TO THE young man in the hospital nightshirt, the continuous moaning of the old voice across the hall was at first a simple irritant, like the clanking of radiator pipes. Could not somebody put a stop to it? was his involuntary, impatient query. He was furious with the hospital, with the doctor, and above all with his own irrelevance in having fallen off a ladder in his friend’s New England studio and landed here, at the county seat, with a broken elbow, in the private wing of an institution that, in everything but the charge per diem, resembled penury itself. The windy old voice perpetually crying “Nurse, nurse!” from just across the corridor, groaning, quavering, soughing, seemed to typify everything that was antiquated and unnecessary in the whole situation. Despite the young man’s efforts to take a more humane view, the notion that his old neighbor could be turned off with one severe twist of the wrist, like a leaking faucet, persisted in the young man’s head, together with the conviction that he himself, in the old man’s position, would have shown more self-control. Once he had allowed himself to voice this comparative judgment, however, he was immediately filled with chagrin, for he was a just young man, of a cool but chivalrous disposition, and he recognized that there had been nothing, as yet, in his young life to test his powers of self-restraint; all he could say with positiveness was that in order to utter such vivid groans as proceeded from the opposite room he would have to be a different person—i.e., to be ailing and old.
Yet the fact that he knew himself to be, on the contrary, rosy-cheeked, gold-haired, well-favored, a graduate student of history at Harvard University, the indulged son of his parents, did not dispose of his irritation. In fact, it only quickened it by making it appear unreasonable. To grit his teeth and endeavor not to hear would have been the conventional recourse, but his native hospitality and politeness now suddenly forbade him to eliminate the suffering old man from his consciousness, even if this had been physically possible. He felt a social obligation to listen. Yet the faculty of sympathetic attention, the young man rapidly discovered, as he tried remorsefully to exercise it, is like the faculty of hearing: it ceases to reply to a regularly offered stimulus, just as one ceases to be able to hear a clock ticking in a room. He found, upon experiment, that it was possible to replenish his compassion by picturing the old man as dying (in the manner of a jaded libertine who resorts to a mental image to resuscitate the inert fact of love), but even this spur to fellow-feeling soon failed to prick his imagination. In a very short time, he resigned himself to the truth that he could feel sad about the old man but not really sorry, and that for every squeeze of generalized pity, there was a spurt of concrete hatred and repugnance.
“Am I a monster?” he asked himself curiously. “Or is this what everyone secretly feels toward another’s ills, toward the intrusion of a foreign body into the consciousness—a reflex of distaste and censure?” In common with many of his generation who had missed the overseas war, he had kept, up to this moment, a boy’s methodical piety toward the paraplegic, the refugee, the concentration-camp inmate, and even, in a peculiar way (typical also of his age and class), toward the torturer, who seemed to share somehow with the victim the distinction of participating in the actual. Now with the actual close at hand, in the form of a living sufferer, he was astonished to find it more remote from his own center of being, more irrelevant to his purposes and interests, than the sight of a plane crashing he had recently watched in a newsreel. A slight tremor of anxiety went through him: would others extrude him from their midst so casually when his time came, or was he himself deficient in the ordinary corpuscles of humanity?
A screen had been cutting off his view of the invalid across the hall, but at mealtime he gradually became aware of a process of ingestion that was going on in that room, a steady munching and salivating, which he felt rather than heard. This surprised him very much, and once, when the screen was moved, he caught a glimpse of a lump of bedclothes in the middle of the iron bedstead, which surprised him also, in the same way. There was something very active in that lump, very much alive, though how a mere convexity of bedclothes could communicate that impression, the young man could not tell.
All along, some reasoner in himself had been urging on him the idea that the old fellow was not really very sick, but the fact that such a suggestion could even occur to him, was so shocking to his conscience that he had not stopped to consider it on its merits. Now, however, he sat up in bed and began to attend more objectively to his neighbor, who at present was banging feebly with what sounded like a spoon on a glass. A nurse grumbled next door in the diet kitchen; there was a rustle of starched skirts. “Use your bell, Mr. Ciccone,” she commanded. A faint moan answered her; a creak of arch-preservers followed, as the nurse moved swiftly toward the bed. “Mr. Ciccone!” she cried sharply. The young man’s heart gave a lurch (“Forgive me,” he dumbly articulated, winging the thought after the old man, to catch him there, on the brink), but then from behind the screen came a grunt and a gurgling tobaccoey noise, like the mirth of a subterranean river-god. The old man was laughing.
