The Patient Observer - Part 1
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Part 1

The Patient Observer.

by Simeon Strunsky.

NOTE

Of the papers that go to make up the present volume, the greater number were published as a series in the columns of the New York _Evening Post_ for 1910, under the general t.i.tle of The Patient Observer. For the eminently laudable purpose of making a fairly thick book, the Patient Observer's frequently recurrent "I," "me," and "mine" have now been supplemented with the experiences and reflections of his friends Harrington, Cooper, and Harding as recorded on other occasions in the New York _Evening Post_, as well as in the _Atlantic Monthly_, the _Bookman_, _Collier's_, and _Harper's Weekly_.

I

COWARDS

It was Harrington who brought forward the topic that men take up in their most cheerful moments. I mean, of course, the subject of death.

Harrington quoted a great scientist as saying that death is the one great fear that, consciously or not, always hovers over us. But the five men who were at table with Harrington that night immediately and sharply disagreed with him.

Harding was the first to protest. He said the belief that all men are afraid of death is just as false as the belief that all women are afraid of mice. It is not the big facts that humanity is afraid of, but the little things. For himself, he could honestly say that he was not afraid of death. He defied it every morning when he ran for his train, although he knew that he thereby weakened his heart. He defied it when he smoked too much and read too late at night, and refused to take exercise or to wear rubbers when it rained. All men, he repeated, are afraid of little things. Personally, what he was most intensely and most enduringly afraid of was a revolving storm-door.

Harding confessed that he approaches a revolving door in a state of absolute terror. To see him falter before the rotating wings, rush forward, halt, and retreat with knees trembling, is to witness a shattering spectacle of complete physical disorganisation. Harding said that he enters a revolving door with no serious hope of coming out alive. By antic.i.p.ation he feels his face driven through the gla.s.s part.i.tion in front of him, and the crash of the panel behind him upon his skull. Some day, Harding believed, he would be caught fast in one of those compartments and stick. Axes and crowbars would be requisitioned to retrieve his lifeless form.

Bowman agreed with Harding. His own life, Bowman was inclined to believe, is typical of most civilised men, in that it is pa.s.sed in constant terror of his inferiors. The people whom he hires to serve him strike fear into Bowman's soul. He is habitually afraid of janitors, train-guards, elevator-boys, barbers, bootblacks, telephone-girls, and saleswomen. But his particular dread is of waiters. There have been times when Bowman thought that to punish poor service and set an example to others, he would omit the customary tip. But such a resolution, embraced with the soup, has never lasted beyond the entree. And, as a matter of fact, Bowman said, such a resolution always spoils his dinner.

As long as he entertains it, he dares not look his man in the eye. He stirs his coffee with shaking fingers. He is cravenly, horribly afraid.

Bowman is afraid even of new waiters and of waiters he never expects to see again. Surely, it must be safe not to tip a waiter one never expected to see again. "But no," said Bowman, "I should feel his contemptuous gaze in the marrow of my backbone as I walked out. I could not keep from shaking, and I should rush from that place in agony, with the man's derisive laughter ringing in my ears."

The only one of the company who was not afraid of something concrete, something tangible, was Williams. Now Williams is notoriously, hopelessly shy; and when he took up the subject where Bowman had left it, he poured out his soul with all the fervour and abandon of which only the shy are capable. Williams was afraid of his own past. It was not a hideously criminal one, for his life had been that of a bookworm and recluse. But out of that past Williams would conjure up the slightest incident--a trifling breach of manners, a mere word out of place, a moment in which he had lost control of his emotions, and the memory of it would put him into a cold sweat of horror and shame.

Years ago, at a small dinner party, Williams had overturned a gla.s.s of water on the table-cloth; and whenever he thinks of that gla.s.s of water, his heart beats furiously, his palate goes dry, and there is a horribly empty feeling in his stomach. Once, on some similar occasion, Williams fell into animated talk with a beautiful young woman. He spoke so rapidly and so well that the rest of the company dropped their chat and gathered about him. It was five minutes, perhaps, before he was aware of what was going on. That night Williams walked the streets in an agony of remorse. The recollection of the incident comes back to him every now and then, and, whether he is alone at his desk, or in the theatre, or in a Broadway crowd, he groans with pain. Take away such memories of the past, Williams told us, and he knew of nothing in life that he is afraid of.

