©he Beloved Physician. THE BELOVED PHYSICIAN A SERMON In West Church after the Decease of Dr. Calvin Ellis BY C. A. BARTOL BOSTON CUPPLES, UPHAM AND COMPANY 1884 THE BELOVED PHYSICIAN. Colossians iv., 14.—“ The beloved physician.” Note here a twofold sense of love, not for the individual alone for his personal qualities, but for that medical profession whose members more perhaps than those of any other calling come in contact with human nature on its affectionate side. Much of his case may by the client be hidden from the lawyer, or of his conscience by the parishioner from his pastor, but not of the bodily frame by the patient from his doctor; and this necessary confidence begets the rarest intimacy and warmest friendship. The trust in the practitioner may not be immediate, but is soon found to be inevitable, and in serious, chronic, ob- scure, and threatening disorder will perforce be com- plete. The constitution, the heredity, the habit, all behavior that bears on health must be told, on penalty of not having the cause of disease understood, the effect treated, symptoms traced, and cure soundly made. The lady was angry when the shrewd prac- titioner inquired the amount of opium she daily used; and he peacefully answered, I know you take it, I but ask how much. Cordial candor cannot be refused to kindly intent; and, when relief is afforded, the suf- ferer’s gratitude is beyond example lively and strong. The author of The Diary of a Physician relates that a patient to whom he explained that his apprehension 4 of a deadly malady was owing to a disarrangement of his dress forced on him an unprecedented fee. The old attending family physician, who has pulled parent and child through straits of danger edged with death, is unspeakably dear. How I loved and revered the gray-headed, rosy-faced doctor that came on horseback with his saddle-bags, expansive smile, and loud breezy laugh to my mothers door, while I could not get nearer than to a planet to the minister who preached original sin, particular election, and hell-fire. I preferred balm of Gilead in a bottle to the boundless burning brimstone which was not offered as a medicament, but a doom. It made no difference when the doctor pulled my tooth. The tendency of the 'healing art in its professors is to exercise and increase the goodness which fetches a response, finds a sounding-board in the human heart. But what are the qualities or qualifications of the artists, as, if they rebuild the shattered frame, they may justly be called. First, in their vocation, authority to act. This deep and delicate organism or process of mortality we call life, so liable in any organ or nerve to lose its ease and poise, is too precious to be put in ignorant, blun- dering hands, when you would not allow your watch to be regulated or your garment repaired by one who in time-pieces or tailoring is a quack. So, by medical societies, formed to protect the community and rec- ommend right men and measures for bodily restora- tion, a certain course of study and training is rightly required. But to this intellectual a moral condition of verac- ity should be joined. The physician knowing clearly 5 must deal truly, or the benefit of his knowledge will be lost in his negligence or .sacrificed by his rashness and hasty experiment, or by an over-dose that makes of the drug a bane beyond the degree demanded by the morbid state. “ Four times out of five,” said Jacob Bigelow, king of doctors in his day, “it is best for the physician not to move at all.” Said also his contemporary, the sagacious Dr. Shattuck, famous for quantity of medicine, “ The doctor’s business is largely to keep people out of harm’s way.” One may be well grounded in anatomy, pathology, therapeutics, surgery, physiology, and the psychology of these half- spiritual cerebral chords and convolutions that store and convey so much of gladness or distress; and yet, if he be not a truthful man, become a sheer deceiver, a pompous pretender, or mercenary adventurer in this wonderful sea of the human circulations, hiding in his Latin prescriptions, like a cuttle-fish in its own ink- Certainly, a measureless beneficence in the case of the ether-discovery waited on one audacious attempt, from which in actual experience a universal antidote be- came safe; but, ordinarily, it is the weapon which, like David’s sling, has been tried, that,- against ill affec- tions, fever, marasmus, stoppage, or insomnia, ought to be employed; and they deserve discrediting and discarding who plunge into a flood of guesses and vagaries, like a natural philosopher, not observing, but weaving theories for the facts to fit, with this difference,— that serene, untouched nature escapes the punishment which for fool-hardy ignorance human nature has to endure. A third outfit for the doctor of medicine is integ- rity. It is said the minister is sustained on sin, the 6 doctor on sickness, the lawyer on crime. But what men in general desire most, as Satan truly said to God of Job, is recovery from pain and prolongation of life, however many would spend it in transgressing and quarrelling still. Integrity in a doctor means that he will not connive with or cover up with his cloak or doctor’s ermine any of the violations, men and women not a few are prone to, of the moral law. In any legitimate association of doctors it would be considered wrong and unprofessional so to do. He is no doctor who wears a doctor’s livery to destroy, but a ruffian in disguise. But, in the host of claim- ants to