‘This whole place is conceived and designed to remove as many triggers for distress as possible, Herr Fabel,’ said Pohl. ‘Dementia very often leads to confusion and fear. Any aggression stems from feeling isolated in a frighteningly unrecognizable environment. What we have here in the Alte Mühle is a bubble. At one time it was considered best clinical practice to force patients to engage with reality, with the here-and-now. But all that does is confuse and upset them. What we try to do here is to offer as natural and independent a life as we can. All of the shops and cafés you see here are run by members of the care staff, all of whom wear ordinary, day-to-day clothes. Patients go shopping, meet each other for coffee, have their hair done, have meals out. If, in his or her mind, a patient is unaware what decade it is, or if they believe they are somewhere other than the Alte Mühle, then we let them alone . . . so long as they’re happy that is. If their memories or confusion causes them distress, then of course we intervene.’
‘That’s all well and good,’ said Anna. ‘But what about when they start sticking knives in each other?’
‘We don’t accommodate aggressive or violent patients. We’re not geared up for that and never have been. Should a patient become aggressive towards staff or other residents, then, regretfully, we have to pass them on to a facility better equipped to deal with them.’ Pohl shook his head sadly. ‘But there was never any question of that with Herr Schmidt – he has always been an unfailingly pleasant and courteous resident. I can assure you, this has come as a complete shock to us all.’
25
‘Take these things off.’ Heiko Goedecke invested his tone with as much authority as he could muster. The young emergency physician in the Asklepios Klinik Nord often found it necessary to invest his tone with authority: he was small, slender and had a thick mop of dark hair that made him look a decade younger than his thirty-two years. This time, however, his decisive tone was as much to convince himself as anything: the truth was, unconscious and near to death as his patient was, Goedecke was tempted to leave the handcuffs in place.
He looked down at the unmoving figure on the trolley, its ankles and shoeless feet jutting out over the end. As a physician, Goedecke knew what he was looking at: a severe case of acromegaly and gigantism, probably the result of a pituitary gland tumour or disorder. The outward appearance had nothing to do, he told himself, with the character within. Except this character had been brought in handcuffed and heavily guarded.
But as a normal creature of instinct and despite his professional assessment, Goedecke felt he was in the presence of a monster, something less, or more, than human. The features on the huge, stone-hewn face were oversized, heavy and coarse; the brow was massive, the heavy supraorbital ridge like an overhang above the closed, small, sunken eyes. The jaw was huge too, as were the sharp, angled planes of his cheekbones. The oxygen mask sat unevenly on the bulky features, gaps all around it, as if someone had tried to force a child’s mask onto an adult face. It felt to Goedecke like he was looking at a living palaeontological specimen – some monstrous predecessor who had no place among modern men. He turned and saw his nurse also staring down at their patient, equal disquiet clear in her expression.
‘Take these off,’ he repeated. ‘Now.’
‘This is a very dangerous man,’ said the prison officer. Two had come in the ambulance and the other now stood guard at the door. ‘He’s handcuffed for good reason.’
‘This man is dying or close to it. He is no danger to anyone. I need to examine his chest without hindrance. If you don’t take the handcuffs off immediately and my patient dies because I can’t work on him, I will officially name you as a contributory factor in his death.’
The prison officer sighed, came over to the trolley and unfastened the handcuffs.
‘Thank you,’ said the young doctor. ‘A suspected heart attack, you say?’
The officer nodded. ‘About six this morning. He complained about not being able to breathe, and pains in his chest and arms. He was still conscious when we got to him but then he collapsed.’
The doctor and the nurse wired their patient to the monitors and the doctor listened for a heartbeat.
‘This doesn’t look like a heart attack to me. Although he’s enormously hypertensive and there’s serious arrhythmia and bradycardia.’
The prison officer shrugged.
