The Young Physician

by Francis Brett Young

“Ingleby, did you notice anything about the patient’s hands?”

“His hands, sir?’

“Yes . . . his hands.”

“No, sir. Nothing, I’m afraid. I don’t think he was plucking the bedclothes . . . carphology, do they call it?”

“You had better look the word up if you are not sure. No . . . it was a finer movement. He was rolling his thumbs over the tips of his index fingers, just like a man making pellets of bread at a dinner party. There are men who do that. Remember it. It’s a bad sign in a case of lobar pneumonia. Come along, gentlemen. The pneumococcus is a sporting antagonist. Short and sweet. I’d as soon die of pneumonia as anything and have a run for my money. That case has put up a good fight.”

That “case” . . . On the face of it the use of the word seemed to justify the accusation of gross materialism that is so usually made against the profession of medicine. The patient who lay there fighting for his life was, in the physician’s eyes, a case, and not, as Edwin, who had taken notes of his history in the earlier stages of the disease knew him to be, a bricklayer’s labourer from Wolverbury with a wife and six children, two of whom had died in infancy. He was a case: a human body, the soulless body that Edwin had learned in detail through two years of labour in the dissecting room, consisting of a heart hard-pressed, a nervous system starved of oxygen and weakened by the virus of pneumonia, and a pair of clogged lungs. This was the whole truth as far as it concerned the physician. The calamity was a material calamity to be fought with material weapons, and the state of his soul, or his relations with his wife and the rest of the community in which he lived, only mattered in so far as they affected his body and revealed him to have been a clean-living and temperate man. For the rest he was a case; and it were well for the physician to leave the animula, vagula, blandula to the poets. This was one of the hard lessons of medicine.

These were sombre things; but it must not be imagined that they reflected the general tenor of hospital life. The Infirmary, indeed, was so vast as to be microcosmic, and its loves, its jealousies, and its ambitions combined to produce a broad effect of human comedy, not without tears, but leavened by the rich, and often unprintable humour that flourished in the out-patient department. Hospital politics, hospital scandals, hospital romances, combined to make life a vivid and exciting experience. In the toils of the last, spring found W.G. securely bound. Harrop, too, had launched into a desperate affair with a probationer in the children’s wards whom the matron promptly transferred to the infectious block and perpetual quarantine. Edwin and Boyce escaped this epidemic of tenderness that swept through the fourth year like measles. They were far too absorbed in their own interests and discoveries to worry their hearts about anything in a nurse’s cap and apron.

Spring passed in a swift vision of plum-blossom in the Boyce’s Alvaston garden and two weeks of musical debauchery, one Wagnerian and the other of Gilbert and Sullivan. Most of the time they were working at high pressure; but a week before the beginning of the fourth examination, Boyce proposed that they should cycle down together to the country house that his father rented in Gloucestershire, and blow away the vapours of forced ventilation with Cotswold air.

On the eve of an examination it seemed a daring but enthralling plan. Edwin put the proposal before Mr. Ingleby, and was surprised to find that he didn’t object. Indeed, it had seemed to Edwin for several months that his father was curiously distrait and less interested than usual in his work. This consent freed his conscience, and the two friends set off together on a Saturday afternoon in the spirit of abandoned holiday that is the highest privilege of youth. They had decided to take no medical books with them. As far as they were concerned, the examination might go hang; for a whole week they would live with no thought for the morrow, taking long rides over the Cotswolds, lunching at village inns on bread and cheese, returning at night to feasts of beans and bacon and libations of Overton cider.

They started from the infirmary at half-past two, and had soon left the dust and tram-lines of North Bromwich behind. The smooth, wide road that they followed stretched in magnificent undulations over the heights of the Midland plateau from which they could see the shapes of Uffdown and Pen Beacon fading into the west under a pale, black-country sky. In front of them southward the sky was blue.