Authors: H. G. Adler
As soon as Caroline hears these familiar sounds in the foyer, she comes out of a room or the kitchen to ask, “When can we expect you, Leopold? When should I have lunch ready?”
“Caroline, how many times have I told you, a doctor never knows when he’ll be back. The patients need me. Between one and three. I’ll be here as soon as I can. You can keep the food warm. Take care!”
With dignity the doctor leaves the apartment, hurrying on his way to his many patients, all of whom are waiting for the good doctor. He examines them thoroughly and considers each condition seriously, giving the proper diagnosis and writing prescriptions so that everything is well again soon. Leopold struggles against illness, and being a doctor is for him a sacred occupation, one that he chose because he wanted to help people, which is why he must take care never to underestimate the severity of an illness. That’s why it’s also necessary that the patients do exactly what the doctor tells them. He cannot stand objections, it being nothing but a waste of time, though who would dare try it? One glance and the patients shut up or nod their heads in understanding. If they don’t want to do what they’re told, Leopold scolds them by reminding them of all the possible complications and dangers that can threaten one’s life. If they don’t want to listen then he simply says, That’s it, you had better find a different doctor, or, Sorry, but I have to be at the hospital. But it rarely ever comes to this, because no one ever wants to leave the good Dr. Lustig.
Then usually everything goes well and the convalescents or the healed come to the office to thank Leopold and praise his care of them. At the end of it all they ask what the bill is, but the doctor is quite generous and the patients soon breathe a sigh of relief, after which comes more thank-yous, as they feel blessed and close the door behind them as fast as politeness allows. Leopold doesn’t earn much, nor is there much left over for
savings. In the Lustig house the budget is tight, as things have gotten ever more expensive, when the doctor stops to consider. However, he has no idea of the value of money and never asks what is needed to run the house, or what Caroline and the children must live on. As a result, every couple of months Caroline has to sit him down, but he doesn’t quite understand what’s being asked of him; he works the entire day and complains that he can’t just steal money like a common thief.
“I can’t charge as much for my services as can a dress designer for a fancy dress. No, Caroline, I can’t do that. Forgive me. People also need money and they take no pleasure in being sick. They have to be helped. It’s enough that they have to pay for expensive medicines. Illness is a misfortune off of which I don’t want to get rich. I won’t have anything to do with something so unjust and would rather be poor, that’s certain.”
“And the poverty of the doctor and his family is also a misfortune.…”
“You talk too much. Have we not always had plenty of bread and butter? Have we not had a good life for ourselves?”
“It didn’t come from your earnings, my dear Leopold.”
“Where from then? I’ve given you everything, almost everything!”
“You always gave it, Leopold, but it was always too little. Do you hear? Too little!”
Leopold keeps on talking, but Caroline doesn’t pay any attention and leaves the room, thinking that she will never get through to the man because his head is always in the clouds; reality doesn’t exist for him. All he thinks about is his work, not about others, not even his wife or his children, nor in thirty years of marriage has he ever had a notion of what really goes on in his house. No, he knows nothing other than his medicine and his patients, both of which he lives for and sacrifices himself. He has never been hard to please, all he needs is his own comfort, meaning good food, his clothes cleaned and ironed, and a well-tended office. How hard is it to fill these desires, how much could it possibly cost? Yes, but the family also has its own desires and wants to be taken care of, and that all costs money, my dear Leopold. Where are we supposed to get that if the father of the house doesn’t take care of it himself? What the children earn hardly amounts to anything. How is Caroline supposed to earn extra money even if she does have certain skills? No woman should have to work for pay,
thinks Leopold. But how would we manage if Ida didn’t help her sister out? No one should accept money from others, not even from a sister who is herself a sickly widow. The family shouldn’t rely on her. Meanwhile, so many patients are so grateful that they are not satisfied with just paying their bills. At the end of the year they send some wine or other valuable gifts. Yet how expensive they are! As a housewife, Caroline knows the price of things and should figure out what such things are worth. But it never occurs to her to do so.
