an even number his wife would be all right.
It proved to be uneven. He jingled the coins in
his pocket and decided that if the first coin he
drew out came up " Heads," it would be a sign
that his wife was well. It came up "Heads."
Once he found that he had wandered some way
from " The Avenue " and was seized by the panic
that he would not get back there in time. He
ran back all the way to find, when he drew up,
breathless, that he had still twenty-five minutes
to wait.

He thought the train .would never arrive. It
seemed hours and hours late. He looked at his
watch a dozen times. At last he heard the train
rumble in and pull up at the station. The moment
had come. He paced the road to and fro like a
caged beast. He opened his coat the better to
breathe. He took off his hat to wipe his streaming
forehead. He watched the corner at v/hich she

Two Women 103

would appear. She came suddenly in sight. He
saw that she was skipping along, that she was
waving her hand and that her face was beaming
with smiles. As she approached she called out,
"It is all right! "

He rushed to her, she told me, with a yell,
threw his arms round her and hugged her until
she thought she would have fainted. On the way
to the house he almost danced round her. He
waved his hat to everybody he saw and, on enter-
ing the house, shook the astonished maid-servant
so violently by the hand that she thought he was
mad.

That afternoon he enjoyed himself as he had
never done before. The cloud was removed, his
world was a blaze of sunshine again, his wife was
saved. She took him to the golf links and went
round with him as he played, although she was so
weak she could hardly crawl along. His game was
a series of ridiculous antics. He used the handle
of his club on the tee, did his putting with a
driver and finished up by giving the caddie half a
sovereign. In the evening his wife hurriedly in-
vited a few of his choicest friends to supper. It
was such a supper as never was known in " The
Avenue " either before or since. He laughed and
joked, was generally uproarious, and finished by

104 Two Women

proposing the health of his wife in a rapturous
speech. It was the day of his hfe.

Next morning she told him the truth.

I asked her why she had not told him at once.
She replied, " It was his half-holiday and I wished
to give him just one more happy day."

The second episode belongs to the days of my
youth when I was a house-surgeon. The affair
was known in the hospital as " The Lamp Murder
Case." It concerned a family of three — husband,
wife and grown-up daughter. They lived in an
ill-smelling slum in the most abject quarter of
Whitechapel. The conditions under which this
family existed were very evil, although not ex-
ceptional in the dark places of any town.

The husband was just a drunken loafer, vicious
and brutal, and in his most fitting place when he
was lying in the filth of the gutter. He had
probably never done a day's work in his life. He
lived on the earnings of his wife and daughter.
They were seamstresses and those were the doleful
days of " The Song of the Shirt." As the girl
was delicate most of the work fell upon the mother.
This wretched woman toiled day by day, from
year's end to year's end, to keep this unholy family
together. She had neither rest nor relaxation,
never a gleam of joy nor a respite from unhappi-

Two Women 105

ness. The money gained by fifteen hours' con-
tinuous .work with her needle might vanish in one
uproarious drinking bout. Her husband beat her
and kicked her as the fancy pleased him. He did
not disable her, since he must have money for
drink and she alone could provide it. She could
work just as well with a black eye and a bruised
body as without those marks of her lord's pleasure.

As she had to work late at night she kept a
a lamp for her table. One evening the sodden
brute, as he staggered into the room, said that he
also must have a lamp, must have a lamp of his
own. What he wanted it for did not matter. He
would have it. He was, as a rule, too muddled to
read even if he had ever learnt to read. Possibly
he wanted the lamp to curse by. Anyhow, if she
did not get him a lamp to-morrow he would ' * give
her hell," and the poor woman had already seen
enough of hell. Next day she bought a lamp, lit
it and placed it on the table with some hope no
doubt in her heart that it would please him and
bring a ray of peace.

He came home at night not only drunk but
quarrelsome. The two lamps were shining
together on the table. The room was quite bright
and, indeed, almost cheerful ; but the spectacle
drove him to fury. He cursed the shrinking, tired

H

io6 Two Women

woman. He cursed the room. He cursed the
lamp. It was not the kind of lamp he wanted. It
was not so good as her lamp and it was like her
meanness to get it. As she stood up to show him
ihow nice a lamp it really was he hit her in the face
with such violence that he knocked her into a
corner of the room. She was wedged in and unable
to rise. He then took up his lamp and, with a
yell of profanity, threw it at her as she lay on
the ground. At once her apron and cotton dress
were ablaze and, as she lay there burning and
screaming for mercy, he hurled the other lamp at
her.

The place was now lit only by the horrible,
dancing flames that rose from the burning woman.
The daughter was hiding in terror in the adjoining
room. The partition which separated it from her
mother's was so thin that she had heard everything
that passed. She rushed in and endeavoured to
quench the flames ; but streams of burning oil were
trickling all over the floor, while the saturated
clothes on her mother's body flared like a wick.
Her father was rolling about, laughing. He might
have been a demon out of the Pit. Neighbours
poured in and, by means of snatched-up fragments
of carpet, bits of sacking and odd clothes, the fire
was smothered ; but it was too late.

Two Women 107

There followed a period of commotion. A
crowd gathered in the dingy lane with faces up-
turned to the window from the broken panes of
which smoke was escaping. People pressed up
the stair, now thick with the smell of paraffin and
of burning flesh. The room, utterly wrecked, was
in darkness, but by the light of an unsteady candle
stuck in a bottle the body of the woman, moaning
with pain, was dragged out. An improvised
stretcher was obtained and on it the poor seam-
stress, wrapped up in a dirty quilt, was marched
off to the hospital, followed by a mob. The
police had appeared early on the scene and, acting
on the evidence of the daughter, had arrested the
now terrified drunkard.

When the woman reached the hospital she was
still alive but in acute suffering. She was taken
into the female accident ward and placed on a bed
in a corner by the door. The hour was very late
and the ward had been long closed down for the
night. It was almost in darkness. The gas jets
were lowered and the little light they shed fell
upon the white figures of alarmed patients sitting
up in bed to watch this sudden company with
something dreadful on a stretcher.

A screen was drawn round the burnt woman's
bed, and in this little enclosure, full of shadow, a

io8 Two Women

strange and moving spectacle came to pass. The
miserable patient was burned to death. Her
clothes were reduced to a dark, adhesive crust.
In the layers of cinder that marked the front of
her dress I noticed two needles that had evidently
been stuck there when she ceased her work. Her
face was hideously disfigured, the eyes closed, the
lips swollen and bladder-like and the cheeks charred
in patches to a shiny brown. All her hair was
burnt off and was represented by a little greasy
ash on the pillow, her eyebrows were streaks of
black, while her eyelashes were marked by a
line of charcoal at the edge of the lids. She
might have been burnt at the stake at Smith-
field.

As she was sinking it was necessary that her
dying depositions should be taken. For this pur-
pose a magistrate was summoned. With him came
two policemen, supporting between them the
shaking form of the now partly-sobered husband.
The scene was one of the most memorable I have
witnessed. I can still see the darkened ward, the
whispering patients sitting bolt upright in their
nightdresses, the darker corner behind the screen,
lit only by the light of a hand lamp, the motionless
figure, the tray of dressings no longer needed, the
half-emptied feeding-cup. I can recall too the

Two Women 109

ward cat, rudely disturbed, stalking away with a
leisurely air of cynical unconcern.

The patient's face was in shadow, the nurse
and I stood on one side of the bed, the magistrate
was seated on the other. At the foot of the bed
were the two policemen and the prisoner. The
man — who was in the full light of the lamp — was
a disgustful object. He could barely stand ; his
knees shook under him ; his hair was wild ; his eyes
blood-shot; his face bloated and bestial. From
time to time he blubbered hysterically, rock-
ing to and fro. Whenever he looked at his
wife he blubbered and seemed in a daze until
a tug at his arm by the policeman woke
him up.

The magistrate called upon me to inform
the woman that she was dying. I did so. She
nodded. The magistrate then said to her —
having warned her of the import of her evidence
— " Tell me how this happened." She replied,
as clearly as her swollen lips would allow, " It
was a pure accident."

These were the last words she uttered, for she
soon became unconscious and in a little while was
dead. She died with a lie on her lips to save the
life of the brute who had murdered her, who had
burned her alive. She had lied and yet her words

no Two Women

expressed a dominating truth. They expressed
her faithfulness to the man who had called her
wife, her forgiveness for his deeds of fiendish
cruelty and a mercy so magnificent as to be
almost divine.

A SEA LOVER

\
\

\

\

VI

A SEA LOVER

THE man I would tell about was a mining
engineer some forty and odd years of age.
Most of his active life had been spent in Africa
whence he had returned home to England with
some gnawing illness and with the shadow of
death upon him. He was tall and gaunt. The
tropical sun had tanned his face an unwholesome
brown, while the fever-laden wind -of the swamp
had blanched the colour from his hair. He was
a tired-looking man who gave one the idea that
he had been long sleepless. He was taciturn, for
he had lived much alone and, but for a sister, had
no relatives and few friends. For many years he
had wandered to and fro survejnng and prospect-
ing, and when he turned to look back upon the
trail of his life there was little to see but the ever-
stretching track, the file of black porters, the
solitary camp.

The one thing that struck me most about him

was his love of the sea. If he was ill, he said, it

113

114 A Sea Lover

must be by the sea. It was a boyish love evidently
which had never died out of his heart. It seemed
to be his sole fondness and the only thing of which
he spoke tenderly.

He was born, I found, at Salcombe, in Devon-
shire. At that place, as many know, the sea rushes
in between two headlands and, pouring over rocky
terraces and around sandy bays, flows by the
little town and thence awaj^ up the estuary. At
the last it creeps tamely among meadows and
cornfields to the tottering quay at the foot of
Kingsbridge.

On the estuary he had spent his early days,
and here he and a boy after his own heart had
made gracious acquaintance with the sea. When
school was done the boys were ever busy among
the creeks, playing at smugglers or at treasure
seekers so long as the light lasted. Or they hung
about the wharf, among the boats and the pic-
turesque litter of the sea, where they recalled in
ineffable colours the tales of pirates and the Spanish
Main which they had read by the winter fire. The
reality of the visions was made keener when they
strutted about the deck of the poor semi-domestic
coaling brig which leaned wearily against the
iharbour side or climbed over the bulwarks of the
old schooner, which had been wrecked on the

A Sea Lover 115

beach before they were born, with all the dash of
buccaneers.

In their hearts they were both resolved to
"follow the sea" but fate turned their footsteps
elsewhere, for one became a mining engineer in
the colonies and the other a clerk in a stock-
broker's office in London.

In spite of years of uncongenial work and of
circumstances which took them far beyond the
paradise of tides and salt winds the two boys, as
men, ever kept green the memory of the romance-
abounding sea. He who was to be a clerk became
a pale-faced man who wore spectacles and whose
back was bent from much stooping over books.
I can think of him at his desk in the City on some
day in June, gazing through a dingy window at a
palisade of walls and roofs. The clerk's pen is
still, for the light on the chimney-pots has changed
to a flood of sun upon the Devon cliffs, and
the noise of the streets to the sound of waves
tumbling among rocks or bubbling over pebbles.
There are sea-gulls in the air, while far away a
grey barque is blown along before the freshening
breeze and the only roofs in view belong to the
white cottages about the beach. Then comes
the ring of a telephone bell and the dream
vanishes.

ii6 A Sea Lover

So with the man whose Kfe was cast in un-
kindly lands. He would recall times when the
heat in the camp was stifling, when the heartless
plain shimmered as if it burnt, when water was
scarce and what there was of it was warm,
while the torment of insects was beyond bear-
ing. At such times he would wonder how the
tide stood in the estuary at home. Was the
flood swirling up from the Channel, bringing
with its clear eddies the smell of the ocean as
it hurried in and out among the piles of the old
pier.f* Or was it the time of the ebb when
stretches of damp sand come out at the foot
of cliffs and when ridges of rock, dripping
with cool weed, emerge once more into the
sun ? What a moment for a swim ! Yet here
on the veldt there was but half a pint of
water in his can and a land stretching before
him that was scorched to cracking, dusty and
shadowless.

It was in connexion with his illness that I came
across him. His trouble was obscure, but after
much consideration it was decided that an opera-
tion, although a forlorn hope, should be attempted.
If the disease proved to be benign there was pros-
pect of a cure ; if a cancer was discovered the
outlook was hopeless.

A Sea Lover 117

He settled that he would have the operation
performed at the seaside, at a town on the south
coast, within easy reach of London. Rooms were
secured for him in a house on the cliffs. From the
windows stretched a fine prospect of the Channel,
while from them also could be seen the little
harbour of the place.

The surgeon and his assistant came down from
London and I with them. The room in which
the operation was to be performed was hard and
unsympathetic. It had been cleared of all its
accustomed furniture. On the bare floor a white
sheet had been placed, and in the middle of this
square stood the operation table like a machine of
torture. Beyond the small bed the patient was to
occupy and the tables set out for the instruments
the room was empty. Two nurses were busy with
the preparations for the operation and were gossip-
ing genially in whispers. There was a large bow-
window in the room of the type much favoured at
seaside resorts. The window was stripped of its
curtains so that the sunlight poured in upon the
uncovered floor. It was a cloudless morning in
July.

