After the incident M. Halfont maintained so injured and, withal, so dignified an aspect that he could not bring himself to acknowledge a salutation from a student otherwise than by raising a little farther the already elevated arcs of his eyebrows. The ringleaders he ignored completely. His nude scalp shone with self-righteous polishing—possibly he had rubbed into it a little of the butter which had landed there a few days previously.
The food report reached completion. Besides a detailed analysis and abstract of the menus there was also an account of the various unsuccessful attempts made by the students’ committee to obtain an improvement in the diet. It was submitted to Dr. Vernet, who agreed to forward it to the headquarters of the I.S.O.
The food continued bad, but, pending the outcome of the report, there was no further action to be taken; like a clock which has broken down with its spring fully wound, all activity was suspended but the tension remained. Routine assumed the double function of goad and halter, forcing and curbing movement. Everybody became suddenly conscious of, and oppressed by, the succession of little disciplines enforced, the diurnal sequence of cures de silence, heures de repos, promenades gradées. A feeling of mass irritation swept the students’ corridors with the edgy persistency of a mistral.
The formality of medical rounds; the humiliating perspective from which the horizontal view the vertical. As the quarters on an antique clock are sometimes marked by the emergence of one grotesque, the hours by a little procession, so the weekdays brought to each room a single doctor, the Saturdays the three together.
It was this weekly synthesis or compound of medicals which was the most dispiriting. “Attention! Le Médecin Chef!” the sœur de l’étage would shout, throwing open the doors of one bedroom after another. First Dr. Vernet would stride across the room with the jerky step of a marionette whose feet never quite touch the ground. Jerky but without speed, sickly, cynical, discouraged and detached, Dr. Bruneau would follow. Dr. Florent, wedged in a flurry of sisters, would rarely manage to cross the threshold.
Temperature charts were laid in readiness across the bottom of each bed. Whilst Dr. Vernet assessed keenly the implications of the interlaced graphs of temperature, weight and pulse, Dr. Bruneau lolled apathetically against the wall, stared out of the window, or, if a book or magazine lay to hand, seized it so purposefully as to suggest that its perusal constituted the sole reason for his visit.
The weekday visits, however, revealed that Dr. Bruneau’s disinterest in temperature charts was merely feigned; left to himself, he was at his esoteric best. Seizing a temperature chart, he would fold back its flap, apply it at right angles to his cheek, and gaze, whistling and muttering, along the extended range of little peaks. Only those in his special confidence were informed that by this unique method he was able to obtain an invaluable racourci whereby he could distinguish subtle trends and tendencies of temperature unsuspected by his colleagues.
Dr. Florent, too young in the art of healing to embark upon such a display of virtuosity, would merely rise like a ballerina sur les pointes, more than content with such trends and tendencies of temperature as he was able to distinguish from his tentative standpoint between the double doors.
On one occasion a malicious patient, instead of marking his temperature in a series of little peaks below the red line (which was its true position, for his temperature was subfebrile) inscribed it instead in the same relative position above the red line, thus giving the impression of a nightly temperature of 38° or over 100° Fahrenheit. Each day the graph was either foreshortened by Dr. Bruneau or focused from afar by Dr. Florent; every Saturday it was scrutinised and assessed by Dr. Vernet; none remarked what had happened until the patient, tiring at last of so restricted and private a jest, dropped the temperature curve to within its actual limits.
It was a Saturday morning visit which brought two contrasting items of news to Paul and Kubahskoi. Paul’s latest analysis was negative. He was to be allowed up for his midday and evening meals; in a week he could take his first walk outside.
Kubahskoi was still smiling his pleasure and congratulations when Dr. Vernet turned towards him. A few days previously Kubahskoi had had a routine X-ray.
“You have the result, docteur?”
“Oui, mon cher. Ce n’est pas très bien.”
“Pas très bien,” repeated Kubahskoi. He was still smiling, but his features had become as rigid as those of a china Buddha. Dr. Vernet touched his shoulder sympathetically.
“The X-ray has revealed why, after five years with a pneumothorax, you still remain positive. It is because your second lung is infected.” He paused; medical tidings in tuberculosis, like ground glass, are often painful to digest. Then the monody became formalised: the implications of the newly discovered lesions; the dangers of procrastination; the necessity for a few more months of patience. Briefly, in a word, it was essential that a second pneumothorax should be induced.
