Human Traces
Page 29
‘Very calming. I feel my health improving just by being here.’
‘I have called it South Court on the plan I gave the builder. Prosaic, I know, but I wanted no mistakes. And this even smaller one here, which has only six rooms around it, with that lovely iron wall-lamp in the corner, I called it—’
‘Did you call it Lamp Court?’
‘I did, Sonia, I did. And that is how the builder knew to leave it all alone because it was quite untouched by the fire.’
‘Thomas, you have done very well.’
‘There is more to show you.’
‘That is all I can take in for the time being.’
‘Does Jacques like it?’
‘I have never seen him so happy. He cannot wait for his first patients.’
‘There is no need for him to wait. The sooner we begin, the sooner our fame will spread. We will hire more staff as the need arises. I have taken on a clinic at the town hospital each Tuesday. Perhaps Jacques should too – it is a way of meeting people, and I know that the hospital would be happy to have another doctor, particularly one so distinguished.’
They walked back together over the cobbled yard, down the cloister and back into the main house, where they found Jacques installing his books in one of the consulting rooms.
‘I have had a letter already,’ he said, grinning as he held up a blue envelope from the pile on the circular table in the hall. ‘A colleague at the Salpêtrière has referred two private patients who need rest and quiet. He asks if we have room.’
‘I think we might,’ said Thomas. ‘And I have a referral in three weeks’ time from the hospital in town. They could become a good supply for us, though we need also to make a connection with Vienna. When you are settled, Jacques, you and I must go and try to make our mark there.’
‘Yes,’ said Jacques. ‘I have been thinking about that. I feel certain that the quickest way to reach people is to give a paper to a medical society.’
‘And you have just such a paper in your jacket pocket?’
‘It is not finished yet, but I have a draft. It contains the fruits of all my reading and research in Paris.’
‘More Charcot, then?’
‘No, not really. It is based on what I have read in German. And on a remarkable French doctor who arrived in Paris last year from Le Havre. A man called Janet.’
‘But you are not forsaking our old master?’
‘Oh no. On the contrary. It all fits together. That is what is so exciting about it. Will you pass me that box of books over there?’
‘Are you happy with this room?’ said Thomas, handing up some tattered calf-bound volumes to Jacques, who stood on a small stepladder. ‘You can have the end room if you prefer it.’
‘They are identical,’ said Jacques. ‘So far as I can see. So you and I are side by side, looking north. Is that north?’
‘Yes it is. The steady north light that my MonsieurValade always required. I think he will bring his family in the summer, too.’
‘What? All of them? Are they all sick?’
‘Yes.’ Thomas laughed. ‘The girl has anorexia nervosa, the boy infantile paralysis and the wife is the worst afflicted. She has chronic logorrhoea.’
‘And the father?’
‘He is just angry.’
‘We must not become a hotel, Thomas.’
‘I know. But a clinic for people with nervous disorders must be flexible in whom it admits. At least until we are full up and profitable. Anyway, I like Valade.’
‘I understand. And we must make sure they eat well. Food is vital for nervous patients.’
‘Of course. That is where your wife will play her part. I saw her talking to Frau Egger this morning. I am not sure she understood much of Sonia’s schoolroom German, but it was a start.’
‘I need a desk,’ said Jacques. ‘I have a chair but nothing to put my feet up on when I am making a wise diagnosis.’
‘There is more furniture at the far end of the main courtyard. I suppose we shall have to buy some at auction in town. Sonia may have an opinion.’
‘I think she will.’
