The Necessary Evil

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by André Couvreur


  “It’s a utopia,” said the young man.

  “No,” said Savre, “it’s not a utopia.17 Obviously, the organization of the system would be surrounded by real difficulties at first, but it would succeed, my friend. And then, what glory and was radiance for our profession, and how much more our elite, by virtue of their integrity, will enter into the development of contemporary philosophy and morality. For our role in life is very fine, my boy, and I don’t know of any more noble. By the very reason of that importance, it requires men capable of a kind of apostolate, free of egotism and self-aggrandizement. Yes, medicine is relevant to all the great social problems, it touches on all the arts, all virtues and all charity. The practice of medicine requires saints!”

  Savre stopped for a moment to ask the waiter for cigars. Boiling mocha filled their cups; bottles of various liqueurs were distributed on the white tablecloth, which had been changed at dessert. From a box of Havanas, Savre chose a sufficiently crepitant cigar for the student, and lit one himself. The blue-tinted incense rose in perfumed spirals toward the gilded ceiling.

  At that moment, a decorated gentleman came in, young in appearance and clean-shaven, with a black-rimmed lorgnon, escorting a rather pretty brunette wrapped in a red velvet pelisse trimmed with sable fur. He helped her to take off the garment, and then both of them sat down at a table with five settings reserved for them. When they were installed, facing one another, the lady noticed Savre, nodded to him, and then whispered a few words in the ear of her escort, who also turned round and greeted him. Savre responded with a rather cold nod of the head.

  “Who’s that?” Berger asked.

  “It’s one of my former comrades, when I was an intern,” Savre replied. “A Rumanian.”

  “Decorated?”

  “Yes, decorated—no one knows why. Because he’s Rumanian and Jewish. O noble and generous France! O Revolution! There’s another of your creations, the flashy foreigner to whom you accord your privileges and your medals for bravery. That individual, my dear Berger, arrived in France nineteen years ago, having made summary studies in his native country. He wanted to practice medicine, but as he couldn’t be registered with the Faculté, having no baccalaureate, he was hastily accorded equivalence. He therefore obtained his inscription, and, not being subject to the obligation of military service, since he was not French, had plenty of time to prepare for his internship, to which he was admitted. He therefore already enjoyed, at that time, prerogatives, a title, a salary and study facilities only attributable to French citizens who had accomplished their obligations and duties. I believe that, as he was not rich, he was even given a bursary.

  “So he passed his examinations and was accepted as a doctor. Then, as he was a foreigner, he was decorated. Why? Because his government, with whom he had influence, had demanded a medal for him, in the name of foreign entitlement. You can now see the shrewdness of the man. Once a doctor, and decorated, he was naturalized as a Frenchman, and as he had passed the age of active military service, he was appointed as a physician with the rank of major in the reserves. Thus, he’s a French officer. Well, my dear Berger, I say that we’re great imbeciles. What do you think?”

  “I share that opinion,” Berger replied. “But the law has been modified and such things are no longer possible now.”

  “Better late than never,” Savre concluded. “But that’s a good example of our national stupidity. We have in the depths of our French hearts a kind of need for abnegation, a folly of altruism that causes great prejudice to the flight of our national energy. And that dimwittedness is not peculiar to the medical profession; it’s rife throughout all the branches of society, eating away at the heritage that our ancestors acquired at the price of so much hard labor and blood.”

  Savre breathed out the smoke of his cigar and aromatized his coffee with a drop of fine champagne. Facing them, the lady accompanying the decorated colleague never took her eyes off them, perhaps attracted by the student’s pleasant physiognomy. The latter, embarrassed by the persistence of the observation, said to Savre: “And the lady who’s with him, who greeted you. Who’s she?”

  “I’m surprised to see them together,” Savre replied. “The parsimony of the one ought not to be in accord with the prodigality of the other. There must be some commerce behind it. The lady is a courtesan who no longer has any ovaries. She’s keeping up with fashion because, in a certain society, to employ a facile and oft-repeated joke, ovaries no longer bear fruit. She proclaims it loudly enough from the rooftops for me not to be betraying professional secrecy in revealing to you that she’s incomplete. It’s thanks to her that I left Caresco.”

  “How’s that?” asked Berger, interested.

  “For the simple reason that Caresco, in occupying himself with her, carried out an operation whose utility I could not see. That happens to him more often than might be expected. I don’t say that, my friend, to turn you against the surgeon…no. Go to his house and you’ll see admirable things there. But he operates too readily. When you’ve seen that for yourself you’ll leave him of your own accord.

  “So, one day, we were in the consulting room in the Avenue Hoche when we see that demi-mondaine come in with one of her lovers, a kind of prodigal imbecile, an inadequate man to boot, of whom she said to me afterwards—listen to this, it will amuse you—that he had neither a head nor a tail. Caresco interrogates her, examines her, and asks me to examine her. She complains of a few vague pains in the vicinity of the right ovary, but the examination reveals nothing very positive—nothing, at any rate, necessitating an operation. Afterwards, Caresco proposes the removal of the ovary. She accepts, begging him to take out both of them; that’s what she’s come for. The inadequate man supports her request, and the double removal is decided. Then, not wanting to be involved in that speculation, I handed in my resignation to Caresco, under some pretext or other.”

