Adventures in Two Worlds

  ‘It’s a grand dinner the day. And I’m fair famished with hunger!’

  She began to eat with a rare good appetite. And at that I left her to it.

  Chapter Eight

  As spring wore towards summer, Tannochbrae was ablaze with flowers. Strange though it may seem in such northern latitudes, the Scottish people love their gardens and cultivate them with surprising skill. My patron was no exception to the rule, and in his gardener, Alexander Deans, he possessed a horticultural treasure who came every day, regular as the clock, from the neighbouring township of Knoxhill, to keep the grounds of Arden House blooming, trim, and tidy.

  One day, Deans was planting in the front bed of lawn when Dr Cameron came down the gravel drive.

  ‘Day, Alex,’ he called out across his shoulder; then, drawing up short, ‘ Good God, man! What do you think you’re doing?’

  Alex was planting calceolarias in the big round bed – masses of beady, yellow calceolarias.

  ‘Don’t ye know I cannot endure that yellow trash?’ Cameron exclaimed. ‘Where’s my red geraniums – my bonny Scarlet Wonders?’

  These red geraniums were an institution at Arden House, where, indeed, the garden grew by solemn ritual, the slow procession of the seasons producing the same procession of favourite plants, year in year out, the flowers remembered, anticipated, beloved.

  In particular, Cameron loved his red geraniums. The vivid scarlet splash upon the shorn green lawn of Arden House was quite a feature of the village, and visitors would stop openly in the roadway to admire – affording Cameron a naïve and never-failing delight.

  ‘I’m asking you,’ Cameron said again, ‘ where’s my red geraniums?’

  Alex stood up, a short and rather stocky figure, in his shirt sleeves, his face weathered, his hands large, encrusted with dry soil. Without looking at the doctor, but keeping his gaze sheepishly upon the ground, he remarked:

  ‘Yellow is a braw colour. You’ve no idea! It reminds me of the yolk of an egg!’ And he gave a slight snigger.

  Dr Cameron was staggered. Deans was a most respectful man, steady as a rock; he’d worked at Arden House for close on fifteen years. Drunk, thought Cameron, but somehow that didn’t seem to fit. As he was in a hurry, he had no time to take the matter further. He said, very quietly:

  ‘Get out these calceolarias, Alex. And get in the geraniums quick.’ Then he went out of the gate.

  Yet, when he came back from his case, Alex was gone and the front bed of the lawn brimmed over with the yellow calceolarias.

  That was the beginning, and soon there were growing whisperings of the strange conduct of Alex Deans. He who had been so silent and self-contained was now guilty of the wildest eccentricities. He would argue fiercely, stupidly, and come to blows about a trifle. His language, too, had taken a rude turn for the worse. Neighbours had heard him abusing his sister Annie, who kept house for him.

  The climax came six weeks later, when a note arrived at Arden House from the county medical officer of health, Dr Snoddie of Knoxhill. The message was for Cameron, and it said briefly:

  ‘Come round at once. I want you to certify a dangerous lunatic.’

  It was afternoon, a grey, wet day – what Cameron called ‘whingey weather’ – and today, in a chastened fashion, he had called it worse, for he was laid up by his old enemy, the asthma.

  He was not in bed, but in his study armchair, with a tartan rug across his knees, a half-made fiddle upon his lap, and a balsam inhalation at his elbow. I was in the opposite chair, going over the morning’s round which I had done alone.

  ‘Dear, dear!’ said Cameron when he had taken the note from Janet, discovered his glasses on his forehead, and read the peremptory message. ‘Poor Alex! I’m downright grieved about this!’ And he made as though to discard the rug.

  But, observing him from the doorway, Janet remarked firmly, ‘You’re not putting one foot out of this house today.’

  He looked at her over his spectacles, then subsided with a wheezy sigh.

  ‘Well, well, Janet. Say that one of us will be along presently.’

  When the housekeeper had gone Cameron handed the note to me.

  ‘You’ll know,’ he reflected, ‘ that the law requires two independent medical reports before a man can be certified insane. Believe me, that’s the sole reason Snoddie has sent for me. You’ll agree that I don’t often speak ill of my neighbours. But he’s a man who has no use for anybody but himself.’ He wheezed again, and made a grimace at the fire. ‘And while I think of it – just watch yourself with him when you’re about it. He bears you no great love since that affair with Shawhead.’

