Even in my first assistantship in the Rhondda we had lived better. Then we were always sure of a blazing fire and a hot meal. Now, more often than not, we had neither. All our small receipts seemed consecrated to paying off the drug bill and the quarterly obligation, looming ahead, to Dr Tanner.
We ate infrequently and only the cheapest kinds of food. How well do I remember coming in, fagged – less with work than anxiety – and sitting down to a dish that we were all sick of. ‘This muck again,’ I would mutter. ‘ What kind of doctor am I? Is nobody ever sick in this part of town?’ More often than not, however, I would begin to eat silently, having first glanced across at my wife ‘Have you had your milk?’
Yes, she was supposed to drink milk for on top of all this worry, we cared for each other more than ever, and she was again in that state euphemistically known as ‘an interesting condition’ – in fact, our second son was due to appear, and in truth did appear, in about three months.
Chapter Twenty-One
That first year in Bayswater, marked by much hardship and by an intensity of purpose which never for a moment relaxed, was as great a martyrdom as that suffered by the early Christians. But by keeping our sense of humour and laughing off our trials and discouragements we managed to survive. And it was wonderful when the tide gradually turned and began, vigorously, to flow our way.
It is true that I worked desperately hard. To attain a particular objective, one must give everything, offer unsparingly the sum total of one’s capabilities – and in these twelve months I did not take a single half-day’s holiday. Yet I must admit that good fortune had its part in our ultimate success. I was lucky to make friends with the policeman on point duty, a good Scot by the name of Sergeant Blair, who got me many a useful fee for casualty work; and with the proprietor of the neighbourhood chemist’s shop, who often sent along customers who had asked to be ‘recommended’ to a good doctor. Nor must we forget a certain native shrewdness which secured for me an entry into many of the private hotels which are so numerous in Bayswater.
Summoned in the middle of the night to some poor waitress, or cook, or scullery-maid, who was sickening with influenza, or perhaps (this happened more than once) had surprised her unsuspecting employer by developing labour pains, in short, the kind of patient whom few of the other doctors wanted, I would get out of bed, treat the unfortunate woman like a duchess, visit her every day for a month, and finally wind up with several of the guests of the hotel in my waiting-room.
‘Doctor, you did such wonderful things for poor Sarah Jones, I wonder if you could help my gastritis.’
And Doctor did, of course – there was nothing I would not, or could not, put my hand to, and everything that I attempted seemed to come off. A growing reputation is a thrilling, tingling tonic for the struggling practitioner. Instead of sitting chafing, waiting for patients to arrive, the entire day seemed too short for fulfilment of the demands made upon me. As though this were not enough, an event occurred which must surely have been arranged by a benevolent Providence.
Late one November evening, as the mist swirled up from the Thames and the traffic of the busy street was stilled, the night bell rang. I had not yet turned in, but was sitting up in my dressing-gown, trying to master an abstruse article on diabetic metabolism in the current number of the Medical Journal. I answered the bell myself. When I opened the door the haloed light of the street lamp revealed a young maidservant, hatless, coatless, and in a breathless panic of agitation. Her mistress, Mrs. Arbuthnot, at No. 5 Palace Gardens, had taken poison. She had run for the family doctor only to find that he was away from home. Would I, for God’s sake, come at once?
There is an instinct, or it may only be experience, which permits the long-suffering practitioner to determine, in one illuminating and heart-searching glance, the nature of a call. And in the open countrified countenance of this little maid, in her sincerity, her obvious distress, even in the neatness of her simple uniform, I saw, despite that ominous word ‘poison’, nothing but what was good. Without a word I took up my emergency bag, which stood ready on the hall table, hailed a taxi that was crawling past in the fog, and bundling into it, still in my dressing-gown, told the driver to make all speed towards Palace Gardens.
Within four minutes we were there. Number 5 was a small but handsome flat, solidly furnished in the Victorian style, with warm carpets, rich velvet curtains, and spotless antimacassars on the horsehair armchairs. In the bedroom, collapsed on the old-fashioned brass bedstead and quite unconscious, was a fragile little old woman in a lace nightgown. Upon the bedside table were two bottles of medicine, exactly similar in size and shape: the one an obvious bismuth stomach mixture marked ‘One tablespoonful as required’; the other, dark blue in colour and bearing a scarlet label: ‘The Liniment. Poison. Not to be taken.’
