ADVOCATUS DIABOLI
It was May. The bas-relief crescent of woods that ringed the asylum glistened with generous green. New flowers blossomed every night, and leaves that had hung with folded wings opened to the air. No longer gentle silver columns, the birch trees were loud white flames. The heart-shaped leaves of the poplars drank in the sun’s warmth and absorbed its bright hues. Bare mounds of loam showed like honeycombs scattered on the joyous landscape.
Kauters ordered Stefan to examine an engineer named Rabiewski, who had been brought by car from the nearby town. The patient’s wife recounted the strange transformation of her husband in recent months. He had been a skilled worker, but after the Germans came and bombed the factory, he began supporting himself by teaching vocational courses. Easygoing and phlegmatic, he had been a passionate fisherman, book collector, and vegetarian. An honest man, he would not hurt a fly. Since the beginning of the year, he had been sleeping more and more. By now it had got so, he would doze off during dinner and wake up with a start like a beetle that had been poked. He became lazy and reluctant to go to his lectures, and at home he was a different man; he would fly into a rage for no reason at all and then quiet down equally suddenly. He would fall asleep for hours and wake up with a throbbing headache. He also began to tell strange jokes—he would burst out laughing at things no one else found funny.
The orderly, a strapping young man known as Young Joseph, to distinguish him from the orderly Joseph, had deft hands that could break the most despairing clinch; he led Rabiewski into the examining room. The patient was a fat, balding man with a wreath of gray hair. He wore a purple hospital robe as he limped to a chair and dropped into it so awkwardly that his teeth snapped together. He answered questions only after a long pause, or after they had been rephrased in the simplest possible terms. At one point he noticed the stethoscope lying on the desk and began to giggle.
Having scrupulously recorded the history of the illness, Stefan began to test the engineer’s reflexes. He had him lie down on the oilcloth-covered examining table. The day was bright with sunshine, and reflected prisms showered from all the chrome fittings in the room. While Stefan was tapping the patient’s tendons, Kauters appeared.
“Well, how does it look?” he asked, brisk and animated. He listened to Stefan’s exposition with satisfaction.
“Interesting,” the surgeon said. “For the moment let’s put: suspectio quoad tumorem. We’ll do a specular eye examination. And a tap. And then…”
He took the hammer and struck Rabiewski’s thin leg.
“Aha! What’s this? Please touch your right knee with your left heel. No, not like that. Show him,” he told Stefan, and walked over to the window. Stefan explained. Kauters came back with a leaf he had tom from a branch near the window, rubbing it between his fingers. Sniffing his slender, sinewy hand, he said with content, “Perfect. Ataxia too.”
“Cerebellar, doctor?”
“Perhaps not. Too early to tell. But there is a disturbance in thinking. Abulia. Now let’s see.” He tore a sheet of paper from his notebook and drew a circle on it. Then he showed it to Rabiewski. “What’s this?”
“It’s a part,” the engineer answered after long thought. His voice sounded pained.
“A part of what?”
“A spiral.”
“You see!”
Stefan reported the incident with the stethoscope.
Kauters rubbed his hands. “Perfect. Witzelsucht. A textbook case, don’t you think? I’m convinced it’s a small tumor in the frontal lobe. Time will tell. Please write everything down.”
The patient was lying on the table, his slightly goggled eyes staring at the ceiling. As he exhaled noisily, his lips parted to reveal long, yellow teeth.
That evening, Stefan came down with a headache and fever. He took two aspirin, and Staszek brought a bottle of vodka, which should have helped. But the weakness, chills, and fever lasted for four days. On the fifth day Stefan was finally able to get out of bed. After breakfast he went straight to Rabiewski’s room, curious to find out what was happening. The ordinary hospital bed had been replaced by a special one with nets at the sides and on top. The engineer lay as if caught in a web in the cage that they created, no more than a foot and a half high. His whole body seemed swollen. Kauters was leaning over looking at him attentively, moving his head out of the way when the prisoner tried to spit in his face. The thick lines around Rabiewski’s mouth were white with foam. The surgeon took off his glasses and Stefan had his first clear look at his eyes. They bulged, devoid of any sparkle, and were dark like the eyes of an insect seen through a magnifying glass.
