by Uwe Tellkamp
‘You’re always demanding staff, more staff!’ Scheffler, the Rector, raised his hands after Müller had stated his case. Gorbachev’s plump peasant’s face, friendly and unretouched, looked down on the meeting from the place where Andropov and Chernenko had previously hung. Josta brought documents; in the sixth or seventh month, Richard guessed after a look at her stomach.
‘We have none! You know that as well as I do. The planning of requirements –’
Rykenthal, the head of the Paediatric Clinic, broke in, scornfully repeating ‘planning of requirements’. The Paediatric Clinic was falling down, the roof was not watertight; on the top floor the damp patches had now joined hands by their amoeba-like finger processes; black mould was sprouting like a strong growth of beard in the rooms closed down by the authorities. Naturally Rykenthal, a stocky man with the aura of a hippopotamus, a magician’s bow tie and butterfly-blue paediatrician’s eyes, demanded that an end should finally be put to this deplorable state of affairs (‘I don’t know, colleagues, how often I’ve had to make this point already’); at that Reucker became restless and emphasized the, in his opinion, more urgent problems in Nephrology; Heinsloe, the head of Administration, was asked for his opinion but all he could do was, as usual, spread his arms regretfully. ‘The funds, gentlemen, we lack the funds. And the building resources, where do we find them!’ Material, gentlemen, he couldn’t wave a magic wand.
‘There has been an application for a room for hand operations for over five years now,’ Richard broke in, furious when he noticed the looks of pleasure following Josta. ‘It’s surely not possible that in the whole of Dresden we cannot find the means for that minor matter.’
‘All due respect for your private ambitions, Herr Hoffmann, but I have to remind you that the Ear-Nose-and-Throat section has had an application for a new operating theatre in for thirteen years –’
‘What are you calling private ambitions?’
‘You can continue to do operations on the hand in Outpatients, as you have until now, Herr Hoffmann, but it’s preposterous that my patients have to have their dialysis in the ward corridor, because the extension, which was promised years ago –’
‘Please, gentlemen! Our resources are limited. Let us think what is the best use we can make of them. Most urgent, it seems to me, are the repairs to the Paediatric Clinic. My grandson was in there recently, there are drips from the ceiling on the top floor, the nurses have to put bowls underneath them …’
Clarens was sitting quietly in a corner, stroking his beard; he said nothing and was asked nothing. A frail man, Richard thought, whom people automatically wanted to do something for, give him an orange, for example, less in order to be friendly than from a feeling of embarrassment and in order to be noticed by him – Clarens, sitting there as if he were counting their sins, found it impossible to fight, almost disappeared beside the broad-shouldered representatives of the various surgical fields, all fully convinced of their own importance and of that of their requests. Leuser’s urologist’s jokes seemed to cause him physical pain, his hands and ears went an indignant sky-grey, then paled to the colour of synthetic honey when the full-time Party Secretary of the Medical Academy spoke. A humorously down-to-earth workaholic, more interested in doing than talking, who liked to see everyday detail from the perspective of a Party youth camp morning ceremony, whose Chto delat? – What is to be done? – and Kak tebya zovut? – What are you called? (difficulty or enemy) – had stuck with him from a reservoir construction site in Siberia where, during his (‘heart-stirring! heart-stirring!’) days as an official of the Free German Youth, he had had hands-on experience of communism.
‘Always the same,’ Richard moaned outside, ‘lots of talk, nothing done.’ Having left the Administration building, Clarens and he were walking down the Academy road. Clarens talked about suicide. He was an internationally renowned expert on suicide and sometimes said he was lucky to be able to pursue his passion in this country, only the old Austro-Hungarian Empire had had more plentiful material. ‘Oh to be a Viennese psychiatrist,’ Clarens sighed. The suicide cases in the Austrian Empire had shown greater imaginativeness, a tendency to grotesquely droll and out-of-the-way methods, while the Germans mostly ‘ended it all’, at which Clarens put his hand to the back of his neck, jerked it up and stuck his tongue out as he made the death rattle. There were those who used gas, of course, with their peaceful expressions and delicate cherry cheeks; peaking in May and at Christmas; sleeping pills, of course, mostly women, men preferred harder methods. A hammer drill, for example, straight into the heart. Richard remembered the case: the man, a railwayman with long and honoured service, had turned up in Outpatients the night after his retirement party, with all his medals on and the drill in his chest; like all the others, he’d waited at the duty sister’s desk and, when his turn came, made his request. Or the foreman at the garden centre who for his supper one day ate a bowl of chopped-up dieffenbachia with salad dressing and ended up in Intensive Care the next day with his stomach pumped out. Clarens’s enthusiasm suddenly turned into frustration: he was respected throughout the world – at home, on the other hand … plenty of material, true, but also plenty of obstacles and hurdles. Above all when he wanted to pursue research into the causes. Abruptly he changed the subject. ‘Are you still in contact with Manfred?’
