Read CHAPTER IV - AT THE LONDON HOSPITAL of A Labrador Doctor, free online book, by Wilfred Thomason Grenfell, on ReadCentral.com.

I have never ceased to regret that there was not more corporate life in our medical school, but I believe that conditions have been greatly improved since my day. Here and there two or three classmates would “dig” together, but otherwise, except at lectures or in hospitals, we seldom met unless it was on the athletic teams. We had no playground of our own, and so, unable to get other hospitals to combine, when a now famous St. Thomas man and myself hired part of the justly celebrated London Rowing Club Headquarters at Putney for a united hospitals’ headquarters, we used to take our blazers and more cherished possessions home with us at night for fear of distraint of rent.

They were great days. Rowing on the Thames about Putney is not like that at Oxford on a mill-pond, or as at Cambridge on what we nicknamed a drain that should be roofed over. Its turgid waters were often rough enough to sink a rowing shell, and its busy traffic was a thing with which to reckon. But it offered associations with all kinds of interesting places, historical and otherwise, from the Star and Garter at Richmond and the famous Park away to Boulter’s Lock and Cleveden Woods, to the bathing pools about Taplow Court, the seat of the senior branch of our family, and to Marlow and Goring where our annual club outings were held. Twice I rowed in the inter-hospital race from Putney to Mortlake, once as bow and again as stroke. During those early days the “London” frequently had the best boat on the river.

Having now finished my second year at hospital and taken my preliminary examinations, including the scientific preliminary, and my first bachelor of medicine for the University of London degree, I had advanced to the dignity of “walking the hospitals,” carried a large shining stethoscope, and spent much time following the famous physicians and surgeons around the wards.

Our first appointment was clerking in the medical wards. We had each so many beds allotted to us, and it was our business to know everything about the patients who occupied them, to keep accurate “histories” of all developments, and to be ready to be quizzed and queried by our resident house physician, or our visiting consultant on the afternoon when he made his rounds, followed by larger or smaller crowds of students according to the value which was placed upon his teaching. I was lucky enough to work under the famous Sir Andrew Clark, Mr. Gladstone’s great physician. He was a Scotchman greatly beloved, and always with a huge following to whom he imparted far more valuable truths than even the medical science of thirty years ago afforded. His constant message, repeated and repeated at the risk of wearying, was: “Gentlemen, you must observe for yourselves. It is your observation and not your memory which counts. It is the patient and not the disease whom you are treating.”

Compared with the methods of diagnosis to-day those then were very limited, but Sir Andrew’s message was the more important, showing the greatness of the man, who, though at the very top of the tree, never for a moment tried to convey to his followers that his knowledge was final, but that any moment he stood ready to abandon his position for a better one. On one occasion, to illustrate this point, while he was in one of the largest of our wards (one with four divisions and twenty beds each) he was examining a lung case, while a huge class of fifty young doctors stood around.

“What about the sputum, Mr. Jones?” he asked. “What have you observed coming from these lungs?”

“There is not much quantity, sir. It is greenish in colour.”

“But what about the microscope, Mr. Jones? What does that show?”

“No examination has been made, sir.”

“Gentlemen,” he said, “I will now go to the other ward, and you shall choose a specimen of the sputum of some of these cases. When I return we will examine it and see what we can learn.”

When he returned, four specimens awaited him, the history and diagnoses of the cases being known only to the class. The class never forgot how by dissolving and boiling, and with the microscope, he told us almost more from his examination of each case than we knew from all our other information. His was real teaching, and reminds one of the Glasgow professor who, in order to emphasize the same point of the value of observation, prepared a little cupful of kerosene, mustard, and castor oil, and calling the attention of his class to it, dipped a finger into the atrocious compound and then sucked his finger. He then passed the mixture around to the students who all did the same with most dire results. When the cup returned and he observed the faces of his students, he remarked: “Gentlemen, I am afraid you did not use your powers of obsairvation. The finger that I put into the cup was no the same one that I stuck in my mouth afterwards.”

Sir Stephen Mackenzie, who operated on the Emperor Frederick, was another excellent teacher under whom we had the good fortune to study. Indeed, whatever could be said against the teaching of our college, in this much more important field of learning, the London Hospital was most signally fortunate, and, moreover, was famed not only in London, but all the world over. Our “walking class” used to number men from the United States to Australia, insomuch that the crowds became so large that the teachers could not get room to pass along. It was this fact which led to the practice, now almost universal, of carrying the patient in his bed with a nurse in attendance into the theatre for observation as more comfortable and profitable for all concerned.

On changing over to the surgical side in the hospital, we were employed in a very similar manner, only we were called “dressers,” and under the house surgeon had all the care of a number of surgical patients. My good fortune now brought me under the chieftaincy of Sir Frederick Treves, the doyen of teachers. His great message was self-reliance. He taught dogmatically as one having authority, and always insisted that we should make up our minds, have a clear idea of what we were doing, and then do it. His ritual was always thought out, no detail being omitted, and each person had exactly his share of work and his share of responsibility. It used greatly to impress patients, and he never underestimated the psychical value of having their complete confidence. Thus, on one occasion asking a dresser for his diagnosis, the student replied:

“It might be a fracture, sir, or it might be only sprained.”

“The patient is not interested to know that it might be measles, or it might be toothache. The patient wants to know what is the matter, and it is your business to tell it to him or he will go to a quack who will inform him at once.”

All his teachings were, like Mark Twain’s, enhanced by such over-emphasis or exaggeration. He could make an article in the “British Medical Journal” on Cholecystenterostomy amusing to a general reader, and make an ordinary remark as cutting as an amputation knife. He never permitted laxity of any kind in personal appearance or dress, or any imposing on the patients. His habit of saying openly exactly what he meant made many people fear, as much as they respected, him. However, he was always, in spite of it, the most popular of all the chiefs because he was so worth while.

