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10— The Survivor
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10—
The Survivor

Case History

I was a resident in radiation therapy at a large university teaching hospital when Mr D, age sixty, became my patient for a fairly advanced bladder cancer. His urologist had recommended surgery, but Mr. D had refused. Because his tumor was quite advanced, his prognosis was not very good no matter what we did.

Mr. D came in with his wife. During the usual history taking and physical examination it struck me that he was a very peculiar person. I had the impression that he wanted to say more than he was actually saying. Finally, when we started talking about why he had refused surgery, Mr. D said that to explain he had to tell me something about his life. He realized, he said, that we might think his decision strange, and he wanted me to understand.

During World War II, around the time of the attack on Pearl Harbor, Mr. D had been a combat soldier in the Philippines. He had surrendered with the American troops on Bataan Peninsula in April 1942, had been on the Bataan Death March, where he had seen thousands of men die, and had remained a prisoner of the


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Japanese for three-and-a-half years, until the end of the war. He said he could not really talk about what he had seen or experienced, but he knew he had never been the same since then. He admitted that he was an impossible person to live with and that he had made life very difficult for his wife and children. Over and over, he said he knew he was strange and his behavior was strange, but what had happened on Bataan was so horrible that nobody could understand what he had been through. Because of that he could not accept surgery. He could not stand any more pain or suffering.

His wife was very supportive. It was obvious that she had gone through a lot with him over the years.

During his treatments, which lasted about seven weeks, I saw Mr. D about once a week. Each time he said the same thing; he apologized for his behavior so often it seemed as though he were apologizing for being alive. Always, he referred to Bataan but never elaborated. He just repeated that awful things had happened.

After his treatments, Mr. D did well for about six months until he again began to experience bleeding from the bladder. We repeated some tests. They showed that his cancer had recurred and was growing rapidly. He quickly deteriorated. What was worse, he began to have constant intractable pain. We put him in the hospital to give him as much pain medication as possible. His tumor kept spreading. It struck me that, after having lived through the horrors of Bataan and having suffered a terrible life as a result, Mr. D was now dying a horrible, painful death. Despite all the advances of medical science, there was very little we could do to help besides give him pain medication, and even that was not very effective.

I remember going to see Mr. D when he was quite close to death. He was in a lot of pain, and I felt as though he were projecting all his pain and suffering onto me, as though he were blaming me for how miserable he was and for everything that was happening. As I talked with him, I had the impression that during the thirty-five or so years since Bataan, this man had blamed himself for having survived or at least had felt guilty about it. Now, because I was surviving him, he seemed to wish to transfer all that anger and guilt onto me. He made me feel terrible.

The day before he died, Mr. D looked right at me and said, "Oh, I had a lot of confidence in you, and you really let me down."


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That was the last thing he ever said to me.

Then and later, I tried to wipe his words and his look from my mind, but now and then, like avenging furies, they come back to gnaw at me. Because this man had lived through terrible events, he viewed life differently from most people. His survivor's outlook had had a profound impact not only on his behavior but also on his relationship to life.

Yet why was I, a doctor, not a former prisoner of war, so disturbed by this survivor?

Bataan

Although Mr. D could not translate into words the horrors of his past, some other survivors of Bataan did. Through their words we may begin to get a picture of, and a feeling for, what Mr. D saw and survived. The narrative below is composed of historical facts combined with the recollections of numerous survivors of the Bataan Death March.

On April 9, 1942, about 10,000 American troops surrendered to the Japanese on Bataan Peninsula in the Philippines. After three-and-one-half years of imprisonment, only about 4,000 survived. What had happened during the interval?

