A Simple Intervention E-Book

Yael Inokai

• Herausgeber: Peirene Press
• Kategorie: Gesellschafts- und Liebesromane
• Sprache: Englisch

Seitenzahl: 200

Veröffentlichungsjahr: 2024

Beschreibung

A ground-breaking surgical intervention promises to free women from psychological disorders. The procedure is painless, the risks are minimal, and patients are calmer and more compliant after healing. The doctor promises them a new and productive life, free from suffering – can it be so simple? Meret is a nurse on the surgical ward. The hospital is her home, and her uniform is her identity. She supports her patients through their interventions and is proud to be a part of the solution. But when she falls in love with another nurse, she crosses an invisible boundary and her certainty in the system begins to crumble. With echoes of Kazuo Ishiguro and Margaret Atwood, this is the story of a world of rigid hierarchies and a love with its own rules.

Leseprobe

123

A SIMPLE INTERVENTION

Yael Inokai

Translated from the German by Marielle Sutherland

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CONTENTS

TITLE PAGEMARIANNE12345678910111213SARAH123456789101112MERET1234567891011121314151617ABOUT THE AUTHORSCOPYRIGHT

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A SIMPLE INTERVENTION6

7

October. A time for ghosts. I see myself in the mirror as a young woman again. Conviction in my eyes. Unclouded by doubt. I’m in my mid-twenties, and I understand the world.

Later, when I knew more, I longed to go back to that time. When my belief in my work protected me.

I was a nurse in a hospital pioneering new kinds of interventions. These interventions were meant to free people from psychological disorders and release them into a new future – a real future, not just a continued existence.

I hung on to this hope. After all, our work wasn’t exactly lacking in hopelessness. Often enough, there was nothing more we could do. Nothing more. Other nurses would never have put it like that. We were there right through to the end, of course, and beyond. But for me, this verdict tore open an abyss every time.

I was the one who assisted the doctor during the intervention. He navigated his instruments to the affected area of the brain and neutralized it. The patients were awake during the procedure. That’s how we made sure we didn’t damage any healthy tissue. I kept them occupied and took away their fear. I called this compassion. I told myself: I can do this because I have compassion. 8

It was a simple intervention. The after-effects could be painful, but they were only temporary. Then something new would begin. That’s what I was taught. And I clung to it.

9

MARIANNE10

11

1

The first impression of the day: rain on the window. Footsteps. The clatter of bikes being pulled off stands and loaded up before the first of us got on and rode off into the morning.

The nurses’ halls of residence were on the edge of town. The road on the right led down to the industrial estate. We always went left, past the terraced houses with their steeply pitched roofs, then through the wood until we got to the hospital. At the halfway point was a turn-off towards the town.

The house had its louder and quieter hours. But never silence. Sometimes a dream tore my night to shreds and I’d lie there in the dark, listening to the building. I’d hear the water rushing through the pipes behind the wall and think of the flat I’d grown up in, which for most of my childhood I’d believed was made of paper. I’d lie there listening to the others falling into their beds, each tired body ten times heavier than when awake, and I’d realize how much a bed has to support: bones and flesh and blood, and all a person has seen.

Just before the alarm clock went off, I’d fall back to sleep. Those few minutes always catapulted me far away, 12 and I’d need a few more to get back again. I would stretch my toes from under the blanket, then my fingers – the only part of me that wasn’t buried was my head. My shoes were never where I thought I’d put them. Each time, my feet found the cold floor. The shock struck my soles like lightning. Comeonnow,nodawdling.

Our room was furthest from the toilets. They were at the end of a long corridor, which was narrow and cold, with two windows opening straight out onto the courtyard. Every morning, I did my shivery little dance as I waited there in the queue to relieve myself.

A sour smell hovered over the washbasins. Arms were raised, armpits wiped with flannels. The stench of uneasy dreams, too, hung in the air, as poor souls tried to rub the sandy residue of sleep from their eyes.

I washed my hands and slapped cold water onto my cheeks, forehead and mouth. I drank, then spat out the night that always lay furred on my tongue.

After the bathroom ritual, I put on one of my dresses. I chose according to the weather. Their purpose was to get me from door to door. I was careless with them. Other people pointed out the tears, holes and stains.

Breakfast in the dining room was a brief affair. Five minutes were enough. Hardly any of us were hungry at that time of day. There were some, like me, who were conditioned to eat when food was there. They ate the porridge and apples impassively and were grateful for the weak coffee. There were those who devoured two or three portions, storing it up for later. There were also a few lively types who treated breakfast like a proper meal. 13No one left it untouched. A nurse with an empty stomach was no good to anyone.