One incident recurs to my mind which I must recount as an example when psychology failed. A Whitechapel “lady,” suffering with a very violent form of delirium tremens, was lying screeching in a strait-jacket on the cushioned floor of the padded room. With the usual huge queue of students following, he had gone in to see her, as I had been unable to get the results desired with a reasonable quantity of sedatives and soporifics. It was a very rare occasion, for cases which did not involve active surgery he left strictly alone. After giving a talk on psychical influence he had the jacket removed as “a relic of barbarism,” and in a very impressive way looking into her glaring eyes and shaking his forefinger at her, he said: “Now, you are comfortable, my good woman, and will sleep. You will make no more disturbance whatever.” There was an unusual silence. The woman remained absolutely passive, and we all turned to follow the chief out. Suddenly the “lady” called out, “Hi, hi,” and some perverse spirit induced Sir Frederick to return. Looking back with defiant eyes she screamed out, “You! You with a faice! You do think yerself clever, don’t yer?” The strange situation was only relieved by his bursting into a genuine fit of laughter.

Among other celebrated men who were admired and revered was Mr. Harry Fenwick on the surgical side, for whom I had the honour of illustrating in colours his prize Jacksonian essay. Any talent for sketching, especially in colours, is of great value to the student of medicine. Once you have sketched a case from nature, with the object of showing the peculiarity of the abnormality, it remains permanently in your mind. Besides this, it forces you to note small differences; in other words, it teaches you to “obsairve.” Thus, in the skin department I was sent to reproduce a case of anthrax of the neck, a rare disease in England, though all men handling raw hides are liable to contract it. The area had to be immediately excised; yet one never could forget the picture on one’s mind. On another occasion a case of genuine leprosy was brought in, with all the dreadful signs of the disease. The macula rash was entirely unique so far as I knew, but a sketch greatly helped to fix it on one’s memory. The poor patient proved to be one of the men who was handling the meat in London’s greatest market at Smithfield. A tremendous hue and cry spread over London when somehow the news got into the paper, and vegetarianism received a temporary boost which in my opinion it still badly needs for the benefit of the popular welfare.

Among the prophets of that day certainly should be numbered another of our teachers, Dr. Sutton, an author, and very much of a personality. For while being one of the consulting physicians of the largest of London hospitals, he was naturally scientific and strictly professional. He was very far, however, from being the conventionalist of those days, and the younger students used to look greatly askance at him. His message always was: “Drugs are very little use whatever. Nature is the source of healing. Give her a chance.” Thus, a careful history would be read over to him; all the certain signs of typhoid would be noted and his comment almost always was: “This case won’t benefit by drugs. We will have the bed wheeled out into the sunshine.” The next case would be acute lobar pneumonia and the same treatment would be adopted. “This patient needs air, gentlemen. We must wheel him out into the sunshine” and so on. How near we are coming to his teaching in these days is already impressing itself upon our minds. Unfortunately the fact that the doctors realize that medicines are not so potent as our forbears thought has not left the public with the increased confidence in the profession which the infinitely more rational treatment of to-day justifies, and valuable time is wasted and fatal delays incurred, by a return of the more impressionable public to quacks with high-sounding titles, or to cults where faith is almost credulity.

Truly one has lived through wonderful days in the history of the healing art. The first operations which I saw performed at our hospitals were before Lord Lister’s teaching was practised; though even in my boyhood I remember getting leave to run up from Marlborough to London to see my brother, on whom Sir Joseph Lister had operated for osteomyelitis of the leg. Our most famous surgeon in 1880 was Sir Walter Rivington; and to-day there rises in memory the picture of him removing a leg at the thigh, clad in a blood-stained, black velvet coat, and without any attempt at or idea of asepsis. The main thing was speed, although the patient was under ether, and in quickly turning round the tip of the sword-like amputation knife, he made a gash in the patient’s other leg. The whole thing seemed horrible enough to us students, but the surgeon smiled, saying, “Fortunately it is of no importance, gentlemen. The man will not live.”

The day came when every one worked under clouds of carbolic steam which fizzed and spouted from large brass boilers over everything; and then the time when every one was criticizing the new, young surgeon, Treves, who was daring to discard it, and getting as good results by scrupulous cleanliness. His aphorism was, “Gentlemen, the secret of surgery is the nailbrush.” Now with blood examinations, germ cultures, sera tests, X-rays, and a hundred added improvements, one can say to a fisherman in far-off Labrador arriving on a mail steamer, and to whom every hour lost in the fishing season spells calamity, “Yes, brother, you can be operated on and the wound will be healed and you will be ready to go back by the next steamer, unless some utterly unforeseen circumstance arises.”

The fallibility of diagnosis was at this very impressionable time fixed upon my mind a fact that has since served me in good stead. For what can be more reactionary in human life than the man who thinks he knows it all, whether it be in science, philosophy, or religion?

During my Christmas vacation I was asked to go north and visit my father’s brother, a well-known captain in Her Majesty’s Navy, who was also an inventor in gun machinery and sighting apparatus, and who had been appointed the naval head of Lord Armstrong’s great works at Yarrow-on-the-Tyne. All that I was told was that he had been taken with such severe pains in the back that he needed some one with him, and my new-fledged dignity of “walking the hospitals” was supposed to qualify me especially for the post. Already my uncle had seen many doctors in London and had been ordered to the Continent for rest. After some months, not a bit improved, he had again returned to London. This time the doctor told his wife that it was a mental trouble, and that he should be sent to an asylum. This she most indignantly denied, and yet desired my company as the only medical Grenfell, who at such a crisis could stay in the house without being looked upon as a warder or keeper. Meantime they had consulted Sir C.P., who had told my uncle that he had an aneurism of his aorta, and that he must be prepared to have it break and kill him any minute. His preparations were accordingly all made, and personally I fully anticipated that he would fall dead before I left. He put up a wonderful fight against excruciating pain, of which I was frequently a witness. But the days went by and nothing happened, so I returned to town and another young doctor took my place. He also got tired of waiting and suggested it might be some spinal trouble. He induced them once more to visit London and see Sir Victor Horsley, whose work on the brains of animals and men had marked an epoch in our knowledge of the central nervous system. Some new symptoms had now supervened, and the famous neurologist at once diagnosed a tumour in the spinal canal. Such a case had never previously been operated on successfully, but there was no alternative. The operation was brilliantly performed and a wonderful success obtained. The case was quoted in the next edition of our surgical textbooks.

