Tooker depicted waiting for a more specifically governmental bureaucracy in his painting, “The Government Bureau.” In that painting, the waiting people are reproduced several times to emphasize their anonymity, and the multiple bureaucrats peer out from frosted windows with only their eyes and noses visible — bringing to mind the concept of the “medical gaze” promulgated by the French philosopher,  Michel Foucault.

In another Tooker painting, “Ward,” he renders patients’ anonymity and a sense of abandonment in the hospital setting–with government bureaucracy invoked by the American flags hanging on the wall.

Image Credit
The Waiting Room, George Tooker, 1959. Collection of the Smithsonian American Art Museum. Image used for educational and critical commentary purposes.

George Tooker documentary videos from Columbus Museum

In 2019, a prominent obstetrician/gynaecologist in Toronto was found guilty of administering intravaginal medications to his obstetrics patients for the purposes of inducing labour without consent. He was subsequently dismissed from his position at the hospital and his career ended. The story was covered in detail in an exposé published in Toronto Life magazine. 

The details of the case are lurid. In the modern age, most obstetricians do group call. Gone are the days when an expectant mother would have both her prenatal care and delivery done by the same physician. Newborn babies are wont to arrive in the world at any given moment, and the traditional obstetrician who drops everything they are doing to attend these deliveries, often in the middle of the night and often with a full day of office work the next day, is all but extinct. Obstetricians now share call duties with a team of physicians. Now, when you sign up with a certain obstetrician, there’s no guarantee that that specific doctor will be the one to deliver your baby, only that someone from their group will be doing the delivery. 

In Ontario, obstetricians are paid more for delivering babies on weekends than they are on weekdays. It’s a nice little reward for doctors who usually work long and unpredictable hours. But in this one hospital, the obstetrics department began to notice that one of their staff had a propensity for babies being delivered predominantly on weekends and evenings and began tracking the matter. 

In time, they discovered that this doctor was inserting tablets of misoprostol into the vaginas of late term pregnant patients in order to induce labour on specific days that were to his advantage, often when the date in question was a weekend. Misoprostol has the ability to induce contractions and is often used in medical abortions. It is not considered to be a medication safe to use in pregnant women to induce labour on command. Needless to say, the patients did not give informed consent for the procedure, nor were they offered the option to decline.The doctor in question was a prominent member of Toronto’s Chinese Canadian community. He had a reputation for being a doctor to the rich and chic. Famous Hong Kong celebrities flew to Canada to have their babies delivered by him and my own patients flocked to him in droves. 

In Toronto, getting a referral to a community obstetrician of choice to deliver your baby is like trying to get your child into an elite private school–no doubt, these actions are often being done by the same parents, just a few years apart. Obstetricians have a set number of expectant mothers they can carry for any given month and once that quota is exceeded, they can’t accept any more patients. In those years when I first started working as a family physician, Chinese immigrant women in my community knew to race to our office as soon as they suspected they were pregnant, so as to get into the front of this doctor’s queue. They were then told by the obstetrician’s office that they were expected to pay a three-hundred-dollar administrative fee in order to guarantee this doctor would be present for the delivery, which they gladly paid.^⁠1 

At the time, it seemed reasonable. Three hundred dollars and your doctor would buck the modern trends of group call and shared team duties and promise to come in on his night off to personally deliver your baby. It all seemed legitimate and altruistic, a call back to a simpler time. If only. 

When the story broke, there was the expected furor in the local medical community. Certainly, the salacious nature of the case, the prominence of the doctor in question, the #MeToo movement which was also taking place around this time, gave the story its pull. 

In the local Chinese community, the story had buzz as well. Toronto, with its large Chinese-speaking population, has several Chinese daily newspapers and the story made headlines in the local Chinese newspapers and filtered its way through all of us. It felt like everyone’s mother had heard of this doctor; he was that well-known. 

As I spoke to patients and friends and colleagues, I discovered so many people around me had had their children delivered by this doctor in the preceding decades. As they reflected on their obstetrics journeys, the stories were all the same. Yes, it was true, many of their babies had happened to arrive on a weekend. Yes, the labour started soon after an assessment, right on schedule and with what had seemed like fortuitous timing at the time. Now, in retrospect, it all seemed fishy and possibly sinister. 

