by A. J. Cronin
‘Yes.’ Andrew nodded. ‘What’s your evidence?’ Bramwell began, clearing his throat, to read what he had written upon the form. It was a full, flowing account of certain of Hughes’s actions during the previous week, all of them conclusive of mental derangement. At the end of it Bramwell raised his head. ‘Clear evidence, I think!’
‘It sounds pretty bad,’ Andrew answered slowly. ‘Well! I’ll take a look at him.’
‘Thanks, Manson. You’ll find me here when you’ve finished.’ And he began to add further particulars to the form.
Emlyn Hughes was in bed and seated beside him – in case restraint should be necessary – were two of his mates from the mine. Standing by the foot of the bed was Olwen, her pale face, ordinarily so pert and lively, now ravaged by weeping. Her attitude was so overwrought, the atmosphere of the room so dim and tense, that Andrew had a momentary thrill of coldness, almost of fear.
He went over to Emlyn and at first he hardly recognised him. The change was not gross, it was Emlyn true enough, but a blurred and altered Emlyn, his features coarsened in some subtle way. His face seemed swollen, the nostrils thickened, the skin waxy, except for a faint reddish patch that spread across the nose. His whole appearance was heavy, apathetic. Andrew spoke to him. He muttered an unintelligible reply. Then, clenching his hands, he came out with a tirade of aggressive nonsense, which, added to Bramwell’s account, made the case for his removal only too conclusive.
A silence followed. Andrew felt that he ought to be convinced. Yet inexplicably, he was not satisfied. Why, why, he kept asking himself, why should Hughes talk like this? Supposing the man had gone out of his mind, what was the cause of it all. He had always been a happy contented man – no worries, easy going, amicable. Why, without apparent reason, had he changed to this!
There must be a reason, Manson thought doggedly, symptoms don’t just happen of themselves. Staring at the swollen features before him, puzzling, puzzling for some solution of the conundrum, he instinctively reached out and touched the swollen face, noting subconsciously, as he did so, that the pressure of his finger left no dent in the oedematous cheek.
All at once, electrically, a terminal vibrated in his brain. Why didn’t the swelling pit on pressure? Because – now it was his heart which jumped! – because it was not true oedema but myxoedema. He had it, by God, he had it! No, no, he must not rush. Firmly, he caught hold of himself. He must not be a plunger, wildly leaping to conclusions. He must go cautiously, slowly, be sure!
Curbing himself, he lifted Emlyn’s hand. Yes, the skin was dry and rough, the fingers slightly thickened at the ends. Temperature – it was subnormal. Methodically he finished the examination, fighting back each successive wave of elation. Every sign of every symptom, they fitted as superbly as a complex jig-saw puzzle. The clumsy speech, dry skin, spatulate fingers, the swollen inelastic face, the defective memory, slow mentation, the attacks of irritability culminating in an outburst of homicidal violence. Oh! the triumph of the completed picture was sublime.
Rising, he went down to the parlour where Doctor Bramwell, standing on the hearth-rug with his back to the fire, greeted him.
‘Well? Satisfied? The pen’s on the table.’
‘Look here, Bramwell,’ Andrew kept his eyes averted, battling to keep impetuous triumph from his voice. ‘I don’t think we ought to certify Hughes.’
‘Eh, what?’ Gradually the blankness left Bramwell’s face. He exclaimed in hurt astonishment, ‘ But the man’s out of his mind!’
‘That’s not my view,’ Andrew answered in a level tone, still stopping down his excitement, his elation. It was not enough that he had diagnosed the case. He must handle Bramwell gently, try not to antagonise him. ‘In my opinion Hughes is only sick in mind because he’s sick in body. I feel that he’s suffering from thyroid deficiency – an absolutely straight case of myxoedema.’
Bramwell stared at Andrew glassily. Now, indeed, he was dumbfounded. He made several efforts to speak, a queer sound, like snow falling off a roof.
‘After all,’ Andrew went on persuasively, his eyes on the hearth-rug, ‘Pontynewdd is such a sink of a place. Once Hughes gets in there he’ll never get out. And if he does he’ll carry the stigma of it all his life. Suppose we try pushing thyroid into him first.’
