Paying the Doctor

by Mary Roberts Rinehart

After a day of unusual anxiety and fatigue, Dr. Elton found himself snugly wrapped up in a liberal quantity of blankets and bed-quilts, just as the clock struck twelve one stormy night in February. For over half an hour he had lain awake, racking his brain in reference to two or three critical cases which were on his hands; but tired nature could keep up no longer, and the sweet oblivion of sleep was stealing over his senses. But just as he had lost himself, the bell over his head began to ring furiously, and brought him into the middle of the floor in an instant. Pushing his head out of the window, he interrogated the messenger below, just too late to save that individual the trouble of giving the bell-rope another violent demonstration of his skill.

"Mr. Marvel wants you to come and see Charley immediately," replied the messenger.

"What's the matter with Charley?"

"He's got the croup, I believe."

"Tell him I'll be there in a moment," said Dr. Elton, drawing in his head. Hurrying on his clothes, he descended to his office, and, possessing himself of some necessary medicines, it being too late for the family to send out a prescription, wrapped his cloak around him, and turned out into the storm.

It was at least half a mile to the residence of Mr. Marvel, and by, the time the doctor arrived there, he was cold, wet, and uncomfortable both in mind and body. Ascending to the chamber, he was not a little surprised to find Charley, a bright little fellow of some two years old, sitting up in his crib as lively as a cricket.

"O doctor! we've been so frightened!" said Mrs. Marvel, as Dr. Elton entered. "We thought Charley had the croup, he breathed so loud. But he don't seem to get any worse. What do you think of him, doctor?"

Dr. Elton felt his pulse, listened to his respiration, examined the appearance of his skin, and then said, emphatically--

"I think you'd better all be in bed!"

"It's better to be scared than hurt, doctor," responded Mr. Marvel.

"Humph!" ejaculated Dr. Elton.

"Don't you think you'd better give him something, doctor?" said Mrs. Marvel.

"What for, ma'am?"

"To keep him from having the croup. Don't you think he's threatened with it?"

"Not half as much as I am," replied the doctor, who made a quick retreat, fearing that he would give way too much to his irritated feelings, and offend a family who were able to pay.

Next morning, on the debtor side of his ledger, under the name of Mr. Marvel, Dr. Elton made this entry; To one night-visit to son, $5. "And it's well for me that he's able to pay," added the doctor, mentally, as he replaced the book in the drawer from which he had taken it. Scarcely had this necessary part of the business been performed, when the same messenger who had summoned him the night before, came post-haste into the office, with the announcement that Mrs. Marvel wanted him to come there immediately, as Charley had got a high fever.

Obedient to the summons, Dr. Elton soon made his appearance, and found both Mr. and Mrs. Marvel greatly concerned about their little boy.

"I'm so 'fraid of the scarlet fever, doctor!" said Mrs. Marvel. "Do you think it's any thing like that?" she continued with much anxiety, turning upon Charley a look of deep maternal affection.

Dr. Elton felt of Charley's pulse, and looked at his tongue, and then wrote a prescription in silence.

"What do you think of him, doctor?" asked the father, much concerned.

"He's not dangerous, sir. Give him this, and if he should grow worse, send for me."

The doctor bowed and departed, and the fond parents sent off for the medicine. It was in the form of a very small dose of rhubarb, and poor Charley had to have his nose held tight, and the nauseous stuff poured down his throat. In the afternoon, when the doctor called, on being sent for, there were some slight febrile symptoms, consequent upon excitement and loss of rest. The medicine, contrary to his expectation, heightened, instead of allaying these; and long before nightfall he was summoned again to attend his little patient. Much to his surprise, he found him with a hot skin, flushed face, and quickened pulse. Mrs. Marvel was in a state of terrible alarm.

"I knew there was more the matter with him than you thought for, doctor!" said the mother, while Dr. Elton examined his patient. "You thought it was nothing, but I knew better. If you'd only prescribed last night, as I wanted you to, all this might have been saved."

"Don't be alarmed, madam," said the doctor, "there is nothing serious in this fever. It will soon subside."

Mrs. Marvel shook her head.

"It's the scarlet fever, doctor, I know it is!" said she, passionately, bursting into tears.

"Let me beg of you, madam, not to distress yourself. I assure you there is no danger!"

"So you said last night, doctor; and just see how much worse he is getting!"

As Dr. Elton was generally a man of few words, he said no more, but wrote a prescription, and went away, promising, however, at the earnest request of Mrs. Marvel, to call again that night.

About nine o'clock he called in, and found Charley's fever in no degree abated. Mrs. Marvel was in tears, and her husband pacing the floor in a state of great uneasiness.

"O doctor, he'll die, I'm sure he'll die!" said Mrs. Marvel, weeping bitterly.

