The Doctor\'s Dilemma

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This etext was produced by Eve Sobol, South Bend, Indiana, USA

TRANSCRIBER'S NOTE: The edition from which this play was taken
was printed with no contractions, thus "we've" is written as
"weve", "hadn't" as "hadnt", etc. There is no trailing period
after Mr, Dr, etc., and "show" is spelt "shew", "Shakespeare" is
Shakespear.

THE DOCTOR'S DILEMMA

BERNARD SHAW

1906

I am grateful to Hesba Stretton, the authoress of "Jessica's
First Prayer," for permission to use the title of one of her
stories for this play.

ACT I

On the 15th June 1903, in the early forenoon, a medical student,
surname Redpenny, Christian name unknown and of no importance,
sits at work in a doctor's consulting-room. He devils for the
doctor by answering his letters, acting as his domestic
laboratory assistant, and making himself indispensable generally,
in return for unspecified advantages involved by intimate
intercourse with a leader of his profession, and amounting to an
informal apprenticeship and a temporary affiliation. Redpenny is
not proud, and will do anything he is asked without reservation
of his personal dignity if he is asked in a fellow-creaturely
way. He is a wide-open-eyed, ready, credulous, friendly, hasty
youth, with his hair and clothes in reluctant transition from the
untidy boy to the tidy doctor.

Redpenny is interrupted by the entrance of an old serving-woman
who has never known the cares, the preoccupations, the
responsibilities, jealousies, and anxieties of personal beauty.
She has the complexion of a never-washed gypsy, incurable by any
detergent; and she has, not a regular beard and moustaches, which
could at least be trimmed and waxed into a masculine
presentableness, but a whole crop of small beards and moustaches,
mostly springing from moles all over her face. She carries a
duster and toddles about meddlesomely, spying out dust so
diligently that whilst she is flicking off one speck she is
already looking elsewhere for another. In conversation she has
the same trick, hardly ever looking at the person she is
addressing except when she is excited. She has only one manner,
and that is the manner of an old family nurse to a child just
after it has learnt to walk. She has used her ugliness to secure
indulgences unattainable by Cleopatra or Fair Rosamund, and has
the further great advantage over them that age increases her
qualification instead of impairing it. Being an industrious,
agreeable, and popular old soul, she is a walking sermon on the
vanity of feminine prettiness. Just as Redpenny has no discovered
Christian name, she has no discovered surname, and is known
throughout the doctors' quarter between Cavendish Square and the
Marylebone Road simply as Emmy.

The consulting-room has two windows looking on Queen Anne Street.
Between the two is a marble-topped console, with haunched gilt
legs ending in sphinx claws. The huge pier-glass which surmounts
it is mostly disabled from reflection by elaborate painting on
its surface of palms, ferns, lilies, tulips, and sunflowers. The
adjoining wall contains the fireplace, with two arm-chairs before
it. As we happen to face the corner we see nothing of the other
two walls. On the right of the fireplace, or rather on the right
of any person facing the fireplace, is the door. On its left is
the writing-table at which Redpenny sits. It is an untidy table
with a microscope, several test tubes, and a spirit lamp standing
up through its litter of papers. There is a couch in the middle
of the room, at right angles to the console, and parallel to the
fireplace. A chair stands between the couch and the windowed
wall. The windows have green Venetian blinds and rep curtains;
and there is a gasalier; but it is a convert to electric
lighting. The wall paper and carpets are mostly green, coeval
with the gasalier and the Venetian blinds. The house, in fact,
was so well furnished in the middle of the XIXth century that it
stands unaltered to this day and is still quite presentable.

EMMY [entering and immediately beginning to dust the couch]
Theres a lady bothering me to see the doctor.

REDPENNY [distracted by the interruption] Well, she cant see the
doctor. Look here: whats the use of telling you that the doctor
cant take any new patients, when the moment a knock comes to the
door, in you bounce to ask whether he can see somebody?

EMMY. Who asked you whether he could see somebody?

REDPENNY. You did.

EMMY. I said theres a lady bothering me to see the doctor. That
isnt asking. Its telling.

