The Tower: A Novel (78 page)

‘Well, young man, fresh out of college?’ First bed on the right, a professor of Slav linguistics, emigrated from the Sudetenland to escape the Nazis, emigrated from the Sudetenland to escape the Czechs. Two lacerated arms laboriously emerged out of the white cover made from guinea pig skins: injuries from sabre-slashes (long-established jealousy between long-established rival sword collectors).

‘My son. He simply came straight from school in Waldbrunn to the ward here, wanted to see what kind of thing I did.’

‘Really proud of him, our doc. Start ’em young, my old man used to say,’ the riverboat engineer in the fourth bed on the right cried, closing a catalogue of toupees and waving two mangled fingers; he was twenty-two and still wore his hair long, even though a considerable part of it had been caught up in the rotor of his engine and a patch of scalp the size of his palm had been torn off. The light went out.

‘Good night.’ Third bed on the left, a forklift truck driver from Kofa, the Dresden canned food factory; craniocerebral trauma after falling, drunk, from the dam of Kaltwasser reservoir. In the ward room
the late shift were sitting in the dark, a nurse lit candles; in the light of the flame her face looked calm; the objects in the circle of brightness had an unreal, rapt, Christmassy air about them. Nurse Lieselotte hurried to the end of the ward and unlocked the medicines cupboard, where she kept some torches and replacement batteries. The Intensive Care Unit! Richard thought, but already Kohler had come running in through the door followed by Dreyssiger, beams of light moved over the walls of North I. Dreyssiger cried, ‘The operating theatre, they’re down there, nothing’s working. The heart–lung machine’s stopped.’

The telephone was still working. Richard called the ICU. No one answered. ‘What about the anaesthetists, can they keep the oxygen going?’ he asked Dreyssiger over his shoulder.

‘No.’ Just ‘no’, it was Kohler who had said it in an expressionless, impassive tone. ‘If the emergency generator won’t start up’

‘– if it starts up’

‘– they’ll have to insufflate with a bag valve mask’

‘– why’s it not starting up’

‘Just like in the war,’ said one of the nurses anxiously; it was Gerda, who was almost seventy.

‘Africa.’

‘And what do things look like in the operating theatre?’

‘Like Africa. I just told you.’

‘– it’s just not starting’

‘Bananas, jungle.’

In the ward room it smelt of eucalyptus oil, Kohler had knocked the medicine basket off the table.

‘– more like Russia. Russia, so’

‘Africa.’

‘Oh do shut up.’

‘– or can you hear something? It’s not starting up.’

‘The emergency plan will come into force.’

‘Funny
that the telephone’s still working.’

‘Comes via a relay station, low voltage. Everything can be dead all round, they’ll still get a tone,’ Dreyssiger said.

‘Africa. Central Congo.’

‘We must go to the ICU,’ Richard said. ‘Nurse Lieselotte, will you please call in all available staff. Robert, you’re coming with us, we can use anyone who can give a hand now.’

They ran to the Intensive Care Unit. Cones of light blazed up, stamping meal carts, nurses’ legs, distraught faces out of the deep-sea darkness of the clinic, somewhere a bedpan clattered onto the floor. Someone was thumping on the lift door, ghostly footsteps echoed in the stairwell. The Medical Academy was a concentrated mass of black stone; there was still light on in Nuclear Medicine, as there was in Administration. Shadowy figures could be seen dashing to and fro. In the ICU a string of torches was hanging over the insufflation beds, candles had been lit. The duty anaesthetist was just switching to pressurized oxygen, the compressor for room-air insufflation, which came out of the walls, had stopped working, as had the monitors over the patients’ heads. ‘An unstable patient, Herr Hoffmann.’

‘Still no current in the emergency generator sockets.’ One of the nurses was transferring cables. ‘What a mess.’

Richard looked at the noradrenaline drip. The patient attached to it seemed peaceful, like a figure in a painting by one of the Old Masters: a scene in a cave. One nurse was constantly measuring his pulse, another his blood pressure. The slightest bit too little or too much and his condition would be up and down like a roller coaster, they had to take countermeasures, that tied staff down.

‘CVP?’ the anaesthetist asked, pressing one of the patient’s fingernails, checking the recapillarization time. One nurse bent down to the venotonometer that measured the central veinous pressure.

‘We could use a man,’ the anaesthetist said. ‘It could take some time until ours get here. Most don’t have a telephone.’