Gordon's was quite a different case. The group about the table burst out laughing when Gordon a.s.sured us that above all things else in this world he is afraid of elephants. He agreed with Bowman that in the lat.i.tude of New York City and under the zoologic conditions prevailing here, it was a preposterous fear to entertain. Gordon lives in Harlem, and he recognises clearly enough that the only elephant-bearing jungle in the neighbourhood is Central Park, whence an animal would be compelled to take a Subway train to One Hundred and Twenty-fifth Street, and lie in wait for him as he came home in the twilight. But irrational or no, there was the fact. To be quashed into pulp under one of those girder-like front legs, Gordon felt must be abominable. To make matters worse, Gordon has a young son who insists on being taken every Sunday morning to see the animals; and of all attractions in the menagerie, the child prefers the elephant house. He loves to feed the biggest of the elephants, and to watch him place pennies in a little wooden box and register the deposits on a bell. What Gordon suffers at such times, he told us, can be neither imagined nor described.

My own story was received with sympathetic attention. I told them that the one great terror of my life is a certain man who owes me a fairly large sum of money, borrowed some years ago. Whenever we meet he insists on recalling the debt and reminding me of how much the favour meant to him at the time, and how he never ceases to think of it. Meeting him has become a torture. I do my best to avoid him, and frequently succeed. But often he will catch sight of me across the street and run over and grasp me by the hand and inquire after my health in so hearty, so honest a fashion that I cannot bear to look him in the face. And as he beams on me and throws his arm over my shoulder, I can only blush and shift from one foot to the other and stammer out some excuse for hurrying away.

Pa.s.sers-by stop and admire the man's affection and concern for one who is evidently some poor devil of a relation from the country. One Sunday he waylaid me on Riverside Drive and introduced me to his wife as one of his dearest friends. I mumbled something about its not having rained the entire week, and his wife, who was a stately person in silks, looked at me out of a cold eye. Then and there I knew she decided that I was a person who had something to conceal and probably took advantage of her husband.

No; the more I think of it, the more convinced am I that very few men pa.s.s their time in contemplating death, which is the end of all things.

Only those people do it who have nothing else to be afraid of, or who, like undertakers and bacteriologists, make a living out of it.

II

THE CHURCH UNIVERSAL

Harding declares that a solid thought before going to bed sets him dreaming just like a bit of solid food. One night, Harding and I discussed modern tendencies in the Church. As a result Harding dreamt that night that he was reading a review in the _Theological Weekly_ of November 12, 2009.

"Seldom," wrote the reviewer, "has it been our good fortune to meet with as perfect a piece of work as James Brown Ducey's 'The American Clergyman in the Early Twentieth Century.' The book consists of exactly half a hundred biographies of eminent churchmen; in these fifty brief sketches is mirrored faithfully the entire religious life, external and internal, of the American people eighty or ninety years ago. We can do our readers no better service than to reproduce from Mr. Ducey's pages, in condensed form, the lives of half a dozen typical clergymen, leaving the reader to frame his own conception of the magnificent activity which the Church of that early day brought to the service of religion.

"The Rev. Pelatiah W. Jenks, who was called to the richest pulpit in New York in 1912, succeeded within less than three years in building up an unrivalled system of dancing academies and roller-skating rinks for young people. Under him the attendance at the Sunday afternoon sparring exhibitions in the vestry rooms of the church increased from an average of 54 to an average of 650. In spite of the nominal fee charged for the use of the congregation's bowling alleys, the income from that source alone was sufficient to defray the cost of missionary work in all Africa, south of the Zambesi River. Dr. Jenks's highest ambition was attained in 1923 when the Onyx Church's football team won the championship of the Ecclesiastical League of Greater New York. It was in the same year that Dr. Jenks took the novel step of abandoning services in St. Basil's Chapel, now situated in a slum district, and subst.i.tuting a moving-picture show with vaudeville features. Thereafter the empty chapel was filled to overcrowding on Sundays. To encourage church attendance at Sunday morning services, Dr. Jenks established a tipless barber shop. Two years later, in spite of the murmured protests of the conservative element in his congregation, he erected one of the finest Turkish baths in New York City.

