times when the heat in the camp was stifling, when the heartless plain
shimmered as if it burnt, when water was scarce and what there was of
it was warm, while the torment of insects was beyond bearing. At such
times he would wonder how the tide stood in the estuary at home. Was
the flood swirling up from the Channel, bringing with its clear eddies
the smell of the ocean as it hurried in and out among the piles of the
old pier? Or was it the time of the ebb when stretches of damp sand
come out at the foot of cliffs and when ridges of rock, dripping with
cool weed, emerge once more into the sun? What a moment for a swim! Yet
here on the veldt there was but half a pint of water in his can and a
land stretching before him that was scorched to cracking, dusty and
shadowless.
It was in connexion with his illness that I came across him. His
trouble was obscure, but after much consideration it was decided that
an operation, although a forlorn hope, should be attempted. If the
disease proved to be benign there was prospect of a cure; if a cancer
was discovered the outlook was hopeless.
He settled that he would have the operation performed at the seaside,
at a town on the south coast, within easy reach of London. Rooms were
secured for him in a house on the cliffs. From the windows stretched a
fine prospect of the Channel, while from them also could be seen the
little harbour of the place.
The surgeon and his assistant came down from London and I with them.
The room in which the operation was to be performed was hard and
unsympathetic. It had been cleared of all its accustomed furniture.
On the bare floor a white sheet had been placed, and in the middle
of this square stood the operation table like a machine of torture.
Beyond the small bed the patient was to occupy and the tables set out
for the instruments the room was empty. Two nurses were busy with the
preparations for the operation and were gossiping genially in whispers.
There was a large bow-window in the room of the type much favoured at
seaside resorts. The window was stripped of its curtains so that the
sunlight poured in upon the uncovered floor. It was a cloudless morning
in July.
The hard-worked surgeon from London had a passion for sailing and had
come with the hope that he might spend some hours on the sea after his
work was done. His assistant and I were to go with him.
When all the preparations for the operation were completed the patient
walked into the room erect and unconcerned. He stepped to the table
and, mounting it jauntily, sat on it bolt upright and gazed out
earnestly at the sea. Following his eyes I could see that in the
harbour the men were already hoisting the mainsail of the little yawl
in which we were to sail.
The patient still sat up rigidly, and for so long that the surgeon
placed a hand upon his shoulder to motion him to lie down. But he kept
fixedly gazing out to sea. Minutes elapsed and yet he moved not. The
surgeon, with some expression of anxiety, once more motioned him to lie
down, but still he kept his look seawards. At last the rigid muscles
relaxed, and as he let his head drop upon the pillow he said, “I have
seen the last of it—the last of the sea—you can do what you like with
me now.” He had, indeed, taken, as he thought, farewell of his old
love, of the sea of his boyhood and of many happy memories. The eyes
of the patient closed upon the sight of the English Channel radiant in
the sun, and as the mask of the anæsthetist was placed over his face he
muttered, “I have said good-bye.”
The trouble revealed by the surgeon proved to be cancer, and when, some
few days after the operation, the weary man was told the nature of his
malady he said, with a smile, he would take no more trouble to live. In
fourteen days he died.
Every day his bed was brought close to the window so that the sun could
fall upon him, so that his eyes could rest upon the stretch of water
and the sound of waves could fall upon his tired ears.
The friend of his boyhood, the clerk, came down from London to see him.
They had very little to say to one another when they met. After the
simplest greeting was over the sick man turned his face towards the
sea and for long he and his old companion gazed at the blue Channel in
silence. There was no need for speech. It was the sea that spoke for
them. It was evident that they were both back again at Salcombe, at
some beloved creek, and that they were boys once more playing by the
sea. The sick man’s hand moved across the coverlet to search for the
hand of his friend, and when the fingers met they closed in a grip of
gratitude for the most gracious memory of their lives.
The failing man’s last sight of the sea was one evening at sundown
when the tide was swinging away to the west. His look lingered upon the
fading waves until the night set in. Then the blind of the window was
drawn down.
Next morning at sunrise it was not drawn up, for the lover of the sea
was dead.
