As we grow accustomed to the world in the Whistlers’ room, Alverdes introduces a new patient whose story is perhaps the strangest of all. Furlein has no physical wound yet he too has returned from the Front unable to speak—“it was an effort for him to produce even a hoarse whisper”—and he has difficulty breathing. Furlein’s is one of a range of conditions relating to speech. He is probably suffering from aphonia (inability to talk above a whisper), but similar military casualties also were diagnosed with psychogenic dysphonia (inability to speak loudly) or functional mutism (inability to speak at all). All of them are specific forms of what is now called post traumatic stress disorder (PTSD), but which in 1916 went by a variety of different names, including shell shock, neurasthenia, or mental shock. During the First World War, thousands of German casualties of this kind poured into military hospitals on the front and at home. Many were admitted to the Department of Psychiatric and Nervous Disorders at the Charité Hospital in Berlin. There were two schools of thought amongst specialists treating these patients. Some believed that the breakdowns had been triggered by incidents at the war itself: a kind of traumatic neurosis. Others identified their patients as having “a psychopathic constitution” which predisposed them to hysteria. By 1917, this became the dominant discourse, with a range of therapies designed to help the patient recover their disordered nervous system and physical functions.
Electro-therapy was one frequently a treatment option for such disorders. The chief proponent for its use in treating aphonia was Richard Hirschfeld at the Charité, and he devised both a technological and diagnostic system that was adopted across the profession. Electro-therapy comprised the application of an electric current of varying strength to the part of the body affected by loss of function, for between two and five minutes, sometimes accompanied by exercises or hypnosis before a return to the current’s application. The current was applied using a Faradic brush: an electrode embedded into a long-insulated handle that attached to a small generator. The electrode’s end was made of densely packed, nickel-plated copper wire bristles, that delivered currents of electricity when applied to the dry skin of the body directly in brief strokes or taps. Recovery rates were generally said to be high although there were few outcome studies that looked to see if functional problems returned after treatment. It is this treatment that Quint uses on Furlein, rather than sending him on to a more appropriate institution, but it is not the only one. Several weeks before he fires up the generator, and applies the brushes to the patient’s non-functioning throat, Quint recognises the Whistlers’ own expertise by immersing Furlein in the therapeutic community of the Whistlers’ room itself where, in some of the most tender scenes of the entire novel, its more permanent inhabitants can care for him in their own unique ways.
We meet the fourth Whistler late in the novel. Unexpectedly, he is an English prisoner of war named Harry Flint. Flint has also been shot in the throat and transferred to the ward from a prisoner-of-war camp hospital. Although this seems unusual, the treatment of seriously injured prisoners of war in specialist medical units in Germany was not uncommon. London’s Imperial War Museum holds an archive for one such patient, whose history has particular similarities to that of Harry Flint. James Grey, of the Middlesex Regiment, was injured in the very opening days of the war, in August 1914. He was shot in the face during the retreat from Mons, captured, and spent the few months shuttling around the prisoner-of-war camp hospital network in increasingly desperate attempts to cope with his casualty. He could only consume liquid broth and was unable to speak. Finally, weakened and close to death, he was sent for treatment at Germany’s leading hospital for jaw injuries, the Westdeutsche Kieferklinik in Dusseldorf.
Grey’s archive is small but contains one fascinating artefact—a photograph album full of images taken whilst he was a patient in the Klinik. Text from the novel might easily be applied as captions for the photographs. We see Grey wearing “the hospital uniform of blue and white striped linen, and over it a kind of round cape” that is described in Alverdes’ story. On his head was a washed-out cap of the same material just as Harry wears. Grey must also have earned the trust of his wardmates, as Harry tries to do in the novel. The album shows images of him alongside his German counterparts in his bed on the ward and then, as he was treated and grew stronger, in his striped uniform out in the garden of the Klinik, walking or seated together on a bench. The archive also tells us that Grey’s German became good enough for him to help patients from the nearby ward for the blind with walks in to the garden (just as Benjamin does with Deuster) and to read their letters to them.
