"If you can afford to wear jewellery you can afford a doctor. A hospital is a charitable institution," said Dr. Tyrell.
He handed back the letter and called for the next case.
"But I've got my letter."
"I don't care a hang about your letter; you get out. You've got no business to come and steal the time which is wanted by the really poor."
The patient retired sulkily, with an angry scowl.
"She'll probably write a letter to the papers on the gross mismanagement of the London hospitals," said Dr. Tyrell, with a smile, as he took the next paper and gave the patient one of his shrewd glances.
Most of them were under the impression that the hospital was an institution of the state, for which they paid out of the rates, and took the attendance they received as a right they could claim. They imagined the physician who gave them his time was heavily paid.
Dr. Tyrell gave each of his clerks a case to examine. The clerk took the patient into one of the inner rooms; they were smaller, and each had a couch in it covered with black horse-hair: he asked his patient a variety of questions, examined his lungs, his heart, and his liver, made notes of fact on the hospital letter, formed in his own mind some idea of the diagnosis, and then waited for Dr. Tyrell to come in. This he did, followed by a small crowd of students, when he had finished the men, and the clerk read out what he had learned. The physician asked him one or two questions, and examined the patient himself. If there was anything interesting to hear students applied their stethoscope: you would see a man with two or three to the chest, and two perhaps to his back, while others waited impatiently to listen. The patient stood among them a little embarrassed, but not altogether displeased to find himself the centre of attention: he listened confusedly while Dr. Tyrell discoursed glibly on the case. Two or three students listened again to recognise the murmur or the crepitation which the physician described, and then the man was told to put on his clothes.
When the various cases had been examined Dr. Tyrell went back into the large room and sat down again at his desk. He asked any student who happened to be standing near him what he would prescribe for a patient he had just seen. The student mentioned one or two drugs.
"Would you?" said Dr. Tyrell. "Well, that's original at all events. I don't think we'll be rash."
This always made the students laugh, and with a twinkle of amusement at his own bright humour the physician prescribed some other drug than that which the student had suggested. When there were two cases of exactly the same sort and the student proposed the treatment which the physician had ordered for the first, Dr. Tyrell exercised considerable ingenuity in thinking of something else. Sometimes, knowing that in the dispensary they were worked off their legs and preferred to give the medicines which they had all ready, the good hospital mixtures which had been found by the experience of years to answer their purpose so well, he amused himself by writing an elaborate prescription.
"We'll give the dispenser something to do. If we go on prescribing mist: alb: he'll lose his cunning."
The students laughed, and the doctor gave them a circular glance of enjoyment in his joke. Then he touched the bell and, when the porter poked his head in, said:
"Old women, please."
He leaned back in his chair, chatting with the H.P. while the porter herded along the old patients. They came in, strings of anaemic girls, with large fringes and pallid lips, who could not digest their bad, insufficient food; old ladies, fat and thin, aged prematurely by frequent confinements, with winter coughs; women
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