The Beloved Physician: An Appreciation of Edward Livingston Trudeau

I

WHEN Dr. Edward Livingston Trudeau died the other day, many people wondered, suddenly realizing their impression that it was long years since he had joined the little band of heroes who have gone down in the battle against disease. And many must have asked themselves what manner of man this was who, sick unto death over forty years ago, could from scantiest materials build a little laboratory in the wilderness and exert an influence which cannot be measured by its practical materialization into five hundred sanitaria for the treatment of tuberculosis by fresh air, rest, and sound philosophy. Here was a man who, from his invalid’s chair, revolutionized the sanitation of business offices and of uncounted homes where ignorance shrank from pure air and sunshine. If I assume the task of sketching that indomitable character, it is only because I was privileged for many years to be Dr. Trudeau’s friend, to whom he chose occasionally to reveal in some degree his inner self.

It may, at the outset, be well to sketch briefly his voyage through the world which benefited so richly from his journeying. He was born in New York City in 1848 of French parents. His mother was a daughter of Dr. François Eloi Berger, a Parisian practicing in New York, and his father a descendant of a Huguenot family, which, leaving France for Canada, later drifted down the Mississippi to New Orleans. Near the Southern city James Trudeau, who was an intimate friend and fellow traveler of the naturalist painter, Audubon, owned a plantation which was confiscated by General Butler in the Civil War. He died later as a result of wounds received while in command of a Confederate post, Island Number Ten, on the Mississippi.

When Edward L.,the youngest of his three children, was but little over two years of age, his mother went with her father, Dr. Berger, to Paris. Here the boy was educated at the Lycée Bonaparte. When he was eighteen years of age Edward returned to New York, and found himself hardly able to speak the language of his native city.

He attended the Columbia School of Mines, and after graduation entered the United States Navy. An elder brother who had preceded him to Annapolis was stricken with tuberculosis. Edward nursed his brother up to the hour of the latter’s death six months later, and thus first came into personal contact with that disease to the extermination of which he devoted the rest of his life. He entered the New York College of Physicians and Surgeons, and in the year of his graduation, 1871, practiced medicine in New York City. In the same year, unconscious that he was doomed to his brother’s disease, he married Miss Charlotte Beare, of Douglaston, Long Island, to whom he ever attributed the inspiration of his labors through nearly half a century. The marriage was a perfect one, although attended by many sorrows. Three of their four children died. One son survives — Dr. Francis B. Trudeau. The death of Dr. Edward L. Trudeau, Jr., in 1906, was a great blow to his father and a loss to the medical profession.

It was in 1873 that Dr. Trudeau left New York City with the doom of tuberculosis pronounced upon him. He was only twenty-five; the gates of life seemed shut in his face, for it was believed that he had less than six months to live. Hardly able to stand alone, he was taken to Paul Smith’s in the Adirondacks by a friend who was also a distant relation,—Louis Livingston. Smith’s was then a hunters’ inn in the heart of the wilderness, forty miles from the nearest railway point at Ausable Forks. The guide who carried Dr. Trudeau upstairs and put him to bed described his burden as ‘weighin’ no more’n a lambskin.’ And the same guide lived to see that lightweight, defeat a local champion in a backwoods ring!

A college-mate of Trudeau’s, Edward H. Harriman, was then staying at Paul Smith’s. Harriman, Livingston, and ‘Uncle’ Paul Smith took turns nursing the sick doctor through nights which he was not expected, in nature, to survive. And yet he outlived them all! He improved at Paul Smith’s, then tried a winter at St. Paul, Minnesota. Here he suffered a relapse and was brought back to the Adirondacks, where he again improved. It was at about this time that, being joined by Mrs. Trudeau and their two children, Ned and Charlotte, the family passed through a terrible ordeal on a journey from Malone to Paul Smith’s. A blizzard arose, and the trip, which usually occupied less than a day, took over forty-eight hours. Paul Smith handled the team and wagon. After plunging through miles of snowdrift in the teeth of a biting norther, the horses fell down exhausted. The family’s baggage had previously been abandoned at Barnum Pond. Paul Smith made the sick man as comfortable as possible, wrapped the children in blankets, and buried them for warmth in the snow. When the blizzard abated, the family reached the hunter’s place, after two days of unspeakable hardship.

