At the Hôpital X

Numéro 57’s eyes were still open, his mouth also open, his small face contorted into an expression of agony. What most impressed me, however, was the whiteness of his face. It had been pale before, but now it was little darker than die sheets. As I gazed at the tiny, screwed-up face it struck me that this disgusting piece of refuse, waiting to be carted away and dumped on a slab in the dissecting room, was an example of ‘natural’ death, one of the things you pray for in the Litany.

This is from ‘How the Poor Die,’ George Orwell’s essay on his experience in the ‘Hôpital X’ where he was treated for ‘an exceptionally fine specimen of a bronchial rattle’ that drew ‘as many as a dozen students queuing up to listen to my chest.’ I thought of his article when reading much of the recent debate on assisted dying. What’s new here is that major religious leaders like George Carey and Desmond Tutu have come out in support of the proposed law. Others are opposed. Justin Welby and many other faith leaders signed a statement ahead of the Lords debate on this:

The bill raises the issue of what sort of society we wish to become: one in which life is to be understood primarily in terms of its usefulness and individuals evaluated in terms of their utility or one in which every person is supported, protected and cherished even if, at times, they fail to cherish themselves.

This is from Cranmer’s blog, which adds: ‘Opposition to ‘do anything which is destructive of life’ is one of the few general rules which unites all of the world’s religions.’

Assisted suicide is a difficult and troubling issue. It troubles me because it is only raised in certain contexts. Take a man of twenty-five with a diagnosis of paranoid schizophrenia who has been in and out of prisons and psych wards his whole life. He wants to kill himself and has no job, no friends and no prospects. The natural response would be to shout ‘Don’t do it’ – it would even be the natural response to a suicidal 25 year old with terminal cancer and a prognosis of six months – but when a 75 year old falls into a painful illness the question of ‘assisted dying’ does come up even though if he recovers the old man could live another 20 years.

It is also the case that people do conspire to have their elderly relatives ‘got out of the way’ – today just as in Orwell’s time: ‘In the bed beyond that a veteran of the war of 1870 was dying, a handsome old man with a white imperial, round whose bed, at all hours when visiting was allowed, four elderly female relatives dressed all in black sat exactly like crows, obviously scheming for some pitiful legacy.’ Even the eugenics Godwin has some weight behind it. There is no idea so insane that it cannot be hammered into respectability by bourgeois intelligentsia in free countries.

So assisted dying troubles me and there are good arguments against it. However I could do without the drone of sanctimony that always seems to accompany these arguments. After George Carey surprised everyone by supporting the Bill, the Plymouth Herald responded with ‘Two bishops in charge of the largest Christian denominations in Plymouth have spoken out to defend the sanctity of life’ – as if no one else on the planet was aware or has ever spoken up for this sanctity, as if anyone who disagreed with them was axiomatically a misanthrope and hater of all things. I go on Twitter, and I see Marko Attila Hoare, a man I respect, complain that ‘When will atheists begin to show the same respect as religious believers for the sanctity of human life?’ Well, some of us are ahead on that, Marko – we’re not the ones slaughtering people in Iraq, at any rate. Not that this is even an issue of religious versus secular. I was at the Harrogate crime festival over the weekend, and the highlight was a discussion with the great psychological suspense writer Sophie Hannah. One thing Hannah said stayed with me: ‘The most dangerous people are the ones who think of themselves as the good guys – the people I really fear.’ The attempted monopoly on virtue, the scramble for the moral high ground – you cross the road to avoid these people, and if they are waving a placard that says ‘PRO-LIFE’ you don’t even check the traffic first.

So let’s go back to Orwell’s para. Looking upon the unfortunate man dead in the Hôpital X, he thought to himself: where did we get the idea that ‘natural death’ was even any good, let alone the best way to go?

There you are, then, I thought, that’s what is waiting for you, twenty, thirty, forty years hence: that is how the lucky ones die, the ones who live to be old. One wants to live, of course, indeed one only stays alive by virtue of the fear of death, but I think now, as I thought then, that it’s better to die violently and not too old. People talk about the horrors of war, but what weapon has man invented that even approaches in cruelty some of the commoner diseases? ‘Natural’ death, almost by definition, means something slow, smelly and painful.

Orwell didn’t get to be old, but his lifetime encompassed two world wars and he himself was almost killed in the Spanish Civil War. Maybe his attitude reflects a time when getting old wasn’t guaranteed. For most of human history we have been preoccupied with quantity of life. As Carson McCullers had it: ‘Life could become one long dim scramble just to get the things needed to keep alive.’ Now that we’ve outlived conscription and killed the smallpox the emphasis is on how we sustain ‘quality of life’ in the long difficult years that follow retirement. Perhaps Orwell in his sickbed saw the future: pampered generations that have annulled or at least limited all the things that murder human beings will still have to confront the fact that ‘However great the kindness and the efficiency, in every hospital death there will be some cruel, squalid detail, something perhaps too small to be told but leaving terribly painful memories behind, arising out of the haste, the crowding, the impersonality of a place where every day people are dying among strangers.’

At the end of the day, people don’t want to die screaming and rotting, they don’t want to have their savings eaten up by corrupt care homes and that is why provision for ‘assisted dying’ in certain cases will probably be made. As the great man said: ‘it is a great thing to die in your own bed, though it is better still to die in your boots.’


(Image: Buzzfeed)

One Response to “At the Hôpital X”

  1. arianne azar-carey Says:

    Death is such a mystery, and yet we either are rushing towards it, or fleeing from it. Euthanasia, is a bit of a mixed bag but in the end it is about who holds that power and for what intent. If we would all practice mindful living then perhaps we could also practice mindful dying–but alas, that is for the fortunate few.

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