‘Have you thought about a place to live?’ she asked.
‘Martin hasn’t told you?’
‘Martin doesn’t tell me anything. I’m his mother.’
‘Well, I found this pretty little place in Zehlendorf, not far from the Wannsee.’ Alma smiled as she cut into a potato. ‘It isn’t for sale just yet, but I’ve spoken to the owners. In the meantime, I suppose we shall have to get an apartment in town.’
‘Martin’s always worked in Berlin,’ his mother said. ‘I can’t see the attraction. From what I read, it seems so dirty and dangerous. What does your father think?’
Alma gave Kirsch an apologetic look. ‘I’m afraid he agrees with you, Frau Kirsch. He’s always saying the city needs a thorough cleaning out.’
‘A doctor has to go where he’s needed, Klara,’ his father said. ‘Not where he happens to enjoy the scenery.’
His mother shrugged. ‘Are there really no mad people in Wittenberg? Or Leipzig? Or is it just their kind of insanity is too dull and provincial?’
Kirsch reached for his wineglass while everyone laughed. His father had unearthed a bottle of Riesling from the cellar, one of a case bought for some putative celebration long ago, and now past its best.
‘There are no posts,’ Kirsch said.
‘What about the university? Couldn’t you teach there?’
Alma put her hand on his forearm. ‘I’ve always thought Martin was a born teacher.’
His mother nodded. ‘He was a wonderful surgeon when he was in the army. I still have a letter from his commanding officer, Colonel Schad. He said Martin was the best man in his unit.’ She turned towards her son. ‘I’ve never understood why you left the profession, Martin. Good surgeons are always in demand.’
Kirsch had never explained to the family the real reasons why he had abandoned conventional medicine. As far as they were concerned, he had simply followed a new interest, the way the Kirsch men always did, with no regard for the financial consequences.
‘He’s his own harshest critic,’ Alma said.
He shook his head. ‘Not at all.’
‘But I’m sure he won’t have to stay at the clinic much longer, unless he wants to, of course.’ Alma made it sound like a prison sentence. ‘He’s becoming quite well known. That paper he wrote, for example –’
‘That’s nothing,’ Kirsch said, because it was nothing, or at least not much. His one and only contribution to psychiatric literature, it had been published in the Annals of Psychiatric Medicine, a new publication with a derisory circulation, printed in Munich.
‘Well, my father said –’
‘Your father read my paper?’
Alma squeezed his arm. ‘Of course he did. He was very impressed. In fact, he said he was going to show it to some people.’
A gratified look passed between his mother and father.
‘What kind of people?’ Kirsch asked.
Alma smiled and shrugged. ‘Medical people, I suppose. His company does make medicines you know, darling.’ She looked down at her plate and began delicately dabbing at her meat. ‘And he supports all kinds of institutions in the medical field.’
Kirsch was about to tell them that he had no intention of leaving the Charité, that Dr Karl Bonhoeffer was arguably the most distinguished psychiatrist in Germany and that there could be few more experienced mentors. But then he thought about the summons he had received for the next morning and the idea lost its appeal.
‘It’s as well Martin has you to look out for him, Alma,’ his mother said. ‘He cares a great deal about his books. But getting on in the world…’
His father made to refill Alma’s glass, but smilingly she covered it with her hand. ‘The funny thing is, when they were boys, it was Max who was the thinker,’ he said. ‘Martin was the practical one. We thought he’d be an engineer or a businessman. He was always taking things apart to see how they worked.’ He chuckled as he poured himself another glass of wine. ‘There are still clocks in this house that tell the time most eccentrically, thanks to Martin’s boyhood interventions. Isn’t that so, Klara?’
But his mother didn’t seem to be listening any more. She was staring down at the lace tablecloth, absently smoothing it out with her fingers. His father grimaced momentarily, as if suddenly aware of having said the wrong thing. For a moment nobody spoke. Then his mother took a sharp breath and glanced up at the ceiling in the direction of Max’s room.