After the surrender, the Japanese made the prisoners march some sixty miles to a rail line that would take them to Camp O'Donnell. This forced march of approximately 72,000 men—10,000 Americans plus some 62,000 Filipinos who had also surrendered on Bataan—is known to history as the Death March. On it, thousands died: approximately 600 to 700 Americans and between 5,000 and 10,000 Filipinos.[1]

It was beastly hot on the Death March, but the Japanese allowed the prisoners almost no food or water. Parched, famished, and exhausted, many of the prisoners were—or


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became—very sick. They were made to sit or stand in the tropical sun for hours. At times, they were forced to run. Any prisoner who fell behind was bayoneted. Death was everywhere. It "got so bad . . . that you never got away from the stench of death."[2]

At night, the prisoners were herded into a "bullpen. . . . There was a lot of dust, dirt, filth on the ground. Everybody had dysentery. There were no toilets. It was absolutely horrible. . . .[P]eople . . . were screaming and going nuts. . . . It was like being in a cage with animals."[3]

When the prisoners arrived at Camp O'Donnell, things got even worse. "In O'Donnell our boys were dying forty, fifty, sixty a day. We couldn't bury them fast enough."[4] "I buried so many of my friends. . . . The shock of it was hell."[5]

Later, many of the Americans were sent to Cabanatuan, another POW camp. Illnesses were rampant: diphtheria, malaria, dysentery, beriberi, and dry beriberi. The survivors of the Death March were "like walking zombies. Skeletons walking towards you with skin hanging on the bones. . . . Heads looked like skulls."[6]

To survive one often had to be merciless. Sometimes Americans stole from each other. "There wasn't much stealing because there wasn't much available. But there was a certain amount. I'm sure many a man who swiped something carries the guilt with him today."[7]

As the war progressed, the Japanese began to fear that the Americans would recapture the Philippines, and they shipped their American prisoners to Japan. The boats on which they were sent became known as the Hell Ships. How can one describe these ships?

How do I describe a packed, hot, filthy, stinking ship's hold that turned slowly into a mad house? . . . Most of the guys won't or can't talk about them. . . . They put 500 of us in one hold and 500 in the other. . . . Tropical sun on a steel deck. Body heat from 500 men packed together. All around men began passing out. . . . It must have been 120 or 125 degrees in that hold. The Jap's favorite trick was to cut off our


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water. . . . [People went crazy.] The next guy that went screaming by . . . [was] caught and killed [by his fellow prisoners.] . . . Several others were also killed.[8]

On another Hell Ship, men "went mad. Some drank urine. Some turned vampire."[9] "One person near me cut another person's throat and was holding his canteen so he could catch the blood."[10]

When their Hell Ships reached Japan, the Americans had to perform hard labor in the coal mines, steel mills, and elsewhere. "Being beaten was something you understood would happen to you daily. You were either going to get slapped or you were going to get beaten on the head with a sledgehammer handle."[11]

When the war finally ended, some new heartaches began for the former POWs. Long after their liberation, many survivors had trouble relating to people or were haunted by nightmares and fears.

I couldn't talk to people. I couldn't even talk to my parents. . . . I couldn't get along with anybody.[12]

It wasn't anger as much as it was fear. . . . There were no psychiatrists waiting for us. . . . I was so goddamn nervous. . . . I couldn't sleep."[13]

I spent a year in the Army hospital. . . . [The doctors said I was fine.] . . . I felt rotten all the time. . . . I used to sleep walk at night and had those hallucinations. . . . In the hallucinations I would meet dead men walking down the street. . . . [I]t kept happening, in broad daylight.[14]

Some of the survivors married and made life a hell for their families.

I got married in March of '46. Then I neglected my wife miserably. . . . I've asked my wife many times since those days how come she kept on. . . . No other woman would have stayed with me.[15]

Even after thirty or more years, some of the nightmares of their captivity, both physical and mental, remained.