The Klinik has other similarities to the hospital in Alverdes’ novel. It is set in beautiful cultivated grounds of a mature garden and tall trees, with a view of the Rhine in the distance. The two consultants who were its medical directors, Christian Bruhn and August Lindemann, conceived it as a specialist facial repair hospital, with the expectations that their patients would be there for long periods of time, for both treatment and rehabilitation. They were intolerant of the military authorities who ran the hospital, and both had international reputations of which they were justly proud. They spoke excellent English, and so were able to explain to Grey the exact nature and treatment of his injuries in his own language. Lindemann was cited throughout the war by British surgeons, such as Harold Gillies, as fundamental to the development of the surgical repair of facial wounds. After the war, as Surgeon Quint would have been reassured to know, German experts such as Lindemann were able to re-establish their relationships with their international counterparts, at least until the degradation of the German medical community by the policies of the Nazi regime, begun in 1933.
Not all medical treatment or infrastructure was the same in both Britain and Germany. In a brief but fascinating aside, Alverdes notes a difference between the reaction of Harry and Benjamin to their being referred to the skin clinic portion of the hospital, known as “The Ritterburg.” They are both suffering from skin conditions that (as a result of the scabies mite) are causing their skin to break out in itchy, painful and contagious lesions. What puzzles Harry (and perhaps the novel’s British readership) is that Benjamin feels great shame in being transferred to the skin clinic for treatment. Since medieval times, German medicine was structured so that venereal diseases and skin conditions were combined as one specialty. (This continues to be the case in some continental European countries where consultants may certify in dermato-venereology.) Because of this structure, the shame and subsequent ostracizing of venereal disease patients also attached itself to those suffering from skin conditions, and the visible marks of dermatological conditions accrued a similar moral dimension—sin on the inside manifesting in exterior signs. (The term “Ritterburg” means a knight’s castle—a fortified place where sufferers were contained or imprisoned, where their treatment was also a form of punishment—a very different ethos from the Whistlers’ room.)
So, for Harry, and especially for Benjamin, there is relief to be back in their own world of the Whistlers’ room, amongst their own kind, with its gentle rhythms and language, and once again the view of the trees and the Rhine in the distance. But time passes, and their recovery remains slow and fragile. Winter comes, and snow. A regimental band plays rousing patriotic tunes outside their window. Then, quickly, in sudden steps, everything in their world changes. Alverdes ends the story here, almost as the echoes of the bugles and drums of the band fade away in the cold air of the garden. All that is left to us as we close the book are the memories of the slight, quiet silver piping of the Whistlers forever in their room. This, I think, is as it should be. Alverdes has delivered a message as essential then as it is now. When the blasts and crashes of war are over, we must remember to listen for the sights and sounds of those lives forever changed, who speak in whispers of the world of pain to which they too are confined.
Emily Mayhew
London, 2017
I
The large room with the wide
terrace in front and the view over the park and fields and a glimpse of the Rhine in the distance beneath a brown cloud of smoke was known throughout the hospital as the Whistlers’ Room. It was named after the three soldiers who had been shot in the throat and awaited their recovery there. They had been there a long while; some said since the first year of the war. The stretcher-bearers who were the first to bandage them under fire in the shelter of ruined houses or in dugouts roofed over with planks and turf, pronounced on them a sentence of speedy death; but in defiance of all precedent and expectation they came through, for the time at any rate.
The process of healing, however, overshot its mark: for the bullet holes were covered over on the inner side of the windpipe by new flesh in such thick rolls and weals that the air passage was speedily blocked, and a new channel had to be made to meet this unforeseen threat of suffocation. So the surgeon’s knife cut a small hole in the neck below the old wound, which was causing a more and more impassable block. At this point a tube was sunk into the windpipe, and the air then passed freely in and out of the lungs.