“The tumor is growing,” Stefan said in a half-whisper. The surgeon paid no attention. He backed away again when the patient managed to turn his head and sprayed saliva. The patient grunted, tensing the muscles of his immobilized body.
“Pressure on the motor region,” Kauters murmured.
“Are you thinking of operating, doctor?”
“We’ll do a tap today.”
That evening, the brain that was lashing Rabiewski’s body seemed to reach a paroxysm of vexation. Knots of muscles cramped and rippled beneath his sweaty skin. The netting on the bed resonated like strings on a musical instrument. Stefan gave him two injections, which did not help much: the chloral narcosis stilled the fury only for a short while. When he came out of the anesthesia, the engineer reacted to the first light he had seen in many hours and mumbled hoarsely, “I know… it’s me… help.”
Stefan shivered. After the tapping of spinal fluid, there was an insignificant improvement. Kauters sat in the room for days on end, pretending that he had just come in to check when Stefan happened to appear. At first Stefan merely wondered why the surgeon was stalling. Then he grew depressed: the chances for a successful operation were decreasing every day.
The state of excitement passed. The engineer was able to sit in a chair. Pale and unshaven, he was the shadow of the burly man who had arrived three weeks earlier. His eyesight was gradually failing. Stefan no longer dared to ask about the date of the operation. Kauters was obviously upset, as if waiting for something to happen. Rabiewski had become his favorite patient, and the surgeon brought him lumps of sugar and sat watching him smack his lips and try to orient himself in relation to his own body, touching his thigh, his calf, his foot. His senses were slowly declining, and the world was fading for him. If you screamed into his ear, his twitching eyelids indicated that he could still hear.
On June 10, Kauters stuck his head out the door and called Stefan in from the corridor. The room was almost empty: no table or chairs. Rabiewski was back in his net, swollen, naked, and huge.
“Pay close attention,” Kauters said, beaming.
Rabiewski’s body shuddered, his hands burrowing in the netting like unconscious animals. Then violent convulsions began. The cage screeched, its iron legs banging against the floor. The bed almost tipped over, and both doctors had to press it hard against the wall. The attack subsided as quickly as it had come. The body hung in the net like a board. Feverish shudders ran through an arm or a leg. Then this, too, ceased.
“Do you know what this is?” the surgeon asked Stefan, as if he were giving an examination.
“Irritation of the motor region caused by pressure from the tumor?”
Kauters shook his head. “No, my friend. The cortex has entered necrosis. An ‘acortical man’ is emerging. Freed from the cortex’s inhibiting influence, the older, earlier evolved parts of the brain, still unaffected, are speaking up. That attack was Bewegungssturm, the motor storm, which occurs in all animals from infusorians to the birds. The animal is trying to escape, in the face of a threat to its life. The subsequent torpidity is the second stage of the same reactive apparatus. The so-called Totstellreflex, playing dead. Dung beetles do the same thing. See what it looks like? Now it’s receding beautifully!” he cried, excited. The engineer, racked by cramps, was now arching his back, pressing against the nets.
“Yes… that c
omes from the quad protuberance. A classic case! The mechanism that served the amphibians millions of years ago now emerges in Homo sapiens when the more recently evolved parts of the brain drop away.”
“Should I make the preparations for an operation?” Stefan asked, unable to look either at the convulsing body or at the surgeon’s joy,
“What? No, no. I’ll let you know.”
After his rounds, Stefan looked in on Sekułowski. Their relations had developed from their earlier unsettled state into a clearly established order: the master and the pupil who had to put up with his abuse. As a rule Stefan did not discuss patients with him, but Rabiewski was an exception: Stefan was desperate and needed advice. He dared not act on his own, and he was not sure what he could do anyway. Go to Pajączkowski? But that would mean lodging a complaint against Kauters, who was his superior and an experienced physician. So he settled on describing the engineer’s condition to the poet, even if that might cause an outburst of passion and indignation. But Sekułowski himself had not been feeling well of late, and he was eager to hear the tale of someone worse off than he.
