Once 3 or 4 dozen strong, the pigeon flock kept getting whittled down until only one bird was left. ‘The Taube’ they called him around the Square for want of a better name. He was a tough old geezer, his coat streaked with grey with healed slash marks on his legs and wings where he’d fought off the cats.
The Taube wasn’t afraid of anyone. He liked to strut out into the traffic, his chest puffed to bursting and clicking his beak loud till the ladies came running. He serviced 3 or 4 of them right on the spot in full view of the traffic. He had no shame and he had no fear.
And that's why the Taube had his accident!
TWO YEARS
OF OPACITY
The pain was unbearable because there was too much of it. You can’t feel a shark's bite because it hurts so bad. It was that kind of pain.
Pt. was admitted at 8:59PM on 3/30/30. Vitals present but faint. Multiple fractures including broken pelvis, right arm above and below the elbow, right leg. 3rd degree burns on his face and upper torso. Skin debridement entire right side down to the bone.
His chart was kept on a clipboard hung at the bottom of the bed. The day's entries were recorded there on a three-hole pad of letter-size paper. At the end of the day the pages were transferred to a maroon-colored binder stamped with the letter ‘K’.
The binders were kept in a cupboard above the sink. Clinic staff was required to wash their hands every time they entered or left the patient's room. The green soap dispenser next to the sink was filled daily.
4/1/30.Pt.asleep.
4/2/30.Pt.still sleeping. NPO >midnight. Prep for surgery @ 6AM.
He woke up. There was more light. He was moving. Doors swung open and closed. Clicking metal and the telltale phenol smell. The lights went out and so did he.
4/3/30. Right leg fractured in eight places, three of them above the knee. Amputation was considered but ruled out due to the pt's age. The broken bones were articulated manually and pins were inserted to hold them in place. Pt. will not walk upright again, if at all.
The nurse was in the room now. He could smell her verbena. He tried closing his eyes but couldn’t. Would she unwrap the bandages so he could close his eyes? But he couldn’t talk! He tried as hard as he could but he just couldn’t talk!
He could hear the room noises but he couldn’t speak. The pain he could feel when he felt anything at all. But could he see? Taste? It didn’t matter now and probably never would matter. The war. He was wounded at Arras but that was a long time ago. They patched him up enough to send him back in the line. But this was different. This was a reduction, a general loss of things.
Then he remembered the accident. He liked driving fast so that's why he got the Hispano. What a beautiful machine! All that orange with the brown trim. Nothing like it on the road and she really knew how to move!
He loved speed but was too good a driver to let it get the best of him. Fast and careful is how he drove. Never reckless. So how did he have the accident?
Before he could start on the answer, he fell asleep.
7/10/30.Pt.sleeps 10, 12 hours per day and sometimes more, Consult for sleep narcosis with Dr. Drisolia.
Armand Drisolia was a goateed little gent from Verona. Educated at Pisa, the oldest university in the world, he was an authority on sleep diseases of which sleep narcosis is one of the most prevalent - and most troubling!
He arrived late one afternoon by taxi. Declining an invitation to see the patient right away, he asked to be served dinner instead since he was quite hungry from the trip.
There’d been a summer snowstorm - not all that uncommon at this altitude - which caused the good doctor to don a cloak over his herringbone tweeds.It was a purplish silk affair that billowed out whenever he moved, giving this learned man from Verona the appearance of a beetle.
A medical medal hung across his buttoned vest which bobbled in sympathy to the missed-meal cramps burbling quietly in his belly.
These syncopating motions, of the billowing cape and the bobbling medal, encouraged the Clinic staff that they were in the presence of a dynamic man, and one who would finally wake #4 from his troubling slumbers.
But the cook was unable to accommodate the doctor's request for osso buco. Would braised lamb shanks do?
There were some leftovers from the day's lunch in the cooler.He rescued a pair from the congealed gravy in the tray and, wiping off the slime, dressed them in sherry wine and tossed them in the oven to freshen.
