Delusion and Reality

I

WHEN I was hurried to a hospital at a half hour’s notice one afternoon last February, I little realized what lay before me. It never entered my head that the emergency operation which so upset all my plans for the day and week would have to be followed by two others, or that I was to spend more than three months in the hands of physicians, surgeons, and nurses, to the intense anxiety and later, when I emerged convalescent, to the astonishment of friends and a family which appeared to have more need of me than ever before. Nor could I have foreseen into what a strange world I was about to plunge — a world of fantastic unrealities all intertwined with the clearest verities and with blendings of the real and the unreal that would have perplexed the profoundest philosopher.

It would be futile to try to recall them in anything resembling their jumbled entirety. But a few of the delusions and certain realities seem worth diverting from the road to forgotten things. Some appear as patches of an individual lurid color that may suddenly be inserted into a life of no uncommon hue; others merely as starting points for reflection that may have a bearing upon other lives to which the hospital has meant or may at any moment mean something. Let me begin with a delusion pure and simple and pass through a half-light to a region in which the realities seem in retrospect to have been clearly in the ascendant.

The Hoover Administration was at its last gasp, and so, to all appearances, — though far from realizing it at the time, — was I. Does it seem presumptuous to link my personal fortunes with those of the nation? I should not venture to do so but for a curious dream, vision, or delirious imagining that came to me soon alter the hospital bed became my long habitation. The vision had to do with my coming to the hospital, with whatever it might hold for me, and occurred soon after my arrival. Certainly one and possibly two operations had intervened. I seemed to see myself borne at a terrific speed, as if in a racing motor car or an aeroplane skimming the ground, along a straight avenue at the end of which rose an immense wall of solid masonry, with a bull’s-eye of white stone at its centre. That was the spot I knew myself destined to hit. In the world of fact there was nothing more like it than Connecticut Avenue in Washington, with the McClellan statue as one’s objective, only without the comforting avenues of escape by deflection to the right or left rear. There was, however, a feeling that after my smash-up I might be able to drag myself round the ends of the wall and find a peaceful stretch of grass and trees — ‘ bright fields beyond the swelling flood’ — where I might lie down and recover my strength.

Nor was this quite all of my vision. In the rush to inevitable disaster the impending fate of the Hoover Administration, with which my sympathy had always been limited, seemed curiously joined with my own. We were going to smash together. I do not remember feeling any special concern for what was to befall my fellow victims of ruin. If they too were to drag their bruised and battered forms past an end of the masonry wall into the pleasant pastures that were my only hope, no such vision was vouchsafed to me. Was it to the general discredit of human nature that self-preservation seemed to be uppermost in my distracted mind?

In that wandering portion of my ordinarily placid being, the Presidency and all that concerned it held an amazingly important place. When I was well out of the woods, my day nurse informed me of one of the delusions that had given particular amusement to those about me. I had apparently conceived the idea that there was an effort on foot to install me as President of the United States. My protest was vigorous: ‘No, I am altogether too busy; besides, my family would not like it at all’ — nolo episcopari with a vengeance! Yet while at my worst I had enough hold on reality to dictate a night-letter telegram to the President-elect on March 1, three days before he assumed office. There was at least the excuse of certain personal dealings in the year before his nomination. If the communication ever reached him, it must have appeared merely as one of thousands of similar expressions of good will. Like many arrows shot forth in the form of messages, it was bound to mean a good deal more to the bowman than it could transmit to the target, for in the welter of delusion in which I was living at the time I seemed to stand on a rock of reality when I contrived somehow to piece the following words together: —

Even in the backwater of a hospital where I have lately undergone two operations am acutely conscious of a new spirit in America. I believe this to be your own spirit. The true Democrat of the old order who has always known the new order to be a vital part of it seems coming into his own. God bless you and your Administration to the good of the whole world.

