Fresh Meat: The Russian Donation by Christoph Spielberg

The Russian Donation by Christoph Spielberg, Dr. Felix Hoffmann’s first case, won the 2002 Friedrich Glauser Prize for best first German-language crime novel (available in English January 22, 2013).

Why would a reasonably happy, successful doctor be compelled to investigate the unremarkable death of a former indigent patient? Good question, but in The Russian Donation, that’s just what Dr. Felix Hoffmann does. We learn about his nature quickly when he refers to himself as “a Don Quixote in scrubs.” But fortunately there’s a championship soccer game on TV and a quiet night is anticipated—at least until after the game.

That changes when a patient arrives in the ER and Felix decides to take a quick look at him before sending the paramedics and doctor on ambulance duty through to ICU. What he finds is a man with advanced jaundice probably due to liver failure or other fatal problems and a nagging thought that he knows the patient.

Like hospitals everywhere, there’s paperwork involved and Felix rightly supposes the men bringing in the body connected to life-saving devices were looking to pass that on to him. Still, when he checks on the autopsy the next day, he discovers new paperwork and the body gone to the funeral home with no autopsy performed. Thus the mystery begins and the rest of it is a series of events that keeps Felix from letting go of his questions.

One thing is obvious with Felix—he cares about his patients. Even the patients he deals with after beginning his investigation are a concern, not a burden. In one scene, he goes through and just talks with patients without dealing with the medical issues, and he’s humbled by their perseverance and acceptance of what’s happening in their lives.

I found the pace of the novel a bit like a doctor looking for a diagnosis. He consults with others (including his brilliant mathematician girlfriend who’s a bit more adventurous than Felix) and he keeps coming up with more questions. It’s an interesting mix of learning the daily workings of a hospital and delving into the things patients never think about and probably shouldn’t know.

Christoph Spielberg is an award-winning author (the Agatha-Christie-Krimipreis for German crime writing) who lives in Berlin, where The Russian Donation is set. He’s also a cardiologist, which means what he writes has credibility and substance. He’s still a practicing physician though he continues to write novels and short stories. This character is the basis of a series of books that have been picked up for TV movies by German ZDF television.

While I enjoyed the book immensely, I found myself wishing he’d pick the pace up occasionally. I never wanted to put it down, but I did want to move along a little faster. However, I found the ending of the book very satisfying and completely plausible considering the events that led up to the finale.

This is the scene in which Felix’s questionable patient arrives at the ER:

“What have you got for us, Schreiber?” I asked in a deliberately casual tone, every inch the experienced attending physician who doesn’t ever lose his cool. After all, the guy on the stretcher wasn’t my patient.

“Give us the key, Hoffmann! Whaddya want? The man’s being ventilated, needs a jug full of catecholamine and has a pacemaker. Do you guys really want to take care of him down here?”

Pretty sassy for a doctor who was just a month into his second year of residency, but I could tell that Schreiber was pretty stressed and releasing a jug of catecholamine into his own system right then. He was also clearly proud that he’d done the All-Round Worry-Free Package all on his own. He knew he could expect some praise for that.

“Well done, Schreiber. Now let me take a peek.”

However, I could see only the patient’s face and upper body; the rest of him was buried beneath a tangle of high-tech medical paraphernalia. The patient’s pupils rested motionless in deep yellow eyeballs, and his upper body reminded me of a map, with large patches of dark bluish-red oceans forming around dirty yellow continents on the chest and shoulders. It was a case of advanced jaundice with massive hemorrhaging below the skin, probably the result of a total collapse of liver function—an extremely bad prognosis. A feast for the ICU and one that was almost certain to have a fatal outcome. Despite his color, the face looked familiar.

“You’re right, Schreiber. Doesn’t look good.” I glanced at the screen.  “Have you looked at the ECG monitor recently?”

The ECG monitor was blinking and peeping away rhythmically, which was a reassuring sound as long as you didn’t look at the monitor. There it became clear that the cable from the pacemaker Schreiber had installed was giving the patient’s heart a slight, well-meant jolt of electricity sixty times a minute. Patients often think that they won’t die with a pacemaker. This patient was already good and dead.

Now Schreiber saw it too, and his paramedics recognized the problem as well.

“He was breathing fine a minute ago,” they chorused.

Whatever gaps there might be in their training, paramedics have that statement hammered into them by the fire department really well. I looked at the patient’s motionless pupils, then into Schreiber’s innocent, Nordic blue eyes.

“Intubation, ventilator, and still he breathed his last. Amazing!”

The translation read beautifully so I got everything I should from the story. This is an entertaining book, but I have no doubt that Christoph Spielberg will, like another favorite writer Robin Cook, make you think twice about going to the hospital.

 

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Leigh Neely is a former newspaper and magazine editor. She currently does freelance work, recently had a short story published in the anthology, Murder New York Style: Fresh Slices, and is a contributor to the blog WomenofMystery.net. She and her collaborator, Jan Powell, have a book, Second Nature by Neely Powell, coming out next spring.

Read all posts by Leigh Neely for Criminal Element.