John Irving - Until I Find You

The rest of the team members were women. In Heather’s view, they were the most formidable. Dr. Regula Huber, for example—she was head of internal medicine. She was a Swiss woman in her forties, blond and tireless. There were many elderly patients at the Sanatorium Kilchberg; an internist was kept busy there. Most of the older patients had been committed by family members; these patients were not free to leave.

Heather told Jack that she’d had many meetings with Professor Ritter and the team of doctors looking after William; on every occasion, Dr. Huber’s pager had gone off and she’d left to attend to an emergency. In the case of William Burns, who’d been committed to the psychiatric clinic by his daughter but had stayed of his own volition—happily, without protest—Dr. Huber, like Dr. Berger, first wanted to rule out a few things.

Did their father have an underfunctioning thyroid gland? (This could make you feel cold.) No, he did not. Did he have Curshman-Steinert disease? Thankfully, no! And why was William Burns so thin ? Because he didn’t drink, and he thought that overeating was a sin; their dad kept to a strict diet, as if he were a fashion model or a jockey or an actor. (Like father, like son!)

It was Dr. Huber who treated, or attempted to treat, their dad’s arthritis. She’d recently tried a new class of nonsteroidal anti-inflammatory drugs that were supposed to be more stomach-friendly than the older anti-inflammatories, but they gave William so much gastric irritation that Dr. Huber instead applied a conventional drug topically.

And it was Dr. Huber who took the view that some so-called placebos worked— that is, if the patients thought they did. She raised no objection to William’s fondness for hot wax and ice water, or his taking glucosamine with the extract of shark cartilage. William Burns also wore copper bracelets, except when he was playing the piano or the organ.

Heather liked Dr. Huber, whom she called a pragmatist. (Jack thought inexplicably of Frances McDormand, one of his favorite actresses.)

The third German, Dr. Ruth von Rohr, had a curiously incomplete title—she was some sort of department head. Of what department was unclear, or perhaps deliberately not stated. She was a tall, striking woman with a wild mane of tawny hair that had a silver streak, which Heather said looked natural but couldn’t have been. Dr. von Rohr had a regal, head-of-department demeanor. She usually let others speak first, although her impatience was demonstrable and calculated. She knew when to sigh, and she had considerable dexterity in her long fingers—in which she frequently twirled a pencil, almost never dropping it. When she spoke—usually last, and often dismissively—she turned her prominent jaw and angular face in profile to her audience, as if her head were about to be embossed on a coin.

“On the other hand,” she liked to begin, as if she were head of the doubt department—as if the silver streak in her hair were a banner to that gray area of every argument. It was Dr. von Rohr’s job to make the others feel less sure of themselves; she liked opening the door to those things that could never be ruled out.

Everyone at the Sanatorium Kilchberg thought that William Burns was a model patient. He had to be happy there; after all, he’d not once attempted to run away. He rarely complained about the place, or his treatment. Yes, he occasionally gave in to his demons; he had his rages and irrational moments, but he had far fewer of these episodes in Kilchberg than he’d experienced in the outside world. Jack’s sister maintained that their father was where he belonged; remarkably, William seemed to accept this. (Hadn’t he positively embraced the idea? Dr. Horvath had enthusiastically asked.)

Yet it was Dr. von Rohr’s department to raise the un asked question. “Isn’t hospitalism a second disease for some of our patients?” she would inquire, just when everything seemed fine. “What if we’re too successful with William? In a sense, if he’s happy here, haven’t we made him dependent on us and this place? I’m just asking,” she was fond of saying, once a seed of doubt had been sown.

It was Dr. von Rohr who would not stop asking why William often felt cold. “But what triggers this?” she frequently inquired. (At the Sanatorium Kilchberg, Jack’s sister had told him, the word triggers was hugely popular.)

It was Dr. von Rohr who suggested that William Burns might have a narcissistic personality, or even a narcissistic personality disorder. He shampooed his gray-white, hippie-length hair daily; he was very particular about which conditioner and gel he used. (He’d had a fit—a running-naked-and-screaming episode—because his hair dryer had blown a fuse!) And then there was the meticulousness of his tattoos, not to mention how protective he was of them. For the most part, he concealed them. He wore long-sleeved shirts, buttoned at the throat, and long pants, and shoes with socks—even in the summer. (Yet when William Burns wanted you to see his tattoos, he showed you all of them.)

It was not uncommon among schizophrenics to wear long pants and long-sleeved shirts; they felt so unprotected. But Jack and Heather’s dad wasn’t diagnosed with schizophrenia. The issue Dr. von Rohr had raised was William’s fastidiousness, his vanity—the way he watched his weight, for example. “Isn’t William an impossible perfectionist?” Dr. von Rohr would say. “I’m just asking.”

The osteoarthritis was the reason William Burns could no longer play the organ professionally—hence his early retirement, which had precipitated his mental decline. But he could have kept teaching—even keyboard skills, albeit to a limited degree, Heather had said. William certainly could have continued to teach musical theory and musical history; yet he had retired totally, and perhaps unnecessarily.

“A failure to live up to previous standards or expectations, which can also lead to someone’s early retirement, is a signature feature of a narcissistic personality, isn’t it?” Dr. von Rohr had said to the team. (The “I’m-just-asking” part was always implied, if not stated.)

“A piece of work,” Jack’s sister had called her. “A head-of-department type, if I ever met one.”

Trying to envision Dr. Ruth von Rohr, Jack thought of Dr. García, who was a good listener, and who raised a lot of unasked questions. Boy, was Dr. García ever a head-of-department type!

Last, but not least, was the sixth member of the team—an attractive young woman, authoritative but self-contained—Dr. Anna-Elisabeth Krauer-Poppe. She always wore a long, starched, hospital-white lab coat—seemingly not to assert her medical credentials but to protect her fashionable clothes. (She was Swiss but her clothes weren’t, Heather had claimed.)

Like the two unambiguous hyphens in her name, Dr. Anna-Elisabeth Krauer-Poppe was as perfectly assembled as a Vogue model in Paris or Milan; she seemed too chic to be Swiss, although she’d been born in Zurich and her knowledge of the city was as irreproachable as her command of her field. Dr. Krauer-Poppe was head of medication at the Sanatorium Kilchberg, where it was everyone’s opinion that she knew her prescriptions as well as she knew her clothes.

It had frustrated her that William was not treatable with those new (and so-called stomach-friendly) nonsteroidal anti-inflammatory drugs and that he could tolerate only the topical solution. His hot-wax routine made Dr. Krauer-Poppe cringe, not least for what a mess William made of what he was wearing when he picked the dried wax off. And to see him with his hands plunged in ice water must have made Dr. Krauer-Poppe want to change her entire ensemble. (As for the copper bracelets, she couldn’t even look at them; the glucosamine, particularly the extract of shark cartilage, she dismissed as “a folk remedy.”)