S. Weir (Silas Weir) Mitchell.

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Butbor's definitive EOitton







Copyright. 1891. 1892, by





HIS book is a broken record of por-
tions of the lives of certain friends
of mine, and of what I, Owen North,
physician, have seen and heard. My
people, who were of the Society of
Friends, came from Wales, and were
with Penn in the Welcome, but had lapsed from grace
and followed the religious guidance of Hicks. I was
further emancipated by the study of medicine, which
I took to because it interested me and not of necessity,
since at the age of twenty-one I was a man of ample
means, free to do as I liked. After a year of hospital
work, and three years of added study in Europe, I came
home to settle in my native city.

Whatever value this irregular account of myself and
my friends may have is due to the care with which I
have watched the developmental growth of character.
I like, therefore, to say at the outset what I appear to
myself to have been leaving the reader who likes to
follow me to learn for himself what life did to foster
the good or ill that was mine by nature. In early


manhood I was shy, reserved, and self-conscious. Al-
ways ambitious, and disliking failure, my youth did
not supply me with such other competence of motives
as to urge me to success in consecutive study. What
I liked to do I did fairly well When older I found
that the power to do best what I enjoyed doing led at
last to the easier doing of whatever I willed to do. I
cannot remember that as a boy any intellectual work
had for me the smallest attraction. In those days it
was thought in my native city not quite reputable to
have no distinct occupation in life, and under this
influence I began to study medicine. As I became in-
creasingly interested in the studies of the profession I
had chosen, I was curiously surprised to find that the
capacity to concentrate my thoughts, which I never
had in youth, rapidly grew ; in fact I developed later
than most men. About the time I began to like scien-
tific study I lost for life the sense of ennui which had
been one of the peculiarities of my childhood, and too,
with success, became quietly sure of myself and more
and more capable of sustained effort. Finally my
long absence abroad enabled me usefully to escape
from many of the narrowing associations of my youth,
and to enter on life untrammeled. I found, indeed,
as I grew older, that the comrades of my youth were
no longer such. I had moved away from them ; but
friendly time brought others whom I learned to love
better and with more reason. It is only needful to
, add that I succeeded in my profession, and at the out-
break of the great civil war was in an enviable posi-
' tion, having a practice far beyond what would have
been possible in Europe at my time of life.


The call of war stirred me in many ways. My peo-
ple had been Friends from the day of their landing in
America, but I myself had ceased to be, like them,
troubled with scruples as to war. I only hesitated as
to how best I could serve my country. That in some
way I must do this was clear to me. As to slavery I
had been little disturbed j it was a gangrene sure in
time to die of its own accursedness. But the thought
of a dismembered land, and, above all, the final insult
of Sumter, settled for me, as it did for thousands, what
I ought to do.

I soon saw that as a surgeon I could be of most use.
I was, as the world goes, rich, and had no need to
consider the future. Accordingly I gave up all my
appointments, and entered the service as an assistant
surgeon in the regular army. Of this life I mean to
say little.

I could wish that some one would fitly record the
immense services of my profession during the great
war, but this is not the place to do so ; and I content
myself with the merely personal statement that I was
almost incessantly occupied with field duty. This
open-air life gave me the physical vigor I somewhat
lacked ; and this I saw occur in many others. Despite
5 the cripples made by war, and those who came out of
I it diseased, I am disposed to think that the survivors
1 returned to civil life with, on the whole, a larger cap-
ital of available energy than the like number would
have possessed had there been no contest. I was soon
to learn in person how valuable was this toughening