The hard-worked surgeon from London had a
passion for sailing and had come with the hope that
he might spend some hours on the sea after his

ii8 A Sea Lover

iwork was done. His assistant and I were to go
with him.

When all the preparations for the operation
were completed the patient walked into the room
erect and unconcerned. He stepped to the table
and, mounting it jauntily, sat on it bolt upright
and gazed out earnestly at the sea. Following his
eyes I could see that in the harbour the men were
already hoisting the mainsail of the little yawl in
which we were to sail.

The patient still sat up rigidly, and for so long
that the surgeon placed a hand upon his shoulder
to motion him to lie down. But he kept fixedly
gazing out to sea. Minutes elapsed and yet he
moved not. The surgeon, with some expression of
anxiety, once more motioned him to lie down, but
still he kept his look seawards. At last the rigid
muscles relaxed, and as he let his head drop upon
the pillow he said, " I have seen the last of it —
the last of the sea — you can do what you like with
oie now." He had, indeed, taken, as he thought,
farewell of his old love, of the sea of his boyhood
and of many happy memories. The eyes of the
patient closed upon the sight of the English
Channel radiant in the sun, and as the mask of the
anaesthetist was placed over his face he muttered,
" I have said good-bye."

A Sea Lover 119

The trouble revealed by the surgeon proved to
be cancer, and when, some few days after the
operation, the weary man was told the nature of
his malady he said, with a smile, he would take
no more trouble to live. In fourteen days
he died.

Every day his bed ,was brought close to the
window so that the sun could fall upon him, so
that his eyes could rest upon the stretch of water
and fhe sound of waves could fall upon his tired
ears.

The friend of his boyhood, the clerk, came down
from London to see him. They had very little
to say to one another when they met. After the
simplest greeting was over the sick man turned his
face towards the sea and for long he and his old
companion gazed at the blue Channel in silence.
There was no need for speech. It was the sea that
spoke for them. It was evident that they were both
back again at Salcombe, at some beloved creek,
and that they were boys once more playing by
the sea. The sick man's hand moved across the
coverlet to search for the hand of his friend, and
when the fingers met they closed in a grip of
gratitude for the most gracious memory of their
lives.

The failing man's last sight of the sea was

120 A Sea Lover

one evening at sundown when the tide was
swinging away to the west. His look Hngered
upon the fading waves until the night set
in. Then the blind of the window was drawn
down.

Next morning at sunrise it was not drawn up,
for the lover of the sea was dead.

A CASE OF "HEART FAILURE"

VII

A CASE OF "HEART FAILURE"

WHAT a strange company they are, these
old patients who crowd into the surgeon's
memory after a Hfetime of busy practice ! There
they stand, a confused, impersonal assembly, so
illusive and indisiinct as to be little more than
shadows. Behind them is a dim background of
the past — a long building wdth many windows that
I recognize as my old hospital, a consulting room
with familiar furniture, an operating theatre,
certain indefinite sick-rooms as well as a ward in
which are marshalled a double row of beds with
blue and white coverlets.

Turning over the pages of old case books, as
one would idle with the sheets of an inventory,
some of these long departed folk appear clearly
enough, both as to their faces and the details of
their histories ; but the majority are mere ghosts
with neither remembered names nor features,
neither age nor sex. They are just fragments of
anatomy, the last visible portions of figures that

are fading out of sight. Here, among the crowd,

123

124 A Case of "Heart Failure"

are the cheeks of a pretty girl encircled by white
bandages and the visage of a toothless old man
with only one ear. I can recollect nothing but
their looks. They belong to people I have known,
somewhere and somehow, in the consulting room
or the ward. Here a light falls upon " that
knee," "that curious skull," "that puzzling
growth." Here is a much distorted back, bare
and pitiable, surmounted by coils of beautiful
brown hair. If the lady turned round I should
probably not recognize her face ; but I remember
the back and the coils of hair.

This is a gathering, indeed, not of people, but
of " cases " recalled by portions of their bodies.
The collection is not unlike a medley of fragments
of stained glass with isolated pieces of the human
figure painted upon them, or it may be comparable
to a faded fresco in a cloister, where the portions
that survive, although complete in themselves,
fail to recall the story they once have told.

It is curious, when so much is indefinite, how
vividly certain trivial items stand forth as the sole
remains of a once complete personality. All I
can recall of one lady — elderly but sane — was the
fact that she alwaj^s received me, during a long
illness, sitting up in bed with a large hat on her
head trimmed with red poppies. She also wore

A Case of "Heart Failure" 125

a veil, which she had to lift in order that I might
see her tongue. She was further distinguished by
a rose pinned to her nightdress, but I recall with
relief that she did not wear gloves.

Of one jolly boy the only particular that
survives in my mind is a hare's foot which was
found under his pillow when he was awaiting an
operation. It had been a talisman to coax him
to sleep in his baby days, when his small hand
would close upon it as the world faded. His old
" nanny " had brought it to the nursing home,
and had placed it secretly under his pillow, know-
ing that he would search for it in the unhappy
daze of awakening from chloroform. He wept
with shame when it was discovered, but I am sure
it was put back again under the pillow, although
he called his " nanny " " a silly old thing."

Then, again, there was the whistling girl.
She was about sixteen, and had recently learnt
whistling from a brother. Her operation had
been serious, but she was evidently determined to
face it sturdily and never to give way. She
expressed herself by whistling, and the expression
,was even more realistic than speech. Thus as I
came upstairs the tone of her whistling was defiant
and was intended to show that she was not the
least afraid. During the dressing of the wound

126 A Case of " Heart Failure "

the whistling was subdued and uncertain, a
rippling accompaniment that conveyed content
when she was not hurt, but that was interrupted
by a staccato '* whoo " when there was a dart of
pain. As soon as my visit was over the music
became debonair and triumphant, so that I often
left the room to the tune of Mendelssohn's
"Wedding March."

On the other hand, among the phantoms of
the case book are some who are remembered with
a completeness which appears never to have grown
dim. The figures are entire, while the inscription
that records their story is as clear as it was when
it w^as written.

In the company of these well remembered
people is the lady whose story is here set forth.
More than thirty years have passed since I saw
her, and yet I can recall her features almost as
well as if I had met her yesterday, can note again
her little tricks of manner and the very words
she uttered in our brief conferences. She was 3
woman of about twenty-eight, small and fragile,
and very pretty. Her face was oval, her com-
plexion exquisite, while her grey-blue eyes had in
them the look of solemn wonder so often seen
in the eyes of a child. Her hair came down low
on either side of her face, and was so arranged

A Case of *' Heart Failure " 127

as to remind me of the face of some solemn lady
in an old Italian picture. Her mouth was small
and sensitive, but determined, and she kept her
lips a little apart when listening. She was quiet
and self-possessed, while her movements and her
speech were slow, as if she were weary.

She was shown into my room at an hour when
I did not, as a rule, receive patients. She came
without appointment and without any letter of
introduction from her doctor. She said that she
had no doctor, that she came from a remote place
in the north of England, that she had an idea what
was the matter with her, and that she wanted me
to carry out the necessary operation. On investi-
gation I found that she had an internal growth
which would soon imperil her life. I explained
to her that an operation would be dangerous and
possibly uncertain, but that if it proved successful
her cure would be complete. She said she would
have the operation carried out at once, and asked
me to direct her to a nursing home. She displayed
neither anxiety nor reasonable interest. Her mind
was made up. As to any danger to her life, the
point was not worth discussing.

She had informed me that she was married,
but had no children. I inquired as to her parents,
but she replied that she was an orphan. I told

128 A Case of " Heart Failure "

her that I must write fully both to her doctor and
to her husband. She rephed, as before, that she
had no doctor, and that it seemed a pity to worry
a strange medical man with details about a patient
who was not under his care. As to her husband,
she asked if I had told her all and if there would
be anything in my letter to him that I had not
communicated to her. I said that she knew the
utmost I had to tell. " In that case," she replied,
" a note from you is unnecessary." I said, " Of
course, your husband will come up to London? "
To which she remarked, " I cannot see the need.
He has his own affairs to attend to. Why should
any fuss be made? The operation concerns no
one but myself."

I asked her then what relative or friend would
look after her during the operation. She said,
"No one. I have no relatives I care about;
and as to friends, I do not propose to make my
operation a subject for gossip." I explained to
her that under such circumstances no surgeon
would undertake the operation. It was a
hazardous measure, and it was essential that she
should have someone near her during a period of
such anxiety. She finally agreed to ask an elderly
lady — a remote connexion of hers — to be with
her during her stay in the nursing home.

A Case of " Heart Failure " 129

Still, there was some mystery about the lady
that I could not fathom, something evidently that
I did not know. There was a suggestion of reck-
lessness and even of desperation in her attitude
that it was difficult to account for. As she sat in
the chair by the side of my desk, with her hands
folded in her lap and her very dainty feet crossed
in front of her, her appearance of indifference was
so pronounced that no onlooker would imagine
that the purport of our converse was a matter of
life and death. One little movement of hers
during our unemotional talk was recalled to my
mind some days later. She now and then put her
hand to her neck to finger a brooch in the collar
of her dress. It was a simple gold brooch, but
she appeared to derive some comfort, or it may
be some confidence, from the mere touching
of it.

The operation was effected without untoward
incident of any kind. It was entirely successful.
The wound healed by what is known as ' ' first
intention," there was no rise of temperature and
no surgical complication. But the condition of
the patient caused an uneasiness that deepened
day by day. She became restless and apathetic
and at the same time very silent, answering
questions only in monosyllables. She resisted no

130 A Case of " Heart Failure *'

detail of treatment, but accepted everything with
a lethargic complacency impossible to overcome.

That, however, was not all. She appeared to
be possessed by an indefinite anxiety which was
partly expressed by an intense attitude of expecta-
tion. She was expecting a letter, looking out for
it day after day and hour after hour. She listened
to the door and to any sound on the stair as an
imprisoned dog might listen for the steps of its
master. This terrible vigil began on the second
or third day after the operation. When I made
my visit about that time she asked me if I had
given orders that she was to have no letters. I
assured her I had not done so and that she should
have every letter the moment it arrived. But no
letter came.

Whenever I made my appearance her first
question was, " Did you see a letter for me in the
halU " I could only answer " No." Then she
would press me with other inquiries : '* How often
does the postman come.^ Is he not sometimes
late? Has there been any accident on the rail-
way? Do letters get occasionally lost in the
post? " and so on interminably. If anyone came
into the room there was always a look of expecta-
tion on her face, an eager searching for a letter in
the hand or on a tray. If a knock w^as heard at

A Case of "Heart Failure*' 131

the front door, she at once inquired if it was the
postman, and very usually asked me to go to the
top of the stair to ascertain.

The sisters, the nurses and the patient's friend
could tell me nothing. No letter of any kind
arrived. The poor, tormented creature's yearning
for a letter had become a possession. I inquired
if she had written any letters herself. The sister
said that, as far as was known, she had written
but one, and that was on the eve of her operation.
Although she should have been in bed at the time,
she insisted on going out for the purpose of posting
the letter herself.

She rapidly became weaker, more restless,
more harassed by despair. She was unable to
sleep without drugs and took scarcely any food.
Feeble and failing as she was, her anxiety about
the coming of a letter never abated. I asked a
physician versed in nervous disorders to see her,
but he had little to propose. She was evidently
dying — but of what?

She was now a pitiable spectacle, emaciated
and hollow-eyed, with a spot of red on her cheek,
an ever- wrinkled brow and ever-muttering lips.
I can see to this day the profile of her lamentable
features against the white background of the
pillow. Pinned to the pillow was the brooch that

132 A Case of " Heart Failure

)j

I had noticed at her neck when I saw her in my
consulting room. She would never allow it to
be removed, but gave no reason for her insistence.
I have seen her hand now and then move up to
touch it, just as she had done during our first
interview.

I was with her when she died. As I entered
the room there was still the same expectant
glance at the door. Her lips, dry and brown,
appeared to be shaping the question, " A letter
for me? " There was no need to answer " No."
At the very last — with a display of strength that
amazed me — she turned over with her face to the
wall as if she wished to be alone ; then, in a voice
louder than I had known her to be capable of
for days, she cried out," Oh, Frank! Frank! "
and in a moment later she was dead.

Her death was certified, with unconscious
accuracy, as due to " heart failure."

Here was a mystery, and with it a realization
of how little we knew of this lady who had died
because she wished to die. I was aware that her
husband's christian name was William, but beyond
that I knew practically nothing of him. The
sister of the nursing home had both written and
telegraphed to the husband, but no reply had been
received. It was afterwards ascertained that he

A Case of " Heart Failure " 133

was away at the time and that the house was
shut up.

