Illness – Therapy – Death

Set in a lung sanatorium, The Magic Mountain is not only a novel about time (which I will discuss in part 4) but also a novel about illness. Not just any illness, but tuberculosis, an illness that was almost incurable at the time. Hans Castorp arrives in 1907 and will only leave because the war breaks out in 1914. The first antibiotic to work against TB was only discovered in 1940. Penicillin, which was  discovered in 1928, did not work against TB.

I remember thinking the whole time while reading about the therapy that Mann was writing satire. I could really not believe any of this to be true. It sounded too wild. Behrens, the head of the clinic, came across as charlatan and Dr Krokowski, the psychoanalyst who helps the patients with the psychological side of their illness, felt like a caricature of Freud.

The most important part of the therapy described in the novel is the reclining cure. The patients must lie for six hours per day on their balconies. Three times per day for two hours after the main meals, to be precise. Even in winter, with temperatures that were below zero, they had to follow this strict regime. All the patients developed a special system to wrap themselves in blankets and costly fur bags. Because the balconies were open at the front and one could easily climb from one to the next, some of the naughtier patients used these breaks to visit each other for other than therapeutic reasons. I won’t elaborate but let’s just say, there’s a lot of erotic tension all through the novel, and many of the patients have affairs.

Lying in the cold air for hours seemed wild to me but not wilder than the so-called collapse therapy which included pneumothorax, diaphragmatic paralysis, and thoracoplasty surgery. The collapse therapy had dramatic and unpleasant side effects which are described in detail. It was applied because it was meant to give the lung a rest.

As I mentioned before, I had a hard time believing these were real therapies, but the depiction of these wild practices is actually very accurate.

I found an article online about an event at the Thoraxklinik Heidelberg which took place this summer to celebrate Thomas Mann’s 150^th anniversary. The article focuses on the therapies described in the novel and states that they were the only successful methods at the time.

TB has resurfaced since 2017 in Germany, with numbers climbing slowly every year. Apparently, TB is the infectious disease that has claimed the most deaths. One third of the world population is currently infected, however, in many the illness lies dormant.

When the book was published in 1924 there was outrage among the doctors who read it. They felt it was a very unfavorable depiction of the therapy. They also felt that the real doctor who inspired Mann to create Behrens’ character should sue Mann. Thomas Mann got his inspiration because his wife spent a few months at the Berghof. She was initially diagnosed with TB, although she was never really afflicted.

Mann said in his defense that he didn’t mean to criticize the therapy but that his book had to be seen as a social commentary. He criticized what he called high luxury sanatorium for the ultra-rich. In his opinion, the doctor in charge was thinking more about money than the patients’ cure that’s why he continuously prolonged their stay.

We don’t hear about many people who are cured from TB in the book. The majority seems to get worse and many die. But while death is a constant companion, it has become the custom to pretend it doesn’t happen. Patients notice that seats at tables were suddenly empty and quickly reoccupied by new arrivals, but they don’t mention it. It was all hush hush and the descriptions of the way the dead people were secretly being removed from the sanatorium are rather grotesque. Hans makes fun of this until he begins to know the people who are about to die or have died. Unlike most of the other patient’s, Hans decides not to ignore the deaths and those who are in the final stages of the illness, but to visit some of the moribund. While death is initially seen as something almost comical in the novel, it becomes more and more tragic as the book progresses. But not everyone dies of the illness. There are characters who choose to end their own life.

As mentioned before, Mann intended this to be social criticism of the capitalist prewar society. Hans, or the narrator, sometimes mention prices and even if we were speaking about current Swiss francs, some of these are exorbitant. The Berghof might not offer a cure but it’s certainly a most lucrative and luxurious establishment. Behrens’ greed becomes particularly apparent when he administers extremely expensive oxygen doses to patients who have less than hours to live. Some of the patients know probably very well that they are overpaying their stay but feel it’s justified because only very few can afford this. It’s a bit like they were staying at one of those exclusive clubs not everyone can join or afford.

Illness is also a motif, a symbol, and its use in the book is far more complex than what I’ve described above. There’s a philosophical analysis of it too and, I’m pretty sure, it was also meant as a metaphor for the times. The world was getting sicker and sicker and soon this sickness would lead to mass deaths.