Then the crystallised cherry tossed into the middle of the bitter citrus fruit: “If the second pneumothorax can be effected without complications, there is no reason why you should not completely regain your health.”
For months the newspapers had been full of reports about the potentialities of the new wonder drugs. Kubahskoi—clutching at a straw—asked whether instead of a pneumothorax he might be given a course of streptomycin. Dr. Vernet shook his head. “Non, mon vieux, for you it would do no good. You must have a second pneumothorax. I will create it in a few days.”
The day before the induction, Kubahskoi neither ate nor spoke to any of his friends. Throughout the whole of the afternoon he sat on the balcony, his chin resting on the rail, and remained staring fixedly across the mountains until the sun had set and the forests were lost in shadow.
And there were no complications; Dr. Vernet described it as the perfect pneumothorax. An analysis was made a fortnight after the induction—the result was positive; two weeks later there was a second analysis and the initial result was confirmed. When Dr. Vernet was making his Saturday round, Kubahskoi pointed dejectedly to the two red crosses on his temperature chart. “Mon vieux,” said Dr. Vernet, “it is, alas, well known that with a second pneumothorax one never becomes negative before a period of six months.”
When he compared his situation with Kubahskoi’s, Paul became increasingly conscious of his own good fortune. But it was only when he was able to get up and make the acquaintance of other students who were in bed that he could assess the depth of the abyss from which he had escaped. And the symbol of his escape was now inscribed in red on his temperature chart: B.K. –. How easily—merely at the cost of several critical days—he had achieved it.
Now he met young men and women who had been ill for several years, who had undergone whole series of operations, who had witnessed the passing of their youth from a bed in a hospital ward, and whose case-histories, biographies and autobiographies were summed up, concisely, synonymously, on any one of the multifarious leaves of their temperature chart by the sinister, the Damoclean, marking: B.K.+.
Some of these students had been imprisoned in concentration camps; the conditions in which they had lived had induced T.B. of the bone or of the lung, sometimes both. One form of imprisonment had been exchanged for another; where they had been confined to cells, they were now confined to beds, where they had lain in fetters, they now lay in plaster casts. They had previously existed in daily dread of summary death; it was now only the method, not the threat which had altered.
Paul knew himself well: he had neither the courage nor the stoicism of his fellow patients, and the thought of physical pain demoralised him. A line from Milton ran often through his mind: “Square my triall to my proportion’d strength”. He could have borne no more than he had suffered, and his suffering, as each day he realised more fully, had been as nothing.
It was the first occasion that he had left the sanatorium since he had entered it five months previously. Wrapped in his old army greatcoat and wearing his stoutest shoes—for despite the fact that it was nearly April the roads were thick with snow—he walked down the slope which led from Les Alpes to the station, and recalled the freezing December evening of his arrival. At that time the weight of his greatcoat had seemed so insupportable that he had contemplated quietly abandoning it in the snow. Having reached the bottom of the slope, he started to mount a slight incline—the relative lightness of his step was the most tangible evidence of his recovery.
Crossing a small bridge over the railway he heard a train ascending the steep track. A curious, disconcerting, utterly distinctive sound—how was it that he had forgotten it? He stopped, closed his eyes, attempted to break down the concert of sounds into its component parts: the noise of the diesel, the groaning of the couplings between the coaches, the click of the ratchets biting into the slotted track. Then he resumed his walk. Perhaps when, in a few weeks, he left for England, he would again forget it, though, like certain stilled voices once familiar, its echo would persist in some recess of his brain, ever available—in appropriate circumstances—to establish instantaneous prodigies of recognition.
The sun was shining brilliantly. It glazed the surface of the great mounds of snow which lined the edge of the pavements, and through which, at intervals, gaps had been cut to provide access to the road.
Each turn provided fresh vistas of sanatoria. They varied from large modern buildings to chalets on the wooden façades of which were painted: ‘Sanatorium-Pension. Bons Soins. Tout Confort. Cuisine Soignée. Prix Très Modérées’. They were everywhere, on all levels, clustered as tightly and haphazardly as booths on a fair-ground.
The narrow main street of the village had been constructed along a natural ridge in the mountain. One side was lined with low, modern shops, the other dropped away as sheerly as the edge of a precipice. Paul hurried across the road, anticipating an extended view; but there was only the outer belt of Brisset, its faubourgs, environs, départements, a density of sanatoria covering all that was visible of the lower slopes.
