Georg Letham (39 page)

Since a poison had invaded the bloodstream, every effort had to be made to eliminate it by flushing the renal system as thoroughly as possible. Would serum be used to combat the vomiting? No. Medication? No. Just horizontal positioning of the body. That was the treatment! And when paroxysms still came up from the distended abdomen, when more retching convulsed it, I gently held the child down on the bed in the vaunted horizontal position, the only proper one. What a joke! Y.F. and a temperature of forty-two–and horizontal positioning and ice chips to swallow are the best I can offer!

I spoke encouragingly to the child. I did not stint on promises that I knew to be false. The mulatto, who had been watching these terrible things and whose face had become as pale as a black person's can, would not leave the child. I pushed her out the door, chased her off to the hospital kitchen to bring up some chilled lemonade. In the kitchen area there were special vessels with finely chopped ice between the double walls (this was neither the first nor the last case of its kind). The child refused it. I sent the nanny, who had not yet had a real break, back
down for champagne from the director's private cellar. With a table knife I cut the wire that held in the cork. The child had as little interest in it as in the lemonade. Perhaps the carbon dioxide in the champagne, the acetic acid in the lemonade caused more irritation of the inflamed, raw membranes of the mouth, throat, and stomach. The nanny had to go down again. She muttered and looked at me spitefully with her brown dog's eyes. This time I had a sorbet brought and patiently fed it to the child after having to take the spoon out of the nanny's clumsy hands. I tried to keep the spoon from touching her lips and swollen tongue.

I was called to the other patient, the canal worker, who was somewhat better, but still wretched enough. I did not go. March turned up, wanted me to accompany him to breakfast, I said no, he went, and then (that boy!) he came back with fruit and a freshly washed handkerchief. I sent him away. I thought about nothing, was unable to think about anything but the little creature whose fever continued to climb, though her hands and feet were cold to the touch. More than forty-three degrees.

The little Portuguese girl seemed to want something. We, the mulatto and I, were unable to make out the stammered word formed by the bleeding tongue amid the constant retching and vomiting. The black woman hung her silver rosary around the child's neck and also Mama's valuable pearls–the foolish, godforsaken mother had given them to the victim of her doting love to take along to the hospital. But none of these things was what the child wanted. A last wish–and unsatisfiable like all true wishes!

Or is that not so?

For a long time we–that is, the mulatto, the Portuguese girl's former nanny, and I, her doctor–couldn't understand the stammered word. We finally did. It was
wine
. In short order I obtained a bottle of soft golden wine instead of the champagne. But she only shook her head, vomited with effort, and, already half dazed, repeated her request in a failing voice. At last we understood. She wanted not
vin
, but
raisins
–grapes. Possibly the juice of freshly pressed grapes would be especially mild, sweet, easy on a tongue that had lost its epidermis–or possibly she just thought so now. Perhaps she had been comforted by freshly picked grapes while under the weather with some innocuous ailment at the Swiss school. Grapes thrive in the sunny parts of Switzerland, particularly the Vaud region. But here, practically on the equator?

Could it be completely impossible to get hold of such fruit? The people in the hospital's business office just shook their heads at this odd request. It was all I could do to make sure someone at least tried to find grapes at the produce markets. What was the use? They came back with everything but grapes. Giant yellow mangoes that looked like Calville apples, a few thick, sticky drops oozing from their lacerated, ruptured skins like resin from the bark of a tree. Fine stuff. Terrific fruit. We mixed its juice with bits of ice, but the child refused it. We brought fresh local sugarcane, almond green, fibrous, somewhat woody stalks a yard long, which had a strange fragrance perhaps most comparable to wine (the native population believed it quenched the thirst better than any alcoholic beverage, and without increasing the perspiration). She refused it. She began to weep. It was an unnatural, drawn-out crying, from the chest and throat. Babies cry like this, but from their
loose, slobbery lips–weary of the world and of life even before they have come to know them in their full glory. It rang in my ears, it was ghastly. It was not the weeping of a half-grown person. It was the sobbing–soulless, mechanical, perhaps, but for that reason all the more poignant–of a completely childlike being. My heart broke with the bitterness of it. I thought I would do anything to at least make this weeping stop. So still more fruit from the Eden-like gardens. We brought her West Indian bananas–here they had none of the insipid flavor of the unripe fruit imported to Europe, but tasted of honey and cloves. She only opened her mouth to vomit; she wanted neither the bananas nor the fresh bluish dates with a tinge of white bloom, a rarity here in the tropical zone, that the head nurse had gone to great lengths to obtain. We offered her pineapple, freshly picked that morning from plots outside the city, still with its corona of spiny sap green leaves. The mulatto sliced it with a silver knife. Grotesquely amid all this misery, her own mouth was watering, the rubbery black lips were dripping saliva, for she had eaten nothing in forty-eight hours, so absorbed was she in the care of her darling. But we had no luck with the fresh pineapple, either.

