The Chosen Ones

by Steve Sem-Sandberg

  *

  Mother and Daughter Only a few days later, she meets Mrs Althofer in the office in pavilion 1. Sophie’s mother wants to speak to Doctor Jekelius and, when she learns that he is away, asks to see Doctor Hübsch. Mrs Althofer is in many ways the spitting image of her dwarf child. The same reddish-blonde hair springing from the same perfect hairline. Their curving eyelids are similar, too, but the mother’s eyes look so heavy that she can’t lift them enough to see Anna Katschenka’s face. A meeting was arranged for today at nine o’clock but it would appear that Doctor Hübsch has preferred to be unavailable, she says as her gaze slides past Katschenka to follow the stair rail. Sister Katschenka says that this is not a matter she can deal with and suggests that the office staff could set up a new appointment. But Mrs Althofer insists that the agreed meeting should take place and eventually becomes very loud on her daughter’s behalf. Apparently Doctor Hübsch had personally assured her that her daughter would get well and now, what’s happened to that promise? You’re keeping my little girl locked up day and night! You don’t give her anything to eat or drink! You treat her worse than a base animal! Next, Anna Katschenka is baffled to find herself holding Mrs Althofer’s small, clenched fists in her hands. For a brief moment, the surprise they both feel at the prevented exchange of blows dampens the underlying fury and the two of them, the ward sister and the mother, stand on the stairs with their faces close together. Then a door slams a little further upstairs and a white-coated Doctor Gross bends over the railing to speak to them:

  Doctor Hübsch is off sick today,

  but if you wish, Mrs Althofer, you can speak with me …!

  Later that day, Doctor Gross will enlighten Katschenka and her new colleagues about exactly what type of woman they are dealing with in Mrs Althofer and, particularly, what kind of mother. One of those who can’t make up her mind: will she or won’t she let go of her child? And because she is incapable of squaring her conscience, she continues to haunt the periphery of the institution where her child is being cared for, all the while complaining loudly about how appallingly the little girl is looked after and how unpleasant the staff are to her mother. Nothing but a charade, from beginning to end, Doctor Gross emphasises, because in her rational moments, Mrs Althofer knows that she can have her child back any time she so decides. Against medical advice, that goes without saying, but no matter. That right belongs to her in this situation, as it would to all mothers. The problem is that, in her heart of hearts, Mrs Althofer doesn’t want to. She is aware that if she ever were to hug Sophie’s shrunken, malformed body to her breast again, she would be at an utter loss as to how to handle this new burden. It is a fact that she doesn’t have the time to look after her child. She has to work. Food is hard to come by. Who would look after little Sophie while her mother carries out her office duties? As Mrs Althofer has repeatedly pointed out herself, she has a responsible post as the trusted secretary of a large legal firm. And Mrs Althofer’s own mother, who selflessly used to care for her granddaughter while her daughter was at work; well, the old lady has spent the last few weeks in hospital with an attack of gallstones. And Mr Althofer has been called up. So typical of how families live nowadays. There’s a war on, after all. Each and every one of us must be prepared to make sacrifices. We can only conclude that Mrs Althofer’s stubborn meanderings amount to nothing more than her way of quieting a constantly nagging, very uneasy conscience. Because, by coming here and badgering members of staff and complaining, Mrs Althofer at least gives the pretence of doing something even though she knows deep down, as does everyone else, exactly what a repulsive and miserable condition this child is in, how depressingly feeble and unworthy it has become. Yes, Mrs Althofer knows full well but cannot bring herself to state it in so many words, Doctor Gross says. She would really be so endlessly grateful if we could only lift this burden off her shoulders but is unable to put that into words, as well; like all these mothers who keep accusing us of stealing their children.

  *

  Decursus Morbi In the evening, Sophie runs a high temperature. Anna Katschenka is not on duty at the time but one of the day nurses had made an entry in the case notes: before the onset of the fever, the girl had been very restless for several hours, first noted early that afternoon. The child twists and turns, also emits short, almost inaudible shrieks. The following morning, the perfect hairline is edged with a ribbon of small, shiny drops of sweat. The child is febrile. Temp. 38.5. During the months and years that follow, Anna Katschenka, as the ward sister, will be responsible for keeping case notes up to date. Back then, another hand is making entries in Sophie Althofer’s notes. The writing is stronger than Katschenka’s, with neat rows of sloping letters. The notes include something of the patient’s earlier history. She was a much longed-for girl, born to two apparently perfectly normal parents. Their only child. At birth, it was noted that the baby had shorter than normal limbs, with hands and feet especially reduced in size, and a protruding breastbone – one of the so-called pectus anomalies, the ‘pigeon chest’ or pectus carinatum. The misshapen thorax is associated with narrowing of the ribcage and sharp-edged ribs that threaten to compress the internal organs. Various treatments were used at an early stage, beginning with a cradle designed to straighten the limbs. On the family doctor’s advice, Mrs Althofer gave the infant a nightly bath in rock-salt brine. All available nutritional supplements were purchased, including Vigantol oil, Bio Malt and cod liver oil. At the age of three and a half, the child suffered from severe headaches in connection with a cold, and later fell ill with a high fever and strong muscular pains. The tentative diagnosis was polio. The child’s mental development, which had been normal, became affected and she stopped speaking or in any other way communicating with others.

