The Necessary Evil

by André Couvreur

  It was the second injection of the day. Soeur Cunégonde, unalarmed by the man’s sex, pinched the skin of the thigh, plunged the needle in horizontally, and injected the clear liquid. What compunction there was in that gesture, what generous commiseration in her expression!

  Every evening, the good sister injected the patients. It was so pleasant for her to think about the calm night that the poor sufferers would have, without the persecution of the blade, without the anguish that causes sudden awakening, gripping the throat and squeezing the heart, and brings forth the incoherent babble of fear. And then, did not that insomnia also entrain that of the sister, the nurse, who would be constrained to quite the soft warmth of the bedclothes to address reassuring words that would send the patient back to sleep?

  Yes, along with the injection, the good Soeur Cunégonde passed on a little of her devotion, convinced that the clear solution was truly a blessing of heaven, which, by means of those few droplets slipped beneath the skin, plunged the entire being into a profound forgetfulness, a blissful annihilation, a holy intoxication, a lacuna in life...limbo on earth, she often repeated to herself.

  They went into other rooms. Visits had already been carried out by Bordier; the dressings did not need disturbed again. The surgeon contented himself with taking pulses and looking at temperature charts. He also made a few banal comments, calmed anxieties with a smile. Some patients were accompanied by relatives, mothers or spouses, who stood up as he entered, serious, attentive and respectful. He bowed humbly, looking away, and then, before leaving, distributed reassuring words, the manna of hope. It was Faith that entered with him; his soul experienced a constant pride in that.

  In a room on the second floor he was struck by the insipid odor particular to suppurating wounds. The man in the room, who was poor, had undergone an operation a month before to remove a strange abdominal cyst, of an unknown nature, a large incision having been made in the abdomen without any attempt being made to seek the origin of the cyst. The man had been laid low as much by fever as by morphine. His skin burning, his cheeks red and prominent, collapsed on the bed facing the wall, he did not even turn round when Caresco came in. The latter took off the dressing. From a gaping hole circled by vinous flesh, a black and fetid pus was escaping through a rubber drain. Above the hole, the ribs displayed their arches, with which the skin seemed to have fused, so much was the poor devil eaten away by the malady.

  “The cavity is always washed thoroughly, Sister?”

  “Twice a day make boric injections. A great deal of pus comes out, and also a kind of black pulp. Monsieur Bordier thinks that he’s going to die.”

  “It’s necessary to make a counter-opening. The cavity never drains on that side.”

  He looked at the man, who still seemed lost in the mirages of his fever. Momentarily, he thought about giving him chloroform, to suppress the sharp pain of the new wound he was about to inflict, but was it really worth the trouble of disturbing so many people—the sisters, and Bordier—and wasting so much time for a simple stroke of the scalpel? He also reflected that the man was poor, hat he had carried out the operation gratuitously, that he would even have difficulty recovering the expenses of a stay in the sanitarium.

  “Bring the apparatus nearer, Sister.”

  The wheeled tale was pushed by the sister. He selected a scalpel from the tray and swiftly, profoundly, plunged it into the side. The man uttered an atrocious cry of surprise and pain.

  “Don’t move—it’s over.”

  He searched the depths of the flesh with long forceps, through the opening he had just made, shoved, and caused the apparatus to reappear through the first orifice. Between the jaws of the forcers he fixed a rubber drain, and pulled again, drawing the tube through the path he had just created. The man groaned dully; a tear ran through the gray hair on his hirsute face.

  Soeur Cunégonde took his hands and patted them. “Come on, Monsieur, calm down. Remember that Our Lord Jesus Christ also had his side pierced, and did not complain. And in his case, it was to save humankind, while in yours, it’s only to save you.”

  Oh! Our Lord Jesus Christ! The poor fellow was impressed by that! Already he had been reclaimed by his burning inertia; his limp head fell back on the pillow, his cheeks, paled momentarily by the unexpected pain, were covered in scarlet again. He sank into the empty gulf of his misery, insensitive to the cold jet that the surgeon caused to pass through his agonized and bloody flesh.