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I still get captured about once every month. Actually, it's harder on my wife. I never wake up, but she does. She doesn't know how to cope with this nightmare. . . . I'd venture to guess that there's something wrong with all of us, each and every one of us who survived. A human mind can't go through what we went through without something being wrong. . . . I've got sense enough to know that I'm not all I ought to be.[16]

Had Mr. D been able to articulate his experiences and emotions, these are some of the things he might have said, some of the death encounters he might have described. Although the specifics of Bataan are unique to the survivors of Bataan, these people exhibit certain traits that are often found in other survivors. Among them are frequent references to death, suffering, fear, pain, anxiety, guilt, and the unforgettable memory of a death-marked past. Psychiatry and literature offer further insights into the survivor's world.

The Survivor and the Death Imprint

According to Robert Jay Lifton, the psychiatrist noted for his studies of the survivors of Hiroshima and for what he calls "the general psychology of the survivor": "We may define the survivor as one who has come into contact with death in some bodily or psychic fashion and has remained alive. . . . The key to the survivor experience . . . is the imprint of death."[17] Typical among the survivor's traits, Lifton finds, are the death imprint, death anxiety, death guilt, a life of grief, and psychic numbing. Very briefly, these traits may be characterized as follows:

1. The death imprint, which is "indelible," results from the survivor's "extraordinary immersion in death."[18]

2. Death anxiety is the result of the survivor feeling a "sense of heightened vulnerability" to the world around him and, above all, to his own death.[19]


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3. Death guilt describes the survivor's struggle with guilt for having survived while others died or for having survived, perhaps, at another person's expense. It is the guilt "over what one has done to, or not done for, the dying while oneself surviving."[20] In addition, death guilt captures how the survivor feels guilty about feeling glad that he is alive: he knows "the tainted joy of having survived amid others' deaths."[21] Lifton calls this combination of guilt and gladness the survivor's "guilt over survival priority" that is, the survivor feels guilty—but also glad—that he made survival his first priority.[22]

4. The survivor's "life of grief" characterizes how the survivor mourns not only for the dead who were close to him but also for the anonymous dead and for "a way of life that has been 'killed?" In sum, he mourns for his former self, for what he was prior to the intrusion of death and death conflicts.[23] Surviving, therefore, is a kind of terrible rite de passage during which one self dies symbolically and a new self—a sadder self forever imprinted with the image of death—is born. For these reasons, surviving always involves a terrible sense of loss and grief.

5. Psychic numbing, which is "the cessation of feeling," comes to "characterize the entire life style of the survivor," according to Lifton.[24] Psychic numbing describes the cessation of feeling in its chronic form, psychic closing off in its acute form. These psychic processes are defense mechanisms through which a person shuts himself off from death itself: "the unconscious message is, 'If I feel nothing, then death is not taking place'"[25] Still, although psychic closing off and psychic numbing are protective mechanisms, they are also, in a way, destructive processes because they themselves are a "form of symbolic death."[26] After all, if a person is numbed, he not only feels less but he also feels less alive .


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With the Bataan experiences and Lifton's insights in mind, it is possible to enter deeper into the world of the survivor, this time through literature. Because literature not only reflects life, and reflects upon life, but also heightens and deepens our perceptions of life, we feel that literature, more than any other medium, can help us understand the death-imprinted worid of the survivor. We therefore enter the universe of Elie Wiesel, survivor of the Holocaust.

Elie Wiesel

Elie Wiesel was born in Sighet, Transylvania. When in his teens, he was deported with his family and the other Jews of his community to Auschwitz and then to Buchenwald. His father, mother, and younger sister died in the concentration camps.

Night is the tale of his life—or rather death-life—in those camps. His first night in Auschwitz indelibly stamped him with the imprint of death that would cloud the rest of his life.

Never shall I forget that night, the first night in camp, which has turned my life into one long night, seven times cursed and seven times sealed. Never shall I forget that smoke. Never shall I forget the little faces of the children, whose bodies I saw turned into wreaths of smoke beneath a silent blue sky. . . . Never.[27]

For months, Wiesel and his father survived together in the camps, though just barely. The adolescent saw thousands die, and he witnessed countless people fight or harm each other in their struggles to survive. When forced by the Nazis to run for miles through snow and freezing rain, he saw a son, who was stronger than his father, purposely outrun his father so that he would not be held back by the old man and, like the old man, killed. When packed together, starved, dehydrated, and freezing in an uncovered cattle


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wagon in the middle of winter, he saw a son kill his own father to steal from him a scrap of bread. Images of death never leave his eyes.

