Cries from the depths

Reflections on sickness, as warning of our own mortality or as metaphor of civilization’s sins, began with the biblical plagues. Three recently published books, whose writing spans a full century from 1887 to 1987, remind us that illness is a period piece. Time and place define our maladies, along with their treatments, determining how dire is our case and, crucially, who shall be saved.

Struggling to find a language of sickness, one not hobbled by metaphor, all writers acknowledge defeat. “No words to express it, only howls of pain could do so,” Alphonse Daudet wrote. Novelist, playwright and journalist, Daudet was a longtime resident in a particular country of the sick, that of syphilitics whose compatriots included many of his literary betters, Baudelaire, Flaubert and de Maupassant, to name a few. “When everything is over, when things have calmed down,” he continued, “[words] refer only to memory, and are either powerless or untruthful.”

Daudet, who died in 1897, is the only one of his fellow sufferers known to have kept a journal of his disease, jottings that map the shrinking terrain of this progressive, agonizing and, in those days, largely mortal illness. “In the Land of Pain” is a new edition of these notes, rendered into graceful English and knowledgeably introduced by novelist Julian Barnes, author of “Flaubert’s Parrot.” Contrary to Barnes’ claim, his is not the first translation into English; in 1934, 37 years after the author’s death and four years after his family allowed the text to be published in France, a Daudet specialist at Yale translated the notes as “Suffering.” The one-word title of the earlier version alerts us to a tense telegraphic style closer to Daudet’s entries, which seem to have been penned in haste, before the writer’s next spasm. No English word, however, can yield the associations of the French title, “La Doulou,” Provencal for douleur, pain. In the dialect still spoken by peasants in the Provence of Daudet’s childhood, doulou, with its suggestion of a diminutive, addresses pain as an intimate familiar presence.

Recently given new life by AIDS, syphilis has killed millions since its emergence in the 16th century. And like AIDS, the origins of the disease in the New or Old World are still in some dispute. In Europe, despite the vast numbers of those afflicted in mind and body, syphilis, no less than AIDS, was stigmatized, its victims adding shame and secrecy to their sufferings. Syphilitics in the 19th century, Daudet among them, were likely to be solid bourgeois, husbands and fathers, wives and mothers, for whom denial of infection, along with the double life the disease exposed, involved a family conspiracy. Cloaked in euphemism, syphilis even had its own coded diagnosis: The later degenerative symptoms were attributed to a “disease of the marrow.”

What made the affliction especially cruel was the long period of dormancy, years in many cases, that followed its onset, which was confined to the genital area. When the primary infection disappeared, the victim could forget about the time bomb that ticked, in the form of neurosyphilis, waiting to destroy the brain and/or spinal cord; the dreaded paresis, whose symptoms appeared as insanity, and jabes dorsalis (literally, a wasting of the back), the motor ataxia that caused loss of control in the limbs, accompanied by excruciating pain.

Daudet begins his account in the past: “Warning signs going back a long way. Strange aches; great flames of pain furrowing my body, cutting it to pieces, lighting it up” before moving to his present sense of being encased in armor “ ... like a hoop of steel, cruelly crushing my lower back. Hot coals, stabs of pain as sharp as needles. Then, chloral, the tin-tin of my spoon in the glass, and peace at last.” But there were also bromide and morphine, the latter requiring heavier and more frequent hits. This was the stage of the disease that sent Daudet and fellow sufferers, often accompanied by families, on ritual visits to spas whose treatments were heralded, in the underground information system, as promising a cure or at least relief.

As a writer, Daudet specialized in the closely observed character “types” that were the dwindling legacy of French naturalism. He was also a social animal who, even in extremis, found diversion -- and subject matter -- in the tics and foibles of the other “regulars” at the spa, the famous hot springs at Lamalou to which they returned year after year. But he also took note of fellow visitors at the baths in his fashionable Paris neighborhood, which reserved a discreet back room for “special” treatments, among them the terrible Seyre “suspension” imported from Russia, which involved hanging the ataxic patient, sometimes by the jaw alone, in an attempt to stretch the spine. At Lamalou, he observed national differences among the guests: “Russians, both men and women, go into the baths naked. No way of hiding your disease! Alarm among southerners!” Humor allowed him to distance himself from the “Ataxia Polka” and the “sound of sticks and crutches, sometimes the noise of someone falling over.” But these sharp mocking takes on his fellow patients also measured his own premature decline: “In my cubicle at the shower baths, in front of the mirror: what emaciation! I’ve suddenly turned into a funny old man.”

“In the Land of Pain” begins about 1887, when Daudet’s syphilis was far advanced; two years earlier, his neighbor, the famous Dr. Charcot, had pronounced him “doomed.” But he had become infected almost immediately after arriving in Paris, in 1857, when he was 17. Ever the snob, the writer assured a friend that he had caught the disease not from any common streetwalker, but from a court lectrice employed to read aloud to the royals and, therefore, a “lady from the top drawer.” In the intervening years, Daudet rose to become one of France’s preeminent men of letters (a profession now just slightly more obsolete than lamplighter), a literary celebrity, bestselling author and, not coincidently, a very rich man. He married and produced three children.