A little later my father’s health began to fail in London, the worries and troubles of a clergyman’s work among the poor creatures who were constantly passing under his care utterly overwhelming him. We had agreed that a long change of thought was necessary and he and I started for a fishing and sight-seeing tour in Norway. Our steamer was to sail from the Tyne, and we went up to Newcastle to catch it. There some evil fiend persuaded my father to go and consult a doctor about his illness, for Newcastle has produced some well-known names in medicine. Thus, while I waited at the hotel to start, my father became persuaded that he had some occult disease of the liver, and must remain in Newcastle for treatment. I, however, happened to be treasurer of the voyage, and for the first time asserting my professional powers, insisted that I was family physician for the time, and turned up in the evening with all our round-trip tickets and reservations taken and paid for. In the morning I had the trunks packed and conveyed aboard, and we sailed together for one of the most enjoyable holidays I ever spent. We travelled much afoot and in the little native carriages called “stolkjaerre,” just jogging along, staying anywhere, fishing in streams, and living an open-air life which the increasing flood of tourists in after years have made much less possible. We both came back fitter in body and soul for our winter’s work.

My father’s death a year later made a great difference to me, my mother removing to live with my grandmother at Hampstead, it being too lonely and not safe for her to live alone in East London. Twice our house had been broken into by burglars, though both times fruitlessly. The second occasion was in open daylight during the hour of evening service on a Sunday. Only a couple of maids would have been in the house had I not been suffering from two black eyes contracted during the Saturday’s football game. Though I had accompanied the others out, decidedly my appearance might have led to misinterpretations in church, and I had returned unnoticed. The men escaped by some method which they had discovered of scaling a high fence, but I was close behind following them through the window by which they had entered. Shortly afterward I happened to be giving evidence at the Old Bailey on one of the many cases of assault and even murder where the victims were brought into hospital as patients. London was ringing with the tale of a barefaced murder at Murray Hill in North London, where an exceedingly clever piece of detective work, an old lantern discovered in a pawnbroker’s shop in Whitechapel miles away from the scene of the crime was the means of bringing to trial four of the most rascally looking villains I ever saw. The trial preceded ours and we had to witness it. One of the gang had turned “Queen’s evidence” to save his own neck. So great was the hatred of the others for him and the desire for revenge that even in the court they were hand-cuffed and in separate stands. Fresh from my own little fracas I learned what a fool I had been, for in this case also the deed was done in open daylight, and the lawn had tight wires stretched across it. The young son, giving chase as I did, had been tripped up and shot through his abdomen for his pains. He had, however, crawled back, made his will, and was subsequently only saved by a big operation. He looked in terrible shape when giving evidence at the trial.

The giving of expert evidence on such occasions was the only opportunity which the young sawbones had of earning money. True we only got a guinea a day and expenses, but there were no other movie shows in those days, and we learned a lot about medical jurisprudence, a subject which always greatly interested me. It was no uncommon sight either at the “London” or the “Poplar,” at both of which I did interne work, to see a policeman always sitting behind the screen at the foot of the patient’s bed. One man, quite a nice fellow when not occupied in crime, had when furiously drunk killed his wife and cut his own throat. By the curious custom of society all the skill and money that the hospital could offer to save a most valuable life was as usual devoted to restoring this man to health. He was weaned slowly back from the grave by special nurses and treatment, till it began to dawn upon him that he might have to stand his trial. He would ask me if I thought he would have to undergo a long term, for he had not been conscious of what he was doing. As he grew better, and the policeman arrived to watch him, he decided that it would probably be quite a long time. He had a little place of his own somewhere, and he used to have chickens and other presents sent up to fellow patients, and would have done so to the nurses, only they could not receive them. I was not personally present at his trial, but I felt really sorry to hear that they hanged him.

Many of these poor fellows were only prevented from ending their own lives by our using extreme care. The case of one wretched man, driven to desperation, I still remember. “Patient male; age forty-five; domestic trouble fired revolver into his mouth. Finding no phenomena of interest develop, fired a second chamber into his right ear. Still no symptoms worthy of notice. Patient threw away pistol and walked to hospital.” Both bullets had lodged in the thick parts of his skull, and doing no damage were left there. A subsequent note read: “Patient to-day tried to cut his throat with a dinner-knife which he had hidden in his bed. Patient met with no success.” Another of my cases which interested me considerably was that of a professional burglar who had been operated upon in almost every part of the kingdom, and was inclined to be communicative, as the job which had brought him to hospital had cost him a broken spine. Very little hope was held out to him that he would ever walk again. He was clear of murder, for he said it was never his practice to carry firearms, being a nervous man and apt to use them if he had them and got alarmed when busy burglaring. He relied chiefly on his extraordinary agility and steady head to escape. His only yarn, however, was his last. He and a friend had been detailed by the gang to the job of plundering one of a row of houses. The plans of the house and of the enterprise were all in order, but some unexpected alarm was given and he fled upstairs, climbed through a skylight onto the roof, and ran along the gables of the tiles, not far ahead of the police, who were armed and firing at him. He could easily have gotten away, as he could run along the coping of the brick parapet without turning a hair, but he was brought up by a narrow side street on which he had not counted, not having anticipated, like cats, a battle on the tiles. It was only some twelve or fifteen feet across the gap, and the landing on the other side was a flat roof. Taking it all at a rush he cleared the street successfully, but the flat roof, black with ages of soot, proved to be a glass skylight, and he entered a house in a way new even to him. His falling on a stone floor many feet below accounted for his “unfortunate accident”! After many months in bed, the man took an unexpected turn, his back mended, and with only a slight leg paralysis he was able to return to the outside world. His long suffering and incarceration in hospital were accepted by the law as his punishment, and he assured me by all that he held sacred that he intended to retire into private life. Oddly enough, however, while on another case, I saw him again in the prisoner’s dock and at once went over and spoke to him.

“Drink this time, Doctor,” he said. “I was down on my luck and the barkeeper went out and left his till open. I climbed over and got the cash, but there was so little space between the bar and the wall that with my stiff back I couldn’t for the life of me get back. I was jammed like a stopper in a bottle.”

