Delphi complete works of.., p.310
Delphi Complete Works of Stephen Leacock, page 310
Part III. The Doctor and the Contraption
Chapter I. Medicine As It Was
I SUPPOSE THAT when an up-to-date doctor of today looks at you or me, or at any one of us, he sees something very different from what we see. In place of a human personality — a soul looking out from the infinite depth of the human eye — he sees a collection of tubes, feed-pipes, conduits, joints, levers, and food and water tanks. He sees thirty-five feet of internal elastic piping, a hundred and ten feet of wiring, together with a pound and a half of brain, arrayed behind a couple of optical lenses set in gimbals. In other words, what he sees is not a man at all but a complicated machine contraption, probably running very badly, wheezing in the pipes and clogged in the carburetor. Naturally he wants to get at it, just as a garage man longs to tear a motor to pieces. He would like to take a monkey-wrench and tighten up its joints; turn a hose into it and flush out its piping; or better still, put a new boiler into it and throw the old one away.
This is what is called the Medical Instinct. There is something fierce, as it were, to the verge of comicality in what a doctor would like to do to a patient short of driving shingle nails into him with a tack hammer. Even that might come in handy.
But contrast the change there has been in the common practice of medicine within a couple of generations. Compare the medicine of fifty years ago with the medicine of today and we can easily foresee the further progress of the science.
Thus, first:
Medicine Year, 1880
THE SAVIOUR OF MEN
In the old-fashioned days when a man got sick he went to a family doctor and said he was sick. The doctor gave him a bottle of medicine. He took it home and drank it and got well.
On the bottle was written, “Three times a day, in water.” The man drank it three times a day the first day, twice the second day, and once the third day. On the fourth day he forgot it. But that didn’t matter. He was well by that time.
The place where he visited the doctor was the doctor’s own house, in the room called the “surgery” which was the same room as the one where they played euchre in the evening. There was no apparatus in it, except fishing rods and shotguns.
The doctor mixed the medicine himself at the tap over the sink. He put in anything that he had — it didn’t matter much what. As a matter of fact the man began to feel better as soon as he saw the medicine being mixed.
The doctor didn’t take an X-ray of the patient. He couldn’t. There weren’t any. He didn’t test his blood pressure or examine his arteries; people had none then.
Very often after the patient had gone away the doctor, if he was a thoughtful man, would sit and smoke a pipe and wonder what was wrong with the man anyway. But he never, never expressed any such wonder or doubt to the man himself. His profession had learned this maxim from Hippocrates and it had come down as an unbroken tradition. The medical profession never talked medicine to the patient.
Sometimes the doctor suspected that the man was really ill. But he never said so. Only after the patient was quite well again, did the doctor tell him how ill he had been. Hence every illness appeared in retrospect as a close shave in which a timely dose of medicine had saved a human life. This raised the whole tone of the business. The doctor appeared as a saviour of men. As he got older his beard — all doctors wore beards — became tinged with grey; his person acquired an easy dignity; his expression, something of nobility. He cured the patient by his presence. Beyond that, all he needed was a bottle of medicine and a cork. In an extreme case, he sat beside the patient’s bed in a long vigil that might last all night. But the patient was well in the morning.
For convalescence the doctor prescribed a “light diet.” This meant beefsteak and porter.
Such medicine, of course, was hopelessly unscientific, hopelessly limited. Death could beat it round every corner. But it was human, gracious, kindly. Today it is replaced by “machine medicine” with the mechanical test, the scientific diagnosis, the hospital, the X-ray. All this is marvellous. But no one has yet combined it with the Art of Healing.
As witness:
Chapter II. Medicine Year, 1932
THE DOCTOR AND the Contraption
The Contraption sits huddled up in its serge suit in a consultation office chair. Its locomotive apparatus is doubled up beneath it, folded at the joints. The thing is anxious, but the doctor doesn’t know that. The poor Contraption is consumed with something like panic that is gripping it by the feed-pipe. But it makes as brave a show as it can.
“It’s a little hard to say,” says the doctor, “just what the trouble is.”
He has been making a few preliminary investigations by punching and listening in.
“I don’t know that I quite like that heart,” he adds, and then relapses into a reflective silence.
“Yes,” he continues, as he comes out of his reverie, “there are symptoms there that I don’t like — don’t like at all.”
Neither does the Contraption, but he keeps quiet.
“There may be,” says the doctor, “an ankylosis there.”
What an ankylosis is and what it does, the Contraption doesn’t know. But the sound of it is quite enough.
“It’s just possible,” says the doctor as another bright idea occurs to him, “that there’s an infiltration into the proscenium.”
These may not be the exact medical terms that the doctor uses. But that is what they sound like to the Contraption.
“Is that so?” he says.
“However, we’ll keep that under observation till we see what we find. You say you never had hydrophobia?”
“Not so far as I remember.”
“That’s interesting. The symptoms seem to suggest hydrophobia, or just possibly hendiadys.”
The doctor reflects a little more, then he begins to write on little bits of paper.
“Well,” he says in a cheerful tone, “we’ll try it out anyway.”
He writes out little orders for X-rays, blood tests, heart tests.
