by John Irving
Yet it was Dr. von Rohr's department to raise the unasked question. "Isn't hospitalism a second disease for some of our patients?" she would inquire, just when everything seemed fine. "What if we're too successful with William? In a sense, if he's happy here, haven't we made him dependent on us and this place? I'm just asking," she was fond of saying, once a seed of doubt had been sown.
It was Dr. von Rohr who would not stop asking why William often felt cold. "But what triggers this?" she frequently inquired. (At the Sanatorium Kilchberg, Jack's sister had told him, the word triggers was hugely popular.)
It was Dr. von Rohr who suggested that William Burns might have a narcissistic personality, or even a narcissistic personality disorder. He shampooed his gray-white, hippie-length hair daily; he was very particular about which conditioner and gel he used. (He'd had a fit--a running-naked-and-screaming episode--because his hair dryer had blown a fuse!) And then there was the meticulousness of his tattoos, not to mention how protective he was of them. For the most part, he concealed them. He wore long-sleeved shirts, buttoned at the throat, and long pants, and shoes with socks--even in the summer. (Yet when William Burns wanted you to see his tattoos, he showed you all of them.)
It was not uncommon among schizophrenics to wear long pants and long-sleeved shirts; they felt so unprotected. But Jack and Heather's dad wasn't diagnosed with schizophrenia. The issue Dr. von Rohr had raised was William's fastidiousness, his vanity--the way he watched his weight, for example. "Isn't William an impossible perfectionist?" Dr. von Rohr would say. "I'm just asking."
The osteoarthritis was the reason William Burns could no longer play the organ professionally--hence his early retirement, which had precipitated his mental decline. But he could have kept teaching--even keyboard skills, albeit to a limited degree, Heather had said. William certainly could have continued to teach musical theory and musical history; yet he had retired totally, and perhaps unnecessarily.
"A failure to live up to previous standards or expectations, which can also lead to someone's early retirement, is a signature feature of a narcissistic personality, isn't it?" Dr. von Rohr had said to the team. (The "I'm-just-asking" part was always implied, if not stated.)
"A piece of work," Jack's sister had called her. "A head-of-department type, if I ever met one."
Trying to envision Dr. Ruth von Rohr, Jack thought of Dr. Garcia, who was a good listener, and who raised a lot of unasked questions. Boy, was Dr. Garcia ever a head-of-department type!
Last, but not least, was the sixth member of the team--an attractive young woman, authoritative but self-contained--Dr. Anna-Elisabeth Krauer-Poppe. She always wore a long, starched, hospital-white lab coat--seemingly not to assert her medical credentials but to protect her fashionable clothes. (She was Swiss but her clothes weren't, Heather had claimed.)
Like the two unambiguous hyphens in her name, Dr. Anna-Elisabeth Krauer-Poppe was as perfectly assembled as a Vogue model in Paris or Milan; she seemed too chic to be Swiss, although she'd been born in Zurich and her knowledge of the city was as irreproachable as her command of her field. Dr. Krauer-Poppe was head of medication at the Sanatorium Kilchberg, where it was everyone's opinion that she knew her prescriptions as well as she knew her clothes.
It had frustrated her that William was not treatable with those new (and so-called stomach-friendly) nonsteroidal anti-inflammatory drugs and that he could tolerate only the topical solution. His hot-wax routine made Dr. Krauer-Poppe cringe, not least for what a mess William made of what he was wearing when he picked the dried wax off. And to see him with his hands plunged in ice water must have made Dr. Krauer-Poppe want to change her entire ensemble. (As for the copper bracelets, she couldn't even look at them; the glucosamine, particularly the extract of shark cartilage, she dismissed as "a folk remedy.")
But when it came to William Burns's obsessive-compulsive disorder, Dr. Krauer-Poppe had prescribed an antidepressant; the medication had had a calming effect. She'd tried two drugs, in fact, Zoloft and Seropram. Each one had its merits, both being selective serotonin reuptake inhibitors used to treat depression.
