- Walking the Paris Hospitals: Diary of an Edinburgh Medical Student, 1834–1835
Writing one's day-to-day experiences has become a popular literary genre, displaying the variety and richness of human life. Sharing information today through blogs or online diaries contributes to our understanding of events and personalities. This anonymous journal, written by a British medical student, highlights his impressions about the academic year before graduation that he spent in Paris [End Page 369] between 1 November 1834 and 30 June 1835. The author, enrolled at the University of Edinburgh, was among many foreigners eager to supplement their studies in what was then unquestionably the mecca of Western medicine. The text offers a valuable window into the workings of the renowned Paris Medical School.
The unfiltered daily entries reveal a highly motivated and curious medical student determined to make the most of his limited sojourn in the City of Lights. Frugal, searching for cheap lodgings and meals, eschewing a busy social life, he comes across as an extremely focused individual busily shuttling between teaching hospitals from early morning to evening—including Sundays—to witness clinical rounds, surgical procedures, and autopsies. Interspersed between his hastily written observations are brief expressions of ambiguity about French culture and religion. As time wore on, the student's mood grew hostile; he seemed to perceive that every Frenchman took delight in taking advantage of "raw" Englishmen. "This beastly Paris," he commented on Christmas 1834, "I detest it more and more everyday of my life" (p. 91).
What is missing from the diary, however, are thoughtful reflections about his experiences. Time, of course, was of the essence, "interesting" patients the goal. The diary is full of passing comments about seeing "capital cases," "absolutely nothing of any consequence," "can't say I much benefited." The Parisian hospitals and clinics were, of course, veritable museums of pathology, with human specimens drawn from the poorer sectors of a metropolis suffering from numerous "fevers," prominently including tuberculosis, typhoid fever, and syphilis. There are also glimpses of practical skills that this British student definitely wanted to learn. In addition to "walking" the wards, he enrolled in special evening sessions conducted by midwives on the use of the vaginal speculum and forceps, and a private course on diagnosis through the use of the stethoscope and percussion hammer.
The downside of a medical education in Paris can be inferred from vivid comments about the large number of students crowding the hospital wards, lecture rooms, and autopsy tables. Rounds by medical luminaries, who were in charge of many patients, could be very speedy and perfunctory, with magisterial comments muffled by the distance from the selected inmate and drowned out by the usual hustle and bustle prevailing in the ample wards. Lecture rooms to witness surgery or case presentations filled up quickly, with eager students even seeking seats during prior, less popular lectures in order to prevent having to hover outside the doorways. Moreover, the diarist was uncomfortable with the dehumanizing approach to French patients, specifically commenting on famous surgeons—cruel "slashers"—who were more interested in developing their techniques than concerned with the welfare of their charges.
However, the diary remains silent about the two major criticisms made by other foreign visitors. The first is the almost total passivity of a Parisian education except for the house staff, the appointed "élèves internes": foreign students observed too much but personally did very little. The sensory overload with "capital" cases was often ephemeral and unstructured, and proved dehumanizing. Finally, while a year spent in Paris could have definitely enhanced professional prestige, how much did it actually matter for subsequent private practice in an English town? The observed [End Page 370] clinical spectrum assembled in Parisian hospitals reflected the risks and ecology of disease typical of a great European metropolis. It is doubtful whether the British diarist—tentatively identified as James Surrage of Clifton—would...