She Who Waits I didn’t know her, Hedwig Blei says (speaking about Anna Katschenka). Of course, she worked in pavilion 15, Jekelius appointed her to ward sister. I was there, nursing in the gallery wing, only for a few, fairly short periods and I thank the Lord to this day for being spared. My post was in pavilion 17 and even though both belonged to the same clinic, in practice there was little contact. It was only at the time when Katschenka started to take on some of Sister Bertha’s duties that I got to know her a little better and, I must say, I never resented her as many of the others did. I felt that she might well be one of the nurses who are said to live for their work. Always there when she was needed. Always knew what was missing or what should be done. Never lost control, never lost her temper. Why, I’m not even sure she had a temper. She got around at this slow processional pace, sort of queenly, and the way she moved drove some people to distraction. Oh, hang on, let me hold up your train for you, I once heard Hilde Mayer say behind Katschenka’s back. There was a rumour going around that she had had an affair of sorts with Doctor Jekelius in the past and that she went for the Spiegelgrund job just to serve under him; the story was that when he was called up later on, only about a year after she started, and then the entire institution was restructured, her world collapsed around her ears. I don’t know if I believe any of that talk. There were so many rumours I sometimes had the feeling people got by on telling tales about each other and finding fault, and passing it on, or informing on someone, you know, for failing to show the right degree of political commitment or whatever it might be. That was something the Nazis brought with them and it did create an atmosphere of distrust and constant begrudging. I haven’t come across anything as bad anywhere else. Anyway, if it was true that Katschenka had a special place in her heart for Jekelius, I must say that she took his departure quite coolly. I never saw the slightest crack in the façade she maintained against the rest of us. On the other hand, I did have a feeling that she was always waiting for something. I don’t know what it could have been. Perhaps she just expected that she would crack. Or that someone would command her to crack. I know that she was one of the few who stayed behind with the children after von Schirach had capitulated and the entire leadership of the institution scarpered. It actually doesn’t surprise me at all. Would you like me to say a little more about the others who worked in the clinic? First of all, I should make it clear that the two pavilions had quite different functions. The children in number 15 were the ones selected for ‘treatment’. Pavilion 17 was for patients under observation and was meant to be a transit station where the children would only stay for about a month, maybe a couple at most, until someone reached a decision about them, one way or the other. Even so, some of the children were kept on for a really long time or sent back and forth between the wards. Take Felix Keuschnig, who started out in 17, and then went to 15, then to 17 again. Of course it was totally forbidden to spoil the children. But it couldn’t be helped, some of the ones who were around for a long time became favourites. Sooner or later, everyone picked a pet to make a fuss of. Even Sister Katschenka. She had taken a fancy to a retarded boy they called Pelikan (it might have been his real name), whom she had trained to open the door for her whenever she visited the ward. That was quite typical.
About Emilie Kragulj– a dog. That’s all. I won’t say any more;
About Nurse Kleinschmittger – spent all her time badmouthing people (I don’t think I’ve ever met anyone so quick to abuse others);
About Nurse Bohlenrath – I barely knew who she was (she worked on one of the wards for bedridden little ones);
About Hilde Mayer – she was quick and got on with things, a real workhorse. Before, she had been a psychiatric nurse at Steinhof and it showed. There were those who thought she was brazen, always ready to speak her mind about whatever it was. But she wasn’t a snooping, false bitch like Kragulj. They said that Mayer was a Nazi; I mean, an actual party member. But she insisted it was a misunderstanding and that she had signed up because they demanded it of her if she was to keep her job. Everybody says that, of course, but just in Mayer’s case it wouldn’t surprise me if it was true.
About Erna Storch – now, she was a Nazi. She married a German from Sudetenland. I think she ran away with him after the war. I remember that she used to go around collecting for Winter Aid. Storch was in pavilion 15 at first, then in 17.
Frank was another one, Marie Frank, I think. A nice girl as I remember, who had a very hard time when the Russians came.
And Nurse Sikora. She was one of the ones who ran away. Sikora worked in pavilion 17 for a while. Built like a barn and an out-and-out sadist, if you ask me. It seemed to me that she positively enjoyed tormenting children. She often worked herself up into such a rage she could hardly breathe. To be honest, I think there were quite a few of those at Spiegelgrund. They were drawn to the place because there you were given the opportunity. To torture people to death, that is.
The Piano Player There is a piano in the first-floor day room, pushed up against the wall to be out of the way of nurses and others who need to pass by. Felix Keuschnig sits at the piano and plays for hours every day. He sits so straight you can see the tense tendons at the back of his neck. He strikes the keys unhesitatingly, with full force, and always plays incredibly fast: as if the music were already composed within him and he is in a hurry to make his hands execute the essential but clumsy mechanical movements. Nurse Blei stands or sits by him, listening. Sometimes, she suggests a song for him to play and they sing it together. Simple rhymes or songs for children, like ‘Fuchs du hast die Gans gestohlen’ (‘Fox, you’ve stolen the goose’). Or ‘Alle Vögel sind schon da’ (‘All the birds are already here’). Often, she needs only to hum the words and he picks out the melody on the keys, with the proper chords, and then sings along. His voice is breaking and sounds rough and hoarse (at least when he speaks) but he never misses a note. When he plays, he uses only the black keys. The white keys are dangerous, he says. You’ll drown if you touch them. For him, playing is constant vigil, to keep safely on firm ground. Felix can play for hours on end without a break. If he is interrupted and someone attempts to make him think of something else, he howls like an animal, and he has been known to go for Nurse Hedwig’s face and scratch it. That is why she sits by him, ready to catch the twisting, unwilling body that alternates between rigid, harsh resistance and slack, leaden weight. At these times, it becomes necessary to pilot him with cunning and gentle force out into the deaf, white, toneless world again, and preferably to do it quickly before Sikora or Storch or one of the others starts up the usual line about never seen such an awful lot of fuss and why does she waste so much time on that good-for-nothing: remarks also made within her hearing in kitchens and staff rooms, whispered behind doors that slam shut as soon as she comes near. On Sundays, Felix’s mother visits him. Felix knows and counts down every week, starting at seven. Now it’s just four days to go, he will say, holding up the right number of fingers. But even though ahead of every visit he is buoyed up with expectation, he becomes cross and contrary on the day and, when his mother actually arrives, doesn’t want to talk anymore. He cringes and fools around, rolls his eyes until only the whites show, climbs and clings onto whatever is at hand. Now and then, he emits loud howls, rather like mating calls, which embarrass all of them and his mother in particular. Blei observes his mother’s hands as they keep sliding over the boy’s body, caressing, protecting and attempting to cover it up, all at the same time. Felix’s mother explains, explains away. Felix caught polio when he was one and a half, she says. The illness seemed to fade by the time he was four. For several years, he was a perfectly normal child who sang a lot and played like everyone else. The discipline problems began at puberty. He found it increasingly impossible to sit still, began to say things he didn’t mean, lost concentration quickly and could become bad-tempered abruptly and unreasonably. Reluctantly, his mother agreed to register him with a Biedermannsdorf specialist children’s home that ran support classes. When what they had to offer didn’t help, he was taken in at Pressbaum. That’s how it was these days: all children with something out of the ordinary about them had to be reported to the authorities, who made all the decisions about how to proceed, even if it was just something like certain learning difficulties, as in Felix’s case. At Pressbaum, he contracted an inflammation of the gums which was left untreated for so long that the entire jaw area of his face became swollen and he had to have an operation. All this did Felix no favours, he got worse in every way and, in the end, it was decided that he should be transferred to Spiegelgrund. Felix’s mother had no complaints about the care her son was getting here, she wanted to assure Hedwig Blei about that; but mightn’t it have been better for the lad to stay at home or, at least, come home for Christmas and Easter? This was a matter she had raised in letters to the institution’s board but no answer had been forthcoming. One of the secretaries in the office had told her in confidence that she didn’t have hope. They wouldn’t let go of Felix until he was fourteen. She then turned to the Gau-Jugendamt, the regional youth authority, even applied for an audience with the Reich Governor himself. Wherever she turned, she was cold-shouldered. But why shouldn’t Felix be allowed to stay in his own home, when it is obviously good for him? Take his feet, for instance. At home we saw to it that he wore good shoes with the right kind of insoles, to help him walk properly. But at Pressbaum, they took the shoes away from him. They said that shoes were for well children and that if Felix couldn’t walk normally he should stay in bed. But he must exercise his muscles to strengthen them, his mother said, how on earth can he ever get well unless his muscles are built up? And then she burst into tears. When she entered the day room, she had been walking ahead firmly and resolutely, and had used the German greeting. Now, this grown woman weeps because she isn’t allowed to be with her son. Between the tears, she says that Felix isn’t an idiot. Why, he can count and read and write, and has anyone ever heard a child sing and play so angelically?