I was determined to find out the meaning of
the tragedy, but it was some months before I was
possessed of the whole of the story. The poor
lady's marriage had been unhappy. Her husband
had neglected her, and they were completely
estranged. She formed a friendship with a man
of middle age who lived near by. This is he
whose christian name was Frank and who was, I
imagine, the giver of the brooch. The friendship
grew into something more emotional. She
became, indeed, desperately attached to him,
and he to her. Their intimacy was soon so
conspicuous as to lead to gossip in the neighbour-
hood, while the state of the two lovers themselves
was one of blank despair. She looked to him as
Pompillia looked to Caponsacchi. He was her
saviour, her '* soldier saint, the lover of her life."
To him she could repeat Pompillia's words : " You
are ordained to call and I to come."

It became evident in time that the only course
the two could adopt was to run away together.
She, on her part, counted no cost and would have
followed him blindly to the world's end. He, on
the other hand, hesitated. He did count the cost
and found it crushing. His means were small.

134 A Case of " Heart Failure "

His future depended on himself. An elopement
would involve ruin, poverty and squalor as well
as, in time, a fretful awakening from a glorious
dream.

He did the only thing possible. He told her
that they must part, that he must give her up,
that he must not see her again, that he must not
even write to her. It was a wise and, indeed,
inevitable decision ; but to her it seemed to fore-
tell the end of her life. He kept the compact,
but she had not the strength to accept it. It was
something that was impossible. She endeavoured
to get in touch with him again and again, and in
many ways, but without success. Hard as it was,
he had kept to his resolve.

Then came the episode of the operation. Now,
she thought, if she wrote to him to say that she
was in London and alone and that she was about
to undergo an operation that might cause her
death, he must come to see her or he must at
least reply to her letter. She felt assured that
she would hear from him at last, for, after all
that had passed between them, he could not deny
her one little word of comfort in this tragic
moment.

She wrote to him on the eve of her operation.
The rest of the story I have told.

A RESTLESS NIGHT

VIII

A RESTLESS NIGHT

IT was in Rajputana, in the cold weather, that
,we came upon the dak bungalow. I was
proceeding south from a native state where I had
met an officer in the Indian Medical Service.
He was starting on a medical tour of inspection,
and for the first stage of the journey we travelled
together. He was glad to have a member of
his own profession to talk to.

towards the end of the day we halted at this
dak bungalow. It was situated in a poor waste
which was possessed of two features only — dried
earth and cactus bushes. So elemental was the
landscape that it might have been a part of the
primeval world before the green things came into
being. The cactus, bloated, misshaped and scarred
by great age, looked like some antediluvian growth
which had preceded the familiar plants with leaves.
If a saurian had been in sight browsing on this
ancient scrub the monster would have been in
keeping. Some way distant across the plain was

a native village, simple enough to be a settle-
J 137

138 A Restless Night

ment of neolithic men. Although it was but a
splash of brown amidst the faded green it conveyed
the assurance that there were still men on the
earth.

The bungalow was simple as a packing-case.
It showed no pretence at decoration, while there
was in its making not a timber nor a trowel of
plaster which could have been dispensed with.
In the centre of the miserly place was a common
room with a veranda in front and a faintly-
suggested kitchen at the back. Leading out of
the common room, on either side, was a bedroom,
and the establishment was complete. The central
room was provided with one meal-stained table and
two dissolute-lookmg chairs of the kind found in
a servant's attic. The walls were bare save for
certain glutinous splashes where insects had been
squashed by the slipper of some tormented guest.
The place smelt of grease and paraffin, toned by
a faint suggestion of that unclean aromatic odour
which clings to Indian dwellings. The bedrooms
were alike — square chambers with cement floors,
plain as an empty water-tank. An inventory of
their respective contents was completed by the
following items — one low bedstead void of bed-
ding, one chair, one table with traces of varnish
in places and one looking-glass in a state of

A Restless Night 139

desquamation. To these may be added one
window and two doors. One door led into the
common room, the other into a cemented bath-
room containing a battered tin bath, skinned
even of its paint.

We each o£ us had an Indian servant or bearer
who, with mechanical melancholy, made the toilet
table pretentious by placing upon it the entire
contents of our respective dressing bags.

After dinner, of a sort, we sat on the peni-
tential chairs and smoked, leaning our elbows on
the table for our greater comfort. The doctor
was eloquent upon his medical experiences in
the district, upon his conflicts with pessimistic
patients and his struggles with fanaticism and
ignorance. The average sick man, he told me,
had more confidence in a dried frog suspended
from the neck in a bag than in the whole British
Pharmacopoeia. Most of his narratives have
passed out of my memory, but one incident I
had reason to remember.

It concerned a native from the adjacent village
who was working as a stone-mason and whose eye
was pierced by a minute splinter of stone. As a
result the eye became inflamed and sightless, save
that the man retained in the damaged organ an
appreciation of light. As bearing upon the case

140 A Restless Night

and its sequel I must explain the circumstances of
" sympathetic ophthalmia." When an eye is
damaged as this was, and inflammation ensues, it
is not uncommon for the mischief to spread to the
sound globe and destroy that also. In order to
prevent such a catastrophe it is necessary to remove
the injured and useless eye as promptly as possible.
That was the uniform practice in my time. The
operation in question was urged upon the native
an order to prevent sympathetic ophthalmia in the
sound eye, but he declined it, preferring to consult
a magician who lived a day's journey from the
village. The consultation took place and the man
returned to the local dispensary ; for although he
still had good vision in the sound eye it was
beginning to trouble him.

The surgeon considered that the operation was
now probably too late ; but he yet urged it upon
the ground that there was some prospect of success,
while, on the other hand, failure could make the
patient's condition no more desperate. The man,
persuaded against his will, at last consented, and
the useless eyeball was removed. Unfortunately
the operation wm too late ; the sound eye became
involved beyond recovery and the miserable native
found himself totally blind. He ignorantly
ascribed his loss of sight to the operation.

A Restless Night 141

Before my friend left the station the man was
brought into his room for the last time, and when
it was explained to him that he was in the doctor's
presence he threw his arms aloft and, shrieking
aloud, cursed the man of healing with a vehemence
which should have brought down fire from heaven.
He called upon every deity in the Indian myth-
ology to pour torments upon this maimer of men,
to blast his home and annihilate his family root
and branch. He blackened the sky with curses
because the darkness which engulfed him pre-
vented him from tearing out with his nails the
eyes of this murderous Englishman. Foaming and
screaming, and almost voiceless from the violence
of his speech, he was led away to stumble about
his village, where for weeks he rent the air with
his awful imprecations. Whether the poor man
was now alive or dead the doctor could not say,
for he had heard no more of him.

In due course we agreed that the time had
come to go to bed. The doctor said that he always
occupied the right-hand bedroom when he came
to the bungalow, but as it was found that my
servant had deposited my bedding and effects in
this particular sepulchre, he retired to the chamber
across the hall.

I did not look forward to a night in this so

142 A Restless Night

called '' Rest House." The bedroom was as com-
fortless as a prison cell and as desolate as the one
sound room in a ruin. There was some comfort
in contemplating the familiar articles displayed on
the dressing-table, yet they looked curiously out
of place.

I locked the door leading to the common room,
but found that the door to the bathroom had no
lock; while there was merely a bolt to the outer
door that led from the bathroom into the open.
This bolt I shot, but left the intermediate door
ajar, feeling that I should like to assure myself
from time to time that the far room was empty.
There was one small paraffin lamp provided, but
the glass shade of it had been broken, so that it
iwas only when the wick was very low that it would
burn without smoking. By the glimmer of this
malodorous flame I undressed and, blowing it out,
got into bed.

The place was as black as a pit, as stifling and
as silent. I lay awake a long time, for the still-
ness was oppressive. I found myself listening to
it. It seemed to be made up of some faint, far-off
sounds of mysterious import of which I imagined
I could catch the rhythm. It was possible tc
believe that these half-imagined pulsations were
produced by the rush of the earth through space,

A Restless Night 143

and that the stillness of the night made them
audible.

I went to sleep in time and slept — as I after-
wards discovered — for some hours, when I was
aroused by a noise in the room. I was wideawake
in an instant, with my head raised off the pillow,
listening rigidly for the sound that I must have
heard in my sleep. The place was in solid dark-
ness. I felt that there was something alive in the
room, something that moved.

At last the sound came again. It was the
pattering of the feet of some animal. The creature
was coming towards the bed. I could hear others
moving along the floor, always from the bathroom,
until the place seemed to be alive with invisible
creatures. Such is the effect of imagination that
I conceived these unknown animals to be about
the size of retrievers. I wondered if their heads
would reach the level of the couch, until I was
relieved to hear that many were now running about
under the bed. I resolved to shout at them but
fancied that the noise of my own voice would be
as unpleasant to hear as the voice of another and
unknown human being in the room.

I noticed now a faint odour of musk, and was
glad to think that these pattering feet belonged
to musk-rats, and that these animals must have

144 A Restless Night

entered through the drain hole I had observed
in the outer wall of the bathroom. I dislike rats,
and especially rats in a bedroom. This prejudice
was not made less when I felt that some of them
were climbing up on to the bed. I was certain
I could hear one crawling over my clothes which
lay on the chair by the bedside. I was certain
that others were searching about on the dressing-
table, and recognized — or thought I did — the
clatter of a shoe-horn that lay there. I recalled
stories in which men had been attacked by hordes
of rats, and I wondered when they would attack
me, for, by this time, the whole room seemed
to be full of rats, and I could picture legions
swarming in from the plain outside in a long
snake-like column.

In a while I was sure that a rat was on the
pillow close to my head. My hair seemed to be
flicked by the whiskers of one of these foetid
brutes. This was more than I could tolerate, so
I sprang up in bed and shouted. There was a
general scuttle for the far door; but it was some
time before I ventured to pass my hand over the
pillow to assure myself that a rat was not still
there.

I had a mind to get out of bed and light the
lamp ; but to do this seemed to be like taking a

A Restless Night 145

step into a black pit. I lay down again. For a
while all was quiet. Then came once more the
pattering of feet from the direction of the bath-
room, the sickly odour of musk and a conviction
that at least a hundred rats were pouring into the
room. They crept up to the bed and ran about
beneath it with increasing boldness. I was
meditating another shout when there came a sound
in the room that made every vein in my body
tingle. It arose from under the bed, a hollow
scraping sound which I felt sure was due to the
movement of a human being. I thought it was
caused by the scraping of a belt buckle on the
cement floor, the belt being worn by a man who
was crawling on his stomach. I disliked this sound
more than the rats.

At this moment, to add to my discomfort, I
felt a rat crawling across my bare foot, a beast
with small, cold paws and hot fur. I kicked it off
so that it fell with a thud on the floor. I shouted
again and, driven to desperation, jumped out of
bed. I half expected to tread on a mass of rats,
but felt the hard floor instead. I went to the
dressing-table and struck a light. The place was
empty, but I could not see under the bed. The
match went out and in the blackness I expected
some fresh surprise to develop. I managed

146 A Restless Night

to strike another match and to light the
lamp.

I placed it on the floor and looked under the
bed. What I saw there I took at first to be a
piece of a human skull. I got a stick and touched
it. It seemed lighter than a dried bone. I
dragged it out into the room. It was a cake of
unleavened bread, much used by the natives —
dried up into a large curled chip. The rats had
been dragging this away and had so produced the
scraping sound which I had exaggerated into some-
thing sinister.

Having convinced myself that the room was
empty I blocked up the drain-hole in the outer wall
by placing the bath in front of it and, feeling
secure from any further disturbance, returned to
bed, leaving the lamp alight on the table.

For a long time I kept awake, watching every
now and then the bathroom door to satisfj'- myself
that I had succeeded in keeping the beastly animals
out. During this vigil I fell asleep and then at
once embarked upon a dream, the vividness and
reahty of which were certainly remarkable.

The most convincing feature was this. The
dream, without a break, continued the happenings
of the night. The scene was this identical bedroom
at this identical moment. The dream, as it were.

A Restless Night 147

took up the story from the moment that I lost
it. Owing to my close scrutiny every detail of
the vile chamber had already become as clearly
impressed upon my brain as if it had been fixed
by a photographic plate. I had not — in my dream
— fallen asleep again, but .was still wideawake and
still keeping a watch over the bathroom door for
the incoming of the rats.

The bathroom door was just ajar, but the very
faint glimmer of the lamp did not enable me to
penetrate the darkness that filled it. I kept my
eye fixed on the entry when, in a moment, to my
horror, the door began to open. The sight was
terrifying in the extreme. My heart was thumping
to such a degree that I thought its beats must be
audible. I felt a deadly sinking in my stomach,
while the skin of my back and neck seemed to be
,wrinkling and to be dragged up as might be a
shirt a man is drawing over his head. There is no
panic like the panic felt in a dream.

A brown hand appeared on the edge of the
door. It was almost a relief to see that it was a
human hand. The door was then opened to its
utmost. Out of the dark there crept a middle-
aged man, a native, lean and sinewy, without a
vestige of clothing on his body. His skin shone in
the uncertain light, and it was evident that his

148 A Restless Night

body, from head to foot, was smeared with oil.
The most noticeable point about the man was that
he was blind. His eyelids were closed, but the
sockets of his eyes were sunken as are those of a
corpse. With his left hand he felt for the wall,
while in his right hand he carried a small stone-
mason's pick. His face was expressionless. This
was the most terrible thing about it, for his face
was as the face of the dead. He crept into the
room as Death himself might creep into the
chamber of the dying.