REDPENNY. Well, is the lady bothering you any reason for you to
come bothering me when I'm busy?

EMMY. Have you seen the papers?

REDPENNY. No.

EMMY. Not seen the birthday honors?

REDPENNY [beginning to swear] What the--

EMMY. Now, now, ducky!

REDPENNY. What do you suppose I care about the birthday honors?
Get out of this with your chattering. Dr Ridgeon will be down
before I have these letters ready. Get out.

EMMY. Dr Ridgeon wont never be down any more, young man.

She detects dust on the console and is down on it immediately.

REDPENNY [jumping up and following her] What?

EMMY. He's been made a knight. Mind you dont go Dr Ridgeoning him
in them letters. Sir Colenso Ridgeon is to be his name now.

REDPENNY. I'm jolly glad.

EMMY. I never was so taken aback. I always thought his great
discoveries was fudge (let alone the mess of them) with his drops
of blood and tubes full of Maltese fever and the like. Now he'll
have a rare laugh at me.

REDPENNY. Serve you right! It was like your cheek to talk to him
about science. [He returns to his table and resumes his writing].

EMMY. Oh, I dont think much of science; and neither will you when
youve lived as long with it as I have. Whats on my mind is
answering the door. Old Sir Patrick Cullen has been here already
and left first congratulations--hadnt time to come up on his way
to the hospital, but was determined to be first--coming back, he
said. All the rest will be here too: the knocker will be going
all day. What Im afraid of is that the doctor'll want a footman
like all the rest, now that he's Sir Colenso. Mind: dont you go
putting him up to it, ducky; for he'll never have any comfort
with anybody but me to answer the door. I know who to let in and
who to keep out. And that reminds me of the poor lady. I think he
ought to see her. Shes just the kind that puts him in a good
temper. [She dusts Redpenny's papers].

REDPENNY. I tell you he cant see anybody. Do go away, Emmy. How
can I work with you dusting all over me like this?

EMMY. I'm not hindering you working--if you call writing letters
working. There goes the bell. [She looks out of the window]. A
doctor's carriage. Thats more congratulations. [She is going out
when Sir Colenso Ridgeon enters]. Have you finished your two
eggs, sonny?

RIDGEON. Yes.

EMMY. Have you put on your clean vest?

RIDGEON. Yes.

EMMY. Thats my ducky diamond! Now keep yourself tidy and dont go
messing about and dirtying your hands: the people are coming to
congratulate you. [She goes out].

Sir Colenso Ridgeon is a man of fifty who has never shaken off
his youth. He has the off-handed manner and the little audacities
of address which a shy and sensitive man acquires in breaking
himself in to intercourse with all sorts and conditions of men.
His face is a good deal lined; his movements are slower than, for
instance, Redpenny's; and his flaxen hair has lost its lustre;
but in figure and manner he is more the young man than the titled
physician. Even the lines in his face are those of overwork and
restless scepticism, perhaps partly of curiosity and appetite,
rather than of age. Just at present the announcement of his
knighthood in the morning papers makes him specially self-
conscious, and consequently specially off-hand with Redpenny.

RIDGEON. Have you seen the papers? Youll have to alter the name
in the letters if you havnt.

REDPENNY. Emmy has just told me. I'm awfully glad. I--

RIDGEON. Enough, young man, enough. You will soon get accustomed
to it.

REDPENNY. They ought to have done it years ago.

RIDGEON. They would have; only they couldnt stand Emmy opening
the door, I daresay.

EMMY [at the door, announcing] Dr Shoemaker. [She withdraws].

A middle-aged gentleman, well dressed, comes in with a friendly
but propitiatory air, not quite sure of his reception. His
combination of soft manners and responsive kindliness, with a
certain unseizable reserve and a familiar yet foreign chiselling
of feature, reveal the Jew: in this instance the handsome
gentlemanly Jew, gone a little pigeon-breasted and stale after
thirty, as handsome young Jews often do, but still decidedly
good-looking.

THE GENTLEMAN. Do you remember me? Schutzmacher. University
College school and Belsize Avenue. Loony Schutzmacher, you know.