We were lying before Petersburg, very weary of the


siege, with its many failures. An attack at dawn on
the left flank of Lee's extending lines necessitated the
usual ambulance service, and for this I was detailed.
The effort on our part failed, and the return attack
cut off for a time my ambulance party and a number
of wounded. We were in a rather dense wood, and
remained unperceived until toward evening ; nor was
it prudent to attempt escape. The firing had been dis-
tant and irregular most of the day, and near dark,
hearing the groans of wounded men somewhat nearer
to the edge of the wood, I took a sergeant and two
men, and went in search of them. There were many
dead, and, lying among them, three more or less badly
hurt; one of these needed immediate amputation of
an arm, and we set about this at once. Meanwhile a
sharp firing broke out on the right ; the balls began to
fly over us so that the twigs fell about us from the
trees. Rarely does a man have to operate under fire.
This time it fell upon me to do so, and as I began my
assistant suddenly cried out, "It is no use, doctor."
A sharp convulsion shook the body of the wounded
man, and, looking up, I saw that a bullet had gone
through his head. A moment later I felt a blow on
the back of my neck, and lost consciousness.

I cannot say how long I remained insensible. By
degrees I began to see the trees, the moon, and the
swift hurry of clouds across its brightness. I faintly
remember that at first I connected their quick motion
with retreat and failure, and was hurt with the shame
of it. Then again I lost it all, and for a time how
long I do not know rose to brief spells of dream-
haunted consciousness. The sadness of dawn was in


the sky before I was fully myself. I heard the moan
of wounded men, and knew that it was my duty to
take care of them. I tried to rise, and could not ; my
arms and legs were alike motionless. I made an im-
mense effort, and knew that it was in vain. I was also
paralyzed as to sensation, and could not feel that I>
touched the ground. But about my neck I felt the
blood dried stiff in my collar. I must, however, have
been still bleeding freely, for again I lost myself while
divided between wonder and horror at my state.

At about sunrise I was awakened by familiar voices,
and presently was rolled over and inspected by a hos-
pital steward and one of my brother surgeons, to
whom were soon added two line officers. I could not
speak, but could hear more and more easily as they
lifted me to a stretcher and made my obituary in a
few brief and not altogether eulogistic phrases, with a
final remark by a captain that " He treated me at Cold
Harbor and got me a long sick-leave, and gave derned
little medicine, too."

One man remarked, "Good fellow, but a dreamy
sort of a cuss." And thus, having died for my coun-
try, and heard its opinion of me in little, I came to
myself. As my bearers trudged along I had first a
misty recognition of the fun of it, then curiosity as to
where I was hit, but at length pain in my neck from
the to-and-fro roll of the stretcher as my bearers,
keeping step from habit, moved toward camp.

At last I was able to say, " Break step. I 'm not

" By George ! The doctor 's alive ! " exclaimed one
of my aids, and so, after this excursion out of my wits,


I got into a good tent and, after a more thorough ex-
amination, was sent home to die.

A bullet had passed through the muscles at the back
of my neck and paralyzed the spinal column without
directly wounding it. For several months I lay quite
powerless, all that there was of me within control of
my will being the head and its contents. I could not
stir arm or leg; I even spoke with difficulty; and
would awake gasping for breath at night, because
my will was more or less needed to keep my chest in

I was for weeks, as I well knew, on the margin of
another world, and absolutely clear in mind to consider
the peril I had no wish to die, despite my horrible
state, for I had no pain, and it is pain which makes
the ill man indifferent to living. Neither did the
nearness of death alarm me. I remember that I con-
cluded that the naturalness of death must be strongly
set in our instinctive being, because, although I have
seen many wounded or ill men die slowly without
suffering, and fully possessed of reason, obvious fear
of death, when death is near, scarcely exists, and most
men, under these conditions, seem to await their fate
with calmness. In fact, I can recall only one case
where a man, conscious of death at hand, showed in-
tensity of fear.

I lay at rest, if rest it can be called, in my own
rooms, and had all that means could give me. Friends
I had too, for I have a talent for friendship, and these
came and sat with me or read to me. I remember,
however, that some who were very dear to me in
health did not seem to fit into my new conditions of


life, and that in my helplessness the women whom I
was able to see were always the more acceptable visit-
ors. I suspect that at this time I must have been very
sensitive. Certain persons depressed me ; I could not
easily say why others soothed. Now and then came
some one who made me feel as though I had taken a
strong tonic.