The echoing spaces of the main house began to fill with the sound of movement. Josef hired men from the village to fetch the furniture that had been stored in the North Hall; beds, armchairs and tables were redistributed among the empty rooms to the background noise of hammering and castors running over floorboards. The big range in the kitchen was riddled, fired and set to work, while the huge cylindrical heaters in their painted ceramic jackets were readied for the cool evenings. Boys were brought in to scythe the long grass, and after every hour of work they lined up outside the kitchen in the stable yard for drinks to be handed through the window; the lawns in the courtyards were mown and rolled; with long coaxing, the main fountain was made to throw up a spout of rusty water, which, after several noisy eructations, eventually calmed itself and ran clear into its carved stone basin. Water hoses were trained on the inside of the stable block, while the mare and the gelding stood outside and stamped on the cobbles, cropping hay from the iron manger. When the men had finished with the furniture, they were handed paint and brushes and sent to work on the stable doors; many of them were accompanied by their wives and daughters, who brought down cobwebs from the high ceiling of the hall, polished the wide expanse of wooden flooring and threw open the windows of the bedrooms to air the mattresses, while others washed and dried the sheets in the scullery below. In the kitchen, Frau Egger set her largest pots on the stove, from which, with Daisy’s help, she was able to keep a running table of bread, soup and sausage available to the workers as they passed the dining room or sat down in the hall to rest.
For two weeks, the house and grounds, supervised by Sonia, were onthe move; the company of helpers ran through the arteries of the extended body like red cells in a convalescent patient. Colour and function began to return; the old courtyards stirred themselves and the shuttered windows opened their eyes on to the lake and the cold mountains. Meanwhile Thomas and Jacques each morning took the horse and trap into the city, where they set about trying to find patients. At the hospital, they arranged for Jacques to run a free clinic specialising in neurological cases; if the demand was low, he was to act also as consultant physician. They went to see the editor of the local newspaper and organised for him to send a reporter to the schloss to write an article about their renovation of the house and their projected clinic. For many hours they sat in a coffee house, writing drafts of their prospectus. When Thomas had visited his English asylum to collect Daisy and Mary (overcrowding meant the Committee had, in the event, been pleased to see them go, so, slightly to Daisy’s disappointment, no escape had been necessary), he had been given permission by Faverill to appoint him consultant emeritus; he knew Faverill’s name would mean nothing in a province of Austria-Hungary, but he thought it a good idea to load the official documents with as many doctors and qualifications as they could. Jacques wrote to three colleagues at the Salpêtrière asking if they, too, might lend their lustre from afar.
Their next visit was to the bank, where they found a florid, genial man called Leopold in a small office overlooking the town hall. He sat back in his chair and looked at the pair of them with something close to amazement.
‘We do not have many . . . visitors in our town,’ he said. ‘I wonder what made you choose this region for your venture.’
Pure chance and instinct, Thomas wanted to say, but felt he should provide a more businesslike reason, so talked of the relative proximity toVienna, the climate and the mountains.
‘And doubtless you would like me to lend you some money,’ said Herr Leopold.
Thomas explained that he had paid for two years of the lease in advance, using money he had saved from his private practice. The renovation works had been paid for by Monsieur Kalaji, Valade’s princely patron in Paris, who had been so pleased by the paintings that had resulted from their European tour that he had asked to take a stake inThomas’s new enterprise. With what Jacques had also contribute
d from teaching and private practice in Paris, they had thus been able to meet all their costs to date and came to him therefore ready to start business without being a schilling in debt. Such happy circumstances were unusual, he imagined.
The bank manager smiled again. Thomas noticed that he was inspecting Jacques’s boots, which were of an ordinary French design, but one obviously unknown in Carinthia.
Until they had a regular income from patient fees, however, Thomas continued, they would need a facility to borrow. They needed to acquire some electrical apparatus and to convert two of the downstairs rooms in the main courtyard into a water treatment centre. Jacques began to explain the great hydrotherapy room that had been planned for the Salpêtrière, with showers as powerful as fire brigade hoses, but Thomas interrupted to say that their own plan was more modest.
‘I see,’ said Herr Leopold. ‘And how many staff do you intend to employ?’
‘We intend to build up slowly as the number of patients rises,’ said Jacques. ‘By the time we reach fifty patients, we shall need twenty or more nurses, an electrician to work the faradic and galvanic apparatus, a hydrotherapist, a masseur for the male patients and a masseuse for the women.’
‘The electrician is a specialised job, quite skilful,’ said Thomas. ‘So is the massage, but it need not cost us a great deal. We have a masseuse in training already and if I did not insist on paying her she would do it for nothing.’
