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‘You could make jelly with those,’ Elizabeth Cruikshank suggested, looking away from me to the garden. ‘It makes good jelly, quince.’
I dropped by Cath Maguire’s office later on my way home.
Maguire was a lesbian but not the sort that doesn’t get on with men. I had occasionally speculated what had made Maguire prefer her own sex. She was an attractive, sparky woman and while not my type exactly certainly could have been many men’s. But when I once tentatively started on this line, she shut me up by saying, ‘You’re not suggesting that women are second best or anything, are you, Dr McBride?’
But one lucky consequence of Maguire’s preference was that we had the kind of good-natured intimacy which is only possible between a man and a woman where sex will never be a factor. And I’d long given over questioning the whys and wherefores of Maguire’s sexuality. What mattered to me was that I trusted her instincts and depended on them to fill out my own.
‘How’re you getting on with Mrs Cruikshank?’ I asked.
‘Elizabeth? I like her. Quiet, like I said. Doesn’t make demands. Probably doesn’t make enough. Always very polite.’
‘Any visitors?’
‘None I’ve seen, anyway. A couple of phone enquiries from her children but so far as I know they haven’t visited.’
So she had children. I wouldn’t have guessed this and there was no mention of them on her record. She looked almost too girlish to have given birth. ‘How many?’
‘Two, I gather. A boy and a girl. The girl was a bit, you know, stand-offish but the boy sounded nice.’
By the phone in her room was a book squashed face down. Maguire read two or three books a week.
‘Does she read?’
‘She’s got a couple of books out of the library, but now you come to mention it, I’ve not seen her read them, unless she keeps them for nights.’
‘What are they? Did you see?’
Maguire screwed up her face as she did when trying to concentrate. It gave her a look of a small girl which always made me feel warm towards her.
‘Not fiction anyway.’
Maguire devoured fiction. Her favourite author was Ruth Rendell but I’d noticed some surprising ones too. For a time she seemed to be reading her way through Proust.
‘She used to be a librarian.’
‘Really? I wouldn’t mind that job myself.’
‘Too late,’ I said. ‘I need your help here.’
‘You know, I don’t know if in the long run a really great story isn’t more help.’
7 (#ulink_6bcd7ce4-497f-5e59-9424-e31eab73777c)
THAT AUTUMN, OLIVIA HAD DECIDED TO ENROL IN SOME evening classes and she was out at one of them when I got home. She had a tendency to these sudden enthusiasms. They rarely lasted, and I therefore hadn’t bothered to ask much about this latest. I was never quite abreast of which class was when, partly because I was glad to have an hour or two to myself. Olivia never forbade me anything openly but it’s not so agreeable to listen to Schubert, or Bach, when the person with you would rather hear The Archers. Not that I’ve anything against The Archers—it was more that Olivia had something against Schubert: she assumed respect for my tastes but somehow it had the discouraging effect of dislike.
I had a deadline for a paper I was reviewing for a clinical journal, which was an added reason for preferring my own thoughts. So when the phone rang and interrupted them I was put out till I heard Gus Galen’s voice.
‘Can you beat it?’ Gus was one of those people who never announce themselves, as if one spent one’s time simply waiting to hear from them alone. ‘They’ve got that baboon Jeffries giving the keynote address. What the hell is a “keynote” anyway, when it’s at home?’
‘I don’t know,’ I said. ‘A musical metaphor maybe?’
Gus was referring to the international conference on anxiety and depression which was to take place the following year.
‘Nothing melodious about Jeffries’ approach. It wasn’t so long ago he was advocating bloody lobotomies.’
Lobotomy, or leucotomy, the surgical severance of the frontal lobe of the brain from the subcortical area, became fashionable as a remedy for intractable depression in the late thirties and during the forties and fifties something like 80,000 such surgical operations were performed before it dropped out of style again. But since 1970 there had been a revival of interest in the procedure.
Gus was one of the first modern neurological experts to query the wisdom of this, which, as with everything else, he did vociferously.
‘They claim it worked on monkeys but I wonder what the poor beasts would say about it if they could speak,’ he said, not long after our first encounter. ‘Those baboons haven’t a bloody clue how it works on humans, if it works at all, which I doubt. Monkeying about with the brain like that as if they were God All Bloody Mighty, though God would have more sense than to be so interfering.’ As with many of his other associations, Gus appeared to have some informal access to the mind of God.
There was, and still is, a political division in our profession between an interventionist approach, which roughly speaking means drugs and ECT, and the so-called ‘talking cure’. Most psychiatrists practised a largely unconsidered mixture of the two, but Gus was passionately against the hard-line attitude and his training in neurology combined with his forceful personality gave him clout.
