The Atlantic Monthly/Volume 18/Number 109/Invalidism


One of the first tendencies of sickness is to centralization. Every invalid at least begins by being pivotal in the household. But with the earliest hint that the case is chronic, things recoil to their own centres again; people begin to come and go in the gayest way; they laugh and eat immensely, and fly through the halls asking if one couldn't take a bit of stuffed veal. And while one still sinks lower, failing down to the verge of the grave, it is only to hear of the most cherished friends in another town leading the whirl with tableaux and private theatricals. Finally is realized the dire denouément, that, though one lay with breath flickering away, the daily grocer would come driving up without any velvet on his wheels or any softness in his voice, and that the whole routine of affairs is to proceed, whoever goes or stays. This cold-heartedness it seems will kill one at any rate. Rather the universe should sigh and be darkened. To pass unheeded is worse than to die. Just now it is impossible to compass even the satirical mood of Pope, who declared himself not at all uneasy that many men for whom he never had any esteem were likely to enjoy the world after him. But before one has time to die, the absent friends write such a kind, sorry letter, in which they do not say anything about private theatricals, and, as Thad Stevens said of that speech, one knows of course that it was all a hoax! Then the people who eat stuffed veal repent themselves, and send in a delicate broth or a bit of tenderloin, hovering softly in a sudden regard, and at length a healthier thought is born. It is to arise with desperate will, put a fresh rose in the bonnet and a delusive veil over the face, creeping down to the street with what steadiness can be summoned. There one meets friends, and is pretty well, with thanks, and is congratulated. Affairs grow brilliant, but the veil never comes up; underneath there is some one forty years old and an invalid. Having thus moved against the enemy's works, it is best to retire upon what spirit there is left. It is after this sally that, when the landlady hears a hammering of a Sunday, she comes directly to the room of this robust person, who is obliged to confess that, even if so inclined, she has not strength enough to break the Sabbath.

But the anxiety of every one to show some friendliness to a sufferer is only equalled by the usual inability. We all read of that Union soldier in the hospital visited by an elderly woman bound to do something when there was nothing to be done, and who finally succeeded in bathing the patient's face, while he, poor fellow, still struggling in the folds of the towel, was heard to exclaim, "That's the fourteenth time I've had my face washed to-day!"

Far more unobtrusive is the benevolence which goes into one's kitchen, sending thence to the sick-room those dainties which, after all, are so much too good to be eaten. It seems to be taken for granted that sick persons eat a great deal, and that most of them might share the experiment of Matthews, who began the diary of an invalid and ended with that of a gourmand. I fear that these kindly geniuses would sometimes feel a twinge of chagrin at seeing their elaborate delicacies in process of being devoured by the most rubicund people in the house. But it matters not; it is the sending and getting that are the dainties. Amid all these niceties, however, the office of nurse might certainly be made a sinecure; and just at this point her labors are really quite arduous; for any invalid blessed with many favoring friends soon would sink under the care of crockery and baskets to be properly delivered, while to attend to the accompanying napkins is little less than to preside over a small laundry. And then, as every one tastefully sends her choicest wares to enhance their contents, the invalid also finds that she is the keeper of all the best dishes of the best families.

There is nothing like a well-fought resistance in the early stages of invalidism. Keep up the will, and if need be the temper. There are times when to grow heavenly is fatal,—when one is to let the soul run loose, and to gather up the gritty determination of Sarah, Duchess of Marlborough, who, when told that she must be blistered or die, exclaimed, "I won't be blistered, and I won't die!" Indeed, it is often necessary to reverse the decision of the doctor who gives one up, and simply end by giving him up. The numbers are untold who have died solely from being given up,—I do not mean of the doctors. Poor, timid mortals! they only heard the words, and meekly folded their hands and went. On the other side, there is no end to the people who have been given up all through their lives, and who have utterly refused to depart. They have a kind of useless toughness which prevents them from dying, without endowing them to live. These animated relics often show no special fitness for either world, and they are not even ornamental.