‘It means his blood pressure is through the roof and his heart rate is incredibly slow and irregular. He’s going to go into arrest if we don’t give him the right treatment right away.’ Goedecke frowned. It was all consistent with the acromegaly: arrhythmia and cardiac failure were a common cause of death with sufferers; but Goedecke’s instincts as a doctor told him something didn’t quite fit. ‘Is there any way your prisoner could have had access to drugs like ketamine or xylazine?’
‘Not that I know of,’ said the prison officer. ‘It’s always possible, of course, but he’s in high security and his cell is turned over regularly.’ He nodded towards the prone giant on the trolley. ‘As soon as he starts to come to, we get the cuffs back on. Like I said, this is one very dangerous character.’
‘If he comes to, which is doubtful.’ The young emergency doctor turned to the nurse and had just started to give instructions when the alarm on the heart monitor started to sound.
‘He’s going V-fib . . .’ The doctor started compressions, his flattened hands child-small and slim on the huge barrel of Frankenstein’s chest. He frowned as he watched the fluttering trace of ventricular fibrillation on the monitor. His giant patient was within seconds of going asystole. And once he flatlined, there would be no getting him back. ‘Take over compressions . . .’
The nurse pushed down on the chest while the doctor charged the defibrillator. He set the charge to 200 joules.
‘I’m going to shock him, but I want you to keep compressions going between. If we don’t get him started on the second jolt, I want you to prepare three hundred milligrams of amiodarone and adrenalin. Clear!’
The nurse stood back. ‘Clear.’
The vast body barely twitched from the jolt of electricity. A spike on the monitor, a moment of normal sinus rhythm, then back to V-fib. Goedecke was losing him. He increased the level to 350 joules and held the paddles out from his body, waiting for the recharge whine to change to the ready signal.
‘Is he dead?’
Goedecke ignored the prison officer. ‘Clear.’
When the nurse acknowledged and stood back he reapplied the paddles to the huge chest. This time there was more movement as the electricity pulsed through the body. The stone-hewn face remained motionless. Goedecke experienced a moment of inappropriate black humour as he thought of the irony of a physician trying to bring a monster like this to life with jolts of electricity. Perhaps there was already an angry mob of torch-wielding villagers surrounding the hospital.
When he checked the monitor, he saw a moment of heart rate turbulence, then, after what seemed an age, the restoration of normal sinus rhythm. He told the nurse to set up an intravenous drip to start delivery of 500 milligrams of adrenalin as well as getting some beta-blockers into the patient’s system.
After a while of watching the monitor, Goedecke turned to the prison officer. ‘Once he’s stabilized, we’ll move him to intensive care. He’s not out of the woods yet. Far from it.’
‘When will he be able to be moved back to the prison hospital wing?’
‘Not for a while.’ Goedecke went over to the emergency room’s wall phone and called the intensive care unit.
*
There had been dreams. Such strange, dark, frightening, happy, wonderful dreams. He knew instinctively that he had been standing on the threshold that separated the living from the dead. He had turned back from that and now he stood on a second threshold, the one between light and dark, between the dreaming and the awake world. But for a moment he hung there.
From somewhere above and distant, he watched himself. He saw himself as he had been as a boy: quiet, gentle, c
lever. He watched his twelve-year-old self, standing shirtless and patient, while his mother talked to the old doctor. He had always thought of him as the old doctor, his memory preserving the perspective of a twelve-year-old, but seeing him now, he realized the specialist could only have been in his early fifties. Jochen remembered this visit. He recognized the room. It had been back when he had still been normal, just. Before Jochen Hübner had become Frankenstein.
But the signs had already started.
At the time, Jochen hadn’t known why his mother had taken him to the doctor, a specialist in Barmbek, but he had guessed it was something to do with the way he had started to grow faster than the other boys. And he had noticed other changes. His voice had become deeper. Too deep. And his hands and feet had hurt him. They too had started to become too big, too quickly. He had been a clever boy, full of academic promise, but all young Jochen had wanted was to be a footballer, to maybe play for Sankt Pauli one day. But the school coach had told him that, while Jochen was clearly highly skilled, he simply lacked the on-pitch aggression of a winner. And anyway, he had started to become clumsy of late. Uncoordinated.