But one thing that I noticed was that this doctor’s actions were met with largely a collective sigh of indifference by the Chinese Canadian community. The lack of outrage most people had towards the story felt odd. Remember, this story was occurring near the height of the #MeToo movement. The idea of a doctor administering intravaginal medications without consent should have, in the West, been seen on the level of battery. At the very least, I expected people to think of it as a violation of a woman’s body. But in the Chinese community, amongst the population that knew this doctor the best, the reaction was muted. Most of his patients that I encountered shrugged off the story. When the subject came up, they were quick to point out to me that he was an outstanding doctor who had helped many people and were disappointed to hear that the doctor was no longer practising. 

In China, women’s reproductive rights is an issue with a thorny history, especially over the last several decades, most of which I was oblivious to until I started working with my own patients. 

The most blatant and obvious reproductive rights issue is China’s One-Child Policy, which ran from 1979 to 2015. During these years, families in China were limited to having only one child, except in special circumstances. The One-Child Policy was formulated in response to the Chinese government’s fear of overpopulation. 

In my naive understanding of China, I was taught the official narrative, that people who had more than one child were subject to higher rates of taxation, and it was the punitive toll of this taxation that kept parents in line. 

But the truth was more complex. What were people’s expectations about birth control? What happened when people didn’t agree with the government’s policy? What happened to people who had an extra child on purpose? What happened if they had a child accidentally?  

When I started working, I soon noticed that all middle-aged women from mainland China had intrauterine contraceptive devices implanted in their uterus. Mostly, they had had these devices placed after delivering a baby years earlier. In many cases, these IUCDs had been present in these patients’ uterus for so long that many of them often forgot to mention it to me, only informing me about the presence of these devices sometimes when they were in their late fifties or early sixties, long after the device had ceased to perform any useful function. Often times, we’d discover that these devices were present during a routine ultrasound, and the patient would remember that yes, they had been wearing an IUCD for so long that they had simply forgotten about it–it had simply become a part of them. This wasn’t an entirely benign situation. The longer an IUCD remained in, the greater the chance it would slowly embed into the tissue of the uterus. Albeit rarely, there are case reports of it rupturing the uterus of women after decades being left in. 

Even after I realized that so many of my patients were wearing IUCDs, I still didn’t fully understand what this meant. I had in my mind envisioned the Western model of women’s reproductive care, that the mother had informed her obstetrician in China at some point after the delivery that she would have an IUCD inserted because yes, she was certain she didn’t want to have another child for a few years. I envisioned a long conversation where a medical professional gave the patient a series of options about contraceptive care. Did the patient want an IUCD? Or maybe to try the birth control pill? Or did the patient want to use natural family planning methods? It was only gradually that it dawned on me, that these were conversations we only had in the West, not conversations women had in China. They weren’t given the option of having an IUCD inserted. They were simply told what to do, or had it done unto them. 

But my women patients didn’t seem bothered by this. They never expressed outrage at having an IUCD. It was again, the collective shrug of indifference. It wasn’t that different than being told that they had to pay taxes. Or have a mandatory retirement age. It was just another curious aspect of life in modern China.  

I couldn’t envision what it meant for a society to exist where a government somewhere could decree that all women would be forced to have a copper intrauterine device placed in their uterus upon having a baby, whether they liked it or not, and that it would remain in place indefinitely. It seemed even more preposterous that almost all the decisions said government made were made by men–the Chinese Communist Party is well known for being almost exclusively male at its highest levels. 

The actual IUCDs that the patients wear bear mentioning also. In North America, IUCD devices like the Copper-T, or Mirena, are little metal or plastic objects that are inserted into the uterus, with a trailing piece of string that dangles out of the uterus. The device itself prevents either ovulation or implantation of the embryo, depending on the IUCD in question. The little piece of string is designed to allow the device to be removed easily in a doctor’s office, where a doctor can tug on the string with a pair of forceps and remove the device. 

In China, the IUCD device is inserted without a string, making it deliberately more difficult for people to remove, even with proper medical equipment. 

As a result, many of my patients, after decades of wearing the IUCD, found that the device could not be easily removed. Canadian-trained gynaecologists, used to the simplicity of tugging on a piece of string and changing the IUCD every four or five years as per the manufacturer’s instructions, couldn’t always remove the Chinese IUCDs. Sometimes, it was because the Canadian-trained gynaecologists didn’t have the practice grabbing IUCD’s without the string. At other times, it was because the device had been put in place so long ago that it had shifted position and could no longer easily be removed. Some of my patients had to go under general anesthesia to have the device removed. Others got on airplanes and flew back to China to get the device removed there by the experts. All of this, I gradually realized, was part of the long-term consequences driven by China’s One-Child Policy. 