"The Rev. Coningsby Botts, Ph.D., LL.D., D.D., was regarded as the greatest pulpit orator of his day. His Sunday evening sermons drew thousands of auditors. Of Dr. Botts's polished sermons, our author gives a complete list, together with short extracts. We should have to go far to discover a specimen of richer eloquence than the sermon delivered on the afternoon of the third Sunday after Epiphany, in the year 1911, on 'Dr. Cook and the Discovery of the North Pole.' On the second Sunday in Lent, Dr. Botts moved an immense congregation to tears with his sermon, 'Does Radium Cure Cancer?' Trinity Sunday he spoke on 'Zola and His Place in Literature.' The second Sunday in Advent he discussed 'The Position of Woman in the Fiji Islands.' We can only pick a subject here and there out of his other numerous pastoral speeches: 'Is Aviation an Established Fact?' 'The Influence of Blake Upon Dante Gabriel Rossetti,'

'Dalmatia as a Health Resort,' and 'Amatory Poetry Among the Primitive Races.'

"The Rev. Cadwallader Abiel Jones has earned a pre-eminent place in Church history as the man who did most to endow Pittsburg with a permanent Opera House. Our author relates how in the winter of 1916, when the noted impresario Silverman threatened to sell his Opera House for a horse exchange unless 100 Pittsburg citizens would guarantee $5,000 each for a season of twenty weeks, Dr. Jones made a house-to-house canva.s.s in his automobile and went without sleep till the half-million dollars was pledged. He fell seriously ill of pneumonia, but recovered in time to be present at the signing of the contract. Dr.

Jones used to a.s.sert that there was more moral uplift in a single performance of the 'Mikado' than in the entire book of Psalms. One of his notable achievements was a Christmas Eve service consisting of some magnificent kinetoscope pictures of the Day of Judgment with music by Richard Strauss. Tradition also ascribes to Dr. Jones a saying that the two most powerful influences for good in New York City were Miss Mary Garden and the Eden Musee. But our author thinks the story is apocryphal. He is rather inclined to believe, from the collocation of the two names, that we have here a distorted version of the Biblical creation myth.

"The Fourteenth Avenue Church of Cleveland, Ohio, under its famous pastor, the Rev. Henry Marcellus Stokes, exercised a preponderant influence in city politics from 1917 to 1925. Dr. Stokes was remorseless in flaying the bosses and their henchmen. At least a dozen candidates for Congress could trace their defeat directly to the efforts of the Fourteenth Avenue Church. The successful candidates profited by the lesson, and, during the three years' fight over tariff revision, from 1919 to 1922, they voted strictly in accordance with telegraphic instructions from Dr. Stokes. In the fall of 1921 Dr. Stokes's congregation voted almost unanimously to devote the funds. .h.i.therto used for home mission work to the maintenance of a legislative bureau at the State capital. The influence of the bureau was plainly perceptible in the Legislature's favourable action on such measures as the Cleveland Two-Cent Fare bill and the bill abolishing the bicycle and traffic squads in all cities with a population of more than 50,000.

"Our author lays particular stress on the career of the Rev. Dr. Brooks Powderly of New York, who, at the age of thirty-five, was recognized as America's leading authority on slum life. Dr. Powderly's numerous books and magazine articles on the subject speak for themselves. Our author mentions among others, 'The Bowery From the Inside,' 'At What Age Do Stevedores Marry?' 'The Relative Consumption of Meat, Pastry, and Vegetables Among Our Foreign Population,' 'How Soon Does the Average Immigrant Cast His First Vote?' 'The Proper Lighting for Recreation Piers,' and, what was perhaps his most popular book, 'Burglar's Tools and How to Use Them.'

