The surgeon appreciated her, because she was indispensable to him. They were like two accomplices, lending their courage and abilities to the same cause, which consisted for the one of serving his personal interests and for the other in serving the community to which she was attached. Of an unexaggerated piety, and a cool and constant activity, she was, with a different objective, as accurate in calculation and as interested as Caresco.
Armored by her profession, she remained indifferent to the suffering of the poor wretches that came into the homicidal house to serve as subjects for the young surgeon’s experiments, but she had an astonishing compassion for the tribulations of the rich. He acne-ridden face did not pale at a death to which she had implicitly contributed; her pulse-rate did not increase and no anguish gripped her throat; but she had such a fashion of crying after an unfortunate result: “God has recalled her!” that the exclamation disarmed all hearts.
She had an intuition of the degree of grief that the families of the deceased were experiencing, and, basing her judgment on the verity or the fiction of that grief, always knew whether to say nothing or to offer her condolences—banal, to be sure, but those to which one always listens in moments of rude suffering. With an extreme skill, enveloping the temporary residents with seemingly irrelevant questions, she penetrated their intimate lives, their relations, their fortunes; she entered into their state of mind by means of a slow violation of their thoughts, and took possession of information that was often useful to her master.
She did not say much, but was very active, without ostentation, like a hand in the shadows. Nothing is the house remained unperceived by her, even things that she had never seen. Everything pivoted around her, and she gradually assumed the importance of an axle around which a machine turns.
In the depths of her soul, while sometimes suspecting that she was giving impetus to a frightful mechanism, she nevertheless devoted herself to the realization of a benevolent work—useful, at any rate, to the community of which she was the obscure and powerful servant. Under her orders, eight other sisters and the domestics were occupied in caring for the patients, maintaining vigils, cooking and cleaning. Caresco had understood the prestige that the presence of the sisters could offer him when a ferocious reaction had expelled them from the hospitals.
“Sister, would you be good enough to take care of this young patient, who is going to be staying with us for a while?”
Soeur Cunégonde had already embraced the young cripple. Caresco made a sign to her and drew her into the embrasure of a window.
“Well, the Baronne is a lost cause,” he said. “Has the family been informed?”
“I’ve sent for the abbé to administer extreme unction, but the family hasn’t been told.”
“Do so quickly, Sister—it’s time.”
“A doctor came a little while ago; he’s the Baronne’s physician. He wanted to see her. I refused, on the pretext that it’s not a custom of the house.”
“You did well, Sister. Colleagues must never…that’s all I need!”
As her master did not seem to be in a good mood, Soeur Cunégonde dared not tell him that the physician had gone away furious, proclaiming that he would tell the Baron everything.
Caresco left the farmer’s wife in the grip of the pious servant. He went along the corridor, his footsteps muffled by the carpet. As he went past the Baronne’s door, he could still hear the sound of groaning, disturbing the peace of the corridor. It was the Baronne uttering her last plaints.
He shrugged his shoulders. What did one more death matter to him? Had he not done everything he could to preserve the creature’s life? In truth, perhaps one might have dispensed with an operation, but that would have meant no more of a life for the poor woman than spending day after day lying on a chaise-longue. Then again, it would also liberate her husband, whom the company of an ever-suffering spouse would have plunged into an abyss of constant desolation.
In sum, logically, he had done well in attempting the operation, since its success would have cured the invalid, and in failing, he was saving her from a world of bitterness and pain.
Taking his reflections further, he considered himself a useful force. The work of death accomplished, the cadaver would be returned to the humus and would disintegrate in obscure conflicts, becoming pasture for new animal evolutions, infinitely small, which would be annihilated in their turn, melting into the earth to permit the birth of new beings. Death, which he assisted, served prey to life, in a monstrous cycle that destroyed some in order to create others.
Thus it was that he, Armand Caresco, played his role in Creation.
He went back down to his consulting room to continue his beneficent work.