For a more detailed discussion of the One-Child Policy, see Barbara Demick’s Daughters of the Bamboo Grove. Demick, an L.A. Times journalist, chronicles her two-decade odyssey to help reunite an American-raised Chinese adoptee named Esther with her birth family in China. Esther was abducted as a two-year-old and then trafficked to an orphanage during China’s international adoption industry heyday in the early 1990s. As it turns out, she has a twin sister, Shuangjie, who stayed with her birth family and the story provides a fascinating case study of the entire issue of women’s reproductive rights and the issue of international adoption. 

In the book, Demick lays out China’s One-Child Policy and its ramifications on the grassroots level, where neighbourhoods were policed by local government family planning offices. These units were akin to local mafioso-like organizations, gangs of thugs who were given carte blanche by the local governments to cajole, threaten, and beat people into towing the party line. And, to top it off, they weren’t above kidnapping the children who violated the government’s restrictions on family planning. 

When it comes to the One-Child Policy, there is a tendency for us as Westerners to discuss it as tomfoolery–a straightforward story of failed macro-economic policy, that the One-Child Policy was short-sighted and hastened China’s likely imminent economic decline. And while this narrative may be accurate, it only scratches the surface. The reality of what happened to people on a personal level is much more complicated. 

As Demick describes it, in the nineties, the One-Child Policy essentially created the market conditions for international adoption and the trafficking of kidnapped children. It isn’t a huge leap of logic to understand that the One-Child Policy begets well-meaning people from the West wanting to adopt babies from China and being willing to pay good money to do so. Once money is involved, human traffickers realize that if they can get good money for babies, then all they need to do is to get more and more babies. Now, cue the kidnappings and forced baby abductions and we get to where we were. It’s a frightening cycle, which only illustrates yet again how economic policy can trickle down to the level of the individual in thousand-fold ways. 

There’s another aspect to Chinese family planning worth pointing out here, which is the desire to have more male children. The Chinese culture is by no means alone in this. Historically, many groups around the world prized boys over girls. In China, the reasons for this have long been established. Traditionally, Chinese culture has long placed an emphasis on families having male heirs. According to Chinese culture, family lineages pass through sons, and daughters are raised but then handed over to other families when they marry, unable to continue lineages of their own. At its most basic level, this meant that your son could look after you in your old age but your daughter couldn’t. 

Growing up as an immigrant in Canada, I accepted that the preference for boys over girls was probably one of those older, primitive world views that Chinese people held in the past, but, like binding women’s feet, surely not something anyone still believed in modern times. After all, I had grown up in a North America where women voted, moms were entering the work force en masse, and dual-income households were becoming more and more the norm. I took it for granted that modern people everywhere would value boys and girls equally. 

And while I had read in books about the gender imbalance in China, about how the One-Child Policy had created a nation with a surplus of boys over girls, I took it as just another example of primitive, traditional Chinese thinking, something from the old world, not something that I would have to deal with directly as a doctor in Canada. 

So imagine my surprise, when in my early years of practice, patients started approaching me, forcing me to confront some of these gender issues head on. 

One patient, an older woman who was already the mother of multiple girls, discovered that she was pregnant again. At the eighteen-to-twenty-week ultrasound, to her disappointment, she discovered that she was having a girl, again. A few weeks later, despondent, she came to my office, asking for a referral for an abortion. She explained to me that she wasn’t primitive or old-fashioned. Indeed, she wasn’t against having girls per say. But she already had so many that it seemed fair that she really didn’t want another one. 

By this point in the pregnancy, she was already precariously close to the twenty-four-week cutoff for late term abortions. In Canada, abortions past twenty-four weeks aren’t allowed. Would it be possible for me to change her estimated date of confinement to so that she could squeeze in just within the 24 week window?^⁠2 I refused to do this, and she ended up returning to the clinic multiple times in the next several weeks, each time suggesting that, telling us in fact, that she had remembered her last menstrual period date wrong. And that if we used her revised calculation, her current pregnancy actually fit in the twenty-four-week window. Needless to say, I did not acquiesce and eventually this patient drifted out of my practice. I never did find out what happened to her and her family of girls. 

