The Birth of Love (13 page)

Professor Wilson, I have now returned to my desk, and can resume my account. The heat here is fetid, and works against the concentration. But naturally one can write a letter, even under such conditions. I believe I had described to you how I decided to return to the asylum, to seek further conversation with Professor Semmelweis. It was late afternoon by the time I arrived back at that foul place, and I rang the bell for some time without gaining a response. Finally when the door opened it was clear that my return displeased Herr Meyer. He met me in the anteroom, and there was none of his false friendliness. Rather he was intractable and surly, and claimed at first that Herr S could not see me.

‘It is simply not possible,’ he said, shaking his head. ‘He has suffered an unfortunate relapse.’

‘I would like to see him anyway, if you would be so kind,’ I said, briskly.

‘You do not understand. He is in no fit state to receive visitors. Your visit this morning induced his collapse.’ As if otherwise poor Professor Semmelweis was kept in pristine conditions, in sublime equanimity, and it was only my visit which might be blamed for any diminution in his general health …

‘Then I should like to try to help him, to revive his spirits a little.’

‘I do not think that is a good idea,’ said Herr Meyer.

‘I assure you, I have information about his state that must be conveyed to him, if you have any compassion.’

‘The man is not to be informed of anything. The man is to be restrained from harming himself and others, and to be treated as I see fit,’ said Herr Meyer. He was becoming quite agitated himself, his face glowing with something I feared was combative glee, for men such as Meyer are oppressed by various forces themselves, and if they have the opportunity they enjoy a chance to assert themselves.

‘The man is called Professor Semmelweis, by the way,’ I said. ‘He is an esteemed doctor and I suggest you show him more respect.’

‘I shall receive no instruction on how to conduct myself in my asylum.’

‘You should need none, had you any moral sense to guide you.’

Had one of my friends not been a benefactor of this ruinous place – a matter which has been the cause of many disagreements between us, on the occasions when I have mentioned the maltreatment which is quite ordinary in this asylum – I do believe this vicious man Meyer would have thrown me out. As it was, he really had little choice, and so, clicking his tongue in fury, and refusing to speak further to me, he conducted me along the corridor. This time, Professor Semmelweis was slumped in his chair, his chin against his chest. He was still in chains. He was wringing his hands as he had done earlier, and I now realised this must represent washing, and must refer to his former researches and to his yearning for a cleanliness which his vile surroundings denied him.

‘Herr Meyer, would you be so good as to provide this man with some hot water, and soap, and a towel,’ I said. Herr Meyer looked at me in disgust, as if no inmate of his could have any cause for such things, but I repeated my request in a sharper tone, and he retreated with a bad grace.

I stood there, still uncertain about how to proceed, as the poor man wrung his hands and gazed into space. Or perhaps he was fixed on a vision I could not apprehend, but he looked inert and unstimulated, and for a while I felt quite overwhelmed by his state and the hopelessness of his situation.

Then I said, ‘Herr S, I visited you this morning. I do not know if you remember me.’

There was no response, and so I stood there silently once more, watching him for a time. He seemed quite unaware of my presence. I wondered indeed if he had suffered the final Great Reversal, and would never return from his wolf-light existence again. I thought it might be the case, that he had passed to the other realm, and could hardly comprehend me at all, just as his motives and beliefs were now obscure to me. And indeed I was not sure if this was so dreadful a fate for a man as troubled as Professor Semmelweis, to lapse entirely from the world that perplexed him, though I pitied his wife and children who longed, no doubt, to see him cured.

I was thinking perhaps I should leave the man to his demolition of the self, and hope that he found some consolation along the journey, but then something interesting occurred. Herr Meyer returned with a bowl of water, and a piece of grimy soap and a towel that was almost too disgusting to handle, yet I was obliged to accept them, having nothing else to
assist my cause. Expecting little from the gesture, yet moved to try nonetheless, I turned to Professor Semmelweis and said, ‘Sir, I thought perhaps you might like to wash your hands?’

At that, he looked up and regarded me with vague interest. The blankness, the emptiness of his expression, was replaced with something like recognition. He looked at the water, and then he took the soap. For a moment he paused. Then he placed his hands in the water. He shivered with relief. The effect upon him of the water was very palpable. He rubbed his hands vigorously with the soap and dipped them many times in the water.

‘You can leave us now,’ I said to Herr Meyer, and he departed with an angry scowl.

