Arrowsmith

by Sinclair Lewis

Chapter VIII

I.

And always Martin's work went on—assisting Max Gottlieb, instructing bacteriological students, attending lectures and hospital demonstrations—sixteen merciless hours to the day. He stole occasional evenings for original research or for peering into the stirring worlds of French and German bacteriological publications; he went proudly now and then to Gottlieb's cottage where, against rain-smeared brown wallpaper, were Blake drawings and a signed portrait of Koch. But the rest was nerve-gnawing.

Neurology, O.B., internal medicine, physical diagnosis; always a few pages more than he could drudge through before he fell asleep at his rickety study-table.

Memorizing of gynecology, of ophthalmology, till his mind was burnt raw.

Droning afternoons of hospital demonstrations, among stumbling students barked at by tired clinical professors.

The competitive exactions of surgery on dogs, in which Angus Duer lorded it with impatient perfection.

Martin admired the professor of internal medicine, T. J. H. Silva, known as "Dad" Silva, who was also dean of the medical faculty. He was a round little man with a little crescent of mustache. Silva's god was Sir William Osler, his religion was the art of sympathetic healing, and his patriotism was accurate physical diagnosis. He was a Doc Vickerson of Elk Mills, grown wiser and soberer and more sure. But Martin's reverence for Dean Silva was counterbalanced by his detestation for Dr. Roscoe Geake, professor of otolaryngology.

Roscoe Geake was a peddler. He would have done well with oil stock. As an otolaryngologist he believed that tonsils had been placed in the human organism for the purpose of providing specialists with closed motors. A physician who left the tonsils in any patient was, he felt, foully and ignorantly overlooking his future health and comfort—the physician's future health and comfort. His earnest feeling regarding the nasal septum was that it never hurt any patient to have part of it removed, and if the most hopeful examination could find nothing the matter with the patient's nose and throat except that he was smoking too much, still, in any case, the enforced rest after an operation was good for him. Geake denounced this cant about Letting Nature Alone. Why, the average well-to-do man appreciated attention! He really didn't think much of his specialists unless he was operated on now and then—just a little and not very painfully. Geake had one classic annual address in which, winging far above otolaryngology, he evaluated all medicine, and explained to grateful healers like Irving Watters the method of getting suitable fees:

"Knowledge is the greatest thing in the medical world but it's no good whatever unless you can sell it, and to do this you must first impress your personality on the people who have the dollars. Whether a patient is a new or an old friend, you must always use salesmanship on him. Explain to him, also to his stricken and anxious family, the hard work and thought you are giving to his case, and so make him feel that the good you have done him, or intend to do him, is even greater than the fee you plan to charge. Then, when he gets your bill, he will not misunderstand or kick."

II.

There was, as yet, no vision in Martin of serene spaciousness of the mind. Beyond doubt he was a bustling young man, and rather shrill. He had no uplifted moments when he saw himself in relation to the whole world—if indeed he realized that there was a deal of the world besides himself. His friend Clif was boorish, his beloved Leora was rustic, however gallant she might be, and he himself wasted energy in hectic busyness and in astonishment at dullness. But if he had not ripened, yet he was close to earth, he did hate pretentiousness, he did use his hands, and he did seek iron actualities with a curiosity inextinguishable.

And at infrequent times he perceived the comedy of life; relaxed for a gorgeous hour from the intensity wearing to his admirers. Such was the hour before Christmas vacation when Roscoe Geake rose to glory.

It was announced in the Winnemac Daily News that Dr. Geake had been called from the chair of otolaryngology to the vice-presidency of the puissant New Idea Medical Instrument and Furniture Company of Jersey City. In celebration he gave a final address to the entire medical school on "The Art and Science of Furnishing the Doctor's Office."