Searingly, Wiesel describes his ambivalent feelings about his own father. When his father was dying, he realized that he—like the boy who had purposely outrun his old father—would also feel relieved to be rid of him because his father was consuming some of his energy, which he himself desperately needed to try to survive. We sense here not only Wiesel's feelings of guilt but also his intense and smoldering anger at the inhuman world around him, at his father for being weak, and, perhaps most of all and everlastingly, at himself. They had arrived at Buchenwald, and on their first night there Wiesel had been separated from his father. The next day, he says,

I had followed the crowd without troubling about him. I had known that he was . . . on the brink of death, and yet I had abandoned him.

I went to look for him.

But at the same moment this thought came into my mind. "Don't let me find him! If only I could get rid of this dead weight, so that I could use all my strength to struggle for my own survival, and only worry about myself." Immediately I felt ashamed of myself, ashamed forever.[28]

Wiesel did find his father, and some days later his father died. Wiesel explains how he then felt a horrible feeling of liberation. The last word he had heard his father utter was his own name: "Eliezer." A Nazi official had been beating his father, and the dying man had called out for his son. But Elie had not gone to help his father because his own "body was afraid of also receiving a blow."[29] When he awoke at dawn the next day, his father's body was gone. Numbed as he was, the son could not weep about his father's death—or about anything—although he did feel some vestigial twinges of guilt.


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I did not weep, and it pained me that I could not weep. But I had no more tears. And, in the depths of my being, in the recesses of my weakened conscience, could I have searched it, I might perhaps have found something like—free at last!

After his liberation, Wiesel saw himself as still bound—forever bound—to death. He had not looked at himself in a mirror since he and his family had been routed from their homes in Sighet. When he did look for the first time, what he saw when he gazed at himself in the mirror—and what he would continue to see ever after—was the face of a corpse: "from the depths of the mirror, a corpse gazed back at me. The look in his eyes, as they stared into mine, has never left me."[30]

Several of Wiesel's fictions continue the survivor's story, while delving into different aspect of the survivor's world. His novel The Accident is particularly rich. In this first-person tale, the narrator, like Wiesel, is a survivor of the concentration camps. A beautiful woman named Kathleen loves him, but he is unable to really love her or anyone because his past seems more real to him than the present. When he is run over by a taxi and almost killed, his accident (or was it a suicide attempt?) is a mere trifle to him in comparison to the death-life he came to know in the camps. Forever haunted by his death-imprinted past, he wants to go "where I can think about myself without anguish, without contempt: where the wine . . . is pure and not mixed with the spit of corpses; where the dead live in cemeteries and not in the hearts and memories of men."[31]

Survivors, he says, are different from other people.

[They are the] living-dead. You must look at them carefully. Their appearance is deceptive. . . . They look like the others. They eat, they laugh, they love. . . . Like the others. But it isn't true. . . . Anyone who has seen what they have seen cannot be like the others. . . . You have to watch them carefully when they pass by an innocent-looking smokestack, or when they lift a piece of bread to their mouths. Something in them shud-


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ders and makes you turn your eyes away. These people have been amputated; they haven't lost their legs or eyes but their will and their taste for life. The things they have seen will come to the surface again sooner or later. And then the world will be frightened and won't dare look these spiritual cripples in the eye.[32]

The survivor is, according to Wiesel, a numbed person, a wounded person, an amputee, a "spiritual cripple." Because of his death-imprinted past, he is deprived of the capacity for joy, hope, or ecstasy. (We think here of Mr. D.)

In the extreme, the survivor's bondage to his death-marked past leads to madness, Wiesel says. For not only can the survivor not forget: he also never wants to forget .

