Human Traces (34 page)

is one of the most completely described neurological ' "For God's sake, Jacques, do you not read the papers and journals? Do you not see how Charcot's heirs are respectfully trying to distance themselves from him?" "Then they are wrong. Hysteria is a protean disease which can imitate ' "It cannot imitate every damned thing. I read a paper the other day in which the patient was diagnosed with hysteria, caused by some emotional stress that made her stammer. It was quite clear to any disinterested doctor that she had Tourette's syndrome, first identified by our old friend and colleague Georges Gilles of that name at the Salpetriere." "Explain to me the pains in Katharina's wrists and fingers," said Jacques. "I... I will in due course," said Thomas. "But, please, my dear Jacques, please consider that in this instance you may have made a mistake." He saw Jacques struggling with himself. "I will consider it," he said eventually, 'but I do not expect to change my mind." Thomas sighed. "Let us say no more about it for the time being. We both need time to reflect. Tomorrow night, by the way, Valade is dining with us and we are going to talk about railways. I shall see you in half an hour." He did not trust himself to say any more to Jacques, so left the room and ran upstairs to change. He was sure that the schloss could not proceed and flourish until Jacques admitted his error and examined all the consequences that flowed from it. Thomas knew this process was essential for the wellbeing of the joint venture; but how pure, he wondered, were his motives in thinking so? Perhaps there had always been a rivalry between him and Jacques and this was his chance to assert himself as the senior partner. Maybe he was anxious, too, that there be no taint of mental illness, hereditary or otherwise, in the woman with whom he was now so abjectly yet exhilaratingly in love. He straightened his tie in the mirror. At least he was going to see her in a few minutes; presumably she would come in to dinner. Whatever happened to their life's work, there was the consolation of seeing her across the room. It seemed at that moment, as he stared into his own face in the looking glass, to be enough; and perhaps, he thought, it really was enough. He went to examine Kitty the next morning after breakfast. He took her temperature and felt her pulse. She let her arm rest on his thigh, and he dug down between the veins and sinews to feel the small throb through his finger. He let his watch run a full minute to be quite sure. "You are definitely alive," he said. "I have seldom felt better." Thomas smiled. "It took humans a very long time to understand that not being alive was a single thing. They saw people losing blood in battle, or losing breath or losing weight, losing their minds or falling asleep, but they had different words for each cessation. The idea that all these calamities were versions of the same thing being dead took them millions of years to understand. That is why they propped them up in tombs and expected them to come back or carry on, depending on what kind of interruption they had had." Kitty smiled. "Why not?" "Exactly. The only thing common to all these deaths was loss of conscious thought. But since they did not know what conscious thought was, how could they possibly be aware of its absence least of all in others?" Kitty stood up. She wore a long beige skirt, tight at the hip and broad at the hem over buttoned brown boots; on top she had a high-necked blouse with a silver brooch beneath a green woollen jacket. "Quite soon I shall be ready to leave," she said. "Yes." Thomas tried to sound casual. "And where shall you go?" "I thought I might go to England for a time. My mother's family is in London. And you?" "Me? I have an enormous amount of work to do here. Your case has precipitated a certain... Crisis of confidence which we have not yet overcome. In fact, we have not even confronted it." "In view of that," said Kitty,"perhaps we should both forget anything which passed between us yesterday' Thomas could feel her steady gaze on him. He looked up from where he was sitting on the edge of the bed. "I could never forget what happened," he said. "It was the most extraordinary moment of my life." "But since I have been passed from the care of one doctor to another then it would not do ' "It would not do for you to be passed on so quickly to Dr. Bern thaler like ' "Like a hot potato?" "Like a parcel." Thomas smiled. "It has its comic side." "It does, Thomas." He stood up, went over to where she stood and took both her hands in his. "I have fallen in love with you," he said. "It is better to say it." There was a slight flush in Kitty's cheeks, but not the feverish discolouration of the preceding days. "Be careful, Thomas. You have worked so hard and for so long. I