“Thirst” does not appear in the index of Moore’s Handbook of Pain and Palliative Care, but thirst seemed to be the last discomfort that Laura felt. In her final two weeks, when she was on morphine and a Fentanyl patch and apparently not feeling any somatic or visceral pain, she still would eagerly take ice chips, applesauce, or yogurt, and signal when her mouth was dry. Hunger went first. She only stopped drinking the day before she died.
Thirst does not seem to fit very well into the typical three-part division of pain into somatic, visceral, and neuropathic. Neuropathic pain occurs when the central nervous system sends signals even though there hasn’t really been any “tissue dysfunction.” (Ransom et al. 249)
Thirst emerges when there is “tissue dysfunction” in the form of a lack of fluid, to varying degrees inside and outside the cells. This imbalance sets off hormonal secretions which, combined with changes in osmotic pressure, directly induce signals from the lamina terminalis to other regions of the brain to generate signals to the body to drink, i.e., thirst. Thirst to some extent is visceral as defined by Ransom because it is also generated by signals from the neuroreceptors in the viscera, the arteries, the heart, and the lungs to the hindbrain. (McKinley and Johnson) But the direct involvement of the brain as a receptor of hormonal and osmotic signals does contradict the classical Cartesian model of pain: injury hits; nerves transmit; brain perceives. (Gatchel et al. 1) This model is also known as the “‘specificity theory,’ because it connotes that a painful stimulus is transmitted along a single pathway to a specific pain center in the brain.” (D. Epstein)
As Atul Gawande (120) puts it, “Pain … [is] … far more complex than a one-way transmission from injury to ouch.” Gawande (125) himself may say that the first component of pain is a distinct sensation. And Nietzsche (1974, 252) may say that pain is like the captain of a ship yelling commands. But, as we have just seen regarding thirst, a lot happens before that distinct sensation, before the captain yells.
In neuropathic pain, the captain-brain can yell even without nerve signals from injured tissue. On the other hand, the captain-brain may not yell even in the presence of signals from injured tissue. To account for this, Ronald Melzack developed the theory that there are “gates” in the brain through which the injury signal must pass. This “gate-control” theory still looked at pain as a one-way transmission, in which the brain produces physical pain and can do so even without injury/stimulus. (Gawande 122, Gatchel et al. 2) As such, Gate-Control Theory could not adequately account for all the complexities of pain. Melzack, therefore, proposed a more interactive model in which pain results from the output of a network he calls a “neuromodule” or “neuromatrix,” which works like a computer program. Linking “virtually every region of the brain,” the neuromatrix gathers input from “sensory nerves, memory, mood, and other centers.” Once this input attains a certain level, the neuromatrix triggers “a complex response that includes not just a distinct sensation but also motor activity, a change in emotion, a focusing of attention, a brand-new memory.” (Gawande 125-126) David Epstein describes the neuromatrix as “essentially a blueprint of a full body that exists in the brain whether or not the full body exists in physical space.” But Gawande describes it more as a computer model that interacts with and in all dimensions.
Just as Gatchel and his co-authors introduce a philosophical claim into a scientific paper when they call nerve stimulation “objective” and the pain response to this stimulation “subjective,” Melzack embeds some strong philosophical presumptions in his neuromatrix theory of pain, most particularly when he writes that the neuromatrix aims to bring a “body-self” back to “homeostasis.” This terminology is no more scientific than Lǎozǐ’s observation more than 2,000 years ago:
The reason I have really bad pain ( 患 )
is because I have a body-self (身)
If I didn’t have a body-self (身),
would I have pain ( 患 )? (Lǎozǐ 13)
The characters of interest to the present discussion are 患 huàn, variously translated as pain, malady, distress, disaster, suffer, trouble, danger, stress, and 身 shēn, variously translated as body, person, personality, life, status.
Saying that these terms are more philosophical than scientific does not make them wrong. It just makes them fair game for philosophical musings. The key scientific, i.e., testable, concept in the neuromatrix theory is that pain occurs after the “neural network output.” (Gatchel et al. 3) Pain does not directly result from “sensory input evoked by injury, inflammation, or other pathology,” as in the old Cartesian perspective on pain. (Melzack 1378)
One could, of course, dodge these questions about thirst as pain and like Buytendijk (23) put thirst and hunger in the category of “‘vital’ sensations of displeasure” and pain in that of “unpleasant sensory perceptions.” D.M. Armstrong (111-115) considers thirst an intransitive sensation like pain, but he sees it only as “the desire to drink” sometimes involving dryness in the mouth. Let’s consider Charlotte Delbo’s experience of thirst during her time in Auschwitz and see just how much thirst might be an experience other than pain.
