A Fight in Silence

by Melanie Metzenthin

  Yours, etc.

  Dr Richard Hellmer and Dr Paula Hellmer (née Engelhardt)

  The two membership cards were torn in half.

  ‘I apologise for flying off the handle like that,’ said Richard rather meekly after he had read the letter.

  ‘Don’t worry about it,’ said Paula, putting her arms around his neck. ‘I just reminded myself that expectant fathers can be moody too.’

  He managed a laugh. ‘You’re a cheeky one today!’

  ‘I’m allowed to be. In fact, it’s the basic right of all pregnant women to be cheeky.’ But she became serious again as she told him about her phone call with Leonie. ‘Do you think they’re deliberately filtering out Jews?’ she asked him.

  ‘Yes, that’s exactly what I think. I just wonder where it’s all going to end. I’m dreading the elections in the summer.’

  ‘Do you really think it could get any worse? Surely we’ve hit rock bottom and will start to see signs of new hope and peace to warm people’s hearts. I’d like our baby to be born into a world at peace.’

  ‘We’ll do that for him, whatever else is going on,’ Richard promised her. And Paula knew he meant it.

  Chapter 19

  Richard’s new position meant his work as consultant shifted into a new direction. Of course, he continued to be devoted to his patients and always tried to establish a rapport with even the most obstinate of individuals, but most of his time was now taken up with the preparation of expert statements.

  This was usually related to the continuity of invalidity pension payments. Wartime veterans whose mental health had been damaged as a result of their experiences in combat had to demonstrate at regular intervals that they still fulfilled the conditions for receipt of their pension. During the course of this work, Richard had noticed how a new system of patient appraisal was gradually coming into use among psychiatrists, a system based on the beliefs of Professor Alfred Hoche of Freiburg. Very few expert witnesses dared ever to contradict the famous and respected academic, something which infuriated Richard, particularly as each time he heard the name he couldn’t help thinking of ‘approving the destruction of life unworthy of life’. In Hoche’s opinion, a war pension should be granted only to those whose mental illness could be directly related to a brain injury suffered in the war. All other psychological illnesses were not seen by the Freiburg professor as causally related to wartime trauma; rather, they were caused by a weak psychological disposition and any connection to military experience in the field was purely coincidental. In evidence he cited many men who had withstood similar experiences without lasting damage. Therefore, he stated, due to their inferior constitution, they could not be equated with true disabled war veterans and had no entitlement to the state services provided for those other veterans.

  Each time Richard found this argument in an expert statement, he would channel his professional passion into the most skilful counterargument he could muster. It wasn’t long before he had earned a reputation for developing hard-nosed, caustic points of opposition that were used in many controversial cases.

  One day in June 1932 he found himself working on the case of one of their long-term patients who had lived for many years in one of the open houses and was able to carry out simple jobs on the land. The man had literally been buried alive in the trenches after a grenade went off and was the only one of his group to survive. He had endured hours buried among his comrades’ shredded remains before he was found. While buried he had developed some of the symptoms of schizophrenia, hearing the voices of God and the Devil and believing himself chosen by a higher power for special deeds.

  At first people blamed it on the shock, but his behaviour became increasingly erratic and he was eventually diagnosed as schizophrenic. Sometimes he lost all control and thought he was being buried alive again and needed to escape. At these times he would start screaming and was prone to attack anyone who stood in his way. The tragedy was that the man had a wife and two daughters. At the time of his experience in the trenches, the younger child had been a babe in arms and the elder one had just turned three. Given the severity of her husband’s illness and the demands of her young family, his wife had struggled to cope and her only possible course of action had been to have him admitted to special residential accommodation. His health meant that he could no longer provide for his family, so the invalidity pension was their sole source of income. But now a notification had come from his pension office claiming that a new appraisal of his case based on the examination of records had shown there was no connection between his mental illness and his traumatic wartime experiences. Not only were his pension payments to be stopped but the six months’ already received had to be repaid.

