A Perfect Madness

by Frank H. Marsh

EIGHTEEN

  Erich, Görden Hospital, 1941

  The night was good to Erich this time, no more other worlds to hide from, no more monsters to fight and slay. Dreams as they should be came to him, dancing magically throughout the night in his sleeping thoughts. Even though his father had sternly warned him about duty and honor and the consequences of failure, he still was his father’s son, and Erich knew his father would help him. With the start of his morning shift at the hospital still two hours away, an early morning walk in the cool air along the Havel River was the right place to prepare the words he would soon speak to his father. He would tell him then that performing one’s duty only out of fear has no honor, no goodness attached to it, unless it is the right thing to do at the moment. And surely now, all that was being expected of him was wrong.

  Erich arrived at the hospital fifteen minutes early and went straight to the East Ward, where he saw Maria laughing with two nurses leaving from the night shift. As he approached them, the two nurses quickly walked away, leaving Maria alone standing by her desk.

  “Good morning, Herr Doctor. You look fresh and well.”

  “Thank you, I am. What time will the committee be here? Do we have time to see the children again before they arrive?” Erich asked in an excited tone.

  Hesitating, Maria picked up the children’s files, handing them to him.

  Erich hurriedly opened the first file, which was little Brigitte’s. A form that he had never seen before lay on top of the admitting sheet. But he read no further. On the left side of the form, the names of his father and Dr. Catel and Dr. Heinze were printed.

  “My father was with the committee?” he asked, not believing his eyes.

  “Yes. Dr. Brandt was detained in Berlin. They met here very early and left. That’s all I know. Dr. Heinze will be here soon to walk the morning rounds with you.”

  “My father was with them?” Erich asked a second time, not listening to Maria’s words.

  The winds of hope that had filled his sails this morning became as still and listless as an ocean calm, where he would flounder helplessly. On the right side under the heading “Treatment” were three columns with a space available parallel to each of the three names. A bold plus mark had been penciled in the left column by each name, which included his father’s. Erich’s heart sank and he asked Maria to get him a drink of water. The plus mark meant only one thing: the killing of the child. It had no other meaning. There was no other way to say it. All he had hoped for was one minus sign noted in the middle column, which would have allowed the child to live. His father could have done this, but didn’t.

  Maria returned with a glass of water, placed it on the desk, and sat down next to Erich. The blood had drained from his face, leaving him as white as the paper he had been reading.

  “You look sick. Let me get you a cold towel,” Maria said, starting to stand up.

  “No don’t, this will pass. It’s not easy to accept being betrayed by your father. He knew how I felt about this whole goddamned mess. Yet, his plus mark is bigger and bolder than the other two.”

  “Perhaps he meant to tell you, time has so little meaning now for all of us in this war.”

  “No, the bastard sat across from me at dinner several days back and said nothing, not a word about the committee. Duty with honor was the topic he had chosen for discussion—my duty and his honor,” Erich said hatefully.

  Erich started to open the second file but stopped and put it back with the others in the stack. There was no reason to read it, he knew. The plus marks of death would be there, too. These four children were in worse shape than little Brigitte—blind or deaf, or both, and badly deformed. Two one-year-olds with dangling microcephalic heads no bigger than an apple. Another sightless and deaf with two stubs for legs. The fourth child, deaf and an imbecile—there was no other way for Erich to describe him. All were innocent victims of some misguided step in evolution’s wiring at some unexpected moment in their mother’s womb. But Erich knew there would be others to come, thousands perhaps, whose only deformities were hidden in the terrors of their twisted insane minds. They were the frightening ones, scorned by a society that delighted in keeping the threshold low between that which was normal and abnormal. There was no room for the delightful eccentricities of silly people.

  Maria saw Dr. Heinze approaching from the far end of the main hall before Erich did and moved to the front of the station to greet him. Erich remained seated at the desk, acknowledging Dr. Heinze’s presence only after he stood before him and spoke.

  “Good morning, Nurse Drossen. Good morning, Herr Dr. Schmidt.”