This priceless gift nature has given only to a few.
It cannot be acquired; no imitation of it succeeds;
nor is its quality easy of analysis. It is not manner,
neither is it dependent on a sanguine temperament, as
one might fancy. Nor is it a part of such mere un-
thinking manners as make some men always willing
to predict success. One comes here to the question of
professional manners, a delicate matter of which I
thought a good deal as I became a more and more
sensitive human instrument. There is no place where
good breeding has so sweet a chance as at the bedside.
There are many substitutes, but the sick man is a
shrewd detective, and soon or late gets at the true man
inside of the doctor.

I know, alas ! of men who possess cheap manufact-
ured manners adapted, as they believe, to the wants
of "the sick-room" a term I loathe. According to
the man and his temperament do these manners vary,
and represent sympathetic cheerf ulness or sympathetic
gloom. They have, I know, their successes and their
commercial value, and may be of such skilful make as
to deceive for a time even clever women, which is say-
ing a great deal for the manufacturer. Then comes
the rarer man who is naturally tender in his contact
with the sick, and who is by good fortune full of edu-


cated tact. He has the dramatic quality of instinctive
sympathy, and, above all, knows how to control it. If
he has directness of character too, although he may
make mistakes (as who does not ?), he will be, on the
whole, the best adviser for the sick, and the complete-
ness of his values will depend upon mental qualities
which he may or may not possess in large amount.

But over and above all this there is, as I have urged,
some mystery in the way in which certain men refresh
the patient with their presence. I fancy that every
doctor who has this power and sooner or later he is
sure to know that he has it also learns that there are
days when he has it not. It is in part a question of
his own physical state; at times the virtue has gone
out of him.

The gift is not confined to men. One middle-aged
woman had it for me when I lay helpless in my palsied
state. She was a person so simple, so direct, so easily
sure to do and so certain to abide by the right thing,
that to unthinking people she may have appeared to
be commonplace. An angelic form of good sense
dominated by tenderness underlay the positiveness of
her character and was a part of her nature. More-
over, she possessed also sense of humor, that gentlest
helpmate in life. I do not mean that she was cre-
atively humorous; she was only appreciatively and
apprehensively humorous.

I had a rather grim but most able surgeon. He
seemed to me to have a death-certificate ready in his
pocket. He came, asked questions, examined me as if
I were a machine, and was too absorbed in the phys-
ical me to think about that other me whose tentacula he


knocked about without mercy, or without knowledge
that tenderness was needed. Our consultant was a
physician with acquired manners. He always agreed
with what I said, and was what I call aggressively
gentle ; so that he seemed to me to be ever saying with
calm self -approval, " See how gentle I am." I am told
that with women he was delightfully positive, and I
think this may have been true, but he was incapable of
being firm with the obstinate. His formulas distressed
me, and were many. He was apt to say, as he entered
my room, " Well, and how are we to-day ? " And this
I hated, because I once knew a sallow undertaker who,
in the same fashion, used to associate himself with the
corpse, and comfort the living with the phrase, " We
are looking quite natural to-day."

My soft-mannered and mellifluous doctor who
thought well of himself was nevertheless a most in-
telligent physician j but some people possess no mirror
for social conduct, and the court fool, who tells men
the truth, is out of fashion. He went along in lif e not
knowing how absurd he was at times. To have known
would have lessened his usefulness. Self -ignorance is
sometimes an essential condition of utility.