‘Why, doctor,’ Bramwell quavered, ‘I don’t see –’
‘Think of the credit for you,’ Andrew cut in quickly. ‘If you should get him well again. Don’t you think it’s worth it. Come on now, I’ll call in Mrs Hughes. She’s crying her eyes out because she thinks Emlyn is going away. You can explain we’re going to try a new treatment.’
Before Bramwell could protest Andrew went out of the room. A few minutes later when he came back with Mrs Hughes the Lung Buster had recovered himself. Planted on the hearth-rug he informed Olwen in his best manner ‘that there might still be a ray of hope’ while, behind his back, Andrew made a neat tight ball of the certificate and threw it in the fire. Then he went out to telephone to Cardiff for thyroid.
There was a period of quivering anxiety, several days of agonised suspense, before Hughes began to respond to the treatment. But once it had started, that response was magical. Emlyn was out of bed in a fortnight and back at his work at the end of two months. He came round one evening to the surgery at Bryngower, lean and active, accompanied by the smiling Olwen, to tell Andrew he had never felt better in his life.
Olwen said:
‘We owe everything to you, doctor. We want to change over to you from Bramwell. Emlyn was on his list before I married him. He’s just a silly old woman. He’d have had my Emlyn in the – well, you know what – if it hadn’t been for you and all you’ve done for us.’
‘You can’t change, Olwen,’ Andrew answered. ‘It would spoil everything.’ He dropped his professional gravity and broke into genuine youthful glee. ‘ If you even try to – I’ll come after you with that bread knife.’
Bramwell, meeting Andrew in the street, remarked airily:
‘Hello, Manson! You’ve seen Hughes about, I suppose. Ha!
They’re both very grateful. I flatter myself I’ve never had a better
case.’
Annie said:
‘That ol’ Bramwell, struttin’ about the town like he was
somebod-ee. He don’t know nothing. And his wife, bah! She can’t
keep her servants no time.’
Miss Page said:
‘Doctor, don’t forget you’re workin’ for Doctor Page.’
Denny’s comment was:
‘Manson! At present you’re too conceited to live with. You’re
going to make a most hell of a bloomer. Soon. Very soon.’
But Andrew, hurrying to Christine full of the triumph of the
scientific method, kept everything he had to say for her.
Chapter Nine
In July of that year the Annual Conference of the British Medical Union was held in Cardiff. The Union, to which, as Professor Lamplough always informed his students in his final address, every reputable medical man ought to belong, was famous for its Annual Conferences. Splendidly organised, these Conferences offered sporting, social and scientific enjoyments to members and their families, reduced terms at all but the best hotels, free charabanc trips to any ruined abbey in the neighbourhood, a memento art brochure, souvenir diaries from the leading surgical appliance makers and drug houses, and pumproom facilities at the nearest spa. The previous year at the end of the week’s festivity generous free sample boxes of Non-Adipo biscuits had been sent to each doctor and his wife.
Andrew was not a member of the Union, since the five guinea subscription was, as yet, beyond his means, but he viewed it a little enviously from a distance. Its effect was to make him feel isolated and out of touch in Drineffy. Photographs in the local newspaper of an array of doctors receiving addresses of welcome on a beflagged platform, driving off at the first tee of the Penarth Golf Course, flocking upon a steamer for a sea trip to Weston-super-Mare served to in
tensify his sense of exclusion.
But midway through the week a letter arrived bearing the address of a Cardiff hotel which caused Andrew a more pleasurable sensation. It was from his friend Freddie Hamson. Freddie, as might be expected, was attending the Conference and he asked Manson to run down and see him. He suggested Saturday, for dinner.
Andrew showed the letter to Christine. It was instinctive now for him to take her into his confidence. Since that evening, nearly two months before, when he had gone round to supper, he was more than ever in love. Now that he could see her frequently, and be reassured by her evident pleasure in these meetings, he was happier than ever he had been in his life. Perhaps it was Christine who had this stabilising effect upon him. She was a very practical little person, perfectly direct and entirely without coquetry. Often he would join her in a state of worry or irritation and come away soothed and tranquillised. She had a way of listening to what he had to say, quietly, then of making some comment which was usually apropos or amusing. She had a lively sense of humour. And she never flattered him.
