St. Bernard's: The Romance of a Medical Student. Edward Berdoe

College of Surgeons, in anatomy and physiology. It is the desire of both teachers and the hospital itself, that as large a proportion as possible of the students shall present themselves for examination at the regular time, as the credit of the school depends on the proportion of passes. Every effort is made to urge the men on, and the teaching staff take the utmost pains to perfect the knowledge of their pupils, and thoroughly instruct them in the subjects they will be required to know. They hold test examinations, and send the men up in batches; those of most promise go up first, while the backward ones are detained till the last efforts have been put forth to fit them for the day of trial. Elsworth was sent up in the first batch, and passed creditably. Having thus proved that he had a sufficient knowledge of the rudiments of his work, he was at once permitted to act as a dresser or surgeon’s assistant in the wards of the hospital proper. This is the first bit of promotion which the successful student obtains. The nurses could do pretty well all the work he has to do, as far as the dressing goes; but this is purposely left to him, that he may pick up instruction and experience.

      CHAPTER IX.

      “WALKING THE HOSPITAL.”

      We easily forget our faults when they are known only to ourselves. —La Rochefoucauld.

      Doctor. Is it not natural to die? Then if a dozen or two of my patients have died under my hands, is not that natural?

      Lisette. Very natural, indeed.

– Mrs. Inchbald.

      And if you die,

      Why then you lie

      Stretched on the bed of honour.

– Dibdin.

      Early the following morning, Elsworth presented himself to young Dr. Wilson, the house surgeon in charge of the wards under the chief care of the surgeons, to whom he was appointed dresser.

      Hitherto he had done no practical work in the wards at all. It was against the regulations for any student to be a dresser in the surgical wards till he had passed his primary or first professional examination, at the end of his second winter session.

      He had opportunities of learning the countless little details of minor surgery in the out-patient departments day by day, but now he was to be introduced to a very different kind of work. He would have some forty or fifty patients to study and report upon, to watch the progress of their maladies, or the processes of their cure, to dress the wounds, bandage, apply the remedies ordered by the house surgeon, or the surgeon-in-chief, and himself perform such operations as in their discretion he might be entrusted with. Everybody must have a beginning, and upon whom can one begin surgery so well as an hospital patient? Your dentist began upon somebody; he did not acquire without practice that nice skill, that rapidity, almost amounting to sleight of hand, by which he jerks out your offending molar, before you are half aware he has begun. To be sure, he had a long course on sheeps’ heads from the butchers, and then at the hospital or dispensary, he tugged away at the mouths of poor children, or men and women of low degree, who could not afford the chemist’s shilling, or the still cheaper barber’s fee, and who, getting the job done for nothing, could not reasonably complain of the several bungling attempts with the wrong instruments applied in the wrong way, and often to the wrong tooth.

      “I say, young man,” said a poor carpenter to an hospital novice, after the fifth attempt to lug out his grinder had been fruitlessly made. “Do they pay you here by time or by the job?”

      Even your hair-dresser must have cut somebody’s hair for the first time. You may be sure it was not a duke’s. “We allus begins on children’s at the Workhus schools,” was the answer of a master barber to an inquiry as to the method of learning the art. Here, then, were fifty live subjects, all human, at the mercy of our new dresser. That young blacksmith with the broken rib thinks he is here simply to get it mended. He will think so in a fortnight’s time, but the officials know better; the mended rib is a mere contingency. The butcher lad in the corner bed has compression of the brain. He shall be cured, if possible. Meanwhile, he shall make himself useful to those who want to investigate the latest theory of “localisation of brain functions.”

      He shall be trephined – that is to say, a round hole shall be neatly cut in his cranium, and the brain exposed at the injured part; and while the organ of the mind is open to the view, are there not many pretty ideas to be discoursed of, and various experiments awaiting trial? Are there not galvanic batteries at hand? Is not the man at their mercy? He has ether or chloroform, and able men of science about him; and, if they don’t cure him, they will doubtless get information that will enable them to cure some much more important personage! It is not enough to have done all this on a monkey; it needs a man before you can be quite sure. Ultimately they will do it with safety to a gentleman, a duke, a royal prince, and the successful operation will make somebody’s fortune. So as every rising surgeon carries a royal surgeon’s baton in his instrument bag, have at the butcher!

      The house surgeon “went round” with our new dresser, and explained the nature of each case in very brief terms, and in a perfunctory manner. It was his duty to instruct his dressers, and he did it after a fashion; but he was not paid to do anything of the sort, and, with the young and partially-educated, there is often a sort of contempt for those who know just a little less than they do. The scorn felt and expressed by the Board School child who knows decimals, for his companion just beginning vulgar fractions, is nothing to the sense of superiority assumed by a house surgeon appointed a few weeks since, and aged twenty-three, towards his unqualified dressers, who cannot go up for examination for another six months. And the dresser, in his turn, looks down from his exalted post on those late companions of his who failed at the primary, and have not yet achieved the right to handle cases in the wards.

      Elsworth was shown a number of beds, of the occupants of which he was required to write complete family histories, going into the minutest details, as practice in note-taking. He was called on to carry out, with the assistance of the nurses, daily, all the directions as to the dressings and bandaging required by the nature of the case; and was encouraged to avail himself, while doing so, of any and every means that would assist him in the acquisition of his art, so far as it was consistent with the regular treatment of the patient, and was not calculated to alarm him or make him think it was not actually connected with his cure. Our house surgeon was going in for ophthalmology, and he never missed an opportunity of dropping belladonna into every patient’s eyes, and taking stock of his retina with the ophthalmoscope. Whether you had cracked your skull or broken your leg, fractured a rib or sprained your ankle, your eyes must be examined minutely, on the chance of something pretty turning up to show the professor of ophthalmology. Dr. Wilson was such an enthusiast on eyes that one day, happening to pass through one of the out-patient wards, he caught sight of a working man in whose visual organs he instantly detected something of interest. Immediately he had him under a lamp, and set to work making sketches of the morbid appearances in the retina, explaining to the other students the beautiful things to be seen therein. Now the patient had not come about his eyes, but being troubled with indigestion, wanted a bottle of medicine to cure it; and he was naturally surprised that for three mortal hours eighteen young gentlemen should be examining his eyes, which wanted no treatment but the sight of a little more weekly pay; and marvelled that no questions should be asked him about the ailment which caused him discomfort. He was still more amazed when, as evening drew on, one after another went away, and nobody prescribed anything for him at all! However, one of the resident staff saw him before the place was closed, and he had a bottle of “house mixture,” and went away more satisfied; but still wondering at the singular ways of doctors.

      Let us go round the wards with Dr. Wilson and our hero, his new assistant.

      Here is a middle-aged woman, evidently having but a short time to live, yet this afternoon Dr. Wilson says his chief proposes to perform upon her a capital operation. He has not the least hope it can save her life, but the chance of performing such an operation arises but seldom; and it is but just and kind to the house surgeon, who wants all the practical work he can get, to let him assist. So the woman and her friends are duly pressed to consent that this – “the only means of saving her life” – shall forthwith be done. To this end all the nurses are instructed to urge her. At last she submits. She will be carried to the operating