Fortunately, not all the stories are so odd. Some patients from China have told me that they were pleasantly surprised to discover that in Canada, at the eighteen-week ultrasound, doctors could reveal the gender of their future children to them if they wished. Finally, they could prepare for the upcoming birth of their child knowing what colour to paint the child’s bedroom and what colour clothes to buy in advance. In China, I was told, this information was kept strictly confidential because the government was afraid that people would go looking for abortions if they found they were pregnant with a girl. 

Of course, now the situation in China is flipped. After decades of the One-Child Policy, China suddenly finds itself facing an economic slowdown, the prospect of an aging population and a more educated working class that wants no part of having more children. More and more young people in China are choosing not to even marry, not to mention start families. 

In a twist of dramatic irony, those same family planning units that harassed women for decades into having less children, have suddenly been tasked with the job of encouraging increased reproductive rates. 

What will the Chinese government do when it’s time to raise its low birth rate? What will it do when it realizes it can’t convince its citizens to get pregnant more readily by offering tax incentives? After all I’ve seen and experienced, it’s something I don’t even want to think about but could be just around the corner. 

I’ve long struggled to understand this concept of just how powerful the Chinese government is and how much impact it is able to have on its citizenry. Because my grandparents fled China after the Civil War in 1949 and my parents grew up in Taiwan under martial law, I’ve always had a bird’s-eye view of how Chinese politics can affect the lives of everyday people. I have an aunt who I’ve never met because she didn’t make it out of China in 1949 and became separated from our family–she wouldn’t see my father, her brother, for almost forty years. In recent years, I’ve read countless books about government reforms in China. I saw how China handled Covid-19 in the news. I’ve visited China and seen the gleaming new buildings and multi-lane superhighways humming with electric vehicles. But none of it has spoken to me as loudly as this collective shrug of indifference that I’ve encountered from my patients when it comes to women’s reproductive rights. 

Sometimes, I wonder what the psychic toll of a person doing something they don’t really want to do might be. What if they’re forced to get a tattoo that they don’t want? Or forced to cut their hair in a certain way? 

What if they’re forced into a marriage they don’t want? Or forced to have a baby they don’t want? Or forced to give the baby away against their will? 

They don’t even have the option of agreeing to any of these things. What if these actions are just done to them whether they like it or not? 

But then what about this: what is the psychic toll if they’re to wear an IUCD for the next thirty years, whether they would like to or not? 

What’s the toll if they’re given intravaginal misoprostol so that their baby can be born on an auspicious day? 

What’s the toll if they’re given intravaginal misoprostol so that an obstetrician can deliver the baby on a day convenient for him? 

If all of these decisions are simply made for a person by an aggressive husband, we’d call it abuse and everyone would be screaming bloody murder. But if these decisions are decreed by an even higher authority, an all-powerful political party or an all-seeing authoritarian government, then what? Would everyone just accept it as just another cultural fact of life, like using chopsticks instead of a fork? It seems like they would. 

To hear further discussion about Barbara Demick’s Daughters of the Bamboo Grove, have a listen to my discussion about it on Apollo On Call, the podcast of medhum.org. 

1. In Canada, health care is publicly funded but doctors can charge fees for services not covered by the public health care system. This can take the form of administrative fees as well as fees for certain medical and surgical procedures that the government health insurance doesn’t cover. 
2. The estimated date of confinement is the projected due date for a pregnant mother. It can be calculated as 40 weeks from the date of the pregnant woman’s last menstrual period, or estimated using prenatal ultrasounds. 

Web Image by Medhum.org and Fred Moon 

Additional Chapters from A Chinese City Doctor’s Notebook

When Your Body Isn’t Yours 

01.12.26 686

From Tigers to Otaku

09.16.25 1539

The Happiest Couple

07.28.25 1290

The Things We Don’t Talk About When We Talk About Dying 

05.13.25 1870

Before modern medicine, superstition mediated pregnancy and childbirth. Once, divine wrath or distressing mental images risked what was called a monstrous birth. To reduce risk today, pregnant women consult prophetic prenatal technologies and the ceaseless cacophony of digital media. Twice pregnant, New York Times pop culture and internet reporter Amanda Hess found herself both drawn to and repelled by media advice and the collection of data enticed by apps or insisted on during clinical encounters.  

Her book Second Life: Having a Child in the Digital Age—part wry memoir, part savvy investigative reporting—asks whether current technologies deliver a better, if not perfect, baby or the maternal well-being they augur. She, even more significantly, worries about the consequences, personal, relational, and ethical, of pursuing perfection.  