The young man uttered a limp cry. Everything had abruptly coalesced: the name Mr. Ciccone, the pictorial bass with a crack in it, the tremolo and the quaver. Mr. Ciccone was acting. And instantly that collection of noises, to which the young man had been vainly striving to assign a poignant universal reality, acquired life and character. The unseen Mr. Ciccone presented himself: yellow skin, rheumy yet brilliant black eyes, white mustachios, thin liver-spotted hands, long white nightshirt. An Italian grocer, the young man conjectured, with a son in dentistry or the automobile business; a natural obstructionist and fraud, posed, in a white apron, with a mime’s sense of the picturesque, against the escarole and the pomegranates, the barrels of imported almonds and walnuts, weighing out the parmigiano on the non-Detecto scales. The young man laughed joyously aloud. Mr. Ciccone was off his conscience and lodged preferentially in his heart.
From this moment, he came to wait for the groans and laments, for the plaintive tinkle of the spoon on the glass, the short puffs of indignation, the struggle against the bedpan and the hypodermic syringe. Mr. Ciccone, as he soon learned from one of the internes, was not in fact very sick; a leg injury and a mild diabetic condition had combined to put him in the hospital, where he was regarded as a “character” by the nurses on the floor. All day long, they scolded the disobedient old party, who was continually bored and mischievous but never would trust his bell to summon attention. He felt cozened by this “bell” or light, not being able to hear it ring, and preferred to rely, in any personal emergency, on his own histrionic powers, weakly crying, “Nurse, nurse!”, tapping with the spoon on the glass, gasping, choking, playing dead. He was able to counterfeit extremity with such various and graphic realism that, though he had been some time in the hospital, the nurses would still rustle in alarm down the corridor (“Coming, Mr. Ciccone!”), only to find the old man, with the covers drawn up to his chin, chuckling at them and demanding a game of casino or a glass of Coca-Cola. Sometimes, when a new student relief nurse was on the corridor, Mr. Ciccone would actually get his way and would be sitting up in bed, finishing the forbidden beverage, when the head floor-nurse would fly in, all indignant cap and rattling keys—“Why, Mr. Ciccone, you know that Coca-Cola is bad for you”—and whisk the glass out of the room.
Mr. Ciccone, naturally, took medicine only under protest. He would bargain for a game of cards in exchange for good behavior, and, failing this, two or three times a day he would put up a convincing resistance to the sedatives, enemas, milk of magnesia, penicillin or insulin injections called for by his chart, only stopping short of direct physical combat, and, having concentrated a whole battery of nurses in his room, submitting all of a sudden with an exaggerated show of weakness as though to twit them for their display of force. After each of these submissions, he would moan for a long time, harrowingly, so that the delighted young man across the way could trace (as he knew someone was meant to) the whole nefarious course of the medicine down Mr. Ciccone’s injured gullet into his protesting stomach or through the tissues of his aged buttocks up to his shuddering heart.
The young man, too, execrated the routines of the hospital. The dreary food, dirty rooms, noise, lack of conveniences, the understaffed and officious personnel with its eternal “Doctor’s orders” vexed his intellect far more than his comfort, yet, on his own behalf, as a private patient, he could not nerve himself to complain. Conditions in hospitals all over the country, so he had heard, or read in an article, were nearly as absurd as this; someone ought to speak out against being waked up, as he was, two and a quarter hours before breakfast, at six every morning, on the pretext of having his temperature taken or his bandage examined, and waked up again (assuming he had been allowed to fall asleep) at three in the afternoon with a basin of lukewarm water, a toothbrush, and an order to “wash up” for the night. The idea of paying twelve dollars a day for this nonchalant and peremptory “care” was a constant insult to his acumen, but to protest on this basis was to imply that, had he been paying less, he would have had fewer grounds for objections. This, to a young man of liberal views, was not a tenable position. For purposes of social criticism, he could have wished himself a patient in the wards, where the very generalized injustice of the situation would have given him a right to speak. Shyness, the wish to appear a “good” patient, chivalry toward the nurses, all contributed to silence his criticism, but in his own eyes he was restrained, above all, by the sense that a demonstration against bureaucratic routine and authoritarian slovenliness on the part of a single private patient would so plainly lack a “popular” character.
