7. On the influence of tuberculosis on Camus’ early life and work, 1931-1941

And how it prefigures the plague symbol


There is an additional layer to the composition of The Plague that needs to be considered, one that acts as a thread which pulls together many of the ideas and experiences which have already been examined in previous instalments of this newsletter, and which perhaps suggests an initial impulse to using a medical illness as the structuring symbol for his novel.

Sometime in December or January, 1930-31, when Camus was barely seventeen years old, he began coughing up large quantities of blood. He was taken to a public hospital in Algiers and diagnosed with tuberculosis: his right lung was infected. In 1951, looking back at this period, Camus referred ironically to his tuberculosis as a ‘fortunate illness’ – in the same sense perhaps that he initially referred to the ‘liberating plague’ – in which he doesn’t downplay the negative impacts of this illness on his health, the severe limitations it imposed upon him personally, but in which he also acknowledges, if only in hindsight, the possibilities it afforded him, and that it was the interplay between both which had shaped – and continued to shape – the course of his life.

Contracting tuberculosis in Algeria in the 1930s was tantamount to a death sentence, particularly in the poor quarter of Algiers where Camus lived with his family in poverty: Camus, his older brother and their mother, together with his uncle and grandmother, were all sharing a two room dwelling. Although Robert Koch had isolated the tubercule bacillus in 1882, there had been little advance in medical treatment for tuberculosis into the 1930s. In the gap between diagnosis and cure, certain images and judgments emerged to contain people’s fears of the unknown. Writing in 1957, Camus recalled the initial shame attached to having tuberculosis:

In our well-policed society we recognize that an illness is serious from the fact that we don’t dare speak of it directly. For a long time, in middle-class families people said no more than that the elder daughter had a “suspicious cough” or that the father had a “growth” because tuberculosis and cancer were looked upon as somewhat shameful maladies.

These cultural images, associated with tuberculosis, considered the disease as a form of social deviance, an expression of a weak moral character, criminality, uncontrolled libido, and self-destructive tendencies.

Patients were prescribed folk-cures: overeating, especially large amounts of red meat, and drinking blood. Travel was also thought to facilitate recovery, especially to mountain sanatoriums, where the high altitude was thought to heal damaged lung tissue. Neither of these was generally available to people living in poverty, however. A more invasive treatment was artificial pneumothorax – or collapsed lung – therapy. This is an invasive procedure in which air is injected between lung and chest wall, so the lung collapses, allowing the lesions of the infected area to heal, albeit temporarily.

Camus never knew his father, who died during the First World War, before Camus had even turned one. And yet, it was because Camus’ father had died in the service of France that Camus was later entitled to free medical treatment when he contracted tuberculosis. Without this, he would most probably have died. Fortunately, also, Camus’ uncle ran his own butcher shop, and so Camus was given access to raw meat and fresh blood, a luxury. When the authorities ordered the teenage Camus out of his family home – because he was infectious and considered a contagious threat to their safety – he was able to move in with his uncle, where he was given, for the first time in his life, a room of his own, albeit a room in semi-quarantine.

His uncle was an anarchist and a voracious reader and Camus was given access to his library of French classics, Algerian literature, and books about Mediterranean culture. He found some comfort in reading, even while suffering from the enforced separation from his family. He had previously enjoyed an active life, dominated by playing soccer and swimming in the ocean, but now he was often bedridden or else too weak for such activities and so was forced to rest. This also gave him more time to think. In this way, tuberculosis had foreclosed many external aspects of Camus’ young life, while at the same time opened up new interior possibilities which he may otherwise have not pursued. 

At the same time, Camus tentatively began a lifelong friendship with a teacher from his school. Jean Grenier had only arrived in Algeria at the beginning of that first year, a few months before Camus had first fallen ill. Noticing Camus was absent from class, Grenier tracked him down at his home. Camus was ashamed of his poverty and his illness and Grenier was initially met with stony silence. Camus was taught by Grenier again the following year when Camus repeated (because of his illness) his final lycée year. And then, coincidentally, Grenier transferred to the University of Algiers the same year Camus entered the university, where he became one of Camus’ lecturers and, finally, his diploma supervisor.

