by Peter Ford
As a specimen of humanity, Merrick was ignoble and repulsive; but the spirit of Merrick, if it could be seen in the form of the living, would assume the figure of an upstanding and heroic man, smooth browed and clean of limb, and with eyes that flashed undaunted courage.
CHAPTER 12
The Figure in Time’s Fabric
As is usually the case with those who, in any sphere of life, have no fear of breaking eggs to make omelettes, Frederick Treves possessed enemies as well as friends. Those who admired him did so unstintingly, but he also had his detractors among his medical colleagues. Some considered he had built his career on a certain rather unprofessional flair for publicity. He certainly possessed a notably happy knack for being in the right place at the right time. Even one of his more ardent admirers, Dr D. G. Halsted, stated in Doctor in the Nineties that Treves first became famous because of the care he lavished on the Elephant Man. It is only one step from such a statement to the innuendo that he used his association with Merrick for self-advancement and showmanship. ‘The question is,’ Tom Norman asked bluntly, ‘who really exploited poor Joseph? I, the showman, got the abuse. Dr [sic] Treves, the eminent surgeon (who you must admit was also a showman, but on a rather higher social scale) received the publicity and praise.’
The shadow side of Treves’s benevolence undoubtedly existed but was naturally never touched on by him or any spokesman for the London Hospital. As a part of the gratitude he owed, Joseph Merrick had needed to be ever-available for inspection by medical students and emininent scientists as well as shown off to visitors and Treves’s friends and acquaintances. Tom Norman had heard a whisper that Joseph was far less happy with these circumstances and their dependence on charity than Treves ever implied or admitted. It even reached his ears that Joseph had sometimes asked, ‘Why can’t I go back to Mr Norman?’ Joseph’s omission in never divulging the fact of his mother and sister being crippled, his brother dead, may be put down to a suppression of painful memories for a complexity of reasons; but it may also in part represent a determination to preserve an area of privacy from the world, and even from Frederick Treves.
A milder accusation in circulation was that the hospital administrators had exploited Merrick as a publicity device in their fundraising campaigns. Meanwhile, in the streets outside, the people of the East End, mistrustful as always of the motives of authority, held for many years to the belief that the Elephant Man sold his body to the hospital in return for the care it offered him.
The public appeals made by the hospital on Joseph’s behalf, and Carr Gomm’s conscientious stewardship of the funds, make any business transaction involving the disposal of Joseph’s body seem unnecessary and unlikely. As for the Elephant Man’s publicity value to the hospital, it existed but was incidental. There is no evidence for any calculated or cynical exploitation in the dealings of the hospital and Frederick Treves with Joseph Merrick. To the question of whether Joseph’s unexpected return to the scene in 1886 contributed to the growth of Treves’s fame and fortune, however, the reply must be: very probably it did. Stephen Trombley, Treves’s biographer, confirms the phenomenal extent to which the case of the Elephant Man placed him in the public eye.
The line of development being taken by Treves’s career as a distinguished medical personality was well established by the time he first met the Elephant Man. The association is unlikely to have made much difference to his ultimate professional status, but in the context of Treves’s need to build up his private Wimpole Street surgeon’s practice (his surgical duties in the public wards of the London Hospital being unpaid), Joseph’s reappearance could hardly have been more timely. It is hard to believe that the flurry of public interest in December 1886 did anything other than draw his name to the attention of the rich and influential and enhance the prosperity of his practice. It may even have been an important stepping stone in bringing him to the notice of the Prince and Princess of Wales.
In other words, it must have contributed a significant momentum to Treves’s financial success, but only the most puritan moralist could blame him for unhesitatingly accepting his good fortune. The one valid question is whether his success in any way compromised his integrity as a surgeon, and that it did nothing of the kind is the decisive answer.
There is nothing to support any accusation that he deliberately set out to utilize his knowledge of Joseph Merrick’s case for financial gain. At the outset he can hardly have foreseen the course events were to follow and his preliminary investigations amounted to no more than a diagnostic foray to try to elucidate a mystery. Thereafter his only writings on or presentation of the case were exclusively to professional colleagues or in medical journals. Not until the last year of his life, long after retirement from active practice, did he publish his recollections of Merrick for a more general audience in The Elephant Man and Other Reminiscences.
Even while Joseph was still alive, Treves was continuing to add corner-stones to his career in the shape of his medical writings. His third book, Intestinal Obstruction: Its Varieties, with their Pathology, Diagnosis and Treatment, based on the essay which won him the Jacksonian Prize of the Royal College of Surgeons in 1883, came from the press in 1884 and was swiftly regarded as a medical source book. The next year he produced The Anatomy of the Intestinal Canal and Peritoneum, based on his Hunterian Lectures. The book represented the high point of his achievement as a surgeon writer, becoming a classic of medical literature. In 1886, he edited a three-volume textbook of surgery with contributions from thirty-five leading surgeons of the day, A Manual of Surgery by Various Authors.