I realized at once in my dream that this was
the native about whom my friend had been speak-
ing before we had retired for the night. This
man had heard of the doctor's arrival, would
know my room as the one he usually occupied,
and had now come there to murder him.

I was so fascinated by the sight of this
unhuman creature moving towards me that I
could not stir a muscle. I was raised up in bed,
and w^as leaning on one elbow like an image on
a tomb. I was so filled with the sense of a final
calamity that I felt I had ceased to breathe.
There were, indeed, such a clutching at my throat
and such a bursting at my heart that the act of
breathing seemed wellnigh impossible. Had I
been awake I should, without doubt, have shouted

A Restless Night 149

at the uncanny intruder and attacked him, but in
the dream I was unable to stir, and the longer I
remained motionless the more impossible did it
appear that I could move. My limbs might have
been turned into stone.

The figure crept on, feeling his way by the
wall. There was a sense of an oncoming,
irresistible fate. Every time that a horrible bare
foot was lifted, advanced and brought to the
ground I felt that I was one step nearer to the
end. The figure seemed to grow larger as it
approached me. The hand, \vith outstretched
fingers, that groped its way along the wall was
like a claw. I could hear the breathing of the
creature, the breath being drawn in between the
closed teeth. I could see the muscles of the arm
that held the pick contract and relax. There was
now in the air the loathsome smell of the unclean
native mixed with the odour of oil.

One more step and he was so near that I could
see the faint light glimmer on his teeth and could
notice that they were dry. The outstretched,
claw-like hand that felt its way along the wall was
now nearly over my head. In another moment
that awful pick would crash into my skull or
plunge into my neck. I bowed my head instinc-
tively so that I should not see the blow coming.

150 A Restless Night

and at the same time I thought it would be less
terrible if the iron were driven into my back
rather than into my head or face.

The evil creature was now close to the bed.
The extended arm was clawing along the wall
above my pillow, for I had now shrunken as low
as I could. With my head bent I could now see
nothing of the man but his wizened thigh, upon
which the muscles rose and fell. A bony knee-cap
was advanced slowly, and then I saw a shadow
move on the floor. This I felt was the shadow
of the arm with the pick raised to strike.

I was mesmerized as would be a rabbit in a
corner within a foot of a snake. Suddenly the
lamp flame gave a little crackle. The sound,
breaking the silence, was intensified into an
explosion. It seemed to call me to my senses.
With one maddened half-conscious effort I rolled
gently off the bed, away from the pursuer, and
slipped, between the couch and the wall, on to
the floor.

I made little noise in doing this, for my body
was uncovered, the bed was very low, and the
space between it and the wall so narrow that I
was let slowly down to the ground. To the blind
man I may merely have turned in bed.

As I lay there on the floor I could see the two

A Restless Night 151

sinewy feet close to the couch and could hear the
awful hand moving stealthily over the very pillow.
I next knew that he was bending over the couch
to find what was between the bed and the wall.
Turning my head, I saw a shadowy hand descend
on the far side of the bed, the fingers extended
as if feeling the air. In a moment he would reach
me. His hand moved to and fro like the head of
a cobra, while I felt that with a touch of his
tentacle-like fingers I should die. The climax of
the dream was reached.

I was now well under the bed. In a paroxysm
of despair I seized the two skinny ankles and
jerked them towards me, at the same moment
lifting the frail bed bodily with my back so that
it turned over on its side away from the wall.
The wretch's feet being suddenly drawn away
from him, he fell heavily backwards upon the bare
floor, his head striking the stone with a hollow
sound. The edge of the bedstead lay across him.
The feet, which I still held, were nerveless, and
he made no movement to withdraw them. I crept
back clear of the bed and, jumping upright against
the wall, bolted through the bathroom and out
into the plain. I had a glimpse of the man as I
went by. He was motionless and his mouth hung
open.

152 A Restless Night

I ran some way from the bungalow before I
stopped. I was like a man saved from the scaffold
as the very axe was about to drop. There was a
gentle air blowing, cool and kindly. Above was
a sky of stars, while in the east the faint light
of the dawn was appearing behind the Indian
village.

For a moment or two I watched the door
leading from the bathroom, expecting to see the
man with the pick creep out, but the anticipation
of the sight was so dread that I turned away and
walked to the other side of the bungalow. Here
my greatest joy was merely to breathe, for I
seemed to have been for hours in a suffocating
pit.

The relief did not last for long. I was seized
with another panic. Had I killed the man? I
felt compelled to return to the abhorred room and
learn the worst. I approached it with trembling.
So curious are the details of a dream that I found
— as I expected — the bolt on the outer door
wrenched off and hanging by a nail. I stepped
into the disgusting place, full of anxiety as to
what further horror I had to endure. The little
lamp was still alight. The bedstead was on its
edge as I left it, but the man was gone. There
was a small patch of blood where his head had

A Restless Night 153

struck the floor, but that was the sole relic of the
tragedy.

I awoke feeling exhausted, alarmed and very
cold. I looked at once at the floor for the patch
of blood, and, seeing nothing, realized, to my
extreme relief, that I had been merely dreaming.
It was almost impossible to believe that the events
of the latter part of the night, after the departure
of the rats, had not been real. At breakfast I
retailed to my companion the very vivid and
dramatic nightmare in which I had taken part.
At the end he expressed regret for the mistake
the servants had made in allotting us our rooms
overnight, but I am not sure that that regret
was perfectly sincere.

IN ARTICULO MORTIS

IX

IN ARTICULO MORTIS

THE recent work on " Death and its
Mystery,"^ by Camille Flammarion, the
eminent astronomer, cannot fail to be of supreme
interest. The second vohime of the series,
entitled "At the Moment of Death," will more
especially appeal to medical men, and it is with
this volume and with the reminiscences it has
aroused that I am at present concerned.

About the act or process of dying there is no
mystery. The pathologist can explain precisely
how death comes to pass, while the physiologist
can describe the exact physical and chemical pro-
cesses that ensue when a living thing ceases to
live. Furthermore, he can demonstrate how the
material of the body is finally resolved into the
elements from which it was formed.

The mystery begins in the moment of death,
and that mystery has engaged the thoughts and
imaginations of men since the dawn of human
existence. It was probably the first problem that

1 Fisher Unwin, London, 1922.

157

158 In Articulo Mortis

presented itself to the inquisitive and ingenious
mind, and it may be that it will be the last to
occupy it. Beyond the barrier of death is "the
undiscovered country " where a kindly light falls
upon Elysian Fields or happy hunting grounds, or
fills with splendour the streets of an eternal city.
To some, on the other hand, there is no such
country but only an impenetrable void, a blank,
a mere ceasing to be. Certain who read these
tworks of the learned astronomer may perhaps feel
that he has thrown light upon the great mystery.
Others may affirm that he leaves that mystery still
unillumined and wholly unsolved, while others
again may think that he makes the mystery still
more mysterious and more complex.

M. Flammarion deals with the manifestations
of the dying, with agencies set in action by the
dying, and with events which attend upon the
moment of death. He affirms that in addition
to the physical body there is an astral body or
"psychic element" which is "imponderable and
gifted with special, intrinsic faculties, capable of
functioning apart from the physical organism, and
of manifesting itself at a distance."

This leads to the theory of bilocation where the
actual body (at the point of death) may be in one
place and the astral body in another. It is this

In Articulo Mortis 159

power of bilocation which explains the phantasms
and apparitions of which the book gives many
detailed records. These apparitions may be objec-
tive— that is to say, may be visible to several people
at the same time — or they may be subjective or
capable of being perceived only by the subject or
seer. " These apparitions," the author states,
" are projections emanating from the soul of the
dying." They are astral bodies detached for the
moment from the physical body of which they are
part. "It is," the author continues, " at the
hour of death that transmissions of images and of
sensations are most frequent" (p. 108).

These phantasms appear, either in dreams or
in broad daylight, to the friends of dying persons.
They may announce in words, " I am dying," or
** I am dead." They may merely appear with
signs upon their faces of alarm or of impending
dissolution. They may appear as bodies lying
dead upon a couch or in a coffin. They may pre-
dict the hour of their death, but more usually
their appearance coincides with the exact moment
at which their physical bodies ceased to exist.

M. Flammarion gives numerous instances of
these apparitions seen under such varying circum-
stances as have been named. In certain examples
the phantom appears to have substance and to be

i6o In Articulo Mortis

capable of making its presence actually felt. Thus
in one case the subject saw the apparition of her
sister who was dying in a place far away, and at
the same time ' ' felt a hand brush lightly against
the sheets." The subject, when questioned, said :
"No, no, it wasn't a dream! I heard her
steps ; they made the floor creak. I'm sure of
it; I wasn't dreaming; she came; I saw her"
(p. 345).

It may be further noted that persons who
announce their deaths to others by visions or by
spoken words may at the time of such warning
be in perfect health. Moreover, the apparition may
announce to the dreamer the exact date of the
speaker's own death many days in advance. In
one such instance a man — then in sound health
— appeared to a friend in a dream on August 2
and informed him that he (the subject of the
apparition) would die on August 15. The event
happened as foretold. An instance which in-
volved an interval of years is recorded by Robert
Browning the poet. Seven years after his wife's
death she appeared in a dream to her sister. Miss
Arabel Barrett. Miss Barrett asked the appari-
tion, " When will the day come on which we
shall be reunited? " The dead woman answered,
" My dear, in five years." Five years, lacking a

In Articulo Mortis i6i

month, after this vision, Miss Barrett died of heart
disease.

In messages or warnings from the dying M.
Flammarion affirms that telepathy (or the trans-
mission of thought to a distance) plays an im-
portant part. 'More than this, he says : " It is
beyond doubt that at the moment of death a subtle
shock, unknown in its nature, at times affects those
at a distance who are connected with the dying
person in some way. This connexion is not
always that of sympathy." The method in which
telepathy acts is explained b}^ the author in the
following words: " It is admitted that a kind of
radiation emanates from the dying person's brain,
from his spirit, still in his body, and is dispersed
into space in ether waves — successive, spherical
waves, like those of sound in the atmosphere.
When this wave, this emanation, this effluvium,
comes into contact with a brain attuned to receive
it, as in the case of a wireless-telegraph apparatus,
the brain comprehends it — feels, hears, sees "
(p. 284).

The manifestations produced by these passages
between the living and those who are on the point
of death are very varied. They may take the form
of warnings, predictions or notifications of death.
They may be conveyed vast distances and are

i62 In Articulo Mortis

usually received at the very moment at which the
body from which they emanate ceases to be.
Warnings or announcements may be conveyed by
voices or by visions of various kinds. The voices
may be recognized as those of the dying, or the
actual death scene, " visioned from a distance,"
may be presented complete in every detail. Some
of the manifestations may take a physical form,
such as knockings upon doors and windows, the
sound of footsteps or of gliding feet, the moving
of articles of furniture, the falling of portraits from
the wall, the opening of doors, the passage of a
gust of wind.

Many of the phenomena appear to me to be
hardly worthy of being recorded. As illustrations
I may quote the movement of a hat on a hat peg
used by the deceased, the violent shaking of an
iron fender to announce a daughter's death, the
fact that about the time of a relative's decease a
table became " split completely along its whole
length," while on another like occasion a gas jet
went out in a room in which a party was sitting,
playing cards.

The following circumstance will not commend
itself to the reasonable as one that was dependent
upon a supernatural agency. " My grandmother,"
a student writes, " died in 1913. At the hour of

In Articulo Mortis 163

her death the clock which hung in her room
stopped, and no one could make it go again. Some
years afterwards her son died, and the very day of
his death the clock again began to go without
anyone having touched it." "It is strange,"
comments M. Flammarion, "that the spirit of
someone dying or dead should be able to stop a
clock or start it again." Assuredly it is more
than strange. The same comment might apply to
the following testimony provided by a gardener
in Luneville. " A friend, when one day cleaning
vegetables, seated in a chair, was struck on the
knee by a turnip which was on the ground, and
heard at the same instant two cries : ' Mother !
Mother ! ' That same day her son, a soldier,
was dying in our colony of Guiana ; she did not
hear of his death until very much later."

M. Flammarion's work is probably the most
orderly, temperate and exact that has appeared
on the subject of death from the point of view of
the spiritualist. It has been the work of many
years and its conclusions are based upon hundreds
of reports, letters and declarations collected by the
writer. To many readers the book will, no doubt,
be convincing and inspiring, while possibly to a
larger number of people the author's position will
appear to be untenable, and much of the evidence

164 In Articulo Mortis

upon which his conclusions are based to be
either incredible or impossible. With those who
may hold this latter opinion I am entirely in
accord.

