The Johns Hopkins Hospital Nov. 14, 1919.
Lady dear,
Thanks for the book. I have picked it up at odd moments & it has made me laugh.
I am sorry to hear of Miss Ball's condition. Gastric complaints are dirt common in Pott's of the spine, & unless there was some other symptom such as fever, or jaundice etc. I cannot imagine why one would operate. Of course the abdominal viscera are displaced, in this condition, & the liver twisted. It is bound to be when a 3 inch tuck is taken in the vertebral column. But Pott's are bad operative risks on account of the compressed lung condition. I do hope she gets along OK. She has suffered so much. It seems a shame to have operated on her unless it was a life & death matter.
Dr. M. is slowly getting about, is on crutches now. Things have been going badly since his incarceration. Your friend Dr. Scott got mad because Dr. [...] married against her advice, so she has been taking it out on everybody[.] I'm sure glad I'm not in the House. As it is I have not escaped her temper. You know she has always "picked on me" for special reasons that I suppose she really can't help. This fall I ventured to criticize histories made by an irresponsible interne on the staff. They were so untrue that I was ashamed to show them to students. Something had to be done & she said she couldn't remedy matters. I took the matter to the Chief. She got mad & has been taking it out in catspit. [?] In league with her is a little half baked peer who has charge of the men's side. I wouldn't mind it myself but they have made life so miserable for poor Miss Meagher who is the nurse in charge of this interne's ward that she is leaving. It is a nasty mess. And how wrong such thin[gs] are due to people whose personal difficulties are project upon others as righteous indignation.
Unfortunately I sent Miss Ball a reprint about the time I sent you one. It certainly is nothing for her to be reading now, & if you could [...] her of it I'd be glad. I sent one to Dr. U., Mr. Hayes & Miss Blakely also.
By the way, on reading your letter over again I notice the inflamed chronic appendix. Of course it would have to be there. I dare say mine is blushing like a 16 yr. old lover this very minute if I could see it. I have yet to hear of an exploratory laparotomy for any reason from a displaced uterus to an encysted hair brush in where there was not found "a badly inflamed appendix." The patient has got to feel comforted for some loss, & the doctor needs reassurance also, so why not the appendix? To see the thing in a jar afterwards, all white and helpless gives one a great sense of satisfaction. We are as delightfully [...] as in the days of Galen & Hippocrates, but how mad it makes us to realize it.
I have many reflections on teaching. I am getting more & more forward over marks as a standard of academic intelligence. I have to work for the "office" but I do it wholly on the man's ability to use his common sense rather than his memory. Science ought to do it, but it doesn't. Yesterday 6 of the first men of the class missed a left facial palsy with drooping lid, & corner of mouth & all the rest. Why?
1. The Pt. was in this building.
2. She didn't complain of the thing that ailed her.
3. They had never read aobut a condition like it in a book.We mark too much on gorging & regurgitation.
Your omnipotent,
Esther