Sleeplessness was so prominent in her case and so evidently the central physical symptom that its control was difficult and required a regular campaign for success.  With sleep restored and the resumption of eating, the most of her acute symptoms were passed, though a profound depression remained.

Her husband, thoroughly abashed and ashamed, made furtive attempts at reconciliation.  These were absolutely rejected, and from her attitude it was obvious that no reconciliation was possible.  “Had he not been found out,” said the wife, “he would still be living with her.  I can never trust him again; I would die before I lived with him.”

Little by little her pride recovered, for in such cases the deepest wound is to the ego, the self-valuation.  The deepest effort of life is to increase that valuation by increasing its power and its respect by others; the keenest hurt comes with the lowering of the valuation of one’s own personality.  A woman gives herself to a man, without lowering a self-feeling if he is tender and faithful; if he holds her cheap, as by flagrant disloyalty, then her surrender is her most painful of memories.

With the recovery of pride came the restoration of her interest in her children, and her purposes reshaped themselves into definite plans.  Part of the process in readjustment in any disordered life is to centralize the dispersed purposes, to redirect the life energies.  She agreed that she would accept aid from the husband, as his duty, but only for the children.  For herself, as soon as the children were a year or so older, she would go back to industry and become self-supporting.  Her plans made, her recovery proceeded to a firm basis, and I have no doubt as to its permanence.  Nevertheless, life has changed its complexion for her, and there will be many moments of agony.  These are inevitable and part of the recovery process.

I shall not attempt to settle the larger problem of whether she should have forgiven her husband and returned to him.  Granting that his repentance was genuine, granting that no further lapse would occur, she would never be able to forget that when he deceived her he had acted the part of a devoted husband.  She would never be able fully to trust him, and this would spoil their married happiness entirely.  “For the children’s sake,” cry some readers; well, that is the only strong argument for return.  But on the whole it seems to me that an honest separation, an honest revolt of a proud woman is better than a dishonest reunion, or a “patient Griselda” acceptance of gross wrong.

Case XI.  The unfaithful wife.

In such cases as the preceding and the one now to be detailed, the difficulties of the physician are multiplied by his entrance into ethics.  Ordinarily medicine has nothing to do with morals; to the doctor saint and sinner are alike, and the only immorality is not to follow orders.  To do one’s duty as a doctor, with one’s sole aim the physical health of the patient, may mean to advise what runs counter to the present-day code of morals.  This is the true “Doctor’s Dilemma.”  In such cases discretion is the safest reaction, and discretion bids the physician say, “Call in some one else on that matter; I am only a doctor.”