From a Surgeon’s Diary - ebook

I. THE ADVENTURE AT HEATH CREST

First published in _Cassell’s Magazine_, December 1904

“I’m sure my husband would prefer you not to cycle much, Dr Wilkinson. It’s quite true you are in the country as soon as you get over the Heath, and out there, of course, it doesn’t matter so much; but the Hampstead patients are all carriage people, and I know they wouldn’t like their doctor to call on a bicycle.”

“Oh, I quite understand the point, Mrs Walland,” I replied. “I only mentioned it with the idea of getting a little exercise when I went out to Finchley, and so on.”

“I am confident my husband’s interests will be safe in your hands,” said the lady majestically. “With a high-class practice like this one cannot be too circumspect; there is so much jealousy among the successful practitioners.”

Dr Walland was attending the International Medical Congress at Vienna. He had not impressed me as being an ardent scientist, but then, as everybody knows, these gatherings are only a species of superior picnics, and Vienna, too, is the gayest capital in the world.

Poor man! A very short stay in the house enlightened me as to his motives. Mrs Walland early remarked that it was only her dread of the Channel, and her fear of what might befall the household in her absence, that had prevented her accompanying her husband; and after but a very few hours of her society I felt sure that the Congress had commended itself to Walland by the distance it put between them. But the solid fee I was earning by the charge of an equally solid practice was some compensation for all I had to suffer in Mrs Walland’s society.

I may remark that I had had a not unsuccessful career at the hospital. As soon as I was qualified I had filled the usual staff appointments of house-surgeon and house-physician, which, at a hospital like Bart’s, it is no small honour to have held. But when my two years of work were finished, I found that my troubles were only beginning. There were no more scholarships open to me, even if I could have afforded the time to work up for them; my mother’s income was sufficient for herself alone, and I steadily set my face against her repeated offer to realise a small portion of her small capital for me to buy a practice with.

As to this, there is no more speculative investment than the purchase of a practice. I should never have felt comfortable had any portion of my mother’s income depended upon my success or failure, especially as I had had so little experience of private practice–little more, indeed, than was derived from sitting in the consulting room of my old friend, Nosbury, on an occasional evening when he went courting, and either repeating his prescriptions, or staving off those patients who consented to see me with a “placebo” calculated to last them until the day after tomorrow. So, in default of anything more permanent, I determined to go in for what are called _locums_for the time being.

It must have been about the third day after I took up the work that I was sent for to “Heath Crest.” I remember the morning well. I had gone after breakfast to a patient of the poorer class out at Hendon, which was about the periphery of Walland’s district, and enjoyed a glorious free-wheel first down the Bishop’s Avenue and then, after a short pull up the North Road, down again by way of Finchley, and passing the house on my way over the Heath I felt a longing to examine it from the inside.

It was not for any great beauty it possessed, for of architectural grace it had little, standing four square behind its railing-spears as baldly as a block of unpolished granite. But I was taken by the prim old garden stretching for quite a considerable way beside the road, with a cedar showing above the wall, and especially by just a glimpse of the delicately fluted columns and double fan-light of the doorway in the Adam style.

Mrs Walland was out when the message came, or doubtless I should have had a minute history of Mr Fahbwerker, his business, his income and his wife–especially his wife. But, as it happened, this was spared me, and when I tapped the brass knocker at Heath Crest I knew nothing of the patient I was about to see.

The house was luxuriously, even magnificently, furnished. My steps fell noiselessly on the ankle-deep rugs as I crossed the hall and was shown into a room on the ground floor, where a lady with fluffy yellow hair awaited me. She appeared nervous and agitated as she explained she was Mrs Fahbwerker, that she had sent for me on account of her husband, and would I sit down while she told me something about him? She related how he was a financier, had been much troubled over affairs on the Gold Coast where he had large business interests, had lately become sleepless and subject to fainting attacks. Dr Walland had said he might die in one of them. Did I think that excessive worry would be likely to cause them? etc., etc. She seemed, indeed, to carry a perfect diary of her husband’s symptoms in her head, so much so that when I expressed a wish to see the patient for myself she continued her history all the way upstairs, and even into the sick-room.

Mr Fahbwerker was certainly very ill, and when I came to examine him I could make allowances for even a greater degree of excitement than his wife displayed. Cold and almost pulseless, his every movement seemed feeble. Although he was quite conscious, his voice was no more than a hoarse whisper; but, strange to say, I could find not the slightest reason for this alarming state of things, which appeared to be due to heart-failure pure and simple. In any case, his condition was most critical, and I lost no time in giving him a hypodermic injection of ether and prescribing some hot strong coffee. He was so far gone that he took a considerable time to rally. I even thought at one time of applying electricity to the heart, and it was quite an hour before I felt justified in leaving him.