  When the man’s wife, weeping and in despair, had appeared in Richard’s office, he had promised her he would do everything in his power to help with her claim.

  He was working on his statement, pondering his choice of words for his final assessment, when his telephone rang.

  ‘Hellmer here.’

  ‘And here!’ It was Paula’s voice. ‘I just had to phone you. Have you got a minute?’

  ‘Of course. But what’s up?’

  ‘I went to Dr Torgau this morning, and he said there’s no doubt.’ She paused for dramatic effect. ‘We’re having twins. He could feel two little heads!’

  Richard took a sharp intake of breath. ‘Twins? Are you serious?’

  ‘I am! I wouldn’t joke about something like this.’ She gave a laugh of delight. ‘Now we’ve just got to wait and see if they get in the right position for the birth, but Dr Torgau is confident that everything will be all right.’

  ‘What if they don’t turn?’ As soon as he’d asked the question, he kicked himself, because he didn’t want to worry Paula. But the very word ‘twins’ reminded him of all the stories of difficult births and risks to the mother. Of infants dismembered inside their mother, of emergency Caesareans and complications ending in death . . . he tried to shake off all such thoughts, but the images persisted.

  ‘Of course they’ll turn properly!’ said Paula happily, her buoyant mood clear from her voice. She didn’t seem worried at all, although she also seemed to have read his thoughts. ‘And if they don’t, we can rely on Finkenau. After all, they’ve got a modern operating theatre, and a Caesarean using a Pfannenstiel incision carries no greater risk than a spontaneous delivery.’

  ‘I don’t know whether to be happy or concerned,’ Richard admitted. ‘A Caesarean always carries a risk.’

  ‘Complication rates at Finkenau are below five per cent at the moment.’

  ‘Did you know all that before, or have you just asked today?’

  ‘I did a lot of research on this for my doctorate because post-partum infection rates were significantly lower for mothers who’d had a Caesarean. I was even present in the operating theatre when twins were delivered by section. Richard, it’s straightforward. The babies came into the world in about fifteen minutes. What took the time was the stitching afterwards – the uterus, abdominal fascia and the skin. That took the doctors around half an hour. So if you include setting up and giving the anaesthetic, you can assume one hour at most for a Caesarean. And since people have opted for the Pfannenstiel method, the mother is not left with a huge scar. I was very impressed when I saw this young mother’s scar after seven days. Only a thin red line, almost hidden by the fold in her belly.’

  ‘I see.’

  ‘Come on, you should be celebrating our efficient family planning. Why have two pregnancies with double the risk when you can achieve the same outcome in nine months?’ She laughed that carefree, happy laugh again.

  ‘I don’t know what to say,’ he confessed.

  ‘That’s unusual for you! Please don’t worry, Richard. It’ll be all right, I promise.’

  ‘Yes.’

  ‘You don’t sound convinced. Listen, I’ve bought cinema tickets to celebrate. They’re showing No Money Needed at the Capitol. Heinz Rühmann and Hans Moser. It starts at eig
ht. Make sure you’re home in time.’

  ‘Whatever my lady says!’

  ‘I can’t wait to see you.’

  ‘Same here.’

  Once he’d hung up, it took him a while to concentrate on his work again. Paula’s confidence helped him banish the horrific images of complications during the birth, and he resolved to look forward to the twins with the same unreserved joy he’d sensed in her. Then he turned his attention to the expert-opinion statement once more, as the words for the final assessment had now come to him:

