by John Berger
Later in the front room she sat down on the bed and allowed herself to ask the question for which she had really sent for him.
‘Doctor, can a woman of my age have heart trouble?’
‘It’s possible. Did you ever have rheumatic fever when you were a child?’
‘I don’t think so. But I get so out of breath. And if I bend down to pick something up, I can scarcely stand up proper again.’
‘Let me have a listen. Just pull up your blouse.’
She wore a very worn black lace petticoat. The room was as little furnished as the kitchen. There was a large bed in one corner with some blankets on it and some more blankets on the floor. There was also a chest of drawers with a clock on it and a transistor radio. The windows were overgrown with thick ivy and since there was no plaster ceiling and holes in the rafters, the room scarcely seemed geometric and was more like a hide in a wood.
‘We’ll examine you properly when you come up to the surgery but I can promise you now that you haven’t got a serious heart disease.’
‘Oh I’m so relieved.’
‘You can’t go on like this. You know that don’t you? We’ve got to get you out of here –’
‘There’s lots more unfortunate than us,’ she said.
The doctor laughed, and then so did she. She was still young enough for her face to change totally with her expression. Her face looked capable of surprise again.
‘If I won the football pools,’ she said, ‘I’d buy a big house and start a big home for children, but they say they make all kinds of difficulties these days for that kind of thing.’
‘Where were you living before you came here?’
‘In Cornwall. It was lovely there by the sea. Look.’
She opened the top drawer of the chest and from among her own stockings and children’s socks she took out a photograph. It showed herself in high-heeled shoes, a tight skirt and a chiffon scarf round her head with a man and a small child walking along a beach.
‘That’s your husband?’
‘No, that’s not Jack, that’s Cliff and Stephen.’
The doctor nodded, surprised.
‘I’ll say that for Jack,’ she continued, ‘he never makes no distinction between the kids that are his and those that are mine like. We share fifty-fifty. He’s better to Steve than his own father. It’s just that he can’t touch me.’
She looked at the photograph, holding it out at arm’s length.
The doctor asked whether she and her husband wanted to stay in the area and what would they think if he tried to get them a Council house. She answered without glancing away from the photo.
‘You have to ask Jack about that. We do everything fifty-fifty.’
Still holding the photograph she let her arm fall on to her lap and looked at the doctor, her eyes now angry.
‘Can you tell me if I’m too old? Jack says I’m too old. I only want it every two or three months.’
‘That’s all to do with your being tired and feeling you can’t cope.’
‘I’ve had a bellyful all right. Sometimes I think I just can’t go on. I just want to lie down and stop.’
She got up and put the photograph back in the drawer. ‘Do you like music?’ she said and switched the radio on. Then after a few bars, she switched it off. She stood there against the chest, a quite different expression on her face: as though switching the radio on and off had reminded her of something.
‘It just doesn’t mean anything to me. It doesn’t touch me. When he makes love to me it’s like a wet rag across my face. I know what real love is like you see. With the father of Stephen, when I got Stephen it was beautiful. We came together and I was able to come to him with all of me. I know what they mean when they say it is the most wonderful thing in the world, it was like that when I got Stephen because I could come to him and he wanted me like that. And I shall never forget it – I lie awake and think of it yet – because it has never been like that again when it was like heaven when I got Stephen.’
We fell in love with it ten years ago – for the view. And I must say we’ve never regretted it, not even in the winter. It’s so peaceful. Do you know last spring when I was walking along the path from the village I saw something standing in the front gate. I could see it as I turned the corner by the wood. It looked like a dog but it didn’t, if you know what I mean. And do you know what it was? It was a badger. It just stood there between the gate-posts and stared at me. I didn’t know what to do. Can they be dangerous? I just didn’t know. Hugh was playing golf and so I went to ask Mr Hornby, and he came back with me, but by that time it had gone. But that isn’t the end of the story. The badger has come to stay I think. He’s invited himself. You remember the deep snow we had last winter, I don’t know what we’d have done then without Mr Hornby, he cleared the path through the wood, otherwise you just couldn’t get through, it was up to my waist, and it was very cold too, the cold was cruel, anyway as I was saying in the night I used to hear something on the roof, something moving about, I woke up Hugh several times and he said it was the snow shifting but I knew it wasn’t because it was too cold you see for the snow to be moving, and in the morning I went to look and do you know there were his footsteps in the snow on the roof, would you believe it? I suppose he was so cold up there in the wood behind that he came down in the dark for a bit of warmth. He could have nestled up against the chimney – Hugh says not, but I’m sure he could – and got nice and warm. I often think of him up there when I’m sitting by the fire thinking. Of course it’s silly but you can see what I mean about it being very peaceful, can’t you? I mean you wouldn’t get badgers in Birmingham where we used to live when Hugh was still at work …’ she continues endlessly.
When she phones it is usually about him rather than herself.
‘I’m worried about him, doctor, he’s got a pain in his back and I think it might be a slipped disk. It all came on in that wet spell last week when he insisted upon digging the vegetable garden, the first chance for two months, he said, and now he can’t straighten up.’
Sometimes it sounds more serious.