What he had seen, however, of conditions in the private wing did not inspire him to transfer to the men’s ward for the mere privilege of playing the rebel there. He was determined simply to get well and be shut of this place as quickly as possible. He had been put in the hospital by his friend, and by his friend’s wife, whom, as a matter of fact, he had been leaning forward to kiss when he fell off the ladder in the studio. They had sent him a bunch of bronze chrysanthemums and left him more or less to himself; he could imagine that Mrs. X regarded the fall as some sort of “judgment” for their series of desultory indiscretions; she had not, in any case, during their single stiff visit to his bedside, directed her eyes fully into his.
For this, the young man was thankful. For his own part, he had no wish to see either of the Xes again and had only feared that the accident, and the whole atmosphere of crisis surrounding it, would enclose him in a triangle by a sheer convention of the prevailing social geometry. Whatever had happened to prevent this—whether Mrs. X had “told” her husband, whether he had “guessed,” or whether the accident had brought home to them what a nuisance, after all, other people (guests, in particular) really were, a common discovery of couples—the young man did not care. Throughout their visit, he himself had chattered incessantly about the hospital, Mr. Ciccone, the personal traits of the different nurses, never stopping to inquire about the farm, the pig, the projected dinner party, Mr. X’s painting, while husband and wife exchanged glances, like promissory notes on a future conversation, indicating that they would never have believed, if illness and isolation had not shown them, how intensely trivial and self-centered this friend in the nightshirt was.
The solitude in which they left him, and the repudiation of their transient intimacy, gave the young man occasion to assess in his own terms the twenty-four-year-old person who, shorn of all identifying marks and validating references, was lying cranked up in the scarred hospital bed. His preoccupation with the gossip of the corridor was, he quite readily conceded, a confession of envy and inferiority. He felt a sort of jealousy of this whole affairé world of illness and medication from which he was excluded. He wished to know its language and be accepted by it, yet the consciousness that his injury was a minor one made him hesitate to trench upon it. He believed that the nurses looked askance at him and treated him with subtle discrimination, as though questioning the professional wisdom of the doctor in detaining him here so long. He would have liked to say that he agreed with them, that he, too, could not understand why a mere fractured elbow should require so protracted a stay in bed, to assure them that it was not of his own desire but by the arbitrary will of another that he was there presuming on their patience.
This sense of his own nothingness in contradistinction to some darker reality had been threatening him, he now perceived, from childhood. The tone of his mother’s voice, sad, velvety, genuflectory, pronouncing the words “They’re poor” came back to him now with horror. “And are we rich?” he heard himself pipe. “No, dear, just comfortable”—the tone was of modest complacency, tinted with social awareness. In Cambridge, among his fellows, with the Xes, even, on their farm, he had achieved a minor entrée—he could be found, like a point on a social graph. But here, where no attachments secured him, where no one knew his history or his friends, he felt himself suddenly floating, uncircumstantiated, a mere transparency, and this sense of himself as an absence was so compelling that he was startled by the sight of his face, which looked at him through its eyeholes like a Christmas mask when they brought him in a mirror to shave by. The mortification of being alone, unvisited, unjustified, of having his name spelled wrong every day on the menu he was given to check for his choice of dishes, of having no bedroom slippers or pajamas (à la mode enough in Cambridge but a source of daily wonder here) had so wrought upon him that he had anticipated, without realizing it, an actual pauperization of his features. The sight of the familiar gold forelock, full lips, and snub nose was terribly disconcerting, as though he looked upon himself in effigy.