  21/01/1941

  […] the child was admitted to Spiegelgrund as her mother stated ‘I cannot cope any more’.

  22/01

  [notes in Doctor Gross’s writing]

  […] The child is well nourished, overall status good. Deep tendon reflexes elicited bilaterally and at normal power. Babinski reflex and Rossolimo’s sign negative.

  The child tends to lie on its back, hardly ever moves its pathetic stumps of arms and legs. Cannot sit upright without support, the head falls backwards due to an apparent lack of muscle power. Pupils fix on stationary objects but she does not reach or grasp. No real eye contact possible.

  On examination, the child gives an impression of a marked degree of idiocy.

  02/02

  [notes alternately in Doctor Gross’s and Doctor Türk’s writing, with added entries made by the day duty nurse]

  […] Sophie appears not to suffer from any physical pain but will emit an incessant low, wailing sound (especially on days when her mother has visited).

  Sophie is calm and biddable but will not eat unless spoon-fed & seems not to feel hunger in the ordinary sense.

  Weight reduction: 800g. […]

  08/02

  Strong epileptiform convulsions. The girl is tied down to prevent self-inflicted injuries. She still refuses nourishment. Luminal prescr.

  09/02

  Continued muscular spasms, less extensive.

  As the restlessness is not reduced by the evening, administration of Luminal.

  11/02

  Condition not improved. Visible decline in the child’s overall status.

  Further weight loss recorded: 800g.

  Generally weakened. Apathetic.

  At this point, Mrs Althofer writes a letter to the board of the institution and demands that they should let her have her child back. Her stated reason is that she felt unable to establish contact with her daughter on her latest visit, an experience she describes as ‘something completely new’. Even though Sophie has chosen not to communicate ‘as people normally do’, Mrs Althofer insists that mother and daughter had developed ‘their own language’ and that they could speak fluently with each other. The girl had been happy and often laughed. When I held her by her waist and lifted her
high in the air she would choke with laughter and whisper in her tiny voice, ‘Thank you, Mummy!’ It is with deep distress that I have been forced to realise that my girl is no longer herself. You have written [Mrs Althofer refers to a letter from Doctor Jekelius] that no amount of wishful thinking can make my daughter well again and that at Spiegelgrund she will receive all the care and attention a child needs. Are you telling me to be grateful that my daughter seems no longer able to recognise her own mother?

  16/02

  […] Fever 39.0°. Suspected viral bronchitis. Decongestant prescr.

  When Katschenka checks on her that evening, Sophie seems to be sleeping peacefully for the first time in weeks. Her smooth features show no sign of the earlier distortion. Anna would like to stop and place a hand on her face. But there are so many children. Soon afterwards, she is called to pavilion 17, where a boy is banging his head against the wall. He has to be restrained. In the other ward, a boy has come down with scarlet fever and must be isolated at once. Hildegard Mayer is bullying a girl, she shouts and hits the child. Nurse Mayer really has an awful temper. By the time Katschenka returns to pavilion 15, Sophie has been moved to the gallery wing. Her temperature has gone up again and she is breathing irregularly. Each breath seems to be ejected separately, one by one, from her misshapen chest. The pallor of her face has turned grey, and her skin is unnaturally glossy, like a sheet of shiny, thick paper. There might well have been glimpses of awareness in her eyes before but now they are empty beneath their heavy lids. Anna thinks that her face shuts you out, like a blank wall. Later that day, a so-called Schlechtmeldung, a bad news announcement, is put in the mail.

  Wien, 16 February 1941

  For the attention of Mrs Althofer

  I regret to have to inform you that your daughter’s health has undergone a severe decline. Her condition must now be regarded as worrying.

