Illness strikes
From Guises of Desire, Chapter 4
……Bertha stood at the foot of the bed with her mother and Willi while the doctors examined her father. Like twin vultures, Bertha thought, as they bent over him, bald heads rising out of hunched black-clad shoulders, beaky noses pointing out from broken-veined rough-skinned cheeks, withered eyelids fluttering as they gave each other knowing looks. Hands, a tangle of ropy purplish veins, as spare of flesh as talons, explored her father’s chest, tapping it to assess the quality of the sound, applying the stethoscope front and back. They murmured to each other, their exchanges peppered with unfamiliar words. Pleura, axilla, expectoration, intercostal. Surely if it was something straightforward they would use ordinary words like ‘chest’ and ‘cough’ and ‘lungs’. Oh dear God, now they were pushing a needle into him, between his ribs. Professor Aschenbach was drawing something out. The syringe was filling up with a yellowish fluid. Bertha turned her head away. She caught Willi’s eye. No, she mustn’t let him see her flinch. She turned back again. Professor Aschenbach had emptied the fluid from the syringe into a bowl. He swilled it around, eyeing it keenly, then lifted it to his nose, sniffing as if savouring the bouquet of a freshly opened bottle of claret. How could he bear to inhale such a noisome odour? Even from where she stood Bertha was almost vomiting from it.
‘As I thought.’ Professor Aschenbach laid the bowl down on the bedside table.
The examination had confirmed Doctor Bettelheim’s original suspicions – a subpleural abscess. The doctors were now going to proceed with the drainage. Professor Aschenbach explained what was involved. Dr Bettelheim would anaesthetize Mr Pappenheim – they had brought all the necessary equipment – and he himself would perform the operation. A small opening in the chest, the insertion of a tube, aspiration of the purulent matter. It would all be over very quickly and Mr Pappenheim would already be greatly relieved by the time he recovered consciousness. Would the family members like to remain in the room? Willi begged to be excused. He had an engagement in town; in any case he would only be in the way. Selfish milksop! Bertha had seen how he had kept his eyes averted throughout the examination, passing his hand constantly over his nose, trying to ward off the fetid odours. So much for all his cosy confabs with Papa about politics and business. What use was he when he was really needed?
Willi backed out of the room, muttering something incoherent.
Mrs Pappenheim, apologetic and indulgent, excused him. ‘He’s still only a boy.’
Dr Bettelheim had raised the lid of a black case and was removing a rubber bag with tubes attached to it. Professor Aschenbach had opened his bag, revealing a set of knives and other sharp and pointed instruments.
Bertha moved over to the window. She would not watch this. She looked out. A beautiful summer’s day. The Kohn family next door were preparing to set off for a picnic. An open carriage stood ready for them in the street. The coachman was helping the maid to load the hamper. The two little girls ran out of the house shrieking, chased by their black spaniel. Their mother, shielded from the sun by a pale pink parasol, shooed them into the carriage. Their father, following behind, scooped up the dog and handed it in after them.
The room was filling with a strange odour. Sweet and sickly. Like rotten pears. She half turned. Dr Bettelheim was administering the anaesthetic. Her father was already unconscious, a rubber mask over his nose and mouth. Professor Aschenbach was selecting an instrument. Bertha looked quickly away again. Willi had just come out of the house, straw boater perched jauntily on the back of his head. He started to walk down Kaltenbachstrasse, twirling his cane, as insouciant as a spring lamb. How dared he!
That horrible smell. She was feeling faint. The ether must be leaking somewhere. They could all fall unconscious. She looked round again, for reassurance. She could see only the two doctors huddled over her father’s body. Suddenly there was a faint gurgling and a swooshing and a stench which swamped the ether smell. Professor Aschenbach was holding a large bowl to the side of her father. It was filling up with a thick, frothy liquid. The bile rose in her throat. She averted her eyes, looking towards her mother. How could Mamma sit there, impassive, observing this vile butchery without a flicker of fear or disgust?
She looked down into the street again. She must think about something else, anything but the scene in the room behind her. The Kohns’ carriage had gone. She wondered what Willi was doing. With his stupid friends, probably, those cocky young men he spent all his time with, giving each other knowing looks, laughing at things she didn’t find amusing.
A sharp, clean smell cut through the putrid emanations of ether and pus. Professor Aschenbach was washing out the cavity with antiseptic solution, explaining to her mother that this would have to be done regularly over the next few days. Dr Bettelheim would visit daily, he was saying, but Mrs Pappenheim might also like to engage the services of a nurse. A drain would be left in place, with a dressing on top of the wound which would need to be changed several times a day.