He still had the impression that the manager was not fully listening; but that might be a good thing, he thought: the rising number of employees was beginning to worry him.
‘And what about other staff?’
‘We have a lampman, who will have a boy to help him. A housekeeper and a maid. We probably need a cook, four or five other maids and half a dozen cleaners.’
‘And what about yourselves?’
Thomas and Jacques looked at one another; they had not considered the question.
‘I strongly recommend that in the early days you do not draw too heavily against the profits,’ said Herr Leopold. ‘There is always that temptation in a partnership, particularly when you are working hard and feel as though you have earned your reward. Try to think ahead.’
‘Very well,’ said Jacques.
Herr Leopold stood up. ‘What I require from you,’ he said, ‘is a list of salaries and wages for the first two years. I also need a good estimate of how much you will spend on the further equipment you mentioned and an accurate projection of the costs of medicines and of the domestic and catering expenses. When we have those figures, then you must organise a structure of fees that shows a healthy profit. If you can show me that by running on an average of two-thirds capacity your business makes a profit, then I shall be prepared to make you a loan over a period of three years at the bank’s current rate of interest. That will doubtless be less favourable than the terms of your Parisian gentleman, but I am obliged to make a small profit for my employers as well.’
‘Of course,’ said Jacques. ‘We understand.’ Sonia can do the figures, he was thinking.
‘I suggest we meet again a week from today at the same time. Might I ask one last question? I know that these places are fashionable at the moment, especially in the mountains. Is there something particular about yours?’
‘Oh yes,’ said Jacques. ‘We aim to cure the patients who put their trust in us and to run a profitable clinic. But we hope to do much more than that. We intend to establish beyond doubt how the mind works. We are going to show what makes us human. That is why your bank must not miss this chance to help.’
Herr Leopold, more puzzled than ever, showed them to the door. ‘Cows!’he called after them as they retreated down the cobbled street. ‘Keep some cows!’
In the course of the next week, over many cream-topped cups of coffee and slices of apple and cherry cake, Jacques and Thomas debated the name they should give to the clinic. Jacques wanted to call it Schloss Seeblick, but Thomas objected that no one ever called a castle after its view. ‘Lake View Castle is absurd,’ he said, ‘and anyway you can only see the lake from our bedroom and half a dozen others.’ Jacques countered that schloss did not really mean castle anyway, but country house. The alternative name, ‘mountain view’, would have applied to more rooms, but made it sound as though they were in a stagnant valley looking up, while Seeblickor Lake View, they agreed, suggested elevation, pure air and optimism. Haus Seeblick, Thomas said, sounded like a boarding house at Bridlington, and after trying out Seeschlössl and Seeburg, they settled on the original Schloss Seeblick. If there was an element of nonsense in it, they agreed, it was not inappropriate.
‘In due course,’ said Jacques. ‘We will need to move to a mountain home. All the best sanatoriums are up in the hills.’
‘Do you mind if we make this one work first?’saidThomas. ‘We are above sea level anyway.’
‘We are in the foothills.’
‘In more ways than one.’
Thomas wiped some cream from his lips. ‘So, Schloss Seeblick, sanatorium for nervous diseases . . . Hospital, hydro, spa?’
‘We do not have baths.’
‘We shall have water treatments.’
‘That does not make us a spa,’ said Jacques. ‘And I am not sure about “nervous diseases”. The word “disease” makes it sound as though all our patients will have organic illnesses.’
‘All right,’ said Thomas. ‘Disorders.’
‘That is a fine word. Congratulations.’
‘You don’t think we should use the word “psychiatric”?’
‘No,’ said Jacques. ‘The word “nerves” is the accepted euphemism. Everyone knows what it means. And in fact not all our patients will be psychiatric cases.’
‘We could call it the Mountain View Private Madhouse.’
‘We could, Thomas, but we will not. We will call it the Schloss Seeblick, then in smaller print on the next line, “sanatorium and clinic for nervous disorders”. “Sanatorium” suggests that people can stay for a year, and “clinic” will encourage those who just want to look in for a consultation. Then in the text we shall make it clear that we cater for everything from the most intractable dementia to the mildest exhaustion. And we should say that we have a speciality in neurological illness.’
