CHAPTER XXI.
TAKEN IN.
Although hospitals have been intended as a blessing and benefit to the poor, they have too often proved the reverse, on account of the ignorance on the part of their administrators of the true principles of health.—Encyclopædia Britannica.
There are diviner, truer laws,
That teach a nobler lesson still.
Procter.
One of the greatest blots upon hospital management of the present day is the abuse of alcoholic drinks. The immense amount of spirits needlessly, and often not harmlessly, given to the patients is a serious tax on the resources of the charities, and a fertile cause of dram-drinking in the people at large. As you pass along the wards and read the cards over the beds, indicating the diet and amount of drink ordered by the medical officers, it is startling to see how many sick or convalescent patients are ordered six ounces of whisky or brandy a day. Now six ounces represent three wineglassfuls of good average size, or say nearly two bottles a week. This is expensive, to say the least—of very questionable service in most cases to say nothing more. That the custom has its advantages in an hospital like the one we were describing is indisputable—to the medical staff. Where a system obtains by constant worrying and painful, or at least unpleasant physical examinations, it is of great assistance to doctors and nurses to have at hand an unfailing means of putting and keeping the patient in good humour and benevolent docility. Does he object to be “mauled about,” as he sometimes inelegantly calls his dose of “palpation and stethoscopy,” his equanimity is at once restored by the comfortable words of the doctor, “An ounce of brandy, sister!” Should he object to his treatment, and rebel against the hallowed customs of the place, considering he has a right to the orderly arrangement and general integrity of his own limbs, he is a lucky fellow if upon an early date his spirit card is not reduced, or even taken away altogether. You could not manage St. Bernard’s on its present lines without alcohol. The medical school would not have a chance with it. Let us follow, say, Thomas Smith from St. Giles to the hospital. He has inflammation of the lungs, is very weak and ill, has been badly fed and cannot in his own home obtain proper care and nursing. His clergyman kindly gives him a letter for the hospital. He is advised to be at the out-patient department at one o’clock. To make sure, the poor fellow’s cab is there by half-past twelve; the great waiting-hall is already filling. The physician of the day arrives a little after two. About three, if he is lucky, Smith’s turn will come. He is not sorry. It was weary waiting, sitting upright on a hard bench in a great noisy, draughty room, with many distressing and painful sights around him; and when the kind, gently speaking physician tells his wife to strip him to the waist, he begins to think he is going to be cured straight off by some of the superabundant medical force surrounding him.
There are many interesting clinical features in Tom Smith’s case, and the doctor lectures long and learnedly to the score of good-natured, athletic young gentlemen whom he has just been informed are “sucking doctors.” They have all come provided with stethoscopes, and after the examining physician has thoroughly thumped, pummelled, and “auscultated” poor Smith’s chest, back and front, as many of the aforesaid young men who are invited, or who can be induced to interest themselves, “have their go” at the patient, and are very kindly and patiently shown precisely where the mischief is, and what is the exact stage of its progress; but all this could not be got through without an ounce or two of brandy in a drop of water, in a measure glass that stands handy. And everybody having quite done, with many remarks, such as, “You see the point I was driving at, Mr. Dobbs?” or, “You are quite convinced my theory of pneumonia is correct, Mr. Murphy?” poor, shivering, sick and faint Tom Smith is sent up to the wards to bed, under the care of an entirely fresh physician, physician’s assistant, clinical clerks, and students of the in patient department.
None of those men who have spent so much time over the case, will probably ever see it again. Smith’s cards, papers, and books having all been duly made out, signed and registered, he is conducted, say, to Magdalen ward, where he is put to bed and made comfortable. If he has brought any tea and sugar with him, he can have a cup; but these things are luxuries not provided by the charity.
When the staff has dined, the house physicians and surgeons, accompanied by their clinical clerks, dressers, and nurses, go their rounds. All the fresh cases that have come in during the day have to be examined. All that Tom Smith has undergone in the out-patient department goes for nothing, and the process is now still more carefully repeated. A minutely exact record of the “physical signs” is made; all that drumming of the fingers on the poor tender chest, that long stethoscoping at the panting lungs, whose every movement causes acute distress, has to be undergone; the heart sounds are scrupulously noted; its size and the line of demarcation of the liver and other organs recorded, not by the qualified doctor temporarily in charge of the case alone, but, by his kind permission, his assistant clerks also, for their education, verify all the recorded facts for themselves. “An ounce of brandy, sister!” and the man suppresses his growing discontent. His night temperature is recorded on the card above his bed, and now, if so disposed, he may say his prayers and compose himself to sleep. At six in the morning he will have to get his breakfast, for work in a hospital must begin early, or the wards will not be scrubbed and tidied up by ten o’clock, when the doctors go their morning rounds.