RIDGEON. What! Loony! [He shakes hands cordially]. Why, man, I
thought you were dead long ago. Sit down. [Schutzmacher sits on
the couch: Ridgeon on the chair between it and the window]. Where
have you been these thirty years?

SCHUTZMACHER. In general practice, until a few months ago. I've
retired.

RIDGEON. Well done, Loony! I wish I could afford to retire. Was
your practice in London?

SCHUTZMACHER. No.

RIDGEON. Fashionable coast practice, I suppose.

SCHUTZMACHER. How could I afford to buy a fashionable practice? I
hadnt a rap. I set up in a manufacturing town in the midlands in
a little surgery at ten shillings a week.

RIDGEON. And made your fortune?

SCHUTZMACHER. Well, I'm pretty comfortable. I have a place in
Hertfordshire besides our flat in town. If you ever want a quiet
Saturday to Monday, I'll take you down in my motor at an hours
notice.

RIDGEON. Just rolling in money! I wish you rich g.p.'s would
teach me how to make some. Whats the secret of it?

SCHUTZMACHER. Oh, in my case the secret was simple enough, though
I suppose I should have got into trouble if it had attracted any
notice. And I'm afraid you'll think it rather infra dig.

RIDGEON. Oh, I have an open mind. What was the secret?

SCHUTZMACHER. Well, the secret was just two words.

RIDGEON. Not Consultation Free, was it?

SCHUTZMACHER [shocked] No, no. Really!

RIDGEON [apologetic] Of course not. I was only joking.

SCHUTZMACHER. My two words were simply Cure Guaranteed.

RIDGEON [admiring] Cure Guaranteed!

SCHUTZMACHER. Guaranteed. After all, thats what everybody wants
from a doctor, isnt it?

RIDGEON. My dear loony, it was an inspiration. Was it on the
brass plate?

SCHUTZMACHER. There was no brass plate. It was a shop window:
red, you know, with black lettering. Doctor Leo Schutzmacher,
L.R.C.P.M.R.C.S. Advice and medicine sixpence. Cure Guaranteed.

RIDGEON. And the guarantee proved sound nine times out of ten,
eh?

SCHUTZMACHER [rather hurt at so moderate an estimate] Oh, much
oftener than that. You see, most people get well all right if
they are careful and you give them a little sensible advice. And
the medicine really did them good. Parrish's Chemical Food:
phosphates, you know. One tablespoonful to a twelve-ounce bottle
of water: nothing better, no matter what the case is.

RIDGEON. Redpenny: make a note of Parrish's Chemical Food.

SCHUTZMACHER. I take it myself, you know, when I feel run down.
Good-bye. You dont mind my calling, do you? Just to congratulate
you.

RIDGEON. Delighted, my dear Loony. Come to lunch on Saturday next
week. Bring your motor and take me down to Hertford.

SCHUTZMACHER. I will. We shall be delighted. Thank you. Good-bye.
[He goes out with Ridgeon, who returns immediately].

REDPENNY. Old Paddy Cullen was here before you were up, to be the
first to congratulate you.

RIDGEON. Indeed. Who taught you to speak of Sir Patrick Cullen as
old Paddy Cullen, you young ruffian?

REDPENNY. You never call him anything else.

RIDGEON. Not now that I am Sir Colenso. Next thing, you fellows
will be calling me old Colly Ridgeon.

REDPENNY. We do, at St. Anne's.

RIDGEON. Yach! Thats what makes the medical student the most
disgusting figure in modern civilization. No veneration, no
manners--no--

EMMY [at the door, announcing]. Sir Patrick Cullen. [She
retires].

Sir Patrick Cullen is more than twenty years older than Ridgeon,
not yet quite at the end of his tether, but near it and resigned
to it. His name, his plain, downright, sometimes rather arid
common sense, his large build and stature, the absence of those
odd moments of ceremonial servility by which an old English
doctor sometimes shews you what the status of the profession was
in England in his youth, and an occasional turn of speech, are
Irish; but he has lived all his life in England and is thoroughly
acclimatized. His manner to Ridgeon, whom he likes, is whimsical
and fatherly: to others he is a little gruff and uninviting, apt
to substitute more or less expressive grunts for articulate
speech, and generally indisposed, at his age, to make much social
effort. He shakes Ridgeon's hand and beams at him cordially and
jocularly.

