Authors: William Styron
“Why is he not in a hospital?” he had asked furiously. “Why is he lying here like this?” Ghita, the mother and wife, had come then—wild-haired, consumptive herself, feverish, wobbling ever near hysteria—trailed by an evil old crone from the hills, carrying amulets, potions, charms. “Ask Caltroni!” Ghita had screeched. “Ask the doctor! He says there is no use! What hospital! Why put a man in a hospital when it is no use! And when there is no money to pay!” (All this in front of the squalling children, in front of Michele, sunk in his hammock dreaming his gentle smile, while cackling Maddalena, the rustic thaumaturge, hovered over, gat-toothed and with swelling blue varicose veins, waving the amulet like a censer.) “He is going to die anyway!” she had yelled. “Ask the doctor! You’ll see!” And, some days later, he had indeed gone to see the doctor, climbing the dark fish-smelling stairs to an office aerie where, munching on a piece of stringy goat cheese, pompous and vain, evasive, a wop Sydney Greenstreet paradoxically radiating a quality of ignorance and ineptitude so overpowering that it was like a kind of brownish aureole around him, Caltroni held forth, amid a magpie’s nest of rusty probes and forceps and speculums superannuated at the time of Lord Lister.
“Perchè?”
he had said, and spread pudgy nicotine-brown fingers.
“Non c’è speranza. È assolutamente inutile”
And had paused, savoring the pronouncement. “It is what is known as generalized consumption. There is not a hope in the world.” And Cass, feeling the blood knocking outrageously at his temples (by then his need
to do
something had become like a panic, a fierce drive up ward and outward from his self that had begun to cut like flame through the boozy dreamland, the nit-picking, the inertia, the navel-gazing), said loudly and impatiently: “What do you mean there is not a hope in the world? I’m no doctor but I know better than that! I read the papers! There are
drugs
for this now!” Whereupon Caltroni, stupidity like ooze around his pink lips, had closed his eyes behind his pince-nez, pressed his fingers together, a rich wise gesture, absurdly vain, sacerdotal:
“Vero.
I do believe there is a drug. It is somewhat like penicillin. The name escapes me.” And opened his eyes. “It is an American product, I believe. But it is in exceedingly short supply in Italy. I myself have never had the opportunity to use it, although in Rome—” He paused. “In any case it could do no good with the
peasant”
—speaking the patronizing word,
campagnuolo,
delicately, as if it were a germ—“he is far gone, and besides he could never be in any position to pay—” But Cass had risen, stalked to the door, shouting over his shoulder:
“Che schifo! Merda!
I wouldn’t let you perform an abortion on my cat!” And felt instant shame, aware even as he slammed the flimsy door shut that the ignorant doctor’s sin was only the venial one of being born in the south of Italy, where, soggy and defeated, even his vanity a sham, he would be reconciled in despair until the end of his days to pricking boils and salving the teats of mangy cows and prescribing quack pills and ointments to people who repaid him—because that is all they had—in goat cheese.
But still Michele continued to get worse: he had no strength to lift himself from the hammock, he had a constant headache, he began to complain of pain in his leg, his attacks of coughing were monstrous to see and hear. Through Cass’ tutelage in plundering Mason’s storeroom (once he took off for a week in Capri with Rosemarie, which made for a field day among the groceries), Francesca saw to it that Michele was fed, and Ghita and the children too, but the sick man’s appetite was poor. Every day Cass visited him; they talked endlessly of America, land of lost content, of gold. For Michele’s sake, he embroidered long lies, baroquely colored. Once, describing in much detail, of all places, Providence, Rhode Island, which Michele, for reasons known only to himself, longed to see, Cass felt sudden pain and longing himself, and annoyance at the demeaning nostalgia, and, breaking off in mid-sentence, wondering at the feeling, realized simply that whatever else he might say against his native land, there would not be this particular gross wrong and insult to mortal flesh. And he looked down at Michele, consumed by a tenderness that he could not understand; seeing the man’s eyes closed in sleep, he thought for an agonizing moment that he was dead. Then shortly after this, sometime around the middle of June, an odd thing occurred which Cass considered a good omen: one day there had come to the Bella Vista a young doctor from Omaha, Nebraska, and his wife, obviously honeymooners—the doctor a short, intense type with a reddish butch crew-cut and square red mustache like matched hairbrushes, his bride gangling and plain, possessing an earnest athletic look and the flatly contoured powerful legs of a miler. The couple was obviously distraught to begin with; they stayed long enough to play one or two desultory sets of tennis on the Bella Vista’s single dusty court, and then (doubtless it was fear of heights, Windgasser observed unhappily, that morbid phobia which had caused even more extroverted-looking tourists than the doctor and his wife to flee the towering crag of Sambuco) had skedaddled sweatily away—possibly all the way back to flat Omaha—frantically chartering a private car to take them to Naples and in their haste leaving behind them, among other things, their tennis rackets, a set of barbells, a douche bag, and several books. It was one of these books—
The Merck Manual of Diagnosis and Therapy,
subtitled:
A Source of Ready Reference for the Physician
—that Cass, having come to beg from Windgasser another extension on the rent, saw on the hotel desk that very evening, and then tucked into his pocket with a secret glow of discovery. And it was through the manual that he finally set up shop as an M.D.
