Beware of Pity
‘Of course,’ I said mechanically, and those were the first words that passed my lips during the whole of this story. Not only did I feel stunned by his astounding revelations, which had turned my whole idea of Kekesfalva inside out like a glove; but I was also appalled at my own obtuseness and stupidity. To think that I had been going about the world at the age of twenty-five with such unseeing eyes! During all these weeks I had been a daily visitor to the house, and, befogged by my own pity, I had refrained, out of a stupid feeling of delicacy, from ever asking either about Edith’s illness or about the mother who was so obviously missed in the house, had never asked how this curious old man had come by his wealth. How could I have failed to see that those veiled, almond-shaped, melancholy eyes were not those of a Hungarian aristocrat, but that their keen yet weary gaze reflected the age-long tragic struggle of the Jewish race? How had I failed to perceive that in Edith yet other elements were mingled, how failed to realize that over this house hung the spectral shadow of a strange past? In a flash I now called to mind a whole series of minor incidents, remembered with what a frosty stare our Colonel had on one occasion dismissed Herr Kekesfalva’s greeting, merely raising two fingers half-way to his cap, and how my friends had talked of the ‘old Manichaean’. I felt as one does when the curtains in a dark room are suddenly drawn aside, and the sunlight is so blinding that everything swims purple before one’s eyes and one reels in the dazzling glare of the almost inconceivable flood of light.
But, as though he had guessed what was going on in my mind, Condor leaned over me with almost professional solicitude, and his small, soft hand patted mine reassuringly.
‘You couldn’t possibly have known, Herr Leutnant; how could you? You have been brought up, after all, in a secluded world, a world apart, and you are, moreover, at the fortunate age when one has not yet learned to regard anything out-of-the-ordinary with immediate suspicion. Believe me, as an older man, I know there is no need to be ashamed of being taken in by life now and again; it is, if anything, a blessing not yet to have acquired that over-keen, diagnostic, misanthropic eye, and to be able to look at people and things trustfully when one first sees them. You could not otherwise have helped the old man and his poor sick child so splendidly. No, don’t be astonished, and, above all, don’t be ashamed — you have instinctively behaved in the best possible way!’
Hurling his cigar-stump into a corner, he stretched himself and pushed back his chair. ‘But now I think it’s about time for me to be going.’
I also rose, although I still felt somewhat dizzy. For something strange was taking place within me. I was agitated in the extreme, was even plunged into a state of heightened awareness by all the astonishing things I had heard; at the same time I was conscious of a dull pressure on my brain, a pressure on a quite definite spot. I remembered clearly that while Condor had been talking I had wanted to ask him something, but had not had the presence of mind to interrupt him; there had been some question I had wanted to put at a particular point in his narrative. And now that I was free to ask any question I pleased, I could no longer remember what it was; it must have been swept away in the excitement of listening. In vain I tried to trace back the thread of the whole conversation — it was just as when you feel a quite specific pain in some part of the body and are yet unable to locate it. As we crossed the now half-deserted public bar I was entirely taken up with the mental effort of trying to remember.
We stepped outside. Condor looked up. ‘Aha!’ he said, smiling with some satisfaction. ‘I could tell the whole time that the moonlight was too bright. We’re going to have a thunderstorm, and a pretty bad one too. We shall have to hurry.’
He was right. The air, it was true, still hung motionless and sultry over the sleeping houses, but dark, ominous clouds were chasing across the sky from the east, shrouding from moment to moment the pale, dying moon. Half the sky was already completely darkened; black as a giant tortoise, the compact metallic mass surged forward, now and again spangled by distant summer lightning, and at each flash came a low reluctant growl, like that of an angry animal, from the background.
‘In half an hour’s time we shall be for it,’ pronounced Condor. ‘I at least shall reach the station without getting wet, but you, Herr Leutnant, you had better turn back, or you’ll get a thorough wetting.’
But I was dimly aware that I still had something to ask him, although I did not yet know what; the memory of it was drowned in dull blackness, just as the moon above us was drowned in chasing clouds. I could feel a certain thought hammering at the portals of my brain; it was like a persistent, gnawing ache.