During this first year at university, Grenier published a collection of lyrical essays called, Les Iles (Islands). In 1959 Camus wrote the preface for the republication of this collection, in which he states: ‘I believe I already wanted to write at the time I discovered Les Iles. But I really decided to do so only after reading this book.’ Grenier introduced Camus to eastern religion and philosophy, as well as to ancient Greek literature. He would also supply Camus with the latest French literature and intellectual journals from mainland France, such as Nouvelle Revue Française: where, in 1934, Camus discovered Antonin Artaud’s essay, “The Theatre and the Plague” – Camus’ own physical condition would have made him receptive to the possibilities of Artaud’s intermingling of medical and literary forms. Camus was also drawn to reading other tubercular writers during this decade, such as Thomas Mann, André Gide, and Franz Kafka, whose works are scattered with literal and metaphoric references to the disease.

In 1937, four years after Grenier’s collection of lyrical essays was published, Camus published his own collection of lyrical essays – The Wrong Side and the Right Side – followed by a second collection, Nuptials, in 1939. Both works imitated Grenier’s lyrical style, which Camus developed, and, in The Myth of Sisyphus, made his own. ‘Knowing me,’ Grenier later wrote of Camus, ‘and seeing that I was writing, he thought that “writing” was possible.’

It was a possibility, however, overdetermined by Camus’ tuberculosis.  

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Unsurprisingly, in Camus’ early writing, his notes and essays, being autobiographical in nature, are replete with observations about Camus’ own illness; even if they are sometimes veiled. He was also by then acutely aware of the role of illness in those around him, and in death generally, which had ceased to be for him an abstract event in some vague and distant future, but a diurnal probability. Suicide, for example, was common among tuberculosis suffers: which contributed, unfairly, to the image of the tubercular character as being inherently self-destructive. In one of his earliest attempts at writing, an essay called “The Hospital in a Poor Neighbourhood”, which he drafted in 1933, around the age of twenty, Camus describes all the patients in a tubercular ward:

But then there were peals of laughter over an astonishing suicide story. Early in his illness, the man [a hairdresser] had found himself prevented from working, weakened, with no resources, and in despair over the poverty that had settled on his wife and children. He had not been thinking about death, but one day he threw himself beneath the wheels of a passing automobile. “Like that.” Only, the driver had braked in time, and in his fury as a man in good health whom someone is trying to annoy, he chased the hairdresser away with a well placed kick. The hairdresser had not dared consider suicide since. 

And later, in his notebooks, from 1938:

At the hospital. The tubercular patient who is told by the doctor that he has five days to live. He anticipates and cuts his throat with a razor. Obviously, he can’t wait five days. One of the male nurses tells journalists: “Don’t mention it in your papers. He’s suffered enough already.”

Camus’ first published collection of lyrical essays, The Wrong Side and the Right Side, was largely structured by the theme of illness. The first essay, “Irony”, for example, describes a series of vignettes about figures struggling with illness, each in their own way. One figure, an old man trapped in a relationship with an old woman, feels his illness separates him from her, and so he spends an increasing amount of time away from their house. ‘After all, he prefers being in the street, being there rather than at home, where for hours on end fever veils the old woman from him and isolates him in his room,’ Camus writes, adding: ‘Out in the street, however few people he may meet, he is never alone. His fever sings.’ Finally, Camus attempts to bring all these vignettes together and, in doing so, he begins to describe his own position in relation to the experience of illness and death:

None of this fits together? How very true! A woman you leave behind to go to the movies, an old man to whom you have stopped listening, a death that redeems nothing, and then, on the other hand, the whole radiance of the world. What difference does it make if you accept everything? Here are three destinies, different and yet alike. Death for us all, but his own death to each. After all, the sun still warms our bones.

The second essay in the collection, “Between Yes and No,” is a sustained meditation on Camus’ relationship with his mother. It reinforces the position he reached at the end of the previous essay. The crucial scene in this essay is once more concerning illness: it is a description of a night when Camus, as a young man, slept beside his mother when she was ill, mute and frightened by the ordeal. And yet, this description bleeds into a mediation on his own experience, which confirmed his separation from the rest of his family, and from the world at large:

It was only later he realized how alone they had been that night. Alone against the others. The “others” were asleep, while they both breathed the same fever. Everything in the old house seemed empty. . . . All that remained was a great garden of silence interrupted now and then by a sick woman’s frightened moans. He had never felt so lost. The world had melted away, taking with it the illusion that life begins again each morning. Nothing was left, his studies, ambitions, things he might choose in a restaurant, favorite colors. Nothing but the sickness and death he felt surrounded by. . . And yet, at the very moment that the world was crumbling, he was alive. Finally he fell asleep, but not without taking with him the tender and despairing image of two people’s loneliness together.  

