by Herman Koch
“My sweet, jealous little man,” Caroline said.
In a practice like mine, the key is not to worry too much about medical standards. About what is, strictly speaking, medically responsible. In the “creative” professions, excess is more the rule than the exception. Collectively, my patients account for ten well-filled bottle banks a week. I could tell them the truth. The truth is somewhere around two or three glasses a day. Two glasses for women, three for men. No one really wants to hear that truth. I press my fingertips against the liver. I test it for hardening. How many glasses of alcohol do you drink in the course of a day? I ask. They can’t fool me. Alcohol comes out through the skin. A beer before dinner and after that no more than half a bottle of wine, they say. Alcohol seeps out through the pores and evaporates right off the skin. I have a good nose. I can smell what they drank the night before. Painters and sculptors stink of old gin or eau-de-vie. Writers and actors of beer and vodka. Female writers and actresses, when they breathe, give off the sourish smell of cheap Chardonnay on ice. They might hold up a hand to cover their mouths, but the eructations can’t be stopped. Of course, I could say something. I could try to get to the bottom of things, as they say. A beer or half a bottle of wine: Don’t make me laugh! The patients would leave. The same way they left to escape their previous family doctor. A doctor who, like me, pressed his finger against their livers and felt the same thing I did—but who then went on to tell them the truth. If you go on like this, your liver will rupture within a year. The end is an extremely painful one. The liver can no longer process the waste. It spreads out through the rest of the body. It piles up in the ankles, the ventricles, the whites of the eyes. The whites of the eyes first turn yellow, then gray. Parts of the liver die off. The actual rupture is the final stage. So the patients leave and come to me. So-and-so—a good friend, male or female, a colleague—told them about a physician who doesn’t worry too much about how much alcohol you knock back in the course of a day. Well, listen, that maximum-number-of-glasses-a-day stuff is all pretty relative, I say. You only live once. Clean living is one of the major inducers of stress. Just look around. Has it ever occurred to you how many artists live to be eighty or more, even though they’ve always lived a life of riot? I see my new patient starting to relax already. A smile appears on his or her face. I name names. Pablo Picasso, I say. Pablo Picasso knew how to bend an elbow. Mentioning the name serves a twin purpose. Because I refer to my patients in the same breath as a world-famous artist, they feel like Pablo Picasso himself, even if only for a moment. I could put it differently. You’re a much bigger lush than Pablo Picasso ever was, I could say. The only thing is, you don’t possess a tenth of his talent. When you look at things clearly, it’s simply a waste. A waste of alcohol, that is. But I don’t say that. And the other names I don’t mention. The names of the geniuses who drank themselves to death. At the end of the afternoon on the last day of his life, Dylan Thomas returned to his room at New York’s Chelsea Hotel. “I’ve had eighteen straight whiskies. I think that is a record,” he told his wife. Then he lost consciousness. At the autopsy it turned out that his liver was four times the normal size. I say nothing about Charles Bukowski, about Paul Gauguin, about Janis Joplin. The important thing is how you live, I say. People who can enjoy life last longer than the sourpusses who eat only plants and slurp organic yogurt. I tell them about the vegetarians with terminal intestinal disorders, the teetotalers who die in their late twenties after a cardiac arrest, the militant nonsmokers whose lung cancer is detected too late. Look at the Mediterranean countries, I say. People there have been drinking wine for centuries, but they tend to be healthier than people here. There are certain countries and peoples I omit on purpose. I don’t talk about the average life expectancy of the vodka-swilling Russian. If you don’t live, you’ll never get old, I say. Do you know why the Scots never come down with the flu? You don’t? Let me tell you … Having reached this point, I have a new patient almost in the bag. By heart, I reel off a list of the whisky distilleries: Glenfiddich, Glencairn, Glencadam—and here I reach the crucial moment in our first appointment: I hint at the fact that I enjoy the occasional drink myself. That I’m just like them. One of them. Not completely, of course. I know my place. I’m not an artist. I’m only a simple family doctor. But a family doctor who happens to value quality of life more than a one-hundred-percent healthy body.
