A Simple Intervention, page 3
‘You mean during my training?’
He blinked. His way of nodding when it was too painful to move.
‘I liked it.’ I wasn’t lying. I understood why nurses were attracted to this kind of work. In the second year of my training, I’d attended operations, one under the doctor’s direction. I’d been amazed by the precise timing of everything. In theatre, even the smallest manoeuvre was orchestrated. And the person on the table – who, when awake, could be the most difficult thing of all – slept.
‘And you’ve never thought of transferring?’
‘No.’
‘Why not?’
I returned his gaze. I didn’t understand the genuine interest it harboured.
‘Well, you’re thorough. You follow procedures. You work quickly and calmly when required. You love medicine and believe in progress. At least that’s what the ward manager says about you. And, in my experience, the ward manager is always right.’ He cleared his throat. ‘So that raises the question – why aren’t you where the progress is happening? Why work on the ward when you could be in theatre?’
Most surgeons had a quick temper. They were known for their outbursts, and they cultivated them. We knew exactly what to expect. Coarse insults and bluster followed simple rules.
It was different with the doctor. Calmer. I’d witnessed that myself. He simply asked for his instruments, dedicated himself to his patient, gave instructions. He never shouted. He never even broke out in a sweat. When I came out of theatre that day and washed my hands, I realized I was shaking. So calm had it been in there that my body didn’t know what to do with itself.
‘I’d miss the nuances. In dealing with people.’
‘Tell me about these nuances.’
Something within me laughed. I bit my lip to stop it coming out.
‘Give me an example.’
It wasn’t customary for the doctors to ask us about our work. Not so openly. They usually did their best to conceal the fact that they needed our knowledge.
‘Let’s say a patient is hovering between life and death.’ I slid forward on my chair a little. ‘And I know, as the guidelines state, that I should address them by their surname because… first names are reserved for us nurses.’
The corners of his mouth twitched. A smile? I feared so. I didn’t want him to smile at me. I didn’t want him to like me. I’d been able to avoid anything like that so far. Being liked by a doctor rarely ended well.
‘But I’ll ask this patient for her first name. Or I’ll look for her first name in the files if she can’t tell me. I’ll use it when I’m caring for her.’
‘Why?’
‘Because… a surname is an attribution. Something she moves through the world with. But her first name is what people have always called her. Before she could even speak. It’s inside her. Deeper than…’ I fell silent. Expressing these thoughts in front of him felt like I was revealing a secret. A childish secret. The doctor had the power to tear it to pieces in mid-air – a power I’d just given him.
He placed his hand on his chest. ‘So, if I were lying here, half-dead, and you called me Jonas, would you be calling me back to the land of the living?’
I looked down at his desk. A photo of his daughters stood there. Whenever he called them he always shouted into the receiver, as if the line to his house was particularly bad. You could hear him sometimes through the closed door as you passed by. That’s when you knew he was talking to one of his girls.
‘I certainly wouldn’t call you Jonas. Whatever the circumstances.’
He folded his arms. ‘I’d like to know more about these nuances. Soon. We’ll talk again.’
And we did. After that, he often invited me into his office after my shift. He had someone bring me coffee. He said he was interested in compassion. He believed that research had neglected the human factor in medical treatment. He wanted to find out more about it.
I filled him in on the nurses’ different attitudes. That compassion was frowned upon by many of them. That some judged it to be dangerous. And that others were convinced it was an essential part of our work. It was the older nurses who influenced attitudes on their respective wards. On ours, the belief prevailed that it was a good thing. Indispensable. That’s how I’d been trained.
Sitting in his office, he nearly always began our conversation with an observation: ‘I noticed that at the end of your shift, you took the time to write a letter for the patient. You wrote it, but the patient had to dictate it. You insisted on this. But it would probably have been easy for you to formulate this letter yourself.’ He said, ‘You commit details to memory. A preference for milk in tea. An enthusiasm for films.’ His observations were always followed by the same question: ‘Why? Try to explain it to me in a basic way, as if I had no idea about anything.’
I grew accustomed to the hours in his office. It was a place where I was given privileges. ‘What would you say to me releasing you from your night shifts? Then you’ll always be there when I have questions or want to show you something.’
Sometimes, in the middle of a conversation about medicine, he’d give a dismissive wave and ask me instead about my family. ‘A wild child,’ was his diagnosis the first time I told him about Bibiana and one of her escapades. ‘My youngest can’t be tamed either. The older siblings hold the world together, and the little ones trample it to pieces. That seems to be a law of nature.’ He reached for the telephone. ‘I wish I could split myself in half, then we could continue our conversation into the night. But my daughter isn’t at home today. It’s the first night she’s sleeping elsewhere, and I promised she’d still hear my voice.’ He dialled the number. He looked down at his desk, briefly deprived of his usual certainty. ‘To be honest, I’m a little nervous myself. She’s sleeping at her aunt’s. It’s not as if she’s on a trip round the world. I really hope it’s a good line.’ He raised his hand to bid farewell and I stood up and left the room, closing the door behind me. ‘Hello?’ I heard him shouting as I paused in the corridor.