VII
A CASE OF “HEART FAILURE”
What a strange company they are, these old patients who crowd into the
surgeon’s memory after a lifetime of busy practice! There they stand,
a confused, impersonal assembly, so illusive and indistinct as to be
little more than shadows. Behind them is a dim background of the past—a
long building with many windows that I recognize as my old hospital, a
consulting room with familiar furniture, an operating theatre, certain
indefinite sick-rooms as well as a ward in which are marshalled a
double row of beds with blue and white coverlets.
Turning over the pages of old case books, as one would idle with the
sheets of an inventory, some of these long departed folk appear clearly
enough, both as to their faces and the details of their histories;
but the majority are mere ghosts with neither remembered names nor
features, neither age nor sex. They are just fragments of anatomy, the
last visible portions of figures that are fading out of sight. Here,
among the crowd, are the cheeks of a pretty girl encircled by white
bandages and the visage of a toothless old man with only one ear. I can
recollect nothing but their looks. They belong to people I have known,
somewhere and somehow, in the consulting room or the ward. Here a light
falls upon “that knee,” “that curious skull,” “that puzzling growth.”
Here is a much distorted back, bare and pitiable, surmounted by coils
of beautiful brown hair. If the lady turned round I should probably not
recognize her face; but I remember the back and the coils of hair.
This is a gathering, indeed, not of people, but of “cases” recalled
by portions of their bodies. The collection is not unlike a medley
of fragments of stained glass with isolated pieces of the human
figure painted upon them, or it may be comparable to a faded fresco
in a cloister, where the portions that survive, although complete in
themselves, fail to recall the story they once have told.
It is curious, when so much is indefinite, how vividly certain trivial
items stand forth as the sole remains of a once complete personality.
All I can recall of one lady—elderly but sane—was the fact that she
always received me, during a long illness, sitting up in bed with a
large hat on her head trimmed with red poppies. She also wore a veil,
which she had to lift in order that I might see her tongue. She was
further distinguished by a rose pinned to her nightdress, but I recall
with relief that she did not wear gloves.
Of one jolly boy the only particular that survives in my mind is a
hare’s foot which was found under his pillow when he was awaiting an
operation. It had been a talisman to coax him to sleep in his baby
days, when his small hand would close upon it as the world faded. His
old “nanny” had brought it to the nursing home, and had placed it
secretly under his pillow, knowing that he would search for it in the
unhappy daze of awakening from chloroform. He wept with shame when it
was discovered, but I am sure it was put back again under the pillow,
although he called his “nanny” “a silly old thing.”
Then, again, there was the whistling girl. She was about sixteen, and
had recently learnt whistling from a brother. Her operation had been
serious, but she was evidently determined to face it sturdily and never
to give way. She expressed herself by whistling, and the expression
was even more realistic than speech. Thus as I came upstairs the tone
of her whistling was defiant and was intended to show that she was not
the least afraid. During the dressing of the wound the whistling was
subdued and uncertain, a rippling accompaniment that conveyed content
when she was not hurt, but that was interrupted by a staccato “whoo”
when there was a dart of pain. As soon as my visit was over the music
became debonair and triumphant, so that I often left the room to the
tune of Mendelssohn’s “Wedding March.”
On the other hand, among the phantoms of the case book are some who are
remembered with a completeness which appears never to have grown dim.
The figures are entire, while the inscription that records their story
is as clear as it was when it was written.
In the company of these well remembered people is the lady whose story
is here set forth. More than thirty years have passed since I saw her,
and yet I can recall her features almost as well as if I had met her
yesterday, can note again her little tricks of manner and the very
words she uttered in our brief conferences. She was a woman of about
twenty-eight, small and fragile, and very pretty. Her face was oval,
her complexion exquisite, while her grey-blue eyes had in them the look
of solemn wonder so often seen in the eyes of a child. Her hair came
down low on either side of her face, and was so arranged as to remind
me of the face of some solemn lady in an old Italian picture. Her mouth
was small and sensitive, but determined, and she kept her lips a little
apart when listening. She was quiet and self-possessed, while her
movements and her speech were slow, as if she were weary.
