Dr Finlay's Casebook

by A. J. Cronin

  ‘Home, darling,’ said Bess.

  Janet, watching from the window as they piled into the car, threw up her hands and wailed:

  ‘That’s Finlay for ye! After I’ve made him a lovely tea, wi’ the treacle scones he’s sae fond o’, he’s off like a flash and I’ll no’ see him till his evening surgery. Ah weel! I canna waste such a lovely tea, I’ll just sit down in the kitchen, stir up the fire and eat it a’ masel’.’

  Dr Cameron’s Appendix

  Lovely autumnal weather was blessing Tannochbrae with blue skies and bright sunshine that warmed the crisp, cool air. Of course, the practice was always busy at this time of year but, as he sat down to a good breakfast of porridge and sweet milk followed by grilled kippers and toast, Finlay felt that he might manage to get off to the moors with his new gun for an hour in the early afternoon. As Janet brought in his second kipper he remarked pleasantly, ‘I’m surprised that Dr Cameron has not appeared for breakfast – he loves a morning like this.’

  ‘No, Dr Finlay,’ Janet formally replied. ‘Our chief is not down yet. In plain truth I question if he will come down at all. When I took in his morning coffee and his shaving water he was still in his bed, without a word, layin’ there prostitate.’

  ‘Prostrate, surely, dear Janet,’ Finlay corrected with a laugh.

  ‘It may amuse you, Dr Finlay. But if you had seen him, ye might have thought it was no laughing matter.’

  Finlay was certainly not laughing at his chief’s indisposition, slight though it may be. He knew very well that Dr Cameron was essential to their joint practice; not only to take over a fair portion of the work, but to lend his authority and support in all important and difficult decisions.

  With this in mind, Finlay, having downed his second kipper, and third cup of coffee, hurried upstairs to his chief’s room, expecting to find him shaving, a lengthy and serious task with, of course, the open blade.

  Dr Cameron had risen from his bed, and though unwashed and unshaven, was trying to dress himself in his full professional attire. The will was obviously there, but when he saw Finlay, the worthy old doctor staggered slightly, just saving himself from falling by a dramatic clutch at the big wooden end of his bed.

  ‘No, sir, you must not get up. Not under any circumstances.’ And supporting him with both arms Finlay laid him back again on the bed, studying him with an anxious eye.

  ‘I’m heart-sorry to bother you, dear Finlay, but I don’t feel quite up to the mark this morning.’

  ‘Do you have any pain, sir?’

  ‘Some twinges in the left lower abdomen.’

  ‘Let me have a look, sir.’ As Finlay gently passed his hand over the affected area his chief winced perceptibly. ‘Is there any stiffness there, lad?’

  As Finlay gently touched it with the flat of his hand, the muscle stiffened and became tense.

  ‘It seems to me, sir, that your appendix is involved.’

  The sufferer emitted a sigh that was half a groan.

  ‘That damned appendix of mine has been troubling me off and on for years.’

  ‘Surely you think it time for you to have it out, sir?’

  ‘What! At a time like this, the turn of the seasons, one of our busiest o’ the entire year?’

  ‘But sir, when your health is concerned . . .’

  ‘Do you think I would lie down now, give up at our busiest time o’ the year?’

  ‘But, sir . . .’

  ‘Leave you to carry the whole weight o’ the practice on your own back, with anything up to thirty cases to visit every day; and the surgery chock-full every morning and night, and odd times o’ the day as weel! Never, Finlay. I’d see myself in my grave first.’

  Ignoring this panegyric Finlay produced his thermometer and placed it between the good Dr Cameron’s lips. A minute later the patient himself withdrew it, gave a loud sigh of annoyance and shook it down.

  ‘I’m not showing you this, lad, or you’ll have me laid up for a week.’

  Finlay did not reply. He picked up his thermometer, wiped it with his handkerchief and replaced it in its case.

  ‘You are to stay in bed, sir, whether you wish it or not.’ He then withdrew the key from the inside of the door, passed through, and locked the door from the outside.

  To Janet, who, of course, had been listening in the passage, he handed the key. ‘Janet dear, don’t let the good doctor up till I come in from my round. Give him only liquid and light food. I’ll see him when I get back. Tell me, are there many in the surgery?’