Charlotte Delbo was arrested on March 2, 1942 for her work in the French resistance. She was held for almost six months in the Santé prison, where she said good-bye to her husband the night before he was executed on May 23, an event she re-created in her play, Une scène jouée dans la memoire. (Delbo 2001) In August 1942 she was transferred to the fort at Romainville where she met other women who joined her in a convoy of 230 to Auschwitz –Birkenau on January 24, 1943. The women marched into the camp on Wednesday January 27, 1943 singing the Marseillaise. Almost 180 of them were dead by August, when Charlotte was moved to Raïsko, a less killing work site in the greater Auschwitz complex. (Delbo 1997) In the end, only 49 survived.
The first volume of Delbo’s memoir Auschwitz and After is titled “None of Us Will Return.” In it, Delbo presents intense scenes of people in pain. Some of her vignettes work like Buddhist charnel house meditations. Her chapter on “Thirst” is one of the few instances where Delbo focuses on her own pain more than the pain of others. (Delbo (1995) 70-75)
As she does throughout her memoir Delbo uses verse and prose poetry to bring the reader into the situation. She structures “Thirst” like a prose ballad, with a refrain or chorus between the “stanzas.”
In the first “stanza” Delbo contrasts the thirst of the desert with the “thirst of the marsh” where she worked in Auschwitz. The thirst of the desert is just a “pathetic chapter” in an “explorer’s tale” for children, ending with the arrival of a lost caravan bringing “goatskin bottles” filled with water. The thirst of the desert is “experienced in the sun, the drying wind,” but the thirst of the marsh is “more searing.” It “crushes” and “overcomes” reason, which “wavers” at first and then “succumbs.” Instead of days, it “lasts for weeks” with no rescue caravan ever appearing, nor even mirages. “Just mud, slime. Mud and not a drop of water.” Deliberate or not, an allusion to Coleridge and the thirst of the ancient mariner. Significantly, Delbo does not contrast the reality of her pain with the desert tale as if it were a work of fiction. We are reading about her pain. She is working for us to experience her pain with the same realism she accords to the explorer’s tale.
Delbo closes the first “stanza” with the refrain:
There is the thirst of the morning and the thirst of the evening, the thirst of the day and the thirst of the night.
In the second “stanza,” Delbo’s pain rolls over and through her in waves. The first wave of thirst hits her as soon as she wakes up. Then she feels another wave after her small cup of tea brings no relief, another during roll-call when all she can do is want to get to the small brook near their road to the work site, another wave of fear when she runs down to the brook, another as she struggles to break the ice and fill the cup, another as she juggles the cup while running back just ahead of the SS and their dogs.
Other forces repeat and interact to drive these waves through and over Delbo. These forces are: not!, death, obsession, madness, and shame.
Throughout the second stanza, not! crashes against Charlotte Delbo and inside her when: her lips move, but no sound comes out; her “mouth is paralyzed;” she sees the others still drinking tea after she’s done, but her mouth is “not even damp” and her “cheeks are glued to the teeth, the tongue is hard and stiff, the jaws locked”; she can no longer feel whether it’s “colder or less cold”; she’s so thirsty she wants to shout; and she “feels my mouth’s dryness” as she runs her finger over her gums.
Death appears when she wakes in the morning in the “anguish” that “fills your whole being, an anguish as gripping as that of dreams.” She becomes fully aware of “the state of being dead” through the “powerlessness” of mouth muscles that “want to attempt articulation and do not articulate.” “What persists is the feeling of being dead,” which becomes “dread … to the point of madness” and “obsession.” She gives us the details of her struggle with the urge to drink the soapy water in which the inmate guards have washed their feet.
As noted before, Charlotte obsessed about dashing to the brook to get some water. Her comrades are beside themselves with anxiety and concern over Delbo’s “madness,” but Delbo does not see their worry through her thirst. To Charlotte’s comrades, she is crazy. They tell her to watch out for herself. She ignores them. They tell each other that they need to watch her because she not only goes on insane runs to get water, “she just stands there, looking vague,” when she is supposed to be working, or at least look like she’s working. When the guards shout at her, she just “wanders off anywhere.”
Shame emerges after the brook water begins to restore Charlottes senses—“saliva … words … sight … life … breathing … heart … lucidity.” With the return of sight, she sees “little Aurore”—sick, exhausted, fevered, discolored lips, haggard eyes, and very thirsty. Aurore is too weak to make the run to the brook, nor can anyone else do it for her. Aurore’s eyes beg Charlotte for water. Although Charlotte does not look, she can feel Aurore’s “thirsty gaze” upon her. She feels ashamed, but remains “insensitive to the supplication in her eyes.” Yet, every morning Charlotte drinks in front of Aurore and feels ashamed again afterwards. As Simone Weil writes, “those who have themselves been mutilated by affliction … are in no state to help anyone at all, and they are almost incapable of even wishing to do so.” (Weil (1973) 120) We return to the role of the onlooker in shame in another post.