cannot be responsible for some calamity that would affect all of you Sonia as well, and her child." "I would not allow that to happen." "I am perfectly prepared to allow any minor indiscretion that may have happened yesterday to be forgotten, and never to make reference to it again." "I'm afraid that is entirely impossible." "Please be serious. For the pleasure of indulging some whim, you must not risk everything you have dedicated your life to achieving." "I would not do that. This is no whim, I assure you." "Are you certain?" Thomas felt Kitty's eyes searching his own, trying to see through them. "I could not be more certain of anything," he said. She held his gaze for a moment longer. "In that case," she said, 'you may kiss me." She threw her arms round his neck and turned her face up towards his. He kept his eyes open as he touched her pale lips with his, and as he pulled her closer to him, the tip of his tongue accidentally touched the tip of hers. He stroked the fair hair back from her forehead. She looked to him so charged with beauty, so complete and ready for whatever life lay ahead of her, that he could not believe the good fortune of his timing. Why had no one else come before him and carried this woman away? "What will we do now?" she said. Thomas held her at the elbows. "I am ready to be bad in a good cause," he said. "Very bad?" She sat down on the bed and it seemed natural for him to sit next to her; he placed his hand on the beige skirt, where it was stretched across her thigh. Since she made no protest, he left it there. "In ten days' time," he said, 'when you leave my care, I shall have no conflict of interest." "Can you wait ten days to kiss me again?" "Of course I can." He laughed. "What sort of libertine do you take me for?" "One who leaves his hand on a woman's thigh when he is talking to her." "I cannot help my hand." Thomas was so disturbed by her proximity that he did not know what he was saying. "Tell me something," said Kitty. "Those English girls you brought over with you. Did you ever... With either of them?" "You really must have a very low opinion of me," he said. "No, no." She sounded truly alarmed, he thought, no longer playing with him. "I do not have a low opinion of you. Quite the contrary. It was just a silly jealousy on my part. I am ashamed of it already. But I wanted it to be me who first discovered what a wonderful man you are. And you are, you are. You do not know it, but that in itself is wonderful." Thomas was touched by her words, though he did not want to think about their implications. "So there we are, Kitty," he said. "I shall wait ten days, and in that time I shall visit you once a day, or maybe twice if your temperature is elevated in the morning or if either of us is aware of any change in your condition." "And can you wait?" "I can wait." He looked at her face, which was smiling and anxious eager, he thought, to please him. "But would you grant me one favour?" "What is it?" "Do you have freckles on your legs like those on your arms?" "Yes, though less dense. I hate them." "I love them. And where do they finish? Do they cover all your skin? Or do they stop?" "They stop," she said, taking his hand and replacing it a little higher up her thigh, 'about here." Thomas stood up. "You would not, I suppose, dear Kitty, if I promised to ask no more favours, allow me just to see?" Kitty blushed. "Good heavens, I ' "Just to see. It is no more than the nurse saw, or old Obmann or ' "All right. Just for a moment' She went over and locked the door, then came back and undid the waistband of her skirt. She lowered it to the ground and lifted up the petticoat beneath; it was an armful for her to hold above the top of the silk stocking, so he could see the golden skin of her thigh as it paled into white near the top. There was something childish, tomboyish in the slimness of the thigh and the sharp patella; Thomas was moved by a vision of the active girlhood it suggested to him. She looked down at him, her face burning. Despite what he had promised, he held out his hand and touched her thigh at the point where the pigmentation changed, as though he expected the texture to be different where the freckles ended; the petticoats let out a gasping rustle as she quickly lowered them. Three days later, Thomas went to Trieste to visit the lawyer acting on behalf of the owner of the schloss to see if they would agree an extension to the lease, which would otherwise expire at the turn of the century. The lawyers were discouraging. Although the original agreement was thought to contain an option to renew at the same terms for a further five years, it turned out that this was not binding. Thomas was given to understand that the owner would wish to repossess the schloss and that they would do well to consider looking for a new home. However, he