From this, Camus’ thoughts are refined toward valuing simplicity. ‘In the same way, every time it seems to me that I’ve grasped the deep meaning of the world, it is its simplicity that always overwhelms me. My mother, that evening, and its strange indifference.’ This essay is also interesting because it marks the initial articulation of the absurd, and is the first use of the term to appear in Camus’ published essays prior to The Myth of Sisyphus: ‘What is it then that keeps him in this room, except the certainty that it’s still the best thing to do, the feeling that the whole absurd simplicity of the world has sought refuge here.’



During the period 1936-1938 Camus also made his first attempt at writing a novel, a manuscript titled A Happy Death. This overlaps with the period in which he wrote and published the first of his two early collections of lyrical essays, and perhaps when he had already started upon the second: many of the autobiographical scenes and ideas and images from these essays appear in this manuscript, structured around an imagined plot: the protagonist, Patrice Mersault, is hired by a man who is suffering from a physical disability and who wants to die, but he lacks the courage to commit suicide. He hires Mersault to kill him, and in return Mersault is given enough money to live modestly, but independently. And yet, on the same day Mersault commits the murder, he exhibits the first symptoms of a mysterious illness that eventually kills him. ‘Past the square, [Mersault] was suddenly aware of the cold, and shivered under his light jacket. He sneezed twice, and the valley filled with shrill mocking echoes which the crystal sky carried higher and higher.... He sneezed a third time, and shivered feverishly.’ And then, at the end of part one: ‘The next morning, Mersault killed Zagreus, came home and slept all afternoon. He awoke in a fever. That evening, still in bed, he sent for the local doctor, who told him he had flu.... A week later, Mersault boarded a ship for Marseilles... [he] had a violent attack of fever the day after he arrived in Lyons.’  

Of course, this mysterious illness is not very mysterious at all, and it becomes clear that Mersault is, in fact, suffering from tuberculosis – although this is never explicitly stated so in the manuscript. It is, however, revealed contiguously in the narrative in two ways. The first way is through explicit references to tuberculosis in the narrative, but related to characters other than Mersault. There are several examples in the text; but one, in the second chapter, is when Mersault and his friend, Emmanuel, go to their regular café, owned by Celeste. Here we meet Celeste’s son, René, described as a ‘consumptive’:

René, his son, was eating a boiled egg over in a corner. “Poor lad,” Emmanuel said, thumping his own chest, “he’s had it.” It was true, René was usually quiet and serious. Though he was not particularly thin, his eyes glittered. Just now another customer was explaining to him that “with time and patience, TB can be cured.” René nodded and answered solemnly between bites.

The second way that tuberculosis appears in the narrative is through the many images that were associated with the disease in the early 20th century – this time stated in explicit relation to Mersault. For example, the notion that damp climates are bad, while higher, drier climates are good for curing the disease. In one scene, toward the end of the novel, Mersault faints, and when he awakens, his housemate, Claire, says:

   “It’s none of my business, but I don’t think this place is good for you. It’s too near the sea – too damp. Why don’t you go and live in France – in the mountains?”

   “This place isn’t good for me, Claire, but I’m happy here. I feel in harmony with it.”

   “Well, then you could be in harmony – longer.” 

Finally, there is an image of tuberculosis providing the sufferer with moments of lightness and lucidity, usually following an attack. This image recurs frequently throughout this novel, and it is in these moments that Mersault gleans the positive aspects of his condition: ‘He felt weak, and his weakness made him mysteriously lighter, gayer, and his mind grew more lucid.’

So when, after all this, Mersault’s doctor, Bernard, wants to take an X-ray of Mersault’s chest, it can perhaps be safely assumed that it is tuberculosis that he is looking for. Soon after, however, and still officially undiagnosed, Mersault dies.   

