October 1920

Everyone familiar with medical literature is aware of the, fact that surgeons who operate upon the genital organs of either sex are liable to attack, but this is particularly so in the case of males. Like most men in practice in one locality for many years, several such cases have come under my observation, both in my own practice and that of others. For the benefit of some of the junior members I may relate a few incidents that occurred to myself.

The first was that of a young man who had contracted gonorrhoea several times, with subsequent strictures. I had no dealings with him in any of his gonorrhoeal attacks, but he came to me to be relieved of his strictures. This involved him in time, exposure, suffering, and expense, with much food for reflection. One night in his own home he became exasperated, seized his razor, and amputated his penis close to the pubis. Next morning I found him in one of my beds in the hospital. In a sane moment he said, “Thank your stars, doctor, that I did not come to see you last night, for I was desperate and ready for any foolish act.”

The next case was that of a young man suffering from varicocele. I knew him well, but was not his medical adviser. He had agreed to operation, and asked his surgeon to get me to give him chloroform. This I did, but had neither part nor say in the operation. Judge of my surprise when a few months afterwards he came to me in a state of great excitement, declaring that we had ruined his life, as he was in constant pain, and had more or less lost the power of sexual intercourse. I examined him carefully and found the testis shrunk to a mere nothing. This was probably due to some injury to the cord or inclusion of it in the ligature or the pressure due to the varicocele. He vowed vengeance, and extracted it in his own fashion to his own satisfaction.

The third case was that of a middle-aged man of a religious, nervous, almost fanatical disposition. I had known him casually for a few years, but had no dealings with him. One day in a state of great misery he consulted me about an abscess in the left testicle, with more or less hernia testis. I told him the right procedure was to have the organ removed, and that he had better consider the matter. Then he said that was the very advice his family doctor had given him, but he was no surgeon, and would I operate? This I did with the aid of his usual adviser. He made a rapid recovery and expressed gratitude to be rid of so painful an encumbrance. Some six months afterwards he came to me and said he was suffering intense pain in the scar and stump, and that the cure was ten times worse than the disease. So far as the parts were concerned things were quite normal, nor did he show any signs of pain in them while his attention was diverted. I at once recognised that I had to deal with a possibly desperate man, and was upon my guard. During the next three years he paid me several visits, and always the same tale of pain, sleeplessness, and loss of sexual power, with a veiled desire for revenge upon his tormentors. One day he entered my waiting-room, and as he was the only one present the conversation went on there. After the usual formalities he said, “Are you a Christian, doctor?,” to which I replied, “Yes, and I hope you are one also.” During this short chat I noticed him trying to pull his hand out of his overcoat pocket, as if it contained something. I at once said, “Leave it there,” and with this a revolver fell upon the floor. He was too nervous to execute his purpose, and left, never to return.

Turning, now, to women, I was frequently consulted by a farmer’s wife about chronic leucorrhoea, ovarian pains, and excessive child-bearing. She was more or less a physical wreck, and I could do little for her. On one occasion I was called to see her at her home. I made a vaginal examination and found a small ovarian tumour. There was some interregnum in the hospital so far as gynaecology was concerned, so l took her into the female surgical ward and operated myself. We removed the tumour and ovary after the usual preparation. When operating I noticed that the uterus was unusually large, although she declared that she had menstruated a few days before admission. She made a good recovery and was much improved in health by the rest, good food, and nursing. Seven months afterwards she was delivered of a full-grown child, to which all our interference made no difference. Years rolled on and back she came, loudly denouncing me, saying I had “spayed her” (removed ovaries), and her husband would not look at her. She pestered me for a year or two and abused and vilified me to her entire satisfaction. Her case is recorded in the pages of the N.Z. MEDICAL JOURNAL.

The next two cases came together. They were women whom I recommended to the hospital for operation because of ovarian tumours. Both of them were about thirty, and married, and in each case both ovaries were removed. In the hospital I had no dealings with them, as they were in the hands of the gynaecologist. They made good recoveries, but for several years afterwards they complained bitterly of indescribable feelings and desires and of being unsexed and ruined. They hurled every sort of vile motive and epithet at both the operator and myself and vowed every manner of vengeance and reprisal. In men one finds that their minds run towards some form of violence, while women resort to that old and many-edged weapon that can pour forth honey or poison at will. It is somewhat disconcerting to be thus abused and vilified while doing one’s best to relieve the suffering of one’s fellow creatures, and so long as one acts honestly and to the best of one’s abilities one always has the satisfaction of having done the right thing. There is, however, another philosophy in the world, namely, that of the man who says, “Well, I generally find that those for whom I do least thank me most. Choose ye, therefore, which leader ye shall follow.”