XIII
‘GOOD MORNING, FRÄULEIN. I am Doctor Maierbrugger. How are you feeling?’
‘Much better, thank you.’ Kitty levered herself up on the pillows and tried to remember if she had seen this grey-haired gentleman in his silver spectacles before; the last two days had passed in a haze of morphia and men’s faces bent over her bed.
‘The surgeon, Herr Obmann, is extremely pleased with the outcome of his operation. I believe he paid you a visit this morning.’
‘Yes. He came when the nurse changed the dressing. He did seem pleased with . . .’ She tailed off.
‘With himself?’ Maierbrugger raised his eyebrows. ‘It is a characteristic of the profession.’
Kitty smiled. ‘And when may I go home?’
‘Not yet, alas. We need to observe you a little longer. To begin with, I would like to look at your throat, if I may. Open your mouth wide. Thank you. Now I am going to listen to your heart, if you would care to open your nightdress a little. There. I hope it is not too cold.’
Kitty looked down at the crown of Maierbrugger’s head, red flaky scalp through a gash of grey hair, as he moved the diaphragm of his stethoscope over her skin. Free from pain, she felt happier than she had for some time and was beginning to be impatient with the exaggerated care to which she was being subject.
‘Are your parents alive, Fräulein?’
‘My mother is alive. My father died a few years ago. Of a heart complaint.’
Maierbrugger nodded. ‘Did you nurse him? Were you in proximity?’
‘Yes.’
‘But you also have a history, I understand from Doctor Midwinter, of throat infections.’
Kitty pursed her lips. ‘Not a history exactly. I suppose I was sometimes sick as a child.’
‘Did it cause you to miss school?’ His voice was rasping.
‘On occasions, yes.’
Maierbrugger tapped a pen against the clipboard he had taken from the end of her bed. ‘I understand that at one point you had some involuntary movements of the shoulders and the face. Is that correct?’
‘Yes. At one time the muscles seemed to have a life of their own. This shoulder particularly. It was a little alarming. But it stopped. I have not been troubled by it for a considerable time.’
‘Did you have movements in the hips as well?’
‘No.’
‘Not the entire St Vitus in that case. However, Fräulein, I have little doubt that you have been suffering from rheumatic fever. It is a distressingly common ailment, which varies a great deal in severity. Its early symptoms can include the spasms you have described, particularly in children and young people. The main symptoms, however, are pains in the joint, such as you have suffered in your fingers and wrists, and an intermittent fever, which I understand you have also had.’
Kitty said, ‘But I do not really feel unwell any more.’
‘Good. I suspect you have had a number of attacks and that your most recent and most acute one is now receding. If you rest, you can expect to return to full health.’
‘Is that all?’
‘Not quite,’ said Maierbrugger. ‘The disease can damage the heart valves. We have little way of knowing whether or not it has done so. Your throat problems suggest you may have contracted it as a child, and if in its various recurrences it has so far caused no problems then you are probably safe. If, however, you caught it from your father and the heart problem that killed him was caused by a weakness of the valves, then the outlook is somewhat less good. However, I must say that I could hear no irregularities when I listened to your heart just now.’
‘And is there any treatment?’
‘Nothing yet, alas. We believe it to be caused by a bacterium, but we have no means of suppressing it.’
‘So what do you recommend?’
‘Take precautions to avoid throat infections. And lead a well-governed life that does not place undue stress on the heart. That does not mean lying down all day; it means moderation in all things. And then we hope for the best.’
‘I see.’
‘You should rest for at least a fortnight, however, to recover from the operation as well as from the illness.’
Kitty inhaled. ‘So you do not believe that any of my illness has been caused by . . . By the circumstances of my life. By emotion or bereavement.’
‘I think it extremely unlikely that a personal feeling might influence the activity of the microbe we believe to be responsible for streptococcal infection.’
‘Thank you.’
