by Sylvia True
“Ancient history.” Inga glanced across the room at Cathy.
“Where is she?” Sabine asked.
“She died many years ago. Long before you were born.”
“Oh.” Sabine paused. “In Germany?”
Inga twisted her watch.
Cece walked toward the table. “Hi Omama. Hi Sabine. Can I join you?”
“Yes,” Inga said.
“Not right now,” Sabine told Cece, who paused for a moment, worried she might have done something wrong.
“I just need to talk to Omama about a few things,” Sabine said.
“Right.” Cece moved on.
Sabine turned back to Inga. “How did your sister die?”
“Some,” Inga began, “some sort of chest problem.”
“Were you close to her?” Sabine asked.
“Yes.” She took a breath. “But enough about that.”
“How old were you when she died?” Sabine asked, keeping her voice soft and low.
“I said, enough,” Inga protested. “It was a long time ago.” She looked directly into Sabine’s eyes. “Hashing over the past will not help your present situation.”
“But it’s interesting,” Sabine said. “I’d like to know more about it. What it was like in Germany before the war. How did you decide on Switzerland? No one ever talks about it.”
“What will you do with yourself?” Inga asked. “What interests do you have?”
“I’m—” Sabine hesitated. “I don’t mean to sound pushy, but what interests me is what life was like for you in Germany. Before the war. How were you treated?”
“I try not to think too much about that time. I find it unhelpful to dwell on a past you can’t change.”
“What if the past can, you know, help us not make the same mistakes?”
“Yes, I understand that. God forbid we allow another man like Hitler to have power. But my life, that is rather insignificant.”
“Maybe not to me,” Sabine said, and smiled.
Inga sighed. “I will tell you that it was not always pleasant. I recall waking up one morning and seeing the words ‘pig Jew’ painted on the stone wall that surrounded our garden.” The story was true, although it had not bothered Inga much at the time. There were graver concerns. But Sabine wanted something, and this was harmless enough.
“And your sister—was she there when that happened?”
“I believe she was away at the time.” Inga reached for her tea, but her hand trembled so severely she could not pick up the cup.
“Are you all right?” Sabine asked.
Inga’s heart fluttered. “Yes. Would you mind getting me a glass of water?”
Sabine stood immediately and Inga was glad for the reprieve. That she allowed the conversation to get so out of hand was either a sign of her old age or an indication of a strength that Inga had not previously seen in Sabine. Or perhaps it was neither. Perhaps it was a slow and painful excavation of a past that was getting more difficult to keep buried.
Chapter Fourteen
Diagnosis
Prina, Germany 1935
For the first month that Rigmor lived at Sonnenstein, she only left her room to meet with Bohm. Arnold tried to get her to tour the gardens, but every time Rigmor reached the threshold, her shoulders curled, and as she placed a hand on the doorframe, she claimed the room spun. They would turn around and Arnold would suggest the couch, but she insisted she felt too weak and needed to be in bed.
He visited her on his lunch break and at dinner time. He asked what sort of tests Bohm was using and she told him—nothing more than interviews and a few cards with words and splashes of ink. Arnold hoped that Bohm would discover something that he had missed.
In conversations with colleagues, Arnold became aware of his complete insignificance. No one had known he was coming. Rigmor, on the other hand, was well-known, as a “Jewess,” “artist,” “heiress,” or “hysteric.” Arnold even caught a snippet of a malicious rumor, that Rigmor and Bohm were lovers. Nothing could have been further from the truth.
Arnold enjoyed his work with the feebleminded patients. He liked making the rounds and asking people how they were feeling. He would often sit with patients and play chess or cards. No one rushed. Arnold did not adhere to any formal model of psychotherapy. For the most part, he simply listened. His favorite patient, Wilhelm, was a stout country lad, with the shoulders of an ox. Wilhelm talked of milking cows and planting potatoes. At Sonnenstein, he helped with the garden and impressed everyone with his knowledge of flowers. He knew every class, subclass, genus, species, order, and variety of plant. He knew the colors, the smells, and the lifespan. He also loved to listen to football games on Sunday and plan for his return to the family farm. Asked by Arnold why he resided in Sonnenstein, Wilhelm muttered something about a misunderstanding. The doctor in charge of the ward told Arnold that Wilhelm had fornicated with a sheep and that the likelihood he would return home was slim to none. Arnold did not believe the story about the sheep and decided that he would help Wilhelm in whatever way he could.
In the evening, as was dictated by the Third Reich, Hitler’s speeches were broadcast, but few people at Sonnenstein listened. Wilhelm and Arnold often visited the gardens during those times. One particularly beautiful evening, as the clouds flared in shades of orange and pink, Wilhelm explained the life cycle of the bluebell, that they grew from bulbs buried deep underground where there was more moisture, that their journey began after the germination of the seed on the surface, and that the small bulb sprouted special roots that contracted and pulled the bulb downward. Wilhelm knelt next to the flowerbed and held the head of a blue flower.
“Dr. Richter,” a voice called.
They both turned. An orderly raced toward them, arms flailing.
“What is it?” Arnold asked, fearing terrible news about Rigmor.