What wonder that I was confused even by the realities of the time! Quite unable to read newspapers, I received from nurses, doctors, and family visitants — as a reader of occasional headlines might receive — some glimmering of what was going on in the world without. Could it be possible that the expiring ’lame duck’ Congress had voted to submit to the states the repeal of the Eighteenth Amendment? From my chief companion in hitting the bull’s-eye on the masonry wall I could not withhold a certain sympathy when told of his final draught from the cup of humiliation — that closing of banks on his last morning in office which led at once to the closing of every bank in the country. I might have thought this but part and parcel of the unreality in which I was living had not my nurse told me of receiving her weekly stipend largely in the form of small checks, of which she was instructed not to attempt the cashing of any for a larger amount than five dollars.

No sooner had the fourth of March been left behind than things began to happen in the national life — the authorization of a mildly ‘authoritative’ beer, followed rapidly by other legislative acts of Congress astoundingly cooperative with an astounding President, acts too familiar to need recital here — which, reported in the bare outline I was capable of grasping, filled me with wonder. Had the telegram which left my bedside at a time so charged with delusion related itself to reality after the fashion of a prophecy fulfilled? Here was at least one exhilarating thought.

II

It is indeed largely on thoughts, and not with that ‘skin and shell of things’ which play so dominating a part in everyday life, that one learns to live in the course of a protracted illness. Before this surgical experience of mine, near the latter end of what cannot be less than a longish fife, I had never visited a hospital except as a caller on unfortunate friends. My three months gave to me what many of them had managed to distribute over a considerable number of years, and I could not help feeling that they had chosen the better part. Even my glimpse of their strange plight had made me realize how abnormal the normal world must look from a hospital bed. Could there be just outside the walls a city full of men and women, boys and girls, vigorous enough to be pursuing untrammeled all the labors and pleasures, sometimes rolled into one, to which the human race is addicted? Can there be a state of existence in which doctors and nurses are superfluous? Here they are so nearly everything that a life in which they are nothing is well-nigh inconceivable. If such thoughts cross the mind of a mere visitor, they can hardly fail to become paramount when weeks stretch into months and one becomes an inhabitant.

Doctors and nurses — how extraordinary in action and at close range are these functionaries of a life-saving station which ministers to so infinitely greater a number of human beings in desperate straits than any outpost of mercy and salvation on the most perilous coast! There must, of course, be some element of luck in falling into the hands of better or worse representatives of the art and science of healing, but surely I have heard many persons declare after a serious illness, ‘What wonderful doctors I had, and what wonderful nurses!’ and have encountered few utterances of blame instead of praise.

Indeed, the doctors and nurses can hardly help developing admirable qualities. Without them they would never have chosen their arduous, self-sacrificing professions, which in turn do everything to cultivate the best that is in them. Scientific knowledge, manual skill, mechanical ingenuity, the wisdom and tact required for delicate human relationships — all these the doctor must possess; so, in her own degree, must the nurse, and to these she must add a provision of patience and gentleness through all the ‘twelve-hour shift’ from which even the workers in steel mills have long been exempted. These qualities in constant operation are among the realities of a hospital experience, and how a nurse maintains her equanimity through weeks and weeks of continuous attendance upon one person, without so much as a Saturday afternoon or Sunday off, is still beyond me. When a competent reformer (which I am not) starts an organized movement to substitute three eight-hour shifts for the present two twelve-hour terms of servitude, I for one shall be ready to join it. My own day nurse informed me that, besides never having cared for anyone else so ill who finally recovered, she had never been so long in the uninterrupted care of one person. Yet her patience and devotion — like those of the equally memorable night nurse — never faltered.

I fain would count among the delusions that dreadful young male attendant who was left by my side one night when my nurse could not leave me long enough unwatched to go to her nocturnal supper. Though clad in white, he stood over me like a raven, and croaked out, ‘Well, there is no denying the fact that any operation for a man over thirty-five is a major operation — and very serious. Now we young fellows have the resiliency that makes the difference. But over thirtyfive . . .’