  Even if another influence on the patient’s mental health condition cannot be fully ruled out, the effects of wartime damage presented in this case are irrefutable. As a result of a grenade attack, the patient was buried alive amid the largely mutilated corpses of his fellow soldiers and had to wait hours for help while oxygen levels ran increasingly low. In addition to suffering severe physical injury, he also suffered psychological damage of at least equal severity, for he remained in fear of his life over a number of hours with no possibility of being able to save himself. To equate this individual’s state of mortal fear with the more customary mortal fear experienced by men in the trenches, in the way the first expert statement has done, is inadmissible because fighting soldiers in the trenches retain at least the prospect of self-defence and control over their actions, whereas a man buried alive is robbed of all bodily and mental means of defending himself and is restricted in all possible movement. The man who is buried alive has nothing left but to struggle for every breath until rescue arrives, and has not even the smallest possibility of taking control of his situation in the way that soldiers in a trench are still able to do. Further demonstration of the inappropriacy of comparing the two situations is the fact that the patient had previously been deployed to the Front for a period of eighteen months without any lasting change in his mental state. Compare this with cases of wartime neuroses, where patients struggle with significant symptoms even without the trauma of ‘live burial’, and, in the case of this patient, this speaks of a particularly strong mental constitution. It can therefore be deduced without a doubt that it is uniquely and specifically the experience of being buried alive, something which goes far beyond what any human being can endure, that became an essential influence in the onset of the illness. Even under the purely hypothetical admission that there could have been a hereditary disposition to schizophrenia, the onset of illness lies in direct correlation with the trauma of being buried alive. It remains a matter of speculation as to whether the onset of illness would have come about if the patient had not experienced trauma of this type.

  Six weeks later he heard that the pension office had accepted the argument presented in the expert statement and would continue to pay the invalidity pension.

  Chapter 20

  During the night of 8 August 1932, Paula went into labour. When Richard drove her to Finkenau the waters had already broken and the first baby’s head was pressing down hard in her pelvis. The cervix, however, had dilated very little and took the whole day to open further. Richard waited in vain at his desk for the call to say he was now a father. Kurt Hansen tried to distract him, but all Richard could think about were the possible complications. He knew this was because he felt so out of control and helpless and tried to take his mind off his worries, but neither patient care nor paperwork helped.

  At five he packed up and drove over to Finkenau. He arrived around half past and heard that his wife was still in the delivery room. The nurse he spoke to was brisk in response to his questions. ‘It’s all taking its course. Honestly, you men are always so impatient!’

  ‘It depends on what you think is impatient. My wife’s been here for eighteen hours already.’

  ‘Yes, and that’s how it is with twins: they need time. Now go and have a coffee or a walk and let us get on with our work.’

  ‘And how’s my wife?’

  ‘Well, what do you think? Having a baby’s no fun. You certainly ask some stupid questions.’ And she walked off.

  For a while Richard wandered up and down the empty corridor, but nobody brought him any information on Paula’s progress. In the foyer there was a public telephone, and not knowing what else to do, he called Fritz.

  ‘Shall I come over and keep you company?’

  ‘Would you really?’

  ‘Of course – what do you think? Now calm down and tell yourself everything’s OK, because if anything was wrong with Paula or the babies, they’d have told you by now. They certainly called me about Doro, even though I was in the operating theatre at the time.’

  ‘Paula called you,’ Richard remembered.

  ‘Yes, because she happened to be there. I’m sure that Brandes would have phoned me himself otherwise. Even if it was just because he wanted a nice specimen for his collection.’

  That sent a shiver through Richard. He usually admired Fritz for the way he’d started to talk openly about his son but today it stirred up his worries.

  ‘I’ll wait for you in the foyer. Thank you for offering to come.’

  Another twenty minutes passed with still no news and nobody bothering to acknowledge his presence. Finally, Fritz appeared, carrying a briefcase.

  ‘Brought some provisions,’ he said, winking at Richard. ‘If this lot are ignoring you, then we don’t need to worry about our behaviour either.’ He produced two bottles of beer from his briefcase and handed one to Richard.

  ‘So we’re just going to sit here and drink beer out of the bottle?’

  ‘If it bothers you that much, I’ll see if I can get some glasses. We wouldn’t want to lower our standards!’

  In spite of his anxiety, Richard couldn’t help but laugh when Fritz really did come back with a water glass for each of them. They sat down together on the huge wooden bench in the foyer and Fritz poured each of them a beer. As they were about to chink glasses, the grumpy nurse reappeared.