  ‘It’s chock-full to the door, doctor. And there’s three mair calls has just come in from the Anderston Building. But listen to me, sir, ye’re not getting out of my sight till ye’ve had a big strong cup o’ hot coffee and a piece o’ hot buttered toast. I’ve kept it warm . . .’

  A faint tinkle from the sick room interrupted her. Her lips compressed slightly. ‘Ay, I thocht so! It will be runnin’ up and down for me a’ day. But he’ll have to wait till I see you off first, warm and weel fed.’

  Indeed, thus fortified, Finlay went into the teeming surgery and almost two hours later braved the chill, wet streets to begin his visits. At noon these were still uncompleted, but by putting his back into the task, he was home by half past two. His first words to Janet were ‘How is our invalid?’

  ‘I’m going to see you eat your dinner first, sir. I’ve kept it a’ nice and hot for you.’

  Chilled, tired and hungry, Finlay did not resist. Janet watched him with concern as he hungrily swallowed everything she put before him.

  ‘Feel better now, sir?’

  ‘Thanks to you, my own dear wee Janet, I feel more like myself.’

  ‘I was feared to tell you sir, until you had ate, sir, that three mair calls came in from that same Anderston Building.’

  ‘Damn! They’ve got a regular ’flu epidemic there! Well, never mind. How is our own patient?’

  Janet’s lips drew tight together. ‘As snug and comfortable as my carrying out his orders can make him. He has a lovely fire in his room, fruit juice and fresh pears by him on his bedside table, and he’s lyin’ back against his pillows readin’ this morning’s Chronicle where I noticed there’s a bit on the front page about hissel’! “Our patrons will read with regret of the illness of our most worthy and beloved Dr Cameron. During his enforced absence his practice will be sustained by his young, active assistant Dr Findlater.” ’

  Grimly, between set teeth, Janet ground out the words, ‘How dae ye like that, Dr Finlay, sir? I’d swear by my own Bible I never in a’ my life kent such bluidy insolence!’

  ‘It could just be a printer’s error, Janet.’

  ‘Printer’s error be damned. He wrote it out hissel’, put it in an envelope and last night, bid me take it tae the office o’ the Chronicle. If I had kenned whit it was I’d have put it down the closet. For it’s a’ part o’ his plan to blow himself up and keep you down.’

  Finlay managed a smile, but his jaw was set firm. After half the day in the pouring rain, in and out of the sick rooms of Anderston Buildings, this was the last straw.

  ‘Has the poor invalid asked for anything special?’

  ‘He wanted a hot clout, wrung out, just before ye came back and had me lay it on his belly. But when I went upstairs a minute later, it was flung on the floor.’

  Finlay reflected deeper. ‘Janet! D’ye think all this is put on for our benefit?’

  ‘For his ain benefit, ye mean, sir. This is the second time in succession that he has brocht out his cursed appendix just at the busiest time o’ the year. Aye, and let you slave your guts out while he lies cosy in bed wi’ all sorts of delicacies to his hand. Believe it or no, he wants me to run out for a jar o’ the best calf-foot’s jeely.’

  As they left the dining-room together Finlay spoke firmly. ‘Dear Janet! If this is real appendix trouble he must have it out immediately. If it’s no’, I want to find out exactly what is the matter wi’ him!’

  ‘He has it fixed in his heid, sir, that hi
s appendix is the trouble. You’ll never shift him.’

  ‘Then we’ll shift his appendix!’

  And Finlay went straight to the phone. Then, having closed the door of the cabinet, he rang an old professor, Mr Nicol, MS, FRCS, one of his teachers at the Royal Infirmary of Glasgow. Not to anyone did Finlay divulge the nature of his conversation. Even Janet who listened hard outside, heard not a word of it.

  But early that afternoon a beautiful shining ambulance, complete with uniformed driver, attendant and white-clad nurse seated beside a soft-blanketed couch, drew up at Arden House. Immediately the attendant descended, bearing a portable stretcher, and accompanied by Finlay, entered the sick-room, guided perhaps by the invalid’s sonorous snores.

  Three minutes later, borne on the litter by Finlay and the attendant, that same invalid was in the ambulance, tended by the nurse, with Finlay and the uniformed attendant on the outside seat beside the driver. Then with a low Rolls-Roycean purr the ambulance sped off en route to Glasgow.

  What the good doctor’s thoughts might be as he lay in comfort being driven he knew not where, only Dr Cameron could tell. Finally he murmured a single interrogation to the nurse. Whereat she replied, ‘To the finest hospital in Scotland, sir. Where the best surgeon in Great Britain will examine and treat you.’

