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St. Bernard's: The Romance of a Medical Student

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2017
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If to the city sped – what waits him there?
To see profusion that he must not share;
To see ten thousand baneful arts combined,
To pamper luxury and thin mankind.

    Goldsmith (“Deserted Village”).

What is the perfect life for a Christian man or woman? It was settled once for all by our Lord. “Sell all that thou hast and give to the poor” – and live in a cave, on the top of a column, in a monastic cell, or beg for daily bread from door to door? Would that fulfil the command? The nineteenth century has no place for St. Simeon’s Pillar; the cells of the monks are turned to other uses than that of contemplation, which is not quite in the way of the age of steam and the telegraph; and begging and alms-giving are denounced by students of social economy. What is the precise application, then, of our Saviour’s teaching to the present day? Though deaths from starvation and terrible tales of privation are not uncommon in our great cities, and the condition of the unskilled working classes is particularly unsatisfactory, there is no question that our poor even at their worst are better off by far than those of our Lord’s time. Admitting the work that remains to be done in helping to raise the lower sections of society, it is in a moral rather than a material direction that our efforts must be exerted; and though our Lord’s command to sell all and feed the poor is not perhaps to be interpreted literally, because the literal is not now the highest interpretation of the injunction, yet never was there a time when it was more the duty of Christian people to make great, ay, the greatest sacrifices for their fellow-men than the present. The law provides against the starvation of any human being dwelling in our midst; but it is souls rather than bodies which languish for food, and are fain to be filled with carrion. The separation which many years has been going on between class and class; the locating the workers in quarters given over to dirt, squalor, and dullness; the exodus of the cultivated minds to more congenial sections of our greater towns, where the signs of labour and the noise of work cannot disturb or annoy them; the drawing off the classes from the masses, depriving the poor man of the society, the encouragement, the teaching, the example, the brightness, the wealth, and the culture of the more leisured – it is this which is slowly but surely working, not alone the degradation of the deserted people, but a terrible punishment for the deserters. There is not a work of art, not a lofty aspiration, not a burst of song, not a beautiful face, nor a well-stored intellect, but is part of the heritage of the poor. We have as much right to cut off the poor man’s oxygen or his nitrogen as to deprive him of any of the elements needful for the nourishment of his soul.

Walk through the unlovely streets where the worker dwells in London. Note the changes that have taken place in them during the past fifty years. Once there were mansions in them, where their employers dwelt. Now these deserted places are let off in tenements, since their former occupants have long ago left them for brighter and wealthier parts of the town. Grim, dirty, and neglected parish churches stand in the midst of graveyards filled with the tumble-down monuments of rich residents whose descendants never visit them, scorning to go east of Temple Bar, even to pay their respects to the tombs of their ancestors. Within these temples of prayer the monuments round the walls tell sadly of better days and a prosperity that contrasts oddly with the decadence of the present. Hard work here for the clergy, with much begging from distant and richer parishes to maintain the services and ministrations of the Church, even in their crippled form. True, money is sent from the West, but where are the workers? The men and women who could help the clergy in a hundred ways to mitigate the evil surroundings? And Lady Millefleurs will have to know, sooner or later, that she has not charity, though she sell all her goods to feed the poor, and give her body to be burned, while she will not give herself a living sacrifice to humanity. How is she to do this? How is she to fulfil the command to sell all she has and give to the poor? Simple enough. Give up Belgrave Square and settle in Bethnal Green! Forsake Tyburnia and dwell in Whitechapel! Then, and not till then, will she follow her Master’s commands. Very unpleasant, doubtless; but consider what she would learn. At a great cost she has acquired much human knowledge of a kind, not enough to keep her, perhaps, from falling into the error of the often-quoted lady, who wondered why the poor who could not get bread did not live on those nice twopenny cakes to be had in Bond Street. What good would be done by this retrogression from progress? Just think of a few ways of helping the poor. Look at the East End and suburban vestries, boards of guardians, and public bodies generally. Why are they so corrupt, so hard to move, so gluttonous and backward? That is not far to seek. Consider the mental calibre, the social status, the education and tastes of the men who compose them too generally. The gentry are far away, where they only see the poor as rare and interesting objects on which to bestow Bibles, blankets, soup, and occasional recitations and songs. They spend their days in places where the clergy are compelled to preserve with care a few exotic paupers as specimens, that it may be demonstrated now and then that “the poor ye have always with you.” Granny, in her clean cap, white apron, and neat gown, sitting in a well-scrubbed room, reading the Bible with the help of a pair of horn spectacles, by the side of a not depressingly low fire, is all the idea of poverty with which many a high-born lady has any acquaintance. How about “slumming” which Mr. Punch declared recently was so fashionable? There never was very much of it; there is less now, and that doesn’t count. It never did the least good, nor was it likely it should. The great wrong done to the poor by the complete alienation of the rich cannot be condoned by spasmodic visits to their wretched homes by ladies and gentlemen, who go to see them as they go to the Zoo; by their occasional presence at the opening of a bazaar for a poor church; nor by the exhibition of their well-appointed equipages to the admiring gaze of the denizens of Tourniquet’s Rents. This wrong cannot be remedied by gifts of money, nor by loans of pictures and objets d’art.