‘No, I’ll risk it,’ I replied.
‘Let’s look sharp, then. The faster we walk, the better. My legs are quite stiff after all that sitting about.’
Stiff legs — that was it, that was the clue! A light immediately flooded my consciousness. In a flash I knew what it was I had wanted to ask Condor all this time, what I had to ask him, what I had promised Kekesfalva to ask him. The whole time my unconscious had been busied solely with Kekesfalva’s question: was the child incurable or not? Now I must put that question. And so, as we strode through the deserted streets, I began somewhat diffidently:
‘Forgive me, Herr Doktor ... all you have told me is, of course, frightfully interesting to me ... frightfully important, I mean. And you will understand that for that very reason I should like to ask you something further ... something that has worried me for a long time, and ... after all, you’re her doctor, you follow the case as no one else can. I’m a layman, and can’t have any real idea ... and I should very much like to know what you really think about it. I mean, is this paralysis of Edith’s a passing illness, or is she incurable?’
Condor jerked his head up sharply, and his pince-nez flashed at me. Involuntarily I shrank from the vehemence of his gaze, which seemed to probe beneath my skin. Did he suspect that Kekesfalva had put me up to this? But the next moment he had lowered his eyes, and far from slackening his pace was striding out even more vigorously than before.
‘Why, of course,’ he muttered, ‘I might have expected that! It always comes to that in the end. Curable or incurable, black or white. As though it were as simple as all that. Even “well” or “ill” are words that no self-respecting doctor should utter with a clear conscience, for where does illness begin and health end? And he should certainly avoid such expressions as “curable” and “incurable”! Of course they are very common, both of them, and one can’t get along in practice without them. But you’ll never get me to utter the word “incurable”. Never! I know that it is to the most brilliant man of the last century, Nietzsche, that we owe the horrible aphorism: a doctor should never try to cure the incurable. But that is about the most fallacious proposition of all the paradoxical and dangerous propositions he propounded. The exact opposite is the truth. I maintain that it is precisely the incurable one should try to cure, and, what is more, that it is only in so-called incurable cases that a doctor shows his mettle. A doctor who from the outset accepts the concept “incurable” is funking his job, capitulating before the battle begins. Of course I know that it is easier, more convenient, to pronounce certain cases “incurable” and, after pocketing one’s fee, to turn one’s back on them with a sigh of resignation — indeed, extremely convenient and profitable to concern oneself exclusively with those cases that have been shown to be curable, in which one can turn up page so-and-so of the medical text-book and find the whole treatment set out for one in black and white. Ah well, those that care to can go in for that kind of witch-doctoring. As for me, it seems to me as pitiable a thing as if a writer were only to attempt to say what had already been said, instead of trying to force into the medium of the spoken word the unsaid, nay, the unsayable; as though a philosopher were to expatiate for the ninety-ninth time on what has long been known instead of tackling the unknown, the unknowable. Incurable — that is, after all, only a relative, not an absolute, concept. For a progressive science such as medicine incurable case
s are only so for the time being, within the time-limits of our own age, within the compass of our present knowledge, that is to say, within the limits of our restricted perspective. But it’s not a question merely of the moment. In hundreds of cases where today we know of no cure, tomorrow, the day after, a cure may be found, for medical science is, after all, making tremendous strides. So for me, you see, I would have you note’ — he said this irritably, as though I had offended him — ‘there are no incurable illnesses. On principle, I never give a case or a patient up, and no one will ever wring from me the word “incurable”. The utmost that I would say in the most desperate case would be that an illness was “not yet curable”, that is to say, that contemporary science had not yet found a cure for it.’
Condor was striding along so vigorously that I had some difficulty in keeping up with him. Suddenly he slowed down his pace.