There’s a place for drugs, and with schizophrenia or bipolar states only a fool or a miracle worker would attempt to manage without them. But, by and large, I was of Gus’s mind. In fact—and of course he knew this—it was as a result of seeing the consequences of a lobotomy that I began my analytic training.
Mr Beet was a retired bank manager, a man with a large florid face gone blurred around the edges. He was neat as a guardsman, always in a pressed shirt and jacket and tie, but in the way that a small child is turned out, when the impression matters more to the dresser than the dressed. It was his wife who kept him trim. Her hobby was making padded coat hangers, a distraction, I surmised, from the sight of her husband’s motionless misery. He had been an active man once, she told me with remembered pride, though overactive when the anxiety dominated. By the time it was my job to monitor her husband he sat with his mouth never properly closed. You couldn’t say he stared out of the window—his eyes were too horribly devoid of any directed interest.
Mrs Beet had soft English skin and fine hair and delft-blue eyes and seemed always to be holding on to some part of her husband, his hand, his elbow, his knee, patting it to remind him—or perhaps herself—that she was there. Despair, and loyalty, had taught her to make the hangers, when she came with him to the hospital for his occupational therapy. I imagine he simply sat there and she, like a mother with an awkward child, covered the hangers for him. One Christmas, she gave me three as a present. ‘I don’t suppose you’ll have any use for them, Dr McBride, but maybe your wife would like them, that is if…’ I reassured her that I had a wife. She was a sensitive woman and would have hated to make a mistake about my marital status, or my sexuality. Olivia, unusually, welcomed the gift: the padded contours, it turned out, were useful for her evening clothes.
I speculated sometimes about Mrs Beet and where she had ended up. It was unlikely that her husband lived long in that condition. ‘He was depressed before, yes, Doctor,’ she told me in her deferential yet subtly assertive tone, ‘and anxious. But anxiety and depression aren’t the worst things. They never told us how it would be afterwards. Nothing’s as bad as seeing him like this with all the light, and with all the sorrow too, gone from his eyes.’
‘I agreed to do the response,’ Gus said, ‘but I’ve got this prostate problem hanging over me and there seems to be a feeling I shouldn’t push my luck for the next month or two afterwards. All right if I get you to take my place?’
Mrs Beet appeared unassuming but she had a certain tenacious force which had a way of ensuring that the apparition of her mutilated husband stayed somewhere in the back rooms of my mind. It made one of its haunting reappearances now.
‘Oh, God, Gus,’ I pleaded, trying to dodge the reproachful recollection, ‘I’d much rather not.’
This was a major colloquium and I was reluctant to take on Jeffries, who regarded intellectual opposition as tantamount to declaration of war. He could block the career of those who were hostile to his views and although I wasn’t ambitious I was cautious. As I say, I liked a quiet life.
‘Why not?’ I was aware the tone was being made deliberately peevish. Gus had a whim of iron and didn’t scruple to bend you to it. ‘Time someone other than me made a noise.’
‘I haven’t your enthusiasm for mud-stirring, Gus.’
‘Don’t need to say anything startling. Just say how you might treat a serious-seeming case without zapping their brain cells to smithereens with drugs we don’t understand or bloody electrical impulses ditto. You must have someone you’re seeing who fills the bill.’
When I next saw Elizabeth Cruikshank the year had crossed the shadow line when the clocks change and the late-afternoon light, an hour further from the sun, had begun to fail.
‘Spring forward, fall back’ was how my mother taught us to remember which way the clocks moved at the spring and autumnal equinoxes and, as with many of her proverbial sayings, the words stayed in my mind. They stayed my mind, too, those familiar phrases, providing some kind of outposts of reassurance. Perhaps it was her way of mothering me, or perhaps—more fairly—it was an element of her mothering I was able to accept.
Poor Mother. I rejected her as much as she rejected me—and for the same reason. Neither of us could bear the other with Jonny gone—or, rather, neither of us could bear that he had gone and we were, each of us, the reminder that he had. It was years before it occurred to me that my mother believed I blamed her for Jonny’s death every bit as much as I believed she blamed me. After all, it was she who had been uncharacteristically ill that fatal morning and allowed her two small sons to go off unsupervised.
Maybe I did blame her? I can’t be sure. There’s so little I am sure of now, but I was surer in the St Christopher days. I was sure, for example, that the business of Elizabeth Cruikshank’s marriage was unimportant. It wasn’t, I would have bet my pension on it, the relationship with Neil which had left her knocking at death’s door.
As we spoke, that afternoon, I was aware that I had come to associate his name with the onset of lethargy. Drowsiness stole through me, and I began to feel impatience over the man whose impression remained too nebulous to be the centre of the mystery which had brought his wife to me. As we sat with the room darkening round us, I had an acute sense of her feeding me titbits of trivia.
‘We lived in Hampstead at first. But we moved to be near Neil’s parents.’
‘Did you miss Hampstead?’