Many of the so-called manifestations, such as
the spirit visitants, the visions and the voices, can
be as fitly claimed to be illusions and hallucina-
tions as ajfirmed to be due to the action of the
psychic element or astral body. The tricks of
the senses are innumerable. The imagination,
stimulated and intensified, can effect strange
things in sensitive subjects ; while, on the other
hand, the powers of self-deception are almost
beyond belief, as the experience of any physician
will attest. Belief in the supernatural and the
miraculous has a fascination for many minds, and
especially for minds of not too stable an order.
Such persons seem to prefer a transcendental
explanation to one that is commonplace.
Apparitions are not apt to appear to those who
are healthy both in body and in mind. Dreams,
it will be admitted by all, are more often due to
indigestion than to a supernatural or a spiritual
agency. Voices are heard and non-existing things
^re seen by those whose minds are deranged, and
it must be allowed that not a few of the men and
women upon whose evidence M. Flammarion de-

In Articulo Mortis 165

pends exhibit a degree of emotional excitement
or exaltation which borders on the abnormal.

I think, moreover, it would not be unjust to
suggest that certain of the narratives are exag-
gerated and that an element of invention is
possible and, indeed, probable in many of them.
There is an impression also that some of the circum-
stances detailed have been misinterpreted or mis-
applied or have been modified by events which
have followed later and to which they have been
adapted as an afterthought. Above all I am
reluctant to believe that the dying, in the solemn
and supreme moment of passing away from the
earth, can be occupied by the trivialities — and,
indeed, I would say by the paltry tricks — which
are accredited to their action in this book.

It is only fair to point out that the volume
now discussed is written by an eminent man of
science who has been trained all his life in methods
of precision, in the judicial examination of reported
facts and in the close scrutiny of evidence. Further
it may be said that the terms "incredible" and
' ' impossible ' ' would have been applied a few years
ago to any account of the telephone or of wire-
less telegraphy, while the same expressions would
assuredly be employed by a medical man when
told, not so long since, that there was a ray capable

i66 In Articulo Mortis

of making a human body so transparent as to
render visible not only the bones but the details
of their internal construction.

In common with others who have been for
many years on the staff of a large hospital, I have
seen much of death and have heard even more
from those who have been in attendance on the
dying. In this experience of a lifetime I have
never met with a single circumstance which would
confirm or support the propositions advanced by
M. Flammarion. This is obviously no argument.
It is merely a record of negative experience.
The only two events, within my personal know-
ledge, which bear even remotely upon the present
subject are the following.

I was, as a youth, on a walking tour in the
south of England with a cousin. We put up one
night at a certain inn. In the morning my com-
panion came down to breakfast much excited and
perturbed. He declared that his father was dead,
that in a vivid dream he had seen him stretched
out dead upon the couch in his familiar bedroom
at home. He had awakened suddenly and noted
that the hour was 2 a.m. That his father had
expired at that moment he was assured, so assured
that he proposed to return home at once, since
his mother was alone. Inasmuch as the journey

In Articulo Mortis 167

would have occupied a whole day, I suggested
that, before starting, he should telegraph and seek
news of his father. With great reluctance he
consented to this course and the telegram was
dispatched. A reply was received in due course.
It was from the father himself expressing surprise
at the inquiry and stating that he was never better
in his life. Nothing, it transpired, had disturbed
the father's rest at 2 a.m. on this particular night.
Nothing untoward happened. My uncle lived for
many years, and finally died one afternoon, and
not, therefore, at 2 a.m.

The other incident is associated with an actual
death and with a strange announcement, but the
announcement is not to be explained by any of
the theories propounded by M. Flammarion. The
facts are these. I was on a steamship which was
making a passage along that coast known in old
days as the Spanish Main. We put in at Colon,
and remained there for about a day and a half. I
took advantage of this break in the voyage to
cross the Isthmus by train to Panama. The
names of those who were travelling by the train
had been telegraphed to that city, which will
explain how it came about that on reaching the
station I was accosted by one of the medical
officers of the famous American hospital of the

i68 In Articulo Mortis

place. He begged me to see with him a patient
under his care. The sick man was an EngUshman
who was traveUing for pleasure, who was quite
alone and who had been taken ill shortly after
his arrival on the Pacific. He was the only
Englishman, he said, on that side of the
Isthmus.

I found the gentleman in a private ward.
He was a stranger to me, was very gravely ill,
but still perfectly conscious. I had nothing fresh
to suggest in the way of treatment. The case was
obviously hopeless, and we agreed that his life
could not be extended beyond a few days and
certainly not for a week. It was a satisfaction
to feel that the patient was as well cared for as if
he had been in his own home in England. I
returned to Colon. Travelling with me was a
retired general of the Indian Army. He had
remained at Colon during my absence. I told
him my experience. He did not know the patient
even by name, but was much distressed at the
thought of a fellow-countryman dying alone in
this somewhat remote part of the world. This
idea, I noticed, impressed him greatly.

Two days after my return from Panama we
were on the high seas, having touched at no port
since leaving Colon, On the third day after my

In Articulo Mortis 169

visit to the hospital the general made a curious
communication to me. The hour for lunch on
the steamer was 12.15. My friend, as he sat down
to the table, said abruptly, " Your patient at
Panama is dead. He has just died. He died at
12 o'clock." I naturally asked how he had
acquired this knowledge, since we had called
nowhere, there was no wireless installation on the
ship, and we had received no message from any
passing vessel. Apart from all this was the
question of time, for the death, he maintained,
had only just occurred. He replied, *' I cannot
say. I was not even thinking of the poor man.
I only know that as the ship's bell was striking
twelve I was suddenly aware that he had, at that
moment, died." The general, I may say, was a
man of sturdy common sense who had no belief
in the supernatural, nor in emanations from the
dying, nor in warnings, nor in what he called
generally " all that nonsense." Telepathy — in
which also he did not believe — was out of the
question, since he and the dead man were
entirely unknown to one another. My friend
was merely aware that the news had reached him.
It was useless for me to say that I did not think
the patient could have died so soon, for the
general remained unmoved. He only knew that

170 In Articulo Mortis

the man was dead whether I expected the event
or whether I did not.

When we reached Trinidad I proposed to go
ashore to ascertain if any news had arrived of the
death at Panama. The general said it was waste
of time. The man was dead, and had died at
noon. Nevertheless, I landed and found that a
telegram had appeared in which the death of this
lonely gentleman was noted as having taken place
on the day I have named. The hour of his
death was not mentioned, but on my return to
England I was shown by his relatives the actual
cablegram which had conveyed to them the news.
It stated that he had died at Panama on that
particular day at twelve o'clock noon. No
coincidence could have been more precise.

The general, to whom the event was as
mysterious as it was unique in his experience,
ventured one comment. He said that during his
long residence in India he had heard rumours of
the transmission of news from natives in one part
of India to natives in another, which reports —
if true — could not be explained by the feats of
runners nor by any system of signalling, since
the distances traversed were often hundreds of
miles. We were both aware of the rumour,
current at the time, that the news of the defeat

In Articulo Mortis 171

at Colenso was known in a certain Indian bazaar
a few hours after the guns had ceased firing.
This, we agreed, was assuredly an example of
loose babble — started by a native who hoped to
hear of the failure of the British — and that this
gossip had become, by repetition, converted into
a prophecy after the occurrence.

For my own part I must regard the Panama
incident as nothing but a remarkable coincidence
of thought and event. My friend was inclined
to regard it as an example of the sudden trans-
mission of news of the kind suggested by his
Indian experience. Why he of all people should
have been the recipient of the message was beyond
his speculation, since he had no more concern
with the happenings at Panama than had the
captain of the ship, to whom I had also spoken
of the occurrence.

A further subject of some interest, suggested
by M. Flammarion's work, may be touched upon.
In the contemplation of the mystery of death it
may be reasonable to conjecture that at the
moment of dying, or in the first moment after
death, the great secret would be, in whole or in
part, revealed. There are those who believe that
after death there is merely the void of non-
existence, the impenetrable and eternal night of

172 In Articulo Mortis

nothingness. Others conceive the spirit of the
dead as wandering, somewhere and somehow,
Ibeyond the Hmits of the world. It is this behef
which has induced many a mother, after the
death of her child, to leave the cottage door
open and to put a light in the window with some
hope that the wandering feet might find a way
home. Others, again, hold to the conviction that
those who die pass at once into a new state of
existence, the conditions of which vary according
to the faith of the believer.

In the face of the great mystery it would be
thought that those who have returned to life after
having been, for an appreciable time, apparently
dead might have gained some insight into the
unknown that lies beyond. Cases of such recovery
are not uncommon, and not a few must have
come within the experience of most medical men
of large practice. I have watched certain of such
cases with much interest, i^mong them the most
pronounced example of apparent lifelessness was
afforded by the following occasion.

A middle-aged man, in good general health,
was brought into the theatre of the London
Hospital to undergo an operation of a moderate
degree of severity. The administration of an
auEesthetic was commenced, but long before the

In Articulo Mortis 173

moment for operating arrived the man collapsed
and appeared to be dead. His pulse had stopped,
or at least no pulse could be detected, the heart-
beat could not be felt, he had ceased to breathe,
all traces of sensation had vanished, and his
countenance was the countenance of the dead.
Artificial respiration was at once employed,
injections of various kinds were given, electricity
was made extended use of, while the heat of the
body was maintained by hot bottles liberally
disposed.

The man remained without evidence of life
for a period so long that it seemed to be
impossible that he could be other than dead. In
the intense anxiety that prevailed, and in the
excitement aroused, I have no doubt that this
period of time was exaggerated and that seconds
might have been counted as minutes ; but it
represented, in my own experience, the longest
stretch of time during which a patient has
remained apparently without life. Feeble indica-
tions of respiration returned and a flutter at the
wrist could again be felt, but it was long before
the man was well enough to be moved back to
the ward, the operation having been, of course,
abandoned.

I determined to watch the recovery of con-

174 In Articulo Mortis

sciousness in this instance, for here was a man
who had been so far dead that, for a period almost
incredible to believe, he had been without the
signs and evidences of life. If life be indicated
by certain manifestations, he had ceased to live.
He was, without question, apparently dead. It
seemed to me that this man must have penetrated
so far into the Valley of the Shadow of Death
that he should have seen something of what was
beyond, some part, at least, of the way, some
trace of a path, some sight of a country. The door
that separates life from death was in his case surely
opening. Had he no glimpse as it stood ajar?

He became conscious very slowly. He looked
at me, but I evidently conveyed no meaning to
his mind. He seemed gradually to take in the
details of the ward, and at last his eye fell upon
the nurse. He recognized her, and after some
little time said, with a smile, " Nurse, you never
told me what you heard at the music hall last
night." I questioned him later as to any experi-
ence he may have had while in the operating
theatre. He replied that, except for the first
unpleasantness of breathing chloroform, he
remembered nothing. He had dreamed nothing.

At a recent meeting (1922) of the British
Medical Association at Glasgow Sir William

In Articulo Mortis 175

MacEwen reports an even more remarkable case
of a man who was brought into the hospital as
"dead." He had ceased to breathe before
admission. An operation upon the brain was
performed without the use of an anaesthetic of
any kind. During the procedure artificial
respiration was maintained. The man recovered
consciousness and, looking round with amazement
at the operating theatre and the strange gather-
ing of surgeons, dressers and nurses, broke his
death-like silence by exclaiming, "What's all
this fuss about? " It is evident from cases such
as these that no light upon the mystery is likely
to be shed by the testimony of those who have
even advanced so far as to reach at least the
borderland of the "undiscovered country."

I might conclude this fragment with some
comment on the Fear of Death. The dread of
death is an instinct common to all humanity.
Its counterpart is the instinct of self-preservation,
the resolve to live. It is not concerned with the
question of physical pain or distress, but is the
fear of extinction, a dread of leaving the world,
with its loves, its friendships and its cherished
individual affairs, with perhaps hopes unrealized
and projects incomplete. It is a dread of which
the young know little. To them life is eternal.

176 In Articulo Mortis

The adventure is before them. Death and old
age are as far away as the blue haze of the
horizon. It is about middle age that the
realization dawns upon men that life does not last
for ever and that things must come to an end.
As the past grows vaster and more distant and
the future lessens to a mere span, the dread of
death diminishes, so that in extreme old age it
may be actually welcomed.

Quite apart from this natural and instinctive
attitude of mind there is with many a poignant
fear of death itself, of the actual act of dying
and of the terror and suffering that may be
thereby involved. This fear is ill-founded. The
last moments of life are more distressing to
.witness than to endure. What is termed " the
agony of death " concerns the watcher by the
bedside rather than the being who is the subject
of pity. A last illness may be long, wearisome
and painful, but the closing moments of it are,
as a rule, free from suffering. There may appear
to be a terrible struggle at the end, but of this
struggle the subject is unconscious. It is the
onlooker who bears the misery of it. To the
subject there is merely a moment —

"When something hke a white wave of the sea
Breaks o'er the brain and buries us in sleep."

In Articulo Mortis 177

Death is often sudden, may often come during
sleep, or may approach so gradually as to be almost
unperceived. Those who resent the drawbacks of
old age may take some consolation from the fact
that the longer a man lives the easier he dies.