My good little woman friend supplied me with what

my doctors did not, and to this day I cannot tell how

she did it. Despite, however, her too rare visits, and

(those of others who were less helpful, I had a horrible

i amount of time on my hands. Much reading wearied

' me, and so I lay imprisoned within the limits of my

memories, or took a curious interest in the minutiae of

the little life or action I could see in my room or

through my windows. I watched for long months the


leaves come and flourish and depart from a tree (a
horse-chestnut across the street), and saw its varnished
buds unfold to queer insect shapes and then spread
out into green tents. The spider which spun on my
window-pane I would not allow to be disturbed, and
even the flies were sources of interest. Far away were
two weathercocks ; one was too motionlessly conserva-
tive to stir with the breeze, but now and then, when
the wind was east, it was correct. It seemed to me
like the man with one unchanging opinion, and with
whom the world comes some day to agree. The other
cock was an honest, mutable fellow, and warned me
that a norther was on the way to torment me, as it
always did, with a horrible sense of futile restlessness.
I used to lie and wonder whether the cock was chosen
for a sign of changeful winds because it was a re-
minder to the unstable Peter. But these trifles are of
the intimate life of chronic sickness, and perhaps are
of little interest to the thoughtless who are well.

The man thus imprisoned within himself recovers
by effort a vast amount of memorial property pre-
sumed to have been lost. If I shut my eyes and lay
still, as, indeed, I had to do, and then seized firmly on
some remembrance of verse or prose or events, by de-
grees it seemed to aggregate other memories long for-
gotten. It was like a process of crystallization to
stir up the fluid is apt to disturb the formative action.
If I stopped to think, compare, and conclude, I found
that I interfered with the process of accumulative
recollection. My favorite amusement was to recall
men I had known, and to construct for them in my
mind characters out of what I had seen or heard of


them under the varying conditions of camp, battle, or
wounds. This would lead me to anticipate what their
future lives would be and how in certain crises of ex-
istence they might act. I did this also for myself over
and over, until it seemed to me that I could be sure of
my precise conduct under any and almost every variety
of circumstances. Some of the insights I thus won by
these excursions into the puzzle-land of character used
to startle me at times, because it seemed as though the
concentration and intensity of attention imposed upon
me by my state enabled me, from the memory of a
single interview or incident, to work out easily the
whole characteristics of a man. This power did not
continue in as full force when my conditions of life
were altered. What it left with me was an unusual
fondness for the study of men and women, and this I
take to be a rare taste, because although people make
guesses at character, and novelists and dramatists are
presumed to study it for a purpose, and some men of
affairs have an almost instinctive appreciation of what
a man in contact with a given matter will do, the
tendency to study character for its own sake from a
naturalist's point of view is most uncommon. In fact,
too, the business-man's working knowledge of char-
acter and the writer's are distinct, says George Eliot ;
the former cannot put in words what he uses any more
than the latter can use in the give and take of life
what he can so well put on paper.

I look back with surprise at the months I passed as
a crippled man, my head alone alive. My cheerfulness
was due to temperament, and also to what I may call
the temperament of my disease, for people who have


spinal lesions without pain are apt to be more calm
and unirritable than those who have certain visceral
disorders. Consumptives are said to be hopeful, but
the sick liver predicts damnation. A learned divine
said a thing of extraordinary wisdom when he an-
nounced that no man, however secure he may be in
mind as to his future lif e, ever dies a triumphant death
with disease below the diaphragm.
/ On the 8th of May, 1866, 1 observed that I could
wiggle the second toe of my left foot. I have ever
since had a peculiar affection for this little sub-mem-
ber of my locomotive organs. Head and toe were now
both alive, and seemed to salute each other across a
length of motionless body. I indicated this immense
fact to my affable doctor. He put on his glasses and
looked. Then he said, " You will get welL"
To which I replied, " I always was sure of that."
I saw that it was disagreeable to him to be thus
anticipated by hope, and so said no more. In the
evening he brought the consulting surgeon, and
triumphantly pointed out the prophetic conduct of
this hitherto uninteresting part of me.

