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IN 1967, one of the indefatigable nursing sisters in the Hermann Pavilion on the Baumgartnerhohe placed on my bed a copy of my newly published book Gargoyles, which I had written a year earlier at 6o rue de la Croix in Brussels, but I had not the strength to pick it up, having just come round from a general anesthesia lasting several hours, during which the doctors had cut open my neck and removed a fist-sized tumor from my thorax. As I recall, it was at the time of the Six-Day War, and after undergoing a strenuous course of cortisone treatment, I developed a moonlike face, just as the doctors had intended. During the ward round they would comment on my moon face in their witty fashion, which made even me laugh, although they had told me themselves that I had only weeks, or at best months, to live. In the Hermann Pavilion there were only seven rooms on the ground floor, accommodating thirteen or fourteen patients who had nothing to look forward to but death. They would shuffle up and down the corridor in their hospital dressing gowns, then one day disappear for ever. Once a week the great Professor Salzer, the foremost authority on pulmonary surgery, would appear in the Hermann Pavilion, always wearing white gloves and walking with an enormously imposing gait, while a bevy of nursing sisters flitted almost noiselessly around him as they escorted him, a very tall and very elegant figure, to the operating theater. This famous Professor Salzer, whom the private patients had to perform their operations, staking everything on his reputation (though I had had mine performed by the senior ward surgeon, a stocky farmer's son from the Waldviertel), was an uncle of my friend Paul, the nephew of the philosopher whose Tractatus Logico-pizilosophicus is now known to the whole of the scholarly world, to say nothing of the pseudoscholarly world. At the very time when I was lying in the Hermann Pavilion, my friend Paul was some two hundred yards away in the Ludwig Pavilion, though this, unlike the Hermann Pavilion, did not belong to the pulmonary department, and hence to the so-called Baumgartnerhohe, but belonged to the mental institution Am Steinhof. Male Christian names are given to all the pavilions on the Wilhelminenberg, which occupies a vast area in the west of Vienna and has for decades been divided into two parts—a smaller part, reserved for chest patients and called the Baumgartnerhohe for short (this was my territory), and a larger one, occupied by mental patients and known as Am Steinhof. It seemed grotesque that my friend Paul should be in the Ludwig Pavilion of all places. Whenever I saw Professor Salzer striding purposefully toward the operating theater, with never a glance to left or right, I could not help recalling how, time and again, my friend Paul had described his uncle alternately as a genius and a murderer, and every time I saw the Professor entering or emerging from the operating theater, I wondered whether I was seeing a genius or a murderer entering, a murderer or a genius emerging. This man's medical fame exercised a great fascination over me. Before my stay in the Hermann Pavilion, which is still devoted to lung surgery and specializes above all in lung cancer surgery, I had already seen many doctors and made a habit of studying these doctors, but from the moment when I first saw Professor Salzer, he put all the others in the shade. He was magnificent in every way, and this magnificence I found utterly unfathomable. His persona seemed to consist partly of the man I saw and at the same time admired, and partly of the rumors I had heard about him. According to my friend Paul, Professor Salzer had for rnany years been able to work miracles: patients who had apparently no chance of survival had gone on living for decades after he had operated on them, while others, so Paul told me time and again, had died as the result of a sudden unforeseen change in the weather under a knife grown nervous. Be that as it may, although Professor Salzer really was a world authority, and at the same time my friend's uncle, I did not let him operate on me, precisely because he exercised such a tremendous fascination over me and because his absolutely universal fame filled me with abject terror and made me decide, ultimately because of what I had heard from my friend Paul about his uncle Salzer, in favor of the worthy senior surgeon from the Waldviertel and against the great authority from Vienna's First District. During my first few weeks in the Hermann Pavilion, moreover, I had repeatedly observed that Professor Salzer's patients were the ones who did not survive their operations; his world fame was doubtless going through a bad patch, and this made me suddenly afraid of him. I therefore opted for the senior surgeon from the Waidviertel—which, as I now see, was undoubtedly a fortunate