It happened that just as Sister Agnes left St. Bernard’s, a number of ladies of wealth and position had formed themselves into a community, without any distinctly religious badge or dogmas, for the purpose of residing together in an East London district. They took a large, old-fashioned house in the Commercial Road, called in a skilful architect and a builder, had it put in thorough repair and properly adapted to the purposes of colonization by the well-to-do. They were women of ample leisure, intelligence, and business capacity, and were impressed by the idea that if one would help the poor and ignorant, it could only be done effectually by teaching them how to help themselves. They did not propose to inculcate the religious opinions of any particular section of the Christian Church; they wore no distinctive dress, had no politics in particular, and were only actuated by a desire to see for themselves what was the real life and what were the real needs of the working people with whom they went to reside. They knew that in a great measure the deplorable unloveliness of East London was due to the fact that it was deserted by people of wealth and capacity for helping their neighbours, and that the best way of doing good in the locality was work and residence there. “The problem was how to make the working people realize their spiritual and social solidarity with the rest of the capital and the kingdom; how to revive their sense of citizenship, with its privileges which they have lost, and its responsibilities which they have forgotten. Among these privileges should be education, rational amusement, and social intercourse, best supplied by local clubs, with their various guilds, classes, and societies. Among the duties, on the other hand, which require to be revived, thrift and prudence stand pre-eminent; and thrift and prudence can only be taught by those who will associate with the people and thus induce them to face the elementary laws of economy. This is especially the case with regard to that population question to which all the other problems are subordinate. The levity with which lads and girls enter upon matrimony without any adequate provision (a levity which would be criminal if it were not so unconscious), can only be met by convincing them that prudence in this matter is a duty which is as fully recognized in other grades of society as it is ignored by themselves. The sympathy and example of educated people living in their midst does more good in all these ways than the foundation of any number of new charitable institutions. Destitute London requires their personal help as well as their subscriptions.”

Such was the plan which had worked so admirably at Oxford House, Bethnal Green, established by a number of Oxford men for just this work; and these good women rightly argued: If such an institution worked by men has been found so useful, how much more effectual would be something on similar, but less ambitious lines, if worked by women! Reform the women, you reform the men and the next generation. Make the home life what it should be, and you have made virtue and decency, not only possible, but easy and pleasant.

It was brave of these good Oxford men to go and live in the gloomiest part of surely the gloomiest and poorest parish of East London; but though they might stimulate the brains of the people amongst whom they laboured, and do good in a thousand ways, it was impossible for them to hope to achieve the influence of women in the home. The men could capture the outworks; women were required to secure the citadel. So they spent their money liberally, and went to work at the courts and alleys that run off right and left of this great thoroughfare from the Docks to the City. One of their great ideas was an hospital for Women and Children – not a place for teaching doctors their business, or giving them scope for their fads, – not “happy hunting grounds” for “cases,” but wards for the restoration to health with all possible speed of sick folk of the neighbourhood who could not effectually be tended at home. It was an axiom with the Lady Head of the Home, which was called Nightingale House, that no sick person should be removed to the hospitals who could be effectually and comfortably treated at home. She argued that we do great harm by making hospitals the universal resource of the lower classes, even of those who have sufficiently comfortable homes. She maintained with great force that much of the tenderness of family life is fostered, nay, created, by the mutual care of parent and child, husband and wife, brother and sister, in seasons of illness and in the hour of death; and held that if we deduct from our feelings all which we owe to sources of this kind, the residue would represent all that we can expect from the working classes under the present system. Thus if the home were not over-crowded and the disease not infectious, she held that it should be nursed and doctored in the family. As much kindly aid and sympathy, as much attention and skill as possible these ladies lent, but there was no removal from home unless absolutely necessary. Sister Agnes was just the woman to be matron of this hospital for women and children; and as the plan was completely to her mind, she was soon installed in her new office.

