*
Two Lives From that time, she seems to lead two lives. With her parents, she chats contentedly about her new, secure post at Steinhof and the remarkable Doctor Jekelius who looks after his staff so well. Sometimes, she also tells them about the children she cares for at the institution, the poor little things – that’s how Hilde Mayer describes them – with their comical notions, and about the games the nurses think up to amuse and distract the few who have enough sense to be distracted. She never says a word about the circumstances that have led to the children’s institutionalisation or gives the slightest hint of any of the repulsive defects and health problems they suffer from, but instead manages to suggest that these are quite normal children, though maybe a little slow to develop. Doctor Jekelius had assured her that euthanasia would be considered only in extreme cases. He expanded on this theme: only when we are one hundred per cent certain that being cared for in this institution will never lead to anything better than conditioned responses that please the staff; only when the child is so retarded or afflicted by such grave defects of hereditary or racial biological origin that the only predictable outcome is endlessly drawn-up pain and degradation; only then will we choose to abandon attempts to extend artificially the tormented existence of such children and instead end its life, something we will do, as instructed, in the most humane way possible. However, Anna Katschenka had no doubt at all that the committee in Berlin had been notified of just about all of the children in pavilion 15 and that new patients were routinely referred on admission. Nor had it taken long for her to understand that most of the children on the ward had already been prescribed the ‘treatment’ but some were still there only because it was due start later. She never grasped the logic of the timing. On her daily rounds, all she knew was that some of the children were ‘sentenced’ but not whether they had weeks or months to live. However strange and distressing she found it, nothing stopped her from carrying out the necessary day-to-day work. Children rated as unfit to live still had to be washed and changed regularly, and fed with solid or liquid food as required. Those who couldn’t swallow must somehow be made to in the end, and those who were immobile had to be turned to prevent bedsores developing. And all ought to be talked to and cared for, perhaps even sung to, as Anna found herself doing to a little girl whom no one and nothing could comfort. She sang the same songs she had once sung to the children in Professor Knöpfelmacher’s infection wards. They were childish verses and riddles, like the one about the fox who stole all the hens in the coop. Then the knotted, hard muscles in the little girl’s face relaxed slowly and the large, infantile mouth began sucking on its own tongue, then two fingers went into her mouth and she fell asleep. A few hours later that same girl woke and convulsed badly. They had to tie her hands to bars at the head end of the bed to stop her from scratching her face. While Nurse Sikora tried to bottle-feed her, Anna Katschenka phoned for Doctor Türk who came at once, as tight-lipped and focused as ever, inspected the girl’s throat and prescribed scopolamine injections since the child clearly could no longer chew and swallow on her own. A week later, the girl had to be moved to the gallery wing where the most severely ill children were cared for or, more to the point, where they kept the children whose ‘treatment’ had advanced to the last stage and who had only a few hours left to live. Along the wall, opposite the row of tall windows with the ventilator panels always open to let the persistent stench of Lysol and faeces escape, the febrile children were bedded down under thick white duvets. It looked like a line-up of little mummies. Some might cough, making rough, painful sounds as if a spoon was scraping the inside of their frail chests. Most of them lay quite still, their lids half closed over cloudy eyes. The hardly audible breathing of one child after another would cease and all that was left of them was the mess on the sheets. The alkaloid agent that was pumped into their bodies to dull their restlessness and convulsions seemed, at least in these huge quantities, to affect the mucous lining of the intestines and cause the faeces to become semi-liquid and stained with blood. The bitter stench of shit mixed with medication was so overpowering that nothing you washed the floors with could remove it, and however often you cleaned and aired the place, it was still there. The smell would never go away. Outside, the corpse-porters were waiting with their covered carts to take the bodies to the mortuary, where they were washed and made ready for the post-mortem examination. The soiled bed linen was bundled up and the packages taken on the little train to the laundry. And that was it. A casual visitor might have been surprised at how quiet and orderly the procedure was. No one struggled to save lives here. No dashing about, as Nurse Mayer might have put it. The two ward medics, doctors Türk and Gross, came and went at their own serene pace. If some especially interesting case had been admitted, the doctors might all turn up and cluster around the bed. Their discussions could become lively but rarely loud. Doctor Jekelius never joined these case conferences. Often, it was Doctor Gross who took the lead with his usual pompous authority. And it was also Doctor Gross who usually decided about whether to carry out encephalographic examinations on the children, or any other investigations. The young patients who had been subjected to lumbar puncture, and especially those who had to have several punctures, which of course took much longer, were often in terrible shape when they were returned to the ward. It took just a few hours for some of them to fall ill with nausea, vomiting and severe spasticity. And then it was time for scopolamine injections again. Instinctively, Katschenka knew that it was wrong to up the dosage of pain-reducing and tranquillising agents to this extent, especially