Back in my room, the only thing left to do was put on my thin jacket. I closed the door behind me and joined the stream of nurses making their way down the steps, putting on their shoes at the bottom and heading towards their bikes. I reached straight for the familiar handlebars. We got on and set off. We said nothing. The bikes performed their own rattling concert.

I’d been working at the hospital for eight years. I couldn’t imagine any other world. Or any routine other than this, among nurses getting ready for their duties.

14

2

I was proud of who I was when I wore the uniform. I remember exactly how it felt in the hospital changing room, morning after morning: the starched, white material on my skin, fastening the buttons, pinning on the watch, putting on the cap. The person I became as I did so. The version of myself I liked most.

My ward was on the fifth floor. I’d completed most of my training there, and then I’d stayed.

Before the start of the shift, I washed my hands. They no longer flinched under the cold water. They’d got used to the constant washing. For the first few months, they were red and cracked, incessantly sore, screaming at me as I lay in bed at night trying to sleep. But the body can get used to just about anything.

Then came the handover. The night nurses tried not to let the past few hours show on their faces. They looked at me, and gave me nothing more than a room number. A few looked right through me, the abyss in their eyes.

Nothing but a room number. Someone had died. Every time, there was that disbelief at the back of my throat. 15

When I entered the rooms, they’d already been cleaned. In the beginning, it was my job to remove the traces of the deceased. I’d scrub death out of the room and restore order to the things left behind. Back then, each book, each photo evoked a feeling of nausea. I was glad when that passed.

Then I was put in charge of the suitcases. I had to deal with them before the millstones of my day ground into motion. Death was a matter for the night. Only rarely did anyone dare be the exception.

The suitcases were always waiting for me on the table. Everything the deceased had taken out on arrival had been packed up again. I undid the buckles and checked whether this had been done carefully. Then I closed the cases, pulled them down from the table and took them to the lost property room. We kept them there for six weeks. If no one claimed them, we gave them to charity.

Now and again, I noticed the cases had been collected. I saw women, men and children in the corridors. They sat on the benches with the open cases, their hands buried in jumpers and dresses, holding a book someone had been reading a few days before. At a loss, they rummaged through pictures, papers and perfume bottles. Perhaps they were amazed everything was still there. Or perhaps these people they thought they’d known so well had become mysteries once more.

Other suitcases were left behind. I didn’t want to, but I became good at guessing in advance which ones these would be. I put these suitcases on the shelf right at the back, so I didn’t have to see them every time I opened the door. I still hoped someone would come and take them, 16just as I hoped someone would come and sit in the empty chairs by the beds for a few minutes, hold out a hand and say hello. It’s no more difficult than breathing. And yet there’s nothing more difficult.

The older nurses said: Work with time. Time will be on your side. Not today, not tomorrow, but eventually, when you’ve been here long enough and you’ve lost count of the number of people you’ve cared for.

In principle, it was easy. Each of us was capable of putting it all behind us – the days, months and years filled with all the doubts they held for a young person. Eventually, the pull of time would be strong enough. All you had to do was keep going.

The nurses said: Get up every morning like you did the morning before. Eat, drink your coffee, get on your bike, ride to work, carry out your duties, and you’ll keep a level head. If you do things over and over again, you’ll get better at them, until the work is inside you. Just like your lungs are inside you. Just like your heart is inside you. That’s when you’ll stop fearing that something will affect you too much. You’ll start seeing the bigger picture instead of individual faces. Nausea? Don’t worry – it’ll pass.

One time, a suitcase dropped to the floor. Its owner had travelled a long way and she’d run out of strength over the last few metres. All I heard was the dull thud as it hit the floor, but I knew she’d be standing outside in the corridor, waiting for me.

One suitcase among thousands, with two books, two photos, a pen, a pencil, a passport, a dress, a cardigan, 17a nightdress, underwear, slippers, a brush, perfume, nail polish, a key and a pack of cards.

The older nurses said I should work with time. It would free me from such images.

Sarah never believed that. ‘I’ll never forget my patients’ faces. What makes you think time is on our side?’

18

3

There was a book. I’d opened it countless times to read it to my sister. ‘Once upon a time…’ The story of a vixen who fell asleep in the basket of a hot-air balloon and accidentally flew round the world.

As a child, Bibi wouldn’t have any other bedtime story, only ever this one. I could even use it to guide her back to bed when she was sleepwalking.

She was born five years after me, to everyone’s surprise. For a while, she shared a room with me and my older brother, Wilm – the flat had only two bedrooms, and one belonged indisputably to my parents. But one day, Wilm packed his things, announced he’d never survive growing up with two sisters at such close quarters, and moved into the kitchen. Every morning, he folded up his bed, and by day it served as a bench where all three of us sat to eat at the table. Bibi and I were only allowed to take a seat once he’d thrown the bedspread over it.