With us—those who have known the time of death— . . . [things are] different. There, we said we would never forget. It still holds true. We cannot forget. The images are there in front of our eyes. . . . I think if I were able to forget I would hate myself. Our stay there planted time bombs within us. From time to time one of them explodes. And then we are nothing but suffering, shame, and guilt. We feel ashamed and guilty to be alive, to eat as much bread as we want, to wear good, warm socks in the winter. One of these bombs . . . will undoubtedly bring about madness. It's inevitable.[33]

"We feel ashamed and guilty to be alive." Wiesel's words name, in their starkness, anguish, and honesty, some of the survivor's continuing torments and anxieties. If Mr. D had been able to verbalize his feelings, he too might have voiced some of these same searing sentiments.

We return to the question: Why did Mr. D's doctor remain haunted by his death-imprinted patient? Might a doctor also, in a way, be imprinted with death? In other words, might a doctor be a kind of survivor?

"The key to the survivor experience . . . is the imprint of death," wrote Lifton. That indelible imprint is the result of the survivor's extraordinary immersion in death. What


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does a physician experience that could resemble such an immersion and leave such an imprint?

We immediately think of some of the physican's earliest experiences during his training, his months spent with the cadavers of anatomy class, those all too palpable—and real—images of the death that is man's inevitable fate. We think, too, of the doctor's further training and encounters, his days and nights on the hospital wards where he comes to know, intimately, the rhythms, sights, sounds, and scents of suffering, pain, disease, dying, and death. In a way, then, we begin to feel that because of the doctor's exposure to and, in a sense, immersion in death (hands and mind plunged into the cavity of the cadaver), the doctor may be a kinsman of the survivor or even a kind of survivor himself. We find signs of that kinship in the words of some doctor-writers.

Doctors and Survivors

Oliver St. John Gogarty (1878–1957), who roomed with James Joyce for two years and became the model for Buck Mulligan in Ulysses , was a poet, novelist, essayist, Irish senator, and practicing physician. Into his witty novel about medical school life, Tumbling in the Hay , he inserts a poignant vision of the doctor as a death-imprinted survivor. In the passage below, a professor of medicine warns his students that because of their experiences as physicians, their lives will be forever changed. Different from the layperson, they will always see in life the relentless pull of the grave. More, they will recognize that their struggles against disease and death can never really be victorious because, eventually, death always wins. He tells his students:

Turn back now if you are not prepared and resigned to devote your lives to the contemplation of pain, suffering and squalor. . . . Your outlook on life will have none of the deception that is the unconscious support of the layman: to you all life


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will appear in transit. . . . You will see . . . the pull of the grave that never lets up for one moment, draw down the cheeks and the corners of the mouth and bend the back until you behold beauty abashed and life itself caricatured in the spectacle of the living looking down on the sod as if to find a grave. . . . You can never retreat from the world, which is for you a battlefield on which you must engage in a relentless and unceasing war from which you know that you can never emerge victorious.[34]

William Carlos Williams also exhibits signs of the death imprint. When the doctor-author thinks about his "cases / At the hospital" in his poem "The Visit," he calls himself "a spade-worker."[35] His story "Danse Pseudomacabre" is clearly marked by death, for the title evokes and appears to mock the medieval tableaux that were called danse macabre, the dance of death or the dance of the dead (see chap. 2, above). In the medieval danse macabre, a figure of death was depicted with its mortal victims. The aim of the art and the accompanying verses was to make people fear death and think about their eternal salvation. In Williams's "Danse Pseudomacabre," the doctor is awakened by the telephone in the middle of the night. As he rouses himself, he exhibits several traits often associated with survivors—he appears numbed, anxious, grief stricken, and filled with thoughts of death. "I have awakened . . . unsurprised, almost uninterested, but with an overwhelming sense of death pressing my chest together as if I had come reluctant from the grave to which a distorted homesickness continued to drag me, a sense as of the end of everything."[36] Seeing his wife sleeping beside him, he contemplates sadly and fearfully her inevitable death and his own. "Christ! Christ! how can I ever bear to be separated from this my boon companion, to be annihilated, to have her annihilated? How can a man live in the face of this daily uncertainty? How can a man not go mad with grief, with apprehension?" But the doctor-narrator must practice his profession, and so, suppressing his death anxieties, he goes out to treat his patient. As he does, he


