The Necessary Evil

by André Couvreur

  No corner of the human body would then remain inaccessible to his scalpel; all those maladies, supposedly incurable because no one had dared go to do battle with them on location, would become susceptible to cure thanks to his innovations. Was not the human machine comparable to certain industrial machines that one dismantled in order to find the defective components, to change and improve them?

  In his dreams of devouring ambition, of apotheosis, he calculated the results of his scientific conquests: fortune, first of all, the millions brought into his coffers solely by dint of his talent and intelligence, without recourse to the dishonoring power of capital—for his entire edifice was built with his ideas and his fingers. What would the fabulous sum be of those masses of gold extracted from the inexhaustible mine that was his brain?

  To begin with, he would abandon his present house in the Avenue Hoche, which would become insufficient in the near future. On land that he would buy outside Paris, bathed in healthy woodland air near one of the outlying railway stations, he would commission the building, in accordance with his own plans and incorporating all the genius of his modifications, an immense sanitarium, a veritable model hospital for the rich, with several operating theaters, laboratories, spacious rooms, a park, all the perfections of a rich and luxurious organization.

  There, he would be able to suppress the undesirable proximity of the rich and the poor, and operate upon everyone according to their fortune. He did not even refuse himself the idea of also building a house for the unfortunate, whom he would treat gratuitously, or in return for very feeble remunerations—not with a humanitarian objective, but in order to possess another field of experimentation and demonstration, which would permit him to continue to invite foreign colleagues to witness astonishing manifestations of his surgical genius. There, he would form pupils: an entire innovative surgical school surging from his example would spread the publicity of his doctrines and his skill throughout the world.

  And who could tell whether, one day, the government, distressed not to be seconding such an active authority, might not seek to sanction the Force that threatened to take the pupils away from the hospitals, by consecrating it officially, by creating a special chair for the surgeon, like the one already created during the Empire for another scientist, also an Israelite?15 Then along with wealth, the manna of honors would fall, and he would only have to pick it up to satisfy his glory and gorge his ambition.

  And what bankruptcy for his enemies, the officials—what a muddy puddle in which he would enjoy seeing them flounder, as one sees inferior organisms battling in a miserable and repulsive conflict in a drop of dirty water through the objective lens of a microscope!

  Those ferocious ambitious ideas had always haunted his soul. He sometimes extended them to the worst limits, in moments of unhealthy excitement, after periods of hard work in which he had racked the fibers of his brain. It seemed then that he no longer had an accurate appreciation of the regions that he might attain, and his dreams bordered on delusions of grandeur. Some of the people who approached him at those moments were amazed by the flight of his ambition, and, like Dr. Savre, had the anxious suspicion of a mental unbalance. But Caresco recovered quickly, dominated even so by the sense of practicality, and it had required his strong and stupid passion for Mathilde de Guinac to drag him into the disastrous consequences of a debt of a hundred thousand francs.

  Now, resolved not to succumb to wretched financial embarrassments, he allowed a monstrous project to germinate within him. In fact, for the sum of sixty thousand francs that he still lacked, was he going to see the edifice that he had built with so much somber effort and shady endeavor crumble? Was a man of his stripe going to be defeated by something so trivial and fall back into the mud?

  No, he would fight, he would emerge victorious, by whatever means, in order to resume thereafter his surge toward the road of triumph.

  But before arriving at the worst solutions, he would make a supreme effort by the regular means that were even more pleasing to his character, stamped with a hereditary prudence.

  So, that day, he decided to go and see a few of his most faithful suppliers of operations, to ask them to hasten the execution of those that they had in suspense. Warmly wrapped up in his fur cloak, beneficent in the dry and frosty weather that covered the roofs, balconies and trees on the boulevards with a white glacis, in the caress of the air warmed by a hot-water bottle, he sank into a corner of his coupé and began his round of visits, like the representative of a large industrial concern visiting his clients in quest of business.