Ausgezeitnet!, exclaimed Dr. Drisolia with a nod to this German-speaking section of Switzerland, repeating his acclaim several times as he rummaged through the platter of shanks. Offered both wine and beer he declined, declaring himself to be a teetotaler. But when he finished his meal it was clear from his slurred speech that this eminent specialist was tipsy.
No worries. All he needed was a good night's sleep. He would be fresh as a daisy in the morning, ready to give the patient his undivided attention.
7/17/30.Pt. begins 2nd week of consultation with Dr. Drisolia. Average sleep time lower.Significance of the trend is the?
7/24/30.No change.
7/31/30. Plaster cast on pt's right leg removed. Routine debridement. Intact muscle mass noted. Pt. sleeps 17 hours reversing a trend.
8/15/30.Dr. Drisolia leads CPC conference in the auditorium.Many q's; few a's. Sleep narcosis is ruled out but pt's excessive sleep remains unexplained.
9/2/30.Consultation ends. Dr. Drisolia returns to Verona.Pt. sleeps two days and one night Pt. is examined for de cubitus.Lift team is assigned to move him every two hours to prevent outbreak.
9/15/30. Pt's skin color shows slight improvement, No signs of de cubitus. Excessive sleep remains a concern.
He woke up this morning and went right back to sleep. He knew it was in the morning because his regular sleep habits sent him to bed between 1 and 2 AM. Never a heavy sleeper, he was up at 6. But he couldn’t see so there was no reason for him to get out of bed. He went back to sleep just like he did yesterday and the day before.
Lately he’d been trying to piece together the elements of his present circumstances while he drifted off to sleep. There were gaps. Not all of him was there. Large portions were missing. It was very unsettling.
He had to put himself back together. What did he know besides the pain? He took inventory: the Car Wreck. He was driving the Hispano and had swerved too tight. A hay wagon was on the road. He didn’t know what happened to it. The horses were screaming.
The screams were terrible. He’d never heard sounds like that save for that sludge of meat and bone when the bullets hit the men that July morning on the Somme. Sludge and meat and bone.
The men dropping without a sound.
Arras!
Taking inventory was like tapping into a river, but there was another river running under this one. Two discrete currents with different speeds and different directions on the compass.
Doesn’t water mix with water? It's supposed to mix so why not now? Arras and the car wreck is all he had. There was a lot more but it was all in the other river. Then the sleep caught up with him.
He woke up tired. There was nothing better to do so he took another inventory: the Car Wreck. Horses screaming. Arras. He’d enlisted with some of the staff. Staff? Friends, colleagues? Who were they and where did they work?
Pt. scheduled for auditory consult on 9/17 with Dr. Kinsolving. Change in sleep pattern is noted. Pt. displays muscle strain, agitation.
Lerus Kinsolving conducted his evaluation with practiced efficiency, never once unbuttoning his collar nor taking off his low black topper. His cufflinks were miniature golf balls perched atop golden tees that gave the man a regular look in spite of himself. He ordered the nurses around and grew testy when they didn’t seem to understand him; he spoke in a thick brogue.
The exam went on for two days at the end of which Dr. Kinsolving was observed talking to the patient.
9/18/30. Auditory test results are all within normal range. However, pt's hearing has extraordinary range and
perception. He can hear the surgical procedures underway in the amphitheatres two floors removed!
Our test battery had one unintended consequence: the pt. spoke, haltingly of course due to the damage to his voice box but speech nonetheless!
Recommend follow-up to explore restorative surgery.
***
Spend time in a hospital and you will know the mortal tedium of a hospital hallway, the frenetic graspings for health by day, the pure terror at night.
Alone! Imagine that you're alone, thrust onto this boundary between the fearsome darkness and the frenetic light.
Sleep through it. Sleep it off to awake at 4, morning or afternoon is no matter. No matter because here in the hospital time stops and clocks freeze. Progress is erased; the chance of completion wavers.