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sees his work and all of life in terms of a dance of life and death: "Either dance or annihilation."[37] That night, the patient he is summoned to see will live. The next night, however, he is called to a house where an infant is dying of acute meningitis, and he can do nothing. As this short story ends, we are left with the impression of the ebb and flow of life and death, which the doctor calls the danse pseudomacabre, as if to make light of his own fears. But the images of the dance and of the doctor as a death-imprinted survivor remain with us, whether or not the author tries to mock—or mask—his apprehensions.

In his first-person narrative "Rounds," Richard Selzer actually describes himself, as well as the widow of one of his patients, as a "survivor." Edna's dying husband is hooked up to all sorts of tubes and life-sustaining gear. Edna wants to kiss her husband but cannot because of all the gear. She asks the surgeon to pull out the tubes; instead, he sends her home to rest.

When Edna returns to the hospital at 8 o'clock that night, her husband's body has already been taken away. The surgeon-narrator describes the scene, highlighting the widow's loss—and his own. "Edna and I sit on opposite sides of the empty bed. Our voices echo. We are hollow-voiced survivors."[38] Obviously, the surgeon feels guilty—guilty that he had sent the wife home (even though he could not have known that her husband would die during those hours); guilty, perhaps, because he had been unable to keep his patient alive; and guilty, probably, because he had prevented the wife from kissing her husband one last time.

"I'm sorry," [the surgeon says]. . . .

"You should be," [the wife says]. . . . "You gypped me."[39]

The widow's last words, fired at the surgeon, sting with the survivor's pain and anger. But what the widow-survivor does not realize is that the doctor-survivor is suffering from some of the same emotions she feels: pain, anger, guilt, frustration, and loss.


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A doctor, therefore, may be understood as a kind of survivor, as the selections from Gogarty, Williams, and Selzer have illustrated. A doctor may also be portrayed as a survivor by a lay writer, as in Camus's The Plague .

The Plague

Dr. Bernard Rieux, the narrator of Albert Camus's novel The Plague , is a survivor in several senses. He is a doctor; he is a person who lives through the plague that closes off his city for months; and he survives not only his close friend, Tarrou, but also his wife. (As the epidemic ends, Dr. Rieux learns that his wife, who had been in a sanitarium out of town, has died of tuberculosis.) Here is me doctor-survivor's story, as Dr. Rieux chronicles it.

Suddenly in "194_," the plague strikes Oran, Algeria, and the city must be quarantined. All the people trapped there become "prisoners of the plague."[40] As time passes, Dr. Rieux finds himself numbed to the pain and suffering around him, and his numbing—which is the survivor's psychic numbing—is his only relief. "Rieux had learned that he need no longer steel himself against pity. One grows out of pity when it's useless. And in this feeling that his heart had slowly closed in on itself, the doctor found a solace, his only solace, for the almost unendurable burden of his days."[41]

As the death toll mounts to nearly seven hundred per week, the doctor and the entire populace suffer from a sense of immersion in death. Because there is no known remedy for the plague, one of the hardest things for Dr. Rieux is that he cannot really help or even try to heal. All he can do is diagnose the disease and then send victims and their families into isolation. And he finds that because he, the doctor, cannot help people, they resent and even hate him.

