Rudyard Kipling

“ Realising these things, as I have had good reason to realise them, I do not think I need stretch your patience by talking to{31} you about the high ideals and the lofty ethics of a profession which exacts from its followers the largest responsibility and the highest death-rate—for its practitioners—of any profession in the world. If you will let me, I will wish you in your future what all men desire—enough work to do, and strength enough to do your work. ”

“ You have been exposed—you always will be exposed—to the attacks of those persons who consider their own undisciplined emotions more important{29} than the world’s most bitter agonies—the people who would limit and cripple and hamper research because they fear research may be accompanied by a little pain and suffering. But you have heard this afternoon a little of the history of your profession. ”

“ To do us poor patients justice, we do not often dispute doctors’ orders unless we are frightened or upset by a long continuance of epidemic diseases. In that case, if we are uncivilised, we say that you have poisoned the drinking water for your own purpose, and we turn out and throw stones at you in the street. If we are civilised, we do something else. But a civilised people can throw stones too. You have been, and always will be exposed to the contempt of the gifted amateur—the gentleman who knows by intuition everything that it has taken you years to learn. ”

“ I have had the good fortune this afternoon of meeting a number of trained men who, in due time, will be drafted into your permanently mobilised army which is always in action, always under fire against Death. ”

“ Whitbread, the younger, introduced a friend of his own, whose treatment by compression he averred to have resulted in “joyful declarations” on the part of patients that they were “greatly relieved.” It sounds an ungracious return for the Whitbread benevolence to hear that the Governors remained “uncontaminated by that love of quackery which is so common among the gentry of England.” But we are told that the treatment “often gave much pain, and often appeared to hasten the end; and in the latter it did not retard the progress of the disease.” ”

“ It may not have escaped your professional observation that there are only two classes of mankind in the world—doctors and patients. I have some delicacy in confessing that I belong to the patient class—ever since a doctor told me that all patients were phenomenal liars where their own symptoms were concerned. ”

“ He may not even claim the exciting rewards, such as they are, of the politician or the artist, nor the more showy compensations due to the soldier’s peril. He cannot boast of diplomatic victories and forensic triumphs: he does not hear the thunders of a crowded audience: he may not display a row of decorations to an admiring world. ”

“ Your training shows you daily and directly that things are what they are, and that their consequences will be what they will be and that we deceive no one but ourselves when we pretend otherwise.{30} Better still you can prove what you have learned. If a patient chooses to disregard your warnings, you have not to wait for a generation to convince him. ”

“ Nobody will care whether you are in your bed or in your bath, on your holiday or at the theatre. If any one of the children of men has a pain or a hurt in him you will be summoned. And, as you know, what little vitality you may have accumulated in your leisure will be dragged out of you again. ”

“ The students of the Medical School are the physicians and surgeons of to-morrow, and it should be no small encouragement to them to hear their profession described in such honourable terms. Many men and women, probably a great majority, regard all doctors as necessary evils. For surgeons they entertain rather a fearful{15} admiration; the physician they dismiss with the complacent summary that it is curious that medicine should have made no progress whilst surgery has advanced by leaps and bounds ”

“ Every sane human being is agreed that this long-drawn fight for time which we call Life is one of{25} the most important things in the world. It follows therefore that you, who control and oversee this fight and you who will reinforce it, must be amongst the most important people in the world. ”

“ Amongst provocative causes of the disease, the habit of “smoking tobacco” and the profession of sweeping chimneys were noted as most frequent. Confidence had long been placed in the healing virtues of Wiltshire Holt Water, which came from a spring near Bradford-on-Avon; but discredit was thrown upon this in the following manner: “A young gentleman who acted as House Surgeon to The Middlesex Hospital, had omitted to procure a supply of the Wiltshire Holt Water, which was in much request. ”

“ The hospital is open to anybody who chooses to seek help and refuge there, free of all charge and cost. Amongst the honorary staff—those who give their services for nothing—are some of the first physicians and surgeons in London.
In this connection attention may be called to what Mr. Kipling says of people who “cadge round the hospitals.” There must be some abuse by people who can well afford to pay their own doctors, and for whom the benefits of free hospitals were never intended. Such abuse is demoralising to themselves and adds obvious difficulties to the career of the private practitioner. ”

“ Of course it is a little unfortunate that Death, as the senior practitioner, is always bound to win in the long run, but we non-combatants, we patients, console ourselves with the idea that it will be your business to make the best terms you can with Death on our behalf ”

“ If you choose to fly a Red Cross flag over a desert you can turn it into a centre of population towards which, as I have seen, men will crawl on hands and knees. You can forbid any ship to enter any port in the world. ”

“ Human beings, with rare exceptions, are tenacious of life, and are most unwilling to die. Doctors, on their side, live with the single purpose of postponing death: not one of them will compromise the matter for a moment. It can never be a question with him whether a life is worth preserving, or whether there is{17} reluctance to let it go. ”

“ It is hardly necessary to point out that the cases of which we read have their origin, almost always, in some trouble of mind, real or imaginary, and are not to be ascribed to a desire to escape from physical pain or misery. ”

“ You remain now perhaps the only class that dares to tell the world that we can get no more out of a machine than we put into it; that if the fathers have eaten forbidden fruit the children’s teeth are very liable to be affected. ”

“ How far and how fast that progress is to continue depends to a large extent upon the opportunities available; of able and devoted workers there will be no dearth. The Middlesex Hospital is doing{14} its best, and will earnestly endeavour to facilitate scientific research for the good of the public, so long as public assistance and support are forthcoming. ”

“ It has long ago decided that you have no working hours that anybody is bound to respect, and nothing except extreme bodily illness will excuse you in its eyes from refusing to help a man who thinks he may need your help at any hour of the day or night. ”

“ A distinct, and most important, branch of the Hospital is the Cancer Charity with its Research Laboratory. The history of this department is certainly worth a little notice. It was established in 1792, mainly through the munificence of an anonymous donor, who turned out to be Mr. Whitbread, father of the famous Whig member of Parliament. It began with the allocation of one ward in the hospital to the care of patients who were to be kept in “until{10} relieved by art or released by death”—a phrase retained to the present day. The disease was described by Mr. ”

“ You will find that such people have been with you—or rather against you—from the very beginning, ever since, I should say, the earliest Egyptians erected images in honour of cats and dogs on the banks of the Nile. ”

“ It seems to be required of you that you must save others. It is nowhere laid down that you need save yourselves.{27} That is to say you belong to the privileged classes. May I remind you of some of your privileges? You and kings are about the only people whose explanations the police will accept if you exceed the legal limit in your car. ”

“ However, I have been ordered—on medical advice—not to talk about patients, but doctors. Speaking then, as a patient, I should say that the average patient looks upon the average{24} doctor very much as the non-combatant looks upon the troops fighting on his behalf. The more trained men there are between his dearly beloved body and the enemy, he thinks, the better. ”