Among many interesting experiences, one especially I shall never forget. Like the others, it occurred during my service for Sir Frederick Treves as house-surgeon, and I believe he told the story. A very badly burned woman had been brought into hospital. Her dress had somehow got soaked in paraffin and had then taken fire. Her terribly extensive burns left no hope whatever of her recovery, and only the conventions of society kept us from giving the poor creature the relief of euthanasia, or some cup of laudanum négus. But the law was interested. A magistrate was brought to the bedside and the husband sent for. The nature of the evidence, the meaning of an oath, the importance of the poor creature acknowledging that her words were spoken “in hopeless fear of immediate death,” were all duly impressed upon what remained of her mind. The police then brought in the savage, degraded-looking husband, and made him stand between two policemen at the foot of the bed, facing his mangled wife. The magistrate, after preliminary questions, asked her to make her dying statement as to how she came by her death. There was a terrible moment of silence. It seemed as if her spirit were no longer able to respond to the stimuli of life on earth. Then a sudden rebound appeared to take place, her eyes lit up with a flash of light, and even endeavouring to raise her piteous body, she said, “It was an accident, Judge. I upset the lamp myself, so help me God”; and just for one moment her eyes met those of her miserable husband. It was the last time she spoke.

Tragedy and comedy ran hand in hand even in this work. St. Patrick’s Day always made the hospital busy, just as Christmas was the season for burned children. Beer in an East London “pub” was generally served in pewter pots, as they were not easily broken. A common head injury was a circular scalp cut made by the heavy bottom rim, a wound which bled horribly. A woman was brought in on one St. Patrick’s Day, her scalp turned forward over her face and her long hair a mass of clotted blood from such a stroke, made while she was on the ground. When the necessary readjustments had been made and she was leaving hospital cured, we asked her what had been the cause of the trouble. “’Twas just an accidint, yer know. Sure, me an’ another loidy was just havin’ a few words.”

On another occasion late at night, we were called out of bed by a cantankerous, half-drunken fellow whom the night porter could not pacify. “I’m a regular subscriber to this hospital, and I have never had my dues yet,” he kept protesting. A new drug to produce immediate vomiting had just been put on the market, and as it was exactly the treatment he required, we gave him an injection. To our dismay, though the medicine is in common use to-day, either the poison which he had been drinking or the drug itself caused a collapse followed by head symptoms. He was admitted, his head shaved and icebags applied, with the result that next day he was quite well again. But when he left he had, instead of a superabundance of curly, auburn hair, a polished white knob oiled and shining like a State House at night. We debated whether his subscription would be as regular in future, though he professed to be profoundly grateful.

I have digressed, but the intimacy which grew up between some of my patients and myself seemed worth while recounting, for they showed me what I never in any other way could have understood about the seamy side of life in great cities, of its terrible tragedies and pathos, of how much good there is in the worst, and how much need of courage, and what vast opportunities lie before those who accept the service of man as their service to God. It proved to me how infinitely more needed are unselfish deeds than orthodox words, and how much the churches must learn from the Labour Party, the Socialist Party, the Trades-Union, before tens of thousands of our fellow beings, with all their hopes and fears, loves and aspirations, have a fair chance to make good. I learned also to hate the liquor traffic with a loathing of my soul. I met peers of the realm honoured with titles because they had grown rich on the degradation of my friends. I saw lives damned, cruelties of every kind perpetrated, jails and hospitals filled, misery, want, starvation, murder, all caused by men who fattened off the profits and posed as gentlemen and great people. I have seen men’s mouths closed whose business in life it was to speak out against this accursed trade. I have seen men driven from the profession of priests of God, making the Church a stench in the nostrils of men who knew values just as well as those trained in the universities do, all through alcohol, alcohol, alcohol. This awful war has been dragging its weary course for over four years now, and yet England has not tackled this curse which is throttling her. We sing “God save the King,” and pretend to believe in the prayer, and yet we will not face this glaring demon in our midst. Words may clothe ideas, but it takes deeds to realize them.

My parents having gone, it became necessary for me to find lodgings which I did, “unfurnished,” in the house of a Portuguese widow. Her husband, who had a good family name, had gone down in the world, and had disappeared with another “lady.” The eldest son, a mathematical genius, had been able to pay his way through Cambridge University by the scholarships and prizes which he had won. One beautiful little dark-eyed daughter of seven was playing in a West End Theatre as the dormouse in “Alice in Wonderland.” She was second fiddle to Alice herself, also, and could sing all her songs. Her pay was some five pounds a week, poor enough for the attraction she proved, but more than all the rest of the family put together earned. At that time I never went to theatres. Acquaintances had persuaded me that so many of the girls were ruined on the stage that for a man taking any interest in Christian work whatever, it was wrong to attend. Moreover, among my acquaintances there were not a few theatre fans, and I had nothing in common with them. The “dormouse,” however, used to come up and say her parts for my benefit, and that of occasional friends, and was so modest and winsome, and her earnings so invaluable to the family, that I entirely altered my opinion. Then and there I came to the conclusion that the drama was an essential part of art, and that those who were trying to elevate and cleanse it, like Sir Henry Irving, whose son I had met at Marlborough, must have the support of a public who demanded clean plays and good conditions both in front and behind the screen. When I came to London my father had asked me not to go to anything but Shakespearian or equally well-recognized plays until I was twenty-one. Only once did I enter a music hall and I had plenty to satisfy me in a very few minutes. Vaudevilles are better than in those days. The censor does good work, but it is still the demand which creates the supply, and whatever improvement has occurred has been largely due to the taste of the patrons. Medical students need all the open air they can get in order to keep body and soul fit, and our contempt for the theatre fan was justifiable.

My new lodgings being close to Victoria Park afforded the opportunity for training if one were unconventional. To practise throwing the sixteen-pound hammer requires rough ground and plenty of space, and as I was scheduled for that at the inter-hospital sports, it was necessary to work when not too many disinterested parties were around. Even an East-Ender’s skull is not hammer-proof, as I had seen when a poor woman was brought into hospital with five circular holes in her head, the result of blows inflicted by her husband with a hammer. The only excuse which the ruffian offered for the murder was that she had forgotten to wake him, he had been late, and lost his job.