Occasionally, despite her calmness, they had great arguments, for she had a mind of her own. She told him, with a smile, that her argumentativeness came from a Scottish grandmother. Perhaps her independent spirit came from that source too. He often felt that she had great courage, which touched him, made him long to protect her. She was really quite alone in the world except for an invalid aunt in Bridlington.
When it was fine on Saturday or Sunday afternoons they took long walks along the Pandy Road. Once they had gone to see a film, Chaplin in the Gold Rush, and again to Toniglan, at her suggestion, to an orchestral concert. But most of all he enjoyed the evenings when Mrs Watkins was visiting her and he was able to enjoy the intimacy of her companionship in her own sitting-room. It was then that most of their discussions took place, with Mrs Watkins, knitting placidly yet primly resolved to make her wool last out the session, no more than a respectable buffer state between them.
Now, with this visit to Cardiff in prospect, he wished her to accompany him. Bank Street School broke up for the summer holidays at the end of the week and she was going to Bridlington to spend her vacation with her aunt. He felt that some special celebration was needed before she took her leave.
When she had read the letter he said, impulsively:
‘Will you come with me? It’s only an hour and a half in the train. I’ll get Blodwen to unchain me on Saturday evening. We might manage to see something of the Conference. And in any case I’d like you to meet Hamson.’
She nodded.
Excited by her acceptance he had no intention of being baulked by Miss Page. Before he approached her upon the matter he placed a conspicuous notice in the surgery window:
Closed Saturday Evening.
He went into the house gaily.
‘Miss Page! According to my reading of the Sweated Medical Assistants Act, I’m entitled to one half day off a year. I’d like mine on Saturday. I’m going to Cardiff.’
‘Now look you here, doctor.’ She bristled at his demand, thinking that he was very full of himself, uppish; but after staring at him suspiciously she grudgingly declared, ‘Oh, well – you can go, I suppose.’ A sudden idea struck her. Her eye cleared. She smacked her lips. ‘Anyhow I’ll have you bring me some pastries from Parry’s. There’s nothing I fancy better than Parry’s pastries.’
On Saturday, at half past four, Christine and Andrew took train for Cardiff. Andrew was in high spirits, boisterous, hailing porter and booking clerk by their first names. With a smile he looked across at Christine, seated on the opposite seat. She wore a navy blue coat and skirt which intensified her usual air of trimness. Her black shoes were very neat. Her eyes, like her whole appearance, conveyed a sense of appreciation of the expedition. They were shining.
At the sight of her there, a wave of tenderness came over him and a fresh sense of desire. It was all very well, he thought, this comradeship of theirs. But he wanted more than that. He wanted to take her in his arms, to feel her, warm and breathing, close to him.
Involuntarily he said:
‘I’ll be lost without you – when you’re away this summer.’
Her cheeks coloured slightly. She looked out of the window. He asked impulsively:
‘Shouldn’t I have said that?’
‘I’m glad you said it, anyway,’ she answered without looking round.
It was on his tongue to tell her that he loved her, to ask her, in spite of the ridiculous insecurity of his position, if she would marry him. He saw, with sudden lucid insight, that this was the only, the inevitable solution for them. But something, an intuition that the moment was not apt, restrained him. He decided he would speak to her in the train coming home.
Meanwhile he went on, rather breathlessly:
‘We ought to have a grand time this evening. Hamson’s a good chap. He was rather a blade at the Royal. He’s a smart lad. I remember once,’ his eyes became reminiscent, ‘there was a charity matinee in Dundee for the hospitals. All the stars were appearing, you know, regular artistes, at the Lyceum. Hanged if Hamson didn’t go on and give a turn, sang and danced, and by George! he brought the house down!’
‘He sounds more like a matinee idol than a doctor,’ she said, smiling.