I have somewhere seen the invalid enjoined to talk as if well, but treat himself as if ill. And to certain temperaments a little of this diplomacy, or secretiveness, is often very important. Once an admitted invalid, and the dikes are down. Then begin to pour in all sorts of worthy, but alarming and indiscreet persons,—they who accost one in the street declaring one is so changed, and doesn't look fit to be out,—they who invidiously inquire if you take any solid food, as if one walked the world on water-gruel,—they who come to try to make you comfortable while you do live. All these are very kind, but to a sanguine person they are crushing.

We are all aware that there is no surer way to produce a given state of mind or body, than to constantly the victim as if he were in that state. It is a familiar fact that a stout yeoman once went home pale and discomfited from a little conspiracy of several wags remarking how very ill he looked; and that another, who was blindfolded, having water poured over his arm as if being bled, finally died from loss of blood without losing a drop; and Sir Humphrey Davy mentions one wishing to take nitrous oxide gas, to whom common atmospheric air was given, with the result of syncope. And if the well can be thus wrought on, what can be expected of the weak? This habit of depressing remark comes possibly from the feeling that invalids like to magnify their woes, ailments being regarded as their "sensation," or stock in trade. True, there is now and then one made happier by hearing that he seems exceedingly miserable; but it is more natural to brighten with pleasant words, and a morning compliment of good looks will often set one up for the day. Indeed, we fancy that most persons, knowing their disease, in their own minds, prefer that it should chiefly rest there. To discuss seems only to define it more sharply, and to be greatly condoled is address only debilitating. Montaigne, to avoid death-bed sympathies, desired to die on horseback; while against the eternal repeating of these ills for pity, he says that "the man who makes himself dead when living is likely to be held as though alive when he is dying."

Likewise the friendliness which keeps reminding one of the fatal end serves none. It is both impolitic and impolite; as if there were an unsightly mole upon the face, and every visitor remarked, as he entered, "Ah, I see you still have that ugly mole!" With all these comforters it is finally better to do without their devotions than to be subjected to their discouragements. How much Pope resented this rude style of criticism may be seen from his tart exclamation, "They all say 't is pity I am so sickly, and I think 't is pity they are so healthy."

Yet that incurable sufferer, Harriet Martineau, testifies that when a friend said to her, with the face of an angel, "Why should we be bent upon your being better, and make up a bright prospect for you? I see no brightness in it; and the time seems past for expecting you ever to be well,"—her spirits rose at once with the sturdy recognition of the truth. And Dr. Henry, with the same directness, wrote to his friend, "Come out to me next week; I have got something important to do,—I have got to die."

This must surely be called the heroic treatment; but for those who are not equal to such, it is good to have a physician of tact, who shall not doom them regularly every day. Plato said that physicians were the only men who might lie at pleasure, since our health depends upon the vanity and falsity of their promises. And yet one is not usually deceived by this flattery; but it is vastly more comfortable to hear pleasant things instead of gloomy, and the sick would rather prefer a dance to a dirge. Of this amiable sort must have been the attendant who caused Pope to say, "Ah, my dear friend, I am dying every day of a hundred good symptoms"; and still more charming the adviser chosen by Molière, who, when asked by Louis XIV., himself a slave to medicine, what he did about a doctor, said, "O sire, when I am ill, I send for him. He comes; we have a chat and enjoy ourselves. He prescribes; I don't take it,—I am cured."

Perhaps few are aware of the various heroisms of the chronic patient. It must have been prophetic that the Mexicans of olden time thus saluted their new-born babes: "Child, thou art come into the world to endure, suffer, and say nothing." It is grand to be upborne by a spirit unperturbed, although flesh and nerve may strike through the best soul for a moment; even as the great and equable Longinus, on his way to execution, is said to have turned pale and halted for an instant; while we all know, that, after the Stuart rebellion, the rough old Duke Balmoral, a lesser man, never faltered, but, with boisterous courage, cried out for the fatal axe to be carried by his side.

