Chapter 1
The double buzz of the telephone startled Doktor Heimann out of his early-morning fog, and he swore as he nearly overturned his coffee cup – badly needed coffee – while reaching for the phone. The display on his phone said it was the security chief, and he frowned in confusion. Security?
"Ja, hier ist Heimann. Was geht's?"
"Herr Doktor Heimann, guten Morgen, here is Security Chief Dreist. This is, well, very strange. But one of our security guards has just come back from his rounds with someone he found in the garage. Older guy, he seems conscious but in bad shape. Can you send someone down to the Notaufnahme to look at him?"
"Found him? In the garage? Was he near – ach, never mind, it does not matter." Heimann looked at the piles of paper scattered across his desk, and thought. Personnel reviews, student scheduling, preparation for next week's budget meeting… none of it was essential, and it had been too long since he had had his hands on an interesting case. Might this be it? "I will come down myself. Bis gleich!"
In the emergency department, Heimann stood outside the small room where his possible patient had been put. The man looked like he was in his 60s, moderate height, maybe a little below average, but very low body weight. Hair looked a mix of brown and grey, but it was long and matted, as was his beard. Sitting upright, but eyes closed; the man's back was straight but was he leaning slightly to the side? Odd. Clothes, hmmm… clothes were dirty, ill-fitting and looked ill-constructed, or else they'd been worn until they were falling apart. Frankly, Heimann thought to himself, he looked like a rough sleeper who had wandered into the parking garage. Why had Dreist bothered him with this? Well, he was here, the "patient" was here, he might as well take a look.
"Also, Schwester, what do we have here?" He continued to watch the man sitting on the gurney and spoke to the nurse standing on the far side of the gurney.
"Morgen, Doktor Heimann! I do not know. One of the guards found him in the garage and brought him here. I have asked him his name, and where he's from, but he did not answer. In fact, he does not do anything on his own, he has to be led. I wonder if he is an abandoned Opa?"
"Hmmmm." Heimann watched the man for a few more seconds. Still sitting straight-backed, no apparent awareness of the people speaking about him, or anything else really. "Well, even if we cannot take a history we can do an examination. Let us begin!"
Three hours later, Heimann sat down heavily in his desk chair, hands full of the stranger's medical findings and the record that he and Krankenschester Strauss had made during the exam. The stranger was covered in scars, some of which almost looked to Heimann's eyes like bullet wounds. His first years in emergency medicine had been with the German army in Afghanistan, and he'd seen a lot of bullet wounds. In fact, he realized as he scanned the notes he'd taken, he'd seen a lot of wounds like those on their unbekannt, and not just the apparent bullet wounds.
Scars on the back, abdomen, all extremities, even on the hands, and it almost looked like the hands had taken the worst damage. In fact, it looked like the hands had been badly hurt, then repaired by cosmetic surgery, and then hurt again. How very strange! There were no bruises or sores that suggested this was an abuse case, an elder dumped by someone who could no longer care for him and didn't care what happened.
Heart rate low with a murmur, but the lungs were worst. He held a chest X-ray up to the light coming through his window, and shook his head. Unless he missed his guess, Herr Unbekannt had tuberculosis. Maybe not active, not right now, but definitely there. Well, they had him in the right ward, and had started him on the right meds, so unless it was drug-resistant TB, they'd do what they could for him.
What was strangest about this patient was his complete… absence. As Schwester Strauss had said, he went where he was led, he complied when he was tugged or prodded, but without that direction he didn't do a thing. When he was moving, his eyes were open, but they were empty, no one home. He showed no awareness of being spoken to, but the clatter when Strauss had dropped a basin had provoked a start, so he wasn't deaf. He had put up with everything they had done to him – undressing, a bath, shaving his head and face, the X-rays, blood work, dental exam, everything – almost as if he was sedated, or not even human but a particularly patient steer. The only similar cases Heimann had ever seen were cases of severe dementia, and it was possible that this was similar, but he didn't think so.
He pulled out the rest of the X-rays, and pushed himself up to look at them on the lightbox. Mein gott, he thought. The hands have been damaged indeed, have all the bones in both hands been broken? All the long bones as well, multiple rib fractures, one collar bone, but they were all healed. He leaned closer to the lightbox, and peered. These on the right arm were newer fractures, maybe a year or two by the amount of healing, but they had not been well tended. What on earth had happened to this poor soul?