As for the side effects, Heather had said, their father had tolerated the dizziness, the dry mouth, the drowsiness, and the loss of appetite; the latter was the most persistent problem. (But William was so devoted to being thin that his loss of appetite probably thrilled him.) He'd complained about occasionally painful and prolonged erections, and there were certain "changes"--which Heather had not specified to Jack--in William's sexual interest and ability. But over time, William Burns appeared to have tolerated--or at least accepted--these side effects, too.
The drugs did not impair William's motor functions. His keyboard skills were unaffected by the antidepressants. The music he'd committed to memory remained intact, and he could sight-read music as quickly as ever.
Dr. Krauer-Poppe had worried that William's ability to concentrate might suffer, and he admitted to being more easily distracted; it took him longer to memorize new pieces, and he occasionally complained of fatigue, which was unusual for him. He was used to having more energy, he said; on the other hand, he was sleeping better.
Dr. Krauer-Poppe had also watched William closely for signs that prolonged administration of the drugs might make him feel indifferent or less emotional; this was sometimes referred to as "the poop-out syndrome," Dr. Krauer-Poppe said, but William had shown no such signs. According to Heather, their father was indifferent to nothing or no one--and he was, "regrettably," as emotional as ever.
Dr. Krauer-Poppe thought that, in William's case, the antidepressants had been successful. She noted that his sexual "changes" did not include impotence, another possible side effect; she called the drugs "an acceptable trade-off." (Dr. Krauer-Poppe was a woman at ease with hyphens, apparently. No one like her came to Jack's mind.)
Jack couldn't wait to meet these people, and he was relieved that he was meeting them first--that is, before he would see his father.
William Burns had been twenty-five when he met Jack's mom; he'd been twenty-six when Jack was born. At that age, how long would Jack have stayed married to anyone? And what if he'd fathered a child at twenty-six, when he and Emma were burning the candle at both ends in L.A.? What kind of dad would he have been?
Jack knew what Dr. Garcia's answer would be--her less-than-one-word response: "Hmm."
Jack checked into the Hotel zum Storchen on the Weinplatz. His room overlooked the Limmat, where he watched a tour boat drifting past the hotel's riverfront cafe. He was staying in the Old Town--cobblestoned streets, many of them for pedestrians only. The church bells seemed to ring every quarter hour, as if Zurich were obsessed with the passage of time. He shaved and dressed for dinner, although it was still only midafternoon.
In the taxi--at the airport, in Kloten--Jack had considered going directly to the Sanatorium Kilchberg, but his appointment with Professor Ritter and the others wasn't until late afternoon. He didn't want to risk running into his father before he'd met with the doctors. Although he wasn't expecting Jack, William would surely have recognized him.
Jack had questioned the clinic's decision not to tell his father that he was coming, but both Heather and the psychiatric team had thought it best if Jack's dad didn't know; if he knew, he would be too anxious.
Nor had Dr. Krauer-Poppe recommended upping William's dosage of the Zoloft or the Seropram, whether they told him about Jack or not. Even Dr. von Rohr had refrained from making her usual, on-the-other-hand argument; in fact, she said that giving William more antidepressants might make him near-catatonic or completely out of it for his son's first visit.
Dr. Horvath, the hearty Austrian and deputy medical director who often jogged with William, had told his patient to expect "a special visitor." Since it was too soon for more visiting time with his daughter, William was probably expecting someone from the world of music--a musician from out of town, a fellow organist making a guest appearance at a concert or playing in a church in Zurich. (Such distinguished vi
sitors occasionally came to Kilchberg to pay William Burns their respects.)
Jack had asked the concierge at the Storchen to recommend a restaurant within walking distance of the hotel. William would be allowed to have dinner with his son, although Professor Ritter or one (or more) of the doctors at the clinic would accompany him.
"Better make the reservation for three or four people," Heather had told Jack. "They won't want you to take him away from the sanatorium alone. And believe me, Jack, you wouldn't want to do that--not the first time, anyway."
The concierge--a laconic man with a hoe-shaped scar on his forehead, probably from hitting a car's windshield with his head--had booked a table for four at the Kronenhalle. It was an excellent restaurant and a pleasant walk, the concierge had assured Jack. "And because you're Jack Burns, I actually managed to get you a table--even on such short notice."