‘It may be that I am expressing myself in too complicated, too abstract terms. It’s difficult to get these things sorted out when hurrying to catch a train. But perhaps an example will serve better to illustrate what I mean, a very personal example, moreover, and one associated for me with a very painful experience. Twenty-two years ago, when I was a second-year medical student, just about your age, my father, who had always been a strong, healthy man of untiring energy, and whom I worshipped, fell ill. The doctors diagnosed diabetes, one of the most horrible and malignant diseases that can ever afflict a human being. For no apparent reason the body ceases to assimilate nourishment, fat and sugar are no longer absorbed, and as a result the person affected wastes away and dies a lingering death from starvation. I won’t harrow you with all the details; three years of my own youth were embittered by this dread disease.
And now listen to this. In those days no cure whatever for diabetes was known to so-called medical science. The patient was subjected to all the tortures of a strict diet, every ounce of food was weighed, every mouthful measured, but the doctors knew — and I, as a medical student, of course also knew — that it was merely a matter of postponing the inevitable end, that for two, possibly three, years my father would starve slowly and miserably to death in a world teeming with food and drink. You can imagine how I, as a medical student, rushed from specialist to specialist, pored over all the books and monographs on the subject. But the only answer I could extract from either books or people was the one word that has ever since been unendurable to me: “incurable”, “incurable”. Ever since that time I have loathed the word, for I had to stand by, in full realization of my utter powerlessness to help, and watch the person I loved best on earth meet a more pitiable end than an insentient beast. He died three months before I qualified.
And now pay careful attention to what I say. The day before yesterday one of our foremost biochemists read a paper to the Medical Society in which he told us that in America and in the laboratories of one or two other countries attempts to find a gland extract for the cure of diabetes had met with considerable success. In another ten years, he affirmed with certainty, diabetes would be a curable disease. You can imagine how upset I was by the thought that had there been in existence at that time a few hundred grammes of a certain substance, the person I loved best on earth would not have suffered such torture, would not have died, or at least we should have had some hope of saving him. Try to understand what a terrible effect the verdict “incurable” had on me at that time, for I had dreamed day and night that a remedy would, should, must, be found, that someone would succeed in discovering it, perhaps I myself. Syphilis, which at the time when we students entered the university was, as we were warned in a specially printed memorandum, “incurable”, has also since become curable. Nietzsche and Schumann and Schubert and I know not how many more of its tragic victims did not by any means die, therefore, of an “incurable” disease, but of a disease that was not curable at the time when they lived — yes, if you like, it was in a double sense that they died prematurely. What new, unhoped-for, fantastic discoveries, which but yesterday were inconceivable, does not each day bring to us doctors! Every time, therefore, that I come across a case that other doctors have given up with a shrug of the shoulders, my heart is constricted with anger at the thought that I have as yet no knowledge of the cure that tomorrow, the day after tomorrow may bring, but it beats too with the hope that perhaps I shall find it, that perhaps someone will discover it in time, just in time, to cure my patient. Everything is possible, even the impossible — for where the medical science of today stands before a locked door another door is sometimes unexpectedly opened. Where our present methods fail, efforts must be made to discover fresh ones; and where science is of no avail, there is always the chance of a miracle. Yes, miracles happen even today in the world of medicine, miracles that are performed in a blaze of electric light, in the face of all logic and experience, and sometimes one can perform them oneself. Do you think I would torture that child and let myself be tortured, did I not hope ultimately to do her some real good, to pull her through in the end? Hers is a difficult case, I admit, a stubborn case; I have been working on it for years without making as much headway as I should like. But for all that I shall not give it up.’
I had listened with rapt attention, and had understood clearly all that he had said. But without realizing it, I had been infected by old Kekesfalva’s obstinacy, his anxiety and fear. I wanted to be told more, something more definite, more precise. And so I proceeded to question Dr Condor.
‘You think there is a possibility of an improvement, then — that is to say ... you have already achieved a certain degree of improvement, haven’t you?’
Dr Condor was silent. My remark seemed to annoy him. He stumped along more and more vigorously on his short legs.
‘How can you say that I have achieved a certain degree of improvement? Have you remarked it? And what do you know about the whole thing, anyway? You’ve only known the patient for a few weeks, whereas I’ve been treating her for five years.’