Case Notes Doctor Gross had been duty doctor when Felix Keuschnig was admitted to Spiegelgrund and carried out the statutory medical examination. Gross had weighed and measured and assessed, and then made notes on his conclusions:
[…] intelligence appears structured as per average. Pat. can count and write simple words (capitals only). His behaviour is foolish – ludicrous. Doesn’t reply to questions. Fairly good musical talents rendered useless by his other defects. Fundamentally unteachable and incapable of work. Probably a persistent post-encephalitic condition leading to mental decline. […] The child’s mother shows a tendency to hysterical reactions.
The last note had been added because the boy’s mother had insisted on bothering him, Doctor Gross, with her silly insistence that Felix would be better off at home. There is a note in the margin recording that the mother is employed by the Wehrmacht which is followed by (!), the exclamation mark intended to draw attention to the contrast between the mother’s occupation and the fact that her child is unfit to live. Gross has also taken pictures of Felix, three in all, which show: one, the boy resists handling with his arms stretched straight out; two, he squints with his eyelids pulled back; three, he grimaces so wildly that his jaw seems dislocated, which makes him look imbecile. Felix behaves like this when making body contact with anyone, including his mother, at least initially. But of course Doctor Gross couldn’t have known that.
There Is No Harm in the Boy Felix is one of the ward’s bed-wetters. Still, he is dry during the day. Mostly, his state of mind is calm, at least if you compare him with the other children on the ward. As Nurse Hedwig writes in one of her day notes: Felix is a kind and well-behaved child who calmly puts up with most things; his happiest moments are when he sits at the piano. What Blei does not add is that Felix keeps himself to himself almost all the time when he isn’t allowed to play the piano or his mother isn’t visiting. He never plays with other children unless compelled and doesn’t even talk with them. If you ask him for something he puts on the same stupid squint as when he feels disturbed or stressed. He gives gormless, irrelevant answers to even the simplest questions and can be crude and offensive. When a meal is served, he doesn’t say thank you as he has been told but instead Servos Kreutzer! And he gulps down the food with incredible greediness, as if he hasn’t seen food before or as if he could never be satisfied. There is ward time set aside for singing lessons, which is why the piano is there. But instead of leading the song herself and encouraging all the unwilling, half-witted children to sing along with her, though that admittedly only results in a distressing, baying noise, Nurse Hedwig allows Felix to sit down at the piano first and then tries to make as many children as possible gather around him. Felix accepts this. She whispers some of their songs in his ear and Felix plays and she sings and shows the children where to sing along or clap their hands, and they all sit around the piano, their eyes alight with excitement and hands raised, ready and eager to clap. And Felix plays song after song, all in the same safe key of C-sharp. When they’ve run through the songs, he starts from the beginning again. There is no end. Long after the other children have drifted away, he carries on hammering and crashing on the black keys. Then, a huge labour begins. She has to catch his resisting arms and make his entire oppositional body come to rest. At nearly fourteen, Felix is physically approaching adulthood. All the same, once he has calmed down, he curls up in her arms like a child. As if to show that that he might well have agreed to a temporary truce but that the contest has not ended, he often sits with his forehead pressed against hers and his eyes pierce hers like spears. All the same, the way he encloses her with his warm, moist breath is loving. She doesn’t dare release him until they have sat eyeballing each other for ten minutes or more. There is no harm in this boy, she writes in her notes.
An Accident People from the country know how to look after themselves, Hedwig Blei had declared to Anna Katschenka. Nurse Blei had only failed once in her life to look after somebody else. That person was her younger brother, Nicolas. He and his older brother were as different as day and night. Matthias, like his father, seemed born to farm. He was slow to react but his mind was orderly and determined. By contrast, Nicolas was impulsive, proud, quick to anger and sometimes over-confident. Perhaps Hedwig loved him because she had been used to protecting him from early on (God knows, he did need a protector) but it could also be that she saw one side of her own personality reflected in his quick, fiery temperament, a side of her that at the time she couldn’t or felt she shouldn’t show. Ever since July 1936, when local and voluntary civil defence militias had been forbidden by the state, there had been flare-ups of trouble at the border with Czechoslovakia. Nazis, mostly Sudeten Germans, crossed the border at night to agitate and distribute flyers. Plenty of people in the area sympathised with them, but their father, Anton Blei, had no time for the Brownshirts. As far as he was concerned, they were criminals, the lot of them. When he saw young people march behind the banners of National Socialism, he would turn away and spit into the roadside dirt. Now, these people were suddenly around at night, even taking shortcuts across his own yard. The border guards never seemed to do more to stop them than they absolutely had to and whatever the insurgents were up to, they did boldly. Nico said that they smuggled arms as well. In the end, he and Matthias joined a handful of other local men in a voluntary Grünbach civil defence force. The men took turns to keep guard at night. It was illegal, of course, and a punishable offence. But who would stop them? The terrain was rough, a hilly highland that was hard to defend. Nico said he had an idea where some of the arms caches were. One suspect area was an old granite quarry where several insurgents had been spotted recently. The quarry had been abandoned long ago and had become overgrown. It was hard to reach unless you used the open road where you always ran the risk of being seen, so instead they decided to try getting into it from the back, down a narrow ravine. Nico, who was the slimmest and most agile of them, was roped up and four men took the weight at the top of the ridge. More rope, pay it out, more, Nico kept shouting. His voice grew fainter and fainter the further down he got. Then the rope went slack. An alarming silence fell. After waiting for half an hour, Matthias leaned over the edge and shouted his brother’s name. The answer was a violent explosion. A cloud of stone dust and black smoke rose from the ravine. The explosion must have triggered a rockfall higher up on the mountain because they suddenly had to dive for cover from loose stones racing towards them and down into the smoke-filled ravine. Afterwards, no one could explain how it all started, or how the dynamite complete with blasting caps had ended up in the quarry. The newspapers reported the accident, if they did at all, in terms such as ‘inexplicable’. When the emergency team reached Nico, he was still alive but both his legs had been nearly torn off at the knees and had to be amputated. He had a few weeks at home after the operation but was not the same Nico. He sat in his wheelchair by the window, staring outside with a distant look on his face. He never answered the questions about what he had discovered in the quarry, just turned his eyes away. Soon, he went down with a high temperature and the doctor thought that the wounds had become septic. They took him to the hospital again, but he had lost consciousness by the time he arrived. He died that night. Because Nico had been the younger son, he had left few possessions for them to inherit but Hedwig ended up keeping his best black shoes, bought for his first communion at thirteen. She brought them with her when she went to Linz to train to become a children’s nurse, and again when she moved to Wien and took up a post at the newly opened clinic at Spiegelgrund. From time to time, she would pull the shoelaces out, polish Nico’s black shoes and lace them up again. But dead people do not grow back into their old shoes, regardless of size. The enigmatic accident and Nico’s sudden death made something inside Hedwig Blei freeze. She stands on the verge, watching the arrogant, insecure Hitlerjugend youths march past. In Linz, she sees the motorised Wehrmacht units roll across the bridge as joyful shouting fills the air and the local NSDAP cadres roar and sing so the streets echo with the noise until late at night. And she smiles, too, and the band of freckles glows on her blonde face. Those who don’t know her well can never guess how she feels. She always comes across as easy-going, chatty and friendly, very much her older brother’s sister. But behind the bright freckles, fury has hardened into a wall. Only those who have worked with her for a long time have tales to tell about the way her skin can suddenly pale to a chalky white, how the folds between her eyes deepen and her eyes cut like broken glass. Felix also notices when it happens. Then, the infantile spasms in his face vanish and he stands very still, as if listening for something.