Jack went outside the hotel and watched the swans and ducks swimming in the Limmat. He checked the time on his watch against the clock towers of the two most imposing churches he could see from the Weinplatz, where he could also see a taxi stand. It was only a ten-or fifteen-minute drive to Kilchberg from the Storchen, and he didn't want to be early or late.
Jack felt guilty about how much he had blamed his mother for everything. If she'd been alive and Jack were waiting to meet her for the first time, he believed he would have felt as nervous and excited about that as he felt about meeting his dad. It suddenly seemed ridiculous that he couldn't forgive her; in fact, Jack missed her. He wished he could call her, but what would he have said?
It was Miss Wurtz who was waiting to hear from him; it was Caroline Jack should have called. But all he could think about was talking to his mother.
"Hi, Mom--it's me," he wanted to tell her. "I'm not doing this to hurt you, but I'm on my way to meet my dad--after all these years! Got any advice?"
Jack took a taxi out of town, along the shore of Lake Zurich--a nice drive, the road passing close to the lake the whole way. A theater festival had set up tents along the waterfront. It was sunny and warm, but the air was dry--mountain air, not nearly as humid as it had been in Edinburgh. There were these sudden, dramatic moments when Jack could see the Alps beyond the lake. Everything was clean, almost sparkling. (Even the taxi.)
Kilchberg was a community of about seven thousand. Because of all the sailboats on the lake--and the stately homes, many with gardens--the town somewhat resembled a resort. Jack's taxi driver told him that the right shore of the lake was slightly more prosperous. "Europeans prefer to face west," he said. Kilchberg, on the left shore of Lake Zurich, faced east.
But Jack thought Kilchberg was charming. There was even a small vineyard, or at least what looked like a working farm, and the sanatorium was high on a hill overlooking the lake, with a spectacular view of Zurich to the north; to the south were the Alps.
"Most of the patients take the bus from the Burkliplatz--there's a sanatorium stop in Kilchberg," his taxi driver told him. "I mean the patients who are free to come and go," he added--looking warily at Jack in the rearview mirror, as if he were certain that Jack had escaped. "You might want to consider taking the bus next time--the number one-sixty-one bus, if you can remember that."
The driver was Middle Eastern, or possibly Turkish. (He'd mentioned "Europeans" with evident distaste.) His English was much better than his German, which was as clumsy and halting as Jack's. When they'd first tried to speak German together, Jack's driver had quickly switched to English instead. Jack wondered why he'd been mistaken for a patient at the clinic; the taxi driver was not much of a moviegoer, maybe.
Not so the preternaturally thin young woman in running shoes and a jogging suit who greeted Jack in what he thought was the main entrance to the hospital part of the clinic. There was a waiting room and a reception desk, where the young woman was pacing back and forth when Jack came in. A fitness expert, he assumed--perhaps she was the nurse in charge of physical therapy, or a kind of personal trainer to the patients. She should put on a little weight, Jack was thinking; one can take the athletic-looking thing too far.
"Stop!" she said, in English--pointing to him. (There was no one else in the entranceway or the waiting room; there was no one behind the reception desk, either.) Jack stopped.
A nurse appeared, emerging hurriedly from a corridor. "Pamela, er ist harmlos," the nurse said.
"Of course he's harmless--he's not real," Pamela said. "The medication is working. You don't have to worry about that. I know he's harmless--I know he's not real."
She sounded American, yet the nurse had spoken to her in German and she'd understood the nurse. Maybe the thin young woman had been a patient in the clinic for a long time--long enough to learn German, Jack speculated.
"Es tut mir leid," the nurse said to Jack, leading the young American woman away. ("I'm sorry," she said.)
"You should speak English to him," Pamela said. "If he were real, he would speak English--like in his movies."
"I have an appointment with Professor Ritter!" Jack called after the nurse.
"Ich bin gleich wieder da!" the nurse called back to him. ("I'm coming right back!")
They had disappeared down the corridor, but Jack could still hear the too-thin patient--her voice rising. It registered as a kind of insanity on his part that he'd mistaken her for someone who worked at the place.
"They don't usually say anything," Pamela was telling the nurse. "Normally they just appear--they don't talk, too. God, maybe the medication isn't working!"
"Das macht nichts," the nurse told her, gently. ("It doesn't matter," she said.)