‘There is no need,’ Bertha heard her mother say. ‘My daughter and I will do the nursing. If you could just tell us what is required.’
Bertha listened, aghast, to the doctor’s instructions. Again she felt bile rise in her throat. Why couldn’t Mamma have agreed to hire a nurse?
A bell sounded in the street below. The local dairyman was coming up Kaltenbachstrasse with his cow. He stopped outside the house as Ilse came out with a jug. Bertha watched as they stood in laughing banter, then the dairyman squatted down by the swollen udder. Seizing a teat, he propelled a jet of milk into the jug. Bertha heard again the gush of infected matter from her father’s chest, smelt the noisome odour. She closed her eyes, revolted at the thought of drinking the milk, revolted at the thought of ever eating or drinking anything again.
Her mother was thanking the doctors. Dr Bettelheim had removed the mask from her father’s face and was packing his equipment. He and Professor Aschenbach would sit with the patient for a while, he said, until he came round and they were sure that his condition was satisfactory.
Mrs Pappenheim turned to her daughter. ‘Bertha, I think you should go and get some sleep now. You’ll be sitting up again at night.’
Bertha dashed from her father’s room to her own, borne on a wave of relief. She lay down on her bed. It was over. The tension in her began to wash away. The room was dim, cool and fresh, the light filtered through the slats of the half-closed blinds. She closed her eyes. But as soon as she did so the scenes in the sickroom reared up again before her. The rubber mask over her father’s face, the syringe thrust into his chest, the knife slashing in between his ribs, and that awful stuff that had come pouring out. Surely there must be something terribly wrong for him to have so much nastiness inside him. And even though it had been drained away now, what was to stop whatever it was that had caused it doing the same again? Professor Aschenbach had talked about hope. With full rest and a good diet, he had said, we may hope for improvement. Why had he said improvement? Improvement wasn’t the same as being better. He had also talked about the mountain air and the fact that Papa was away from his affairs in the city. But that hadn’t stopped him deteriorating so dramatically in the time that he’d been here in Ischl. What good had the rest and mountain air done him in the past few weeks?
Bertha jumped up. She had to talk to someone. She would go down to Klara.
She tiptoed along the hall, towards the front door. She turned the handle quietly, opened the door and stepped out. But no! She was in the room occupied by Miss Thomson.
The governess sat by the window, Percy on her knee, a glass of water in her hand. The dog’s long pink tongue slurped in and out of the water, slithering over the rim of the glass. Bertha felt a fresh gush of bile. She pressed her hand to her mouth and rushed from the room, out of the apartment. She ran down to the floor below and rang the bell.
Klara opened the door.
‘Bertha, whatever is wrong?’
‘Oh, Klara, I’m so frightened.’ Tears started to flow. ‘Papa is so ill with his lungs and I’m afraid he’s going to die.’
‘Bertha, you mustn’t upset yourself like this.’ Klara took Bertha’s arm and drew her inside and into her bedroom. She sat her down on the bed and settled down beside her. ‘Now tell me all about it.’
Bertha recounted the doctors’ visit, the anaesthetic, the rubbery apparatus, the sinister bag of instruments, the cutting of the chest, the worrying conversations conducted in grave voices, the sickroom duties that she was going to have to carry out.
Klara took both of Bertha’s hands in hers. ‘Bertha, listen to me. You know that Professor Aschenbach is the best doctor in the whole of Austria for lungs. Lots of people get better from illnesses like this. Just wait, by the end of summer when it’s time for you all to go back to Vienna he’ll be as well as ever he was.’
‘But my sister Henriette, she died from tuberculosis. And we’ve heard of so many people now in Vienna who have had it and died.’
‘Bertha, no one has said that your father has tuberculosis. And even if he has, this isn’t Vienna. This is Ischl , which is the best possible place for anyone who’s ill.’
Bertha felt some of Klara’s cheerful confidence begin to flow into her. She listened to Klara prattle on about the pure air and the spas, the baths full of salt and sulphur and all manner of good things. It was true. And it was fourteen years since Henriette had died. Doctors had discovered so many new treatments since then. Why, every day there were new discoveries.
‘Perhaps you’re right.’
‘Of course I’m right.’ Klara jumped up. ‘Come now, let’s go out into the garden and have a game of quoits.’
Bertha dried her eyes and followed Klara downstairs to the quoits pitch at the bottom of the lawn. Once outside her spirits lifted further. The grass was newly mown, its scent still lingering; the bushes blazed with summer colour and the sun shone gaily overhead. The glacier-clad peaks of the distant Dachstein massif stood out clean and pure. A bee, hovering over a yellow rose, buzzed soothingly. The scenes of sickness indoors were a world away.
