 CHAPTER I. THE ELLIFANT MAN. In the Mile End Road opposite to the London Hospital, there was, and possibly still is, a line of small shops. Among them was a vacant greengrocers which was to let. The whole of the front of the shop, with the exception of the door, was hidden by a hanging sheet of canvas, on which was the announcement that the elephant man was to be seen within, and that the price of admission was toughens. Painted on the canvas in primitive colours was a life-size portrait of the elephant man. This very crude production depicted a frightful creature that could only have been possible in a nightmare. It was the figure of a man with the characteristics of an elephant. The transfiguration was not far advanced. There was still more of the man than of the beast. This fact, that it was still human, was the most repellent attribute of the creature. There was nothing about it of the pitiableness of the misshapened or the deformed, nothing of the grotesqueness of the freak, but merely the loathsome insinuation of a man being changed into an animal. Some palm trees in the background of the picture suggested a jungle, and might have led the imaginative to assume that it was in this wild that the perverted object had roamed. When I first became aware of this phenomenon the exhibition was closed, but a well-informed boy sought the proprietor in a public house, and I was granted a private view on payment of a shilling. The shop was empty and grey with dust, some old tins, and a few shriveled potatoes occupied a shelf, and some vague vegetable refuse the window. The light in the place was dim, being obscured by the painted placard outside. The far end of the shop, where I expect the late proprietor sat at a desk, was cut off by a curtain, or rather by a red tablecloth suspended from a cord by a few rings. The room was cold and dank for it was the month of November, the year I might say, was 1884. The showman pulled back the curtain and revealed a bent figure crouching on a stool and covered by a brown blanket. In front of it, on a tripod, was a large brick heated by a Bunsen burner. Over this, the creature was huddled to warm itself. It never moved when the curtain was drawn back. Locked up in an empty shop and lit by the faint blue light of the gas-jet, this hunched-up figure was the embodiment of loneliness. It might have been a captive in a cabin, or a wizard watching for unholy manifestations in the ghostly flame. Outside, the sun was shining, and one could hear the footsteps of the passers-by, a tune whistled by a boy, and the companionable hum of the traffic in the road. The showman, speaking as if to a dog, called out harshly, Stand up! The thing arose slowly and let the blanket that covered its head and back fall to the ground. There stood revealed the most disgusting specimen of humanity that I have ever seen. In the course of my profession I had come upon lamentable deformities of the face due to injury or disease, as well as mutilations and contortions of the body, depending upon like causes. But at no time had I met with such a degraded or perverted version of a human being as this lone figure displayed. He was naked to the waist, his feet were bare, he wore a pair of threadbare trousers that had once belonged to some fat gentleman's dress suit. From the intensified painting in the street I had imagined the elephant man to be a gigantic size. This, however, was a little man below the average height, and made to look shorter by the bowing of his back. The most striking feature about him was his enormous and misshapened head. From the brow there projected a huge bony mass like a loaf, while from the back of the head hung a bag of spongy fungus-looking skin, the surface of which was comparable to a brown cauliflower. On top of the skull were a few long, lank hairs. The osseous growth on the forehead almost occluded one eye. The circumference of the head was no less than that of the man's waist. From the upper jaw there projected another mass of bone. It protruded from the mouth like a pink stump, turning the upper lip inside out and making the mouth a mere slobbering aperture. This growth from the jaw had been so exaggerated in the painting as to appear to be a rudimentary trunk or tusk. The nose was merely a lump of flesh, only recognisable as a nose from its position. The face was no more capable of expression than a block of nailed wood. The back was horrible, because from it hung as far down as the middle of the thigh, huge sack-like masses of flesh covered by the same loathsome cauliflower skin. The right arm was of enormous size and shapeless. It suggested the limb of the subject of elephantiasis. It was overgrown also with pendant masses of the same cauliflower-like skin. The hand was large and clumsy, a fin or paddle rather than a hand. There was no distinction between the palm and the back. The thumb had the appearance of a radish, while the fingers might have been thick tuberous roots. As a limb it was almost useless. The other arm was remarkable by contrast. It was not only normal, but was moreover a delicately shaped limb covered with fine skin and provided with a beautiful hand, which any woman might have envied. From the chest hung a bag of the same repulsive flesh. It was like a duelap suspended from the neck of a lizard. The lower limbs had the characters of the deformed arm. They were unwieldy, drop-sicle-looking and grossly misshapened. To add a further burden to his trouble, the wretched man when a boy developed hip disease which had left him permanently lame, so that he could only walk with a stick. He was thus denied all means of escape from his tormentors. As he told me later he could never run away. One other feature must be mentioned to emphasise his isolation from his kind. Although he was already repellent enough, there arose from the fungus skin-growth with which he was almost covered, a very sickening stench which was hard to tolerate. From the showman I learned nothing about the elephant man except that he was English, that his name was John Merrick, and that he was twenty-one years of age. As at the time of my discovery of the elephant man I was a lecturer on anatomy in the medical college opposite, I was anxious to examine him in detail and to prepare an account of his abnormalities. I therefore arranged with the showman that I should interview his strange exhibit in my room at the college. I became at once conscious of a difficulty. The elephant man could not show himself in the streets. He would have been mobbed by the crowd and seized by the police. He was, in fact, as secluded from the world as the man in the iron mask. He had, however, a disguise, although it was almost as startling as he was himself. It consisted of a long black cloak which reached to the ground. Once the cloak had been obtained I cannot imagine. I had only seen such a garment on the stage wrapped about the figure of a Venetian bravo. The recluse was provided with a pair of bag-like slippers in which to hide his deformed feet. On his head was a cap of a kind that never before was seen. It was black, like the cloak, had a wide peak and the general outline of a yachting cap. As the circumference of Merrick's head was that of a man's waist, the size of this headgear must be imagined. From the attachment of the peak a gray flannel curtain hung in front of the face. In this mask was cut a wide horizontal slit through which the wearer could look out. This costume, worn by a bent man hobbling along with a stick, is probably the most remarkable and the most uncanny that has yet been designed. I arranged that Merrick should cross the road in a cab and to ensure his immediate admission to the college I gave him my card. This card was destined to play a critical part in Merrick's life. I made a careful examination of my visitor, the result of which I embodied in a paper, footnote, British Medical Journal, December 1886 and April 1890. I made little of the man himself. He was shy, confused, not little frightened, and evidently much cowed. Moreover, his speech was almost unintelligible. The great bony mass that projected from his mouth blurred his utterance and made the articulation of certain words impossible. He returned in a cab to the place of exhibition, and I assumed that I had seen the last of him, especially as I found the next day that the show had been forbidden by the police and that the shop was empty. I supposed that Merrick was imbecile and had been imbecile from birth. The fact that his face was incapable of expression, that his speech was a mere spluttering, and his attitude that of one whose mind was void of all emotions and concerns gave grounds for this belief. The conviction was no doubt encouraged by the hope that his intellect was the blank I imagined it to be. That he could appreciate his position was unthinkable. Here was a man in the heyday of youth who was so violently deformed that everyone he met confronted him with a look of horror and disgust. He was taken about the country to be exhibited as a monstrosity and an object of loathing. He was shunned like a leper, housed like a wild beast, and got his only view of the world from a peephole in a showman's cart. He was more over lame, but had one available arm, and could hardly make his utterances understood. It was not until I came to know that Merrick was highly intelligent that he possessed an acute sensibility and, worse than all, a romantic imagination that I realized the overwhelming tragedy of his life. The episode of the Elephant Man was, I imagined, closed. But I was fated to meet him again two years later under more dramatic conditions. In England the showman and Merrick had been moved on from place to place by the police, who considered the exhibition degrading and among the things that could not be allowed. It was hoped that in the uncritical retreats of Mile End a more abiding peace would be found, but it was not to be. The official mind there, as elsewhere, very properly decreed that the public exposure of Merrick and his deformities transgress the limits of decency. The show must close. The showman in despair fled with his charge to the continent. Whether he roamed at first, I do not know, but he finally came to Brussels. His reception was discouraging. Brussels was firm. The exhibition was banned. It was brutal, indecent and immoral, and could not be permitted within the confines of Belgium. Merrick was thus no longer of value. He was no longer a source of profitable entertainment. He was a burden. He must be got rid of. The elimination of Merrick was a simple matter. He could offer no resistance. He was as docile as a stick sheep. The impresario, having robbed Merrick of his poultry savings, gave him a ticket to London, saw him into the train, and no doubt in parting condemned him to perdition. His destination was Liverpool Street. The journey may be imagined. Merrick was in his alarming outdoor garb. He would be harried by an eager mob as he hobbled along the key. They would run ahead to get a look at him. They would lift the hem of his cloak to peep at his body. He would try to hide in the train or in some dark corner of the boat, but never could he be free of that ring of curious eyes or from those whispers of fright and aversion. He had but a few shillings in his pocket and nothing either to eat or drink on the way. A panic dazed dog with a label on his collar would have received some sympathy and possibly some kindness. Merrick received none. What was he to do when he reached London? He had not a friend in the world. He knew no more of London than he knew of Peking. How could he find a lodging or what lodging housekeeper would dream of taking him in? All he wanted was to hide. What most he dreaded were the open street and the gaze of his fellow men. If even he crept into a cellar the horrid eyes and the still more dreaded whispers would follow him to its depths. Was there ever such a homecoming? At Liverpool Street he was rescued from the crowd by the police and taken into the third-class waiting-room. Here he sank on the floor in the darkest