  Outside, Jamie was waiting with the gig. He buckled the weatherproof flap round me, and we went bowling through the drizzle together. Presently, on the outskirts of Knoxhill, a row of old houses sprang out of the mist. We drew up at the end house – a house with two acres and a bit, forming a garden that reached from its gable to the embankment, land which the unhappy Deans had laboriously reclaimed and enriched.

  In the front parlour downstairs the county medical officer was waiting with the rapidly mounting irritation of a self-important man who, if waiting is to be done, prefers that others should wait on him. As I came in he exclaimed:

  ‘You’re slow, sir, confoundedly slow. If you were my assistant I’d learn you to be sharper.’

  It occurred to me to say that I was not his assistant; but, mindful of Cameron’s warning, I held my tongue.

  ‘You know what’s wanted,’ he went on. ‘I’ve seen the poor devil upstairs. He’s quite demented. You’ll have no difficulty. Let’s have your certificate. I want to get away.’

  As I went upstairs he called after me:

  ‘Hurry up, will you. I’m a busy man, and I’m going out to dinner tonight.’

  Alex Deans was in bed – no doubt as a measure of restraint. His sister sat beside him, her red eyes indicating that she had been weeping. Immediately I came in she rose without a word. Her silence was so hopeless, the whole atmosphere of the room so dim and tragic, that I had a momentary sense of chill. I looked at Alex, and at first I hardly recognised him. The change was not gross, it was Deans sure enough, but a blurred and altered Deans, his features coarsened in some strange and subtle way. His face seemed swollen, the nostrils thickened, the lips broad, the skin waxy, except for a faint reddish patch that spread across the nose. His appearance was apathetic, and when I spoke to him he muttered some absurd reply so slurred it was unintelligible.

  ‘How long has he been this way?’ I asked his sister.

  She answered dully:

  ‘Two days – or near enough. But before he was – just raging.’

  ‘How do you mean?’

  ‘Nothing …’ She hesitated, added with extreme reluctance, ‘He set about me, that was all – and he used to be so kind to me.’

  The man on the bed stirred restlessly.

  ‘I’ll kill the lot of you,’ he mumbled. ‘ You put poison on the weeds. Hand me the trowel. I maun dig … dig … dig … for worms!’

  Silence fell upon these crazy words. The words of a lunatic? Perhaps! Yet I was not satisfied. It may be that Snoddie had roused a contrary devil in me, firmed my resolution to have no preformed opinion thrust down my throat. But really it was deeper than that. In all the practice of medicine nothing is more supremely difficult than the art of diagnosis, for here the temptation is to assess the existing symptoms simply on their face value. If, for example, a patient complains of stomach distress, he is likely to be regarded as a gastric case when, in fact, the basic malady responsible for his symptoms may be something quite different, perhaps an obscure condition of the blood or of the nerves.

  I have no reason to extol myself as a diagnostician – indeed, later I shall reveal how lamentably I failed in this respect – yet at this moment, confronted by that case, a sense of warning, of intuition stirred in me. I lifted Deans’s hand – it was dry and rough, the fingers slightly thickened at the ends. I took his temperature ?
?? it was subnormal. I pressed the swollen, oedematous face – the swelling was firm, inelastic, and did not pit on pressure.

  I thought hard, spurning the obvious solution, and all at once a light broke upon me. I had it! Myxoedema. Deans wasn’t insane. He was a clear case of thyroid deficiency.

  Every sign and every symptom – they fitted in, neatly, like a jigsaw puzzle. The defective memory, slow mentation, steady deterioration of intellect; the outbursts of irritability, of homicidal violence; the clumsy speech, dry skin, spatulate fingers, and swollen, inelastic face. There was real triumph in the completed picture.

  Controlling myself, I rose. As, with great deliberation, I pushed my chair back against the wall, Annie said drearily:

  ‘There’s pen and ink on the table there, Doctor – beside the papers.’

  ‘Time enough, Annie,’ I answered. ‘I’m not in the mood for writing at the moment.’