  Erich nodded but did not smile.

  “I have reviewed the files again, Dr. Heinze. Perhaps we should see the children now,” he said curtly, handing the files to Maria and walking towards the infant Brigitte’s room without waiting for Dr. Heinze.

  In her room, and the others that followed, Erich carefully described in descriptive detail, to the amazement of Dr. Heinze and Maria, each and every affliction suffered by the five children and where there might be a good possibility of therapy. No one looked closely at the children, though, nor touched them. The diagnostic pictures he painted were too vivid to doubt. When they were through, Erich looked at his watch. The medical rounds with Dr. Heinze had taken only fifteen minutes; killing them would take longer—an absurdity in itself that Erich would not soon forget.

  Back at the nurse’s station, Dr. Heinze told Erich to come to his office in twenty minutes to a staff meeting of all attending doctors. There the treatment of these children and those that were to come would be finalized. Erich again said nothing, only nodding that he would. He had yet to speak Dr. Heinze’s name, or show him the courtesy his position demanded. Ignoring all protocol, he had walked ahead of him in the hall and to the rooms, not behind him, or even next to him—as if it were his only means of protesting the absurdity of what they were acting out—a fact that didn’t go unnoticed by Dr. Heinze and Maria. But Erich knew that the few grains of sand left in the hourglass would soon fall to the bottom, freezing him forever in all that was around him as if it were a new unseen dimension in time.

  Maria stood silent, watching Erich, waiting for him to acknowledge her presence, even though she was standing close to him. A healthy hue was in his face again, and his hands were calm and his walk deliberate as he moved to her desk and sat down.

  “I will need a notepad to take with me to the meeting. They will talk about the final therapy procedure, I am sure,” Erich said anxiously, motioning to Maria, who quickly opened a side drawer under the counter, retrieving a blue notepad for him.

  “I will be here when you return, should you need to talk about what is to happen,” Maria said softly, as Erich started down the hall towards Dr. Heinze’s office.

  Six doctors, besides Erich, took their seats in front of Dr. Heinze’s desk waiting for his appearance, which usually came exactly ten minutes after everyone had assembled. It was a disarming trick he had learned from waiting on Philipp Bouhler in the Health Ministry. Important people are never punctual, nor should they be. It is our right, he believed. Then for the next two hours, continually mixing patriotic fervor with substance, Dr. Heinze spelled out to the small group the medical protocol to be followed, how they would welcome the children sent to them, and how they would kill them. Everything he was saying displayed a sophistication of thought by the Chancellery and Health Ministry in planning the program to be undertaken at Görden. It would not be a one-time event, Erich realized, but a mass undertaking that had been carefully crafted by leaders in the Ministry, which included his father.

  Strangely though, of all that Dr. Heinze had said, it was the lie that the doctors would be compelled to tell the parents about their child’s death that bothered Erich the most. After the death of a child, the attending doctor was to write the parents a kind and gentle letter, telling them of their child’s death from unexpected complications, nothing more. There would be nothing entered in the medical records of the
child other than time of death and a fictitious cause. To Erich, everyone knew there was nothing more sacred in a physician-patient relationship than the truth, and the lying and the killing they were ordering were not the same. The killing could be explained with reason, as a cold necessity like Hitler had said, but not a lie. And no mother should be lied to when it came to the death of her child, or anything else for that matter. Lying is a man’s way of trying to hide from God, his mother had told him, and He won’t let you do that more than once or twice before shipping you off to hell, which frightened him terribly. Lying to yourself didn’t count with God, though she thought it should, because you were only fooling and hurting yourself. So, he never lied again to his mother, or himself, or to anyone else. He would pretend though, which wasn’t lying, because he always knew it wasn’t real, much like pretending his father really did love him.

  Clearly disturbed by what he was hearing, Erich grew restless, stirring in his chair, crossing and uncrossing his legs trying to get comfortable, and somehow shut his ears to the nonsense sputtering endlessly from Dr. Heinze’s mouth. Finally, swept up by the drama of the moment, Dr. Heinze rose and walked slowly from behind his desk, pausing for a moment in front of each doctor until he came to Erich, where he stood in silence, staring hard at him.