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Camus thought the novel manuscript a failure. But he didn’t abandon the work entirely, attempting instead an almost complete overhaul, to create a new novel. He jettisoned the autobiographical aspects, depersonalising the text, the better to allow the central character to delineate himself. Camus kept, from the first part of A Happy Death, the brief descriptions of the death of Mersault’s mother, his attendance at her funeral, and the effect (or lack thereof) this event had on his life. Camus developed this material significantly, bringing it to the forefront of his new narrative. ‘Maman died today,’ the new manuscript began. The story then unfolded more chronologically, the first part ending in a murder scene. But there is a marked difference in the second parts of each work. Both deal with the consequences of a murder on the life of the murderer, but both travel in different directions. In A Happy Death the murder goes unsolved, while in the new manuscript the murderer is immediately apprehended, and a court case ensues. But the two manuscripts converge once more at the end of each, both finishing on the cusp of each protagonists’ death: in the first, this is from tuberculosis, while in the second, it is from the guillotine. Finally, an additional ‘u’ is added to Mersault’s name, and he becomes Meursault.

And so, The Stranger is born from the ruins of A Happy Death.  

Even here, Camus’ tuberculosis plays an integral role. Take, for example, the central moment from The Stranger, the murder scene:   

my forehead especially was hurting me, all the veins in it throbbing under the skin...  All I could feel were the cymbals of sunlight crashing on my forehead... That’s when everything began to reel... My whole being tensed and I squeezed my hand around the revolver. The trigger gave.

This is a rewriting of the murder scene from A Happy Death, and yet in that earlier manuscript, this description is explicitly linked to the state of a tubercular fever, in which the protagonist becomes removed from himself, and feels capable of anything – such as squeezing a trigger:

He looked again at his hands, which lay like living, wild animals on his knees... He knew them, recognized them, yet they were distinct from himself, as though capable of actions in which his will had no part. One came to rest against his forehead now, pressing against the fever which throbbed in his temples.

Finally, this tallies with a description from Camus’ notebooks from 1937, in period immediately prior to writing A Happy Death – an experience of fever and subsequent withdrawal from the self – in an explicit, and by then all too familiar description of his own illness: ‘On the way to Paris: this fever beating in my temples. The strange and sudden withdrawal from the world and from men. The struggle with one’s body.’

In the transfiguration of story and character from the first manuscript to the second, all literal references to the illness are removed, but their metaphoric elements remain, and are present in structuring all of the essential characteristics of Meursault and are used to create the pervasive mood of the novel. During the court case, for example, the prosecution against Meursault ticks off all the charges of social deviance and amorality otherwise associated with the tubercular character.

Here the execution at the end of The Stranger becomes the metaphoric corollary to the death sentence of tuberculosis – part physical, part social – as described more literally in A Happy Death: a death sentence that later, in The Plague, will be imposed over an entire township.

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It is during this period, through the practical experience of redrafting A Happy Death into The Stranger, which lies the seeds of Camus’ theory of the novel, and his preference for symbol over allegory. Meanwhile, Camus’ illness continued to shape the direction of his life at significant junctures, in the years before writing The Plague, each moment closing one door, but opening another. His ambition in going to university was not to become a Nobel Prize winning author. More modestly, he wanted to become a school teacher, like his mentor Jean Grenier, which was perhaps only an alternative to what his uncle had in mind: he wanted Camus to become a butcher. In the end, however, Camus was barred from teaching – because of his tuberculosis. He attempted other work, but struggled with keeping regular hours, due to his need for rest, and sporadic time off to recuperate. Instead, he fell into journalism, which allowed him to work more independently on his creative pursuits. While doing so, the Second World War started. Camus attempted more than once to enlist. His brother did also, and was successful. Camus failed, each time on medical grounds – his tuberculosis kept him from war. This also afforded him time to complete his novel, The Stranger, and his long essay manuscript, The Myth of Sisyphus, instead of shelving them indefinitely.

This, in turn, created the conditions under which Camus would, in early 1941, begin working on his next literary project, a novel, with the central symbol being a particular illness, the possibilities of which he had, in one form or another, been meditating on for the previous decade.

Next week we will examine how these early experiences and reflections on Camus’ own tuberculosis, as well as more contemporary experiences and reflections, informed the composition of The Plague, during the period 1941-1947.

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While you’re on Substack, check out Covidian Æsthetics, a newsletter that examines the shifts in sensibility and focus brought on by the COVID-19 pandemic. A good place to start may be this guest post by Logan Berry about Antonin Artaud (yes, it goes into Artaud’s essay on theatre and plague):

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