My patients include a former secretary of state who weighs well over three hundred pounds. A former secretary of state for culture with whom I swap recipes. Though I shouldn’t be swapping anything with her at all. Sometimes I almost can’t breathe, Doctor, she says, after sinking down panting in the chair. I ask her to unbutton her blouse, just to bare her upper back, and I raise my stethoscope. The sounds from inside a body that’s too fat are not like those from a body with enough room for all the vital organs. It all has to work a lot harder in there. There’s a struggle for space going on. A struggle that is lost before it’s even started. The fat is everywhere. The organs are hemmed in on all sides. I pick up my stethoscope and listen. I hear the lungs, which have to push the fat aside with every breath. Breathe out very slowly, I say. And I hear the way the fat moves back in to resume its place. The heart doesn’t beat, it pounds. The heart is working overtime. The blood has to be pumped in time to the farthest points of the body. But the arteries are surrounded by fat, too. Now breathe in slowly, I say. The fat braces itself. It moves aside a little when the lungs try to fill with air, but it never fully surrenders its ground. It’s a fight for thousandths of an inch. Invisible to the naked eye, the fat is readying for the final offensive. I move the stethoscope around to the front of the body. Between the former secretary of state’s breasts there glistens a little runnel of sweat, like a waterfall viewed from a distance, a waterfall somewhere far up a mountainside. I try to avoid looking at the breasts themselves. As always, I think the wrong kinds of thoughts. I can’t help it. I think about the former secretary of state’s husband, a “dramaturge” who spends most of each year out of work. About who’s on top or who lies underneath. First he’s on top. But he can’t get a grip anywhere. He slides off her body the way you might slide off a half-filled waterbed, or a carelessly inflated raft. Or he actually sinks into it too far. His hands clutch at the flesh. What he needs, in fact, are ropes and grappling hooks. This isn’t working, his wife says, panting, and pushes him off. Now he’s on the bottom. I imagine the breasts above his face, how they descend slowly. First there is a total eclipse. The light goes out. Then there is no room to breathe. The “dramaturge” shouts something, but all sound is muffled by the breasts. Now they’re covering his entire face. They’re too warm, and not completely dry anymore, either. A purple nipple the size of a saucer seals off his mouth and nostrils. Then, with a dry pop, the first rib breaks beneath the weight of his wife’s three-hundred-pound body. She doesn’t notice a thing. She gropes around for his dick and stuffs it inside her. Everything down there is too fat as well, so it takes a while before she’s sure he’s really inside her. Meanwhile, more ribs give way. It’s like a ten-story building: The contractor didn’t pay much attention to the drawings, and the builders start pulling down a load-bearing wall on the ground floor. At first there are only a few deep fissures, then the whole construction begins to sway. At last the building collapses. She starts licking his ear. That’s the last thing he feels. And hears. A Saint Bernard’s tongue filling his auricle. Exhale, one more time, I say. How is your husband? Is he working again? I could tell her that things can’t go on like this any longer. It’s not just that the vital organs have too little space. The joints, too, are overtaxed. Everything is being destroyed. The kneecaps, the ligaments in her ankles, the hips. Like an overloaded tractor-trailer. On a downhill run the brakes overheat, the truck jackknifes and then shoots through the guardrail into a ravine. But I open my desk drawer and pull out a recipe. An oven dish of pork loin, with plums and red wine. It’s a recipe I cut out of a magazine. The former secretary of state likes to coo
k. Cooking is her only hobby; nothing else interests her. Sooner or later she’ll cook herself to death. She’ll die facedown in a saucepan.