Farther down the street he came upon a series of step gardens, levelled with snow, their parterres showing like December graves in a paupers’ cemetery. Low trees skirted the periphery of the gardens, their lopped-off branches forming the skulls of white carnival heads brought to a state of dripping decomposition by the sun’s rays.
Many patients were taking their midday walk. They were of all ages, though the young predominated. Brave youth of Brisset, bravely attired, jeunesse aussi dorée que possible! Young girls in ski-clothes, eyes a little too bright, cheeks a little too flushed, figures a little too slim. Young men, firm, vigorous, golden-skinned, the pears or peaches of a dishonest fruit vendor, resplendent without and rotten within.
Paul went into one of the crowded cafés and sat down at a table. His untrained, insensitive ear could scarcely distinguish between many of the languages. But there were key words—keys not to the origins of the speaker, but to his condition. ‘Pneumothorax’, ‘pleuroscopie’, ‘thoracoplastie’—all rolled with equal facility about Oriental and Western tongues. It seemed that everyone was discussing his own condition or that of his neighbour! Paul pushed aside the cup of coffee which he had just ordered, paid an inflated price and left the restaurant.
Every Wednesday the billiard-room of the sanatorium was turned into a cinema. Admission: three hundred francs for private patients, who sat in armchairs; one hundred francs for students, waiters and kitchen staff, who sat on benches.
Who and what were the private patients? They lived on their own floors, gave parties in their rooms, ate their meals at different times from the students, and in the evenings congregated in their own Salon des Privés. Occasionally they would be seen chatting in twos and threes at the foot of the main staircase, or in little groups advancing self-consciously but aloofly through noisy ranks of students to the salle à manger. Sometimes, hands in the pockets of their dressing-gowns, they wandered aimlessly up and down the corridors; sometimes they strolled into the music-room, where one would strum on a piano and another would tap a lethargic accompaniment on the drum. It was only at the cinema that they could be encountered in a body.
There being only one projector, there were a number of intervals of several minutes whilst the reels were changed. Owing to the maladroitness of the projectionist the reels would sometimes overrun, always with the same curious consequences. The picture and sound track, in the middle of a gesture, a word, would suddenly change to a crowd of half-naked studio Indians executing a war dance. Then the camera would focus on a small group of dancers, then on one, a girl. Waving a tomahawk and wearing only tiger-skin trousers which did not reach to her navel, she would shimmy, retreat and bend backwards over a great drum. Her breasts would grow taut, her pectoral muscles would tense, and then, as the audience stamped and cheered and the projectionist woke up, the mysterious and tantalising film would end in a shriek from the sound track, and the screen would reflect nothing more than the glare of the projector lamp.
The quality of the sound was poor: in an American or English film an English-speaking member of the audience could often only interpret the dialogue by following the French or German subtitles. As the private patients were composed of even more disparate nationalities than the students, and as, more often than not, they were confined to one language, their own (which frequently corresponded neither with the language of the film nor its subtitles), they would talk throughout the film to their fellow nationals, either endeavouring to interpret the action or, if it had ceased to interest them, discussing their state of health, their symptoms, their treatment, or the nature of the operations with which they were threatened.
It was in this way that Paul became acquainted with a new cult-cry: “Liquide.”
“What is ‘liquide’?” he whispered to Kubahskoi, whilst the reels were being changed. For answer, Kubahskoi took a bunch of miniature X-rays from his pocket, and, selecting one, passed it to him. One side of the chest was clear; on the other a level, opaque mass reached as high as the fifth rib. “Pleural fluid,” he explained. It had been the consequence of a visit to Geneva, where he had passed a few hours in a night club and had subsequently caught a cold. He had been fortunate. After a month of aspirations the fluid had stopped and it had been possible to maintain his pneumothorax. Usually fluid caused adhesions between the lung and the chest wall, and then there was nothing for it …
“Ribs out?”
“Ribs out!”
Immediate panic resolutions to avoid catching cold. Woollen waistcoats, extra underclothes from England, always a coat when out walking. During the rest of the film Paul could not prevent himself from experiencing in anticipation what was now surely inevitable. The slight indiscretion, the change in the weather, the chill, the next X-ray, Dr. Vernet sympathetically patting him on the shoulder, the cracking sound as rib after rib was torn from his side …
At the end of the film he encountered M. Halfont in the passage. This gentleman greeted him affectionately, took his arm, and strolled with him towards the lift shaft.
