I can’t recall now what it was that prompted me to dig out my old Penguin edition of vol 4 of Orwell’s Collected Essays, Journalism and Letters, to seek out a specific essay; but I’m glad I did because as usual George is spot on… The essay in question is called “How The Poor Die“, and it was first published in November 1946. In it, Orwell looks back to time spent in a public ward of a French hospital in 1929 (presumably during the time covered in “Down and Out in Paris and London”); and what he relates is quite chilling…
Orwell was, of course, really living down and out in Paris at the time, and so when he was taken ill with pneumonia he had no option but the nearest hospital because he certainly couldn’t afford a doctor… The treatment he received was quite shocking: cupping, a mustard poultice, indifference from the various doctors and nurses, and disgustingly insanitary conditions where disease must have spread unchecked. Patients died and were left in their beds until someone could be bothered to move them; whether you were actually treated by the doctors often depended on how ‘interesting’ your illness was; and running through all this was an attitude from those supposedly caring of total disinterest, with most of them treating the patients as if they were less than human.
A few feeble protests that I uttered got no more response that if I had been an animal. I was very much impressed by the impersonal way in which the two men started on me. I have never been in the public ward of a hospital before, and it was my first experience of doctors who handle you without speaking to you, or, in the human sense, taking any notice of you.
Orwell escapes as soon as he’s well enough, though not before he’s thoroughly shocked by what he’s experienced; and he compares it with the kind of treatment he would have received in an English hospital which would have been very different. However, this was in the pre-NHS days, so presumably the kind of treatment you got still depended on how much money you had (something which I picked up in my reading of the British Library Crime Classic, “The Port of London Murders” – here, the struggle from hand to mouth and the cost of medical care was very much an issue). Anyway, Orwell rounds up his essay reflecting on the fact that in 1929 medical treatment was often viewed with suspicion, being still in its infancy in many ways, and up until the introduction of anaesthetics most people tried to avoid doctors and hospitals…
As always, Orwell is a wonderful essayist – immediate, clear, getting to the point, yet setting his scene wonderfully and capturing the experiences he lived through so vividly. “How the Poor Die” was profoundly moving in places, focusing on the poor suffering people with no way out other than a cold, lonely death. Orwell seems of the opinion that it’s better to die young and quickly, rather than a long and lingering and eventually painful death at an old age – and I can see where he’s coming from…
This essay also set me thinking about our own NHS, so lauded, yet often criticised, underfunded and under threat. Having read about the cost of healthcare, and the horrors of trying to get treatment, in the USA, I’m glad we have the system we do; although I think other countries have more efficient systems than ours. And I see the NHS is under attack again at the moment; I try not to stray into politics too much on the Ramblings, for the good of my blood pressure; but having witnessed what Orwell saw and went through, all those years ago, I really think we need to start protecting and improving the system we already have in place. As always, Orwell’s wonderful writing really does bring clarity and focus the mind!
Lisa Hill
Jun 25, 2021 @ 08:09:44
Well, I would say that we have a good system here in Australia, albeit two tiered which means you can go private if you have the money, but if there’s one thing the pandemic should have taught all the developed nations, it’s that (1) we should have adequate health care for everybody, because anyone who’s sick is a risk to everyone else and (2) that we should have adequate health care in all the other countries as well because anyone who’s sick is a risk to everyone else.
kaggsysbookishramblings
Jun 25, 2021 @ 11:26:13
Yes, as Simon mentions, we have the same thing. However, you’re spot on – the health of one can affect the health of all, and we should be making sure the whole population has good health care. It affects our whole species…
BookerTalk
Jun 25, 2021 @ 18:35:51
I’ve heard such good things from friends about the Aus health system and the speed with which you can get things like scans/diagnostic tests done. My husband unfortunately had experience of the NZealand system which I think is similar and it was fantastic (and free).
kaggsysbookishramblings
Jun 26, 2021 @ 08:25:18
It should be like that the world over, I feel.
Lisa Hill
Jun 28, 2021 @ 06:41:43
It’s a basic human right, I reckon, affordable health care…
kaggsysbookishramblings
Jun 28, 2021 @ 10:21:47
Agreed!!
Tredynas Days
Jun 25, 2021 @ 08:28:20
I agree with Lisa. Ours is a two tier system in the UK: pay for rapid treatment, or wait a year for NHS treatment- from the same doctors
kaggsysbookishramblings
Jun 25, 2021 @ 11:25:15
It is – it’s an improvement on the USA but it’s by no means perfect!