  “We’ll get him out of this, Sister,” Caresco said. “He did well to come and find us. He’d already be dead if he’d remained in the hands of the hospital surgeons.”

  In the moral as well as the physical sense, he washed his hands. He added: “The old woman’s gone, then?”

  “Yes, Doctor. She no longer had a temperature, but she was half-mad. She was talking about killing you.”

  He shrugged his shoulders. He felt uneasy, however. Although his conscience was anesthetized in remembering the dead, he feared the imprecations and reproaches of the living, only responding to them by abstention and flight. He went out on to the landing. From a door that stood ajar opposite, muttered prayers emerged, which caused him to suspend his march and held him there, hesitating.

  With Soeur Cunégonde behind him, he went into the chapel, a spacious room at the far end of which was an altar, with rows of simple benches in front of it. On the walls were naïve decorations, the work of the sisters, and the ex-votos of patients. Two sisters were kneeing down, praying aloud. One was old and let the act of faith fall indifferently from her lips; the other, whom he did not recognize, was young and pretty, pale beneath her head-dress. Caresco went to kneel down beside her, pretended to pray, and violated her purity with his desire.

  The son of Israel that he still was coveted the handmaiden of the Christian God momentarily. He judged her to be thin beneath her habit, however; he evoked his adipose mistress, and forgot the white head-dress. Then, five minutes having gone by, he crossed himself and left, followed by Soeur Cunégonde, radiant at the fervor of her new convert.

  He went downstairs, darted a glance into his study and the reception room, and then went back across the vestibule and into the operating theater. Dusk was beginning to extend its ashes over things. He switched on the electric light, and a bright sheet of light bathed the room. Under the blaze, the nickeled plaque of the sterilizer, the linen autoclave and the metal boxes lit up with white reflections. In a closed glass display case the shining instruments were lined up, their multivarious forms confused.

  A skillful scene-setter for the edification of colleagues, Caresco demanded that all those objects should always be scrupulously maintained and exposed to universal appraisal. No surgical establishment in Paris could offer such an assembly and such a variety of rare implements, the majority of which bore the seal of his inventive and practical imagination, and facilitated surgical interventions by means of ingenious modifications, appropriate curvatures and clever mechanisms, ornamented for all eventualities.

  He opened the display case, and picked up forceps, curettes and a probe at random, inspected them minutely. Not a single speck of dirt or stain of rust; everything was clean and correct.

  He replaced the objects in the glass cage, satisfied. “That’s very good,” he said to Soeur Cunégonde, who was expecting praise.

  At that moment Bordier came in, attracted by the unusual flamboyance of the room. He was still clad in his white smock, his arms bare and his hands reddened by caustic solutions.

  Caresco held out his hand. “Well, is everything going smoothly?”

  “Yes, apart from the man with the suppurating cyst. I thought of making a second opening; I’ve had chloroform prepared...”

  “No need. It’s been done without chloroform. He bawled a little…but that’s of no importance.”

  The wretch, who could have soothed the pain and had not wanted to! Bordier shuddered in revulsion. Should he, at that moment, hurl his resignation in his face?

  No, he would wai
t. He had changed his mind. He had seen the seven patients who had undergone operations a few days before showing very mild post-operational consequences. There had, however, been two interventions of an unexpected difficulty, two relatively desperate cases, and those patients were doing well, seemingly on their way to recovery. Caresco would have saved two lost lives. He did not think that anyone else, among surgeons of renown, was capable of having acted as brilliantly—with the result that, given his slightly impulsive character, lacking active resolution, afflicted with a versatility due to his pampered education, he had put off the moment of decision, wanting to conserve the hope of having served a useful and beneficent man.

