Doctor and Patient
by S. Weir Mitchell
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I should say something as to the home-life of girls who go through the ordinary curriculum of city day schools were it not that I have of late so very fully reconsidered and rewritten my views as to this interesting question. I beg to refer my unsatisfied reader to a little book which, I am glad to know, has been helpful to many people in the last few years.[11]

[Footnote 11: "Wear and Tear," pp. 30 to 60. J.B. Lippincott Company, Philadelphia, 1887.]


A good many years ago I wrote a short paper, meant to capture popular attention, under the title of "Camp Cure." I have reason to think that it was of use, but I have been led to regret that I did not see when it was written that what I therein urged as desirable for men was not also in a measure attainable by many women. I wish now to correct my error of omission, and to show not only that in our climate camp-life in some shape can be readily had, but also what are its joys and what its peculiar advantages.[12] My inclination to write anew on this subject is made stronger by two illustrations which recur to my mind, and which show how valuable may be an entire out-door life, and how free from risks even for the invalid. The lessons of the great war were not lost upon some of us, who remember the ease with which recoveries were made in tents, but single cases convince more than any statement of these large and generalized remembrances.

[Footnote 12: "Nurse and Patient," and "Camp Cure," by S. Weir Mitchell. J.B. Lippincott Company Philadelphia.]

I knew a sick and very nervous woman who had failed in many hands to regain health of mind. I had been able to restore to her all she needed in the way of blood and tissue, but she remained, as before, almost helplessly nervous. Wealth made all resources easy, and yet I had been unable to help her. At last I said to her, "If you were a man I think I could cure you." I then told her how in that case I would ask a man to live. "I will do anything you desire," she said, and this was what she did. With an intelligent companion, she secured two well-known, trusty guides, and pitched her camp by the lonely waters of a Western lake in May, as soon as the weather allowed of the venture. With two good wall-tents for sleeping-and sitting-rooms, with a log hut for her men a hundred yards away and connected by a wire telephone, she began to make her experiment.

A little stove warmed her sitting-room at need, and once a fortnight a man went to the nearest town and brought her books. Letters she avoided, and her family agreed to notify her at once of any real occasion for her presence. Even newspapers were shut out, and thus she began her new life. Her men shot birds and deer, and the lake gave her black bass, and with these and well-chosen canned vegetables and other stores she did well enough as to food. The changing seasons brought her strange varieties of flowers, and she and her friend took industriously to botany, and puzzled out their problems unaided save by books. Very soon rowing, fishing, and, at last, shooting were added to her resources. Before August came she could walk for miles with a light gun, and could stand for hours in wait for a deer. Then she learned to swim, and found also refined pleasure in what I call word-sketching, as to which I shall by and by speak. Photography was a further gain, taken up at my suggestion. In a word, she led a man's life until the snow fell in the fall and she came back to report, a thoroughly well woman.

A more notable case was that of a New England lady, who was sentenced to die of consumption by at least two competent physicians. Her husband, himself a doctor, made for her exactly the same effort at relief which was made in the case I have detailed, except that when snow fell he had built a warm log cabin, and actually spent the winter in the woods, teaching her to live out in the air and to walk on snow-shoes. She has survived at least one of her doctors, and is, I believe, to this day a wholesome and vigorous wife and mother.

What large wealth did to help in these two cases may be managed with much smaller means. All through the White Mountains, in summer, you may see people, a whole family often, with a wagon, going from place to place, pitching their tents, eating at farm-houses or hotels, or managing to cook at less cost the food they buy. Our sea-coast presents like chances. With a good tent or two, which costs little, you may go to unoccupied beaches, or by inlet or creek, and live for little. I very often counsel young people to hire a safe open or decked boat, and, with a good tent, to live in the sounds along the Jersey coast, going hither and thither, and camping where it is pleasant, for, with our easy freedom as to land, none object. When once a woman—and I speak now of the healthy—has faced and overcome her dread of sun and mosquitoes, the life becomes delightful. The Adirondacks, the Alleghanies, and the Virginia mountains afford like chances, for which, as these are in a measure remote, there must be a somewhat more costly organization. I knew well a physician who every summer deserted his house and pitched tents on an island not over three miles from home, and there spent the summer with his family, so that there are many ways of doing the same thing.