‘He’s been in bed for three days and he has great difficulty in breathing. When he breathes at night – and I simply can’t get to sleep listening to him – I keep on thinking he’s talking, his breathing sounds like words, doctor.’
She is there at the door waiting.
‘I’m so glad you’ve come. His whole body is collapsing. I better let you talk to him yourself, because he won’t tell me what he’s complaining of, he won’t come out with it, he’s funny like that you know, he just says all his organs are going. Which? I say. What do you mean? But he won’t tell me, he just says all his organs.’
The husband, aged seventy-three, explains that he can’t hold his water and that he has some pain in the lower part of the abdomen. The doctor checks his chest and stomach. He does a rectal examination to feel the prostate and to discover whether any growth is pressing on the bladder. He tests the urine for sugar and albumen. The sugar is just problematic. He diagnoses a mild urinary infection.
Thirty-six hours later she phones.
‘He just can’t take any liquid at all now. He can’t drink. He hasn’t taken a drop since yesterday breakfast. And he keeps on falling asleep. Right in the middle of my talking to him he just falls off – I don’t know what to do. He just can’t keep awake, not even when I’m talking to him, he just falls asleep and then he’s sleepy and he falls asleep again even when I’m talking to him.’
The doctor smiles into the phone. Yet, just conceivably, if almost impossibly, the sleeping might be the beginning of a diabetic coma: the diabetes made manifest by the urinary infection. To be certain he must do another blood test for sugar.
At that gate where the badger stood, he pauses and looks down at the view with which they fell in love, and then he remembers her saying in a more intense, more sibilant voice than her ordinary one:
‘All we’ve got is each other. So we have to be very stri
ct. We watch over each other carefully when we are ill, we do.’
It is apart from the house: a building the size of two garages. It consists of a waiting-room, two consulting rooms and a dispensary. It is on the side of the hill which overlooks the river and the large wooded valley. From the other side of the valley it is almost too small to be visible.
On the door of the building is a notice which reads: Dr John Sassall M.B., Ch.B., D.Obst.R.C.O.G.
The consulting rooms do not seem clinical. They seem lived-in and cosy. But they are neater than most living-rooms and, despite their smallness, there is more clear space. This is the working area where the patient is examined or treated or manipulated.
The rooms remind one of a ship’s officer’s cabin. There is the same cosiness, the same ingenuity in fitting many things into a small space, the same odd juxtaposition of domestic furniture and personal effects with instruments and appliances.
All this makes the examining couch look like a bunk. It has two sheets on it and an electric blanket. Whenever patients are due, Sassall switches the blanket on a quarter of an hour beforehand, so that if a patient has to strip and be examined, it will not strike as cold. He has a fastidious sense for detail. He is a short man; the chair in which the patients sit is exactly six inches lower than his own chair by the desk. Before he gives an injection he says: ‘You’ll just feel a tap.’ As his hand comes down, holding the syringe, he opens his little finger and with the side of his hand flicks hard against the skin by the side of where the needle will go in a fraction of a second later, and this distracts the patient from registering the prick of the needle.
The surgery is unusually well equipped. There is stoving equipment for sterilizing and the instruments necessary for the suture of tendons, minor amputations, the removal of cysts, cauterization of the cervix, the application and removal of plaster for minor fractures. There is an anaesthetic machine: an osteopathic table: a sigmoidoscope. He says that he is constantly frustrated because he has not got his own X-ray plant or his own equipment for elementary bacteriology.
If possible, he always wants to prove everything for himself.
Once he was putting a syringe deep into a man’s chest: there was little question of pain but it made the man feel bad: the man tried to explain his revulsion: ‘That’s where I live, where you’re putting that needle in.’ ‘I know,’ Sassall said, ‘I know what it feels like. I can’t bear anything done near my eyes, I can’t bear to be touched there. I think that’s where I live, just under and behind my eyes.’
As a boy Sassall was much influenced by the books of Conrad. Against the boredom and complacency of middle-class life ashore in England, Conrad offered the ‘unimaginable’ whose instrument was the sea. Yet in this offered poetry there was nothing unmanly or effete: on the contrary, the only men who could face the unimaginable were tough, controlled, taciturn and outwardly ordinary. The quality which Conrad constantly warns against is at the same time the very quality to which he appeals: the quality of imagination. It is almost as though the sea is the symbol of this contradiction. It is to the imagination that the sea appeals: but to face the sea in its unimaginable fury, to meet its own challenge, imagination must be abandoned, for it leads to self-isolation and fear.
What resolves the contradiction and, in resolving it, places the whole drama on a level incomparably higher and more noble than the average petty life of self-seeking advancement, is the ideal of service. This ideal has a double meaning. The Service stands for all those traditional values which a privileged few who have faced and met the challenge esteem: esteem not as an abstract principle but as the very condition of practising their craft efficiently. And at the same time service also stands for the responsibility which the few must always carry for the many who depend upon them – the passengers, the crew, the traders, the ship-owners, the brokers.