He watched himself, the doctor, his mother. He knew he had something important to do in the awake world but, for the moment, he was content to watch as the doctor measured his younger self’s hands, his feet; the length of his legs. He knew he was watching ghosts: his mother had been dead for a long time and the doctor longer still. But it was nice to see his mother again. To hear her voice.
And it was nice to see himself not a monster.
The dream was gone. There was a light above him, white, hard and sharp. And with it came pain. In his chest, in his arms, in his head.
He felt dizzy and sick and his heart started to race. Something beeped in harmony with his heartbeat.
‘They will inject you with epinephrine – adrenalin,’ his guardian had told him. ‘To regulate your heart rate. It will also help you wake quickly and will make you stronger. You will feel a rush. That is when you have to wake. That’s when you have to escape. It all hangs on that.’
*
Goedecke waited on the phone until he was connected to the admissions office. He arranged for Hübner to be admitted to ICU and for two orderlies to come and assist with the transfer.
‘I want to get the handcuffs back on him,’ said the prison officer.
Goedecke shook his head. ‘There’s too much risk of him hurting himself. But we can use medical restraints that will do the same job without risk of injury.’ He turned to the nurse. ‘Can you dig up some secure restraints?’
When the nurse left the room, the prison officer moved closer to Goedecke.
‘There’s something you should know about your patient. Something that should go on his notes. He is a danger to women – well, he’s a danger to everyone, extremely and unpredictably violent. But the thing you have to be aware of is that he is very specifically a danger to women. An extreme danger. If he’s going to spend any time in the hospital we’ll need to notify the Polizei Hamburg. I’m sure they’ll want to put an armed guard on him to support the JVA prison officers.’
‘What did he do?’
‘You don’t want to know the details, but his victims will never get over what was done to them. Trust me, he looks like a monster for whatever medical reasons, but the fact is he doesn’t just look like a monster, he is a monster. What’s behind the appearance is much worse. We need him to be as secure as possible. In the meantime, we’ll go through to intensive care with him. I’ll go and tell my colleague.’
The prison officer went out into the hall.
Goedecke, suddenly alone with his unconscious patient, felt distinctly uneasy. He checked the monitor again. Heart rate normal. No arrhythmia. He frowned again. It was too good, too swift a recovery.
Goedecke leaned over to examine his patient, peeling back an eyelid to check pupil dilation.
Both eyes opened.
The young doctor found himself looking directly into the small, black eyes of his patient, glittering cold under the beetling brow. He turned to call the prison guard who was still out in the hall. Or at least he thought about turning to call the prison guard – the body on the trolley moved so fast that he caught Goedecke between decision and commission. Frankenstein’s arm shot out and up like a loosed harpoon, the vast hand fastening itself around his neck. The young doctor tried desperately to scream, to shout for help, but no sound came from the squeezed-shut throat.
Frankenstein swung his legs off the trolley and sat up, his hand still clamped around the boy doctor’s throat. First casting a look to the double doorway, he leaned the mass of his face into Goedecke’s, his small dark eyes locked on the young man’s.
‘This is your decision,’ he hissed, his voice quiet but still resonant. ‘This could be your time – the place and the time you die. Is that what you want?’
Goedecke tried to shake his head but could only manage tiny movements. His eyes pleaded for his life.
‘If you make a sound,’ said Frankenstein, ‘then I will snap your neck. I either leave here free, or everyone dies. Everyone.’
He let go of Goedecke’s neck. The young man backed away until he came to rest against the hip-high wall unit in the corner of the emergency room.
‘Is there another way out of here?’ Frankenstein asked, tearing off the monitor pads from his chest and the IV drip from his arm.
Goedecke shook his head, his eyes filled with the terror that the wrong answer would cost him his life.