As to the question of expense, there is no need to say much. All over our sparsely-inhabited land places wild enough are within easy reach, and the journey to reach them need not be long. Beyond this, tent-life is, of course, less costly than the hotel or boarding-house, in which such numbers of people swelter through their summers. As to food, it is often needful to be within reach of farm-houses or hotels, and all kind of modifications of the life I advise are possible.

As to inconveniences, they are, of course, many, but, with a little ingenuity, it is easy to make tent-life comfortable, and none need dread them. Any book on camp-life will tell how to meet or avoid them, and to such treatises I beg to refer the reader who wishes to experiment on this delightful mode of gypsying.

The class of persons who find it easy to reach the most charming sites and to secure the help of competent guides is, as I have said in another place, increasing rapidly. The desire also for such a life is also healthfully growing, so that this peculiarly American mode of getting an outing is becoming more and more familiar. It leads to our young folks indulging in all sorts of strengthening pursuits. It takes them away from less profitable places, and the good it does need not be confined to the boys. Young women may swim, fish, and row like their brothers, but the life has gains and possibilities, as to which I would like to say something more. In a well-ordered camp you may be sure of good food and fair cooking. To sleep and live in the air is an insurance against what we call taking cold. Where nature makes the atmospheric changes, they are always more gradual and kindly than those we make at any season when we go from street to house or house to street.

My brothers during the war always got colds when at home on leave, and those who sleep in a chinky cabin or tent soon find that they do not suffer and that they have an increasing desire for air and openness.

To live out of doors seems to be a little matter in the way of change, and that it should have remarkable moral and intellectual values does not appear credible to such as have not had this experience.

Yet, in fact, nothing so dismisses the host of little nervousnesses with which house-caged women suffer as this free life. Cares, frets, worries, and social annoyances disappear, and in the woods and by the waters we lose, as if they were charmed away, our dislikes or jealousies, all the base, little results of the struggle for bread or place. At home, in cities, they seem so large; here, in the gentle company of constant sky and lake and stream, they seem trivial, and we cast them away as easily as we throw aside some piece of worn-out and useless raiment.

The man who lives out of doors awhile acquires better sense of moral proportions, and thinks patiently and not under stress, making tranquil companions of his worthy thoughts. This is a great thing, not to be hurried. There seems to me always more time out of doors than in houses, and if you have intellectual problems to settle, the cool quiet of the woods or the lounging comfort of the canoe, or to be out under "the huge and thoughtful night," has many times seemed to me helpful. One gets near realities out of doors. Thought is more sober; one becomes a better friend to one's self.

As to the effect of out-door life on the imaginative side of us, much may be said. Certainly some books get fresh flavors out of doors, and you see men or women greedily turn to reading and talking over verse who never dream of it when at home. I am tempted to mention the poets, and even the other authors who gain a kindly rubric for their work from the gentle company of lake and wood and stream. I should frankly name Walt Whitman and Thoreau, and pause pretty soon in wonder at the small number of poets who suggest out-door life as their source of inspiration. A good many of them—read as you lie in a birch canoe or seated on a stump in the woods—shrink to well-bred, comfortable parlor bards, who seem to you to have gotten their nature-lessons through plate-glass windows. The test is a sharp one, and will leave out some great names and let in some hardly known, or almost forgotten. Books to be read out of doors would make a curious catalogue, and would vary, as such lists must, with every thoughtful reader, while some would smile, perhaps with reason, at the idea of any such classification. Certainly all would name Wordsworth, and a few would add Clough, whilst the out-door plays of Shakespeare would come in, and we should soon be called on to feel that for this sort of congenial open-air poetic company we have still to fall back on the vast resources of English verse. Somehow, as yet, our own poets have not gotten fully into imaginative relation with what is peculiar in our own flowers, trees, and skies. This does not lessen our joy in the masters of English verse, because, of course, much of what they have sung has liberal application in all lands; yet is there something which we lose in them for lack of familiar knowledge of English lanes and woods, of English flowers and trees. A book of the essentially American nature—poems found here and there in many volumes—would be pleasant, for surely we have had no one poet as to whom it is felt that he is absolutely desirable as the interpretive poetic observer who has positive claims to go with us as a friendly bookmate in our wood or water wanderings. I have shrunk, as will have been seen, from the dangerous venture of enlarging my brief catalogue. What I have just now spoken of as one's bookmates will appear in very different lights according to the surroundings in which we seek to enjoy their society. If, as to this matter, any one doubts me, and has the good luck to camp out long, and to have a variety of books of verse and prose, very soon, if dainty of taste, he will find that the artificial flavoring of some books is unpleasantly felt; but, after all, one does not read very much when living thus outside of houses. Books are then, of course, well to have, but rather as giving one texts for thoughts and talk than as preachers, counsellors, jesters, or friends.