"In running through the appendix to Mr. Ducey's volume," concludes the reviewer, "we come across an interesting paragraph headed, 'A Curious Survival.' It is a reprint of an obituary from the New York _Evening Post_ of August, 1911, dealing with the minister of a small church far up in the Bronx, who died at the age of eighty-one, after serving in the same pulpit for fifty-three years. The _Evening Post_ notice states that while the Rev. Mr. Smith was quite unknown below the Harlem, he had won a certain prestige in his own neighbourhood through his old-fashioned homilies, delivered twice every Sunday in the year, on love, charity, pure living, clean thinking, early marriage, and the mutual duties of parents towards their children and of children towards their parents.

'In the Rev. Mr. Smith,' remarks our author, 'we have a striking vestigial specimen of an almost extinct type.'"

III

THE DOCTORS

The quarrels of the doctors do not concern me. I have worked out a cla.s.sification of my own which holds good for the entire profession. All doctors, I believe, may be divided into those who go clean-shaven and those who wear beards. The difference is more than one of appearance. It is a difference of temperament and conduct. The smooth-faced physician represents the buoyant, the romantic, what one might almost call the impressionistic strain in the medical profession. The other is the conservative, the cla.s.sicist. My personal likings are all for the newer type, but I do not mind admitting that if I were very ill indeed, I should be tempted to send for the physician who wears a Vand.y.k.e and smiles only at long intervals.

The reason is that when I am really ill I want some one who believes me.

That is something which the clean-shaven doctor seldom does. He is of the breezy, modern school which maintains that nine patients out of ten are only the victims of their own imagination. He greets you in a jolly, brotherly fashion, takes your pulse, and says: "Oh, well, I guess you're not going to die this trip," and he roars, as if it were the greatest joke in the world to call up the picture of such dreadful possibilities.

When he prescribes, it is in a half-apologetic, half-quizzical manner, and almost with a wink, as if he were to say, "This is a game, old man, but I suppose it's as honest a way of earning one's living as most ways." While he writes out his directions, he comments: "There is nothing the matter with you, and you will take this powder three times a day with your meals. It is just a case of too much tobacco supplemented by a fertile fancy. Rub your chest with this before you go to bed and avoid draughts. And what you need is not medicine but the active agitation for two hours every day of the two legs which the Lord gave you, and which you now employ exclusively for making your way to and from the railway station. This is for your digestion, and you can have it put up in pills or in liquid form, according to taste. And the next time you feel inclined to call me in, think it over in the course of a ten-mile walk."

Now this may be cheering if somewhat mixed treatment, but it has nothing of that sympathy which the ailing body craves. The case is much worse if your smooth-faced physician happens to be a personal friend. The indifference with which such a man will listen to the most pitiful recital of physical suffering is extraordinary. You may be out on the golf links together, and he has just made an exceptionally fine iron shot from a bad lie and in the face of a lively breeze. He is naturally pleased, and you take courage from the situation. "By the way, Smith,"

you say, "I have been feeling rather queer for a day or two. There is a gnawing sensation right here, and when I stoop----" "That must have been 180 yards," he says, "but not quite on the green. You don't chew your food enough. Take a gla.s.s of hot water before your breakfast--and you had better try your mashie!" Of course, no one likes to talk shop, especially on the golf links. Still you think, if you were a physician and you had a friend who had a gnawing sensation, you would be more considerate. After the game he lights his cigar and orders you not to smoke if the pain in your chest is really what you have described it.

"In me," he says, cheerfully, "you get a physician and a horrible example for one price."

