A Fight in Silence

by Melanie Metzenthin

  ‘Think about it. If you leave this child to research, his time on earth won’t have been in vain.’

  ‘His time on earth isn’t in vain in any case!’ Richard’s tone was icy.

  Dr Brandes grimaced angrily but said nothing further as he left.

  Paula was still gathering up Dorothea’s things when the chaplain arrived to perform a rapid baptism ceremony for little Gottlieb.

  An hour later Richard and Paula set down Fritz, Dorothea and the child outside their home.

  ‘If you need anything, please do let us know,’ said Richard to Fritz as he got out of the car.

  Fritz nodded then helped his wife step out of the car with the baby.

  Gottlieb Ellerweg passed away peacefully in his mother’s arms four days later and was laid to rest at Ohlsdorf Cemetery in the presence of his loving family and their friends.

  Chapter 14

  After Gottlieb’s burial, Fritz didn’t talk about his son, but he and Dorothea wore black for the next few weeks. He put on a show of normality but Richard knew how much his friend was suffering, and it wasn’t just because the baby had died. Somehow, the baby’s condition had become known and the hospital was full of gossip. Although it couldn’t be established exactly who had started it, Paula’s frequent visits to Finkenau for her doctorate led her to suspect Brandes. The doctor had been angered by the way Fritz, a fellow professional, of all people, had been so stubborn and sentimental – as he disparagingly referred to it – that he had deprived the anatomical collection of a valuable specimen. The worst of it was that a lot of his colleagues agreed with him. Yes, it was a tragedy to have a baby with an abnormality, but let’s face it, the child hadn’t been right and death was a release. Some viewed it as provocation that not only had Fritz chosen to let ‘the being’ decay in the ground instead of handing it over to the noble cause of research, but that he continued to dress in black, even one week after Gottlieb’s burial. As far as they were concerned, Fritz and Dorothea should have been relieved that the child hadn’t survived to become a dribbling idiot.

  Richard did all he could to support his friend, as did Professor Wehmeyer, who was one of the few who respected Fritz’s need to mourn and protected him from the latent criticism of other colleagues. Fritz himself was single-minded and held his ground against the underlying hostility until eventually the news about his son lost its novelty and people turned their attention to other things. Richard, however, never forgot how other doctors had criticised his friend for the decision he had made and even attacked him for it. He was certain that Fritz would never forget it either.

  At the end of March, Richard completed the compulsory period working in surgery and then started as a junior doctor in psychiatry on 2 April 1929. He’d originally applied to the hospital at Friedrichsberg, easy to reach from Rothenburgsort, where he and Paula had found their own flat very soon after their wedding. However, the vacancy he’d been offered was at the Langenhorn asylum in Ochsenzoll, an outpost of the hospital at Friedrichsberg. Richard hadn’t been very enthusiastic about this at first, mostly because of the long journey to work and the bad transport connections. His father-in-law consoled him with the fact that the Langenhorn facility was very modern and offered far more opportunities for promotion for a committed young doctor than the Friedrichsberg hospital. And as Richard had a car, the twenty-three-kilometre drive was not an insurmountable obstacle.

  On his first day, Richard reported to the lead consultant, Dr Sierau, and was immediately impressed with the place. ‘You won’t find any caged beds and straitjackets here now,’ Dr Sierau had explained. ‘Last year we managed at long last to put an almost complete end to those archaic modes of treatment and we now treat all our patients with understanding and care. The switch to new methods was hard and the first few nights were both disturbing and disturbed, but it took only a few days for most of our patients to adjust to the new ways of doing things. Now they conduct themselves as calmly as before but without the old means of enforcement. They’re quite easy to deal with, and less prone to violent and destructive behaviour.’

  Dr Sierau looked through Richard’s references. ‘I can see you completed your doctorate on different treatment methods for the mentally ill, Dr Hellmer. You would be a real benefit to our secure unit. Make yourself known to Kurt Hansen, the senior nurse there, a very experienced man who’ll be able to tell you a great deal. As will Dr Morgenstern, the senior consultant, and a genuine supporter of our new approach to caring for the insane.’

