W. Somerset Maugham: Of Human Bondage

81. CHAPTER LXXXI (continued)

They came in one by one and walked up to the table at which sat Dr. Tyrell. They were old men and young men and middle-aged men, mostly of the labouring class, dock labourers, draymen, factory hands, barmen; but some, neatly dressed, were of a station which was obviously superior, shop-assistants, clerks, and the like. Dr. Tyrell looked at these with suspicion. Sometimes they put on shabby clothes in order to pretend they were poor; but he had a keen eye to prevent what he regarded as fraud and sometimes refused to see people who, he thought, could well pay for medical attendance. Women were the worst offenders and they managed the thing more clumsily. They would wear a cloak and a skirt which were almost in rags, and neglect to take the rings off their fingers.

"If you can afford to wear jewellery you can afford a doctor. A hospital is a charitable institution," said Dr. Tyrell.

He handed back the letter and called for the next case.

"But I've got my letter."

"I don't care a hang about your letter; you get out. You've got no business to come and steal the time which is wanted by the really poor."

The patient retired sulkily, with an angry scowl.

"She'll probably write a letter to the papers on the gross mismanagement of the London hospitals," said Dr. Tyrell, with a smile, as he took the next paper and gave the patient one of his shrewd glances.

Most of them were under the impression that the hospital was an institution of the state, for which they paid out of the rates, and took the attendance they received as a right they could claim. They imagined the physician who gave them his time was heavily paid.