‘For a while now we haven’t seen very much of each other.’
‘He seems to hold something against you. He doesn’t have a good word to say for you. – Oh, this November weather! It makes you quite melancholy. And what use is a melancholy psychiatrist to my patients? And they say there’s going to be a frost.’
Richard didn’t respond. He was thinking about the contradictory nature of his companion: sparse appearance – and robust joviality when he got onto his favourite topic … Clarens had other favourite topics as well, he loved the fine arts, sculpture less than drawing, which he called the ‘chamber music of the visual arts’, he was a regular visitor to some studios, knew Meno’s boss very well, also Nina Schmücke and her circle. A further favourite topic was the history of Dresden, in pursuit of which Clarens, who lived in Blasewitz, would often cross the Blue Miracle on foot to go up on the funicular or cable-car to the Urania meetings or Frau Fiebig’s soirées in Guenon House.
‘Did you get a new geyser?’ he asked, clasping his arms round his body. On their way to the meeting in Administration they still hadn’t been able to see their breath. Electric carts clinked and clattered past, shivering students headed for the canteen.
‘No. I know an engineer who improvised something.’
‘The one you’re tinkering at your vintage car in Lohmen with?’
Richard looked up in surprise. ‘How do you know about that?’
‘I recently went to see Dietzsch and bought a little print. Money well invested, I should think.’ Clarens told him that a kind of second market had grown up among a number of artists. Now gallery owners from the Federal Republic regularly visited the studios, looked at this and that, bought this and that. And had no inhibitions about talking to other ladies and gentlemen who also looked at this and that and, by now, were also buying this and that.
‘What is it Manfred’s saying about me?’
‘Oh, it’s not good, not good. I thought you were friends?’ Clarens breathed in deeply and, as it seemed to Richard, with relish. He refused to say what it was that was ‘not good’. Was he slandering Weniger? What would happen if he grabbed Clarens by the tie and shook him … what would appear? A hideous face, a goblin with features distorted with malice? If only one could see behind the masks, explore the mines inside people.
‘Just sounding brass,’ Richard muttered.
‘And a gold tiepin,’ Clarens murmured, taking Richard by the arm and pointing to the rowans along the road, which were being covered in hoar frost before their very eyes.
‘I found the meeting pretty wearying,’ Clarens said. ‘Difficulties, jealousies, constant psychoses … Leuser’s coprolalia, and the ful
l-timer a blindissimus realitensis totalis.’ The psychiatrist made a dismissive gesture. In such situations he preferred to go to the laundry, he said, there were always some overalls or other to be collected, the steam reminded him of his childhood and the busy little irons were so soothing. God, the suicides, the lunatics, including Party secretaries and other psychiatrists!
Richard went to the wards. Nurse Lieselotte was waiting with the cart for the rounds. ‘Your son’s here.’
‘Christian? What’s happened?’ – The alarm of the trauma surgeon whose thoughts immediately go to broken bones, blunt-force traumas, traffic accidents and injuries from machines.
‘No, it’s only me.’ Robert came out of the nurses’ room with an expression of gentle consideration well beyond his years.
‘Coffee?’ Nurse Lieselotte turned her searching look away from Richard’s face, which was gradually recovering its normal colour; he nodded, still confused, shyly embraced Robert. Patients at the other end of the corridor, in dressing gowns, taking little steps as they pushed stands with infusion bottles, stopped.
‘The nurses say you’re doing your rounds; can I come too? I’ve got a coat.’ On his index finger Robert held up a dissecting-room coat that closed at the back, threadbare from washing; they kept some on the ward for forgetful students.
‘I thought you were at school? Have you no classes?’
‘Finished. Came back on the bus, thought: let’s have a look at what Richard does.’
