Georg Letham (4 page)

At least momentarily, a positive result from a scientific experiment affords the investigator terrific satisfaction. I use the word “terrific” advisedly.

All the nightly vigils, all the diligent, exhaustive study, all the gnawing doubts and anxieties, all the time and expense, everything the investigator loses by giving up a social life, giving up reading, going to the theater and to concerts, above all by giving up a truly vigorous, conscious family life–it is all (for the moment) richly repaid by the feeling of knowledge gained, of having solved a puzzle, of having increased man's power over things.

The renowned French physiologist Claude Bernard once called the scientific laboratory the “battlefield” of the experimenter. Certainly blood is shed. But there is a victory, too. And when he describes the task of the experimenter as to
prévoir et diriger les phénomènes
, who will dare to disparage the scientific investigator as a “cold mechanic of medicine”? No, he is much more like an experimenter-demigod probing
the depths of the cosmos. And if he really is what he should be as an experimenter, he rises above the vulgar interests of men. He becomes a tragic figure. Or–and here the conflict begins–is he only a tragicomic figure? Was his “scientific result,” which in the best case is hauled for decades or a century through medical journals and scientific periodicals and books under his byline, really worth the trouble? Was it in many instances not even worth the electrical current that flowed through the lamps in his laboratory while he worked? Does it give meaning to meaninglessness? Does it take the horrifying out of the horror? Does it help? Can it be gratifying? Does the investigator's interest not turn immediately to other problems, precisely like the hand of a cold mechanic? Is his thirst for happiness and inner peace ever appeased? Did the suffering of the sacrificed animals bring the investigator great things? If so, did it bring the nation great things too? Humanity? Did it transform the terrible disorder of nature into order and meaningful structure?

After the war I returned to my wife and immediately reopened the private surgical and gynecological clinic. But human disease could not hold me now. In my earlier zeal, I had made do with trained nurses. Now I brought in an assistant physician.

Success or failure, recovery with adverse effect or without it: I had seen the cheapness of an individual life too close at hand in combat and in military epidemic hospitals. Previously I had sacrificed animal lives on a vast scale in order to find something that might be of use in restoring even one human being to health. Now it was the opposite. Animal experiments became the main point.

With great caution, so as not to arouse the suspicions of my wife, I
resumed my bacteriological experiments alongside my work as a physician, and as ill luck would have it, two of my patients at the time perished within a short period “following successful surgery.” There are such strings of bad luck everywhere, in accordance with the law of large numbers, but here there was a connection, as follows. I was concerned at that time with the etiology of scarlet fever. Notoriously, the bacterial cause of this exanthem (like that of numerous other infectious diseases, I mention only lethargic encephalitis and yellow fever among many) is still wrapped in complete mystery. Every known method has been tried without success despite the greatest experimental ingenuity and the keenest determination. No one on earth has seen the “virus” of scarlatina, scarlet fever, in the flesh! And yet it exists. It must be possible to find it. But how?

Now the matter of scarlet fever is particularly curious. Other pathogenic microorganisms are found as fellow travelers of this disease, identified streptococci readily seen on suitable specimens under the microscope; spherical bacteria arranged in chains can be cultured without difficulty on synthetic growth media. They cause ulcerations, they excrete extremely virulent toxins, they produce, when injected or circulating “naturally” in the bloodstream of the scarlet-fever victim, dangerous effects, beginning with high fever and ending in death.

The following line of thinking seemed plausible to me. The true pathogen of scarlet fever and yellow fever and so forth must, as has been gathered, be so small that it can traverse even the tiniest pores of the clay filter through which the bacillus cultures have been drawn. But the streptococci involved in scarlet fever, while not as big as potatoes, are of measurable size, even measurable volume and weight–and they never pass through such a small-pored filter, they remain in
the old culture fluid, while the scarlet-fever toxin and pathogen slip through.