“Ah, monsieur,” said he, “it gives us all great pride and pleasure that you have now so good a mien—at the time of your bad days we were very frightened for you. Each day I asked your news of Dr. Vernet. You have pulled yourself well out of it—the liquide can play you some dirty turns …”
“Liquide! I had liquide?”
“Oh yes—up to here!” And very gravely M. Halfont stubbed his thumb into Paul’s chest. And whilst Paul stared at him in amazement M. Halfont took his hand, shook it loosely, then scuttled down the stairs flanking the lift shaft, his arms and legs working like those of a toy miller swarming down a pole.
And M. Halfont’s information was quite correct. At the next consultation Dr. Vernet confirmed that one of the facets of Paul’s critical state after the induction of the pneumothorax had been a serious pleural effusion. But by exceptional luck the fluid had been absorbed, and had caused no complications.
“And so,” said Dr. Vernet, “you are our triumph—a most successful case. We took a risk, bien entendu, but, as you will agree, it has been vindicated. There is a quotation, monsieur, that you will recall for me from Hamlet—a play to which I was much addicted at the university. It was that bad diseases need big remedies.”
“Diseases desperate grown …” quoted Paul, and Dr. Vernet listened intently and bade him to repeat it three times. Then Dr. Bruneau walked into the bureau, and Paul was ordered to recite it once again, and very slowly, whilst Dr. Vernet translated it word by word for his colleague.
“You see Voltaire was quite wrong about Shakespeare,” cried Dr. Vernet. “This phrase I will have engraved in stone above the door of Les Alpes, and inset into the walls of our operating theatres!”
“Il y a un proverbe français qui dit que le remède est souvent pire que le mal …” replied Dr. Bruneau.
Dr. Vernet laughed. “I will engrave that as well so that my patients can consider both sides of the question.” He turned to Paul. “I am lucky to have a metaphysical assistant who secures me from the wild excesses of my natural optimism!” Then somewhat tartly to Dr. Bruneau: “On peut aussi bien dire que souvent le mal est pire que le remède …”
“Ça depend le mal, et ça dépend le remède …”
“Evidemment!” Dr. Vernet’s mood had changed. “And whilst philosophers theorise on what depends on what, men of science are getting on with their work—which is what we shall do now. And remark well—when philosophers fall ill they come to doctors to get cured. But I have not yet found anyone whose state required him to have recourse to a philosopher.”
Dr. Bruneau bowed assent. Dr. Vernet resumed his official manner, and initialled Paul’s temperature chart to signify that the consultation was over. “You will see,” he said, “that I have changed your horaire. You are now to go for walks in the morning as well as in the afternoon. After the evening cure you will stay up until ten o’clock.”
In the way that all advance contains elements of regression, that all celebration is not without a seasoning of regret, so Paul was both delighted and defeated by his new horaire. He had formed the habit of studying all morning; now it was required that he should get up and dress at eleven o’clock. And being basically undisciplined, and only capable of real application when there was no alternative to it, his concentration wandered, he continually looked at his watch, and the now very attenuated morning managed both to drag unbearably and, for all practical purposes, to pass in a flash.
Then, sickened by his capacity for repining, no matter what his circumstances, he made a conscious rejection of the new conflict which was threatening to drain all satisfaction from the first part of the morning, all enjoyment from the second. ‘After all,’ he told himself, ‘I might very well be dead.’ What did it matter if he lost a few more weeks or months of study? The important, the primary, thing was to convalesce.
Usually he took his morning walks alone, exploring the roads and pathways about Les Alpes, sometimes looking in the bright shop windows, noting each item of their highly priced contents as admiringly and impersonally as a visitor gazing into show cases in a museum. One morning, encountering Angus Gray and David Bean out together, he joined with them for some distance. Then, at a place where the road forked, Angus Gray left them, for he had some purchases to make in the village. Paul and David continued together.
“You know,” said David Bean, smiling, “you have completely upset my calculations and theories.”
“How is that?” asked Paul.
