Village doctor

“ I couldn't hold her mouth open myself as well as mind the kettle, so I just called in my mate Thomas, to help and hold her up, and open her mouth for the kettle spout."
The life of the village doctor is a hard one. Never certain of a meal, and never certain of a sound, undisturbed sleep, he has to take his victuals and his rest by snatches, but then he inhales the fresh, pure air, and that maintains him in health. He has to keep his natural weakness and natural impatience under great control. ”

“ A kind-hearted village doctor, finding that a poor woman he was attending needed nourishing food, got his wife to send her a jelly.
Some time after he went to the cottage, found the ground-floor room untenanted, but heard a trampling, groaning, and struggling going on upstairs. He accordingly ascended to the bedroom, to see a labouring man sitting on the bed, holding up the sick woman's head, whilst another labouring man—her husband—was standing on the bed, one foot on each side of the patient, with a black kitchen kettle in his hand, endeavouring to pour the contents down her mouth. ”

“ Before I pass on to the great witch doctor, the physician, I must detain you with a brief account of the neglected-by-traveller-because-less-showy African village apothecary, a really worthy person, who exists in every West African district I know of; often, as in the Calabar and Bonny region, a doctor whose practice extends over a fair-sized district, wherein he travels from village to village. If he comes across a case, he sits down and does his best with it, may be for a fortnight or a month at a time, and when he has finished with it and got his fee, off he goes again. ”

“ The doctor's duty in a fever-stricken village is not merely to cure disease in a stricken patient. He has a higher duty yet which will bring no pecuniary reward, to prevent the healthy from being stricken, to seek out, to remove or to eradi- cate the causes of disease, and take as much or greater pride in the continued health and good sanitary condition of his station or village as in the number of his cures. ”

“ In no novel have we come across so adequate a presentment of them as in the village doctor—worthy confrère of Mrs Gaskell’s country surgeon and of Balzac’s médecin de campagne—the rustic savant, interested in the scientific and social movement of his times yet homely in his private tastes and standards of life ”

“ The villagers all thronged around, loudly discussing the nature of his illness: one of them was saying: "Our pulse is the pulse of vegetarians and fish-eaters: nothing but harm can arise from the use of leeches, purgatives, and blisters. The best kind of treatment for us is that of the old village doctor; and then, if no relief is obtained, and grave symptoms occur, a doctor using the English methods might be called in." ”

“ JIM ADVISES A DOCTOR.
do, when you get to the village. Shut the door, and blindfold the doctor tight and fast, and make him swear to be silent as the grave, and put a purse full of gold in his hand, and then take and lead him all around the back alleys and everywheres, in the dark, and then fetch him here in the canoe, in a roundabout way amongst the islands, and search him, and take his chalk away from him, and don't give it back to him till you get him back to the village, or else he will chalk this raft so he can find it again. It's the way they all do. ”

“ There was not one of the young village people so well known as the doctor's little girl, who drove with him day by day, and with whom he kept such delightful and trustful companionship. If she had been asked in later years what had decided her to study not only her profession, but any profession, it would have been hard for her to answer anything beside the truth that the belief in it had grown with herself. ”

“ All the people in the village, particularly babies and old people—people whose souls are delicate—must be kept awake during the operation, and have a piece of cloth over the nose and mouth, and every one must howl so as to scare the sisa off them, if by mischance it should escape from the witch doctor. ”

“ Their initiation into their full M.D. degree used to consist in a prolonged solitary fast in the forests, till, overtaken by a sort of frenzy, they rushed back to the village, where such people as desired to [130] show a fine religious fervour would offer their arms for the doctor to take bites out of. ”

“ Very few agricultural women have a medical man present at their confinement; they usually entrust themselves to the care of some village nurse, who has a reputation for skill in such matters, but no scientifically acquired knowledge—who proceeds by rule of thumb. The doctor—almost always the parish doctor, though sometimes the club officer—is not called in till after the delivery. The poor woman will frequently come downstairs on the fourth day ”

“ He was a popular doctor, enjoyed a great reputation in his neighbourhood, maintained a large family of unmarriageable daughters, and lived in comfort in a cosy cottage embowered in elms, with its pleasant garden full of old-fashioned flowers.
This old gentleman's method, on being sent for, was at once to take a gloomy view of the case. "My dear fellow," he would say to the patient, "this is a very aggravated malady. I ought to have been sent for before. If you die, it is your own fault. I ought to have been sent for before. A stitch in time saves nine. ”

“ Well, imagine a remote village or a mountain valley or a far island settlement very difficult to get to, where there lived a thousand or perhaps ten thousand people. Rarely fewer, rarely more. Among that small population there were no medical doctors and no dentists, no drugs, no vaccinations, no antibiotics. ”

“ Men and a hurdle had to be fetched from the farm that was in sight, the doctor had to be summoned from a village three miles away, and then he was asked to wait lest there should be need of a further errand to a cottage hospital. ”

“ As the population gets smaller, the doctor's work becomes more laborious and less remunerative. The institution of district nurses has been a great success, and I wish there were more of them. A sympathetic and competent nurse is a valuable asset in a crofting or seafaring community. In one district of Mull, recently visited, I found that the nurse was also the village librarian. She was quite at home both with lotions and literature, and could recommend a poet or prepare a poultice with equal skill. ”

“ What scorn was poured by the doctor on the quack remedies employed by the old women of the parish! And yet, when we look back to the treatment recommended and the potions administered by the faculty in days gone by, I am not sure that the recipes of the old grandams were not the best—at least, they were harmless, and such were not the hackings, cuppings, and bleedings, the calomel, etc., of the faculty. A good many of the village remedies were charms, and charms only, and consequently rubbish. ”

