Authors: Joanna Kavenna
‘They would complain of feeling a little flushed and faint, and the doctors would aim to reassure them, but often we would know anyway that the worst would soon be upon them. Every woman knew precisely the symptoms of childbed fever, and the look in their eyes when they realised they had succumbed was dreadful to behold. And beside them were their babies – these desperate tiny creatures, so plaintive and powerless, who just hours earlier the mothers had held and loved and been so delighted to see – but now in their illness these women would cry out when the babies were placed upon their abdomens, and they would speak of a pain in their bellies, and then they would vomit horribly and shudder, and cry about their babies and how they must feed them, and their temperatures would fly up the scale, and higher and higher, and the babies would cry because the mothers could not suckle them or hold them, oh these poor babies, these poor mothers – it was terrible to witness the decline of these mothers, just when they had performed this most vital act, summoning life, and when these new lives were crying out for them – yet despite this they were shivering with cold, their teeth chattering, and then they were hot and flushed, and they perspired and stank. That was when you knew their agony would soon be over – when the stink emanated from them, a smell of decay, coming from this womb which had so recently sustained life. The womb was infected, with vile particles, and these women were destroyed from within. They slipped away, no longer recognising the babies they had loved so briefly and intensely. And when they died, the babies were often left orphaned,
their lives ruined too by the horrible demise of their mothers. If no relative came, these helpless creatures were sent to the orphanage, and half of them died within the first year.’
*
I sat there in silence for a moment, wondering at the change in this man. You must perceive it, Professor Wilson, even through my flawed account. Indeed to witness it first-hand was most disturbing, so stark did it seem. I had no understanding of how it might have occurred. It was rather as if Professor Semmelweis had been replaced by another man; as if the morning had presented me with an interloper, or perhaps the interloper was before me and the real, more confused and desperate Professor Semmelweis had been vanished through the twisted ministrations of Herr Meyer. Of course his appearance was the same, but the character was so very different, it was hard to understand what had occurred. I had not believed him absolutely lost to reason before, and had rather imagined – as I mentioned – that he was poised between the world we recognise and another psychic realm we generally regard as beyond our concerns, or only of concern in so far as we seek to police and restrain those who occupy this world. Yet now, as he described these unfortunate women, Professor Semmelweis was upset – the man was trembling in his grief and self-blame – and he was not eloquent in the ordinary way, but he might have passed for little more than agitated and eccentric. He would have been heeded at a supper party, though people might have said he ran on a little, lacked a sense of when to pause. And the hand-wringing, perhaps that would have attracted notice. It is true, his gestures were overblown and distracting, but, relative to the state of nerves in which I had previously found him, he was greatly changed. And though his
memory was still betraying him constantly, he was picking a way through its blanks, eking out dreams and recollections. His general demeanour made me suspect his condition was one of fits and regressions, and that he might sink into an episode and then later appear relatively recovered, before descending once more. I had not previously seen an inmate who presented so dramatic an oscillation between lucidity and stupor, between his regressions and his advances, but thus I found him.
*
‘You are remembering women you treated?’ I said.
‘I killed many of them. Before I knew about the way the contagion spread. I was one of the arch murderers in the Vienna General Hospital, because I was young and eager to learn my profession and so I performed an unusual number of autopsies. In the mornings I would always attend the autopsies of women who had died of childbed fever, and then I would hurry to the lying-in wards, and examine the living. And they would grow feverish, and often they would die. Personally I infected innumerable women, and deprived innumerable babies of their mothers’ love.’
‘Is this what you have been trying to forget?’
‘I do not forget it,’ he said, sharply. ‘It torments me. Besides I think there are other crimes upon my head. These are the gravest, I confess. These must be the gravest, the successive murders I have committed. But you see, I have done something else, I know.’
‘Tell me of your theory that puerperal sepsis is conveyed by the hands of doctors,’ I said, aiming to move the discussion away from these themes which merely distressed him. But he had found his motif, and did not yet want to discard
it. He said, ‘I understand now why my former colleagues have banished me.’
‘No one has banished …’ I began, but he said, ‘They fear me, because I remind them of their guilt. My very presence accuses them. These are feted men. They are accustomed to praise. And I offer them only condemnation. This is anomalous and they despise it. Fortunately for them, they are the majority, they are the respectable keepers of orthodoxies, applauded for their efforts to maintain everything, to conserve untruth and protect fiction, and so it is perfectly easy for them to dismiss me. They dismiss me powerfully, even with anger in their voices, and everyone follows them. In a sense, their anger is absurd, because how could I ever really damage their great reputations, the names they are so proud of, when I am a single voice and they form a chiming chorus? How?’ He stopped at this, and looked at me.
I said, ‘Perhaps you have worried them.’
‘They are not worried. That is their gravest crime. They are not worried at all,’ he said bitterly.
‘Tell me of your theory,’ I said again.
‘I perceive quite clearly now that I was once a fool and because of my foolishness thousands of women died. I failed to convince my colleagues. Here in Vienna, I proved my theory, but then I was secretive and reluctant to present my findings. For years I failed to communicate what I had discovered, and during these years thousands of women died.’
‘But I am told you wrote a book,’ I said.
‘Who told you that?’ And now there was his former suspicion, his tone hoarse and abrasive. I said, ‘A friend, no one you need be concerned about,’ and he seemed to accept this response. ‘I did write a book. I worked hard on it, thinking it would finally convince my opponents. And yet they
massed to condemn it. The reviews were monstrous. They vandalised my argument, just to save themselves. And I became angry and lost the argument altogether. So you might say my crime is twofold. I am a murderer because of my reluctance, my secrecy. Then I am a murderer because of my anger.’
‘But I do not yet understand your theory. I would be glad if you could explain it to me.’
He said, ‘Are you a doctor?’ – by this remark he revealed that however much he had regained a sense of his own past, his awareness of his immediate environment was tenuous indeed, and I was but a shade, a presence beside him, hardly an individual at all.
‘I am not,’ I said, again.
‘Well, you may know that it is not yet accepted in Austria that puerperal sepsis is contagious, that this deadly infection can be prevented by something as simple as washing the hands. Simply washing the hands.’ And now he splashed his hands frantically in the basin of water, so that most of it spilled over the sides, and he held up his hands to me. ‘A little chlorinated lime solution. A thorough wash. That is all that is required. In my native land, this theory of mine has been generally adopted for some years now. There at least my conscience is clear. But Austria and the world in general have defeated me. I have failed entirely to convince anyone beyond my own land.’
‘How do you know you failed to convince anyone?’
At that he leaned towards me, as far as he could. There was a rancid stink coming from him. Something like decay, the decay of the faculties naturally, and also a general bodily decline. The man reeked of stale blood, from the various wounds on his head and hands. He was leaning towards me,
emanating these smells of disorder, as he said, ‘We must remember, it is far too late for Frau Engel, murdered by Dr Fuchs. And it is too late for Frau Adler, murdered by my esteemed colleague Dr Kuhn. Though perhaps she was murdered by his student, Herr Hirsch. Then it is too late for Frau … oh I cannot remember her name. It is in my mind but I cannot summon it. This woman was most certainly murdered by Dr Roth. You must know him. He is one of my most vehement critics, and one of the biggest murderers of them all. He moves from ward to ward, snuffing out lives. That man is Death, death to mothers. All these women, let us remember, and hundreds like them, thousands like them, had been delivered of healthy babies. So we must consider the hundreds of motherless children. The hundreds of mothers denied their destiny, to love and nurture their young.’
*
He was staring at me with awful intensity again, the dead and lonely gaze, more unpleasant to behold even than his hand-wringing and sudden surges of violent energy. Yet he did not see me, I now perceived, he saw merely the past and perhaps these ranks of women, reproaching him, but nonetheless his expression discomfited me, and I turned to my notebook, and began once more to write.