reflected as he sat on the train going home, they still had more than four years to run, and by then their lives might be very different. Soon after his return, Kitty prepared to leave. "I wish you would stay," he said, when he went to her room on the day of her departure. "I cannot," she said, folding some clothes into a trunk. "I am quite well now and if I eat any more of Frau Egger's food I shall not be able to fit into any of my skirts. Look how tight this one is at the waist already. I cannot face the thought of my mother's house in Vienna just at the moment. So if I spend a week in Paris with Gustav on the way back, then perhaps a month in London, I shall be back in Vienna by the end of June at the latest." "Where will you live?" "I shall find an apartment to rent and begin to do some work." Thomas was aware that there was only one way that he could make her stay, one question he could put to her; but he sensed that she wanted to be alone, not fussed over, that she needed time to clear her head after all she had been through and that for him to pose any question to her now would be tactless. He understood how she felt, but could not stop himself from saying, "Carinthia is beautiful in June. The wild flowers..." Kitty looked up from the trunk. "I know' At the main railway station, he put his arms round her when he heard the whistle of the arriving train. He did not care if any of the other passengers might recognise him. "You will come back, won you?" She kissed him lightly on the lips. Her face was anxious. "If you want me to." "Dear God, I do." He paid the porter to help with her luggage, then walked quickly down the platform without looking back, out through the ticket hall and on to the forecourt, where Josef was waiting. The succeeding weeks went by slowly. Sonia grew larger and slower, but was said by the gynaecologist to have passed the most dangerous stage of her pregnancy; she found it difficult, however, to deal with all the paperwork of the schloss if, as was recommended, she did no work before lunch. A girl called Lisl was hired to help in the mornings, but seemed unable to spell. Thomas found himself restless. He went for long walks down to the lake and excursions round its five-mile shore. He thought about Kitty, and feared that she had been driven away by a combination of his ardour and Jacques's preposterous misdiagnosis. However much he tried to put it to one side of his mind, he found himself increasingly angry with Jacques for his refusal to accept responsibility for his failings. One evening, he went into the office, unlocked the cabinet and took the paper Jacques had written about Kitty from her file. He then shut himself in his own consulting room and wrote a response to it, as Sonia had requested. He need not necessarily hand it over to Jacques, he thought; he would give him time to change his mind spontaneously; but at least the expression of his dismay might help him concentrate again on his own work. He wrote:

Fraulein Katharina von A A young woman with lower abdominal pain and occasional vomiting. Intermittent amenorrhoea. Previously diagnosed by the family physician with uterine fibroids. You dismiss this diagnosis because she is too young and has had no increased menstrual flow. You at once give up on any organic cause when even a student would suspect ovarian trouble of some kind: if not fibroids, cysts. Her skin and muscle tone are normal. She has chronic joint pain in shoulders, elbows, wrists and fingers; also a temperature, irregular pulse; tendency to infections of the throat; and at an earlier date tics and spasms that look like Sydenham's chorea. Instead of seeing these symptoms as a whole, you separate them and dismiss those that do not interest you. So her raised temperature is a chill, she says, and this you accept without question. You have nothing to say about the pulse. The family physician brusquely rejected in the matter of the fibroids is now welcome: the pains are indeed caused by too much typing and secretarial work. The chorea, although a closed episode, is treated by you as though active presumably because it gives you an entry into neurology. The temperature, the pulse, the aches, the history of throat trouble and the chorea are given five separate authorities respectively: hers, none, the physician's, none again, and yours. Had you looked at the symptoms taken together, you would have seen a classic case of rheumatic fever. It was not difficult to see. I saw it. Maierbrugger saw it. In fact he rejoiced in such an astonishingly complete and uncomplicated presentation. Her eyes were normal, save for astigmatism, which the oculist had correctly diagnosed. You were prepared to accept this. Aspects of her case did trouble you. You stress that she was an affectionate character, well-meaning, dutiful, principled, gentle, a