Plumping up the pillow behind his back, Sekułowski delivered a long exposition: “Once—maybe it was in ‘The Tower of Babel,’ I said that man presents a particular image to me. It is as if someone had labored for centuries to make the most beautiful golden sculpture, adorning every centimeter of its surface with varied forms: hushed melodies, miniature frescos, all the beauty of the world captured in a single totality obeying a thousand magical laws. And this sublime sculpture is mounted in the depths of a huge roiling dung heap. That, more or less, is man’s position in the world. What genius, what precise craftsmanship! The beauty of the organs! The stubborn mind that harnesses the impassioned atoms, electron clouds, and wild elements, imprisons them in the body, and compels them to deeds alien to their nature. The infinite patience of designing the joints, the complex architecture of the bones, the labyrinth of circulating blood, the miraculous optical system, the finery of the fabric of nerves, thousands upon thousands of mutually restraining mechanisms, rising above anything we can think of. And all of it completely unnecessary!”
Stefan, shocked, was unable to reply. The poet smacked his hand against a large open book that had been covered by sheets of paper now strewn across the bedding: it was an anatomical atlas Stefan had lent him.
“What a disparity of means and ends. Your engineer vegetated, oblivious to what was fettered inside him, until suddenly the cells slipped their chains and their powers—until then directed inward, doing the bidding of kidneys and intestines—were suddenly liberated! The explosion of a thousand pent-up potentials. The spirit bursts through its chrysalis and appears in sudden enlargement: a watch with its works in revolt.”
“Are you thinking of the malignancy?”
“That’s what you call it. But what a name for it! You see, doctor, your ideas are pickled in formalin. For God’s sake, show a little imagination! Cancer? That is simply the side door, the Seitensprung, of the organism. My Blind Powers, securing the living tissue against accidents of a hundred thousand kinds, seem to have left one vent ajar. Everything was working perfectly, and suddenly—out of control! Have you ever seen a child playing with a watch, the way the child pulls off the hour hand, which makes the second hand spin and buzz like a horsefly? Instead of measuring the hours, the hands gobble up fictitious time! A tumor is a little sprout that grows from one mutinous cell. Slowly, you understand? Slowly it develops in the brain, draws nourishment from the blood, invades, eats through, and destroys those well-tended flower gardens planted in the human fodder…”
“You may be right,” said Stefan, “but why doesn’t Kauters operate?”
The poet, writing so feverishly that his pen point kept making holes in the paper, did not reply. There was a long silence. Outside the window, a bronze ray broke through the clouds and lit the treetops. The room drank in the light, which abruptly vanished. Stefan’s heart was pounding. Suddenly he asked, entirely out of context; “Excuse me. Why did you write Reflections on Statebuilding?”
Sekułowski, who had been lying on his side, turned and looked Stefan in the eye. Stefan could see the blood rising in the poet’s face, but he still was glad that he had asked the question.
“What do you care?” Sekułowski retorted in a deep voice that Stefan had not heard before. “Please stop boring me! I have to write!”
And he turned his back on Stefan.
Stefan decided to see Staszek. Perhaps he could help.
Staszek tied a ribbon around the thesis he was working on and put it away in a drawer. He complained to Stefan. The hospital did not keep him busy, he was bored with the patients. It was an enormous effort to put in his hours. He could not walk, sit, or lie down; Nosilewska’s image stayed with him constantly.
“You’ve got to make up your mind,” Stefan said, overcome by sudden compassion. “If you want, I’ll invite her to my room tonight, you come along, and then I’ll say I have to get things ready for an operation and I’ll leave you alone with her.”
But Nosilewska declined the invitation. She was busy copying out data from a large German anatomy textbook. The green ink staining her fingertips made her look girlish. She said she had to go see Rygier right away. Rygier had once taught anatomy in medical school, and he could help her with some of this pathology material.
Staszek, who had been waiting in Stefan’s room for the results of the expedition, now found new reasons to suffer. He was convinced that Rygier had invited Nosilewska for extra-scientific purposes.
“Well, maybe,” Stefan thought. “Do you love her?”
Staszek shrugged. He was sitting sideways in the chair, his legs hanging over the arm, kicking nervously.