  The pathway to the secure unit took Richard diagonally across the grounds, and his first impression was of the sheer size of the whole estate. It was a village in itself. It boasted fields of vegetables, orchards full of fruit trees, some livestock, as well as its own church to cater for the patients’ spiritual health. The patients themselves lived in small pavilion-style buildings which were run along the lines of an open country house, albeit fitted with the necessary security measures. The secure unit where Richard was to work was surrounded by a high wall and bars had been fitted to the windows.

  Kurt Hansen was a fatherly man in his mid-forties with a bit of a paunch and nerves of steel, and Richard found him immediately likeable.

  ‘It’s like raising children,’ he commented as he took Richard around the building. ‘Do you have any children, Dr Hellmer?’

  ‘Not yet.’

  ‘Then you’ll get some good experience here until such time as you do. Our patients need understanding because there’s so much they can’t grasp for themselves, but at the same time they need an iron hand, as plenty of them know perfectly well what the rules are and want to break them. They can be absolute rascals.’ He gave a gentle laugh. ‘Don’t be fooled by them – some of our friends here are up to every trick in the book and are remarkably shrewd. Come on, let me show you around our home.’

  ‘Thank you.’

  ‘My pleasure.’ He opened one of the doors. ‘This is your office. If you need anything, just tell me. As you can see, you even have your own telephone.’ Kurt Hansen gestured towards the dark wooden desk, the gleaming new device ready and waiting. ‘Our senior consultant is very proud that every doctor has his own telephone.’

  ‘Well, I hadn’t expected that! My wife and I are still waiting for our own line to be put in at home. We should be getting one in a couple of months’ time.’ Richard hung up his coat and put on the white coat that had been left out for him, then followed the nurse through the unit.

  ‘The patients here are in observation rooms because they have to be watched at all times. Here in this unit we’ve got two observation rooms, each with twelve beds.’

  Hansen opened the door to one of these rooms. Three male patients lay in their beds, but otherwise the room was empty. ‘The garden’s open at this time of day,’ he explained, ‘and we do encourage as many of them as possible to get some fresh air. It doesn’t work with all of them. You just accept them as they are.’

  Richard noticed how light and brightly decorated the room was. The walls were painted a pale yellow and matching curtains hung at the windows.

  Hansen continued through the room to a door at the back. ‘These are bathrooms for the long soak.’ Inside were a pair of glazed enamel bathtubs that were used for calming any highly agitated patients and which, if necessary, could be closed over with a canvas cover so that only the patient’s head was visible.

  ‘A long soak is a good way to calm someone, but in the last couple of weeks we’ve barely needed them. Of course, we have normal baths too – they’re at the other end of the hallway.’

  Richard nodded.

  He was then led to the day rooms, also used for games. The walls were decorated with landscape paintings, lending the place the air of a comfortable living room rather than a stark institution.

  The last stop on Richard’s tour was the garden, which was surrounded by a high wall. Most of the patients were out here, sitting in the sun or simply walking round and round. Some were playing board games with the nurses.


  ‘It’s got the feel of a sanatorium, don’t you think?’

  Richard nodded again. ‘Very peaceful,’ he said.

  ‘We try to build relationships with the patients, but it’s always precarious. Eventually, the plan is to transfer them to supervised living in the open country houses when they’re ready. But don’t go thinking it’s always like the first days of spring around here! It gets pretty wild at times, and that’s when we really have to roll our sleeves up and get stuck in.’

  ‘I’m not afraid of that,’ said Richard.

  ‘Nor should you be. That’s not for top brass like you, that’s work for the foot soldiers,’ Kurt Hansen said with a good-natured smile.

  Richard learned a lot about himself in those early weeks. He had approached his work full of ideals, driven on by his determination that no patient should ever suffer the pain his brother, Georg, had endured. The humane approach and the widespread rejection of restraint in Langenhorn fitted well with his vision for modern psychiatry.