Surviving this ordeal, seeming even to have thrived upon it, Dr. Trudeau began to consider seriously the possible advantages in pulmonary diseases of exposure to pure cold air. He proposed to spend a winter in the Adirondacks, where the frigid season is prolonged and the thermometer occasionally stands at forty degrees below zero. His friends and medical advisers considered his proposition as a kind of suicidal mania, all except Dr. Loomis and Mrs. Trudeau. Dr. Trudeau had been impressed with the theory of Brehmer, the Silesian, and of Dettweiler, a patient and pupil of Brehmer, that the consumptive was not harmed by inclement weather, provided he accustomed himself to living out of doors, at rest. With the approval of Loomis and Mrs. Trudeau, the doctor carried out his experiment, the results of which practically revolutionized the science of treating tuberculosis. Trudeau so improved that presently he began to practice medicine among the Adirondack natives. He continued to do so for several years, often traveling forty miles in a day or night and in all sorts of weather, to usher, perhaps, some little woodsman into the world, or even to allay anxiety by his mere presence. It has been said that his bedside manner did more than physic in ninety per cent of his cases. Half of his bills were never rendered and a quarter of the other half never paid; but tears would come into the eyes of many a woman when she saw him in after years; and men called him ‘the beloved physician.’

I have beside me as I write some old prescriptions that were found in the ragged ledger of a general store in the wilderness of forty years ago, when stovepipes and pills were sold over the same counter. There are three of them that reveal as many phases of this humane country doctor, who often came in the night, dressed in mackinaw, pontiacs, and moccasins. Apparently, if the family pig or cow or dog was ailing, Dr. Trudeau was summoned through the wilderness. Here is a prescription calling for carbolic oil, tar, sulphur, and olive oil — which, a veterinary doctor tells me, could not be improved upon to-day as a cure for mange. ‘Sig:' writes Trudeau at the end of the prescription; then, remembering that his patient might lack appreciation even of dog-Latin, he dashes his pen through the word and adds, ‘Rub on the dog several times ’!

There was no liquor license in the woods in those days, and little whiskey, licit or otherwise; yet there was an allabiding thirst, and men made their own poteen if they could get pure alcohol and some spirits of rye. Trudeau believed that, if a man liked an occasional drink, it was his human right to have it — in reasonable measure. But if the man abused the doctor’s confidence, from that day on he went parched and prescriptionless.

Again, one finds an early prescription for a common symptom of tuberculosis. I brought this prescription to Dr. Trudeau not very long ago and asked him what he would prescribe now — after thirty-five years.

‘That — if anything,’ he said; ‘but probably nothing — no physic at all. Open the window — go to bed — and keep your nerve!’

During these early years Trudeau lived the life of the people in many ways. Being restored to health, he hunted and fished with the other sons of the wilderness. Every year up to 1913 he brought home his string of trout and killed his buck. His skill with the rifle was remarkable. It was a natural gift. On one occasion he outmatched all competitors, then, on a challenge, picked off his own empty cartridge shells suspended from the branch of a tree on strings. And as for boxing, it is said that one evening at Paul Smith’s a local champion coaxed the doctor to put on the gloves.

‘I promise not to hurt ye,’ said the amateur bruiser.

Where the doctor acquired the gentle art no one seems to know; but when the local champion picked himself up at the end of the bout, he allowed that ‘the doctor’s the quickest thing with the mitts I ever run up ag’in!’