  I gave her a reassuring glance and went downstairs. I entered the parlour. There, in a voice purposely restrained, I told Dr Snoddie that I could not certify the patient.

  He stared at me, dumbfounded.

  ‘Have you gone crazy, too?’

  ‘I sincerely hope not!’

  ‘Then why the devil won’t you certify?’

  ‘Because, in my opinion, Deans is not mad. I regard him as suffering from myxoedema.’

  Dr Snoddie’s smooth, pink face mottled slowly to a patchy red.

  ‘Good God Almighty! Are you setting up your opinion against mine? Haven’t I seen the man? Haven’t I certified him myself? He’s a lunatic – a homicidal lunatic.’

  I kept my voice low.

  ‘That’s not my view. In my opinion, Deans is only sick in mind because he’s sick in body. It would be criminal to send him to the asylum until a full course of thyroid treatment has been tried. That’s why I refuse to certify. And now, as it’s not my case and there’s nothing more for me to do I’ll say good night.’

  I drove home with a set face, distressed that circumstances had again brought me into conflict with this man. He was such an ignoramus that I felt sure he had not even heard of myxoedema.

  As soon as we were at the front door of Arden House I gave the reins to Jamie, jumped out, and went straight upstairs. When I had told my story to Cameron he threw off his rug.

  ‘Jamie!’ he shouted. ‘Fetch Annie Deans here as fast as the gig will carry her.’

  So it happened, then, that, on Dr Cameron’s advice, Deans’s sister was persuaded not to press for immediate commitment, but to give the treatment I had suggested a chance.

  The responsibility was entirely mine, and I trembled lest I had made a dreadful mistake. Cameron’s interest was intense. Though he said nothing, I felt his inquiring glance upon me many times in the course of the next few weeks. But I had learned from him the virtue of silence and matched his growing curiosity with stoic reticence.

  One morning, however, at breakfast, I asked if I might have an hour off in the afternoon.

  ‘What for?’

  ‘To take a little walk,’ I answered dryly, ‘ with a friend.’

  That very afternoon, as the old doctor pottered about the garden with his pruning knife, the gate swung open and two figures appeared. Riveted, he stood watching us approach.

  ‘Well,’ I said, rather breathlessly, though I had meant to be studiously offhand, ‘here’s your gardener back.’

  It was Alex – the old Alex, lean and hardy, with the familiar diffident smile. In his eyes was the look of a man who had been through hell, but the old steadiness was there, the old honesty.

  ‘How are ye, man?’ asked Cameron mechanically.

  ‘I’m fine,’ said Deans shyly. ‘All but my hand.’

  ‘Alex has just had his hand wrung by a hundred different people,’ I explained. ‘As we came through the village, you know.’

  There was a pause. Cameron blew his nose hard.

  ‘What are ye standing there for!’ he said at last. ‘Away in to Janet and get your tea.’

  When Deans had gone he took my arm. Now for it, I thought. It was the moment, the great moment,

  when Cameron would commend me.

  Yet as we walked towards the house all that came from this

  dour old Scot was:

  ‘Thank God I’ll have my geraniums next summer.’

  But there was a rare friendliness in his voice.

  Chapter Nine

  It would appear that I was rapidly distinguishing myself, ‘ getting on fast’, as they say in Tannochbrae, yet perhaps my progress was a trifle too speedy, perhaps I was acquiring too high an opinion of myself. There were moments when, in the face of my cheerful cocksureness, Dr Cameron stroked his chin reflectively and stole a dry look at me. But if there was amusement in his eye, he masked it and said nothing.

  On the day before Hogmanay, a fine crisping day with a cold sparkle in the air, I was working out a Fehling’s test in the little room off the surgery. Known previously as ‘the back room’, it had, in a rush of scientific zeal, been rechristened by me ‘the laboratory’. This afternoon when Cameron indicated that he had a case to visit in Knoxhill, I had airily remarked:

  ‘Righto! I’ll tackle the test in the lab.’

  Now, with my pipe between my teeth, I watched the blue liquid in the test tube bubble above the bunsen and slowly turn brick-red – sugar, by Jove! Just as I’d suspected. Another smart piece of diagnosis.

  I was interrupted by the opening of the door. Janet stood before me.