  A young schizophrenic called Herbert, suffering from an advanced form of dementia praecox at the age of twenty-one, reminded Richard of his brother, although he bore no particular resemblance to Georg. Perhaps it was because of his helpless expression and agitation whenever he didn’t understand what was happening around him. Richard didn’t quite know why, but he felt sure he could work with Herbert and help him reach a degree of stability that would allow him to move into one of the open houses and take up a useful occupation. Kurt Hansen repeatedly warned him that Herbert would only take advantage of this goodwill and eventually break any promises made, but Richard was unwavering in his opinion. From then on, he gave Herbert plenty of attention and one day took him for a walk through the grounds to show him the herd of dairy cattle. His face trusting and childlike, Herbert followed him, pointing at the rhododendrons in bloom along the main pathways and looking pleased when they met other people.

  They reached the cows just at milking time and an elderly man with Down’s syndrome gave Herbert a slightly clumsy explanation of how to do the milking. Herbert was quickly fired up and wanted to have a go straight away. Richard had no objection and was surprised to see how deft the young schizophrenic could be.

  ‘I’d like to do that all the time,’ he said to Richard on the way back. ‘May I try it again?’

  ‘We’ll see,’ said Richard, finding it hard to quash the young man’s enthusiasm.

  Once they were back, he spoke to Kurt Hansen and asked what conditions had to be met by inmates before they could live in an open house and work on the land.

  ‘You really want to do that for Herbert?’ Hansen was sceptical. ‘Nothing’ll come of it. Today he’ll think it’s wonderful, but tomorrow he’ll lose all interest and make a run for it, get drunk somewhere and get into trouble.’

  ‘Have we tried?’

  ‘Last autumn he was sent out to help with the harvest. It didn’t go well. He kept it up for two days, then cleared off and the police brought him back. Dr Morgenstern thinks it’s too soon to try it again. The lad’s too hot-headed.’

  Richard spoke to Dr Morgenstern about Herbert during his rounds and related the milking episode.

  ‘And now you believe he’ll really stick at it, Dr Hellmer?’

  ‘That I don’t know. But I do know I saw a childlike joy in his eyes instead of the dull stare we see him with in here. Wouldn’t it be worth a try?’

  The consultant removed his spectacles and polished them as he observed Richard from the corner of his eye.

  Putting his glasses back on, he said eventually, ‘You have a big heart, but you wouldn’t be doing the lad any favours. He won’t keep it up.’

  ‘Because he failed at the autumn harvest?’

  ‘Yes. He lacks the necessary seriousness. He sees something, wants it, but equally fast he loses interest and goes looking for the nearest distraction.’

  ‘Maybe taking some responsibility for the animals would bring him an inner sense of structure. After all, living creatures demonstrate their feelings, unlike harvested fruit.’

  Dr Morgenstern smiled indulgently. ‘You’re new here, full of idealism and the desire to make the world a better place. I value characteristics like these in our young doctors – one can lose that all too quickly. Carry on with Herbert’s excursions and you’ll see how he soon loses interest.’

  ‘And if he doesn’t?’

  ‘Then we’ll discuss the matter again in two weeks.’

  ‘Thank you.’

  ‘Don’t thank me yet, Dr Hellmer. I’d rather you show me that you can motivate Herbert in the longer term to take a lasting interest in some occupation.’

  Kurt Hansen seemed unconvinced and gave an almost imperceptible shake of the head, but Richard was confident that Herbert would be the first of many whose lives could once again become worthwhile with his help.

  After two weeks of regular excursions with Herbert, Richard saw his efforts rewarded when Dr Morgenstern agreed to Herbert’s transfer to one of the open country houses. Richard was triumphant at having made such a significant breakthrough and drove home that evening thoroughly elated.

  When he arrived at work the following day, however, he learned that Herbert was back in the secure unit. Immediately after his transfer, he had climbed over the fence and absconded. The police had brought him back in the middle of the night after he’d got drunk in a pub nearby, not paid for his drinks and then had a punch-up with other customers.