Of course I simplify. And Conrad would not be the great artist he is if this were a fair summary of his attitude to the sea. But the simplification is enough to allow us to see why Conrad might appeal to a boy who was in revolt against his middle-class family background but who had no interest in becoming a Bohemian. He admired physical prowess. He enjoyed being practical and using his hands. He was inquisitive about things rather than feelings. He was stirred – like many boys of his class and generation – by the ideal of a moral example which might shame the opportunism of his elders.
In fact by the age of fifteen he had decided to become a doctor rather than a sailor. His father was a dentist and consequently he had the opportunity of meeting doctors socially. When he was fourteen he was already hanging round the dispensary of the local doctor: nominally helping to wrap up medicine bottles, actually trying to listen to the consultations taking place in the next room. Yet a doctor can well be imagined as the equivalent of a Master Mariner.
Sassall’s image of a doctor at that time was:
‘A man who was all-knowing but looking haggard. Once a doctor came in the middle of the night and I could see that he slept too – his pyjama trousers were poking out through the bottom of his trousers. But above all I remember he was in command and composed – whereas everybody else was fussing and agitated.’
Compare this to Conrad’s first introduction of the captain of the Narcissus:
Captain Allistoun, serious, and with an old red muffler round his throat, all day long pervaded the poop. At night, many times he rose out of the darkness of the companion, such as a phantom above a grave, and stood watchful and mute under the stars, his night-shirt fluttering like a flag – then, without a sound, sank down again…. He, the ruler of that minute world, seldom descended from the Olympian heights of his poop. Below him – at his feet, so to speak – common mortals led their busy and insignificant lives.
In both impressions there is the same sense of authority: an authority which pyjama trousers or a night-shirt in no way diminish. Or consider Conrad’s description of one of the worst moments in Typhoon. With the exception of the one word gale, it might describe the crisis of an illness, with the voice of Captain MacWhirr transformed into that of a doctor.
And again he heard that voice, forced and ringing feebly, but with a penetrating effect of quietness in the enormous discord of noises, as if sent out from some remote spot of peace beyond the black wastes of the gale; again he heard a man’s voice – the frail and indomitable sound that can be made to carry an infinity of thought, resolution, and purpose, that shall be pronouncing confident words on the last day when heavens fall, and justice is done – again he heard it, and it was crying to him, as if from very, very far – ‘All right’.
From such material Sassall constructed his ideal of responsibility.
During the war Sassall served in the Navy as a surgeon. ‘That was the happiest time of my life, doing major surgery in the Dodecanese. I was dealing with very real distress and on the whole making a success of it.’ In Rhodes he taught peasants elementary medicine. He saw himself as a life-saver. He had proved his skill to himself and his ability to take decisions. With this proof came the conviction that those who lived simply, those who were dependent upon him, possessed qualities and a secret of living which he lacked. Thus, whilst having authority over them, he could feel he was serving them.
After the war, he married1 and chose a remote country practice under the National Health Service, becoming the junior partner of an old doctor who was much liked in the district but who hated the sight of blood and believed that the secret of medicine was faith. This gave the younger man plenty of opportunity to go on working as a life-saver.
He was always overworked and proud of it. Most of the time he was out on calls – often having to make his way over fields, or walk, carrying his black boxes of instruments and drugs, along forest paths. In the winter he had to dig his way through the snow. Along with his instruments he carried a blow-lamp for thawing out pipes.
He was scarcely ever in the surgery. He imagined himself as a sort of mobile one-man hospital. He performed appendix and
hernia operations on kitchen tables. He delivered babies in caravans. It would almost be true to say that he sought out accidents.
He had no patience with anything except emergencies or serious illness. When a man continued to complain but had no dangerous symptoms, he reminded himself of the endurance of the Greek peasants and the needs of those in ‘very real distress’, and so recommended more exercise and, if possible, a cold bath before breakfast. He dealt only with crises in which he was the central character: or, to put it another way, in which the patient was simplified by the degree of his physical dependence on the doctor. He was also simplified himself, because the chosen pace of his life made it impossible and unnecessary for him to examine his own motives.
After a few years he began to change. He was in his mid thirties: at that time of life when, instead of being spontaneously oneself as in one’s twenties, it is necessary, in order to remain honest, to confront oneself and judge from a second position. Furthermore he saw his patients changing. Emergencies always present themselves as faits accomplis. At last, because he was living among the same people all the time, and because he was often called to the same cottage several times for different emergencies, he began to notice how people developed. A girl whom three years before he had treated for measles got married and came to him for her first confinement. A man who had never been ill shot his brains out.
One day he was called to a couple of old-age pensioners. They had lived in the Forest for thirty years. Nobody had anything very special to say about them. They went every year on the Old Folks’ Annual Outing. They usually went to the pub at about eight every Saturday evening. A long time before, the wife had worked as a maid in the big house of a near-by village. The husband had worked on the railway. The husband said that his wife ‘was bleeding from down below’.
Sassall talked to her a little and then asked her to undress so that he could examine her. He went into the kitchen to wait until she was ready. There the husband looked at him anxiously and took the clock from the mantelpiece to wind it. At this age if the wife has to go into hospital, it can be the beginning of the end for them both.
