The case of Mr. Z

The medical doctors amoung the readership of this blog will be well aware that a doctor’s examination and diagnosis takes into account all factors, medical and social. In this post, Dr Sutherland relates the case of Mr. Z:

Mr. Z was an insurance agent, dying of consumption. As soon as I entered the dingy hall of his little house I had a feeling of some impending evil. Some houses carry that impression, which is not related to riches or poverty. Mrs Z was a tall woman, who had once been handsome, but was now untidy and unkempt. When she brought me to her husband’s bedside I realised that no love was lost between them. The case of Mr. Z was hopeless, but at the end of the week he began to have attacks of sickness and colic, which apparently had no relation to his cough, but to – his food. After two days I found myself in the most terrible position in which a doctor can find himself – of suspected poisoning. It was possible to have a chemical analysis of the product of the sickness, but that would cost money. These people were poor and mean, and they would want to know why an analysis was necessary. I remembered the advice of my old teacher, Sir Henry Littlejohn. “To save your patient and yourself there is only one thing to do – let the poisoner see that you suspect.”

Before leaving the house I told Mrs. Z hat I wished to speak to her, and we entered the dusty, frowsy sitting-room. I stood with my back to the window and she stood at the back of a chair, facing me.

“I know what you want to tell me, Doctor. He can’t last much longer. The sickness is making him weak.”

“Mrs. Z, who cooks your husband’s food?”

Her face went scarlet, then white, and she was gripping the back of the chair tightly. “Why do you ask a thing like that?”

“Because I don’t think your husband’s food is agreeing with him, and you might be able to find something that suits him better.”

There was no more sickness, and a month later Mr. Z died, so far as I know, from natural causes.

from The Arches of the Years