We had been used to think Andrew Jackson an iron-built conqueror, who never knew a pain, until Parton told of the violent cramp which would seize him while marching at the head of his army, when he simply threw himself over a bent sapling in the forest till the spasm subsided, and marched on. The same endurance nerved him to the end. For many of his last years not free for one hour from pain, he still sat at the White House, never intermitting any duty, although the mere signing of his name drew its witness of suffering from every pore. It is with sorrow, too, that we have lately read that the beloved Florence Nightingale has been held by disease, not only to her room, but to a single position in it, for a whole year. And one of our own poets, even dearer to his friends for the sainthood of suffering, still ever is pressing on with tuneful courage. Hear him singing,

"Who hath not learned in hours of faith
The truth, to flesh and sense unknown,
That Life is ever lord of Death,
And Love can never lose its own?"

Named among the valiant, yet more sad than heroic, was poor Heine on his "mattress-grave." Most pathetically did he lay himself down, this "soldier in the war for the liberation of humanity." Of the last time that Heine left the house before yielding to disease, he says: "With difficulty I dragged myself to the Louvre, and almost sank down as I entered the magnificent hall where the ever-blessed goddess of beauty, our beloved Lady of Milo, stands on her pedestal. At her feet I lay long, and wept so bitterly that a stone must have pitied me. The goddess looked compassionately on me, but at the same time disconsolately, as if she would say, 'Dost thou not see that I have no arms, and thus cannot help thee?'"

Not less touching was the pathos of Tom Hood, in his long years of consumption; but the tone was gayer than the gayest. See him write to a friend: "My dear Johnny, aren't you glad to hear now that I've only been ill and spitting blood three times since I left you, instead of being very dead indeed?" To this he adds: "But wasn't I in luck, after spitting blood and being bled, to catch the rheumatism in going down stairs!"

One long struggle was his against prostration and over-work; but always the same buoyant wit,—writing the cheeriest things with an ebbing life; the hero fighting against fatal odds, but always under a light mask,—and ridiculing himself most of all;—

"I'm sick of gruel and the dietetics;
I'm sick of pills and sicker of emetics;
I'm sick of pulse's tardiness or quickness;
I'm sick of blood, its thinness or its thickness;
In short, within a word, I'm sick of sickness."

And others there be, not heroes, who yet have simulated heroism in their blithe indifference to fate;—Lord Buckhurst, who is said to have "stuttered more wit in dying than most people have in their best health"; Wycherley, who took a young bride just before death, and was "neither afraid of dying nor ashamed of marrying"; Chesterfield, who in his last days, when going out for a London drive, used smilingly to say, "I must go and rehearse my funeral"; Pope, who was the victim of incessant disease, which yet never subdued his rhetoric; Scarron, a paralytic and a monstrosity, the merriest man in France, for whom the nation never gave any tears but those of laughter;—all these, down to the easy-minded old Dr. Garth, who died simply because he was tired of life,—"tired of having his shoes pulled on and off."

Strong persons go swinging securely up and down; they are the people of affairs, their nerves are not shaken by anything less than cholera reports; saving these, they should belong to the Great Unterrified of the earth. To them it is hardly given to understand those minute annoyances that beset nerves which are in an abnormal state, especially when one is the prisoner of a single room. Then one is eternally busy with the dust and small disorders around,—the film on the mirror, the lint-drifts under the stove, the huge cobwebs flying from the corners, the knickknacks awry on the mantel-piece; then one finds the wall-paper is not hung true, and gazes at flaws in the ceiling till they grow into dancing-jacks, and hears the doors that slam, like the shock of a cannon. These are torments so minute that there seems no virtue even in bearing them. Ah! to mount to execution for an idea,—that were glorious and sustaining; but to endure the daily burden of these petty tortures,—one never hears the music play then.

Among the articles to be desired of science is a false hand, or a spectral arm, that shall reach miraculously about,—not a fruit-picker or a carpet-sweeper, but something working with the fineness of an elephant's trunk,—thus to end the discomfort of those orange-seeds spilled on the far side of the room, while, lying inactive, one reaches, reaches, with a patient power which, if transformed into the practical, would push an army through Austria.

Another thing that the invalid has to endure is from the thoughtlessness of visitors. How often, when summoned from the sick-room for any purpose, do they briskly remark, in Tom Thumb style, "I'll be back in a very few minutes!" Hence one lies awake by force, keeping several errands to be despatched on the return, changing variously all the little plans for the next hour or two, and waits. My experience generally is that they have not come back yet.