And now Leopold is no longer a doctor. The world into which he came with all of his industry and thoroughness slowly grew ill and died. It had to do with an affliction that the doctor at first did not notice and then later never completely understood. Above all he did not see that this sickness had to be fought off with powerful medicines, for there was nothing about it in his thick medical books, nothing in his journals. Indeed it was a different kind of infirmity, against which no amount of rest, no diet, no radiation worked, not even the healing powers of the almost forgotten and yet so comforting mustard plaster. No, this was no case for that part of medicine that Leopold knew well, namely general practice, which involved internal ailments that one had to carefully tap and listen to, or childhood illnesses that Leopold recognized at a glance. Instead, it was an affliction without cause, undetectable by eye or ear, though the affliction was nonetheless there, overpowering and quickly spreading, a part of psychology, something for which Leopold had never had much use. You couldn’t do much for someone suffering from mental illness except to secure the environment in which he was isolated and give him sedatives to keep him calm whenever he became a danger to himself or his keepers.
The sickness had crept out of nowhere without a sign to alert the medical world before suddenly everyone fell sick. It was the first epidemic of mental illness, but no one recognized it as such, neither the patients nor the doctors. No one told anyone he was sick, for as a result of the epidemic everyone was crazy, and once they finally recognized what was happening it was too late. Therefore the afflicted neither came to Dr. Lustig’s office nor asked him to visit them. He would have given them a talking to, yes, he would have, yes indeed.… But also the psychiatrists, these charlatans who were of no use, because they knew nothing about medicine and were
only considered doctors out of a sense of tolerance he could not understand. “When you’re not capable of anything, that’s when you become a psychiatrist!” Leopold often said. Indeed, if only the condition had made itself known then they could have warned others about it and continued to publish information about ongoing case histories, but all sense of duty was abandoned, the spread of the epidemic was not thwarted, appeals to the authorities went unanswered, no warnings came from the medical associations, even the professors of the medical schools remained silent. Nobody had a clue, not even the public health officials of the Ministry of Health had done the least thing to try to stop the spread of this threatening disease.
Once the unknown epidemic spread throughout the country it was too late. Now people noticed something was wrong, yet they still didn’t grasp what it was, not even Leopold, for no one had allowed him to examine or treat them, which would have allowed him to report on the type and nature of the illness. “Totally crazy is what they are!” But that is not a clinical diagnosis, rather layman’s terms that undermine the authority of serious medicine, and sadly the hand lets the stethoscope fall, no sounds are heard, only twanging sounds, the patients perhaps having no lungs or heart. What Leopold had accomplished as a doctor suddenly meant nothing. That’s why Leopold took it especially hard when he was stripped of his right to practice. Sadly he read through the decision of the medical board, though he understood completely what it meant.
Dear Dr. Lustig,
In compliance with the order handed down by the Minister of Health on March 23 of this year in regards to the protective measures concerning the classification of the entire health service as set down in the applicable statutes found in Section 2, Paragraph 1, I am writing to inform you that your right to practice medicine, whether for financial compensation or not, will be officially revoked as of July 1 of the current year.
Failure to comply with the ban outlined in this letter will be subject to the penalties set down in Section 4 of the ordinance
quoted above, which we are giving you full notice of here. The right to treat immediate members of your family (as mentioned in Section 6 of the aforementioned ordinance) will remain exempt from the overall ban on further practice.
Because the jurisdiction of the aforementioned ordinance (Section 5, Paragraphs 1–3) clearly applies to you, no recourse to this decision will be possible.