Orthopaedic Shoes One morning, Hedwig takes Nico’s old shoes to the orthopaedic workshop. The orthopaedic surgeon, Doctor Grieck, is doubtful at first. He wants a formal referral, he says, then he blames lack of time and, anyway, the shoes would be far too large and unwieldy for a child. But Nurse Blei is stubborn. She has been palpating the distorted ankles and arches of Felix’s feet for weeks and is by now feeling quite sure about what is required. In the end, Doctor Grieck reluctantly agrees to try out a pair of loose insoles, and maybe also to strengthen the heel if necessary. Whatever else, she must bring the boy along. Doctor Grieck is a grumpy man with bushy grey eyebrows and grey hair in a spiky fringe around his bald head, which is crowned with a protruding, egg-shaped bulge. He sits on a low stool in front of Felix with the boy’s left foot in his lap while Felix stands in front of him. The boy’s eyes are glued to that smooth, shiny egg-shape. He looks as if he would like to touch it but doesn’t dare. Just for once, he is on his best behaviour, doesn’t grimace or resist the stranger’s large hands that are touching his legs and feet. Perhaps the setting has silenced him. The orthopaedic workshop, with its high ceiling and long row of windows overlooking the old hospital garden, is a little like a schoolroom. It is a sunny, breezy day. The crowns of the trees are swaying in the wind and casting long shadows like pale curtains that sweep across the room’s white walls and low workbenches. On the worktops lie finished or part-finished prosthetic arms and legs, and a whole hand with splayed rubber fingers. In the old days, Grieck and his team dealt with shoe lasts, strengthened soles and raised heels for people with club foot, when they had time in between making crutches and walking frames for elderly patients. But ever since the German clinical experts arrived with their lists of names and the hospital gradually emptied of the ill and the old, that kind of work is few and far between, Grieck says or rather mutters. Now, they mostly make prostheses for injured soldiers. Hedwig Blei stands nearby, watching intently as Nico’s old shoes are adjusted to fit Felix’s feet. She doesn’t say anything. In pavilion 17, the doors at the back of the building have been opened wide so that children who are able to walk unaided can be outside. The area around the terrace is fenced off and nurses from the wards in the pavilion take turns to keep an eye on the children. Felix takes his first steps in his new shoes inside this enclosure. Like so many children damaged by polio, he has grown used to dragging and sliding his feet on the ground in order to avoid having to put his body weight on one leg only and now, when he really must move using his own muscle power, he hesitates a great deal and takes small, jerky steps as if wading in ice-cold water, while his posture is enough to express his resentment: one shoulder is pushed up close to the side of his face, his arms are bent and his hands left to dangle uselessly in front of his chest. Hedwig Blei watches from the day room window and sees him move towards the far end of the enclosed area, as usual trying to get as far away from the other children as he possibly can. Paaah…! the boy Pelikan wheezes. He has joined her at the window. Pelikan never goes outside willingly and prefers to creep from room to room, turn up in the doorways and listen along the walls, so he can keep tabs on what is going on, especially if it involves the other children; and next, goodness, look at that boy, what’s he up to? Nurse Storch says. By now, she too stands at the window, watching the yard. Storch points at Felix. He has stopped and stands stock-still, looking down on his shoes as if in some mysterious way they have stuck to the ground. Nurse Sikora steps down from the terrace and starts to walk towards Felix. She seems agitated but determined and when Felix turns towards her – probably in response to what she is shouting at him – everyone can see the stain, roughly shaped like the African continent, which has spread across the crotch of his baggy trousers. The usual grimace disfigures his face as he turns to Nurse Sikora and, naturally, Sikora slaps his ugly face hard and then drags him, shoes and all, back into the building. The slam of the terrace door echoes all the way upstairs. And what’s the point, anyway, Nurse Storch mutters, giving that boy new shoes…?
Fatherlands The next day, she is called to the matron’s office. Klara Bertha is at her desk and looks as if she has just bitten into something bitter and nasty. Sikora has clearly passed on the gossip. I hear that Nurse Hedwig has set out on her own initiative to supply the idiots with new footwear? she (Bertha) says. And Hedwig replies: they were my brother’s shoes. Bertha: perhaps he had better have them back now. Hedwig: my brother is dead, he died defending his country. At first, Sister Bertha seems quite upset but she soon recovers her old, safe expression of patient goodwill. She keeps looking at Nurse Blei as if expecting her to explain just which country she has in mind or what, generally speaking, she means by ‘country’. But Hedwig Blei doesn’t elaborate. Instead, she says: Where I come from, we’re not used to letting things go to waste. Bertha: and where does Nurse Blei come from, if you don’t mind me asking? The amusement is back in her voice but also a hint of relief. As if Matron feels reassured now that any discussion of the country’s defence has been dropped. She starts leafing through some papers, pretending to be preoccupied. You’re good with children, Nurse, she says. Your colleagues recognise it. You will now return to nurse in the gallery. An urge to dress the children as you fancy is not quite so likely to arise there.
The Miraculous Births There is an outer and an inner world. The outer one is filled with unceasing clamour while the stillness in the inner world is like that of an early winter morning when the snow has just stopped falling. Hedwig Blei remembers such a morning. She was four or maybe five years old. They had just finished breakfast when a chorus of voices from the yard started to call to them. Outside, their neighbours and even folk from as far away as Grünbach were crowded closely together. Their frost-reddened faces seemed suspended inside a drifting cloud of vapour created by their breaths. They were on their way to Ratschnig’s farm nearby, where a heifer was about to give birth to a monster calf. The words ‘monster calf’ stuck in her memory, as did the sight of all the bulkily dressed people stomping about in the thick layer of new snow, their shouting voices sliding across a silence that had been blown clean by the snow-laden wind. At Ratschnig’s (once they got there), it was like a Christmas fair. Everyone was yelling and laughing, the dogs were barking and howling and tugging at their leads. The crowd was especially dense near to the cowshed door. Nico, who was bony and quick on his feet, had managed to squeeze inside and could report afterwards how the men had hauled the calf out (he didn’t know if it was born alive or not) tied to a long rope, carried it out into the barnyard and set to beating and stabbing it with spades and bars while the farmer had kept shouting spare the head … spare the head … As the years went by, the monster birth was added to the many portents or local accidents that served as measuring rods sunk into the flow of time. This or that, people would say, happened the year the monster calf was born at Ratschnig’s. It somehow added weight to the event. The episode stayed in Hedwig’s mind, too. Not just because of the calf. After all, her childish eyes hadn’t been allowed to see it. But everything that surrounded its birth seemed etched into her memory with unreal precision: the silence after the snowfall, the winter sky clearing into a nearly turquoise blue, and all their neighbours standing in the yard as if they had gathered to look for someone missing, a runaway or a suspected drowning perhaps (one of them had brought a hurricane lamp, though it was already light). And she remembers their elated eagerness, as if the local folk had already fantasised about the heavy tools they would use to beat the calf to death. And there was the thought of the calf itself: how it must have felt as it was pulled out of its mother’s large, warm womb into a world of noise and shouts and iron bars that thumped and hit and, then, this terrible pain. There are no monster births, as her mother used to say: all living things born to God are miracles. This was how she had wanted to see the children in pavilion 15. But it was not to be. In the eyes of those who administered and managed the clinic, its patients were not actually children but specimens, living examples of neurological and physiological defects, or of various pathological processes, all conditions whose progress were worth observing. Nothing was real in any other sense, not even the convulsions and the pain that plagued some of the children continuously. If they were sedated, it was not to ease their suffering but to put a stop to their screaming. The doctors would arrive at regular intervals to study them, to select whose life should be taken immediately and whom it might be worth troubling to keep under observation for a little longer. Once the decision to eliminate had been made, they would return to take notes about the actual dying. In a group, always. For it would not do to look into the eyes of the newborn animal: the creature obviously has no idea about the infernal flaw that makes it unfit to live. It’s easier to kill if you are part of a group. When you act with others, you don’t personally kill a living thing but join a battle against a common threat. The staff in pavilions 15 and 17 showed absolute obedience to their superiors, not only because the strictly hierarchical order diffused responsibility so that no one individual took a life, but also because it reduced killing into an outcome of the order of things. It also followed that you must not allow yourself a second’s inactivity. Standing around, crestfallen and empty-handed, gave you time to think. As Hedwig Blei admitted afterwards, it wasn’t that there was such a tremendous amount of work to do on the ward. Truly, the daily routine was relatively light because most of the children were heavily sedated most of the time. But being constantly on the move prevented you from taking in how absurd the situation was: this was a clinic for severely ill children which did not specialise in making the patients better, or at least provide them with appropriate treatment, but, on the contrary, in avoiding any treatments that would