The Einstein Girl

by Philip Sington

  ‘Accusations?’

  ‘I believe that is my right.’

  Bonhoeffer sighed. ‘The issue is not one of accusations, Dr Kirsch. The issue is one of suitability, and the wider need to effect reductions in our budget.’

  ‘But the incident with Nurse Ritter … Dr Mehring’s experiment –’

  ‘All of that could be – can be overlooked.’

  ‘If I resign.’

  ‘If you seek a position elsewhere, giving your notice at the appropriate time. If you do that, there will be no need to examine the matter further.’ Bonhoeffer sat down at his desk, spreading his hands across the unruly mass of paperwork. ‘Frankly, I wonder at you wanting to waste your talents on a profession you no longer believe in. I read your paper. It’s practically a letter of resignation in itself. I should have realised sooner, but I’d no idea you would seek to put your ideas into practice.’

  Some last-minute cuts by the editor of the Annals of Psychiatric Medicine had left the language of his paper starker and more uncompromising than Kirsch had intended, but the central proposition was unchanged: that the classification of psychiatric illnesses was unscientific. The nineteenth-century pioneers of the discipline had set out to create a mirror of general medicine. They had adopted its assumptions and its methods. They held it as axiomatic that there was a clear dividing line between the psychologically ill and the psychologically healthy; that there was a finite number of distinct mental illnesses, and that these would be identifiable through a rigorous delineation of symptoms. They also assumed that the causes of these illnesses would turn out to be biological, and therefore treatable only through medication or surgery.

  It was for this reason that the early decades of modern psychiatry had been spent painstakingly breaking down, categorising and labelling the behaviour of mental patients. The modern panoply of psychoses sprang from these efforts: schizophrenia, schizotaxia, paranoia, hypomania, personality disorder, mood disorder, neurotic depression, psychotic depression, involutional depression – with every year more types and sub-types being added until they could be counted by the dozen. When a patient’s behaviour did not fit neatly into an existing category, the usual response was simply to propose a new one: a paranoid sub-type of depression, perhaps, or a depressive sub-type of paranoia.

  It all seemed as rational as clockwork, but it didn’t fit the facts. In Kirsch’s experience, definitions of the most frequently identified psychoses varied from place to place and from time to time. To the great Emil Kraepelin schizophrenia or dementia praecox was a disease afflicting the intellect, the ability to reason; to the leading Swiss psychiatrist Eugen Bleuler, its sphere was cognitive and emotional; whereas to Kurt Schneider, a contemporary whose work was widely admired, it was a disorder inducing hallucinations and delusions – an imagination running wild. Kirsch had noticed these differences even as a student. As a practitioner, he often came across equally striking inconsistencies in his patients’ psychiatric histories.

  This was what his paper was about. Kirsch had identified fifty patients in Berlin institutions who had been diagnosed more than once by different psychiatrists. He had successfully tracked down their records in all but seven cases. Just as he had come to expect, the diagnoses were often at odds with each other, even where the most reputable practitioners were involved. As far as he was concerned, the inescapable conclusion was that the edifice of modern psychiatry was built on sand. How could different diseases be identified if practitioners could not agree on the symptoms? And if individual diseases could not be identified, what hope was there of developing individual remedies? Perhaps the mechanism of the mind was not, after all, like the mechanism of the body, something that could be broken down, function by function, organ by organ. Perhaps aberrant behaviour – itself a concept that resisted precise definition – should not be seen as a symptom of something else, part of a code that only the expert practitioner could decipher. Given the complexities, it seemed to Kirsch that the most reliable guide to the mental landscape of a patient was the patient himself. He was better placed to explain his behaviour and his experiences than anyone else. Yet wherever Kirsch went, the patient was the very last person anyone thought to consult. Because, of course, the patient was insane.

  These more constructive suggestions had been cut from the published article. For some reason, the editor had only found room for Kirsch’s critique of existing psychiatric methodology. At the time he had not objected, since it was only his critique that was supported by evidence. But now, he was aware of how exposed it had left him.