After that he seems for a time to have abandoned the pen to concentrate more on the scalpel. A young engineer was admitted to the London Hospital in December 1886, suffering from typhlitis, as appendicitis was then known. The generally prescribed treatment at the time was complete bed rest, with doses of opium to relieve the pain and enemas to relieve the bowels. The engineer recovered after six weeks, but it was known that the condition would inevitably recur and could next time be fatal. Treves was therefore consulted for suggestions of an alternative treatment, and he recommended surgery. It was a controversial and bold decision in so far as medical orthodoxy considered that acute typhlitis should simply be left to run its course.
When he opened up his patient Treves found the trouble lay in a kinking of the appendix trapping mucus and leading to inflammation. As Treves prepared to remove the appendix and freed the peritoneal folds (the layers of membrane that line the abdominal cavity), the appendix sprang back into its normal position. Treves therefore simply sewed his patient up again and the man duly recovered, though he was kept under anxious observation for nearly two months. There was no recurrence of typhlitis in the engineer, and, so far as is known, this was the first operation undertaken in Britain to treat chronic, relapsing appendicitis. It made Treves a leading authority in this particular branch of surgery.
Meanwhile Treves’s reputation as a surgeon spread far and wide in fashionable circles. Sir Henry Irving consulted him when he inhaled the nozzle of a throat spray into his lung. He performed a desperate tracheotomy by the light of an oil lamp on the Victorian painter and president of the Royal Academy, Sir John Millais, who was a victim of throat cancer. Another rich patient, a Mr Fielden, donated £22,000 to the London Hospital in gratitude for what Treves had been able to do for him and the hospital built a complete isolation block on the strength of it. Mr Fielden then made further donations of £62,000 and left the hospital £100,000 in his will.
In the 1890s, Treves resumed his medical authorship, producing in 1891 a large two-volume textbook, A Manual of Operative Surgery, concerned solely with the practical aspects of treatment by operation. An abridged version followed a year later, and in 1895 his last full-length medical textbook, A System of Surgery, also in two volumes, was published. He was writing these during an intensely busy period as he continued to fulfil his duties as consulting surgeon to the London Hospital. He did not resign from his post there until 189
8, the year after Queen Victoria’s Diamond Jubilee celebrations.
A sequence of personal honours was now the inevitable corollary to the advances in his career. Following the outbreak of the Boer War in 1899, he saw service in South Africa as a surgeon to one of the field hospitals. He witnessed the relief of Ladysmith before a severe bout of dysentery laid him low. While he was still recovering, the Court Circular announced that Queen Victoria had been pleased to appoint Mr Treves as one of her surgeons-in-ordinary. Within a year the queen was dead and the Prince of Wales had succeeded to the throne as Edward VII. On 4 May 1901 the following announcement appeared in the Court Circular:
Mr Frederick Treves was introduced to the King’s presence when His Majesty conferred upon him the honour of Knighthood and invested him with the insignia of a Knight Commander of the Royal Victorian Order. Sir Frederick Treves who was Surgeon in Ordinary to her late Majesty Queen Victoria and is Surgeon in Ordinary to the Duke of Cornwall and York was recently appointed one of the honorary Sergeant Surgeons to the King.
Since the Royal Victorian Order is awarded personally by the monarch, and for services only to the sovereign and his or her family, it might have seemed that Treves was at the zenith of his ambitions. Yet only a year earlier a personal and ironic tragedy had struck at the family of this surgeon who was probably his country’s leading expert in acute appendicitis. His younger daughter, Hetty, was struck down by the condition at the age of eighteen, and became mortally ill. He called in two eminent colleagues, but they could only gently tell him that if he could do nothing for her then no one in the country could do better. Her death cast a shadow over all the years that followed, though his most dramatic encounter with appendicitis was yet to follow. When Edward VII became ill almost on the eve of his coronation in June 1902, appendicitis was diagnosed. It was decided that an operation on the king’s appendix was imperative if his life was to be saved and that the coronation must be postponed; it was Treves who stood by to make the historic cut and who drained the offending abscess, deciding it was not essential to remove the appendix itself. Twenty-one years later, in its obituary notice of the surgeon, The Times wrote:
Though Treves had eminent colleagues who supported him, he was in principal charge and the real responsibility for the operation and postponing the Coronation rested wholly on his shoulders. Only a man of inflexible resolution, perfectly convinced of the correctness of his diagnosis and proposed treatment, could have carried it through.
In Edward VII’s Coronation Honours List, Treves was one of those who received a baronetcy.
It surprised many that this was the point when, apparently at the height of his powers, Treves chose virtually to bring his medical career to a close. But, he had once said, no surgeon should operate after the age of fifty. His was to be no idle retirement: he retained his royal appointments and became involved, among other things, as a founder member of the British Red Cross Society and in setting up the Radium Institute in London to pioneer the uses of radium in British medicine. The wealth he had accumulated, however, meant he had no further need to work for a living, while King Edward had granted him the use of Thatched House Lodge in Richmond Park as a home. There had always been about him something of a writer manqué, but it is hardly possible to build up a literary reputation by composing medical textbooks, however elegant their phrasing.
