The Doctors Dilemma: Preface | Page 8

and patience are exploited by
selfish hypochondriacs. They must do all these things or else run
pecuniary risks that no man can fairly be asked to run. And the
healthier the world becomes, the more they are compelled to live by
imposture and the less by that really helpful activity of which all
doctors get enough to preserve them from utter corruption. For even the
most hardened humbug who ever prescribed ether tonics to ladies
whose need for tonics is of precisely the same character as the need of

poorer women for a glass of gin, has to help a mother through
child-bearing often enough to feel that he is not living wholly in vain.
THE PSYCHOLOGY OF SELF-RESPECT IN SURGEONS
The surgeon, though often more unscrupulous than the general
practitioner, retains his self-respect more easily. The human conscience
can subsist on very questionable food. No man who is occupied in
doing a very difficult thing, and doing it very well, ever loses his
self-respect. The shirk, the duffer, the malingerer, the coward, the
weakling, may be put out of countenance by his own failures and frauds;
but the man who does evil skilfully, energetically, masterfully, grows
prouder and bolder at every crime. The common man may have to
found his self- respect on sobriety, honesty and industry; but a
Napoleon needs no such props for his sense of dignity. If Nelson's
conscience whispered to him at all in the silent watches of the night,
you may depend on it it whispered about the Baltic and the Nile and
Cape St. Vincent, and not about his unfaithfulness to his wife. A man
who robs little children when no one is looking can hardly have much
self-respect or even self-esteem; but an accomplished burglar must be
proud of himself. In the play to which I am at present preluding I have
represented an artist who is so entirely satisfied with his artistic
conscience, even to the point of dying like a saint with its support, that
he is utterly selfish and unscrupulous in every other relation without
feeling at the smallest disadvantage. The same thing may be observed
in women who have a genius for personal attractiveness: they expend
more thought, labor, skill, inventiveness, taste and endurance on
making themselves lovely than would suffice to keep a dozen ugly
women honest; and this enables them to maintain a high opinion of
themselves, and an angry contempt for unattractive and personally
careless women, whilst they lie and cheat and slander and sell
themselves without a blush. The truth is, hardly any of us have ethical
energy enough for more than one really inflexible point of honor.
Andrea del Sarto, like Louis Dubedat in my play, must have expended
on the attainment of his great mastery of design and his originality in
fresco painting more conscientiousness and industry than go to the
making of the reputations of a dozen ordinary mayors and
churchwardens; but (if Vasari is to be believed) when the King of
France entrusted him with money to buy pictures for him, he stole it to

spend on his wife. Such cases are not confined to eminent artists.
Unsuccessful, unskilful men are often much more scrupulous than
successful ones. In the ranks of ordinary skilled labor many men are to
be found who earn good wages and are never out of a job because they
are strong, indefatigable, and skilful, and who therefore are bold in a
high opinion of themselves; but they are selfish and tyrannical,
gluttonous and drunken, as their wives and children know to their cost.
Not only do these talented energetic people retain their self- respect
through shameful misconduct: they do not even lose the respect of
others, because their talents benefit and interest everybody, whilst their
vices affect only a few. An actor, a painter, a composer, an author, may
be as selfish as he likes without reproach from the public if only his art
is superb; and he cannot fulfil his condition without sufficient effort
and sacrifice to make him feel noble and martyred in spite of his
selfishness. It may even happen that the selfishness of an artist may be
a benefit to the public by enabling him to concentrate himself on their
gratification with a recklessness of every other consideration that
makes him highly dangerous to those about him. In sacrificing others to
himself he is sacrificing them to the public he gratifies; and the public
is quite content with that arrangement. The public actually has an
interest in the artist's vices.
It has no such interest in the surgeon's vices. The surgeon's art is
exercised at its expense, not for its gratification. We do not go to the
operating table as we go to the theatre, to the picture gallery, to the
concert room,