‘What’s
it like in the operating theatre, have you heard anything?’ Richard asked.

‘Your boss’s broken off the operation. Insufflation’s continuing manually. One patient in the recovery room – another doctor who can’t get away. And the neurosurgeons want to start on a tumour. Haha.’

Kohler stayed at Intensive Care; Richard, Dreyssiger and Robert went to the A&E. The corridors, also lit by strings of torches, were jam-packed with moaning patients on stretchers; ambulance sirens wailed and died away. No one seemed to be coordinating things, doctors and nurses were rushing to and fro. Porters brought more and more new patients; doors were flung open and slammed shut; exasperated voices from the treatment rooms called for bandages, nurses, drugs. The waiting area by the desk, behind which Nurse Wolfgang was dealing with complaints and demands with a stoical expression on his face, looked like a field hospital. Faintly lit by the candles on the desk, injured people were sitting on the floor, rocking to and fro; a young girl had been laid on a blanket, pale, she endured the lamentations of two older women in silence. Forcefully and with words of comfort, Dreyssiger pushed his way through to the desk. Patients in A&E wheelchairs were either sitting in silence or waving their arms around, most probably with ankle injuries; as he passed Richard glanced at the swollen joints, trying to repress the wave of images, memories of his injuries during the 13 February air raid, the screaming, whimpering wounded who were waiting with him amid detonating bombs, the machine-gun rattle of an isolated Wehrmacht unit, the heat from the burning surgical and paediatric clinics; at that time the Academy had still been called the Gerhard Wagner Hospital, after the Reich doctors’ leader.

‘Have you seen any of the technical guys?’ Nurse Wolfgang called to Dreyssiger. ‘It’d help if they got a cable laid.’

‘X-rays possible?’

‘No.
No CAT scanner either.’

‘Then close down,’ said Richard. ‘We can’t deal with all this. We can’t operate.’

‘I’ve called regional headquarters, Herr Hoffmann. They say all the Dresden hospitals want to close down.’

‘But not all of them can have a power cut?’

‘They’re not sending us any multiple traumas, that’s all I managed to get out of them.’

‘Who’s coordinating things?’

‘Grefe. But he can’t get out of the plaster room.’

‘Are there any beds at all?’

‘No.’

Dreyssiger went into a treatment room. Richard picked up the phone. ‘I’m sure the boss will turn up soon, until then I’ll coordinate the surgical clinics. – The line’s busy.’

‘Eddi!’ Wolfgang shouted, waving vigorously to a brawny man in the blue overalls of Technical Services. Eddi was its head, he was a former boxer, there was a punchbag in his office and on the walls, between bunches of boxing gloves, were photos of famous welter- and heavyweights. Eddi panted, ‘The diesel! Someone’s siphoned off the diesel from the emergency generator.’

‘Nonsense.’

‘I’m telling you, Wolfgang. And there’s no reserve, it’s enough to drive me mad.’

‘There must be a few fuckin’ litres of diesel somewhere in the hospital! People are stuck in the lift.’

‘It’s being seen to. We’ll have to jack it up. Internal and Gynaecological’ve got diesel but they need it for their own generators.’

‘Dad,’ Robert said, he’d squeezed himself into a corner behind the desk, ‘there’s some people from the Western Channel 2 out in the car park. Four big diesel lorries, I saw them when I came up to your ward.’

Eddi
said, ‘Touch wood’, and he and Robert ran off.

‘Are you just standing around or is someone going to see to us?’ a man in a leather hat said in a querulous voice through the sliding window of the enquiry desk. ‘Oh, Herr Hoffmann.’ Griesel took a step back. ‘I’d no idea it was you, neighbour. I can’t believe how long we have to wait here.’ Suddenly his expression changed. ‘Wouldn’t it be possible …’

‘All patients have equal rights,’ Richard said, a bit too loud for Griesel’s liking.

‘It caught me out on the way home from work, you see …’ Griesel went on in placatory tones and bowing in an ingratiating manner. ‘Our house hasn’t been hit, by the way.’

Emotions a doctor couldn’t afford to permit himself bubbled up like boiling milk inside him as he watched Griesel push his way through the patients back to his chair; hatred and contempt for that man, the conditions, the whole system. To pay them back in their own kind, to be able, just once, to retaliate to power with power, to have an outlet for the impotent rage piling up inside him day after day! He goes to the back of the queue, Richard felt like saying, Wolfgang would have understood and probably approved. The deep-rooted, feared esprit de corps of health professionals. Richard didn’t say it. All patients have equal rights. The welfare of the sick is the final law, that was what was written in Latin on a board in the entrance to Accident and Emergency:
Salus aegroti suprema lex
.

