“It is not the happy who are grateful. It is the grateful who are happy.”

Zeit-Fragen, Juli 2023 ∙ Moritz Nestor

zf. On the occasion of the General Assembly of the Swiss Hippocratic Society on 29 June 2023 in Zurich, the public was invited to a panel discussion dealing with the understanding of the medical and nursing professions. The following text is the abridged version of the author’s contribution.

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What is the value of the medical and nursing professions? I would like to illustrate this with the example of my father – namely, his gratitude to the nurse who nursed him back to health for long, long months in the military hospital in Görlitz in 1943. He also passed on to me his gratitude that his life could be saved at that time. I found a word by Sir Francis Bacon (1561–1626) that fits well with this: “It is not the happy who are grateful. It is the grateful who are happy.” Modern man is puzzled. He would have said it the other way round. It often seems to me that we today have almost forgotten what it actually means to be grateful.

In 1943, after more than three thousand kilometres of transporting the wounded, my father arrived barely alive at the reserve military hospital in Görlitz, where he lay for more than half a year until his headshot and frostbite had healed. There he also received the death notice of his beloved friend Otto, “Fallen in the East”. They had been twenty radiant high school graduates in 1935. In 1945, ten were still alive.

In the military hospital in Görlitz, Pentecost 1943

In the only surviving photo from the time in the military hospital, my beaming grandfather and Sister Hilde, the nurse who nursed my father back to health, are standing at the head of the sickbed. The Görlitz site priest Heuser visited him repeatedly and gave him a small New Testament that fit into his uniform’s breast pocket. Father had it re-bound in 1974, as he noted, because it soon fell apart from so much reading, especially those verses about resisting the “works of Satan”. My parents, sister Hilde and the priest carried my father through that difficult time spiritually in the truest sense of the word.

My father had been brought up in great gratitude towards his parents and the old people from whom the children get everything they need to live. Under the Nazis, he had become a typical youthful know-it-all who now liked to rub the “new times” under “old people’s” noses.

With unrelenting force, in a cauldron northwest of Stalingrad on 6 January 1943, a Russian shell in a terrible instant turned a proud first lieutenant into nothing. When he awoke from his swoon and gradually understood that there was something that could simply destroy you, he was overcome with shame, for the first thing he remembered was an old cobbler whom he had accosted some ten years earlier as a fresh-faced SA youth: “Dude, there was no Jesus.” The old man replied to him then, smiling sheepishly, “Young man! Watch out, one day God will touch you just like that with his little finger, and then you’ll lie there and you’ll realise it’s God.” But father only thought, “You stupid cobbler!” How one thinks at eighteen. He had thoroughly forgotten the old cobbler. Now he thought of him again, ashamed, for he had learned the divine commandment that one should honour old age. “Perhaps I will get home safely, he has touched me; now I know that God exists,” he stammered. He was driven home, as helpless as a small child, through the snowy desert of the Russian winter retreat, on a horse-drawn sleigh, in an ambulance, in a freight wagon, three thousand kilometres and more.

The shame turned father into a repentant sinner who began to rise from the entanglements of life, to work his way up out of the swamp, and who sought the strength to throw it all behind him. In 1948 he wrote to his new love, my future mother: “I once wanted to storm the heaven of glory. Now I smile at the vain little fool in me and i am happy when it is granted to me to occupy a small hill, to build my house there and to work downwards from there by looking upwards and orienting myself from there.” So he got to know some of the good and bad sides of life better than the self-righteous.

How my father found her again after the cursed end of the cursed war, I don’t know. But as long as Sister Hilde lived, she came regularly to visit us in the family, at the end with white hair and a crooked back, and father always held his relationship with her in high esteem, was grateful to her – all his life long. When he began teaching mathematics and physics after the war, Sister Hilde came to him in the classes at his request and told the astonished children how he had come to her in the department in 1943, battered and half dead.

In her presence, he, who was quick to flare up, was another. He called her warmly “Sister Hilde” and she always greeted him harshly and cordially: “How are you, Nestor?” When she died at the age of over eighty, she left behind a black cane with a silver crutch, which she had walked with for the last few years and which she held in memory of her father. She had been his sister in his most difficult time.

For almost thirty years, until the end of Sister Hilde’s life in the early seventies, the former nurse from the Görlitz military hospital in 1943, who gave him her help at that time, remained connected to the first lieutenant, who had been gifted in his “mattress tomb”, by an invisible and unwritten contract. And this happened of one’s own free will. For one can only be truly grateful voluntarily. The contract between the two was the loyalty that comes from such human bonds.

They were never on a first-name base (the German “Du”), used always the formal form to address (the German “Sie”). But in their deep mutual respect they touched the human in a fundamental way that makes healing and caring professions infinite, more than a first-name base ever could. He was forever grateful to her. As long as she lived and beyond her death – until he also died in 1980. Nearly half a century this bond of loyalty persisted.

