May 15, 2011

Dear Cyndy,

Thank you for your letter. It's very quiet in Konnarock.  The only human being, aside from Margaret, whom I encounter with regularity is the friendly fat girl who presides over the garbage dump. She was on very good terms with Margrit, her mother helped my mother with the house work, and she thinks a car with Massachusetts license plates, reminding her of my parents, is something special. A striking contrast to Nantucket, where waste disposal occurs under the hostile gazes of a squadron of harpies who peer through the required transparent plastic bag to make sure I'm not cheating on the stringent recycling requirements.

With nothing going on in the real world except for the cordial garbage reception, I wouldn't have anything to write about, if I weren't endowed with the gift of gab, but lack of substance has never impeded my composition.  The imagination never sleeps and doesn't need the New York Tines to persuade it that the world is in a sorry state.

Two of my patients have been told that they have malignancies, unrelated to the eyes, so it's not missed diagnoses for which I might be blamed. One has been shown X-rays demonstrating numerous skeletal metastases and is consumed with anxiety about the pain with which she assumes these shadowy emblems of death are about to torture her. Another, a scientist, has been informed that he has chronic lymphocytic leukemia and understands that it is unpredictable whether he will succumb to the disease within a year or live with it in remission for another two decades and die of other causes, and can't quite cope with the uncertainty. What should I tell them?

It occurs to me that for each of the patients the disease which he or she experiences is nowadays defined by the physician. In a world without "modern medicine" the gradual loss of strength, the pain and weakness which one might feel would be received as inevitable concomitants of being alive and growing old. In a very real sense, it seems to me, it is the physician who makes the patient conscious of the illness as an identifiable disorder. The physician is the cause of the illness as an assault on the patient's integrity, because in the absence of his intrusion the symptoms would be interpreted by the patient as integral to his existence. In this perspective the presumption to know, the "diagnosis" which defines the illness as an "abnormality" contributes greatly to the patient's distress and to his loss. If true, then as a physician, I have much to answer for; arguably garbage collection would have been a more salubrious, a less destructive enterprise.

Caner Cetinkaya, the German physician who grew up in the apartment house in which I was born, has replied to my letter.  He tells me that his parents are immigrants from the Black Sea coast of Turkey who came to Germany in 1971 to find work.  Caner is one of four children, all born in Germany. An older brother is an architect in Hamburg, a sister is a teacher in Koeln, a younger brother is studying sociology in Berlin.  Caner wants to continue to correspondence with me, in part, he says, because he's never encountered anyone who so caresses (streichelt) the language. It's a strange world, Cyndy, and unpredictable.

A friend of Margrit's, a Berlin physician, now retired, named Margret Steinrueck began, subsequent to Margrit's death, exchanging letters with me. Most recently she wrote me about an automobile trip to Schulpforta in Sachsen-Anhalt, Germany's illustrious preparatory school, - its most famous alumnus: Nietzsche - where her father-in-law was a teacher and which was attended by her husband and all his brothers.  Schulpforta is but a few kilometers from the cathedral in Naumburg which Margret Steinrueck and her family also visited on this occasion. "Der Naumburger Dom" was much venerated by my parents for its impressive and unique late gothic statuary.  I don't know how many pilgimages my parents made to Naumburg, but on one of them, 1936 or 1937, they took me along, a trip that I didn't forget.  One of the books that miraculously survived the destruction of the family belongings and that was among my parents' dearest mementos in the fifty years they spent in Konnarock, was an impressive artbook "Der Naumburger Dom und seine Bildwerke" which since the death of my parents, I have kept at its place on the bookshelf in the back room.  When Margret Steinrueck reported her trip to Naumburg, I thought I would refresh my memory and take another look at the pictures. Instead I was distracted by discovering, next to the Naumburg tome, by a black folder in which was clamped a manuscript typed in German, a short story describing the life in Nazi Germany of a family recognizable as my own.  I looked in vain for an author's name; I couldn't remember having ever seen the story, not to speak of having written it myself. As I read page after page and found more and more corrections in my own handwriting, I could no longer deny responsibility. I must have written it when I was 17 or 18 years old, probably in college, and shown it, at the time, to my parents. I can't remember their ever commenting, but many emendations in my mother's handwriting attest to the astuteness of her literary judgment.

I'm saddled now with a memento which I can't ignore, embarrassed by the author's naivete, by the uncritical idealization, by the absence of irony, and by the obvious insecurity of vocabulary and syntax. Like discovering an ancient picture and asking myself: Did I really look like that? I've made a beginning of coming to terms with my adolescent self by scanning the 60 or so pages into the computer. I've started to type the pdf file into text, resisting the impulse to make corrections.  If it seems worthwhile, the rewriting can be done later, 

For the rest, I've been taking the advice of Elliot Perkins.  the master of Lowell House, who advised me, about the time that I might have been composing the rediscovered manuscript, that I should bridle my intellect, and start working with my hands.  That's exactly what I've been doing, putting the seven large rooms of this basement in order, and installing 9 additional light fixtures in the long dark hallway. Best of all: no inspector! No one's going to tell me to hire an electrician to have it all pulled out.

I haven't been giving much thought to Nantucket. We'll probably be there in July and August mimicking the tourists while, to flatter the wiring inspector I add the final frills to my installation.  With respect to the plumbing, I did have one possibly consequential insight. Mr. Gordon, as I may have written to you, told me: "In some respects your plumbing is more code compliant than ours." He never gave me specifics. But I have an idea: I suspect that one of the most objectionable facets of my work, what drives Mr. Ciarmataro up the wall, is that I disdained to try to conceal the waste pipes from the second floor bathrooms; they course through a ceiling corner of the first floor baths at a 45 degree angle. That's not impermissible. The plumbing code does not require concealment.  But the wealthy off-islanders who pay five or eight million dollars to have a house built for them in the Island, don't expect to see waste pipes exposed to view. The licensed plumbers, therefore, go to much trouble to conceal these pipes, but frequently they can't do so without violating the building code, and the building inspector, as a matter or policy let's them get away with it.

Here are the details: To conceal a 3" waste pipe from the room below, it must be placed within the ceiling joist cavity. Many if not most ceiling joists are of nominal 2x10 lumber, which means the actual depth is 9.25 inches. The building code specifies that the maximum permissible diameter of a hole in a ceiling joist is 1/3 of its depth, i.e. 3.083 inches. The smallest permissible waste pipe has an inside diameter of 3 inches; the outside diameter is 3.25 inches. One can't thread a 3.25 inch pipe through a 3.083 inch hole. As a matter of fact, one can't buy a bit to drill a 3.083 inch hole. I'd wager that all these liucensed code compliant Nantucket plumbers are drilling 4" diameter holes into 2x10 joists, thereby impermissibly weakening the structure. If given the chance, I'll try on deposition to elicit from Mr. Ciarmataro the admission that 4" hole in 2x10 joists is how we do things on Nantucket. The prospect of sworn testimony that dozens upon dozens of custom built Nantucket homes have been impermissibly weakened by excessive drilling of their floor joists will make a class-action lawyer drool at the mouth.  For the Appeals Court there's the argument that Mr. Ciarmataro is demanding that my code compliant plumbing be ripped out so that I can pay big money to a Nantucket plumber to make a non-compliant installation under Mr.  Ciarmataro's auspices, because that's how we do it on Nantucket.

Enough for tonight. Stay well. Don't let any doctors infect your thoughts with diagnostic fantasies, and give my best to Ned.

Jochen

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