How the Poor Die , George Orwell
In the year 1929 I spent several weeks in the Hôpital X, in the fifteenth arrondissement of Paris. The clerks put me through the usual third-degree at the reception desk, and indeed I was kept answering questions for some twenty minutes before they would let me in. If you have ever had to fill up forms in a Latin country you will know the kind of questions I mean. For some days past I have been unequal to translating Réaumur into Fahrenheit, but I know that my temperature was round about 103, and by the end of the interview I had some difficulty in standing on my feet. At my back a resigned little knot of patients, carrying bundles done up in coloured handkerchiefs, waiting their turn to be questioned.
After the questioning came the bath – a compulsory routine for all newcomers, apparently, just as in prison or the workhouse. My clothes were taken away from me, and after I had sat shivering for some minutes in five inches of warm water I was given a linen nightshirt and a short blue flannel dressing-gown – no slippers, they had none big enough for me, they said – and led out into the open air. This was a night in February and I was suffering from pneumonia. The ward we were going to was 200 yards away and it seemed that to get to it you had to cross the hospital grounds. Someone stumbled in front of me with a lantern. The gravel path was frosty underfoot, and the wind whipped the nightshirt round my bare calves. When we got into the ward I was aware of a strange feeling of familiarity whose origin I did not succeed in pinning down till later in the night.
It was a long, rather low, ill-lit room, full of murmuring voices and with three rows of beds surprisingly close together. There was a foul smell, faecal and yet sweetish. As I lay down I saw on a bed nearly opposite me a small, round-shouldered, sandy-haired man sitting half naked while a doctor and a student performed some strange operation on him. First the doctor produced from his black bag a dozen small glasses like wine glasses, then the student burned a match inside each glass to exhaust the air, then the glass was popped on to the man’s back or chest and the vacuum drew up a huge yellow blister. Only after some moments did I realize what they were doing to him. It was something called cupping, a treatment which you can read about in old medical text-books but which till then I had vaguely thought of as one of those things they do to horses.
The cold air outside had probably lowered my temperature, and I watched this barbarous remedy with detachment and even a certain amount of amusement. The next moment, however, the doctor and the student came across to my bed, hoisted me upright and without a word began applying the same set of glasses, which had not been sterilized in any way. A few feeble protests that I uttered got no more response than if I had been an animal.
I was very much impressed by the impersonal way in which the two men started on me. I had never been in the public ward of a hospital before, and it was my first experience of doctors who handle you without speaking to you, or, in a human sense, taking any notice of you. They only put on six glasses in my case, but after doing so they scarified the blisters and applied the glasses again. Each glass now drew out about a dessert-spoonful of dark-coloured blood. As I lay down again, humiliated, disgusted and frightened by the thing that had been done to me, I reflected that now at least they would leave me alone. But no, not a bit of it. There was another treatment coming, the mustard poultice, seemingly a matter of routine like the hot bath. Two slatternly nurses had already got the poultice ready, and they lashed it round my chest as tight as a strait jacket while some men who were wandering about the ward in shirt and trousers began to collect round my bed with half-sympathetic grins.
I learned later that watching a patient have a mustard poultice was a favourite pastime in the ward. These things are normally applied for a quarter of an hour and certainly they are funny enough if you don’t happen to be the person inside. For the first five minutes the pain is severe, but you believe you can bear it. During the second five minutes this belief evaporates, but the poultice is buckled at the back and you can’t get it off. This is the period the onlookers most enjoy. During the last five minutes, I noted a sort of numbness supervenes. After the poultice had been removed a waterproof pillow packed with ice was thrust beneath my head and I was left alone. I did not sleep and to the best of my knowledge this was the only night of my life – I mean the only night spent in bed – in which I have not slept at all, not even a minute.
During my first hour in the Hôpital X, I had had a whole series of different and contradictory treatments, but this was misleading, for in general you got very little treatment at all, either good or bad, unless you were ill in some interesting and instructive way. At five in the morning the nurses came round, woke the patients and took their temperatures, but did not wash them. If you were well enough you washed yourself, otherwise you depended on the kindness of some walking patient. It was generally patients, too, who carried the bed-bottles and the grim bed-pan, nicknamed la casserole. At eight breakfast arrived, called army fashion la soupe.
It was soup, too, a thin vegetable soup with slimy hunks of bread floating about in it. Later in the day the tall, solemn, black-bearded doctor made his rounds, with an interne and a troop of students following at his heels, but there were about sixty of us in the ward and it was evident that he had other wards to attend to as well. There were many beds past which he walked day after day, sometimes followed by imploring cries. On the other hand if you had some disease with which the students wanted to familiarize themselves you got plenty of attention of a kind. I myself, with an exceptionally fine specimen of a bronchial rattle, sometimes had as many as a dozen students queueing up to listen to my chest. It was a queer feeling – queer, I mean, because of their intense interest in learning their job, together with a seeming lack of any perception that the patients were human beings. It is strange to relate, but sometimes as some young student stepped forward to take his turn at manipulating you he would be actually tremulous with excitement, like a boy who has at last got his hands on some expensive piece of machinery. And then ear after ear – ears of young men, of girls, of Negroes – pressed against your back, relays of fingers solemnly but clumsily tapping, and not from any one of them did you get a word of conversation or a look direct in your face. As a non-paying patient, in the uniform nightshirt, you were primarily a specimen, a thing I did not resent but could never quite get used to.
After some days I grew well enough to sit up and study the surrounding patients. The stuffy room, with its narrow beds so close together that you could easily touch your neighbour’s hand, had every sort of disease in it except, I suppose, acutely infectious cases. My right-hand neighbour was a little red-haired cobbler with one leg shorter than the other, who used to announce the death of any other patient (this happened a number of times, and my neighbour was always the first to hear of it) by whistling to me, exclaiming ‘Numéro 43! ’ (or whatever it was) and flinging his arms above his head. This man had not much wrong with him, but in most of the other beds within my angle of vision some squalid tragedy or some plain horror was being enacted. In the bed that was foot to foot with mine there lay, until he died (I didn’t see him die – they moved him to another bed), a little weazened man who was suffering from I do not know what disease, but something that made his whole body so intensely sensitive that any movement from side to side, sometimes even the weight of the bed-clothes, would make him shout out with pain. His worst suffering was when he urinated, which he did with the greatest difficulty. A nurse would bring him the bed-bottle and then for a long time stand beside his bed, whistling, as grooms are said to do with horses, until at last with an agonized shriek of ‘Je pisse! ’ he would get started.
In the bed next to him the sandy-haired man whom I had seen being cupped used to cough up blood-streaked mucus at all hours. My left-hand neighbour was a tall, flaccid-looking young man who used periodically to have a tube inserted into his back and astonishing quantities of frothy liquid drawn off from some part of his body. In the bed beyond that a veteran of the