With sincere greetings,
Dr. Kmoch
President of the Medical Board
Leopold had only to see this to understand that the sickness had become much more powerful than he had ever imagined. There was no recourse against this condition; the sickness had spread so wide, leaving behind weakened tissues, metastasis, and a radical condition whose prognosis was no longer even within reach. Caroline had to ask Frau Lischka to have Herr Lischka take down the sign next to the door of the building, for there was no more Dr. Lustig the moment his license had been revoked, the patients heading off down the street without having been tended to because the medical board had ordered it so. Leopold, however, packed up the instruments that would soon be confiscated, though of course he was given a receipt for them, all of it taken care of officially, followed out to the letter, indeed everything carried out the door in proper fashion, perhaps carried off to the medical board, perhaps to Dr. Kmoch’s apartment, the examination couch the only thing left behind, since it was probably too old and wasn’t worth anything, and oh yes, of course, they also didn’t take the washstand, it remained behind, though it was no longer filled with water. For who was there left who could do that since Emmy had been let go, something that the ministry itself had ordered. Meanwhile, eighteen months later Leopold began his journey to Ruhenthal, the city of prisoners.
It was then that Leopold said to Zerlina, “You know, child, I will be needed there. Prisoners also get sick and have illnesses like normal people. They’ll be happy to have an experienced doctor and a former surgeon major among them.”
But when Leopold arrived, they laughed at the old man as he repeatedly and stubbornly insisted, “My dear sirs, I am a doctor! I have practiced medicine for forty years. I’m healthy and can be of help to you.”
“We already have plenty of young doctors here who are of no use to us. We could plaster the walls with them. There’s already too many!”
“But I’m experienced! I’m a good doctor! Perhaps you might even find some former patients of mine who will attest to how I have helped them in the past.”
“Ridiculous! You’re no doctor to us, you’re just an old man who has seen his better days and is used up and done for! Go ahead, rest on your laurels!”
“Even when they’re old many realize their greatest accomplishments!”
“That doesn’t matter to us. First of all, we’ve already told you that we don’t need you, and second, no one here who is older than sixty is allowed to practice medicine. Do you understand?”
Leopold, however, understood nothing, though he heard every word. It hurt him deeply that no one wanted anything to do with him. Clearly the people here were also afflicted with this unknown sickness that forbid a doctor to be a doctor. When there’s a sickness that prevents doctors from practicing, then medicine is useless, it having collapsed and become nothing more than a fable from the good old days when there were still doctors who studied, graduated, and did their residencies, after which they set up their own practices, placed a sign next to the front door, and then worked for as many years as it pleased them or their health allowed. No one could revoke their right to practice as long as they took their work seriously and practiced it in a knowledgeable manner. Only criminals and frauds were expelled from this noble profession amid scandal and shame, but this seldom occurred, because fortunately there were only a few certain individuals who grossly insulted the honor of the profession. Standing in front of the Ruhenthal officials, Leopold pointed silently to the stethoscope he had saved and managed to carry with him through all his travels, pointing to it proudly and boldly, as if challenging the officials, though they looked on keenly and laughed loudly as one of them grabbed hold of the stethoscope.
“You don’t need that here, Doctor. Still, our doctors will be glad to have it, for we’re running short of stethoscopes.”
Leopold stood there looking pale, a tear falling from his eye. When the official saw that, he responded in mock compassion.
“Hey now, take it easy! It’s easy to get sick here, because people much younger than you get sick, and then a young, talented doctor will show up to take care of you. He’ll hold your stethoscope in his hands and will be able to tell right away what sounds your heart and lungs are making. Here it’s important that one gets a good diagnosis, for there’s hardly any medicine, and we have to save what we have. But at least we know what people need and what’s causing them to die.”
“I can listen without a stethoscope, young man, but you have to have medicines available. You have to! Otherwise nothing can be done!”
“We don’t have any, or at least hardly any, Doctor, and yet we manage.”
“You mean to say you heal people here only through diet, bed rest, and physical therapy?”
“Diet and bed rest? What are you thinking of? And you want to be a doctor! Here it’s death that does the healing when nature isn’t able to help on its own.”
Still laughing, the officials left, Leopold surrounded by laughter all around him, Caroline laughing as well, just like everyone. Only Leopold remained serious and rigid and stared hard through the murky room.