Sister Agnes had made many friends amongst her patients at St Bernard’s, and many of them and their relatives came to see her at her new home, and sought her advice in their troubles and difficulties. Her great experience and ability enabled her to penetrate to the bottom of many a little mystery. She often wondered how she could so long have been cognisant of the things that took place and had not sooner rebelled. Often a husband or wife who was a patient at the old place would write home, and the letters would be brought to her for her opinion. A poor carman at the docks one day brought her a letter which his wife had sent him the previous day. The poor man did not know what to make of it. His wife had gone to the hospital merely on account of loss of appetite and strength, and the doctors, after “overhauling her like a barge as was in dry dock,” as he expressed it, had come to the conclusion that she had a tumour “somewhere internal,” and if she did not have it taken out she would soon die.

“In course, Mum,” said he, “the doctors ought to know best; but my belief all along is they be nothing but practisin’ on her.”

Then he gave the Sister the letter his wife had sent him; which was expressed in Mrs. Stubbins’ forcible vernacular. The dialect of a denizen of the London slums abounds in idioms, which were intelligible enough to Sister Agnes from long acquaintance, but she could not help smiling as she read the poor woman’s epistle.

“St Bernard’s Hospital, 16th July.

“Dear Jack, —

“I write these few lines for to let you now how I am gettin along in this plaice. I have bean hear six weaks to-morrer, which is little Jemmie’s birfday. I ain’t undergond the hoperation as I cum for yet, bekos the doctor says my sistem ain’t reddy fur to stand it yet. My patients is allmost gon, Jack, with waitin in suspends so long. Sumtimes I begin to think as the doctors ain’t acting straight with me. They makes a dredful hurtin examinashun everry morning with more’n a dozzun yung stoodents a-lookin on, which ain’t proper in my opinyun, and they talks a lot of Latin and says it is a verry pretty case. One feller sed it was you-neek or somethin of that sort, and Doctor Stanforth would be back in a fortnit and must see it. As for phizzik I swer I ain’t had a drop of anythink but pepermint water sins in this plaice I’ve bin; but I’ve bin pulld about shameful, as ain’t fit for no respectful marrid woman, for what objek I can’t for the life on me see. Now, Jack, do mind and keep Lizzie at her scholin, and don’t let Billy and Polly run wild in the streets. I don’t like meself at all in this plaice, and ef the tumour aint sune tuk out I shall bunk it, so I tell yer strayt. I wish you’d ask Dr. Phelps what thear littel gaim is hear. I beleaf I am only kep as a speciment, bekos my cais is curous; anyhow, I ain’t a-bein dun no good to, and they’ll find I’m sloped afore long. 2 on em in saim ward as me bunked it last week.

    “Your lovin wife,
    “Matilda Stubbins.”

“Now, Mum,” said the man, “what I wanted to ask you was this. Mrs. Foster, our relieving officer’s wife, I have heerd tell had a tumour in her inside, asking your pardon for speaking like that afore a lady; but you don’t mind me, I hopes, and she went to a ladies’ ’orspital in the West End, and they was a-going to take her pretty nigh all to bits, as the sayin’ is, tellin’ her she’d be a dead woman in no time if it warn’t done; and while the poor thing was a-prayin’ and a-screwin’ of her courage up for to have it done, a lady told her how she had bin cured of the same thing by drinkin’ of gallons and gallons of still water, think they called it.”

“Distilled water,” said the Sister.

“Maybe your right, lady; anyways, she drunk pretty nigh a hogshead of it, besides wearing a tin bottle full of it hot round her innards, savin’ your presence, and she got well in three months and the tumour went right away. I have heerd Mr. Foster say so hisself. Now I wants to ask you if so be as you thinks as my poor Tilly could be cured with these ’ere waters like that?”

“Well, I can’t tell you that, Stubbins, but if you like I will get a clever doctor I know to see her, and tell us all about the case; but my advice to you, from what I know of St. Bernard’s, is to get her away at once. If the operation must be done, we will find some other hospital, after we have tried what we can do with less severe means.”