  He forgot what Savre had said, believing that the skeptic in question had exaggerated the dark side of the situation, perhaps speaking under the influence of rancor, and resumed an unqualified admiration for the man touched by the wing of genius, of conceptions so vast, with such an organized brain and scintillating hand. He sought and found excuses for the faults that were the underside of his qualities; he forgot the treason of his gaze, the slackness of his handshake.

  He went into the next room to put on his city clothes, and then came back to Caresco.

  “By the way, did you know that Madame de Jancy is dead?”

  “Madame de Jancy?”

  “Yes, Madame Bise’s sister-in-law. The funeral is tomorrow. Are you coming to the ceremony?”

  “I don’t know…I don’t think so.”

  Madame de Jancy…the fulgurance of a memory caused him to see Madeleine again, fixed in her catalepsy, in the midst of lightning-flashes thunder and rain. What dominated that reappearance was the medical attitude of the young woman, the purity and vagueness of her blue eyes, the stiffness of her limbs, and their insensibility—not the abomination of the criminal act that he had committed. To his infamy, he accorded no concern; he no longer thought about it, as a vagabond forgets the chicken whose throat he has cut in a corner of a wood.

  Was he not, in fact, a vagabond too, a pariah on the earth, in the midst of all his scientific glory, devoid of friends, devoid of love, devoid of children, with no hearth other than one hired too cheaply for a mistress, pursued, ever unfulfilled, like his ancestor the Wandering Jew, across the inevitable stony ground of life, by the insatiable demands of his egotistical and ferocious heart?

  CHAPTER XI

  Aline Romé, Madeleine’s cousin, sitting at the table where she was eating lunch with her parents, seemed more impatient than ever that day to finish the meal. Distractedly, she listened to the conversation that had been pivoting for three days around the same subject: the death and funeral of Madame de Jancy.

  When the initial surprise had passed and the first tears had been dried, the family had gradually grown accustomed to the sad shock, and the concert of monotonous reflections was now attenuating, with lowered voices and weary, moderated gestures. It was like a remembrance, a prolongation of attitudes struck in the mortuary chamber before the pale and cold cadaver and behind the pomp of the coffin.

  Yes, the funeral had gone well, without a single discordant note. Madeleine had shown an astonishing resilience and courage; but she had been suffering since the event. The repercussion of the mental shock seemed to have struck her physically, and her stomach could no longer tolerate any aliment. Monsieur Cartaux, summoned to see the young woman, had not been unduly worried. Anyway, Aline could provide fresh news, since she had been to see her cousin that morning, in company with a chambermaid.

  “Isn’t that right, Aline?” asked Madame Romé.

  But Aline was not attending to the conversation. Staring into space, lost in the mirages of her reflections, she was kneading a piece of bread in the tips of her slender fingers. Her brown hair, her pale and delicate complexion, her vaguely-arched eyebrows surmounting the bistre of her eyelids went marvelously with mourning-dress, harmonizing with her somber costume.

  “Isn’t that right, Aline?” her father repeated, surprised by such inattention.

  She did not reply, content to inline her head in a melancholy fashion.

  “Come on, child, what’s the matter with you?” Monsieur Romé went on. “You’re not speaking, you’re not listening and you’ve scarcely touched your plate. What’s wrong my dear?”

  With the rebelliousness of a spoiled child, to whom everything is permitted, she replied: “You know very well what’s wrong, but you don’t want to admit it. I’m suffering from a liver complaint. Do you think it’s for pleasure that I leave my food—I can’t swallow it. I assure you that I can’t. I’ve got a stabbing pain here”—she pointed at the right side of her waist—and I can scarcely tolerate my corset. Yes, there...”

  As she plunged further into her explanation, she felt a blush invading her cheeks. Was she lying? No, not absolutely. But why was she obstinate in that fiction? Why was that young woman, healthy in body, born of sturdy stock, and thus far well-balanced herself, in spite of certain social frequentations that might have been harmful to her if she had not been protected by her education, so persistent in that absurd desire to be, and above all to appear to be, ill, without wanting to reflect on all the anxiety and sadness that the comedy might provoke among those surrounding her?