But the commonest experience is when life itself seems to hang on the arrival of the doctor. Indeed, it is safe to say that never have lovers been so waited for as the doctor. Wasn't that his carriage at the door? Medicine is out! new symptoms appear! it is only an hour to bedtime! and, oh! will the doctor come, do you think? One listens more intently; but now there are no carriages. There are express-wagons, late ice-carts, out-of-town stages, or here and there a light rolling buggy, that seems running on to the end of the world. There are but few foot-passengers either, and they all go by without halting, and there is no indication in the steps of any man of them that he would be the doctor if he could. Thus one wears through the night uncomforted, yet one does not usually die. I have also seen the doctors sitting in their offices expectant, and probably quite as much distressed that everyone went by without stopping. So the balances are kept.

The foregoing grievances are often put among the foolish humors of invalids, but they are quite reasonable compared with many of the droll fancies on record. Take the instance of the elderly man who had been dying suddenly for twenty years; whose last moments would probably amount to a calendar month, and his farewell words to an octavo volume. His physician he pronounced a clever man, but added, pitifully, "I only wish he would agree to my going suddenly; I should not die a bit sooner for his giving me over." It is evident the physician had not the shrewdest insight, or he would have granted this heady maniac his way. "Ah!" would exclaim the constantly departing patient, "all one's nourishment goes for nothing if once sudden death has got insidiously into the system!" More famous were Johnson with his inevitable dried orange-peel, and Byron with his salts. Goethe, too, after renouncing his Lotte, coquetted with the idea of death, every night placing a very handsome dagger by his bed and making sundry attempts to push the point a couple of inches into his breast. Not being able to do this comfortably, he concluded to live. Years after, when he sat assured on his grand poet throne, he must have smiled at it, as with Karl August he "talked of lovely things that conquer death." And still more refined and genuine was the vapor of the imaginative young girl who died of love for the Apollo Belvedere.

Yet it is but fair to mention that the laugh is not all on this side. It is an historical fact that the public has its medical freaks, without being called an invalid, and that whole nations "go daft" on the shallowest impositions. At one time the English were made to believe that all diseases were caused by the contraction of one small muscle of the body; at another, Parliament itself helped make up the five thousand pounds given by the aristocracy to one Joanna Stephens for an omnipotent powder, decoction, and pills, composed chiefly of egg-shells and snail-shells; at another time every one drank snail-water for everything, or to prevent it, and then tar-water became the rage. In Paris the Royal Academy once procured the prohibition of the sale of antimony, on penalty of death, and in a year or two prescribed it as the great panacea. Pliny reports that the Arcadians cured all manner of ills with the milk of a cow (one would like to see them manage the bilious colic).

Mesmer, who was luminous for a while, did not fail to dupe the people. When asked why he ordered bathing in river instead of spring water, he said, "Because it is warmed by the sun."

"True, yet not so much but it has to be warmed still more."

Not posed in the least, Mesmer replied, "The reason why the water which is exposed to the rays of the sun is superior to all other water is because it is magnetized. I myself magnetized the sun some twenty years ago!"

Yet the name of Mesmer has founded a system, while that of Dumoulin, who, with simple wisdom, observed, on dying, that he left behind him two great physicians, Regimen and River-water, has gained but a scanty fame.

Says Boswell, "At least be well if you are not ill"; but the dear public is always ill. In our own country, with an apparently healthy pulse, it has drank the worth of a marble palace in sarsaparilla, and has built a hotel out of Brandreth's pills. It has fairly reeled on Schiedam Schnapps; and even the infant has his little popularities, having passed from catnip and caraway to Mrs. Winslow's Soothing Syrup. There is never a time when the public will not declare upon any well-advertised remedy its belief in the motto of the German doctors, "We do cure everything but death."

It is often interesting to note the various phases which invalidism takes on. Sometimes one seems folded in a dense dream,—has gone away almost beyond one's own pity, and has not been heard from for months. It is to be hoped that friends who hunt "the greyhound and turtle-dove" will meet the missing, and duly report. Meantime one resides in a mummified state,—a dim thinkingness that may be discovered when another coming in says with vigor the thing one had long thought without quite knowing it; in this demi-semi-consciousness it had never pecked through the shell. This looks very imbecile, and is charitably treated to be only called invalid.