All the while, he pursued every opportunity for sexual adventure. Not even the agonies of the disease’s final stages, including two operations for hydrocele, painfully swollen testicles, slowed the author’s manic promiscuity. Where sex was concerned, he had always been “a complete cad,” he confessed, bedding everything willing and female, including his friends’ mistresses. And every month or so, he felt driven by a need to wallow “in filth,” he said. Barnes seems to view this triumph of the libido over physical debility as a tribute to Daudet’s stoicism; between the two operations, when a lesser man “would have slept in his trousers,” Barnes notes, Daudet, undeterred, went on the prowl. He was rewarded by finding a very young girl, whose face, he reported, “still had the delicacy and openness of childhood.” His friend Edmond de Goncourt (whose brother Jules had recently died of the same disease) was similarly impressed. Neither Daudet’s male confidants nor his recent commentators raise the issue of the numbers of women he must have infected with the deadly spirochete during four decades as a predatory syphilitic.

His career of urban debauchery gives an ironic spin to Daudet’s literary specialty. Unread and largely forgotten today, the writer’s slight, charming novellas of rustic life in his native Provence, “Lettres de mon Moulin” and “Tartarin de Tarascon,” were considered small masterpieces in their time and, until the 1950s, served as teaching texts in French classes; the author’s purity of language and celebrations of rural innocence were deemed perfect reading for schoolgirls (this reviewer among them) who hoped that swotting away at this innocuous stuff would enable them to read Emile Zola’s “Nana” in the original.

Politically, Daudet’s sunny evocations of a rural past served a very specific agenda. His lovable cast of rustics and provincials celebrated “Papa’s France,” a Golden Age before, as he saw it, urbanism and industrialization, bankers and Jews conspired in its destruction. His son, Leon, took this pastoral nostalgia for a fatherland that never was to its sinister conclusion, becoming a co-founder, with Charles Maurras, of l’Action Francaise, the home-grown French fascism that paved the way for Petain and the Nazi occupation. Daudet the younger, one could say, inherited his father’s social disease, writ large.

The distance that yawns between the sick and the healthy -- the “army of the upright” -- is the terrain mapped by Virginia Woolf in a marvelously elegant essay, “On Being Ill.” First published -- reluctantly -- by T.S. Eliot in the New Criterion of January 1926, it was reissued as a single volume by the Woolfs’ Hogarth Press, with a jacket design by the author’s sister, Vanessa Bell, in 1934. The new edition by Paris Press, an enterprise devoted to reprinting “neglected work by groundbreaking women writers,” presents the text as a near-facsimile, with a few textual changes to modernize punctuation and spelling.

On first reading, Woolf’s pages constitute the most impersonal of the genre “personal essay.” Avoiding the naked “I,” she performs a fan dance around her theme in which aphorisms and epigrams skim the surface like stones skipping across a pond. As Woolf’s recent biographer Hermione Lee reminds us, in a wonderful introduction, the essay “ ‘treats’ not only illness, but language, religion, sympathy, solitude and reading,” commenting along the way on “dentists, American literature, electricity, an organ grinder and a giant tortoise, the cinema, the coming ice age, worms, snakes and mice, Chinese readers of Shakespeare, housemaids’ brooms swimming down the River Solent, and the entire life-story of the third Marchioness of Waterford.”

Playfully, Woolf wonders why illness has not eclipsed love as literature’s great subject. “Novels, one would have thought, would have been devoted to influenza; epic poems to typhoid” -- which, in fact, had killed Woolf’s brother -- “odes to pneumonia, lyrics to toothache.... But of all this daily drama of the body, there is no record.”

Daudet, a conservative in matters of style as in politics, died convinced that a vocabulary of physical torment could never exist. Woolf, the modernist, saw beyond the present “poverty” of her native language and its restricted subject matter. Arguing for the need of a new idiom, a form of expression beyond the constrictions of culture and the literary canon, Woolf was fearless in her own quest. “English, which can express the thoughts of Hamlet, and the tragedy of Lear, has no words for the shiver and the headache,” she wrote, desirous for something “more primitive, more sensual, more obscene,” but also “a new hierarchy of the passions; love must be deposed in favor of a temperature of 104; jealousy give place to the pangs of sciatica; sleeplessness play the part of villain, and the hero become a white liquid with a sweet taste -- that mighty Prince with the moths’ eyes and the feathered feet, one of whose names is Chloral.”

Woolf had nothing to learn from William S. Burroughs or other literary chroniclers of addiction who, in language “primitive,” “sensual” and “obscene,” can be said to have written with the needle. Still more astonishing, she predicted those who would liberate English from the burden of a formal written language: “To us it is a sacred thing and therefore doomed to die, unless the Americans, whose genius is so much happier in the making of new words than in the disposition of the old, will come to our help and set the springs aflow.”