Hess couldn’t resist interacting with chatty, advice-giving apps. One first tracks her fertility and then, in weekly installments, shows her what a developing “creepily realistic CGI fetus” looks like. (Another app likens fetal development to the temptations on Parisian bakery shelves. A macaron, for instance.) Visual creepiness aside, Hess has unsettling thoughts about surrendering intimate information about her body to unknown recipients. She discovers that a popular app she regularly consults was developed by two brothers in Belarus backed by venture capitalists. Its surveillance exposed her to endless marketing schemes that hardly considered anyone’s well-being or financial resources. Curious about the history of fertility tracking before and after apps, Hess discovers a throughline of troubling eugenic ideologies. It travels through the advice of a popular pregnancy influencer. 

Deep into Hess’s first pregnancy, a “concerning” routine ultrasound detected what could be Beckwith-Wiedemann syndrome (BWS), a rare genetic condition. Its possibility sent Hess anxiously scanning the internet, against her doctor’s advice, for medical information and possible maternal causes. Was it the wine? The Ativan? A fever? Her age? Unspecified guilt followed. But neither the internet, genetic testing, nor her doctor could reassure her about a cause or the possible extent of the condition. The internet images she sought of children with the full range of BWS anomalies hardly quelled her anxieties. Only after her son’s birth was a form of BWS confirmed.  

Hess sympathizes with the wish to deliver a healthy baby and the temptation to seek any available service or technology to that end. After all, that’s what she wanted. However, the prospect of birthing a child with an anomalous body leads her to question the meaning of the ubiquitous parental qualification: “As long as the baby is healthy.” Healthy, she finds, translates to normal. Anticipating a not-normal child makes her feel protective of her son even before his birth. After it, she deflects thoughtless remarks from strangers about his enlarged tongue protruding from his lips. (Corrective surgery later enables less compromised breathing and speech.) She and her husband care for and about him for the distinct person he is. About her initial anxieties about his body, Hess writes, “My nightmare . . . ended when I met my son.”  

Hess’s standout chapter “Growth” recounts her evolving response to her son’s imperfections and her efforts to manage others’ IRL and internet responses to him—a task she finds essential to parenting him. I hope this chapter is widely read, certainly by future parents, but also by clinicians, genetic counselors, and those who teach them.  

Some accounts of caring for an imperfect child cast the child and the parental relationship as special. Some view chronic illness or disability as a familial burden. Hess does neither. Instead, she folds caring for her son into the course of her life and her family’s. In that way, she continues a contribution of Michael Berube’s complicated 1996 Life as We Know It, however, adding a millennial’s navigations of current medical technologies and media static. Hess further envisions a world that participates in the care of all children, one that refuses to blame or isolate families with less-than-perfect children. That world would reduce parental anxieties more than screening for concerning “problems.” Philosopher of care and mother of a profoundly disabled child, Eva Kittay, would agree. 

Some readers might say that Amanda Hess’s financial and other resources make her generous perspective possible. She agrees. She’s half of a two-parent family. As journalists, she and her husband have more flexible schedules than countless other parents. But in the world Hess encourages, parental status would be irrelevant to their child’s care. 

Without being prescriptive, Hess’s lively, self-reflective story provokes readers to think twice about rejecting imperfect children—anyone’s—and to notice the eugenic logic underwriting rejection. Her book tests the claim that ever-evolving technologies enhance maternal well-being, empower parental choice, and guarantee healthy babies. (Ironically, a researcher Hess encountered reported on increasing evidence of BWS in IVF conceptions, many intended to screen for anomalies.) In fact, far more children are permanently harmed during their lives than are born ill or disabled. Rather than relying on the billion-dollar industry of prenatal testing, aren’t we better off, Hess asks, accepting and taking better care of all children however they’re born? 

Second Life: Having a Child in the Digital Age
Amanda Hess  
Doubleday, 2025, 272 pages 

He was wrong.  

In Nazi Germany, sleep was a poor protection from the horrors of the external world, as Charlotte Beradt, a Berlin journalist, found out. Beradt, a Jew and a Communist—and thus an ultimate outsider in Hitler’s state—began having unsettling dreams shortly after the Nazi takeover of the government in 1933, dreams of being “chased, tortured, shot at, [and] scalped,” from which she awakened drenched in sweat. Wondering if others might be having similar experiences, she began collecting dream reports from neighbors, friends, and acquaintances, aided in some cases by a friendly physician who would ask his patients about their dreams in the context of their office visits. She recorded them in her notebook or on scraps of paper, often in coded language so they would be unrecognizable to prying eyes, especially of the police. This project engaged her from 1933 until she left Germany in 1939, ultimately winding up in New York City and settling among a community of German expatriates and refugees, including Hannah Arendt. She originally published her dream reports in 1966; this new English translation by Damion Searls appeared in 2025. 