  ‘No operation I hope, dear nurse, I’m no’ that bad.’

  ‘Do you feel able to undertake all your professional duties?’

  ‘Who kens, nurse. It a’ depends on how I feel the morns morn.’ There was a pause. ‘Ye ken, dear nurse. I’ve aye had a tendency to this appendix trouble in the winter. Not a great deal o’ pain in the stomach, mind ye, I can aye eat well, but nae strength at all, ye ken, nae incentive to work at a’.’

  ‘Weel, try and get a wee sleep now. I’ll wake ye when we’re at the Royal.’

  Although he did not sleep, the good doctor was silent until they drew up at the huge hospital.

  ‘Tell Finlay to bide with me,’ he exclaimed as he was borne into the intimidating recesses of the giant infirmary. Once he was safely in a side room on the surgery floor Finlay left him and sought out Professor Nicol, who welcomed him warmly, then listened intently as Finlay described Dr Cameron’s symptoms.

  ‘And all this comes on exactly when the work in your practice is at its heaviest and hardest?’

  ‘Aye. I’ve scarce had a moment to myself all day.’

  ‘Ye’ve not examined him?’

  ‘No, sir! He’ll submit only to an expert.’

  ‘Well!’ said Professor Nicol grimly. ‘Bring him in right away.’

  In a few moments the patient was wheeled in, completely stripped and covered with a sheet.

  ‘Greetings, fraternal greetings, Dr Cameron. How are you feeling now?’

  ‘Verra weel indeed, professor. In fact absolutely perfect.’

  ‘Ready to start work in your practice this very minute?’

  ‘That, professor, with a’ the good will in the world, I could scarcely guarantee it. Ye see, it’s this business of my appendix.’

  ‘Ah, what a pity, dear doctor. It pains you?’

  ‘It’s not exactly a pain, professor, sir, it’s a kind of a sort of weakness!’

  ‘I understand perfectly, dear doctor. Now perhaps you will permit me to examine you.’

  ‘That’s exactly why I am here, sir.’

  Quickly, Professor Nicol removed part of the sheet and studied the left region. Then, gently, he placed his hand on the affected part. Immediately the patient stiffened his muscles till his lower abdomen was hard as a brick.

  ‘Exactly as I feared,’ said the professor. Then turning to his smile. ‘A clear, cut-and-dried case of psychotic phobia centred immediately.’

  ‘Dear heaven, professor! Ye’re not going to cut me open sae soon!’

  Without deigning to reply, Professor Nicol watched the patient being trundled out, then turning to Finlay with a grim smile. ‘A clear, cut and dried, case of psychotic phobia centred on the appendix. Didn’t you realise that yourself Finlay?’

  ‘I did suspect it, sir. But what on earth can one do about it?’

  ‘Operate immediately! Remove the affected part and the fixation disappears. At least he’ll have no appendix to blame for lying in his bed and stopping off work!’

  In the operating theatre Dr Cameron was already prepared and under the anaesthetic. Quickly Professor Nicol washed and prepared his hands, then took up his scalpel. After a few swift and expert strokes the incision was made; and a small, exceedingly healthy-looking appendix was exposed and skilfully removed. The small incision was then re-stitched.

  ‘What a wonderful operation, sir. So neat and swift,’ Finlay exclaimed. ‘But what a pity the appendix is so small. It’s just a wee healthy thing. He’ll never believe getting that thing out had cured him.’

  ‘I have precisely the same thought, dear Finlay. Come with me. I think a trip to my Pathology Department would be in order.’

  Leading the way into an annexe at the end of the corridor, Nicol selected a jar from the end of the shelf. ‘This came out of a sick, really sick, old woman this morning. Isn’t it a beauty – for our purpose?’

  Dangling in the spirit that almost filled the jar was the longest, most hideously inflamed and peptic appendix imaginable, complete with a bag of pus at the end. It was the worst Finlay had ever seen, and yet, for his purpose, the best appendix ever.

  ‘This should convince Cameron, the lazy old dog,’ Nicol laughed. ‘He can display it with pride, as evidence that he is cured. Now come lad, and have a coffee and a bun with me. I can see that ye’ve been sadly overworked lately. But now we’ll be having no more of that nonsense.’