I had no wish to argue the point with him, and must have made it clear that I needed no more of his conversation, for he relapsed into a merciful silence. My own was broken next morning when I begged to have that particular beginner excluded thenceforward from my room. He was not a delusion, but only a glaring exception.

To this creature of ill omen, however, I owed more than to anyone else in the hospital — a frank confronting of the idea of death. It must have been always at the back of my mind, where, in my struggle for life, I was content for the most part to leave it. When it came to the fore, — as of course it did from time to time, — it was not, as I look back upon it now, in any suggestion of a ‘king of terrors.’ I was vaguely conscious of its presence in rooms near by, and must have realized that it had a way of stalking rather familiarly up and down the corridors. Perhaps one’s weakness reconciles one to almost anything. Perhaps the arduous, weekson-end exercise of patience — one of the least tractable of virtues — sharpens one’s capacity for accepting the inevitable. It does not seem to me now that the termination of life in one’s present experience of it can ever again seem so dreadful a thing as it had sometimes appeared before. Perhaps I have never dreaded it in proportion to its full deserts.

If a sonnet of Sir Philip Sidney’s had been in my unsteady hands at the hospital as it is now in my firmer grasp, I should even then have subcribed to its lines: —

All this has to do with one’s own death. When it comes to the death of another, quite a different philosophy must be called into play.

III

They tell you that a patient has a good deal to do with his own recovery. Possibly he has, but one would hesitate to suggest that he can hope to be much more than a cog in the mechanism of his welfare. It is a question whether he can be even that unless he acquires early in his illness a confidence in his doctors and nurses which inclines him to a thoroughgoing coöperation with them, to offer not even a passive resistance — in fact, to add his effort, however feeble, to theirs, however powerful.

One of the realities of which I am firmly convinced is that the strongest of all incentives to effort comes from outside the hospital walls. To lie within them and not to feel that in the world one has left for a time there are those, of the nearest nearness, who ardently desire one’s restoration to familiar paths, and that there are friends who share, sometimes in a degree quite unexpected, in this desire — that would indeed hamper beyond computation one’s power to help one’s helpers. To the unfriended, to the lonely in strange places, — even as to the uncared-for, the wounded in wars, cut to pieces not with salvation but with destruction in view, — the sympathy of the watchfully, skillfully tended patient, fortified by the knowledge that his recovery is a matter of genuine concern to others, goes out in abundant measure. If a spark of the spirit of fight remains in him, he is bound to puff it into such flame as it can achieve. To rekindle his dying fires he will draw upon every resource, physical and spiritual, of which he finds himself possessed, and of all these forces he may well discover that the invisible friends, and more than friends, who mingle their realities with the delusions of his hospital room are the truly potent and effectual.

While this sense of indebtedness to others was at its first full flood, in an early stage of a convalescence now well advanced, was it possible to give adequate brief expression to an overmastering feeling? It was not possible for one just issuing from the deepest waters to define the result of such an effort otherwise than with the well-worn ‘ De Profundis ’: —

Of all the many things, then, learned through a long communing with realities, none remains more clearly defined than the wreck of an old delusion. How often have I refrained, when friends have suffered illness and sorrow, from the expression, through a message, or flower, or whatever token, of a natural sympathy! There was not quite a sufficient warrant of intimacy; somebody would be put to the trouble of writing a note of thanks — there were as many excuses as if one had been bidden to a Biblical wedding feast. Never again! The smallest word, joined with other waftings from without, makes its own contribution to a curative force of incalculable power. Fortunate the patient, face to face with the necessity of furthering his own recovery, who finds his weariness and weakness turned into some semblance of strength by the mere knowledge that friends, not yet admitted to his room, are standing, as it were, by his door, like reënforcements to exhausted troops! Without their help the bull’seye in the masonry wall might well have been the end of me.