Up above, Soeur Cunégonde haggled over prices with the farmer’s wife, while the lame boy hung on to his mother’s skirts, in tears at having to inhabit that calm and empty room, sensing fear and the unknown stir round his tender soul.
An ultimate cry of anguish from number six reached their ears.
CHAPTER VI
Soeur Cunégonde, who monitored everything, came up from the basement where she had gone to inspect the boiler, which was only lit in that warm season in order to heat the operating theater. That morning, Armand Caresco was conducting an operating session to which he had invited a considerable number of foreign surgeons attracted to Paris by the surgical conference.
When she reached the vestibule, Soeur Cunégonde opened a door opposite that of the reception room and went into a simple, narrow room which, solely furnished with a bed on wheels, was used exclusively for putting patients to sleep. She went to interrogate a thermometer attaché to the wall, and, observing that the temperature was not elevated, went to put her hand over the heating vent that was emitting warm effluvia in a corner. The current bathed her hand; she lingered in that warm caress for a minute, pleasant at the beginning of September. Then she went into the operating theater next door, pausing on the threshold to gaze at the ensemble.
It was there that Armand Caresco had set out on display all the luxury, so costly in its simplicity, of the surgical apparatus. There were no more tapestries, no more curtains, no more gilt, and no more furniture ornamented with futile sculptures, and yet, the eye was immediately seduced by the clean white harmony that everything emitted.
The operating theater was a room between eight and ten meters long and as many wide. The walls, rounded at the corners in order not to give any purchase to the dust that contained gems of infection, were varnished with white paint, and on one side, a large window fitted with frosted glass let in considerable daylight, further augmented by that of a skylight in the ceiling.
Sunk into the wall, a chamber for the sterilization of instruments added the bright note of its nickel. Placed methodically, white marble tables were aligned, covered by sterilized sheets, preciously protected by an impermeable envelope, and other tables, on which metal boxes filled with sterilized compresses were disposed, with trays designed to receive the instruments emerging from the sterilizer when the operation began.
In one corner, there was an autoclave for the disinfection of linen, and two wheeled carts with fountains containing antiseptic liquids for the surgeon’s hands. In an alcove next to the entrance door there was a bright white marble wash-basin, impeccably clean, with two taps for hot and cold water. Finally, in the middle, the adjustable operating table with its extended leg-guards and its system of nickeled handles and shiny gears.
In sum, there was nothing frightening in all that for the eye of someone in need of an operation. So Soeur Cunégonde gazed at the apparatus with interest, admiring above all the meticulous cleanliness of the remotest corners, the mosaic surfaces so easily washable, over which it was sufficient to pass a damp sponge after reach operation to remove the bloodstains and the human debris, and return them to their initial cleanliness.
She also inspected the operating table, which seemed so elegantly constructed, easily mobile in all directions, perfected in its slightest details and
able to give the body of a patient the most various positions, in accordance with the necessities of the surgical intervention. She experienced a certain contentment at that spectacle, like a factory worker in love with his work considering with joy the mechanisms that power his tools, or a painter gazing with satisfaction at the palette and brushes that are to aid his art.
Pressed for time, however, she undertook her customary tasks, arranging the bowls and the cloths, methodically putting the tables in their customary places, turning the rack of the operating table to raise it up slightly. Then, remembering that she had forgotten the scalpel, which was only disinfected at the last moment in order not to wear away the blade, she ran to the consulting room and came back with a box full of metal scalpels. She picked out several, tried the blades lightly on the skin of her index finger and then, having chosen one, she went to plunge it is a saucepan full of phenol that was boiling on a gas burner beside the sterilizer.
At that moment, someone knocked on the door, which opened to allow the appearance of an opulent mass, corpulent and bearded, surmounted by vast gold-rimmed spectacles and a top hat. It was a professor from Vienna by the name of Stermann, a surgeon celebrated in his homeland; passing through Paris he had come to watch Caresco operate. He came forward, holding out a visiting card to Soeur Cunégonde, who did not seem surprised by his arrival.