Ralph Meier was too fat as well, albeit in a different way. A “more natural” way, you might say. At first his true girth was hard to identify. The extra weight hung all over his body like a roomy overcoat. But during his first appointment I once again heard noises one rarely hears inside healthy people. I placed my stethoscope on his bare back. First of all there was the breathing. It sounded heavy and labored, as though the air, scarce enough already, had to be drawn to the surface from a well that was far too deep. There was an audible echo to his heartbeat. An echo like the ringing of a bell. And farther down, in his intestines, in the pit of his stomach, I heard a brewing and a bubbling. He had a fondness for shellfish and game birds, as I would witness later. Small birds—quail, partridge. He pulled the skeletons apart and stuck them in his mouth. He slurped the marrow from the cervical vertebrae, ground spinal cords between his teeth to get the last juices out of them. “I’m onstage every evening,” he said. “And in the afternoon we’re rehearsing a new play. I can’t keep up the pace.” A colleague had mentioned my name, he said. A colleague who had been a patient of mine for years. He’s the one who had told him about the pills. About how easy I was about prescribing those pills—Benzedrine, amphetamines, speed—whatever I, as his doctor, thought was best for him. I bent over the stethoscope. I seriously asked myself what havoc those pills would wreak on this body. Benzedrine, amphetamines, speed—all different names for the same thing, in fact. The pulse quickens, the pupils dilate, the blood vessels, too. For a few hours, we are able to go back into overdrive.
You could, indeed, call me “easy” when it comes to prescribing certain medicines. That’s right, I’m easy. Why should anyone lie awake half the night when one milligram of lorazepam will knock them out till noon? Medicines are what boost the quality of life. I have colleagues who warn their patients about the dangers of habituation. They give someone a prescription for Valium, but when the patient asks for a renewal, they suddenly get all fussy. I’m not like that. Some people need a kick in the ass, others just need to think less for a couple of hours. The beauty of all these medicines is their simplicity. Five milligrams of Valium really does calm you down; less than three milligrams of Benzedrine is enough to make someone bounce off the walls till five in the morning. Some men are afraid to go into shops or talk to girls. After two weeks on Seroxat, though, the patient will return home with twelve Hugo Boss shirts, an Alan Setscoe desk lamp, and five new pairs of pants from the G-Star RAW Retail Store. After three weeks he’s chatting up every girl at the club. Not one or two—no, all of them. He no longer lets himself be put off by silly giggles or outright refusal. He has no time for giggling or for refusals. “The night is still young” is for losers, for the pizza faces who hang around for seven hours with beers in their hands and then go home alone. The night is not young—if there’s one thing Seroxat has taught him, it’s that. The night starts now. The sooner it gets going, the longer it lasts. He has a perfect pickup line. Or rather, he doesn’t have to think about lines anymore. All lines are good. They’re especially good when you’ve forgotten them already, thirty seconds later. They’re conspicuous by reason of their simplicity. You’re looking good, he says to the girl who looks good. Is there also a Mr. Mulder? he asks the woman who introduces herself as Esther Mulder. I never used to be able to come up with lines like that, the Seroxat-user says. Your place or mine? Your eyes are prettiest when you smile. If we leave now, we’ve still got the whole evening ahead of us. May I touch you there, or would you hold that against me? After five minutes with you I felt like I’d known you all my life. It’s—he doesn’t know how else to put it—liberating to come up with lines like that. Simplicity, that’s what it’s all about. Simplicity is telling a pretty woman that she’s pretty. You never say, Do you know that you’re very pretty? A pretty woman already knows that. Do you know that you’re very pretty? is something you only say to an ugly woman. A woman who’s never heard that before. Her gratitude will know no bounds. Later in the evening she’ll put up with anything: A dirty, unwashed dick right in her face. An unwashed prick that sprays a month-old backlog of old sperm all over her. All over her navel, her lips, her eyelids. Yellow sperm. Yellow as the pages of a book that no one wanted to read, which is why it was left out in the sun beside the deck chair. Filthy, worthless sperm that smells like a half-finished bottle of fermented dairy drink stuck at the back of the fridge and then forgotten. On the other hand, though, it does happen sometimes. No, let me put it differently: You can be dead sure that a pretty woman almost never gets to hear how pretty she is. That none of the other men at the party have the courage to say that. You often hear pretty women complaining to one another about that: that their looks are so much taken for granted. As though it were all just par for the course, like the Mona Lisa, the Acropolis, or the view of the Grand Canyon from Grandview Point. We have no words to describe pretty women. We’re speechless. Tongue-tied. We talk around their beauty. Been to any nice restaurants lately? the tongue asks. Got any plans for the summer? The pretty woman replies normally. At first she’s relieved to be spoken to so normally. To have someone just talk to her about day-to-day things. So normal. So ordinary. As though she’s not pretty at all, just a person like anyone else. But after a while something starts bothering her. Because it is kind of weird. The pretty woman wears her beauty like a feather headdress. So it’s kind of weird when someone goes on talking without making any reference to the headdress.
