Of Human Bondage W. Somerset Maugham (epub e reader txt) 📖

ages, children, gave one an impression which was weird and horrible. They suggested the grim drawings of Daumier. All the rooms were painted alike, in salmon-colour with a high dado of maroon; and there was in them an odour of disinfectants, mingling as the afternoon wore on with the crude stench of humanity. The first room was the largest and in the middle of it were a table and an office chair for the physician; on each side of this were two smaller tables, a little lower: at one of these sat the house-physician and at the other the clerk who took the “book” for the day. This was a large volume in which were written down the name, age, sex, profession, of the patient and the diagnosis of his disease.

At half past one the house-physician came in, rang the bell, and told the porter to send in the old patients. There were always a good many of these, and it was necessary to get through as many of them as possible before Dr. Tyrell came at two. The H.P. with whom Philip came in contact was a dapper little man, excessively conscious of his importance: he treated the clerks with condescension and patently resented the familiarity of older students who had been his contemporaries and did not use him with the respect he felt his present position demanded. He set about the cases. A clerk helped him. The patients streamed in. The men came first. Chronic bronchitis, “a nasty ’acking cough,” was what they chiefly suffered from; one went to the H.P. and the other to the clerk, handing in their letters: if they were going on well the “words Rep 14” were written on them, and they went to the dispensary with their bottles or gallipots in order to have medicine given them for fourteen days more. Some old stagers held back so that they might be seen by the physician himself, but they seldom succeeded in this; and only three or four, whose condition seemed to demand his attention, were kept.

Dr. Tyrell came in with quick movements and a breezy manner. He reminded one slightly of a clown leaping into the arena of a circus with the cry: Here we are again. His air seemed to indicate: What’s all this nonsense about being ill? I’ll soon put that right. He took his seat, asked if there were any old patients for him to see, rapidly passed them in review, looking at them with shrewd eyes as he discussed their symptoms, cracked a joke (at which all the clerks laughed heartily) with the H.P., who laughed heartily too but with an air as if he thought it was rather impudent for the clerks to laugh, remarked that it was a fine day or a hot one, and rang the bell for the porter to show in the new patients.

They came in one by one and walked up to the table at which sat Dr. Tyrell. They were old men and young men and middle-aged men, mostly of the labouring class, dock labourers, draymen, factory hands, barmen; but some, neatly dressed, were of a station which was obviously superior, shop-assistants, clerks, and the like. Dr. Tyrell looked at these with suspicion. Sometimes they put on shabby clothes in order to pretend they were poor; but he had a keen eye to prevent what he regarded as fraud and sometimes refused to see people who, he thought, could well pay for medical attendance. Women were the worst offenders and they managed the thing more clumsily. They would wear a cloak and a skirt which were almost in rags, and neglect to take the rings off their fingers.

“If you can afford to wear jewellery you can afford a doctor. A hospital is a charitable institution,” said Dr. Tyrell.

He handed back the letter and called for the next case.

“But I’ve got my letter.”

“I don’t care a hang about your letter; you get out. You’ve got no business to come and steal the time which is wanted by the really poor.”

The patient retired sulkily, with an angry scowl.

“She’ll probably write a letter to the papers on the gross mismanagement of the London hospitals,” said Dr. Tyrell, with a smile, as he took the next paper and gave the patient one of his shrewd glances.

Most of them were under the impression that the hospital was an institution of the state, for which they paid out of the rates, and took the attendance they received as a right they could claim. They imagined the physician who gave them his time was heavily paid.

Dr. Tyrell gave each of his clerks a case to examine. The clerk took the patient into one of the inner rooms; they were smaller, and each had a couch in it covered with black horsehair: he asked his patient a variety of questions, examined his lungs, his heart, and his liver, made notes of fact on the hospital letter, formed in his own mind some idea of the diagnosis, and then waited for Dr. Tyrell to come in. This he did, followed by a small crowd of students, when he had finished the men, and the clerk read out what he had learned. The physician asked him one or two questions, and examined the patient himself. If there was anything interesting to hear students applied their stethoscope: you would see a man with two or three to the chest, and two perhaps to his back, while others waited impatiently to listen. The patient stood among them a little embarrassed, but not altogether displeased to find himself the centre of attention: he listened confusedly while Dr. Tyrell discoursed glibly on the case. Two or three students listened again to recognise the murmur or the crepitation which the physician described, and then the man was told to put on his clothes.

When the various cases had been examined Dr. Tyrell went back into the large room and sat down again at his desk. He asked any student who happened to be standing