“Well, it’s like this. Probably you didn’t know, but I spent a year in a sanatorium in England before coming out here. There was not much wrong with me, just a few infiltrations on one lung, but they were obstinate and took a long time to clear. Now, in the sanatorium there was a nursing sister who had been there for over twenty years, and she had developed an extraordinary faculty. She was able to predict the outcome of any case, irrespective of diagnosis or prognosis. Nor did she require any foreknowledge of the patient’s condition or case history; her findings were based on no more than a casual glance during a ward round. Frequently her opinions would appear utterly without foundation, as for example when she pronounced a light case with an excellent prognosis as hopeless. But events invariably showed her to be right. In the same way, she might see a patient who was clinically in a very bad way, and if she said of him, “He’ll pull through,” then he did. At last the staff came to accept her powers as miraculous and left it at that.
“Now because, as a medical student, I was allowed, when I was better, to take part in medical rounds, I was able to see her faculty at work. Whenever I questioned her about what it was she looked for, she told me that in fact she looked for nothing at all. All her judgements were based upon immediate sensory impressions in which she allowed her reason to play no part, and she insisted that she possessed no faculty which another person could not easily develop.
“From then on I began to make independent judgements on new patients, after which I would compare my own findings with hers, and to my astonishment I found that, except in cases where I had let my reason interfere with my first intuitive impressions, they always corresponded. So gradually I learned to rely on my intuition, and at last I reached the point when she and I were in complete agreement about all the new cases that we saw.”
The two young men had now passed above the village and were branching off on a narrow mountain path which led circuitously back to Les Alpes. The sun had become obscured by clouds and an icy wind cut into their faces. Paul buttoned his khaki greatcoat up to his neck.
“What bearing has all this on me?” he asked.
“It must be fairly obvious, and since you have proved me wrong there is no reason why I should not tell you, though I would never have done this before. When I first saw you on Victoria Station, I had the immediate impression that you would never return to England—you and one other of our party. Then, when we arrived at Les Alpes, I received every corroboration from your X-ray plate—though I must emphasise that, even without this, my opinion would have been in no way affected. And now it seems that I am wrong.”
He became silent, and they continued along the path for several minutes without exchanging a word. A sudden gap in the side of the mountain brought into view a great forest of deciduous trees, the peaks of which protruded grotesquely through a uniform covering of glazed and brittle snow. Clouds like breakers rolled up the valley, whilst below and slightly preceding them a gigantic shadow flowed along its whole expanse: in no time the basin of the valley was completely obscured by a swirling sea of clouds, the extremities of which no sooner lapped the edges of the mountains than they swelled and started to rise.
“Who was the other you thought would not survive?”
“I obviously can’t tell you. And anyway it’s only because I’ve been proved so utterly wrong in your case that I’m mentioning the matter at all. A few days ago I saw your latest X-ray, and whilst of course the lung is still in a very bad state, there is no reason why one day it should not be completely healed.” He laughed self-deprecatingly. “I won’t deny I feel a bit piqued to see my theory tossed overboard, but I’m glad for you at any rate.”
“Thank you,” said Paul. He reflected for a few minutes. Then he said: “In a sense, I, too, made the same mistake.”
“What do you mean?”
“I mean that at the outset I also thought that my case was hopeless.”
“And you think that you were mistaken?”
Paul raised his eyebrows: “I don’t understand you.”
“I mean, wherein do you think your error lay?”
“It lay,” said Paul, and he spoke a little acidly, “it lay in confounding my pessimism with what I took to be my powers of intuition. Premonitions which relate to oneself are probably symptoms of a sickly temperament; when they relate to others, it seems to me that they are more likely symptoms of something worse.”
“You explain your own error,” said David Bean, laughing, “but I don’t think that you throw any light on mine. But most probably you are right, and the whole process of intuition is invalid.”
The sea of clouds was rising rapidly, seeping into and filling crevices and fissures in the rock, expanding progressively its periphery whilst maintaining its density. The young men quickened their step as they saw the roofs of the sanatoria below them becoming obscured, then completely lost, in the swelling, mounting cloud. And as they were descending through a small wood on the slope which led to Les Alpes, the mist rippled about their ankles, rose almost instantaneously to their stomachs, then enveloped them completely. A sudden flash of lightning diffused a transient luminosity throughout the thickening folds of cloud; it was followed by a hollow, grotesquely echoing crash of thunder. A few drops of rain penetrated the foliage of the wood; then came the torrent.
Fortunately there was not far to go, and David Bean ran the rest of the way, but Paul, restricted by his limited breathing capacity, managed no more than slightly to increase his pace.