The committee had done its best to make the old school house hospitable. Paraffin lamps burned in the corners. Winter bouquets of willow and jasmine had been placed either side of the door and in the corners of the room. Footlights had been strung along the bottom of the platform so that the musicians’ shadows would play over the wall behind them, where an old imperial flag was on display. But with the ensemble tuning up, most of the seats were still empty.
Kirsch’s mother was distraught. ‘The weather may have held people up,’ she said. ‘Tell them not to start yet.’
She stood by the door, holding the programmes, refusing to come inside. The reward for her persistence was a solitary latecomer who arrived on a bicycle and then left again without paying. When she was finally persuaded to come and sit down, she did not stay, but got up at the end of each piece and went outside again just to see if there were any more people waiting.
The music itself seemed curiously out of place. Most of the performers were slight, bespectacled young men, the kind that usually failed to pass muster for military service on grounds of general delicacy, if not bad eyesight, and their playing had a wistfulness and refinement that evoked nothing of the parade ground, let alone the battlefield. The audience, a mixture of veterans, villagers and local dignitaries, sat motionless on their folding chairs, staring blankly at the proceedings, respectfully aware that such examples of high culture were the ultimate proof of the superiority of German civilisation, but at the same time wishing there could be more in the way of a tune. All things considered, Kirsch thought, a brass band would have suited the occasion better, except perhaps that Max had always hated brass bands and would invariably cover his ears if one marched by.
After the ensemble had taken their bows, everyone stood up and sang the national anthem. Then finally the audience trailed out, visibly relieved to be out of their seats. A collection box had been placed by the door for any further donations to the memorial fund, but having already paid for their tickets, most people seemed to think they had made sacrifices enough.
The pastor, who had breezed in without even attempting to buy a ticket, was the only person who seemed oblivious to the mood of disappointment. ‘A beautiful occasion, Frau Kirsch,’ he said, bounding up afterwards. ‘It should become an annual event.’
‘We had rather hoped one event would be enough,’ his father said. ‘We shall have to think again.’
‘But it was beautiful,’ Alma said. ‘I shall never forget it.’
Kirsch’s mother looked at her in surprise, then smiled gratefully. ‘Then it was all worth it. No matter what else.’
They filed out of the school house and wandered through the village in the gathering dusk. They passed the spot where the memorial was supposed to go, a triangle of grass which, as children, Kirsch and his brother had used as the finishing line for their bicycle races.
Alma took his arm again. ‘How much more money do they need?’ she asked softly.
‘For the memorial? A few hundred Reichsmarks. The problem is, the longer it takes them to raise it, the more they have to raise.’
Alma pulled him a little closer. ‘Tell your mother not to worry. It’s such a good cause. She’ll have the money, I’m quite sure.’
Eleven
Back in his rented room that night, Kirsch pulled the curtains closed. He stripped off his jacket, sweater and shirt, and turned towards the mirror. On his upper arm what had begun as a small bruise had deepened and blackened, the surface skin around the puncture wound turning dry and shiny. The muscle ached, as if a splinter of cold stone
were fixed inside it. What he had feared was true: the subcutaneous tissue was dying. It was a danger with Salvarsan, as with any compound of arsenic. Besides the hours of nausea, the cramps and the vomiting, the injection had to be completely within the walls of the vein. Any fluid leaking into the surrounding tissue would cause necrosis. Then there was the vein itself: Salvarsan could induce blood clots at the site of injection, causing the vessel to swell and become irritated, and creating a risk of infection. Maybe that was the problem. Squinting in the dim electric light, he traced the basilic vein with his fingers, searching for sensitivity, but it was hard to feel anything through the dead weight of pain.