  “We doctors are warriors for the Fatherland, too. Everyone here should think carefully on these words, lest we forget them,” he said calmly but with a hidden agenda of terror clearly behind his voice.

  Then he left the room, which had suddenly become cold with an eerie uneasiness that everyone felt. No one spoke, nor stood to leave for several minutes, each afraid of what the others might think and say behind his back.

  Erich did not return to the East Ward, but walked straight to the medical library and sat down at the second of the two tables there. To him, the ancient Greek playwrights couldn’t have written a greater drama. Only the chorus of chanting voices was missing. All of their virtues and struggles were carefully rolled up in a bundle of nonsensical emotions and placed before him on the table. Duty and fear and courage and all the others, even suicide, were all there laid out to be seen and wrestled with. It was not an “Either/Or” moment of truth, as long argued by Kierkegaard, whom he fancied greatly. Instead, it was a decision to survive, to stay alive one more day, and then the day after, until God finally decided to change the barrel organ tune that everyone was dancing to.

  Strangely, Erich tried to imagine what Julia would say if she were here with him this very moment. The courage she would bring to the table, though, would be unfair, because he had no equal to it. His father’s thoughts meant nothing either, because they had long been anchored in drifting sand, blown about by the winds of change each passing day. But his mother’s decision at this moment, he knew, would be from her heart, what roads she believed in traveling, though they might be the wrong ones. Courage had no merit to her because it was a male thing; only duty counted. Whether it was right or wrong didn’t matter. Goodness came to you in performing one’s duty, nothing more. The duty to tell the truth, or tend to your neighbor, or fight for your country were all one and the same, Christian virtues to the core, so it seemed to her. However, neither she nor Julia were doctors. Whatever they believed in, the ancient sanctity of the physician/patient relationship was missing for them. This holy treasure, carefully wrapped through the centuries with the fabric of Hippocrates’s robe, transcended all other duties. And it was this treasure the Health Ministry set about changing, making the physician/patient relationship beholden to the state.

  Erich walked back to the stack of journals near the door and lifted from the bottom shelf the journal he had taken and returned unread, The New German Physician. Nothing original was offered in the words before him until he reached the core of the arguments being made for what a German physician should be, particularly in wartime. With so many of Germany’s best and bravest facing death on the battlefields, the argument went, it was imperative on the physician “to come to terms with counter-selection in their own people.” He had never heard the term “counter-selection” used in medicine, or anywhere else for that matter. It was presented coldly for the first time, as a moral choice that the new physician must consider.

  What came next in the treatise surprised Erich even more by its careful reasoning. Infant mortality is a process of natural selection, with the majority of the cases affecting the constitutionally inferior. But now advances in medicine dramatically interfere with this selection. Therefore, the task of the new German physician becomes that of restoring the balance of nature to its original form through the process of counter-selection. Not to do so would be ethically unacceptable. This was it, what the physician should be about, and it bothered Erich because it made good sense and was quite seductive. Unless the incurable die, true healing of the sick and protecting the nation’s health would be impossible.

  Still, by itself, this summons to a new understanding of what a German physician should be about was not enough to change how he felt, though it might be for other young doctors. Yet he knew, when the physician’s primary duty to alleviate suffering of the sick was combined with the idea of counter-selection, two goods could be achieved without one negating the other. But to euthanize the incurable to ease suffering was an irreversible step on the slippery slope to hell, which he was unprepared to take, at least for the moment. Even though an acceptable solution to the problem he faced was before him by simply following the orders of the Health Ministry, what was missing was the sacred commitment that makes all medicine worthwhile. Without it, everything would be a lie. He would be swallowed up by the hungers of self-deception. Erich pushed aside the journal on the table, sitting for a moment before leaving for the East Ward. It was late and much remained to be decided, but waiting to do so was no longer an option for him. Even time had become a vaunted foe of sanity, so it seemed.