She was shown into my room at an hour when I did not, as a rule,
receive patients. She came without appointment and without any letter
of introduction from her doctor. She said that she had no doctor, that
she came from a remote place in the north of England, that she had an
idea what was the matter with her, and that she wanted me to carry
out the necessary operation. On investigation I found that she had an
internal growth which would soon imperil her life. I explained to her
that an operation would be dangerous and possibly uncertain, but that
if it proved successful her cure would be complete. She said she would
have the operation carried out at once, and asked me to direct her to
a nursing home. She displayed neither anxiety nor reasonable interest.
Her mind was made up. As to any danger to her life, the point was not
worth discussing.
She had informed me that she was married, but had no children. I
inquired as to her parents, but she replied that she was an orphan.
I told her that I must write fully both to her doctor and to her
husband. She replied, as before, that she had no doctor, and that
it seemed a pity to worry a strange medical man with details about
a patient who was not under his care. As to her husband, she asked
if I had told her all and if there would be anything in my letter
to him that I had not communicated to her. I said that she knew the
utmost I had to tell. “In that case,” she replied, “a note from you is
unnecessary.” I said, “Of course, your husband will come up to London?”
To which she remarked, “I cannot see the need. He has his own affairs
to attend to. Why should any fuss be made? The operation concerns no
one but myself.”
I asked her then what relative or friend would look after her during
the operation. She said, “No one. I have no relatives I care about;
and as to friends, I do not propose to make my operation a subject for
gossip.” I explained to her that under such circumstances no surgeon
would undertake the operation. It was a hazardous measure, and it was
essential that she should have someone near her during a period of such
anxiety. She finally agreed to ask an elderly lady—a remote connexion
of hers—to be with her during her stay in the nursing home.
Still, there was some mystery about the lady that I could not fathom,
something evidently that I did not know. There was a suggestion of
recklessness and even of desperation in her attitude that it was
difficult to account for. As she sat in the chair by the side of my
desk, with her hands folded in her lap and her very dainty feet crossed
in front of her, her appearance of indifference was so pronounced that
no onlooker would imagine that the purport of our converse was a matter
of life and death. One little movement of hers during our unemotional
talk was recalled to my mind some days later. She now and then put her
hand to her neck to finger a brooch in the collar of her dress. It was
a simple gold brooch, but she appeared to derive some comfort, or it
may be some confidence, from the mere touching of it.
The operation was effected without untoward incident of any kind.
It was entirely successful. The wound healed by what is known as
“first intention,” there was no rise of temperature and no surgical
complication. But the condition of the patient caused an uneasiness
that deepened day by day. She became restless and apathetic and at
the same time very silent, answering questions only in monosyllables.
She resisted no detail of treatment, but accepted everything with a
lethargic complacency impossible to overcome.
That, however, was not all. She appeared to be possessed by an
indefinite anxiety which was partly expressed by an intense attitude of
expectation. She was expecting a letter, looking out for it day after
day and hour after hour. She listened to the door and to any sound
on the stair as an imprisoned dog might listen for the steps of its
master. This terrible vigil began on the second or third day after the
operation. When I made my visit about that time she asked me if I had
given orders that she was to have no letters. I assured her I had not
done so and that she should have every letter the moment it arrived.
But no letter came.
Whenever I made my appearance her first question was, “Did you see a
letter for me in the hall?” I could only answer “No.” Then she would
press me with other inquiries: “How often does the postman come? Is
he not sometimes late? Has there been any accident on the railway? Do
letters get occasionally lost in the post?” and so on interminably. If
anyone came into the room there was always a look of expectation on her
face, an eager searching for a letter in the hand or on a tray. If a
knock was heard at the front door, she at once inquired if it was the
postman, and very usually asked me to go to the top of the stair to
ascertain.
The sisters, the nurses and the patient’s friend could tell me nothing.
No letter of any kind arrived. The poor, tormented creature’s yearning
for a letter had become a possession. I inquired if she had written any
letters herself. The sister said that, as far as was known, she had
written but one, and that was on the eve of her operation. Although she
should have been in bed at the time, she insisted on going out for the
purpose of posting the letter herself.