“Now,” he says in conclusion. “Don’t be alarmed. You may blow up on the street. But I don’t think so. I’m not much afraid of that. It’s possible that your brain will burst open at the sides. But I’m not alarmed if it does. If your eyes fall out on the street, let me know.”
These are not his exact words. But they give exactly the impression that his words convey.
“I will,” says the Contraption.
“And now,” says the doctor, who by this time has warmed up to the case and is filled with artistic interest, “about diet — I think you’d better not eat anything — or not for a month or so; and don’t drink; and you may as well cut out tobacco, and you’d better not sleep.
“And above all,” concludes the doctor with a sudden burst of geniality that he had forgotten to use sooner, “don’t worry. You may blow up at any time, but don’t let that worry you. You may fall dead in a taxi, but I’m not alarmed if you do. Come back in a week and I’ll show you the X-ray plates. Good-bye.”
The Contraption goes away for a week. That means seven days, or 168 hours, or 10,080 minutes, or 604,800 seconds. And he knows every one of them. He feels them go by.
When he comes back in a week he finds the doctor beaming with interest.
“Look at them,” he says, holding up to the light some photographic plates.
“What are those?” asks the Contraption.
“The brain,” says the doctor. “You see that misty-looking spot — there, just between the encephalon and the encyclopædia — ?”
“What is it?” asks the Contraption.
“I don’t know yet,” the doctor says. “It’s a little early to say. But we’ll watch it. If you don’t mind, I think we’ll probably open your head and take a look. They are doing some wonderful things now in the removal of the brain. It’s rather a nice operation, but I think I may take the risk. I’ll let you know. Meantime you’re following out our instructions, I hope, not eating anything.”
“Oh, no.”
“And nothing to drink or smoke.”
“Oh, no.”
“That’s right. Well, now, in a day or two we’ll know more. I’ll have your blood by that time and the sections of your heart and then I think we’ll begin to see where we are. Good-bye.”
A week or so later the doctor says to his lady secretary, “That Contraption in the serge suit, wasn’t he to have come in this morning?”
The lady looked over a memorandum book. “Yes, I think he was.”
“Well, call him up on the ‘phone. He doesn’t need to come. I’ve had all his hospital reports and they can’t find anything wrong at all. Tell him they want him to come back in six months and they may find something then. But there’s absolutely nothing wrong with him now, unless it’s his imagination. And, oh, by the way, tell him this — it will amuse him. That cloud on the X-ray plate that looked like a clot on the brain turns out to be a flaw in the glass. He’ll have a good laugh at that.”
The secretary vanishes into the telephone room and it is some little time before she comes back.
“Well?” says the doctor, “did you get that gentleman on the ‘phone?” He calls him a gentleman now because medical interest in him is over.
“I got his house,” she answers, “but they say the gentleman is dead. He died last night.”
“Dear me!” says the doctor gravely. “So we were wrong after all; we should have tested for something else. Did they say anything about how he died?”
“Yes. They say that as far as they know he died from gas. He seems to have turned on gas in the bedroom on purpose.”
“Tut, tut,” says the doctor, “suicidal mania! I forgot to test him for it!”
Chapter III. The Walrus and the Carpenter
BUT, STILL, HUMANITY gets used to anything and thrives on it. Already this new method of medicine, this tinkering, testing, inoculating, is a recognized part of our common life. Already we can see developing in it the healing art of the future; or rather, not the healing art which is a thing lost in the past and surviving only by the wayside. What is replacing it, is better called the art of reconstruction. Its aim is not to heal the patient; he’s not worth it; reconstruct him; make him over. If his engine doesn’t work, put a new one in him. Everyone today knows in a general sort of way something of what is being done in reconstructive surgery. Bones are taken out and new ones put in. Patches of skin from Mr. Jones are grafted on to Mr. Smith. No one cares to think out too completely the gruesome details or to ask where they are leading. But the goal is plain enough. And no doubt when it is reached all idea of gruesomeness will have vanished from it. Ideas of that sort are only secondary and relative, things with no basis in absolute reality. An octopus looks terrible; a cooked lobster looks delicious. If no one had ever seen a cooked lobster, a whole supper party would rise, shrieking with terror at the sight of one.
Thus it would seem probable that with the triumphant progress of reconstructive surgery, all sense of terror or gruesomeness will pass away. We are quite used to people with false teeth; we are getting used to people with lifted faces; and presently we shall not shrink in alarm from a friend who has just bought a brand new stomach:
In witness of which:
Medicine Year, 2000
THE WALRUS AND THE CARPENTER
“Now, I’d like to have him pretty well made over from the start,” said the self-assertive lady to the doctor.
As she said it she indicated a miserable-looking creature, evidently her husband, sitting flopped in a chair, gazing feebly at his wife and at the doctor.
The woman was of that voluble, obtrusive, assertive type that has made the two sexes what they are.
The man was of the familiar pattern of the henpecked husband, with a face as meek in expression as the countenance of a walrus, and with the ragged drooping moustache that belongs with it.
“Oh, I don’t know about that,” he murmured.