‘I missed the Heath.’
None of this told me more than that she was still unwilling to let me into the circumstances of her concealed catastrophe. And, indeed, I had no right to any inroad into it. Besides, there’s a rhythm to all nature, including human nature, and like a good naturalist a prudent analyst knows how to wait.
‘How long were you and Neil together before you married?’
‘A few months? I can’t remember.’
‘He doesn’t seem to have left much impression on your memory.’
‘Neil was all right. It was me that was wrong.’
‘In what way “wrong”?’ I tried to keep the note of curiosity out of my voice but by now I longed to know.
It had grown too dark to see her distinctly and, reluctantly, as I try to avoid artificial light as long as possible, I switched on the bronze lamp, in the figure of Hermes, which I had on the table by my chair.
I’m fond of this lamp. I bought it in Paris when I once took Bar Buirski there, while she was still Bar Blake.
Outside, I made out the shape of the ginger tom poised on the fence and beside him, in weird juxtaposition, I could see a reflection of my lamp and my patient in the blue armchair, the few feet between us expanded into an unnavigable mirage of air.
At that moment she began to speak, and, as she did so, the cat dropped down to merge with her image in the glass in an action so swift I almost jumped up in protest. It was as if a bird was being targeted with that intent feline spring. I can still see the orange shape leaping into the reflection of Elizabeth Cruikshank, as I can hear her near inaudible words.
‘I was faithless.’
‘Can you say more?’
‘Another time. It’s not possible now.’
8 (#ulink_ca7c18de-e238-5b2b-9b9d-d28bda8fe8b4)
GUS RANG ME THAT EVENING WHILE OLIVIA WAS BESIDE ME in her dressing gown, her toes, like twin neat rows of glossy rubies, resting on my mother’s embroidered footstool. She’d asked my help in varnishing her nails. I sometimes think my mother was right and I’d have made a better career as a surgeon: I’ve a remarkably steady hand.
When I spoke of work in front of Olivia I was always conscious of a slight awkwardness, and there were times, more than made me quite comfortable, when I wished I could leave the room, or ask her to leave. I conducted the conversation with Gus in the shorthand I’d developed for such occasions.
‘I’ve been thinking,’ I said, ‘I’ll do that thing for you.’
‘Great stuff.’ I could tell he was delighted. ‘Got someone up your sleeve?’
‘Exactly how long have I got?’
‘The back end of May. No need for any earth-shattering stuff. Just your natural sweetness and light will do.’
‘Thanks a million. I’ll be crucified by Jeffries & Co. if I go on about “sweetness and light”.’
‘Better men than you have been crucified. I’ll be at your side to fend off the baboons if the bloody medics let me.’
A patient who might have fitted Gus’s purpose for the conference paper was a young Pakistani student studying maths and physics at Sussex University. He’d been found wandering in the early hours on a trunk road outside Brighton. The police patrol that had picked him up reported him ‘disoriented and apparently praying’. He was brought into St Kit’s where a diagnosis of schizophrenia had finally been applied.
Pages of a notebook covered with seemingly bizarre thoughts and disconnected prose, and an inability to name the current British prime minister, had formed the basis of this diagnosis. Later, when the confused young man had been formally admitted, and I was present at his case conference, I pointed out that precious few of us, in a state of distress, would be able to name the prime minister of Pakistan and that the seemingly deranged sentences in the boy’s notebooks were attempts at formal logic. As a result of this intervention he was given over to my care.
He was agitated, desperately homesick, distraught, but not, I concluded, psychotic. I took him off the Modecate injections and tried to restore some sort of equilibrium. They don’t say so in the textbooks but a lot can be effected through patience and calm. Maguire and I were in agreement that if this commodity were available on the NHS there would be far fewer admissions to psychiatric hospitals.
I’m not sure why there is something shaming about having no one to confide in but in my view a good deal of aberrant behaviour stems from unbearable isolation and the socially unacceptable sense of being quite alone. Hassid, I concluded, was suffering not so much a nervous as a social breakdown. Away from his close-knit Karachi family, his religion, his customary diet (food plays a much larger part in emotional stability than is usually acknowledged) and the regular ritual practices he had been raised in, he had lost his bearings.
I can’t pretend to have liked all my patients but those I did like tended to be the ones I found I was able to help most. I could never decide if it was gratitude at having some positive effect on their lives that made me like them, or if liking makes some significant therapeutic difference. In any case, I liked Hassid, I understood that he was lonely, but his character also caught my curiosity and I established his trust through an indistinct memory, that grew to a clear recollection, which enabled me to identify the repeated appearance of ‘iff’ in his notebooks, not as some schizophrenic misspelling, as had been supposed, but the correct logical term for ‘if and only if’. As a result of this lucky strike he confided to me the sad account of what had occurred.