In my own wood-life or canoe journeys I used to wonder how little I read or cared to read. One has nowadays many resources. If you sketch, no matter how badly, it teaches and even exacts that close observation of nature which brings in its train much that is to be desired. Photography is a means of record, now so cheaply available as to be at the disposal of all, and there is a great charm of a winter evening in turning over sketch or photograph to recall anew the pleasant summer days. Beyond all this, there is botany. I knew a lady who combined it happily and ingeniously with photography, and so preserved pictures of plants in their flowering state. When you are out under starry skies with breadth of heaven in view, astronomy with an opera-glass—and Galileo's telescope was no better—is an agreeable temptation which the cheap and neat charts of the skies now to be readily obtained make very interesting.

I should advise any young woman, indeed, any one who has the good chance to live a camp-life, or to be much in the country, to keep a diary, not of events but of things. I find myself that I go back to my old note-books with increasing pleasure.

To make this resource available something more than the will to do it is necessary. Take any nice young girl, who is reasonably educated, afloat in your canoe with you, and ask her what she sees. As a rule she has a general sense that yonder yellow bank, tree-crowned above the rippled water, is pleasant. The sky is blue, the sun falling behind you. She says it is beautiful and has a vague sense of enjoyment, and will carry away with her little more than this. Point out to her that the trees above are some of them deciduous poplars, or maples, and others sombre groups of pines and silky tamarack with a wonder of delicate tracery. Show her that the sun against the sloped yellow bank has covered the water with a shining changeful orange light, through which gleam the mottled stones below, and that the concave curve of every wave which faces us concentrates for the eye an unearthly sapphire the reflex of the darkening blue above us. Or a storm is on us at the same place. She is fearless as to the ducking from which even her waterproof will hardly protect. The clouds gather, the mists trail on the hills, ragged mosses on the trees hang in wet festoons of gray, and look in the misty distance like numberless cascades. It rains at last, a solid down-pour; certain tree-trunks grow black, and the shining beech and birch and poplar get a more vivid silver on their wet boles. The water is black like ink. It is no longer even translucent, and overhead the red scourges of the lightning fly, and the great thunder-roar of smitten clouds rolls over us from hill to hill.

All these details you teach her and more, and paddle home with a mental cargo of fresh joys and delicious memories. My young friend is intelligent and clever, but she has never learned to observe. If she wants to know how, there is a book will help her. Let her take with her Ruskin's "Modern Painters." It will teach her much, not all. Nor do I know of any other volume which will tell her more.[13] Despite its faults, it has so many lessons in the modes of minute study of outside nature that it becomes a valuable friend. Although ostensibly written to aid artistic criticism, it does far more than this and yet not all. Other books which might seem desirable are less so because they are still more distinctly meant to teach or assist artists or amateurs. What is yet wanted is a little treatise on the methods of observing exterior nature. Above all it should be adapted to our own woods, skies, and waters. What to look for as a matter of pleasure, and how to see and record it, is a thing apart from such observation as leads to classification, and is scientific in its aims. It is somewhat remote also from the artist's study, which is a more complex business, and tends to learn what can be rendered by pencil or brush and what cannot. Its object at first is merely to give intelligent joy to the senses, to cultivate them into acuteness, and to impress on the mind such records as they ought to give us at their best.

[Footnote 13: "Frondes Agrestes," Ruskin, is a more handy book than "Modern Painters," but is only selections from the greater volumes recommended. "Deucalion" is yet harder reading, but will repay the careful reader.]