“I won’t answer stupid questions. I can’t work or read, I can’t sleep, I’ve lost control of my thoughts, I’m going to hell in a handbasket, and that’s it.
Stefan nodded. “It could be love. Let me ask you a couple of crucial questions. First, would you use her toothbrush?”
“Come on!”
“Yes or no.”
Staszek hesitated. “Well, maybe yes.”
“Do you feel a ripping and bursting in your chest, a divine fire?”
“Sometimes.”
“Well, well. And now you’re in a state because she’s going to Rygier’s? Amor fulminans progrediens in stadio valde periculoso. The diagnosis is a snap. No time for preventive measures. You need treatment.”
Staszek looked at him gloomily. “Don’t be a fool.”
Stefan smiled because it had just occurred to him that if he wanted Nosilewska himself, he would have no trouble at all. “Don’t get angry. I’ll invite her tomorrow—or better yet, after the operation, once I get that off my mind.”
“What do you mean? What’s the difference what’s on your mind?”
“Oh, so you’re jealous of me too!” Stefan laughed. “I’ll get some bromural for you, okay?”
“Thanks, but I have my own.”
Staszek took a book from the shelf: Magic Mountain. He leafed through it, put it down, and took The Green Python instead.
“It’s a detective story. Terrible,” Stefan warned.
“So much the better. Then it’ll fit my mood.”
He headed for the door. Stefan’s sympathy suddenly vanished. “Listen,” he asked, “would you rather if she betrayed you or if something bad happened to her?”
“First, she can’t betray me, because there’s no connection between us. And anyway, what kind of choice is that?”
“It’s a psychological test. Answer.”
Staszek pushed the door open and slammed it as he rushed out. Stefan lay down on the bedspread in his clothes. Belatedly he realized that he had been angry with Staszek all evening because he had been unable to talk to him about the engineer. He got up, went to the shelf, and looked for the neurosurgery text. Maybe Kauters was doing the right thing. But he couldn’t believe that. The text settled nothing. The sheer curtain rustl
ed at the open window. Someone knocked at the door.
It was Kauters.
“Dr. Trzyniecki, please come to the operating room right away.”
Stefan jumped up, but the surgeon was already gone, the fluttering folds of his unbuttoned smock disappearing into the dark corridor. Stefan ran down the stairs, forgetting to turn off the light in his room.
It was a warm, damp night. The wind carried the strong tickling smell of ripe grain. Stefan cut across the grass and ran up the iron steps to the second floor of the surgical wing, dew glistening on his shoes. White figures moved back and forth behind the frosted glass.
The operating room had begun as a small facility for procedures such as draining abcesses, to avoid having to transport patients to town. But there had been room for expansion, and Kauters had seized the opportunity. Now there was a table that could handle any kind of operation, along with oxygen bottles, a wall-mounted electric bone cutter, and a diathermal unit that resembled an oversized radio. A short passageway, lined with the usual little yellow tiles, led to a second room where rows of chemical bottles, piles of rubber hoses, and linen under a glass bell stood on metal tables. Two wide cabinets held instruments neatly laid out on perforated trays. This corner full of sharp scalpels, hooks, and pincers glimmered even in the dark. Balls of catgut were soaking in amber lugol on a separate table. Rows of glass tubes containing white silk sutures shined on a shelf above.
Sister Gonzaga rolled the instrument cart up to the massive, three-legged operating table. Next she brought up the big nickel sterilizers, that looked like beehives on their high stands. Stefan was disoriented. He could not ask the nurse who the patient was. Gonzaga had already begun scrubbing up, so he threw on a long rubber apron and began to soap his hands under a roaring stream of water. Drops splashed onto the mirror and left opal tracks as they rolled down the mercury surface. White suds formed a ring in the basin.
Suddenly he heard Kauters’s voice inside. “Take it easy, will you?” Then there was a deep sigh, as if someone was lifting a weight. Through the swinging doors, Stefan saw the bald head of the older male orderly, Joseph, who had Rabiewski’s inert form draped over his shoulder. He set him down on the table with a bang.
Hospital of the Transfiguration Page 9