make them harder to kill. The reason, it was argued, was that such children constituted a major threat against the Germanic peoples. Not that this was something you could discuss. The entire clinical unit operated under a duty of silence so total that it seemed like mental quarantine. But people had to talk about something, of course. Hence, the gossiping. No one escaped the wagging tongues, not superiors, not colleagues (when absent). The gossip offered one way, at least, of talking about what was going on. The clinic’s staff included several former Steinhof employees, some of whom had been there long before the reorganisation. Like Hilde Mayer, who often spoke about when the so-called medical experts had turned up at the main asylum (most of these experts were Germans and members of the SS). They had walked around from ward to ward, always led by Doctor Jekelius because he was the one who made the final decisions. Later, the psychiatric nurses had been ordered to take the selected patients to the waiting buses and, though some of the elderly ones knew no better than to think that they had caused too much trouble where they were and that’s why they had to be moved, the majority understood only too well, and wept and tried to hang on to whatever they could reach – beds, door posts, stair railings. By then, many of the nurses were in tears, too, although perhaps not always for the reasons one might have assumed. Naturally, some people were remembering their own old and ill, like I did, for instance, Mayer said, but the Lord be praised, my old folk were still mentally sound and, she added, I seem reasonably sane as well, at least as far as I can judge. Still, to be honest, most of the nurses were probably thinking of themselves and their jobs. What will happen to them, they worried away, now that the psychiatric patients are carted off and the hospital is to close? They might well be surplus to requirements. Jekelius gave a reassuring speech to the entire staff in which he said that there would surely be enough work for everyone. Their (here he meant his and his colleagues’) work had, to the best of his knowledge, only just begun. When he had finished, there were no more tearful faces to be seen. When Hedwig Blei thought about Jekelius, she was often reminded of something her father used to say: you recognise the cock pheasant by his feathers. To her, the doctor was an embodiment of affectation: his gentle voice, so strenuously soft that one had to stand on tiptoe to hear what he was saying; his deliberately graceful movements, used to emphasise every word he uttered. Jekelius was seen, almost always, in the company of others. In his case, this was not because of some inner need to blend in. Somehow, Jekelius always managed to be a little behind, or drifting away from the group, as if wanting to keep his distance from those who were closest to him. It meant that it was always the others who had to turn to address him, while he never had to come after them. A man who behaves like this wants to be seen at any cost. Vain and self-assured, certain of his absolute power. Hedwig saw him only very rarely, though. His absences were due to his in-service travels or other tasks and, besides, he had no medical reason to stay at Spiegelgrund. The day-to-day running of the clinic was the responsibility of Doctor Gross and Doctor Türk, who were in charge of one ward each. The staff in pavilion 15 was working on a duty rota that meant Nurse Hedwig was on nights at least twice a week. According to the regulations, one doctor should be on call every night but Hedwig Blei had only rarely seen either of them. The rule was also that the doctor must only be called when a patient’s condition worsened enough to require medical attention or when one of the children died and the doctor had to sign the death certificate. But it happened often enough that Gross, who, like Türk, had been provided with a house on site, took his time to ‘come down’, making the point that turning up twice was surely unnecessary. If he didn’t come, the dead child was left lying until the morning. What was wrong with that? Overall, Hedwig Blei said, the lack of drama was striking, perhaps in particular when it came to the killing and the dying. Even though nobody had cared to state it openly, Blei had realised almost at once that the children’s lives were taken deliberately. True, hints were dropped all the time. Don’t you think these children are sleeping a little too much? Nurse Frank had asked rather rashly when she was new to nursing in the gallery, and Hilde Mayer had replied: Just practising for their eternal sleep! Give Mayer half a chance and she’d let her tongue run away with her. But, perhaps there was no need to speak out. The attitude of the clinic’s leadership sent its own unmistakable message. They often couldn’t be bothered even to begin treating a patient or to complete a treatment once it had begun. Why, they weren’t even prepared to have the temperature on the ward kept at a comfortable level. Wartime scarcity was blamed, hence the need to save fuel. Nonetheless, the staff was ordered to keep the windows open at all times, even during raw, damp and cold days in winter, even though the children were in very poor condition and often febrile. Most of the severely ill patients stayed in the gallery for just a few weeks but, even so, many years later Hedwig Blei had clear memories of some of them. A baby boy, six or seven months old, called Heinz something (she no longer remembers his surname) had a tumour on his back, a fist-sized growth like a knobbly little rucksack. He could only lie on his side with his face pressed against the sheet. In this awkward position, he breathed like a wounded animal, his frail ribcage heaving up and down like the gill slits of a fish. A small girl in the bed next to him cried out all the time, as if something was slowly tearing itself to pieces inside her. No one tried to find out what caused the pain. She was prescribed huge doses of morphine and died within a week. Several of the children were tied to their beds to stop them from hurting themselves or eating their stools. Some of them had been strapped down for so long that their wrists had deep, infected gashes that seeped fluid and pus. A seven- or eight-year-old girl had initially been restrained but the ties had to be removed when blisters on her lips spread and turned into large, weeping sores. Hedwig Blei had asked Cläre Kleinschmittger for a little salicylic acid to apply to the girl’s lips. Two days later, Kleinschmittger mentioned that salicylic acid had been taken from the medicine cupboard to Katschenka, who demanded to know the circumstances. Kleinschmittger told her that Blei had used the drug. A long time had passed since their meeting in the sluice room when Blei had asked Katschenka if she was married. Now, their respective ranks had been clearly established. I will never forget her coming towards me with that slow, processional pace of hers, Blei said. Katschenka had already caught my eye but because her whole face was so immobile, down to the muscles and bones, she always seemed to be smiling. It took an age for her to reach me. When I told her what I had needed the medicine for, she said that in this ward we never use anything unnecessarily. Soap and water would have been sufficient, she told me; that was all, no reprimand, nothing, only the gaze she fixed on me, so cold, as if I had done something disgusting, almost perverse. Afterwards, they had to apply the straps again because the girl wouldn’t stop scratching. She must have been in utter torment but Doctor Türk just prescribed more morphine, and when Blei arrived the following morning, the girl was lying very still. Her swollen eyelids were closed and her hair stuck out in stiff, sweaty tufts around her head. No one had bothered even to disentangle her hair and comb it. Why should they, she was going to die soon anyway. When the doctors did their rounds, Katschenka always kept a step or so behind them. It was her job to summarise what the nurses had written in the day notes about each patient. Just two or three sentences, whispered into the ear of the medic on duty. Nothing more was required to indicate the child’s condition and many of her short confidences were dismissed by the doctors before she had finished whispering. There was no telling whether that was due to plain indifference or whether everything had already been decided and matters were taking their due course, so there was nothing more to say. But sometimes Hedwig Blei felt sure she had seen an expression of distaste flit across Doctor Gross’s face and der kommt dran, he would say. Blei says: I will always remember that phrase of his, that’s that, then. Katschenka didn’t bat an eyelid, just stood there, her grey face as impenetrable as always, waiting for Doctor Gross to move on to the next bed, but I’m certain that she understood the doctor’s intentions perfectly and knew to whom and at what dose a certain drug would be administered in the evening. She was the perfect ward sister. Like a clock counting down the minutes to death. Meanwhile, she watched and waited and saw to it that everyone else was doing her duty. Not even Hilde Mayer, who would tell jokes and make fun of everyone, ever dared to stand up to Katschenka. The children died, one after the other, and later on, when Doctor Illing had succeeded Jekelius, the death rate was two or three every night. Once a child had finally given up the ghost and the death certificates had been filled in and signed, the body was wrapped in a simple shroud and sent off to autopsy via the back door to avoid any troublesome confrontations. By then, the child’s parents would already have been informed but Katschenka insisted that no relatives must be admitted to the pavilion. If they wanted to see their child one last time, it had to happen somewhere else. Blei had, several times, witnessed incidents when upset relatives tried to force their way in. The porters had to be called and if they couldn’t handle the situation, someone phoned the police. But there was never a word of criticism from the staff, not even after alarming, violent incidents such as these. What mattered was the clockwork running of the institution. In one of the secretarial rooms, Marie Kölbl was typing out the standard letters to the families of the dead children. The letters had been dictated in good time. The door to Kölbl’s room was always kept closed and if the clatter of the typewriter ever stopped, it was only because she got up to open or close the window. Afterwards, the typing started again, sounding stronger or fainter, but it never stopped for any length of time.
