“I don’t see that there is anything more that you can do. What do you think is the real trouble? Have they some kind of religious scruple about surgery?”

“No. They’re Thirteeners, whatever that means. But the preacher was at the house the other day when I called—a fellow named Beamis—and when I explained the situation to him he was perfectly reasonable. Tried to persuade her to go to hospital. Did everything he could, really. But the old girl kept sobbing and moaning ‘Don’t let ‘em take me; please don’t let ‘em take me’. I felt like a fool.”

“There’s no need for you to feel like that, Jimmy. You’ve given the best advice—the only advice, really. If they don’t take it, you can throw up the case, but I wouldn’t, if I were you. If people are determined to commit suicide by the long and painful course of going against medical opinion, it’s hard to watch, but I don’t think you want to be known as the kind of doctor who throws up cases.”

“I had a little hope until this week. The younger daughter is home, now. You’ve heard of her; she’s the girl that’s being educated with old Mrs Bridgetower’s money. They insisted on putting off a final decision till she came. She’s far above the rest of them, and she’s certainly not scared. I’ve talked to her very frankly; she knows exactly what’ll happen. I got her to the point of saying that her mother should go to hospital. ‘I’ll tell her myself’, she said, and we went into the room together. But the old lady must be a mind-reader. She snatched the girl’s hand, and began to scream. ‘Monny, don’t let ‘em take me; Monny, don’t let ‘em get me in that place’, she shrieked, over and over again. The girl looked dreadful; I was really sorry for her. Her mother made her swear, then and there, with a Bible in her hand, that she should not be taken to hospital. ‘You see how it is’, she said to me, and I suppose I do, in a way. But she said a funny thing to me, as I was leaving. ‘You realize that your decision may be bringing about your mother’s death?’ I said—”

“Now Jimmy, that was a mistake.”

“Yes, I know it was, but I was mad. It’s all so senseless! But she looked me straight in the eye and said: ‘My decision may do so, Dr Cobbett, but your decision would do so beyond any doubt. My mother lives by the spirit as well as by the flesh; if I kill the spirit by delivering her, frightened and forsaken, into your hands, what makes you think that you can save the flesh?’ Now what do you make of that? A layman ever dare talk to you in that way?”

“Speaking after more than thirty years of practice, I think the girl is right. Under stress, you know, Jimmy, people sometimes speak wiser than they know. I suppose if the girl had said yes, you could have doped the mother enough to get her to hospital and operate on her. But it would have been a serious risk. And—I don’t know—if the whole cast of her mind, and her level of intelligence, and everything about her is against having her life saved by science, I question if we’ve any cast-iron moral right to save it.”

“The job of the profession is to preserve life, under all possible circumstances.”

“Oh, I know. I was taught that, too. And as long as you never learn any thing but medicine, you’ll probably continue to think so.”

“I’m sorry you take it like that, Father.”

“Don’t be hurt, Jimmy. I’m sorry you’ve got such a miserable case. But they do turn up, from time to time. Hang on; it’s your duty, and it can’t last long.”

Mrs Gall’s illness had already lasted for two weeks and two days when Monica came home. The first violent onset had utterly demoralized Mr Gall, who fully believed his wife’s agonized protests that she was dying. He had no experience of illness, except for occasional coughs and colds, and the Galls had no physician, now that old Doctor Wander, who had attended to the children, had died. He had called Alice, and Alice had called young Dr Cobbett. But she did not call him until morning, heeding the widespread complaint of doctors about night calls, and had been scolded by Dr Cobbett when he arrived, for not calling him sooner. By that time Mrs Gall had discovered that if she lay very still, with her knees up, and breathed as shallowly and as slowly as possible, her pain was less. But she was deeply frightened.

She was only a little less frightened when the doctor disposed of her fear that she had cancer. This was her secret dread, which she had hugged to herself for years. But if it were not cancer, what was it? Dr Cobbett talked in big, unfamiliar words, but it emerged that he did not know what it was, either. Myocardial infarction; what could that be? Acute pancreatitis; an obstructive neoplasm; volvulus of the small intestine? Young Dr Cobbett was kindly and able, but he was not above astonishing the simple. When Mrs Gall, feebly supported by her husband, showed strong resistance to going to the hospital, he astonished them even more, in the hope of breaking down their determination. But it was useless, and as he could not put Mrs Gall in hospital by force, he had to leave her at home, and get Nurses Gourlay and Heffernan to take care of her. The nurses were as much affronted as he by the Galls’ refusal to accommodate themselves to the needs of medical science, and they let their displeasure be felt. Nurse Gourlay, indeed, made no secret of the fact that if she had her way, there would be a law to compel people to do what the doctor said was best for them.

Mrs Gall was down, but she was not out. Pain and fright lent her courage, and she gave Nurse Gourlay a piece of her mind; for Nurse Heffernan, a softer sort of woman altogether, she reserved her fears that she might die, and her dread that her ailment might yet turn out to be cancer. Nurse Heffernan seized the chance to say that if only Mrs Gall would go to hospital, like a good girl, they’d have her leppin’ like a goat in a couple of weeks. But Mrs Gall was firm: no hospital.

Her resolution was strengthened by morphia, which Dr Cobbett ordered in doses sufficient to control her pain. But in her morphia dreams there detached itself from some submerged mass of fear and floated upward into Mrs Gall’s consciousness a notion that she was being held against her will in a bawdy-house, which was also a hospital, and where the wildest indecencies were demanded of her. She had too much cunning to confide these dreams to Nurse Heffernan, who would certainly have derided them, because of her professional stake in hospitals; she told them instead to her daughter Alice, during the eight hours of the night when neither nurse was on duty.

It was Alice who insisted that Monica should be sent for. She was not a bad or unkind daughter, but she took her duties as Charles Proby’s wife heavily, and she was impatient of what she considered “nonsense”. Not to go to the hospital was nonsense. To have delusions of being in a bawdy-house was nonsense. There were times when Alice was very close to thinking that being ill, which involved claims upon the time and charity of busy, ambitious young matrons, was nonsense. Nonsense had to be stopped. And why should she carry the weight of all this nonsense when Monica was living abroad, free of all care, thinking of nobody but herself?

“Every tub must stand on its own bottom,” said Alice, and went to see Mr Snelgrove. It was on the sixteenth day of Mrs Gall’s illness that Monica arrived home, and was greeted by her father with his pathetic cry of fear that Mrs Gall might die.

Dr Cobbett and the nurses seized upon Monica as a new ally. By this time Dr Cobbett was virtually certain that Mrs Gall had acute cholecystitis and might die even if she were now moved to the hospital. But it was his task to do everything in his power to save her, and he would have risked an operation at an even later date: it must also be admitted that he loved to have his own way, and wanted to beat down this insurrection against the righteous forces of Hygeia.