He was a neatly finished person, Geake, eye-glassed and enthusiastic and fond of people. He beamed on his loving students and cried:

"Gentlemen, the trouble with too many doctors, even those splendid old pioneer war-horses who through mud and storm, through winter's chill blast and August's untempered heat, go bringing cheer and surcease from pain to the world's humblest, yet even these old Nestors not so infrequently settle down in a rut and never shake themselves loose. Now that I am leaving this field where I have labored so long and happily, I want to ask every man jack of you to read, before you begin to practice medicine, not merely your Rosenau and Howell and Gray, but also, as a preparation for being that which all good citizens must be, namely, practical men, a most valuable little manual of modern psychology, 'How to Put Pep in Salesmanship,' by Grosvenor A. Bibby. For don't forget, gentlemen, and this is my last message to you, the man worth while is not merely the man who takes things with a smile but also the man who's trained in philosophy, practical philosophy, so that instead of day-dreaming and spending all his time talking about 'ethics,' splendid though they are, and 'charity,' glorious virtue though that be, yet he never forgets that unfortunately the world judges a man by the amount of good hard cash he can lay away. The graduates of the University of Hard Knocks judge a physician as they judge a business man, not merely by his alleged 'high ideals' but by the horsepower he puts into carrying them out—and making them pay! And from a scientific standpoint, don't overlook the fact that the impression of properly remunerated competence which you make on a patient is of just as much importance, in these days of the new psychology, as the drugs you get into him or the operations he lets you get away with. The minute he begins to see that other folks appreciate and reward your skill, that minute he must begin to feel your power and so to get well.

"Nothing is more important in inspiring him than to have such an office that as soon as he steps into it, you have begun to sell him the idea of being properly cured. I don't care whether a doctor has studied in Germany, Munich, Baltimore, and Rochester. I don't care whether he has all science at his fingertips, whether he can instantly diagnose with a considerable degree of accuracy the most obscure ailment, whether he has the surgical technique of a Mayo, a Crile, a Blake, an Ochsner, a Cushing. If he has a dirty old office, with hand-me-down chairs and a lot of second-hand magazines, then the patient isn't going to have confidence in him; he is going to resist the treatment—and the doctor is going to have difficulty in putting over and collecting an adequate fee.

"To go far below the surface of this matter into the fundamental philosophy and esthetics of office-furnishing for the doctor, there are today two warring schools, the Tapestry School and the Aseptic School, if I may venture to so denominate and conveniently distinguish them. Both of them have their merits. The Tapestry School claims that luxurious chairs for waiting patients, handsome hand-painted pictures, a bookcase jammed with the world's best literature in expensively bound sets, together with cut-glass vases and potted palms, produce an impression of that opulence which can come only from sheer ability and knowledge. The Aseptic School, on the other hand, maintains that what the patient wants is that appearance of scrupulous hygiene which can be produced only by furnishing the outer waiting-room as well as the inner offices in white-painted chairs and tables, with merely a Japanese print against a gray wall.

"But, gentlemen, it seems obvious to me, so obvious that I wonder it has not been brought out before, that the ideal reception-room is a combination of these two schools! Have your potted palms and handsome pictures—to the practical physician they are as necessary a part of his working equipment as a sterilizer or a Baumanometer. But so far as possible have everything in sanitary-looking white—and think of the color-schemes you can evolve, or the good wife for you, if she be one blessed with artistic tastes! Rich golden or red cushions, in a Morris chair enameled the purest white! A floor-covering of white enamel, with just a border of delicate rose! Recent and unspotted numbers of expensive magazines, with art covers, lying on a white table! Gentlemen, there is the idea of imaginative salesmanship which I wish to leave with you; there is the gospel which I hope to spread in my fresh field of endeavor, the New Idea Instrument Company of Jersey City, where at any time I shall be glad to see and shake by the hand any and all of you."

III.

Through the storm of his Christmas examinations, Martin had an intensified need of Leora. She had been summoned home to Dakota, perhaps for months, on the ground that her mother was unwell, and he had, or thought he had, to see her daily. He must have slept less than four hours a night. Grinding at examinations on the interurban car, he dashed in to her, looking up to scowl when he thought of the lively interns and the men patients whom she met in the hospital, scorning himself for being so primitive, and worrying all over again. To see her at all, he had to wait for hours in the lobby, or walk up and down in the snow outside till she could slip to a window and peep out. When they were together, they were completely absorbed. She had a genius for frank passion; she teased him, tantalized him, but she was tender and unafraid.

