ned to the most careful nurse. But the other is
done with intention. A patient in such a state is not going to the East
Indies. If you would wait ten seconds, or walk ten yards further, any
promenade he could make would be over. You do not know the effort it is
to a patient to remain standing for even a quarter of a minute to listen
to you. If I had not seen the thing done by the kindest nurses and
friends, I should have thought this caution quite superfluous.[2]

[Sidenote: Patients dread surprise.]

Patients are often accused of being able to "do much more when nobody is
by." It is quite true that they can. Unless nurses can be brought to
attend to considerations of the kind of which we have given here but a
few specimens, a very weak patient finds it really much less exertion to
do things for himself than to ask for them. And he will, in order to do
them, (very innocently and from instinct) calculate the time his nurse
is likely to be absent, from a fear of her "coming in upon" him or
speaking to him, just at the moment when he finds it quite as much as he
can do to crawl from his bed to his chair, or from one room to another,
or down stairs, or out of doors for a few minutes. Some extra call made
upon his attention at that moment will quite upset him. In these cases
you may be sure that a patient in the state we have described does not
make such exertions more than once or twice a day, and probably much
about the same hour every day. And it is hard, indeed, if nurse and
friends cannot calculate so as to let him make them undisturbed.
Remember, that many patients can walk who cannot stand or even sit up.
Standing is, of all positions, the most trying to a weak patient.

Everything you do in a patient's room, after he is "put up" for the
night, increases tenfold the risk of his having a bad night. But, if you
rouse him up after he has fallen asleep, you do not risk, you secure him
a bad night.

One hint I would give to all who attend or visit the sick, to all who
have to pronounce an opinion upon sickness or its progress. Come back
and look at your patient _after_ he has had an hour's animated
conversation with you. It is the best test of his real state we know.
But never pronounce upon him from merely seeing what he does, or how he
looks, during such a conversation. Learn also carefully and exactly, if
you can, how he passed the night after it.

[Sidenote: Effects of over-exertion on sick.]

People rarely,