corner. The police were at a loss what to do with him. They had dealt with strange and mouldy tramps, but never with such an object as this. He could not explain himself. His speech was so maimed that he might as well have spoken in Arabic. He had, however, something with him which he produced with a ray of hope. It was my card. The card simplified matters. It made it evident that this curious creature had an acquaintance and that the individual must be sent for. A messenger was dispatched to the London Hospital, which is comparatively near at hand. Fortunately I was in the building and returned at once with the messenger to the station. In the waiting-room I had some difficulty in making a way through the crowd, but there on the floor in the corner was Merrick. He looked a mere heap. It seemed as if he had been thrown there like a bundle. He was so huddled up and so helpless-looking that he might have had both his arms and his legs broken. He seemed pleased to see me, but he was nearly done. The journey in want of food had reduced him to the last stage of exhaustion. The police kindly helped him into a cab, and I drove him at once to the hospital. He appeared to be content, for he fell asleep almost as soon as he was seated and slept to the journey's end. He never said a word, but seemed to be satisfied that all was well. In the attics of the hospital was an isolation ward with a single bed. It was used for emergency purposes, for a case of delirium tremens, for a man who had become suddenly insane, or for a patient with an undetermined fever. Here the elephant man was deposited on a bed, was made comfortable, and was supplied with food. I had been guilty of an irregularity in admitting such a case, for the hospital was neither a refuge nor a home for incurables. Conic cases were not accepted, but only those requiring active treatment, and Merrick was not in need of such treatment. I applied to the sympathetic chairman of the committee, Mr Carr Gom, who not only was good enough to approve my action, but who agreed with me that Merrick must not again be turned out into the world. Mr Carr Gom wrote a letter to the Times detailing the circumstances of the refugee, and asking for money for his support. So generous is the English public that in a few days, I think it was a week, enough money was forthcoming to maintain Merrick for life without any charge upon the hospital funds. There chanced to be two empty rooms at the back of the hospital, which were little used. They were on the ground floor, were out of the way, and opened upon a large courtyard called Bedstead Square, because here the iron beds were marshalled for cleaning and painting. The front room was converted into a bed-sitting room, and the smaller chamber into a bathroom. The condition of Merrick's skin rendered a bath at least once a day a necessity, and I might hear mention that with the use of the bath, the unpleasant odor to which I have referred ceased to be noticeable. Merrick took up his abode in the hospital in December 1886. Merrick had now something he had never dreamed of, never supposed to be possible, a home of his own for life. I at once began to make myself acquainted with him, and to endeavour to understand his mentality. It was a study of much interest. I very soon learned his speech so that I could talk freely with him. This afforded him great satisfaction, for curiously enough he had a passion for conversation, yet all his life had had no one to talk to. I, having then much leisure, saw him almost every day, and made a point of spending some two hours with him every Sunday morning when he would chatter almost without ceasing. It was unreasonable to expect one nurse to attend to him continuously, but there was no lack of temporary volunteers. As they did not all acquire his speech, it came about that I occasionally had to act as an interpreter. I found Merrick, as I have said, remarkably intelligent. He had learned to read, and had become a most voracious reader. I think he had been taught when he was in hospital with his diseased hip. His range of books was limited. The Bible and prayer book he knew intimately, but he had subsisted for the most part upon newspapers, or rather upon such fragments of old journals as he had chance to pick up. He had read a few stories and some elementary lesson books, but the delight of his life was a romance, especially a love romance. These tales were very real to him, as real as any narrative in the Bible, so that he would tell them to me as incidents in the lives of people who had lived. In his outlook upon the world he was a child, yet a child with some of the tempestuous feelings of a man. He was an elemental being, so primitive that he might have spent the twenty-three years of his life immured in a cave. Of his early days I could learn but little. He was very loath to talk about the past. It was a nightmare, the shudder of which was still upon him. He was born, he believed, in or about Lester. Of his father he knew absolutely nothing. Of his mother he had some memory. It was very faint and had, I think, been elaborated into his mind into something definite. Mothers figured in the tales he had read, and he wanted his mother to be one of those comfortable lullaby singing persons who were so lovable. In his subconscious mind there was apparently a germ of recollection in which someone figured who had been kind to him. He clung to this conception and made it more real by invention, for since the day when he could total no one had been kind to him. As an infant he must have been repellent, although his deformities did not become gross until he had attained his full stature. It was a favourite belief of his that his mother was beautiful. The fiction was, I am aware, one of his own making, but it was a great joy to him. His mother, lovely as she may have been, basically deserted him when he was very small, so small that his earliest clear memories were of the workhouse to which he had been taken. Worthless and inhuman as his mother was, he spoke of her with pride and even with reverence. Once when referring to his own appearance he said, It is very strange for, as you see, mother was so beautiful. The rest of Merrick's life up to the time that I met him at Liverpool Street Station was one dull record of degradation and squalor. He was dragged from town to town and from fair to fair, as if he were a strange beast in a cage. A dozen times a day he would have to expose his nakedness and his piteous deformities before a gaping crowd who greeted him with such mutterings as, Oh, what a horror, what a beast. He had had no childhood, he had had no boyhood, he had never experienced pleasure, he knew nothing of the joy of living nor of the fun of things. His sole idea of happiness was to creep into the dark and hide. Shut up alone in a booth awaiting the next exhibition, how mocking must have sounded the laughter and merriment of the boys and girls outside who were enjoying the fun of the fair. He had no past to look back upon and no future to look forward to. At the age of 20 he was a creature without hope. There was nothing in front of him but a vista of caravans creeping along a road, a rose of glaring show-tents, and of circles of staring eyes with, at the end, the spectacle of a broken man in a poor law infirmary. Those who are interested in the evolution of character might speculate as to the effect of this brutish life upon a sensitive and intelligent man. It would be reasonable to surmise that he would become a spiteful and malignant misanthrope, swollen with venom and filled with hatred of his fellow men, or on the other hand that he would degenerate into a despairing melancholic on the verge of idiocy. Merrick, however, was no such being. He had passed through the fire and had come out unscathed. His troubles had ennobled him. He showed himself to be a gentle, affectionate and lovable creature, as amiable as a happy woman, free from any trace of cynicism or resentment, without grievance and without an unkind word for anyone. I have never heard him complain. I have never heard him deplore his ruined life or resent the treatment he had received at the hands of callus keepers. His journey through life had been indeed along a veer dolorosa. The road had been uphill all the way, and now when the night was at his blackest and the way most steep, he had suddenly found himself, as it were, in a friendly inn, bright with light and warm with welcome. His gratitude to those about him was pathetic in its sincerity and eloquent in the childlike simplicity with which it was expressed. As I learned more of this primitive creature, I found that there were two anxieties which were prominent in his mind, and which he revealed to me with diffidence. He was in the occupation of the rooms assigned to him, and had been assured that he would be cared for to the end of his days. This, however, he found hard to realise, for he often asked me timidly to what place he would next be moved. To understand his attitude it is necessary to remember that he had been moving on and moving on all his life. He knew no other state of existence. To him it was normal. He had passed from the workhouse to the hospital, from the hospital back to the workhouse, then from this town to that town or from one showman's caravan to another. He had never known a home nor any semblance of one. He had no possessions. His sole belongings, besides his clothes and some books, were the monstrous cap and the cloak. He was a wanderer, a pariah, and an outcast. That his quarters at the hospital were his for life he could not understand. He could not rid his mind of the anxiety which had pursued him for so many years. Where am I to be taken next? Another trouble was his dread of his fellow men, his fear of people's eyes, the dread of being always stared at, the lash of the cruel mutterings of the crowd. In his home in Bedstead Square he was secluded, but now and then a thoughtless porter or a wardmate would open his door to let curious friends have a peep at the Elephant Man. It therefore seemed to him as if the gaze of the world followed him still. Influenced by these two obsessions he became during his first few weeks at the hospital, curiously uneasy. At last, with much hesitation, he said to me one day, When I am next moved, can I go to a blind asylum or to a lighthouse? He had read about blind asylums in the newspapers and was attracted by the thought of being among people who could not see. The lighthouse had another charm, it meant seclusion from the curious. There at least no one could open a door and peep in at him. There he would forget that he had once been the Elephant Man. There he would escape the vampire showman. He had never seen a lighthouse, but he had come upon a picture of the Eddy Stone and it appeared to him that this lonely column of stone in the waste of the sea was such a home as he had longed for. I had no great difficulty in ridding Merrick's mind of these ideas. I wanted him to get accustomed to his fellow men, to become a human being himself, and to be admitted to the communion of his kind. He appeared day by day less frightened, less haunted looking, less anxious to hide, less alarmed when he saw his door being opened. He got to know most of the people about the place, to be accustomed to their comings and goings, and to realize that they took no more than a friendly notice of him. He could only go out after dark, and on fine nights, Benchage to take a walk in Bedstead Square, clad in his black cloak and his cap. His greatest adventure was on one moonless evening when he walked alone as far as the hospital garden and back again. To secure Merrick's recovery and to bring him as it were to life once more, it was necessary that he should make the acquaintance of men and women who would treat him as a normal and intelligent young man, and not as a monster of deformity. Women are felt to be more important than men in bringing about his transformation. Women were the more frightened of him, the more disgusted at his appearance, and the more apt to give way to irrepressible