A medical friend of mine had among his
patients a very old couple who, having few
remaining interests in the world, had taken up
the study and arrangement of their health as a
kind of hobby or diversion. To them the subject
was like a game of "Patience," and was treated
in somewhat the same way. They had made an
arrangement with the doctor that he should look
in and see them every morning. He would find
them, in the winter, in a cosy, old-fashioned room,
sitting round the fire in two spacious arm-chairs
which were precisely alike and were precisely
placed, one on the right hand and one on the left.
The old lady, with a bright ribbon in her lace cap
and a shawl around her shoulders, would generally
have some knitting on her knees, while the old
gentleman, in a black biretta, would be fumbling
with a newspaper and a pair of horn spectacles.

The doctor's conversation every morning was,
of necessity, monotonous. He would listen to
accounts of the food consumed, of the medicine
taken and of the quantity of sleep secured, just

178 In Articulo Mortis

as he would listen to the details of a game of
" Patience." Now and then there would be some
startling " move," some such adventure as a walk
to the garden gate or the bold act of sitting for
an hour at the open window. After having
received this report he would compliment the
lady on her knitting and on the singing of her
canary and would discuss with the gentleman such
items of news as he had read in the paper.

On one morning visit he found them as usual.
The wife was asleep, with her spectacles still in
place and her hands folded over her knitting.
The canary was full of song. The midday beef
tea was warming on the hob. The old gentle-
man, having dealt with his health, became very
heated on the subject of certain grievances, such
as the noise of the church bells and the unseemly
sounds which issued from the village inn. He
characterized these and like disturbances of the
peace as " outrages which were a disgrace to the
country." After he had made his denunciation
he said he felt better.

Your wife, I see, is asleep," said the doctor.
Yes," replied the old man; "she has been
asleep, I am glad to say, for quite two hours,
because the poor dear had a bad night last
night." The doctor crossed the room to look at

In Articulo Mortis 179

the old lady. She was dead, and had, indeed,
been dead for two hours. Such may be the last
moments of the very old.

Quite commonly the actual instant of death
is preceded, for hours or days, by total uncon-
sciousness. In other instances a state of semi-
consciousness may exist up to almost the last
moment of life. It is a dreamy condition, free
of all anxiety, a state of twilight when the
familiar landscape of the world is becoming very
indistinct. In this penumbra friends are recog-
nized, automatic acts are performed, and remarks
are uttered which show, or seem to show, both
purpose and reason. It is, however, so hazy a
mental mood that could the individual return to
life again no recollection of the period would, I
think, survive. It is a condition not only free
from uneasiness and from any suspicion of alarm,
but is one suggestive even of content.

I was with a friend of mine — a solicitor — at
the moment of his death. Although pulseless
and rapidly sinking, he was conscious, and in the
quite happy condition just described. I suggested
that I should rearrange his pillows and put him in a
more comfortable position. He replied, " Don't
trouble, my dear fellow ; a lawyer is comfortable in
any position." After that he never spoke again.

i8o In Articulo Mortis

In connexion with this semi-somnolent state
it is interesting to note how certain traits of
character which have been dominant during Ufe
may still survive and assert themselves — it may
be automatically — in those whose general con-
sciousness is fading away in the haze of death.
The persistence of this ruling passion or phase of
mind was illustrated during the last moments of
an eminent literary man at whose death-bed I
was present. This friend of mine had attained
a position of great prominence as a journahst.
He had commenced his career as a reporter, and
the reporter's spirit never ceased to mark the
intellectual activities of his later life. He was
always seeking for information, for news, for some
matter of interest, something to report. His
conversation, as one acquaintance said, consisted
largely of questions. He always wanted to know.
When he was in extremis, but still capable of
recognizing those around him, the dire sound of
rattling in his throat commenced. He indicated
that he wanted to speak to me. I went to his
bedside. He said, in what little voice remained,
" Tell me : Is that the death rattle? " I replied
that it was. " Thank you," he said, with a faint
shadow of a smile; " I thought so."

THE IDOL V/ITH HANDS OF CLAY

X

THE IDOL WITH HANDS OF CLAY

THE good surgeon is born, not made. He
is a complex product in any case, and often
something of a prodigy. His qualities cannot
be expressed by diplomas nor appraised by
university degrees. It may be possible to
ascertain what he knows, but no examination can
ehcit what he can do. He must know the human
body as a forester knows his wood ; must know
it even better than he, must know the roots and
branches of every tree, the source and wanderings
of every rivulet, the banks of every alley, the
flowers of every glade. As a surgeon, moreover,
he must be learned in the moods and troubles of
the wood, must know of the wild winds that may
rend it, of the savage things that lurk in its
secret haunts, of the strangling creepers that may
throttle its sturdiest growth, of the rot and mould
that may make dust of its very heart. As an
operator, moreover, he must be a deft handicrafts-
man and a master of touch.

He may have all these acquirements and yet

183

i84 The Idol with Hands of Clay

be found wanting; just as a man may succeed
when shooting at a target, but fail when faced by
a charging lion. He may be a clever manipulator
and yet be mentally clumsy. He may even be
brilliant, but Heaven help the poor soul who has
to be operated upon by a brilliant surgeon.
Brilhancy is out of place in surgery. It is
pleasing in the juggler who plays with knives in
the air, but it causes anxiety in an operating
theatre.

The surgeon's hands must be delicate, but
they must also be strong. He needs a lace-
maker's fingers and a seaman's grip. He must
have courage, be quick to think and prompt to
act, be sure of himself and captain of the venture
he commands. The surgeon has often to fight for
another's life. I conceive of him then not as a
massive Hercules wrestling ponderously with
Death for the body of Alcestis, but as a nimble
man in doublet and hose who, over a prostrate
form, fights Death with a rapier.

These reflections were the outcome of an
incident which had set me thinking of the equip-
ment of a surgeon and of what is needed to fit
him for his work. The episode concerned a young
medical man who had started practice in a humble
country town. His student career had been

The Idol with Hands of Clay 185

meritorious and indeed distinguished. He had
obtained an entrance scholarship at his medical
school, had collected many laudatory certificates,
had been awarded a gold medal and had become
a Fellow of the Royal College of Surgeons. His
inclination was towards surgery. He considered
surgery to be his metier. Although circumstances
had condemned him to the drab life of a family
doctor in a little town, he persisted that he was,
first and foremost, a surgeon, and, indeed, on
his door-plate had inverted the usual wording and
had described himself as " surgeon and physician."
In his hospital days he had assisted at many
operations, but his opportunities of acting as a
principal had been few and insignificant. In a
small practice in a small town surgical oppor-
tunities are rare. There was in the place a
cottage hospital with six beds, but it was mostly
occupied by medical cases, by patients with
rheumatism or pneumonia, by patients who had
to submit to the surgical indignity of being
poulticed and of being treated by mere physic.
Cases worthy of a Fellow of the Royal College
of Surgeons were very few, and even these seldom
soared in interest above an abscess or a broken
leg.

Just before the young doctor settled down to

M

i86 The Idol with Hands of Clay

practise he married. It was a very happy union.
The bride was the daughter of a neighbouring
farmer. She had spent her life in the country,
was more famiUar with the ways of fowls and
ducks than with the ways of the world, while a
sunbonnet became her better than a Paris toque.
She was as pretty as the milkmaid of a pastoral
picture with her pink-and- white complexion, her
laughing eyes and her rippled hair.

Her chief charm was her radiant delight in
the mere joy of living. The small world in which
she moved was to her always in the sun, and the
sun was that of summer. There was no town so
pretty as her little town, and no house so perfect
as "the doctor's" in the High Street. "The
doctor's " was a Georgian house with windows
of many panes, with a fanlight like a surprised
eyebrow over the entry and a self-conscioUs brass
knocker on the door. The house was close to the
pavement, from which it was separated by a line
of white posts connected by loops of chain.
Passers-by could look over the low green wooden
blinds into the dining-room and see the table
covered with worn magazines, for the room was
intended to imitate a Harley Street waiting-
room. They could see also the bright things on
the sideboard, the wedding-present biscuit box.

The Idol with Hands of Clay 187

the gong hanging from two cow-horns and the
cup won at some hospital sports. To the young
wife there never was such a house, nor such
furniture, nor such ornaments, nor, as she
went about with a duster from room to room,
could there be a greater joy than that of keeping
everything polished and bright.

Her most supreme adoration, however, was for
her husband. He was so handsome, so devoted,
and so amazingly clever. His learning was
beyond the common grasp, and the depths of his
knowledge unfathomable. When a friend came
in at night to smoke a pipe she would sit silent
and open-mouthed, lost in admiration of her
husband's dazzling intellect. How glibly he
would talk of metabolism and blood-pressure ;
how marvellously he endowed common things
with mystic significance when he discoursed upon
the value in calories of a pound of steak, or upon
the vitamines that enrich the common bean, or
even the more common cabbage. It seemed to
her that behind the tiny world she knew there
was a mysterious universe with which her well-
beloved was as familiar as was she with the
contents of her larder.

She was supremely happy and content, while
her husband bestowed upon her all the affection

i88 The Idol with Hands of Clay

of which he was capable. He was naturally vain,
but her idolatry made him vainer. She considered
him wonderful, and he was beginning to think
her estimate had some truth in it. She was so
proud of him that she rather wearied her friends
by the tale of his achievements. She pressed
him to allow her to have his diploma and his
more florid certificates framed and hung up in
the consulting room, but he had said with chill-
ing superiority that such things '* were not
done," so that she could only console herself by
adoring the modesty of men of genius.

One day this happy, ever-busy lady was seized
with appendicitis. She had had attacks in her
youth, but they had passed away. This attack,
although not severe, was graver, and her husband
determined, quite wisely, that an operation was
necessary. He proposed to ask a well-known
surgeon in a neighbouring city to undertake this
measure. He told his wife, of course, of his
intention, but she would have none of it. " No,"
she said, " she would not be operated on by stuffy
old Mr. Heron. ^ He was no good. She could
not bear him even to touch her. If an operation
was necessary no one should do it but her
husband He was so clever, such a surgeon, and

1 The name is fictitious.

The Idol with Hands of Clay 189

so up-to-date. Old Heron was a fossil and behind
the times. No ! Her clever Jimmy should do
it and no one else. She could trust no one else.
In his wonderful hands she would be safe, and
would be running about again in the garden in
no time. What was the use of a fine surgeon if
his own wife was denied his precious help! "

The husband made no attempt to resist her
wish. He contemplated the ordeal with dread,
but was so influenced by her fervid flattery that
he concealed from her the fact that the prospect
made him faint of heart and that he had even
asked himself : '' Can I go through with it.^ "

He told me afterwards that his miserable
vanity decided him. He could not admit that he
lacked either courage or competence. He saw,
moreover, the prospect of making an impression.
The town people would say : " Here is a surgeon
so sure of himself that he carries out a grave
operation on his owti wife without a tremor."
Then, again, his assistant would be his fellow-
practitioner in the town. How impressed he
would be by the operator's skill, by his coolness,
by the display of the latest type of instrument,
and generally by his very advanced methods. It
was true that it was the first major operation he
had ever undertaken, but he no longer hesitated.

igo The Idol with Hands of Clay

He must not imperil his wife's faith in him nor
fail to realize her conception of his powers. As
he said to me more than once, it was his vanity
that decided him.

He read up the details of the operation in
every available manual he possessed. It seemed
to be a simple procedure. Undoubtedly in nine
cases out of ten it is a simple measure. His
small experience, as an onlooker, had been limited
to the nine cases. He had never met with the
tenth. He hardly believed in it. The operation
as he had watched it at the hospital seemed so
simple, but he forgot that the work of expert
hands does generally appear simple.

The elaborate preparations for the operation
— made with anxious fussiness and much clinking
of steel — were duly completed. The lady was
brought into the room appointed for the opera-
tion and placed on the table. She looked very
young. Her hair, parted at the back, was
arranged in two long plaits, one on either side
of her face, as if she were a schoolgirl. She had
insisted on a pink bow at the end of each plait,
pleading that they were cheerful. She smiled as
she saw her husband standing in the room look-
ing very gaunt and solemn in his operating dress
— a garb of linen that made him appear half -monk.

The Idol with Hands of Clay 191

half -mechanic. She held her hand towards him,
but he said he could not take it as his own hand
was sterilized. Her smile vanished for a moment
at the rebuke, but came back again as she said :
"Now don't look so serious, Jimmy; I am not
the least afraid. I know that with you I am safe
and that you will make me well, but be sure
you are by my side when I awake, for I want
to see you as I open my eyes. Wonderful
boy! "

The operation was commenced. The young
doctor told me that as he cut with his knife into
that beautiful white skin and saw the blood well
up behind it a lump rose in his throat and he felt
that he must give up the venture. His vanity,
however, urged him on. His doctor friend was
watching him. He must impress him with his
coolness and his mastery of the position. He
talked of casual things to show that he was quite
at ease, but his utterances were artificial and
forced.