“You have a very lovely wife,” Ralph Meier said, for instance, the first chance he got. He was sitting across from me at my desk and at least he didn’t beat around the bush. It was during his second visit to my office, a little less than a week after the opening night of Richard II. He had simply shown up again, unannounced, without an appointment. “Could I just bother him for a moment?” he’d asked Liesbeth, my assistant. “It’ll only take a minute.”
I thought at first that he had come back for a new prescription, but the pills weren’t even mentioned during that second visit. “I was in the neighborhood, anyway,” he said, “so I thought, I’ll swing by and ask him in person.”
“Oh yeah?” I tried to look at him as blandly as possible, but I couldn’t help it, there was no stopping it: The only thing I could think about was that look on his face the week before, when he examined my wife from head to foot.
“We’re throwing a party on Saturday,” he said. “At our place. If the weather’s nice it’ll be in the yard. I wanted to invite you and your wife.”
I looked at him and thought my own thoughts. Would he have invited us if I had been married to a woman other than Caroline? I wondered. A less tasty woman?
“A party?” I said.
“Judith and I. Saturday, it will be twenty years since we met.” He shook his head. “Unbelievable. Twenty years! Where does the time go?”
“He doesn’t waste any time,” I said. “He goes straight for the kill.”
We were sitting at the kitchen table. The dishwasher was bubbling. Lisa had already gone to bed, Julia was in her room doing her homework. Caroline divided the last of the wine between us.
“Marc, come on!” she said. “He just likes you, that’s all. You shouldn’t always go looking for ulterior motives.”
“Likes me! He doesn’t like me at all. He likes you. He told me so, in so many words. ‘You have a very lovely wife, Marc!’ That’s how he looked at you in the theater. The way a man looks at a very lovely woman. Don’t make me laugh!”
Caroline sipped her wine, then tilted her head slightly and looked at me. I could see it in her eyes: She found this entertaining, this unexpected attention from the famous actor Ralph Meier. I couldn’t really blame her. If I were to be completely honest, I found it entertaining as well. It was, in any case, a lot more entertaining than having famous actors not even notice your wife, I told myself. But then I thought about that dirt
y look of his. His raptor look. No, it wasn’t all pure amusement.
“You’re saying he only invited us to his party because he’s after me,” Caroline said. “But that doesn’t make sense. He invited us to that opening night, too, didn’t he? And he hadn’t even seen me yet.”
She had a point there, I had to admit. Still, these were two different things, an invitation to an opening night and an invitation to a party at someone’s private home.
“So turn it around for a moment,” I said. “Your birthday’s next month. Would you invite Ralph Meier to your party?”
“Well …” Caroline looked at me teasingly. “No, okay,” she said. “I don’t suppose I would, no. You’re right as far as that goes. All I’m trying to say is that you shouldn’t always assume the worst. Maybe he really does like us. Both of us, I mean. It could be that, couldn’t it? I talked to his wife for a long time the other evening. I don’t know, sometimes you have that feeling, that you click immediately. I had that with Judith. Who knows, maybe she told Ralph to invite us.”
Judith. I’d forgotten her name again. The first time I’d forgotten it was less than a second after shaking her hand in the theater lobby. The second time was this morning, when Ralph Meier had started talking about the party.
Judith, I admonished myself inwardly. Judith.
I’ll be honest. When she held out her hand and told me her name, I looked at her the way every man looks at a woman who enters his field of vision for the first time.
Could you do it with her? I asked myself, looking her deep in the eyes. Yes, was the response.
And Judith looked back. It’s only ever a matter of a few fractions of a second, of making eye contact for just that little bit longer. That’s how Judith and I looked at each other. Just a little longer, strictly speaking, than one might consider entirely respectable. And while I was forgetting her name, she smiled at me. It wasn’t so much her mouth that smiled, it was above all her eyes.