Frank Tallis: Vienna Secrets

Edlinger introduced himself, briefly described the patient’s condition, and handed Liebermann a weighty buff file. Liebermann sat down and flicked through the summary: Baron Klemens von Kortig: mood shifts, delusions of grandeur, irrational rages, gambling, spending sprees, vertigo, headache, digestive problems, vomiting, “lightning pain” in the hands and feet. It was unusual to see a man quite so young in the advanced stages of tertiary syphilis, but presumably, like many of his peers, on reaching puberty the baron had immediately enjoyed the sexual favors of the peasant girls on his father’s estate. He was now paying a heavy price for these plein air romances.

“What did you give him?” asked Liebermann.

“Morphine,” Edlinger replied.

“Why?”

“He was agitated. I wanted him to settle down.”

“The other patients were being disturbed,” interjected Nurse Heuber.

“But the syphilis has spread to his heart,” said Liebermann.

The aspirant and the nurse presented a united front: void expressionless faces.

“Never mind,” said Liebermann, shaking his head. “I’d better go and see him. Where is he?”

Nurse Heuber led Liebermann out onto the ward. It smelled of carbolic. The other patients watched their progress as they approached the last bed, which was hidden behind a screen.

Baron von Kortig, propped up with pillows, was fast asleep. His hair was lank, sweat glistened on his brow, and his eyelids were red and swollen. The hospital gown he wore was rucked at the shoulders, revealing long pale arms and thin white fingers.

Liebermann stood at the end of the bed. He looked at his patient with an expression unique to clinicians, a combination of devotion and predatory interest: a paradoxical look, compassionate yet calculating.

He noted that the baron’s head was nodding with each heartbeat, and positioned himself closer. He bent forward and examined the man’s fingernails. Edlinger was standing in the light, and Liebermann gestured that he should take a step back. Liebermann observed the subtle blushing beneath the transparent keratin, the color coming and going. He squeezed von Kortig’s bony wrist and felt the flow of blood-its physicality-his fingers being raised by the pressure, and their subsequent fall. He then lifted von Kortig’s arm and felt the pulse collapse, the loss of power and only a residual tap, tap, tap. It was ominously weak, its actual presence sometimes indistinguishable from an anticipatory tactile illusion.

Liebermann asked Edlinger for his stethoscope.

Pressing the diaphragm against the baron’s chest, Liebermann listened.

Lubb-dub, lubb-dub, lubb-dub…

There was something very wrong.

He heard a rumbling on the second component of the beat, a rumbling that became more marked when he placed the diaphragm of the stethoscope closer to the left edge of the patient’s sternum. When he listened to the patient’s lungs, he heard a loud crackling. They were horribly congested.

Liebermann took off the stethoscope and handed it back to Edlinger.

“Aortic regurgitation. The infection has all but destroyed his heart. I’m afraid there’s nothing we can do.”

“He’s dying?” cried the aspirant, the pitch of his voice climbing with surprise.

Liebermann quickly raised his finger to his lips.

“Yes,” he whispered, looking once again at von Kortig’s blushing fingertips.

Nurse Heuber made the sign of the cross and excused herself. The sound of her brisk step, captured and amplified by the vaulted ceiling, fell silent when she reached the anteroom. Liebermann explained, sotto voce, to the aspirant how he had determined the severity of von Kortig’s condition. He then suggested to Edlinger that he should go and make a relevant entry in the patient’s notes.

There was no reason for Liebermann to stay on; however, having become involved in the young baron’s care, he felt a curious sense of obligation, a compulsion to remain a little longer.

Liebermann found a chair, placed it behind the screen, and sat by the patient. He checked von Kortig’s pulse again and plumped up the pillows: maintaining him in an upright position would make it easier for the poor fellow to breathe. The gas lamps were humming, and the steady persistence of their inanimate drone lulled Liebermann into a pensive, melancholy state. His mind produced a loose circle of associations: death, mortality, the importance of seizing opportunities because of the brevity of life, Miss Lydgate, sexual desire, syphilis-and, again, death.

Suddenly Liebermann became aware that something had changed. There was a difference in the acoustics of the ward. Where there had hitherto been a constant rhythmic accompaniment to the humming gas lamps-von Kortig’s shallow, stertorous breathing-there was now an absence. Liebermann looked up, expecting the worst, expecting to be confronted with the terrible stillness of the dead; however, what he saw almost made him jump. Von Kortig had opened one eye and was staring at him intently.

“I’m sorry,” said the aristocrat in a cracked, wheezy voice. “But you are?”

“Dr. Max Liebermann.”

“Liebermann, you say.” The other eye opened. “Liebermann… Ah yes, of course. Karl’s friend. I am sorry. My memory isn’t as good as it once was… You were my guest last summer-at the hunting lodge.”

It was probably the effect of the morphine. Liebermann did not have the heart to challenge him.

Von Kortig winked. “What a summer, eh?”

“Yes,” Liebermann replied softly. “What a summer…”

“Those girls from Paris… Have you ever encountered a more sporting group of ladies?”

“No… I haven’t.”

The young baron paused for a moment and smiled wistfully.

“Hugo, eh? What a fool he was. His father was furious, you know-when he heard. He’s threatened to disinherit him. That land has been in the Meissner family for generations. Although, who am I to criticize. We’ve all been there, haven’t we? Luck seems to be on your side, you’re dealt one fantastic hand after another, you get overconfident, and then…” Von Kortig paused, lifted his arm, but was too weak to hold it up. When it hit the sheet, he winced.

“Are you coming again this year?”

“If I can.”

“Good. Karl will be pleased.”

The dying young man looked at the screen, but his eyes were focused on a distant, imaginary horizon.

“I must say, I’m looking forward to it again this year-more so than ever before.” He closed his eyes and croaked, “Is there any champagne left? Put a few drops of cognac in mine, there’s a good chap.” The young man drifted out of consciousness, and when he came to again, he said, “They’re not going to keep me in here for very much longer, are they?” A note of anxiety had crept into his voice.

“No,” said Liebermann.

“Good. What did you say your name was?”

“Liebermann.”

“Ah yes… Liebermann.” Von Kortig’s breath was suddenly labored. “Look, there’s nothing wrong, is there?”

“Wrong?”

“Well, to be honest, I’m not feeling too good.”

“You need rest, that’s all. Close your eyes. Get some sleep.”

“That’s not a bad idea. I am feeling awfully tired.”

Von Kortig’s eyelids slowly closed.

Liebermann, moved by the terrible irony of their exchange, looked away. Through a gap in the screen he could see the entrance to the anteroom. Nurse Heuber appeared-and behind her stood a priest. Liebermann got up quietly and walked to the other end of the ward.

“I trust I am not too late, Herr Doctor,” said the priest, a man not very much older than Liebermann. “Nurse Heuber did her best.” He turned to face the nurse and smiled.

“Thank you for coming. But…” Liebermann grimaced. “I am not altogether sure that your ministrations will be in the patient’s best interests.”