‘Sir, I think I understand your dreams of blood,’ I said.

‘I am afraid I do not know who you are,’ he said. He was still dipping his hands in the water, removing them to rub more soap upon them, dipping them again.

‘I came to visit you this morning. We discussed your dreams of blood and also your fears that you had committed a crime. Also you mentioned a woman with blue eyes whom you feared. Do you remember any of this?’

‘You came to visit?’

‘Yes.’ And I told him – once again – my name and the nature of my studies.

There was a splash as his hands entered the water again. He looked down at his fingers, moved them in the water, applied soap carefully to each finger. I pressed on, while he was relatively attentive.

‘You spoke of a man who had disturbed you greatly. Indeed the mere mention of his name caused you to fall into a sort of fit. So I shall not say it again. However, because of this name I believe I know who you are. I could tell you your name and your former profession, if you would like to know.’

I thought this would cause him to descend again, but he remained calm. He was splashing his fingers in the water, almost like a child, watching the ripples and bubbles he caused. Then he turned to me and said, ‘I believe I have already regained those details.’

‘You do?’

‘Yes, I have been thinking more clearly. I came round, as if from a long sleep. I do not know when I woke, but I was not alone. That man’ – he nodded his head towards the corridor – ‘was with me. I said nothing to him, yet I knew that something had changed. I had a kernel, just a kernel. It was as if someone had cried out to me, and they had spoken my name.’

‘Who are you, will you tell me?’

‘Of course, I have no regard for my reputation any more. It is simply not important. I believe my name is Semmelweis and I was once a doctor. I was a doctor but then I was quite rightly and justly deprived of my profession. It is right that I should be incarcerated, quite right, and better for everyone.’

This was a transformation I had not anticipated. Indeed I was unsure what to say for a moment, not wanting to disturb his new state. He was now almost measured; certainly there was something pensive, contemplative about him. He was splashing his hands, but there was nothing frenzied
about the gestures now; he was moving his fingers quite gently in the water.

‘I have been thinking about Aristotle’s concept of the soul,’ he was saying. ‘That its residence is in the heart, yet it is also the form of the body. It permeates the entire body, though emanating from a single point. And somehow I remembered the beat of a heart, heard through the skin. Two hearts, I recalled, the mother’s and the galloping pace of her unborn child’s. I remembered the beat of these two points, two souls, contained within a single body. I was thinking how curious it is, that a philosopher such as Aristotle had failed to consider what it is to be a pregnant woman, who contains another life point, another point emanating life to a body, within herself. Surely this must change our notion of the human form? Surely this must change our sense of bodily autonomy, when many a woman spends decades with another self – various other selves – contained within her, as she moves successively from one pregnancy to another? And I began to remember. Myself, I remembered myself, leaning over a woman who was rounded and immense with child. At first I thought it was my wife. I thought I must be remembering the birth of one of our children, yet then I saw a number of these women, and I saw myself again, passing from one to the other.’

‘What do you think this meant?’ I said.

‘I realised I had been a doctor. That was the first small revelation I was permitted. That I had been a doctor and that I tended to women in childbirth. Then suddenly I knew my name. I heard the women saying it to me, their voices full of fear and hope. At first I could not hear them clearly, but then their words – the single word – became clear to
me. They said it in tones of relief, that I had come – these women trusted that I could assist them, perhaps even save them. And all the while another voice was saying to me, “Do not approach them, do not, in your arrogance, approach them!”

‘In my vision I ignored this voice entirely, I continued to move from one to another, and gradually as I pressed my ear against the rounded mass of their bodies, I heard the hearts stop. The tiny galloping baby hearts stopped, and then the women threw up their hands and died.’

‘This is a dreadful vision,’ I said.

‘I think I have done something very grave, which is that I – in my small person – have somehow changed the course of many women’s lives, and of the lives of their children. And it is wrong for a single human to have wielded such power. Thereby I have insulted God, the ledger is marked, and I must suffer.’

‘You have done a great deal of good, I suspect.’ I said. ‘I can tell you, Professor Semmelweis, that you developed a theory about the way in which puerperal sepsis is spread. You argued that it was spread by the hands of doctors. That doctors infected women with this disease during internal examinations.’

‘Puerperal sepsis?’

I thought for a moment he would not be able to recall his medical expertise, and indeed for some time he stared at his hands, as he splashed them in and out of the water.