I am not concerned to dwell upon the medical de-
tails of my case except as they bear upon life or char-
acter. Sensation came back first, and in about a
month I could move both legs and arms ; but I had
become the victim of a new experience. As my loco-
motive powers increased I suffered agonizing pain
in the back and neck and arms. It was almost my
first enduring personal sensation of acute pain, and it
lasted long enough to enable me to make acquaintance
with every variety of torment. Civilized mankind has


of will ceased to torture, but in our process of being
civilized we have won, I suspect, intensified capacity to
suffer. The savage does not feel pain as we do ; nor,
as we examine the descending scale of life, do animals
seem to have the acuteness of pain-sense to which we
have arrived, a fact I have often observed in regard to
wounded horses on the battle-field. I had at one time
served awhile as assistant surgeon in the wards of a
hospital to which were sent most of the bad cases of
wounded nerves. In this abode of torment, where
sixty thousand hypodermatic injections of morphia
were given and needed within a year, I saw every form
of suffering. But personal acquaintance with pain is
quite another matter. It inclines me to think that
every doctor ought to go through a sharp little course
of colic, gout, and, if you please, a smart fitjrf hyster-
ics before venturing on the practice of his profession.
An old friend of mine used to say that all clergymen
should have a mild education in iniquity as a prepara-
tion for their career, but this I hardly hold to as a
serious opinion.

Assuredly I had never realized the influential quali-
ties of pain as I now came to do. Of all the means
not of his own making which degrade, debase, and
morally ruin a man, pain seems to be the most potent.
I became irritable, perverse, ungrateful, and selfish. I
lay abed thinking how I could put my tortures into
language descriptive enough to impress the infernal
calm of that placid doctor, who came and went, and
was as cool as I had been in the wards of that museum
of anguish to which I have above referred. I had
been wont to think and speak philosophically of pain,


but this continual and ingeniously varied torture was
to me a novel experience, and left on my mind the be-
lief that certainly an abode of eternal torment would
have the effect of making men hopelessly regret lost
opportunities, but would as surely make them morally
worse, if it left them leisure to think at all.

I steadily resisted all efforts to induce me to use
sedatives until one day, toward evening, when I had a
new performance in my hands, as if they were being
rasped with hot files. Then I yielded, and my doctor
gave me a hypodermatic injection of morphia. I lay
awake all night in perfect comfort, heedless of the
passage of time, and wondering at the bliss of relief.
'T was heaven bought with hell, for the next day I
was doubly tormented.

None who have not known long chronic illness can
conceive of the misery enforced idleness inflicts on a (
\J man used to active life. This intensity of ennui, com- j
parable only to that which some children suffer, is
eased by morphia. The hours go by almost joyously.
Misfortunes trouble no longer. One drifts on an en-
, chanted sea. This death of ennui is the most efficient
\ bribe which opium offers.

I dreamed a great deal during my long sickness,
and not always unpleasantly. At one time, in my
younger life, I read that Lord Coke kept a diary of his
dreams, in the belief that from them he could learn
more of his true character. Before I took morphia I
followed his example for a time, dictating my dreams
to my nurse ; but I soon tired of this, as I observed
that often in dreaming I could, as it were, examine my
own mental state, and always to the effect of conclud-


ing that what I did, said, or thought was as I would
have done under the like circumstances when awake,
except that I rarely seemed to myself to laugh in
dreams, whereas, when awake, life was full of humor-
ous aspects to me. Under morphia I was capable of
mirthful visions, which occurred to me while I was
awake at night. Dreams are very personal things, and
this may be why my father always insisted to me when
a child that it was bad manners to relate dreams, and
certainly nothing interests one less than to be told the
dreams of another man. I had, however, two experi-
ences in this matter which are so amusing and curious
that I venture to relate them as additions to the rather
grim literature of opium.

I had taken one night a grain of morphia, and then
another like dose, and thereupon passed into a sweet
sleep. In an hour I awoke and began to see things,
chiefly scenes from the "Arabian Nights," and then,
abruptly, the following :

I had been for some years, as I have said, in practice
in a great city, and now I saw my little study with all
its belongings set out clearly in the darkness of my
chamber. A maid servant entered and told me that a
patient wished to see me. I said, or seemed to say,
"Ask him to walk hi." Upon which the woman opened
both leaves of the folding-door between me and my
waiting-room. This excited my wonder until I saw
enter with difficulty a man of enormous bulk. He
looked at the chairs, and finally sat down with care on
a lounge, remarking :

" At hotels I have to be careful ; they put it in the


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