  ‘Typical man. Your wife is having the most difficult time of her life and you sit here drinking beer. This is a hospital!’

  ‘See? Works every time,’ said Fritz. ‘A drop of alcohol anywhere in a hospital and a raging nurse comes running. Pleased to see you. Sister Mathilde, it’s a long time since we last stood at the same operating table.’

  ‘Dr Ellerweg! I might have guessed.’ She put her hands on her hips, but instead of the torrent of anger that Richard was expecting, she laughed and Fritz joined in.

  Richard looked from one to the other in some confusion.

  ‘Sister Mathilde and I are old acquaintances,’ Fritz explained. ‘If I said we were old friends, she’d bite my head off for being disrespectful.’

  ‘Not just for that either.’ Sister Mathilde wagged her finger at Fritz in mock anger. It was obvious she liked Fritz.

  ‘And how’s my wife?’

  ‘Come on, Sister Mathilde, spit it out. You can see my friend’s practically dying with worry here and I can only keep him alive with liquid refreshment for so long.’ Fritz pointed at Richard’s glass.

  ‘I’ve come to tell you that everything is all right. Congratulations, Dr Hellmer, you have two healthy babies – a girl and a boy. And as you might expect, your daughter was a very good girl and arrived quickly, but your rascal of a son took his time and had to be delivered by forceps. Just typical of a man.’

  ‘And my wife?’

  ‘She’s done very well. At the moment she’s still in the delivery room as she needed stitching afterwards. But I can show you the babies through the window of the newborn ward. Provided you leave the beer here!’

  ‘Can’t throw it away!’ said Fritz. ‘To your twins!’ They chinked glasses this time and drained them.

  ‘Men!’ Sister Mathilde shook her head as she turned to lead the way to the ward, but there was rather more warmth in her voice now that Fritz was here.

  ‘She’s OK, really,’ whispered Fritz. ‘Bark’s worse than her bite. She was our theatre sister up to about a year ago and I always really liked working with her, but when she didn’t get the
promotion she wanted, she moved here to Finkenau and I was sorry to see her go.’

  At last they arrived at the ward and Richard could see his children, even though there was a pane of glass between them to protect the newborns from visitors’ germs. His daughter was bigger, her bright blue eyes already taking in everything, her head covered in downy fair hair. His son looked more delicate and had Richard’s dark hair. The mark of the forceps still showed on his temples and, unlike his sister, he blinked only once, as if tired, then fell asleep in the arms of his nurse.

  ‘Congratulations again on two little smashers!’ Fritz said, clapping Richard warmly on the shoulder. ‘The little lad looks a bit battered but that’ll sort itself out.’

  ‘I know.’ As he gazed at his two healthy offspring, Richard’s worries started to melt away and slowly, very slowly, a tremendous joy grew in his heart.

  ‘Have you thought about names?’

  ‘What do you think? We’d chosen a boy’s name as well as a girl’s back when we didn’t know it was to be twins. Paula wanted Emilia for a girl and Georg for a boy, after my dear departed brother.’

  ‘And what if it had been two boys or two girls? Would it have been Georg and Emil, or Emilia and Georgina?’ Fritz grinned and got a playful dig from Richard.

  ‘We’ve got exactly what we need for these two.’ As he stood there with Fritz, he felt almost dizzy with happiness. He wanted to shout for joy.

  ‘What shall we do now? Another beer?’

  ‘I want to see Paula first.’

  Fritz glanced up at the clock. ‘It’s getting on for eight. I don’t think they’ll allow visits now.’

  ‘Then see if you can charm Sister Mathilde again. I’m not leaving till I’ve seen Paula.’

  Fritz’s sweet talk did the trick and the new father was permitted a short visit to his wife.

  ‘I’m so proud of you,’ said Richard. ‘And I couldn’t even grab you a bunch of flowers on the way.’