  He crossed disreputable thresholds, climbed dark stairways to penetrate into insanitary rooms in which “midwives,” matrons with dirty fingernails, were exploiting dolor and misery, correcting by somber practices the amorous imprudences of whom to whom social tyranny, shame or cowardice forbade a radiant maternity.

  Often, these abortive maneuvers resulted in further infirmity, an unfortunate whose organs of conception were no longer anything but a suppurating wound through which life and joy ebbed away in pus. It was Caresco who then magnified his role as benefactor by rendering them to health or eternity by an operation. And he approached those frightful matrons without disgust or repugnance, with the insouciant humor of a courtier touting for business, conscious that his work is honest and sure. Was it him who provoked the abortion, him who occasioned the horrible maladies? No, he was the savior, the skillful artisan who repaired the damage done by others.

  Generally, the harvest of these kinds of measures was not very fruitful, but it had sometimes brought wealthy women to his sanitarium who, after refusals met in the consulting rooms of physicians, had also had recourse to these birds of prey, into whose claws, terrified by the threat of a scandal, they had hurled themselves. It was in the hope of a similar windfall that Caresco pursued his visits tenaciously, welcomed by smiles of complicity, dirty handshakes in which there was an infamous understanding, criminal compromise and, in some cases, gratitude.

  At other times, his carriage stopped outside houses of a more bourgeois appearance. A marble plaque on the wall indicated a doctor’s residence, with days and hours of consultation. There, too, he found the slavish welcome of base collaborators, poor fellows uprooted from their native soil who had come to plant themselves in the Parisian mud, retained in the soil of the great city by mirages of luxury, hopes of a quick fortune, or even by habit, passion or vice that only the agglomeration and swarming of masses could allow them to dissimulate.

  He knew that these pariahs of medicine were reduced to the worst expedients, and that, in order to live, deprived of the subsidies necessary to await a clientele, they would accept his propositions. How many among these sons of ambitious peasants would have done better to remain in their fields pushing ploughs in order to fecundate he nurturing earth, breathing the healthy air of the woods, raising a happy and strong family instead of coming in displaced legions to swell the muddy tides of great cities, to attempt a frightful struggle, to waste in sterile efforts the purest radiations of their vigor and energy?

  Those reflections inundated Caresco’s mind while he climbed the staircases of those unfortunates, while he waited, before the empty seats of miserable reception rooms, for the appearance of men in black frock-coats with haggard features and unkempt hair, in whose faces he read the disappointment of having to deal with a colleague and not a client. But he, with his fine assurance, warmed them up regardless with a fire of hope and promises, insinuations of fruitful collaboration, enveloping them in his strange persuasion.

  All of them, conquered in advance by his renown, by the honor of his approach, promised to come and visit his operating theater, to witness his brilliant sessions. Unfortunately, for the moment, they had nothing to offer him; work was scarce, the struggle difficult. The free hospitals were draining the greater part of the clientele; the mutual societies were absorbing the rest. And from those bitter mouths and weary throats emerged plaints of injustice and discouraged explosions, with which Caresco mi
ngled his own, exposing his ideas of resistance and renovation, ironic paradoxes, and also anger against the great usurpers of medicine, the official parvenus who gave no thought to the humble, losing, as soon as they emerged from the beaten track, any idea of confraternity, any sentiment of union and commiseration.

  Certainly, he was not moved by such an implacable egotism, and he understood the needs and sufferings of the disinherited. They could, therefore, confide their surgical interventions to him without fear; he would know how to show his gratitude effectively.

  He concluded the tour of his visits under an impression of lamentation and ruin. The sadness of all those wretches had made its mark on him, and his soul oscillated momentarily toward distress. But there was only a minute of discouragement, and his arrogant temperament hoisted him up again toward triumph. Even supposing that things were going badly, did he not still have ten days before the due date of his settlement with Israel? In ten days, he would find the fifty thousand francs that he lacked. The next day, he would operate on the Savoie child and Aline Romé; those two operations alone, counting ten thousand francs each, would reduce the deficit to thirty thousand.