*
‘Surely you should consider all the women you have saved?’ I said, after a pause.
‘I have forgotten the statistics. I must remember them. If you would only let me think I will remember them. Your questions are so incessant, I cannot think.’
*
Thus castigated, I fell silent, and eventually he said, ‘I believe there was a colleague of mine. There was a colleague
… the details are clouded by my fetid brain. He was called Kolletschka, that was his name. His first name I am trying to remember … he was a good colleague, even a friend. And what was his first name? He has been dead now many years. I was a youth when he died. How long ago is it that Kolletschka died?’
‘I do not know, I am afraid,’ I said.
‘Why? Why do you not know?’ Again the anger, the sudden flash of aggression. ‘My friend – I have forgotten his name …’
‘Kolletschka.’
‘… was performing an autopsy on a woman who had died of … of this disease … you know what I am referring to … and in the course of this he cut his hand with a scalpel and fell ill. The nature of his illness was similar to the sufferings of those women, even unto his horrible death. So after he died – I was most shocked and dismayed, naturally, and thought much about why he had died – I realised that he had clearly caught his infection from the direct contact of his blood with the infected blood of the dead woman. Or with some particles that came from her body, and went straight into my friend’s blood.’
‘So this is how you came to believe that these fevers, or distempers of the blood, were in fact transferred somehow from one person to another?’
‘By the hand,’ he said, and again he held up his raw and grimy hand. ‘By these doctor’s hands, infected with poisons from the dead, or from others who were dying, and then thrust into the wombs of mothers.’
‘So it was not merely the dead, it was anyone who had the disease?’
‘No, my friend. More even than that. And no one under
stood this. They thought I meant only the dead. But I meant any fetid or decayed tissue, any infected rancid tissue within any body. So there was a doctor who treated a woman with an infected cancerous breast, and then his next patient developed childbed fever. Anything! A corpse was not required! But the fools misunderstood that too.’
‘That is most unfortunate.’
‘They were too foolish to understand. And I was too foolish to explain it clearly. But I did something. I did a few small things. For a while in Vienna, before I was banished back to Budapest, I forced my colleagues to wash their hands in chlorinated lime solution, and instantly the cases of childbed fever were significantly reduced. For a full six months we had no deaths at all from the disease, an extraordinary, unprecedented statistic.’
‘But with such success, why did no one believe you?’
*
Well, that made him rage. This simple question converted him from a lucid melancholic into a frothing maniac. He lashed out wildly, and for some minutes he was bestial and appalling, shuddering and pouring his rage into the room, so it crashed against me like a sea in storm. He slammed his hands on his face, on his knees, anywhere they would fall, raving and grinding his teeth. I stood up, and perhaps I was even a little afraid. Not for my own person, rather there was something distressing about the sight itself, the spectacle of a personality unravelling, inner chaos released. For I believe that we all contain within us these unbridled forces, and yet we marshal them in our minds, somehow, and sometimes we enslave and contain them too rigidly, and either they wither and die or they burst forth like the eruption of a volcano. They are ancient phenomena of nature, these forces
that course through us, and here was this man, like a tempest raging in a single human frame; it was compelling and awful to view. Indeed I merely observed him for a time, while he raged and frothed and seemed likely to be overcome altogether. Yet then, almost as suddenly as he had begun, he stopped his bellowing, and paused. He rubbed his eyes, as if he had awoken from a deep sleep. He was exhausted by his labours; his voice was trembling, and at first he could not phrase a sentence. He was trying to summon his lucid state again, I thought. ‘I … I …’ he said, ‘I … believe they have always found my proofs inadequate … Even though they were as clear as day …’ He looked weak now, ashen-faced, his mouth filmy with saliva and his skin glistening, and he wheezed as he said, ‘They have always talked to me about proof. Where is your proof of the real nature of contagion? How can you physically demonstrate the transference of disease from one body to another? I tell them – if they have not already turned away, which most often they have – that they must look at the women I saved. Aware as I was that my colleague, Koll …’