Doctor and Patient

by S. Weir Mitchell

But no matter how careful we may be, how thoughtful as to the true needs of these young lives, we may be sure that our daughters will be more likely to have to face at some time the grim question of pain than the lads who grow up beside them.

For both there are always the little ailments of childhood,—the hurts, the accidents, and the disorders or the diseases of youthful years. All come in for a share. Let us be careful how we deal with them. I have often watched with interest a mother beside the girl or boy in temporary pain. As a rule, she assumes from the beginning that the hurt boy is to be taught silent, patient endurance. What! you, a boy, to cry! Be a man! Among his comrades he is a "cry-baby" if he whimpers, "a regular girl," "a girl-boy." He is taught early that from him endurance is expected; the self-conquest of restrained emotion is his constant lesson.

If it be a girl who suffers, she is assumed to be weak, and it is felt that for her tears are natural and not to be sternly repressed; nor are her little aches and complaints dismissed as lightly as are her brother's. She is trained to expect sympathy, and learns that to weep is her prerogative. The first gush of tears after a hurt of body or mind is in some mysterious way a relief, and not rudely to be chidden; but, on the whole, it is wise and right to teach patience and unemotional endurance to the sex which in life is sure to have the larger share of suffering. To be of use, this education must begin reasonably early, and we may leave to the mother to make sure that it is not too severe.

As a girl grows older, we ask and expect some measure of restraint in emotional expression as regards any of the physical or moral troubles which call out tears in the child; for the woman who is wise understands that unrestrained emotion and outward expressions of pain or distress are the beginnings of that loss of self-rule which leads to habitual unrestraint, and this to more and more enfeeblement of endurance, and this, again, to worse things, of which more in the future.

We are dealing now with pain. My simple practical thesis is that pain comes to all soon or late, that the indirect consequences are most to be feared, and that endurance in the adult, rational endurance, must be won by a gradual education, which can hardly begin too early. But of what use are these stern lessonings in the bearing of what none can quite escape? Do they enable us to diminish pain or to feel it less? Indirectly, yes. One woman cries out for instant easement if in pain or distress, unschooled to endure. She claims immediate relief. Another, more resolute, submits with patience, does not give way, as we put it, tries to distract her attention, knowing that even as distinct suffering as toothache may be less felt in the presence of something which interests the mind and secures the attention. Nothing, indeed, is more instructive than to watch how women bear pain,—the tremendous calamity it is to one, the far slighter thing in life it is to another. I speak now of transient torments. When we come to consider those years of torture which cruel nature holds in store for some, no one blames the sight of the moral wreck it is apt to make of the sufferer. On the other hand, there is nothing I ever see in my profession so splendid as the way in which a few, a rare few, triumph over pain, which we know must often rise to the grade of anguish, and from which scarce a day is ever free.

I recall well one woman who for years, under my eyes, was the subject of what, with due sense of the force of the word, I call torture. At times she shut herself up in her room, and, as she said, "wrestled with it." This happened every day or two for an hour or more. The rest of the time she was out, or busy with her duties, but always in some pain. Meanwhile, although failing slowly, she was the life and joy of many, the true and gentle counsellor, the sure support of all who leaned on her for aid. At her dinner-table, in chat with friends, or over a book, no one who did not know her well could have dreamed that she was in such pain as consigns lower natures to disability. Her safeguard from utter wreck was a clear and resolute faith, a profound and unfailing interest in men and things and books, which gave strange vigor to her whole range of intellectual activities. But above all she possessed that happiest of gifts, the keen, undying sense of the humorous, the absurd, the witty. As she once said, "All life laughs for me." It followed her to death, as it has certain others as noble. When dying, she said some gay thing which disturbed a dear friend. The sufferer, well knowing her own state, looked up. "I must laugh, dear," she said; "I would not feel that the other world was the good place I think it if I did not believe I could laugh there too." She once said to me, in the midst of a storm of acute suffering, that pain seemed to her a strange sort of a joke. I hardly knew what she meant, but it shows the reigning mood of one who used to better ends a life half pain than most of us use the untroubled health of existence. Very irritable in youth, her clear brain and strong sense of duty overcame it in proportion to the growth of what in others creates it. All opiates she disliked, and could rarely be induced to take them. "If my mind gets weaker, I shall go to pieces——;" and, laughing always, "the bits would be worthless as the scattered bricks of a sound house." Surely such a life is a fruitful lesson in the uses of endurance, for be sure that both she and all around her were the better and happier, yes, and she the less a sufferer, for her mode of dealing with a life of pain.

The illustration I have given saves me from dwelling at great length on the values of all the means within a woman's control for lessening the evil consequences of suffering, and if to few is given the largest moral and mental outfit for such a struggle, none are without the power to cultivate what they have, and, in the lesser ills of life, to make use of the lesson we may hope and know few will be called on to apply to an existence such as hers.

Pain of body, hurt of mind, all the sad gamut from discomfort to anguish, depend for their influence on her life upon how nature and training enable the woman to meet them.

To endure without excess of emotion saves her from consequent nervousness, and from that feebleness of mind and body which craves at all cost instant relief. It is the spoiled child, untaught to endure, who becomes the self-pampered woman. Endurance of pain has also its side-values, and is the handmaid of courage and of a large range of duties. Tranquil endurance enables the sufferer to seek and to use all the means of distraction which this woman I have described did use. It leaves the mind free, as it never can be otherwise in the storm of unrestraint, to reason on her troubles, and to decide whether or not her pain justifies the use of drugs, for on her the physician must measurably rely for this knowledge, and as she is morally strong or weak the decision will be.

There are those, indeed, who suffer and grow strong; there are those who suffer and grow weak.