GENERALIZED HEMATOGENOUS TUBERCULOSIS
.
Subacute Form: The onset of this form of the disease is …insidious. Fatigue, loss of weight, malaise, and fever develop over several weeks. The infection is less overwhelming than in the acute form and fewer lesions are established in the various organs. A greater variety of manifestations develop, however, because the patient lives longer, allowing for the development of local lesions. Lymphadenopathy is more prominent, splenomegaly more frequently seen, and progressive ulcerative pulmonary tuberculosis often develops subsequent to miliary “seeding.” Symptoms and signs of genitourinary tuberculosis, bone and joint tuberculosis, or skin tuberculosis frequently develop during the illness. A ma-jority of the patients die within three to six months but some live for many years with partially healed lesions in the organ systems involved.
He committed such passages to memory, finding in this one, or at least in its final line, almost as much to hope for as to cause him despair. For if it was true that
some
did live for many years, was there not an outside chance that Michele might join the saved? In the Bella Vista library, between
Middlemarch
and
East Lynne,
he discovered an enormous rat-chewed dictionary and looked up “splenomegaly"; rushing down to Tramonti that very evening he prodded gently at Michele’s spleen, found that it was swollen, outsized, like a rubber tire, and figured that at least Caltroni’s diagnosis had been correct.
Streptomycin or di-hydrostreptomycin is of considerable value in the treatment of the acute and subacute forms of the disease. In addition to specific antibiotic therapy, active supportive treatment is indicated for the patient with severe acute miliary tuberculosis. He may be so ill as to require I.V. hydration and alimentation and vitamin supplements. Blood transfusions may be helpful.
And he thought: Shit a brick, how am I going to give him any blood? But that problem he would grapple with when he came to it. The drugs were the immediate, the pressing thing and by dawn of the next day—his mind aswarm with monstrous words like sarcoidosis, histoplasmosis, coccidioidomycosis, but with a rage to cure flaming in his breast—he knew at least where he could get his hands on some streptomycin. That morning he had presented himself early at Mason’s door, for once neatly attired, as befits an up-and-coming doctor of medicine.
And Mason had held out on him. No, he had not really held out on him at last; he
had
given in, languidly accoutered himself in his spotless flannels, and with Cass had tooled over to the PX pharmacy, where, making use of his elaborate connections, he had obtained the thirty cc. of streptomycin—plus two hypodermic syringes, and ten ampoules of morphine, too, to ease the pain in Michele’s leg: that was part of the bargain. For bargain it was, a deal—there was no largesse involved—and for this alone, almost, Cass would be unable to forgive him. He had made his plea, straight and simple ( “sMason, see, it’s Francesca’s father, he’s in
awful
shape and what he needs, you understand, is this new wonder drug that I’d figured you might be able to get for me …” And so on), and had elicited only an Olympian shrug and
this
rejoinder: “Crap, Cass, now
please
don’t consider me the Flintheart of all time but you know as well as I do that if each individual American went around nursing every sick distressed Italian that came along he’d go broke in about a week even if he had twenty million dollars.” And swiveled in the bright morning sunlight, immaculate, swank, streamlined, and scrutable in his flannels, and poured two cups of coffee from the spout of a gleaming electric Koffee King. “I’m a bastard, I know,” he said, self-mocking, “but face it, can’t you? If one must accept the notion of a welfare state with all of its committed millions, and European Recovery or whatever it’s called, then one must realize that one has already done his bit. Really, Cassius, I mean this. If I told you how much Federal income tax I paid last year you’d call me a liar. I mean, dollbaby, I’ve already kicked in with a couple of gallons of antibiotics.” Yet a bargain was finally struck after several hours’ conversation during which, for the first time, Mason broached his opinions upon the value of erotica, and in fact showed Cass a stack of his juiciest lithographs. “It might just be the thing, dollbaby,” Mason had said, “to get you around that psychic block of yours.” In his morning haze, the prospect was deceptively titillating. And later he regretted it. But the bargain was struck. For one filthy picture, to be skillfully executed: rent money, brandy, streptomycin. They took off for Naples at noon. And late that same evening, just before he started to fulfill his part of the bargain and began painting the atrocious picture in encaustic, meticulously applied, he had at least the satisfaction of seeing a full gram of the hard-won stuff flow from his own syringe into Michele’s veins. All he lacked was a diploma.