  Richard was thunderstruck to find Herbert, the very picture of misery, sitting on his old bed in the observation room, his face bruised from the brawl and his eyes bloodshot from the alcohol to which he was so unaccustomed.

  ‘What was the point of all that, then?’

  ‘Oh, Doctor, I had a real thirst on me and I hadn’t been there for ages.’

  ‘But you promised me you would keep to our agreement.’

  ‘Yes, I will do that. Promise. Can I go back to see the cows now?’ He looked at Richard with a trusting expression like that of an abandoned child. This time, however, it had no effect on Richard. He was so disappointed and angry with himself for not heeding the warnings of more experienced colleagues and for thinking that he knew better.

  ‘Sorry, no more excursions to see the cows for the time being.’

  ‘Why not?’

  ‘You broke the rules. You ran off, got drunk, didn’t pay your way and you got into a fight. And all that on the first night. I am bitterly disappointed.’

  ‘I’m sorry. I’ll never do it again. Promise.’

  Richard didn’t waver. ‘No more cows for the time being. You need a bit more time. Dr Morgenstern was right.’

  Kurt Hansen greeted Richard with an encouraging clap on the shoulder. ‘Don’t take it too much to heart, sir. You were well intentioned, but we know what we’re dealing with here. It was clear from the start.’

  ‘But why did Dr Morgenstern agree to the transfer if he knew all along that Herbert would abscond? This could have had terrible consequences.’ He swallowed hard when he imagined all the things that could have happened.

  ‘I want to be quite open with you, Dr Hellmer. You believe in the goodness of every patient and your heart’s in the right place, but our patients are only human. They’re neither angels nor devils. Unlike those doctors who see the patients as wilful devils to be subjected to constant discipline, you’ve got the makings of a good psychiatrist. But even those who think like you need to recognise that idealism doesn’t always achieve the right end and can have serious consequences. And the sooner you experience this for yourself, the better. Herbert has only ever run off in order to get drunk and sometimes he gets a punch on the nose, like last night. Nothing worse than that has ever happened because Herbert’s actually a very nice lad.

  ‘That’s why Dr Morgenstern was prepared to let you have your way. So you could find out at first-hand how easy it is to fall for a patient’s trusting looks and promises that are genuinely meant at the time – Herbert real
ly means it and that’s how he persuaded you. But when it comes down to it, he just can’t do it. We all knew it wasn’t going to work. Dr Morgenstern gave you the chance to find out this way because he thinks a lot of you, so consider it a compliment, but you’ve still got a fair bit to learn.’

  ‘So you wanted to bring me down to earth with a bit of a bump.’ Richard forced a smile, although inside he felt ashamed of himself. Had he really been so pig-headed that nobody trusted him to listen to the facts? Yes, apparently. He remembered how happy he’d felt the evening before when he’d related his first big success as a budding psychiatrist to Paula. She’d been so proud of him, and yet now he had to tell her that his supposed great success had actually been a hard lesson. He sighed.

  It was with mixed feelings that Richard went into the doctors’ canteen. How on earth was he to keep his credibility with colleagues after this incident with Herbert? He took a deep breath, gathered himself and took a seat on the same table as Dr Morgenstern and Dr Krüger. Krüger was around Richard’s age and had started at the asylum just before him. They’d crossed paths now and then and had greeted one another, but Richard had had little to do with him so far.

  As Richard sat down at the table, Krüger observed him with not a little amusement.

  ‘I hear you may just have experienced your first personal Waterloo?’

  Richard was not usually short of a riposte, but his sense of shame went so deep that he couldn’t summon a suitable reply.

  ‘If that’s what you want to call it,’ was all he said.

  ‘“Waterloo” seems rather harsh,’ observed Dr Morgenstern. ‘It’s something we’ve all had to go through once.’

  ‘I haven’t,’ said Krüger. ‘Naivety and unrefined compassion are not appropriate when treating the mentally ill.’

  Still no response from Richard, as he focused on the goulash on his plate.