Note: When Dalrymple’s long-running BMJ column ended in 2012, he had a backlog of about 60 unpublished pieces, and he kindly gave them to us to post here at Skeptical Doctor. We are posting them on Wednesdays to coincide with the schedule of his old BMJ column. We hope you enjoy them.

Jean Reverzy (1914 – 1959) was a general practitioner in Lyon whose first book, Le Passage (translated into English as The Crossing), was published in 1954. It was a best-seller, my copy from the year of its publication saying on the cover that it was one of the first forty-thousand printed, and it won the Prix Renaudot. Reverzy was a very good writer whose work, however, was largely forgotten until republished in a single volume in 2002. Literary neglect is not necessarily the consequence of absence of worth, however: which is the hope, or excuse, of all failed scribblers.

The narrator of Le Passage is a general practitioner in Lyon, and its protagonist is Palabaud, a Frenchman who returns home to his native Lyon from the South Seas, where he has kept a small hotel, to die. Though not a drinker, he suffers from cirrhosis; his illness starts with what sounds like hepatitis – sudden loss of appetite, nausea at the presence of smells – but there is no indication of how he might have caught the variety that could have progressed to cirrhosis.

Death, its meaning and how to meet it, was an important subject for Reverzy. He wrote in a letter, “If you want to write, learn to die.” His father had been killed in the First World War when he was one year old, and shortly before he wrote the book Reverzy suffered a prolonged attack of anxiety with the apprehension (correct as it turned out) that his own life would be a short one. He went on a journey to Tahiti for several months, and wrote the book on his return.

The Passage is not only that of Palabaud’s from France to Tahiti and back again, but that of all of us from life to death. Reverzy captures much in this comparatively short book with great sensitivity and exquisite simplicity. There are also moments of comedy, if of the somewhat painful variety. Here Palabaud is visited on his deathbed by his landlord and landlady who not long before had suspected him, on no grounds at all, of being a criminal on the run, and are now doubly embarrassed in the face of death:

“You’re not any worse?”
“You’ve got a very nice room…”
“I never knew that hospitals were so comfortable…”
“You have a nice view of the hill…”
“They’re doing a lot of building over there.”

Palabaud is the patient of Professor Joberton, one of the “great” doctors of Lyon whose reputation is in excess of his actual accomplishment. He arrives in Palabaud’s room with an entourage of acolytes, and examines him summarily. He and the entourage leave the room and Palabaud can hear him say to them outside:

I have there a patient in such a condition that I hope that none of you will disturb him. Let us leave him to die in peace. He arrived from the other end of the world, from Haiti. The diagnosis presents no great difficulty, it is a cirrhosis in the terminal phase. What is worthy of note and reflection is the deep decay of the patient that you no doubt noticed from the door, which is much greater than mere cachexia…

As it happens, I once returned from the South Seas with an enlarged liver, about 30 years after the publication of Le Passage. The professor entered my hospital room with a large entourage and started to talk of the prognosis of the illness of the Nigerian in the bed opposite mine, first saying to the patient, “Now don’t you listen to any of this.”