When Dr Maierbrugger had left the room, Kitty sank back onto the pillows and closed her eyes. She felt exhausted, yet dizzily relieved. Although she had been an active girl, a tomboy as she had told Dr Rebière, the prospect of a quiet life without undue exertion seemed, in her weakened state, attractive; it would make her begin her life again, away from her family. She had no wish to return to her mother’s house now that her irritating stepfather was resident there; her indifference to him had, after all Dr Rebière suggested, turned to revulsion and distrust. Perhaps she would go to Paris, where her brother was working and, until she found employment of her own, she could be the housekeeper in his apartment near the Place des Vosges.
She longed for normality again, to know that all the thoughts and hopes she had had, and all the private desires, were merely human and forgivable. She blushed when she remembered some of the confessions she had made to Dr Rebière; the hot blood in her face made her eyes sting for a moment and she moved her head uneasily on the pillow. At the time, she had experienced remarkably little shame. His manner was so correct, so scientifically inquiring, that she had felt like a peculiarly fascinating and complex musical instrument, not like a woman at all.
Her embarrassment subsided and gave way to a smile. She ought perhaps to feel angry with Dr Rebière for misleading and exposing her; but her relief at the absence of pain in her womb and at the knowledge that her other ailments had a simple cause was now so overwhelming that there was no room for harsh emotion.
In fact, she would probably return to the schloss for the two weeks’recommended rest. There was something powerfully attractive about the place, something she had loved even when in distress; and now that the causes of all her pain had been removed, there was nothing to prevent her from enjoying the scenery, the company, the sumptuous cooking and the play of sunlight on the bricks of the small, hidden south courtyard where she would read her book in peace.
There was a knock on the door, and the nurse’s head appeared. ‘Another visitor for you, Fräulein.’ It was Sonia.
When he returned from the hospital, Thomas knew he would be unable to sleep, so went outside for a walk; he prowled the furthest reaches of the grounds, then walked all the way down to the lake itself and sat on the wooden jetty. He imagined Fräulein Katharina von A bringing a legal action against the schloss, though it would admittedly be hard for her to prove that she had suffered material harm as a result of their misdiagnosis. He pictured critical reports in the newspapers that would relate how a young woman of impeccable character had been subject to intense and lewd speculation which had transpired to have no basis in reality. Against these charges they could argue that they were not alone among neurologists and psychologists in making such psychosomatic connections; they could point to a small but growing literature in Vienna and Paris. No matter what defence they raised, however, the reputation of the sanatorium would be undermined; it would never again be looked upon as what Valade had called the city on a hill: it would be tainted for ever by a suspicion of bad science, credulity and a sort of brutal opportunism, a desire to supply a sensational cure for an ailment it had partially invented. He remembered something troubling that Faverill had once said to him about the snake-oil salesmen of Colorado whose potions met a crying need. Jacques and he had not been able to cure madness, so they had fabricated something that they could cure; and whatever happened now, the burnish of their great enterprise, its innocent lustre, was gone.
In the m
orning, he took Sonia to one side after breakfast and asked her to cancel his first consultation, then come to his room.
‘Does Jacques know anything?’
‘No,’ said Sonia, closing the door behind her.
He explained to her what had happened. ‘It is good news for the patient, whose pains have been cured by Obmann’s knife, but for us . . .’ He opened his hands wide. ‘It is ruin. Disaster.’
Sonia’s thoughts were for Jacques, and what this reverse might mean to him, but she tried to see the consequences for them all.
‘Thomas, before you become too despondent, let us just think for a moment. It appears that Jacques has made a misdiagnosis. This often happens in difficult areas of medicine, does it not? It was made in good faith and no harm has resulted. On the contrary, a second opinion was promptly provided by a fellow-doctor – you – and it now appears that the patient is cured, or soon will be. She may not be so much angry with Jacques as grateful to you. Don’t forget, she was simply a sick girl and now she is well.’
‘It is possible.’