“ There was a great change in the village; there were more small factories now which employed large numbers of young women, and though a new doctor had long ago come to Oldfields who had begun by trying to supersede Dr. Leslie, he had ended by longing to show his gratitude some day for so much help and kindness. More than one appointment had been offered the heroine of this story in the city hospitals. She would have little trouble in making her way since she had the requisite qualities, natural and acquired, which secure success. ”

“ The funds of the Public Library of Arrowhead Village allowed the managers to purchase many books out of the common range of reading. The two learned people of the village were the rector and the doctor. These two worthies kept up the old controversy between the professions, which grows out of the fact that one studies nature from below upwards, and the other from above downwards. The rector maintained that physicians contracted a squint which turns their eyes inwardly, while the muscles which roll their eyes upward become palsied. ”

“ Many of the people who lived in the village had outlying land and were farmers of it, but beside the doctor's there were some other households which the land supported indirectly, either through professions or because some kind ancestor had laid by enough money for his children and grandchildren. The ministers were both excellent men; but Dr. Leslie was the only man who looked far ahead or saw much or cared much for true success. ”

“ Richmond,” I explained stiffly, “on a little matter of business connected with the work of the Village Improvement Society. It was reported at our last meeting that the condition of your front yard is very bad.”
“My front yard! I see.” The doctor looked quizzical but serene, and glanced out over his shoulder to the lawn.
“Our Association,” I continued bravely, “aims to incite the pride of householders in the appearance of the village as well as in their own homes; and your place here is conspicuous, facing the common as it does. ”

“ It takes a great deal to change the mind of an old-school doctor.
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I was surprised to find that Dilava, Deva Deva and Mafulu ran over 90 per cent infections. This upset all my previous convictions, but when I stopped to consider it, this was not so remarkable. One carrier, coming in from the outside world, could easily infect a village, for these settlements were perched on narrow ridges not over twenty feet wide. In Okaka, for example, there was barely elbow room and no attempt at sanitation. Here, when the natives left home, they must all follow the same trail. ”

“ Almost within a generation a radical change has taken place in the relation of town and country as regards the profession of medicine. The old barriers which half a century ago separated the sick in the streets from the sick in fields and forests have been swept away. The city physician now twenty-five miles away can often arrive more quickly than a country doctor who lives five; and a surgeon can come in an hour who formerly needed half a day. ”

“ It is a fear of this professional isolation which causes the average young doctor to start his practice in the city where he has better facilities, and which is largely responsible for the small number of young doctors in rural counties. It is, of course, impossible to have a hospital in every hamlet, but it is possible to have a good hospital and laboratories at every county seat or small city center, so that there will be at least one such medical center in a county. ”

“ The next object is the village surgeon; a busy, merry, bustling, prying, talkative, little gentleman, who amuses one patient with all the scandal he has been able to pick up about another; but, notwithstanding, a most important person, and people feign illness for the gratification his visits communicate; constant in his morning calls from house to house, he continues to pick up all the flying rumours of the day ”

“ She was soon out of bed at the other end, and calling for help and a light the snake was quickly despatched.
The doctor in this place has charge of a district sixty miles in diameter, and always expects his fees before leaving his house; but although he has so large a district, I question if he makes his fortune, for although acres are many, people are few, and the salubrity of the climate does not favour the medical profession. ”

“ Taking her into my confidence, I told her of my ideal of a snug country practice—one of those in which the assistant does the night-work and attends to the club people, while there is a circle of county people as patients. There are hundreds of such practices in England, where a doctor, although scarcely known outside his own district, is in a position which Harley Street, with all its turmoil of fashionable fads and fancies, envies as the elysium of what life should be. ”

“ With such diseases, as with the infectious and contagious diseases, the presence of one case in the clinic should lead straight to the inference that there are others elsewhere, out of sight but no less important from the point of view of public good. This conclusion should lead in turn to the search through a social worker for the cases of disease which do not present themselves to any physician, which may be totally unknown even to the patient himself, yet which are important to the health of the nation. ”

“ On every plantation stands an infirmary, with negress nurses and a dispenser of drugs always in readiness. Some of the larger fazendas have a resident doctor, but generally two or three neighbouring planters maintain one conjointly. The proficiency of the surgeons has risen with the increased demand for their services, and new chairs of medicine have been established in the universities of the eastern cities. ”

“ Every county and community needs such a doctor who is skilled in treating social disease, but one of her chief functions will be to act as an educational director in promoting the study of local social conditions by the existing organizations in every community and in discovering and training leadership for carrying out a constructive program as it is evolved. In some way there should be a volunteer committee or worker in each community associated with the county social worker to advise concerning policies and to carry on much of the local work under her supervision and training. ”

“ The doctor of a country settlement was then—they have become so common now as to place it in the power of nearly every planter to own a physician, and consequently they attract little regard—a very important character in the community. ”

“ The doctor’s satisfaction is quite as great as if he had cut down a whole Leicestershire field in the fastest thing of the season. His heart warms towards those undersized, harsh-coated, slab-sided little friends of his as he stands watching the negro woman breaking up their supper of hot corn-bread with buttermilk as a treat, on the back porch. ”

“ As soon as it is known through the neighbourhood that a doctor is in residence, all sorts of needs will be cropping up, and instead of your neighbours falling ill in order to give you employment, it is much more likely that they will have to turn to and nurse the patients who are brought from a distance and dumped upon your hands to repair. ”