Then he shook himself, or shook involuntarily, and turned to me. His aspect was more animated now, and he said, ‘I forget your name.’

‘Robert von Lucius.’

‘Herr von Lucius, I must thank you. I confess I have
wandered greatly in my thoughts but now everything is clearer. You have supplied the crucial element I lacked.’

‘I am sorry but I do not understand.’

‘I am Professor Ignaz Semmelweis and my field was obstetrics. You are quite correct.’

‘And you worked …’

‘I worked in the First Division of the Vienna General Hospital. For several years. I am not sure when it was. I do not know the year at present.’

‘The year is now 1865.’

‘Then it was some time ago that I arrived at this hospital. Perhaps twenty years ago. I was young and I was a student doctor. I had not chosen obstetrics as my first profession. I would have preferred to study something else, but I think my family was not a wealthy one, and I had to accept whatever position I could obtain. I was an assistant to …’ Herr Semmelweis was now rubbing his forehead avidly, spreading dirty water across his face. And I hesitated, for I suspected this must be Johann Klein, and I did not want to lose him to another fit.

‘To the head of the lying-in ward,’ I said, hurriedly.

‘That is correct. His name will come to me. It is not important at the moment.’

‘But you worked as this man’s assistant during the 1840s?’

‘I believe at the time there was a terrible epidemic – when I arrived there was an epidemic. In the First Division it raged, this epidemic of puerperal sepsis. Childbed fever, that is what the midwives called it. Naturally we thought our definition more precise, yet the women died all the same, however we defined the disease. And it was clear that they died in greater numbers in the First Division, where
the teaching hospital was. The doctors worked there and their students. In the Second Division, which was staffed by midwives, and only rarely by doctors, childbed fever did not kill so many women. It was a mystery which tormented us all. The women would weep when they were told they must come to the First Division. I remember that. They knew they were being sent somewhere dangerous. They begged for their lives. The allocation was random – it depended on the day you arrived. They tried to wait, I remember. Some women would try to wait until the Second Division day before they came into hospital. Often they were too late and they birthed their babies on the streets. They brought them into the world while squatting in the gutters, but even this was less likely to cause them to die than coming to the First Division.’

‘This cannot have been the case.’

‘During times of epidemic, yes. The First Division was a charnel house. It was a breeding ground for death. It was horrible to see it. And yet now I forget the word they gave it. What was the word for this thing which killed the women?’ And he turned to me with a ragged expression. I perceived that he feared this period of lucidity might be fleeting, that he must glean as much information as possible while he could phrase questions and attend calmly to the answers.

‘Puerperal sepsis.’

‘Yes, that is it. I remember –
De Mulierum Morbis
– what is that?’

‘Hippocrates.’

‘Yes, that is right, and it says something, I must remember it.’ The horrible gestures had resumed, intensified by his desperation. He had become more urgent about the washing of his hands and so he had set his chains jangling again.
We waited, with only the noise of the chains between us. Then he said, ‘I have it … I think … “And so Thasus, the wife of Philinus, having been delivered of a daughter was seized with fever attended with shaking chills as well as pains in the abdomen and genital organs.” It is that. Something of that nature. And Thasus suffers agonies for twenty days after the birth of her daughter, and then she dies. Puerperal sepsis is an illness which takes the form of a fever, with a chill. The majority of patients manifest signs of the disease on the third day after birth. They have a headache, and cold fits followed by extreme heat, perspiration and thirst. Abdominal pain begins as a mild symptom but becomes increasingly severe. The pulse increases in pace, and the patient tends to lie on her back and appear listless. She loses her appetite. The tongue is usually white, though it can become dark and furred as death approaches. Respiration becomes laboured due to abdominal pain and distention, and the patient is nauseous and prone to attacks of vomiting. The production of milk is suppressed, though lochia continues. A few particularly unfortunate patients lapse into delirium and mania. During an epidemic, so-called, the mortality rate might be as high as eighty per cent, as opposed to a normal rate of twenty-five to thirty per cent. It is a monstrous disease. And these are women who a few days earlier were young, beautiful, at the height of their strength, birthing a child in all their vigour. The birth might have been entirely routine. Yet in the First Division every woman in labour was examined several times by doctors and students, for the purposes of research and teaching, even if their labour hardly required it. The students were often inexperienced, and sometimes they would push their hands clumsily into the women, hurting
them even as they writhed in the usual agony. Students and doctors would delve deep inside these women, and then the women would become ill.