expressions of aversion when they came into his presence. Moreover, Merrick had an admiration of women of such a kind that it attained almost adoration. This was not the outcome of his personal experience. They were not real women, but the products of his imagination. Among them was the beautiful mother, surrounded at a respectful distance, by heroines from the many romances he had read. His first entry to the hospital was attended by a regrettable incident. He had been placed on the bed in a little attic, and a nurse had been instructed to bring him some food. Unfortunately, she had not been fully informed of Merrick's unusual appearance. As she entered the room, she saw on the bed, propped up by white pillows, a monstrous figure as hideous as an Indian idol. She had once dropped the tray she was carrying and fled with a shriek through the door. Merrick was too weak to notice much, but the experience I'm afraid was not new to him. He was looked after by volunteer nurses, whose ministrations were somewhat formal and constrained. Merrick, no doubt, was conscious that their service was purely official, that they were merely doing what they were told to do, and that they were acting rather as automata than as women. They did not help him to feel that he was of their kind. On the contrary, they, without knowing it, made him aware that the gulf of separation was immeasurable. Feeling this, I asked a friend of mine, a young and pretty widow, if she thought she could enter Merrick's room with a smile, wish him good morning, and shake him by the hand. She said she could, and she did. The effect upon poor Merrick was not quite what I had expected. As he let go her hand, he bent his head on his knees and sobbed until I thought he would never cease. The interview was over. He told me afterwards that this was the first woman who had ever smiled at him, the first woman in the whole of his life who had shaken hands with him. From this day the transformation of Merrick commenced, and he began to change little by little from a hunted thing into a man. It was a wonderful change to witness, and one that never ceased to fascinate me. Merrick's case attracted much attention in the papers, with the result that he had a constant succession of visitors. Everybody wanted to see him. He must have been visited by almost every lady of note in the social world. They were all good enough to welcome him with a smile and to shake hands with him. The Merrick whom I had found shivering behind a rag of a curtain in an empty shop, was now conversant with duchesses and countesses and other ladies of high degree. They brought him presents, made his room bright with ornaments and pictures, and what pleased him more than all, supplied him with books. He soon had a large library, and most of his day was spent in reading. He was not the least spoiled, not the least puffed up. He never asked for anything, never presumed upon the kindness meted out to him, and was always humbly and profoundly grateful. Above all, he lost his shyness. He liked to see his door pushed open and people to look in. He became acquainted with most of the frequenters of Bedstead Square, would chat with them at his window, and show them some of his choicest presence. He improved in his speech, although, to the end, his utterances were not easy for strangers to understand. He was beginning, moreover, to be less conscious of his unsightliness, a little disposed to think it was, after all, not so very extreme. Possibly this was aided by the circumstance that I would not allow a mirror of any kind in his room. The height of his social development was reached on an eventful day when Queen Alexandra, then Princess of Wales, came to the hospital to pay him a special visit. With that kindness, which has marked every act of her life, the Queen ended Merrick's room smiling, and shook him warmly by the hand. Merrick was transported with delight. This was beyond even his most extravagant dream. The Queen has made many people happy, but I think no gracious act of hers has ever caused such happiness as she brought into Merrick's room, when she sat by his chair and talked to him as a person she was glad to see. Merrick, I may say, was now one of the most contented creatures I had chance to meet. More than once he said to me, I am happy every hour of the day. This was good to think upon when I recall the half-dead heap of miserable humanity I had seen in the corner of the waiting-room at Liverpool Street. Most men of Merrick's age would have expressed their joy and sense of contentment by singing or whistling when they were alone. Unfortunately, poor Merrick's mouth was so deformed that he could neither whistle nor sing. He was satisfied to express himself by beating time upon the pillow to some tune that was ringing in his head. I have many times found him so occupied when I have entered his room unexpectedly. One thing that always struck me as sad about Merrick was the fact that he could not smile. Whatever his delight might be, his face remained expressionless. He could weep, but he could not smile. The Queen paid Merrick many visits and sent him every year a Christmas card with a message in her own handwriting. On one occasion she sent him a signed photograph of herself. Merrick, quite overcome, regarded it as a sacred object and would hardly allow me to touch it. He cried over it, and after it was framed and had put up in his room as a kind of icon. I told him that he must write to her Royal Highness to thank her for her goodness. This he was pleased to do, as he was very fond of writing letters, never before in his life having had anyone to write to. I allowed the letter to be dispatched unedited. It began, my dear princess, and ended, yours very sincerely. Unauthorized as it was, it was expressed in terms any courtier would have envied. Other ladies followed the Queen's gracious example and sent their photographs to this delighted creature who had all his life been despised and rejected of men. His mantelpiece and table became so covered with photographs of handsome ladies, with dainty knickknacks and pretty trifles, that they may almost have befitted the apartment of an adonis-like actor or of a famous tenor. Through all these bewildering incidents and through all the glamour of this great change, Merrick still remained in many ways a mere child. He had all of the invention of an imaginative boy or girl, the same love of make-believe, the same instinct of dressing up, and of personating heroic and impressive characters. This attitude of mind was illustrated by the following incident. Benevolent visitors had given me, from time to time, sums of money to be expended for the comfort of the C-de-Mont elephant man. When one Christmas was approaching, I asked Merrick what he would like me to purchase as a Christmas present. He rather startled me by saying shyly that he would like a dressing bag with silver fittings. He had seen a picture of such an article in an advertisement which he had furtively preserved. The association of the silver fitted dressing bag, with the poor wretch wrapped up in a dirty blanket in an empty shop, was hard to comprehend. I fathomed the mystery in time for Merrick made little secret of the fancies that haunted his boyish brain. Just as a small girl with a tinsel coronet and a window curtain for a train will realise the conception of a countess on her way to court, so Merrick loved to imagine himself a dandy and a young man about town. Mentally, no doubt, he had frequently dressed up for the part. He could make believe with great effect, but he wanted something to render his fancied character more realistic, hence the jaunty bag, which was to assume the function of the toy coronet and the window curtain, that could transform a mite with a pigtail into a countess. As a theatrical prop, the dressing bag was ingenious, since there was little else to give substance to the transformation. Merrick could not wear the silk hat of the dandy, nor indeed any kind of hat. He could not adapt his body to the trimly cut coat. His deformity was such that he could wear neither collar nor tie, while in association with his bulbous feet, the young blood's patent leather shoe was unthinkable. What was there left to make up the character? A lady had given him a ring to wear on his under-formed hand, and a noble lord had present him with a very stylish walking stick. But these things, helpful as they were, were hardly sufficing. The dressing bag, however, was distinctive, was explanatory, and entirely characteristic. So the bag was obtained, and Merrick, the elephant man, became, in the seclusion of his chamber, the Piccadilly exquisite, the young spark, the gallant, the nut. When I purchased the article, I realised that as Merrick could never travel, he could hardly want a dressing bag. He could not use the silver-backed brushes in the comb because he had no hair to brush. The ivory-handled razors were useless because he could not shave. The deformity of his mouth rendered an ordinary toothbrush of no avail, and as his monstrous lips could not hold a cigarette, the cigarette case was a mockery. The silver shoehorn would be of no service in the putting on of his ungainly slippers, while the hat brush was quite unsuited to the peaked cap with its visor. Still, the bag was an emblem of the real swell and of the knockabout Don One of whom he had read. So every day Merrick laid out upon his table with proud precision the silver brushes, the razors, the shoehorn, and the silver cigarette case, which I had taken care to fill with cigarettes. The contemplation of these gave him great pleasure, and such is the power of self-deception that they convinced him that he was the real thing. I think there was just one shadow in Merrick's life. As I have already said, he had a lively imagination, he was romantic, he cherished an emotional regard for women, and his favourite pursuit was a reading of love stories. He fell in love, in a humble and devotional way, with I think every attractive lady he saw. He no doubt pictured himself the hero of many a passionate incident. His bodily deformity had left unmarred the instincts and feelings of his years. He was amorous, he would like to have been a lover, to have walked with the beloved object in the languorous shades of some beautiful garden, and to have poured into her ear all the glowing utterances he had rehearsed in his heart. And yet, the pity of it, imagine the feelings of such a youth when he saw nothing but a look of horror creep over the face of every girl whose eyes met his. I fancy when he talked of life among the blind, there was a half-formed idea in his mind that he might be able to win the affection of a woman if only she were without eyes to see. As Merrick developed, he began to display certain modest ambitions in the direction of improving his mind and enlarging his knowledge of the world. He was as curious as a child and as eager to learn. There were so many things he wanted to know and see. In the first place, he was anxious to view the interior of what he called a real house. Such a house as figured in many of the tales he knew, a house with a hole, a drawing room where guests were received, and a dining room with a plate on the sideboard and with easy chairs into which the hero could fling himself. The workhouse, the common lodging house, and a variety of mean garrets were all the residents as he knew. To satisfy this wish, I drove him up to my small house in Wimpole Street. He was absurdly interested and examined everything in detail and with untiring curiosity. I could not show him the pampered menials and the powdered footmen of whom he had read, nor could I produce the white marble staircase of the mansion of romance, nor the gilded mirrors and the brocaded divans which belonged to that style of residence. I explained that the house was a modest dwelling of the Jane Austen type, and as he had read Emma, he was content. The more burning ambition of his was to go to the theatre. It was a project very difficult to satisfy. A popular pantomime was then in progress at the