A commotion outside the entrance, floodlight beams flashing to and fro, powdery snow coming in through the door. Eddi and an auxiliary brought in Robert, who was holding his arm.

‘I slipped and fell. Stupid.’ Robert shrugged his shoulders. ‘It’s all frozen outside. But we’ve got the diesel.’

His wrist was swollen but his hand didn’t show a bayonet deformity, as with a fracture in a typical position. Robert gave a quiet cry when Richard examined it.

‘Volar
radial fracture, the non-typical type.’

‘Meaning?’ Robert asked in a deliberately calm voice.

‘Prickling in your fingers? Any numbness?’

‘A bit, yes. It’s cold outside.’

‘We’ll have to X-ray it. If that confirms what I think, it means an operation. You can wait in there.’ Richard pointed behind the desk. Once Robert had gone, Richard couldn’t control himself any more and swore. If the lad had fallen with his arm outstretched a plaster cast would have done the job.

‘Smith-Thomas?’ Wolfgang, who’d watched Richard examine him through the desk window, asked, using the technical term for the fracture.

‘It’ll need an operation, yes.’ Richard stamped his foot in his fury, a ridiculous sight and, for the patients waiting, not one to inspire confidence.

Müller came in, behind him the man with the floodlight, followed by one carrying a microphone on a long boom like a fishing rod; three other men, in sharply creased trousers and bomber jackets, had overpowered the cameraman and were dragging him out of the flurries of snow, where a second cameraman was coolly filming the scene, into the crowded waiting area. They stopped short for a moment when they saw all the patients. The cameraman who’d been detained took advantage of that to free himself and protest loudly. The floodlight dug a dazzling white tunnel though A&E.

‘There will be no filming in my clinic and certainly not by your lying station,’ Müller cried angrily.

‘But you take our fuel!’

‘The diesel has been confiscated,’ announced one of the three men in bomber jackets. ‘This is an emergency, as we’ve already explained to you.’

‘The fuel taken will, of course, be replaced, Citizen Capitalist,’ shouted the second of the three in the silence that had arisen all around;
even the two women beside the young girl had broken off their lamentations.

‘We need everyone we can get.’ Müller pointed to the three in bomber jackets. ‘You are to help charging the room sterilizers. No, gentlemen, we have no time for discussion. You will do what I, as head of this clinic and of the emergency team, tell you until the Rector and your immediate superiors arrive. No sterile material means no operations. The central sterilizer isn’t working. You’ – he pointed to the West German television men – ‘can make yourselves useful transporting patients and clearing paths. Have them shown what to do, Nurse Wolfgang. Will you please come with me, Herr Hoffmann.’ Müller waved Richard out through the swing door into the corridor to the vestibule and wards. ‘A word in your ear. A difficult situation within a difficult situation. I’ve just had a phone call.’

When Richard said nothing, he went on, ‘A call from the top, Barsano himself. His daughter is on her way to us, he claims. With these African conditions out there … He’s asked me to have our most experienced trauma surgeon operate on his daughter, should an operation be necessary.’

‘My son’s been injured, Herr Professor.’

‘Oh.’

‘Volar radial fracture, the nerve has probably been compressed.’

‘Hm. But you can reset it and put it in plaster, Herr Hoffmann. I know it’s not a permanent solution but it’ll do until the morning and then you can take your time over it.’

‘I’d prefer not to wait until the morning. The results don’t get better if you leave it.’

‘I know that,’ Müller, exasperated, replied with a sweeping gesture. ‘I have a suggestion: when the generator starts, we’ll at least have power in the ICU again and then Herr Kohler can join us. Never operate on a relative, you know that. And you’ve trained up Herr Kohler very well.’

Richard, alarmed, didn’t reply. That possibility had never occurred
to him. The maxim he had followed in training Kohler was not in the Hippocratic Oath: If you have to instruct your enemy, teach him just enough to make sure he won’t harm the patients, but not enough that he can replace you.

‘All patients have equal rights,’ Richard muttered. There were sounds of the jacking-up operation from the lift shaft, metal on metal, someone calling for pliers.