The Stark Munro Letters by Arthur Conan Doyle (novels to improve english .txt) đź“–
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I’ll send across any surgical cases which may turn up. To-day, however, I think you had better stay with me, and see how I work things.”
“I should very much like to,” said I.
“There are one or two elementary rules to be observed in the way of handling patients,” he remarked, seating himself on the table and swinging his legs. “The most obvious is that you must never let them see that you want them. It should be pure condescension on your part seeing them at all; and the more difficulties you throw in the way of it, the more they think of it. Break your patients in early, and keep them well to heel. Never make the fatal mistake of being polite to them. Many foolish young men fall into this habit, and are ruined in consequence. Now, this is my form”—he sprang to the door, and putting his two hands to his mouth he bellowed: “Stop your confounded jabbering down there! I might as well be living above a poultry show! There, you see,” he added to me, “they will think ever so much more of me for that.”
“But don’t they get offended?” I asked.
“I’m afraid not. I have a name for this sort of thing now, and they have come to expect it.
But an offended patient—I mean a thoroughly insulted one—is the finest advertisement in the world.
If it is a woman, she runs clacking about among her friends until your name becomes a household word, and they all pretend to sympathise with her, and agree among themselves that you must be a remarkably discerning man.
I quarrelled with one man about the state of his gall duct, and it ended by my throwing him down the stairs.
What was the result? He talked so much about it that the whole village from which he came, sick and well, trooped to see me. The little country practitioner who had been buttering them up for a quarter of a century found that he might as well put up his shutters. It’s human nature, my boy, and you can’t alter it. Eh, what? You make yourself cheap and you become cheap. You put a high price on yourself and they rate you at that price.
Suppose I set up in Harley Street tomorrow, and made it all nice and easy, with hours from ten to three, do you think I should get a patient? I might starve first. How would I work it? I should let it be known that I only saw patients from midnight until two in the morning, and that bald-headed people must pay double. That would set people talking, their curiosity would be stimulated, and in four months the street would be blocked all night.
Eh, what? laddie, you’d go yourself. That’s my principle here. I often come in of a morning and send them all about their business, tell them I’m going off to the country for a day. I turn away forty pounds, and it’s worth four hundred as an advertisement!”
“But I understood from the plate that the consultations were gratis.”
“So they are, but they have to pay for the medicine.
And if a patient wishes to come out of turn he has to pay half-a-guinea for the privilege. There are generally about twenty every day who would rather pay that than wait several hours. But, mind you, Munro, don’t you make any mistake about this! All this would go for nothing if you had not something, slid behind—I cure them. That’s the point. I take cases that others have despaired of, and I cure them right off. All the rest is only to bring them here. But once here I keep them on my merits. It would all be a flash in the pan but for that. Now, come along and see Hetty’s department.”
We walked down the passage to the other room. It was elaborately fitted up as a dispensary, and there with a chic little apron Mrs. Cullingworth was busy making up pills. With her sleeves turned up and a litter of glasses and bottles all round her, she was laughing away like a little child among its toys.
“The best dispenser in the world!” cried Cullingworth, patting her on the shoulder. “You see how I do it, Munro. I write on a label what the prescription is, and make a sign which shows how much is to be charged. The man comes along the passage and passes the label through the pigeon hole. Hetty makes it up, passes out the bottle, and takes the money. Now, come on and clear some of these folk out of the house.”
It is impossible for me to give you any idea of that long line of patients, filing hour after hour through the unfurnished room, and departing, some amused, and some frightened, with their labels in their hands.
Cullingworth’s antics are beyond belief. I laughed until I thought the wooden chair under me would have come to pieces. He roared, he raved, he swore, he pushed them about, slapped them on the back, shoved them against the wall, and occasionally rushed out to the head of the stair to address them en masse. At the same time, behind all this tomfoolery, I, watching his prescriptions, could see a quickness of diagnosis, a scientific insight, and a daring and unconventional use of drugs, which satisfied me that he was right in saying that, under all this charlatanism, there lay solid reasons for his success. Indeed, “charlatanism” is a misapplied word in this connection; for it would describe the doctor who puts on an artificial and conventional manner with his patients, rather than one who is absolutely frank and true to his own extraordinary nature.