‘Now don’t be highbrow, Chris! You’ll like Freddie.’
The train ran into Cardiff at quarter past six, and they made directly for the Palace Hotel. Hamson had promised to meet them there at half past but he had not arrived when they entered the lounge.
They stood together watching the scene. The place was crowded with doctors and their wives, talking, laughing, generating immense cordiality. Friendly invitations flew back and forwards.
‘Doctor! You and Mrs Smith must sit next to us tonight.’
‘Hey! Doctor! How about these theatre tickets!’
There was a great deal of excited coming and going, and gentlemen with red tabs in their buttonholes sped importantly across the tessellated floor with papers in their hands. In the alcove opposite an official kept up a booming monotone: ‘Section of O-tology and Larin-Gology this way please.’ Above a passage leading to the annexe was the notice, Medical Exhibition. There were also palms, and a string orchestra.
‘Pretty social, eh?’ Andrew remarked, feeling that they were rather outlawed by the general hilarity. ‘And Freddie’s late as usual, hang him. Let’s take a took round the Exhibition.’
They walked interestedly round the Exhibition. Andrew soon found his hands full of elegant literature. He showed one of the leaflets to Christine with a smile. Doctor! Is your surgery empty? We can show you how to fill it! Also there were nineteen folders, all different, offering the newest sedatives and analgesics.
‘It looks like the latest trend in medicine is dope,’ he remarked, frowning.
At the last stand, on their way out, a young man tactfully engaged them, producing a shiny watch-like contraption.
‘Doctor! I think you’d be interested in our new indexo-meter. It has a multiplicity of uses, is absolutely up to the minute, creates an admirable impression by the bedside, and the price is only two guineas. Allow me, doctor! You see, on the front, an index of incubation periods. One turn of the dial and you find the period of infectivity. Inside,’ he clicked open the back of the case, ‘ you have an excellent haemoglobin colour index, while on the back in tabulated form –’
‘My grandfather had one of these,’ Andrew interrupted him firmly, ‘but he gave it away.’
Christine was smiling as they came back through the alcove again.
‘Poor man,’ she said, ‘ nobody ever dared laugh at his lovely meter before!’
At that moment, as they re-entered the lounge Freddie Hamson arrived, leaping from his taxi and entering the hotel with a pageboy carrying his golf-clubs behind him. He saw them at once and advanced with a wide and winning smile.
‘Hello! Hello! Here you are! Sorry I’m late. I had my tie to play off in the Lister Cup. I never saw such luck as t
hat fellow had! Well, well! It’s good to see you again, Andrew. Still the same old Manson. Ha! Ha! Why don’t you buy yourself a new hat, my boy!’ He clapped Andrew on the back, affectionate-hail-fellow-well-met, his glance smilingly including Christine. ‘ Introduce me, stick-in-the-mud! What are you dreaming about?’
They sat down at one of the round tables. Hamson decided they must all have a drink. With a crack of his fingers he had a waiter running for them. Then, over the sherry, he told them all about his golf match, how he was absolutely set to win when his opponent had started sinking his mashie shots at every hole.
Fresh complexioned, with blond brilliantine-plastered hair, a nicely cut suit and black opal links in his projecting cuffs, Freddie was a well turned out figure, not good-looking – his features were very ordinary – but good-natured, smart. He looked a trifle conceited perhaps, yet, when he exerted himself, he had an attractive way. He made friends with ease, in spite of which, at the university, Doctor Muir, pathologist and cynic, had once glumly addressed him in the presence of the class. ‘You know nothing, Mr Hamson. Your balloon-like mind is entirely filled with egotistical gas. But you’re never at a loss. If you are successful in cribbing your way through the nursery games known here as examinations, I prophesy for you a great and shining future.’
They went into the grill room for dinner, since none of them were dressed, though Freddie informed them he would have to get into tails later in the evening. There was a dance, a confounded nuisance, but he must show up at it.
Having nonchalantly ordered from a menu gone wildly medical – potage Pasteur, sole Madame Curie, tournedos à la Conference Medicale – he began recalling the old days with dramatic ardour.