She rapidly became weaker, more restless, more harassed by despair. She
was unable to sleep without drugs and took scarcely any food. Feeble
and failing as she was, her anxiety about the coming of a letter never
abated. I asked a physician versed in nervous disorders to see her, but
he had little to propose. She was evidently dying—but of what?
She was now a pitiable spectacle, emaciated and hollow-eyed, with a
spot of red on her cheek, an ever-wrinkled brow and ever-muttering
lips. I can see to this day the profile of her lamentable features
against the white background of the pillow. Pinned to the pillow
was the brooch that I had noticed at her neck when I saw her in my
consulting room. She would never allow it to be removed, but gave no
reason for her insistence. I have seen her hand now and then move up to
touch it, just as she had done during our first interview.
I was with her when she died. As I entered the room there was still the
same expectant glance at the door. Her lips, dry and brown, appeared to
be shaping the question, “A letter for me?” There was no need to answer
“No.” At the very last—with a display of strength that amazed me—she
turned over with her face to the wall as if she wished to be alone;
then, in a voice louder than I had known her to be capable of for days,
she cried out, “Oh, Frank! Frank!” and in a moment later she was dead.
Her death was certified, with unconscious accuracy, as due to “heart
failure.”
Here was a mystery, and with it a realization of how little we knew
of this lady who had died because she wished to die. I was aware that
her husband’s christian name was William, but beyond that I knew
practically nothing of him. The sister of the nursing home had both
written and telegraphed to the husband, but no reply had been received.
It was afterwards ascertained that he was away at the time and that
the house was shut up.
I was determined to find out the meaning of the tragedy, but it was
some months before I was possessed of the whole of the story. The poor
lady’s marriage had been unhappy. Her husband had neglected her, and
they were completely estranged. She formed a friendship with a man of
middle age who lived near by. This is he whose christian name was Frank
and who was, I imagine, the giver of the brooch. The friendship grew
into something more emotional. She became, indeed, desperately attached
to him, and he to her. Their intimacy was soon so conspicuous as to
lead to gossip in the neighbourhood, while the state of the two lovers
themselves was one of blank despair. She looked to him as Pompillia
looked to Caponsacchi. He was her saviour, her “soldier saint, the
lover of her life.” To him she could repeat Pompillia’s words: “You are
ordained to call and I to come.”
It became evident in time that the only course the two could adopt
was to run away together. She, on her part, counted no cost and would
have followed him blindly to the world’s end. He, on the other hand,
hesitated. He did count the cost and found it crushing. His means were
small. His future depended on himself. An elopement would involve
ruin, poverty and squalor as well as, in time, a fretful awakening from
a glorious dream.
He did the only thing possible. He told her that they must part, that
he must give her up, that he must not see her again, that he must not
even write to her. It was a wise and, indeed, inevitable decision; but
to her it seemed to foretell the end of her life. He kept the compact,
but she had not the strength to accept it. It was something that was
impossible. She endeavoured to get in touch with him again and again,
and in many ways, but without success. Hard as it was, he had kept to
his resolve.
Then came the episode of the operation. Now, she thought, if she wrote
to him to say that she was in London and alone and that she was about
to undergo an operation that might cause her death, he must come to see
her or he must at least reply to her letter. She felt assured that she
would hear from him at last, for, after all that had passed between
them, he could not deny her one little word of comfort in this tragic
moment.
She wrote to him on the eve of her operation. The rest of the story I
have told.
VIII
A RESTLESS NIGHT
It was in Rajputana, in the cold weather, that we came upon the dâk
bungalow. I was proceeding south from a native state where I had met
an officer in the Indian Medical Service. He was starting on a medical
tour of inspection, and for the first stage of the journey we travelled
together. He was glad to have a member of his own profession to talk to.
