It’s All Right - He Only Died was found in The Big Sleep author’s archives with a note underlining his contempt for doctors who turned away poor patients

A lost story by Raymond Chandler, written almost at the end of his life, sees the author taking on a different sort of villain to the hardboiled criminals of his beloved Philip Marlowe stories: the US healthcare system.

Found in Chandler’s archives at the Bodleian Library in Oxford by Andrew Gulli, managing editor of the Strand magazine, the story, It’s All Right – He Only Died, opens as a “filthy figure on a stretcher” arrives at a hospital. The man, who smells of whisky, has been hit by a truck, and staff at the hospital are loth to treat him because they assume he will be unable to pay for his care. “The hospital rule was adamant: A fifty dollar deposit or no admission,” writes Chandler.

Gulli said the story was one of the last things Chandler ever wrote – it is believed to have been written between July 1956 and spring 1958. Chandler died in 1959. “He’d been in and out of hospital, he’d tried committing suicide once, and he’d had a fall down the stairs,” said Gulli. “The story mirrors some of his experiences of that time. It’s about what he calls a ‘transient’, a homeless man who gets hit by a truck and who finds himself in a hospital that is reluctant to treat someone who can’t pay the bill. And of course there’s a twist at the end.”

The Strand is publishing the story this weekend, complete with an author’s note from Chandler in which he reveals his fury at the US healthcare system. The doctor who turned away the patient, Chandler writes, had “disgrace[d] himself as a person, as a healer, as a saviour of life, as a man required by his profession never to turn aside from anyone his long-acquired skill might help or save”.

According to Chandler scholar Dr Sarah Trott, the story is “a prime example of Chandler as social critic and visionary in American literary history”, and unlike anything else Chandler wrote, with its serious tone, “bordering on sinister”.

“The story’s unsympathetic dialogue, paired with Chandler’s damning assessment, in itself unique, suggests a deep personal dissatisfaction with American healthcare, where the amount of money a person carries can dictate the level of care they receive,” Trott writes in an assessment of the story also published in the Strand. “It is a contemporary life-or-death story; a cautionary tale about the problematic nature of assumption and appearance in a ‘cash-is-king’ society, and a disturbing commentary about the American dream, where the competition to remain employed means not running a hospital ‘for charity’, even if it requires denying medical attention to a seriously ill patient.”

Trott called its publication timely, given the current situation with US healthcare, pointing out that Chandler was a British citizen until 1956, and would have had experience of the contrasting service of the NHS. “It feels relevant today,” agreed Gulli. “Things don’t change.”

Gulli, who has previously unearthed stories languishing in archives by major names including William Faulkner and HG Wells, said that he had given up on finding anything new by Chandler.

“I was very pessimistic,” he said. “You don’t see all the times I’ve found something by a great writer and it’s not that good, it would be a minus on their reputation.”

He speculated that Chandler might have decided not to publish the story because it was so different from his Marlowe tales. “I think perhaps, since this was unlike anything he’d ever written that he might have decided not to publish it,” he said. “To me, this shows the activist side to Chandler, particularly with the author’s note. This was not Marlowe showing up some of the LA phonies, this was Chandler penning a social message.”