A number of the boys in my class were learning to swim. There was only one bathing lake and once the waters were troubled we drew the line at going in to give lessons. So we used to meet at the gate at the hour of opening in the morning, and thus be going back before most folks were moving. Nor did we always wait for the park keeper, but often scaled the gates and so obtained an even more exclusive dip. Many an evening we would also “flannel,” and train round and round the park, or Hackney Common, to improve one’s wind before some big event. For diet at that time I used oatmeal, milk, and eggs, and very little or no meat. It was cheaper and seemed to give me more endurance; and the real value of money was dawning on me.

Victoria Park is one of those open forums where every man with a sore spot goes out to air his grievance. On Sundays there were little groups around the trees where orators debated on everything from a patent medicine to the nature of God. Charles Bradlaugh and Mrs. Annie Besant were associated together in iconoclastic efforts against orthodox religion, and there was so much truth in some of their contentions that they were making no little disturbance. Hanging on their skirts were a whole crowd of ignorant, dogmatic atheists, who published a paper called “The Freethinker,” which, while it was a villainous and contemptible rag, appealed to the passions and prejudices of the partially educated. To answer the specious arguments of their propaganda an association known as the Christian Evidence Society used to send out lecturers. One of them became quite famous for his clever arguments and answers, his ready wit, and really extensive reading. He was an Antiguan, a black man named Edwards, and had been a sailor before the mast. I met him at the parish house of an Episcopal clergyman of a near-by church, who, under the caption of Christian socialism, ran all kinds of social agencies that really found their way to the hearts of the people. His messages were so much more in deeds than in words that he greatly appealed to me, and I transferred my allegiance to his church, which was always well filled. I particularly remember among his efforts the weekly parish dance. My religious acquaintances were apt to class all such simple amusements in a sort of general category as “works of the Devil,” and turn deaf ears to every invitation to point out any evil results, being satisfied with their own statement that it was the “thin edge of the wedge.” This good man, however, was very obviously driving a wedge into the hearts of many of his poor neighbours who in those days found no opportunity for relief in innocent pleasures from the sordid round of life in the drab purlieus of Bethnal Green. This clergyman was a forerunner of his neighbour, the famous Samuel Barnett of Mile End, who thought out, started, and for many years presided over Toynbee House, the first big university settlement in East London. His workers preached their gospel through phrases and creeds which they accepted with mental reservations, but just exactly in such ways as they believed in absolutely. At first it used to send a shiver down my spine to find a church worker who didn’t believe in the Creed, and stumbled over all our fundamentals. At first it amazed me that such men would pay their own expenses to live in a place like Whitechapel, only to work on drain committees, as delinquent landlord mentors, or just to give special educational chances to promising minds, or physical training to unfit bodies. Yet one saw in their efforts undeniable messages of real love. Personally I could only occasionally run up there to meet friends in residence or attend an art exhibition, but they taught me many lessons.

Exactly opposite the hospital was Oxford House, only two minutes distant, which combined definite doctrinal religion with social work. Being an Oxford effort it had great attractions for me. Moreover, right alongside it in the middle of a disused sugar refinery I had hired the yard, converted it into a couple of lawn-tennis courts, and ran a small club. There I first met the famous Dr. Hensley Henson, now Bishop of Hereford, and also the present Bishop of London, Dr. Winnington-Ingram a good all-round athlete. He used to visit in our wards, and as we had a couple of fives courts, a game which takes little tune and gives much exercise, we used to have an afternoon off together, once a week, when he came over to hospital. Neither of these splendid men were dignitaries in those days, or I am afraid they would have found us medicals much more stand-offish. I may as well admit that we had not then learned to have any respect for bishops or church magnates generally. We liked both of these men because they were unconventional and good sports, and especially in that they were not afraid to tackle the atheist’s propaganda in the open. I have seen Dr. Henson in Whitechapel debating alone against a hall full of opponents and with a fairness and infinite restraint, convincing those open to reason that they were mistaken. Moreover, I have seen Dr. Ingram doing just the same thing standing on a stone in the open park. It may all sound very silly when one knows that by human minds, or to the human mind, the Infinite can never be demonstrated as a mathematical proposition. But the point was that these clergy were proving that they were real men men who had courage as well as faith, who believed in themselves and their message, who deserved the living which they were supposed to make out of orthodoxy. This the audience knew was more than could be said of many of the opponents. Christ himself showed his superb manhood in just such speaking out.

Indelibly impressed on my mind still is an occasion when one of the most blatant and vicious of these opponents of religion fell ill. A Salvation Army lass found him deserted and in poverty, nursed and looked after him and eventually made a new man of him.

Far and away the most popular of the Park speakers was the Antiguan. His arguments were so clever it was obvious that he was well and widely read. His absolute understanding of the crowd and his witty repartee used frequently to cause his opponents to lose their tempers, and that was always their undoing. The crowd as a rule was very fair and could easily distinguish arguments from abuse. Thus, on one Sunday the debate was as to whether nature was God. The atheist representative was a very loud-voiced demagogue, who when angry betrayed his Hibernian origin very markedly. Having been completely worsted and the laugh turned against him by a clever correction of some one’s, he used the few minutes given him to reply in violent abuse, ending up that “ladies and gentlemen did not come out on holidays to spend their time being taught English by a damned nigger.”

“Sir,” Edwards answered from the crowd, “I am a British subject, born on the island of Antigua, and as much an Englishman as any Irishman in the country.”

Edwards possessed an inexhaustible stock of good-humour and his laugh could be heard halfway across the Park. As soon as his turn came to mount the stone, he got the crowd so good-natured that they became angry at the interruptions of the enemy, and when some one suggested that if nature were that man’s God, the near-by duckpond was the natural place for him, there was a rush for him, and for several subsequent Sundays he was not in evidence. Edwards was a poor man, his small salary and incessant generosity left him nothing for holidays, and he was killing himself with overwork. So we asked him to join us in the new house which we were fitting up in Palestine Place. He most gladly did so and added enormously to our fun. Unfortunately tuberculosis long ago got its grip upon him, and removed a valuable life from East London.