Bibi often visited him when she was sleepwalking. Wilm could tell the story of the vixen without so much as a glance at the book. Sometimes, half-asleep, I could hear him. First, the startled cry when our sister appeared by his 19bed in the middle of the night, her eyes vacant because she was somewhere else entirely. Then the words, his warm voice croaking occasionally.

When I moved out to start my training, Bibi slipped the tattered book into my suitcase when I wasn’t looking. I only found it a few weeks after I arrived at the nurses’ halls. The onset of winter called for a thick woolly cardigan. She’d wrapped the book inside. With a message on the first page: So you’ll find your way back to me.

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4

The woman and I were both twenty-five. I saw in her notes that our birthdays were only three days apart. I kept that in mind.

Her father was running late. So to begin with she stood by herself in the hallway, looking around. She wasn’t shaking, and there was no fear in her eyes. People can get the better of these things, but the body can’t be outwitted altogether. Hands become clammy, losing their grip on the luggage they’ve been clutching. And the suitcase betrays with a loud thud how much is packed inside. Never because its owner expects to be staying a long time. A heavy suitcase wants to bring the feeling of home, with all its superfluous knick-knacks, into a strange room, to make staying there just about bearable.

She arrived in the morning. I already had one intervention behind me. The patient was now drifting slowly, and without complications, out of anaesthetic stupor and back into her aching body. The doctor operated in the mornings – that was his favourite way to start the day. He also liked the nights, the emergencies. He didn’t grumble when he was called out to the hospital in the small hours. But 21he didn’t cope well in the afternoons. Those hours when the morning had grown weary and was listlessly awaiting the break of dusk. That’s when the doctor withdrew to his room and did his paperwork.

The woman had picked her suitcase back up off the floor. She was unmistakably an Ellerbach. Tall, with an upright posture and a face that could never have belonged to a poor person. This face went with money and a certain recognition in the world. A family of industrialists, known all over town. Their factories were on the industrial estate behind the nurses’ halls. They were also a family of philanthropists. This was at the heart of their work, something the father never tired of emphasizing in public. The company’s foundation funded school and library renovations and scholarships for gifted students. It turned private land into public parks. The Ellerbachs were inscribed on the town. Their names were on plaques all around it.

I thought about this when I saw the woman in the flesh for the first time. I knew her face from the newspaper. There were four of them, the Ellerbach children. Three brothers and her. She was the youngest. Her name was Marianne.

As I extended my hand towards her, she handed me her suitcase, not mistaking the gesture for a greeting, as others did.

‘Hello. Are you here to fetch me?’ At first, she didn’t look at me at all. She was still studying her surroundings. Her eyes followed two nurses walking past us. This gave me time to form a first impression and swallow my surprise at how little she stood out despite everything. ‘It’s a nice day, isn’t it?’ Her gaze lingered on a half-open door to a 22room. She tried to peer inside. ‘But it’s so… white in here. Doesn’t it bother you?’

She abandoned her reconnaissance and turned to me, looking straight at me for the first time. I too was tall. She hadn’t been expecting that. With others, she was always looking down at the tops of their heads, but she was eye level with me.

‘You’re tall,’ she observed, laughing so loudly that the two nurses in the corridor turned to look at us.

‘My name’s Meret,’ I said.

‘That suits you.’

There was a blue box. It was my toolbox for interventions of this kind. It was full of things to keep people occupied: books, pictures, puzzles, card games, matches, a flip book, a little concertina. Most of them had been left behind – I took them from the suitcases before they went to charity.

These things were for me too. They gave me something to hold on to. I felt confident when I took the blue box from the cupboard and brought it to my patients.

Choosing something for Marianne Ellerbach was easy. When she opened her case, I saw a pack of cards between the brush and the perfume. That’s how I knew she’d like the pack in the box. It was a particularly beautiful deck, with a delicate pattern.

‘I noticed our birthdays are only three days apart,’ I said. ‘You were born first, on September the twelfth, and then it was my turn, on the fifteenth.’

‘Really?’ She stopped arranging her things and, without the slightest hesitation, sat down on the bed, jiggling her 23feet from side to side. I realized she had so much freedom. Wherever she went, she could simply sit down. She never stopped to ask herself whether a space was meant for her.

We both looked over at the door, expecting her father and the doctor to come in. I knew so much about her, and she knew nothing at all about me. I knew about her episodes. There was a rage within her that could grow and grow until it detonated, battering everything around it with savage words, screaming and violence. This rage came on quickly. If you were anywhere in its vicinity, you rarely had enough time to get to safety. When it happened, her three brothers’ physical superiority was of no use to them. Marianne’s rage was bigger than they were.