Would it then be conceivable that the unknown scarlet-fever pathogens are tiny freeloaders or parasites living on the much larger bodies of the streptococci, and that they are both being separated by the filter? Some such thing is imaginable, maybe even worth an experiment. Good! I devoted myself to this question, setting up experiments that would answer it one way or the other.

In my office I discharged my tasks as one discharges a duty. I neglected none of the imperatives of antisepsis when I performed the two operations mentioned above. And yet! And yet!

The first was an appendectomy in the “cold” or nonacute stage, generally an entirely safe intervention. Nevertheless a septic fever resembling streptococcal fever had already developed on the evening following the operation. What was inexplicable to my assistant was the appearance of virulent streptococci in the blood of the patient. I will keep it short. We lost the patient. Had I unwittingly transmitted dangerous microorganisms? My wife tried to console me. She took an interest in my successes and failures as a physician. I could not be silent, the thing touched her. I forced myself to stay away from the laboratory for a few weeks. Everything went splendidly in the interval. Even technically difficult operations were successful, and my patients marveled at my “gentle, blessed touch”!

But the day came when it was necessary to transfer the costly and painstakingly prepared scarlet-fever streptococcus cultures to fresh medium. Otherwise these organisms, which were living in the old culture fluid and continuously excreting toxins in the incubator, maintained at a uniform thirty-seven degrees, would eventually have
poisoned, sterilized, exterminated themselves. They had to be settled on virgin soil. This job too I performed with extreme care. I used rubber gloves to handle the glass rods tipped with flame-sterilized platinum loops when I transferred tiny drops of the old culture into vessels containing fresh nutrient. My clandestine visit to the laboratory might have taken six or eight minutes at most. The cab was waiting by the side entrance of the Pathology Institute with its meter running, which is why I am able to estimate the time.

Moreover I was firmly resolved not to perform any operations during the next few days. I had, of course, washed my hands, my body, with the greatest possible fastidiousness following this visit to the laboratory, had even had my hair cut. Out of pure self-interest alone, I had done everything I could in order not to be infectious. As ill luck would have it, I must now repeat those ominous words, my wife welcomed me home with the news that there had been a call about a friend of my brother and sister, a woman. There was severe pelvic bleeding. My name came to mind for many reasons.

This was the second calamity. This time I could not be said to have done anything unwittingly. I would have liked to say no. But my wife pressed me; my siblings, who otherwise lived their own lives just as they let me live mine, besieged me with entreaties, particularly my sister. I wanted to have my assistant do the operation. Objections all around. He had so little experience, he was heavy-handed, etc., and most of all: no one wanted an outsider to know too much about the operation. I gave in and performed it. Again a minor, ten-minute procedure, assisted only by the clinical nurse, as, in view of its nature, we wished to prevent the assistant from finding out about it. For the law is not for such things. I knew the patient, a pretty, Rubenesque, golden blonde individual.
She was a widow, prominent in society–she wished to avoid a scandal, had to avoid one. I did not understand it entirely, but I complied with her fervent request. Misplaced compassion! The man involved did not show himself.

This time I was not as calm as I had been after the appendectomy. I went out again to the clinic late in the evening or at night.

My wife was waiting down at the gate in her car. She had on her lap a small, long-haired, wheat-colored dog, a kind of Pekingese, the pet of her daughter, who was traveling. As I stood beside the bed of my patient, still asleep after the anesthesia, I looked down at the street. My wife seemed to be getting along well with the little dog. Her long, beautiful fingers played in the silkily gleaming, slightly wavy coat of the large-eyed little creature, sprightly unlike most of its breed. Suddenly it barked and snapped at my wife's gloved fingers, which she had held out to it. It was summer, the car was open, the trees in front of the clinic swayed in the breeze. A fine day, very fine. Meanwhile the nurse had taken the patient's temperature. It was 37.1. This is actually a fairly normal temperature, but I could not shake an uneasy feeling. And at the same time a sensation, an intuition (how shall I put it?) that only an experimenter will recognize. Could there be something amiss? Something that was not as it should be? Not from the experimental subject's standpoint, perhaps–but surely everything was fine . . . I will not go on with this. I will merely state the patient's course. The patient contracted an exanthem resembling scarlet fever. But the blood was persistently free of streptococci. Had I transferred not the streptococcus but the invisible scarlet-fever virus this time? My theory–was it correct? Had the unknown virus still clung loyally to the streptococcus cultures?