He was sick lonely when he saw her off at the Union Station. His examination papers were competent but, save in bacteriology and internal medicine, they were sketchy. He turned emptily to the laboratory for vacation time.

He had so far displayed more emotion than achievement in his tiny original researches. Gottlieb was patient. "It iss a fine system, this education. All what we cram into the students, not Koch and two dieners could learn. Do not worry about the research. We shall do it yet." But he expected Martin to perform a miracle or two in the whole fortnight of the holidays and Martin had no stomach with which to think. He played in the laboratory; he spent his time polishing glassware, and when he transplanted cultures from his rabbits, his notes were incomplete.

Gottlieb was instantly grim. "Was gibt es dann? Do you call these notes? Always when I praise a man must he stop working? Do you think that you are a Theobald Smith or a Novy that you should sit and meditate? You have the ability of Pfaff!"

For once, Martin was impenitent. He mumbled to himself, as Gottlieb stamped out like a Grand Duke, "Rats, I've got some rest coming to me. Gosh, most fellows, why, they go to swell homes for vacation, and have dances and fathers and everything. If Leora was here, we'd go to a show tonight."

He viciously seized his cap (a soggy and doubtful object), sought Clif Clawson, who was spending the vacation in sleeping between poker games at Barney's, and outlined a project of going into town and getting drunk. It was executed so successfully that during vacation it was repeated whenever he thought of the coming torture-wheel of uninspiring work, whenever he realized that it was only Gottlieb and Leora who held him here. After vacation, in late January, he found that whisky relieved him from the frenzy of work, from the terror of loneliness—then betrayed him and left him the more weary, the more lonely. He felt suddenly old; he was twenty-four now, he reminded himself, and a schoolboy, his real work not even begun. Clif was his refuge; Clif admired Leora and would listen to his babbling of her.

But Clif and Martin came to the misfortune of Founder's Day.

IV.

January thirtieth, the birthday of the late Dr. Warburton Stonedge, founder of the medical department of Winnemac, was annually celebrated by a banquet rich in fraternalism and speeches and large lack of wine. All the faculty reserved their soundest observations for the event, and all the students were expected to be present.

This year it was held in the large hall of the University Y.M.C.A., a moral apartment with red wall paper, portraits of whiskered alumni who had gone out to be missionaries, and long thin pine boxes intended to resemble exposed oak beams. About the famous guests—Dr. Rouncefield the Chicago surgeon, a diabetes specialist from Omaha, a Pittsburgh internist—stood massed the faculty members. They tried to look festal, but they were worn and nervous after four months of school. They had wrinkles and tired eyes. They were all in business suits, mostly unpressed. They sounded scientific and interested; they used words like phlebarteriectasia and hepatocholangio-enterostomy, and they asked the guests, "So you just been in Rochester? What's, uh, what're Charley and Will doing in orthopedics?" But they were full of hunger and melancholy. It was half-past seven, and they who did not normally dine at seven, dined at six-thirty.

Upon this seedy gaiety entered a splendor, a tremendous black-bearded personage, magnificent of glacial shirt-bosom, vast of brow, wild-eyed with genius or with madness. In a marvelous great voice, with a flavor of German accent, he inquired for Dr. Silva, and sailed into the dean's group like a frigate among fishing-smacks.

"Who the dickens is that?" wondered Martin.

"Let's edge in and find out," said Clif, and they clung to the fast increasing knot about Dean Silva and the mystery, who was introduced as Dr. Benoni Carr, the pharmacologist.