Drury Lane Theatre, but the problem was how so conspicuous a being as the elephant man could be got there and how he was to see the performance without attracting the notice of the audience and causing a panic or at least an unpleasant diversion. The whole matter was most ingeniously carried through by that kindest of women and most able of actresses, Mrs. Kendall. She made the necessary arrangements with the Lassie of the theatre. A box was obtained, Merrick was brought up in a carriage with drawn blinds, and was allowed to make use of the royal entrance so as to reach the box by a private stair. I had begged three of the hospital sisters to don evening dress and to sit in the front row in order to dress the box on the one hand and to form a screen for Merrick on the other. Merrick and I occupied the back of the box which was kept in shadow. All went well, and no one saw a figure more monstrous than any on the stage mount the staircase or cross the corridor. One has often witnessed the unconstrained delight of a child at its first pantomime, but Merrick's rapture was much more intense as well as much more solemn. Here was a being with the brain of a man, the fancies of a youth, and the imagination of a child. His attitude was not so much that of delight as of wonder and amazement. He was awed, he was enthralled, the spectacle left him speechless, so that if he was spoken to he took no heed. He often seemed to be panting for breath. I could not help comparing him with the man of his own age in the stalls. This satiated individual was bored to distraction, would look wearily at the stage from time to time, and then yawn as if he had not slept for nights, while at the same time Merrick was thrilled by a vision that was almost beyond his comprehension. Merrick talked of this pantomime for weeks and weeks. To him, as to a child with the faculty of make-believe, everything was real. The palace was the home of kings, the princess was of royal blood, the fairies were as undoubted as the children in the street, while the dishes at the banquet were of unquestionable gold. He did not like to discuss it as a play, but rather as a vision of some actual world. When this mood possessed him he would say, I wonder what the prince did after we left, or do you think that poor man is still in the dungeon? And so on and so on. The splendor and display impressed him, but I think the ladies of the ballet took a still greater hold upon his fancy. He did not like the ogres and the giants, while the funny men impressed him as irreverent. Having no experience as a boy of romping and ragging, of practical jokes or larks, he had little sympathy with the doings of the clown, but I think, moved by some mischievous instinct in his subconscious mind, he was pleased when the policeman was smacked in the face, knocked down, and generally rendered undignified. Later on another longing stirred the depths of Merrick's mind. It was a desire to see the country, a desire to live in some green, secluded spot, and there learn something about flowers and the ways of animals and birds. The country, as viewed from a wagon on a dusty high road, was all the country he knew. He had never wandered among the fields, nor followed the windings of a wood. He had never climbed to the brow of a breezy town. He had never gathered flowers in a meadow. Since so much of his reading dealt with country life, he was possessed by the wish to see the wonders of that life for himself. This involved a difficulty greater than that presented by a visit to the theatre. The project was, however, made possible on this occasion also by the kindness and generosity of a lady, Lady Knightley, who offered Merrick a holiday home and a cottage on her estate. Merrick was conveyed to the railway station in the usual way, but as he could hardly venture to appear on the platform, the railway authorities were good enough to run a second-class carriage into a distant siding. To this point Merrick was driven and was placed in the carriage unobserved. The carriage, with the curtain drawn, was then attached to the mainline train. He duly arrived at the cottage, but the housewife, like the nurse at the hospital, had not been made clearly aware of the unfortunate man's appearance. Thus it happened that when Merrick presented himself, his hostess, throwing her apron over her head, fled gasping into the fields. She affirmed that such a guest was beyond her powers of endurance, for when she saw him, she was that took as to be in danger of being permanently all of a tremble. Merrick was then conveyed to a gamekeeper's cottage which was hidden from view and was close to the margin of the wood. The man and his wife were able to tolerate his presence. They treated him with the greatest kindness, and with them he spent the one supreme holiday of his life. He could roam where he pleased. He met no one in his wanderings, for the wood was preserved and denied to all but the gamekeeper and the forester. There is no doubt that Merrick passed in this retreat the happiest time he had as yet experienced. He was alone in a land of wonders, the breath of the country passed over him like a healing wind. Into the silence of the wood the fearsome voice of the showman could never penetrate. No cruel eyes could peep at him through the friendly undergrowth. It seemed as if in this place of peace all stain had been wiped away from his solid past. The Merrick who had once crouched terrified in the filthy shadows of a myelin shop was now sitting in the sun, in a clearing among the trees, arranging a bunch of violets he had gathered. His letters to me were the letters of a delighted and enthusiastic child. He gave an account of his trivial adventures, of the amazing things he had seen and of the beautiful sounds he had heard. He had met with strange birds, had startled a hare from her form, had made friends with a fierce dog, and had watched the trout darting in the stream. He sent me some of the wildflowers he had picked. They were of the commonest and most familiar kind, but they were evidently regarded by him as rare and precious specimens. He came back to London, to his quarters in Bedstead Square, much improved in health, pleased to be home again and to be once more among his books, his treasures and his many friends. Some six months after Merrick's return from the country he was found dead in bed. This was in April 1890. He was lying on his back as if asleep, and had evidently died suddenly and without a struggle, since not even the coverlet of the bed was disturbed. The method of his death was peculiar. So large and heavy was his head that he could not sleep lying down. When he assumed the recumbent position, the massive skull was inclined to drop backwards, with the result that he experienced no little distress. The attitude he was compelled to assume when he slept was very strange. He sat up in bed with his back supported by pillows, his knees drawn up, and his arms clasped around his legs, while his head rested on the points of his bent knees. He often said to me that he wished he could lie down to sleep like other people. I think on this last night he must, with some determination, have made the experiment. The pillow was soft, and the head when placed on it must have fallen backwards, and caused a dislocation of the neck. Thus it came about that his death was due to the desire that had dominated his life, the pathetic but hopeless desire to be like other people. As a specimen of humanity Merrick was ignoble and repulsive, but the spirit of Merrick, if it could be seen in the form of the living, would assume the figure of an upstanding and heroic man, smooth-browed and clean of limb, and with eyes that flashed undaunted courage. His tortured journey had come to an end. All the way he, like another, had borne on his back a burden almost too grievous to bear. He had been plunged into the slough of despond, but with manly steps had gained the further shore. He had been made a spectacle to all men in the heartless streets of Vanity Fair. He had been ill-treated and reviled, and bespattered with the mud of disdain. He had escaped the clutches of the giant despair, and at last had reached the place of deliverance, where his burden loosed from off his shoulders and fell from off his back, so that he saw it no more. End of Chapter 1 Recording by Mike Casey, Madison, Wisconsin The Elephant Man and Other Reminiscences by Frederick Treves The Old Receiving Room A house surgeon at a great accident hospital in the east of London happens upon strange scenes, some pathetic, some merely sordid, together with fragments of tragedy in which the most elemental passions and emotions of humanity are displayed. The chief place in which this experience has gained is The Receiving Room. I speak of a hospital not as it is now, but as it was some fifty years ago. The Receiving Room is a bare hall, painted stone color. It contains as furniture, rows of deal benches, and as wall decoration a printed notice, framed and glazed, detailing vivid measures for restoring the apparently drowned. Below this helpful document is fixed an iron-bound money box. There is, moreover, a long desk in the hall where entries are made, and certificates and other papers are issued. As a room for the reception of the sick and suffering, it is a cold, harsh place, with about it an air of cynical indifference. This hall serves as a waiting room, and there are nearly always some people waiting in it. It may be a sniffing woman who is called for her dead husband's clothes. It may be a still breathless messenger with a midwifery card in her hand, or a girl waiting for a dose of emergency medicine. There may be some minor accident cases also, such as a torn finger, a black eye like a bursting plum, a child who has swallowed a half-penny, and a woman who has been knocked about cruel, but has little to show for it except a noisy desire to have her husband locked up. In certain days of stress, as on Saturday nights, when the air is heavy with alcohol, or on the occasion of a big dock accident, the waiting room is crowded with excited folk, with patients waiting their turn to be dressed, with policemen, busybodies, reporters, and friends of the injured. On each side of the waiting hall is a dressing room, one for women, one for men. Into these rooms the accident cases are taken one after the other. Here the house surgeon and his dressers are engaged, and here the many-sided drama of the receiving room reaches its culminating point. It is an uninviting room, very plain, and like the outer hall, bears an aspect of callus unconcern. By the window is a suspiciously large sink, and on the ledge above it a number of pewter pouringers. One side of the room is occupied by a mysterious cupboard containing dressings, gags, manacles, emetics, and other unattractive things. In the center are a common table and two hard chairs. The most repellent thing in the room is a low sofa. It is wide, and it is covered with very thick leather, which is suspiciously shiny and black. It suggests no more comfort than a rack. Its associations are unpleasant. It has been smothered with blood, and with every kind of imaginable filth, and has been cleaned up so often that it is no wonder that the deeply stained leather is shiny. It is on this grim black couch that the case, just carried into the hospital, is placed. It may be a man ridden over in the street, with the red bone ends of his broken legs sticking through his trousers. It may be a machine accident, where strips of cotton shirt become tangled up with torn flesh in a trail of black grease. It may be a man picked up in a lane with his throat cut, or a woman dripping foul mud who has been dragged out of a river. Sometimes the occupant of the sofa is a snoring lump of humanity so drunk is to be nearly dead, or it may be a panting woman who has taken poison and regretted it. In both cases, the stomach pump is used with nauseating incidents. Now and then the sofa is occupied by a purple-faced maniac, who is pinned down by sturdy dressers, while a straight jacket is being applied to