Like the time when Josta was in hospital in Friedrichstadt and Daniel had called her by her Christian name; it must have become general by now, Richard thought. Oh well. Nurse Lieselotte brought his mug with the coffee, a stethoscope, reflex hammer and protractor for Richard.
There were eight patients in the first ward. As they entered they were hit by the smell of sickness, a smell Richard, since his student days, had inhaled more often than what people call ‘fresh air’; the smell of sickness: that mixture of urine, faeces, pus, blood, medication and serum in the bandages and drain bottles, the smell of cold sweat on unshaved skin (they were in a men’s ward, with the women the smell was more of urine titrated with the sickly sweet, over-camomiled efforts of a cosmetic industry that had the humility of a poor relation), of cognac, a breeding ground for bacteria, medicinal spirit and vinegar (the dusting water in which the student nurses and nursing auxiliaries dipped their cloths to clean bedsteads, strip lights, bedside tables); the smell of PVC, wiped with Wofasept; of something age-old that seemed to incubate in the walls of the wards, in the white, washable oil-based paint with an olive-green stripe chest-high – where the arms are bound during arrests, where the respiratory trees branch, where the heart is. Seven of the eight patients had tried to sit up in their beds and had remained in this stand-to-attention position, as the nurses called it, one hand on the bar of the bed trapeze, rusty steel painted tooth-yellow and sagging under the weight; the eighth patient was in a body cast, his arms and trunk immured in the white suit of armour that had square windows over his wounds to allow drains (perforated plastic tubes as thick as your finger and bent like a shoemaker’s awl) to draw off the secretions from the wounds. His left leg, also in plaster, was held up in the air on the stirrup of a Kirschner wire bored into the ankle bone and pulled down, via a cord and pulley, by iron discs, the white paint of which had completely flaked off. His head, from which a pair of eyes looked with quiet anxiety at the nurse and Richard, was in Crutchfield tongs that, fixed in the skull above his ears, were stretching his cervical vertebrae, also via a pulley and weights. The optician, second bed on the left, immediately repeated his offer of marriage to Nurse Lieselotte, who, he said, would never lack for spectacles; moreover, he went on, it was pointless wasting time and money on the poor guy with the skull-hoops, who, he added with the crude humour of some patients, was going to kick the bucket anyway. His own leg, on the other hand, healed? when? And from Nurse Lieselotte, whose stony looks were clearly the visual equivalent of a thumbs-down, he ordered a sledgehammer so that he could finally smash the eternal brass band music of the sky pilot (second bed on the right, a priest, pale as a fish fillet, who had broken his lower leg while removing two bugs, one from the confessional and the other from the Saviour’s crown of thorns) and the revolutionary hymns of the comrade community policeman (third bed on the right, midfacial fracture, at the moment he was on the bedpan behind a screen; on his bedside table were the two Karls, May and Marx), he couldn’t stand any more of their ideological warfare.
‘Well, young man, fresh out of college?’ First bed on the right, a professor of Slav linguistics, emigrated from the Sudetenland to escape the Nazis, emigrated from the Sudetenland to escape the Czechs. Two lacerated arms laboriously emerged out of the white cover made from guinea pig skins: injuries from sabre-slashes (long-established jealousy between long-established rival sword collectors).
‘My son. He simply came straight from school in Waldbrunn to the ward here, wanted to see what kind of thing I did.’
‘Really proud of him, our doc. Start ’em young, my old man used to say,’ the riverboat engineer in the fourth bed on the right cried, closing a catalogue of toupees and waving two mangled fingers; he was twenty-two and still wore his hair long, even though a considerable part of it had been caught up in the rotor of his engine and a patch of scalp the size of his palm had been torn off. The light went out.
‘Good night.’ Third bed on the left, a forklift truck driver from Kofa, the Dresden canned food factory; craniocerebral trauma after falling, drunk, from the dam of Kaltwasser reservoir. In the ward room the late shift were sitting in the dark, a nurse lit candles; in the light of the flame her face looked calm; the objects in the circle of brightness had an unreal, rapt, Christmassy air about them. Nurse Lieselotte hurried to the end of the ward and unlocked the medicines cupboard, where she kept some torches and replacement batteries. The Intensive Care Unit! Richard thought, but already Kohler had come running in through the door followed by Dreyssiger, beams of light moved over the walls of North I. Dreyssiger cried, ‘The operating theatre, they’re down there, nothing’s working. The heart–lung machine’s stopped.’
