The Journey of Anna Eichenwald

by Donald Hunt

  Paula and Peter entered the hall and sat down next to Isaac. He was at a loss for words. How could he describe what he had witnessed?

  “Well?” demanded Paula.

  “Yes,” said Isaac. “She did very well. Very very well.”

  Erin approached her parents and Paula threw her arms around her daughter, crying. Peter was all smiles.

  That evening the family celebrated over dinner. Relieved to have the performance behind her, Erin was buoyant. She looked around the table and captured the faces of each member of her family. It was etched in her memory, a shining, still moment of incandescence.

  It took almost three weeks before Erin received the letter stating that she had been chosen as one of the two apprentice violinists for the Berlin Symphony. Within two weeks she would begin preparation for the fall season. Her one-year apprenticeship would then transition into her professional career as a violinist. Erin’s goal was to become a concert violinist. No one doubted she would achieve it.

  Berlin was a city that loved music. One of its legendary figures was an Italian, Ferruccio Busoni, who had moved to Berlin in 1894. It did not take him long to become known as a master pianist. Small in stature, Busoni had a somewhat stooped appearance. But he was strikingly handsome with long flowing hair and a chiseled face. Busoni’s greatest accomplishment was the revision of much of the piano literature of Bach. He also created transcriptions of Bach’s organ music, still considered classics.

  A number of promising young pianists followed Busoni to Berlin; most notably, Vladimir Horowitz, Wilhelm Backhaus, and Claudio Arrau. All of them were admired. But the standard of excellence was set by Arthur Schnabel. He was a stocky man with a thick grey moustache. Although not a true virtuoso, Rudolf Serkin had once stated of Schnabel, that “he was the greatest influence on us all.”

  Professional jealousy is common, and among musicians it is no different.

  “How is your friend, the great adagio player?” Rachmaninoff once sneered to a member of the Schnabel circle. Rachmaninoff was a showman and very popular in his own right. But he was not held in the same regard as Schnabel. His concerts with the Philharmonic were stirring. But he played to the crowd and thus, could not reach the level of Schnabel, considered the foremost interpreter of Beethoven and Schubert. In 1927, the world marked the 100th anniversary of the death of Beethoven.

  Arthur Schnabel had studied the life and music of the great composer, and had great compassion for him. An account of an opera rehearsal by Beethoven had never left his mind. In one or Beethoven’s last efforts at conducting, the singers and orchestra members were very focused on their conductor, but were having great difficulty following his gestures. Finally the music became chaotic…then silence. Beethoven seemed confused, and seemed not to understand the reason for the breakdown. It was then that he realized he could no longer conceal his deafness.

  As Beethoven was gradually becoming deaf he had written, ‘it was impossible to say to others; speak louder…shout! I am deaf!’ Schnabel desired to honor this genius composer and do it in Berlin. To accomplish this, he planned to play the cycle of all 32 Beethoven Sonatas. A series of seven consecutive Sunday concerts was scheduled all at the Volksbuhne (People’s Theater) in Berlin’s working class district rather than in Symphony Hall. Schnabel was a modest man and did not like calling attention to himself.

  Among the nearly 2,000 Berliners in the Theater were Paula Nitschmann and her friend Kathe Kollwitz, the artist. They both had a love of music, but their bond of friendship was based on another reason. They each had sons named Peter who had gone to war. Kathe’s Peter had not returned.

  Almost a year had passed since Paula had accompanied Kathe on a pilgrimage to the Belgian village of Reggevelde. It was there that her 18-year old son had lost his life, just three months after the start of the war. Kathe had received information of the possible burial site for her Peter. They found the cemetery with the entrance blocked with barbed wire. Circling around to the side they found a narrow, little used path, then entered and began their search.

  “Paula! Look at this,” cried Kathe.