  ‘It is one thing to take issue with a colleague’s approach,’ Bonhoeffer said. ‘It is quite another to systematically disrupt his work.’

  ‘There was nothing systematic about my intervention, Herr Director. I had reason to believe Sergeant Stoehr’s life was in danger.’

  ‘Dr Mehring says you were mistaken in that assumption. And I’m inclined to believe him, given that he is familiar with the procedure and you are not.’

  ‘I’ve read what there is on insulin coma therapy. I have data from the Lichterfelde Sanatorium showing unequivocally how dangerous it is.’

  Bonhoeffer pushed back from his desk. ‘Why would you bother to study a procedure that you consider a waste of time?’

  ‘Because it was being used on one of my patients, to his detriment.’

  ‘Or his benefit. Surely it’s too early to say, isn’t it? Or have you entirely dismissed the possibility that you might be wrong?’

  Bonhoeffer’s sarcasm was like something uttered under the shadow of pain. Kirsch tried not to look flustered.

  ‘I don’t doubt that the treatment will make Sergeant Stoehr more pliable. It’s done that already. But I see no evidence that this amounts to an improvement in his mental health, or that it’s to his benefit in any other way.’

  ‘You seem to forget why Patient Stoehr was brought here. He was plainly a threat to those around him. If Dr Mehring’s treatment reduces this threat, surely that’s a worthwhile improvement.’

  ‘For society perhaps, but not for the patient.’

  ‘I see. So society’s interests are of no importance to you.’

  ‘They may be important, but they aren’t my responsibility. My responsibility is to my patient.’

  Bonhoeffer shook his head. Kirsch could sense his disappointment at a promising career turned bad.

  ‘You were a military surgeon before you turned to psychiatry, weren’t you? During the war.’

  The dead flesh in Kirsch’s arm began to throb. Instinctively he covered the wound with his hand.

  ‘Yes.’

  ‘You patched up the young men who were brought to you, didn’t you?’

  ‘The lucky ones.’

  ‘And you sent them back to the front, where no doubt many of them were subsequently killed. Correct?’ Kirsch didn’t answer. ‘Now, was that in their best interests? Or was it in the interests of the war effort, of the Fatherland, of society?’

  ‘I didn’t send them.’

  The pain was worse now, pulsing and hot. Kirsch felt it in his veins.

  ‘Perhaps it would have been better for them if you had let their wounds fester a little, or carried out some precautionary amputations. They would still be alive.’

  ‘I didn’t send them.’

  Bonhoeffer regarded him steadily. ‘No. You just let them be sent. As your duty required.’

  Kirsch got to his feet. In his dreams the man who had infected him was always one of those who had gone back. It was revenge, of course. One death for another. Quid pro quo.

  It was a struggle to keep his balance. ‘If you’ll excuse me, Herr Director.’

  ‘That’s how it is now, Dr Kirsch. Nothing’s changed. The medical profession’s first priority – civilian or military – is to safeguard the health of society. The interests of the healthy cannot always be subordinated to those of the sick. You must see that.’

  Even now, Kirsch wondered if a complete retraction of his positio
n might save the day. Bonhoeffer’s declarations had a forced quality that suggested even he was not convinced by them.

  ‘I cannot judge those things, Herr Director: the interests of society, the interests of the healthy. I can only deal with what I see, one patient at a time. All the rest is …’ He thought for a moment, wanting to find the precise words, though his pulsing temples made it hard to think at all. ‘… an abstraction.’

  Alone in his office Kirsch began to draft his letter of resignation. The nib of his pen moved unsteadily across the paper. It scratched and scored, then dried up completely. He shook the pen violently, but the reservoir was empty.

  In one of the recreation rooms a gramophone was playing. The sound of strings drifted up through the courtyard, as if from the bottom of the sea. He listened, trying to catch the tune.

  He closed his eyes, but Bonhoeffer was still there, staring at him over the top of his spectacles. You just let them be sent.

  What was he going to tell Alma? How was he going to explain? It wasn’t going to be easy finding another position. He brought his hands to his face. Perhaps he should refuse to resign: go down fighting and take Heinrich Mehring with him. That way, he might at least do some good.