A Life in Books
Jun 25, 2021 @ 10:46:31
We are extrordinarily lucky in the UK with the NHS which is not to say it’s not in need of reform given that it was set up for a very different population, just not by this or any Conservative government.
kaggsysbookishramblings
Jun 25, 2021 @ 11:24:07
We are, I agree, although I also agree that reform is needed. Taking a bit of the red tape and admin out, and re-routing that funding to pay staff more and recruit more staff and take the strain off hospitals would help…
Margot Kinberg
Jun 25, 2021 @ 12:11:35
Orwell really was a fascinating person, whatever one’s politics. And I couldn’t agree more that his writing is excellent, too. I always enjoy learning about the experiences different writers have had that have influenced their work, too. Thanks for bringing this to my attention.
kaggsysbookishramblings
Jun 25, 2021 @ 13:53:03
He was, and I always find his writing so lucid. I hope you can read some of his essays, as I always find them so fascinating and thought-provoking!
Roger
Jun 25, 2021 @ 14:38:11
The problem with the NHS is that it’s become the British national religion. No-one dares question it, but no-one takes it seriously or thinks about how to improve it. “Improve” here does not mean make it cheaper.
kaggsysbookishramblings
Jun 25, 2021 @ 15:15:13
No, cheapness is not the thing. Instead, I think it needs the layers of outsourcing and admin peeled away, and funding poured into providing trained staff and equipment. Staff that are paid properly and not overworked. My mum was an auxiliary nurse, in the times a ward was run by a Sister, the staff were all employed directly by the hospital and everyone took a pride in their job and their ward. Alas, times have changed and not for the better.
neeruahcop
Jun 25, 2021 @ 17:24:07
That makes me want to read something by Orwell immediately. It is ages since I have read anything by him though he is so good.
kaggsysbookishramblings
Jun 26, 2021 @ 08:32:15
He’s just great – fiction or essays or long-form non-fiction, I love his writing.
heavenali
Jun 25, 2021 @ 18:09:47
It’s a long time since I read any Orwell, I have enjoyed several of his novels. However, I haven’t read any of his non fiction. Orwell’s essay is serves as a reminder how (imperfect though it is) we in the UK should all be grateful for the NHS.
kaggsysbookishramblings
Jun 26, 2021 @ 08:31:46
Orwell’s such a great writer generally, I think, and his essays are fabulous. And yes, flawed as it is, I’m so glad we do have the NHS.
BookerTalk
Jun 25, 2021 @ 18:34:14
I was introduced to Orwell’s essays when he was on our A level Eng lit syllabus (a very welcome change from Chaucer and Milton) but I’ve not come across this one. You’ve tempted me to get this collection.
How was he able to do a comparison to the British health system unless he was ill a second time otherwise wouldn’t it be just second hand info?
kaggsysbookishramblings
Jun 26, 2021 @ 08:30:57
I do love Orwell’s essays, and these four Penguins have a wonderful selection of essays, letters etc so are lovely for dipping into. As for his health, it was never brilliant (and of course he was shot in the Spanish Civil War) so by the time he wrote this essay in 1946 I imagine he’d seen the inside of a number of hospitals…
JacquiWine
Jun 25, 2021 @ 18:45:22
I like how you go back to Orwell’s non-fiction on a fairly regular basis, Karen, it’s clearly a very strong touchstone for you. Like Ali, I don’t think I’ve ever read any of his essays…a salutary reminder of some core principles in these turbulent times.
kaggsysbookishramblings
Jun 26, 2021 @ 08:29:40
It is – Orwell’s non-fiction is always so clear-sighted that I feel it brings me focus. He’s a great essayist and always get to the nub of things.
ellenandjim
Jun 25, 2021 @ 18:48:44
Thank you for this, and you are justified by this immediate situation of the pandemic. I have been in one of these hospitals “for the indigent” in the US (in New York City) and what is described of the appalling conditions and bad treatment is not exaggerated. The US lost so many people for many reasons: but one was the one you mention prevalent in the UK in Orwell’s time: a justified unwillingness to go to a doctor or hospital.
kaggsysbookishramblings
Jun 26, 2021 @ 08:28:59
Yes – I can imagine that the cost of the treatment alone in America would mean many people wouldn’t or couldn’t get treatment. Which *is* shocking in a 21st century western country.
piningforthewest
Jun 25, 2021 @ 22:23:22
I think I enjoy Orwell’s essays even more than his fiction. I’m so happy that we have the NHS despite it not being perfect, but I’m alarmed that the Tories have sold off so many bits of it – under the counter so to speak, and seem to be allowing US entities to get their paws on it. The pay rise that the government offered the workers is scandalous.
kaggsysbookishramblings
Jun 26, 2021 @ 08:27:46
His essays *are* outstanding, aren’t they? And yes – our system has flaws but that’s happening to it under the Tories is shocking and they don’t care because they’re creaming off all the money they can for themselves and their cronies. Horrid.
Julé Cunningham
Jun 25, 2021 @ 22:52:52
You definitely do not want the employer-based market system we had in the US before President Obama started making changes. We still have a long way to go, however.