Difficult to describe my state of mind during the period that followed.
The animal experiments secretly resumed at full tilt, the microscopy and culturing throughout the day whenever I was not by the bed of the poor delirious patient, and at night, since I was unable to sleep and could not bear the presence of my all-too-tender wife, the visits to gambling clubs, where I was now dogged by misfortune, by bad luck.

In addition the acquaintance made of a beautiful, very young, light blonde gambler, with whom I took up intending at first only to satisfy a momentary craving and whom I then installed in a first-class hotel and attempted to surround with great luxury.

Finally the death of my patient, the “almost” airtight result of my final experiments, the tearfulness of my wife, who did not understand my elevated mood despite these events. Suddenly the reversal. I noticed a suspicious redness on my underarm. Had I myself been infected in my experiments? I almost confided in my wife. For until then I had remained silent. But everything passed off well. I remained healthy. A big question mark still hung over the experiments, but on the other hand I was fortunate elsewhere. The young person loved me. She proved this by demanding a lot from me: money, time, love.

I did what I could. I was short of time most of all. Love can sometimes be a substitute for money. Money can sometimes substitute for love. There is no substitute for time.

As a result of my large expenditures on my work and on M. (the girl) as well as my gambling losses, I now ran into certain financial difficulties, which were not particularly pressing at first. The household cost money too, my income was not significant, my savings practically zero. But I was able to borrow money, the gentlemen at the gambling club knew
quite a number of fairly respectable moneylenders, and for a time I paid my short-term debts to one lender with loans I obtained from a second or third.

If I had at least had some peace! I needed every minute of my time. I pressed my wife to do some traveling. She resisted. Her tenderness began to take on a more desperate character from one day to the next; only seldom did her naturally happy, sunny nature come through. My stepdaughter insinuated herself into the foreground after a period of haughtily avoiding us. She would not leave her mother and persistently tried to alienate my wife from me. But that aging, love-addicted woman only became more attached to me, gazed at me with her shining, light gray eyes, did her best to be near me all day long.

In the course of my scientific investigations I had neglected my practice almost entirely. I had forgotten important appointments–had, to give only one example of this kind, scheduled an elderly patient for surgery but was not at the clinic by his side when the time came. How difficult it was for me to persuade him later that I had his best interests at heart, that intensive radium treatment would stand him in much better stead than a surgical procedure. He believed it all in the end and died peacefully in his bed, instead of on the operating table. But who knows, perhaps my “gentle, blessed touch” could have gained him a few more years of life after all. And this same old man had a liking for me. He remembered me in his will, if not with a proper bequest, then at least with encomia, and lauded in particular my “loving heart.” Well, peace to his ashes. In my “loving heart” there was little peace. And no love.

My waiting room became emptier and emptier every day, the telephone calls were increasingly ones of a personal nature, that is to say,
they were from my expensive golden blonde mistress and her sister, to whom I was lately held by “bonds of love,” and further I was being hounded by creditors, who had abruptly begun to be troublesome. It was a natural idea to attempt to stop the gaps in my budget with winnings from gambling, given that luck had favored me early on. But regrettably this was not the case now. Perhaps I was too worn out when I came to the club, for at that time my experiments were of the greatest importance to me, requiring the closest attention and the greatest care. Nothing is more humiliating for an experimenter than to present his results to his audience of physicians, to lay himself open to the criticism of shrewd, skeptical reviewers, and then see his results unable to withstand the sharpest scrutiny. It was imperative to avoid this. Unfortunately things were very far from what they should have been.