About a dozen beds away from me was numéro 57 – I think that was his number – a cirrhosis of the liver case. Everyone in the ward knew him by sight because he was sometimes the subject of a medical lecture. On two afternoons a week the tall, grave doctor would lecture in the ward to a party of students, and on more than one occasion old numéro 57 was wheeled on a sort of trolley into the middle of the ward, where the doctor would roll back his nightshirt, dilate with his fingers a huge flabby protuberance on the man’s belly – the diseased liver, I suppose – and explain solemnly that this was a disease attributable to alcoholism, commoner in the wine-drinking countries. As usual he neither spoke to his patient nor gave him a smile, a nod or any kind of recognition. While he talked, very grave and upright, he would hold the wasted body beneath his two hands, sometimes giving it a gentle roll to and fro, in just the attitude of a woman handling a rolling-pin. Not that numéro 57 minded this kind of thing. Obviously he was an old hospital inmate, a regular exhibit at lectures, his liver long since marked down for a bottle in some pathological museum. Utterly uninterested in what was said about him, he would lie with his colourless eyes gazing at nothing, while the doctor showed him off like a piece of antique china. He was a man of about sixty, astonishingly shrunken. His face, pale as vellum, had shrunken away till it seemed no bigger than a doll’s.
One morning my cobbler neighbour woke me by plucking at my pillow before the nurses arrived. ‘Numéro 57! ’– he flung his arms above his head. There was a light in the ward, enough to see by. I could see old numéro 57 lying crumpled up on his side, his face sticking out over the side of the bed, and towards me. He had died some time during the night, nobody knew when. When the nurses came they received the news of his death indifferently and went about their work. After a long time, an hour or more, two other nurses marched in abreast like soldiers, with a great clumping of sabots, and knotted the corpse up in the sheets, but it was not removed till some time later. Meanwhile, in the better light, I had time for a good look at numéro 57. Indeed I lay on my side to look at him. Curiously enough he was the first dead European I had seen.
I had seen dead men before, but always Asiatics and usually people who had died violent deaths. Numéro 57’s eyes were still open, his mouth also open, his small face contorted into an expression of agony. What most impressed me however was the whiteness of his face. It had been pale before, but now it was little darker than the sheets. As I gazed at the tiny, screwed-up face it struck me that this disgusting piece of refuse, waiting to be carted away and dumped on a slab in the dissecting room, was an example of ‘natural’ death, one of the things you pray for in the Litany. There you are, then, I thought, that’s what is waiting for you, twenty, thirty, forty years hence: that is how the lucky ones die, the ones who live to be old. One wants to live, of course, indeed one only stays alive by virtue of the fear of death, but I think now, as I thought then, that it’s better to die violently and not too old. People talk about the horrors of war, but what weapon has a man invented that even approaches in cruelty some of the commoner diseases? ‘Natural’ death, almost by definition, means something slow, smelly and painful. Even at that, it makes a difference if you can achieve it in your own home and not in a public institution.
This poor old wretch who had just flickered out like a candle-end was not even important enough to have anyone watching by his deathbed. He was merely a number, then a ‘subject’ for the students’ scalpels. And the sordid publicity of dying in such a place! In the Hôpital X the beds were very close together and there were no screens. Fancy, for instance, dying like the little man whose bed was for a while foot to foot with mine, the one who cried out when the bed-clothes touched him! I dare say Je pisse! were his last recorded words. Perhaps the dying don’t bother about such things – that at least would be the standard answer: nevertheless dying people are often more or less normal in their minds till within a day or so of the end.
In the public wards of a hospital you see horrors that you don’t seem to meet with among people who manage to die in their own homes, as though certain diseases only attacked people at the lower income levels. But it is a fact that you would not in any English hospitals see some of the things I saw in the Hôpital X. This business of people just dying like animals, for instance, with nobody standing by, nobody interested, the death not even noticed till the morning – this happened more than once. You certainly would not see that in England, and still less would you see a corpse left exposed to the view of the other patients.
I remember that once in a cottage hospital in England a man died while we were at tea, and though there were only six of us in the ward the nurses managed things so adroitly that the man was dead and his body removed without our even hearing about it till tea was over. A thing we perhaps underrate in England is the advantage we enjoy in having large numbers of well-trained and rigidly-disciplined nurses. No doubt English nurses are dumb enough, they may tell fortunes with tea-leaves, wear Union Jack badges and keep photographs of the Queen on their mantelpieces, but at least they don’t let you lie unwashed and constipated on an unmade bed, out of sheer laziness. The nurses at the Hôpital X still had a tinge of Mrs Gamp about them, and later, in the military hospitals of Republican Spain, I was to see nurses almost too ignorant to take a temperature. You wouldn’t, either, see in England such dirt as existed in the Hôpital X. Later on, when I was well enough to wash myself in the bathroom, I found that there was kept there a huge packing-case into which the scraps of food and dirty dressings from the ward were flung, and the wainscottings were infested by crickets.
When I had got back my clothes and grown strong on my legs I fled from the Hôpital X, before my time was up and without waiting for a medical discharge. It was not the only hospital I have fled from, but its gloom and bareness, its sickly smell and, above all, something in its mental atmosphere stand out in my memory as exceptional. I had been taken there because it was the hospital belonging to my arrondissement, and I did not learn till after I was in it that it bore a bad reputation. A year or two later the celebrated swindler, Madame Hanaud, who was ill while on remand, was taken to the Hôpital X, and after a few days of it she managed to elude her guards, took a taxi and drove back to the prison, explaining that she was more comfortable there. I have no doubt that the Hôpital X was quite untypical of French hospitals even at that date. But the patients, nearly all of them working men, were surprisingly resigned. Some of them seemed to find the conditions almost comfortable, for at least two were destitute malingerers who found this a good way of getting through the winter.
The nurses connived because the malingerers made themselves useful by doing odd jobs. But the attitude of the majority was: of course this is a lousy place, but what else do you expect? It did not seem strange to them that you should be woken at five and then wait three hours before starting the day on watery soup, or that people should die with no one at their bedside, or even that your chance of getting