Sometimes a woman would clutch his sleeve, crying shrilly: "Doctor, you'll save him, won't you?" But he wasn't there for saving life; he was there to order a sick man's evacuation. How futile was the hatred he saw on faces then! "You haven't


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a heart!" a woman told him on one occasion. She was wrong; he had one. It saw him through his twenty-hour day, when he hourly watched men dying who were meant to live. It enabled him to start anew each morning. He had just enough heart for that.[42]

When the weekly death toll finally begins to fall, people start to hope once more. To Rieux, they seem to be "setting forth at last, like a shipload of survivors, toward a land of promise."[43] But the doctor knows that because of their experiences they have been marked by a vision of death they can never erase: "one can't forget everything, however great one's wish to do so; the plague was bound to leave traces . . . in people's hearts."[44]

The doctor, too, is imprinted with death and, therefore, changed forever. Just as the epidemic is slowing down, his friend Tarrou dies. All day and night the doctor sits by his friend's bed, but he is unable to save him: "This human form, his friend's, . . . was foundering under his eyes in the dark flood of the pestilence, and he could do nothing to avert the wreck."[45] The night after Tarrou's death, Rieux has the "feeling that no peace was possible to him henceforth, any more than there can be an armistice for a mother bereaved of her son or for a man who buried his friend."[46]

As the novel ends, Dr. Rieux says that the tale he told of the plague "could not be one of a final victory. It could be only the record of what had had to be done, and what assuredly would have to be done again in the never ending fight . . . by all who . . . strive their utmost to be healers."[47] These words capture something essential about the doctor as a survivor. They suggest that, in one way or another, the doctor is a survivor who strives to be a healer and must continue to strive to be one "in the never ending fight." After all, the struggle against disease and death goes on and on, even though the doctor-survivor knows that in the end he cannot be victorious. But it is the struggle that counts, and it is the continual struggle that continually makes the doctor


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a survivor, with all the pain and knowledge that that vision implies.

Reflections

Indelibly marked with the imprint of death, the survivor—whether he is a person who has lived through the horrors of war or some other catastrophe or a doctor who has lived through, and continues to live through, the pain, death, and dying he must face daily as part of his profession—is someone who has learned what it is to fight for life, while knowing that in the end he can never really win. Always, the survivor's eyes are haunted by a vision of death. It is the look of the corpse that gazed back at and never left Elie Wiesel when, for the first time after his ordeal, he looked at himself in a mirror. And it is the look, described by Gogarty's professor of medicine, of always seeing in life "the pull of the grave."

Psychic numbing or "the cessation of feeling," one of the survivor's characteristic traits, as chronicled by Lifton, actually helps explain something essential about a doctor. How often do we hear doctors accused of being cold, unfeeling, or insensitive? But coldness or insensitivity—psychic numbing—is actually a part of the survivor's heritage. And while such numbing is a means to dull pain, it is also a sign of the pain itself, both the survivor's pain and the doctor's pain. There is, after all, no need for this kind of numbing unless pain is already present .

We have called the doctor a survivor or a kind of survivor, but by no means do we wish to imply that a doctor is exactly like a survivor who has lived through the magnitude of suffering and death immersion that a survivor of Bataan, Hiroshima, the Nazi death camps, or any other catastrophe has known. The doctor and other survivors share a similarity in kind of experience but not at all in degree. Obviously, while a doctor—like other survivors—knows a


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death immersion, the intensity of the doctor's experience is totally different because his death immersion does not threaten to engulf him directly or immediately

We think back to Mr. D, the survivor of Bataan. Although he had outlived his terrible past, he was not really able to live or relish life because he had been ruined by what he had survived. And so, when he was dying, he was bitter with his doctor for being, precisely, what he himself had been: a survivor. Yet this unfortunate man who accused his doctor actually had a secret kinship with him which neither the patient nor the physician, at that time, recognized or understood. In fact, this tormented patient helps us understand—and feel—through his muteness, anger, and pain what it means to be a survivor and, in a curiously related way, what it means to be a doctor. Both the patient and the doctor he angrily accused are, in different but related ways, survivors—people whose eyes have been filled with, and forever changed by, an ineradicable image of death.


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