Is it mere helplessness that one lies so remote from all but surface sensation, day after day gazing at the address of letters that come, with a passive wonder of how soon she is to vacate her name? Also a friend calls to say that to-morrow he travels afar. It seems then that he will be too much missed, and the parting has its share of unutterable longing. But by the morrow it is not the one left who is sorry. The new sun shines on an earth miles off from yesterday. The night has given many windings more in the folds of this resigned mummy, that now lies securely as an insect in a leaf. Given the beloved hand, and all things may go as they will.

"Our hands in one, we will not shrink
From life's severest due;
Our hands in one, we will not blink
The terrible and true."

And sometimes one bounds to the other side of sensation,—has a terrible rubbed-the-wrong-wayedness, and is as much alive as Mimosa herself. This is often on those easterly days which all well-regulated invalids shudder at, when the very marrow congeals and the nerves are sharp-whetted. Then, Prometheus-like, one "gnaws the heart with meditation"; then, too, always fall out various domestic disasters, and it is not easy to see why the curtain-string should be tied in a hard knot that must be cut at night, or why the servants can't be thorough, deft-handed, and immaculate. One has indigestion, scowls fiercely, tries to swallow large lumps of inamiability, and fears she is not sublime.

It is a saying of Jean Paul, that "the most painful part of corporeal pain is the uncorporeal, namely, our impatience and disappointment that it continues." Whether this be true or not, what with the worry and constant pressure, these physical disabilities often appear to sink into the deepest centre of the being. Hence, if one have had a cough for a very long time, it would seem that the soul must keep on coughing in the next world. If so, this gives a subtile sense to the despatches of departed spiritualists, who telegraph back in a few weeks that their pain is nearly gone,—as if the soul were not immediately rid of the bad habits of the body.

But most demoralized in æsthetic sense must be that invalid who does not constantly look to the splendid robustness of health. Sickness has been termed an early old age; far worse, it is often a tossing nightmare in which the noble ideal of fairer days is only recalled with reproachful pain. Towards this vision of vigor the victim seems to move and move, but never draw near. Well might Heine weep, even before the stricken Lady of Milo. An old proverb says, that "the gods have health in essence, sickness only in intelligence." Blessed are the gods! One can quite understand the reckless exulting of some wild character, who, baffled with this miserable mendicancy everywhere, at length discovered the idea that God was not an invalid. He was probably too much excited to perfect his rhyme, and so tore out these ragged lines:—

"Iterate, iterate,
Snatch it from the hells,
Circulate and meditate
That God is well.

"Get the singers to sing it,
Put it in the mouths of bells,
Pay the ringers to ring it,
That God is well."

Therefore make a valiant stand against that ugly thing, disease. By all Nature's remedies, hasten to be out of it. Fight it off as long as possible, defy it when you can, and refuse "to hang up your hat on the everlasting peg." Be reinforced in all honorable ways. If not too ill, read the dailies; know the last measure of Congress, the price of gold, and the news by the foreign steamer. Disabuse the world for once of its traditional invalid, who sits mewed up in blankets, and never goes where other people go, because it might hurt him. Be out among the activities; don't let the world get ahead, but keep along with the life of things. Then, if invalidism is to be accepted, meet it bravely and serenely as may be; and if death, then approach it loftily, for no one dies with his work undone, and no just-minded person can wish to survive his service. None should aspire to say, with the antiquated Chesterfield, "Tyrawley and I have been dead these two years, but we don't choose to have it known."

But happy they on whom the deep blight has not fallen, and who day by day restore themselves to the grand perfection of manly and womanly estate; happy again to "feel one's self alive" and

"Lord of the senses five";

happy again to "excel in animation and relish of existence"; happy to have gathered so much strength and hope, that, when begins the melody of the morning birds, again shall the joy of the new dawn, with all the possible adventure and enterprise of the coming day, thrill through the heart.

This work was published before January 1, 1926, and is in the public domain worldwide because the author died at least 100 years ago.