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ART AND MEDICINE
Year : 2006  |  Volume : 7  |  Issue : 3  |  Page : 116-117 Table of Contents     

Behind the times


Date of Web Publication17-Jun-2010

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How to cite this article:
. Behind the times. Heart Views 2006;7:116-7

How to cite this URL:
. Behind the times. Heart Views [serial online] 2006 [cited 2022 Jan 24];7:116-7. Available from: https://www.heartviews.org/text.asp?2006/7/3/116/63926

The practice of medicine is an art . . . The good physician treats the disease; the great physician treats the patient who has the disease.

My first interview with Dr. James Winter was under dramatic circumstances. It occurred at two in the morning in the bedroom of an old country house. I kicked him twice on the white waistcoat and knocked off his gold spectacles, while he, with the aid of a female accomplice, stifled my angry cries in a flannel petticoat and thrust me into a warm bath. I am told that one of my parents, who happened to be present, remarked in a whisper that there was nothing the matter with my lungs. I cannot recall how Dr. Winter looked at the time for I had other things to think of, but his description of my own appearance is far from flattering. A fluffy head, a body like a trussed goose, very bandy legs, and feet with the soles turned inwards - those are the main items which he can remember.

From this time onwards the epochs of my life were the periodical assaults which Dr. Winter made upon me. He vaccinated me, he cut me for an abscess, he blistered me for mumps. It was a world of peace, and he the one dark cloud that threatened. But at last there came a time of real illness - a time when I lay for months together inside my wicker-work basket bed, and then it was that I learned that that hard face could relax, that those country-made creaking boots could steal very gently to a bedside, and that that rough voice could thin into a whisper when it spoke to a sick child.

And now the child is himself a medical man, and yet Dr. Winter is the same as ever. I can see no change since first I can remember him, save that perhaps the brindled hair is a trifle whiter, and the huge shoulders a little more bowed. He is a very tall man, though he loses a couple of inches from his stoop. That big back of his has curved itself over sick beds until it has set in that shape. His face is of a walnut brown, and tells of long winter drives over bleak country roads with the wind and the rain in his teeth. It looks smooth at a little distance, but as you approach him you see that it is shot with innumerable fine wrinkles, like a last year's apple. They are hardly to be seen when he is in repose, but when he laughs his face breaks like a starred glass, and you realize then that, though he looks old, he must be older than he looks.

How old that is I could never discover. I have often tried to find out, but without ever getting quite to the source. His mind must have been open to impressions very early, but it must also have closed early, for the politics of the day have little interest for him, while he is fiercely excited about questions which are entirely prehistoric. He shakes his head when he speaks of the first Reform Bill and expresses grave doubts as to its wisdom, and I have heard him, when he was warmed by a glass of wine, say bitter things about Robert Peel and his abandoning of the Corn Laws. The death of that statesman brought the history of England to a definite close, and Dr. Winter refers to everything which had happened since then as to an insignificant anti-climax.

But it was only when I had myself become a medical man that I was able to appreciate how entirely he is a survival of a past generation. He had learned his medicine under the obsolete and forgotten system by which a youth was apprenticed to a surgeon, in the days when the study of anatomy was often approached through a violated grave. His views upon his own profession are even more reactionary than his politics. Fifty years have brought him little and deprived him of less. Vaccination was well within the teaching of his youth, though I think he has a secret preference for inoculation. Bleeding he would practice freely but for public opinion. Chloroform he regards as a dangerous innovation and he always clicks with his tongue when it is mentioned. He has even been known to say vain things about Laennec, and to refer to the stethoscope as "a newfangled French toy." He carried one in his hat out of deference to the expectations of his patients; but he is very hard of hearing, so that it makes little difference whether he uses it or not.