I’d seen plenty of photos of the Ellerbach family in the local newspaper. The father surrounded by his three sons, his daughter and his wife – a fixed point of orientation for everything in the picture, even the furniture. Marianne was always standing beside the same brother, the youngest, one and a half years older than her. He looked astonishingly like his father.

In our family photos, Bibi was always standing beside Wilm. Always beside her big brother, who had his father’s hair, nose and mouth. But not his eyes.

While Marianne’s eyes wandered slowly around the room, I watched her. You couldn’t tell she had episodes. Certainly there was that loud laugh, and the restlessness in her limbs. And she was childlike. The way she stared so unashamedly at whatever she liked, anything or anyone, she could have been a good fifteen years younger. Apart 24from that, there was no sign of her disorder. But of course, the seemingly normal can take a turn. I knew that by now.

When her father came in, she didn’t stand up. ‘Morning,’ he said to his daughter. She returned his greeting with a dispassionate nod. She was probably the only person in the world who didn’t intuitively stand up when he entered the room. I myself took a step backwards – it was automatic.

She let him kiss her on the forehead. He placed his hand briefly on the back of her head and drew her towards him. ‘Now, now,’ he murmured. For a moment, maybe a second, he wasn’t an Ellerbach. He didn’t fill the entire room. He was just a father being affectionate towards his daughter. She carried on jiggling her feet from side to side, not a grown woman but a child surrendering to this affection.

When the doctor arrived, I was surprised to see that even he seemed paler next to the Ellerbachs. Like a photo whose colours had faded. He was usually impressive in his appearance. It wasn’t anything to do with physical attributes. The doctor was neither tall nor broad-shouldered, nor was his face in any way distinctive. But he knew who he was. And it was this certainty that won everyone over.

‘Good morning,’ said the doctor, and when the customary response didn’t come, he turned to me, indicated the file in my hand and instructed me to ‘Take notes, please.’ He might as well have said ‘Breathe, please.’

Marianne’s father had specifically asked that the doctor meet her on her own first, without his assistants. A special request for special patients. Made by anyone else, it would 25have been indignantly refused. But this time the doctor even sat down on a chair so he could be at eye level with his patient. ‘These episodes—’ he began.

‘That’s not me!’

He nodded, grateful for the interjection. ‘No, it’s not you. Of course not. Which is why I’d like to help you get rid of this rage. If you will allow me.’

She nodded hesitantly.

‘There’s something inside you, and I’m going to put it to sleep. It won’t bother you any more. And then it will sleep forever. It’s as simple as that.’

The doctor explained the procedure to her, leaving out any words that might cause her unnecessary anxiety. Her father had been given a different version. And the staff yet another. But what he was saying here was no less true. As simple as his explanation was, it was a delicate undertaking. Fear made things delicate.

The woman listened, cutting in to ask, ‘Will it hurt?’

‘No, it won’t hurt.’

For the first time since the others had come into the room, she sought my gaze. I nodded affirmatively. No pain. Pain came later. But we didn’t talk about that right then.

The doctor pivoted back to her episodes. He started with these and ended on these, so she wouldn’t forget how serious her disorder was, or even consider that she might be able to carry on living like this. ‘You have to think of your disorder as a flood tide,’ he said. ‘The sea ebbs, then it comes back again. Just as surely as it ebbs, it will come back again. The further it ebbs, the higher the water will rise when it comes back.’ He waited, trying to gauge from 26Marianne’s eyes whether the metaphor had had any effect. ‘Eventually, this flood tide will drag everything with it. It will leave us with no option but to treat it with medication, so we can protect you and your loved ones.’

He pulled out two photos from among his papers and showed them to her. A young woman, the same age as her. And the same woman, a little older, after the medication had done its damage.

Marianne gave the photos a perfunctory glance. They didn’t give her the intended fright. But she would think about them later, when the doubts grew within her, and with them the urge to get out of bed and leave.

‘It is important that you are awake during the procedure,’ the doctor said finally. He didn’t always broach the subject so cautiously. There’d been occasions when, pushed for time, he’d simply brought it up just before leaving the room and I was left to deal with it. But not in her case. She was given a precise, judicious introduction in carefully chosen words. ‘You’ll help us navigate. You’ll be present, but without pain and without fear. You’ll be there. Your eyes will be open—’

‘No,’ she said. Her voice started to crack. ‘I don’t want that. I want to sleep, and when I wake up, I want it all to be over.’

‘It’s like sleeping.’

‘So why can’t I sleep properly then?’

‘It’ll be quicker than going to the dentist’s,’ said her father.

You could always count on that: a relative trying to be helpful but sabotaging everything at the last minute. 27