They heard Dr. Carr, to the pale admiration of the school-bound assistant professors, boom genially of working with Schmiedeberg in Germany on the isolation of dihydroxypentamethylendiamin, of the possibilities of chemotherapy, of the immediate cure of sleeping sickness, of the era of scientific healing. "Though I am American-born, I have the advantage of speaking German from a child, and so perhaps I can better understand the work of my dear friend Ehrlich. I saw him receive a decoration from His Imperial Highness the Kaiser. Dear old Ehrlich, he was like a child!"

There was at this time (but it changed curiously in 1914 and 1915) an active Germanophile section of the faculty. They bent before this tornado of erudition. Angus Duer forgot that he was Angus Duer; and Martin listened with excited stimulation. Benoni Carr had all of Gottlieb's individuality, all his scorn of machine-made teachers, all his air of a great world which showed Mohalis as provincial, with none of Gottlieb's nervous touchiness. Martin wished Gottlieb were present; he wondered whether the two giants would clash.

Dr. Carr was placed at the speakers' table, near the dean. Martin was astonished to see the eminent pharmacologist, after a shocked inspection of the sour chicken and mishandled salad which made up most of the dinner, pour something into his water glass from a huge silver flask—and pour that something frequently. He became boisterous. He leaned across two men to slap the indignant dean on the shoulder; he contradicted his neighbors; he sang a stanza of "I'm Bound Away for the Wild Missourai."

Few phenomena at the dinner were so closely observed by the students as the manners of Dr. Benoni Carr.

After an hour of strained festivity, when Dean Silva had risen to announce the speakers, Carr lumbered to his feet and shouted, "Let's not have any speeches. Only fools make speeches. Wise men sing songs. Whoopee! Oh, tireolee, oh, tireolee, oh, tireolee a lady! You profs are the bunk!"

Dean Silva was to be seen beseeching him, then leading him out of the room, with the assistance of two professors and a football tackle, and in the hush of a joyful horror Clif grunted to Martin:

"Here's where I get mine! And the damn' fool promised to stay sober!"

"Huh?"

"I might of known he'd show up stewed and spill the beans. Oh, maybe the dean won't hand me hell proper!"

He explained. Dr. Benoni Carr was born Benno Karkowski. He had graduated from a medical school which gave degrees in two years. He had read vastly, but he had never been in Europe. He had been "spieler" in medicine shows, chiropodist, spiritualist medium, esoteric teacher, head of sanitariums for the diversion of neurotic women. Clif had encountered him in Zenith, when they were both drunk. It was Clif who had told Dean Silva that the celebrated pharmacologist, just back from Europe, was in Zenith for a few days and perhaps might accept an invitation—

The dean had thanked Clif ardently.

The banquet ended early, and there was inadequate attention to Dr. Rouncefield's valuable address on the Sterilization of Catgut.

Clif sat up worrying, and admitting the truth of Martin's several observations. Next day—he had a way with women when he deigned to take the trouble—he pumped the dean's girl secretary, and discovered his fate. There had been a meeting of a faculty committee; the blame for the Benoni Carr outrage had been placed on Clif; and the dean had said all the things Clif had imagined, with a number which he had not possessed the talent to conceive. But the dean was not going to summon him at once; he was going to keep him waiting in torture, then execute him in public.

"Good-by, old M.D. degree! Rats, I never thought much of the doctor business. Guess I'll be a bond salesman," said Clif to Martin. He strolled away, he went to the dean, and remarked:

"Oh, Dean Silva, I just dropped in to tell you I've decided to resign from the medic school. Been offered a big job in, uh, in Chicago, and I don't think much of the way you run the school, anyway. Too much memorizing and too little real spirit of science. Good luck, Doc. So long."

"Gggggg—" said Dean Silva.

Clif moved into Zenith, and Martin was left alone. He gave up the double room at the front of his boarding-house for a hall-room at the rear, and in that narrow den he sat and mourned in a desolation of loneliness. He looked out on a vacant lot in which a tattered advertisement of pork and beans flapped on a leaning billboard. He saw Leora's eyes and heard Clif's comfortable scoffing, and the quiet was such as he could not endure.