I said “infinite”. There are some jobs that come and go with popularity. But the healing and caring professions are perpetual. Infinite. Because it’s an eternal destiny that humans become ill, that we suffer mentally and need help. Healing and caring therefore does not come and go again – so like the peoples and the cultures in the history of humankind did.

One time “nurse” was an honorary title for the indispensable charitable dimension of nursing care. Everybody is able to empty a jerry or to bring the food. But nursing is more than that. Nursing is not a technique. You cannot foster more efficient, faster, or more streamlined. You cannot program caregiving. And where they still try, they create suffering.

In all high cultures, it was part of the special and unique dignity of women that they could give life. It was part of that dignity that women became “Sisters” (German: “Krankenschwester”) to the sick. To nurses. Why, at the end of the 19th century, in the wars fought by men, did women begin to rescue and care for the sick and wounded in the service of life? The fact that women served as Sisters not for war but for life was the human light on the faces of their suffering husbands and gave them a bit of hope: there is something more than killing. Just like Sister Hilde in 1943.

The spirit of gratitude that blossomed in my father again when his life was saved in 1943 rekindled that “peculiar warmth of human connection that springs from the awareness of one’s obligation” (Bollnow1, p. 130). A warmth of the heart that, like the first little spring plants, melted through the snow and ice spread over the heart by the National Socialism. Gratitude – like my father’s towards Sister Hilde – differs from all other forms of giving and taking in that “performance is not exchanged directly for performance, but in a form that cannot be foreseen and therefore cannot be regulated in a contractual manner an act given voluntarily and without any claim to a service in return creates in the other person the willingness to respond in future cases with a service that is voluntary and not to be obtained through any contractual compulsion. The special dignity of the human relationship characterized by gratitude lies precisely in this voluntary manner, which goes beyond all spoken and unspoken agreements.” (Bollnow, p. 130)

In a grateful attitude we do not see a fellow human being who gives us something as a means to an end, but we feel how warming and life-giving a worthy – because pure human relationship – is which is given to us voluntarily and which towers every rational expediency of a business. Because being there for one another is a gift “that one receives undeservedly. This distinguishes the gift from what one acquires through merit or buys through payment or even through brute force.” (Bollnow, p. 131)

Is not – like that Schwester Hilde – every doctor in some way also always a giver? He gives himself and his skills. Does he always know? It is nature that heals. But he can do something and knows something and can apply it, in this one individual case here, and he can – we hope – avoid damage and reawaken life forces so that nature can unfold its healing powers again. But he is always the most important. It begins with his sympathetic question: “How are you? What’s wrong with you?” And it ends with the deep, warm look of a reawakened person from his pillow: “Thank you, Doctor, for seeing me as a whole person and not just as a broken organ.”

You cannot ask for a gift. It comes to you without having “made any advance payments”. The mature adult knows “that man is basically never able to live by his own efforts, that the best must always be given to him.” (Bollnow, p. 136f.) Before we humans can live independently, we are completely created by our culture during a long period of childhood and adolescence, in the person of our parents and teachers, through whom we receive the culture and its wealth as a gift. But the first gift of our life is the love of the mother. Without the child making any advance payments, which would seem absurd to us, she gives her love to the new life. This love knows no compulsion. And the newborn actively striving for human relationship begins to recognize itself in the mother’s love: I am loved, therefore I am important. And thankfully it stretches out its little arms to this source. The growing childlike self (the “I”) climbs gratefully up to the grown-up counterpart (the “you”) and grows. This love for the mother is the starting point of all ethics – also that of the healing and caring professions, of medicine. If you take away this ethical reason, you also take away its task – and it withers into “medicine without humanity”.

1 Bollnow, Otto Friedrich. Neue Geborgenheit. Das Problem einer Überwindung des Existentialismus. (A New Concealment. The problem of overcoming existentialism), Stuttgart 1955

“To become a fellow sufferer”

“The highest deed that the doctor succeeds in doing here and there is to become a fellow sufferer, reason with reason, man with man, in the incalculable borderline cases of a friendship developing between doctor and patient. […] Then one may ask whether the medical personality does not itself become a healing force in a legitimate way, without having to be a magician or a saviour, without suggestion, without any other deception. The presence of a person with the will to help, who is there for the sick person for a moment, is not only immensely beneficial. The presence of a reasonable person with the power of the spirit and the convincing effect of an unconditionally kind person awakens in others, and thus also in the sick person, incalculable powers of trust, of wanting to live, of truthfulness, without a word being spoken about it. What man can be to man is not exhausted in comprehensibility.”

Karl Jaspers, in: Lindenberg, Wladimir. Schicksalsgefährte sein (Being a fellow sufferer), Munich 1985, p. 14 (Translation Current Concerns)