In 1877 Dr. Trudeau left Paul Smith’s and moved into the adjacent hamlet of Saranac Lake, which was then a lumber centre with six houses and a sawmill. The railway was not constructed to that point until 1888. But when the doctor came to the village, gradual developments began. He was followed by a few patients who had placed themselves in his care as a last hope of cure or prolonged life. The town to-day is a small city, the metropolis of the Adirondacks, which grew up around the beloved physician and his great work. It has a remarkable sanitary system, and a health code after one portion of which New York is said to have reformed its own.

II

It was at Saranac Lake during his first winter there that Dr. Trudeau literally dreamed a dream. Loomis had published a paper in the Medical Record, drawing attention to the climatic value of the Adirondack air for pulmonary invalids, citing the theories of Brehmer and Dettweiler and, no doubt, having in mind Trudeau’s own case. Shortly after reading this paper, Dr. Trudeau fell asleep while leaning on his gun on a fox runway on the side of Mount Pisgah, near Saranac Lake. He dreamed that the forest around him melted away and that the whole mountain-side was dotted with houses built inside out, as if the inhabitants lived on the outside. As he said many years later, at the twenty-fifth anniversary of the founding of the Adirondack Cottage Sanitarium,‘I dreamed a dream of a great sanitarium that should be the everlasting foe of tuberculosis, and lo! — the dream has come true!’

Shortly after a reception held on January 1, 1915, at which all of the sanitarium patients came to shake hands with the founder, I happened to remark to the doctor on the quaintness of his speech for the occasion. He had spoken of the strange new faces before him, and how there had been a time when he was personally acquainted with each and every one, ‘his hopes, his fears, and very often the state of his bank account’; and how the girls even told him of their love affairs and of womanly dreams that too often were never fulfilled. The doctor suddenly leaned forward in his invalid’s chair and said to me in a confidential stagewhisper, —

‘Would you believe it? I did n’t know what my tongue was saying. I felt strangely aloof for the moment. I saw a younger man thirty years before, leaning on his gun, waiting for a fox. There was not a house, not a sign of a human being. Now —’

His face was all aglow as he spread out his hands.

But even after the dream the beginning of the fulfillment did not occur for five or six years. He had built a house in the village. There, in that wonderful year, 1882, when Koch announced his discovery of the tubercle bacillus, Trudeau, who could not read German, received, as a Christmas present from his friend, C. M. Lea of Philadelphia, a translation of that document which the doctor termed ‘the most far-reaching, in its importance to the human race, of any original communication’ — Koch’s Etiology of Tuberculosis. This was young Trudeau’s immediate inspiration. He had an ‘indifferent medical education,’ to quote himself, ‘no apparatus, and no books’; and the remoteness of his surroundings had removed him from contact with medical men to whom he might apply for instruction.

During brief visits to New York — sometimes at the expense of his health — he learned some of the first principles of bacteriology; — and ‘I taught myself the rest as best I could.’

His laboratory was a little room in Saranac Lake, heated by a wood stove (there was no coal). He had a homemade thermostat heated by a kerosene lamp, and in this he succeeded in growing the tubercle bacillus, although he had to sit up o’ nights to see that the living organism was not destroyed by varying temperatures. To regulate this, he invented a little shutter arrangement which could be opened or closed. He obtained the bacillus in pure cultures, and with them repeated all Koch’s experiments. The guinea-pigs used for immunizing tests he had to keep in a hole underground which was heated by another kerosene lamp. He again proved that fresh air and natural hygiene were the deadly foes of tuberculosis, by turning loose on an island rabbits that had been inoculated with the disease. Running wild, they soon recovered; while others, similarly inoculated and kept in unhygienic places, died of the disease in a very short time.

While his enthusiasm was thus running high, he built in 1884 on the side of Pisgah — on the place of the dream — a little shack which is still there and which is known among the great buildings now around it as ‘The Little Red.’ This was the nucleus of the present vast sanitarium. He began with two patients, whom he apparently cured by making them sit all day and sleep all night practically in the open air, the windows being open, with the mercury courting the thermometer bulb.