By now most doctors had switched to administering the drug via intravenous drip. Injections were too hazardous. But for Kirsch, going through the normal medical channels presented difficulties. Another doctor might not agree to prescribe the drug, and certainly not on demand. Confidentiality could not be taken for granted either. A medical man undergoing treatment for a serious communicable disease, even if in a latent phase, was fodder for gossip. Word of such things had a habit of leaking out, if not through the physicians themselves, then through their attendant nurses and secretaries. Besides, some in the profession considered it their duty to report infectious cases to the authorities, especially where they thought the risk of spread was significant. Others believed that infected patients should be prohibited from marrying, on pain of exposure, until their serological tests had been negative for several years. All in all, it was simpler and safer to handle things himself, even if that meant buying the powder from unlicensed traders and preparing the injections, likewise the mercury and bismuth ointments that he kept hidden beneath the washbasin, in case any sores or lesions reappeared.
The electric lights were too weak. He lit the paraffin lamp and pulled off the rest of his clothes. In his case, the first sign of infection had appeared during the war, in the form of small circular swellings on the insides of his fingers. They were brownish and hard, somewhere between a nettle rash and a blister, but barely sensitive, and certainly not painful. They had lasted a few weeks and then healed before there was time to worry about them. Several months went by before further symptoms began to appear: fevers, aching joints and an angry red rash under his arms and across his chest. Even then, it did not occur to him that he was under attack from a lethal disease, that the tiny worm-like spirals of Treponema pallidum were coursing through his body, multiplying, clustering and clumping in his glands and his blood vessels, tunnelling into his nervous system and laying siege to his brain.
Hundreds of the men he treated at the field hospital suffered from the same infection, even the Austrian officers who were brought in on special orders from the High Command because they did not trust their own surgeons. Venereal disease accounted for more loss of manpower at the front than any other kind, except, in the winter months, for pneumonia. But the primary and secondary symptoms of syphilis varied from person to person, and were easily confused with other, less serious conditions. In any case, with so many men dying from their wounds, treating diseases that might take twenty years to prove fatal was not a military priority. Even casualties with the distinctive open sores of the secondary stage, moist ulcers that teemed with bacilli, were not usually isolated or handled with special caution. There was not enough time. Kirsch had no way of knowing when exactly the disease had entered his bloodstream, or which patients might have been responsible. Scalpel cuts were common in the operating rooms, and hygiene frequently sacrificed to speed of intervention. But that did not stop him thinking about it. In dreams he even saw the face of the carrier: he was one of those who had survived his turn on the table, only to die later at the front. This Kirsch knew from the uniform he wore and the blood that covered his face.
It was possible he had caught the disease somewhere else, in more conventional circumstances, but the chancres – the medical term, he later realised, for the small brown swellings – were supposed to appear close to the site of infection. That was why most began in the groin or on the genitals. But in his case they had erupted on the soft flesh of his hands.
The secondary stage of the disease brought headaches and fevers. These plagued him in bouts of several days’ duration, then disappeared so that he was able to function normally again. With the fevers came the bad dreams, visions so starkly clear that even afterwards they seemed more real than any memory of waking life. In those dreams, patients whose faces he thought he had forgotten stood waiting for him wherever he went, blood drained, wounds gaping or partially stitched. They watched him work at the operating table; they stared at him from the ends of corridors. By night and at dawn they stood sentinel in the hospital grounds. He had only to wipe the condensation from a window-pane or a shaving mirror to see the face of a dead man. Even when he was awake, he lived in fear of them. He shunned darkened rooms or empty stairwells. He stayed always close to the light, and where possible in company, although his participation in conversation became noticeably sporadic and forced.
Sometimes in his dreams he saw Max. He would stand on the far side of the drainage ditch that ran along the edge of the grounds. In those days he still had a face, though it was always deathly pale. Once, they brought a man in on a stretcher whose legs had been blown clean off, a man Kirsch knew at once could not be saved. And for a moment that was Max too.