Foreign physicians often introduced themselves, attracted by Caresco’s renown—he was more famous abroad than in France, thanks to his discreet advertising, his publications in the journals of all nations, and his presence at international conferences at which French surgeons generally neglected to appear. No operation took place in his sanitarium without Caresco having a few exotic individuals around him.
He welcomed them in the most amiable fashion, showing himself full of concern and gratitude for them, showing them displays of curious anatomical specimens collected during his operations, knowing facts about each of his visitors, citing results analogous to theirs, always omitting to talk about his Parisian colleagues—the official scientists of the Faculté—or only mentioning them in order to take casual swipes at them, which brought an amiable smile to the lips of his listeners, for human nature is made in such a way that even distant glories always annoy local glories. Then, when they had been seduced by his charming attentions and dazzled by his operating skills, he often took them to dinner in some fashionable cabaret, continuing his work of fraternization with good food and wine.
When he was dealing with young people, future luminaries, he took them to Mathilde’s house for lunch; the food was less succulent and less costly, but the beautiful Tripe-merchant compensated for that defect with her usual camaraderie, with equal attentions and sometimes also with furtive hours of amour in some furnished hotel—sacrifices to her lover’s success, a devotion that swelled the savings she was squirreling away in secret. And all of them returned to their homelands with the name of Caresco on their lips, recommending their colleagues not to neglect, in their visits to the surgeons of Paris, the opportunity to watch the young French surgeon operate in his sanitarium.
That inflated his glory and augmented his fortune. Invalids from all nations were sent to him for consultations by the physicians he welcomed so graciously. Instead of simply giving his advice regarding the desirability of an operation, he surrounded these patients with cares, took possession of their will by virtue of the power of suggestion that radiated from his person and his speech, and, having sufficiently talked them round, operated on them. Sometimes, the foreign colleague was annoyed and wrote an indignant letter protesting against such methods, but Caresco always succeeded in excusing his conduct under the pretext of a complication that required an urgent intervention.
Meanwhile, the large individual with the vast gold-rimmed spectacles was having difficulty making Soeur Cunégonde understand. “Caresco…Caresco…” he jabbered. “Not French…not French...”
The sister beckoned to him to follow her. She took him into the reception room and left him there alone, gesturing toward an armchair in which he sat down heavily.
When the sister returned to the operating theater she found Bordier, who had just arrived, in the process of washing his hands at the basin. His jacket set aside, and his sleeves rolled up, he was scrubbing his arms and hands vigorously; soap foam was flying on to the parquet. The pallor of a bad night, entirely consecrated to the bitterness of the reflections suggested to him by the death of Baronne Spirs, further accentuated the thinness of his features. He watched the acne-ridden face of Soeur Cunégonde come in, scarcely responded to her bonjour, and no longer had the strength to address to her the few amiable words with which he usually gratified her.
An accomplice, that one, he said to himself, and it pained him to add: like me.
He applied a file to his fingernails, carefully, and then plunged his hands into a solution of sublimate, twice.7
At least, he though, as he exaggerated these antiseptic precautions, if any harm is done, it won’t be my fault.
He turned to Soeur Cunégonde, his forearms held apart from his body, avoiding wiping them.
“Let’s see, Sister, what have we to do this morning?”
“One kidney, two livers, a fibroma, a hysterectomy for a fibroma, a tubercular tumor on the foot, a resection of the shoulder and a skull,” Soeur Cunégonde listed. “You know—the little girl who has meningitis? Her grandmother brought her yesterday evening, on behalf of Monsieur Caresco’s father.”
Bordier had counted eight operations. “That will be a lot for one morning. Anyway, we’ll do what we can.”