‘Here, you can start.’ Klara passed Bertha a handful of quoits.
Bertha took aim and tossed the first of her rubber rings. It fell short of the hob. Her second overshot it. She stood aside to let Klara take her turn. As she waited she looked back up at the house. Surely it was wrong of her to be out playing, amusing herself, when her father was so ill.
‘A ringer,’ shouted Klara. ‘Two points for me.’
If Mamma knew that she was out here instead of resting in her room…. Well, if it was all right for Willi to be out larking around town so could she.
Now it’s you again, Bertha.’ Klara put her hand on Bertha’s arm and shook her gently. ‘Bertha, what’s wrong?’
‘Nothing. I’m just waiting for you to take your turn.’
‘But I’ve taken my turn. Look, I’ve got a ringer. Didn’t you see?’
Bertha looked over towards the hob. ‘Oh, yes. Yes, of course.’
‘Right, so it’s your turn now. On you go.’
Bertha picked up a quoit. She felt the hard rubberiness of it in her hand. Like the rim of the mask over her father’s face. There was even a faint whiff of rubber – or was it ether? – wafting up through her nose, making her gag. She threw it hard, away from her. It flew over the hob and into the bushes at the other side.
Klara laughed. ‘You’ll have to go and find it now. Mind you don’t tear your dress on those roses.’
Bertha stepped carefully through the shrubs. As she bent to pick up the quoit a black snake slithered towards her from under a rose bush. The arm she had stretched out for the quoit turned rigid. Bertha stood still. Time stood still. The bee continued to buzz but Bertha no longer heard it. Nor did she hear Klara call her name.
Klara ran up from behind. She called to her again.
‘Bertha, why are you standing there with your arm stretched out? You’ve been standing like a statue.’
Bertha turned round. ‘Have I?’
It seemed to her that she had just woken from a dream. But she could not have been asleep. She was in the garden with Klara. But what was she doing here, in the midst of the rose bushes? She looked at the ground. A dark brown branch, long and straight, lay at her feet. Beside it lay a quoit. She remembered now. They were playing quoits. She bent down, her arm loose again, and picked up the quoit. She felt dazed and lethargic, and as if she was shrouded in a veil, cutting her off from the rest of the world. She must explain to Klara, tell her that she needed to rest. But she could not quite find the words.
‘K…K…’ The name. What was her name? Bertha shook her head, trying to clear the fuzziness. ‘K… Klara. Erm, I…’
‘What is it, Bertha? Are you all right?’
‘I, erm, bed. Need rest.’
‘Of course, Bertha. Let’s go back in.’
The two girls walked back into the house. Klara took Bertha’s arm and tucked it under her own. Bertha said nothing more. Even Klara was silent. They exchanged brief good-byes at Klara’s door.
Bertha let herself into the apartment quietly and went to her room without seeing anyone. She lay down on her bed and sank into a profound sleep……
‘As I thought.’ Professor Aschenbach laid the bowl down on the bedside table.
The examination had confirmed Doctor Bettelheim’s original suspicions – a subpleural abscess. The doctors were now going to proceed with the drainage. Professor Aschenbach explained what was involved. Dr Bettelheim would anaesthetize Mr Pappenheim – they had brought all the necessary equipment – and he himself would perform the operation. A small opening in the chest, the insertion of a tube, aspiration of the purulent matter. It would all be over very quickly and Mr Pappenheim would already be greatly relieved by the time he recovered consciousness. Would the family members like to remain in the room? Willi begged to be excused. He had an engagement in town; in any case he would only be in the way. Selfish milksop! Bertha had seen how he had kept his eyes averted throughout the examination, passing his hand constantly over his nose, trying to ward off the fetid odours. So much for all his cosy confabs with Papa about politics and business. What use was he when he was really needed?
Willi backed out of the room, muttering something incoherent.
Mrs Pappenheim, apologetic and indulgent, excused him. ‘He’s still only a boy.’
Dr Bettelheim had raised the lid of a black case and was removing a rubber bag with tubes attached to it. Professor Aschenbach had opened his bag, revealing a set of knives and other sharp and pointed instruments.
Bertha moved over to the window. She would not watch this. She looked out. A beautiful summer’s day. The Kohn family next door were preparing to set off for a picnic. An open carriage stood ready for them in the street. The coachman was helping the maid to load the hamper. The two little girls ran out of the house shrieking, chased by their black spaniel. Their mother, shielded from the sun by a pale pink parasol, shooed them into the carriage. Their father, following behind, scooped up the dog and handed it in after them.