Presuming the pupil to be like myself, powerless to use the pencil, she is to learn how to put on paper in words what she sees. The result will be what I may call word-sketches. Observe these are not to be for other eyes. They make her diary of things seen and worthy of note. Neither are they to be efforts to give elaborate descriptions. In the hands of a master, such use of words makes a picture in which often he sacrifices something, as the artist does, to get something else, and strives chiefly to leave on the mind one dominant emotion just as did the scene thus portrayed. A few words may do this or it may be an elaborate work. The gift is a rare and great one. The word-paintings of Ruskin hang forever in one's mental gallery, strong, true, poetical, and capable of stirring you as the scenes described would have done, nay, even more, for a great word-master has stood interpretative between you and nature.

Miss Bronte was mistress of this art. Blackmore has it also. In some writers it is so lightly managed as to approach the sketch, and is more suggestive than fully descriptive. To see what I mean read the first few chapters of "Miss Angel," by Anna Thackeray. But a sketch by a trained and poetical observer is one thing; a sketch by a less gifted person is quite another. My pupil must be content with the simplest, most honest, unadorned record of things seen. Her training must look to this only.

What she should first seek to do is to be methodical and accurate and by and by fuller. If wise she will first limit herself to small scenes, and try to get notes of them somewhat in this fashion. She is, we suppose, on the bank of a stream. Her notes run as follows:

Date, time of day, place. Hills to either side and their character; a guess at their height; a river below, swift, broken, or placid; the place of the sun, behind, in front, or overhead. Then the nature of the trees and how the light falls on them or in them, according to their kind. Next come color of wave and bank and sky, with questions as to water-tints and their causes. Last of all, and here she must be simple and natural, what mood of mind does it all bring to her, for every landscape has its capacity to leave you with some general sense of its awe, its beauty, its sadness, or its joyfulness.

Try this place again at some other hour, or in a storm, or under early morning light, and make like notes. If she should go on at this pleasant work, and one day return to the same spot, she will wonder how much more she has now learned to see.

Trees she will find an enchanting study. Let her take a group of them and endeavor to say on paper what makes each species so peculiar. The form, color, and expression of the boles are to be noted. A reader may smile at the phrase "expression," but look at a tattered old birch, or a silvery young beech-hole, "modest and maidenly, clean of limb," or a lightning-scarred pine. Tree-study has advantages because it is always within reach. The axe has been so ruthlessly wielded that you must go far into the woods to get the best specimens of the pine, and the forests about our Maine lakes and in the Adirondacks have been sadly despoiled of their aristocrats. To see trees at their savage best one must go South, and seek the white-oaks of Carolina, the cypress of Florida, but the parks of Philadelphia and Baltimore afford splendid studies, and so also do the mountains of Virginia. Private taste and enterprise is saving already much that will be a joy to our children. A noble instance is the great wild park with which Colonel Parsons has protected the Natural Bridge in Virginia. I saw there an arbor-vitae said by botanists to be not less than nine hundred years old, a chestnut twenty-six feet in girth at the height of my shoulders, and oaks past praise. But trees are everywhere, and if my observant pupil likes them, let her next note the mode in which the branches spread and their proportion to the trunk. State it all in the fewest words. It is to be only a help to memory. Then she comes to the leaf forms and the mode in which they are massed, their dulness or translucency, how sunshine affects their brilliancy, as it is above or falls laterally at morn or eve. Perhaps she will note, too, on which the gray moss grows, and just in what forms, and how the mosses or lichens gather on the north side of trees and on what trees.

I may help my pupil if, like an artist teacher, I give one or two illustrations, copied verbatim from my note-books. The first was written next morning, as it is a brief record of a night scene.

Time, July 21, 1887, 9 P.M. Ristigouche River, New Brunswick, Canada. Black darkness. Hill outlines nearly lost in sky. River black, with flashing bits of white rapid; banks have grayish rocks, and so seem to be nearer than the dark stream limits. Sky looks level with hill-tops. Water seems to come up close. Effect of being in a concave valley of water, and all things draw in on me. Sense of awe. Camp-fire's red glare on water. Sudden opening lift of sky. Hills recede. Water-level falls. This is a barren, unadorned sketch, but it seems to tell the thing.