He always reads, as a duty, his weekly medical paper, so that he has a general idea as to the advance of modern science. He persists in looking upon it, however, as a huge and rather ludicrous experiment. The germ theory of disease set him chuckling for a long time, and his favorite joke in the sick-room was to say, "Shut the door, or the germs will be getting in." As to the Darwinian Theory, it struck him as being the crowning joke of the century. "The children in the nursery and the ancestors in the stable," he would cry, and laugh the tears out of his eyes.

He is very much behind the day that occasionally, as things move round in their usual circle, he finds himself, to his own bewilderment, in the front of the fashion. Dietetic treatment, for example, had been much in vogue in his youth, and he has more practical knowledge of it than any one whom I have met. Massage, too, was familiar to him when it was new to our generation. He had been trained also at a time when instruments were in a rudimentary state and when men learned to trust more of their own fingers. He has a model surgical hand, muscular in the palm, tapering in the fingers, "with an eye at the end of each." I shall not easily forget how Dr. Patterson and I cut Sir John Sirwell, the County Member, and were unable to find the stone. It was a horrible moment. Both our careers were at stake. And then it was that Dr. Winter, whom we had asked out of courtesy to be present, introduced into the wound finger which seemed to our excited senses to be about nine inches long, and hooked out the stone at the end of it.
"It's always well to bring one in your waistcoat pocket," said he with a chuckle, "but I suppose you youngsters are above all that."

We made him President of our Branch of the British Medical Association, but he resigned after the first meeting. "The young men are too much for me," he said. "I don't understand what they are talking about." Yet his patients do very well. He has the healing touch - that magnetic thing which defies explanation or analysis, but which is a very evident fact none the less. His mere presence leaves the patients with more hopefulness and vitality. The sight of disease affects him as dust does a careful housewife. It makes him angry and impatient. "Tut, tut, this will never do!" he cries, as he takes over a new case. He would shoo death out of the room as though he were an intrusive hen. But when the intruder refuses to be dislodged, when the blood moves more slowly and the eyes grow dimmer, then it is that Dr. Winter is of more avail than all the drugs in his surgery. Dying folk cling to his hand as if the presence of his bulk and vigor gives them more courage to face the change; and that kindly, wind-beaten face has been the last earthly impression which many a sufferer has carried into the unknown.

When Dr. Patterson and I, both of us young, energetic, and up-to-date, settled in the district, we were most cordially received by the old doctor, who would have been only too happy to be relieved of some of his patients. The patients themselves, however, followed their own inclination, which is a reprehensible way that patients have, so that we remained neglected with our modern instruments and our latest alkaloids, while he was serving out senna and calomel to all the country-side. We both of loved the old fellow, but at the same time, in the privacy of our own intimate conversations, we could not help commenting upon this deplorable lack of judgment.
"It is all very well for the poorer people," said Patterson, "but after all the educated classes have a right to expect that their medical man will know the difference between a mitral murmur and a bronchitic rale. It's the judicial frame of mind, not the sympathetic, which is the essential one."

I thoroughly agreed with Patterson in what he said. It happened, however, that very shortly afterwards the epidemic of influenza broke out, and we were all worked to death. One morning I met Patterson on my round, and found him looking rather pale and fagged out. He made the same remark about me. I was in fact feeling far from well, and I lay upon the sofa all afternoon with the splitting headache and pains in every joint. As evening closed in I could no longer disguise the fact that the scourge was upon me, and I felt that I should have medical advice without delay. It was of Patterson naturally that I thought, but somehow the idea of him had suddenly become repugnant to me. I thought of his cold, critical attitude, of his endless questions, of his tests and his tappings. I wanted something more soothing - something more genial.
"Mrs. Hudson," said I to my housekeeper "would you kindly run along to old Dr. Winter and tell him that I should be obliged to him if he would step round."

She was back with an answer presently.
"Dr. Winter will come round in an hour or so, sir, but he has just been called in to attend Dr. Patterson."

Extracted from: Round the Red Lamp* by Arthur Conan Doyle

*The Red Lamp is the usual sign of the general practitioner in England.

A. Conan Doyle, Preface, Round the Red Lamp




 

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