Your child would probably never have learnt to sit upright or walk. Your child suffered from recurring convulsions, which no medical treatment could cure to any significant extent. Your child died from an attack of pneumonia that normal children with fully developed immune defence systems can deal with. Your child passed away peacefully and quietly without much suffering. It should be of some comfort to you to know that, for your child, death was a blessed release.
But those miraculous young beings: what did the world look like to them, deep in the sleep of the drowned? Nurse Blei tells the following story: one evening, when she had just turned up for the night shift, the doors banged and strange voices were heard in the corridor. She went to look and saw Doctor Jekelius in the doorway to the main ward. He was dressed like an ordinary citizen in a coat and a hat. Two people stood next to him, a man and a woman, both upper-class types, Blei said, it was easy enough to spot. The woman’s first impulse was to cover her face with her hand to keep the smell at bay and Jekelius put his hand protectively on her arm. Now, now, don’t worry, he said. They had been drinking, the alcohol fumes hung like a cloud around them. Where is the boy? the man said impatiently. Doctor Gross turned up shortly afterwards, so they must have phoned him. The smile on his face was the one he reserved for when he wanted everyone to know that he took no personal interest in what was going on but was present on professional grounds only. Jekelius said that Mr and Mrs whoever (Blei didn’t pick up their name) had decided that they would bring their son home gegen Revers – with a consent form – and that he, Jekelius, had granted them their wish. Even later, after she had grasped the context, Blei couldn’t stop being surprised that Jekelius had let her see him in that state, so obviously the worse for drink. However, Gross seemed not surprised in the slightest or, if he was, hid it well. He took the documents Jekelius gave him, started to look through them and said in an off-hand tone that Nurse Blei should go and dress the boy. The child weighed next to nothing in her hands and was so deeply sedated that he didn’t wake up even when she lifted him close to her face. His thin breath smelled slightly of ammonia. In the morning, when Blei went off duty, the bed was still empty but if Katschenka took note of this, she never showed it. It could be that, to her, the child had died the moment it arrived. An empty bed would anyway soon be filled by another severely ill child. All according to Jekelius’s orders.
The Drowned Just before Christmas, she is back at work in pavilion 17. As usual, Pelikan opens the door for her and, as usual, Felix is playing. But now he doesn’t turn to her when she sits down next to him. He still takes no notice when she strokes his hair and bends forward to whisper in his ear. He just plays more loudly then before, crashing down on the black keys so that the bones in her face feel like shearing and Nurse Sikora shouts from the corridor WILL YOU STOP THAT INFERNAL…! Sikora is on her way into the day room but stops on the threshold when she sees Blei. A false smile spreads over her flat features. Nurse Blei’s little favourite hasn’t been a good boy recently, she says. Then, out comes a long tale of everything Felix has been up to while she was away. Spilled his food, made a noise in the day room, said very bad words to staff, even wandered around hitting other children in the face. All that is part of his routine now. Seems his evil spirit is getting out, Sikora says. One day, she placed him in solitary for a few days and it did him a lot of good. Isn’t that so, Felix? she asks, and pretends to pay attention while Felix becomes very ill at ease, twists and bends, and finally manages to tear himself free from Hedwig’s grip. Hedwig follows him. They sit together in a corner of the room. The boy called Pelikan listens, leaning against the wall. Can’t you hear the row upstairs? he says. Who’s making a row? Blei asks. The girls, Pelikan tells her. She can’t reply because Felix struggles to get away. Finally, she manages to catch his legs between her own so she can grab hold of his face and inspect it. The boy has sores in his mouth running from the corners of his lips upwards to the nostrils. His breath smells badly. She tries to force his jaws apart to see if his gums have become infected again. Then Nurse Sikora is back in the doorway. We have to tie him at night because he can’t keep his hands under control, he just scratches at the sores all the time, she explains. Perhaps it would’ve been better to cut his nails then, Nurse Blei says and holds up Felix’s dirty, uncared-for hands in the light. But Nurse Sikora sees no fingernails. Only one thing preoccupies her: the ineffectual hatred that, for some reason, she feels towards her colleague.
Cancelled Leave The number of children in the pavilion has grown a great deal since Matron had dispatched her to serve time in pavilion 15. Erna Storch tells her why. The reason is that the reform-school side of the institution is constantly sending their ‘hopeless cases’ on to the clinic. Seemingly, Doctor Krenek thinks we’re more likely to succeed with the tasks they can’t manage over there, Nurse Storch says. They have also opened a new section for ‘unteachable’ girls on the second floor. These are the girls Pelikan is listening out for all the time. Most of the girls are there because they have failed to complete their duty-year, the Pflichtjahr, or tried to run away from foster families. Hedwig Blei’s ward is by now so short of space that some beds are placed in hallways and corridors, which tends to make the already tense children even more nervous. One of these displaced children, a boy, just lies on his back, staring into the distance. He refuses to lift his hand to take the mug of water she wants to give him, despite having normal motor control, and fixes his eyes on the wall clock as if his gaze is stuck to the hands. A somewhat undersized nine-year-old with scabies sores on his head – his name is Otto Semmler – potters around the ward all the time, looking for an adult hand to hold. If he doesn’t find anyone, or if Sikora or Storch slaps him or angrily pushes him away, he cries heart-rendingly. He doesn’t want to stay in his bed. Soon, Blei realises that she is accompanied by Otto wherever she goes. It feels like existing with one hand permanently tied behind your back. She wishes that someone would look after Felix, but who would that be? Caring for individual children is not part of anybody’s proper work. Whenever he is allowed to play the piano, he hammers the black keys as if they were nail heads and Nurse Sikora screams as if the nails were driven into her. One Sunday, Hedwig sees Mrs Keuschnig standing between the beds in the corridor, looking upset. She must have visited Felix, because she holds one of the black shoes. What is this? she asks, lifting the shoe by its laces with an expression of unspeakable disgust. Are you preparing for his funeral already? Mrs Keuschnig’s face is long and thin, with marked folds on her cheeks. She gives the impression of someone who has spent her entire life exercising self-control. Now, when she bursts into tears, her eyes flood. With tears trickling down her cheeks, she says that she cannot stand watching what the clinic is doing to her son, their mismanagement means that he has lost ten kilograms in half a year and now she is told that it is Felix’s own fault that he doesn’t eat enough even though the doctor has made a note about a big sore inside his mouth which, it seems, has been caused by malnutrition. She says that she doesn’t dare tell her husband about the bad treatment of their son for fear of how he will react. In letter after letter, she has begged Doctor Jekelius to let Felix come home over Christmas, at least for a few days. It surely can’t be impossible? Just look at how crowded the ward is. Besides, Felix always gets better when he has been at home for a while. But Doctor Jekelius has not replied and every time she has tried to phone him she has been told that he is away on business or engaged with someone else. Hedwig Blei is tempted to tell Mrs Keuschnig that if she wants her son back, she had better be rich and, preferably, have a husband with a top position in the party – maybe her husband isn’t enough of a high-up? Instead, she promises to try to put in a good word for her the next time Doctor Jekelius comes to the ward. But it takes a very long time before he visits pavilion 17 again. Meanwhile, the rumours about his out-of-office activities grow wilder and wilder. Several children, some of whom had already been passed for treatment, have been discharged between one day and the next, or else ‘collected’ from the clinic on unclear premises. One might even get the idea Jekelius is running another clinic on his own, Nurse Mayer suggests. On the side. Where he goes on all his ‘business trips’. Another notion of Mayer’s is that Jekelius was ordered to present himself to Professor Gundel, the city councillor, and that Gundel proceeded to tell Jekelius that his behaviour has attracted unfavourable attention in many quarters, all the way up to the Department of State in Berlin. Mayer claims that she has reason to believe they will ‘see the back of Jekelius’ before the year is out. But when Jekelius finally does turn up on the ward, he seems very far from a broken, haunted man. His movements have the usual, calculated arrogance. He progresses through the ward, followed by Sister Bertha, Doctor Gross and Edeltraud Baar, the psychologist, and if that smile had not been glued to the face of Gross, that exaggeratedly broad, jovial smiling at all and everyone in order to distance himself from his surroundings, one might have thought that nothing had changed. This time, the round stops for a long time at young Keuschnig’s bed. Doctor Gross peers into the boy’s mouth and the two doctors exchange a few brief sentences; but when Jekelius then turns to Blei it is not to explain a planned intervention:
I gather the boy’s mother has been running around the ward. I expect Nurse Blei to keep her at arm’s length in the future. For your information, Nurse Blei, from now on all leave for this boy is cancelled.