To some of his patients he neither said one word nor did he allow them to say one. With a loud “hush” he would rush at them, thump them on the chests, listen to their hearts, write their labels, and then run them out of the room by their shoulders. One poor old lady he greeted with a perfect scream. “You’ve been drinking too much tea!” he cried. “You are suffering from tea poisoning!” Then, without allowing her to get a word in, he clutched her by her crackling black mantle, dragged her up to the table, and held out a copy of “Taylor’s Medical Jurisprudence” which was lying there.
“Put your hand on the book,” he thundered, “and swear that for fourteen days you will drink nothing but cocoa.”
She swore with upturned eyes, and was instantly whirled off with her label in her hand, to the dispensary. I could imagine that to the last day of her life, the old lady would talk of her interview with Cullingworth; and I could well understand how the village from which she came would send fresh recruits to block up his waiting rooms.
Another portly person was seized by the two armholes of his waistcoat, just as he was opening his mouth to explain his symptoms, and was rushed backward down the passage, down the stairs, and finally into the street, to the immense delight of the assembled patients, “You eat too much, drink too much, and sleep too much,”
Cullingworth roared after him. “Knock down a policeman, and come again when they let you out.” Another patient complained of a “sinking feeling.” “My dear,” said he, “take your medicine; and if that does no good, swallow the cork, for there is nothing better when you are sinking.”
As far as I could judge, the bulk of the patients looked upon a morning at Cullingworth’s as a most enthralling public entertainment, tempered only by a thrill lest it should be their turn next to be made an exhibition of.
Well, with half-an-hour for lunch, this extraordinary business went on till a quarter to four in the afternoon.
When the last patient had departed, Cullingworth led the way into the dispensary, where all the fees had been arranged upon the counter in the order of their value.
There were seventeen half-sovereigns, seventy-three shillings, and forty-six florins; or thirty-two pounds eight and sixpence in all. Cullingworth counted it up, and then mixing the gold and silver into one heap, he sat running his fingers through it and playing with it.
Finally, he raked it into the canvas bag which I had seen the night before, and lashed the neck up with a bootlace.
We walked home, and that walk struck me as the most extraordinary part of all that extraordinary day.
Cullingworth paraded slowly through the principal streets with his canvas bag, full of money, outstretched at the full length of his arm. His wife and I walked on either side, like two acolytes supporting a priest, and so we made our way solemnly homewards the people stopping to see us pass.
“I always make a point of walking through the doctor’s quarter,” said Cullingworth. “We are passing through it now. They all come to their windows and gnash their teeth and dance until I am out of sight.”
“Why should you quarrel with them? What is the matter with them?” I asked.
“Pooh! what’s the use of being mealy-mouthed about it?” said he. “We are all trying to cut each other’s throats, and why should we be hypocritical over it? They haven’t got a good word for me, any one of them; so I like to take a rise out of them.”
“I must say that I can see no sense in that. They are your brothers in the profession, with the same education and the same knowledge. Why should you take an offensive attitude towards them?”
“That’s what I say, Dr. Munro,” cried his wife. “It is so very unpleasant to feel that one is surrounded by enemies on every side.”
“Hetty’s riled because their wives wouldn’t call upon her,” he cried. “Look at that, my dear,” jingling his bag. “That is better than having a lot of brainless women drinking tea and cackling in our drawing-room.
I’ve had a big card printed, Munro, saying that we don’t desire to increase the circle of our acquaintance. The maid has orders to show it to every suspicious person who calls.”
“Why should you not make money at your practice, and yet remain on good terms with your professional brethren?” said I. “You speak as if the two things were incompatible.”
“So they are. What’s the good of beating about the bush, laddie? My methods are all unprofessional, and I break every law of medical etiquette as often as I can think of it. You know very well that the British Medical Association would hold up their hands in horror if it could see what you have seen to-day.”
“But why not conform to professional etiquette?”
“Because I know better. My boy, I’m a doctor’s son, and I’ve seen too much of it. I was born inside the machine, and I’ve seen all the wires. All this etiquette is a dodge for keeping the business in the hands of the older men. It’s to hold the young men back, and to stop the holes by which they might slip through to the front. I’ve heard my father say so a score of times. He had the largest practice in Scotland, and yet he was absolutely devoid of brains. He slipped into it through seniority and decorum. No pushing, but take your turn.
Very well, laddie, when you’re at the top of the line, but how about it when you’ve just taken your place at the tail? When I’m on the top rung I shall look down and say, `Now, you youngsters, we are going to have very strict etiquette, and I beg that you will come up very quietly and not disarrange me from my comfortable position.’ At the same time, if they do what I tell
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