  There were what appeared to be several thousand white crosses set in a geometric pattern throughout the cemetery. In the panoramic view, the appearance was one of order and serenity. What had been the chaos of a murderous war had been transformed into a beautiful and spiritual display of remembrance for those who had not survived. The two women walked silently and separately, meandering in no particular pattern, searching. Kathe’s eyes moved slowly from cross to cross. Almost half of the crosses were inscribed with ‘unknown soldier.’

  In this area of Belgium, the Germans were said to have lost 200,000 men in the course of only four years. Kathe began to worry that perhaps her Peter was lying in one of the ‘unknown soldier’ graves. She did not want to be denied the final chance to be near him. An hour passed. Then suddenly, Paula cried out to Kathe. “He’s here! Right here!”

  Kathe took a deep breath and slowly moved to the cross. The midday sun was warm and a gentle breeze caressed her hair as she stood motionless; her beloved son, at last. Kathe whispered, “He would have been 31 this July.”

  Paula placed her arm around her friend and they stood in silence as the minutes passed. Paula had found wild flowers near the entrance to the cemetery. She broke off three stems and handed the flowers to Kathe, watching as her friend placed them on the grave of her son.

  Kathe paused and looked at her own fingers as they released the flowers. For a moment, she was lost in the memory of Peter’s tiny fingers as they had once held a small bouquet of wildflowers he had picked for her. She remembered his sweet face as he had smiled up at her. She remembered everything. How he felt in her arms as she rocked him to sleep. How warm his skin had been as she bathed his tiny body when he had a fever. She recalled taking him to school on his first day and staring back into his anxious eyes as they followed her out the door. She had left him there and her heart had ached.

  The pain in her heart was now so great that she knelt because she could no longer stand. A senseless war had robbed them both. She would carry only his childhood, his early years in life. His future as a man was lost to her forever.

  Standing side by side, the two friends had similar thoughts. One son had been spared and one was lost. Peter’s cross was distinguished from the others by only one thing - his name. In history, his name would be a statistic, but as Kathe walked from Peter’s grave, she believed that God would always know his name.

  The following morning during the auto ride back to Brussels, the winding tree- lined road was a comfort to Kathe. The beautiful countryside and flowered meadows brought serenity and a graceful closure to her anguish.

  “Paula, I had a dream last night. I dreamed there would be another war. In the dream, I imagined that if I and others would drop all we were doing and devote all our efforts to speak out against it, we could prevent it.”

  Kathe was intuitive. But she was wrong. The Second World War was looming, still more than a decade away. But there would be no individual, no group capable of preventing it.

  On that Sunday afternoon in the Volksbuhne in 1927, the two women, friends and mothers of sons, were stirred by Schnabel’s performance and his tribute to a creative genius, composer Ludwig Van Beethoven.

  * * *

  Anna was finally feeling settled in her new appointment as a surgical house officer at the University Hospital. Since her days of anatomy she had dreamed of becoming a surgeon. There were only a handful of female surgeons in all of Europe. Her determination and direct approach to problem solving assured her of success, at least in her own mind. She had observed her male counterparts and seen how they tackled problems head on, looking for a cure rather than a way to manage the disease process.

  Anna’s favorite rotation as a student was on the surgical service, with pediatrics a close second. She would go to the emergency ward as often as possi
ble in the hope of finding a laceration to suture or a fracture to set. Her fellow resident for this rotation was Christian Engel. The chief of the service was Gregor Schracht. Anna admired Dr. Schracht. He had an intuitive sense about sick people - the more difficult the problem, the more intense he became. He was a very skilled surgeon and Anna remained infatuated with his ability to make difficult procedures look easy.

  Of all of Anna’s medical colleagues, Christian Engel was her favorite. They spent long hours together on student rotations, and now as house officers on surgery. Christian was the brother she never had. Although born in Germany, his parents were from the Ukraine and had emigrated in 1894. Christian’s father was an engineer and was employed initially in dam construction projects. He had moved on and was now in road construction. Christian was easy going and enjoyed teasing Anna, taking advantage of her gullible nature. He had been the ring leader in the cadaver prank. Tall, with angular features, Christian had dark hair much like Anna’s, although he perpetually looked as though he needed to shave. Women found his most attractive feature to be his large, brown eyes. He resembled Anna’s own father, but unlike Hanz, he was sardonic and sanguine.