  And afterwards?

  Afterwards, he heard again, with an intense verity of sound, the voice of Madame Bise, who had said to him not long ago: “You’ll have saved us all,” when he had affirmed that an operation was unnecessary in Madeleine’s case. The old woman would reappear, pressing his hand, moved by an intense desire to see her other niece also fall into his clutches—and that desire would respond to a shameful project that he had already secretly caressed.

  What explanation was conceivable of the psychology of that confidence, the abandon—which was not critical, because it was absurd—that was driving the aunt to bring him, bound hand and foot, another victim for immolation? What mental breakdown was impelling her? But history is full of such instances of alienation: the holocausts of which the Bible speaks, the sacrifices of religions, the legendary abnegations of the neurotics of Faith are proof of that.

  Madame Bise’s Faith was in her surgeon; no salvation was possible without him, without the intervention of his genius, and she was about to push her niece toward an abomination, as she would have offered herself to it if Caresco had only made her suppose that she ought to submit herself to his healing practices.

  And he allowed himself to be invaded by the possibility of an iniquitous realization. Why not, after all, operate on Madeleine? All the considerations exciting his deceptive soul led him to that conclusion.

  In the first place, he thought about his personal security. Independently of the considerable sum he could solicit, which would almost full the gap in the hundred thousand francs, might someone not, one day, by counting the months that had elapsed, establish the exact date of the crime, and remember that he had been the only one to go near the girl during the abominable moments when catalepsy had rendered her defenseless, unconscious, like a blind object?

  Evidently, absolute certainty would be impossible, but powerful presumptions would impose themselves, and then, of what resentment, of what hatred, would he be the object, on the part of Georges Ponviane, when the latter realized his fiancée’s condition, and when he divined, after maddening explanations, that only Caresco had been in the conditions favorable to the perpetration of such a crime?

  Then again, humanely, would it not be an act of charity and pity to suppress the cause that might lead to such a disaster in two hearts, and determine the ruination of two young people, equally handsome and equally radiant with life and love? Could one tell to what extremes those excited brains might go? Might they not conceive the idea of terminating an existence that had become impossible, now that a monstrous barrier had arisen amid their intoxication, by a common death? Other examples had been seen, in instances less abominable than the problem of fear and misery that was seething in the surgeon’s brain.

  The more he thought about it, the more imperative the solution became, seeming sure, natural, logical and beneficent. For it is necessary not to forget the scorn in which Caresco held human life. Would he, who, in order to satisfy his cupidity or vainglory, or is need for science and research, did not hesitate to subject organized beings, unities of life, to the risks of operation and anesthesia, hesitate to suppress an embryo, a scarcely-fecundated seed—and it might cost him so much, that seed!—when it was a question of safeguarding his own future, effacing a with a thrust of the scalpel a crime, an absurdity, which he had committed in a moment of recklessness, and also, of sparing from the distress and agony of a separation two hearts that adored one another?

  Then again, his triumph before everything: the abomination of the means to be employed foundered before the result. He had always envisaged himself as a general determined to win a battle, who engages in conflict ferociously and implacably, and will not recoil before any consideration or any sacrifice.

  Already, he was interpreting the nature of the operation that he would attempt, the method of choice, that famous abdominal hysterectomy, so fortunate and so brilliant between his fingers. Already, while his trotter, driven by the coachman, was bringing him rapidly back to Mathilde’s house through the arteries hardened by frost, through the crowds wrapped up against the cold, hastening in all directions to their pleasures or their struggles, amid the comings and goings of carriages that enabled him to perceive, in brief flashes, grave anxious faces or the muffled profiles of pretty women, he was evoking the vision of Madeleine extended on his operating table, her face pale, her abdomen open.