him. This is not the whole of its history nor of its services, for the receiving room nurse who is rather proud of it likes to record that many a man and many a woman have breathed their last on this horrible divan. The so-called dressing room is at its best a messy place, as two mops kept in a corner seem to suggest. It is also at times a noisy place, since the yells and screams that escape from it may be heard in the street and may cause passersby to stop and look up at the window. Among the sick and the maimed who are received in this unsympathetic hall, the most pathetic are the wandering babies and the children. Many are brought in burnt and wrapped up in blankets with only their singed hair showing out of the bundle. Others have been scalded so that tissue paper-like sheets of skin come off when their dressings are applied. Not a few in old days were scalded in the throat from drinking out of kettles. Then there are the children who have swallowed things and who have added to the astounding collection of articles from buttons to prayer book clasps, which have found their way, at one time or another, into the infant interior, as well as children who have needles embedded in parts of their bodies or have been bitten by dogs or cats or even rats. I remember one bloated, half-dressed woman who ran screaming into the receiving room with a dead baby in her arms. She had gone to bed drunk and had awakened in the morning in a tremulous state to find a dead infant by her side. This particular experience was not unusual in Whitechapel. Then there was another woman who rushed in drawing attention to a thing like a tiny bead of glass sticking to her baby's cheek. The child had acute inflammation of the eyeball, which the mother had treated with cold tea. The eye had long been closed, but when the mother made a clumsy attempt to open the swollen lids, something had popped out, some fluid and this thing like glass. She was afraid to touch it. She viewed it with horror, as a strange thing that had come out of the eye. Hugging the child, she had run a mile or so with the dread object, still adhering to the skin of the cheek. This glistening thing was the crystalline lens. The globe had been burst, and the child was, of course, blind. Happily, such a case could hardly be met with at the present day. On the subject of children and domestic surgery as revealed in the receiving room, I recall the case of a boy aged about four who had pushed a dry pee into his ear. The mother attempted to remove it with that common surgical implement of the home, a hairpin. She not only failed, but succeeded in pushing the pee farther down into the bony part of the canal. Being a determined woman, she borrowed a squirt and proceeded to syringe out the foreign body with hot water. The result was that the pee swelled, and being encased in bone, caused so intense and terrible a pain that the boy became unconscious from shock. Possibly the most dramatic spectacle in connection with receiving room life and pre-ambulance days was the approach to the hospital gate of a party carrying a wounded woman or man. Looking out of the receiving room window on such occasion, a silent crowd would be seen coming down the street. It is a closely packed crowd which moves like a clot, which occupies the whole pavement and oozes over into the road. In the center of the mass is an obscure object towards which all eyes are directed. In the procession are many women, mostly with tussled heads, men, mostly without caps, a butcher, a barber's assistant, a trim postman, a white washer, a man in a tall hat, and a pattering fringe of ragged boys. The boys, being small, cannot see much, so they race ahead in relays to glimpse the fascinating object from the front or climb up railings or mount upon steps to get a view of it as it passes by. Possibly towering above the throng would be two policemen, presenting an air of assumed calm. But policemen were not so common in those days as they are now. The object carried would be indistinct, being hidden from view as is the queen bee by a clump of fussing bees. Very often the injured person is merely carried along by hand, like a parcel that is coming to pieces. There would be a man to each leg and to each arm, while men on either side would hang onto the coat. Possibly some Samaritan walking backwards would hold up the dangling head. It was a much prized distinction to clutch even a fragment of the sufferer or to carry his hat or the tools he had dropped. At this period the present day stretcher was unknown in civil life. A stretcher provided by the docks was a huge structure with high sides. It was painted green and was solid enough to carry a horse. A common means of conveyance for the helpless was a shutter, but with the appearance of the modern ambulance the shutter has become as out of date as the sedan chair. Still at this time when anyone was knocked down in the street some bright resourceful bystander would be sure to call out SEND FOR A SHUTTER! The conveying of a drunken man with a cut head to the hospital by the police in the ancient fashion was a more hilarious ceremonial. The patient would be hooked up on either side by an official arm. His body would sag between these two supports so that his shoulders would be above his ears. His clothes would be worked up in folds about his neck and he would appear to be in danger of slipping earthwards out of them. As it was there would be a display of shirt and braces very evident below his coat. His legs would dangle below him like roots while his feet as they dragged along the pavement would be twisted now in one direction and now in another like the feet of a badly stuffed lay figure. He would probably be singing as he passed along to the delight of the people. Of the many receiving room processions that I have witnessed the most moving the most savage and the most rich in color, noise and language was on an occasion when two ladies who had been badly lacerated in a fight were being dragged, carried or pushed towards the hospital for treatment. They were large copious women who were both in an advanced stage of intoxication. They had been fighting with gin bottles in some stagnant court which had become for the moment an uproarious cockpit. The technique of such a duel is punctilious. The round smooth bottoms of the bottles are knocked off and the combatants, grasping the weapons by the neck, proceed to jab one another in the face with the jagged circles of broken glass. The wounds in this instance were terrific. The faces of the two hideously distorted were streaming with blood while their ample bodies seemed to have been drenched with the same. Their hair soaked in blood was plastered to their heads like claret colored seaweed on a rock. The two heroines were born along by their women friends. The police kept wisely in the background for their time was not yet. The crowd around the two bleeding figures was so compressed that the whole mass moved as one. It was a wild crowd, a writhing nod of varagos who roared and screamed and rent the air with curses and yells of vengeance for there were partisans in the fight, the Montague's and Capulets of a ferocious feud. The crowd as it came along rocked to and fro, heaved and kerched as if propelled by some uneasy sea, the very pavement seemed unsteady. Born on the crest of this ill-smelling wave were the two horrible women, one still shrieked threats and defiance in a voice as husky as that of a beast, while now and then she lifted aloft a blood-streaked arm in the hand of which was clutched a tuft of hair torn from her opponent's head. Every display of this trophy called forth a shout of pride from her admirers. The other woman was in a state of drunken hysteria, throwing back her head until the sun illumined her awful features, she gave vent to bursts of maniacal laughter which were made peculiarly hideous by the fact that her nose was nearly severed from her face while her grinning lips were hacked in too. At another moment, burying her head against the back of the woman in front of her, she would break out into sobs and groans which were even more unearthly than her laughter. The whole affair suggested some fearful back-and-alien orgy associated with bloodshed, in which all concerned were the subjects of demoniacal possession. There is, happily, much less drunkenness nowadays and less savagery while the police control of these street scenes is so efficient and the public ambulance so secretive that such a spectacle as I now recall belongs forever to the past. When a crowd bearing a casualty reaches the hospital gates, its progress is stayed. It rolls up against the iron barrier. It stops and recoils like a muddy wave against a bank. The porter is strict. Only the principals, their supporters and the police are allowed to filter through. The members of the crowd remain in the street where they look through the railings to which they cling and indulge in fragments of narrative and comments on the affair and on the prospects of the parties injured. If a scream should escape from the receiving room the watchers feel that they are well rewarded for long waiting while any member of the privileged party who may leave the building is subject to very earnest questioning. It is needless to say that the receiving room is not always tragical, not always the scene of alarms and disorders, not always filled with wild-eyed folk nor echoing the scuffle of heavy feet and the moans of the suffering. It may be as quiet as a room in a convent. I've seen it so many a time and particularly on a Sunday morning in the heyday of summer. Then the sun streaming through the windows may illumine the figure of the nurse as she sits on the awful sofa. She has her spectacles on and is busy with some white needlework. Her attitude is so placid that she might be sitting at a cottage door listening to a blackbird in a wicker cage. Yet this quiet-looking woman, although she has not fought with wild beasts at a thesis, has fought with raving drunkards and men delirious from their hurts and has heard more foul language and more blasphemy in a week than would have enlivened a pirate ship in a year. The receiving room nurse was, in old days, without exception the most remarkable woman in the hospital. She appeared as a short, fat, comfortable person of middle age with a ready face and a decided look of assurance. She was without education and yet her experience of casualties of all kinds, from a bee sting to sudden death, was vast and indeed unique. She was entirely self-taught for there were no trained nurses in those days. She was of the school of Mrs. Gamp, was a woman of courage and of infinite resource, an expert in the treatment of the violent and in the crushing of anyone who gave her what she called lip. She was possessed of much humor, was coarse in her language, abrupt, yet not unkindly in her manner, very indulgent towards the drunkard and very skilled in handling him. She was apt to boast that there was no man living she would not stand up to. She called every male over fifty, daddy, and everyone under that age, my son. She would tackle a shrieking woman as a terrier tackles a rat. While the woman who sauced her, she soon reduced to a condition of palsy. She objected to the display of emotion or of feeling in any form and was apt to speak of members of her sex as a watery-headed lot. She had, like most nurses of her time, a leaning towards gin, but was efficient even in her cups. She had wide powers, for she undertook on her own responsibility the treatment of petty casualties. The dressers regarded her with respect. Her knowledge and skill amazed them, while from her they acquired the elements of minor surgery and first aid. The house surgeons were a little frightened of her, yet they admired her ready craft and were duly grateful for her unswerving loyalty and her eagerness to save them trouble. Her diagnosis of an injury was probably correct, so sound was her observation and wide her experience. She was a brilliant bandager and was accepted by the students as the standard of style and finish