‘Is that not covered by “nervous disorders”?’
‘No. To them that means madness. Neurology means trembling and paralysis.’
‘All right. Pass me the pen and start dictating.’
When at last they had something that was both definite and vague, specific but inclusive, they wrote it out again neatly (Thomas’s handwriting, admired by his namesake at the asylum, was preferred) and took it to a printer recommended by the newspaper editor. They ordered a thousand copies and employed two clerks to send them to registered physicians far and wide, whose names they found in a directory in the town library. They took out advertisements in the local newspaper, in periodicals in Munich and Vienna and, ruing the expense, in the Frankfurter Zeitung. On their return to the bank, they found that Herr Leopold had scrutinised the figures and calculations done by Sonia and had authorised a loan. The following week, at the end of May, their first patients arrived.
Sonia found that her presence was needed most in the kitchens. Thomas had written into the prospectus an undertaking that the schloss could administer the ‘rest cure’ made popular in America, and to fulfil this undertaking they were required to offer not only intensive nursing, baths, massage and electrical treatments but a diet on which the patients, most of them slender neurasthenic young women, were expected to eat prodigiously. They were deemed cured and ready to leave when all their bodily functions, particularly the reproductive, were working regularly, and when they had grown by up to half their initial body weight.
Neither Thomas nor Jacques was much interested in the physiology of the patients or of the cure, but in the early days it brought them half their custom, and if the process told them little of medical interest, all the women did leave looking
healthier and more content, so they felt nothing with which to reproach themselves.
Although Frau Egger’s father was Carinthian, her mother was Viennese and her repertoire in the kitchen included dishes from far beyond the mountains, rich and unstinting; sometimes Sonia felt she and Frau Egger were like foie gras farmers fattening geese. The young women arrived at Schloss Seeblick looking pale and undernourished; many of them had nursed parents or other members of their family on their deathbeds, then, when the strain was over, had fallen ill themselves. They had been too long in stuffy invalid rooms; their eyes were tired from reading in the twilight. Sonia wondered whether some of them had not become infected by the medical procedures they had attended; none had heard of the new germ theory of disease, the work of Koch and Pasteur, which, Jacques had explained to her, was changing the hygiene of hospitals in Europe (he grimaced already to remember the unswabbed wards of the Salpêtrière). One young woman called Bertha had sat for days by her father’s bedside while a drain was inserted into a pleuritic abscess in his lung; sometimes her dress was soaked in his pus, but neither she nor the physician had thought of this as dangerous.
For the first few days at the schloss the rest-cure patients lay immobile in their rooms while one of the nurses attended to every need: they cut up their food and spooned it into their mouths while the women lay supine; they brought them bedpans and gave them daily sponge baths; they fetched cups of hot milk and read books out loud to give their patients’ weary eyes the chance to rest. Daisy had been rapidly trained in nursing by Thomas and was efficient at what she did, though she was restricted to those who spoke English, and even there Thomas made sure the literary expectations were not high. As he walked down the courtyard he would occasionally hear her voice, loud and insistent, hammering out the words of a sentence to her prone charge and it made him smile with a deep, subversive pleasure as he hurried on.
After the patient had been immobile for a week, Mary would be sent in to start the massage. At first, Thomas or Daisy had to take her everywhere in the schloss, but she slowly began to find her way, feeling along the wall of the cloister, then stabbing at the cobbles with her stick and counting off the doorways as she went by. She had learned her craft on Daisy’s body, its modesty preserved in cotton camiknickers, as Thomas explained the rudiments of anatomy. They began with the small bones of the feet and toes and worked their way up, with special attention to the joints, which were rotated through every position. A slight young woman, Mary developed strong muscles in the forearms as she grasped the areolar tissue, sometimes making Daisy squeal, rolled the large muscles of the calf and thigh firmly both ways and kneaded the belly with the heel of her hand. By the end of the treatment, Daisy was so relaxed that her initial self-consciousness had left her and she begged to be left to sleep.