  ‘William Duncan wants Dr Cameron,’ she announced brusquely. ‘Young Duncan, the seedsman. Him that got married three years back and has the cottage on the Markinch road.’

  I looked up in annoyance – Janet, confound her, was still far from deferential in her manner. Then, making a great show of interest in my test tube:

  ‘Dr Cameron’s gone to Knoxhill.’

  ‘I’ve just told Duncan that,’ said Janet primly, ‘and he said you would have to do.’

  In the hall, I found Will Duncan in a state of extraordinary agitation. He stood there, hatless, without an overcoat, a scarf flung haphazard round his neck, fairly shivering with anxiety. It was the baby, he told me. Bad? Oh, yes, dreadfully bad! The little one didn’t seem to get her breath, there was such a fearful whistling in her lungs, and it had come on so sudden, his wife was distracted, for Mrs Niven, of all people, had said it was pneumonia.

  I frowned. Part midwife, part nurse, part ‘layer-out’ of the dead, waddling, interfering, wholly unqualified, the sage femme of the district, entrenched behind a portentious reputation for sagacity – that was Bella Niven, and every doctor in the district hated her heartily.

  ‘I’ll be along at once,’ I said. ‘ You get back and let them know I’m coming.’

  Dr Cameron had the gig, so I had to make the best of the two miles along Knoxhill Road on the bicycle. Not that I minded the exercise; I liked it, to be honest, but I felt it rather inglorious to pedal down the High Street with my bag swinging from the handlebars, the more so as a number of the village worthies, ensconced in the bay window of the Thistle Inn, observed me pass.

  Lomond View was the name of the house, a trig little cottage standing behind a holly tree bright with bunches of scarlet berries. Though I had come fast, young Duncan had come faster. He was already at the door, panting from his run and desperately declaring:

  ‘I’ve just had a word with Mrs Niven, Doctor. She’s no better, not a bit the better.’

  I went upstairs, and no sooner was I in the darkened room than I heard the baby’s breathing; a shrill, half-whistling respiration which caught me up sharp.

  Good God, I thought, there’s something bad here sure enough! To the mother, who stood perfectly distracted by the newly lit coal fire, I said:

  ‘Will you pull back the curtains, please, and let me have a little light?’

  Bella Niven, holding her formidable bosom against the end of the cot, interposed:

  ‘I ordered the curtains to be drawn. D
on’t you know the light frets the child.’

  ‘I’m not a cat,’ I retorted sharply. ‘I can’t see in the dark.’

  Nervously steering a middle course between her two advisers, young Mrs Duncan went to the window. With an agitated hand she half drew back the curtains.

  I bent over the cot. The baby certainly was fretful. Her cheeks were flushed, she twisted and turned, whined pathetically, clutched at the bedclothes, at her face, at everything. And through it all her breathing came and went – shrill, noisy, frightening.

  I took the temperature – 100∞ F. Then with my stethoscope I examined her chest – a difficult job, for she simply would not keep still. She twisted and turned in the semi-darkness like a lively minnow in a pool. Nevertheless, there was no doubt about that breathing, it whistled ominously, a dry note, not exactly pneumonic and not pleuritic, something outside my experience – desperate, unknown. I was worried – really worried. I felt myself confronted by a most obscure disease. Was it pneumothorax, I asked myself – a rare condition I had read about but never seen? It might, yes, conceviably be pneumothorax, or perhaps acute oedema of the lung – but the whistling was too dry, too shrill for that. Sick children were so difficult, the very devil, in fact. If only they could talk – describe their symptoms. Abruptly I straightened myself from the cot. I was baffled, completely baffled.

  As, very slowly, I began to put away my stethoscope, Mrs Niven, with a narrowed eye, scornfully remarked:

  ‘There’s little need for all your thumping and listening. The child has congestion of the lung.’

  In spite of myself I began to feel intimidated.

  ‘It’s not congestion,’ I said – chiefly for the sake of contradicting her.

  ‘You mean it’s worse,’ she asserted instantly.

  ‘The Lord save us!’ whimpered Mrs Duncan.

  I turned to the frightened young mother, but Niven was upon me again before I could utter one word of comfort.

  ‘Since you say it’s not the congestion, what do you say it is?’ she demanded aggressively.