1
33 In England Now A Running Commentary by Peripatetic Correspondents THE idiom is catching, like chickenpox in a Boy Scout camp, and so is the spelling; so by the time I got thru visiting around in Madison, Peoria, and South Bend, I was feeling right to home. I was relieved to find it was now seldom necessary to explain that a Welshman was not a Limey but a Celt, and a Celt was not a draughty sort of drape tied round the middle of Scotsmen. Con- fidence was restored and I faced the return from the wide prairee to New York without any of the horrid feeling of being a fugitive from Ellis Island. (Despite the impeccability of my papers and introductions to the Lambs and the Yale Clubs and the Academy of Medicine, that was how I felt a short month before.) I had no hesitation now in giving the visiting fireman routine a twirl, and sent in my card to the chief of a very famous clinic. I need not have worried the first time. Despite the business of the chief, the clinic, and New York in general, my advent appeared to have a top priority rating, an experience which for me was strictly novel. But this is prolixity-another catching complaint endemic in the Mid-West, in my experience at least. The real point of this fauteil is that I going on a ward round with the chief when in came, in a striking white uniform, who but Miss America, or at least if it was not she herself, certainly a top contender for that honor. She was wheeling a gleaming truck with as many gadgets on it as a B28’s instrument-panel, topped by a shining dome of chromium the shape of an old-fashioned straw bee-hive. I could not even hazard a guess at what this apparatus was, anyhow it was way out of my league. So playing the local rules I cracked, " What gives with the Wasistmeter Doctor ? Is it a super-Geiger counter or is the beautiful lady Flash Gordon’s girl friend ? " " Oh, that’s our clinic Beautitian with her portable apparatus." The chief saw this was still double-talk to me, so he explained further. " A long time ago we found that it was impossible to overestimate a woman’s pre- occupation with her appearance. She might have no more natural endowment than Ziegfeld would have seen in a Flathead Indian, but that is quite irrelevant to the importance her looks have for her. So it’s simple. If they want to go through the motions of beauty-culture why not let them ? Even if we think it is screwy, it is dead serious to the women patients. It keeps them contented and occupied, and I’m sure it is therapeutically beneficial." " It is quite useful diagnostically too," he added with a smile. " When they fail to show interest in the Beautitian’s visit they are very ill indeed. By the way, our Beautitian is of course also a trained nurse, so she can adjust her ministrations to ensure that the patient is not overtired by them." He told me a good deal more of this service the clinic supplied, and though my first reaction was distinctly adverse I was eventually sold on the proposition. After all, why not ? Look at the time, energy, and money the ladies spend on their frontage when they are up and around, and it makes them happy. So if they want to buy themselves a hair do and manicure in hospital, and if this will hasten their recovery, well good luck to them. * * * Having lost more than one encounter with examiners, and having seen and heard my most penetrating remarks become the hackneyed howler of the year, I seized with alacrity the chance of becoming an examiner myself. I have, of course, often examined my examiners, and failed them, but only in those precious unreal moments on going to sleep or waking up. The examination I conducted, this time in reality, was on first-aid. I spent the day feverishly reading the manuals and wondering whether the candidates were doing likewise and feeling as nervous as I did. I survived all the vivas but was disappointed that I had no " howler " with which to regale my friends and puff up my ego. The written papers however saved the day. To a question about the treatment of narcotic poisoning one candidate replied : " I would keep him awake by walking him around the room, at the same time slapping the soles of his feet with a wet towel. Also at the same time I would give an emetic and strong black coffee." If only I had been given this answer in a viva, I might have smiled sweetly, in the way examiners do, and said : " You are assuming, of course, that you possess two pairs of hands and that the patient possesses two pairs of feet and two stomachs." But more probably I wouldn’t have thought of this until the candidate had got away. * * * WARM AGGLUTININ I knew a Warm Agglutinin that worked in our laboratory Who had a most remarkable capacity for oratory. There wasn’t any subject that was vague or allegorical Of which my late acquaintance wouldn’t make himself the oracle ; No germ of an idea that wouldn’t take a rapid root in an Unlimited unstony ground-my friend the Warm Agglutinin. The style of his delivery was varied-now declamatory, Now logical, now pleading, now amusing, now inflam- matory. He argued about everything, both with and without premises ; He spoke for many hours on the Necessity of Nemesis. When two or three erythrocytes were gathered close together He would give them his ideas on the Importance of a Tether; Or a normoblast, regardless of its patent immaturity, Was treated to a talk on the Illusion of Impurity. He said the Song the Sirens Sang was silvery but soluble -A simple thought which made him wax particularly voluble. At first these dissertations were diverting and amusing (We found his manner was, perhaps, a little bit confusing), But slowly we discovered that in any proposition He was never for the Government but with the Opposition. The burden of his argument was always so terrific We never thought at first that he was wholly non- specific ; For some of us were anti-this, and anti-that the rest of us, But he was anti-everything, reacting with the best of us ; Eternal Anti-Anti, anti-Self, and anti-God, he Was a house divided in itself, an Auto-antibody. While many opportunities were present and get-at-able We never found a blessed thing with which he was compatible. We tried to overlook his faults, his lack of specificity, But all was unavailing, he aroused so much publicity. In spite of all our tactfulness and generous expedients He carried in himself the stuff of civil disobedience. The time arrived at length when we had made our last exploratory Attempt to find a little niche for him in our laboratory ; And so he had to leave us for the Desert and the Distance Where, with others like himself, he lives the Image of Existence. Moral The Moral of this anecdote you surely haven’t missed- When a man is Anti-Everything he Ceases to Exist As a Wilful Individual Enjoying the Immunity Extended to an Antibody’s Work in the Community. * * * The other morning, one of my peptic ulcer patients came into my surgery and asked for a certificate proving that he really had an ulcer. He explained that he was a member of the same darts team as his butcher, and the butcher had promised that if he could produce [ medical evidence to show that his ulcer was a reality, he would save him a tender lamb chop whenever there were any. Was I to stand on my dignity and deprive my patient of his vision of a future strewn with succulent lamb chops ? Surely not. So I gave him the certificate. D, * * The physician,had been discussing the parasites that ) may cause diarrhoea. " Tell me," he said suddenly i to one of the students, " all you know about Giardia I; lamblia." " Well," came the reply, " he was the mayor : of New York." * * * . 1 DEAR IF ILLITERATE SIR (June 24),-Peccavi, but how: c about Caesar Bell. Gall. 2, 4 : GaUi qui ea loca incolerent?-