The room was filling with a strange odour. Sweet and sickly. Like rotten pears. She half turned. Dr Bettelheim was administering the anaesthetic. Her father was already unconscious, a rubber mask over his nose and mouth. Professor Aschenbach was selecting an instrument. Bertha looked quickly away again. Willi had just come out of the house, straw boater perched jauntily on the back of his head. He started to walk down Kaltenbachstrasse, twirling his cane, as insouciant as a spring lamb. How dared he!
That horrible smell. She was feeling faint. The ether must be leaking somewhere. They could all fall unconscious. She looked round again, for reassurance. She could see only the two doctors huddled over her father’s body. Suddenly there was a faint gurgling and a swooshing and a stench which swamped the ether smell. Professor Aschenbach was holding a large bowl to the side of her father. It was filling up with a thick, frothy liquid. The bile rose in her throat. She averted her eyes, looking towards her mother. How could Mamma sit there, impassive, observing this vile butchery without a flicker of fear or disgust?
She looked down into the street again. She must think about something else, anything but the scene in the room behind her. The Kohns’ carriage had gone. She wondered what Willi was doing. With his stupid friends, probably, those cocky young men he spent all his time with, giving each other knowing looks, laughing at things she didn’t find amusing.
A sharp, clean smell cut through the putrid emanations of ether and pus. Professor Aschenbach was washing out the cavity with antiseptic solution, explaining to her mother that this would have to be done regularly over the next few days. Dr Bettelheim would visit daily, he was saying, but Mrs Pappenheim might also like to engage the services of a nurse. A drain would be left in place, with a dressing on top of the wound which would need to be changed several times a day.
‘There is no need,’ Bertha heard her mother say. ‘My daughter and I will do the nursing. If you could just tell us what is required.’
Bertha listened, aghast, to the doctor’s instructions. Again she felt bile rise in her throat. Why couldn’t Mamma have agreed to hire a nurse?
A bell sounded in the street below. The local dairyman was coming up Kaltenbachstrasse with his cow. He stopped outside the house as Ilse came out with a jug. Bertha watched as they stood in laughing banter, then the dairyman squatted down by the swollen udder. Seizing a teat, he propelled a jet of milk into the jug. Bertha heard again the gush of infected matter from her father’s chest, smelt the noisome odour. She closed her eyes, revolted at the thought of drinking the milk, revolted at the thought of ever eating or drinking anything again.
Her mother was thanking the doctors. Dr Bettelheim had removed the mask from her father’s face and was packing his equipment. He and Professor Aschenbach would sit with the patient for a while, he said, until he came round and they were sure that his condition was satisfactory.
Mrs Pappenheim turned to her daughter. ‘Bertha, I think you should go and get some sleep now. You’ll be sitting up again at night.’
Bertha dashed from her father’s room to her own, borne on a wave of relief. She lay down on her bed. It was over. The tension in her began to wash away. The room was dim, cool and fresh, the light filtered through the slats of the half-closed blinds. She closed her eyes. But as soon as she did so the scenes in the sickroom reared up again before her. The rubber mask over her father’s face, the syringe thrust into his chest, the knife slashing in between his ribs, and that awful stuff that had come pouring out. Surely there must be something terribly wrong for him to have so much nastiness inside him. And even though it had been drained away now, what was to stop whatever it was that had caused it doing the same again? Professor Aschenbach had talked about hope. With full rest and a good diet, he had said, we may hope for improvement. Why had he said improvement? Improvement wasn’t the same as being better. He had also talked about the mountain air and the fact that Papa was away from his affairs in the city. But that hadn’t stopped him deteriorating so dramatically in the time that he’d been here in Ischl. What good had the rest and mountain air done him in the past few weeks?
Bertha jumped up. She had to talk to someone. She would go down to Klara.
She tiptoed along the hall, towards the front door. She turned the handle quietly, opened the door and stepped out. But no! She was in the room occupied by Miss Thomson.
The governess sat by the window, Percy on her knee, a glass of water in her hand. The dog’s long pink tongue slurped in and out of the water, slithering over the rim of the glass. Bertha felt a fresh gush of bile. She pressed her hand to her mouth and rushed from the room, out of the apartment. She ran down to the floor below and rang the bell.
Klara opened the door.
‘Bertha, whatever is wrong?’
‘Oh, Klara, I’m so frightened.’ Tears started to flow. ‘Papa is so ill with his lungs and I’m afraid he’s going to die.’
‘Bertha, you mustn’t upset yourself like this.’ Klara took Bertha’s arm and drew her inside and into her bedroom. She sat her down on the bed and settled down beside her. ‘Now tell me all about it.’