“You are late for a meeting with the Director. It is nearly six and the meeting was for half five.”
“I don’t recall having a meeting,” Arnold said.
The orderly ran ahead. Arnold followed.
Bohm was tending to his plants when Arnold arrived.
“I didn’t have an appointment on my calendar,” Arnold said. “I’m sorry I am late.”
Bohm waved a hand. “No matter now. Close the door. Let us discuss my findings.”
Arnold sat.
Bohm walked to his desk, picked up a folder, and began to pace. “It seems very clear. It is Dementia Parecox.”
Arnold put a hand on his chest, feeling as if a metal bracket compressed his heart.
“But, you can hardly be surprised,” Bohm said.
“It wasn’t what I expected. It’s not what I would have diagnosed her with.”
“Under whose standards?” Bohm snapped.
Arnold needed a minute to consider and twisted the button on the cuff of his shirt. “I have read all of Blueler’s work,” he said. “And Kraepelin’s, and I don’t believe that Rigmor fits into their criteria.”
“Well, they are certainly not the only two psychiatrists who have studied schizophrenia,” Bohm said.
“No,” Arnold answered, taking a deep breath. “If I remember their first-rank symptoms correctly, I would say Rigmor has none of those.”
Bohm shook his head vigorously. “She most certainly does. In fact, you were the one who told me about the things she calls shadows. How can you not see that as a first-rank symptom?”
“I believe her shadows come from lack of sleep.”
Bohm resumed his pacing. “And the lack of sleep? And the constant nervousness? Are those not symptoms? Both Blueler and Kraepelin have cited those.” He looked at Arnold, as if he had won a point of debate.
Arnold needed time, not combat.
Bohm stopped at his desk and took out two cigars. He handed one to Arnold. “And negative traits? Have you taken note of those?” he asked, and gave Arnold a silver lighter.
Arnold placed the lighter and the cigar on Bohm’s desk. Bohm lit his
cigar and sat. “She has a lack, emphasis on lack, of emotional expression. Her answers to my questions are often characterized by a flat, monotonous voice and avoidance of eye contact. She does not want to leave her room. She seems motivated to do nothing, even though we have many outlets for her here, including a painting studio and music rooms. In fact, we went to a room with a piano, and I asked her to play me something. Anything. Do you know what she played?”
Rather than answer, Arnold thought of Rigmor’s favorite piece, Chopin’s Nocturne in B minor.
“She played a nursery rhyme, and with one finger. It was if she was a child of five.”
“Perhaps she was nervous,” Arnold said. “She never liked to play for an audience. I can attest to having heard her play very complicated and difficult pieces.”
“But is that not part of the disease? A decay of the mind?” Bohm smiled with an affected sadness. “Dear man, I have been crass. Of course this hurts on a personal level, and I have not been sensitive to that. You are a human being first, a doctor second. And as we all know, when we are close to someone it is hard to look realistically at the situation.”
“I do not believe her visions, or whatever you may call them, are a sign of deterioration of her brain.”
“I am not here to have a debate. I understand you might not agree with me, but I was extremely objective, and went above and beyond, so to speak, what another doctor might do.” Bohm opened the folder. “I did a number of word associations, and I categorized many of hers to be loose.”
Arnold sighed.
“Are you in love with her?” Bohm asked.
Arnold jerked backward. “Of course not.”
“Diagnosing patients properly can only help them with treatment,” Bohm said. “It is apparent that her symptoms put her squarely in the diagnosis of schizophrenia.”
Arnold nodded, although he remained skeptical.
Bohm leaned back. “Let me tell you a story, if I can.” He inhaled and blew a mouthful of smoke upward. “I loved my father very much. When I was young, he would kick a ball to me in our garden. He was kind and often showed affection to my brother and me. But then, when I was seventeen, he would talk at dinner sometimes for hours. Most of what he said did not make sense, but I still believed him to be a brilliant man. He drank too much. One evening we had some friends over, and later, I overheard them telling my mother that my father was ill and needed to stop consuming alcohol. I barged into their conversation and told them they had no right to make that judgment.” He leaned forward. “So, you understand,” he said.
Arnold did not understand, nor did he care. He could only think of Rigmor, and how she suffered, and how he’d hoped that Bohm would find she was merely in an acute phase of depression and would recover. He had been naïve to think that. He had been naïve to promise Inga and Frieda that schizophrenia was not a possibility.
“Will you tell the family?” Arnold said.
“I have already written a letter.”
Arnold imagined Frieda reading the letter and collapsing. “And treatment?”
“At the moment I am leaning toward a sleep treatment. Aside from the positive effects, I believe her body could use a good rest.”
“Perhaps,” Arnold said, as his thoughts raced. Would it be better to take Rigmor out of this place? To hire a good nurse and let her rest at home?
“I do understand this has been difficult to hear, but let me leave you with this thought,” Bohm said. “We are on a new leg of this journey, and there will not be a constant need to try to fix things, as now you know that is impossible.”
When Arnold left the office, he felt as if he was walking against a strong wind. His legs moved like trunks of lead.
Most nights, he brought his dinner to Rigmor’s room. Tonight, he didn’t bother with food. She smiled the moment he appeared, but her expression changed when she saw his distress.
