Authors: Steve Sem-Sandberg
*
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 high 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 Boy Pelikan and the Fourteen Holy Helpers
The Bruckhof hospital is not in Totzenbach as she had assumed but stands
surrounded by fields and meadows about a kilometre outside the village. Apart from the main building and a chapel, there is also a long, wooden building on the hospital site: a barn, perhaps, or stables, or a tool shed. The hospital building is three storeys tall, with a splendid Baroque gable and a high, sharply sloping roof topped with an onion-domed turret. Jekelius parks in the narrow shade in front of it, removes his cap, takes a white coat from his doctor’s bag and pulls it on over his jacket. The institution’s director, a red-cheeked, elderly man, is already waiting on the steps to receive them. Accompanied by two nurses in neatly ironed, white uniforms, he leads the way in a nervous, slightly affected manner. The doors to the wards open into long corridors and the whole scene reminds her of Steinhof as it looked in the 1920s, when her grandfather was a patient there. It smells the same, as stale as if the place hadn’t been properly aired for decades. There is something almost sculptural about the bright sunlight that enters through the windows high above the heads of the few patients who have dared to step outside the wards. They are ushered into a smallish room with bare stone walls and a single tall window looking out over the garden. Someone has put a vase full of fresh wild flowers in the window alcove, a gesture that seems somehow touching. The staff has already picked the children to be examined. She can hear their voices on the other side of the door, excited and angry as children always are when jostling for a place in a queue. The director invites them to sit down at a desk in the middle of the room. On it, patient records and case-note folders are tidily arranged and opened for the inspector and his assistant. The two nurses stand by the door, ready to assist as required. Looking indifferent, Doctor Jekelius leafs through the list of patients and then agrees with the director that the children will not be called in alphabetical order (the records are not consistently sorted that way)
but according to the ward and room where the child’s bed is. The voices outside suddenly fall silent, and one by one (as their names are called) the boys and girls come in to stand in front of them, like little actors at an audition, looking confident or scared or trying their luck with frankly ingratiating smiles. Some are obviously imbecile, with protruding lips, wet with saliva. Most of them seem to find it difficult to stand still in the same spot, or to speak coherently enough to string together more than a few sentences at one time, or to speak at all without constantly becoming distracted. They are not intimidated, though, and look curious and intently interested in what is going on. One of the boys tries to grab hold of the spatula used to examine the inside of his mouth and then becomes intrigued by the doctor’s little reflex hammer. Jekelius works calmly, with that thoughtful concentration she has come to think is typical of him. His expression fascinates her, withdrawn and distant but very alert at the same time. He is sparing with comment, but now and then uses a Latin term or some short description, for instance of the appearance of the limbs, or of skin rashes and scars. She makes a note in the margin of the patient’s record of the remarks she has understood. Finally, the room is empty, no one waits in the corridor and the hospital director, visibly relieved, comes over to them. She looks through the list of children again. All names have been ticked apart from one.
Someone called Pelikan is missing
, she says.
Karl Pelikan.
Jekelius looks hard at her for a long moment. The director is pressing the palms of his hands together in front of his chest, almost as if praying.
Why haven’t you had Pelikan called?
Jekelius asks. The director closes his eyes and Jekelius turns to one of the nurses:
this Pelikan, is he not here any longer?
The nurse,
oh, yes, Doctor … Doctor
—
Doctor Jekelius,
Please, would you bring the child to us immediately.
Pelikan is brought. He is a thin, gangly boy of about thirteen or fourteen. Two men support his shoulders but he can walk on his own, though in an odd, jerky, foot-dragging way. Instead of stepping straight into the room, he drags his body along the whole of the short wall next to the door and the two men follow him obediently. She thinks: like royalty. His long, narrow face seems as strangely twisted as his body. His eyes are screwed up below sternly pulled-together eyebrows, as if observing Jekelius with profound distrust, possibly even contempt. Briefly, confused embarrassment fills the room. The two men who support Pelikan are unsure whether to keep propping him up or to set him down, and Doctor Jekelius offers them no instructions. He just stands there, intently scrutinising the boy’s face until the hospital director clears his throat and says, clearly still troubled: