Authors: Joanna Kavenna
‘Kolletschka …’ I said.
‘… died of contagion, I proposed the washing of hands in chlorinated lime solution, especially after my colleagues had performed autopsies. Instantly, the rate of childbed fever was reduced. It went down to one per cent that died. Only one per cent, from the previous heights of thirty per cent. A remarkable decrease. Palpable, I thought. So when they asked me for proof, I said I had none of the real nature of the infection but I had eradicated childbed fever from my section of the hospital. Even the midwives – who you know always had lower rates of childbed fever – I had even improved on their ratio. Had they allowed me to continue,
the hospital would no longer have been so greatly dreaded by pregnant women; they would have come to the First Division gladly and without foreboding. Perhaps I might have expiated my own guilt that way, so I would not now have to suffer …’
‘It is clear you have worked hard to convince others,’ I said.
‘For a time I worked hard to convince my colleagues in Vienna, but then I was banished.’
‘And why was that?’
‘I forget the circumstances of my banishment. It is a terrible thing, but they will not return to me. Perhaps there is someone who can tell me. But I know I had not resided many years in Vienna, when I was forced home again. I fled, I remember that. I had so many enemies. They conspired against me. I was weary of their conspiracies, and so I fled, perhaps that was it. Cowardice and a yearning for my home.’
‘It is a grave shame.’
He was angry once more, so his face was livid with a sort of rash, and his eyes were darting around the room, as if he was hunting out his tormentors. As if they even appeared to him – perhaps they did. I do not know what this man saw, but his thoughts were shattered once more. When he spoke again, he thrust his hands towards me, and he said, ‘I killed a woman, once, with my hands. I remember she was a very young, very frightened woman. She had blonde hair. She was very frightened and said, “Doctor, I have six children and I must get home soon to them.” And I assured her she would. But I murdered her all the same. She died screaming for her children. She was unusual, she did not forget herself. Her baby died a few months later. I murdered her and
her baby. I see her in my dreams and she berates me. She accuses me.’
‘She is perhaps the woman you mentioned earlier?’
‘I see her and then in her I see the others. There are so many. They were in grave pain as I examined them. Their bodies in the grip of childbirth. And I pushed my hands inside them’ – and he made the horrible delving action of earlier – ‘and sometimes I ripped the placenta from their wombs, at the time saving their lives, yet a few days later they were dead anyway.’
‘But, sir, how can you be so certain you caused their deaths?’
‘Oh do not torment me with your foolish questions!’ he cried, and then sank into furious silence.
*
His thoughts were extreme; his accusations were extreme; yet there was a logic to his arguments. If his theory were true, then it was certain the actions of Professor Semmelweis and his colleagues had indeed killed many women. The accusation of murder was extreme, yet when he came to the matter of those colleagues who had refused his suggestions altogether and insisted on proceeding as before, one might suggest they bore a grave guilt. If his suggestions were as trivial as hand-washing then it seemed they might have simply entertained them, just in case he was correct. What did they stand to lose, by occasionally dipping their hands in a solution? I am ignorant of the discipline of obstetrics, yet I feel I might have, in their position, been moved to try this technique. If the epidemic was as relentless and inexplicable as Semmelweis proposed, then why were they not prepared to try anything, simply to ameliorate matters? As we are uncertain about the true causes of every
thing under the sun, why should we not experiment with theories we find outlandish at first?
*
History is full of theories which have been proffered, and self-appointed experts who have rejected them, simply because they were novel, or threatening of a general orthodoxy. Those religious beliefs which dominate in my country, and equally in yours, Professor Wilson, such as the divinity of Christ, and the truth of the Gospels, have at various points been regarded as madness and heresy and the mere expression of them has caused individuals to be slaughtered. Indeed history is a series of rising and falling so-called truths, each generation directed by certain absolutes which are most often cast off by the next. All my studies in early religions and all that I have read of scientific debate throughout the ages have caused me to become convinced that one of the most curious elements of human existence is the naivety with which we assume that now, now and never before, we have all the answers. For did we not, for centuries, believe that the sun followed the earth? And who was the crazed madman who proposed that it did not, that instead the earth ran like a child after the sun? And this man Galileo was tormented and told to abandon his claims, and he recanted in order to save his life. Yet he was right all the same, as we now know. The priests were dogmatic in their refusal of him, and punished him, just as Semmelweis’s colleagues had been dogmatic in their refusal of him. And thus suffering continues. Dear Professor Wilson, perhaps we might say the great unacknowledged evil of our civilisation is dogmatism. Perhaps this is the canker we bear within us, which taints every society we foster. But you will most likely disagree with me; I am merely
rambling from my theme, to which I shall confine myself henceforth.
*
For the reasons I have advanced above, it did not concern me that Professor Semmelweis had been generally dismissed. I mean by this, that the censure of his peers did not convince me of the falsity of his proposals. I had no real knowledge of his field, and so I had no great opinion on whether he was right or not. Semmelweis himself was convinced of his rightness, and in this he was another dynamic zealot, driven to justify himself at every turn. Had he been more measured, he might have won more supporters. Yet it was also his unmeasured determination that led him to the theory, and thus his failure to disseminate it was bound up entirely in the attributes that had generated it in the first place.
*
Thinking to divert his thoughts, which I believed had festered, I said to him, ‘Professor Semmelweis, I must ask if you now recall your wife and children?’
He raised his head at this, and perhaps his anger diminished a little. He said, curtly, but more continently than before, ‘Yes, I think I have a wife and children. I do not remember them.’
‘You only remember your time in Vienna?’
‘I remember the period I spent in the Vienna General Hospital.’
‘That is only a matter of a few years, Professor Semmelweis.’
‘What is your meaning?’
‘I mean that it is a pity, that you can only regain your memories of a very brief period in your life. Your memories
of this period are very clear. But the rest is lost to you, at present.’
He said nothing in reply.
*
It was strange indeed. He had been discoursing fluently on matters concerning puerperal sepsis and his attempts to disseminate his theory. He ran on, unstoppably, when he sighted this theme. But the rest of his life, the fundaments of his existence as a father and husband, had departed from him. It was as if his theory of puerperal sepsis, his struggle to achieve its general acceptance, had so dominated his mind that it returned to him when everything else had fled or faded. He was left with a single theme, an intellectual argument, yet deprived of all his ties of love and friendship.
*
At that moment – quite the worst moment for such an interruption, when everything was so precarious – we were disturbed by Herr Meyer, who had sneaked along the corridor and gained the cell before I noticed him. He stared around, in his proprietorial way, as if this was his kingdom and I was nothing more than a base trespasser. He twitched nastily and seemed to be trying to persuade me to leave then, but I stood my ground. I turned to him and said, ‘Herr Meyer, I desire a little more time with this patient.’
‘You are of course welcome to pursue your enquiries,’ he said, trying to smile, but it was a furious little grimace that made him look like a fox. ‘I merely wondered if you required assistance.’
‘That is most kind. But I have everything I need,’ I replied, casting an ironic gesture at the dank cell and its unhappy resident.
That made him bite his lip, and nod reluctantly, and then once again he greased a path towards the door.
*
Professor Semmelweis was much disturbed by the intrusion, and would not speak for some time. Indeed I feared he would return to his previous inertia. When I could tolerate the suspense no more, I said, loudly, ‘We were speaking of your work at the General Hospital, Professor Semmelweis.’ Perhaps the stridency of my tone retrieved him, for he turned towards me once more, and said, ‘Yes, I believe we were.’
‘You were telling me about the advances you made.’
‘I was telling you how I sought to atone for the slaughter over which I presided.’
‘You accuse yourself too vehemently, Professor Semmelweis,’ I said.