A book for the general market, The Tale of a Field Hospital, had in fact come out of a series of field dispatches he sent home to the British Medical Journal from the war in South Africa, and it had met an encouraging reception. Others were to follow. In 1905 he published The Other Side of the Lantern, an often vivid collection of travel impressions accumulated from a round-the-world trip. It was reprinted five times in the year of publication. The next year he brought out his volume on Dorset for the Highways and Byways counties series. For over seventy years, it has remained a classic of regional topography. To write it he visited every town, village, hamlet and manor house in the county by bicycle, pedalling a total distance of 2,200 miles.
The bonds Treves felt for his native Dorset remained strong throughout his life. He had continued to visit the county at every opportunity, and it reciprocated his interest by electing him first president of the Dorset Society. In 1905 he took a house in Dorchester, close to Max Gate, the home of Thomas Hardy, and while there he developed a former acquaintanceship with the poet and novelist into a close friendship. The desk Hardy used for his writing throughout his life was originally bought from Treves’s father’s shop in the county town.
Other travel books came from Treves’s pen. A trip to the Caribbean produced The Cradle of the Deep (1908), and one to Africa resulted in Uganda for a Holiday (1909). A visit to the Holy Land produced The Land That is Desolate (1911), and then he undertook a close study of Robert Browning’s long narrative poem in an Italian setting, ‘The Ring and the Book’. This he described as: ‘One of the finest, most imaginative and most human poems of the nineteenth century … Some of the passages … are amongst the most beautiful to be found in any country or any age.’ He made an expedition to Italy to work out the topography of the poem, accumulating a profusion of maps, plans and photographs. The photographs he took himself (as he did for several of his other books), and was careful to take them not only in the places described by Browning, but at the right time of day and in the right season of the year. The result was eventually published as The Country of ‘The Ring and the Book’ (1913).
The outbreak of the First World War called a temporary halt to Sir Frederick’s literary efforts and he returned to official duties. Only after the war was he able to move his household to Switzerland, to live on the shores of Lake Geneva and once again to take up his pen. Two more books were produced, The Riviera on the Corniche Road (1921) and The Lake of Geneva (1922). But his health was showing signs of giving way, and only one more book was to come. This was the title by which he was to be longest remembered: The Elephant Man and Other Reminiscences (1923). He was suffering by now from a weakened heart, but had recovered remarkably from a bout of severe pneumonia in 1922. In early December 1923, however, a sudden chill developed into peritonitis, and by the seventh of the month he was dead. His body was cremated at Lausanne.
The Society of Dorset Men arranged for Treves’s ashes to be interred with appropriate ceremony in Dorchester cemetery, though a brief farce intervened when the customs refused to let the small container through unless they were shown the death certificate. Treves’s publisher, Newman Flower, recorded in his book of memoirs, Just As It Happened, how he invoked the name of the king and obtained a special order from the Home Office to get the ashes past this bureaucratic obstacle.
The ceremony was in due course held with a most distinguished gathering, on a day of foul weather amid sheets of driving rain. After moving off from the house in which Treves was born, 8 Cornhill, the funeral procession moved on to St Peter’s Church for a service, then arrived at Dorchester cemetery with its host of mourners. Lord Dawson of Penn represented the royal family; Newman Flower came for Lady Treves. Thomas Hardy himself had chosen the hymns for the funeral service, and determinedly went on to stand in the exposed cemetery, shaking with cold. As the rain poured down his face, the old man brushed aside the pleas of those who feared it would be his death. ‘I have known Treves since he was young,’ he told Newman Flower, ‘and I am going through with it.’
Once he was alone in his study later that night, the great writer who had transformed his native Wessex into an immortal and peopled literary landscape by his novels and poems, confided to his journal the sparest of impressions:
January 2. Attended Frederick Treves’ funeral at St Peter’s. Very wet day. Sad procession to the cemetery. Casket in a little white grave.
The experience of having known Treves, however, coalesced into ‘In the Evening’, a poem published in The Times two days later. Eventually, in its revised and polished version, it was included in Human Shows, Far Phantasies (1925), the penultimate volume of H
ardy’s verse and the last to be published during his lifetime.
In the Evening
IN MEMORIAM FREDERICI TREVES, 1853–1923
(Dorchester Cemetery, Jan. 2, 1924)
In the morning, when the world knew he was dead,
He lay amid the dust and hoar
Of ages; and to a spirit attending said:
‘This chalky bed? –
I surely seem to have been here before?’
‘O yes. You have been here. You knew the place,
Substanced as you, long ere your call;
And if you cared to do so, you might trace
In this grey space
Your being, and the being of men all.’
Thereto said he: ‘Then why was I called away?
I knew no trouble or discontent:
Why did I not prolong my ancient stay
Herein for aye?’
The spirit shook its head, ‘None knows: you went.
‘And though, perhaps, Time did not sign to you
The need to go, dream-vision sees
How Aesculapius’ phantom hither flew,
With Galen’s, too,
And his of Cos – plague-proof Hippocrates,
‘And beckoned you forth, whose skill had read as theirs,
Maybe, had Science changed to spell
In their day, modern modes to stem despairs
That mankind bears! …
Enough. You have returned. And all is well.’
The warmest tribute of all came from Queen Alexandra, the Queen Mother. She sent a cross composed of flowers gathered in her own garden at Sandringham, and with it a card bearing the inscription: