forearmed as to the nature of the case, could have gone quite Iwell if he had liked. Next day the "chief" attended the case and told the relatives that he wished he could have attended at first, because he could have at once stopped the bleeding and in many other ways have done so much better than his assistant had done. He was in the habit of perform. ing this trick. If the case "goes wrong" such a "chief" does not get the discredit of it, but will sometimes remark to others loftily, "I did not attend to the man: I was out: my assistant saw him first I wish I had been able to; I believe I could have saved him."

Young practitioners should have a better chance given them, by "chiefs," of becoming properly interested in their work. They should not be pushed into positions of abject servitude. We should then find more men rising to positions of selfrespecting and public-respected practitioners, not being compelled, after years of serving as assistants, to open shops in the East End for medicine and advice at sixpence--or even fourpence! Many promising young men have all the goodness and grit ground out of them by years of degrading dispenserships-hardly more-because no better chance has been open to them. No wonder that, later on in life, such men are often driven to drink. If all assistants were given quite small shares in whole or part return for their services, they would in most instances turn out better men and render more valuable services to their "chiefs" and to the public. Many "chiefs" are afraid of taking partners: but there would be nothing to fear if they would but treat good men sensibly.

CHAPTER XI

SUBSTITUTES

POSITIONS as substitutes, or locum tenens, for over-worked doctors who want a holiday, are generally held by men who are either recently qualified or who wish to nibble at minor experiences between meals of major ones. A few there are who continue the work for a long time, making it their chief method of practice. As a means of gaining experience I have nothing but the highest opinion of the work; in fact it approaches very nearly-indeed, it is even better than-what I consider an assistant's experience should be, namely, a very short one. It is better, because the young practitioner is thrown to a great extent for the time being upon his own responsibility. And in merely a week or two he has not time to get very far wrong in case he has not had much experience previously.

Strange to say, a man ought not to be a perfect practitioner to fill such a post, if he wish to make a good "locum" in the eyes of his chief. The reader may well be astonished at this confession. He should not be a good man in any sense but morally, to be a desirable "locum," because he might please patients better than his "chief" and make them dissatisfied with their usual lot. I give this little information for two reasons, first, because it is interesting, and, secondly, as preliminary to pointing out that if you are a good "locum" in the eyes of a "chief" you will never be very much good when

working for yourself. A "chief" likes a "locum who does not make himself popular but who is just sufficiently satisfactory to keep the practice going until he returns. Similarly a clergyman will invariably choose a substitute who is not as good as himself. A better than himself would make his parishoners dissatisfied with him when he returned. A curate of my acquaintance used to wonder why he could never get a "living' of his own, since he was always so strongly recommended as a substitute for vicars away on their holidays, until I explained to him that if he were a good preacher he would never be sought after as a substitute.

The "locum" can taste many practices belonging to others, getting little bits of valuable information from each; and thus he may, if he be an observant man, gain experience enough in a few weeks to make him a well-informed and safe man to work for himself in his own practice.

To do "locum" work for more than a few weeks is distinctly unwise. It is so because the work is badly paidand badly paid because practitioners cannot afford expensive holidays and it is very exacting and exhausting in a good many instances even if well paid. Then again the class of work is looked upon as infra dig if a man continue to engage in it. That anyone is good enough to be a "locum" is a well recognised fact, amongst all medical men excepting “locum" practitioners themselves, and a man who is always engaged in such work runs the risk of being considered worth nothing better. The better practitioner a "locum " is the shorter time. will he remain a "locum." As a "chief" I myself would question a man's general abilities who undertook "locum " work as a regular employment. To act in such capacity as will enable a young man to gain an insight into the work of a practice is distinctly wise; but a very few weeks should be sufficient for this.

"Locums" themselves had better take careful note of these

paragraphs, for they are too apt to consider that because they can manage other men's practices they are therefore very smart men and quite capable of managing anything, or anybody, anywhere; and at length they very often become quite confident that they could manage a practice of their own while they are labouring under quite a mistaken idea. I will give

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an example. Dr. Joseph Hornton got married directly after qualifying, and thought he would like to settle down in practice somewhere. His friends persuaded him to act as "locum" for a little time, so that he might learn how to conduct a practice and be the better able to carry on one of his own. He therefore acted for a week or two as substitute for a practitioner who wanted to "attend to matters" on the death of his father. became very popular amongst the patients, and was complimented several times for his cleverness, as many young men are by those who wish to say nice things to them, knowing that they are here to-day and gone to-morrow-guests so to speak. He was very pleased with himself. Many of the patients and people in the district were naturally rather interested in him, if only because he was a change. They received him well because he was to remain only for a short time. Some mothers thought he might be single and suitable for their daughters; so they fussed around him a little. Others seemed as though they had so much respect for their own doctor that they felt it was their duty to make themselves pleasant to his substitute while the former was away. Now it so happened that the "chief" had come in for a fortune from his dead relative, and when he returned he expressed his intention of selling the practice. He remarked to his "locum," on finding him pleased with himself, that he thought he was the very man who would suit the place and people: he persuaded him he would probably do well in the practice. Dr. Hornton really thought so too, after his fortnight's work. at the idea.

He jumped Terms were soon arranged-rather high, it is

true; but the practice changed hands. Soon the new doctor felt this thorough-going practice at his finger-tips-all his own. -he had got such a grip of it, he thought, as he noted all the evidence of cordiality and confidence shown by patients that a man could wish for. We will not follow him through all the months of his early anxious experience, suffice it to say that in twelve months the practice dwindled down to half ts usual size, and its new practitioner had to sell the rest to save it from galloping consumption. well enough as a "locum," for a him far too young afterwards. highly appreciative of him as a single man changed their opinions entirely when he bought the practice and introduced a wife.

The patients had liked him fortnight, but many thought Those who were at first

Therefore "locums" must be warned not to gain false impressions regarding their own abilities: they should carefully take into account what it is that gives them their temporary success in each place they practice, and what has made each "chief" successful.

The reason why some men continue for a long time to act as "locums" is this; in their different fortnight-duration posts they have opportunities of acting as little "chiefs," and they get the sense of their imagined importance sharpened in each place they fill. They may have acted as assistant here and there but have failed in such positions to extract the same blissful admiration and sensation of mastership. They cannot buy practices of their own, or perchance they have bought and failed still they feel they are good enough to be in command somewhere; so they get what little dominion over the public they are able by taking other men's work.

For the benefit of "chiefs" who may at any time have to engage a "locum," I would like to advise them to be careful how they proceed to find one. The safest way is to engage a man who is recommended by a personal friend-who himself