***
“I hope he gets well.” He knew the voice by now. It went with the verbena. There were others in the room but she was there the longest. The lift team came in while she was puttering around but she told them to come back later after she changed the bandages.
He dozed off while she was unwrapping him. He awoke to the sounds of her crying. She's a nurse. Nurses aren’t supposed to cry. He wanted to say something to comfort her but of course he couldn’t talk. Then he felt the cold on his skin. She was looking at him and crying. He fell back to sleep. It was getting easier to do – going back to sleep when he wanted to. He wanted to do that right now.
Later – days, weeks, it didn’t matter – a huge sound rumbled through the room. The windows rattled and the bed bumped against the wall. Avalanche!! And with that, the two rivers merged, flooding him with memories, drowning him down.
He screamed.
***
It snowed a lot that winter and there were prolonged white-outs. The tree boughs groaned under the snow's weight in the boreal forest down below, where the drifts rose up almost to the canopy.
White. White and wet as far as you could see which wasn’t much further than a stone's throw.
2/2/31. Pt's vitals all within normal range. Pt. temp is 98 degrees.
2/9/31. Pt. vitals are normal. Ankle surgery scheduled for 2/15. NPO > midnight on 2/14. Pt. temp is 98 degrees.
2/15/31. Left Tibial Plafond Repair with plates and screws. Foot to remain non-weight bearing for 8 weeks. Pt. returned to his room after overnight stay in the recovery room. BP and WBC slightly elevated. Pt. temp is 98 degrees.
***
One day toward the end of April – it was a Sunday – a strange conveyance drawn by a pair of high-stepping horses was spotted advancing up the roadway to the Clinic. A morning snow flurry had obliterated the landscape and the groundsmen were out sweeping the pathways between the buildings. They hefted their brooms to stare at this vehicle – a troika, as they later learned – smartly negotiate the oval driveway to pull up to the Clinic entrance. Waiting for it there was Dr. Kleist, the acting director, and his two assistants.
Steam was coming out of the horses’ nostrils but they were still full of run and the driver had to steady them as the troika's lone passenger, a comely woman in her 30's, alighted to present her card.
Oksana Feodosia Baranov: the gold lettering scrolled expansively across the crimson card.
Dr. Baranov wore the navy dress uniform of the Soviet Health Service. She bore letters of introduction from her government and from the British Foreign Service as well. These letters explicitly stated the purpose of her visit: to evaluate the patient in Room #4 and to restore him to baseline prefatory to his discharge.
Dr. Baranov's arrival triggered a groundswell of consternation throughout the Clinic. The Acting Director wanted to protest to the authorities until his assistant called his attention to a third letter in the Russian woman's portfolio, this from the president of the Swiss Parliament urging his fullest cooperation with this ‘mission’.
#4 has done nothing but sleep since he was admitted, Kleist fumed. Bring him back to baseline? Bah! He's near catatonic!!
But being a most circumspect man, he instructed his staff to give Dr. Baranov what she wanted, within reason of course, and signaled to the porters to take her steamer trunk to her room. That evening he quietly cancelled the plans to move #4 to the monastery at the end of the month.
The trunk, a large black metal box with leather straps and handles, was much heavier than it looked. Both porters were huffing and puffing by the time they reached the three-step stairway into the building.
Put it down for a few minutes, Dr. Baranov urged. You're both sweating. She spoke in perfect, unaccented English but the porters, not wanting to lose momentum, barreled up the steps toward the door. Fortunately the cook emerged from the building at that moment and seeing that the porters were on the verge of losing control, rushed to help them, using his bulk to help steer the chest to Room #5, Dr. Baranov's quarters during her stay.
Thankfully, #4 and #5 were on the first floor to the left of the admissions desk. The clerks there were used to seeing the dukes and kings and impresarios from the European upper crust and paid scant attention to this ungainly entourage. Only the tiny Alsatian file clerk mooned her beady eyes over at the cook.
He's my ‘cookie’ she liked to whisper to the other girls. I take care of him…and he takes care of me. She sighed and waved an imaginary wisp of hair from her forehead, the sparkle on her ring finger testifying to the trueness of this liaison.
