The Ghosts of Altona (15 page)

‘Did they know each other before?’ asked Anna. ‘I mean, before moving into the home?’

‘I really don’t know for sure, but I certainly got that impression. They were both Altona born and bred. Maybe in the war . . .’ Pohl suddenly looked sad. ‘What will happen to Herr Schmidt now? Will you lock him up?’

‘Normally we would take him to the Presidium for questioning. But given his advanced age and his confused state of mind, we’ll transfer him to the secure psychiatric wing at Ochsenzoll instead. He’ll be clinically assessed there as to whether he’s mentally capable to be charged under the Penal Code, which, frankly, I doubt. I have to say it is a very strange and very sad case. Is there anything about your set-up here that could have been some kind of, well, trigger?’

‘This whole place is conceived and designed to remove as many triggers for distress as possible, Herr Fabel,’ said Pohl. ‘Dementia very often leads to confusion and fear. Any aggression stems from feeling isolated in a frighteningly unrecognizable environment. What we have here in the Alte Mühle is a bubble. At one time it was considered best clinical practice to force patients to engage with reality, with the here-and-now. But all that does is confuse and upset them. What we try to do here is to offer as natural and independent a life as we can. All of the shops and cafés you see here are run by members of the care staff, all of whom wear ordinary, day-to-day clothes. Patients go shopping, meet each other for coffee, have their hair done, have meals out. If, in his or her mind, a patient is unaware what decade it is, or if they believe they are somewhere other than the Alte Mühle, then we let them alone . . . so long as they’re happy that is. If their memories or confusion causes them distress, then of course we intervene.’

‘That’s all well and good,’ said Anna. ‘But what about when they start sticking knives in each other?’

‘We don’t accommodate aggressive or violent patients. We’re not geared up for that and never have been. Should a patient become aggressive towards staff or other residents, then, regretfully, we have to pass them on to a facility better equipped to deal with them.’ Pohl shook his head sadly. ‘But there was never any question of that with Herr Schmidt – he has always been an unfailingly pleasant and courteous resident. I can assure you, this has come as a complete shock to us all.’

25

‘Take these things off.’ Heiko Goedecke invested his tone with as much authority as he could muster. The young emergency physician in the Asklepios Klinik Nord often found it necessary to invest his tone with authority: he was small, slender and had a thick mop of dark hair that made him look a decade younger than his thirty-two years. This time, however, his decisive tone was as much to convince himself as anything: the truth was, unconscious and near to death as his patient was, Goedecke was tempted to leave the handcuffs in place.

He looked down at the unmoving figure on the trolley, its ankles and shoeless feet jutting out over the end. As a physician, Goedecke knew what he was looking at: a severe case of acromegaly and gigantism, probably the result of a pituitary gland tumour or disorder. The outward appearance had nothing to do, he told himself, with the character within. Except this character had been brought in handcuffed and heavily guarded.

But as a normal creature of instinct and despite his professional assessment, Goedecke felt he was in the presence of a monster, something less, or more, than human. The features on the huge, stone-hewn face were oversized, heavy and coarse; the brow was massive, the heavy supraorbital ridge like an overhang above the closed, small, sunken eyes. The jaw was huge too, as were the sharp, angled planes of his cheekbones. The oxygen mask sat unevenly on the bulky features, gaps all around it, as if someone had tried to force a child’s mask onto an adult face. It felt to Goedecke like he was looking at a living palaeontological specimen – some monstrous predecessor who had no place among modern men. He turned and saw his nurse also staring down at their patient, equal disquiet clear in her expression.

‘Take these off,’ he repeated. ‘Now.’

‘This is a very dangerous man,’ said the prison officer. Two had come in the ambulance and the other now stood guard at the door. ‘He’s handcuffed for good reason.’

‘This man is dying or close to it. He is no danger to anyone. I need to examine his chest without hindrance. If you don’t take the handcuffs off immediately and my patient dies because I can’t work on him, I will officially name you as a contributory factor in his death.’

The prison officer sighed, came over to the trolley and unfastened the handcuffs.