‘Stay.’ Frankenstein pointed a huge finger. He was still wearing his sweatpants and he grabbed the white plastic bag that hung at the bottom of the trolley. He took out his T-shirt and sweatshirt, but both had been cut through to get them off his unconscious body. He scanned the room: there would be nothing he could steal that would fit him. He saw some blue surgical scrubs hanging by the door. He grabbed the top and pulled it over his head, but, even though it was sized extra-large and was meant to be a baggy fit, he couldn’t wriggle into it.
He would have to go bare-chested. Frankenstein was not the kind of figure to go unnoticed at the best of times, but stripped to the waist he would draw the attention of anyone who so much as glanced at him. He needed to get out as quickly as possible. His guardian had predicted that he’d be taken to the emergency department of the Klinik Nord. Three, maybe four doors and he would be outside the hospital. A 100 metre sprint and he’d be out onto Tangstedter Landstrasse. He just hoped that his guardian would be there, waiting, like he’d promised.
But there were still the JVA prison guards. And one would be back in the room at any moment.
Frankenstein turned back to Goedecke, who still cowered in the corner.
‘I’m going now,’ he said. ‘I may kill people to get away. If I find out that you raised the alarm after I left, I’ll hunt you down and kill you slowly. You understand?’
The shaking Goedecke nodded dumbly, nursing his bruised throat.
Frankenstein looked around the emergency room for something, anything, he could use as a weapon. He went over to a metal tray that sat on the unit by the window. The scalpels looked ridiculously small in his huge hands.
The door swung open. Frankenstein lunged forward, expecting it to be the prison officer, but it was the nurse returning. She was tall and blonde, about thirty, her pale blue eyes wide with terror as she stared at Frankenstein. She had padded leather restraints in her hands but let them fall.
He didn’t check his momentum but closed the gap before the nurse could scream. The fear. The sweet fear in her eyes. He grabbed her, looping an arm around the small of her back and pulling her into him, his other hand clamping her mouth. He stared into her eyes, now glossed with tears and terror. He held her for a moment, savouring her fear, feeling himself grow hard against her. She felt him and the terror in her eyes deepened. He laughed.
He pushed her away and held her at arm’s length, his hand still clamped over her mouth. There would be time enough for that. Time
enough for them all, later. He raised his other fist, drawing it back. She would go out like a light, but she’d be haunted by this moment, maybe for the rest of her life. It would be a memory he could leave her with. Frankenstein paused, his fist poised ready to smash into the young woman’s face. He turned to Goedecke and smiled.
There was shouting.
Frankenstein turned to see two shaven-headed men in JVA prison officer uniforms. One could only have been about 175 centimetres tall, the other 190, but both were solidly built. The first officer through the door was the smaller of the two and Frankenstein threw the nurse at him as if she had been a doll. Without rushing, he walked forward, shoved the nurse to one side and grabbed the prison officer’s head, holding it between his hands. The officer screamed as Frankenstein stabbed his thumbs deep into his eyes before slamming the back of his head against the wall. The second officer was on him now, trying to prise him away from his colleague. Frankenstein let the first officer drop and slammed his elbow into the mouth of the second. He felt the grinding of teeth breaking and the wetness of blood on his elbow and he spun around to seize the prison officer by the throat, pinioning him against the wall and slamming his free fist over and over into the blood-smeared face.
Now. He had to move now.
Frankenstein reckoned that neither officer was capable of giving chase, and the doctor and nurse were frozen by their terror, so he made his break. He rushed out into the corridor, which was luckily empty of people, and started towards the main hallway that led to the exit. As soon as he appeared in the hallway, a dozen heads turned in his direction. He ignored them and bustled towards the exit, knocking over two people.
A cop.
Frankenstein saw the blue uniform with the red and white Hamburger Tor shield on the upper arm. He avoided eye contact but could see the officer get up as he approached.
The Ghosts of Altona Page 12