SIR PATRICK. Well, young chap. Is your hat too small for you, eh?

RIDGEON. Much too small. I owe it all to you.

SIR PATRICK. Blarney, my boy. Thank you all the same. [He sits in
one of the arm-chairs near the fireplace. Ridgeon sits on the
couch]. Ive come to talk to you a bit. [To Redpenny] Young man:
get out.

REDPENNY. Certainly, Sir Patrick [He collects his papers and
makes for the door].

SIR PATRICK. Thank you. Thats a good lad. [Redpenny vanishes].
They all put up with me, these young chaps, because I'm an old
man, a real old man, not like you. Youre only beginning to give
yourself the airs of age. Did you ever see a boy cultivating a
moustache? Well, a middle-aged doctor cultivating a grey head is
much the same sort of spectacle.

RIDGEON. Good Lord! yes: I suppose so. And I thought that the
days of my vanity were past. Tell me at what age does a man leave
off being a fool?

SIR PATRICK. Remember the Frenchman who asked his grandmother at
what age we get free from the temptations of love. The old woman
said she didn't know. [Ridgeon laughs]. Well, I make you the same
answer. But the world's growing very interesting to me now,
Colly.

RIDGEON. You keep up your interest in science, do you?

SIR PATRICK. Lord! yes. Modern science is a wonderful thing. Look
at your great discovery! Look at all the great discoveries! Where
are they leading to? Why, right back to my poor dear old father's
ideas and discoveries. He's been dead now over forty years. Oh,
it's very interesting.

RIDGEON. Well, theres nothing like progress, is there?

SIR PATRICK. Dont misunderstand me, my boy. I'm not belittling
your discovery. Most discoveries are made regularly every fifteen
years; and it's fully a hundred and fifty since yours was made
last. Thats something to be proud of. But your discovery's not
new. It's only inoculation. My father practised inoculation until
it was made criminal in eighteen-forty. That broke the poor old
man's heart, Colly: he died of it. And now it turns out that my
father was right after all. Youve brought us back to inoculation.

RIDGEON. I know nothing about smallpox. My line is tuberculosis
and typhoid and plague. But of course the principle of all
vaccines is the same.

SIR PATRICK. Tuberculosis? M-m-m-m! Youve found out how to cure
consumption, eh?

RIDGEON. I believe so.

SIR PATRICK. Ah yes. It's very interesting. What is it the old
cardinal says in Browning's play? "I have known four and twenty
leaders of revolt." Well, Ive known over thirty men that found
out how to cure consumption. Why do people go on dying of it,
Colly? Devilment, I suppose. There was my father's old friend
George Boddington of Sutton Coldfield. He discovered the open-air
cure in eighteen-forty. He was ruined and driven out of his
practice for only opening the windows; and now we wont let a
consumptive patient have as much as a roof over his head. Oh,
it's very VERY interesting to an old man.

RIDGEON. You old cynic, you dont believe a bit in my discovery.

SIR PATRICK. No, no: I dont go quite so far as that, Colly. But
still, you remember Jane Marsh?

RIDGEON. Jane Marsh? No.

SIR PATRICK. You dont!

RIDGEON. No.

SIR PATRICK. You mean to tell me you dont remember the woman with
the tuberculosis ulcer on her arm?

RIDGEON [enlightened] Oh, your washerwoman's daughter. Was her
name Jane Marsh? I forgot.

SIR PATRICK. Perhaps youve forgotten also that you undertook to
cure her with Koch's tuberculin.

RIDGEON. And instead of curing her, it rotted her arm right off.
Yes: I remember. Poor Jane! However, she makes a good living out
of that arm now by shewing it at medical lectures.

SIR PATRICK. Still, that wasnt quite what you intended, was it?

RIDGEON. I took my chance of it.

SIR PATRICK. Jane did, you mean.

RIDGEON. Well, it's always the patient who has to take the chance
when an experiment is necessary. And we can find out nothing
without experiment.