The book is divided into eleven chapters, each reporting several dreams that are linked by a common thread. Patterns emerge and are echoed: initially, the loss of privacy and the intrusion of state policies into everyday life. There are dreams in which the dreamer is under surveillance or feel they must conform to state policies; Goebbels and Hitler appear in several of these, or exist in the background. There are Kafkaesque nightmares where household items like stoves and pillows become monitors of activity or nagging and accusatory voices (Beradt refers to the “Orwellian” sense of being watched, noting that the dream content prefigures Orwell’s 1984 by many years).  

Interestingly, after 1935 (and the passage of the notorious Nuremberg Race Laws) dreams show up in the text characterized by a preoccupation with the wish for the ideal Aryan body type (blonde, blue-eyed, tall), or, more commonly, the preoccupation with the dreamer’s falling short of this ideal and being singled out for it. Non-Jewish Germans have dreams in which their noses are too prominent and “the authorities” accuse them, directly or indirectly, of having Jewish ancestry. And in her final chapter, “Jewish Dreamers, or, ‘I’ll Make Way for the Trash, if Needed,’ ” Beradt catalogues the dreams of Jewish Germans, dreams of exile, loss, hounding and pursuit, and self-abnegation. 

The book is a relatively brief (122 pages) compendium of nightmares, some of which have the feel of surrealistic short film clips, which catalogues the increasing encroachment of a totalitarian state on the lives—and into the unconscious worlds—of its subjects. The author’s analyses of dreams bespeak her familiarity with dreamwork concepts (she is referred to in several biographical sketches—not part of the book—as a “member of the Berlin psychoanalytic community,” although she was not a trained psychoanalyst), and many of her interpretations are sophisticated and suggest significant familiarity with Freudian concepts.  

It is worth noting that Beradt has probably surveyed a skewed population; her subjects are mostly people she knows, or referred by people she knows and presumably trusts, and there is a selection bias, in that she has probably not approached, say, Nazi Party members or sympathizers for their dreams. A large number of the dreams seem to date from the early years of the Third Reich, 1933-1935/6; it is possible that in the later years it was just too terrifying to talk about one’s nighttime visions…or that the dreamers had started to leave the country. 

The Third Reich of Dreams makes absorbing and chilling reading. It is fascinating to see how dreams, the realm of the personal unconscious, become infiltrated by and reflective of societal change in real time. Sometimes “the royal road to the unconscious” leads straight to the dreamer’s front door.  

The Third Reich of Dreams  
by Charlotte Beradt, translated by Damion Searls 
c. 1966, 2025 
Princeton University Press 
122 pp. 

Web photo by Ed Wingate 

Kairos is the claustrophobic story of an affair between a 19-year-old woman and a married man more than 30 years her senior. Nothing unique in that situation. But this clandestine relationship unfolds against the backdrop of the last years of the German Democratic Republic before the sudden collapse of the Berlin Wall. This too is familiar territory — from novels like John LeCarre’s The Spy who Came in from the Cold and Ian McEwen’s The Innocent to popular movies like The Lives of Others. What makes Kairos different from anything that I have read about this period is the microscopic view it provides of the dysfunctional relationship between Katharina and Hans and the larger vision of reality that emerges. 

Their initial meeting is a completely chance encounter on a bus in Berlin as they shove to board it and escape the rain. They spy each other immediately and within a few pages are sleeping together. Hans is a married broadcast journalist who seems to have found a secure niche for himself despite state control of the press, while Katharine is a student in theater arts. Literary May-December romances are not uncommon, but the rushed and secretive meetings between the two lovers quickly move into less comfortable terrain. Katharine becomes increasingly insecure and less assertive in her interactions with Hans. Violent sadomasochistic behavior intrudes into their space, and Hans becomes more domineering and demanding. This is not a fuzzy tale of two star-crossed lovers who pine longingly for one another; this is obsessive territory. Over time, distrust and suspicion and mutual cruelty invade the lovers’ trysts. When Katharine leaves Berlin for a period of academic study in Frankfurt, it triggers exaggerated accusations of betrayal by Hans. He blames Katharine for being unreliable and not fully committed to their relationship and calls into question her loyalty to him. There is lots of sex and coded signals and furtive meetings to avoid detection by Hans’ wife and son. But the mood becomes chillier and more tense with each turning page. Eventually, the political uprising across Germany and Eastern Europe ruptures the novel’s narrow field of vision and alters the contour of their illicit relationship.  