‘Thank you,’ said the young doctor. ‘A suspected heart attack, you say?’

The officer nodded. ‘About six this morning. He complained about not being able to breathe, and pains in his chest and arms. He was still conscious when we got to him but then he collapsed.’

The doctor and the nurse wired their patient to the monitors and the doctor listened for a heartbeat.

‘This doesn’t look like a heart attack to me. Although he’s enormously hypertensive and there’s serious arrhythmia and bradycardia.’

The prison officer shrugged.

‘It means his blood pressure is through the roof and his heart rate is incredibly slow and irregular. He’s going to go into arrest if we don’t give him the right treatment right away.’ Goedecke frowned. It was all consistent with the acromegaly: arrhythmia and cardiac failure were a common cause of death with sufferers; but Goedecke’s instincts as a doctor told him something didn’t quite fit. ‘Is there any way your prisoner could have had access to drugs like ketamine or xylazine?’

‘Not that I know of,’ said the prison officer. ‘It’s always possible, of course, but he’s in high security and his cell is turned over regularly.’ He nodded towards the prone giant on the trolley. ‘As soon as he starts to come to, we get the cuffs back on. Like I said, this is one very dangerous character.’

‘
If
he comes to, which is doubtful.’ The young emergency doctor turned to the nurse and had just started to give instructions when the alarm on the heart monitor started to sound.

‘He’s going V-fib . . .’ The doctor started compressions, his flattened hands child-small and slim on the huge barrel of Frankenstein’s chest. He frowned as he watched the fluttering trace of ventricular fibrillation on the monitor. His giant patient was within seconds of going asystole. And once he flatlined, there would be no getting him back. ‘Take over compressions . . .’

The nurse pushed down on the chest while the doctor charged the defibrillator. He set the charge to 200 joules.

‘I’m going to shock him, but I want you to keep compressions going between. If we don’t get him started on the second jolt, I want you to prepare three hundred milligrams of amiodarone and adrenalin. Clear!’

The nurse stood back. ‘Clear.’

The vast body barely twitched from the jolt of electricity. A spike on the monitor, a moment of normal sinus rhythm, then back to V-fib. Goedecke was losing him. He increased the level to 350 joules and held the paddles out from his body, waiting for the recharge whine to change to the ready signal.

‘Is he dead?’

Goedecke ignored the prison officer. ‘Clear.’

When the nurse acknowledged and stood back he reapplied the paddles to the huge chest. This time there was more movement as the electricity pulsed through the body. The stone-hewn face remained motionless. Goedecke experienced a moment of inappropriate black humour as he thought of the irony of a physician trying to bring a monster like this to life with jolts of electricity. Perhaps there was already an angry mob of torch-wielding villagers surrounding the hospital.

When he checked the monitor, he saw a moment of heart rate turbulence, then, after what seemed an age, the restoration of normal sinus rhythm. He told the nurse to set up an intravenous drip to start delivery of 500 milligrams of adrenalin as well as getting some beta-blockers into the patient’s system.

After a while of watching the monitor, Goedecke turned to the prison officer. ‘Once he’s stabilized, we’ll move him to intensive care. He’s not out of the woods yet. Far from it.’

‘When will he be able to be moved back to the prison hospital wing?’

‘Not for a while.’ Goedecke went over to the emergency room’s wall phone and called the intensive care unit.

*

There had been dreams. Such strange, dark, frightening, happy, wonderful dreams. He knew instinctively that he had been standing on the threshold that separated the living from the dead. He had turned back from that and now he stood on a second threshold, the one between light and dark, between the dreaming and the awake world. But for a moment he hung there
.

From somewhere above and distant, he watched himself. He saw himself as he had been as a boy: quiet, gentle, clever. He watched his twelve-year-old self, standing shirtless and patient, while his mother talked to the old doctor. He had always thought of him as the old doctor, his memory preserving the perspective of a twelve-year-old, but seeing him now, he realized the specialist could only have been in his early fifties. Jochen remembered this visit. He recognized the room. It had been back when he had still been normal, just. Before Jochen Hübner had become Frankenstein
.