I stood still. I didn’t want to disappear into the evening. In this office, with him, things became possible. These things were beyond anything I could have accomplished on my own. They were the opposite of hopelessness.
He laughed, then asked his daughter whether he should tell her a story. ‘Or do you want the one you’ve heard a hundred times before? Okay then, I don’t mind…’
I sat down on the bench in front of his office and waited until he’d hung up. He didn’t invite me in again. And I got used to the fact that it was always he who put an end to our conversations.
9
I was to be my own toolkit. The doctor assumed that would be enough. That’s how we got through the first few interventions.
The patients were put into a state in which they were fully conscious but felt no pain. They sat on the operating chair with their upper body tilted back. The doctor and his two assistants stood by the head, and I stood opposite so the patients could always see me. I sang songs. I spelled out words with them. I made up simple puzzles for them to solve.
My fifth patient was young. Eighteen, according to her passport, which she carried with her in a small, lightweight suitcase. She’d been held in a juvenile detention centre before she came to us.
The conversation with the doctor about the impending intervention was brief. She didn’t ask any questions. Once he’d left, I stayed with her. She said, ‘Feel free to go. I’m sure you’re needed elsewhere. I’m fine. Really.’
She barely ate a thing the evening before the intervention. She sipped her water hesitantly, as if each sip was too precious to her. She’d folded the clothes she’d arrived in and was keeping them under the blanket. There was nothing else in her case to wear.
That evening, I couldn’t shake off the feeling that so much was missing. Things were missing, people were missing. No one had accompanied her to the hospital. Even the patients she was sharing a room with didn’t offer her any companionship. With their full suitcases and the prospect of visitors, they didn’t want to be infected with her loneliness.
The next day, I brought Bibi’s book to work. It had often comforted me when I was missing my sister. Why shouldn’t this consolation be transferable? The other nurses in theatre looked like they wanted to laugh at me, but they knew the doctor wouldn’t tolerate it. They exchanged glances as I opened the book and asked the patient to tell me what she could see in the pictures. I remember her attentiveness. Her composure. The nurses’ eyes upon us, briefly bewildered, then turning away.
It was the first object. The beginning of the blue box. From then on, I filled it quickly and used it at every intervention. The doctor praised me for it. He himself brought things for the box, such as the deck of cards. He’d bought it on a trip somewhere. It was so beautiful – it stood out from all the other objects.
She was the only patient I used Bibi’s book with. Her name was Vera. I wasn’t supposed to remember her name. I wasn’t supposed to remember any of the names. It stayed with me nonetheless. Four simple letters on a passport that proved she existed.
I left the book with her until she was discharged. Then I took it home with me to the nurses’ halls and put it back in my wardrobe. It wasn’t meant for the hospital, I thought. Its place was in this room, with me. As long as the book was in this room, Bibi was there too.
10
‘Haven’t you got anything else to do?’ she asked me, shuffling the cards.
‘My work today is you,’ I said.
‘Doing this?’ Marianne Ellerbach looked down at the two piles she’d dealt out.
I nodded. It was absurd, playing cards with a patient during a shift. But that’s what the doctor had asked me to do. An emergency had kept him in theatre overnight. The intervention that was supposed to take place this morning had been postponed until the next day. So I sat with my patient. My time was hers.
That was the power of the doctor: he could put my time at someone else’s disposal. He could release me from the units that modulated a typical day in the hospital: seven minutes for the suitcases, eight minutes to change a bed, fourteen minutes for personal hygiene. God-given units, timed at first by the older nurses, who had a clock hand ticking away inside them. Until I began to grow one inside me too.
‘Where do you live, anyway?’ She turned over the first card. Since the previous day, when I’d told her about Bibi and her game, she’d been asking me all sorts of things. I knew this curiosity. It seized most of the patients lying in these beds. And I knew what kind of escape they were asking for. So I borrowed stories I’d heard at dinner in the nurses’ halls. I borrowed the nurses’ dreams. I borrowed their men. Or I invented another life for my siblings – so simple, so detached from everything that made them who they were, that I was ashamed.
‘I live in a hall of residence for nurses. Not far from here.’
‘With shared rooms?’ There was something about her. I didn’t know what it was. I felt I couldn’t possibly tell her anything borrowed or invented.
‘Yes.’
‘I was at a boarding school for a few years. There were shared rooms there too.’ So she was used to taking her home to another place. I’d thought so. She’d arranged her personal things quickly, expertly, like someone disassembling a circus tent and putting it up again.
‘Did you like it?’
She shrugged. ‘I suppose I did. Sometimes I found it repellent too, that closeness. Constantly being watched. A few girls went rummaging around in each other’s drawers, read other people’s diaries. And the hair in the showers. The little clots of blood that got caught in it.’ She wrinkled her nose. ‘You could never forget you had a body, because everyone… everyone had a body, all of the time.’
‘Yes. That’s what it’s like for us too.’ Always that warm smell in the toilets. Even with my eyes closed I could tell which nurses had been before me, even before I knew their names.
