“There was hardly any traffic…”
“Why are you so anxious to be on time?”
“Pallenberg wants me to take notes. He's examining a new patient-a rare example of Cotard's syndrome.”
“Le delire de negation.”
“You know of it?”
“I read Cotard's Maladies Cerebrales et Mentales when I was a student.”
“Sometimes, Maxim, you can be very irritating.” The waiter arrived with Kanner's coffee and a small glass of water on a silver tray. “The patient is a fifty-six-year-old shop owner,” Kanner continued, adopting the clipped style of a case presentation. “A few years ago he began to complain of feeling like death. His wife arranged for him to stay in a sanitorium-Bellevue, I think-which made him feel better, but after returning to Vienna, he became very depressed. He has since been under the care of a general physician. Recently he caused his wife and children considerable alarm when he claimed that he not only felt like death but actually was dead. A few days ago he requested burial.”
“I believe that when the Cotard delusion reaches its apotheosis, the patient not only denies his own existence but that of the entire universe.”
“It will be interesting to see how Professor Pallenberg deals with such a challenging patient. I wonder what treatment the old boy will favor?”
“Morphine and chloral hydrate. Like he always does. I fear that Professor Pallenberg has yet to learn that a sleeping patient is not necessarily a cured patient.”
Kanner laughed, throwing back his head to reveal the pink-ribbed roof of his mouth.
Liebermann peered over the rim of his coffee cup at the bustling street outside. Among the many pedestrians, he observed a young woman. She was wearing a simple gray pillbox hat, which rested on a cushion of fiery red hair. Her coat was olive green, with black velvet trimmings. She was walking quite fast, and passed out of view almost immediately.
“Excuse me, Stefan,” said Liebermann, quickly rising.
“What is it?”
“I'll be back in a moment.”
He rushed to the door and, leaving the coffeehouse, ran a few steps.
“Miss Lydgate!” he called.
The young woman turned. Her face was pale and her expression intense. She did not smile, but a subtle change in her features suggested pleasure.
“Doctor Liebermann.”
“I was in the coffeehouse and saw you passing by.”
“I am on my way to the Anatomical Institute.”
“For a class?”
“Yes.” Her German was perfect, but modulated with a slight English accent.
“Is everything well?”
Miss Lydgate hesitated, then replied, “I believe so.” But the hesitation was enough to raise a splinter of concern in Liebermann's mind.
“Are you quite sure?” he asked solicitously.
A characteristic furrow appeared on Miss Lydgate's brow. “Actually, Doctor Liebermann, a certain matter has arisen-it is of no great consequence, and I am reluctant to trouble you-but… I would very much value your opinion.”
“Is it a matter connected with your studies?”
Miss Lydgate paused again before saying hesitantly, “In a manner of speaking.”
“Then, I am at your service.”
“Could we meet for tea, perhaps-later in the week?”
“Yes, of course.”
“Thank you. I well send a note.” With this, Miss Lydgate turned and walked away. For a few seconds, Liebermann stood in the middle of the sidewalk, watching the receding back of Miss Lydgate's olive-green coat until it disappeared behind a group of students and medical men.
“Where have you been?” asked Kanner when Liebermann returned.
“I saw Miss Lydgate,” said Liebermann. “You remember Miss Lydgate?”
“Of course. How is she?” asked Kanner.
“Very well,” Liebermann replied before adding more cautiously, “as far as I know.” He sipped his coffee, which was now a little too cold to be palatable. “She is studying medicine now.”
“Really?”
“Yes, she was accepted with a recommendation from Landsteinerwho, incidentally, has also agreed to supervise her thesis on blood diseases.”
“Remarkable,” said Kanner. “Considering…”
“Yes,” said Liebermann, slightly discomfited by the implications of Kanner's unfinished sentence. Liebermann had become very fond of Miss Lydgate and did not like to think of her as a former patient. “She is an extraordinary woman,” he continued. “Her grandfather was a physician to the British royal household, you know, and something of a savant-I believe she must have inherited some of his gifts…”
The door of the little coffeehouse creaked open and a large man with a ponderous gait made his way to a shadowy recess at the rear. The two doctors watched him with the same kind of muted and detached pleasure that might accompany observation of a great sea vessel arriving at its berth. There was something utterly engaging about the man's stately progress. After he had settled, Liebermann's and Kanner's gazes met-each of them was a little embarrassed but also amused that the other had been equally distracted.
“So,” said Kanner, rousing himself from his state of abstraction. “You must be very excited.”
“Why do you say that?” Liebermann's response sounded a little strained-almost querulous.
“Your wedding!” said Kanner. “When is it to be? Have you decided yet?”
Liebermann's fingers worried the edge of the table. “Clara would like us to get married in January.” His voice was curiously flat. “However, I think that perhaps it would be better if we waited until the spring. My situation could be better-and the weather will be more clement, should we decide to travel.”
“Well, Max,” said Kanner, “among your many admirable qualities, self-restraint must rank very highly.”
Liebermann scrutinized the dregs in the bottom of his coffee cup. When he looked up, he did not respond, and his fidgeting fingers conveyed a certain unease.
Kanner's smile faded and he leaned closer to his friend.
“What is it, Max?” His voice softened. “You seem preoccupied.”
Liebermann waved his hand in the air. “It's nothing, Stefan-I'm tired, that's all. I'm not sure these early- morning fencing lessons are such a good idea.”
7
The walls were draped with brightly colored tapestries depicting a fairy tale world of Gothic castles and jousting knights. In the flickering torchlight certain characters became more vivid: a group of gossiping ladies wearing high wimples, two huntsmen and their hounds, a lovelorn page contemplating a volume of poetry. Others faded into shadow. One of the hangings was sinuously undulating in the thermals rising from a nearby stove. Even so, the air was cold and smelled faintly of damp earth. There were no windows, and a low vaulted brick ceiling made the cellar overwhelmingly oppressive.
Pews, arranged in the shape of a horseshoe, faced a wooden throne that had been placed on a small dais. The throne was carved from oak and possessed heavy volute arms. The backrest tapered like a bishop's miter, and close to its top the runic character known as “Ur” (resembling the Greek capital pi) had been crudely carved within a raised circle. Behind the throne, purple curtains suggested holiness and majesty.
Gustav von Triebenbach had aged beyond the middle years of life, but he was still spry and stood head and