in the applying of dressing. She was on duty from early in the morning until late at night and knew little of off hours and half days. In the personnel of the hospital of half a century ago, she was an outstanding figure, yet now she is as extinct as the dodo. The hospital in the days of which I speak was anathema. The poor people hated it. They dreaded it. They looked upon it primarily as a place where people died. It was a matter of difficulty to induce a patient to enter the wards. They feared an operation, and with good cause, for an operation then was a very dubious matter. There were stories afloat of things that happened in the hospital, and it could not be gained said that certain of those stories were true. Treatment was very rough. The surgeon was rough. He had inherited that attitude from the days when operations were carried through without anesthetics, and when he had need to be rough, strong, and quick, as well as very indifferent to pain. Pain was with him a thing that had to be. It was a regrettable feature of disease. It had to be submitted to. At the present day, pain is a thing that has not to be. It has to be relieved, and not to be merely endured. Many common measures of treatment involved great suffering. Bleeding was still a frequent procedure, and to the timid the sight of the red stream trickling into the bowl was a spectacle of terror. There were two still more common measures in use. The seton ended the issue. The modern student knows nothing of these ancient and uncleanly practices. He must inform himself by consulting a dictionary. Without touching upon details, I may say that in my early days as a junior dresser, one special duty was to run around the ward before the surgeon arrived in order to draw a fresh strand of thread through each seton and to see that a fresh pee was forced into the slough of every issue. Quite medieval methods were still observed. The first time in my life that I saw the interior of an operating theatre, I, in my ignorance, entered by the door which opened directly into the area where the operating table stood. I should have entered by the student's gallery. When I found myself in this amazing place, there was a man on the table who was shrieking vehemently. The surgeon, taking me by the arm, said, You seem to have a strong back. Lay hold of that rope and pull! I laid hold of the rope. There were already two men in front of me, and we all three pulled our best. I had no idea what we were pulling for. I was afterwards informed that the operation in progress was the reduction of a dislocated hip by compound pulleys. The hip, however, was not reduced, and the man remained lame for life. At the present day, a well-instructed schoolgirl could reduce a recent hip dislocation unaided. In this theatre was a stove which was always kept alight, winter and summer, night and day. The object was to have a fire at all times ready, where at to heat the irons used for the arrest of bleeding, as had been the practice since the days of Elizabeth. Antiseptics were not yet in use. Sepsis was the prevailing condition in the wards, practically all major wounds separated. Puss was the most common subject of converse because it was the most prominent feature in the surgeon's work. It was classified according to degrees of vileness. Laudable Puss was considered, rather, a fine thing, something to be proud of. Saneus Puss was not only nasty in appearance, but regrettable, while Icarus Puss represented the most malignant depths to which matter could attain. There was no object in being clean. Indeed, cleanliness was out of place. It was considered to be finicking and affected. An executioner might as well manicure his nails before chopping off a head. The surgeon operated in a slaughterhouse suggesting frock coat of black cloth. It was stiff with the blood in the filth of years. The more sodden it was, the more forcibly did it bear evidence to the surgeon's prowess. I, of course, commenced my surgical career in such a coat, of which I was quite proud. Wounds were dressed with charpie, soaked in oil. Both oil and dressing were frankly an exultingly septic. Charpie was a species of cotton waste obtained from cast linen. It would probably now be discarded by a motor mechanic as being too dirty for use on a car. Owing to the separating wounds, the stench in the wards was of the kind not easily forgotten. I can recall it to this day with unappreciated ease. There was one sponge to the ward. With this putrid article and a basin of once clear water, all the wounds in the ward were washed in turn twice a day. By this ritual, any chance that a patient had of recovery was eliminated. I remember a whole ward being decimated by hospital gangrene. The modern student has no knowledge of this disease. He has never seen it and thank heaven never will. People often say how wonderful it was that surgical patients lived in these days. As a matter of fact, they did not live. Or at least only a few of them. Lord Roberts assured me that on the ridge at Delhi during the Indian Mutiny, no case of amputation recovered. This is an extreme instance for the conditions under which the surgeons on the ridge operated were exceptional and hopelessly unfavorable. The attitude that the public assumed towards hospitals and their works at the time of which I write may be illustrated by the following incident. I was instructed by my surgeon to obtain a woman's permission for an operation on her daughter. The operation was one of no great magnitude. I interviewed the mother in the receiving room. I discussed the procedure with her in great detail and I trust in a sympathetic and hopeful manner. After I had finished my discourse, I asked her if she would consent to the performance of the operation. She replied, Oh, it is all very well to talk about consenting, but who was to pay for the funeral? End of Chapter 2 Chapter 3 OF THE ELEPHANT MAN AND OTHER REMININCENCES This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. THE ELEPHANT MAN AND OTHER REMININCENCES by Frederick Treves THE TWENTY CRONA PIECE More than once in speaking at public meetings on behalf of hospitals, I have alluded to my much-valued possession, a twenty-corona piece, and have employed it as an illustration of the gratitude of the hospital patient. The subject of this incident was a Norwegian sailor about fifty years of age, a tall, good-featured man with the blue eyes of his country, and a face tanned by sun and by salt winds to the color of weathered oak. His hair and his beard were gray, which made him look older than he was. He had been serving for three years as an ordinary seaman on an English sailing ship, and spoke English perfectly. During his last voyage, he had developed a trouble which prevented him from following his employment. Accordingly, he had left his ship and made his way to London in the hope of being cured, inquiring for the hospital of London he was directed to the London hospital, and, by chance, came into my wards. He had an idea, as I was told later, that the operation he must needs undergo might be fatal, and so had transferred his savings to his wife in Norway. He was a quiet and reserved man, but so pleasant in his manner that he became a favorite with the nurses. He told them quaintly worded tales of his adventures, and showed them how to make strange knots with bandages. The operation, which was a very ordinary one, was successful, and in four or five weeks he was discharged as capable of resuming his work as a seaman. His ship had, however, long since started on another voyage. One morning, three weeks after he had left the hospital, he appeared at my house in Wimpole Street. My name, he would have acquired from the board above his bed, but I wondered how he had obtained my address. I assumed that he had called to ask for money, or for help of some kind. As he came into my room, I was sorry to see how thin and ill he looked. For when he left the wards, he was well and hardy. He proceeded to thank me for what I had done, little as it was. He had an exaggerated idea of the magnitude of the operation, which idea he would not allow me to correct. I have listened to many votes of thanks to the effulgent language, the gush and the pompous flattery which have marked them, but the little speech of the sailor man was not of that kind. It was eloquent by reason of its boyish simplicity, its warmth, and its rugged earnestness. As he was speaking, he drew from his pocket a gold coin, a twenty krona piece, and placed it on the table at which I sat. I beg you, sir, he said, to accept this coin. I know it is of no value to you. It is only worth, I think, fifteen chillings. It would be an insult to offer it as a return for what you have done for me. That service can never be repaid, but I hope you will accept it as a token of what I feel, of something that I cannot say in words, but that this coin can tell love. When I left my home in Norway three years ago, my wife sewed this twenty krona piece in the band of my trousers and made me promise never to touch it until I was starving. A seamen's life is uncertain. He may be ill. He may be long out of a job. And so, for three years, this coin has been between me and the risk of starvation. When I was in the hospital, I had a wish to give it to you, if it so happened that I got well. Here I am, and I do hope, sir, you will accept it. I thanked him as warmly as I could for his kindness, for his thought in coming to see me, and for his touching offer, but added that I could not possibly take the gold piece, and begged him to put it back into his pocket again, and present it to his wife when he reached home. At this, he was very much upset, pushing the coin along the table towards me with his forefinger. He said, Please, sir, do take the money, not for what it is worth, but for what it has been to me. I am proud to say that since I left the hospital, I have been starving. I have been looking for a ship. I have not slept in a bed since you saw me in the wards. Now, at last, I have got a ship, and thank God, I have kept the coin unbroken so that you might have it. I implore you to accept it. I took it, but what could I say that would be adequate for such a gift as this? My attempt at thanks was as stumbling and as feeble as his had been outright, for I am not ashamed to confess that I was much upset. I have received many presents from kindly patients, silver bowls, diamond scarf pins, gold cigarette cases, and the like. But how little is their value compared with this one small coin? As I picked it up from the table, I thought of what it had cost. I thought of the tired man haunting the docks in search of a ship, often aching with hunger, and at night sleeping in a shed. And yet, all the time with a piece of gold in his pocket which he would not change in order that I might have it. A coin is an emblem of wealth, but this gold piece is an emblem of a rare currency, of that wealth which is, in a peculiar sense, beyond the dream of avarice, a something that no money could buy, for what some could express the bounty or the sentiment of this generous heart. It would be described, by those ignorant of its history, as a gold coin from Norway, but I prefer to think that it belongs to that land of Havala, where there is gold, and of which it is truly said, and the gold of that land is good. End of Chapter 3 Chapter 4 of The Elephant Man and Other Reminisances This is a LibriVox recording. All LibriVox recordings are in the public domain. For more information or to volunteer, please visit LibriVox.org. Recording by Mike Potez The Elephant Man and Other Reminisances by Frederick Treves Chapter 4 A Cure for Nerves In the account of the case which follows, it is better that I allow the patient to speak for herself. I am a neurotic woman. In that capacity, I have been the subject of much criticism and much counsel. I have been both talk to and talked at. On the other hand, I have detailed my unhappy symptoms to many in the hope of securing consolation, but with indefinite success. I am afraid I have often been a bore. For a bore I am told