  Surgical call was every third night. Christian and Anna were paired for this rotation and they alternated first call. The first call had responsibility for evaluating any new problem or emergency. The alternate person was back up if the first call got tied up in the operating room. Gregor Schract was the senior resident in the house and evaluated any patient being considered for surgery. The early evening was spent rounding on the post-op patients. Anna and Christian generally did this together so both would be aware of any potential problems during the night.

  “Hey, Anna, hope all’s quiet!”

  “Probably won’t be, knowing my luck,” she replied with a grin. As Christian disappeared into his call room, he called back to her.

  “Let me know if you get swamped. Otherwise, you know I need my rest.” He smiled at her and closed the door.

  Anna planned to do some reading as was her custom on call. She changed into fresh scrubs and got some coffee. She checked in with the hospital operator and opened her surgical textbook. edited by an American surgeon, William Halstead. In the introduction, Halstead made it clear that the greatest influence on his surgical philosophy had come from German surgeons. On several tours of German speaking countries, he had noticed the overwhelming success of the German educational system in training surgeons of the highest order. Anna had been reading for about 10 minutes when the phone rang. “Dr. Eichenwald, you are needed in the emergency bay.”

  Anna generally took the back stairs three flights down to the emergency area. She knew the charge nurse well.

  “Dr. Eichenwald, the patient is a three week old with two days of vomiting. The pedi resident has been called and is on the way.”

  As Anna entered the nursery area she observed a young couple. The woman seemed to be in her early 20s and tried to smile as she held her son. The baby was listless and Anna immediately noted that he appeared dehydrated. This was the couple’s first child, and the first grandchild in the family.

  “I’m Dr. Eichenwald,” she said, taking the child into her arms. “Any problems with your pregnancy?”

  “None,” the young mother replied. “He was delivered at home by a mid-wife. He was fine until two days ago. He started to be fussy and then he would vomit my breast milk. He hasn’t held anything down for the past 24 hours.”

  “Has he had any fever or diarrhea?”

  “We don’t think so” said the father. He remained standing beside his wife, who now sat down wearily.

  Anna placed the little boy on the exam table. She noted his mouth was very dry and eyes sunken. His heart rate was 154, high for a three week old. His chest was clear and he had no abdominal distention. She placed the end of her little finger into his mouth and he immediately began to suck on it. His abdomen was soft. Gently, she pressed into his tiny abdominal cavity and felt a small lump in the upper abdomen. It was firm, like an olive. The pediatric resident entered the room.

  “I’m going to ask Dr. Schracht to have a look at him,” she said to the resident. “I’ll be back in a second, and I’d like to know what you think.”

  Anna called Dr. Schracht and related the history and her findings. “What do you think?” he asked her.

  She went through several possibilities.

  “I’ll be right down,” he told her.

  Blood work had been drawn and a scalp IV started by the pediatric resident. Gregor Schracht had a good idea of the diagnosis but said nothing until he had examined the child. His exam confirmed his suspicion - hypertrophic pyloric stenosis. Anna had considered this but was unsure, never having seen a case. She stayed in the background.

  Dr. Schracht turned to the parents.

  “Your baby has developed an obstruction just at the end of his stomach. It is from a swollen muscle. The treatment is surgical. If not corrected, he will not survive. If corrected, he should be fine.”

  The mother’s eyes filled with tears and her husband placed his arm around her shoulder. “He’s so small. Will he be able to get through surgery? How dangerous is it?” The baby’s mother looked up with imploring eyes as Dr. Schracht took her hand.

  “He is my responsibility and he will make it. It’s true he is very small, but the problem is straight forward. He will need some fluids and then we need to get started.” Surgery was set for 4:00 a.m. The anesthesia used for children and most adults was open-drop ether. Although an explosive agent, it was extremely safe when properly used.