for very sick children. But what right did she have to express medical opinions? She assumed anyway that the cases that were selected for cranial X-rays were already so ill that the child’s relatives would have given their consent, and she also hoped that these investigations were carried out in order to reach the high scientific goals that Doctor Jekelius always invoked. Besides, it was a comfort to see that in the end the children became calm and somnolent after all their pain, although it was impossible to make them take any nourishment afterwards. What was truly hard to deal with was the way all these interventions were undertaken without a word being exchanged about them, and in an atmosphere of gloom and mutual distrust. She would sometimes catch Nurse Kleinschmittger watching her as she stood in front of the drug cupboard with her list of prescribed medications, as if weighing up what Katschenka might know of all that was unsaid and simply taken as read when it came to the running of the ward. Would she reach a stage at which what was left unsaid would become unbearable? But, no, of course there was no such stage. Rather, it was a relief when one of the members of staff turned what they all knew into a joke; someone like Nurse Mayer, whose uncaring, coarse manner could feel liberating. Isn’t it soon time for little Fritzl to have his next shot? she might say, all mock innocence. Or Emilie Kragulj, who was simply thoughtless, would lift one of the most malnourished children and say the doctor will come soon, unintentionally making Nurse Kleinschmittger smile even as her restless eyes nervously flickered across the room to check on Katschenka. All this meant that they formed a collective after all, without trying to and without any real understanding between then. What they were not allowed to talk about or even mention in front of the others made them bond more tightly than anything else they might have in common. The shadow of all that was unsaid would never disappear. It was no ordinary shadow because somehow those on whom it fell were induced to lean further into it. Katschenka has that darkness inside her. She can’t explain her awareness of the shadow in any other way. When she went home in the evenings, she sat in the tram and all around her people would crowd in, with the workaday briefcases squashed under the arm or between their knees. They were all pure, spotless, and it showed. She paid attention to how she dressed but avoided anything startling, and carried out her duties flawlessly; the shadow grew as flawlessly. She realised that it would soon invade her so thoroughly that none of it would show anymore, inside or outside her. Then, not even the fact
that it existed would seem remarkable.
*
Existence and Will One May morning, she is again told that Doctor Jekelius wishes to see her. This will be the first time he has spoken to her since he showed her that circular but, to her relief, he seems to be in a gentler mood, even expressing regret that he has so little time to spend at Spiegelgrund, since when he is not with Councillor Gundel to discuss urgent matters, he often has to attend medical conferences. And then there’s the problem with all the provincial hospitals under Wien City Council’s control, where local clinics look after children who should be transferred to Spiegelgrund and which he is duty bound to visit. These last few weeks, he has carried out numerous inspection-tours of such clinics. And herein lies the reason why he has asked her to come to his office today. A journey to the Bruckhof hospital in Totzenbach has been scheduled and the plan was that Doctor Hübsch would accompany him, but now she has informed him that she is ill and cannot travel, so he wonders if Sister Anna might be prepared to assist him instead? Of course it is to be seen as an in-service duty. He adds that he will drive an official car and that expenses will be paid.
Sister Anna could perhaps see it as a change from her routine?
They set out early in the morning, on a Monday in July. It must have rained the night before because afterwards she clearly remembers the sloshing sound made by the tyres as the car sped through the quiet streets. The air had a fresh saltiness about it, as always after rain. Doctor Jekelius had offered to collect her at her door but she had declined. She had no wish to be observed from inside the house. In that case, she would have to go to the trouble of coming to his home; she knew the Martinstrasse address, of course, he added with a little smile. She recognised at once the car she had seen that night when a strange woman had been waiting for him. In daylight, the glossy new Opel Kapitän convertible is if anything even more impressive. Jekelius looks suitably sporting in his plus fours, matched by a checked tweed jacket and a cap of the same material. The cap makes his face look more angular than usual, which both attracts and alarms her. She feels a twinge of fear because he suddenly seems a stranger, as if she were landed with an unknown companion. They drive with the top down along Hernalser Gürtel, where the rumbling traffic is already building up to the morning rush, then past Westbahnhof towards Linzer Strasse. He is at ease behind the steering wheel and chats about how pressed he is for time, what with all these inspections and, of course, all the administrative work. She finds it more and more difficult to keep her mind on what he is saying. The sun, still low above the horizon, is dazzling. As they speed along, the wind makes her eyes fill with tears (he clearly has no intention to raise the hood). She congratulates herself that she put her hair up properly and used a scarf to keep it in place. Her mother always went on about how only prostitutes let their hair hang loose. And would add that such girls of course want to hide their faces. (She wonders, why suddenly think about all that?) Jekelius carries on talking but has moved on to the necessity of advancement in medical research and how the profession, despite all the progress during the last few decades, still persists in holding positively medieval views on what constitutes illness. So, what