Having drunk some water, Delbo can speak again and feels moisture in her mouth, but her obsession with the next drink returns. She feels as if “There is never any water. Only the marsh. A muddy swamp.” Later, Delbo “can remember nothing about those weeks,” not even how she found out about the deaths of “so many of those I loved.” As Elaine Scarry (54) notes, “Pain begins by being ‘not oneself’ and ends by having eliminated all that is ‘not itself.’”
This second “stanza” filled with waves of thirst, pain, madness and shame ends with a variation on the refrain
There is thirst of the morning and thirst of the day.
The third “stanza” tells of “the days when we go the other way, away from the stream.” Charlotte does “not know how I can bear the disappointment.” They pass no brook. The midday soup is so salty it burns the sores in her mouth. She gets no moisture from licking the frost off a bush or from the handful of snow she sneaks when the SS are not looking. Only the presence of her friends keeps her from throwing herself into an open water tank as they pass. Polish women, who are taking turns being held by the ankles to reach into the tank for a little water, demand bread in exchange for some of their water. Charlotte goes thirsty because she’s saving her bread to trade it for water in the evening. Worse, a Polish woman spills water out on the ground rather than give it to Charlotte. One of her friends catches Charlotte before she faints at that sight.
Then, as she works all day in the marsh Charlotte dreams about how she will get down to the brook on the way back. The SS guard is ahead of her, and takes his dog to wade in the water, turning it “slimy and fetid.” Despite this, only the watching eyes of all the work-gang leaders keep Charlotte away from the stream.
Another variation on the refrain transitions to the fourth “stanza.”
There is the thirst of the day and the thirst of the evening.
This “stanza,” which is all about evening tea, has its own internal refrain, “thirstier still.” Having obsessed about tea through the evening roll-call, Charlotte boldly shoves her way “to get there ahead of the others.” She drinks “and when I am drunk I am thirstier still.” So she takes her slice of bread and dab of margarine from cell to cell, fearful that no one will trade their tea for her bread. Someone always does, and always after she’s drunk she’s “thirstier than ever before.” Back in her cell, her comrade lets her know that she has saved her tea for Charlotte to drink just before sleeping. Charlotte can’t wait. She drinks and she’s “thirstier still.” Now she can only fantasize about the stream and wish that the SS dog had not soiled the water; otherwise, she might have had another cup to drink. This thought makes her “feel thirsty, thirstier still.”
Now, the final variation on the main refrain opens the last “stanza.”
There is the thirst of the evening and the thirst of the night.
She dreams of drinking, but “the water becomes immediately dry and solid in my mouth.” More water just fills her mouth “with hardening rotting leaves.” She has a glorious dream of an orange section bursting with juice, filling her mouth with “the taste of orange” and bathing her tongue, her palate, her gums, and her throat with a freshness that wakes her up. Try as she might, she can’t get back into this dream. Instead she only feels her mouth full of “the paste of rotting leaves petrified into mortar.” She can’t even taste that. If she could taste anything, it would mean that she still had some saliva in her mouth. With that line, Delbo’s presentation of her thirst ends.
Delbo’s “thirst” is very artfully constructed and presented, moving with the variations in the refrain:
The presentation is so exquisite that the reader begins to question whether it is right to take such pleasure in Delbo’s artistry. Since this artistry is obviously self-conscious, why is it that the more she succeeds in bringing us to feel her overwhelming thirst, the less painful is our reading experience because we are in awe at how she does it?
In Sophie’s Choice, William Styron, in the character of his narrator Stingo, debates with himself about the ethics, aesthetics, and propriety of writing (fiction) about Auschwitz. Reflecting on George Steiner’s Language and Silence, Styron/Stingo confronts a choice between remaining silent about the “unspeakable” or trying to understand. (Styron (1980) 264-265) He (author/narrator) chooses to attempt to understand through the device of a Polish woman who is both a victim and an accomplice of the Nazis. Although Styron never says it directly, at times it seems that he uses the choice that confronts Sophie at the entrance to Auschwitz as a way of punishing an anti-Semite then and for the rest of her life. But Styron’s first question about writing this novel was not the propriety of his authorship, but whether he could write “authentically,” not being from middle Europe, much less having experienced the camps. He claims that Hannah Arendt pushed that objection aside with the argument that “An artist creates his own authenticity; what matters is imaginative conviction and boldness, a passion to invade alien territory and render an account of one’s discoveries.” (Styron 1997)
After she returned from the camps, Charlotte Delbo had one main goal: donner à voir, to make us see. She does not question whether she should be writing so “beautifully” about the horrors of Auschwitz. Her question is whether, even if she gets us to see, her effort will be useless because what we will learn will be “useless.” Her title for the second volume of her memoir is “Useless Knowledge” (La connaissance inutile).