It’s sad to watch the Tories ripping apart the NHS to line their own pockets while all too many people don’t even seem to see what’s going on.
kaggsysbookishramblings
Jun 26, 2021 @ 08:26:49
No, we don’t – I’m sure of that. And it breaks my heard to see what the Tories are doing to the NHS (and indeed our country) at the moment – I don’t usually bring politics into the Ramblings, but they are a dishonest, greedy, nasty, self-serving bunch. 😦
cirtnecce
Jun 26, 2021 @ 02:55:59
I have funnily not read any of Orwell’s non fiction, though I cannot say enough great things about his fiction. I must read some of these soon.
kaggsysbookishramblings
Jun 26, 2021 @ 08:25:49
I think he’s a great essayist – I think I could read him on any subject!
Calmgrove
Jun 26, 2021 @ 11:59:28
I can’t add anything new to either your post or the fine comments here other than to say I concur, and that I must think about reading more Orwell (other than his two most famous works) especially after seeing his early Southwold stamping ground.
kaggsysbookishramblings
Jun 26, 2021 @ 20:35:06
Orwell’s essays are definitely worth exploring I think – I love his writing and he seems to get to heart of things, and so clearly. Highly recommend his non-fiction!
TravellinPenguin
Jun 26, 2021 @ 13:46:53
Orwell was so good. I love his writing and topics he wrote about. Hea.th system in Tasmania is good especially if you are at crisis for something but non insured people can wait a long time for things like hip and knee replacements and elective surgery. Having lived in the USA for 30+ years I can attest as to how awful it is. Certainly only for the rich. Absolutely disgraceful .
kaggsysbookishramblings
Jun 26, 2021 @ 20:34:26
He was – spot on most of the time and extraordinarily prescient. As for the health system in the USA, it really does sound shocking…
lauratfrey
Jun 27, 2021 @ 04:45:33
My kids have recently discovered Orwell’s novels, and like many other commentators, I haven’t read any of his nonfiction. Looks like I’ll have to fix that!
kaggsysbookishramblings
Jun 27, 2021 @ 16:01:07
I’d definitely recommend it! I find him such a clear-sighted commentator, and although he was writing so long ago his thought is still so relevant.
madamebibilophile
Jun 27, 2021 @ 11:49:56
When I saw your title I thought no, I want to die peacefully and ancient! But of course that is an attitude presuming I am living under a functioning NHS…
kaggsysbookishramblings
Jun 27, 2021 @ 11:51:18
Well, yes – peacefully and ancient is a good option if possible, but I think Orwell had seen people dying long, drawn out deaths, and that was (and is) pretty horrid. Peaceful and quick would do me!!
Jonathan
Jun 27, 2021 @ 20:12:10
I haven’t read any of Orwell’s essays but I certainly mean to. I have recently got a copy of The Ministry of Truth by Dorian Lynskey (a book about 1984) from the library and it looks really interesting—a biography of a book…there should be more of those.
My recent experiences with the NHS have revealed that the Emergency Services are very good but the GP services are absolutely terrible. I don’t think the NHS has ever really functioned properly.
kaggsysbookishramblings
Jun 28, 2021 @ 10:23:27
He’s one of the great essayists in my view – such wonderful writing. The Ministry of Truth sounds good, I’ll keep an eye out for it.
And I tend to agree re the NHS – the GPs services are a bit of a disaster at the moment. Needs to be made to function properly.
Constance Martin
Jun 28, 2021 @ 02:29:03
I’ve never read any Orwell either but I am now intrigued. I am sure all our countries’ medical leaders should have learned a lot over the past 16 months but I am not sure they have!
kaggsysbookishramblings
Jun 28, 2021 @ 10:22:17
He’s a very perceptive commentator I find. As for our so-called leaders – I’m afraid I despair on a regular basis… 😦
1streading
Jun 29, 2021 @ 12:15:31
It says a lot for Orwell that the comments are mainly about the issue he raises, all these years later. I think it’s good to be reminded of life before the welfare state as it’s easy to forget how harsh and unfair it was. Arguably the pandemic has reminded us that healthcare isn’t just about doctors – housing conditions have played a large part in many outbreaks.
kaggsysbookishramblings
Jun 29, 2021 @ 13:28:21
It does indeed! And I totally agree about how dreadful life and health could be if you didn’t have money before the NHS. You’re spot on about housing too – that’s another major issue in this country which desperately needs to be sorted out… 😦
buriedinprint
Jul 01, 2021 @ 00:36:40
Surely there is some chilling proverb about the value of having an “interesting” illness. *sigh*
kaggsysbookishramblings
Jul 01, 2021 @ 09:47:13
There probably is. I’d like to live a reasonably long life and then just go quickly one day…