foreign countries-tropical climates: At least we know where they contracted it, if not why or how.
“Of course, primary or secondary, they can take the same general path. But as a rule people with secondary cases grew up in places where Hansen's disease is less arcane than here. They recognize what they've got when they get it. That means they have a better chance of seeking help in time.
“I want you to meet another of our patients. He's the only other primary case we have here at present. He used to be a sort of hermit-lived alone away from everyone in the West Virginia mountains. He didn't know what was happening to him until the army tried to get in touch with him-tell him his son was killed in the war. When the officer saw this man, he called in the Public Health Service. They sent the man to us.”
The doctor stopped in front of a door like the one to Covenant's cell. He knocked, but did not wait for an answer. He pushed open the door, caught Covenant by the elbow, and steered him into the room.
As he stepped across the threshold, Covenant's nostrils were assaulted by a pungent reek, a smell like that of rotten flesh lying in a latrine. It defied mere carbolic acid and ointments to mask it. It came from a shrunken figure sitting grotesquely on the white bed.
“Good afternoon,” the doctor said. “This is Thomas Covenant. He has a primary case of Hansen's disease, and doesn't seem to understand the danger he's in.”
Slowly, the patient raised his arms as if to embrace Covenant.
His hands were swollen stumps, fingerless lumps of pink, sick meat marked by cracks and ulcerations from which a yellow exudation oozed through the medication. They hung on thin, hooped arms like awkward sticks. And even though his legs were covered by his hospital pyjamas, they looked like gnarled wood. Half of one foot was gone, gnawed away, and in the place of the other was nothing but an unhealable wound.
Then the patient moved his lips to speak, and Covenant looked up at his face. His dull, cataractal eyes sat in his face as if they were the centre of an eruption. The skin of his cheeks was as white-pink as an albino's; it bulged and poured away from his eyes in waves, runnulets, as if it had been heated to the melting point; and these waves were edged with thick tubercular nodules.
“Kill yourself,” he rasped terribly. “Better than this.”
Covenant broke away from the doctor. He rushed out into the hall and the contents of his stomach spattered over the clean walls and floor like a stain of outrage.
In that way, he decided to survive.
Thomas Covenant lived in the leprosarium for more than six months. He spent his time roaming the corridors like an amazed phantasm, practicing his VSE and other survival drills, glaring his way through hours of conferences with the doctors, listening to lectures on leprosy and therapy and rehabilitation. He soon learned that the doctors believed patient psychology to be the key to treating leprosy. They wanted to counsel him. But he refused to talk about himself. Deep within him, a hard core of intransigent fury was growing. He had learned that by some bitter trick of his nerves the two fingers he had lost felt more alive to the rest of his body than did his remaining digits. His right thumb was always reaching for those excised fingers, and finding their scar with an awkward, surprised motion. The help of the doctors seemed to resemble this same trick. Their few sterile images of hope struck him as the gropings of an unfingered imagination. And so the conferences, like the lectures, ended as long speeches by experts on the problems that he, Thomas Covenant, faced.
For weeks the speeches were pounded into him until he began to dream them at night. Admonitions took over the ravaged playground of his mind. Instead of stories and passions, he dreamed perorations.
“Leprosy,” he heard night after night, “is perhaps the most inexplicable of all human afflictions. It is a mystery, just as the strange, thin difference between living and inert matter is a mystery. Oh, we know some things about it: it is not fatal; it is not contagious in any conventional way; it operates by destroying the nerves, typically in the extremities and in the cornea of the eye; it produces deformity, largely because it negates the body's ability to protect itself by feeling and reacting against pain; it may result in complete disability, extreme deformation of the face and limbs, and blindness; and it is irreversible, since the nerves that die cannot be restored. We also know that, in almost all cases, proper treatment using DDS — diamino-diphenyl-sulfone-and some of the new synthetic antibiotics can arrest the spread of the disease, and that, once the neural deterioration has been halted, the proper medication and therapy can keep the affliction under control for the rest of the patient's life. What we do not know is why or how any specific person contracts the illness. As far as we can prove, it comes out of nowhere for no reason. And once you get it, you cannot hope for a cure.”