  Since the day when she had seen Armand Caresco for the first time, at Madame Bise’s country property at Les Bolois, she had never ceased to dream about him. The obstinately nasty rumors that had run around regarding the man’s morals, and even Madeleine’s appreciation, had not raised any obstacle to her thoughts. She attributed to the surgeon’s glory the faults that others found in him. Armand Caresco had mistresses? What man didn’t? His gaze was fugitive, his handshake limp? Timidity. He was a Jew? No, he had converted, and with what austere piety! He was avid for money? But was it not necessary to make the rich pay, for the sake of all the poor who could not pay anything?

  And then, what masculine beauty! How intelligent and serious his forehead was, dominated by the undulating forest of his brown hair, expressive of active will, the pride of triumph! And his teeth...how white and superb they were, how they quested for kisses—entire and profound kisses, such as, instinctively, she knew that the amorous must give them! Finally, how glorious he man was, in spite of his youth! How much some admired him, how bitterly others discussed him—that being another form of admiration! Yes, he was the Unique; it was him that she wanted, that she would have, to whom she would get close in spite of all the obstacles.

  However, she had never seen him again during the three months that had almost gone by. She had used her authority as a spoiled child to persuade her parents to abandon their country retreat sooner than in previous years. Back in Paris, in her visits, in the excursions in which she was entrusted to the guard of a chambermaid, at times when the surgeon ought to be in his consulting room, she had directed her walks along the Avenue Hoche.

  Seized by a sudden passion for trinkets, she had undertaken long stations in the shop of a local antiquary. From there, quivering, she had watched the coaching entrance of the sanitarium. Private carriages paused outside; a few people came in or out, who made her shiver. Then, when she could no longer decently prolong her conversation with the antiquary, when she perceived that the merchant was weary of making sales talk, showing her things whose value he talked up but which she subsequently rejected, she swiftly decided on a item that she bought with her savings—savings that were dwindling rapidly in that game—and left, carrying a parcel.

  She went past the house slowly, darting her gaze at the windows with all her will-power, endeavoring to see him through the curtains, clinging to the hope that he might draw them momentarily in order to give her the intoxication of an appearance. But hearts cannot speak through walls, and even aspirations as violent as hers could not pass through stone to awaken the attention of the desired individual. The façade always remained cold and banal, the curtains obstinately closed, the main door mute.

  One evening, after dinner, while her parents were in the small drawing room, yielding to the s
oporific joys of a game of piquet by the soft light of a muted lamp set on the green baize of the card-table, she, in the aggravation of the idle evening and her ever-discontented dream, had gone into the next room to run her fingers over the keyboard of the piano, seeking a release from her enervation in the sad languor of the vague sonorities of Grieg. As she rummaged through the piles of musical scores abandoned on the piano, an article in the Gaulois caught her eye.

  Under the rubric Académie de Médecine, the newspaper related a presentation by Armand Caresco relative to the surgery of the liver. The history of the diseases of that organ and their symptoms was recounted there at length. She read and reread every line, impregnating her brain with them, and, by searching hard, found in herself the elements of one of the maladies described there, under the label of cirrhosis. She experienced the phenomenon common to all those who put their noses into a medical textbook for the first time, and who, by a deception of which they are the sole promoters, feel the symptoms of the malady about which they are reading.

  In her, the discovery of her illness was aided by the desire to conserve the illusion. Was it not the only means of getting close to the surgeon? Why had she never thought of it before?

  That evening, she complained of internal pains to her parents. In the following days, the suffering grew worse; she lost her appetite, felt her strength ebbing away, became disgusted with everything. Dr. Cartaux, summoned by Monsieur Romé, had found nothing precise, and, attributing the troubles to a nervous state, had prescribed cold showers and a bromide to help her sleep. No improvement was produced, however. The young woman submitted to the cold water, but in the evening she threw the spoonful of potion into her chamber pot.