"Don't be alarmed, my dear madam," replied the doctor. "I assure you it is nothing serious."

"Oh, I'm 'sure it's the scarlet fever! It's all about now."

"No, madam, I am in earnest when I tell you it is nothing of the kind. His throat is not in the least sore."

"Yes, doctor, it is sore!"

"How do you know?" responded the doctor, examining Charley's mouth and throat, which showed not the least symptom of any irritation of the mucous membrane. "It can't be sore from any serious cause. Some trifling swelling of the glands is all that can occasion it, if any exist."

Thus assured, and in a positive manner, Mrs. Marvel's alarm in some degree abated, and after ordering a warm bath, the doctor retired.

About three o'clock the doctor was again sent for in great haste. On entering the chamber of his little patient, he found his fever all gone, and he in a pleasant sleep.

"What do you think of him, doctor?" asked Mrs. Marvel, in a low, anxious whisper.

"I think he's doing as well as he can."

"But a'n't it strange, doctor, that he should breathe so low? He looks so pale, and lays so quiet! Are you sure he's not dying?"

"Dying!" exclaimed Dr. Elton,--"he's no more dying than you are! Really, Mrs. Marvel, yon torment yourself with unnecessary fears! Nature is only a little exhausted from struggling with the fever, he will be like a new person by morning."

"Do not mistake the case, doctor, for we are very much concerned," said Mr. Marvel.

"I do assure you, sir, that I understand the case precisely; and you must believe me, when I tell you that no patient was ever in a better way than your little boy."

Next morning, among other charges made by Dr. Elton, were two against Mr. Marvel, as follows: To four visits to son, $4. _To one night-visit to son,_ $5.

"Not a bad customer!" said the doctor, with a smile, as he ran up the whole account, and then closed the book.

In the constant habit of sending for the doctor on every trifling occasion, whether it occurred at noonday or midnight, it is not to be wondered at that a pretty large bill should find its way to Mr. Marvel at the end of the year. And this was not the worst of it; the health of his whole family suffered in no slight degree from the fact of each individual being so frequently under the influence of medicine. Poor Charley was victimized almost every week; and, instead of being a fresh, hearty boy, began to show a pale, thin face, and every indication of a weakened vital action. This appearance only increased the evil, for both parents, growing more anxious in consequence, were more urgent to have him placed under treatment. Dr. Elton sometimes remonstrated with them, but to no purpose; and yielding to their ignorance and their anxiety, became a party in the destruction of the boy's health.

"What is that, my dear?" asked Mrs. Marvel of her husband, some ten months after their introduction to the reader, as the latter regarded, with no pleasant countenance, a small piece of paper which he held in his hand.

"Why, it's Dr. Elton's bill."

"Indeed! How much is it?"

"One hundred and fifty dollars!"

"Oh, husband!"

"Did you ever hear of such a thing?"

"One hundred and fifty dollars, did you say?"

"Yes, one hundred and fifty dollars. A'n't it outrageous?"

"It's scandalous! It's downright swindling! I'd never pay it in the world! Who ever heard of such a thing! One hundred and fifty dollars for one year's attendance! Good gracious!"--and Mrs. Marvel held up her hands, and lifted her eyes in profound astonishment.

"I can't understand it!" said Mr. Marvel. "Why, nobody's had a spell of sickness in the family for the whole year. Charley's been a little sick once or twice; but nothing of much consequence. There must be something wrong about it. I'll go right off and see him, and have an understanding about it at once."

Carrying out his resolution on the instant, Mr. Marvel left the house and proceeded with rapid steps toward the office of Dr. Elton. He found that individual in.

"Good morning Mr. Marvel! How do you do to-day?" said the doctor, who understood from his countenance that something was wrong, and had an instinctive perception of its nature.

"Good morning, doctor! I got your bill to-day."

"Yes, sir; I sent it out."

"But a'n't there something wrong about it, doctor?"

"No, I presume not. I make my charges carefully, and draw off my bills in exact accordance with them."

"But there must be, doctor. How in the world could you make a bill of one hundred and fifty dollars against me? I've had no serious sickness in my family."

"And yet, Mr. Marvel, I have been called in almost every week, and sometimes three or four times in as many days."

"Impossible!"

"I'll show you my ledger, if that will satisfy you, where every visit is entered."

"No, it's no use to do that. I know that you have been called in pretty often, but not frequently enough to make a bill like this."

"How many night-visits do you suppose I have made to your family, during the year?"

"I'm sure I don't know. Not more than three or four."

"I've made ten!"

"You must be mistaken, doctor."

"Do you remember that I was called in last February, when you thought Charley had the croup?"

"Yes."

"And the night after?"

"Yes. That's but two."

"And the night you thought he had the measles?"

"Yes."

"And the night after?"

"Yes. But that's only four."

"And the three times he fell out of bed?"

"Not three times, doctor!"

"Yes, it was three times. Don't you recollect the knob on his head?"

"Yes, indeed!"

"And the sprained finger?"

"Yes."

"And the bruised cheek?"

"Well, I believe you are right about that, doctor. But that don't make ten times."

"You have not forgotten, of course, the night he told you he had swallowed a pin?"

"No, indeed," said the father, turning pale. "Do you think there is any danger to be apprehended from its working its way into the heart, doctor?"

"None at, all, I should think. And you remember"--

"Never mind, doctor, I suppose you are right about that. But how can ten visits make one hundred and fifty dollars?"

"They will make fifty, though, and that is one-third of the bill."

"You don't pretend to charge five dollars a visit, though, doctor?"

"For all visits after ten o'clock at night, we are allowed by law to charge five dollars."

"Outrageous!"

"Would you get up out of your warm bed after midnight, turn out in a December storm, and walk half a mile for five dollars?"

"I can't say that I would. But then it's your business."

"Of course it is, and I must be paid for it."

"Any how, doctor, that don't account for the whole of this exorbitant bill."

"But one hundred day and evening visits here on my ledger will, though."

"You don't pretend to say you have paid my family a hundred visits, certainly?"

"I will give you day and date for them, if necessary."

"No, it's no use to do that," said Mr. Marvel, whose memory began to be a little more active. "I'll give you a hundred dollars, and say no more about it; that is enough, in all conscience."

"I can't do any such thing, Mr. Marvel. I have charged you what was right, and can take nothing off. What would you think of a man who had made a bill at your store of one hundred and fifty dollars, if he were to offer you one hundred when he came to pay, and ask for a receipt in full?"

"But that a'n't to the point."

"A'n't it, though? I should like to hear of a case more applicable. But it's no use to multiply words about the matter. My bill is correct, and I cannot take a dollar off of it."

"It's the last bill you ever make out of me, remember that, doctor!" said Mr. Marvel, rising, and leaving the office in a state of angry excitement.

"Well, what does he say?" asked Mrs. Marvel, who had waited for her husband's return with some interest.

"He tried to beat me down that the bill was all right; but I'm too old a child for that. Why, would you believe it?--he has charged five dollars for every night-visit."

"That's no better than highway robbery."

"Not a bit. But it's the last money he ever gets out of me."

"I'd never call him in, I know. He must think we're made of money."

"Oh, I suppose we're the first family he's had who wasn't poor, and he wanted to dig as deep as possible. I hate such swindling, and if it wasn't for having a fuss I'd never pay him a dollar."

"He's charged us for every poor family in the neighbourhood, I suppose."

"No doubt of it. I've heard of these tricks before; but it's the last time I'll submit to have them played off upon me."

The visit of Mr. Marvel somewhat discomposed the feelings of Dr. Elton, and he had begun to moralize upon the unthankful position he held in the community, when he was aroused from his reverie by the entrance of a servant from one of the principal hotels, with a summons to attend immediately a young lady who was thought to be exceedingly ill.

"Who is she?" asked the doctor.

"She is the daughter of Mr. Smith, a merchant from the East."

"Is any one with her?"

"Yes, her father."

"Tell him I will be there immediately."

In the course of fifteen minutes Dr. Elton's carriage drove up to the door of the hotel. He found his patient to be a young lady of about seventeen, accompanied by her father, a middle-aged man, whose feelings were much, and anxiously excited.

At a glance, his practised eye detected symptoms of a serious nature, and a closer examination of the case convinced him that all his skill would be called into requisition. With a hot, dry skin, slightly flushed face, parched lips, and slimy, furred tongue, there was a dejection, languor, and slight indication of delirium--and much apparent confusion of mind. Prescribing as he thought the case required, he left the room, accompanied with the father.

"Well, doctor, what do you think of her?" said Mr. Smith, with a heavy, oppressed expiration.

"She is ill, sir, and will require attention."

"But, doctor, you don't think my child dangerous, do you?" said the father with an alarmed manner.

"It is right that you should know, sir, that your daughter is, to all appearance, threatened with the typhus fever. But I don't think there is any cause for alarm, only for great care in her physician and attendants."

"O doctor, can I trust her in your hands? But I am foolish; I know that there is no one in this city of more acknowledged skill than yourself. You must pardon a father's fears. Spare no attentions, doctor--visit her at least twice every day, and you shall be well paid for your attentions. Save my child for me, and I will owe you eternal gratitude."

"All that I can do for her, shall be done, sir," said Dr. Elton.

Just relieved from the care of a dangerous case, in its healthy change, Dr. Elton's mind had relaxed from the anxiety which too frequently burdened it; for a physician's mind is always oppressed while the issue, of life or death hangs upon his power to subdue a disease, which may be too deeply seated to yield to the influence of medicine. Now, all the oppressive sense of responsibility, the care, the anxiety, were to be renewed, and felt with even a keener concern.

In the evening he called in, but there was no perceptible change, except a slight aggravation of all the symptoms. The medicine had produced no visible salutary effect. During the second day, there was exhibited little alteration, but on the morning of the third day, symptoms of a more decided character had supervened--such as suffused and injected eyes, painful deglutition, an oppression in the chest, accompanied with a short, dry cough, pains in the back, loins, and extremities; and a soreness throughout the whole body. These had not escaped the father's observation, and with the most painful anxiety did he watch the countenance of the physician while he examined the case in its new presentation. Much as he tried to control the expression of his face, he found it impossible. He felt too deeply concerned, and was too conscious of the frequent impotence of medicine, when administered with the most experienced skill.

In the afternoon he called again, and found the father, as usual, by the bedside. His patient seemed to be in a narcotic sleep, and when roused from it, complained of much giddiness, and soon sunk down again into a state of torpor.

"What do you think of her now, doctor?" asked the father, in a hoarse whisper, on the physician's leaving the chamber of his patient.

"It is impossible to form any correct idea respecting a case like this. I have seen many much worse recover, and have no doubt, as far as human calculation will go, that your daughter will get well. But the fever is a tedious one, usually defying all attempts at breaking it. It must run its course, which is usually some ten or fifteen days. All we can do is to palliate, and then assist nature, when the disease has abated its violence."

It is not necessary to trace the progress of the disease from day to day, until it reached its climax. When the fever did break, and a soft, gentle moisture penetrated the skin, the patient had but a spark of life remaining.

At the close of the fifteenth day, when every symptom indicated that convalescence or death would soon ensue, no one but a physician can imagine the painful, restless anxiety, which was felt by Dr. Elton. He took but little food, and slept hardly any during the whole night, frequently starting from his brief periods of troubled slumber, in consequence of great nervous excitement.

Early in the morning he called at the room of his patient, trembling, lest a first glance should dash every hope to the ground. He entered softly, and perceived the father bending over her with a pale anxious face. She was asleep. He took her hand, but let it drop instantly.

"What is the matter?" asked the father in an alarmed whisper, his face growing paler.

"She is safe?" responded the doctor, in a low whisper, every pulse thrilling with pleasant excitement.

The father clasped his hands, looked upward a moment, and then burst into tears.

"How can I ever repay you for your skill in saving my child!" he said, after his feelings had grown calmer.

It was nearly a month before the daughter was well enough to return home, during most of which time Dr. Elton was in attendance. For fifteen days he had attended twice a day regularly, and for nearly as long a period once a day.

While sitting in his office one day about three o'clock, waiting for his carriage to come up to the door, Mr. Smith entered, and asked for his bill, as he was about to leave. On examining his account-book, Dr. Elton found that he had made about fifty visits, and accordingly he made out his bill fifty dollars.

"How much is this, doctor?" said Mr. Smith, eyeing the bill with something of doubt in the expression of his countenance.

"Fifty dollars, sir."

"Fifty dollars! Why, surely, doctor, you are not going to take advantage of me in that way?"

"I don't understand you, sir."

"Why, I never heard of such an extravagant bill in my life. I have my whole family attended at home for fifty dollars a year, and you have not been visiting one of them much over a month."

"Such as the bill is, you will have to pay it, sir. It is just, and I shall not abate one dollar," responded Dr. Elton, considerably irritated.

Mr. Smith drew out his pocket-book slowly, selected a fifty-dollar bill from a large package, handed it to the doctor, took his receipt, and rising to his feet, said emphatically--

"I am a stranger, and you have taken advantage of me. But remember, the gains of dishonesty will never prosper!" and turning upon his heel, left the office.

"Who would be a doctor?" murmured Dr. Elton, forcing the unpleasant thoughts occasioned by the incident from his mind, and endeavouring to fix it upon a case of more than usual interest which he had been called to that day.

A word to the wise is sufficient; it is therefore needless to multiply scenes illustrative of the manner in which too many people pay the doctor.

When any one is sick, the doctor is sent for, and the family are all impatient until he arrives. If the case is a bad one, he is looked upon as a ministering angel; the patient's eye brightens when he comes, and all in the house feel more cheerful for hours after. Amid all kinds of weather, at all hours in the day or night, he obeys the summons, and brings all his skill, acquired by long study, and by much laborious practice, to bear upon the disease. But when the sick person gets well, the doctor is forgotten; and when the bill appears, complaint at its amount is almost always made; and too frequently, unless he proceed to legal measures, it is entirely withheld from him. These things ought not so to be. Of course, there are many honourable exceptions; but every physician can exclaim--"Would that their number was greater!"