“What is it?” She pushed a few peas around on her plate.
Not telling her would be wrong. And telling her would be heartbreaking. These moments were by far the worst part of a doctor’s work. He began slowly, talking about the different criteria for mental illnesses, and how doctors didn’t always agree on diagnoses. She held his hand and looked into his eyes as if he was the one hearing bad news. Finally, he said the word schizophrenia.
“Don’t take it so hard,” she told him. “Diseases affect people differently. Maybe I have a mild case.”
“I disagree with Bohm’s assessment,” he said.
“Will there be a treatment?”
“There is a new cure that involves the patient sleeping quite a lot.”
She smiled. “I could use some sleep.”
He tried to return her smile, but his lips barely moved. “Before you are given any sort of medicine, I will make sure I fully research the effects.”
“I am not frightened of the procedure. What frightens me is that nothing will be tried. Then the situation is hopeless.”
“You are far from hopeless.”
“Let’s talk of something else.”
They could talk about how little she was eating, or how she barely got out of bed, or how the nurses were treating her. But knowing Rigmor as he did, he knew that she needed to talk about something that didn’t involve her.
“Would you like to learn about the life cycle of the bluebell?” he asked.
Her face opened with delight. “I would like nothing more.”
* * *
Inga read the letter eight times, and each time she saw the words Dementia Parecox, her heart sank deeper
“I have just received the letter from Bohm,” she told Arnold over the phone. “It is a mistake.”
“I agree.”
“Did Bohm get the wrong patient? Did he send the incorrect information? That they would make this sort of mix-up and devastate a family shows tremendous lack of responsibility.”
“It is not a mistake. At least not in terms of the letter and Bohm’s assessment. He believes that Rigmor has schizophrenia.”
“But you told him that was incorrect?”
“I did.”
“We will take Rigmor out.”
There was silence.
“We will come and fetch Rigmor,” she said more loudly.
“She is weak at the moment, and there are other factors.”
“What other factors?”
“Patients diagnosed with schizophrenia are not allowed to leave unless they have been sterilized.”
She shook her head. This was exactly what Frieda had predicted and feared. Exactly what Inga was sure would not happen. “We must find a way around those rules.”
“I have spoken to Rigmor about Bohm’s findings,” Arnold said. “She was not as upset as you might think.”
“Because she doesn’t understand the full consequences. But if she knew.”
“She would like to try the treatment Bohm has prescribed. It is a sleep therapy that was invented a few years ago by a well-known Swiss psychiatrist, Klasei.”
“I have heard of him.”
“It could help. The treatments are safe, and Rigmor will get the rest she needs.”
“I will make enquires.” Inga hung up the phone.
Later that morning Frieda asked to speak to Inga in the drawing room.
Inga explained that Dementia Parecox was a condition of the brain that sometimes left the patient with disordered thinking. She used terms of science—auto-intoxication, endogenous, aetiology, metabolic—to purposefully confuse Frieda, to soften the blow. But Frieda was not easily fooled.
“Bring her home.”
“There is a treatment. One that may be very helpful.”
“You and Arnold have done nothing to improve Rigmor’s situation. Living in a place where there are others who are sicker than she probably gives her ideas. You are feeding this illness, when I believe it should be starved.”
Inga stiffened, steeling herself against her mother’s instigations. “Let me find out about this new treatment, an
d then we can decide.”
“The evidence must be compelling,” Frieda said, and left the room.
Inga called Berne University, where Klasei worked and, by using Rudin’s name, was able to get an appointment over the telephone. A number of his patients had gone into prolonged remission when treated with Somnifen, Klasei said. And although he was reluctant to use the word cured, he did believe that the possibility existed. He stressed the importance of speaking with patients even as they slept. He had witnessed the sickest of patients come out of sleep treatments with an uncanny ability to solve a difficult mathematics problem, or understand something about physics that they did not previously grasp. He told Inga about the dosage he used, and the varying length of time for treatments—a few weeks to a few months, even half a year.
Inga relayed the hopeful news to Frieda, who grudgingly agreed that it was worth a try.
Chapter Fifteen
Visions
Belmont, Massachusetts 1984
Moving from table to table, Inga picked out a wilted daisy here and there, and straightened the tablecloths. When she finished, she sat at the table next to the kitchen door—her spot.
The day after Inga met with Holgart, he came to the ward to check up on her. She treated him with a cool, polite graciousness. He also met with some of the nurses, smiling generously, if a bit condescendingly—patting them on the back, looking pleased with both himself and the staff. No one questioned Inga after Holgart’s appearance and, although she would never like the man, she was grateful for his assistance.
Yesterday Inga sat with Helen. The conversation began in a guarded manner, both of them proceeding cautiously, as if they were positioning pawns at the beginning of a chess match. Inga’s goal was to get a better sense of whether Helen could be trusted as an adviser for Sabine.
“May I ask you something?” Inga said, after they had talked about the weather and the food.
“Of course.” Helen smiled. She was such an attractive woman, so composed.
“What do you hope for?” Inga asked.
“Hope for? In terms of the world? The people here? Sabine?”