The words he dreamed were not exaggerated-they could have come verbatim from any one of a score of lectures or conferences-but their tolling sounded like the tread of something so unbearable that it should never have been uttered. The impersonal voice of the doctor went on: 'What we have learned from our years of study is that Hansen's disease creates two unique problems for the patient-interrelated difficulties that do not occur with any other illness, and that make the mental aspect of being a leprosy victim more crucial than the physical.
“The first involves your relationships with your fellow human beings. Unlike leukemia today, or tuberculosis in the last century, leprosy is not, and has never been, a “poetic” disease, a disease which can be romanticized. Just the reverse. Even in societies that hate their sick less than we Americans do, the leper has always been despised and feared-outcast even by his most-loved ones because of a rare bacillus no one can predict or control. Leprosy is not fatal, and the average patient can look forward to as much as thirty or fifty years of life as a leper. That fact, combined with the progressive disability which the disease inflicts, makes leprosy patients, of all sick people, the ones most desperately in need of human support. But virtually all societies condemn their lepers to isolation and despair-denounced as criminals and degenerates, as traitors and villains-cast out of the human race because science has failed to unlock the mystery of this affection. In country after country, culture after culture around the world, the leper has been considered the personification of everything people, privately and communally, fear and abhor.
“People react this way for several reasons. First, the disease produces an ugliness and a bad smell that are undeniably unpleasant. And second, generations of medical research notwithstanding, people fail to believe that something so obvious and-ugly and so mysterious is not contagious. The fact that we cannot answer questions about the bacillus reinforces their fear-we cannot be sure that touch or air or food or water or even compassion do not spread the disease. In the absence of any natural, provable explanation of the illness, people account for it in other ways, all bad-as proof of crime or filth or perversion, evidence of God's judgment, as the horrible sign of some psychological or spiritual or moral corruption or guilt. And they insist it's catching, despite evidence that it is minimally contagious, even to children. So many of you are going to have to live without one single human support to bear the burden with you.
“That is one reason why we place such an emphasis on counselling here; we want to help you learn to cope with loneliness. Many of the patients who leave this institution do not five out their full years. Under the shock of their severance, they lose their motivation; they let their self-treatments slide, and become either actively or passively suicidal; few of them come back here in time. The patients who survive find someone somewhere who is willing to help them want to live. Or they find somewhere inside themselves the strength to endure.
“Whichever way you go, however, one fact will remain constant: from now until you die, leprosy is the biggest single fact of your existence. It will control how you live in every particular. From the moment you awaken until the moment you sleep, you will have to give your undivided attention to all the hard corners and sharp edges of life. You can't take vacations from it. You can't try to rest yourself by daydreaming, lapsing. Anything that bruises, bumps, burns, breaks, scrapes, snags, pokes, or weakens you can maim, cripple, or even kill you. And thinking about all the kinds of life you can't have can drive you to despair and suicide. I've seen it happen.”
Covenant's pulse was racing, and his sweat made the sheets cling to his limbs. The voice of his nightmare had not changed-it made no effort to terrify him, took no pleasure in his fear-but now the words were as black as hate, and behind them stretched a great raw wound of emptiness.
“That brings us to the other problem. It sounds simple, but you will find it can be devastating. Most people depend heavily on their sense of touch. In fact, their whole structure of responses to reality is organized around their touch. They may doubt their eyes and ears, but when they touch something they know it's real. And it is not an accident that we describe the deepest parts of ourselves-our emotions-in terms of the sense of touch. Sad tales
“You must fight and change this orientation. You're intelligent creatures-each of you has a brain. Use it. Use it to recognize your danger. Use it to train yourself to stay alive.”
