She was shown into my room at an hour when I did not, as a rule, receive patients. She came without appointment and without any letter of introduction from her doctor. She said that she had no doctor, that she came from a remote place in the north of England, that she had an idea what was the matter with her, and that she wanted me to carry out the necessary operation. On investigation I found that she had an internal growth which would soon imperil her life. I explained to her that an operation would be dangerous and possibly uncertain, but that if it proved successful her cure would be complete. She said she would have the operation carried out at once, and asked me to direct her to a nursing home. She displayed neither anxiety nor reasonable interest. Her mind was made up. As to any danger to her life, the point was not worth discussing.
She had informed me that she was married, but had no children. I inquired as to her parents, but she replied that she was an orphan. I told her that I must write fully both to her doctor and to her husband. She replied, as before, that she had no doctor, and that it seemed a pity to worry a strange medical man with details about a patient who was not under his care. As to her husband, she asked if I had told her all and if there would be anything in my letter to him that I had not communicated to her. I said that she knew the utmost I had to tell. “In that case,” she replied, “a note from you is unnecessary.” I said, “Of course, your husband will come up to London?” To which she remarked, “I cannot see the need. He has his own affairs to attend to. Why should any fuss be made? The operation concerns no one but myself.”
I asked her then what relative or friend would look after her during the operation. She said, “No one. I have no relatives I care about; and as to friends, I do not propose to make my operation a subject for gossip.” I explained to her that under such circumstances no surgeon would undertake the operation. It was a hazardous measure, and it was essential that she should have someone near her during a period of such anxiety. She finally agreed to ask an elderly lady—a remote connexion of hers—to be with her during her stay in the nursing home.