Bertha recounted the doctors’ visit, the anaesthetic, the rubbery apparatus, the sinister bag of instruments, the cutting of the chest, the worrying conversations conducted in grave voices, the sickroom duties that she was going to have to carry out.
Klara took both of Bertha’s hands in hers. ‘Bertha, listen to me. You know that Professor Aschenbach is the best doctor in the whole of Austria for lungs. Lots of people get better from illnesses like this. Just wait, by the end of summer when it’s time for you all to go back to Vienna he’ll be as well as ever he was.’
‘But my sister Henriette, she died from tuberculosis. And we’ve heard of so many people now in Vienna who have had it and died.’
‘Bertha, no one has said that your father has tuberculosis. And even if he has, this isn’t Vienna. This is Ischl , which is the best possible place for anyone who’s ill.’
Bertha felt some of Klara’s cheerful confidence begin to flow into her. She listened to Klara prattle on about the pure air and the spas, the baths full of salt and sulphur and all manner of good things. It was true. And it was fourteen years since Henriette had died. Doctors had discovered so many new treatments since then. Why, every day there were new discoveries.
‘Perhaps you’re right.’
‘Of course I’m right.’ Klara jumped up. ‘Come now, let’s go out into the garden and have a game of quoits.’
Bertha dried her eyes and followed Klara downstairs to the quoits pitch at the bottom of the lawn. Once outside her spirits lifted further. The grass was newly mown, its scent still lingering; the bushes blazed with summer colour and the sun shone gaily overhead. The glacier-clad peaks of the distant Dachstein massif stood out clean and pure. A bee, hovering over a yellow rose, buzzed soothingly. The scenes of sickness indoors were a world away.
‘Here, you can start.’ Klara passed Bertha a handful of quoits.
Bertha took aim and tossed the first of her rubber rings. It fell short of the hob. Her second overshot it. She stood aside to let Klara take her turn. As she waited she looked back up at the house. Surely it was wrong of her to be out playing, amusing herself, when her father was so ill.
‘A ringer,’ shouted Klara. ‘Two points for me.’
If Mamma knew that she was out here instead of resting in her room…. Well, if it was all right for Willi to be out larking around town so could she.
Now it’s you again, Bertha.’ Klara put her hand on Bertha’s arm and shook her gently. ‘Bertha, what’s wrong?’
‘Nothing. I’m just waiting for you to take your turn.’
‘But I’ve taken my turn. Look, I’ve got a ringer. Didn’t you see?’
Bertha looked over towards the hob. ‘Oh, yes. Yes, of course.’
‘Right, so it’s your turn now. On you go.’
Bertha picked up a quoit. She felt the hard rubberiness of it in her hand. Like the rim of the mask over her father’s face. There was even a faint whiff of rubber – or was it ether? – wafting up through her nose, making her gag. She threw it hard, away from her. It flew over the hob and into the bushes at the other side.
Klara laughed. ‘You’ll have to go and find it now. Mind you don’t tear your dress on those roses.’
Bertha stepped carefully through the shrubs. As she bent to pick up the quoit a black snake slithered towards her from under a rose bush. The arm she had stretched out for the quoit turned rigid. Bertha stood still. Time stood still. The bee continued to buzz but Bertha no longer heard it. Nor did she hear Klara call her name.
Klara ran up from behind. She called to her again.
‘Bertha, why are you standing there with your arm stretched out? You’ve been standing like a statue.’
Bertha turned round. ‘Have I?’
It seemed to her that she had just woken from a dream. But she could not have been asleep. She was in the garden with Klara. But what was she doing here, in the midst of the rose bushes? She looked at the ground. A dark brown branch, long and straight, lay at her feet. Beside it lay a quoit. She remembered now. They were playing quoits. She bent down, her arm loose again, and picked up the quoit. She felt dazed and lethargic, and as if she was shrouded in a veil, cutting her off from the rest of the world. She must explain to Klara, tell her that she needed to rest. But she could not quite find the words.
‘K…K…’ The name. What was her name? Bertha shook her head, trying to clear the fuzziness. ‘K… Klara. Erm, I…’
‘What is it, Bertha? Are you all right?’
‘I, erm, bed. Need rest.’
‘Of course, Bertha. Let’s go back in.’
The two girls walked back into the house. Klara took Bertha’s arm and tucked it under her own. Bertha said nothing more. Even Klara was silent. They exchanged brief good-byes at Klara’s door.
Bertha let herself into the apartment quietly and went to her room without seeing anyone. She lay down on her bed and sank into a profound sleep……