Little imagination was needed to deduce what had happened: the old lady, falling asleep, had felt a twinge of indigestion, had reached drowsily – forgetful of the presence of the other bottle – for a dose of the palliative mixture, had mistakenly swallowed a portion of the lethal liniment.
This, indeed, as I afterwards learned, was the exact explanation, but at that moment, with the patient in extremis, there was no time to dwell on theories. The old lady was almost gone, the pulse a mere flicker in her slender wrist. But what was the poison? Useless to telephone the chemist and turn him out of bed to hunt through his file of prescriptions. I must decide instantly. The fixed, dilated pupils, that dry flushed skin, the injected eyeballs and fluttering heart-beats suggested one thing – belladonna – a supposition partly borne out by the greenish colour and sickly smell of the liniment. Now belladonna, prepared from the leaves of Atropa belladonna collected when the plant is in flower, is a powerful depressant which, acting through the vague nerve, paralyses the respiratory centre in the brain. Already my patient had begun to gasp convulsively. It must be belladonna … yet … on the other hand, there were at least six other deliria narcotics which could produce the same effect. Well – I must risk it. Quickly I passed a stomach tube, blessing the practice in Loch lea Asylum which had given me skill in this difficult art, and washed out the old lady’s stomach with a solution of saline. Next I pumped into her 15 milligrams of diamorphone hydrochloride, perfect antidote to the atropine alkaloid which is the deadly element in belladonna, yet toxic enough in its own right, if my diagnosis was wrong, to ease her quietly to a better world. Anxiously I studied her, awaiting the result At first I thought she was gone. Instead, however, she began to breathe better, the pulse strengthened, after about fifteen minutes she sighed, opened her eyes, and looked glassily at me.
‘Young man,’ she murmured, ‘what are you doing in my bedroom in your dressing-gown?’
Then she tried to go to sleep again. But we would not, by any means, permit her to do so. All night long, despite her pleadings, the little maid and I marched her up and down the apartment, pausing only at intervals to dose her with black coffee well laced with stimulant When morning came the effects of the drug had worn off, and in about a week, despite the apparent frailty of her constitution and her advanced age – she had long since passed her seventieth year – she made a complete recovery.
Firmly resisting my ethical attempt to return her to the care of her own doctor, whom she characterized – tartly and, I fear, un justly – as a gouty old fool, who could never be found when wanted and was always rushing off to Harrogate to drink the waters which, she averred, should have been more properly reserved for his patients, she adopted me as her physician, insisting that I visit her every day. Thus began my acquaintance, ripening quickly to deep friendship, with one of the most remarkable old ladies I have ever known.
Of Spanish extraction – her maiden name was Mina do Costa – she had been born in Buenos Aires and had married, of all people, an adventurous expatriate Scotsman. Much of her life had been spent in Mexico, where her husband had managed, and finally owned, a large silver mine near Asuncion and where, indeed, during the revolution ‘of
1917, while resisting an attempt of the mob to take over his property, he had been fatally shot. But she had lived everywhere, travelled, in later years, to every corner of the globe, to countries as far apart as India and Brazil, climes as different as Persia and Peru, She had wintered in Nice, in Cairo, attended the opera at Vienna, the festival at Bayreuth, the races at Longchamps, viewed the bullfights of Mexico City and Madrid, assisted in her own casita at the Easter ferialin Seville. One year she spent the spring on the slopes of the Andes; the next, under the scented cherry trees in the shadow of Fujiyama. A complete cosmopolitan, she had spent lavishly, and even now, restricted physically and, to a certain extent, financially, small, shrunken, with sharp little features and fragile bones, she still maintained her cheerful, worldly outlook, and in her bright, birdlike eye there burned, with a kind of humorous irony, the determination to continue to enjoy her life to the last gasp, to pave her footsteps to the grave with thoroughly mundane intentions.