Meanwhile he himself was laboring with his cultures, his home-made thermostat, his guinea-pigs and rabbits. During the week in 1890 when Koch announced his tuberculin as a ‘cure’ for tuberculosis, Dr. Trudeau published in the Medical Record an article describing his failure to obtain any appreciable degree of immunity by injections of sterilized and filtered liquid cultures of the tubercle bacillus (tuberculin). Later experiments with Koch’s tuberculin by thousands of others proved similar failures.

Not long after this, while Dr. Trudeau was lying ill and depressed in New York City, there came from Saranac Lake the news that during the night his house, cultures, guinea-pigs — everything— had been destroyed by fire! It was the last straw. The sick man was in despair; but his indomitable spirit came to the rescue again, and a letter signed by William Osler helped him to accept fresh battle.

‘I am sorry, Trudeau,’ wrote Dr. Osler, ‘to hear of your misfortune, but take my word for it, there is nothing like a fire to make a man do the phœnix trick!’

The phœnix rose from its ashes, with the financial help of George C. Cooper, of New York. Near the ruins of Dr. Trudeau’s first house was built the first and best-equipped laboratory in the United States for the study of tuberculosis. Here Trudeau labored for years, searching, as he often said, ‘in the haystack for the needle that we know is there.’ Here his followers still work at all hours in immunizing experiments and in the testing of proposed specific remedies for the cure of tuberculosis. Here many a ‘patent remedy’ of the ‘cure-consumption’ order has met its Nemesis. Here, years before either Friedmann or Piorkowski tried to commercialize his so-called remedies through the press of two continents, tire turtle-germ of both was weighed in the scientific balance and discarded as useless. It is not a breach of confidence now to reveal the fact that an article entitled ‘Has Dr. Friedmann found a Cure for Tuberculosis?’ which appeared on two pages of the New York Times on the very morning when the Berlin physician landed in New York, came from the Saranac Laboratory and was the work of several scientific brains, with Dr. Trudeau’s as the master-mind on the subject. That article changed overnight the opinions of many in the medical world regarding the merits of Friedmann’s ‘specific.’ Dr. Trudeau had examined the turtle organism years before, and had labeled it, not only harmless, but quite useless, as an immunizing agent in human tuberculosis.

To go back to the early days of sanitarium work, the success Trudeau achieved by his open-air and rest methods attracted great attention. The sanitarium grew swiftly. Other states of the Union built institutions of somewhat similar design and for similar treatment. To-day, as already remarked, there must be fully five hundred sanitaria for this method of treatment of pulmonary tuberculosis throughout the United States and Canada. The valley of the Saranac itself, with the adjacent Adirondack region, contains several private and state sanitaria that owe their inception, directly or indirectly, to the influence of Trudeau.

The Adirondack Cottage Sanitarium is, and has been from the first, a semicharitable institution which treats patients at a sum that does not cover the cost of their board and housing. The annual deficit of the institution is comparatively large, as a result, and up to the time of It is death it was Trudeau’s personality that attracted voluntary contributions for the continuance of the great work. Such names as Harriman, Sage, Schiff, Rockefeller, Tiffany, have figured in the contributors’ lists. E. H. Harriman was ever a friend and admirer of Trudeau and of his altruistic labors for humanity. In the days when ministers of money sat in Harriman’s antechamber, they were allowed to cool their heels while a frail country doctor was ushered in; and the railroad king let great affairs hang fire while he heard the latest yarn about ‘Uncle’ Paul Smith, or became enthralled by the idealism of the practical dreamer who sat opposite him, — a great head on an emaciated body, a voice resonant with faith’s enthusiasm, even while it broke short in a gasp. This man was sending back to life and usefulness twenty per cent of his patients apparently cured, fifty per cent with the disease arrested, and the other thirty per cent with a fighting chance. And while the restless ministers of finance consulted their watches in the antechamber, Harriman listened — and reached for his check-book!