Sitting down again, he scanned the lab results. Dehydrated and anemic, no surprise there. Electrolytes all quite low, urea up, hmmm, were the kidneys going to be a problem? Liver enzymes up, not a good sign. Maybe write an order for a liver ultrasound tomorrow, make sure there was nothing going wrong there. The rest of the labwork showed nothing new, just a maltreated older man with lots of things going wrong. Well, he'd written orders for intravenous feeding and medications that should help to stabilize things, and they'd see how the patient looked the next day. With a sigh, he set the file for "Unbekannt, männlich" aside, and forced himself to go back to the budget.
The next morning, he passed through the ward to see how Unbekannt had done since his admission, and was scanning the chart and half-listening to the 24-hour news channel that had been set on the TV, when one of the nurses came into the room.
"Guten Morgen, Krankenswchester Schmidt, how are you?"
"Ja, danke, Herr Doktor Heimann. And our patient is well, too. Although I am a bit worried about his urine, it is very dark." She held up the collection bag, and Heimann saw she was right. It wasn't as dark as even a weak tea, but clearly they needed to get more fluids in and hope the kidneys were not too bad.
He gently tugged his patient upright – again that very upright posture, odd in someone so non-responsive – and began his examination. As he tipped Unbekannt's face up to check the reactivity of his pupils, the TV began playing a piece about next week's visit by the US President to Berlin, with a clip of the President speaking before it was overridden by the translation into German. If he hadn't been right in front of the patient, he wouldn't have noticed, and he still wasn't sure, but he thought he'd actually seen a reaction. Hmmm, interesting.
"Schwester Schmidt, does our TV network carry the BBC?"
"Yes, I believe so, Doktor. Just one moment." She picked up the remote and clicked, soon bringing up the British channel.
Yes, there had been a reaction! Pupils constricted a bit, some of the muscles in the face contracted, their patient was definitely paying attention to the TV now. Not looking at it, but aware of it in a way he'd not been aware of anything or anyone so far.
"Hello, friend, do you speak English?" No response, but definitely more of an awareness than there had been before. "Schwester, please leave the TV on the BBC for our friend here, I think English is his mother tongue and it might be helpful for him. Otherwise, continue the fluids, and let me know if anything changes."
Back in his cluttered office, Heimann filled his coffee cup, then dug his Rolodex out from under yet another avalanche of paper. D, E, F, yes, there it was, Colonel Franklin, an American doctor he'd met in Afghanistan and kept in touch with. The last time they'd talked, only a month ago, Franklin had just rotated back to Landstuhl Regional Medical Center. While there were English-speaking doctors closer, in fact there were plenty here in Berlin, he trusted the Army medic far more than anyone else. And if some of those scars were bullet wounds… Picking up the handset, he punched in the numbers that would connect him.
"LRMC, Assistant Director Franklin's office, how may I help you?"
"Yes, guten Morgen, here is Doktor Franz-Josef Heimann at Berlin Sankte Teresa Hospital, is Doktor Franklin available, please?"
"Franz-Josef, wie geht's dir? Sorry, my corporal stepped away so I'm answering my own phone. What can I do for you?"
"Hello, Mike, I hope you can help me. We have a mystery patient here, my staff and I thought he was a case of elder abuse at first, but it is not. He has a lot of old bullet wounds, and he seems to be an English speaker. I wonder if you could help me sort it out?"
"Huh. English speaker? Do you think he's a Brit, or one of mine? Or is he Canadian? And what made you think that?"
"Well, it's a small thing, but he is completely non-responsive. Except that when he heard English being spoken, there was something there. Not a lot, but there was, what do you say, there was someone home. As for British or American or Canadian, well, was weiss ich, hein?"
"True enough, it's hard enough for us to tell the difference sometimes! I'd actually meant to give you a call, I'm headed up to Berlin in a couple days and I thought I'd stop by. Shall we set up a time and we'll have a look at your patient?"
They agreed a time, and Heimann hung up the phone with another sigh. Hopefully Franklin would at least have some ideas for him on how to find out more about this unknown patient.
Author's Notes: Sorry, this is a slow burn. Also sorry, things get worse before they get better.