Bedside Manners

The cover of The Appointment: A Novel

In Katharina Volckmer’s debut novel, The Appointment, a patient sits in a medical exam room and monologues at a man named Dr. Seligman for 131 pages. The patient, Sarah, was born in Germany but is now based in London and likes to gossip about her former shrink, Jason, whom she hates. She isn’t sure whether she hates Dr. Seligman, though she initially distrusts him. She wonders if he’s like Jason, who would definitely smile his way “through any atrocity” with the ridiculous conviction that he could forgive all “petty human errors.” This raises an obvious question: if Sarah doesn’t trust doctors, why is she telling a doctor about it?

In the first half of the book, it’s unclear who Dr. Seligman is and why Sarah is supine in his office. Volckmer baits the reader into trying to pick out symptoms from Sarah’s verbal outpouring. Sarah rambles in a stream-of-consciousness style about everything from sex robots to her mother’s caesarean scar, giving the book the feeling of an analysis session. Is Dr. Seligman a psychoanalyst? Sarah’s thoughts do circle childhood trauma (namely, her family’s post-Holocaust German guilt and the “wrongness” of her body). But then Dr. Seligman sticks his head between her legs. Initially, Sarah’s allusions to the appointment are so vague they don’t quite qualify as hints (she says, “I’m not scared of what we are about to do”). Slowly, her asides congeal into clues (she mentions taking hormones and describes Dr. Seligman as a plastic surgeon specializing in “private parts”). About halfway into the novel, Sarah finally says what the appointment is for. By then, even the most half-hearted reader has already solved the mystery. In a tangent about German reticence, Sarah suddenly declares “you are giving a German woman a Jewish cock.” (Sarah refers to herself as a woman and will go by “Emil” post-surgery). Sarah announces what she had only implied in her monologue: a doctor’s diagnosis is a rather paltry shorthand for experience.

Katharina Volckmer.
Katharina Volckmer. Photo: Liz Seabrook

The book doesn’t offer a plot per se, aside from the drama of Sarah’s shifting trust in Dr. Seligman. Initially, Sarah’s skeptical. She tests her Jewish doctor by detailing erotic fantasies about Hitler. She describes a dream in which she’s Hitler basking in “orgiastic applause,” a fetish for Hitler “punishing me with his mighty crop,” and a kink for Hitler’s mustache brushing her “soft parts.” These confessions, she later confesses, are fake. Obviously, the purpose of Hitler erotica is to shock. And, at first, it does—partly because she’s so explicit, and partly because it’s funnier than it is horrifying. But her fantasies aren’t merely provocations. She delivered the same mock-confessions to Jason to “wind him up” and figure out whether she could “tell him about the true nature of my dreams and all the things that were wrong with my body.” He failed the test because he “promised to sign anything attesting to my calm and placid nature if he never had to listen again” and sputtered out the dull therapeutic truism that she is not her thoughts. Sarah couldn’t confide in Jason because he squirmed at her desire. She postures as a Hitler-obsessed German—digs up the dirtiest, most obscene longing she can find and shoves it in Dr. Seligman’s face—to gauge the upper limit of his horror. Sarah fakes a fixation specifically to distract from, and thus guard, her central desire: to become “the boy [she] always wanted to be.”

The novel’s momentum largely comes from Dr. Seligman persistent silence—his ability to continually not say something stupid or horrible. (Sarah answers questions Dr. Seligman presumably asks, but his dialogue is only implied and reads more like Sarah’s anticipation of follow-ups). By muting the doctor, Volckmer doesn’t dilute his character. Rather, she spotlights the subtle ways his presence shapes Sarah’s speech. She discreetly shifts to real confessions, but her contradictory feelings about the doctor are still apparent. Take the three-page anecdote about her preteen days watching boy-band music videos with her best friend. Sarah “detect[ed] a little red glow” on her turned-on best friend’s face, but the videos “did nothing for me; my vagina remained dumb and numb.” It’s an aside that she rushes past, burying the feeling under talk of pop stars’ dumb outfits. But her discomfort pokes through; towards the end of the anecdote, she explains that she couldn’t get off looking at handsome boys on screen because “my body was the wrong recipient. . . . because I couldn’t see these boys with a girl’s eyes.” This is how Sarah expresses her true feelings: they’re specks within a glut of information, like a pill hidden inside a cake.

Sarah takes Dr. Seligman’s silence at this reveal as a sign she can talk about someone she actually slept with. In the second half of the novel, her monologue tightens (relatively speaking) around her romance with K, a man who wept like a child and whose wife paid the bills. They met in the men’s bathroom at a pub. She knew she loved him when she blew him in that bathroom stall because she was neither a woman nor a German, just a mouth. With K “there were no continents, not surnames, no parents, no jobs, no children, and, as far as it was possible, no bodies.” So, months later, when K sat up in the middle of the night, said “be with me always,” then fell back asleep, Sarah snuck out of bed and never came back. She doesn't tell Dr. Seligman that she’s heartbroken, but grief softens her descriptions. Stark, visceral memories (“him holding my head firmly whilst he was fucking me in my mouth”) turn into syrupy reflections (“K poured some of his purple into my veins and bones”). Finally, Sarah pulls out a heartbreak so heavy it capsizes her carefully cultivated spiel.

But something frightening happens when Sarah starts spilling her guts about K—she begins to believe Dr. Seligman cares about her. Initially, she interrupts her monologue to tell him he’s balding and that he’s not handsome enough to be an artist’s muse. As she divulges more, her taunts become affectionate. Near the end of the novel, when she hears his phone ring, she exclaims, “it almost makes me blush that you are spending so much time with me.” She tells him he’s a “good man” who probably kisses his wife goodbye. She gushes: “This new friendship of ours is remarkable in so many ways, and I never thought I could talk like this to someone I know.” The more Sarah misreads Dr. Seligman’s quiet attention to her body as genuine care, the crueler his silence seems.

The novel ends with a final confession and then a poem. Besieged with guilt about how she’s paying for the surgery now that they are “friends,” Sarah admits that she has inherited a “small fortune” from her great grandfather, a Holocaust-era train stationmaster at the stop before Auschwitz. And so, the novel ends as it begins: with Nazis. The final loop back to the topic that started the monologue exaggerates the impossibility of Sarah’s dream: “a clean past.” Revealing the source of her money doesn’t liberate Sarah from her lineage, nor does it alleviate her guilt—she interrupts her own confession to awkwardly assure Dr. Seligman (and herself) that her Nazi-abetting relative “was a devout man…who abhorred the use of weapons.” There’s been some shift—she starts the novel fake crushing on Nazis and ends feverishly admitting she’s related to one. But no matter how far she stretches her monologue it snaps back to its origin. So, when the prose cracks open, it doesn’t feel like catharsis. The poem reads more like a cloying plea than a resolution: “Let us turn this body into / something else. . . . Let us hold hands. / Let us be warriors.” It isn’t clear if Sarah really believes there’s an “us” outside the exam room, or if she just wants to believe it. Either way, all she knows of Dr. Seligman’s life she gleans from seven half-visible family photos on his desk. The end isn’t saccharine, it’s tragic. A good doctor (or, not a totally inept doctor) leaves Sarah with a variation of the pains that she came in with. Even worse, she might not even realize it.

Jensen Davis is a writer in Los Angeles.