  Dr. Heinze was waiting on Erich when he and Maria returned to the nurse’s station. Looking at Dr. Heinze as he approached the counter, Erich decided there wasn’t any one thing pleasant about the man. His appearance defied description, bordering on the comical obscene, if there was such a thing. In many ways, the man looked less human then the children he had just seen. Meanness and ambition have always been great ingredients to cook up a good dose of ugliness, and he had plenty of both. That Erich disliked him was quite apparent to Heinze, and he secretly hoped Erich would falter in carrying out the final therapy for the “misfits”. He could then report him to Bouhler at the Health Ministry. Not only would he rid the likes of Erich from the program, he would likely weaken the prestige his father held with Brandt and the other leaders in the Chancellery, which he envied greatly.

  “You have seen the children again to begin the final therapy?” Heinze asked in his high shrill voice as Erich approached him.

  “No. Should that be a problem?”

  “Only if their beds aren’t empty and ready for the other children who will soon be here.”

  “Will these children die soon enough? That is what you mean, isn’t it?” Erich said with sarcastic anger. “When their time comes, you will know, but for now we should leave them alone.”

  Fuming and red in the face from being challenged by Erich in front of Maria and two other nurses who had joined them at the station, Heinze said nothing more and walked away. Inside, though, his turbulent anger and dislike of Erich churned in his stomach, coated with the bitterness of the digestive acids held there. He would find some way to force young Schmidt’s hand and bring him down. Perhaps seeking the senior Schmidt and Karl Brandt’s return to Görden would force him into a corner from which there was no escape. Once he had crossed the line, euthanizing just one child, any further resistance based on his own sense of integrity would crumble into fine sawdust like termite-infested timber. He would make the call to Dr. Brandt and Dr. Schmidt, but give Erich no reason for their sudden return to Görden from Berlin.

  Erich knew that Dr. Heinze would not let the ugly confrontation pass so
easily and go unanswered. His own standing with Brandt and Bouhler would be in dire jeopardy, too, if he allowed any dissent from the doctors to continue drifting and unsettled. To do so would bring into question the feasibility of the whole program to cleanse the German race of all the misfits. More importantly, the moral element, surreptitiously attached to the program by placing it in the hands of the doctors, would be gone, too.

  Erich waited until Dr. Heinze disappeared from sight down the hall, then moved slowly to Maria’s desk, keeping the children’s files with him. No words had passed between him and Maria this day. It was not that he had chosen to ignore her, but rather, whether she should be involved at any point in the terrible things about to happen. Perhaps she shuddered in the same fear he did but had pushed aside her feelings on right and wrong, reasoning that in these times, like everything else, they simply didn’t matter anymore. With her husband facing death each new day on the Eastern Front, how she felt about her duties as a nurse and whether they were right or wrong was of little consequence. Yet if Maria did believe as he did, should he expect her to jump into the same quicksand he was already sinking in? When the time came, though, he decided, Maria would swallow her own moral longings and become a part of whatever duty asked of her.

  Erich rose from behind the desk and walked past Maria towards the West Ward, leaving her wondering at the coldness of his behavior. As he neared the nurse’s station, two nurses began busily shuffling and reshuffling papers and files they had read ten times over.

  “Is Dr. Schneider on duty today?” he asked the older of the two nurses, whom he surmised was in charge.

  Before responding to him, the older woman glanced quickly at the other nurse, questioning with her look whether she should say anything.

  “Dr. Schneider has been reassigned to another hospital, that is all we know,” she said, looking around as if she were expecting someone.

  “Reassigned? To what hospital?”

  “I don’t know. We haven’t been told anything since two men came by the station late yesterday, and he left with them.”

  As Erich heard these words, his heart began to race, and the palms of his hands grew hot and sweaty. He had known Dr. Schneider only a short while, but sensed, maybe wrongly, that his beliefs about the final therapy were like his own. He had spoken out strongly against killing the Knauer child back in Leipzig, yet still participated as a witness to the dreadful act. The signals to Erich, and to everyone else involved, were as clear as the deep pools of spring water flowing in Triberg, where the bottom seemed on top. Indecision was rejection, should one tarry about carrying through to the end the new therapy program set by the Health Ministry.