  He looked out across the courtyard, through the widow’s veil of tangled branches towards the windows on the other side. Out of the corner of his eye, he saw something move. He peered out further. Outside the kitchens, partially obscured by the fire escape, stood a man in a brown felt hat. He was not a member of staff, but something about him – his baggy, ill-fitting suit, the way his hands were thrust deep into his jacket pockets – was familiar. Then Kirsch remembered: he had been among the reporters camped outside the Charité, a thick-set man with sandy hair and a blush of broken veins across his cheeks. He was talking to someone across the threshold. The stranger nodded, then turned and walked away. It was then that Kirsch saw Robert Eisner close the door behind him.

  The Einstein girl was still newsworthy, apparently: good for a few more column inches, perhaps even a photograph. In his head Kirsch heard the whump of a flash bulb, saw in stark contrast the dark pupils, the pale cheeks, the beautiful bruised mouth. He closed his eyes, reliving the touch of her lips and the sweet scent of her skin.

  He had planned to make her his patient, but that was hardly possible now. Bonhoeffer probably wouldn’t have given his consent even before the Nurse Ritter incident. As far as he was concerned, amnesia was a neurological condition, not a psychological one.

  What would Max have said about it? What would Max have done? Kirsch brought his head to rest against the window-pane. Max would have been fascinated by the Einstein connection, however insubstantial or imaginary. And the girl was his type: small, dark, demure, yet with a directness in her words and actions that cut through the tiresome pretences of life. Max would have liked that, very much.

  The music from the gramophone grew louder, then abruptly stopped. Kirsch felt sure he was no longer alone. He could detect a pressure on the floorboards beneath his feet, hear a steady drawing of breath that was not his own.

  ‘What can I do?’ he asked out loud.

  But Max had already told him.

  He found a pot of ink in the bottom drawer of his desk and refilled his fountain pen. He reached for the form he had prepared, approving the girl’s admission to the clinic and releasing her present custodians from all financial obligation. Then, at the bottom, he wrote Bonhoeffer’s name, carefully forging the signature with the help of a staff memorandum pinned up on the wall outside.

  Thirteen

  The next day, two weeks after she had first been found, Dr Brenner discharged his still unnamed patient to the care of the Charité Psychiatric Clinic. On Kirsch’s instructions, she was allocated a single room on the second floor of the women’s wing, a narrow space with a wash basin, two iron beds, a small wardrobe and a barred window looking out across the yard. The previous occupant, Frau Wassermann, since moved to a private asylum outside the city, had been gripped by an irrational terror of germs. During her time at the clinic she had stolen cleaning materials from the stores, and had been found several times scrubbing the floor or dousing the walls of her room with carbolic and disinfectant. In spite of thorough airing, the smell remained strong. The clinic had other single rooms, but none were available. Kirsch had the floors mopped. He bought lavender pouches and hung them up behind the door and above the iron beds, in an attempt to make the air more breathable. Then, as an afterthought, he stopped at a stall on Grenadierstrasse and bought a pot-pourri of rose petals which he balanced on the shelf of the wash basin, between the taps.

  The registration of the patient was complicated by her lack of identity. Kirsch entered her in the record as ‘Patient E’, the E standing for Elisabeth, the name she had given him at the Tanguero. Unfortunately, because he couldn’t explain his reasoning, the rest of the staff assumed that the E stood for Einstein, ‘the Einstein girl’ being how several newspapers still referred to her. It was a choice that seemed to underscore the importance of her fame, which was the last thing Kirsch had intended, but until a better name came along there was nothing he could do.

  ‘What would you like us to call you?’ he asked her that first afternoon.

  There were armchairs available around the sides of the treatment room, but she had chosen to sit in an upright chair, one of a pair on either side of a small table. Kirsch had taken the other.

  ‘Any name that feels right,’ he said. ‘We have to call you something.’

  She looked at her hands. The nurses had put her in a grey woollen dress that was at least a size too big. Her slender frame was lost inside the heavy folds. She was paler than before: her lips the colour of coral, her bloodless cheeks shiny like bridal satin. One of her eyes was still puffy and on the side of her neck were the purplish traces of a graze.

