"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 unasked 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. Garcia, who was a good listener, and who raised a lot of unasked questions. Boy, was Dr. Garcia 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.")
But when it came to William Burns's obsessive-compulsive disorder, Dr. Krauer-Poppe had prescribed an antidepressant; the medication had had a calming effect. She'd tried two drugs, in fact, Zoloft and Seropram. Each one had its merits, both being selective serotonin reuptake inhibitors used to treat depression.
As for the side effects, Heather had said, their father had tolerated the dizziness, the dry mouth, the drowsiness, and the loss of appetite; the latter was the most persistent problem. (But William was so devoted to being thin that his loss of appetite probably thrilled him.) He'd complained about occasionally painful and prolonged erections, and there were certain "changes"--which Heather had not specified to Jack--in William's sexual interest and ability. But over time, William Burns appeared to have tolerated--or at least accepted--these side effects, too.
The drugs did not impair William's motor functions. His keyboard skills were unaffected by the antidepressants. The music he'd committed to memory remained intact, and he could sight-read music as quickly as ever.
Dr. Krauer-Poppe had worried that William's ability to concentrate might suffer, and he admitted to being more easily distracted; it took him longer to memorize new pieces, and he occasionally complained of fatigue, which was unusual for him. He was used to having more energy, he said; on the other hand, he was sleeping better.
Dr. Krauer-Poppe had also watched William closely for signs that prolonged administration of the drugs might make him feel indifferent or less emotional; this was sometimes referred to as "the poop-out syndrome," Dr. Krauer-Poppe said, but William had shown no such signs. According to Heather, their father was indifferent to nothing or no one--and he was, "regrettably," as emotional as ever.
Dr. Krauer-Poppe thought that, in William's case, the antidepressants had been successful. She noted that his sexual "changes" did not include impotence, another possible side effect; she called the drugs "an acceptable trade-off." (Dr. Krauer-Poppe was a woman at ease with hyphens, apparently. No one like her came to Jack's mind.)
Jack couldn't wait to meet these people, and he was relieved that he was meeting them first--that is, before he would see his father.
William Burns had been twenty-five when he met Jack's mom; he'd been twenty-six when Jack was born. At that age, how long would Jack have stayed married to anyone? And what if he'd fathered a child at twenty-six, when he and Emma were burning the candle at both ends in L.A.? What kind of dad would he have been?
Jack knew what Dr. Garcia's answer would be--her less-than-one-word response: "Hmm."
Jack checked into the Hotel zum Storchen on the Weinplatz. His room overlooked the Limmat, where he watched a tour boat drifting past the hotel's riverfront cafe. He was staying in the Old Town--cobblestoned streets, many of them for pedestrians only. The church bells seemed to ring every quarter hour, as if Zurich were obsessed with the passage of time. He shaved and dressed for dinner, although it was still only midafternoon.
In the taxi--at the airport, in Kloten--Jack had considered going directly to the Sanatorium Kilchberg, but his appointment with Professor Ritter and the others wasn't until late afternoon. He didn't want to risk running into his father before he'd met with the doctors. Although he wasn't expecting Jack, William would surely have recognized him.
Jack had questioned the clinic's decision not to tell his father that he was coming, but both Heather and the psychiatric team had thought it best if Jack's dad didn't know; if he knew, he would be too anxious.
Nor had Dr. Krauer-Poppe recommended upping William's dosage of the Zoloft or the Seropram, whether they told him about Jack or not. Even Dr. von Rohr had refrained from making her usual, on-the-other-hand argument; in fact, she said that giving William more antidepressants might make him near-catatonic or completely out of it for his son's first visit.
Dr. Horvath, the hearty Austrian and deputy medical director who often jogged with William, had told his patient to expect "a special visitor." Since it was too soon for more visiting time with his daughter, William was probably expecting someone from the world of music--a musician from out of town, a fellow organist making a guest appearance at a concert or playing in a church in Zurich. (Such distinguished vi
sitors occasionally came to Kilchberg to pay William Burns their respects.)
Jack had asked the concierge at the Storchen to recommend a restaurant within walking distance of the hotel. William would be allowed to have dinner with his son, although Professor Ritter or one (or more) of the doctors at the clinic would accompany him.
"Better make the reservation for three or four people," Heather had told Jack. "They won't want you to take him away from the sanatorium alone. And believe me, Jack, you wouldn't want to do that--not the first time, anyway."