cure, outnumbering clergy and advocates, with all their black cloth and green bags, there will be some everywhere who can be depended on for mal- practice of this irregular, Bohemian sort; and it has been even an industry, as our chief magistrate so fan- cifully said of a certain species of tanning, in great cities like New York. To protect crime, to shield and deliver it from the appropriate personal, legal, and social results, and thus encourage and multiply it, is itself a heinous and hideous crime, actually com- mitted to a great extent. “ Woe to him,” saith the old prophet, “ who frameth mischief by a law,” because countless calamities arise from one bad law, like the Fugitive Slave law; and woe to him, be his profession divinity, medicine, or law, who contrives misery as gross and wide by any custom of procedure which condones iniquity and operates with the force of a law. Certainly we must discriminate while we judge. Every case stands by itself. There are individuals, rather unfortunate in circumstance than wicked by design, whom it might be cruel and needless to ex- 7 pose, and it is the doctor’s peculiar, pre-eminent grace to be humane; but he must have better than dia- mond scales to weigh with, and it is not generous to society, to civilization, to the human race, but a false kindness to others, while perhaps a selfish greed in himself, to patronize the vileness so ready as a this- tle or nettle to catch and blossom on a broad scale in that field which is the world; and the abundant rec- ompense he may get for counsel and complicity in the prevention of offspring or murder of the unborn, like the shekels Judas first received from priestly hands, and flung down to ring for all ages on the temple floor, is the price of blood. These remarks were an indecorum, but for the penumbra, the shading off in every profession grad- ually from the honor which is bright into transac- tions of doubtful or shameful hue. Honorable men, aware that no creatures are more odious to them or deserving censure and excommunication than some who wear their armor and would train under their banner, will not only pardon, but gratefully rejoice in a fair distinction between genuine promoters of human welfare and such as but ape and mock them, as much as did those of old, disguised as sheep or the thieves that would pass for shepherds, though entering into the fold some other way and not by the door. Some Moses must bid some Aaron to run again with his censer of fire from the altar to stand between the living and the dead till the plague be stayed. In these general strokes, I have blocked out a par- ticular theme. I am to speak of one I have known from a lad of eleven to ripe fifty-seven, blossom and fruit of that tree at whose root no axe can be laid. 8 No man living in this community has ever better answered to the image of a true and good physician than Calvin Ellis; and he so esteemed, he so utterly and enthusiastically loved his profession, that I think nothing could please him more than to be described as wishing and striving to be faithful to its demands. First, he, if any man, bore in his own person its authority, not in the way of assumption and pomp satirized by the French writer, Moliere, and some- times still seen,— for of pretence no man could be more devoid,— but by his preparation and fitness for the work. He was a teacher, and Harvard University owes largely to him its improved methods. He was an investigator, never ceasing to be a student, learn- ing at once the last discoveries at home or abroad ; eminently a scientific doctor well-equipped. As a lect- urer, he was gracious to his pupils and pitiless to their mistakes. Among his comrades, none stood nearer the top of a profession whose summit, in the yet unsearched mysteries of our double nature, is a Him- alaya unreached. Forward practitioners might call him slow, when he was but sure and incapable of a false step in his task. Swift to apply as an axiom was his judgment, the symptoms once known. That susceptibility, which no philosophy has yet reckoned, of the bodily frame to moral and imaginative as well as to strict medical influence, especially in the more delicate physical conditions of women and men, opens a wide margin and undetermined sphere whose wise occupation tasks the greatest genius. Beyond the region of specifics, it leaves the packed medicine-chest without use, yet calls on the trusted doctor to be mas- ter of the situation, as with the sharpest test; and it 9 gives opportunity to the impostor to delude, prevari- cate, and play unfair games on human hopes and fears. From the resources of his own respect and affection, a true-hearted practitioner may bring about what seem magical or unaccountable issues. Your servant, Mad- ame, said Dr. James Jackson, forty years ago, to a dan- gerously sick woman of this flock, pausing and bowing at the foot of her bed ; and, as the gently toned reas- surance fell on her ear, she told me she began to recover at once. Such scarce conscious service in his friendly manner Dr. Ellis rendered. But he was devoid of tricks. He had no airs with hat and coat, cane and gloves, like some ladies with their fans. He was simplicity incarnate, a medical saint. Never anywise, to guess or trifle or rush into what is called heroic practice, did he abuse the weakness that had put a patient into his power. I have had opportunity to observe his style. In the territory of fancy and tentative treatment, it was not his will or nature to travel or disport, “And simple