SIR PATRICK. What did you find out from Jane's case?

RIDGEON. I found out that the inoculation that ought to cure
sometimes kills.

SIR PATRICK. I could have told you that. Ive tried these modern
inoculations a bit myself. Ive killed people with them; and Ive
cured people with them; but I gave them up because I never could
tell which I was going to do.

RIDGEON [taking a pamphlet from a drawer in the writing-table and
handing it to him] Read that the next time you have an hour to
spare; and youll find out why.

SIR PATRICK [grumbling and fumbling for his spectacles] Oh,
bother your pamphlets. Whats the practice of it? [Looking at the
pamphlet] Opsonin? What the devil is opsonin?

RIDGEON. Opsonin is what you butter the disease germs with to
make your white blood corpuscles eat them. [He sits down again on
the couch].

SIR PATRICK. Thats not new. Ive heard this notion that the white
corpuscles--what is it that whats his name?--Metchnikoff--calls
them?

RIDGEON. Phagocytes.

SIR PATRICK. Aye, phagocytes: yes, yes, yes. Well, I heard this
theory that the phagocytes eat up the disease germs years ago:
long before you came into fashion. Besides, they dont always eat
them.

RIDGEON. They do when you butter them with opsonin.

SIR PATRICK. Gammon.

RIDGEON. No: it's not gammon. What it comes to in practice is
this. The phagocytes wont eat the microbes unless the microbes
are nicely buttered for them. Well, the patient manufactures the
butter for himself all right; but my discovery is that the
manufacture of that butter, which I call opsonin, goes on in the
system by ups and downs--Nature being always rhythmical, you
know--and that what the inoculation does is to stimulate the ups
or downs, as the case may be. If we had inoculated Jane Marsh
when her butter factory was on the up-grade, we should have cured
her arm. But we got in on the downgrade and lost her arm for her.
I call the up-grade the positive phase and the down-grade the
negative phase. Everything depends on your inoculating at the
right moment. Inoculate when the patient is in the negative phase
and you kill: inoculate when the patient is in the positive phase
and you cure.

SIR PATRICK. And pray how are you to know whether the patient is
in the positive or the negative phase?

RIDGEON. Send a drop of the patient's blood to the laboratory at
St. Anne's; and in fifteen minutes I'll give you his opsonin
index in figures. If the figure is one, inoculate and cure: if
it's under point eight, inoculate and kill. Thats my discovery:
the most important that has been made since Harvey discovered the
circulation of the blood. My tuberculosis patients dont die now.

SIR PATRICK. And mine do when my inoculation catches them in the
negative phase, as you call it. Eh?

RIDGEON. Precisely. To inject a vaccine into a patient without
first testing his opsonin is as near murder as a respectable
practitioner can get. If I wanted to kill s man I should kill him
that way.

EMMY [looking in] Will you see a lady that wants her husband's
lungs cured?

RIDGEON [impatiently] No. Havnt I told you I will see nobody?[To
Sir Patrick] I live in a state of siege ever since it got about
that I'm a magician who can cure consumption with a drop of
serum. [To Emmy] Dont come to me again about people who have no
appointments. I tell you I can see nobody.

EMMY. Well, I'll tell her to wait a bit.

RIDGEON [furious] Youll tell her I cant see her, and send her
away: do you hear?

EMMY [unmoved] Well, will you see Mr Cutler Walpole? He dont want
a cure: he only wants to congratulate you.

RIDGEON. Of course. Shew him up. [She turns to go]. Stop. [To Sir
Patrick] I want two minutes more with you between ourselves. [To
Emmy] Emmy: ask Mr. Walpole to wait just two minutes, while I
finish a consultation.

EMMY. Oh, he'll wait all right. He's talking to the poor lady.
[She goes out].

SIR PATRICK. Well? what is it?

RIDGEON. Dont laugh at me. I want your advice.

SIR PATRICK. Professional advice?

RIDGEON. Yes. Theres something the matter with me. I dont know
what it is.

SIR PATRICK. Neither do I. I suppose youve been sounded.