But the signs had already started
.

At the time, Jochen hadn’t known why his mother had taken him to the doctor, a specialist in Barmbek, but he had guessed it was something to do with the way he had started to grow faster than the other boys. And he had noticed other changes. His voice had become deeper. Too deep. And his hands and feet had hurt him. They too had started to become too big, too quickly. He had been a clever boy, full of academic promise, but all young Jochen had wanted was to be a footballer, to maybe play for Sankt Pauli one day. But the school coach had told him that, while Jochen was clearly highly skilled, he simply lacked the on-pitch aggression of a winner. And anyway, he had started to become clumsy of late. Uncoordinated
.

He watched himself, the doctor, his mother. He knew he had something important to do in the awake world but, for the moment, he was content to watch as the doctor measured his younger self’s hands, his feet; the length of his legs. He knew he was watching ghosts: his mother had been dead for a long time and the doctor longer still. But it was nice to see his mother again. To hear her voice
.

And it was nice to see himself not a monster
.

The dream was gone. There was a light above him, white, hard and sharp. And with it came pain. In his chest, in his arms, in his head
.

He felt dizzy and sick and his heart started to race. Something beeped in harmony with his heartbeat
.

‘They will inject you with epinephrine – adrenalin,’ his guardian had told him. ‘To regulate your heart rate. It will also help you wake quickly and will make you stronger. You will feel a rush. That is when you have to wake. That’s when you have to escape. It all hangs on that.’

*

Goedecke waited on the phone until he was connected to the admissions office. He arranged for Hübner to be admitted to ICU and for two orderlies to come and assist with the transfer.

‘I want to get the handcuffs back on him,’ said the prison officer.

Goedecke shook his head. ‘There’s too much risk of him hurting himself. But we can use medical restraints that will do the same job without risk of injury.’ He turned to the nurse. ‘Can you dig up some secure restraints?’

When the nurse left the room, the prison officer moved closer to Goedecke.

‘There’s something you should know about your patient. Something that should go on his notes. He is a danger to women – well, he’s a danger to everyone, extremely and unpredictably violent. But the thing you have to be aware of is that he is very specifically a danger to women. An extreme danger. If he’s going to spend any time in the hospital we’ll need to notify the Polizei Hamburg. I’m sure they’ll want to put an armed guard on him to support the JVA prison officers.’

‘What did he do?’

‘You don’t want to know the details, but his victims will never get over what was done to them. Trust me, he looks like a monster for whatever medical reasons, but the fact is he doesn’t just look like a monster, he
is
a monster. What’s behind the appearance is much worse. We need him to be as secure as possible. In the meantime, we’ll go through to intensive care with him. I’ll go and tell my colleague.’

The prison officer went out into the hall.

Goedecke, suddenly alone with his unconscious patient, felt distinctly uneasy. He checked the monitor again. Heart rate normal. No arrhythmia. He frowned again. It was too good, too swift a recovery.

Goedecke leaned over to examine his patient, peeling back an eyelid to check pupil dilation.

Both eyes opened.

The young doctor found himself looking directly into the small, black eyes of his patient, glittering cold under the beetling brow. He turned to call the prison guard who was still out in the hall. Or at least he thought about turning to call the prison guard – the body on the trolley moved so fast that he caught Goedecke between decision and commission. Frankenstein’s arm shot out and up like a loosed harpoon, the vast hand fastening itself around his neck. The young doctor tried desperately to scream, to shout for help, but no sound came from the squeezed-shut throat.

Frankenstein swung his legs off the trolley and sat up, his hand still clamped around the boy doctor’s throat. First casting a look to the double doorway, he leaned the mass of his face into Goedecke’s, his small dark eyes locked on the young man’s.

‘This is your decision,’ he hissed, his voice quiet but still resonant. ‘This could be your time – the place and the time you die. Is that what you want?’

Goedecke tried to shake his head but could only manage tiny movements. His eyes pleaded for his life.

‘If you make a sound,’ said Frankenstein, ‘then I will snap your neck. I either leave here free, or everyone dies. Everyone.’