His hands started shaking: first at mealtimes, then as he was shaving, razor in hand, then in the operating theatre. The shaking came and went, unpredictably. He couldn’t tell if it was another effect of the disease or simply his nerves, the cause neurological or psychological; but the loss of control scared him even more than the visions, because it was a symptom he couldn’t hide. It was then that he turned to medication, helping himself to the necessary supplies from the hospital stores, and preparing them late at night in the privacy of his room: compounds of potassium, iodine, bismuth, mercury, arsenic.
The worst of the second-stage symptoms faded away a few months after the Armistice. It was possible he had cured himself outright. More likely, he had entered what the manuals called ‘the period of latency’, which could last anywhere from a few weeks to thirty years. One in four patients then experienced the tertiary stage, characterised by disfiguring tumours and lesions, the eating away of internal organs, progressive paralysis, insanity, blindness and death. Treatment during the third stage was the most drastic, and the least likely to succeed.
He had no way of knowing if he was safe or not. At different times, he had tested both positive and negative for the disease. But recently he had begun to grow especially uneasy. A familiar stiffness had returned to his joints. Short bursts of fever came and went, so that at night he would sometimes wake up from his nightmares drenched in sweat. And all around his waist and stomach, faint red-brown smudges had appeared on his skin, each one the size of a large thumbprint.
Standing now in the greenish glow of the paraffin lamp, he traced the pattern of discoloration, twisting this way and that. The smudges were more numerous than the last time, especially on his flanks. They overlapped, darkening and reddening. Some were slightly raised. Only his back and shoulders remained unaffected, though the definition of muscle and bone seemed exaggerated, suggestive of an anatomical model. He was losing weight, subcutaneous fat daily melting away.
Alma had noticed it that evening. She had put her arms around him at the station in Berlin when the time had come to say goodbye.
‘You mustn’t work too hard,’ she had said, a hand running up and down the back of his coat. ‘You mustn’t wear yourself out. Promise me?’
He had promised.
‘You wait until we’re married. I’m going to fatten you up like a prize pig. I’ll make you eat steak and dumplings twice a day.’
And she had kissed him with unusual urgency, holding on to him until the last train for Oranienburg was almost pulling out of the station, as if not sure whether to take it or to miss it and, in so doing, strand herself in the city for the duration of th
e night.
Twelve
Dr Bonhoeffer stood by the window, looking out through the fog at the ivy-clad exterior of the main hospital. This part of the building, the side where his counterparts in conventional medicine had their offices, was south-west facing, and the ivy, which grew thickly, had turned to a coppery gold. Being taller than the clinic, the hospital caught the evening sun, the display stopping passers-by in their tracks. Attempts had been made to soften the martial exterior of the clinic by planting various species of creeper, but the aspect was unfavourable, and the spindly limbs that did get a purchase on the brickwork never managed more than a desultory patina of foliage. Worse, the persistent northerly damp had warped the window frames, so that even with the double-glazing there was always a draft.
‘I wanted to give you advanced warning,’ he said. ‘So that you’d have time to look for another position.’ He frowned at his reflection in the window. He was sixty-four, his tall forehead deeply lined, his always tidy hair a ghostly white. ‘I’m sorry it can’t be longer. But I’ve very little discretion in the matter.’
They were not even giving him a chance to explain himself.
‘Shall we agree on Christmas? That should give you time to make arrangements with respect to your existing patients. Of course, you’d best refrain from treating any new ones.’
Kirsch saw now that he had been naïve. The director had no appetite for formal disciplinary procedures. Such things were embarrassing for all concerned. Furthermore, they would give him an opportunity to fight his corner and to question the judgement of his superiors. Lawyers might even be dragged in. How much easier it was to elicit a resignation, in return for decent references and an unblemished record.
‘I know you’ve heard some unfavourable reports, Herr Director,’ he said. ‘But I would appreciate an opportunity to answer the accusations levelled against me.’
The Einstein Girl Page 8