The tube was a small silver pipe of the length and thickness of the little finger. At its outer end there was a small shield, fixed at right angles, not larger than the identity disc that everyone at the front wore next his skin. The purpose of it was to prevent the tube slipping into the gullet; and to prevent it falling out, there was a white tape passing through two eye-holes in the shield and secured behind round the neck by a double slip knot. In fact, however, the pipe was of two parts, closely fitted together, the innermost of which was held in its place by a tiny winged screw. Three times a day it was pulled out by two small handles to be cleaned; for since they could not now breathe through the nostrils, the tubes had become as it were the whistlers’ noses, and when they were not actually bedridden they gladly cleaned them for themselves with the little round brush provided for that purpose.
After it was cleaned the entrance of the tube had at once to be protected against dust and flies by a clean curtain. This was about the size of the hand and rectangular in form. It was cut from a thick roll of white muslin and attached to the tape with pins. It recalled the clerical band that forms part of the official garb of evangelical clergymen. Thus it was that the whistlers, with their spotless white between chin and chest, had always a ceremonial air. They were well aware of it. There was something of this in their whole bearing, and gladly they changed their bibs and tuckers several times a day for even cleaner and whiter ones. When they breathed quickly or laughed, a soft piping note, like the squeaking of mice, came from the silver mouth. Hence they were called the neck whistlers, or the whistlers simply.
Talking, after being for a long while practically dumb, gave them great trouble at first, and they were glad to avoid it, particularly before strangers. When they wished to speak they had to close the mouth of the pipe with the tip of the finger. Then a thread-like stream of air found its way upwards through the throat and played on the vocal cords, or what remained of them; and they, very unwillingly roused from their torpor, emitted no more than a painful wheezing and croaking.
It was not, however, for their cracked notes that the whistlers blushed, but for this to-do with lifting their bibs and feeling with their fingers for their secret mouthpiece; and this predicament they tried every means to disguise. Were a stranger to address them on the roads through the park, or in the wide passages and halls of the great building where in bad weather they sometimes took their walks, they usually forbore returning an immediate answer. They looked in meditation down at their toes, or with head courteously inclined and raised eyebrows gazed into the face of him who accosted them as though earnestly seeking within themselves for a suitable response. Meanwhile, quite without any particular object, they put up a hand to their breasts and after a moment proceeded as though to dally with a shirt button that might be concealed beneath the white pinafore. After this they began to talk and sometimes, if they gained sufficient confidence, their first silence might be exchanged for a cheerful loquacity. It was as though they wished to show that, in the very natural and, indeed, most everyday matter of being hoarse, they were not any different from other men. Why they did this they could not themselves have said; and they did not speak of it to each other. Yet they all behaved as though sworn to secrecy by oath; and when a fourth was added to them, he, from the very first, did likewise.
It was just the same, moreover, with the others in the room upstairs who had lost an arm or a leg. They felt no shyness at being seen by strangers with an empty sleeve or a trouser leg dangling loose and empty; indeed some of them vaunted their docked limbs and even went so far as to instil a kind of grizzly veneration in those who had come off more lightly by a display of their sad stumps. Yet the scraping and creaking of the sometimes not very successful appliances with which they had to learn to walk again, caused them acute embarrassment before strangers. At once they came to a stop and tried to disguise the grasp for the lever that enabled them to fix the artificial joint by catching or pulling at their trousers, or by any other apparently trivial movement. They never, either, displayed an unclothed false hand or foot, and at night when they undressed for bed they concealed the arm they had screwed off by hanging the coat over it, or the leg by leaving it carefully in a corner inside the trouser. For they were always afraid of being surprised by outsiders, and would have liked best being always by themselves.