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33

In England NowA Running Commentary by Peripatetic CorrespondentsTHE idiom is catching, like chickenpox in a Boy Scout

camp, and so is the spelling; so by the time I got thruvisiting around in Madison, Peoria, and South Bend,I was feeling right to home. I was relieved to find itwas now seldom necessary to explain that a Welshmanwas not a Limey but a Celt, and a Celt was not a draughtysort of drape tied round the middle of Scotsmen. Con-fidence was restored and I faced the return from thewide prairee to New York without any of the horridfeeling of being a fugitive from Ellis Island. (Despitethe impeccability of my papers and introductions to theLambs and the Yale Clubs and the Academy of Medicine,that was how I felt a short month before.) I had nohesitation now in giving the visiting fireman routine atwirl, and sent in my card to the chief of a very famousclinic. I need not have worried the first time. Despitethe business of the chief, the clinic, and New York ingeneral, my advent appeared to have a top priorityrating, an experience which for me was strictly novel.But this is prolixity-another catching complaint

endemic in the Mid-West, in my experience at least.The real point of this fauteil is that I going on a wardround with the chief when in came, in a striking whiteuniform, who but Miss America, or at least if it was notshe herself, certainly a top contender for that honor.She was wheeling a gleaming truck with as many gadgetson it as a B28’s instrument-panel, topped by a shiningdome of chromium the shape of an old-fashioned strawbee-hive. I could not even hazard a guess at what thisapparatus was, anyhow it was way out of my league.So playing the local rules I cracked, " What gives withthe Wasistmeter Doctor ? Is it a super-Geiger counteror is the beautiful lady Flash Gordon’s girl friend ? "" Oh, that’s our clinic Beautitian with her portableapparatus." The chief saw this was still double-talk tome, so he explained further. " A long time ago we foundthat it was impossible to overestimate a woman’s pre-occupation with her appearance. She might have nomore natural endowment than Ziegfeld would haveseen in a Flathead Indian, but that is quite irrelevant tothe importance her looks have for her. So it’s simple.If they want to go through the motions of beauty-culturewhy not let them ? Even if we think it is screwy, it isdead serious to the women patients. It keeps themcontented and occupied, and I’m sure it is therapeuticallybeneficial." " It is quite useful diagnostically too,"he added with a smile. " When they fail to show interestin the Beautitian’s visit they are very ill indeed. Bythe way, our Beautitian is of course also a trained nurse,so she can adjust her ministrations to ensure that thepatient is not overtired by them."He told me a good deal more of this service the clinic

supplied, and though my first reaction was distinctlyadverse I was eventually sold on the proposition. Afterall, why not ? Look at the time, energy, and moneythe ladies spend on their frontage when they are up andaround, and it makes them happy. So if they wantto buy themselves a hair do and manicure in hospital,and if this will hasten their recovery, well good luckto them.