As for that annual deficit, a friend who merely sought information once wrote to me as follows: —

‘What sort of a man is Trudeau? Is he what so many say he is, or just a clever doctor who has made a fortune out of the Adirondacks? ’

In a rash moment I referred this to the doctor himself. I do not know that he was ever more upset. He promptly sent me this: —

‘I am always puzzled to know why people cannot understand the spirit of the sanitarium work. To give a patient for $7 what costs $12 or $12.50, and to have a deficit of $27,000 on running expenses for the year, can hardly be a business way to make a man rich! Perhaps it is the imposing appearance of my equipage which makes the world think me a coiner of money!!’

The ‘equipage’ to which he referred with irony was a regular country doctor’s buggy, just large enough to accommodate himself (and Mrs. Trudeau, at a pinch), and drawn by a shaggy mare which the townspeople affectionately termed ‘the old plush horse.’ In his latter years some one presented him with a fine carriage and a high-stepping thoroughbred. When Trudeau was called out to inspect this real equipage, he looked worried.

‘I — I can’t ride in that thing!’ he said. ‘People will think I don’t need any money for my sanitarium! ’

He agreed to accept the gift, however, when it was pointed out that the ancient mare was on her last legs. Thereupon the ‘old plush horse’ was pensioned and given a comfortable stall for life. On the first day of her long holiday Dr. Trudeau visited the stable.

‘Well, Kitty,’ he said, patting the old mare, ‘your troubles are all over. As for me — I expect this old horse will have to keep plodding along until his left ventricle ceases to contract.’

But the matter of that ‘fortune’ troubled him for some time. A month later he sent me another letter, accompanying a financial report underscored in places.

‘This,’ he wrote, ‘is for the gentleman who sized me up as “ a clever business man who has made a fortune out of the Adirondacks.” Tell him I begged all this money personally, but not for myself, as I don’t own a cent of it and draw no salary.’

Whatever he earned from private practice barely covered his living expenses. He raised the money to cover that deficit by what he called his ‘ begging letters.’ I remember he said to me one day after an anxious silence, —

‘I’ve got a young fellow up there [at the sanitarium] who is a first-class radiographer. Then there is a bacteriologist, too. As soon as they get to feeling well they’ll go off and leave me. They are married, or are going to be, I’ve no doubt. If I could only build houses for them and get their wives settled — That’s it!’ he broke off. ‘I’ve got to raise the money for it somehow!’

He raised it, of course. Now there are two new cottages in the sanitarium grounds, and a permanent X-ray expert and a clever bacteriologist have been added to the colony there and to the cause.

When the doctor’s end had been achieved, he told me of his success.

‘But why is every one so good?’ he asked. ‘Why do people work for me?’

‘They work for — you,’ was suggested.

‘No, no — I hope not,’ he protested. ‘They work for my work.’

‘Well, did you ever consider how much your own personality inspires this work?’

‘Oh, come, come!’ said he, as pleasurably confused as a girl complimented for the first time on her looks.

‘What do people call my work?’ he presently asked.

I had never heard it given a name. It was unique. But I ventured the word ‘philanthropy.’ He shook his head.

‘A distrustful word these days. Still — yes — say philanthropy, plus science. The sanitarium is the philanthropy — to cure or console; the laboratory is the science — to find a means of further immunizing toward ultimate, permanent cure.’

It was, as a whole, a science and philanthropy of Christ; a sort of Christian science without intellectual sacrifice. To this philanthropy Trudeau would never permit his name to be attached. It was the Adirondack Cottage Sanitarium— not ‘Trudeau.’ It was the Saranac Laboratory — not ‘Trudeau’ Laboratory. It was usage and the postal authorities that labeled a little branch post-office, ‘Trudeau, N.Y.’

His work and worth were recognized, however, during his lifetime. Among the honors conferred upon him were Master of Science, Columbia University, 1889; Honorary Fellow of the Phipps Institute, 1903; LL.D., McGill University, 1904; and LL.D., University of Pennsylvania, 1913. The lastmentioned degree he received in absentia. Yale offered to confer the degree of LL.D., but the doctor was too ill to be present at the exercises.