For a time all went well. He was showing
off, he felt, with some effect. But when the
depths of the wound were reached a condition of
things was found which puzzled him. Structures
were confused and matted together, and so
obscured as to be unrecognizable. He had read

192 The Idol with Hands of Clay

of nothing like this in his books. It was the
tenth case. He became uneasy and, indeed,
alarmed, as one who had lost his way. He ceased
to chatter. He tried to retain his attitude of
coolness and command. He must be bold, he
kept saying to himself. He made bhnd efforts
to find his course, became wild and finally reck-
less. Then a terrible thing happened. There
was a tear — something gave way — something
gushed forth. His heart seemed to stop. He
thought he should faint. A cold sweat broke
out upon his brow. He ceased to speak. His
trembling fingers groped aimlessly in the depths
of the wound. His friend asked : " What has
happened ? ' ' He replied with a sickly fury :
"Shut up!"

He then tried to repair the damage he had
done ; took up instrument after instrument and
dropped them again until the patient's body was
covered with soiled and discarded forceps, knives
and clamps. He wiped the sweat from his brow
with his hand and left a wide streak of blood
across his forehead. His knees shook and he
stamped to try to stop them. He cursed the
doctor who was helping him, crying out : " For
God's sake do this," or " For God's sake don't
do that ' ' ; sighed like a suffocating man ; looked

The Idol with Hands of Clay 193

vacantly round the room as if for help ; looked
appealingly to his wife's masked face for some
sign of her tender comfort, but she was more
than dumb. Frenzied with despair, he told the
nurse to send for Mr. Heron. It was a hopeless
mission, since that surgeon — even if at home —
could not arrive for hours.

He tried again and again to close the awful
rent, but he was now nearly dropping with terror
and exhaustion. Then the anaesthetist said in a
whisper: "How much longer will you be? Her
pulse is failing. She cannot stand much more."
He felt that he must finish or die. He finished
in a way. He closed the wound, and then sank
on a stool with his face buried in his blood-stained
hands, while the nurse and the doctor applied the
necessary dressing.

The patient was carried back to her bedroom,
but he dared not follow. The doctor who* had
helped him crept away without speaking a word.
He was left alone in this dreadful room with its
hideous reminders of what he had done. He
wandered about, looked aimlessly out of the
window, but saw nothing, picked up his wife's
handkerchief which was lying on the table,
crunched it in his hand, and then dropped it on
the floor as the red horror of it all flooded his

194 The Idol with Hands of Clay

brain. What had he done to her? She! She
of all women in the world !

He caught a sight of himself in the glass.
His face was smeared with blood. He looked
inhuman and unrecognizable. It was not himself
he saw : it was a murderer with the brand of
Cain upon his brow. He looked again at her
handkerchief on the ground. It was the last
thing her hand had closed upon. It was a piece
of her lying amid this scene of unspeakable
horror. It was like some ghastly item of
evidence in a murder story. He could not touch
it. He could not look at it. He covered it with
a towel.

In a while he washed his hands and face, put
on his coat and walked into the bedroom. The
blind was down ; the place was almost dark ; the
atmosphere was laden with the smell of ether.
He could see the form of his wife on the bed, but
she was so still and seemed so thin. The coverlet
appeared so flat, except where the points of her
feet raised a little ridge. Her face was as white
as marble. Although the room was very silent,
he could not hear her breathe. On one side of
the bed stood the nurse, and on the other side the
anaesthetist. Both were motionless. They said
nothing. Indeed, there was nothing to say.

The Idol with Hands of Clay 195

They did not even look up when he came in.
He touched his wife's hand, but it was cold and
he could feel no pulse.

In about two hours Heron, the surgeon,
arrived. The young doctor saw him in an
adjacent bedroom, gave him an incoherent,
spasmodic account of the operation, laid emphasis
on unsurmountable difficulties, gabbled some-
thing about an accident, tried to excuse himself,
maintained that the fault was not his, but that
circumstances were against him.

The surgeon's examination of the patient was
very brief. He went into the room alone. As
he came out he closed the door after him. The
husband, numb with terror, was awaiting him in
the lobby. The surgeon put his hand on the
wretched man's shoulder, shook his head and,
without uttering a single word, made his way
dow^n the stairs. He nearly stumbled over a
couple of shrinking, white-faced maids who had
crept up the stairs in the hope of hearing some-
thing of their young mistress.

As he passed one said : "Is she better,
doctor? " but he merely shook his head, and
without a word walked out into the sunny street
where some children were dancing to a barrel-
organ.

196 The Idol with Hands of Clay

The husband told me that he could not
remember what he did during these portentous
hours after the operation. He could not stay in
the bedroom. He wandered about the house.
He went into his consulting room and pulled out
some half-dozen works on surgery with the idea
of gaining some comfort or guidance ; but he
never saw a word on the printed page. He went
into the dispensary and looked over the rows of
bottles on the shelves to see if he could find any-
thing, any drug, any elixir that would help. He
crammed all sorts of medicines into his pocket
and took them upstairs, but, as he entered the
room, he forgot all about them, and when he
found them in his coat a week later he wondered
how they had got there. He remembered a pallid
maid coming up to him and saying : " Lunch is
ready, sir." He thought her mad.

He told me that among the horrors that
haunted him during these hours of waiting not
the least were the flippant and callous thoughts
that would force themselves into his mind with
fiendish brutality. There was, for example, a
scent bottle on his wife's table — a present from
her aunt. He found himself wondering why her
aunt had given it to her and when, what she had
paid for it, and what the aunt would say when

The Idol with Hands of Clay 197

she heard her niece was dead. Worse than that,
he began composing in his mind an obituary
notice for the newspapers. How should he word
it.'* Should he say "beloved wife," or "dearly
loved wife," and should he add all his medical
qualifications? It was terrible. Terrible, too,
was his constant longing to tell his wife of the
trouble he was in and to be comforted by her.

Shortly after the surgeon left the anaesthetist
noticed some momentary gleam of consciousness
in the patient. The husband hurried in. The
end had come. His wife's face was turned
towards the window. The nurse lifted the blind
a little so that the light fell full upon her. She
opened her eyes and at once recognized her
husband. She tried to move her hand towards
him, but it fell listless on the sheet. A smile —
radiant, grateful, adoring — illumined her face,
and as he bent over her he heard her whisper :
"Wonderful boy."

BREAKING THE NEWS

XI

BREAKING THE NEWS

AMONG the more painful experiences which
X^m haunt a doctor's memory are the occasions
on which it has been necessary to tell a patient
that his malady is fatal and that no measure
of cure lies in the hands of man. Rarely in-
deed has such an announcement to be bluntly
made. In the face of misfortune it is merciless
to blot out hope. That meagre hope, although
it may be but a will-o'-the-wisp, is still a glimmer
of light in the gathering gloom. Very often
the evil tidings can be conveyed by the lips of
a sympathetic friend. Very often the message
can be worded in so illusive a manner as to plant
merely a germ of doubt in the mind ; which germ
may slowly and almost painlessly grow into a
realization of the truth. I remember being
present when Sir William Jenner was enumerating
to a friend the qualities he considered to be
essential in a medical man. "He needs," said
the shrewd physician, "three things. He must
be honest, he must be dogmatic and he must be

N 201

202 Breaking the News

kind." In imparting his dread message the
doctor needs all these qualities, but more especially
the last — he must be kind. His kindness will be
the more convincing if he can, for the moment,
imagine himself in the patient's place and the
patient in his.

The mind associates the pronouncing of a
verdict and a sentence of death with a court of
justice, a solemn judge in his robes, the ministers
of the law, the dock, a pallid and almost breath-
less audience. Such a spectacle, with its elaborate
dignity, is impressive enough, but it is hardly less
moving when the scene is changed to a plain
room, hushed almost to silence and occupied by
two persons only, the one who speaks and the
one who listens — the latter with bowed head and
with knotted hands clenched between his knees.

The manner in which ill-news is received
depends upon its gravity, upon the degree to
which the announcement is unexpected and upon
the emotional bearing of the recipient. There
may be an intense outburst of feehng. There
may be none. The most pitiable cases are those
in which the sentence is received in silence, or
when from the trembling lips there merely escapes
the words, " It has come."

The most vivid displays of feeling that occur

Breaking the News 203

to my mind have been exhibited by mothers when
the fate of a child is concerned. If her child
be threatened a mother may become a tigress.
I remember one such instance. I was quietly
interviewing a patient in my consulting room
when the door suddenly flew open and there
burst in — as if blown in by a gust of wind — a
gasping, wild-eyed woman with a little girl tucked
up under her arm like a puppy. Without a word
of introduction she exclaimed in a hoarse whisper,
"He wants to take her foot off." This sudden,
unexplained lady was a total stranger to me.
She had no appointment. I knew nothing of
her. She might have dropped from the clouds.
However, the elements of violence, confusion and
terror that she introduced into my placid room
were so explosive and disturbing that I begged
my patient to excuse me and conducted, or rather
impelled, the distraught lady into another room.
Incidentally I may remark that she was young
and very pretty ; but she was evidently quite
oblivious of her looks, her complexion, her dress
or her many attractions. I had before noticed
that when a good-looking woman is unconscious
of being good-looking there is a crisis in progress.
The story, which was told me in gasps and
at white heat, was as follow. The child was a

204 Breaking the News

little girl of about three, almost as pretty as her
mother. She was the only child and had developed
tuberculous disease in one foot. The mother had
taken the little thing to a young surgeon who
appears to have let fall some rash remark as to
taking the foot off. This was enough for the
mother. She would not listen to another syllable.
She, whom I came to know later as one of the
sweetest and gentlest of women, changed at the
moment to a wild animal — a tigress.

Without a word she snatched up the baby and
bolted from the house, leaving the child's sock
and shoe on the consulting-room floor. She had
been given my name as a possible person to con-
sult and had dashed off to my house, carrying the
child through the streets with its bare foot and
leg dangling in the air. On being admitted she
asked which was my room. It was pointed out
to her, and without more ado she flung herself in
as I have described. The child, I may say, was
beaming with delight. This dashing in and out
of other people's houses and being carried through
the streets without a sock or a shoe on her foot
struck her as a delicious and exciting game.

The mother's fury against my surgical colleague
was almost inexpressible. If the poor man had
suggested cutting off the child's head he could

Breaking the News 205

not have done worse. "How dare he!'* she
gasped. " How dare he talk of cutting off her
foot ! If he had proposed to cut off my foot I
should not have minded. It would be nothing.
But to cut off her little foot, this beautiful little
foot, is a horror beyond words, and then look at
the child, how sweet and wonderful she is ! What
wickedness!" It was a marvellous display of
one of the primitive emotions of mankind, a pic-
ture, in human guise, of a tigress defending her
cub. By a happy good fortune, after many
months and after not a few minor operations, the
foot got well so that the glare in the eyes of the
tigress died away and she remembered again that
she was a pretty woman.

It is well known that the abrupt reception of
ill-tidings may have a disastrous effect upon the
hearer. The medical man is aware that, if he
would avoid shock, the announcement of un-
pleasant facts or of unhappy news must be made
slowly and with a tactful caution. In this method
of procedure I learnt my lesson very early and in
a way that impressed my memory.

I was a house-surgeon and it was Christmas
time. In my day each house-surgeon was on what
was called " full duty " for one entire week in
the month. During these seven days all accident

2o6 Breaking the News

cases came into his surgeon's wards. He was said
to be " taking in." On this particular Christmas
week I was " taking in." Two of my brother
house-surgeons had obtained short leave for
Christmas and I had undertaken their duties. It
was a busy time ; so busy indeed that I had not
been to bed for two nights. On the eve of the
third night I was waiting for my dressers in the
main corridor at the foot of the stair. I was
leaning against the wall and, for the first and the
last time in my life, I fell asleep standing up. The
nap was short, for I was soon awakened, " rudely
awakened" as novelists would put it.

I found myself clutched by a heated and pant-
ing woman who, as she clung to me, said in a
hollow voice, "Where have they took him?"
The question needed some amplification. I in-
quired who "he" was. She replied, "The bad
accident case just took in." Now the term
"accident" impUes, in hospital language, a man
ridden over in the street, or fallen from a scaffold,
or broken up by a railway collision. I told her
I had admitted no such case of accident. In fact
the docks and the great works were closed, and
men and women were celebrating the birth of
Christ by eating too much, by getting drunk and
by street rioting, which acts involved only minor

Breaking the News 207

casualties. She was, however, convinced he was
" took in." He was her husband. She gave me
his name, but that conveyed nothing, as it was
the dresser's business to take names. With a
happy inspiration I asked, " What is he? " "A
butler," she replied. Now a butler is one of the
rarest varieties of mankind ever to be seen in
Whitechapel, and it did so happen that I had, a
few hours before, admitted an undoubted butler.
I told her so, with the effusion of one eager to
give useful information. She said, " What is the
matter with him?" I replied cheerily, "He
has cut his throat."

The effect of this unwise readiness on my part
was astonishing. The poor woman, letting go
of my coat, collapsed vertically to the floor. She
seemed to shut up within herself like a telescope.
She just went down like a dress dropping from a
peg. When she was as small a heap as was pos-
sible in a human being she rolled over on to her
head on the ground. A more sudden collapse I
have never seen. Had I been fully awake it would
never have happened. We placed her on a couch
and soon restored her to consciousness.