choice. But such speculations are pointless. While I myself saw Professor Salzer at least once a week, though at first only through the crack of the door, my friend Paul, who was after all his nephew, never saw him once during all the months he spent in the Ludwig Pavilion, although Professor Salzer certainly knew of his nephew's presence and it would have been the easiest thing in the world, as I thought at the time, for him to walk the few yards from the Hermann Pavilion to the Ludwig Pavilion. I do not know what reasons he had for not visiting Paul; perhaps they were weighty reasons, or perhaps he simply found it too much trouble to visit his nephew, who had frequently been a patient in the Ludwig Pavilion, whereas this was my first visit to the Hermann Pavilion. In the last twenty years of his life, my friend had to be admitted to the mental asylum Am Steinhof at least twice a year, always at short notice and always under the most terrible circumstances, or, if he was staying in Upper Austria when he was overtaken by one of his attacks, which grew more and more frequent as the years passed, he would be taken into the Wagner-Jauregg Hospital, near Linz. He had been born and brought up in Upper Austria, near the Traunsee, where he had right of domicile in an old farmhouse that had always belonged to the Wittgenstein family. His mental disease, which ought properly to be termed a so-called mental disease, manifested itself very early, when he was about thirty-five. He himself did not talk about it much, but putting together all I know about my friend, it is not difficult to form some idea of its genesis. Even as a child Paul had a predisposition to this so-called mental disease, which has never been precisely classified, having been born mentally sick, already suffering from the so-called mental disease that was to afflict him all his life. Until the day he died, he lived with this so-called mental disease just as naturally as others live without it. It furnished the most depressing evidence of the helplessness of the medical practitioners and of medical science in general. This medical helplessness of the doctors and their science led time and again to the wildest designations for Paul's so-called mental disease, though naturally never to the correct one; all these designations for my friend's so-called mental disease repcated1y proved incorrect, not to say absurd, canceling one another out in the most depressing and disgraceful fashion. The so-called psychiatric specialists gave my friend's illness first this name and then that, without having the courage to admit that there was no correct name for this disease, or indeed for any other, but only incorrect and misleading names; like all other doctors, they made life easy for themselves—and in the end murderously easy—by continually giving incorrect names to diseases. At every end and turn they would use the term manic or depressive, and they were always wrong. At every end and turn they would take refuge (like all doctors!) in yet another scientific term, in order to cover themselves, to protect themselves (though not the patient). Like all other doctors, those who treated Paul continually entrenched themselves behind Latin terms, which in due course they built up into an insuperable and impenetrable fortification between themselves and the patient, as their predecessors had done for centuries, solely in order to conceal their incompetence and cloak their charlatanry. From the very start of their treatment, which is known to employ the most inhuman, murderous, and deadly methods, Latin is set up as an invisible but uniquely impenetrable wall between themselves and their victims. Of all medical practitioners, psychiatrists are the most incompetent, having a closer affinity to the sex killer than to their science. All my life I have dreaded nothing so much as falling into the hands of psychiatrists, beside whom all other doctors, disastrous though they may be, are far less dangerous, for in our present-day society psychiatrists are a law unto themselves and enjoy total immunity, and after studying the methods they practiced quite unscrupulously on my friend Paul for so many years, my fear became yet more intense. Psychiatrists are the real demons of our age, going about their business with impunity and constrained by neither law nor conscience. At last I was able to get up and walk to the window, then to go into the corridor and join all the other death candidates who were still mobile in walking to the far end of the pavilion and back, and one day, when I was at last able to leave its confines, I tried to reach the Ludwig Pavilion. I had seriously overrated my strength, however, and had to give up before reaching the Ernst Pavilion. I had to sit down on a seat that was screwed into the wall in order to calm myself before I could walk back to the Hermann Pavilion unaided. When patients