III

I had intended to omit anecdotes in this brief sketch of Trudeau’s life, from the time that he was carried into Paul Smith’s ‘weighin’ no more’n a lambskin’ up to the latter days when he lay on a final bed of suffering. But the anecdotes would creep in; and now they may stay just where they are, for it was characteristic of Trudeau, even when addressing a grave body of physicians and master-surgeons, to lighten his most serious discourses with anecdotal humor; although the first time he ever tried to address his colleagues, — at Baltimore in the eighties, — he fainted from illness, and, while others restored him, Dr. Loomis read the frail doctor’s address to the gathering.

Even in his own sufferings he found a text for interesting discourse that was flavored with the grim humor of grit. It does not seem long ago that I stood by his bedside while he, with one poor portion of a single lung, labored for breath. The possible benefits of artificial pneumo-thorax had not yet been fully established, yet the doctor had been one of the first to submit to the operation, offering himself, it seemed, as a victim of experimentation, although he told the operating physician that he expected no good results, — ‘For, after all, my dear fellow, the age of miracles is past.’ Yet it eased his sufferings for several years, although at the time he was very ill. He assured me that he was not going to die right away.

‘No such luck!’ said he in the most cheerful manner. ‘But,’ he continued, as connectedly as breath would allow, ‘what is the scheme of this business — of life — suffering — death? I don’t understand. ‘It reminds me of this English “Cat and Mouse” bill. They put a woman in a cell till she’s near dead of starvation. Then they let her out for a square meal — so she can get strength enough to suffer some more. You’ve got to have feeling, you know, to suffer. There’s a philosophy, by the way, for those who fear the agony of death. As you lose the enduring powers of life, you lose also the sensibility to suffering. It must be so. It is so. I have seen it many times.

. . . Cat and mouse,’ he half-mused,— ‘life and death. Death’s the cat — comes and paws until poor life is about dead to all feeling. Then the cat retires into a dark corner and purrs while the mouse gets a little life back, so as to be more sensible of suffering when the cat comes pawing again. I don’t say there’s no reason behind it — but I can’t see it — can you ?’

I may be pardoned personal intrusion for a moment to relate when and where I first saw this remarkable man. I had gone to Saranac Lake in ill health. I asked why there was no statue in the community to the great Trudeau of whom I had read in Stevenson’s Letters. Being reminded that it was not customary to erect statues to the living, I decided to sec this (to me) resurrected person. It happened to be about the time of the twenty-fifth anniversary of the founding of the sanitarium. When he stood up on a platform and, in a voice tense with emotion, told of his dream that was now materialized, I was filled with a sudden comprehension of the amazing thing that was happening — the celebration of that which this frail man had lived to achieve! I wrote several verses and gave them to my own physician, merely as one way of expressing what I thought about it all.

The next morning I was called on the telephone. It was Dr. Trudeau himself; some one had pinned the verses on his pillow on the previous night, and they had added to the happiness of the doctor at the end of one of the proudest days of his life. He asked me to come and see him.

‘Do you know,’ he said when we shook hands, ‘writing verses is something beyond my comprehension. I understand poetry, but not how one can write it. My case is like that of Zeb Robare, a guide over at Paul’s. He was asked by some ladies he w7as rowing the name of a certain mountain up here. “That’s Ampersand,” said Zeb. “But, guide, how do you spell it?” “Ah,” said Zeb, “that’s the hell of it, ma’am. I can climb it easy enough, but I could n’t spell it to save my life! ” That’s how I feel about poetry!’

Oddly coincident, Clayton Hamilton, a writer engaged in a book about Stevenson, called upon Dr. Trudeau to ask about Robert Louis’s sojourn at Saranac Lake. Mr. Hamilton later confessed in cold type, ‘I had come to ask of R. L. S. and remained to admire this hero of innumerable, unnoted battles, — this maker of a City of the Sick, who, because of him, look more hopefully on each successive rising sun.' Trudeau marveled at the feat of juggling English; yet this author wrote in conclusion: ‘ And the best of our tricky achievements in setting words together dwindle in my mind to indistinction beside the labors and spirit of this man.'