  Before him, bare-armed, his torso covered in a white apron stained with blood, there was an aide who was not Bordier—for Bordier must be kept away from it at all costs. He would recruit to assist him, for the occasion, one of those young students or inexperienced doctors by whom he was always surrounded, and under whose eyes he could disguise the operation, passing off the gravid uterus as one of those fibrous tumors that were so frequent.

  At the most, by reason of the inexperience of that occasional aide, the operation would take a few minutes longer. Was it not his custom to operate almost alone? And what a triumph, finally, what security for the future, when, the anatomical specimen having been dissimulated and destroyed, he could return that young woman to her family, to her fiancée, cured, healthy once again, and lull them all with the hope of an impossible fecundity, the hope of a strong and beautiful lineage emanating from two beings so pure and amorous!

  Then again, in the tragic procession, he would find once again a temporary altar for his pride, at which to breathe in the incense of adulation, and depart thereafter buoyed up, reconciled with fortune, toward further adventures.

  But Bordier had to disappear.

  A letter that he found in his mail on re-entering his mistress’ residence furnished him with the pretext for sending him away. The letter had been sent by a lady living in Bordeaux. A few months earlier, she had traveled to Paris for the express purpose of having him remove gallstones from the bile duct. The skillfully-executed operation seemed to have succeeded at first, and the lady had gone home blessing the surgeon, and proclaiming the victory so loudly that two of her friends had also had recourse to Caresco’s talents, for different reasons. Some time ago, however, the malady had recurred and the phenomena of biliary resorption, fever, and an entire cortege of alarming symptoms had frightened the lady, who was begging the surgeon to come to see her in order to attempt a further intervention.

  As he read the missive, Caresco once again felt brushed by the wings of fortune, which, of its own accord, without his solicitation, was flattening the obstacles in his path.

  Immediately, he wrote a note to Bordier asking him to leave for Bordeaux without delay, to follow the rich client, to spend a week with her and to summon him be telegram if a new operation were really necessary. He added that, by reason of the shortage of patients, Bordier’s collaboration was not indispensable to him for the moment, and that if would have recourse to a temporary aide if the need arose, Nor did he neglec
t to add that the case was particularly interesting and that he was counting on the friendship and devotion of his collaborator to accord the client who was requesting his aid not merely the solicitation of a physician but also that of a scientist. And he sealed the letter with an ironic smile.

  He often decorated his maleficent actions in that fashion with a hint of icy humor, which was characteristic of his soul, afflicted by a perversion akin to insanity, in the same way that a lunatic in a madhouse might caress with a rictus the imaginary dagger with which he intends to stab his guardian.

  When Bordier received Caresco’s note he was at table, finishing his dinner. With a newspaper before his eyes, he was consuming the frugal meal, which the domestic had arranged around him, within arm’s reach, without thinking about it. Reading whiled away his solitude, filling the void at the table, preventing him from thinking about the bitterness of a life without a wife and children. He picked up the letter that was held out to him distractedly, his brain still impregnated with the lines that he had just scanned—but when, after having glanced at the envelope, he recognized Caresco’s handwriting, his attention awoke.

  As soon as he read the first words, he felt a kind of relief at being sent away from Paris, far from the house of stress—an unconscious surge of egotism that made him rejoice in not having to take part in the operation on Aline Romé, which he deemed to be wrong. His mind, exempt from dishonesty, as limpid as his blue eyes, could not conceive of the surgeon’s strategy. He took pleasure in the project of going to see Bordeaux, of according himself a respite in his resolution to separate from the surgeon, to resume his former way of life, of serious and honest labor.

  He gave the maidservant a few instructions with regard to his departure, consulted a timetable, decided to leave early the next morning, wrote a few words of consent to Caresco, and then finished his meal with a better appetite, his heart freed from the heavy burden of indetermination. A conflict was still racking him, though. He wondered whether he had the right to abandon Mademoiselle Romé at the moment when the influence—modest, in verity—that he had over Caresco might yet persuade him to renounce an endeavor that was not justified by the young woman’s condition.