Visions of similar cases crowded in upon the good Sister’s recollection – of eviscerated creatures in whom no tumour was discovered to remove; of cases where, on the post-mortem table, sponges, and even instruments, had been discovered carelessly sown up in the patients after operation, and had caused their deaths. Had not Dr. Stanforth ever after said, with a look full of meaning, when about to perform this operation, “Count your sponges, sister!”

Mrs. Stubbins discharged herself from St. Bernard’s without waiting for further treatment, and actually recovered her health perfectly, unassisted even by “still waters.” She always declares that her doctors were like “Helen’s Babies,” who wanted to see the “wheels go round,” and was glad they had not gratified their curiosity on her “works.” Poor woman! she forgave them the wrong they had intended to do her, for in common with her class she believed it was somehow meant for her good, only “they are so fond of hacking folks about at them places.” Good-natured creatures, they sacrifice their poor skins, organs, and limbs, usually with generosity, when a great institution requires it, though the general practitioner cannot touch them with a lancet without protest. It is the éclat does the business.

One day an old pavior smashed his hand. The surgeons at St. Bernard’s wanted to remove three fingers. Not before he had been to see Sister Agnes, he thought. Sister Agnes went in for conservative surgery, and told him to refuse his consent. How often had she known a simple method of dressing save the digits in such a case. In three months the man had the complete use of his hand as before the accident, but that didn’t console the house surgeon, whose fingers had itched “to make a neat little job of it.” The pavior was so grateful to the Sister for her advice that he begged her acceptance of his favourite linnet in a nice cage.

CHAPTER XXXII.

THE RISE OF NIGHTINGALE HOSPITAL

Heaven must be won, not dreamed; thy task is set,
Peace was not made for earth, nor rest for thee.

    Lyra Apostolica.

And so the medical staff of the Nightingale Hospital of fifty beds consisted of a resident doctor, duly qualified both by nature and the colleges – the only true “double qualification” in this world – with a consulting physician and surgeon of eminence who attended twice a week for a proper fee. This last was not at all an honorary appointment, because doctors never do work for nothing if they can help it, any more than bishops, or even kings; and as they were prevented by the constitution of the place from paying themselves in any of the accustomed ways, substantial cheques had very properly to be drawn. No new operations, no new drugs, no treatment of any kind not well established elsewhere were permitted by the governing body (which had several medical men on its board beside the lay members), because it was held that, however desirable it might be to keep abreast of the science of the day, it was first much more important then and there to get the poor women and children of Commercial Road healed of their diseases as soon as conveniently might be done. Science, as far as Commercial Road folk went, was thus baulked of its prey – no great hindrance probably to the human race. The ladies of Nightingale House had not settled in that locality precisely on scientific grounds: they felt they could safely leave Science in the hands of its devotees, these being probably people so ardently in love with it, that they would sacrifice themselves, their bodies and their feelings on its behalf. The laws of supply and demand would doubtless meet that case as they meet others. This scheme was for quite other and (as the originators thought) better purposes; and the patients took kindly to the idea. They did not mind getting well on empiric methods if the doctors did not object to curing them without knowing why. For their part it was a great deal better to go out whole and sound, unscientifically, than to die according to the highest dictates of science, or hobble away maimed for similar reasons. So it worked well all round. The subscribers secured what they paid for; the patients did not complain of getting well on such terms; the doctors had no cause to grumble. It was only the medical journals which declared that the hospital was not up to the standard demanded by an age like the present.

Two large and well-conducted Convalescent Homes were part of the plan – one situated at Hastings, and the other at Godalming; and these contributed at least as much as the hospital itself to the improved health of the parish.

Now it was objected by those who were not friendly to this place that medical knowledge could never be advanced by such a system, and would stagnate and die, if all hospitals were conducted so selfishly. It was answered that medical science could scarcely be in worse plight than it already was, after all its great opportunities and hecatombs of murdered victims, as admitted by the most eminent medical writers.

No objector to the methods of treatment in our great general hospitals could express himself with more force than Sir Astley Cooper, lecturing to the students of Guy’s Hospital, when he said: “Look, gentlemen, at one hundred patients who come into the hospital. What is the miserable treatment of these patients? You are aware that I scarcely ever enter these wards (the medical wards) of the hospital. I will tell you why I do not enter them. I abstain from entering them because patients are compelled to undergo so infamous a system of treatment that I cannot bear to witness it… No consideration shall induce me to repress my feelings, and I do say that the present treatment of patients is infamous and disgraceful, for their health is irremediably destroyed.” On another occasion this great surgeon said: “The art of medicine is founded on conjecture and improved by murder.”