Doctor Gross, who stands close to his superior, looks as if the two of them together have succeeded in some great venture.
It’s these marginal cases. If we give up on them we might as well admit defeat altogether.
This is that last thing she will ever hear Doctor Jekelius say as director. When she comes back from her Christmas break a few days into the New Year, she learns that Jekelius has been called up and has joined the army, and that Doctor Jokl is acting medical director until a permanent solution has been found. Meanwhile, Felix’s condition has become much worse. The swelling that deforms his jaw is now so large he can hardly swallow. He lies on his back and breathes through his mouth, and the open wound inside his mouth must be dreadfully painful because he is whimpering and mewling, and rubbing the back of his head and the side of his face against the bed even though they have tied him down. She knows that they will try to transfer him to pavilion 15 as soon as possible and if he arrives there in the condition he is in now, he won’t leave the place alive. On the Sunday, when she is on night duty, she phones Doctor Türk who is on call that evening to tell the doctor that the boy, whose health has declined rapidly over a short time, now has a high fever. She adds that it might be a symptom of sepsis. Half an hour later, Doctor Türk arrives, at first sceptical about the need to examine Felix at all. Have you managed to make him take any fluids? she asks. Not really, Blei replies. He can’t swallow. Doctor Türk produces a spatula and a torch. While she roots around in the boy’s mouth, Hedwig tells her about the jaw operation Felix underwent just before he arrived at Spiegelgrund, quoting his mother’s description. It’s all in his case notes, she points out. Doctor Türk glances quickly at the notes Blei hands her. Would it be possible to see if they can receive him in pavilion 3? One section of pavilion 3 is set aside for the reform school’s casualty reception and sickbay. I shall have a word with Doctor Hübsch tomorrow, Doctor Türk says. I can’t make that decision. Next morning, Felix is moved to the ward in pavilion 3. Two male nursing assistants carry him between them. Blei accompanies them, and carries the black shoes, the only things in his bedside table (apart from the regulation towel, soap and toothbrush). A nurse called Marie Darnhofer works in pavilion 3. Hedwig now knows that Marie had been at the special children’s care home in Pressbaum while Felix was there. Felix recognises her at once and, for the first time in many weeks, a smile spreads over his swollen face. Two days later, Felix has surgery and when Nurse Darnhofer phones to say that he is out of the anaesthesia, Hedwig goes across to sit with him for a while. Most of his face is covered in a big bandage with only his eyes and the tip of his nose showing. He can’t talk but no longer casts his head about to distract himself from pain. They stay silent. She plays with her fingertips on his arm. Fuchs du hast die Gans gestohlen, she plays. Gib sie wieder her. After a while, Felix plays along on top of his blanket, using his free arm.
Deserters The next time Hedwig Blei can take time off to drop in, two soldiers have been placed in the same ward as Felix. It looks quite strange. The small boy with his chin in bandages bedded down between two grown men who are far too large for their beds. One soldier is asleep with his back turned to the ward and snores fit to make the walls shake. Nurse Marie says that several of her colleagues have asked to be moved here to nurse war casualties. Their applications stress their patriotic zeal but secretly they all hope to find the right man. Marie laughs and Hedwig realises how wonderfully easy it is to talk to Marie. Here in the sickbay there is none of the hostility that makes working in pavilion 17 so grim, what with the busily gossip-mongering Nurse Sikora and Nurse Storch, her puffed-up companion who snoops everywhere and threatens with the sack anyone who doesn’t donate to Winter Aid. Hedwig Blei now and then gives herself errands on other wards where the war-wounded men have been accommodated. Most of patients are young and have been diagnosed with various battle-induced neurotic conditions, which makes them, in the eyes of Wehrmacht officialdom, a bunch of defeatists and deserters, though defeatism isn’t what first comes to mind when you see them, often covered in bandages, some with facial burns or shrapnel wounds. Two of the patients are in wheelchairs after having had both legs amputated. One of them, just a lad, with a wide face and chiselled features, reminds her of her brother. If Nico had lived with his legs blown off and his crushed pelvis, maybe he too would have been forced to stay here. The thought makes her feel sick at heart. The two wheelchair-bound men have been joined by two other patients, who have rigged up a card table between them. When she comes in, all four interrupt their game and their eyes follow her. She smiles at them but they don’t return her smile, only stare as if their eyes can’t quite take in what they see. On her way back, she spots Felix out walking in his black shoes. He is testing himself, all alone on the small lawn behind the pavilion, he takes one step forward, stops, then a couple of sideways steps, then one more forward. He reminds her of a chess piece moving on a very large board. Between black and white squares. Afterwards, when she sits by his bed, he points to his mouth to show her that he is hungry. Then he asks for his mother. And, then, for his piano.
Doctor Illing In the summer of 1942, six months after Jekelius’s call-up to the front, a new medical director is appointed, a Doctor Illing. He is German. Everyone is making a big thing out of this: he comes from there, probably on direct orders from Berlin. Ernst Illing is Jekelius’s diametrical opposite: a stocky, broad-shouldered, energetic man who stalks the corridors at a fast pace. He has a habit of sticking his head forward as he speaks, perhaps to compensate for being short or to make sure the other won’t escape. Illing speaks with a marked Saxony dialect and the powerful tobacco he favours makes his breath smells sour and thick, and it stains the brief grin he bestows automatically on anyone who listens to him and does what he says. His domineering manner and sharp, piercing eyes make Hedwig Blei feel uncomfortable, and the new, stricter rules he enforces worry her. Already, on his first day, he states that visiting will be restricted from now on. No visits unless arranged beforehand with himself or, when he is absent, the acting medical director. Visiting hours must be used to greatest effect and not to indulge the whims of relatives. Your work here is your contribution to the war effort, he announces in his loud, rather high-pitched voice. From now on, it is our duty to the Fatherland to maintain an unimpeachable front to the world. He also emphasises how crucial it is to keep the patient’s case notes up to date. This is a medical establishment, he says. Every detail in the course of disease can become of the utmost importance to diagnostic assessment and the final decisions on treatment options. Illing seems to have recognised Sister Katschenka’s usefulness. She is to act as Matron Bertha’s deputy when the senior nurse has been required ‘for other tasks’. Unlike Jekelius, who only leafed through the case notes, Illing wants to know all there is to know about every child. There is one boy in pavilion 17 who interests Illing in particular. The boy’s name is Jakob Nausedas. He is eleven years old but looks about six. In the photographs Gross took of him, Jakob is almost alarmingly beautiful, with large, deep-set brown eyes, dark hair and delicately sculpted ears. Because he will not lie still at night, he has been placed in a netted bed but so far not in a straitjacket. He usually sits absolutely still in the middle of the bed with his legs crossed under him, staring straight ahead. He is very shy. If someone comes close, he pulls a blanket over his head. Even so, Blei has seen him up and about several times. Unlike many of the children, he seems to have no physical impediments. In fact, he moves like a little angel, leaping along with alternate long and short steps and, as he runs, he puts the front of each foot down first as if to use its arch to lift off. He seems fearful of being hit, holds his hands uncertainly in front of his face or upper body to cover himself, even when it is just Pelikan, on the alert as always, who is on the move to open the door for the caravan of white-clad doctors and nurses. By the time they are all inside, only the tip of Nausedas’s nose and one glinting eye peep out from underneath the blanket. The blanket was with him when he arrived, Nurse Sikora explains to Doctor Illing, who has already asked Blei to lower the side of the child’s bed. Standing next to his chief, Doctor Gross gives an account of the patient’s convulsions followed by paralysis, attacks that usually occur at night. Another characteristic of the fits is that Nausedas’s voice grows deeper and somehow strange. Almost as if the boy was possessed, Sikora suggests. Doctor Illing impatiently skims the notes that Katschenka has given him.
