The Charm of Ireland

by Burton Egbert Stevenson

I put the compositions aside, for a lesson in Gaelic had begun. The teacher wrote on the little blackboard some sentences composed of the strangest-looking words imaginable, and the pronunciation of them was stranger still. But the lesson proceeded rapidly, and it was evident that most of the children understood Gaelic quite as well as they did English. That, of course, is not saying very much; and I fancy that about all these children can be expected to learn is to read and write. Indeed, it is a wonder that they learn even that, for the odds against them are almost overwhelming.

I bade them good-bye at last, and returned pensively to the hotel, and there I found the district physician making some repairs to his motor-cycle. It probably needs them often, for the roads up into the hills are trying for anything on wheels; but he said it was surprising where it would go and how much knocking about it would stand. And then, naturally enough, we fell into talk about his work.

Every poor person in Ireland is, as I understand it, entitled to free medical attendance. The country is divided into districts, in each of which a doctor is stationed, paid partially by the government and depending for the remainder of his income on his private practice. Before a person is entitled to free attendance, he must secure a ticket from one of the poor-law guardians, who have the management of the charities in each district; and no physician is compelled to give free attendance, unless the person asking for it can produce one of these tickets.

"Even then," continued the doctor at Leenane, who was explaining all this to me, "I don't put myself out, if I think the person presenting the ticket can afford to pay. I look him over, of course, and give him some medicine, with instructions how to take it—the law compels me to do that; but I don't bother myself to see whether the instructions are carried out. And if he's really sick, he soon realises that if he wants me to be interested, he's got to pay for it, and he manages to find a guinea or so. This sounds hard-hearted, perhaps; but it's astonishing how many beggars there are in this country, and how the poor-law guardians let themselves be imposed on. Why, people come to me with cards and try to get free attendance who could buy and sell me ten times over! I don't bite my tongue telling them what I think of them, you may well believe. The trouble is, the poor-law guardians are natives of the district and they all have some axe to grind; so the doctor, who is a stranger for whom they care nothing, gets the worst of it. This is about the worst district in Ireland, anyway, so big and poor and full of hills. A man has to work himself to death to make three hundred pounds a year out of it."

Various reflections occurred to me while he was talking. One was that three hundred pounds a year is many, many times the income of the average dweller in Connaught; and another was that, to leave any discretion to the physician in regard to the treatment of charity patients is not without its dangers; and still a third was that, in any sudden emergency, such as might occur at any time, many valuable minutes would be lost if the poor-law guardians had to be hunted up and a card obtained before the doctor could be summoned. I suppose, in such cases, the doctor is summoned first, and the card secured when there is time to do so.

It is probably only in cases of dire need that the district doctor is summoned at all. The fact that he is a stranger and a government appointee is enough to make a large section of the Irish peasantry distrust him. This one told me that he is never called for confinement cases, because every old Irish woman considers herself competent to handle them, and usually is; and that other cases are treated with "home remedies" or visits to holy wells, until they get so bad that the doctor is turned to as a last resort.

"The ignorance of the people is past all belief," he went on. "They haven't any idea of what causes disease; they never heard of germs; they don't know it is unhealthy to have a stinking heap of manure and human excrement under the window or in front of the door; they don't believe there is any reason why a person dying with consumption shouldn't sleep in the same bed with other people, and eat out of the same dishes, and spit all about the place. And so we have typhus, and tuberculosis—you Americans are partially responsible for that."

"In what way?" I asked.

"The people born and reared in these western highlands, with lungs adapted through long generations to this soft, moist climate, can't stand the American atmosphere. When they are poor and live crowded together in your towns, consumption gets them; and then, when they're too far gone to work, they come back home to cough their lives out and poison all their friends. They lie in these dark cabins without a window, which soon become perfect plague-spots; and the children, playing on the filthy, infected floor, get the infection in their lungs; or perhaps they cut their knees and rub it into the sore. Ugh! it makes one sick to think about it. There ought to be a law preventing any such infected person landing in Ireland—you won't let such a one land in America."

I had to admit that that would be one way of dealing with the mischief; and I suggested that another way would be to try to educate the people to some knowledge of the simpler facts of hygiene. But the doctor snorted.