To exist, he suddenly became convinced, was an act of deliberate impersonation. Mr. Ciccone, across the hall, being shaved with an electric razor by a party of laughing student nurses, was a living warrant of this; Mr. Ciccone, imitating old age in a high infirm quaver, was both actor and régisseur—he had seized his part from the director and was executing it con amore. The young man listened with envy; the juvenile bit assigned him and, with him, his whole class and generation of soft-voiced, accommodating extras was too shadowy; he had no cue to rise to in the play. What was it, he asked himself, that sustained Mr. Ciccone and, for that matter, all the lively old mountebanks of the era—Yeats, Augustus John, Freud, Einstein, Churchill? Surely not belief in the self, since the self, as these old men knew, was a joke, a nothing, a point du départ. Mere virtuosity perhaps, and a growing closetful of stage effects—the paunch, the wrinkle, the limp; the jowl, the shank, the bald pate. In the Santa Claus suit of old age, beneath the padding and the pillow, some spry punchinello had hold of the vital principle of artifice.
The young man had been in the hospital two or three days and was sitting up, with bathroom privileges, before a certain suspicion that had been attaching itself to Mr. Ciccone became a verified fact. Mr. Ciccone, like Homer, was not a single individual but a collaboration. There were, astonishingly, four old men on the corridor, of whom the one called Mr. Ciccone was only the ringleader—four old men, bedded in private or semi-private rooms, two of them incontinent, all insubordinate, unsubdued, sworn enemies, every one, of the bedpan, the catheter, and the needle. Antiphonally or singly, they kept up a sort of plain chant, a thin, wheezy dirge that went on, all day long in its eerie unaccentual modality:
At certain times of the day, this cry became more vociferous, when the student nurse, for example, passed through the wing with the penicillin injections. Her entry to the semi-private rooms, at the far end of the corridor, was announced by a violent hubbub: imprecations, sobbing, pleading, the occasional crash of falling furniture. The young man would lay aside his book and wait for the authoritative creak of the head floor nurse proceeding to the scene, the sound of feminine chiding (“Mr. Wright, you’re not being thoughtful, you’re not being thoughtful at all”), the shriek, and then the after-cry, piercing, long-drawn-out, that vibrated through the corridor as the young nurse went on to the next room, to the women, who made no sound, and finally to Mr. Ciccone and himself.
In the case of two feeblest old men down the hall, sincerity and trumpery, so far as the young man could determine, were blended in the act of resistance. The needle, of course, did not hurt much, but in the lumbar regions of their spirit, something, plainly, was being violated. They were childish, in the nurses’ phrase; there was a blur in their minds between actual pain and the imagined representation of it; they did not trouble to distinguish and acted out every fancy with a pure, innocent sort of expressiveness. Mr. Ciccone, by contrast, was a conscious artist and a borrower. Sometimes, in the afternoon, the young man would overhear him softly rehearsing a sound effect that
he had picked up from one of his coevals, essaying it again and again, tentatively, like someone practicing on a flute. Later, in the after-supper lull, the mournful phrase, fully developed, would suddenly issue from Mr. Ciccone’s room, to be taken up again by one of the other Methuselahs, reminded by it of his own aches and miseries, so that the whole corridor would echo with the plaint of the old men, and the single, stolid night nurse would clump, scolding, into the diet kitchen, shut the door, and heat herself a cup of coffee.
This troupe of ancients, as if to confirm the young man’s theories, was handled by the hospital staff, at any critical juncture, with precisely that mixture of indulgence and asperity that characterizes the plain man in his relations with the artist. On the night that the two incontinent old fellows broke a draining-tube and drank a bottle of gentian violet between them, climbed out of bed and shouted in the corridor, an orderly, like a stagehand, came whistling down the hall to subdue them. “What will they think of next?” a white-haired nurse demanded, poking her head gratuitously into the young man’s room; doors slammed, lights went on, the elevator gates clashed. Only Mr. Ciccone’s room remained dark and almost ostentatiously peaceful, though the young man’s ear caught the sound of a dry chuckle, repeated at intervals. Yet the fact was, as the cleaning woman, shaking her head and her mop, confided to the young man in voluptuous brogue the next morning, one of those old rapscallions had just missed a date with Saint Peter.
All the while, the women patients were silent.