Kaunas, now, isn’t that in…?
In Lithuania, Katschenka fills in.
And how come the boy has ended up here?
He’s an orphan, Katschenka says.
He’s actually circumcised, Doctor Gross says and turns away with assumed indifference, as if to say that he is done with this. But as far as Doctor Illing is concerned, nothing can be dealt with that quickly. He bends over the bed and rips the protective blanket from Jakob’s grip. They hear the child’s faint intake of breath; his body is already pressed up against the inside of the net cage over the bed. He breathes in gulps as he lies there like a wounded bird, with his arms and legs pulled up against his body. Doctor Illing pushes and digs with surprisingly strong, capable hands and when he has seen with his own eyes that Doctor Gross’s information is correct, he just flashes his joyless, toothy grin and nods. Nurse Blei wants to let the boy have his blanket back but Illing waves her away, takes a firm grip under the boy’s arms and lifts him upright. Jakob’s head slips this way and that, his eyes roll, too, both pupils flickering like the quivering centre of a spirit level.
Can the little Jew boy be made to stand upright? Talk?
Blei shakes her head mechanically. Katschenka looks down at the case notes as if waiting for a new command.
Doctor Gross, would you see to it that by Monday next, this boy can stand? If you have to, why not give him something to perk him up. Just make him capable of standing upright. I would like to demonstrate this case at my lecture next week.
Nausedas’s Song Marie Darnhofer told her a story about the man who had come to the door of the office in pavilion 1 and asked if this was the place that took in children. He had looked as if he was sleeping rough, unshaven and dressed in a large, worn coat that smelled. The boy he had brought had been standing a few metres away with his face turned to the cloakroom, as he wanted nothing better than to hide among the coats and jackets. The man stated that he was not the child’s father and not any other kind of relation. But he had been given the child in his charge. That was the phrase he used. In his charge. For how long, or who had given him this responsibility and why, he could or would not say. Instead of answering Doctor Gross’s questions (Gross was the medic whose job it usually was to assess the child’s status somaticus), he produced a creased piece of paper on which someone had written down the boy’s name, date and place of birth – born in KAUNAS, it said in large, wobbly capitals. The man said that the child was healthy and, at first, had not presented any problems but, of late, had started to behave very strangely at night, so he didn’t dare to keep him at home anymore. By then, someone in the office had started to smell a rat, phoned the gate porters and asked them to notify the police. When the man saw a policeman come upstairs, he took fright and ran away. The boy also tried to run but was restrained. That’s all. On examination, Doctor Gross was able to confirm what had been suspected by any thinking observer: this was a Jewish child who had been hidden from the authorities. How the boy had come to end up in Wien (if it was true, as the note said, that he was from Lithuania) was beyond investigation. Nor did it seem possible to find out who had protected him and hence if these persons, too, were of Jewish extraction and also in hiding. Whatever was the case, the boy seemed quite unable to provide answers to these or, indeed, any questions. He just stared at you with his large, frightened eyes and, if approached too abruptly, covered his face with his hands and curled up like a scared animal. Because he showed clear signs of debility, he was placed on the ward in pavilion 17 until further information could be obtained. It soon became only too obvious that Nausedas made a row at night. When Hedwig Blei heard him for the first time, she thought that the squeaking noise was from a dormitory window that had been left open and was swinging on its hinges. She opened the door a little and listened into the dim realm of subdued night-light and sweaty, sleepy breathing. If these children slept at all, they were usually restless. In the bluish light, she thought she saw the shadow of someone, presumably Pelikan, slip along the wall. Now, the sound grew stronger and came from inside Nausedas’s bed-cage. If it hadn’t been so loud, she would have assumed that the boy was grinding his teeth, but it was rougher and louder than that, a little like pulling a nail out of warped wood. It gradually became deeper but at the same time began to slide up and down, with a quality more like a vibrating saw-blade. Words emerged from the wavering tune: harsh, angular words, incomprehensible but unmistakably words from a song which formed part of an ever more distinctive melodic line. After a while, she became used to Jakob’s alien song. The children did, too. When she was on nights, she would make her way past from time to time, look through the peephole in the door and see everyone lying nicely and quietly in their beds even though Jakob Nausedas was ‘singing’. One night, there was a tremendous crash from the ward followed by loud shouting and howling. Jakob’s bed was empty, the mobile children had got up and were running around. Pelikan was the liveliest of the lot. His shadow swept up and down along the long wall like a crazy minute hand and he was shouting:
Thunder!
Thunder!
And the song that came from somewhere sounded like distant thunder, short barking pulses as if the swaying melody had stuck in the boy’s throat and had to be coughed out. Little Otto Semmler, who lived in a permanent state of fear, tugged at her hand and pointed to the corner of the room where Nausedas crouched with the blanket over his head. Someone must have let him out of his cage and he had gone to ground in the furthest corner of the room while he ejected his thunder clashes at an ever-madder tempo. Come to think of it, that such a small creature could emit so much noise was just about incredible. She wanted to know who had opened the net cage on Nausedas’s bed? Her question was of course never answered. Pelikan, panting a little, was ready by the door when she left. He sings because he misses his mother, he explained helpfully.
The Living Dead It is said that when a human being dies, the soul leaves the body. But the soul might leave the body long before you die. If that happens, you get to look like Katschenka, Hedwig Blei said and went on to speak about that so seemingly calm, pale face and those eyes, which gazed at her with an expression of deepest benevolence despite the cutting criticism she, in her role as acting matron, was just about to deliver. These days, Sister Katschenka worked from Sister Bertha’s office, although she had never formally been appointed to the post of matron. It was irrelevant, since Sister Bertha could be away for months on end. Besides, as Blei put it, Katschenka was ‘made for the job’: efficient, unswervingly loyal and invariably sensible. Now, she wanted to know how this kind of chaotic situation could ever be allowed to erupt in a ward that was under strict observation around the clock. And, has Nurse Blei found the culprit yet? Who was responsible? Katschenka looks at her in silence, still with that distant but kindly expression. In my opinion, Nausedas got out of his bed by his own efforts, Blei says. Katschenka doesn’t contradict her, just shuffles some papers and remarks that Doctor Illing has decided to X-ray the child’s skull. Just as well to have that done in good time. Good time, before what? But there is really no need for Blei to ask or say anything at all. He’s just a Jew boy, isn’t he?
Encephalography While Jekelius was in charge, ‘puncturing’ children was done only occasionally but, as soon as Illing took over, these interventions became practically a matter of routine. The great majority of the children, including many who were very ill, underwent lumbar puncture followed by cranial X-rays. Hedwig Blei hadn’t grasped the extent of this practice until Miss Block in the office explained that Illing used the encephalographic evidence in a research project he had begun long before he took up the post as Spiegelgrund’s medical director. His goal was to perfect a clinical method for the diagnosis of severe neurological disease, notably the incidence and manifestations of tuberous sclerosis complex. TSC is a rare genetic disorder that leads to small, dense tumours forming in the brain and many other organs. The symptoms are complicated and often contradictory because the tumour locations are so scattered. Illing was keen to record their distribution in the brain and in the cerebral cortex in particular. Miss Block said that she daily spent many hours corresponding with hospitals on Doctor Illing’s behalf, asking for information from case notes and autopsy reports. He has himself found two proven cases of the condition and displays them, not without pride, in his lectures to the medical students in the pavilion 15 auditorium. One of the patients is a boy of about thirteen or fourteen called Julian Eggers, and the other an epileptic girl who is an inmate in the girls’ section of pavilion 17, even though the Berlin department decided that she was to be ‘treated’ and should have gone to the gallery. However, Illing insisted on ‘saving her up’ to let him follow the development of her TSC. Her symptoms and signs were near perfect and, for a start, her face showed the characteristic distribution of small, pale nodules. But the boy also has spots on his face, little leathery patches, and has had quite a few epileptic fits lately. It all adds up to a real monster for us to tackle, Doctor Illing explains to his audience of young clinical students who listen in breathless silence to his expositions of the illness his specimen patients are suffering from:
With regard to racial biology, tuberous sclerosis shows an almost alarming predictability. If only one parent has this disease, which is possible as that person may well be symptom-free, the likelihood is that one or several of his or her children will also acquire it. But its manifestations are treacherous in the sense that overt symptoms may remain dormant so that the condition only emerges in full force in later generations. Because the tuberosities may occur in several organs other than the brain, such as lungs, heart and kidney, and thus cause the symptomatology and course of the disease to vary markedly between individual patients, it is not uncommon for it to be confused with practically every other severe form of paediatric neurological disease. Unless the diagnostic methods are radically improved, we will remain defenceless against this enemy which threatens to undermine our race from within.