is a person who will talk of herself when you want to talk of yourself. My husband says that there is nothing the matter with me, that my ailments are all imaginary and unreasonable. He becomes very cross when I talk of my wretched state and considers my ill health as a grievance personal to himself. He says when he is very irritated that he is sick of my mornings that I look well, eat well, sleep well, and so must be a sound as a woman can be. If I have a headache and cannot go out, he is more annoyed than if he had the headache himself, which seems to be irrational. He is often very sarcastic about my symptoms and this makes me worse. Once or twice, he has been sympathetic and I have felt better, but he says that sympathy will do me harm and cause me to give way more. I suppose he knows because he is always so certain. He says all I have to do is to cheer up, to rouse myself, to pull myself together. He slaps himself on the chest and in a voice that makes my head crack says, look at me, I am not nervous, why should you be? I don't know why I am nervous and so I never try to answer the question. From the way my husband talks, I feel that he must regard me as an imposter. If we have a few friends to dinner, he is sure to say something about the deplorable flabbiness of the minds of some women. I know he is addressing himself to me and so do the others, but I can only smile and feel uncomfortable. I have no wish to be nervous. It is miserable enough heaven knows. I would give worlds to be free of all my miseries and be quite sound again. If I wish to adopt a complaint, I should choose one less hideously distressing than nerves. I have often thought I would sooner be blind than nervous and that then my husband would be really sorry for me, but I would be terribly frightened to be always in the dark. I get a good deal of comfort from many of my women friends. They at least are sympathetic. They believe me, know that my complaints are real and that what I say is true. Unfortunately, when I have described certain of my symptoms, such as the one of my gaspin attacks, they say that they have just such attacks themselves, only worse. They are so sorry for me, but then they will go on and tell me the exact circumstances under which they have had their last bouts. I am anxious to tell them of my other curious symptoms, but they say that it does seem so much good to pour out their hearts to someone and I, being very weak, let them go on, only wishing that they would listen to me as I listen to them. I notice that their husbands have for the most part just some erroneous views about nerves that mine has. Some of them say that they would like to make their menfolk suffer as they do themselves. One lady I know always ends with a reflection. Oh well, I shall not be long here, and when I am dead and under the daisies, he will be sorry he was not more appreciative. He will then know, when it is too late, that my symptoms were genuine enough. I must say that I have never gone to the extreme of wishing to die for the mere sake of convincing my husband of obstinate stupidity. I should like to go into a deathlike trance and frighten him, for then I should be able to hear what he said when he thought I was gone and remind him of it afterwards whenever he became cynical. It is in the morning that I feel so bad. I am really ghastly then. I wake up with the awful presentment that something dreadful is going to happen. I don't know what it is, yet I feel I could sink through the bed. I imagine the walking moments of the poor wretch who has been condemned to death and who is said to have slept well on the night before his execution. He will probably wake slowly and will feel at first hazyly happy and content, will yawn and smile until there creeps up the horrible recollection of the judge and the sentence of the gallows and the hanging by the neck. I know the cold sweat that breaks over the whole body and the sickly clutching about the heart that attend such an awakening, but doubt if any emerging from sleep can be really worse than many have experienced. I can do so little in the daytime. I soon get exhausted and so utterly done up that I can only lie still in a dark room. When I am like that the least noise worries me and even tortures me almost out of my mind. If someone starts strumming the piano or if a servant persistently walks about with creaky boots or if my husband bursts in and tries to be hearty, I feel compelled to scream it is so unbearable. It is on such an occasion as this that my husband is apt to beg me to pull myself together. He quite maddens me when he says this. I feel as full of terror, awfulness and distress as a drowning man and how silly it would be to lean over harbour wall and tell a drowning man in comfortable tones that he could pull himself together. Yet that is what my husband says to me with the irritating conviction that he is being intelligent and practical. I cannot walk out alone. If I attempt it, I am soon panic-stricken. I become hot all over, very faint and so giddy that I reel and have to keep to the railings of the house. I am seized with a hideous feeling that I can neither get on nor get back. I am not disturbed by the mere possibility of falling down on the pavement but by the paralyzing nightmare that I cannot take another step. If anyone were to put me down in the middle of a great square, like the Prasode Dom Pedro at Lisbon and leave me there alone, I think I should die or lose my reason. I know I should be unable to get out. I should fall in a heap, shut my eyes and try to crawl to the edge on my hands and knees, filled all the time with a panting terror. A man who finds himself compelled to cross glassy ice slope which twenty feet below drops over a precipice could not feel worse than I do. If left adrift nor pray more fervently to be clear of the abhorred space and safe, my husband says that this is all nonsense. I suppose it is but it is such a nonsense that would be sense if the gesture were death. The knowledge that I have to go to a dinner party fills me with utterable alarm. By the time I am dressed and ready to start, I am chilled, shaken all over and gasping for breath. The drive to the house is almost as full of horror as the drive of the tumbrell to the guillotine. By the time I arrive I am so ill I can hardly speak and I am convinced that I shall fall down or be sick or shall have to cry out. More than once I have insisted upon being driven home again and my husband has gone to the dinner alone after much outpouring of language. Possibly my most direful experiments have been at the theatre to which I have been taken on the ground that my mind needed change and that a cheerful play would take me out of myself. My worst terrors have come upon me when I have chance to sit in the centre of the stalls with people packed in all around me. I have then felt as if I was imprisoned and have been filled by one intense overwhelming desire, the passion to get out. I have passed through all the horrors of suffocation, have felt that I must stand up, must lift up my arms and gasp. I have looked at the door only to feel that escape was impossible as it would be to an entrapped miner about whom the falls of a shaft had fallen. It is useless for my husband to nudge me and tell me not to make a fool of myself. If I did want to make a fool of myself, I should select some more agreeable way of doing it. It is useless moreover to argue. No argument can dispel the ever-present sense of panic, of being buried alive, or relieve the hopeless feeling of inability to escape. I have set out that I play undergoing tortures beyond expression until I have become collapsed and until my lip had been almost bitten through in the effort not to scream. No one would believe that I, a healthy-looking woman in a new Paris dress sitting among a company of smiling folk, could be enduring as much agony as if I were lodged in an iron cell the walls of which were gradually closing in around me. I am very fond of my clothes when I am well, but there are certain frogs I have come to loathe because they recall times when I have nearly gasped out my life in them. I have taken much medicine, but with no apparent good. I am with a woman who believes in her nerve tonic, since such faith must be a great comfort to her. I knew a poor girl who became for a time a mental wreck, owing to her engagement having been broken off. She refused food and lived for a week, so she told me, on her mother's nerve tonic. She declared that it saved her reason. I tried it, but it only brought me out in spots. I have seen good many doctors, but although they are all very kind, they seem to be dense and to have but the idea of treating the neurotic woman as they would treat a frightened child or a lost dog. I was taken to one doctor because he had a reputation of being very sensible and outspoken. My husband said there was no nonsense about him. He certainly made no effort to be entertaining. After he had examined me, he said that all my organs were perfectly sound. He then began to address me as my dear lady, and at once I knew what was coming. It was to tell me that I wanted rousing and that all I had to do was get out of myself. He said I was not to think about myself at all, which is very good advice to a person who feels on the point of dissolution. He told my husband afterwards in strict confidence that if I was poor woman and had to work for my living, I should be well directly. He went farther and said that what would cure me would be a week of the washing tub at a laundry, I suppose. My husband imparted these confidences to me as we drove home from the doctors and said what a shrewd, common sense man he was. My husband quite liked him. Another doctor I went to was very sympathetic. He patted my hand and was so kind that he almost made me cry. He said he understood how real and intense my sufferings are. He knew I must have gone through tortures. He gave me a great many particulars as to how I was to live and said I was never to do anything I did not like. I wanted to come and see him again, but he insisted that I must go abroad at once to break with my sad associations and afford my shattered nerves a complete rest. He gave me a letter to a doctor abroad, which he said contained a very full and particular account of my case. Something happened to prevent me from leaving England, but six months later I came across the letter and, feeling it was no longer a fuse, I opened it. It began, my dear Harry, and contain a great deal about their respective handicaps at golf and their plans for the summer. The kind doctor ended in this wise in a post script. The lady who brings this is Mrs. Blank. She is a terrible woman, a deplorable neurotic. I need say no more about her, but I hope you won't mind my burdening you with her, for she is the kind of tedious person who bores me to death. However, she pays her fees. My husband sent the letter back to the doctor who wrote it, because he thought the memoranda about the golf handicaps would be interesting for him to keep. As I made no progress, and as my friends were getting as tired of me as I was of myself, it was resolved that I should be taken seriously in hand. I was therefore sent to a nursing home to undergo the rest cure. I had to lie in bed, be stuffed with food, and be massaged daily. I was cut off from all communion with the familiar world, and was allowed to receive neither letters nor newspapers. The idea underlying this measure is, I think, a little silly. It is in the main, an attempt to cure a patient by enforced boredom. The inducement offered is crudely this. You can go home as soon as you feel fit to be well. I did not mind the quiet, nor the lying in bed. The excessive feeding merely made me uncomfortable. The massage was a form of torture that I viewed with great loathing. The absence of the news from home kept me in a state of unrest and apprehension. It was the continued speculation as to what was going on in my household, which prevented me from sleeping at night. The withdrawal of all newspapers was evidently a