But there is one thing that this impressionistic school of medicine has in common with the other kind. Both types are faithful to the funereal type of waiting-room which is one of the signs of the trade. It is a room in which all the arts of the undertaker have seemingly been called upon to bring out the full possibilities of the average New York brownstone "front-parlour." I have often tried to decide whether, in a doctor's waiting-room, night or day was more conducive to thoughts of the grave. At night a lamp flickers dimly in one corner of the long room, and the shadows only deepen those other shadows which lie on the ailing spirit. But this same darkness mercifully conceals the long line of ash-coloured family portraits in gold frames, the ash-coloured carpet and chandelier, and the hideous aggregation of ash-coloured couches and chairs which make up the daylight picture. Why doctors' reception rooms should always so strongly combine the attractiveness of a popular lunch-room on a rainy day with the quiet domestic atmosphere of a county jail, I have never been able to find out, unless the object is to reduce the patient to such a horrible state of depression that the mere summons to enter the doctor's presence makes one feel very much better already.

There are times when to be told that one has pneumonia or an incipient case of tuberculosis must be a relief after an hour spent in one of those dreadful ante-chambers.

The literature in a physician's waiting-room is not exhilarating.

Usually, there is an extensive collection of periodicals four months old and over. From this I gather that physicians' wives and daughters are persistent but somewhat deliberate readers of current literature. The sense of age about the magazines on a doctor's table is heightened by the absence of the front and back covers. The only way of ascertaining the date of publication is to hunt for the table of contents. That, however, is a task which few able-bodied men in the prime of life are equal to, not to say a roomful of sick people, nervous with antic.i.p.ation. Most patients under such circ.u.mstances set out courageously, but only to lose themselves in the first half-dozen pages of the advertising section. Yet the result is by no means harmful. There is something about the advertising agent's buoyant, insinuating, sympathetic tone that is very restful to the invalid nerves. Harrington tells me that the small suburban house in which he lives, the paint and roofing with which he protects it against the weather, the lawn-mower which he has secured in antic.i.p.ation of a good crop of gra.s.s, and the small stock of poultry he experiments with, were all acquired through advertis.e.m.e.nts read in doctors' waiting-rooms. Some physicians take in the ill.u.s.trated weeklies as well as the monthly magazines. In one of the former I found the other day an excellent panoramic view of the second inauguration of President McKinley.

But I am afraid I have wandered somewhat from what I set out to say. I meant to show how different from your clean-shaven doctor is the physician of the conventional beard. There is no trifling with him. He takes himself seriously, and he takes you seriously. His examination is as thorough as the stethoscope can make it; in fact, he listens to your heart-action long enough to make you fear the worst. This is in marked contrast with the smooth-faced doctor, who, as a rule, asks you to show your tongue, and when you obey he does not look at it, but begins to go through his mail, whistling cheerfully. He puts such vital questions as, how far up is your bedroom window at night, and do you ever have a sense of eye-strain after reading too long, and when you reply, he pays no attention. His entire att.i.tude expresses the conviction that either you are not ill at all, or that if you are, you are not in a position to give an intelligent account of yourself. That is not the case with the other physician. He asks precise questions and insists on detailed replies. Nothing escapes him. While you are describing the sensations in the vicinity of your left lung, he will ask quietly whether you have always had the habit of biting your nails.

Under such sympathetic attention the patient's spirits rise. From an apologetic state of mind he pa.s.ses to a sense of his own importance.

Instead of being ashamed of his ailments he tries to describe as many as he can think of. His specific complaint may be a touch of sciatica, but he takes pleasure in recalling a bad habit of breathing through the mouth in moments of excitement, and a tricky memory which often leads him to carry about his wife's letters an entire week before mailing them. The need for a certain amount of self-castigation is implanted in all of us, and it is satisfied in the form of confession. Many people do it as part of their religious beliefs. Others belabour themselves in the physician's office. Men who in the bosom of the family will deny that they read too late at night and smoke too many cigars will call such transgressions to the doctor's attention if he should happen to overlook them. I know of one man suffering from neuralgia of the arm who insisted on telling his doctor that it made him ill to read the advertis.e.m.e.nts in the subway cars. But the doctor who wears no beard does not invite such confidences.