  Half an hour later, when the patient was again in the ambulance, smiling happily and lovingly clutching his specimen, Nicol repeated his injunction, ‘You may start work in the surgery without fail next Monday.’

  ‘Thank you professor, sir, with a’ ma heart. I’ve the evidence that I’m cured right before me.’

  Indeed, when they reached home Cameron stepped nimbly out of the car and into the house.

  ‘Janet, Janet, woman! My appendix is out. See for yourself.’

  When Janet had looked and shuddered, Cameron moved off to his consulting room and placed the specimen on the mantelpiece.

  ‘That will show my patients that I’m cured!’

  ‘Would you like to spend the night here looking at it?’ Finlay asked testily.

  ‘Not on your life. Now it’s here and no’ inside me I feel I’m better. But consider for a moment, dear colleague, and perhaps I may say, friend. Consider what it was like to have that beastly, horrid beeling growth inside my fine body. Do you wonder I had to lie up and refrain from work. Had I forced myself to, I should have burst it and expired in the street, among the slush and rubble of Anderston Buildings.’

  ‘Ay, ye were wise to let me run a’ the risks, sir.’

  ‘Do not be unfeeling, Finlay, I beg of you. I am still suffering from the effects of the operation.’

  ‘Tut, tut, man. Professor Nicol definitely ordered you to take both the surgeries. Indeed, he told me, on the way to the ambulance, that if you did not begin to exercise yourself by getting up and moving around, adhesions might set in and damage your kidneys!’

  ‘He did! Bless my soul. Ah well, I maun buckle to it and keep my kidneys clear.’

  ‘Now it’s time for some o’ that nice hot, strong chicken soup Janet has ready for me. It’ll strengthen me for a hard day’s work tomorrow.’

  As he walked to the dining-room he took Finlay’s arm and murmured tenderly in his ear.

  ‘Dearest Finlay, best assistant in a’ the world, I was sair afraid our wonderful partnership was broken, and all our adventures tegether over and done with. But now, please the good Lord, now we’re all set to carry on our good work and to establish new records of our achievements in the annals of Scottish medicine which may honour us, not only before our colleagues but, please God, in the eyes of our compa
triots.’

  Sad News and an Old Flame

  One fine evening that autumn, when Finlay had a free half-hour after his surgery, he strolled, bareheaded, down the Gielston Road to enjoy the cool air and catch a glimpse of the setting sun as it vanished in a blaze of glory behind the Lammermuir Hills. Alone at this hour and in such a place his mood was meditative and, as had been his habit during the past few months, inclined to sadness and regret. Possibly, in his profession, he had been a success of sorts. But in his personal life? Ah! That brought neither pride nor consolation to his thoughts.

  So many of his contemporaries were married, each with a wife and children to bless and harass them. But he had failed to achieve this natural consummation of a man’s life. His one chance to achieve love and happiness he had been too timid to accept and treasure when it was offered. And in the swift passage of time it was gone, lost forever. Destined when he retired to become that pitiful object, a lonely bachelor; condemned to nights of solitude, without even a dog to lie beside him while he read, or dreamed, the evening away.

  Abruptly he turned – the sky had lost its radiance – and at a brisk pace he started off for the house of Dr Cameron which he must perforce call home.

  He had not gone far before his name was called and the quick patter of running footsteps caused him to turn round.

  A boy, with a strapped bundle of books under one arm, was smiling, and calling to him by name.

  ‘Dr Finlay, sir! I’ve finally caught you. Every night this week I’ve been taking my evening run out here in the hope of meeting you.’

  ‘Bob Macfarlane! Dear Bob!’ Finlay embraced the lad. ‘What in the world are ye doing back in Tannochbrae?’

  ‘It’s rather a long story, doctor, and a tragic one. Did you not read all about it in all the newspapers?’

  ‘I rarely have time for the papers, Bob.’

  ‘Well, it’s just this, Finlay. You know that my father was constantly engaged in steel construction work. The last one was a huge new block of flats in Anderston. Dad was always in demand, for he could climb and balance on the big metal girders like a monkey. Dangerous work but wi’ big, big wages. It was a treat to look up from far below and see him leap across a huge gap, from one narrow girder on to another still floating on the cranes.’ Bob paused, then said steadily: ‘One morning Dad tried too wide a jump, missed the other girder,’ a pause, ‘and fell three hundred feet to the concrete pavement. Thank God he suffered no horrible injuries. He was killed instantly.’