The novel is bracketed by two efforts at historical reconstruction, accomplished by mining written records from the period. This highlights the power of literary narratives to frame our lives, something that Kairos accomplishes so successfully. The plot is spare but Jenny Erpenbeck has created a novel that is very thick with the lives of the two characters, and it is that richness of texture and intimacy, disturbing as it might be, which causes the book to reverberate in your memory long after you put it down. 

Why is that? What Kairos accomplishes better than other books I have read in recent memory is its ability to bring to life the impact of our social and political environment on our inner lives. The tautness of Erpenbeck’s writing, the novel’s ominous and suspicious atmosphere, are a direct reflection of what it might have been like to live in East Germany after the Iron Curtain descended and the Berlin Wall was erected. The East German domestic spy service, the notorious Stasi, infiltrated everyday life. Anyone could be an informer and everyone could be informed on. Petty offenses against the Communist party, minor disagreements between colleagues about policy, and trivial comments among friends about current affairs could quickly escalate into charges of treason, of being an enemy of the state. No one knew exactly what could provoke a summons to a closed room interrogation and a prison sentence. 

 It is in this stultifying environment that Katharine and Hans’s relationship takes shape and it is against this sweeping historical background that we confront and must try to understand their thoughts and actions. Katharine is young but seems deadened by life on the dreary East German side of the Berlin Wall with its brutalist architecture and its color spectrum ranging from shades of gray to shades of gray. For her, even a destructive relationship with an older man, a spiteful and hurtful one at that, may have provided a glimmer of hope for a “real” life. Hans has survived under the Communist regime and achieved a modicum of fame and fortune. But we can only speculate on the cost. Erpenbeck makes it clear that the price was high. The humanity of both main characters has been stunted by their reaction to living in a police state and by internalizing the distrustful depersonalizing actions of the government’s internal espionage apparatus. I suggest that Erpenbeck’s accomplishment is to show how the political environment can influence personal patterns of behavior. 

How would we have held up if forced to live under such conditions? Would one have had the courage to speak truth to power or would one have hunkered down, kept a low profile, and avoided confrontation with the state? What would we have resorted to in order to protect ourselves and our job, family, and friends? Could we have maintained our humanity and dignity? Katharine and Hans lived with these unbearable dilemmas every day and their personalities were gradually warped under the relentless pressure.  

It is easy to devalue the lives of others living in the former East Germany or Soviet Union, or current China or Iran, where men and women are forced to remain in countries that interfere with the freedom to think and express oneself and where every thought and action is under surveillance. But it would be a mistake. We should not lose sight of external factors in this country that threaten our individuality and our humanity. Whether it is political uniformity and social tribalism or blind use of the tools of artificial intelligence, we too must recognize and address the social forces that could impact on how we interact with the world and behave to one another. Like the Stasi in East Germany, these forces have the real potential to diminish our stature as moral agents.  

Neither main character in Kairos is easy to identify with and it is hard to muster sympathy for the plight of either one. But our distaste for Katharine and Hans is tempered by the knowledge that their souls have been distorted, damaged almost beyond repair, by a state that has flattened the complexity of human individuality into a file of incriminating notes based on informer reports. I suspect it may be especially hard for a woman to read this book and suffer along with Katharine as she is manipulated and physically and psychologically abused by Hans. But one cannot escape the reality that Hans too is a victim. Quality literature like Kairos does not aim to rationalize human behavior. What it can do is contextualize fictional characters and in doing so make us understand what some of our fellow human beings are going through a little bit better and with a little more sensitivity. 

Winner: International Booker Prize 2024

A Q&A with Jenny Erpenbeck and translator Michael Hofmann

KAIROS 
Author: Jenny Erpenbeck 
Publisher ‏ : ‎ New Directions; First Paperback Edition (May 14, 2024) 
Hardback: 2021, Penguin Verlag 
Paperback: 304 pages 
ISBN-10 ‏ : ‎ 0811238539 

Photo by Lucy Bruell