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…

By BBC [Public domain], via Wikimedia Commons

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!