Every morning she took The Sporting Times, known to initiates as ‘The Pink ‘Un’, and lighting a cigarette after her breakfast of coffee and croissants, she cocked an eye through the smoke and studied it intently. Then, having reached a decision with the help of Ruff’s Turf Guide, she went to the telephone and bet a few shillings with her bookmaker. Thereafter, she might have an appointment with her hairdresser, or if the weather were fine she would hire a hansom from the adjoining mews – never a taxi – and go for a drive in the Park, In the afternoon she usually played bridge at a neighboring club. On her way home she bought the evening newspaper and scanned the race results width an excitement which, while pleasantly stimulating throughout the day, now reached its peak. If her horse had lost she said something which was not polite, beneath her breath, in Spanish. When it won, she had a glass of champagne at dinner, always an admirable meal, sent in hot from a neighboring hotel and served on fine porcelain and old silver, by the little maid.
Many times she invited me to share this repast with her. And afterward, over a liqueur, smoking her evening cigarette, she would talk of the past. There was in her, apparently, not a shred of sentiment. In contrast to those patients who profusely, often tearfully, voiced their gratitude, then left the district without paying their bills, she never thanked me for having saved her life, as I undoubtedly had done. Indeed, she preferred to tease me for having appeared, half undressed, at midnight in her bedroom – implying, of course, that my intentions had been strictly dishonourable. But one day when I called, she handed me in silence a small tissue-wrapped package. It was an exquisite, gold cigarette case, inscribed with my monogram, the phrase Recede de Mina, and the date 30:4:29 – I have at this moment looked at it to refresh my memory – on which I had first been called to her. When I attempted to express my appreciation, she mockingly brushed aside my halting words.
‘Don’t thank me, Doctor. Thank a horse named Maiden’s Prayer, which just paid me ten to one. By the way, my son got back from Europe yesterday. He wants to know you. May he visit you next week?’
A few days later Manuel Arbuthnot called upon me. He was a man of about forty, short and suave, with brilliant dark eyes, smooth olive complexion, glossy black hair, and a definite inclination towards embonpoint – he lived, I learned later, in perpetual conflict with his figure. Dressed in dark broadcloth of perfect cut, his linen immaculate, a pearl in his somber grey tie, he conveyed an impression of perfect elegance, a trifle over polished perhaps, yet restrained by impeccable good taste. His manner was perfect, too, yet beneath his urbanity I could sense a cool, impersonal proficiency. Without seeming to do so, these glittering, slightly hooded duellist’s eyes were taking me in, appraising my character, the quality of my consulting-room, perhaps even judging, to a penny, the price of the curtains which hung behind my desk.
Such a man, son of such a mother, might well be expected to follow some bizarre pursuit, and I was not surprised when he informed me that he was head ‘ buyer’ for the West End mason named Burrell’s. At that time I had, needless to say, slight knowledge of the extraordinary world of the haute couture, yet no one who peruses the daily news sheets, no matter how cursorily – and my breakfast glance was often hasty in the extreme – could possibly have missed that word Brunelle or have failed to appreciate, if he gave the matter a second thought, the premier importance of this establishment as a purveyor of the latest models to many of London’s most fashionable women.
Manuel said nothing of this; indeed, his visit was brief. He spoke a little of his recent business trip to Paris, where he had been viewing, and buying, the new season’s modes for his house, thanked me politely for my attention to his mother, then rose to go. As he left me at the front door he handed me, with an almost imperceptible bow, his card. At least, I fancied it to be his card until, a moment later, I discovered it to be the address of a firm of tailors: Sandown and Company, 2 Seville Row. Involuntarily, I burst out laughing, but it was not a particularly merry laugh – I felt that my recent visitor was rather too cold a customer for my taste, and that his gratitude had been expressed in a somewhat peculiar form.