He went to the sterilizer and opened the nickeled doors. Long flames of gas maintained a microbicidal heat there. Instruments of various firms—pincers of all dimensions, straight and curved needles, long and short separators, large and small probes, valves, curettes, scissors, gouges, hammers and saws, trocars and rasps, bizarre steel rods contorted according to the necessities of their usage and the imagination of inventors—disposed on iron latticework trays were receiving the immunity of asepsis pell-mell. With the aid of forceps, which he employed in order not to infect the instruments and not to be burned by them, Bordier selected a certain quantity from the heap and submerged them in trays filled with boiling phenol, the vapors of which impregnated the room, gripping the throat.
He inspected the sterilized compresses, the padding in the large nickel boxes, the antiseptic liquids in the mobile carts, and then prepared the threads of catgut and silk for the ligature of vessels, and horsehair for stitches. Then, having nothing further to do, he put on a white smock whose sleeves only came down to the elbows and sat on a stool to await Armand Caresco.
His eyes fell upon a large ivory Christ set above the door, who seemed, by the lamentable gesture of his crucifixion, to be protecting that apparatus, as grim as a torture chamber in the times of the Inquisition. Derision! It was in his name, under his cover, that the surgeon carried out his hazardous work!
In the vestibule, people were arriving. Introduced by a footman, they went to wait in the reception room. The bell rang repeatedly. Soeur Cunégonde was gladdened by that influx; her face blossomed.
“There will be a large audience,” she said. “That’s good. But Monsieur Caresco is late. He must have called in at the church to pray to the Lord to accord him success.”
And she began to tell her rosary beads.
Finally, Caresco appeared, apologizing for being late. His father, who was with him, had gone to join the crowd in the reception room, to ask them to be patient.
“Quickly, Sister, have the fibroma sent down. Bordier, be kind enough to begin the chloroform while I wash and change.”
A woman of about forty, with a bulging abdomen, and a face thinned out by malady and fear, came down, supported by two sisters, her legs weak. She was undressed in the next room and hoisted on to the bed. Her enormous abdomen formed a bump under the chemise. Bordier applied the chloroform compress; a glimmer of infinite anguish passed through her eyes.
She began to breathe noisily, struggled, rebelling with all the congested and vociferous tension of her being. Wisps of gray hair scattered, and she sank into an abysmal world from which she believed that she would never return.
After having lifted the patient’s arm, which fell back inertly, in complete resolution, he palpated the insensitivity of the cornea. Then he abandoned the chloroform compress to a sister and pushed the temporary bed of slumber toward the operating theater. The woman, heavy with the entire weight of her inertia, was deposited on the bed of the operating table; her legs were attached to the sleeves of the table-legs, her arms knotted so that she could not struggle—and Caresco, finally scrubbed, clad in a huge apron of waxed cloth, like an abattoir-worker, judging that he could begin work, left the room to go and fetch the foreigners.
“Come in, come in, Messieurs,” he cried, opening the door of the reception room, calming the impatience of the long wait with his presence.
The guests passed into the operating theater one by one. The surgeon, remaining close to the door to the vestibule, guided them with his voice and gestures…that way, and to the right...
To some, whom he knew, he extended the limpness of his hand; to others, unknown practitioners brought he knew not how, strangers who might not even be physicians—journalists, students or mere lovers of tragic spectacles—he accorded a slight inclination of the head, his eyes always fugitive.
That day, his famous reputation had attracted more than usual: about thirty. The frock-coats or black jackets, some bearing exotic decorations, group themselves in such a fashion as not to miss any of the young master’s gestures. In the meantime, he went to the wash-basin, and, the sleeves of his shirt having been rolled up by Soeur Cunégonde and fixed by means of special pins, he completed a final scrubbing of his arms and hands by steeping them in a solution of sublimate. Then, without wiping them, in order not to reinfect himself and to keep himself impregnated by antisepsis, they went to the operating table, on which the patient was continuing her noisy sleep, with the cornet of chloroform surmounting her pale face, over her nose.
The Necessary Evil Page 8