person of high moral seriousness and so forth. You emphasise that she spoke of her own sufferings in a detached way. One would naturally conclude from this information that she was not a neurasthenic person, but was someone strong-minded and self-possessed, suffering from an acute organic illness. But no: you conclude that her apparent sanity is a symptom of her insanity; it is no less than the belle indifference of the hysteric. She is trapped either way. You cannot immediately find access to her unconscious because you cannot hypnotise her. According to Charcot and to you if people cannot be hypnotised, they are not hysterical. But you do not follow this to its conclusion (viz." that she is not hysterical); you modestly blame your own lack of skill as hypnotist. One of the other diagnostic cornerstones for hysteria is heredity. You can find none. Instead of again concluding that she is not hysterical, you conclude that hysteria is a mysterious disease. On two occasions she has lost her voice. What could be more usual in someone chronically prone to throat infections? Your first diagnosis, however, is that it is caused by a lack of confidence in a foreign language. When, as you admit, this turns out to be mistaken, you do not return to the sore throat; you suggest that the aphonia is caused by a suppressed memory acting psycho somatically we know not how of an act of unremembered fellatio. You do not examine her throat at any stage. Her minor anxiety symptoms low spirits, tendency to insomnia you diagnose as the natural response of a healthy woman to her medical condition. But how can she be both a psychologically healthy woman and a neuropath? Elsewhere, her pathology is such that she is, according to you, incapable of any honest co-ordination between any mental and physical process whatever. But where it suits you, she makes healthy and discriminating responses. She suffers from a mild fear of animals, like the majority of women mice and such like. This, too, you see as morbid; and this unlike her fevers, for instance you do not disregard but wish to make central. So instead of being a characteristic shared with most of her sex, it becomes a symptom of anxiety at remembered or perhaps not remembered acts of masturbation. Her adolescent sexual feelings at boarding school are slightly more intense than those of most girls. They should be examined in the context of her life. She had been a tomboy; she had spent time on a farm; she knew about copulation of animals and so on; she had moved among older people in her father's company. In the context of this childhood and the reserved and proper young adult before you, the adolescent period seems a normal bridging phase. But you do not take it in context, you see it in isolation. The episode with Frau E can also be explained as a transition; though to this too you give a weight it cannot really have had despite admitting that it was a single event and that the two women corresponded as friends happily afterwards. The core of your resolution depends on your belief that K was in love with Herr P, her father's business associate. When she denies it, you merely conclude that that is further proof of how strongly she has buried the idea. If she could ever be aware of it, you suggest, then the secret would not have turned morbid inside her. This is an example of a logic known in my country as Morton's Fork. Damned if you do, damned if you don't. If what she says fits your theory, it is the truth; if not, it is an evasion or an inversion. In your pictographic script', a thing may represent itself, or something else, or its opposite. Such a protean script or alphabet can have no literary meaning, still less a medical application. If you throw all this paper in the bin, Jacques, just answer me this one question. Why did you not ask to speak to Herr P? He was not a remote character from a fictional story. He is Kitty's stepfather! He could have told you almost everything you needed to know. And what about her mother, who brought her to the Schloss. Why did you not recall her? Or go to Vienna to visit her? Reading the paper, one has the impression that you prefer to treat these people as characters in a short story rather than as human beings. You prefer to solve the puzzle with limited information; that is the challenge you have set yourself. There are moments such as the one when you speak of the case's 'considerable therapeutic allure' when you appear to put your own intellectual self-gratification above the well-being of the patient. The bewildering thing is that you lay out with such clarity all the details you needed to solve the case. You return time and time again to her studious good character and the naturalness of her heart's affections. You report that she says of herself that she 'fell in love too