However, I had reason to regret this hasty judgment, for presently there arrived at my surgery, bringing their national health insurance cards and requesting to be placed upon my panel, a number of the staff of Brielle’s – seamstresses, messenger girls, and vend uses. Then came a bevy of those glamorous creatures who acted as mannequins for the house and whose function was, of course, to sell fantastically costly creations, in which they themselves looked ravishing, to women no longer young, fighting a perpetual battle with sagging tissues and expanding waistlines. Of these beautiful models I remember – if only because of the help they gave me – Helena, with her black lustrous eyes, blooming under lip, and glistening teeth; Genevieve, who was tall and willowy, moving with undulating grace; Eloise, an ash-blonde with eyes clear as agates and a fair, perfect skin; and Madeleine, petite and dainty as a woodland nymph. Despite their exotic appearance, these girls were at heart simple and natural. Indeed, it was astounding to discover that each, behind that exquisite façade, that air of sophisticated hauteur, had the same fundamental aspiration – to get out of satin and sequins, of guipure and brocatelle, to marry a decent man, settle down, and have children. The truth is, of course, that they were all continually plagued and persecuted by that type of ‘man about town’ who believes his charm irresistible and who seeks to force it upon pretty and unprotected girls. When they discovered that my interest in them was confined to curing their coughs and colds – I was too settled in my home life to be tempted by exterior distractions – they were quick to accept me as a counsellor and confidant, and to recommend me, not only to their friends, but also, with due discretion, to their clients.
This was a tremendous benefit. A doctor is not permitted to advertise – it is the process of recommendation which does the trick. Thus calls began to come in, at first gradually, then with increasing frequency, from parts of London outside my own district, and far superior to it in social standing. I went to South Kensington, to Knightsbridge, to Mayfair, entering these fine houses in the beginning with great timidity, then with confidence, and finally with that assurance which springs from the knowledge of one’s success.
Most of these patients were women, many of them rich, idle, spoiled, and neurotic. A young doctor with a Scots accent and a string of ‘good’ degrees, strongly recommended by one of Manuel’s young lovelies, was a distinct novelty, regarded with the curious interest they might bestow upon, a species of new lapdog. Yet I was no lapdog, being quick to realize that in order to succeed with such patients the utmost firmness was essential. I was firm, I was stern. I bullied and commanded, I even invented a new disease for them – asthenia. This word, which means no more than weakness or general debility, became a sort of talisman, which procured my entry to more important portals. At afternoon tea in Cardigan Place, or Belgrade Square, Lady Blank would announce to the Honorable Miss Dash – eldest daughter of the Earl of Dot:
‘Do you know
, my dear, this young Scottish doctor – rather uncivilized, but amazingly clever – has discovered that I’m suffering from asthenia. Yes … asthenia. And for months old Dr Brown-Blodgett kept telling me it was nothing but nerves.’
Having created a disease, it was essential to produce the remedy. At this time the system of medication by intramuscular injection was coming into vogue – a process whereby colloidal suspensions of iron, manganese, strychnine, and other tonic medicaments were introduced to the patient’s blood stream, not by the mouth, but through the medium of the hypodermic syringe. Later on, this technique was largely discounted as being in no way superior to the old-fashioned method of oral administration, but at that moment it suited me to perfection.
Having diagnosed asthenia, it was noticeably thrilling for my patient when, in a somber voice, my manner modelled upon that of Priest’s Dr Dieulafoy, whose autocratic demeanour at the bedside subdued even the Due de Guarantees, I declared:
‘Madam, I fear I shall be obliged to submit you to a course of injections.’
Oh, really, Doctor?’ with acute interest.
‘Yes madam. Your condition demands most drastic treatment.’
‘Yet you will cure me, dear Doctor,’ in some agitation.
‘I guarantee it, madam. But two courses may be necessary.’
Injections for asthenia were now as much the mode and as eagerly sought after as Manuel’s new spring gowns. Again and yet again my sharp and shining needle sank into fashionable buttocks, bared upon the finest linen sheets. I became expert, indeed, superlative, in the art of penetrating the worst end of the best society, with a dexterity which rendered the operation almost painless – my standard preamble being, ‘I assure you, dear lady, this will cause you no inconvenience’ – and which increased my reputation by leaps and bounds. Strange though it may seem, the results of this complex process of hocus-pocus – and I was, I assure you, a great rogue at this period, though perhaps not more so than many of my colleagues – were surprisingly, often amazingly, successful. Asthenia gave these bored and idle women an interest in life. My tonics braced their languid nerves. I dieted them, insisted on a regime of moderate exercise and early hours. I even persuaded two errant wives to return to their long-suffering husbands, with the result that within nine months they had other matters than asthenia to occupy them.