Herr Meyer was forgotten, as he said, his ire rising, ‘You shall not be the judge of that, however you presume to assess me. Yet I was telling you about a period of many months, during which no woman died of childbed fever. Elsewhere the disease raged. Only our ward was an oasis. The women there smiled and were glad. They held up their babies, kissed them, suckled them without fear. They were not stricken by sweats and grinding pains and the obscene devastation that puerperal sepsis inflicts. They were not drained of life, life was not drawn out of them in blood. The patients were safe. However my colleagues, instead of applauding and celebrating my achievements, accused me of missing the point entirely. They informed me that we simply needed better ventilation. That there was no proof of the beneficial properties of chlorinated lime solution. That my methods were not scientific. They despised me because I
was an outsider and thought I had no place proposing such a significant adjustment to their rules. Dr Roth called me unprofessional. Simply because I proposed a theory which was not his own! Simply because I did not sit worshipfully at his feet! These doctors claim to be devoted to the pursuit of knowledge but really they are vain and seek to be revered. They want nothing more than the reverence of those they regard as their inferiors. They are boulders in the river, preventing the flow of knowledge. I sought to drag a few of them out! I tried to blast open the dam! I was unequal to the task but I laboured to blast it open anyway. They stood firm and they condemned me. Dr Schneider suggested I was inexperienced! And by then I had two years in Vienna on my record. Two years in which scarcely a woman died.’
*
‘It is most unfortunate,’ I said, because he was staring so plainly and desperately at me, clearly hoping for such a remark. You will notice, Professor Wilson, that by now our conversation had become circuitous, and though I found the recurrences of his thoughts rather frustrating I felt I must allow him to continue with his wild arcs, in case something new materialised. Besides, I was genuinely transfixed by his energy and distress, by the horrible eloquence of his recollections.
‘It is unfortunate, yes,’ Semmelweis said, ‘that I was insulted and dismissed. It is unfortunate, yes, that thousands of women have died. It is unfortunate, yes, that thousands more will die. All of this is most unfortunate, simply because of some stubborn old fools who call themselves doctors.’
‘It is most unfortunate you have become ill,’ I said.
‘Ultimately,’ he said, in a lower tone, ‘I do not matter. It
does not matter what happens to me. I plead for mercy for my wife and children, but not for myself. I deserve to be punished. I was the messenger and failed. I did not transmit my message. Perhaps to the few, but not to the many. What becomes of the failed messenger? It is right, in the end, that he should be consigned to such a place as this,’ and he waved a hand, in disgust, at the cell.
‘But surely you would like to leave, and see your family again?’
‘I long to see them. I long so much …’ He stopped for a moment, overwhelmed. Then he muttered, ‘yet it is right that I should be punished. It is one thing that makes me glad, this fact that I am being punished. No doubt my family is disgraced, but then it is a disgrace to be the child of a murderer, or the wife of one. You are tainted by the murderer’s sin. It is quite right. I am not complaining of my punishment. I merely propose that some of my colleagues should be in here too. There is a professor, I forget his name. He has been murdering women for a good forty years longer than I. Before and after. Before I made my proposals and after. I only have a couple of years of active murder on my conscience and then I have all the murders committed by those I could not convince. But this man said that no doctor could spare the time to wash his hands. An imposition on a busy man! And then he said I was a disgusting fellow anyway, for proposing that a doctor would be dirty in the first place. What was I saying about my colleagues? An appalling slur on a gentleman’s reputation. Appalling arrogance, to tell a gentleman to wash his hands! He explained it all to me, one afternoon. He told me I couldn’t go around insulting other fellows like that. He told me it was arrogant and rude. I lacked decorum, you see, in
my outrageous suggestions that the medical profession might – for an hour, for a day – stop murdering mothers.’
‘Perhaps because women had always died in this way, they assumed it was inevitable.’
‘But they had not always died in this way. They had begun to die in great numbers, in numbers which would be categorised as an epidemic, only when the lying-in hospitals were established, in the last century. Prior to that, there had been incidences, naturally, but nothing on this sort of scale, nothing so catastrophic. Doctors had passed from one house to another, and infected their patients, but they had not conducted autopsies and through this procedure infected dozens of women in the same day.’