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  ROUND THE RED LAMP

  BEING FACTS AND FANCIES OF MEDICAL LIFE By

  SIR ARTHUR CONAN DOYLE BOOKS FOR LIBRARIES PRESS

  FREEPORT, NEW YORK

  First Published 1894

  Reprinted 1969

  STANDARD BOOK NUMBER: 8369-3190-4

  LIBRARY OF CONGRESS CATALOG CARD NUMBER: 77-10 1802

  MANUFACTURED

  By

  HALLMARK LITHOGRAPHERS, INC

  IN THE U.S.A.

  THE PREFACE.

  [Being an extract from a long and animated correspondence with a friend in America.]

  I quite recognise the force of your objection that an invalid or a woman in weak health would get no good from stories which attempt to treat some features of medical life with a certain amount of realism. If you deal with this life at all, however, and if you are anxious to make your doctors something more than marionettes, it is quite essential that you should paint the darker side, since it is that which is principally presented to the surgeon or physician. He sees many beautiful things, it is true, fortitude and heroism, love and self-sacrifice; but they are all called forth (as our nobler qualities are always called forth) by bitter sorrow and trial. One cannot write of medical life and be merry over it.

  Then why write of it, you may ask? If a subject is painful why treat it at all? I answer that it is the province of fiction to treat painful things as well as cheerful ones. The story which wiles away a weary hour fulfils an obviously good purpose, but not more so, I hold, than that which helps to emphasise the graver side of life. A tale which may startle the reader out of his usual grooves of thought, and shocks him into seriousness, plays the part of the alterative and tonic in medicine, bitter to the taste but bracing in the result. There are a few stories in this little collection which might have such an effect, and I have so far shared in your feeling that I have reserved them from serial publication. In book-form the reader can see that they are medical stories, and can, if he or she be so minded, avoid them.

  Yours very truly,

  A. CONAN DOYLE.

  P. S.--You ask about the Red Lamp. It is the usual sign of the general practitioner in England.

  CONTENTS.

  BEHIND THE TIMES.............. 1

  HIS FIRST OPERATION........... 9

  A STRAGGLER OF '15............ 19

  THE THIRD GENERATION.......... 43

  A FALSE START................. 60

  THE CURSE OF EVE.............. 82

  SWEETHEARTS................... 101

  A PHYSIOLOGIST'S WIFE......... 111

  THE CASE OF LADY SANNOX....... 144

  A QUESTION OF DIPLOMACY....... 161

  A MEDICAL DOCUMENT............ 186

  LOT NO. 249................... 205

  THE LOS AMIGOS FIASCO......... 263

  THE DOCTORS OF HOYLAND........ 276

  THE SURGEON TALKS............. 296

  BEHIND THE TIMES.

  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 wickerwork-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 realise 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, and have struck his stream as high up as George IV and even the Regency, 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 anticlimax.

  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 that 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 in 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 practise 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 new-fangled French toy." He carries 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 reads, as a duty, his weekly medical paper, so that he has a general idea as to the advance of modern science. He always persists in looking upon it as a huge and rather ludicrous experiment. The germ theory of disease set him chuckling for a long time, and his favourite 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 so very much behind the day that occasionally, as things move round in their usual circle, he finds himself, to his 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 to 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 a 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 patient 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 vigour gives them more courage to face the change; and that kindly, windbeaten 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 inclinations -- 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 countryside. We both of us 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's 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 the afternoon with a 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."

  HIS FIRST OPERATION.

  It was the first day of the winter session, and the third year's man was walking with the first year's man. Twelve o'clock was just booming out from the Tron Church.

  "Let me see," said the third year's man. "You have never seen an operation?"

  "Never."

  "Then this way, please. This is Rutherford's historic bar. A glass of sherry, please, for this gentleman. You are rather sensitive, are you not?"

  "My nerves are not very strong, I am afraid."

  "Hum! Another glass of sherry for this gentleman. We are going to an operation now, you know."

  The novice squared his shoulders and made a gallant attempt to look unconcerned.

  "Nothing very bad -- eh?"

  "Well, yes -- pretty bad."

  "An -- an amputation?"

  "No; it's a bigger affair than that."

  "I think -- I think they must be expecting me at home."

  "There's no sense in funking. If you don't go to-day, you must to-morrow. Better get it over at once. Feel pretty fit?"

  "Oh, yes; all right!" The smile was not a success.

  "One more glass of sherry, then. Now come on or we shall be late. I want you to be well in front."

  "Surely that is not necessary."

  "Oh, it is far better! What a drove of students! There are plenty of new men among them. You can tell them easily enough, can't you? If they were going down to be operated upon themselves, they could not look whiter."

