“’As I went out from Mr. Birtwell’s that night, and the cold, snow-laden air struck into my face on crossing the pavement to my carriage, cooling my blood and clearing my brain, I thought of Mrs. Carlton and the life that had been placed in my hands, and a feeling of concern dropped into my heart.  A night’s indulgence in wine-drinking was a poor preparation for the work before me, in which a clear head and steady nerves were absolutely essential.  How would I be in the morning?  The question thrust itself into my thoughts and troubled me.  My apprehensions were not groundless.  Morning found me with unsteady nerves.  But this was not all.  From the moment I left my bed until within half an hour of the time when the operation was to begin, I was under much excitement and deeply anxious about two of my patients, Mrs. Voss and Mrs. Ridley, both dangerously ill, Mrs. Voss, as you know, in consequence of her alarm about her son, and Mrs. Ridley—­But you have heard all about her case and its fatal termination, and understand in what way it was connected with the party at Mr. and Mrs. Birtwell’s.  The consequence of that night’s excesses met me at every turn.  The unusual calls, the imminent danger in which I found Mrs. Ridley and the almost insane demands made upon me by her despairing husband, all conspired to break down my unsteady nerves and unfit me for the work I had to do.  When the time came, there was only one desperate expedient left, and that was the use of a strong stimulant, under the effect of which I was able to extract the tumor from Mrs. Carlton’s neck.

“’Alas for the too temporary support of my stimulant!  It failed me at the last moment.  My sight was not clear nor my hand steady as I tied the small arteries which had been cut during the operation.  One of these, ligated imperfectly, commenced bleeding soon after I left the house.  A hurried summons reached me almost immediately on my return home, and before I had steadied my exhausted nerves with a glass of wine.  Hurrying back, I found the wound bleeding freely.  Prompt treatment was required.  Ether was again administered.  But you know the rest, Mr. Elliott.  It is all too dreadful, and I cannot go over it again.  Mrs. Carlton fell another victim to excess in wine.  This is the true story.  I was not blamed by the husband.  The real cause of the great calamity that fell upon him he does not know to this day, and I trust will never know.  But I have not since been able to look steadily into his dreary eyes.  A guilty sense of wrong oppresses me whenever I come near him.  As I said before, this thing is breaking me down.  It has robbed me, I know, of many years of professional usefulness to which I had looked forward, and left a bitter thought in my mind and a shadow on my feelings that can never pass away.