  “Two men—who were they? What did they look like?” Erich asked hurriedly, trying to hold on to the reins of his emotions. He was clearly frightened by what he was hearing.

  “I don’t remember. They said very little, and were here only a few minutes. They seemed quite serious that he go with them, though, and he did.”

  “Without saying a word? Perhaps when he might return?”

  “What I have told you is all we know. It all happened so quickly. Dr. Heinze did say a new doctor will be here soon.”

  “Dr. Heinze?”

  “Yes sir. He came here shortly after the two men left with Dr. Schneider.”

  Erich started to leave, when the nurse who had said nothing spoke up.

  “The new doctor’s name is Franz Kremer, should that mean anything to you.”

  “No, nothing,” Erich said and left to return to the East Ward.

  But the name Franz Kremer did mean something to him. He was the tall, blond Sudeten student who had railed against Julia and all the other Jews in the world at the medical school in Prague. Swept up in the mind-numbing slogans of the National Socialist Party, he despised the weak and timid German warrior, as he thought Erich to be. Coming to Görden as a treatment doctor to erase the “misfits” polluting the German race was more than a medical undertaking to him. He believed himself more than a mere doctor, but as one of the chosen few called to defend the health and well-being of the Third Reich. His own devotion to the cause of cleansing the race was of such a nature that he believed everyone should follow it. And those that chose not to should be eliminated. Erich always felt that Franz would rise high in the eyes of the party, faster than anyone around him, and he was doing so by his presence here at Görden. Through his eyes, as it traditionally was with so many German psychiatrists, and with those that would follow, the tender face of a malformed child was no different from that of an animal. Yet it was not that they saw them as completely animal; it was that they never saw them as human beings.

  Erich knew now there was more than the decided fate awaiting the children. His own existence as well could possibly be determined by Franz’s sudden appearance at the hospital. Mephistopheles had finally tired of wearing the mask of fear, and was now waiting impatiently for him to make the decision to sell his soul should he want to continue living. It was quite simple. Franz knew Julia as a student, but more so, as a Jew. He also knew of Erich’s great love for her and their isolated spirited intimacy, and hated him for it. To Franz, Erich had purposely spit on the spirit of the Nürnberg laws prohibiting such relationships, and in doing so, turned his back forever on the National Socialist Party. Uncompromising revenge against the enemies of the state was an easy road to power, which Franz would gladly surrender to the likes of Dr. Heinze when the time came to do so.

  Erich could think no more, his mind clouded with a gray nothingness. But depression was a better word. In a way he was glad, though, because great moments can rise to the top from the deep oceans of depression, as they had before with him, and perhaps would again. Returning to the East Ward, he walked to the end of the long, dark hall and sat down on a narrow wooden bench beneath a large window. God was turning the barrel organ too fast for him to dance now. So much was happening. His father and the Knauer child and Dr. Heinze, and now Franz Kremer, were all crowding and pushing him at the same time. He could no longer risk, or even imagine, any genuine resistance to the killing program if he wanted to stay alive. There simply were no more places for him to run and hide.

  Erich stood for a second, looking down from the window at a small rose garden below full of nothing but beautiful life, and studied it for a moment. With no mind of its own, a rose will always be a rose, living out its given time in the sun and rain until it withers and dies. Yet while it lives, its simple beauty fills the passions of the eye, making lovers and poets of us all. Looking back down the long, dark hall, he saw no passion for the eye, only pity. Five young precious souls were there, all longing to be set free from their crippled minds and bodies, loved by no one, except perhaps their mother and maybe God. Even then, Erich wondered why God would allow such life to exist. Unlike the rose and its given beauty, they served no purpose. Releasing them from their prison would be God’s way of correcting nature’s mistake.

