Chapter 7 - The Doctor attends
If there was one thing that gave Dr. Broad satisfaction, it was a cash customer. One that paid promptly, this is why his surgery was located within walking distance to the middle-class areas of the town and also very conveniently placed for a farthing (quarter penny) trip on the tram.
Observing a lady arriving on the tram was an assured way of gaining an immediate appointment with the doctor. It was well known fact that a lady on a tram would have her return fair, plus a shilling for the doctor’s consultation and another sixpence for the pharmacist.
Indeed, such a lot could be taken for granted in the mode of arrival. Strange as it might sound in these days of grand philanthropic gestures, his assistants were positively encouraged to discourage; both the working and upper classes. The Working classes were therefore informed of the doctor’s charges before consultation.
It was as easy as selecting off of a menu, with each initial and follow up procedure priced. Everything from a death certificate - which was usually the only time the patient saw the doctor - to childbirth. Each was carefully itemised: childbirth with midwife, childbirth with midwife and registrar, childbirth with midwife and senior partner. Both the patients and the doctor’s success rested on how much you could pay.
As for the upper classes and aristocracy, everything was on account. Usually, on account of the fact that they had no money. Dr. Broad often mused on the fact that if he had to choose between the working and upper classes, he imagined his preference would be for the working class. A much more honest situation, they didn’t whine as much when you told them the bad news. The upper classes seemed to think the world owed them something for nothing. It was in such a frame of mind that Dr. Broad was rested from his thoughts by the knock on his surgery door.
‘Yes,’ he proclaimed in his most positive voice. After all this was his dominion why be shy. The door opened and Mrs Jenkins entered. A tall straight-backed woman with a waspish figure and a face to match. She was dark haired and brown eyed always with pursed lips, as if each word had to fight to be let out.
Mrs Jenkins managed the daily running of the office, as well as overseeing the reception. Her morning routine never fluctuated. As soon as surgery had finished, she would take all pertinent records in regard to today’s surgery, plus the list of house calls to be made into Dr. Broad’s office.
There she occupied her exalted position at a small mahogany table situated at a right angle to Dr. Broad’s impressive desk; which greeted all to his dominion. She laid out the patient records and her lists. It was only now that she spoke, nodding in deference to him.
‘Good morning Dr Broad, I have instructed Jennifer to bring tea into your consulting room for all the doctors’ this morning and arrange for the boy to prepare your car. There are several house visits to be made and some of the younger partners surgeries have overrun by several minutes! A suitable pause was left at this juncture to enable his awareness of the situation before she continued.
‘I leave this point to your attention Dr. Broad.’
‘Excellent Mrs Jenkins.’ Dr. Broad beamed, there were two things here which instantly gratified him; the first was, “his attention” being sought for anything and the next was the knowledge that he had a number of house visits. His trips always now included the use of his auto-mobile, a French DeDion which had been recommended to him due to its ease of operation and reliability. The boy was in reference to George, the housekeeper’s ten-year-old son. It was his job to accompany Dr. Broad on his rounds and ensure that the car was not stolen or tampered with while Dr Broad, was treating the patients.
Indeed, in some parts of the town, it would be vandalised for its ostentatious show of wealth that it betrayed and of course - wherever it was parked - it would always attract a crowd of onlookers. The adults would observe from a distance, while the children would always want to touch it, such was the rareness of an auto-mobile on the streets.
It was now that the junior partners entered. They had all waited as custom dictated outside Dr. Broad’s office, until all were present. The senior of the group knocked and entered the room, observing both Dr. Broad and Mrs Jenkins, in their customary positions. The junior partner stated the obvious.
‘Good Morning Dr. Broad, we are assembled and ready for the practice meeting.’ Dr. Broad experienced an inward sense of satisfaction at this.
‘Excellent, my dear doctor’s please do come in and arrange your seats as usual.’ The first two doctors took the mahogany dining room chairs, these were directly in front of Dr. Broads’ desk. The third chair was taken from its position against the wall. These chairs in contrast to the ones in the junior doctors consulting rooms, had padded fabric seat cushions. Each doctor sat with their case files on their knees.
The agenda of the meeting would take the form of Mrs Jenkins calling first Dr. Broad’s name. He would then relay the relevant information as to each patient seen, describe the ailment, and any treatment given. He would relay information to Mrs Jenkins by informing her in a rather theatrical way.
“Mrs Jenkins, please be so kind to update the patients notes with...” Or “I have updated my desk diary as to their next appointment.” Proceeding through each of his patients’ folders, scanning each in turn before moving it from the pile on his left, to the pile on his right. Once completed, his desk diary would be placed on top, a neat bundle for Mrs Jenkins to take away and update the office diary.
Similarly each doctor was called in turn by Mrs Jenkins. Most were understandably not as elegant as Dr. Broad. This in part, was not down to their oratory but to their preoccupation of balancing their patient folders and diary and attempting the same dexterity of hand without a desk to assist. All would listen intently. Occasionally an interruption would be made, usually by Dr. Broad who would comment one of his several stock phrases.