Towards the end of the day we halted at this dâk bungalow. It was
situated in a poor waste which was possessed of two features only—dried
earth and cactus bushes. So elemental was the landscape that it might
have been a part of the primeval world before the green things came
into being. The cactus, bloated, misshaped and scarred by great age,
looked like some antediluvian growth which had preceded the familiar
plants with leaves. If a saurian had been in sight browsing on this
ancient scrub the monster would have been in keeping. Some way
distant across the plain was a native village, simple enough to be a
settlement of neolithic men. Although it was but a splash of brown
amidst the faded green it conveyed the assurance that there were still
men on the earth.
The bungalow was simple as a packing-case. It showed no pretence at
decoration, while there was in its making not a timber nor a trowel
of plaster which could have been dispensed with. In the centre of
the miserly place was a common room with a veranda in front and a
faintly-suggested kitchen at the back. Leading out of the common room,
on either side, was a bedroom, and the establishment was complete.
The central room was provided with one meal-stained table and two
dissolute-looking chairs of the kind found in a servant’s attic. The
walls were bare save for certain glutinous splashes where insects had
been squashed by the slipper of some tormented guest. The place smelt
of grease and paraffin, toned by a faint suggestion of that unclean
aromatic odour which clings to Indian dwellings. The bedrooms were
alike—square chambers with cement floors, plain as an empty water-tank.
An inventory of their respective contents was completed by the
following items—one low bedstead void of bedding, one chair, one table
with traces of varnish in places and one looking-glass in a state of
desquamation. To these may be added one window and two doors. One door
led into the common room, the other into a cemented bathroom containing
a battered tin bath, skinned even of its paint.
We each of us had an Indian servant or bearer who, with mechanical
melancholy, made the toilet table pretentious by placing upon it the
entire contents of our respective dressing bags.
After dinner, of a sort, we sat on the penitential chairs and smoked,
leaning our elbows on the table for our greater comfort. The doctor
was eloquent upon his medical experiences in the district, upon his
conflicts with pessimistic patients and his struggles with fanaticism
and ignorance. The average sick man, he told me, had more confidence in
a dried frog suspended from the neck in a bag than in the whole British
Pharmacopœia. Most of his narratives have passed out of my memory, but
one incident I had reason to remember.
It concerned a native from the adjacent village who was working as a
stone-mason and whose eye was pierced by a minute splinter of stone.
As a result the eye became inflamed and sightless, save that the man
retained in the damaged organ an appreciation of light. As bearing
upon the case and its sequel I must explain the circumstances of
“sympathetic ophthalmia.” When an eye is damaged as this was, and
inflammation ensues, it is not uncommon for the mischief to spread
to the sound globe and destroy that also. In order to prevent such a
catastrophe it is necessary to remove the injured and useless eye as
promptly as possible. That was the uniform practice in my time. The
operation in question was urged upon the native an order to prevent
sympathetic ophthalmia in the sound eye, but he declined it, preferring
to consult a magician who lived a day’s journey from the village. The
consultation took place and the man returned to the local dispensary;
for although he still had good vision in the sound eye it was beginning
to trouble him.
The surgeon considered that the operation was now probably too late;
but he yet urged it upon the ground that there was some prospect of
success, while, on the other hand, failure could make the patient’s
condition no more desperate. The man, persuaded against his will, at
last consented, and the useless eyeball was removed. Unfortunately the
operation _was_ too late; the sound eye became involved beyond recovery
and the miserable native found himself totally blind. He ignorantly
ascribed his loss of sight to the operation.
Before my friend left the station the man was brought into his room
for the last time, and when it was explained to him that he was in the
doctor’s presence he threw his arms aloft and, shrieking aloud, cursed
the man of healing with a vehemence which should have brought down fire
from heaven. He called upon every deity in the Indian mythology to pour
torments upon this maimer of men, to blast his home and annihilate his
family root and branch. He blackened the sky with curses because the
darkness which engulfed him prevented him from tearing out with his
nails the eyes of this murderous Englishman. Foaming and screaming,
and almost voiceless from the violence of his speech, he was led away
to stumble about his village, where for weeks he rent the air with his
awful imprecations. Whether the poor man was now alive or dead the
doctor could not say, for he had heard no more of him.