Sometimes, however, visitors from outside came to distribute gifts—to the whistlers as well in their room. They made presents of wine, fruit and cakes, and especially of all kinds of scent with which the whistlers gladly and copiously besprinkled themselves. It is true that their sense of smell was for the time in abeyance; but they were all the more gratified to feel that they carried a pleasant aroma about with them. For all that, these occasions of munificence did not long continue. For too often the visitors came to a hasty conclusion that he who could not utter a sound, or only in a treble voice, must necessarily be stone deaf as well, and they proceeded to shout at the whistlers without mercy; and some even pulled out notebooks and wrote in enormous letters what they might just as well have said; or they tried from the very outset to make themselves intelligible by gestures of the most exaggerated description. For the whistlers this was gross insult. The defect which they had now adopted as a peculiarity of their own, seemed to them in a sense a merit, and no longer really a defect at all. But the one that was thus falsely laid to their door wounded them to the quick. And so, no sooner had the unknown visitor entered at one door than they took flight by another. But if they were caught in bed they pretended to be asleep, or put their fingers warningly to their lips, shook their heads with a pretence of regret, and enjoined upon the intruders an alarmed and guilty retreat.
Among themselves the whistlers held lively and intimate talks. They could do so easily in a wordless clucking speech that, in default of a stream of air to make words with, they formed by means of their lips and tongues and teeth. Their powers of comprehension had arrived at such a pitch that in the night, when lights were out and when there was no help from gestures of the hands, they held long talks between three from bed to bed. It sounded like the incessant clucking and splashing in a water-butt under the changing quick patter of heavy drops. For the low fever that seldom left the whistlers, or the effect of the drugs they were given, kept them often long awake. They never talked of a future and seldom of a past before the war. But of their last day at the front and of the exact circumstances in which they were wounded they never tired of giving vivid and stirring accounts; and with such leisure for recollection there was always more and more to add, and sometimes, indeed, an entirely new story was evolved and told for the first time. But not one of them showed any surprise at that.
II
There was one thing, however, to be told of the eldest of the three that could not be varied, and this was that a shell splinter had smashed his jaws and his larynx. His name was Pointner, and he was a peasant’
s son from Bavaria. He had been for over a year in the whistlers’ room, and his case was the worst of the three. He had got blood-poisoning and slowly, almost imperceptibly, his condition became hopeless. He often had to be in bed, with a high temperature, and then there was little he could be tempted to eat. Though well grown and well nourished when he left home, he was now as lank as a young boy. But nothing vexed him so much as when some of the convalescents from other wards picked him up like a child in their arms and offered to carry him about. A dark flush came into his cheeks, and he spat and scratched in rage and hit out unsparingly on all sides with his fever-wasted hands. He was ashamed of weighing so little. Nobody who saw him now would have guessed that he had been a butcher by trade, a master of all the secrets of the slaughter-house and an adept at making sausages. To be sure his time for that was over.
Perhaps Pointner had been once of a hot-blooded and even truculent disposition. He had a photograph of himself as a reservist on the cupboard beside his bed in a highly decorated frame of silver metal. This frame was composed of two gnarled oak trees, whose branches, through which ran broad scrolls bearing inscriptions, were gathered together along the top and bore the crown of a princely house; at their base amid the mighty roots was entwined a bunch of all kinds of swords, flags, rifles and cavalry lances. Between the oaks, however, reservist Pointner was to be seen, his cap, beneath which a love-lock protruded, set rakishly over one ear, and two fingers of the right hand stuck between the buttons of his tunic. In his left was jauntily held a cane bound with a plaited band from which depended a knot. His jaw was unusually strong and prominent, and this gave an aggressive turn to his short stature and the amiable expression of the upper part of his face. “Reserve now has rest,” was written on the photograph, and it was lightly tinted in bright colours. Nevertheless reserve had not had rest and the aggressive jaw had disappeared, and a small boneless and retreating chin had taken its place. It gave his face, with the always slightly parted lips and the white gleam of the upper teeth—which had escaped unscathed—beneath the straw-coloured moustache, a childlike and weak expression. And indeed the alteration in Pointner was more and more marked, though the old hot blood still sometimes came uppermost and made him dangerous.
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