Or this, for a change. Newport. A beach. Time, August 1, 1887; 4 P.M. About me cleft rocks, cleavage straight through the embedded pebbles. Tones ruddy browns and grays. Gray beach. Sea-weed in heaps, deep pinks and purples. Boisterous waves, loaded with reddish seaweed, blue, with white crests, torn off in long ribbons by wind. Curious reds and blues as waves break, carrying sea-weed. Fierce gale off land. Dense fog, sun above it and to right. Everywhere yellow light. Sea strange dingy yellow. Leaves an unnatural green. Effect weird. Sense of unusualness.

Of course, such study of nature leads the intelligent to desire to know why the cleaved rock shows its sharp divisions as if cut by a knife, why yellow light gives such strangeness of tints, and thus draws on my pupil to larger explanatory studies. So much the better.

If when she bends over a foot-square area of mouldered tree-trunk, deep in the silence of a Maine wood, she has a craving to know the names and ways of the dozen mosses she notes, of the minute palm-like growths, of the odd toadstools, it will not lessen the joy this liliputian representation of a tropical jungle gives to her. Nor will she like less the splendor of sunset tints on water to know the secrets of the pleasant tricks of refraction and reflection.

I do not want to make too much of a small matter. No doubt many people do this kind of thing, but in most volumes of travel it is easy to see that the descriptions lack method, and show such want of training in observation as would not be noticeable had their authors gone through the modest studies I am now inviting my pupil to make.

Her temptation will be to note most the large, the grotesque, or the startling aspects of nature. In time these will be desirable as studies, but at first she must try smaller and limited sketches. They are as difficult, but do not change as do the grander scenes and objects. I knew a sick girl, who, bedfast for years, used to amuse herself with what her windows and an opera-glass commanded in the way of sky and foliage. The buds in spring-time, especially the horse-chestnuts, were the subject of quite curious notes, and cloud-forms an endless source of joy and puzzle to describe. One summer a great effort was made, and she was taken to the country, and a day or two later carried down near a brook, where they swung her hammock. I found her quite busy a week later, and happy in having discovered that the wave-curves over a rock were like the curves of some shells. My pupil will soon learn, as she did, that a good opera-glass is indispensable. Let any one who has not tried it look with such a glass at sunset-decked water in motion. I am sure they will be startled by its beauty, and this especially if the surface be seen from a boat, because merely to look down on water is to make no acquaintance with its loveliness. A scroll of paper to limit the view and cut out side-lights also intensifies color. The materials my pupil is to use are words, and words only. Constant dissatisfaction with the little they can tell us is the fate of all who use them. The sketcher, the great word-painter, and even the poet feels this when, like Browning, he seems so to suffer from their weakness as to be troubled into audacious employment of the words that will not obey his will, torment them as he may. Yet, as my pupil goes on, she will find her vocabulary growing, and will become more and more accurate in her use and more ingenious in her combination of words to give her meaning. As she learns to feel strongly—for she will in time—her love will give her increasing power both to see and to state what she sees, because this gentle passion for nature in all her moods is like a true-love affair, and grows by what it feeds upon.

When we come to sketch in words the rare and weird effects, the storm, the sunsets that seem not of earth, the cascade, or the ravage of the "windfall," it is wise not to be lured into fanciful word-painting, and the temptation is large. Yet the simplest expression of facts is then and for such rare occasions the best, and often by far the most forceful.

I venture, yet again, to give from a note-book of last year a few lines as to a sunset. I was on a steam-yacht awaiting the yachts which were racing for the Newport cup.

August 6, time, sunset; level sea; light breeze; fire-red sun on horizon; vast masses of intensely-lighted scarlet clouds; a broad track of fiery red on water; three yachts, with all sail set, coming over this sea of red towards us. Their sails are a vivid green. The vast mass of reds and scarlets give one a strange sense of terror as if something would happen. I could go on to expand upon "this color such as shall be in heaven," and on the sails which seemed to be green, but for the purpose of a sketch and to refresh the traitor memory in the future, the lines I wrote are enough and are yet baldly simple.

Out of this practice grow, as I have said, love of accuracy, larger insights, careful valuation of words, and also an increasing and more intelligent love of art in all its forms; nor will all these gains in the power to observe be without practical value in life.

I trust that I have said enough to tempt others to try each in their way to do what has been for me since boyhood a constant summer amusement.


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