It was a queer little beehive in which we lived in those days, and a more cosmopolitan crowd could hardly have been found: one young doctor who has since made his name and fortune in Australia; another in whose rooms were nearly a hundred cups for prowess in nearly every form of athletics, and who also has “made good” in professional life, besides several others who for shorter or longer periods were allotted rooms in our house. Among the more unusual was the “C.M.,” a Brahmin from India, a priest in his youth, who had been brought back to England by some society to be educated in medical missionary work, but whom for some reason they had dropped. For a short time a clever young Russian of Hebrew extraction who was studying for the Church helped to render our common-room social engagements almost international affairs.

As I write this I am at Charleston, South Carolina, and I see how hard it will be for an American to understand the possibility of such a motley assembly being reasonable or even proper. It seems to me down here that there must have been odd feelings sometimes in those days. I can only say, however, that I never personally even thought of it. East London is so democratic that one’s standards are simply those of the value of the man’s soul as we saw it. If he had been yellow with pink stripes it honestly would not have mattered one iota to most of us.

It so happened that there was at that time in hospital under my care a patient known as “the elephant man.” He had been starring under that title in a cheap vaudeville, had been seen by some of the students, and invited over to be shown to and studied by our best physicians. The poor fellow was really exceedingly sensitive about his most extraordinary appearance. The disease was called “leontiasis,” and consisted of an enormous over-development of bone and skin on one side. His head and face were so deformed as really to resemble a big animal’s head with a trunk. My arms would not reach around his hat. A special room in a yard was allotted to him, and several famous people came to see him among them Queen Alexandra, then the Princess of Wales, who afterward sent him an autographed photograph of herself. He kept it in his room, which was known as the “elephant house,” and it always suggested beauty and the beast. Only at night could the man venture out of doors, and it was no unusual thing in the dusk of nightfall to meet him walking up and down in the little courtyard. He used to talk freely of how he would look in a huge bottle of alcohol an end to which in his imagination he was fated to come. He was of a very cheerful disposition and pathetically proud of his left side which was normal. Very suddenly one day he died the reason assigned being that his head fell forward and choked him, being too heavy for him to lift up.

In 1886 I passed my examinations and duly became a member of the College of Physicians and of the Royal College of Surgeons of England; and sought some field for change and rest, where also I could use my newly acquired license to my own, if to no one else’s, benefit. Among the patients who came to the London Hospital, there were now and again fishermen from the large fishing fleets of the North Sea. They lived out, as it were, on floating villages, sending their fish to market every day by fast cutters. Every two or three months, as their turn came round, a vessel would leave for the home port on the east coast, being permitted, or supposed to be permitted, a day at home for each full week at sea. As the fleets kept the sea summer and winter and the boats were small, not averaging over sixty tons, it was a hazardous calling. The North Sea is nowhere deeper than thirty fathoms, much of it being under twenty, and in some places only five. Indeed, it is a recently sunken and still sinking portion of Europe, so much so that the coasts on both sides are constantly receding, and when Heligoland was handed over by the English to the Kaiser, it was said that he would have to keep jacking it up or soon there would be none left. Shallow waters exposed to the fierce gales which sweep the German Ocean make deep and dangerous seas, which readily break and wash the decks of craft with low freeboard, such as the North Sea vessels are obliged to have in order to get boats in and out to ferry their fish to the cutter.

There being no skilled aid at hand, the quickest way to get help used to be to send an injured man to market with the fish. Often it was a long journey of many days, simple fractures became compound, and limbs and faculties were often thus lost. It so happened that Sir Frederick Treves had himself a love for navigating in small sailing craft. He had made it a practice to cross the English Channel to Calais in a sailing lugger every Boxing Day that is, the day after Christmas. He was especially interested in those “that go down to the sea in ships” and had recently made a trip among the fishing fleets. He told me that a small body of men, interested in the religious and social welfare of the deep-sea fishermen, had chartered a small fishing smack, sent her out among the fishermen to hold religious services of a simple, unconventional type, in order to afford the men an alternative to the grog vessels when fishing was slack, and to carry first aid, the skipper of the vessel being taught ambulance work. They wanted, however, very much to get a young doctor to go out, who cared also for the spiritual side of the work, to see if they could use the additional attraction of proper medical aid to gain the men’s sympathies. His advice to me was to go and have a look at it. “If you go in January you will see some fine seascapes, anyhow. Don’t go in summer when all of the old ladies go for a rest.”

I therefore applied to go out the following January, and that fall, while working near the Great London docks, I used often to look at the tall East Indiamen, thinking that I soon should be aboard just such a vessel in the North Sea. It was dark and raining when my train ran into Yarmouth, and a dripping, stout fisherman in a blue uniform met me at that then unattractive and ill-lighted terminus. He had brought a forlorn “growler” or four-wheeled cab. Climbing in we drove a mile or more along a deserted road, and drew up at last apparently at the back of beyond.

“Where is the ship?” I asked.

“Why, those are her topmasts,” replied my guide, pointing to two posts projecting from the sand. “The tide is low and she is hidden by the quay.”

“Heavens!” I thought; “she’s no tea clipper, anyhow.”

I climbed up the bank and peered down in the darkness at the hull of a small craft, a little larger than our old Roysterer. She was just discernible by the dim rays of the anchor light. I was hesitating as to whether I shouldn’t drive back to Yarmouth and return to London when a cheery voice on deck called out a hearty welcome. What big things hang on a smile and a cheery word no man can ever say. But it broke the spell this time and I had my cabby unload my bags on the bank and bade him good-night. As his wheels rumbled away into the rain and dark, I felt that my cables were cut beyond recall. Too late to save me, the cheery voice shouted, “Mind the rigging, it’s just tarred and greased.” I was already sliding down and sticking to it as I went. Small as the vessel was she was absolutely spotless. Her steward, who cooked for all hands, was smart and in a snow-white suit. The contrast between-decks and that above was very comforting, though my quarters were small. The crew were all stocky, good-humoured, and independent. Democratic as East London had made me, they impressed me very favourably, and I began to look forward to the venture with real pleasure.