  “You did the right thing,” said Berger, “and I won’t go to work for Monsieur Caresco.”

  That was said with a lofty assurance that charmed Savre, and persuaded him of the rectitude of his young friend. He made a gesture of vague insouciance, however, and said: “Wait—judge for yourself. It’s possible that I’m mistaken. But during my collaboration with the surgeon, I was surprised by the truly incredible quantity of women who had him suppress their reproductive organs. Many of them were certainly suffering, carrying disease in their loins and its entire cortege of dolors and annoyances—but how many of them, with sage treatment, would have been able to avoid the horrible subtraction of their viscera!

  “I noticed that it was precisely those who, by virtue of their situation, their fortune and the ease of their existence, were best able to wait for a return to health who were the most impatient for such a risky cure. Are they so given to vice, so avid for the enjoyment of the life they prefer, that, instead of dragging things out as eternal casualties, they cast the dice of the operation on to the green baize of their life? Or is it that the surgeon that they seek out possesses, like our Caresco, such persuasive powers of speech, so convincing and enveloping, that he makes them envisage his intervention as a simple matter, facile, benign and necessary? Both, I think.

  “It’s obvious, however, that in this fin-de-siècle, the psychology of society is being subject to an evolution, and that science, the effects of which ought to lead hearts to such a radiant peace, has very disappointing results! That progress had led to this: that amour is becoming a science of methodical sensuality, calculated to the point that its excesses, which set aside still-susceptible consequences, in these incredulous times, put a brake on the breakdowns and follies of neurosis.

  “Once, in heroic times, that neurosis, avid for satiation, led to mysticism, to the ideal; now it leads to materialism, to sensation. It’s the eternal struggle of the ideal and the material, of faith and skepticism. Yes, skepticism has triumphed, and it is in that direction that the holocaust tends!”

  He stopped momentarily, selecting a bottle. “A glass of chartreuse,
my boy?” he said. “You can see that the infertile have their uses, all the same, since the Charterhouses manufacture this exquisite liqueur for us. You might, however, reply that they could do it just as well while perpetuating the race...” He smiled as he filled Berger’s glass and his own. Then, having moistened his lips with the gilded liqueur, he went on, more seriously.

  “All that leads to depopulation. You see, my dear chap. I have depths of chauvinism that certain intellectuals would qualify as absurd, but which make me regret seeing the population diminish so much in our France, when everywhere else, especially in the East, it is increasing in considerable proportions.

  “You’re smiling, Berger, and I believe that I comprehend your smile. It says to me: ‘Set an example.’ You’re right, and it’s wrong of me to remain a bachelor—but I’m afraid of marriage, my friend! Then again, I’m only thirty-three; all is not lost—and if I take a wife, I promise you that I shall have a fine family, with a host of children twittering around me and making my head ache with their screams. In that alone rests the happiness of the household.

  “But for that depopulation, menacing for the interests, and for the very life, of our nation, it’s not only necessary to seek an explanation in the general egotism that recoils before the responsibilities of a family, or even in the destructive effects of the maladies that are corroding our race, like syphilis and tuberculosis…no, it’s also necessary to seek the reason in the enthusiasm of our surgeons to operate, who, in the hospitals as in the city, for various reasons of interest—whether pecuniary interest or scientific interest—remove so many wombs and ovaries, rendering the loins of so many women sterile.18

  “That is one of the principal causes, and I’m frightened, my dear friend, of the profound scorn in which the majority of the virtuosos of the scalpel hold human life, both present life and future life consequent on reproduction. A little while ago, you cried utopia when I spoke about the idea of an order of physicians. I’ll go much further now, with regard to the particular case of operations on the female genital organs. I’d like a surgeon not to be able to perform an ablation without a special authorization accorded by four inspectors—two physicians and two surgeons—chosen from a kind of jury of special supervision, also recruited from all levels of the medical profession.”

  “But that’s impossible, my dear Savre!” exclaimed Berger, laughing. “No law authorizes such a manner of conduct.”

  “A law would be made,” Savre replied, climbing more enthusiastically the slope of his dream. “A law would be made. We have legislators for that! It would offend susceptibilities, you tell me? It would kill all personal initiative, entrench surgery in practices presently known? First of all, I believe that from the viewpoint of surgery, there isn’t a great deal left to learn: innovation is complete; nothing further can be produced but modifications of procedures—and then, it would be free for anyone to operate as he pleases once authorization is granted.

  “As for offending the susceptibilities of the few, to what extent can that be taken into account, when it’s a matter of the general interest, the vitality of a race? Would the regulation not have the result of reviving our crumbling prestige, which would be a good thing in itself?

  “Yes, once people laughed at physicians; Molière ran the gamut of facile jokes. Now, people no longer laugh at them; they fear them, consider them to be executioners, and the syringe that once appeared to be comical has been transformed into a menacing instrument of torture. And look at the repercussion on our profession: once, medical practice served as a stepping-stone for individuals of modest origin to rise into a superior class; at present, it seems to be the other way around.”