  "I don't think I should look as white."

  "Well, I was just the same myself. But the feeling soon wears off. You see a fellow with a face like plaster, and before the week is out he is eating his lunch in the dissecting rooms. I'll tell you all about the case when we get to the theatre."

  The students were pouring down the sloping street which led to the infirmary -- each with his little sheaf of note-books in his hand. There were pale, frightened lads, fresh from the high schools, and callous old chronics, whose generation had passed on and left them. They swept in an unbroken, tumultuous stream from the university gate to the hospital. The figures and gait of the men were young, but there was little youth in most of their faces. Some looked as if they ate too little -- a few as if they drank too much. Tall and short, tweed- coated and black, round-shouldered, bespectacled, and slim, they crowded with clatter of feet and rattle of sticks through the hospital gate. Now and again they thickened into two lines, as the carriage of a surgeon of the staff rolled over the cobblestones between.

  "There's going to be a crowd at Archer's," whispered the senior man with suppressed excitement. "It is grand to see him at work. I've seen him jab all round the aorta until it made me jumpy to watch him. This way, and mind the whitewash."

  They passed under an archway and down a long, stone-flagged corridor, with drab-coloured doors on either side, each marked with a number. Some of them were ajar, and the novice glanced into them with tingling nerves. He was reassured to catch a glimpse of cheery fires, lines of white-counterpaned beds, and a profusion of coloured texts upon the wall. The corridor opened upon a small hall, with a fringe of poorly clad people seated all round upon benches. A young man, with a pair of scissors stuck like a flower in his buttonhole and a note-book in his hand, was passing from one to the other, whispering and writing.

  "Anything good?" asked the third year's man.

  "You should have been here yesterday," said the out-patient clerk, glancing up. "We had a regular field day. A popliteal aneurism, a Colles' fracture, a spina bifida, a tropical abscess, and an elephantiasis. How's that for a single haul?"

  "I'm sorry I missed it. But they'll come again, I suppose. What's up with the old gentleman?"

  A broken workman was sitting in the shadow, rocking himself slowly to and fro, and groaning. A woman beside him was trying to console him, patting his shoulder with a hand which was spotted over with curious little white blisters.

  "It's a fine carbuncle," said the clerk, with the air of a connoisseur who describes his orchids to one who can appreciate them. "It's on his back and the passage is draughty, so we must not look at it, must we, daddy? Pemphigus," he added carelessly, pointing to the woman's disfigured hands. "Would you care to stop and take out a metacarpal?"

  "No, thank you. We are due at Archer's. Come on!" and they rejoined the throng which was hurrying to the theatre of the famous surgeon.

  The tiers of horseshoe benches rising from the floor to the ceiling were already packed, and the novice as he entered saw vague curving
lines of faces in front of him, and heard the deep buzz of a hundred voices, and sounds of laughter from somewhere up above him. His companion spied an opening on the second bench, and they both squeezed into it.

  "This is grand!" the senior man whispered. "You'll have a rare view of it all."

  Only a single row of heads intervened between them and the operating table. It was of unpainted deal, plain, strong, and scrupulously clean. A sheet of brown water-proofing covered half of it, and beneath stood a large tin tray full of sawdust. On the further side, in front of the window, there was a board which was strewed with glittering instruments -- forceps, tenacula, saws, canulas, and trocars. A line of knives, with long, thin, delicate blades, lay at one side. Two young men lounged in front of this, one threading needles, the other doing something to a brass coffee-pot-like thing which hissed out puffs of steam.

  "That's Peterson," whispered the senior, "the big, bald man in the front row. He's the skin- grafting man, you know. And that's Anthony Browne, who took a larynx out successfully last winter. And there's Murphy, the pathologist, and Stoddart, the eye-man. You'll come to know them all soon."

  "Who are the two men at the table?"

  "Nobody -- dressers. One has charge of the instruments and the other of the puffing Billy. It's Lister's antiseptic spray, you know, and Archer's one of the carbolic-acid men. Hayes is the leader of the cleanliness-and-cold-water school, and they all hate each other like poison."

  A flutter of interest passed through the closely packed benches as a woman in petticoat and bodice was led in by two nurses. A red woolen shawl was draped over her head and round her neck. The face which looked out from it was that of a woman in the prime of her years, but drawn with suffering, and of a peculiar beeswax tint. Her head drooped as she walked, and one of the nurses, with her arm round her waist, was whispering consolation in her ear. She gave a quick side-glance at the instrument table as she passed, but the nurses turned her away from it.