They are a class of persons, not always of one sex, who hang continually, like an incubus, on the physician, and yet are forever a disadvantage to him. They are never well enough to let him alone, and yet seldom ill enough to require much medical advice or treatment. And yet, medicine they will have, of somebody, even if they go to the apothecary for it, without so much as the semblance of a medical prescription of any sort. But then, after all, they are seldom reduced to any such necessity. They usually have on hand prescriptions enough of some sort. A dearth of Yankee physicians—could such a thing possibly occur—would still leave us a supply of Indian doctors, mesmeric doctors, nutritive doctors, etc., etc., to say nothing of doctresses, in liberal abundance, ever ready to prescribe.
When I succeeded Dr. ——, in the chair of medicine, surgery, etc., at ----, I received, as if by contract, if not by inheritance, his whole stock of standing patients. They were not slow to call on, sometimes to call in, the new doctor. Nor was I often long in the house before comparisons began to be made between my predecessor and myself. They did not, of course, directly traduce or slander Dr. ——, but they were very careful to intimate that, having got his name up, he had grown careless about his patients, especially such of them as did not belong to his clique, political or sectarian; and that, on this account, they were almost willing to part with him, and to receive and accept as his substitute one who was not only younger and more active, but also less tinctured with conservatism and aristocracy!
A very large amount of valuable time was spent during the first year of my practice as a physician, in endeavors to do good to these very devoted and loving and loyal patients; for if they did not always call me when I had occasion to pass their doors, I knew full well they expected me, and so I usually called. Besides, in many an instance I was sent for in post haste, with entreaties that I would come and see them immediately; and no atonement for neglect or even delay—if such neglect or delay was ventured—would suffice. And yet, despite of their fears of "monarchy and aristocracy," they were my most truly aristocratic patients. They expected me to come and go at their request, whether anybody else was attended to or not. And, to add to the vexation of the case, though they boasted of having paid most enormous bills to my predecessor, they never, if they could avoid it, paid any thing to me.
Now, I do not suppose that every medical man has as large a share of these standing patients as fell to my unhappy lot; but from the knowledge I have acquired of mankind, and from the acquaintance I have necessarily formed with medical men, I do not think I err when I affirm that they are everywhere numerous, and that they are everywhere not only a pest to society at large, but particularly so to the physician.
But the worst feature of the case is, that after all our efforts, we can seldom, if ever, cure them. They are always hanging upon us like an incubus; and yet like Solomon's daughters of the horseleech, are never satisfied. They take the medicine, and follow the advice, if they like it; or they take such parts of it as they choose, and reject the rest. Or they take the advice and follow us to-day, but get discouraged and abandon us, at least practically, to-morrow; especially if some smart young physician happens to come along, who has more than an average share of empiricism and pretension, and more than he has of real merit.
I must here confess, among other confessions, that at first I was not a little deceived by their open countenances and concealed thoughts, and unintelligent and hence unconfiding professions. It was a long time before I relinquished the hope of doing them good; or at least a portion of them. But I was at length compelled. There was nothing on which to build. If a foundation seemed to be laid one day, it would disappear the next.
One fundamental difficulty lay in the way of these persons to health, as it has to thousands of others. They were all the while talking or thinking about themselves, their ailments and woes and abuses and neglects. They were particularly inclined to turn their attention to their own diseased feelings. Now it may be pretty safe to say that no individual can fully recover from chronic disease,—nervous, stomachic, or glandular—who is always turning his thoughts inward, and watching his own feelings, and perhaps relating his woes to every one he meets with. We must learn to forget ourselves, at least a part of the time, and think of others, if we are in earnest to get rid of chronic disease. I do not say, of course, that everybody would recover of disease, even if they acted right in every particular; but this I do say, that if every person who is ill would act wisely, and if their physicians, in every instance, were wise enough to take the best course, the number of these standing patients would soon dwindle to a very small remnant. Instead of thousands, or tens of thousands, it would soon be reduced to hundreds.