Her story was simple. She and her husband
had met. The two being " full of supper and
distempering draughts " (as BrabantiO would say)

2o8 Breaking the News

had had a savage quarrel. At the end he banged
out of the house, exclaiming, " I will put an end
to this." She had bawled after him, " I hope to
God you will." He had wandered to Whitechapel
and, creeping into a stable, had cut his throat
there and then. The friend who hastened to in-
form the wife told her, with a tactfulness I so
grievously lacked, that her husband had met with
an accident and had been taken to the hospital.
This lesson I never forgot and in the future based
my method of announcing disaster upon that
adopted by the butler's discreet friend.

Although a digression from the present subject
I am reminded of the confusion that occasionally
took place in the identity of cases. All patients
in the hospital who are seriously ill, whether they
have been long in the wards or have been only
just admitted, are placed on "the dangerous
list " and have their names posted at the gate
so that their relatives might be admitted at any
time of the day or night.

A man very gravely injured had been taken
into the accident ward. He was insensible and his
condition such that he was at once put on the
dangerous list, or, in the language of the time,
was " gated." During the course of the evening
n youngish woman, dressed obviously in her best.

Breaking the News 209

bustled into the ward with an air of importance
and with a handkerchief to her Hps. She de-
manded to see the man who had been brought
in seriously injured. She was directed by the
sister to a bed behind a screen where lay the man,
still insensible and with his head and much of
his face enveloped in bandages. The woman at
once dropped on her knees by the bedside and,
throwing her arms about the neck of the uncon-
scious man, wept with extreme profusion and with
such demonstrations of grief as are observed at
an Oriental funeral. When she had exhausted
herself she rose to her feet and, staring at the
man on the bed, exclaimed suddenly, " This is
not Jim. This is not my husband. Where is
he?"

Now, in the next bed to the one with the
screen, and in full view of it, was a staring man
sitting bolt upright. He had been admitted with
an injury to the knee. This was Jim. He was
almost overcome by amazement. He had seen
his wife, dressed in her best, enter the ward, clap
her hand to her forehead, fall on her knees and
throw her arms round the neck of a total stranger
and proceed to smother him with kisses. Jim's
name had been "gated" by mistake.

When she came to the bedside of her real

210 Breaking the News

husband she was annoyed and hurt, so hurt, in-
deed, that she dealt with him rudely. She had
worked herself up for a really moving theatrical
display in the wards, had rehearsed what she should
say as she rode along in the omnibus and con-
sidered herself rather a heroine or, at least, a lady
of intense and beautiful feeling which she had now
a chance of showing off. All this was wasted and
thrown away. An injured knee, caused by falling
over a bucket, was not a subject for fine emotional
treatment. She was disgusted with Jim. He had
taken her in. " Bah! " she exclaimed. " Come
in with water on the knee ! You might as well
have come in with water on the brain ! You are
a fraud, you are ! What do you mean by dragging
me all the way here for nothing .'' You ought to
be ashamed of yourself." With this reproof she
sailed out of the room with great dignity — a
deeply injured woman.

To return to the original topic. In all my
experience the most curious manner in which a
painful announcement was received was manifested
under the following circumstances. A gentleman
brought his daughter to see me — a charming girl
of eighteen. He was a widower and she was his
only child. A swelling had appeared in the upper
part of her arm and was increasing ominously. It

Breaking the News 211

became evident on examination that the growth
was of the kind known as a sarcoma and that the
only measure to save Hfe was an amputation of
the limb at the shoulder joint, after, of course,
the needful confirmatory exploration had been
made.

A more distressing position could hardly be
imagined. The girl appeared to be in good health
and was certainly in the best of spirits. Her father
was absolutely devoted to her. She was his ever-
delightful companion and the joy and comfort of
his life. Terrible as the situation was it was
essential not only that the truth should be told
but told at once. Everything depended upon an
immediate operation and, therefore, there was not
a day to be lost. To break the news seemed for
a moment almost impossible. The poor father
had no suspicion of the gravity of the case. He
imagined that the trouble would probably be dealt
with by a course of medicine and a potent liniment.
I approached the revelation of the dreadful truth
in an obscure manner. I discussed generalities,
things that were possible, difficulties that might
be, threw out hints, mentioned vague cases, and
finally made known to him the bare and ghastly
ti'uth with as much gentleness as I could command.

The wretched man listened to my discourse

212 Breaking the News

with apparent apathy, as if wondering what all
this talk oould mean and what it had to do with
him. When I had finished he said nothing, but,
rising quietly from his chair, walked over to one
side of the room and looked at a picture hanging
on the wall. He looked at it closely and then,
stepping back and with his head on one side, viewed
it at a few feet distant. Finally he examined it
through his hand screwed up like a tube. While
so doing he said, " That is a nice picture. I
rather Hke it. Who is the artist? Ah! I see his
name in the corner. I like the way in which he
has treated the clouds, don't you? The fore-
ground too, with those sheep, is very cleverly
managed." Then turning suddenly to me he
burst out, " What were you talking about just
now? You said something. What was it? For
God's sake say that it is not true ! It is not
true! It cannot be true! "

A QUESTION OF HATS

XII

A QUESTION OF HATS

I HAD had a very busy afternoon and had
still two appointments to keep. The first of
these was in the suburbs, a consultation with
a doctor who was a stranger to me. It was a
familiar type of house where we met — classic
Doric pillars to the portico, a congested hall
with hat-pegs made of cow horns, a pea-green
vase with a fern in it perched on a bamboo
tripod, and a red and perspiring maid-servant.
Further, I became acquainted with a dining-room
containing bomb-proof, mahogany furniture, and
great prints in pairs on the walls, "War" and
"Peace" on one side, "Summer" and
"Winter" on the other. Then there was the
best bedroom, rich in lace and wool mats, con-
taining a bedstead as glaring in brass as a
fire-engine, a mirror draped with muslin and
pink bows, and enough silver articles on the
dressing-table to start a shop. After a discus-
sion of the case with the doctor in a drawing-room

which smelt like an empty church, I rushed off,

215

2i6 A Question of Hats

leaving the doctor to detail the treatment we had
advised, for I found — to my dismay — that I was
twenty minutes late.

The second case was that of an exacting duke
whom I had to visit at regular periods and,
according to the ducal pleasure, I should be at
the door at least one minute before the appointed
hour struck. I was now hopelessly late and con-
sequently flurried. On reaching the ducal abode
I flew upstairs prepared to meet the storm. His
Grace ignored my apologies and suggested, with
uncouth irony, that I had been at a cricket
match. He added that it was evident that I
took no interest in him, that his sufferings were
nothing to me, and concluded by asserting that
if he had been dying I should not have hurried.
I always regard remarks of this type as a symptom
of disease rather than as a considered criticism of
conduct, and therefore had little difficulty in
bringing the duke to a less contentious frame of
mind by reverting to that topic of the day — his
engrossing disorder.

The duke never allowed his comfort to be in
any way disturbed. He considered his disease as
a personal affront to himself, and I therefore
discussed it from the point of view of an
unprovoked and indecent outrage. This he found

A Question of Hats 217

very pleasing, although I failed to answer his
repeated inquiry as to why His Grace the Duke
of X should be afflicted in this rude and offensive
manner. It was evident that his position should
have exempted him from what was quite a vulgar
disorder, and it was incomprehensible that he,
of all people, should have been selected for this
insult.

The inter\iew over, I made my report to the
duchess, who was in a little room adjacent to the
hall. She followed me out to ask a final question
just as I was on the point of taking my hat.
The hat handed to me by the butler was, how-
ever, a new hat I had never seen before. It was
of a shape I disliked. The butler, with due
submission, said it was the hat I came in. I
replied it was impossible, and, putting it on my
head, showed that it was so small as to be
absurd. The duchess, who was a lady of prompt
convictions, exclaimed, "Ridiculous; that was
never your hat ! ' ' The butler could say no
more : he was convicted of error. The duchess
then seized upon the only other hat on the table
and held it at arm's length. " Whose is this? "
she cried. '' Heavens, it is the shabbiest hat I
ever saw! It cannot be yours." (It was not.)
Looking inside, she added, "What a filthy hat!

2i8 A Question of Hats

It is enough to poison the house." Handing it
to the butler as if it had been an infected rag,
she exclaimed, "Take it away and burn it! "

The butler did not at once convey this
garbage to the flames, but remarked — as if talk-
ing in his sleep — " There is a pianoforte tuner
in the drawing-room." The duchess stared with
amazement at this inconsequent remark. Where-
upon the butler added that the new hat I had
rejected might possibly be his. He was at once
sent up to confront the artist, whose aimless
tinkling could be heard in the hall, with the
further message that if the dirty hat should
happen to be his he was never to enter the house
again. The butler returned to say that the
musician did not "use " a hat. He wore a cap,
which same he had produced from his pocket.

While the butler was away a great light had
illumined the mind of the duchess. It appeared
that Lord Andrew, her son-in-law, had called
that afternoon with his wife. He had just left,
his wife remaining behind. It was soon evident
that the duchess had a grievance against her
son-in-law. When the light fell upon her she
exclaimed to me, " I see it all now. This
horrible hat is Andrew's. He has taken yours
by mistake and has left this disgusting thing

A Question of Hats 219

behind. It is just like him. He is the worst-
dressed man in London, and this hat is just the
kind he would wear."

At this moment the daughter appeared. She
had overheard her mother's decided views, and
was proportionately indignant. She disdained
to even look at the hat, preferring to deal with
the indictment of Andrew on general grounds.
She defended her husband from the charge of
being unclean with no little show of temper.
Without referring to the specific hat, she said
she was positive, on a priori grounds, that
Andrew would never wear a dirty hat. Her
mother had no right to say such things. It was
unjust and unkind.

The duchess was now fully roused. She was
still more positive. This, she affirmed, was just
the sort of thing Andrew would do — leave an old
hat behind and take a good one. She would send
him at once a note by a footman demanding the
immediate return of my hat and the removal of
his own offensive headgear.

The daughter, deeply hurt, had withdrawn
from the discussion. I suggested that as Lady
Andrew was about to go home she might inquire
if a mistake had been made. Her Grace, how-
ever, was far too moved to listen to such

220 A Question of Hats

moderation. She wanted to tell Andrew what
she thought of him, and it was evident she had
long been seeking the opportunity. So she at
once stamped off to write the note. In the
meanwhile I waited, gazing in great melancholy
of mind at the two hats. The silent butler also
kept his eyes fixed upon them with a gloom even
deeper than mine. I had hinted that the new
hat might belong to Lord Andrew, but the
duchess had already disposed of that suggestion
by remarking with assurance that Andrew never
wore a new hat. The note was produced and at
once dispatched by a footman.

I have no idea of the wording of the note,
but I was satisfied that the duchess had not been
ambiguous, and that she had told her son-in-law
precisely what were her present views of him in
a wider sense than could be expressed in terms
of hats. The writing of the letter had relieved
her. She was almost calm.

She now told the silent butler to fetch one
of the duke's hats, so that I might have at least
some decent covering to my bare head thus
unscrupulously stripped by the unclean Andrew.
The butler returned with a very smart hat of the
duke's. It had apparently never been worn. It
fitted me to perfection. In this vicarious coronet

A Question of Hats 221

I regained my carriage. I felt almost kindly
towards the duke now that I was wearing his
best hat.

Next day I placed the ducal hat in a befitting
hat-box and, having put on another hat of my
own, was starting for the scene of the downfall
of Lord Andrew. At my door a note was handed
me. It was from the suburban doctor. He very
courteously pointed out that I had taken his hat
by mistake, and said he would be glad if I would
return it at my convenience, as he had no other,
and my hat came down over his eyes. It was
a dreadful picture, that of a respected practitioner
going his rounds with a hat resting on the bridge
of his nose ; but at least it cleared up the mystery
of the new hat. The butler was right. In my
anxiety at being late on the previous afternoon
I was evidently not conscious that I was wearing
a hat which must have looked like a thimble on
the top of an egg.

On reaching the ducal residence I was received
by the butler. He said nothing ; but it seemed
to me that he smiled immoderately for a butler.
The two hats, the new and the dirty, were still
on the table, but the duchess made no appear-
ance. I returned the duke's hat with appropriate
thanks and expressed regret for the stupid mistake

222 A Question of Hats

I had made on the occasion of my last visit.
I then placed the doctor's new hat I had
repudiated in the hat-box ready for removal.

The full mystery was still unsolved, while the
butler stood in the hall like a hypnotized sphinx.
I said, in a light and casual way, " And what
about Lord Andrew? Did his lordship answer
the note? " The butler replied, with extreme
emphasis, "He did indeed! " Poor duchess, I
thought, what a pity she had been so violent and
so hasty.

Still the dirty hat remained shrouded in
mystery, so, pointing to it, I said to the butler,
" By the way, whose hat is that? " " That hat,
sir," he replied, adopting the manner of a show-
man in a museum, "that hat is the duke's. It
is the hat His Grace always wears when he goes
out in the morning." " But then," I asked,
" why did you not tell the duchess so yester-
day? " He replied, "What, sir! After Her
Grace had said that the hat was enough to
poison the house ! Not me ! ' '

Printed by Cassell & Compaky, Limited, La Belle Sauvage, London, E.C.4.

F. 35.1222

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