And suddenly he stood stock-still. ‘I had better tell you once and for all: I have achieved practically nothing, nothing of what I hoped to. I have experimented with her and tried this, that and the other thing just like a quack, to no purpose, utterly in vain. As yet I have achieved nothing whatever.’
His vehemence startled me; obviously I had touched him on the raw.
‘But Herr von Kekesfalva has told me how refreshing Edith has found the electric baths, especially since the injections ...’ I said, trying to placate him.
But Condor cut me short.
‘Nonsense! Arrant nonsense! Don’t let the old fool talk you into believing that! Do you really believe that spinal paralysis can be cured with electric baths and a lot of mumbo-jumbo? Don’t you know our old dodge? When we doctors don’t know which way to turn, in order to gain time we stuff the patient full of all sorts of gibberish and nonsense so that he shan’t realize we are at our wits’ end. Fortunately for us, in the case of most patients Nature helps in the deception and becomes our willing accomplice. Of course Edith feels better! Any form of treatment, whether it’s eating lemons or drinking milk, being ordered hot compresses or cold, at first brings about a change in the organism, and that provides a fresh stimulus, which the eternally optimistic patient mistakes for improvement in his condition. That form of auto-suggestion is our best ally, and even helps the biggest fools of doctors. But there’s a snag in the business. As soon as the novelty has worn off a reaction sets in, and then a rapid change of treatment is necessary, another fake cure must be invented. In “incurable” cases we doctors go on pulling off that sort of swindle until perhaps quite by chance we hit upon the right method. No, no compliments, please, I myself know best how little of what I hoped to do I have done for Edith! Everything that I have tried so far — make no mistake about it! — all this tomfoolery, this electrical treatment and massage, has literally failed to put her on her feet.’
So vehemently was Condor inveighing against himself that I felt impelled to defend him against his own conscience.
r /> ‘But ... I have seen for myself that she can walk,’ I interposed shyly, ‘thanks to your apparatus ... those stretching appliances.’
But at this point Condor no longer spoke, he positively shouted at me, so indignantly and hysterically, moreover, that two belated passers-by turned and looked at us curiously.
‘A swindle, I tell you, a swindle! Appliances to help me and not her! Those appliances are toys to keep her quiet, and no more. It isn’t the child who needs them, but I, because the Kekesfalvas refuse to be patient. It was only because I couldn’t stand his insistence that I had to inject the old man with another dose of confidence. What else could I do but hang those great weights on the child, as one puts shackles on the feet of a refractory prisoner? They’re quite unnecessary ... that is, they may strengthen the sinews a little ... but I couldn’t help myself ... I had to gain time. I am not in the least ashamed of these tricks and subterfuges; you can see for yourself how successful they are. Edith persuades herself that she can walk much better since she has worn the appliances, her father exults at the thought that I have done something for her, everyone is full of admiration for the marvellous genius and miracle-worker, and you yourself consult me as though I were an oracle!’
He broke off and removed his hat in order to pass his hand over his moist brow. Then he gave me a malicious sidelong look.
‘I fear you’re not altogether pleased, eh? I’ve destroyed your conception of a doctor as a helper of mankind and fount of truth? You in your youthful enthusiasm had had a very different notion of medical morality, and are now — oh, I can tell! — disillusioned and even revolted at the thought of such practices. I am sorry, but medicine has nothing to do with morals; every illness is in itself an anarchistic phenomenon, a revolt against Nature, and one must therefore employ every means to fight it, every means. No, no pity for the sick — the sick person places himself outside the law, he offends against law and order, and in order to restore law and order, to restore the sick person himself, one must, as in the case of every revolt, attack ruthlessly, employ every weapon at one’s command, for goodness and truth have never yet succeeded in curing humanity or even a single human being. If a deception helps, then it is no longer a shabby deception but a first-class remedy, and so long as I am unable to do any actual good in a particular case, I must try at least to help the patient to carry on. It’s no easy task, either, Herr Leutnant, to keep on breaking fresh ground for five whole years, particularly when you’re not too pleased with your own skill. In any case, I beg you to spare me your compliments!’