He had learned from one of the nurses that a woman was dying of cancer somewhere in the private wing, but only once, during his first days in the hospital, did he hear a woman’s voice that was not that of a nurse or a visitor—a young woman’s laugh and the sound of a door closing on it. This feminine silence began to disturb him very much; the idea that sick women of various ages and complaints were lying, blanketed, all around him, behind half-closed doors, each sheltering her unknown portion of suffering with a kind of uterine possessiveness, had the effect on him of a tactile sensation—as though he were encased in felt. He found himself with a strange, pressing desire to uncover that female suffering, to make it reveal itself to him by a sob, a gasp, a murmur, to have his ear know its contours, like a pleasure. On the fourth night of his stay, he was awakened suddenly, out of a deep sleep, by prolonged shrieks coming from the darkness, a woman’s voice raised again and again in screams of such appalling vibrancy that his hair stood up on his head. “The cancer patient, at last!”—the jubilant exclamation sprang out of him, quite unintentionally. He sat straight up in bed to listen, trembling with cold and excitement. Here there was no question of hearing or not hearing; these cries transfixed him with horror and yet he listened to them, fascinated, in the tingling stealth of discovery. He knew immediately that he was not meant to hear; these shrieks were being wrung from a being that yielded them against its will; yet in this fact, precisely, lay their power to electrify the attention. “A dying woman screaming in the night,” the young man repeated musingly, as the cries stopped, at their very summit, as abruptly as they had started, leaving a pounding stillness, “this is the actual; the actual, in fact, is that which should not be witnessed. The actual,” he defined, pronouncing the syllables slowly and distinctly in a pedagogical style, “under which may be subsumed the street accident, the plane crash, the atrocity, is pornography.” Closing his eyes, he sank back on a long breath of relief.
He awakened the next morning with a vivid feeling of joy and liberation, as if during the night a responsibility had been sloughed off. He felt blithe and ready to live, selfishly and inconsiderately, like the expressive old men; the actual no longer drew him with its womanish terrors and mysteries, its sphinx-rebuff and invidia. “Cast a cold eye on life, on death,” he sang out, borrowing from old Yeats’s tombstone. “Horseman, pass by.” He was positively elated, in fact, to be young, healthy, and hungry, and, as he meant to tell Dr. Z as soon as he appeared on his rounds, determined to go home to Cambridge on the one-o’clock train. This elation induced in him an unusual talkativeness; to the fat grumpy old nurse who came in with the thermometer, he could not resist an allusion to what he had heard during the night. The old nurse surveyed him tersely, shook down the thermometer without comment, unpinned her watch from her uniform, and, snapping her fingers impatiently, extended her veined hand for his pulse. “Maternity case,” she finally surmised, handing him his toothbrush and the tin basin. “You won’t hear a sound out of Mrs. Miller [mentioning the name of the cancer patient]. She’s quiet as a lamb next door.” The young man turned white at the thought of that deathly stillness so near him; he had imagined the next room to be empty, for not a sound had issued from it, and passing it on his trips down the hall to the bathroom, he had observed that the door was always shut. The next question was drawn from him by a compulsion; he did not wish to ask it and threw it out with diffidence: “She is under opiates, I suppose?”
The nurse surveyed him again with a short, measuring movement of the eye. “Brush your teeth, now,” she commanded curtly. “You know we are not permitted to give out information about the other patients.” She withdrew the bedpan from the commode, jerked off the towel that shrouded it, and slid it under the covers. “Put your light on when you’re through,” she directed. The young man sat up. “But I am allowed to go to the bathroom!” he exclaimed. “Not this morning,” she said firmly. “Doctor says we are to stay in bed this morning.” “But why?” demanded the young man, now thoroughly alarmed and suspicious. The nurse’s creased face snapped shut. “Curiosity killed the cat,” she retorted. “Doctor will be in early to see you.” “I demand—” cried the young man after her, as she bustled out, leaving the door open, but he broke off, conscious of absurdity, for what he had been about to say was “I demand to see a lawyer,” which was ridiculous, for he was certainly free to get up and dress and leave the hospital. The idea of flight suddenly offered itself to him as the only feasible solution. He pictured, with a return of his early-morning gaiety, the rubber-soled chase down the corridor, the escape down the fire-stairs. His imagination, however, faltered at the thought of the office: to leave without paying was unthinkable, yet would they be likely to take a check from him under such unusual conditions? He feared, all at once, to put this question to the test. He felt unequal to the imagined commotion—the painstaking verification of identity, the call to his bank in Boston—and for what purpose, he asked himself, would I do all that, for the mere assertion of my individuality? For the sake of another, he reasoned, I could conceivably do it, if it were a question of rescue or sacrifice; but for myself? He lay back dutifully on the bedpan and in a moment put on his light.