* * *

Having lost more than one encounter with examiners,and having seen and heard my most penetrating remarksbecome the hackneyed howler of the year, I seized withalacrity the chance of becoming an examiner myself.I have, of course, often examined my examiners, andfailed them, but only in those precious unreal momentson going to sleep or waking up. The examination Iconducted, this time in reality, was on first-aid. I spentthe day feverishly reading the manuals and wonderingwhether the candidates were doing likewise and feelingas nervous as I did. I survived all the vivas but wasdisappointed that I had no " howler " with which toregale my friends and puff up my ego. The writtenpapers however saved the day. To a question aboutthe treatment of narcotic poisoning one candidate replied :" I would keep him awake by walking him around theroom, at the same time slapping the soles of his feet witha wet towel. Also at the same time I would give an emetic

and strong black coffee." If only I had been giventhis answer in a viva, I might have smiled sweetly, inthe way examiners do, and said : " You are assuming,of course, that you possess two pairs of hands and thatthe patient possesses two pairs of feet and two stomachs."But more probably I wouldn’t have thought of thisuntil the candidate had got away.

* * *

WARM AGGLUTININ

I knew a Warm Agglutinin that worked in our laboratoryWho had a most remarkable capacity for oratory.There wasn’t any subject that was vague or allegoricalOf which my late acquaintance wouldn’t make himself the

oracle ; -

No germ of an idea that wouldn’t take a rapid root in anUnlimited unstony ground-my friend the Warm

Agglutinin.The style of his delivery was varied-now declamatory,Now logical, now pleading, now amusing, now inflam-

matory.He argued about everything, both with and without

premises ;He spoke for many hours on the Necessity of Nemesis.When two or three erythrocytes were gathered close

togetherHe would give them his ideas on the Importance of a

Tether;Or a normoblast, regardless of its patent immaturity,Was treated to a talk on the Illusion of Impurity.He said the Song the Sirens Sang was silvery but soluble-A simple thought which made him wax particularlyvoluble.

At first these dissertations were diverting and amusing(We found his manner was, perhaps, a little bit confusing),But slowly we discovered that in any propositionHe was never for the Government but with the Opposition.The burden of his argument was always so terrificWe never thought at first that he was wholly non-

specific ;For some of us were anti-this, and anti-that the rest of us,But he was anti-everything, reacting with the best of us ;Eternal Anti-Anti, anti-Self, and anti-God, heWas a house divided in itself, an Auto-antibody.While many opportunities were present and get-at-ableWe never found a blessed thing with which he was

compatible.We tried to overlook his faults, his lack of specificity,But all was unavailing, he aroused so much publicity.In spite of all our tactfulness and generous expedientsHe carried in himself the stuff of civil disobedience.The time arrived at length when we had made our last

exploratoryAttempt to find a little niche for him in our laboratory ;And so he had to leave us for the Desert and the DistanceWhere, with others like himself, he lives the Image of

Existence.Moral

The Moral of this anecdote you surely haven’t missed-When a man is Anti-Everything he Ceases to ExistAs a Wilful Individual Enjoying the ImmunityExtended to an Antibody’s Work in the Community.

* * *

The other morning, one of my peptic ulcer patientscame into my surgery and asked for a certificate proving

that he really had an ulcer. He explained that he was’

a member of the same darts team as his butcher, andthe butcher had promised that if he could produce

[ medical evidence to show that his ulcer was a reality,he would save him a tender lamb chop whenever therewere any. Was I to stand on my dignity and deprive my patient of his vision of a future strewn with succulent lamb chops ? Surely not. So I gave him the certificate.D, * *

The physician,had been discussing the parasites that) may cause diarrhoea. " Tell me," he said suddenlyi to one of the students, " all you know about GiardiaI; lamblia." " Well," came the reply, " he was the mayor: of New York." * * * . _

1 DEAR IF ILLITERATE SIR (June 24),-Peccavi, but how:c about Caesar Bell. Gall. 2, 4 : GaUi qui ea loca incolerent?-