When I got back Mrs Walland had kept luncheon waiting. She was most curious as to what had detained me, and appeared quite nettled at my reticence. Although she returned again and again to the subject I managed to stave off her inquisitiveness, and at length, finding me inexorable, she ceased to catechise me. I have always made it a point (in common with any other man worthy of professional confidence) to refuse to discuss the affairs of patients with those outside their immediate circle. From her behaviour on this occasion, I feared that Mrs Walland was accustomed to find her husband more pliable.

In the course of the afternoon I took the opportunity of being close by to look in again at Heath Crest. I found the patient fairly comfortable. Although he had been taking a prescription I ordered in the morning, Mrs Fahbwerker told me that he had had another, although a slighter, attack not long before.

I must confess that he puzzled me very much. As to the reality of his peril when I first saw him there could be no question; but now that he had mended he presented not the slightest sign of disease. Similar attacks are not unknown to arise from acute dyspepsia, but scarcely to such a dangerous extent as this. Besides, I could find nothing of the sort about him. For the rest he was a fine, well-built man, of the florid German type, in the prime of life. I could really advise little more than to continue the treatment and to keep plenty of stimulants at hand.

On my way downstairs I could not resist stopping to admire the magnificent view from the windows. On the one side was the Heath, with its glorious avenue of chestnuts merging in the woods, which stretched unbroken across the Weald to Harrow; on the other, its huge basin rimmed by the heights of Surrey, spread London, with St Paul’s and Westminster showing like islands above the grey perpetual haze. I turned to congratulate Mrs Fahbwerker, perhaps injudiciously, on so priceless an outlook; but she did not seem to notice my remark, asking me the senseless question which stirs in me fresh resentment every time I hear it:

“Is there any danger, doctor?”

I took refuge in the historical reply of the physician–a mythical one, for aught I know, but it always satisfies:

“Illness is always dangerous.”

I was in the thick of seeing patients that evening when there came an urgent message to visit Mr Fahbwerker, and then, right on the heels of it, a second one to say that he was dead! I had not time to reflect upon it at the moment, but about an hour afterwards Mrs Fahbwerker came herself; she said she had called for the death certificate. She did not seem very greatly distressed, and it occurred to me that perhaps the event so long threatened when it did come at last had been rather a relief in view of the perpetual alarm in which she must have been living of late. As I was momentarily expecting a distinguished literary man who was coming by appointment to be examined for life insurance, it was a relief to find her in so slightly sentimental a mood.

While I dashed off the certificate she told me all about the fatal attack, of its sudden onset, and of its fatal ending before any remedies could take effect. As I have said, I was desperately busy; and as the literary man arrived, for a wonder, punctually to his time, I was very glad to see the back of Mrs Fahbwerker.

I made a strange discovery when the insurer succeeded the widow. I do not mean to imply that there was anything very remarkable in a literary man insuring his life, but I discovered that Walland did a very fair amount of insurance work. When I picked up the book in which he laboriously noted the results of his examinations, it opened at a page on which the name Fahbwerker was prominent. Running through the entry I found it to be the patient who had just died. Walland had passed him as a first-class life, the value of the insurance being five thousand pounds, and, most significant fact of all, the date of the examination was a bare six weeks ago!

I hope the literary man was not unfavourably impressed with the manner in which I examined him, but as I gave him a clean bill of health he had little cause to complain. The fact is, I was so astounded with what I had just read concerning Fahbwerker that I could think of little else; and when at the close of the evening’s work I learned that Mrs Walland had gone out to a concert, I felt inexpressibly thankful at the opportunity to think over my discovery in quiet.

That a man who only six weeks ago was in the best of health should suddenly and without cause develop an acute form of heart disease which proved rapidly fatal, was certainly remarkable. I was still worrying over the mystery, when there came an urgent call elsewhere. As I cycled past Heath Crest and glanced up at the windows, with never a glimmer of light in any of them, I regretted the lateness of the hour which alone prevented me from calling on Mrs Fahbwerker so that I might clear up some of the doubts which troubled me.

My visit was to a poor creature in the last stage of phthisis. When I got to the house I found there had been profuse haemorrhage from the lungs, and was annoyed to find that in the luxury of attending to Fahbwerker that morning the very drug which I now wanted to use must have dropped from my pocket hypodermic case. At least the tiny bottle was missing, and as the patient was practically bleeding to death, I ran on to Walland’s chemist, who was fortunately close at hand.

“I hear that Mr Fahbwerker died tonight,” observed the chemist.

I had replenished my case, and was about to hurry back, when the remark, made with all the urbanity of the man’s calling, arrested me; for, in spite of my present errand, the dead man was still uppermost in my thoughts.

“Yes, it was rather sudden,” I admitted.

“I can’t say I am altogether surprised,” observed the chemist.

“Why? He always had very good health,” said I, ingenuously.

“Yes; but look at the way he was always drugging himself.”

“Drugging himself?”

“Yes. Why, there was hardly a day that Mrs Fahbwerker wasn’t in here for something or other for him.”

“Indeed? What sort of drugs?”

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