Someone had also brought a lovely flower, a wild orchid with an exquisite vanilla-like scent and marvelous coloration on the long, pendulous, bannerlike lilac pink blossoms and the blazing, saffron yellow, luxuriantly brimming pistils.

That sunken eye was blind to the wonders of this terrible world.

The worst was when we had done everything we could think of and had nothing left to try.

The monotonous, aching, endless sobbing filled the cramped, humid little room, broken only by the buzzing of the insects that had
been attracted by the strong smell of the fruit. They harassed the poor defenseless patient so much that the fruit had to be removed. The mulatto woman, a “loving heart” of the first rank but only a mediocre nurse and not someone who could get used to order, flung some of the fruit out the window into the courtyard, where it fell with a slap. The matron came in and gave her a severe look. The mulatto blushed and tossed the rest of the delicacies into a pail. In other respects too there was not as much order as the matron thought necessary. The mulatto sullenly buckled down to work. The heat was frightful.

Now the disease's smell of decaying flesh–which came from the loveliest mouth I had ever seen–mingled with the scent of the rapidly wilting orchid. No one bothered to water it, for why should it live when the child had to die?

Beyond saving, and me a doctor–even God couldn't make sense of it, I said. But now in my despair I clung to the idea that there must be a way out “with God,” some act of violence, some thunderclap that would lift the world off its foundations–and save her. Foolishness! Madness! This was the megalomania of desperation, no more. Smash the thermometer on the edge of the table, the fever would remain. We looked on and said nothing.

Walter appeared, and just his standing next to her gave me a glimmer of hope. Had I not always justly looked up to him, thought him capable of things I myself was not? For me he was the European archetype of the brilliantly practical man, equal to life, unsentimental yet benevolent and humane; more than I, he exemplified natural, clearheaded human understanding, the sum total of all medical knowledge and skill. He represented the lucid mind dominating the vicissitudes of nature, the genius of the great physician. But all he did now was use his four-color
mechanical pencil, held in his left hand, to enter the patient's temperature on her chart in red, her pulse in blue. And while these two lines described the oscillations of a steep wave whose excursions continued to climb, the curve for urine output, in black, fell with every new tabulation.

Intoxication was increasing. Detoxication, in black, was decreasing. It pointed downward like a finger.

On the evening of one of these days (eventually I no longer knew how much time had gone by, whether the sobbing and retching, the fever and deterioration had been going on for three hours or three days), Walter asked me if I had done the usual blood test. A blood test? How could that help? So why do it? For the sake of knowledge? For the sake of clinical and scientific exactitude? I was supposed to puncture the arm of someone I loved more than I loved myself? Yes, even now, when the signs of death were becoming unmistakable and when, with its poison yellow mask, the face that had been so lovely had taken on a ghastly ugliness, yes, only the silky dark blonde hair still held a little of the Monica of the first day–everything else was abysmally ugly, repulsive, abominable, the cracked lips covered with bloody scabs, the skinned tongue, the swollen, bleeding gums, the mouth that I saw gape like a corpse's amid the endless sobbing, there was nothing lovely, nothing adorable left in this apparition; she was no longer a sentient person, her suffering was heavy, wordless, a ghastly spectacle, her sobbing not an expression of conscious affliction but an automatic reflex of the vagus nerve, made oversensitive by the Y.F. toxin–and yet, even now, when everything was as it clinically had to be, I prepared the blood lancet to draw some blood as Walter had instructed me, I had the nanny squeeze the thin, saffron yellow arm above and below the crook of the
elbow to pool a little blood at the puncture site–but I did not press down. I did not prick the skin.