He had gone, nervously, on account of the new and strange environment, to a student party where towards the end of an already confusing evening he’d been slipped a tidy slug of vodka in his soft drink. The unaccustomed alcohol, together with the discovery of what he had innocently imbibed—I gather the idiot who performed this gross act was crass enough also to brag about it—combined to destabilise the poor young man’s mind. His family, he told me, were strict Muslims, and the shame and guilt, along with the physical effects of the alcohol, precipitated a mental crisis. The university suddenly seemed to him a place of evil and satanic darkness, from which he felt an understandable need to flee; which is why the police patrol picked him up shoeless, beating his head and reciting, to them incomprehensible, verses from the Koran.
In those days doctors had more licence. Hassid was patently terrified of returning to his student quarters. I decided the best I could do for him was to keep him with us for a spell. I judged that what he needed most was rest in sympathetic surroundings while he found his feet.
But also there was something in it for me. I enjoyed our sessions together because I discovered that what Hassid wanted, once he had recovered his centre of gravity, was to talk about his passion.
It is a feature of our profession that you are exposed to others’ interests and concerns. Thus, in the course of my duties, I have learned something of seamanship, sheep breeding, tax inspection (and tax avoidance), domestic science, the Petrarchan sonnet, horticulture, dentistry, astrology, astronomy, bell-ringing and the rudiments of how to fly a helicopter.
Hassid’s ruling passion, I discovered, was quantum mechanics. He was mad for Schrödinger’s cat, he idolised Dirac, he worshipped Niels Bohr. What intrigued me most, so far as my limited scientific intelligence was able to comprehend it, was Hassid’s account of their account of the nature of reality.
The structure of existence, which he attempted to convey to me—though often his words flowed by too fast for me properly to grasp them—was a thrilling and disturbing one, a tentative world of ambiguous possibilities rather than things or facts. Electrons, he explained, existed as a sort of misty potential, occupying no physical space in the material world but summoned into being only when a human measurement was made to determine their location.
‘You see, Doctor,’ Hassid said, ‘it is not that electrons are here waiting, like invisible germs to be discovered under the microscope—’
‘Or black swans waiting to be discovered in Australia?’ I interjected in an effort to show I was following.
But Hassid politely dismissed this. ‘Not swans, no, Doctor, not even black ones, because, you see, this is not a question of induction. Electrons are not, in the sense we mean it generally, here at all.’ His expression became sage.
I’ve always thought it remarkable that, while our bodies stand in the visible world, we ourselves are not in the world of three dimensions and our inner life has no position in space. And, equally, how little of another person’s reality is visible to us. We see their form, their features, their shifts of expression but all that constitutes their sense of self remains unseen. And yet this invisible self is what to the individual constitutes their real identity. I wondered, as I limped behind his explanations, if Hassid’s electrons were somewhat similar.
‘It is like a thought before one performs an action. The electron is no place and then’—he waved his elegant hand like a graceful conjuror—‘presto! Suddenly it is here, coming into existence out of seeming nothingness—but it is we’—excitedly he gestured at his chest—‘who bring it out. By what we do to it, you see, we give its state reality.’ His face glowed with intense pleasure at the arcane mystery he was initiating me into.
It wasn’t so surprising, I reflected after one of Hassid’s ‘seminars’, that he’d been mistaken for psychotic. The reality he described had its mad element. For one thing, it seemed to place human understanding at a central place in the universe. But then, great wits are oft to madness near allied. He was an engaging boy. And I warmed to him. But I worried that my feeble scientific understanding was insufficient to aid his adjustment to the ordinary world.
The day after Elizabeth Cruikshank had uttered those cryptic words to me I called by Maguire’s office and found her chatting to Hassid over the library trolley.
‘What’s going on here?’
‘Hassid’s helping us out.’ Making people useful was one of Maguire’s rehabilitation principles.
‘Sister wants me to look after the book trolley, you see, Doctor.’
The greater part of the library collection was the dud end of the old county library supply. Other books had been donated, or left behind, by patients or their visitors. Most of these were crime novels and thrillers, there were a predictable number of romantic novels and blockbusters, some out-of-date travel books, an old restaurant guide and a few uninspiring-looking classics. Wondering who would nowadays read The Swiss Family Robinson, I picked out a tatty copy of Pride and Prejudice.
‘Here you are, Hassid. This is a piece of Englishness which I guarantee won’t corrupt you.’
Hassid looked eager and remembering his tendency to bestow on any light-hearted remark of mine the status of a logical truth, I put the book back. ‘Don’t worry, it’s not doctor’s orders!’
‘Bet you wish it was, though, don’t you, Dr McBride?’ Maguire was aware of my partiality for Jane Austen.
Hassid changed the subject. ‘Doctor, Lennie has asked me to go with him to the match on Saturday.’
‘Lennie the cleaner?’