Her play “Who Will Carry the Word?” opens with a conversation between two French women in the camp. Claire is trying to persuade Françoise not to commit suicide. Claire says to Françoise: “Haven’t you heard them, the dying, who all say, ‘If you return, you’ll tell’? Why do they say that? They say that because none of us is alone and each must render an account to all the others.” (Delbo (1983) 278) Later, other women join the debate. Gina says to Françoise and Réine: “…swear to me, if you return without me, tell my father the truth. Don’t hide anything. You’ll have to tell the truth, even to the mothers.” Françoise, still the skeptic, replies: “I wonder if we will have the strength to tell it. And they won’t believe us. They’ll think that since we have returned, it was not as terrible as we say. By returning we will deny our own story.” (Delbo (1983) 291)
As Françoise says in her Prologue to the play:
So why should I speak?
For the things I would say
Could not be of any use to you. Delbo (1983) 273
Towards the end of the play, Gina, Denise, and Françoise are debating whether they’ve learned anything useful in the camps. Rebutting Gina’s assertion that everything we know is useful, Françoise says:
What use is there in knowing how to read death sitting on a face at the very minute when it pinches the nostrils, clings to the cheek bones and tints the eyelids purple? … In life who needs to see through people, to know in one split second if they’ll share their bread or help others to talk? This is a gift we have acquired here which we’ll have to get rid of because it will be terrible to see everything in that light. Delbo (1983) 316
Françoise continues with her argument that all their knowledge is useless. In the camps there was no ambiguity about who were the tormentors and who the tormented. Not so, in “life.” In words about her thirst that make it obvious that Françoise represents Charlotte, she argues that the beauty of the compassion they have witnessed is useless because “No one dies for anyone else in life.” Denise adds the question whether in “life” will they be able to function without masks, as they’ve had to do in the camps. (317)
Answering the question of connaissance inutile points Delbo in the direction she takes in her writing about her experiences such as in “Thirst.” She writes so skillfully not that her writing can be an object of our enjoyment, but so that we become present in her experience, so that we can see, not just know abstractly. She answers in practice the challenge that she puts in the mouth of Françoise: “We’ll never be able to make them see [donner à voir] what we have seen.” (Delbo  317;  124)
As with the Coleridge reference in “Thirst,” I do not have evidence of Delbo’s knowledge of Joseph Conrad’s famous description of his task as a writer: “My task, which I am trying to achieve is, by the power of the written word to make you hear, to make you feel—it is, before all, to make you see. That—and no more, and it is everything.” (Conrad 82, italics in original)
One view of Delbo’s ability to present what otherwise cannot be said is that she constructs “still photographs … created by words that at once leave a trace on the page and become a repository in which is stored the memory of the dead.” (Brunetaux) This image of how to read Delbo points in the wrong direction. Delbo came out of the theater and went back to the theater after she returned from the camps. “Reading Delbo” may be “like viewing a photograph,” but more to the point, reading Delbo is to participate in a performance. Delbo’s writings do not create “still photographs,” as much as they draw the reader into a drama in motion. Additionally, Delbo was a Communist, who confronts the issues of her own practice. Yes, she was “not limited by the stasis of the monument,” but rather than a “site of memory,” her text aims to bring the reader into a practice and into a dialogue/drama/dialectic with the reader’s own practice. We can see with her because she brings us to see (voir), to live the drama in our hearts, more than to know (savoir) the truth in our heads. Contrary to Elaine Scarry’s thesis about “the inexpressibility of physical pain,” Delbo’s words have brought us before what Scarry calls one of pain’s most “felt-characteristics,” “its compelling vibrancy or its incontestable reality or simply its ‘certainty’.” (Scarry 13)
Charlotte Delbo makes us more than see. As Richard Murphy said about the Irish poet Seamus Heaney, while you read Charlotte Delbo’s scenes you get “the feeling … that you are actually doing what they describe.” Murphy is not only talking about how Heaney writes, he is also implying the task before Heaney’s reader, and Delbo’s. The task of doing what each writer is making. In order to truly read Delbo, one must live with her through these scenes.
In these scenes Delbo does not grieve. She does not console. She does not comfort. She does not heal. If we grieve, if we find consolation, comfort, or healing while reading Delbo, we are not present with her at Auschwitz. We are not doing what she describes. Doing what Charlotte Delbo presents brings us to hear, to feel, above all to see (donner à voir) how thirst hurts beyond a mere desire to drink or a feeling of displeasure.
In the story of Jesus’ death, there is no mention that he complained of pain, but he did say, “I thirst.”