  Savre became excited as he spoke; his rude physiognomy was filled with an even greater rudeness, and Berger understood that he was unveiling his soul, the suffering of whose wound he was hiding beneath an amiable irony.

  As he finished speaking, he saw a pretty young woman come in, with an anxious and careworn face, who came to sit with the couple he had noticed a little while before.

  “Look,” Savre remarked. “That’s Stella, the singer from the Opéra-Comique who’s just come in. Stella…the star. A star who’s fading, for she seems very weary, poor thing. Partying to excess, or illness? Illness, probably, since she has no lover with her and is coming to sit down at a physician’s table.”

  The newcomer while responding to the smiles and attentions of her companions and smoothing the unruly curls of her hair, scanned the restaurant with her eyes, darting toward those unknown faces than recognized her the loveliness of her blue eyes, emphasized by dark circles, and her features, jaundiced by an intimate defect.

  “Look, my boy,” said Savre. “Fix the physiognomy of that Stella in your mind. She has uterine facies. That’s a woman suffering in her abdomen, I’m convinced of it.”

  And, to confirm his diagnosis, Mathilde de Guinac, the beautiful Tripe-merchant, came in, followed by Caresco, filling the room with her carnal presence. The couple distributed handshakes and nods of the head to the right and left, then came to complete the table with five place-settings at which Stella was seated.

  “And she must indeed have an abdominal disease,” Savre continued, in a low voice, “for the operation is in prospect, and will be decided by the end of the meal. You’ll be collaborating in it, my young friend. Be glad, for you’ll see falling between your feet a womb that’s famous from more than one point of view.”

  “I’ll preserve it in alcohol,” replied the student joker, “to remind me of the vanity of the pleasures of the flesh.”

  CHAPTER XVI

  There was the busy disorder of the conclusion of an operation. Berger, the student, who had been replacing Bordier for a week, was finishing the application of cotton wool and a large bandage to the thin body of Stella, the pretty singer, while the sisters hastened to take advantage of the patient’s unconsciousness to remove the chemise stained with blood and antiseptic fluid and slip on another that was immaculate.

  With a sigh of satisfaction, Armand Caresco, his arms bare and his face covered in sweat, abandoned the dangling subject to his aides; she was as limp as a rag, and her head, intoxicated by chloroform, was bobbing at the whim of the movements imparted to it by the torso. He bent down and picked up a lamentable fragment of flesh from among the cotton and linen that lay of the mosaic floor—the sacred viscera that he had just abstracted from the singer’s abdomen with his prestigious skill.

  Around him stood a few colleagues, and a novelist in search of a scene for his book. He deposited the dead, slippery, exsanguinated flesh, from which a few drops of yellow pus were still oozing, on a table and, taking a knife, made a series of deep cuts from which pus spurted. Then, in response to the seemingly-hostile expression of one of his colleagues, he felt a need to justify his operation.

  “You see, Messieurs, that it really was endometritis with double salpingitis. That patient has passed through all the hands of the Faculté. They would simply have allowed her to die. And people say that I don’t operate appropriately!”

  He turned toward the novelist, who had stepped aside, nauseated. “Isn’t it true, my dear Master, that all of this isn’t very pretty to see, and that it takes away the inclination to address sonnets to a woman?”

  The pale man of letters with the thick shock of hair smiled discreetly, like a superior individual who would prefer a nice rhyme to that display of butchery, exciting as it was. Then, before the threat of fainting, he thought it best to run away.

  The other spectators withdrew in their turn, disappointed at only having witnessed a single operation, which had only lasted ten minutes, instead of one of the legendary series that brought all Paris running.

  Soeur Cunégonde came over to Caresco. “Doctor,” she murmured in is ear, “Monsieur and Madame Savoie are in the reception room.”

  “Did you tell them that I was here?” the surgeon groaned.

  “I couldn’t do otherwise, Doctor—but Abbé Marnier is with them.”
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  The presence of the red-faced abbé, who was like a faithful dog, calmed anger that was ready to burst forth. Abbé Marnier was a friend of the house. Once operated on by Caresco for a grave malady, he had avowed a gratitude to his savior that was in accordance with the religious milieu of the establishment and the infantile practices of the sister. Every time a decease terrified a family, he came running, soothing and obliging, to pour out the good word, attenuating the shock of resentment and attributing to the account of the divinity a denouement that as imputable to the excessive temerity and recklessness of the surgeon. He was a good man otherwise, obscure and pious. Many priests had been brought to the house by him, had undergone operations gratuitously, and left blessing the lover of life and preaching holy advertisements.

  After washing his hands, Caresco put on a jacket and went to the reception room. He found the parents there in mourning-dress, the mother with a plaintive despair in her red eyes, the father somber and grave, holding an envelope in his hand. And when Madame Savoie saw the destroyer appear, who had so wretchedly promised the health of his son, now pale and icy, she burst into dolorous sobs, which, shaking her entire body, resounded with an ironic contrast in the large luxurious room, as if hurling a violently bitter reproach at all the wealth and gaudiness.

 

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