Drink was the worst enemy of these men. The quaysides of the fisherman’s quarters teemed with low saloons. Wages were even paid off in them or their annexes, and grog vessels, luring the men aboard with cheap tobacco and low literature, plied their nefarious calling with the fleets, and were the death, body and soul, of many of these fine specimens of manhood.

There was never any question as to the real object of the Mission to Deep-Sea Fishermen. The words “Heal the sick” carved in large letters adorned the starboard bow. “Preach the Word” was on the port, and around the brass rim of the wheel ran the legend, “Jesus said, Follow me and I will make you fishers of men.” Thirty years ago we were more conventional than to-day, and I was much surprised to learn from our skipper that we were bound to Ostend to ship four tons of tobacco, sent over from England for us in bond, as he might not take it out consigned to the high seas. In Belgium, however, no duty was paid. The only trouble was that our vessel, to help pay its expenses, carried fishing gear, and as a fishing vessel could not get a clearance in Belgium. Our nets and beams, therefore, had to go out to the fishing grounds in a friendly trawler while we passed as a mercantile marine during the time we took on our cargo.

So bitter was the cold that in the harbour we got frozen in and were able to skate up the canals. We had eventually to get a steamer to go around us and smash our ice bonds when we were again ready for sea. During the next two months we saw no land except Heligoland and Terschelling or Skilling, as the fishermen called it far away in the offing. Nor was our deck once clear of ice and snow during all the time.

Our duty was to visit as many fleets as we could, and arrange with some reliable vessel to take a stock of tobacco for the use of their special fleet. The ship was to carry about six feet of blue bunting on her foretopmast stay, a couple of fathoms above her bowsprit end, so that all the fleet might know her. She was to sell the tobacco at a fixed price that just covered the cost, and undersold the “coper” by fifty per cent. She was to hoist her flag for business every morning, while the small boats were out boarding fish on the carrier, and was to lie as far to leeward of the coper as possible so that the men could not go to both. Nineteen such floating depots were eventually arranged for, with the precaution that if any one of them had to return to port, he should bring no tobacco home, but hand over his stock and accounts to a reliable friend.

These deep-sea fisheries were a revelation to me, and every hour of the long trip I enjoyed. It was amazing to me to find over twenty thousand men and boys afloat the merriest, cheerfullest lot which I had ever met. They were hail-fellow-well-met with every one, and never thought of deprivation or danger. Clothing, food, customs, were all subordinated to utility. They were the nearest possible thing to a community of big boys, only needing a leader. In efficiency and for their daring resourcefulness in physical difficulties and dangers, they were absolutely in a class by themselves, embodying all the traits of character which make men love to read the stories of the buccaneers and other seamen of the sixteenth-century period.

Each fleet had its admiral and vice-admiral, appointed partly by the owner, and partly by the skippers of the vessels. The devil-may-care spirit was always a great factor with the men. The admiral directed operations by flags in the daytime and by rockets at night, thus indicating what the fleet was to do and where they were to fish. Generally he had the fastest boat, and the cutters, hunting for the fleet always lay just astern of the admiral, the morning after their arrival. Hundreds of men would come for letters, packages, to load fish, to get the news of what their last assignment fetched in market. Moreover, a kind of Parliament was held aboard to consider policies and hear complaints.

At first it was a great surprise to me how these men knew where they were, for we never saw anything but sky and sea, and not even the admirals carried a chronometer or could work out a longitude; and only a small percentage of the skippers could read or write. They all, however, carried a sextant and could by rule of thumb find a latitude roughly. But that was only done at a pinch. The armed lead was the fisherman’s friend. It was a heavy lead with a cup on the bottom filled fresh each time with sticky grease. When used, the depth was always called out by the watch, and the kind of sand, mud, or rock which stuck to the grease shown to the skipper. “Fifteen fathoms and coffee grounds must be on the tail end of the Dogger. Put her a bit more to the westward, boy,” he would remark, and think no more about it, though he might have been three or four days looking for his fleet, and not spoken to a soul since he left land. I remember one skipper used to have the lead brought down below, and he could tell by the grit between his teeth after a couple of soundings which way to steer. It sounds strange even now, but it was so universal, being just second-nature to the men, who from boyhood had lived on the sea, that we soon ceased to marvel at it. Skippers were only just being obliged to have certificates. These they obtained by viva voce examinations. You would sometimes hear an aspiring student, a great black-bearded pirate over forty-seven inches around the chest, and possibly the father of eight or ten children, as he stamped about in his watch keeping warm, repeating the courses “East end of the Dogger to Horn S.E. by /2 and W. point of the island [Heligoland] to Barkum /2 W. Ower Light to Hazebrough N.N.W.” and so on. Their memories were not burdened by a vast range of facts, but in these things they were the nearest imaginable to Blind Tom, the famous slave musician.

Our long round only occupied us about a month, and after that we settled down with the fleet known as the Great Northerners. Others were the Short Blues, the Rashers (because they were streaked like a piece of bacon), the Columbia, the Red Cross, and so on. Sometimes during the night while we were fishing into the west, a hundred sail or more of vessels, we would pass through another big fleet coming the other way, and some of our long trawls and warps would tangle with theirs. Beyond the beautiful spectacle of the myriads of lights bobbing up and down often enough on mighty rough seas for it needed good breezes to haul our trawls would be the rockets and flares of the entangled boats, and often enough also rockets and flares from friends, and from cutters. One soon became so friendly with the men that one would not return at night to the ship, but visit around and rejoin the Mission ship boarding fish next day, to see patients coming for aid. Though it was strictly against sea rules for skippers to be off their vessels all night, that was a rule, like all others on the North Sea, as often marked in the breach as in the observance. A goodly company would get together yarning and often singing and playing games until it was time to haul the trawl and light enough to find their own vessel and signal for the boat.

