The Young Physician

by Francis Brett Young

From such reflections he would be roused by the anæsthetist’s laconic “Ready.” On one side of the operating table he would stand, and on the other L.M. with the theatre-sister ready at his elbow. The surgeon would pick up a scalpel carelessly, as a man picks up a pencil to write, and then, apparently with as little thought, he would make a long, clean incision through the skin and superficial fatty tissues of the abdomen, putting his head on one side to look at it like an artist whose pencil has described a beautiful curve. Then, sharply: “Swabs . . . Ingleby, what the hell do you think you’re doing?” And Edwin would press a swab of gauze to the incision to absorb the blood that escaped from the subcutaneous veins.

“Right.”

Layer by layer the various planes of fascia, muscle, and peritoneum would be opened and neatly laid aside, every one of them slipped in its own pair of artery forceps. Then, from the gaping wound, that L.M. probed with his thin finger, a sickening odour would rise . . . one that Edwin never remembered apart from the other sickening smell of ether.

“Pus. . . I thought so,” L.M. would say. “The brute’s perforated, damn him.” And Edwin knew that yet another creature had been snatched out of the jaws of death.

In the hands of L.M. surgery seemed so simple. His scalpel—for he used fewer instruments than any surgeon Edwin ever knew—was a part of him in the same way as a perfect rider is part of his horse. There was never any hesitation in his surgery, never any room for doubt; everything was straightforward and self-evident from the first incision to the last suture; and he was at his best when he threw into it a touch of bravura, rejoicing in the amazing virtuosity of his own technique and playing, a little, to the gallery.

“There you are,” he would say, “you see there’s nothing in it. Nothing at all but a working knowledge of anatomy and a dollop of common-sense. That’s all surgery. Why on earth should they pay me a hundred guineas for doing a simple thing like that? There’s nothing in it, is there?”

Edwin knew that there was a great deal in it: genius, and more than genius: a life of devotion to one end only; infinite physical strains; cruel disappointments; harrowing mistakes. For even L.M. had made mistakes in his time; and a doctor pays for his mistakes more heavily than any other man.

Apart from the performance of emergency operations, that might take place at any hour of the day or night, the surgeon only occupied his theatre on three mornings in the week; and the greater part of Edwin’s time was devoted to the work of the wards. Here he performed his proper function as dresser, being, under the house-surgeon, responsible for the after-treatment of the patients on whom L.M. had operated This business kept his hands full. Nearly all the acute surgical cases needed dressing daily, and some more than once a day. It was usual for the dresser to leave the second dressing to be done by the house-surgeon on his evening round, or by the sister of the ward, who would doubtless have performed it, as well as either of them; but nothing could induce Edwin, in his newest enthusiasm, to drop a case into which his teeth were fixed.

The morning visits were ceremonial. The great floors of the wards shone like the faces of such patients as were fit to be scrubbed, with a soapy flannel; the rows of beds were set with a mathematical correctness, the sheets turned down at exactly the same level; the water in the jugs stood hot, awaiting the dresser’s hands, his towel lay folded in the jug’s mouth; a probationer, pink-faced and red-armed, stood waiting to do his professional pleasure; morning sunlight flickered over the leaves of aspidistras that flourished in pots on the central tables, and on the trays of dressing instruments that were ready for his hand.

At ten o’clock precisely, Edwin, an older and more experienced Edwin whose shaves were no longer a luxury, whose clothes no longer looked as if he were in the act of growing out of them, and whose collars were adorned by the very latest thing in ties, would enter the ward, roll up his shirtsleeves, and be helped on with a white overall by the obedient probationer—whose main function in life this office seemed to be—or sometimes by the sister herself. The new Edwin, product of six months in hospital, was no longer afraid of these attentions because they happened to be performed by women. In a mild way he was even an amateur of the physical points exhibited by the genus probationer, and had arrived at a touching intimacy with the sisters, who found in him a clean and pleasant mannered youth, and on occasion hauled him out of the difficulties into which his inexperience landed him. Thus attired, he would begin his progress of the ward, followed, wherever he went, by the females who had robed him, the junior pushing before her the wheeled glass table on which the dressings and instruments were kept. For the time being he was, or imagined himself to be, the most important person in the ward, until, perhaps, the house-surgeon entered, and his attendants forsook their allegiance and hastened to put themselves at the service of this superior person.