  Erich stepped back away from the window and folded his arms across his chest in a sudden moment of great elation. Would not God and the world see the greater good for everyone with the compassionate death of these miserable souls serving medical research? At the same time, would he not be honoring his duty to Germany by serving medicine and science? He could forge a connection with a neuropathologist to obtain brains for research from genetic misfits in Germany, and the world would be better for it. All that was necessary, he knew, was to have his father request the assignment of such a specialist to Görden where he could work with him. Almost giddy, Erich walked with lighter steps back to the nurse’s station where Maria was waiting for him.

  “Please give me the children’s files, Nurse Drossen,” he asked, politely smiling.

  Maria did so, puzzled by the dramatic change in Erich’s whole presence. It was unlike anything she had experienced with him. Even his eyes looked strangely odd, looking past her to some distant setting.

  “Now please prepare four small cups of broth with luminal tablets disso
lved in them, and a single hypodermic syringe with 50 mgs of morphine.”

  Hearing Erich’s sobering words, Maria froze, unable to move, her face became flushed and her throat dry, halting questions she wanted to ask him but couldn’t. She had talked boldly of this day with the other nurses on the grounds, but now that it was here she found herself as frightened as a lost child, unable to speak.

  Maria’s emotional collapse surprised Erich. He had thought her cold and impervious to suffering, the ideal companion to assist him in the difficult tasks that awaited them.

  “Maria, we must act now, together. If we don’t, I am afraid the time will never be here for us again. Do you understand what I am saying?” Erich said, his words quick, his voice strong.

  Maria nodded slightly, still not moving to carry out his request. He held out his hand to her.

  “Give me the keys to the cooler where the drugs are stored and follow me.”

  Nothing happened. Erich moved quickly, taking hold of Maria’s arm, running his hand down in the large front pocket of her uniform, searching for the keys. The sudden intimate touching caused her to break free from him and stand braced against the back wall of the station.

  “What is it you want, Dr. Schmidt?” she asked, trembling.

  “Your support Maria, that’s all,” he said softly, trying to calm her.

  Maria hesitated for a second, then walked past him to the small storage room where the pharmaceutical cooler and other hospital supplies were kept. Erich counted the minutes, waiting for her to return, his own resolve weakening with each passing second. At the same time, he kept a watchful eye for Dr. Heinze’s presence in the halls. “The man is all evil and will corrupt the good I am trying to bring about,” he repeated to himself several times for courage. “To have him standing next to me would be unbearable.”

  In a few minutes Maria returned from the storage room carrying a tray with the luminal mixture and morphine syringe. Together in silence, they walked to the far end of the hall and entered the room of Wilheim, one of the two children suffering with the same maladies diagnosed in the Knauer boy.

  “We will keep him asleep on the same dosage of luminal the next four to five days until he can no longer awake. You do understand?” Erich asked, nodding to Maria.

  Maria looked hard at Erich with tears streaming down her face.

  “Yes, but I will give him the broth only after you have given him some. Then we will be in this mess together.”

  Erich quickly took a cup from the tray and, holding the boy’s head, hesitated for a second, then slowly fed him the broth, until the child would take no more, then left the room.

  In the next room, and the two after, the same routine was followed, with Maria though, holding the children while they drank the luminal broth. With only the morphine syringe remaining, they entered Brigitte’s room, where the tiny child lay awake, looking around the room as if she understood what the world was all about. Erich gently lifted Brigitte from the bed, cradling her in his arm as he had done the first day they met, and softly stroked her tiny head, soothing her with his voice.

  “My little Brigitte, you simply were born in the wrong place and at the wrong time.”

  Maria handed him the syringe and lifted Brigitte’s gown, exposing her left hip and buttock, then turned away, unable to watch. Erich slowly injected the 50 mgs of morphine into Brigitte, then waited for her to die in his arms. Before she closed her eyes, a tiny smile, which he had never seen before, broke through her lips as she watched his face, causing him to turn away in tears. This moment would become a memory that he could neither confront and absorb, nor wish away with time. He knew other children would soon follow, yet it was only Brigitte’s smile that he would remember.

  ***