  He waited, but she said nothing. ‘You know, usually we don’t get the chance to chose our names. Other people chose them for us. Isn’t there any name you like?’

  She looked him in the face for the first time that day. ‘Maria,’ she said. Her pupils were dark as jet. ‘Will that do?’

  Maria. The Holy Mother. The blessed Virgin.

  ‘Of course.’

  In his mind Kirsch saw Dr Brenner, squinting between her open thighs. His busy fingers. I saw no evidence of recent sexual activity.

  He cleared his throat, aware now of the disinfectant taste in his mouth. He took out his notebook and wrote Maria at the top of a clean page. At that moment his feelings were not important. The important thing was to establish exactly what the patient did and did not remember. The pattern of memory loss, according to the literature, would be a strong indicator of its cause: concussion, alcohol poisoning, tumour, dementia, psychological trauma or (contentiously) hypnosis.

  ‘I know the police have already questioned you, but it’s important we cover the same ground.’

  ‘Am I yours now?’ The girl was looking down, one leg swinging. He saw her slender white ankles beneath the table, half-concealed by a pair of black woollen socks. ‘My case, I mean.’

  ‘Yes.’

  ‘You changed your mind.’

  ‘I see you remember our conversation. That’s good.’

  ‘Why?’

  ‘Anterograde amnesia is indicative of brain damage. It’s not usually treatable.’

  ‘No, I meant why?’

  ‘Why isn’t it treatable?’

  ‘Why did you change your mind?’

  Kirsch put down his pencil. ‘Would you rather have someone else? I could try to arrange it.’

  The girl frowned. ‘Someone t-took my photograph. When I was in the other hospital, in bed. I looked up and he was s-standing there. The flash blinded me. That’s rude, isn’t it? You’re s-supposed to ask permission, aren’t you, if you want to take someone’s photograph.’

  ‘You should. The newspapers don’t usually bother, I’m afraid.’

  ‘The newspapers?’

  ‘They’re intr
igued by your story. They think you might be a princess or a spy. It would be best to ignore them.’

  ‘What do you think I am?’

  Kirsch smiled and opened his briefcase. ‘I’m keeping an open mind,’ he said, and immediately wondered if that was actually true. ‘Now, I’ve some things for you to look at.’

  He took out a small stack of postcards, and placed them on the table between them. Hohenzollern palaces, soot-blackened and monumental, were captured in sepia tones, all except the summer palace at Sans Souci, which had been coloured in with washes of yellow, green and an implausibly brilliant blue. Finding them had entailed a lengthy trawl through the street markets and a special visit to Schropp’s geographical bookshop.

  ‘All these places are close to where you were found,’ he said.

  The first postcard was of a church, its odd cylindrical steeple rising high into the air, like an ornate factory chimney. The second was of a sturdy baroque mansion with stone steps at the front, flanked with thickly growing ivy. The third showed a lakeside boathouse, with a rowing boat going by on the water.

  ‘The nearest village is called Caputh. People go boating out there. Maybe that’s why you went.’

  He slid the pictures across the table. On the third postcard the name of the town was visible on a sign above the jetty, where the passenger steamers docked in the summer.

  Maria picked it up, frowning. ‘Caputh. That’s a funny name. Like kaput.’ But she wasn’t smiling.

  ‘Do you remember it? The church perhaps?’

  He picked up the first picture. The steeple was unusual; she would know if she had seen it before, but she only seemed interested in the lakeside boathouse.

  ‘I had a ticket.’

  ‘A boat ticket?’

  ‘I don’t know, I … I was holding a ticket.’

  The boathouse was not distinctive in any way. It could have been anywhere. Kirsch questioned Maria further, but she remembered nothing else. It was the same when he asked her about Berlin, about her childhood and where she was born, her education and schooling, her family, her sweethearts. Sometimes she would open her mouth to speak, as if on the cusp of remembering, as if poised on the very brink of a breakthrough. But then a shadow would fall across her face and whatever thought had been so close to forming would dissipate, leaving nothing.