But neither the lady nor the doctor paid much attention to what he murmured.
“He needs nearly everything new,” said the woman, “and I’ve been telling him I’m going to give it to him as a present for our wedding anniversary next month. It will be twenty-five years we’ve been married.”
“Twenty-five years!” said the doctor.
“Of course,” gurgled the lady. “I was just a mere girl when we got married. They used to call me the little Rose Bud!”
“Yes, yes,” murmured the doctor. He was looking at the lady in an absent-minded way, not really seeing her. Perhaps he was thinking that no lapse of time, no passage of generations can alter this type of woman or vary this line of conversation. On the other hand, perhaps he wasn’t. He may have been merely thinking of the case. It was not every day that Dr. Carpenter was called upon to do what was called in his profession “a complete job.” To put in a new bone or two or insert part of a brain or to replace an old stomach was an everyday matter. But to make a subject over from head to toe was still unusual and perhaps a trifle experimental.
“As a matter of fact,” the husband began again, “I’m not so sure that I really need so very much done; in fact so far as I am concerned—”
“Now, John,” interposed his wife, “don’t let me hear any more of that. This is my business and not yours. I’m going to pay for it all out of my own money, and you’re not to say another word.”
The doctor was looking meditatively at the patient. He seemed to be measuring him with his eye. “There’s a lot of him that I can use,” he said.
“How do you mean?” asked the lady.
“Well, for instance, his head. That’s all right. I can use his head as it is.”
“Not his face!” said the lady.
“Yes, even his face, in a way. You’d be surprised what can be done without any radical replacement of tissue. What his face needs is not any change, but more animation, more expression, more alertness. You wait till I’ve put about twenty thousand volts of electricity through it, and see how it looks then.”
“I say,” murmured the man, “I’m not so sure that I feel so very keen about that.”
“You won’t know it,” said the doctor tersely, and then continuing, “and I don’t see why I couldn’t use his frame-work. The arms and legs are all right.”
The woman shook her head.
“He’s not tall enough,” she said.
“Personally,” began the man, but his wife paid no attention to him and went on.
“He needs presence. He makes such a poor appearance when we go out evenings. I’d like him quite a lot taller.”
“Very good,” said Dr. Carpenter. “It’s easily done. I can put in another six inches in the thigh bone simply enough. He’ll look a little short when he sits at table but that won’t matter so much. But of course to get the right proportion you’ll need to alter the arms as well. By the way,” he added as a new idea seemed to occur to him, “do you play golf?”
“Do I play?” said the patient, showing for the first time an obvious animation. “Do I do anything else? I play every day, and yet would you believe it, I’m about the worst player in the club. Take yesterday, for instance, I’d come down the long hole, four hundred and eighty yards in three — right on to the green, and there I stuck — seven more to get into the hole. Seven! Can you beat it?”
“I’ll tell you,” said the doctor. “If you feel that way about it, I might do something about your golf while I am altering your arm.”
“Say, if you could, I’d pay a thousand dollars for that,” said the man. “Do you think you can?”
“Wait a bit,” said the doctor. He stepped into the adjacent telephone cupboard. What he said and what was said to him was not audible to either Mr. Walrus or to his wife. The detailed operations of the medical profession are not either now or in Utopia as noble to contemplate as its final achievements. But if there had been an ear to listen when the dial was turned, this is what it would have heard.
“It’s Dr. Carpenter. What about that Scotch professional golfer that you got yesterday? Is he all gone?”
“Wait a minute, doctor, I’ll ask. . . . No, they say nothing much gone yet. Do you want his brain?”
The doctor laughed. “No, thanks. I want his right forearm. I’ve a client who’ll pay anything that’s fair up to a thousand. Right. Thank you.”
“That’ll be all right,” said the doctor. “I can put a golf adjuster in you; and so now I think we can go right ahead, eh?”
“There’s just one thing,” said the wife, “that I’d like changed more than anything else. John is always so retiring and shy. He don’t make the most of himself.”
“Oh, come, come, June!” protested the man bluntly, “there’s nothing in me to make much of.”
“Well, I think,” the woman went on, “that John’s got what they call an ‘inferiority complex.’ Isn’t that the word? Now couldn’t you do something to his brain to get that out of it?”
Dr. Carpenter smiled.
“That’s not in his brain, Mrs. Walrus; that’s a matter of his glands and there’s nothing easier than to alter that. The adjustment is a little difficult, the only danger is that he may get a little the other way.”
“That’s all right,” said the woman, “that won’t hurt him. He needs it.”
It would be grossly out of place to linger on the details of the weeks of “treatment” which followed for Mr. Walrus. Such things belong only in a book of technical medicine. Even nowadays we prefer to leave all that in a half light, and in future generations, convention will dictate a still greater reticence in regard to the processes of reconstructive surgery. In any case the use of sustained anæsthetics in place of the intermittent anæsthetics of today put a different complexion on the whole affair. Convalescence itself being under anæsthetics, the patient — or rather client, to use the more ordinary term — knows nothing from his entrance into the Refactorium (formerly called hospital) until his final exit. The declaration of such a client that he “felt a new man” had a more literal meaning than now.