Nightingale Hospital could not do worse than this anyway!

CHAPTER XXXIII.

MRS. PODGER BECOMES A SIBYL

There’s a real love of a lie,
Liars find ready-made for lies they make,
As hand for glove, or tongue for sugar-plum.

    – Browning.

In nothing have hospitals improved more of late years than in their nursing arrangements. This seems coincident with the High Church movement which has given the sick poor the inestimable boon of being nursed by gentlewomen who have adopted the noble profession of nursing from the love of God and their neighbour – ousting the Gamp and Harris sisterhood to the great advantage of their patients. Previous to the reform of this branch of charity, great scandals were always arising from the ignorance, incompetence, indolence, and drunkenness of the women employed to attend upon the sick. Very often, too, the poor invalids were robbed by these persons; and when their little possessions were not actually filched, it was necessary to bribe their attendants to do their duty, or to omit it, as the case might be. Many blots on the management of St. Bernard’s were traced to this source by the governing body; and when Miss Rackworth, the matron, died, it was determined to thoroughly reorganize the nursing staff on the new system, which had been proved successful in other hospitals.

The first thing which the new matron did after her installation was to make a clearance of the Mrs. Gamp order of nurse. And it was time! The age has outgrown “Sairey” and her set. The old hussies made it their business to “keep in” with the students, as they could help them in many ways, but the patients who did not “tip” them got scant courtesy. The newer order of skilled and educated nurses kept the students within due bounds; and, feeling that their first duty was to the patients, never, if they could prevent it, permitted their interests to be sacrificed to medical education. Podger’s days were numbered when Miss Kemp took up the reins of government.

Podger had of late presumed to send away several minor cases of casualty, with wet bandages of her own application, when she was in her cups; and the matron demanded her dismissal. It was a sad day for poor Podger when she turned her back on the hospital she loved. She had saved a little money, not so much as she ought, but still something for a rainy day. So she took a small house in Chillingworth Street, near Seven Dials, and set up in the “ointment” line. Filling her parlour window with a few gross of willow boxes, such as doctors use for their stuff, she announced, “Mrs. Podger’s Old Nurses’ Salve for Bad Legs, Boils, etc.,” and published some remarkable cases, which soon brought a little grist to her mill. But she had also furnished apartments to let, and these were taken by a middle-aged lady in the “medium” line of business – Mrs. Sabina Allen she was called. She was of more than middle stature, with jet-black hair, good features, and a general cheap tragedy-queen aspect. She converted Podger in a month, and with the assistance of her little stone jar of “Old Tom,” made her see the ghosts of her deceased relatives floating about the house in the “most permiscuous manner.” Podger was no sooner a disciple of advanced spiritualism, than she entered into partnership with her lodger, and inserted advertisements in The Medium Light and Daybreak, announcing that public séances were held at 15 Chillingworth Street, every Sunday evening, at eight o’clock.

The first Sunday, some seventeen persons attended, and the collection was a great success, as it amounted to no less a sum than eight shillings and sixpence. Dreams of wealth began to float through the brains of the sibyls. Podger did not admit all comers; they had to pass a “preliminary” in the passage before they went upstairs. Podger was the examiner. When the bell rang, she answered it. The applicant would request admission to the séance.

“Are you a spiritualist?”

“Yes.”

“What journal do you read?”

“Daybreak.”

“Do you know any of our friends?”

“Yes; a Mr. Lapworth and a Miss Clegg who attend here.”

“All right, you can come up.”

Then you were led by Podger into a first-floor front room, very frowsy, dark, and stuffy, in which the chairs were arranged in a semi-circle, facing a big chintz-covered sofa. There was a cabinet or screen in front of a cupboard on the left of the fireplace, covered with black cloth, which material also closely draped the windows, and excluded the light from the street lamps and the public-house opposite. The room was already nearly filled, and, in a few minutes, the medium entered, and took her seat on the sofa, with Podger on her left, by the cabinet. When she had seated herself, you saw that the long greasy mark on the wall-paper behind the couch was caused by the contact of the medium’s head as she leaned back fanning herself, and looking pale and weary. The company, on the occasion we describe, consisted of eleven women, more or less young, evidently work-women, and six men. Eight o’clock having struck, Podger put out the gas, and left the room in total darkness, and then struck up a hymn, —

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