CHAPTER XXIV
MY JOURNEYMANSHIP IN MEDICINE
Journeymen in medicine, though without the full responsibilities of the profession, have yet their difficulties. I had mine; and I had not only the ordinary complement of ordinary men, but some which were a little extra.
For example, I was no horseman at all, and people around me knew it. At the first attempt to mount a new horse, and ride out with the old physician, of whom I had purchased my stand, to see his patients, I made an exhibition of my horsemanship which I shall not soon forget, and which I am sure certain wags and half-buffoons and common loungers who witnessed the scene never will.
My horse stood at the post all caparisoned, while I made ready. In setting off, I knew well I must submit to the ordeal of being gazed at and commented on by a crowd assembled in an adjoining store. It was a rainy day, and the crowd would doubtless be much larger than usual. Now my love of approbation was excessive; so great as at times to defeat entirely its object. So in truth, it proved on the present occasion.
When I was ready to go forth on my journey, I mounted my horse and attempted to place my right foot in the stirrup. At this critical instant the gaping multitude in the grocery, presented themselves in quite a formidable column at the door to see the young doctor on his new horse. Their appearance threw my mind off its balance to an extent that prevented me from well-balancing my body, and with every possible exertion I could not get my feet firmly fixed in the stirrups. To add to my trouble, my horse was in haste and trotted off high and hard before I could muster presence of mind enough to check him. I rolled this way and that, till at length, down I came headlong. My hat went one way, and my whip another. A great shout was at once raised by the spectators, but being cured by this time, of my excessive diffidence, and not at all hurt, I could soon join in the laugh with the rest. I could most heartily adopt my old maxim, "It is an ill wind that blows nobody any good;" and I had learned by my fall at least, one thing, at least for the moment; viz., my excessive regard to human approbation. Thenceforward, I rode as I pleased.
But before I enter upon the details and particular confessions of my professional career, it is needful that I should say something of those changes which were made about this time in my physical habits, by means of which I gained at least a temporary victory over my great enemy, the consumption. For it must not be supposed that because I could sit on a horse and ride six, eight, ten, or twelve miles a day, or work in the field or garden half the day, I was out of danger. I had, indeed, gained important victories, but there remained very much land yet to be possessed.
Of my abandonment of all medicine, I have already told you. But I had also greatly changed my dietetic habits. During my excursion of the fifth of July, and subsequently, I had lived almost wholly on what might have been denominated the starvation system. The case was this: I started with less than five dollars in my pocket, and with too much pride to borrow more. That my money might hold out, therefore, though I took care to secure a good, clean bed by nights, even at the full market price (except when I was entertained occasionally, by particular friends), I almost went without food. Many a time was I satisfied, because I was determined to have it so, with a tumbler of milk and a couple of crackers for my breakfast, or even my dinner; and as for supper, I often dispensed with it wholly; and all this too, strange though it may seem, not only without the loss of strength, but with a slow, yet steady, increase.
These dietetic changes, though they were a necessity, were continued and extended from principle. I had known, for a long time, what the laws of digestion, respiration, circulation, cleanliness, exercise, etc., were, but had not fully obeyed them. But I now set myself obeying them up to the full extent of my knowledge. I do not mean to affirm that my obedience was perfect and entire wanting in nothing; but only that I made an attempt at sinless perfection. However, I speak here, of course, of the physical code; for to moral obligation, at that time, I do not mean, now, to refer.
My diet was exceedingly plain and comparatively unstimulating. It consisted chiefly of bread, fruits, potatoes; and, once a day of salted meats. These last should have been exchanged for those which were not pickled, and which are of course less stimulating; but at that time I was not fully aware of their tone and tendency. My drink was water and a little tea; for cider I had long before abandoned.
I paid particular attention to purity of air, and to temperance. Fortunately I resided in a house which from age and decrepitude, pretty effectually ventilated itself. But temperature, as I well knew, must be carefully attended to, particularly by consumptive people. While they avoid permanent chilliness, and even at times, the inhalation of very cold air on the one hand, it is quite indispensable that they should breathe habitually as cool an air as possible, and yet not be permanently chilly. This, by means of a proper dress, by night and by day, and proper fixtures for heating my room, I contrived to secure.