‘I shall go and see her in the hospital. If she has been shamed by what has taken place, why should she seek to broadcast that shame? I suspect she may be so relieved to be well again that all other thoughts will be secondary.’
‘And what shall we do about poor Jacques?’
‘We must break it to him slowly,’ said Sonia. ‘I suggest we use some slight subterfuge. We could say that Katharina developed sudden pains, nothing to do with what she had before . . . I don’t know, but surely you could think of something.’
‘I think we can delay the full impact, but eventually he will need to know because otherwise . . . Otherwise, he may persist in error. It could lead to worse things. Suppose he were to miss an instance of cancer. A doctor inVienna recently diagnosed a patient suffering gastric pains with hysteria. Two months later, she died of cancer of the stomach and he merely commented that hysteria had used the symptoms of the cancer to disguise itself.’
Sonia’s lip began to tremble because she knew how many thousand hours Jacques had worked and with what ardent philanthropic motive.
‘Don’t worry, Queenie,’ said Thomas, seeing her distress. ‘We will manage. I think I must tell him about the cysts. I see no way out of that, and it is an easy mistake to make when you consider how much time he and I have both spent on the pains of hysterical women and the fact that most cysts give no symptoms at all. Hysteria was a fair deduction. I think we can deal with that. As for the rheumatic fever, perhaps we should keep that to ourselves for the time being.’
‘All right,’ said Sonia quietly.
‘Tomorrow, you go into town to visit Katharina. Under no circumstances should she know that Jacques had written anything of her history down, let alone in a paper that he hoped to publish – though I know he would have disguised her identity. She must not know that anyone else is privy to her story. Meanwhile, I shall talk to Jacques.’
‘Very well. But Thomas, will you explain where he went wrong? Perhaps you could put it in a letter. I wouldn’t show it to him, but I should like to understand.’
‘I shall. It is easy for me to do with hindsight. But he was the adventurer. He was the pioneer. We must not forget that.’
Sonia squeezed his hand and went out.
A week after the operation, Kitty returned to the schloss and resumed occupancy of her old room. In the afternoon, Thomas came to see her. He heard a scurrying when he knocked and wondered if she was taking off and concealing her reading glasses before calling out for him to enter. He discovered her sitting on a small balcony with a view down to the lake; she poured some iced lemon from a jug and invited him to join her in the unusually warm spring sunshine.
‘How are you feeling, Fräulein?’
‘Entirely well, thank you. I am very grateful for your intervention.’
‘Thank you. What are your plans now?’
‘I am advised to rest for two weeks, and if you still have room for me, then—’
‘Of course. With pleasure. But I would prefer it if you would be our guest. In view of the time it took us to diagnose you correctly.’
‘That is most generous.’
Thomas looked across at her arms, which were partly bare beneath a sleeveless blouse; the muscle was youthfully firm beneath the pale, teeming freckles. He wondered if she had them also on her legs and at what point they might fade out, because presumably the skin of . . . He remembered himself in time, and coughed; she was looking at him, a little quizzically.
‘I have spoken to Maierbrugger, and it seems that you will need no further treatment. However, you must nominally be under the care of a physician here. We should at least take your temperature twice daily. However, Dr Rebière himself would perhaps no longer . . . I imagine I could ask the nurse, but in view of, in view of . . .’
‘Would you be able to take me on to your own books, Doctor?’
‘That is exactly what I was proposing,’ said Thomas in a rush of relief. ‘In view of what transpired with—’
‘Please do not concern yourself with what happened in my earlier treatment. Dr Rebière was extremely civil and professional. I also found what he had to say extraordinarily interesting. I read a copy of his introductory lecture on the subject of resolution and found it fascinating.’
‘Yes, indeed,’ said Thomas, feeling an unaccountable squeeze of jealousy, ‘it is a fascinating subject.’ He heard his voice – emollient, repetitive – and felt ashamed of it.