The nurse came in and he said coldly, “In the future, would you take the trouble to close the door when you leave the room, particularly during these intimate moments?” Yet even as he began to speak, he felt himself blushing and the final phrase, to which he had meant to impart a sarcastic intonation, was mumbled out thickly, in a tone, almost, of apology. The nurse threw the cover over the bedpan and went out, closing the door behind her with a decisive click.
An hour later, young Dr. Z appeared, all gold fillings, hair en brosse, smile, and rimless spectacles. “We are going to reset that elbow for you,” he announced. “Anyone you want to get in touch with?” The young man opened his mouth to argue. He was free (was he not?), he reminded himself, to get up and dress and leave the hospital. He had only to refuse. The Xes, if it came down to it, could be summoned to bail him out of here. Dr. Z, after all, had no title or charter to his patronage. He had only to tell him that he preferred to have the arm reset, if necessary, in Cambridge, where he had friends and a regular physician; there was nothing in this preference that was derogatory to Dr. Z. The doctor, in his white gown, stood looking down at him, smiling rather inscrutably, as though he were very much aware of what was going on in the young man’s mind. “Those friends of yours,” he suggested, with a flick of the sterile glance in the direction of the dying chrysanthemums, “do you want us to give them a call?” A student nurse knocked and came in with a tray and a hypodermic needle. The young man’s jaws worked and he shook his head wordlessly in reply. It was too late; in the presence of this attentive listener he could not refuse Dr. Z what suddenly, in a curious fashion, appeared to be a favor, the favor of letting him operate on him. The abominable doctor smiled again, lightly, and tapped the foot of the bed in a negligent gesture that seemed to imply a mixture of contempt and approbation, as if he had had little doubt of the outcome of this conflict between them but was nevertheless satisfied to have won.
On the way up to the operating room, being wheeled breezily along by an orderly humming “Who?” the young man had a sudden clear sharp sense of all that he had omitted to do to attach himself to the life of this corridor from which now, irrecoverably perhaps, he thought in panic, he was being trundled away. “Stop,” he asserted faintly, raising his head on the pallet. The idea of defending himself still reached him as from a distance through the drug: Mr. Ciccone, he thought, would never have permitted this; in Mr. Ciccone, he considered tenderly, he had an ally, a veteran aider and abettor. Why, he demanded of himself, had he not taken the simple friendly course, yesterday, when he was sitting up in a chair, of offering to join his neighbor in a game of casino?
The orderly had paused to look down at him. “What’s the matter, chum?” he inquired. The young man struggled up from the confining blankets. They were waiting for the elevator, he realized; it was not too late, if he were insistent, to make a date with Mr. Ciccone for this afternoon or tomorrow; the fact that this notion was absurd made it appear to him all the more urgent and necessary, all the more talismanic. He jerked his raised head in the direction of Mr. Ciccone’s room. “I must speak to the patient in Number Three,” he pronounced, with an effect of hauteur and dignity. The orderly lifted shaggy red eyebrows, peered down the elevator shaft, shrugged, and consentingly set the stretcher in motion, retracing their way along the corridor. “Friend of yours?” he remarked.
In the flush of this victory over self and custom, the young man grew excited and voluble; a passing nurse turned back to look at them. “No,” he said. “To tell the truth, I’ve never actually seen him.” The orderly stared and bumped the stretcher to a standstill, but they were already opposite Number Three. The screen had been moved and the young man hastily nerved himself for the possibility that the real Mr. Ciccone might be something quite different from what he had imagined—a cantankerous misanthrope, for example, who would repulse his overture. But to his surprise the shaded room across the way into which his dilated eyes stared was empty, the bed made up and flat.
Fifteen minutes later, the young man expired under the anesthetic, before the operation proper had begun, the first case of its kind, as Dr. Z explained to Mrs. X, that he had ever come across in his entire practice, where the heart, without organic defect, sound as a bell, in fact, simply stopped beating.