Cleanliness, too, by dint of frequent bathing, received its full share of my attention. It was a rule from which I seldom if ever departed, to wet my body daily with cold water, and follow it up by friction. At home or abroad, wherever I could get a bowl of water I would have a hand bath.
Need I say here that a medical man one who rode daily on horseback paid a proper regard to the laws of exercise? And yet I am well persuaded that not a few medical men exercise far too little. Riding on horseback, though it may sometimes shake off consumption, is not so good an exercise for the mass of mankind perhaps not even for consumptive people themselves as an alternation of walking with the riding. This, also, I took good care to secure.
Physicians are usually either very greatly addicted to the habit of dosing and drugging for every little ill, real or imaginary, or particularly hostile to it. I have seldom found any such thing as a golden mean in this respect, among them. My feelings, saying nothing at present of the sober convictions of my head, led me almost to the extreme of no medicine, if extreme it can be called. I did not even retain my daily tumbler of ale.
Though I began my medical career as an apprentice or journeyman, merely, and went abroad chiefly as the associate of my predecessor, I was soon called upon in his absence, and in other circumstances, to take the whole charge of patients; or at least to do so till a longer experience was available. Thus I was gradually inducted into an important office, without incurring a full and proportionate share of its responsibilities.
CHAPTER XXV
MY TEMPERANCE PLEDGE
The subject of Temperance, in its present associated forms, had, at this time, just began to be agitated. At least, it had just begun to receive attention in the newspapers which I was accustomed to see. It could not be otherwise than that I should be deeply interested in its discussion.
I had been brought up, as I have before intimated, to a pretty free use of cider and tea; but not of ardent spirits or coffee. Neither of these was regularly used in my father's family; though both occasionally were. But I had abandoned cider long before this time, because I found it had a tendency to produce, or at least to aggravate, those eruptive diseases to which I was greatly liable. Temperance, then, in the popular sense of the term, was, to me, an easy virtue.
And yet as a temperance man in the circle of my acquaintance I stood nearly alone. No individual around me was ready to take the ground I occupied. Of this, however, I was not fully apprised, till a patient attempt to recruit the temperance ranks convinced me of the fact. But I will give you a full account of my enterprise, since it has a bearing on my subsequent history and confessions.
And yet as a temperance man in the circle of my acquaintance I stood nearly alone. No individual around me was ready to take the ground I occupied. Of this, however, I was not fully apprised, till a patient attempt to recruit the temperance ranks convinced me of the fact. But I will give you a full account of my enterprise, since it has a bearing on my subsequent history and confessions.
With the aid of a Boston paper which I habitually read, I drew up the customary preamble, declaration, and pledge of a temperance society. It involved the great idea of total abstinence from spirituous liquors; though by the term spirituous liquors, as used at that day, was meant chiefly distilled spirits. Having first affixed my own name to the paper I went to the most influential of my patrons and friends and asked them to sign it likewise. But, reader, will you believe it? not a single subscriber could I obtain far, or near. They all, with one consent, made excuse.
The elder deacon of the most evangelical church in the place where I resided, had for his apology that he suffered seriously from a complaint for which his physicians had prescribed the daily use of gin, "Now," said he, "though there is nothing in the pledge which goes to prohibit the use of spirits in a case like my own, yet as some might think otherwise and charge me with inconsistency, I must on the whole be excused from signing it."
His son, who was also a deacon in the same church with the father, excused himself by saying he was young, and without influence, and it would be far better for the old people to put their names down first. "Perhaps," said he, "I may conclude to sign the paper by-and-by. I will consider well the matter, and if I conclude to sign it, I will let you know."
Other leading men in the church as well as in the town affairs, refused to sign the pledge, because Deacon H. and son would not. It belonged to the deacons in the church, they said, to take the lead in all good things, and not to them. When they had put their names to the document, others would not long hesitate to follow.
In short nobody would consent to sign the paper, and it remains to this day, just as it was when I drew it up; and it is now more than thirty years old. There it is, with my name attached to it, as large as life. I have been President, Vice President, Treasurer, Secretary, and "all hands too," of my would-be Temperance Society, from that day to this. I doubt whether many societies can be found which in thirty years have made so little change as the one under consideration.
