“From this it was evident that the idea of the instrument in question had in some way or other become invested with a greater psychic significance than normally belongs to it—in other words, that to the subject it stood for more than it does for other people. The idea must have got unconsciously associated with some other one, which it symbolized, and from which it derived its additional fulness of meaning. I will forestall the rest of the analysis by saying what this secondary idea was—namely, a phallic one; the way in which this curious association had been formed will presently be related. The discomfort he experienced in hospital on missing the instrument, and the relief and assurance the presence of it gave him, was related to what is known as a ‘castration-complex’—namely, a childhood fear, often continued in a disguised form into adult life, lest a private part of his body should be taken away from him, just as playthings so often were. The fear was due to paternal threats that it would be cut off if he were not a good boy, particularly in a certain direction. This is a very common complex, and accounts for a great deal of general nervousness and lack of confidence in later years.
“Then came a number of childhood memories relating to his family doctor. He had been strongly attached to this doctor as a child, and during the analysis long-buried memories were recovered of a double phantasy he had in his fourth year concerning the birth of a younger sister—namely, that she was the child (1) of himself and his mother, the father being relegated to the background, and (2) of the doctor and himself; in this he thus played both a masculine and feminine part.[55] At the time, when his curiosity was being aroused by the event, he could not help noticing the prominent share taken by the doctor in the proceedings, and the subordinate position occupied by the father: the significance of this for his later life will presently be pointed out.
“The stethoscope association was formed through many connections. In the first place, the physical appearance of the instrument—a straight, rigid, hollow tube, having a small bulbous summit at one extremity and a broad base at the other—and the fact of its being the essential part of the medical paraphernalia, the instrument with which the doctor performed his magical and interesting feats, were matters that attracted his boyish attention. He had had his chest repeatedly examined by the doctor at the age of six, and distinctly recollected the voluptuous sensation of feeling the latter’s head near him pressing the wooden stethoscope into his chest, and of the rhythmic to-and-fro respiratory movement. He had been struck by the doctor’s habit of carrying his stethoscope inside his hat; he found it interesting that the doctor should carry his chief instrument concealed about his person, always handy when he went to see patients, and that he only had to take off his hat (i.e., a part of his clothing) and ‘pull it out.’ At the age of eight he was impressed by being told by an older boy that it was the doctor’s custom to get into bed with his women patients. It is certain that the doctor, who was young and handsome, was extremely popular among the women of the neighbourhood, including the subject’s own mother. The doctor and his ‘instrument’ were therefore the objects of great interest throughout his boyhood.
“It is probable that, as in many other cases, unconscious identification with the family doctor had been a main motive in determining the subject’s choice of profession. It was here doubly conditioned (1) by the superiority of the doctor on certain interesting occasions to the father, of whom the subject was very jealous, and (2) by the doctor’s knowledge of forbidden topics[56] and his opportunity for illicit indulgence. The subject admitted that he had on several occasions experienced erotic temptations in regard to his women patients; he had twice fallen in love with one, and finally had married one.
“The next memory was of a dream, plainly of a homosexual-masochistic nature; in it a man, who proved to be a replacement figure of the family doctor, attacked the subject with a ‘sword.’ The idea of a sword, as is so frequently the case in dreams, represented the same idea that was mentioned above to be associated with that of a wooden stethoscope. The thought of a sword reminded the subject of the passage in the Nibelung Saga, where Sigurd sleeps with his naked sword (Gram) between him and Brunhilda, an incident that had always greatly struck his imagination.
“The meaning of the symptomatic act now at last became clear. The subject had placed his wooden stethoscope between him and his patients, just as Sigurd had placed his sword (an equivalent symbol) between him and the maiden he was not to touch. The act was a compromise-formation; it served both to gratify in his imagination the repressed wish to enter into nearer relations with an attractive patient (interposition of phallus), and at the same time to remind him that this wish was not to become a reality (interposition of sword). It was, so to speak, a charm against yielding to temptation.
“I might add that the following passage from Lord Lytton’s Richelieu made a great impression on the boy:—
‘Beneath the rule of men entirely great
The pen is mightier than the sword,’[57]
and that he became a prolific writer and uses an unusually large fountain-pen. When I asked him what need he had of this pen, he replied in a characteristic manner, ‘I have so much to express.’