Nausedas had also been brought in to model illness in one of Doctor Illing’s lectures. That was why Illing had been so keen that Doctor Gross should get him to ‘stand upright’. That TSC was never on the cards in Nausedas’s case was neither here nor there. In order to determine the incidence of the disease, and its varied forms, whoever seemed a potential case should be included as a useful addition to the control group. Besides, all the children who had undergone encephalography were examined post-mortem and that meant you could compare the results of the investigation with the actual situation in the brain. Hedwig Blei lifts the lid of Nausedas’s cage and frees the boy from his blankets. It won’t hurt, she says. She is lying but knows that the boy won’t understand her. Or perhaps he does, after all, just as an animal understands that its life will soon end. Unusually, he doesn’t resist her, doesn’t even bother to hold his hands in front of his face. She is not allowed to come with him into the X-ray suite but knows from experience how the children are treated, how the nurse undresses them brusquely and straps them down, even children with fevers so high they can hardly sit up, in the same painful position where none of their muscles are at rest: not sitting or even half-sitting, but bending over forward to expose the lower back; then, the long lumbar puncture needle is eased between the lumbar vertebrae and into the space around the spinal cord to extract some of the fluid that circulates around the cord and the brain. It must be carried out very gradually to let the body get used to losing the fluid. And the child’s skin blanches and turns bluish, as if slowly suffocating; then, just as suddenly, the skin blushes and the eyes bulge and roll upwards, white with terror as the pain slashes the child’s head like a thousand sharp knives. Because the child is immobilised, the nurse holds an enamelled basin in readiness for when the stomach contents come spraying out and the child tries to scream though the sound is dampened by the acid matter which continues to flow uncontrollably from its mouth. All the body’s organs lie exposed, like stones rubbing against each other; and the air flows into the spinal canal and rises into the cranial cavity to surround the brain that is no longer suspended in its protective fluid; then, the light goes as white, reality seems as if corroded away from the world. From that day, Nausedas sings no more. She tries to give him the blanket. He does not react. She has never seen anyone look so vulnerable, like a featherless baby bird. His eyes sometimes stare unseeingly, sometimes hide behind closed, quivering eyelids. The next day, his temperature is very high and he doesn’t respond to being touched. They take him to the gallery in pavilion 15 and there he dies a couple of days later.
Certified as cause of death: pneumonia.
Black Keys and White A couple of weeks pass, perhaps a month. The memory of Nausedas fades. After all, new children to care for arrive all the time. One afternoon, Hedwig comes by when Felix Keuschnig is thumping on the piano keys. She decides to tell him to play more quietly but before she reaches him, the chaotic jumble of notes fall into a rhythm that carries a vaguely familiar melody. She stops. It is Nausedas’s song. Felix is running through the chords again and again but can’t keep hold of the sequence. His hands keep slipping off the black keys and onto the white ones, as if the keyboard were slippery, covered with a film of soap. A wave of anger flows through her, so strong it surprises her, and she grabs Felix’s arms to pull him away from the piano. Felix, who knows all the tricks by now, slithers out of her grasp, dashes into the dormitory and runs around slapping the sleeping children’s faces. Fierce slaps. And with every blow, he laughs sharply, triumphantly: Ha! It sounds as if he is imitating someone. She comes after him but he has already found new victims: Ha! Otto Semmler screams, red flares on his face. Other children flee in fear and hide wherever they can, under beds and chairs. Felix runs jerkily and drags his feet as if about to make himself fall over. Finally, she manages to force him down in a corner of the room and calls for help. It is the corner Nausedas fled to when he got out of his bed-cage. Felix, she says. And she starts to sing, as if she knows she has to. It is their song: ‘Fuchs du hast die Gans gestohlen’. Then he hits her too, with astonishing strength, right across the bridge of her nose. It hurts so much that tears spurt from her blinded eyes. Ha! he laughs and is quickly back on his feet. Of course, such behaviour must be punished. Off Felix goes to solitary confinement even though everyone knows that in his case, at least, it’s pointless. He only sits on the bench in there, staring listlessly ahead. He doesn’t try to hit anyone, but won’t speak either. Instead of answering when you address him, his body twists and his face contorts in his usual elaborate grimaces. There he sits, his face working, for ten days. When he comes out, he asks for his mother. Asks and asks, because he has missed one of the statutory visiting days. Hedwig Blei tries to distract him and leads him to the piano but he sneaks away without playing a single note. She wants him to draw but his rough strokes with the pen rip the paper. He draws coarse figures with lines for limbs and large mouths full of sharp teeth. When Illing does his round, she tells him that Felix Keuschnig is showing hopeful improvements but when Doctor Illing glances at Katschenka she simply shakes her head. Children classified as vollständig pflegebedürftig – completely care-dependent – or, as in Keuschnig’s case, just Arbeitsfähigkeit nicht zu erwarten – suitability for work not expected – are welcome additional subjects for Illing’s clinical experiments. Sure enough, one morning Katschenka announces that Illing wants Keuschnig for lumbar puncture followed by pneumoencephalography. They come for him early one morning. By four in the afternoon, she removes the black shoes from his bedside table and places them next to her own in the staff cloakroom. An hour later, Felix is returned to the ward. He is conscious but very weak. She can’t make eye contact with him. He is febrile and complains of pains in his head and the back of his neck. He lies in his bed and worries that someone is trying to throw him out of it. She tells him there is no one. Soon afterwards, he starts vomiting. He throws up again and again until the evening when he becomes feverish and agitated, casts his body from side to side, and waves his arms about as if fighting an invisible enemy. Doctor Türk is on call and Blei asks her to come. She isn’t sure whether Illing has already decided to have the fatal dose administered or whether Türk is just giving Felix the usual sedative. The boy’s eyes look glassy and his face is as white as chalk but he is much less restless, then seems to sleep easily, breathing too lightly but evenly. Anyway, she is going off-duty. Everyone goes but nobody comes, Pelikan says to her as she leaves the day room. She meets Nurse Sikora in the corridor, taking her coat off, ready to start the night shift. Sikora beams sunnily at her. When Hedwig returns to the clinic two days later, Felix has already been transferred to the gallery in pavilion 15. The next day, she asks Sister Katschenka to be allowed to nurse in the gallery again. Katschenka looks up with her usual expression of bland concern. There is no need for additional staff in the gallery at present, Nurse, she says. Besides, I must say that I believe it to be in Nurse Hedwig’s best interests to stay here. When Hedwig goes off work that day, she visits the gallery on the way. Felix is already dead. The end came quickly, Hilde Mayer says. Perhaps that’s just as well. No one wants to see a child suffer. Mrs Keuschnig is waiting on the gravelled path outside. A pale moon hangs in the evening sky. It could be that Mrs Keuschnig has already received information about her son’s death or maybe she felt a premonition of something serious and has turned up here on her own initiative. What have you done? she asks Hedwig. A group of women are standing a little away from the two of them and follow their confrontation with tense faces but neither say nor do anything. Mrs Keuschnig has been standing in the shadow but now she takes a sudden step into the moonlight and her face gleams white as she raises her arms in a disconsolate gesture and asks, her voice sliding into a scream:
What have you done?
Do you feel no shame?
Two porters come at a run from their cabin. They take hold of the screaming woman and propel her off the site. The porters know the routine, well-used to incidents of precisely this kind. The watching women have turned their backs and started out for the tram stop. Nurse Blei returns to pavilion 17. The Pelikan lad opens the door for her and then closes it quickly to prevent anyone from slipping away outside. In the dormitory, the numb childish faces turn to stare at her as if they expect her to say something, but she can’t think how to bring herself to break the silence or, anyway, if there is any silence still to be broken. All that is left now is a white sea. It covers everything.