truth his utmost skill.” As in the college, he was solid and perspicuous, not caring to be eloquent, nor having any oratorical robes to put on; so, in the sick-chamber, was naught vague or mystical in his views of the disorder or means of cure. His authority was in what better than others he knew and could do. If he hated anything, it was the presumption that would substitute for science a riddle, and for art the running of a risk or a bold push after success. Thus, he added to authority the second doctoral mark,— veracity. He was constitutionally sincere, and IO had the truth in his race and blood. His candor, second only to his kindness, was a main reason of the delight we took in his company. But there was no pur- posed display of these traits on his part. None farther than he from being a show-man ! Not so-called demon- strative persons win most our regard; but those from whom virtue escapes, as it went out to the sick woman from the hem of Christ’s garment. To his profession or his patient, no man was ever more true, as I have had occasion well to know. He neither misrepresented the conditions, nor with illusory notions buoyed up what must sink. But never was soldier at his battery more resolute to maintain his position, to stand his ground. He was open as the day; yet, if a patient improperly and impatiently insisted on such a knowl- edge of the situation as could but do instant perhaps fatal harm, he would refuse. If cornered and driven to extremity, he might even contradict the literal fact, understanding that his business was not to kill, but, if he could, at all hazards and in any event, to heal. When a fact is a dagger, and would assassinate, it must be sheathed. Jesus said, “ I am not come to destroy men’s lives, but to save,” and “ I have many things to say unto you, but ye cannot bear them now.” Is this to be untruthful? No, I answer. The truth is not a fact, but a spirit. A fact may be the property of one man. The hunter must not be told the place where I have hidden a fugitive slave, or a thief or burglar in- formed of the letter at which the lock will open in my safe. Many a fact is a private possession, not to be published in the newspaper or on the street. The truth belongs to all men, and it may not be thwarted by, but consist in withholding from some men the 11 fact, as Desdemona was true to Othello in charging herself, not him, as the author of her death. The fact is a circumstance. Truth is the whole relation. If declaring fact or opinion will be a stab to his pa- tient in a sensitive state, if it will be apt to stop the action of the heart or paralyze the brain or asphyxiate the lungs, and aggravate every evil symptom, it is the doctor’s duty not to admit, but reserve not as his but in trust from God. In so doing, he does not compromise, but maintain and illustrate his truth to the person, be the squaring with the external incident what it may. Many a doctor has blurted out a judg- ment which proved incorrect, has pronounced a doom not executed, or by an impulsive word slain a sufferer that might else have lived. There is peril in this doctrine of the right and duty to keep back or gainsay the pathological fact, if in the exercise it have the least selfish taint. But what- ever is practised by pure love is no lie. We lie against God and man when we launch a verity to an end of injury and from a motive of hate. The man I speak of was of a rarely transparent and crystal quality. To no one that ever lived was con- cealment more awkward, difficult, and strange. He was never covert, only close, as he was bound to be, to unbecoming and impertinent questions. I tell my patient his condition, said that old Dr. Shattuck, if he have a strong mind. If any imperative duty will be left behind undischarged, one ought not to be blinded or shut his eyes to his approaching demise. But for a physician to sacrifice the object of his calling to su- perficial and garrulous communication is not truthful- ness, but treachery. 12 On my third point of integrity in my subject I need not dwell. He was so intangible and unap- proachable by any emissary from or refugee in the Alsatia of unlawful and corrupt practice that probably few of us were even less acquainted with it than was he. But, in the professional character, point by point the entire manhood is involved; and than this man no chivalrous knight was ever more without fear and without reproach. His honor was as polished steel, which no breath ever blew on or could have dimmed. J ustice in him was as if it were the natural and only possible thing. He told me, in our last conversation, that he considered it a refined cruelty to keep women out of any posts they are competent to and can be taught and trained to fill. He was a loyal citizen, as earnest in politics as in his especial art; and, sick as he was, he went at the last election in Boston to vote, then returning to his bed, and afterward coming expressly to my house to bless me for my own course. He saw ecclesiastical as distinctly as political tricks, and classified them alike, branding deceivers in the Church and adventurers in the State under the same uncompromising name. He was no hard, uncharita- ble judge. He told me the Athanasian Creed was to him absurd, yet he would not stigmatize any by whom it is held. On any of the old theologies, this radical thinker laid little stress. His speculations and theories he kept to himself. His religion was the tenor of his life and very substance, inseparable in any formula from his soul. He