  Anna and Schracht scrubbed while the baby was put to sleep. Operating on a three week old did have significant risk, but the hydration would help him tolerate the anesthetic and surgery.

  After a sterile prep, a small transverse incision was made in the upper abdomen just to the right of the midline. Schracht quickly placed his index finger into the abdominal cavity and located the enlarged muscle mass. He then allowed Anna to do the same.

  “Now try to grasp it and bring it into the wound,” he said.

  Anna was able to get the mass between her index finger and thumb, then pulled it just to the surface of the wound. Schracht grasped it with a non-crushing clamp. Using a scalpel he divided the muscle until the inner lining of the stomach was bulging through the divided muscle. He carefully showed Anna each step and then helped her close the abdominal cavity. The entire lifesaving procedure, a pyloromyotomy, had taken about 45 minutes.

  As Anna wrote the post-op orders, Gregor Schracht went to talk with the family. Later, he gave Anna the references for the original publications describing the procedure. They were published in 1910 and 1912 by Fredet from France and Ramstedt from Germany. The procedure had become known as the Fredet-Ramstedt operation. As Anna reviewed the publications, she thought it ironic that these men were developing a lifesaving procedure shortly before their countries became bitter enemies on the battlefield.

  She slept for two hours, then met Christian for breakfast. She shared in detail, the events of the night. He was envious.

  “Why didn’t you call me?”

  “I knew you needed your sleep,” she replied with a smile, never looking up. Christian sighed and Anna continued. “You’re the one who taught me the surgical motto.”

  “I know…I know. Eat when you can, sleep when you can, and don’t touch the pancreas!”

  Anna finished her rounds about 11:00 a.m. Her last stop was by the nursery. Her patient had already taken one ounce of water with no problem and would resume nursing later that day. His mother, holding and intermittently rocking him, looked up at Anna.

  “How can I thank you?”

  “Well, he’ll go home tomorrow,” she said. “That’s all the thanks I need. It was Saturday and she was ready for some sleep.

  * * *

  In 1921, Albert Einstein made his first trip to the United
States. He was received as a hero although almost no one understood his theory of relativity. He met with President Warren G. Harding and was involved in fund raising for the Hebrew University in Jerusalem. Now, in 1927, he was returning to deliver a series of lectures on the east coast. His colleague, Hanz Eichenwald, was invited as well to deliver talks on quantum mechanics. On April 1st, Professor and Mrs. Einstein, along with Hanz and Marlene, boarded the train at central station for the trip to Amsterdam, then on to the SS Rotterdam to New York.

  Hanz had a growing interest in aviation and in New York he indulged his interest reading multiple articles on the subject. The most intriguing was the April 8th edition of the New York Times about hotel owner Raymond Orteig and his offer of a $25,000 prize to the first man to cross the Atlantic from New York to Paris, or vice versa, in a heavier- than-air machine. A flight had been made in 1919 from Newfoundland to Ireland, a distance of 1,900 miles. But the distance between New York and Paris was more than 3,500 miles - a much greater challenge.

  There were several contenders. One of the most interesting was listed as ‘C.A. Lindbergh, Air Mail pilot from St Louis!’ This man had flown as a ‘barnstormer’ in Texas. He was known for landing in any field that took his fancy and for taking locals up for joyrides.

  For the attempt, he persuaded Ryan Airlines to allow him to use one of their aircraft. The plane was modified for the 4,000-mile flight with several extra fuel tanks. It carried no radio, only minimal instruments, and had a single engine.

  Three attempts for the prize had already been made. Commander Byrd and two companions crashed their aircraft on a test flight, but no one was seriously injured. Davis and Wooster took off from New York in a critically overloaded plane, crashed and died. A week later, a Frenchman named Nungesser departed from Paris with a co-pilot. They were never heard from again. As the German physicists were preparing for their return sail, Hanz noted that Lindbergh had scheduled his attempt for May 20th.