“Excellent diagnosis Dr. I presume that was after you checked the… That you made your decision?” At which point, a pause while the recipient would either apologise for not explaining themselves clearly to all present, or indeed in some cases flush with embarrassment. But always the reaction would be that of an apology.
The hallowed walls of Dr. Broad’s consulting room had heard many things. The one thing those walls had never heard, was any junior within Dr. Broads’ employ, knowing a more radical or up-to-date treatment. Longevity of a position, at Dr. Broad’s surgery and a possible partnership, was achieved with a bitten lip. After all, with his many company accounts, including some of the smaller coal mines and ship building companies. A registrar’s position with Dr. Broad, would open many doors later, due to the variety of work and the contacts you could make through his professional acquaintances.
As the last syllable died away Mrs Jenkins, placed her pencil down, stood up and went to the door.
‘Mrs Emmett,’ she called.
‘Please ask Mrs Landis, to bring the tea now and if you would be so kind as to collect the patient records.’ Within moments both Mrs Emmett and Mrs Jenkins were in the room, performing their tasks. Each doctor placed their records into Mrs Emmett’s’ care. Thus freeing them up to attend the sideboard at the back of the room, were Mrs Jenkins had placed a tray with tea and a selection of meat sandwiches and bread, the bread lightly spread with butter. If jam or marmalade had been in attendance, this would have signified a Saturday morning, which indeed was not the case.
Mrs Jenkins busied herself while the doctors’ took their tea. Having observed each doctors’ seated position, she placed the patient notes on their seat. There were also instructions for each one, who was making house calls, how to get there, plus additional information on the patient, such as if they were required to request payment before treatment. After several minutes chatting Dr. Broad returned to his seat, this was the signal that the next round was about to begin, each returned to their chair as if by a hidden command.
‘Now Mrs Jenkins, let us proceed with our further business.’ Mrs Jenkins courteously bowed her head slightly to acknowledge Dr. Broad’s request, cleared her throat and began with the usual overview of what work in total beheld them followed by the breakdown as to why she had assigned cases to each.
She again bowed her head to Dr. Broad, acknowledging that it was by his mentoring that she had this ability, both he and his ego returned the nod. She described each case and any special instructions; today was a good day, none of the appointments were questioned. Dr. Broad, now summed up the general situation for the practice, finally thanking those assembled. At which point the sentiment was reciprocated by all present, with their patient notes grasped tightly, they left the room to begin their elected surgeries or rounds. They left the office in a similar procession as the arrival - with the most senior first - exchanging words of advice to each other, usually on the peculiarity of one of the patients a colleague had to visit.
With the room empty Dr. Broad, now opened the sideboard and took his medical case out. Placing it on top he opened it, checking that all was present for the appointments he was to attend. He talked to himself out loud while doing this.
“Oh yes and a new pad of death certificates.” Today was going to be one of those days.
He left the room shouted for George (the housekeeper’s son) and made his way into the private part of the house, stopping in the hall to don his overcoat, gloves and hat and lastly picked up a stout round top cane. He checked his appearance in the hall mirror, he noticed he was becoming rather thick set. His tailor had mentioned it at his last fitting, how the tape measure was stretching more each year, but all in all, he looked every inch the man he thought himself to be.
His right-hand fingers felt inside the watch pocket of his waistcoat taking out his gold watch, he pressed the winding mechanism; the spring opened the case and revealed the white face of the watch. It was a fine timepiece; the slimness of it betrayed its quality, as did the plainness of the case it was housed in. He checked it out of habit as opposed to a need to know the time and went outside. The car stood waiting, all that was required was for Dr. Broad to pass his medical case to George and climb into the car.
It was late in the morning that Dr. Broad’s car stopped outside the Burns house. As he stepped down from the car, the door was opened to him. In the hall Jane observed the formalities, thanked him for coming and asked if he would like to relinquish his outside wear. He thanked her, it was best in these cases to oblige the host. The obvious as usual was stated. He observed her as she did this, she was a handsome woman mid to late twenties, her face betrayed the struggle, she had been through. Her eyes were blackened through lack of sleep over a prolonged period, the complexion sallow, the skin appearing taught; yes she was worn out. She placed his things carefully on the hall stand.
‘I’ll take you to her,’ he followed her up the stairs with Albert in the rear hovering like a supernumerary spectre, nothing was said, there was nothing that could be said.
They entered the room, it was well presented the light from the dying fire gave the room a beautiful soft glow, a scene from a fairy story casting a warm light over the fair-haired child in the bed. Rather than draw the curtains, Jane lit a taper from the box on the mantle piece of twisted tapers made from old newspaper, lifting the glass cover on the gaslight she turned on the gas tap, it popped and hissed as the pressure built. The taper was offered and it ignited, the orange flame flaring as it did. She adjusted it and replaced the cover, the light in the room varied as the pressure of the gas light fluctuated.
It was now that Dr Broad having waited for the room to be lit became industrious. He moved to the child placing his case on the cabinet by the bed stooping over the child, he took her still warm hand feeling for the pulse. He knew it to be non-existent, by just the general observation of the child, he placed her hand back on the sheet and stroked her hair gently as he did so to give some consolation to her parents looking on.