  Professor, Dr E Jekelius

  Medical Director

  The following morning, two of them wash Sophie Althofer’s body. Katschenka props the corpse upright while one of the nursing assistants pulls the mattress and sheets off the bed. The child’s body is lighter than Anna had imagined and easy to hold: the strongly arched pigeon chest fits into the bend of her left arm. They suddenly hear a shrill, piercing scream from the corridor, and Anna briefly fears that Mrs Althofer has arrived and that she is to be the one who hands the dead girl over to her mother. But it is a child who screams. The note about Sophie’s declining health had been put in the post after a deliberate delay to make it too late for Mrs Althofer in case she decided to come along. But she might not come at all, just as Doctor Gross had explained earlier: the mothers may well be tremendously loud and pushy while their children are here, but once the little ones have died, they’ll write and ask us to ‘look after the practical issues’ and that they’ll pay us for our expenses, thank you kindly.

  *

  The Procedure A few days after the death of Sophie Althofer, the office finally informs Anna Katschenka that Doctor Jekelius wishes to see her. Does a child have to die before she is offered the reward of an audience with him? The Jekelius she meets in his study isn’t the humorous, pleasantly jovial doctor she remembers, or believes that she remembers. He doesn’t get up to greet her, and carries on leafing through documents while taking occasional notes. She is left to stand there. When he finally turns to her, he moves in the old, relaxed, carefully controlled way but his face is like a stone wall. There is no way to get through. He slowly places one hand on top of the other and asks if she is becoming familiar with the routines and pace of the ward work. She says yes, since that is obviously what he expects. This unchanging face of his frightens her. He goes on to say that he assumes she has by now observed the miserable condition of most of the children, taken on board the fact that many of them are incurable and also understood how the institution deals with this type of case. She thinks of Sophie, and the far too high dose of phenobarbital she was given, and of how strangely light, almost weightless the child’s body had felt in her arms. Tears fill her eyes. There is nothing she can do to stop them. She feels in her uniform pockets for a handkerchief, can’t find one and tries to turn her head away. Weeping is so undignified but Jekelius doesn’t seem to have noticed that her feelings have got the better of her. His face is still rigid as he leans forward over the desk. I shall now have to remind Sister Anna about the professional oath that binds you and the pledge of confidentiality that you will have made at the same time. As you know, you are, under no circumstances, to communicate any details whatsoever with respect to any individual case to anyone outside the institution. And you are not to ask any unnecessary questions. Has Sister Anna grasped these implications? She nods. The corners of her eyes have almost dried and now she thinks that maybe Doctor Jekelius’s stiffness is related to the message he is trying to convey to her. He sits back in his chair to unlock one of the drawers in his desk, finds a thin sheet of typescript and hands it to her. It is some kind of certificate with a signature at the bottom and the Nazi emblem in the upper left-hand corner. She is far too tense to get a grip on what the lines of typescript actually say. As Sister Anna can see, this circular carries the Führer’s own personal signature, Doctor Jekelius points out. It means that legally, this document has the same status as an already enacted piece of legislation. He pauses to give her time to take in the overwhelming significance of this but, somehow, she is struck mute and also feels unable to grasp what he is trying to tell her and what the circular has to do with any new laws and regulations. She stares at the piece of paper in her hands. So, that’s what Hitler’s signature looks like? Doctor Jekelius continues to speak but in a gentler voice, as if he has sensed her confusion. What we do in certain circumstances, he says, is confined to extreme cases only. And our interventions aren’t crimes, neither morally nor legally, as you can see now. On the contrary, the measures we take should be seen as acts of mercy in the spirit that has always guided medical science, that is to ameliorate or remove sources of pain and suffering. Then he explains the practical aspects of the procedure, how for each patient certain forms are to be completed and sent to the Ministry for Internal Affairs in Berlin, where a dedicated medical committee scrutinises the submissions with great care and sees to it that every individual case is tested before their decision is made and which it is our duty to carry out. But, by now, she has ceased taking in what he says. She gets up, politely excuses herself, but she really must leave. They are waiting for her down in the pavilion. Presumably, he believes that she is upset because of the information he has just entrusted her with and his gloss on the words in that document. She is upset but that isn’t why. Often that day, as well as during many of the days and nights that follow, she returned to the thought of how differently she would have reacted if he had taken her into his confidence rather than laying on that performance. How she would then have understood not only the words he used but, with a will, embraced the meaning of it all. However repellent the new legislation he had spoken of appeared to her, she would nonetheless have been completely loyal to it. Now, it seemed as cold and abstract and impersonal as Jekelius himself. And what of those monstrous children, was there nothing for them except the law? No mercy, no love, no life? She lay awake all night in her old girlhood bedroom in her parents’ flat on Fendigasse. Although their area was usually calm and quiet at night, she seemed to hear a chorus of voices rising from the street: loud, high-pitched voices speaking across each other and then yet cut through by other ones, as sharp and shrill as officers’ commands. The ultimate decisions are not made by us, but by them, in Berlin. All we can do is knuckle under and do as we’re told. None of us can be regarded as personally responsible. We are obliged to obey current legislation. We have no reason to feel guilty.