The telephone was still working. Richard called the ICU. No one answered. ‘What about the anaesthetists, can they keep the oxygen going?’ he asked Dreyssiger over his shoulder.
‘No.’ Just ‘no’, it was Kohler who had said it in an expressionless, impassive tone. ‘If the emergency generator won’t start up’
‘– if it starts up’
‘– they’ll have to insufflate with a bag valve mask’
‘– why’s it not starting up’
‘Just like in the war,’ said one of the nurses anxiously; it was Gerda, who was almost seventy.
‘Africa.’
‘And what do things look like in the operating theatre?’
‘Like Africa. I just told you.’
‘– it’s just not starting’
‘Bananas, jungle.’
In the ward room it smelt of eucalyptus oil, Kohler had knocked the medicine basket off the table.
‘– more like Russia. Russia, so’
‘Africa.’
‘Oh do shut up.’
‘– or can you hear something? It’s not starting up.’
‘The emergency plan will come into force.’
‘Funny that the telephone’s still working.’
‘Comes via a relay station, low voltage. Everything can be dead all round, they’ll still get a tone,’ Dreyssiger said.
‘Africa. Central Congo.’
‘We must go to the ICU,’ Richard said. ‘Nurse Lieselotte, will you please call in all available staff. Robert, you’re coming with us, we can use anyone who can give a hand now.’
They ran to the Intensive Care Unit. Cones of light blazed up, stamping meal carts, nurses’ legs, distraught faces out of the deep-sea darkness of the clinic, somewhere a bedpan clattered onto the floor. Someone was thumping on the lift door, ghostly footsteps echoed in the s
tairwell. The Medical Academy was a concentrated mass of black stone; there was still light on in Nuclear Medicine, as there was in Administration. Shadowy figures could be seen dashing to and fro. In the ICU a string of torches was hanging over the insufflation beds, candles had been lit. The duty anaesthetist was just switching to pressurized oxygen, the compressor for room-air insufflation, which came out of the walls, had stopped working, as had the monitors over the patients’ heads. ‘An unstable patient, Herr Hoffmann.’
‘Still no current in the emergency generator sockets.’ One of the nurses was transferring cables. ‘What a mess.’
Richard looked at the noradrenaline drip. The patient attached to it seemed peaceful, like a figure in a painting by one of the Old Masters: a scene in a cave. One nurse was constantly measuring his pulse, another his blood pressure. The slightest bit too little or too much and his condition would be up and down like a roller coaster, they had to take countermeasures, that tied staff down.
‘CVP?’ the anaesthetist asked, pressing one of the patient’s fingernails, checking the recapillarization time. One nurse bent down to the venotonometer that measured the central veinous pressure.
‘We could use a man,’ the anaesthetist said. ‘It could take some time until ours get here. Most don’t have a telephone.’
‘What’s it like in the operating theatre, have you heard anything?’ Richard asked.
‘Your boss’s broken off the operation. Insufflation’s continuing manually. One patient in the recovery room – another doctor who can’t get away. And the neurosurgeons want to start on a tumour. Haha.’
Kohler stayed at Intensive Care; Richard, Dreyssiger and Robert went to the A&E. The corridors, also lit by strings of torches, were jam-packed with moaning patients on stretchers; ambulance sirens wailed and died away. No one seemed to be coordinating things, doctors and nurses were rushing to and fro. Porters brought more and more new patients; doors were flung open and slammed shut; exasperated voices from the treatment rooms called for bandages, nurses, drugs. The waiting area by the desk, behind which Nurse Wolfgang was dealing with complaints and demands with a stoical expression on his face, looked like a field hospital. Faintly lit by the candles on the desk, injured people were sitting on the floor, rocking to and fro; a young girl had been laid on a blanket, pale, she endured the lamentations of two older women in silence. Forcefully and with words of comfort, Dreyssiger pushed his way through to the desk. Patients in A&E wheelchairs were either sitting in silence or waving their arms around, most probably with ankle injuries; as he passed Richard glanced at the swollen joints, trying to repress the wave of images, memories of his injuries during the 13 February air raid, the screaming, whimpering wounded who were waiting with him amid detonating bombs, the machine-gun rattle of an isolated Wehrmacht unit, the heat from the burning surgical and paediatric clinics; at that time the Academy had still been called the Gerhard Wagner Hospital, after the Reich doctors’ leader.