Yet it became a month of disconnected days, verging, it seemed, ever closer to some shadowland frontier separating reason from madness. He drank, he went without sleep; at Michele’s side at least six times daily and often more, he lost count of the hot treks he made into the valley and back—compelled to do so because hysteric Ghita could not be trusted to make the proper injections, even if in a valley which had never known a cake of ice, much less a refrigerator, there
had
been a place to store the drug (once he struggled into the valley with a huge block of ice, which quickly melted, and he saw that this scheme would be more arduous than a careful program of hikes)—and established a kind of hallucinated rhythmical schedule in which a certain familiar cypress that he passed, or the shallow place where he leapfrogged across a brook, or a boulder that he mounted to short-cut up a slope were only way stations, arrived at without the variation of a minute, upon the route toward that final destination where, pooped and logy with wine or Mason’s booze, he would rest for a while in the fly-swarming heat and talk to Michele (America! America! What lies he told! What paeans, what eulogies he bestowed upon the nation!) and then with great care insert the boiled needle in the rubber stopper of the vial, extract a gram of the rose-colored fluid and slowly pump it into a vein of Michele’s wasted, unflinching arm. Yet Michele, perhaps more slowly than before, but still quite visibly and plainly, grew worse, wasting away like the thin attenuated white stalk of some plant deprived of water and the sun. He saw Michele wither away, and blind outrage seized him as he hiked back up through the valley, storming and raving at his own inadequacy, at Italy, at Mason (thinking: Bleeding God, he could get Michele fixed up just out of his petty cash …), at that black, baleful and depraved Deity who seemed coolly minded to annihilate His creatures not in spite of but almost because of the fact that they had learned to heal their bodies, if not their souls… .
“Questi sono i soli esemplari che si conoscano”
said the finicky scientific radio voice,
“a rigor di termini
—” Mason had fallen silent, and now, as the Cadillac moved swiftly along the spine of the great ridge, a single fleecy cloud eclipsed the sun, bringing a sudden, momentary chill. Feeling the sweat evaporate on his brow, a cool prickle up his back, Cass raised the bottle to his lips and drank. Below in the valley the shadow of the cloud passed westward at tremendous speed, the ragged gray silhouette of some prehistoric bird engulfing fields, farmhouses, trees; behind its trailing edge the sunlight moved voraciously, pursuing the ghost. Slowly the cloud itself passed from the face of the sun, bringing heat to the car once more, and dazzling light. “Say, Mason,” Cass heard himself say with effort, “say, old buddy, tell me something. Are you sure they’ve got that stuff?” “What stuff, Cassius?” he said amiably. “You know, the P.A.S. Last time, I mean Tuesday, are you sure they said you could get it today?”
(Merck
again, the viscous terminology committed to his memory as unshakably as a nursery rhyme:
Para-aminosalicylic acid is indicated chiefly as an adjuvant to streptomycin or dihydro-streptomycin therapy, since it delays the emergence of organismal resistance to these drugs. It may be used alone, however, when streptomycin and dihydrostreptomycin are contraindicated or have proved ineffective, since it possesses antituberculous activ-ity itself.
The last bleeding hope and chance. And how, after watching Michele wither and fail for the last two weeks, it had taken him so long to root this precious information from the manual he would never know; no matter, stumbling upon the passage by sheerest chance as he half-drowsed by Michele’s hammock only three days before, he knew he must get his hands on this stuff whether it prove the ultimate miracle or only one last desperate and futile gesture.) “You sure they said you could get it today?” he repeated. “Sure I’m sure,” Mason said. “Put it out of your mind, dollbaby.” “I can’t—” Cass began, sweating. “I mean, Mason, like all the rest I won’t be able to pay you back right away. I mean, if you can just put it on the tab with all the rest of —” But remarkably, impossibly now—could it really be true?—Mason was saying: “Come on now, Cass, don’t be absurd. I’ll take care of it, call it a gift if you want to. For one thing I priced the stuff Tuesday. It’s cheap. It’s synthesized out of coal tar like aspirin, the pharmacist told me, and they have P.A.S. up the ass. But even”—Cass was gazing at him intently; was that a gentle smile on his face, a smile of benevolence even, or only something else, more complicated and devious, he was doing with his lips?—“even if it were really precious, Cassius, I’d want you to have it—for nothing.” And for an instant he paused, rubbing one lens of his sun glasses with a Kleenex, magnanimously smiling. “I mean, God knows, it’s the very least I can do. She’s a
virulent
little sneak thief—I’ll argue that with you right down the line—but if the old man is as bad off as you say it’s the least I can do to chip in a little bit myself and try to put him back on his feet. After all, it’s not his fault that she’s—well, you know what. So forget about it, Cass, this one’s on me. O.K.?” He didn’t answer. Drowsing now, peering at the valley through half-closed eyes, he felt his jaw drop, the muscles of his limbs growing limp with exhaustion as he thought: I don’t want any of your bleeding charity. Not for Michele’s sake, anyway. I’ll pay you back, Buster Brown. I’ll pay you back for everything.