The relation of my new friends to religion was a very characteristic one. Whatever they did, they did hard. Thus one of the admirals, being a thirsty soul, and the grog vessels having been adrift for a longer while than he fancied, conceived the fine idea of holding up the Heligoland saloons. So one bright morning he “hove his fleet to” under the lee of the island and a number of boats went ashore, presumably to sell fish. Altogether they landed some five hundred men, who held up the few saloons for two or three days. As a result subsequently only one crew selling fish to the island was allowed ashore at one time. The very gamble of their occupation made them do things hard. Thus it was a dangerous task to throw out a small boat in half a gale of wind, fill her up with heavy boxes of fish, and send her to put these over the rail of a steamer wallowing in the trough of a mountainous sea.

But it was on these very days when less fish was sent to market that the best prices were realized, and so there were always a number of dare-devils, who did not care if lives were lost so long as good prices were obtained and their record stood high on the weekly list of sales which was forwarded to both owners and men. I have known as many as fourteen men upset in one morning out of these boats; and the annual loss of some three hundred and fifty men was mostly from this cause. Conditions were subsequently improved by the Board of Trade, who made it manslaughter against the skipper if any man was drowned boarding fish, unless the admiral had shown his flags to give the fleet permission to do so. In those days, however, I often saw twenty to thirty boats all tied up alongside the cutter at one time, the heavy seas every now and again rolling the cutter’s sail right under water, and when she righted again it might come up under the keels of some of the boats and tip them upside down. Thus any one in them was caught like a mouse under a trap or knocked to pieces trying to swim among the rushing, tossing boats.

As a rule we hauled at midnight, and it was always a fresh source of wonder, for the trawl was catholic in its embrace and brought up anything that came in its way. To emphasize how comparatively recently the Channel had been dry land, many teeth and tusks of mammoths who used to roam its now buried forests were given up to the trawls by the ever-shifting sands. Old wreckage of every description, ancient crockery, and even a water-logged, old square-rigger that must have sunk years before were brought one day as far as the surface by the stout wire warp. After the loss of a large steamer called the Elbe many of the passengers who had been drowned were hauled up in this way; and on one occasion great excitement was caused in Hull by a fisher lad from that port being picked up with his hands tied behind his back and a heavy weight on his feet. The defence was that the boy had died, and was thus buried to save breaking the voyage supported by the fact that another vessel had also picked up the boy and thrown him overboard again for the same reason. But those who were a bit superstitious thought otherwise, and more especially as cruelty to these boys was not unknown.

These lads were apprenticed to the fishery masters largely from industrial or reformatory schools, had no relations to look after them, and often no doubt gave the limit of trouble and irritation. On the whole, however, the system worked well, and a most excellent class of capable seamen was developed. At times, however, they were badly exploited. During their apprenticeship years they were not entitled to pay, only to pocket money, and yet sometimes the whole crew including the skipper were apprentices and under twenty-one years of age. Even after that they were fitted for no other calling but to follow the sea, and had to accept the master’s terms. There were no fishermen’s unions, and the men being very largely illiterate were often left victims of a peonage system in spite of the Truck Acts. The master of a vessel has to keep discipline, especially in a fleet, and the best of boys have faults and need punishing while on land. These skippers themselves were brought up in a rough school, and those who fell victims to drink and made the acquaintance of the remedial measures of our penal system of that day were only further brutalized by it. Religion scarcely touched the majority; for their brief periods of leave ashore were not unnaturally spent in having a good time. To those poisoned by the villainous beverages sold on the sordid grog vessels no excess was too great. Owners were in sympathy with the Mission in trying to oust the coper, because their property, in the form of fish, nets, stores, and even sails, were sometimes bartered on the high seas for liquor. On one occasion during a drunken quarrel in the coper’s cabin one skipper threw the kerosene lamp over another lying intoxicated on the floor. His heavy wool jersey soaked in kerosene caught fire. He rushed for the deck, and then, a dancing mass of flames, leaped overboard and disappeared.

Occasionally skippers devised punishments with a view to remedying the defects of character. Thus one lad, who through carelessness had on more than one occasion cooked the “duff” for dinner badly, was made to take his cinders on deck when it was his time to turn in, and go forward to the fore-rigging. Then he had to take one cinder, go up to the cross-tree, and throw it over into the sea, come down the opposite rigging and repeat the act until he had emptied his scuttle. Another who had failed to clean the cabin properly had one night, instead of going to bed, to take a bucketful of sea water and empty it with a teaspoon into another, and so to and fro until morning. On one occasion a poor boy was put under the ballast deck, that is, the cabin floor, and forgotten. He was subsequently found dead, drowned in the bilge water. It was easy to hide the results of cruelty, for being washed overboard was by no means an uncommon way of disappearing from vessels with low freeboards in the shallow water of the North Sea.

A very practical outcome in the mission work was the organization of the Fisher Lads’ Letter-Writing Association. The members accepted so many names of orphan lads at sea and pledged themselves to write regularly to them. Also, if possible, they were to look them up when they returned to land, and indeed do for them much as the War Camp Community League members are to-day trying to accomplish for our soldiers and sailors. As every practical exposition of love must, it met with a very real response, and brought, moreover, new interests and joys into many selfish lives.

I remember one lady whose whole care in life had been her own health. She had nursed it, and worried over it, and enjoyed ill health so long, that only the constant recourse to the most refined stimulants postponed the end which would have been a merciful relief to others. The effort of letter-writing remade her. Doctors were forgotten, stimulants were tabooed, the insignia of invalidism banished, and to my intense surprise I ran across her at a fishing port surrounded by a bevy of blue-jerseyed lads, who were some of those whom she was being blessed by helping.

The best of efforts, however, sometimes “gang aft agley.” One day I received a letter, evidently written in great consternation, from an elderly spinster of singularly aristocratic connections and an irreproachableness of life which was almost painful. The name sent to her by one of our skippers as a correspondent who needed help and encouragement was one of those which would be characterized as common let us say John Jones. By some perverse fate the wrong ship was given as an address, and the skipper of it happened to have exactly the same name. It appeared that lack of experience in just such work had made her letter possibly more affectionate than she would have wished for under the circumstances which developed. For in writing to me she enclosed a ferocious letter from a lady of Billingsgate threatening, not death, but mutilation, if she continued making overtures to “her John.”