Stevenson, by the way, produced some of his greatest essays during the winter of 1887-88, while he was under Dr. Trudeau’s care at Saranac Lake. Stories of the relationship of the two men have been told and retold. At one time I sent a version of the oftrepeated ‘oil’ story to the doctor for confirmation. It was to the effect that Stevenson, after he had written ‘The Lantern-Bearers’ for the Scribners, went to see Trudeau’s ‘ light ’ in the laboratory. Stevenson was shown, in the effects of tuberculosis in guinea-pigs, the ravages of the disease that kills one human being in every seven. The sensitive author bolted out of the house, declaring that while Trudeau’s lantern might be very bright, to him it ‘smelled of oil like the devil/ Fearing that the anti-vivisectionists might make capital of the story, I took the liberty of modifying it. Dr. Trudeau wrote, —

‘I thank you for your motive in changing the end of the oil story. I had never thought of the anti-vivisectionists. Had I thought, I could have told you a little more about it. Stevenson saw no mutilated animals in my laboratory. The only things he saw were the diseased organs in bottles, and cultures of the germs which had produced the disease. These were the things that turned him sick. I remember he went out just after I made this remark: “This little scum on the tube is consumption, and the cause of more human suffering than anything else in the world. We can produce tuberculosis in the guinea-pig with it; and if we could learn to cure tuberculosis in the guinea-pig, this great burden of human suffering might be liftedfrom the world.” ’

It is true that Trudeau and Stevenson differed a great deal on a great many subjects, but so far as I have been able to judge from much that the doctor has told me, they agreed on so many of the greater things of life that they had to disagree about trivial matters for the sake of something to discuss. They actually got into heated argument over the great issue as to which is superior, the American system of transferring baggage, or the British method of handling luggage!

Dr. Trudeau assured me, incidentally, that Stevenson had no active symptoms of tuberculosis while at Saranac Lake, but had apparently had the disease and may have developed active symptoms after he went away. He did not die of tuberculosis, although this might have been a contributing cause. Trudeau had a full report made to him regarding the circumstances of Stevenson’s death at Samoa in 1894.

This paternal interest in ex-patients was characteristic of Trudeau. Particularly he liked to address a word of parting advice to a young man going back, apparently cured, to a life of continued usefulness. Here is a typical letter of this kind: —

‘Do take my advice and don’t presume upon your physical endurance. When you have once been in the grip of the tiger you ought not to give him a chance to get you again, for he has downed many as good a man as you are; and you must not act on impulse, but use your head and self-control, even if you can’t accomplish all you want to in life. If you can’t have a whole loaf, try and be satisfied with a half one, or else the graham bread will get burned in good earnest and you won’t have any loaf at all!’

His attitude toward the patients, who came to him from all lands, ranks, and conditions, was ever eloquent of the man’s human kindness and sympathy. Many came as broken in spirit as in health, and often with but two hopes: one, that Trudeau would perform the great miracle; the other, that a physician of his reputation would not charge more than this latest victim of tuberculosis could scrape together. I know of one case in which the new patient said, ‘Doctor — before you do anything—I haven’t much money. How — how much will it cost?’

‘Much depends on how much you ’ve got, and how bad you are,’ said Trudeau, himself assisting to unbutton the patient’s collar. ‘You see,’ he went on disarmingly, ‘if you are not very bad, it will cost you quite a lot, so I can use the money for those who are. If you are a really bad case — Well — Say “Ninety-nine,” please, and keep on saying it while I listen to your chest,.’

The doctor’s face became grave as he noted the vibrations caused by the reiterated ‘nine-nine-nine.’ When the examination was over the patient asked, —

‘ How bad — I mean — how much will it be, doctor?’