‘Do you go into town sometimes?’
‘Now and again, yes.’
‘And what do you do there?’
‘Errands.’
She seemed uneasy. ‘You’re not a nun, are you?’
‘I go out too!’
‘Good. Good for you.’
I didn’t hanker after restaurants and dancing like the other nurses. I only rarely went with them. And then I was like everyone else. But it wasn’t my world.
Marianne put down a card. A smile spread across her face. She was about to win. ‘Once I knocked out my room-mate’s tooth.’ Her eyes went back down to the table.
‘Because you were in a rage.’
‘We were both in a rage. I just threw a better punch.’
I tried to read her face, her eyes, her nose, the corners of her mouth, so I could work out why she was telling me this.
‘Then she gave me the tooth as a farewell gift.’
‘That’s… bizarre.’
‘She wasn’t good with words.’
‘And the tooth said something specific, did it?’ I put down the next card without taking my eyes off her.
‘Put some effort into it!’ she exclaimed. She took the card from the table and pressed it back into my hand. I couldn’t help laughing. That seemed to annoy her even more.
‘My sister used to do that too,’ I explained. ‘When she knew I was letting her win.’
‘But you’re not letting me win. You’re just losing.’ She tapped the outermost card in my hand. ‘Try that one.’
I did. Her anger abated.
‘You don’t need to worry about your sister,’ she said. In response to her questions, I’d told her about Bibi’s travels. About the semi- and near-disasters she’d already drifted into. ‘She’ll come back one day. Then she can be treated too.’
‘She’s not coming back.’ I’d only recently articulated this. It still felt strange on my tongue, like a foreign body.
‘Of course she’s coming back. You wouldn’t believe how many times I’ve run away.’
‘No, you don’t understand. She said goodbye. The way we say goodbye in our family.’
‘You mean you say cheerio instead of goodbye?’
‘Never part on bad terms.’
She shook her head. ‘You’re a strange one, Sister.’
11
My sister cried. She was never ashamed of her tears. It enraged me. I wanted to wipe her tears from her cheeks with sandpaper. Other times, I put my arms around her and held her. ‘Just cry,’ I’d say, and that’s what she’d do, uncontrollably. She’d shake, giving off noises like an injured animal.
There was a man on our street who liked her. That wasn’t unusual. Bibi drew something out of people. They smiled at Bibi. They ruffled her hair. They told her she was a very special girl.
He lived three blocks down from us, on the ground floor, with his wife and his two girls. We saw him frequently. He worked late, so he was at home in the mornings and afternoons. There was nearly always one window open. He seemed to be immune to cold, rain and wind.
The neighbours liked him. They stopped by his window for a cigarette. They passed him letters they wanted him to translate. He could speak three foreign languages.
His wife lived in a different rhythm to him. They only saw each other for a few hours a day. My mother thought that was why they got along so well and walked hand in hand down the street at weekends. No one else over the age of seventeen did that.
Once, for a joke, my sister threw fallen leaves through his open window, armfuls of them, and of course there was some dog poo in there too. But instead of giving her a good telling-off, the man laughed at her cheek and made fun of the leftover dog poo still stuck to her hand. From then on, he greeted us whenever we passed by. ‘What are you up to?’ he asked. ‘Where are you off to?’ he asked.
‘Idiot,’ my sister said. ‘Does he think his daughters are the only ones who go to school?’ She waved without smiling.
He loved her for that. ‘There’s nothing like a stern face, is there, Bibi?’ he said, pulling down the corners of his mouth as if to prove it.
My sister clenched her fists. ‘Bibiana,’ she protested. ‘My name’s Bibiana.’
‘But if you like someone, he can call you Bibi, don’t you think?’
‘But I don’t like you.’
He laughed again.
Every now and then, when we were playing in the street at weekends, the man would appear. He’d walk by, stop, smoke a cigarette, then wave his stupid wave. He bothered me. I knew he wasn’t interested in me, and in any case he wasn’t doing anything wrong. He’d just stand there, watching us and smiling.
I wanted to complain about him, but somehow I didn’t know who to complain to. If I complained directly to him, he was bound to invite us into his flat to talk it over. Or he would complain to our parents in return, and we would likely be grounded. The neighbours were out of the question, too. They held him in high esteem but thought little of us children: we were always imagining things. Bibi wanted to be someone special – and she was, but not in any way she could benefit from. She understood this, even though she couldn’t put it into words.
More and more often, she wanted to take detours. We had to run half the way to get to school on time. Wilm only did this with us twice. ‘Stop acting like that,’ he rebuked his sister. ‘Why can’t you behave normally? What’s going on?’
She tried to explain it to him.
‘Has he offended you?’
‘No.’
‘Has he offended anyone else?’
‘No.’
‘Has he said something stupid?’
‘No.’
‘Has he touched you?’
‘No.’
‘Well then…’
‘Well then what?’
‘Well then, I don’t get it.’
‘Neither do I!’
‘So just stop.’
‘Stop what?’
‘Acting like that. I’ve already told you.’