‘What a wonderful life you have here,’ said Kitty, smiling. ‘A beautiful house, your sister to look after you and, as I understand it from Daisy, your best friend to work with. No man could ask for more.’
Thomas felt a drop of sweat at the top of his spine. This woman was a saint – no, not a saint, there was nothing worthy or dull about her: she was a goddess. She had forgiven them, she had redeemed their life’s work from destruction; the clarity of her thought was such that she had welcomed the surgeon’s knife, bore no grudge and was able to make herself pleasant to him – intimate almost – with her bare arms and guileless blue eyes. Dear God.
He breathed in. He had better start behaving like the man of science to whom she wanted to entrust herself. ‘Yes,’ he said. ‘I am very happy here. Happiness creeps up on you, does it not? You never see it arrive, but one day you hesitate and you are aware that there is something . . . Additional. I noticed it this morning when I came up from the lake. It was the smell of the hawthorn blossom along the path – not really a beautiful scent in itself, not like a rose – a faint something of the cat about it I always think, but it seems to me the smell of England, of childhood summers – evenings in the woods, walking over dry lanes, when time was endless. To be transported back, you must be open to suggestion, you must already be a little happy, perhaps.’
Kitty laughed. ‘And when you were a child, was your sister there all the time?’
‘Yes. That was one reason I was so content, I suppose. She was no angel, of course, Sonia. She did many spiteful, elder-sisterly things, but I must have been a profoundly irritating child and it was no more than I deserved. I was a boy running round in a small village and no one really took control of me. Sonia was my only confidante.’
‘And she, too, is happy?’
‘Yes, indeed. Sublimely so, I think. She is expecting a child in the autumn. Please do not tell anyone. I should perhaps not have told you.’
Kitty laid her hand for a moment on his arm. ‘I promise. But what can have made a wild young boy from a remote English village into a man trying to establish cures for insanity? That is your aim, is it not?’
‘Yes, it is. One must say that for me to end up here is an unlikely story. But all men come from somewhere.’
‘You had no personal interest, no members of your family who were afflicted in some way?’
‘No, not like Jacques, whose brother, as you probably know, is a patient here. And that has always been his driving force and ambition, to fi
nd a cure for Olivier’s illness.’
‘But you? You speak so well, if you will forgive me saying so, about feelings. Did you never experience anything unusual yourself?’
Thomas thought. ‘Periodically, I have had spells of what psychiatrists call melancholy or depression, but not severe. Sometimes so slight in fact, that it was only when it left me that I recognised that I had been suffering from it. I noticed that the trivial aspects of a day – the arrival of the postman, sunlight, food, the company of a friend – were bringing me pleasure and for how long it had not been so – when the sound of the letters on the mat was simply the start of more oppressive debt and toil.’
He wanted to ask Kitty about her own feelings, but did not wish to reveal how much he knew of her history, and felt sure that she would welcome a rest from questioning.
‘But you have never experienced any of the more remarkable symptoms of some of the poor people here?’ said Kitty.
‘I have never believed that I am the King of Prussia, no.’
Kitty poured some more lemon. ‘And while Dr Rebière pursues his theory of resolution, where is your work taking you?’
‘I think we are in the same room, but we are looking out of different windows.’
‘Thank you, Doctor.’ Kitty laughed. ‘That is quite clear now. Are you plasterers or decorators?’
Thomas turned his gaze on her – the long, unsmiling, weighing-up scrutiny that Sonia had once found so intimidating. ‘A little of each. The room is where the mind and body meet. Jacques is working, as you know, on a particular affliction and on what of general application can be extracted from that. I am looking at other forms of illness, generally more severe, and seeing if they are like rheumatic fever – a germ – or like bereavement, an idea. Or perhaps they are both. I am particularly interested in the way in which one such severe illness, a psychosis as we people call it, may have entered the human animal – how it came in, why it seems so unhelpfully prevalent, why there seems to be no equivalent in other animals, whether it is in fact related to a particularly significant moment of human development.’