is illness? he asks her. It is probably a rhetorical question, because he only glances fleetingly at her where she sits picking at the ends of her scarf. Illness, he says, is something that afflicts people blindly. Or so it is believed. A punishment sent by God whose hand reaches out from heaven and singles someone out for no rhyme or reason. But, on the contrary, nothing to do with the body happens at random. The biology of heredity has demonstrated with unassailable clarity that there is no disease of the organism; no, not even ordinary infections, which cannot be explained in terms of inherited factors. The causes of damage are already lodged within the body, long before we see the first symptoms of disease. It follows that medical science must adopt a different perspective of time. Taking a patient’s history should not only entail asking if Mr A has had symptoms of this or that illness before. A useful, goal-oriented examination must include the patient’s entire medical history as well as his social and racial background. Sister Anna surely understands that we should learn to see time as a space, but above all learn how to make the art of healing more fit for purpose. How many dimensions would you say there are, Mrs Katschenka? (The question is so abruptly asked that at first she doesn’t take on board that she is supposed to say something. But when she turns towards him, his eyes still look straight ahead and both his hands grip the steering wheel.) Most people would reply that there are three, he goes on without pausing. Three dimensions that define space and then, perhaps, time as well. However, personally, I would answer that there are only two. The first dimension is existence. Most people live in it. And in existence, only the most base and trivial needs are recognised. When someone who simply exists falls ill, he experiences a base, animalistic need to be cured. He doesn’t for a moment consider why he fell ill, why the illness afflicted just him or what would be the use or sense of curing him. The other dimension is the will, which is outside the reach of most. Your will enables you to prove that you, in yourself, feel free to rule over the material and physical contingencies of your own life and the lives of others. Duty and law both derive from the will. Likewise, the freedom to sacrifice yourself for a higher cause. Likewise, the ability to think in categories such as lifetimes rather than just lives, or in terms such as peoples or races rather than individuals who are either well or ill. For as long as medical science operates only at the level of human existence it will never truly heal, only remove or mitigate the symptoms and, even so, only temporarily. Medicine acts, as it were, blindfolded. It remains unaware of precisely whose symptoms are removed or, worse still, if such a removal has any significance or is useful in a wider context. The enlightened form of medical science that encompasses both dimensions always intervenes with some defined intention. This is when it becomes possible to treat also in order to cure. That is, you remove not only the external symptoms of the disease but also clarify its fundamental causation, and can hope to eliminate the factors that have allowed it to emerge and take hold. This might sound strange, coming from the mouth of a medical man, but it is my whole-hearted, firm belief that even the most severe conditions can be cured by the action of the will alone. Our Führer is the sovereign incarnation of the will, of course, he adds quickly. It is actually said unemphatically, as a dutiful afterthought. He is driving very fast by now. It occurs to her (and it might well be the effect he wanted) that they are leaving mere existence behind and are travelling exclusively in the dimension of the will. She quite enjoyed the speed at first but she is beginning to feel sick. It scares her that she has no sense of where she is, whether the countryside is spreading wide and open around them or, on the contrary, if they are hurtling so fast through a narrow tunnel that its walls can’t be made out, and suddenly the old nausea overwhelms her, taking her over as brutally as it did that time in the sports ground on the day she met Hauslich.
Please, I have to ask you to stop for just a moment, Doctor Jekelius …
She didn’t mean to, but she has touched his arm. He turns to her and his eyes look dismissive and stern. In the shade of the brim of his tweed cap, his jawline looks hard, even threatening. But he does slow down and then stops outside a rustic building that seems to be some kind of inn. He stares at it for a while before, in a sudden rush, he says that he must make a phone call, leaves her and slams the car door shut. After a while, the engine sounds in her head die down and, with them, the dizziness and nausea. All is quiet around her now. The sun shines in a cloudless sky. It is baking hot. She sticks her arm out and touches the car door. The sensation of hot metal against her skin is pleasurable with just a hint of pain. The realisation of how quickly feeling sick can give way to feeling so wonderfully well makes her a little ashamed. She closes her eyes. In the silence, she hears the chirping of grasshoppers and smells the rough odour of decaying grass from the roadside ditch. When she opens her eyes again, she sees larks swirling h
igh above the ripening cornfields. She turns to look for Jekelius and catches sight of cardboard boxes on the rear seat. The boxes are packed full of tins and jars of preserves. She can’t resist taking a closer look. Cured ham, asparagus, champignons; desirable luxury goods in these deprived times. Who are they meant for? They are travelling on duty, after all, so all this can hardly be intended for the staff or the patients at the hospital they are going to inspect. She quickly straightens up when she sees him walking towards the car. The sun is behind him and his slim body seems to dissolve and reform in the heat haze that rises from the tarmac. She waits, ashamed again, with lowered head and thumping heart. They’re waiting for us at Bruckhof now, is all he says before starting the engine.
The Chosen Ones Page 8