The smell of liniment was prevalent in the room and for all his ostentatious show, he like most had started off as a junior doctor over thirty years ago with one cheap suit and two shirts in a North Shields dockside practice. He knew this smell, he had first smelt it in 1870, on one of his first visits to another dead child, it was the smell of the local poor nurse. He moved his body slightly, to block the view of the parents and his keen hands checked the upper torso of the child. There as expected he found a poultice applied to the chest. He moved the bed clothes to one side, raising the poultice, his fears became realised.
There was a burn mark that had penetrated the skin, it looked more like a corrosive wound. These dressings were normally applied hot, but this must have been agony for the child, he knew instantly, this was the work of one of the local woman, these women were called on by families who could not afford the doctors prices. His rage was such that, it indeed was fortunate his face was not turned to Jane, it was true, he probably could have not saved the child, but at least she would not have gone through this agony.
He replaced the covers and having composed himself, turned around.
‘I’m afraid it was the influenza. I am so sorry for your loss.’ He motioned with his opened hand to the door.
‘If we could go downstairs. I have the necessary certificates with me that you will require.’ Jane lead the way to the front parlour, reserved for Sunday afternoons and special guests. It was a very neat room with a fine mahogany dining table at the back of it. Dr. Broad noticed that both ink and pen and some paper to act as a blotting pad had already been laid out.
He sat placing his bag on the floor beside him. He took out a new certificate and set to work filling in the necessary details. There were several copies required, as he finished each he explained who it was for and the process to follow.
‘Would you like me to ask Mr Taylor to come and help you with the arrangements?’ There was a pause before she responded.
‘Yes, that would be kind. I was going to ask Albert to go but...’ For the first time her voice tailored off.
‘Please, my dear Mrs Burns. I shall see My Taylor within the hour and ask him to attend.’ Enough had been said, with the formalities completed, Dr. Broad rose from the table and extending his condolences again, made his way into the hall. Albert and Jane accompanied him into the hall, Jane handing him his outside wear.
‘Oh Doctor... I’m sorry your account, I need to settle it.’ Although to his junior partners Dr Broad portrayed a man who took a shilling where he found it, if the truth were known, he despised the commercial side of his operation.
‘Ah yes, well.’ He was quite uncomfortable, he would have been happier for them to attend the surgery and settle the account at a later time.
‘It’s five shillings for the visit and certificate.’ He knew though that these were proud people, who would not owe the world a penny. The words nearly caught in his throat as he said them, he really hated this part, especially charging for a child. A small purse was opened and the necessary monies taken out and given to him. He thanked them, his faculties as a physician returning to him.
‘Have you any other children Mrs Burns?’ She answered in the affirmative.
‘Yes Doctor three boys, two older and one younger than...’ She hesitated for a moment, ‘than Alice.’
‘Are they in the house now?’
‘No doctor, they are with Albert’s parents.’
‘Do any of them have the flu or any symptoms?’ She again responded in the negative. He picked up his hat from the hall stand, placing it in the same hand in which he was carrying his doctor’s bag. He now fixed his gaze on her, ensuring that she was looking directly at him.
‘If you notice anything, no matter how small, I want to see you and the boys.’ He finished his statement by now looking at Albert who nodded. There was no point in him labouring the point any further, they had first-hand experience of the possible consequences of not. Placing his hat on and taking his cane from the umbrella stand he took his leave, the door closing behind him.
The fresh air rushed into his nostrils, the smell of the poor nurse would remain with him for slightly longer. The door opening had been the primer for Bob to leap into action instructing the children, who he had already not allowed within three feet of the car to.
‘Stand clear Dr. Broad is here.’ He set the magneto and controls as required and went to the front of the vehicle inserting the cranking handle, on the first pull it burst in to life within a second they had both mounted the vehicle, the accelerator was adjusted, the gear engaged and the handbrake disengaged as they clattered along the cobbles.
George was informed that there were two more visits after which he would be dropped off on the way back at Mr Taylor’s, where he would inform him of the houses he would visit. This was pleasing to George as Dr. Broad would furnish him with two pennies for doing this task; one which was meant for the tram back and the other, his treat to buy some candy. Though George would spend one and keep the other.
He would also get a penny from Mr Taylor for being prompt. George always thought it a curious state of affairs, that Mr Taylor’s pleasure was in others sorrow. The more sorrow he brought to Mr Taylor, the more the likelihood of an additional penny. There was not a lot that the Dr. Broad and George had in common, other than their love of the car, so this was usually the topic of conversation. Today Dr. Broad’s thoughts lay heavy on his mind. George tried to engage him with his youthful enthusiasm. Quoting a passage attributed to the mayor, he had read in the Echo, on the “leaps and bounds in social care which had been put in place over the last year of his administration.” Usually, this would engage Dr. Broad with some favourable excuse to talk until there next call, but today the answer was shorter and more concise.
‘Strange, I feel as if we haven’t moved on since 1870.’