Jack Burns was a movie star in a psychiatric clinic; not surprisingly, the first patient who saw him thought he was a talking hallucination. (Not a bad definition for an actor, Dr. Garcia might have said.)
When the nurse came back, she was shaking her head and talking to herself--almost inaudibly and in German. Were it not for her uniform, and if he hadn't seen her before, Jack would have believed that her self-absorbed muttering marked her as a patient. She was a short woman in her fifties, stout and brusque with curly gray hair--a former blonde, Jack guessed.
"It's funny that the first person you, of all people, should meet here is our only American," the nurse said. "Bleibel," she added, vigorously shaking Jack's hand.
"Excuse me?"
"Waltraut Bleibel--I'm telling you my name!"
"Oh. Jack Burns."
"I know. Professor Ritter is expecting you. We've all been expecting you, except for poor Pamela."
They went outside the building and walked across a patio; there was a sculpture garden and a shallow pond with lily pads. (Nothing anyone can drown in, Jack was thinking.) Most of the buildings had big windows, some of them with those black silhouettes of birds painted on the glass. "Our anti-bird birds," Nurse Bleibel said, with a wave of her hand. "You must have them in America."
"I guess I went to the wrong building," Jack told her.
"A women's ward wouldn't be my first choice for you," Nurse Bleibel said.
The grounds were beautifully maintained. There were a dozen or more people walking on the paths; others sat on benches, facing the lake. (No one looked insane.) There must have been a hundred sailboats on the lake.
"I take William shopping for clothes, on occasion," the nurse informed Jack. "I've never known a man who likes shopping for clothes as much as your father does. When he has to try things on, he can be difficult. Mirrors are a challenge--triggers, Dr. von Rohr would call them. But William is very well behaved with me. No fooling around, generally speaking."
They went into what appeared to be an office building, although there were cooking smells; maybe a cafeteria, or the clinic's dining hall, was in the building. Jack followed the nurse upstairs, noting that she took two steps at a time; for a short woman in a skirt, this required robust determination. (He could easily imagine his dad not being inclined to fool around with Waltraut Bleibel.)
They found Professor Ritter in a conference room; he was s
itting all alone, at the head of a long table, making notes on a pad of paper. He jumped to his feet when Nurse Bleibel brought Jack into the room. A wiry man with a strong handshake, he looked a little like David Niven, but he wasn't dressed for tennis. His pleated khaki trousers had sharply pressed pant legs; his tan loafers looked newly shined; he wore a dark-green short-sleeved shirt.
"Ah, you found us!" the professor cried.
"Er hat zuerst Pamela gefunden," Nurse Bleibel said. ("He found Pamela first," she told him.)
"Poor Pamela," Professor Ritter replied.
"Das macht nichts. Pamela just thinks it's her medication again," the nurse said as she was leaving.
"Merci vielmal, Waltraut!" Prof. Ritter called after her--a bilingual "Many thanks!" in French and Swiss German.
"Bitte, bitte," Nurse Bleibel said, waving her hand as she had at the anti-bird birds on the big windows.
"Waltraut has a brother, Hugo, who takes your father to town--on occasion," Professor Ritter told Jack. "But Hugo doesn't take William shopping for clothes. Waltraut does a better job of that."
"She mentioned something about mirrors," Jack said. "She called them triggers, or she said one of the doctors did."
"Ah, yes--we'll get to that!" Professor Ritter said. He was a man used to running a meeting. He was friendly but precise; he left no doubt about who was in charge.
When the others filed into the conference room, Jack wondered where they'd been waiting. On what signal, which he hadn't detected, had they been summoned forth? They even seemed to know where to sit--as if there were place cards on the bare table, where they put their almost identical pads of paper. They'd come prepared; they looked positively poised to take notes. But first Jack had to endure the obligatory handshakes--which, in each case, went on a shake or two too long. And each doctor, as if their meeting had been rehearsed, had a characteristic little something to say.
"Gruss Gott!" Dr. Horvath, the hearty Austrian, cried--pumping Jack's hand up and down.
"Your on-screen persona may precede you, Mr. Burns," Dr. Berger (the neurologist and fact man) said, "but when I look at you, I see a young William first of all!"