Like a silhouette outlined against drawn shades, we see and hear Woolf the patient behind every sentence, behind the persiflage and free association that can make “On Being Ill” appear -- even annoyingly -- a purely bookishexercise. Along with every great writer, she exploits the limitations of language; her reticence works to her advantage. When it came to translating “howls of pain,” she reveals by concealing: indirection as deflection, like the tantalizing silhouette, makes us study the figure more closely. In every instance, Woolf’s revelations of the sufferer’s state of mind expose “On Being Ill” as an inside job: The isolation of the sick, the fear of abandonment, of being ignored and forgotten as the healthy household bustles about its business; or the reverse, the arrogance of those who presume to know, to feel for you. Nor does she forget the perks of sickness, high among them the dispensation of rudeness: “There is, let us confess it (and illness is the great confessional), a childish outspokenness in illness; things are said, truths blurted out, which the cautious respectability of health conceals. About sympathy for example -- we can do without it.”

Bullies or bores (usually both), stoical or querulous, the sick are burdensome. And who knew this better than Woolf? (She might do without sympathy but not constant care.) For nibbling at every polished phrase, beneath her surface of satiny prose, is the real sickness: early suicide attempts; followed by years of periodic breakdowns, signaled by periods of starvation; related physical symptoms (“fevers, faints, headaches, jumping pulse, insomnia”) and “treatments” worse than the disease: teeth extractions, dubious drugs and “a regime of restraint,” Lee calls it, “rest cures,” extreme diets, “no work allowed.”

If the vocabulary of physical suffering defaults to “figures of speech,” the voice of emotional disturbance sinks, more helpless still, into metaphor: Whether “darkness visible” or “noonday demons,” these cries from the depths fail to enlighten us about the particularity of the pain. We forget, moreover, in our age of victim celebrity, how recent were the shame and stigma of mental illness, the silence that shrouded the sufferer, arguably more suffocating than that of any sexually transmitted disease then or now.

“On Being Ill” speaks to the inseparable nature of psyche and soma, the tormented mind and body as one. A quarter century after Woolf’s essay, Robert Lowell was still circumspect in writing of the breakdowns that led to his periodic commitment. Despair is, quite literally, displaced onto its setting, inaugurating the literature of institutionalized illness. As he writes in “Waking in the Blue”:

This is the way day breaks in Bowditch Hall

at McLean’s ....

... Cock of the walk,

I strut in my turtle-necked French sailor’s jersey

before the metal shaving mirrors,

and see the shaky future grow familiar

in the pinched, indigenous faces

of these thoroughbred mental cases,

twice my age and half my weight.

We are all old timers,

each of us holds a locked razor.

In “Sloan-Kettering,” the Israeli poet Abba Kovner records the last months of his life as a patient in New York’s center for cancer treatment. After a heroic youth as a Freedom Fighter during the Vilna ghetto uprising against the Nazis in 1941, followed by years of guerrilla warfare in the forests of Lithuania, Kovner arrived in Palestine in the late 1940s. Once more, he took up arms, urging on his comrades with the now-mythic plea: They must never again “allow themselves to go like sheep to the slaughter.” A soldier-poet, Kovner became the iconic literary figure for a nation at constant war, and Israel honored him with every award, along with vast reserves of popular affection.

The poignancy of his last collection, then, lies not only in the stark fact of its finality; the subject of these poems (published in Hebrew as a single poema) is the trope of the aged warrior reduced to a dying animal. For Kovner the poet, there was a special blow: Suffering from throat cancer, he had to endure the surgical removal of his vocal chords.

Unlike those of the other writers considered here, Kovner’s memory is not placed at the service of recalling pain. A patient who knows that this stay represents his last slim hope, he is never allowed to forget his present condition or the probability that there will be no literary dividend of his afflictions. Not least of these is the assault upon his humanity; he is reduced daily, by hospital routine, to the passive object of “procedures.” In the haze of painkillers, Kovner relives, sometimes in dreams, the days of heroic sufferings, the dangers and daring of battle:

Every man sitting with his gun. They pass the night

in burrowed earthen dugouts, well camouflaged,

young men and women together....

To wake up mute

in a strange bed

and without the fear of the forest.

Now, bravery consists of enduring solitude and its terrors: “The visiting hour he yearned for / has passed, / the night he dreads / has come.”

For this edition, Leon Wieseltier, literary editor of the New Republic, has provided a stirring foreword, summoning heroic memories of the survivor generation that this poet continued to inspire. But Kovner is no Lowell. Not helped by a frumpy translation, the tributes to orderlies and doctors, to the unsparing efforts and skills devoted to saving his life, rarely rise above the banality of remarks delivered at a hospital benefit dinner. It may be that the original Hebrew conveys the fabled bluntness of Israeli speech, cutting through rhetoric to accuse the outrages of mutism and death. Or possibly, Kovner’s last work, however short of great poetry, serves as another reminder, along with Daudet’s journal and Woolf’s essay, that the distance from the sickbed to the corridor outside is the longest journey, the one for which there are no words.