easily' but that she had never had sexual relations with a man and distrusted her emotions. Her mother agreed that she was inclined to be 'too affectionate'. Yet she was virgo intacta. If there is a sexual mental conflict, it is there open and acknowledged, and it is the most natural tension that a healthy young woman could have, between affectionate exuberance and the need to be proper. And if you accept this part of her self-diagnosis, why can she not acknowledge that she has fallen in love with Herr P? After all, she has the habits of emotional honesty and intellectual self-criticism. Why one earth would they fail her in the case of the visiting lawyer? The vomiting of her lunch when she hears of her father's death, is taken by you to be a symbolic rejection of her future life without Herr P. We can now see that it may have been caused as vomiting can be by the ovarian cyst. My guess is that it was a simple shock reaction. To be more sure about this, of course, we need to know whether the soup just 'came up', or whether there was paroxysmal vomiting. But you do not ask. Talking of not asking, I would mention here also the renewed menstrual period after two and a half weeks. You note this, but attach no importance to it. It does not occur to you to palpate the ovary or re-examine that part of the abdomen. If you can hypnotise her (though you know you have so far failed) that will provide an easier way of sorting out this problem. You prefer to retry autosuggestion, rather than simply examining her body. The lo cum tenens who knocks at her door is diagnosed by you as a 'delegate' memory, standing in for Herr P. But why? Again, you could have asked Herr P himself if ever he broke in on K! No delegates, surrogates, inversions or pictographic symbolism. Just: did you or did you not? We come to the dream, which provides much of the fabric of your resolution. In it, she is haunted by a sense of absence. She believes the missing person is her father, who has recently died. No, you conclude, it is Herr P, the irritating lawyer. Do you not remember the dreams you had when your own father died? Time and again, you movingly told me, you had this feeling of something not satisfactorily completed. Yet to K you deny the possibility a puzzling absence sense of presence. What has happened to your dream theories? In the lecture you gave us in the North Hall, you were circumspect and scholarly about how they might help. Now you are doctrinaire. A dream is always an expression of a suppressed wish. Everything is the opposite of what it seems unless it is not, when it may be itself again. Anything can represent anything else or its opposite! When you run into problems, you resort to a sleight of hand. In the matter of K's lost voice, for instance, when you can find no conclusion, you escape thus: "I did not doubt that the circumstances of the other instance of her aphonia, which she claimed not to remember, had also involved a separation." But why did you 'not doubt'? When K firmly rejects your interpretation, your narrative continues with a conjunction such as 'as we have seen' or 'now that it was established' when nothing has been 'seen', still less 'established'. When you stub your toe on a large 'but', you simply gloss it to an 'and'; if a daunting 'however' blocks your path, you hurry through by calling it 'moreover'. Your story flows, but it does not connect. I think your analysis of the words she used 'my hands were tied' and so on is ingenious, but I do not think it is conclusive. "Suggestive' is about as far as one might reasonably take it. Incidentally, two can play at that game. You yourself use the word 'interpolated': "Although she would not concede that the incident I had interpolated into her story was necessarily true, she was not in a position to recognise it as something she had actually experienced: I believed it would have taken hypnosis to achieve that." Is the word 'interpolated' there to give unwitting encouragement to the sceptical reader? Or is it, like her hand metaphors, a betrayal of an 'unconscious' fear? The sentence above is, alas, characteristic of the circular logic that underlies your resolution. Paradox offers you a permanent escape, as in this sentence: "She cried out in remonstrance that she had no such desire, though this was of course entirely to be expected since, had she been conscious of her true feelings, they would not have been suppressed." There is a tenet of science that no truth can be established unless its hypothesis contains the possibility within itself of being disproved. Your theory of resolution fails that test, because its selective recourse to paradox makes it intrinsically and permanently self-verifying. (Incidentally, it is not 'known' that masturbation to orgasm precipitates amenorrhoea; it has merely been asserted by various