have lain in bed for weeks or even months and are at last able to get up, they completely overrate their strength. They simply try to do too much, and such foolishness can easily set their recovery back by several weeks; indeed many patients, by engaging in such sudden activity, have managed to bring about the death that they initially evaded through an operation. Though I am a practiced patient and have had to live with more or less serious diseases all my life—including extremely serious and so-called incurable diseases—I have often relapsed into a casual attitude to disease and been guilty of unpardonable stupidity. The proper way for a sick person to proceed is to start by taking just a few steps, four or five, then ten or eleven, then thirteen or fourteen, and finally twenty or thirty—not to get straight up and go straight out, which can often be fatal. But when a patient is confined to bed for months on end, he is longing to get out; he cannot wait for the moment when he will be able to leave the sickroom, and naturally he is not content to walk just a few paces into the corridor: he has to go out and kill himself. Many patients die through going out too soon, not through any failure of the medical art. Doctors can be blamed for many things, but however indolent they are, however lacking in conscience or even intelligence, basically all they want to do is to improve their patient's condition. But the patient has to play his part too; he must not sabotage the doctors' efforts by getting up too soon (or too late!) or by going out too soon and too far. On this occasion I had gone much too far: even the Ernst Pavilion was too far—I should have turned back when I got to the Franz Pavilion. But I was determined to see my friend. I sat on the seat outside the Ernst Pavilion, exhausted and completely out of breath, and gazed through the trees toward the Ludwig Pavilion. Being a chest patient and not a mental patient, I thought, I probably wouldn't have been allowed into the Ludwig Pavilion anyway. It was strictly forbidden for the chest patients to leave their compound and visit that of the mental patients, and vice versa. It is true that there were high fences separating the two areas, but these were in places so rusty as to be no longer secure; there were big gaps everywhere, through which it was possible at least to crawl from one area to the other, and I recall that every day there would be mental patients in the chest patients' area and chest patients in the mental patients' area, though when I made my first attempt to get from the Herrnann Pavilion to the Ludwig Pavilion I did not know about this daily traffic. Later I became familiar with the sight of mental patients in the chest patients' area and saw with my own eyes how they had to be rounded up by the attendants in the evening, put into straitjackets, and driven back into their own area with rubber truncheons, uttering pitiful screams which pursued me into my nightly dreams. It was of course mere curiosity that prompted the chest patients to leave their own area and go across to see the mental patients, hoping for something sensational that would break up the appalling daily routine of deadly boredom and recurrent thoughts of death. And it was no vain hope. I was never disappointed when I left the pulmonary department to visit the mental patients, who, wherever they were to be seen, would be up to their curious antics. One day I may venture upon a separate account of the conditions I witnessed in the mental department. Sitting on the seat outside the Ernst Pavilion, I reflected that it would now be a whole week before I could make a second attempt to reach the Ludwig Pavilion, for it was clear that today I could do no more than return to the Hermann Pavilion. I sat on the seat and watched the squirrels scurrying to and fro and up and down the trees in what seemed, from where I was sitting, like an endless park. They appeared to have one consuming passion—to snatch up the paper tissues that the chest patients had dropped all over the ground and race up into the trees with them. They ran in all directions and from all directions, carrying paper tissues in their mouths, until in the gathering dusk all one could see were the paper tissues, a multitude of white dots darting hither and thither. I sat there enjoying the sight and naturally linking it with the thoughts that it seemed to conjure up automatically. It was June, and the windows of the Ernst Pavilion were open, and from these windows a rhythmical composition of rare device, a brilliant counterpoint of coughing performed by the inmates, was borne upon the evening air. . . .Excerpted from Wittgenstein's Nephew by Thomas Bernhard Copyright © 1982 by Suhrkamp Verlag; translation copyright © 1988 by Alfred A. Knopf, Inc.. Excerpted by permission of Vintage, a division of Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.