was practical, but interested in whatever concerned the common weal, and could talk philosophically on any matter. The 13 interlocutor must be very able, failing to find in him, if not a master, a match. He was discerning, and could see things on the serious or humorous side, once telling me of a lawyer who had used him and consumed his day getting testimony from him as a medical expert, and then dropped him like a squeezed orange, without suitable pay. He was generous, of his own motion advancing a thousand dollars to meet the expense of a card-catalogue of the medical library in this city, so unostentatiously that, so far as I know, this is the first public notice of a gift which any blazonry would to his mind have spoiled. How could this catholic Puritan help being beloved in his home, among his kinsfolk and friends, by his com- rades and in the sick-room ? The narrow way as he trod it became a royal road. He was the soul of honor, a pattern of fidelity, model of sanctity, example of an unspotted life. Some ten years ago began his own failure of health. For the last three years, his patience has covered his pangs. How unexacting and uncomplaining he was! Once only, just before the last mortal attack, he remarked to me, “ I can bear the pain, if I might be spared the sickness, the dreadful nausea.” We knew not how soon his prayer would be answered and he be spared! He had said he would visit a certain patient, if he had to crawl on his hands and knees. Patient and physician both now are where they run and are not weary, walk and faint not, mount up on wings as do the eagles. But what words are there for this heroic martyrdom on earth, clothed in such a luminous countenance of good cheer ? I know not how to compare or portray it. The man who must presently disappear from the deck of the foundering ship, or be suffocated in the upper story of the burning house, or washed away by the torrent from the dam among the roaring hills, or go over the rapids to the Niagara cataract in his boat, resembles the victim of a fatal disease, save that his trouble is short. But not only to face the inevita- ble end of chronic illness, but endure the broken or crippled tools of one’s faculties, to view the prospect of disability in middle life, when the prime of hope has become the bloom of success; to relinquish, not the reward of merit, but prize of beneficent service, is a hardship one can be made equal to only by an absolute trust in God, such as our friend felt, and was made brave and blessed by. On what but the rock could he build? Here and herein is the so much de- bated immortality of the soul. This, indeed, is spirit manifest, whose definition is that which cannot die. Here is something God may think it worth his while to keep alive out of “ the wreck of matter and the crush of worlds,” if he would preserve anything, or in any kindred companionship care to continue himself. When we come to ourselves and to one another in this temper, to bear and do all he wills,— be it pain, disease, or death,— ready, as we may be for any lot of extinction, if he please, it is impossible to think our- selves or one another out of being. Dead spirit is a contradiction in terms. Our knowledge is small, our ignorance vast, and how the immensity is peopled no telescope reveals. Marvellous is it that the only part to us known to be inhabited, of the creation, is this little mote ! Yet that the universe we are deni- zens of has other occupants and space for our spirits, 15 who, whenever by love and thought exalted, can doubt? The happiest of moods is the child’s first sensation going into the man’s last sentiment of trust. Immortality is not an article in our creed or word on our tongue, but a confidence in our Father, who cannot do without his children any more than they can do without him. It has fallen to me several times in the course of my ministry to commemorate wise and good phy- sicians in this place, bearing in mind that the Master at first sent forth his disciples both to preach the gospel and to heal the sick ; and moreover in poor return of speech for favors without money and without price from many members of the medical brotherhood and sisterhood received. Aside from the fond womanhood that comforts one’s home, and without which were no home to console, let me affirm that with the patience, liberality, disinterestedness, devo- tion unto death of doctors, I have found nothing else in this world to compare. Despite competing theories or jealous rivalries in different modes of practice or in the same school, I believe the doctors of Boston, of either sex and every name, will be glad of such even inadequate word as I have been stirred to speak concerning one of whom the fraternity in all its ranks and ages may well - be proud. He was coming to be a consulting physician more and more. There will be none save witnesses to his tender and conscientious respect for the rights of his seniors or juniors in consultation or in the care of those patients often unavoidably transferred from hand to hand, as the cars of diverse railways in the exigencies of business are scattered and mixed throughout the land. 16 Doctor Ellis .longed for the betterment of the healing art, and had commenced a work touching on the diagnosis and treatment of disease. He was, from broken health, unable to finish what we may hope will appear in some form, to add to the evidence of his unsurpassed thoroughness in his chosen pur- suit. Perfection is in no man. All men err or come short. Most