For about four years from the time of getting up the above-named temperance society, strange as the assertion may seem, I retained the right to use a little beer and a good deal of coffee. But in May, 1830, I abandoned all drinks but water, to which custom I have ever since adhered and in which I shall probably die.
CHAPTER XXVI
TRIALS OF A YOUNG PHYSICIAN
The poet Cowper, in his delineations of a candidate for the pulpit, prescribes, as one needful condition or qualification,
"That he is honest in the sacred cause."
So, when I entered upon the medical profession, which I regarded as next of kin to sacred, I deemed honesty quite a high recommendation; and whatever in the abstract appeared to me to be right, I endeavored to pursue through the routine of every-day life. Alas, that I should ever have had occasion to doubt the policy of common honesty!
I was called to see Mrs. . The case was an urgent one. There was no time for deliberation or consultation. I understood her case but very poorly; yet I knew that in order to success I must at least seem to be wise. Besides, what was to be done must be done quickly; so I boldly prescribed. My prescription was entirely successful, and I left the house with flying colors. I left, moreover, with the full consciousness of having acted in the main like an honest man.
A few days afterward I was sent for by Mrs. , who immediately filled my ears with the most piteous complaints, the sum total of which was that she was exceedingly nervous, and I told her so. Of course I did not complain of culpability or crime. But I told her, very plainly, that she needed no medicine nothing but plenty of air and exercise, and less high-seasoned food. My great frankness gave offence, and impaired my reputation. She employed, in my stead, Dr. Robinson, who continued to attend her till his bill amounted to a sum sufficient to buy a good carriage and harness, and till his credit for skill was advanced in a degree corresponding.
Mr. B.'s child was sick, and his wife besides. He came for my predecessor; but, not finding him at home, though he still remained in the place, he was compelled to Hobson's choice myself or nobody; Dr. Robinson lived at too great a distance. I was accordingly employed, and was soon on the spot. The child was very sick; and for some little time after my arrival I was so much occupied in the performance of my duties that I paid no attention to any thing else. But having prescribed for both my patients, I sat down quietly to look over the newspaper.
Presently I heard from Mrs. B. a deep groan. I was immediately at her bedside, anxious to know the cause. "Oh, nothing at all," she said, "except a momentary feeling of disappointment because Dr. did not come." I said to her, "You can send for him now, madam, as soon as he returns. Do not think yourselves compelled to adhere to me, simply because you have been obliged to call me once. I will yield most cheerfully to the individual of your preference."
Mrs. B. apologized. She knew I had done as well as I could, she said; and perhaps no one could have done better. "But little Leonora," said she, "is dreadfully sick; and I do very much want to see Dr. B. He has had more experience than you. These young doctors, just from the schools, what can they know, the best of them?"
I saw her difficulties; but, as I have already intimated, I did not look so wise as Dr. B., nor had I so grave a face, nor so large an abdomen. I could neither tell so good a story, nor laugh so heartily; I could not even descend to that petty talk which is so often greatly preferred to silence or newspaper reading, not only by such individuals as Mrs. B. and her friends, but by most families. A physician must be a man of sympathy. He need not, however, descend to so low a level as that of dishonesty; but he must come down to the level of his people in regard to manners and conversation. He must converse with them in their own language. He must not only seem to be devoted, unreservedly, to their interests, but must actually be so. This confession is most cheerfully and sincerely and honestly made; and may he who reads it understand.
On a certain occasion I was called to prescribe in a family where the disappointment was so great that the patient was actually made worse by my presence, and an unfavorable turn given to the disease. It may be said that people ought not to yield themselves up to the influence of such feelings; and it is certainly true that they ought not. But sick people are not always rational, nor even judicious. Dr. Johnson says: "Every sick man is a rascal;" but we need not go quite so far as that. Sickness changes us, morally, sometimes for the better, but much oftener for the worse; and in general it makes us much less reasonable.
But it is far enough from being my intention to present a full account of the trials incident to the life of a young medical man; for, in order to do this, I should be obliged to carry you with me, at least mentally, to places which you would not greatly desire to visit. Physicians can seldom choose their patients; they are compelled to take them as they find them. They will sometimes be called to the vilest of the vile and the filthiest of the filthy.