Winfried Sebald - The Emigrants

In response to my request, Dr Abramsky described shock treatment in greater detail. At the start of my career in psychiatry, he said, I was of the opinion that electrotherapy was a humane and effective form of treatment. As students we had been taught — and Fahnstock, in his stories about clinical practice, had repeatedly described in graphic terms — how in the old days, when pseudo-epileptic fits were induced by injecting insulin, patients would be convulsed for minutes, seemingly on the point of death, their faces contorted and blue. Compared with this approach, the introduction of electric shock treatment, which could be dispensed with greater precision and stopped immediately if the patient's reaction was extreme, constituted a considerable step forward. In our view, it seemed completely legitimate once sedatives and muscle relaxants began to be used in the early Fifties, to avoid the worst of the incidental injuries, such as dislocated shoulders or jaws, broken teeth, or other fractures. Given these broad improvements in shock therapy, Fahnstock, dismissing my (alas) none too forceful objections with his characteristic lordliness, adopted what was known as the block method, a course of treatment advocated by the German psychiatrist Braunmiihl, which not infrequently involved more than a hundred electric shocks at intervals of only a very few days. This would have been about six months before Ambrose joined us. Needless to say, when treatment was so frequent, there could be no question of proper documentation or assessment of the therapy; and that was what happened with your great-uncle too. Besides, said Dr Abramsky, all of the material on file — the case histories and the medical records Fahnstock kept on a daily basis, albeit in a distinctly cursory fashion — have probably long since been eaten by the mice. They took over the madhouse when it was closed and have been multiplying without cease ever since; at all events, on nights when there is no wind blowing I can hear a constant scurrying and rustling in the dried-out shell of the building, and at times, when a full moon rises beyond the trees, I imagine I can hear the pathetic song of a thousand tiny upraised throats. Nowadays I place all my hope in the mice, and in the woodworm and deathwatch beetles. The sanatorium is creaking, and in places already caving in, and sooner or later they will bring about its collapse. I have a recurring dream of that collapse, said Dr Abramsky, gazing at the palm of his left hand as he spoke. I see the sanatorium on its lofty rise, see everything simultaneously, the building as a whole and also the minutest detail; and I know that the woodwork, the roof beams, door posts and panelling, the floorboards and staircases, the rails and banisters, the lintels and ledges, have already been hollowed out under the surface, and that at any moment, as soon as the chosen one amongst the blind armies of beetles dispatches the very last, scarcely material resistance with its jaws, the entire lot will come down. And that is precisely what does happen in my dream, before my very eyes, infinitely slowly, and a great yellowish cloud billows out and disperses, and where the sanatorium once stood there is merely a heap of powder-fine wood dust, like pollen. Dr Abramsky's voice had grown softer as he spoke, but now, pausing first to review (as I supposed) the imaginary spectacle once more before his mind's eye, he returned to reality. Fahnstock, he resumed, had been trained in neurology at an asylum in Lemberg, immediately before the First World War: at a time, that is, when psychiatry was primarily concerned with subduing those in its custody, and keeping them in safe detention. For that reason he was naturally inclined to interpret the recurrent desolation and apathy of sick patients exposed to continued shock therapy, their growing inability to concentrate, their sluggishness of mind, their muted voices, and even cases when patients entirely ceased to speak, as signs of successful therapy. So to his mind the docility of Ambrose was a result of the new treatment. Ambrose was one of the first of our patients to undergo a series of shocks, over a period of weeks and months; but that docility, as I was already beginning to suspect, was in fact due simply to your great-uncle's longing for an extinction as total and irreversible as possible of his capacity to think and remember.

Once again Dr Abramsky fell silent for a lengthy spell, occasionally scrutinizing the lines on his left hand. I believe, he then went on, looking up at me, I believe it was Fahnstock's unmistakably Austrian intonation that predisposed me towards him at first. He reminded me of my father, who was from Kolomea and, like Fahnstock, came from Galicia to the west after the dissolution of the Habsburg empire. Fahnstock tried to re-establish himself in his home town, Linz, whilst my father tried to start up in the liquor trade in Vienna, but both fell foul of circumstances, the one in Linz and the other in Vienna's Leopoldstadt. In early 1921 my father emigrated to America, and Fahnstock must have arrived in New York during the summer months, where he soon resumed his career in psychiatry. In 1925, following two years at the state hospital in Albany, he took up a position at Samaria, a newly established private sanatorium. At about the same time, my father died when a boiler exploded in a soda factory on the Lower East Side. After the accident, his body was found in a partly poached state. When I was growing up in Brooklyn I missed him very much. Even in the face of the greatest adversity he was confident; my mother, by contrast, seemed only a shadow after his death. I now think that, when I myself began as an assistant at the Samaria, I was uncritically on Fahnstock's side because much about him recalled my father. But when Fahnstock began to believe, towards the end of his career, that he had discovered a psychiatric miracle cure in the block or annihilation method, and when he, who had never had the slightest scientific ambition, increasingly became caught up in a kind of experimental mania and even planned to publish a paper about Ambrose, then, and only then, did it dawn on me that his fanatical interest as well as my own vacillation were, in the end, merely proof of our appalling ignorance and corruptibility.

It was almost evening. Dr Abramsky led me back through the arboretum to the drive. He was holding the white goose wing, and from time to time pointed the way ahead with it. Towards the end, he said as we walked, your great-uncle suffered progressive paralysis of the joints and limbs, probably caused by the shock therapy. After a while he had the greatest difficulty with everyday tasks. He took almost the whole day to get dressed. Simply to fasten his cufflinks and his bow tie took him hours. And he was hardly finished dressing but it was time to undress again. What was more, he was having constant trouble with his eyesight, and suffered from bad headaches, and so he often wore a green eyeshade — like someone who works in a gambling saloon. When I went to see him in his room on the last day of his life, because he had failed to appear for treatment for the first time, he was standing at the window, wearing the eyeshade, gazing out at the marshlands beyond the park. Oddly, he had put on armlets made of some satin-like material, such as he might have worn when he used to polish the silver. When I asked why he had not appeared at the appointed time, he replied (I remember his words exactly): It must have slipped my mind whilst I was waiting for the butterfly man. After he had made this enigmatic remark, Ambrose accompanied me without delay, down to the treatment room where Fahnstock was waiting, and submitted to all the preparations without the least resistance, as he always did. I see him lying before me, said Dr Abramsky, the electrodes on his temples, the rubber bit between his teeth, buckled into the canvas wraps that were riveted to the treatment table like a man shrouded for burial at sea. The session proceeded without incident. Fahnstock's prognosis was distinctly optimistic. But I could see from Ambrose's face that he was now destroyed, all but a vestige of him. When he came round from the anaesthetic, his eyes, which were now strangely glassy and fixed, clouded over, and a sigh that I can hear to this day rose from his breast. An orderly took him back to his room, and when I went there early the following morning, troubled by my conscience, I found him lying on his bed, in patent-leather boots, wearing full uniform, so to speak. Dr Abramsky walked the rest of the way beside me in silence. Nor did he say a word in farewell, but described a gentle arc with the goose wing in the darkening air.