Uwe Tellkamp - The Tower

‘Volar radial fracture, the non-typical type.’

‘Meaning?’ Robert asked in a deliberately calm voice.

‘Prickling in your fingers? Any numbness?’

‘A bit, yes. It’s cold outside.’

‘We’ll have to X-ray it. If that confirms what I think, it means an operation. You can wait in there.’ Richard pointed behind the desk. Once Robert had gone, Richard couldn’t control himself any more and swore. If the lad had fallen with his arm outstretched a plaster cast would have done the job.

‘Smith-Thomas?’ Wolfgang, who’d watched Richard examine him through the desk window, asked, using the technical term for the fracture.

‘It’ll need an operation, yes.’ Richard stamped his foot in his fury, a ridiculous sight and, for the patients waiting, not one to inspire confidence.

Müller came in, behind him the man with the floodlight, followed by one carrying a microphone on a long boom like a fishing rod; three other men, in sharply creased trousers and bomber jackets, had overpowered the cameraman and were dragging him out of the flurries of snow, where a second cameraman was coolly filming the scene, into the crowded waiting area. They stopped short for a moment when they saw all the patients. The cameraman who’d been detained took advantage of that to free himself and protest loudly. The floodlight dug a dazzling white tunnel though A&E.

‘There will be no filming in my clinic and certainly not by your lying station,’ Müller cried angrily.

‘But you take our fuel!’

‘The diesel has been confiscated,’ announced one of the three men in bomber jackets. ‘This is an emergency, as we’ve already explained to you.’

‘The fuel taken will, of course, be replaced, Citizen Capitalist,’ shouted the second of the three in the silence that had arisen all around; even the two women beside the young girl had broken off their lamentations.

‘We need everyone we can get.’ Müller pointed to the three in bomber jackets. ‘You are to help charging the room sterilizers. No, gentlemen, we have no time for discussion. You will do what I, as head of this clinic and of the emergency team, tell you until the Rector and your immediate superiors arrive. No sterile material means no operations. The central sterilizer isn’t working. You’ — he pointed to the West German television men — ‘can make yourselves useful transporting patients and clearing paths. Have them shown what to do, Nurse Wolfgang. Will you please come with me, Herr Hoffmann.’ Müller waved Richard out through the swing door into the corridor to the vestibule and wards. ‘A word in your ear. A difficult situation within a difficult situation. I’ve just had a phone call.’

When Richard said nothing, he went on, ‘A call from the top, Barsano himself. His daughter is on her way to us, he claims. With these African conditions out there … He’s asked me to have our most experienced trauma surgeon operate on his daughter, should an operation be necessary.’

‘My son’s been injured, Herr Professor.’

‘Oh.’

‘Volar radial fracture, the nerve has probably been compressed.’

‘Hm. But you can reset it and put it in plaster, Herr Hoffmann. I know it’s not a permanent solution but it’ll do until the morning and then you can take your time over it.’

‘I’d prefer not to wait until the morning. The results don’t get better if you leave it.’

‘I know that,’ Müller, exasperated, replied with a sweeping gesture. ‘I have a suggestion: when the generator starts, we’ll at least have power in the ICU again and then Herr Kohler can join us. Never operate on a relative, you know that. And you’ve trained up Herr Kohler very well.’

Richard, alarmed, didn’t reply. That possibility had never occurred to him. The maxim he had followed in training Kohler was not in the Hippocratic Oath: If you have to instruct your enemy, teach him just enough to make sure he won’t harm the patients, but not enough that he can replace you.

‘All patients have equal rights,’ Richard muttered. There were sounds of the jacking-up operation from the lift shaft, metal on metal, someone calling for pliers.

‘I can understand you, believe me. But Barsano has protected you. There are those, and not only here in the clinic, who are unhappy with the opinions on certain things you often express quite openly.’ A fragment of the pocket-torch light from South I slipped into the stone in Müller’s signet ring. Beautifully cut, Richard thought. Does he take it off when he’s doing an operation? It wouldn’t fit under the gloves and disinfection to a surgical level wouldn’t be possible either. Why not operate on Robert, take the reprimand and resign?

‘And suggest you have to prove yourself. Nonsense, if you ask me. As if you hadn’t proved yourself here.’

Not a threat, more a plea for understanding. Richard sensed he was getting nowhere the way things were. ‘So far we’ve no power, no X-ray, we can only use one room, if any at all.’

‘The CAT scanner’s working again. Tellkamp has been informed, he’s waiting. The technicians are running a cable from Admin and Nuclear Medicine to us. We’ll be able to operate and X-ray again, even if we don’t have mains current very soon — which I reckon we will. For the moment the generator ought to be enough for the ICU. I’m only halfway through my operation too.’ Müller suddenly spoke in an unusually understanding tone: ‘We’ll manage. You never know, Fräulein Barsano might arrive immediately and you’ll be able to operate on both. Lord alone knows what’s wrong with her: sent with multiple traumas, arrives with athlete’s foot.’

‘But why here, of all places. Can’t she be treated up there in Friedrich Wolf?’

Müller nodded. ‘I’m sure they won’t have a power cut up there, but I’ve no idea, Herr Hoffmann. — Thank you for your cooperation.’

Accident and Emergency did not empty. The doctors from the various surgical areas had formed teams (no one there said ‘collectives’ any more, Richard thought), those from Internal Medicine went to and fro between the wards, Endoscopy and Outpatients. Whenever Richard thought the stream of patients was slackening off, the outside door would swing open and Rapid Medical Assistance, a taxi driver or a relation would bring more people with injuries. They also brought news of how things were in the city outside. From what they said, which was immediately passed on by the nurses rushing in and out, by doctors, porters, waiting patients, the situation outside must be chaotic. Trams were stuck on Platz der Einheit, the power was off there too, passengers had forced open the doors, the people who lived in Neustadt didn’t have far to go and could trudge home through the snow; anyone who wanted to get across Marienbrücke to the city centre tried to hitch a lift from one of the cars crawling past; worst off of all were those who had to go up to the high residential area: with no possibility of hitching a lift, they were faced with several kilometres on foot. The Elbe was covered with a sheet of ice, a Czech tug had been squeezed against the Blue Miracle, the bridge had had to be closed. None of the ferries between the north and south bank were running any more. When Richard went out to get a breath of fresh air, the Academy looked like a darkened honeycomb: the roofs waxy with ice, the snow on the paths and roads knee-deep. In many of the ten-storey buildings in Johannstadt, in the new developments of Prohlis and Gorbitz, the central heating wasn’t working; the people there were shivering in their beds, envious of those on the slopes of the Elbe with their tiled stoves that devoured coal and produced ash but also — and that was the important thing — warmth.

In Outpatients no one seemed to know who had already been treated and who still needed treatment, who could be transferred to a ward and where which of their colleagues was occupied with which case. Wolfgang was still ensconced behind the desk, flanked by sheets of paper on which he tried to provisionally record the details of the arriving and departing patients, telephones were ringing, always someone wanting to know something: patients when they’d be treated, family members where their relations had got to, staff where there were supplies of syringes, bandages, admission forms — and couldn’t someone finally make a decent cup of coffee, after all the emergency generator was working now!