punishment devised by a man. It was no punishment to me, nor would it be to the average woman. The nurse, of course, kept me informed of current events, as she was extremely fond of talking and thereby rendered a newspaper unnecessary. She told me of the occasions when my husband called to inquire and always said he looked very well and remarkably cheerful. She walked past my house once and came back with the information that the drawing room blinds were up and that the sun was streaming into the room. This worried me a great deal, as I don't like faded carpets and silks and am very fond of my furniture. After I had been in the home for a few days, I discovered that the institution was not wholly devoted to rest cure cases, but that it was also a surgical home where many operations were performed. This frightened me terribly, because I began to wonder whether an operation had been an item of the program when I was taken seriously in hand. I arrived at the conclusion that I was being prepared for operation, that I was being built up with the result that I was prostrated by alarm. I felt that at any moment a man with a black bag might enter the room and proceed to chloroform me. There came upon me a conviction that I was being imprisoned, that I had been duped and trapped. Above all was the awful feeling which nearly suffocated me, that I was powerless to escape. I thought my husband had been most based to desert me, like this and hand me over, as it were, to unknown executioners. I have a dread of operations which is beyond expression. The mere thinking of the process of being chloroformed makes me sick and faint. You are held down on a table, I believe, and then deliberately suffocated. It must be as if a man knelt upon your chest and strangled you by gripping your throat with his hands. When I was a small girl I saw a cook dispose of a life mouse by sinking the mousetrap in which it was imprisoned in a bucket of water. I remember that the struggles of the mouse as seen underwater were horrible to witness. When I grew up and was told about people being chloroformed for operation, I always imagined that their feelings would be as hideous as those of the drowning mouse in a trap. I told all my suspicions and alarms to the nurse who laughed at me contemptuously. She said, you are merely a nerve case, merely thought I. No surgeon ever thinks of operating on a nerve case. The greater number of the patients here come for very serious operations. They are real patients. As she conversed further, I must confess that my pride began to be touched. I had supposed that my case was the most important and most interesting in the establishment. I had the largest room in the house while the fussing over me had been considerable. I now began to learn that there were others who were in worse plight than myself. I, on the one hand, had merely to lie in bed and sleep. They, on the other, came to the home with their lives in their hands to confront an appalling ordeal. I was haunted by indefinite alarms. They had to submit to the tangible still of the surgeon's knife. I began to be a little ashamed of myself and of the trouble I had occasioned. Compared with me, these women were heroines. They had something to fuss about, for they had to walk alone into the valley of the shadow of death. I had many times said that I wished I was dead, but a little reflection on the modes of dying made me keep that wish ever after, unexpressed. My nurse deplored that she was not a surgical nurse. To nurse an operation case is real nursing, she said. There is nothing satisfactory in work like that. I am only a mental nurse, you see. A confession which humbled me still further. It was in September that I entered the home, and as the leading surgeons were still out of London, there were no operations. When October came, the gruesome work has resumed. The house was set vibrating with excitement. In this, I shared as soon as I discovered that the operating theatre was immediately over my bedroom. Almost the first operation happened to be a particularly momentous one, concerned with which was none other than the great surgeon of the day. His coming was anticipated with buzz of interest by the nurses, an interest which was even shared by the mental nurse in whose charge I was. I could learn very little about this great case, say that it was desperate and the victim was a woman. I know that she entered the home the night before, for my nurse planned to meet her on her way to her room. I know also that just before the hour of closing, the house I heard sobbing on the staircase as two people slowly made their way down. I came to know afterwards that one was the husband, the other the daughter. The operation was to be at 9 in the morning. By 6 am, the whole house was a stir. There was much running up and down the stairs. Everybody was occupied. My morning toilet and breakfast were hurried through with little ceremony. The nurse was excited, absent-minded and disinclined to answer questions. After my breakfast was cleared away, she vanished. It was supposed that I was never to be left alone, and did not appear again until noon. When she did come back, she found me an altered woman. I lay in bed, in the solitary room with my eyes fixed upon the white ceiling over my head. I was terrified beyond all reason. There was everywhere the sense of an over-strung activity, hushed and ominous, which was leading on to tragedy. I knew that in the room above me was about to be enacted a drama in which one of the actors was death. There was considerable bustle in the room in question. They were moving something, very heavy, into the middle of the floor. It was, I am sure, the operating table. Other tables were dragged about and adjusted with precision. Above the ceaseless patter of feet I could hear the pouring of water into basins. I knew when the surgeon and his assistants arrived, for I heard his voice on the stair. It was clear and unconcerned, the one strong and confident thing among all this pretentious preparations. Heavy bags were carried up from the hall to be deposited on the floor above. I could hear the surgeon's firm foot overhead and noticed a further moving of tables. There came now a clatter of steel in metal dishes which made me shiver. I looked at the clock on my table. It was three minutes to nine. What of the poor soul who was waiting? She also would be looking at the clock. Three minutes more and she would be led in her nightdress into this chamber of horrors. The very idea paralyzed me. If I were in her place, I should scream until I roused the street. I should struggle with every fiber of my body. I should cling to the door until my arms were pulled out of their sockets. A barrel organ in the road was playing a trivial waltz. A boy was going by whistling. The world was cheerfully indifferent, while the loneliness of the stricken woman was horrible beyond words. As the church clock struck nine, I knew that the patient was entering the room. I fancied I could hear the shuffle of her slippers and the closing of the door. The last hope of escape behind her. A chair was moved into position. She was stepping onto the table. Then came an absolute silence. I knew they were chloroforming her. I fancied that the vapor of that sticky drug was whoosing through the ceiling into my room. I was suffocated. I gasped until I thought my chest would burst. The silence was awful. I dared not scream. I would have rung my bell, but the thought of the noisy to make held me back. I lay glaring at the ceiling. My forehead covered with drops of cold sweat. I rung my fingers together, lest all sensation should go out of them. In a while, there came three awful moans from the room above. And then, once more, the moving of feet was to be heard, whereby I felt that the operation had begun. I could picture the knife, the great cut, the cold callousness of it all. For what seemed to me to be intermobile hours, I gazed at the ceiling. How long was this murdering to go on? How could the poor moaning soul be tortured all this while and endure another minute? Suddenly, there was a great commotion in the room above. The table was dragged round rapidly. There were footsteps everywhere. Was the operation over? No. Something had gone wrong. A man dashed downstairs calling for a cab. In a moment, I could hear the wheels tear along the street and then return. He had gone to fetch something and rushed upstairs with it. This made me wonder for a moment what had happened to the husband and daughter who were waiting in a room off the hall. Had they died of suspense? Why did they not burst into the room and drag her away while there was yet time? The lower part of the house was practically empty and I was conscious that two or three times the trembling couple had crept up the stairs to the level of my room to listen. I could hear the daughter say, What shall we do? What shall we do? And then the two would stumble down the stairs again to the empty room. I still glared at the ceiling like one in a trance. I had forgotten about myself, although there was such a sinking at my heart that I could only breathe in gasps. The loathsome bustle in the room above continued. Now as I gazed upwards, I noticed, to my expressionless horror, a small round patch of red appear on the white ceiling. I knew it was blood. The spot was as large as five shilling pieces. It grew until it had become the size of a plate. It burned into my vision as if it had been a red hot disk. It became a deeper crimson until at last one awful drop fell up on the white coverlet of my bed. It came down with a weight of lead. The impact went through me like an electric shock. I could hardly breathe. I was bathed with perspiration and was as wet and as cold as if I had been drugged out over winter's river. Another drop fell with a thud like a stone. I would have hidden my head under the bedclothes, but I dared not stir. As each drop fell on the bed, the interval came quicker until there was a scarlet patch on the white quilt that grew and grew and grew. I felt that the evil stain would come through the coverings hot and wet to my clenched hands which were just beneath, but I was unable to move them. My sight was now almost gone. There was nothing but a red haze filling the room, a beating sound in my ears, and the drop recurring like the ticking of some awful clock. I must have become unconscious, for I cannot remember the nurse entering the room. When I realized once more where I was, I found that bedclothes had been changed. There was still the round red mark on the ceiling, but it was now dry. As soon as I could speak, I asked, is she dead? The nurse answered, no. Will she live? Yes, I hope she will, but it has been a fearful business. The operation lasted two and a quarter hours, and when the great blood vessel gave way, they thought it was all over. Was she frightened? I asked. No, she walked into the room, erect and smiling, and said in a jesting voice, I hope I have not kept you waiting, gentlemen, as I know you cannot begin without me. In a week, I returned home cured. My nerves were gone. It was absurd to say that I could not walk in the street. When that brave woman had walked, smiling, into the place of gags and steel. When I thought of the trouble I had made about going to the play, I recalled what had passed in that upper room. I began to think less of my case when I thought of hers. The doctor was extremely pleased with my recovery, while his belief in the efficacy of the rest cure became unbounded. I did not trouble to tell him that I owed my recovery, not to his tiresome physique and ridiculous massage, but to that red patch on the ceiling. The lady of the upper room got well. Through the instrumentality of the nurse, I was able to catch sight of her when she was taking her first walk abroad after the operation. I expected to see a goddess. I saw only a plain little woman with gentle eyes and a very white face. I knew that those eyes had peered into eternity. Some years have now passed by, but still, whenever I falter, the recollection of that face makes me strong.