persons lack consistency or character, like a solution that has not precipitated or crystal- lized. This man, whatever his errors unknown to me may have been, had none of the leaven of the Phari- sees, which is hypocrisy. He never made duplicity his starting-point, or any blind alley his goal. No man or woman did he ever maltreat or betray. Who- ever knew him sees him still, a figure we cannot mis- take, clear in his conscience, stout in his conviction, unaggressive and unyielding, of a true and noble spe- cies, so marked that in every trait we can make him out. He was a plain dealer with such as asked his advice, and so deep and warm in his comrades’ hearts that, could their united skill have availed for his suc- cor, our brother had not died. If we inquire why, in this house of human life, such fiery anguish must be so long and severely borne, save in recognition of the will of God, and as monumental example of what his grace can do in the human soul, there is no reply. When this little live human dwelling is caught with flaming woe, the whole world takes the color of the conflagration; and, as, when a wooden lodging is on fire, the inmate looks around for some exit, so a departure is mercifully pro- vided from this inn of flesh, this theatre of time. l7 Death is the door out. Organic decline, with its slow stages, is a somewhat chronic fire-escape. As when, by a vomitory from some crowded hall, one finds him- self released from pressure and refreshed with breath- ing the open air, so must it not be with the spirit dis- emprisoned from the oppressive and tormenting clay? But, long as trial or torture may last, the divine beauty in our humanity of what we call thq affections does not fade. Be the physician’s prognosis what it may, loving sentiment, the core of our being, is prog- nostic of everlasting life. What is the title-deed to such an inheritance ? I answer, Care for another and abnegation of self. Can I forget, here or hereafter while I live, that my friend wished to see me when he was ready to die, but would not have me sent for, only I might come in, if I called? Such sacrifice in agony, with never a question or morsel of com- plaint, bespeaks an imperishable nature. He that will lose his life for my sake shall save it. No mat- ter for the sake of whom or what it may be lost, gospel or daily stint, humblest friend or savior of the world! The man, dear to me, whom I cease not to love now that on earth he is dead, needed not to be consecrated to that to which he was inclined. His duty was delight in the fulfilling of what was set be- fore him, in or out of his calling, in any professional or social tie. The beloved physician, absent from sight and speechless to our ears, through me, as inter- preter of some syllable of his new language and an- gelic tongue, greets you to-day. I have a vision of him speaking or seeming to speak, not as Dean of the Medical Faculty or Jackson Pro- fessor of Clinical Medicine, not as the father confes- 18 sor which the doctor necessarily becomes, more than any priest in his curtained alcove, holding secrets as vital of private persons and families as any in the priestly breast; but in purely unofficial and friendly tones, wearing no distinguishing garb, plainly dressed, without ring or glittering pin or velvet gown. His quick motion, alert and vigorous step, ten and even seven years ago, expressed and befitted his mental poise, his well-grounded persuasions, and that sturdy will for action and enterprise which in the latter period he has had to expend inwardly on fortitude intense. But the soft, low-pitched voice and deep blue eye tell of a sensibility in that benignant form which equal and span his resolve. In his port and manner is proof that he exists to serve, and that work for him is not labor, but joy. Go to Florida, I said to him, two seasons since: you will have an Ital- ian climate there without crossing the sea. I should take my disease with me, he answered; and what should I have to do ? I think he has gone to heaven and with his occupation is still pleased. If we ask, What is his bequest to his fellows, juniors and peers ? I would put it in Paul's words,— Know ye not that your body is the temple of the Holy Ghost? Can there be a worthier or more re- sponsible employment than to stand guard over and repair what the Supreme Power builds for its own shrine, or a more unpardonable sin than the sacrilege by which this altar is in any way wilfully ruined and rent? We touch heaven, says a German author, re- peating the apostle’s thought, when we lay our hand on a human frame. Benvenuto Cellini, the great Italian sculptor and worker in precious stones, said to 19 his students, This is what I worship, holding out to them in his hand a small bone from the lower part of a dissected body. We may well adore the Fash- ioner, if in nothing else, for this astonishing system of flesh and blood. Ole Bull said that the last violin- makers do not furnish instruments so fine as those of Stradivarius, and others formerly eminent in that line, because they no longer consider it a holy mission. Our friend, whose translation is a gain to him,— but grievous loss to us,— did consider it a holy mission to heal. How reverently I have seen him make a stethoscope of his ear! Ever tender, firm, yet lowly all his handling of his patients. What love of men and women followed him here, seeks him beyond, and salutes him there ! His legacy to his brethren is his own sacred discharge of his personal and profes- sional trust.