Over the next few days a tangle of questions rose up about ‘that Russian woman’ and spread throughout the entire facility with bacterial tenacity – and to the monastery as well. This fever would rage unchecked throughout her stay at the Clinic.
That there were curious political reasons for choosing this emissary – for that's what Dr. Baranov was - became clear when it was later learned that she was attached to the Soviet stavka. Much sought out by the various branches of the Russian military, she was credited with restoring the ‘fighting spirit’ to the high ranking members of the officer corps. Her methods and techniques are classified. They won’t be found in the professional journals and therefore have never been subjected to peer review. Her list of patients of all ranks, including admirals and generals, speaks for itself. Dr. Baranov was also on the faculty of the Kirov Military Medical Academy and has lectured at Sandhurst.
After her departure, ‘Case Baranov” took on a life of its own. Shrouded in intrigue, it survived the 2nd World War, the Cold War, the Soviet collapse, the Balkan troubles and the second coming of Islam. A visitor to the Klingenstein Clinic today would hear fresh revelations about ‘that Russian woman.” And her ‘miracle cure’ of #4.
As for the patient in #4, he was discharged one week after Dr. Baranov departed. His identity remains unknown to this day.
BOOK THREE
NATHAN’S FAMOUS
AT CONEY ISLAND
It was his travelling year, two short missions and then a third, where he had to stand in for an injured colleague. Combined, they kept him on the road for 11 months, the longest he’d ever been away from Victoria. She’d come with him on his second tour: six weeks in Washington. Her brother Tom was in town on military business. They took the train up to New York for a family reunion, the first time they’d all be together since before the war.
Victoria's parents were ‘regular’ which counted for a lot in America. They didn’t put on airs. They were comfortable rather than rich. Their house, a two-story white clapboard with yellow trim, had been built 40 years ago but was still considered new.
Phibes had met Eddie and Nacio de Guire at the wedding. He recalled that the first impressions were favorable, but this time they would have a whole weekend in proximity. Why did their daughter marry a man twice her age, loomed in the background
Anton Phibes never made excuses for himself; he didn’t have to.
As it turned out, the weekend was too busy for any of this interior fretting. Victoria's best friend, Mindy, came down from Boston and coaxed her into a quick trip to Forest Hills. Victoria's family, following in a second car, got so
tangled up in traffic that by the time they arrived at the stadium, Vicky and Mindy were caught up in a tough doubles match with two scrappy women from the NYU tennis team. They lost the first set and were down 3-1 in the second when Victoria's serve finally kicked in. She hit nothing but aces to take the second set, 6-3. This took all the wind out of their opponents and they coasted to a 6-0 win in just 20 minutes.
Phibes and her folks were waiting at courtside with hugs and kudos. Tom teased his sister about being rusty. But you’ve still got that killer serve, he added. What were you trying to do, dig a hole in the backcourt?!
That's against the rules. The groundskeepers wouldn’t like it. Victoria never gave her brother an edge.
Spoken like a winner. C’mon, let's go eat. My treat, he said leading them out to the parking lot where he hopped into his two-seater with a ‘Just follow me’ and drove off. Luckily the traffic was light and they were able to keep up with him all the way to Coney Island.
Nathan's Famous was the perfect pick. There was still plenty of heat left in the afternoon sun and all its windows had been thrown open to keep the place from getting stuffy. Nathan's was packed even at this early hour and their group was lucky to capture the last remaining plank table in the room.
Tom was training to be a fighter pilot. America's first line of defense, he exclaimed, and offense too. General Doolittle will have us ready just in case Reparations weren’t being paid, the bread lines were getting longer and there was trouble in the streets pushed by some new rabble rousers on the political scene. The name heard most often was that of a newcomer: Adolf Hitler.
Tom broke off his narrative and grabbed Victoria's hand. C’mon sis, let's go for a dip.
But Tom, we just got here.
Dr. Phibes in The Beginning Page 10