RIDGEON. Yes, of course. Theres nothing wrong with any of the
organs: nothing special, anyhow. But I have a curious aching: I
dont know where: I cant localize it. Sometimes I think it's my
heart: sometimes I suspect my spine. It doesnt exactly hurt me;
but it unsettles me completely. I feel that something is going to
happen. And there are other symptoms. Scraps of tunes come into
my head that seem to me very pretty, though theyre quite
commonplace.

SIR PATRICK. Do you hear voices?

RIDGEON. No.

SIR PATRICK. I'm glad of that. When my patients tell me that
theyve made a greater discovery than Harvey, and that they hear
voices, I lock them up.

RIDGEON. You think I'm mad! Thats just the suspicion that has
come across me once or twice. Tell me the truth: I can bear it.

SIR PATRICK. Youre sure there are no voices?

RIDGEON. Quite sure.

SIR PATRICK. Then it's only foolishness.

RIDGEON. Have you ever met anything like it before in your
practice?

SIR PATRICK. Oh, yes: often. It's very common between the ages of
seventeen and twenty-two. It sometimes comes on again at forty or
thereabouts. Youre a bachelor, you see. It's not serious--if
youre careful.

RIDGEON. About my food?

SIR PATRICK. No: about your behavior. Theres nothing wrong with
your spine; and theres nothing wrong with your heart; but theres
something wrong with your common sense. Youre not going to die;
but you may be going to make a fool of yourself. So be careful.

RIDGEON. I sec you dont believe in my discovery. Well, sometimes
I dont believe in it myself. Thank you all the same. Shall we
have Walpole up?

SIR PATRICK. Oh, have him up. [Ridgeon rings]. He's a clever
operator, is Walpole, though he's only one of your chloroform
surgeons. In my early days, you made your man drunk; and the
porters and students held him down; and you had to set your teeth
and finish the job fast. Nowadays you work at your ease; and the
pain doesn't come until afterwards, when youve taken your
cheque and rolled up your bag and left the house. I tell you,
Colly, chloroform has done a lot of mischief. It's enabled every
fool to be a surgeon.

RIDGEON [to Emmy, who answers the bell] Shew Mr Walpole up.

EMMY. He's talking to the lady.

RIDGEON [exasperated] Did I not tell you--

Emmy goes out without heeding him. He gives it up, with a shrug,
and plants himself with his back to the console, leaning
resignedly against it.

SIR PATRICK. I know your Cutler Walpoles and their like. Theyve
found out that a man's body's full of bits and scraps of old
organs he has no mortal use for. Thanks to chloroform, you can
cut half a dozen of them out without leaving him any the worse,
except for the illness and the guineas it costs him. I knew the
Walpoles well fifteen years ago. The father used to snip off the
ends of people's uvulas for fifty guineas, and paint throats with
caustic every day for a year at two guineas a time. His brother-
in-law extirpated tonsils for two hundred guineas until he took
up women's cases at double the fees. Cutler himself worked hard
at anatomy to find something fresh to operate on; and at last he
got hold of something he calls the nuciform sac, which he's made
quite the fashion. People pay him five hundred guineas to cut it
out. They might as well get their hair cut for all the difference
it makes; but I suppose they feel important after it. You cant go
out to dinner now without your neighbor bragging to you of some
useless operation or other.

EMMY [announcing] Mr Cutler Walpole. [She goes out].

Cutler Walpole is an energetic, unhesitating man of forty, with a
cleanly modelled face, very decisive and symmetrical about the
shortish, salient, rather pretty nose, and the three trimly
turned corners made by his chin and jaws. In comparison with
Ridgeon's delicate broken lines, and Sir Patrick's softly rugged
aged ones, his face looks machine-made and beeswaxed; but his
scrutinizing, daring eyes give it life and force. He seems never
at a loss, never in doubt: one feels that if he made a mistake he
would make it thoroughly and firmly. He has neat, well-nourished
hands, short arms, and is built for strength and compactness
rather than for height. He is smartly dressed with a fancy
waistcoat, a richly colored scarf secured by a handsome ring,
ornaments on his watch chain, spats on his shoes, and a general
air of the well-to-do sportsman about him. He goes straight
across to Ridgeon and shakes hands with him.

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