I cheated for the sake of appearances. I took a tiny drop of the blood flowing from the gums and spread it on the glass slide, to simulate a specimen for Walter.

That evening Monica often reached for her throat, sometimes with her left hand, sometimes her right, gasping as though she were suffocating. The nurses took the valuable pearls from around the child's neck and washed both with warm water, first her neck, then the necklace, then put the necklace back on her.

It had great value, it was real.

I remember that in my old life I once called money the best medicine.

It was another person who said that, another mind that had believed it.

I want to say something else, since I promised myself that I would be completely honest, as honest as the human spirit, deceitful from the womb, can be.

It was at bottom quite an insignificant matter. I mention it here more for the sake of completeness than anything else.

Adrenal extract is recommended by many physicians for hemorrhaging from the mucous membranes, as in this case those of the mouth, pharynx, stomach, and bowel. So that nothing would be left untried, I had the preparation brought from the hospital dispensary. I had filled the standard Pravaz syringe, holding one cubic centimeter, with the colorless, crystal-clear liquid. I had placed the syringe on the night
table with the bevel of the needle facing upward and outward and had begun cleansing the injection site.

At that instant the poor little one's dreadful sobbing had increased. I could have borne anything else more easily, even the shrillest screaming and the most furious struggling. Anything but this monotonous, soulless sobbing. I couldn't bear it, couldn't bear it anymore.

I stroked the child's hair, I fed her a little vanilla ice, melted, yellowish, with tiny particles of vanilla in it, which ran back out of the corners of her mouth mixed with bloody froth. Fruitless effort, fruitless torment.

I saw that all was lost. I saw something else. The pharmacy nurse, who for want of a staff pharmacist was the one who took care of the prescriptions in the hospital dispensary, had been unable to decipher my handwriting, had prepared a solution ten times the proper strength, and had conscientiously noted the abnormally strong concentration as such on the vial, with an exclamation point. I immediately sprayed the lethal dose through the needle into the air, and because I wasn't careful enough, a droplet of it got the label wet, so that the black ink of the pharmacy nurse's handwriting ran. One zero too few or too many–it was illegible now. Good poison–or useless medication?

At that moment I thought of my wife. I saw before me the vial of the toxin that I had used to murder the poor woman, I saw the finely made old syringe that I had used in my crime glinting on a mirrored tabletop with the bevel of its slightly bloody needle pointing outward and upward. “All things return in this short life”–this thought flashed upon my mind. Flashed like a light, and I saw.

For a second I hesitated. I understood my fervent wish that this dreadful sobbing, this mindless animal suffering of a totally doomed
being simply cease. Whatever the cost. Why not fill the syringe again, give this wasted yellow arm a jab–a split second, one deep breath, and it's all over. Horribly over, but over. Only those who have sat with someone beyond help for weeks or even just days or only so much as a few hours, with ears and eyes and heart and soul rebelling furiously against this useless torment, will have understood me.

But I did not make this split-second movement, and will that also be understood? That I, Georg Letham the younger, let fate take its course?

I almost believe that the meaning of my punishment flashed upon me at that moment. I was the only one who could sit in judgment upon myself now. I was the only one who could punish myself. Part of the punishment I had to serve was to have to watch my darling's agonizing death and be unable to help. Never in my much-too-long life was it ever so difficult to do something as it was now not to lift a finger. But I understood that a human life has an absolute worth. I understood the connection between what went before and what came later. Was that so difficult? It was difficult. So difficult that until that day it was impossible. It was not until I had set my foolish, blundering heart on such a person, unalterably, against all reason (what could I expect of the beloved child, what did I know of her but the long since wasted face, the ravaged features–I had scarcely heard the sound of her voice, had never seen the child walk, dance, be happy!), not until now, when I had taken my place among the infinitude of suffering,
pointlessly
doomed people, as one of their own, that a loss could wound me, that I could do penance. Could? Could? No! No! Had to.