For reply Trudeau — and one can imagine the great sympathy that flooded the beloved physician’s face—handed the patient a ten-dollar bill.

‘ I owe you — that much — at least,’ he said.

One can imagine the rest — that speech which he employed so often and to so many: —

‘ Don’t take it too seriously, but just seriously enough. I am no better off in health than you are, and both you and I, old man, will be a great deal worse before we’re better.’

When, however, he sent some promising young man back into the battle of life, a repaired asset to the world, he liked to refer to him as ‘ another young gladiator with a new blade in his sword.’ The following, which he sent to me one day, explains the simile: —

‘ My sympathies are naturally in the world with the vanquished. My favorite statue is that great one of Victory carrying the dying gladiator, his broken sword in hand. The world applauds and bows before success and achievement; it has little thought for those who fall by the way, sword in hand; and yet it takes most courage to fight a losing fight!’

Speaking of this same statue, ‘ Gloria Victis,’ a fine copy of which stood in the hall of his house, he said one day early in the great European war: ‘When he created that thing, I wonder did the sculptor, Mercié, realize that he was modeling the glory of Belgium in ruin?’

Others saw something of the doctor’s own heroic spirit in that figure, with the broken sword in the drooping right hand, and the left arm still held aloft as if the dying warrior challenged even death — ‘ Moriturus, te saluto! ’

The last active labor of Dr. Trudeau was the writing of his autobiography, and perhaps the last service of the writer on behalf of the beloved physician was the proof-reading of its pages. The doctor was seized with his mortal illness just after the last pages were written and before he had decided upon a title for his work. The single word, ‘ Aquiescence,’ was proposed as descriptive of the life of a man who accepted adverse conditions and, like the master of a ship, turned the ill wind to advantage. The word was taken from a sentence which he had once written to me, ‘The conquest of Fate comes not by rebellious struggle, but by acquiescence.’

When the title was suggested to the doctor, he was unable to speak, but smiled and shook his head. Later, when he was a little better, he dictated to his secretary, ‘If the world finds a sermon in my life-story — good; but I don’t want any one to think I was trying to preach one.’

Possibly the impression has been given in these pages that Trudeau was an approachable person. He was, to some; to many he was quite unapproachable, especially interviewers. He feared a scribe. To the present writer he repeatedly said, ‘ Remember —I trust you; but don’t you ever publish what I’m telling you until after I am where I won’t care what the world says about me.’

Even to his most intimate friends he was difficult of approach when, after ‘studying the ceiling’ for many long days, he was irritated beyond human self-control by his sufferings. But even then he could be played like a fine instrument if the player had technique. If the doctor was in that depth of depression out of which he would chant a ‘De Profundis’ of blackest pessimism, all that was necessary was to agree with him that life was ‘ a senseless business’; whereupon he would draw his sword of optimism and flash the text engraven upon its bright blade: ‘O ye of little faith!’ But if you told him he looked well and you hoped he felt so, he would say, ‘I don’t. I’m utterly miserable!’ and sink back in his invalid’s chair with a smile that seemed to add, ‘There’s little sport in an easy game.’

Characteristic of the man’s philosophy was his own comment on his fits of melancholy, vouchsafed once to a fellow sufferer who had been in depths of depression : ‘ If you go down to the depths at times, you have many glimpses of higher things that people of more even temperament never get; and after all, the ideal is the beautiful in life; the facts of life are hideous.’

He once told a visitor some tales of his experiences with the great human tragedy — told them as if they belonged to the great human comedy, for his humor was irrepressible. But the visitor did not laugh; he went away a sadder and a wiser man. Possibly he thought the doctor hardened; but I shall never forget the expression of Trudeau’s face when I asked him directly if he had not become so accustomed to tragedy that it no longer touched his emotions. The smile left his face; his eyes looked out and beyond with a suddenly moist softness, and he said slowly, ‘Pity, as an emotion, passes. Pity, as a motive, remains.’