C
IRCUMSTANCES AROSE WHICH MEANT THAT
I
WAS OBLIGED
to postpone my next appointment with Elizabeth Cruikshank.
In the days when social policy over the treatment of the mentally ill was more conservative, many hundreds of men and women in Britain had been confined to ‘care’ for the bulk of their adult lives. One of my duties at St Stephen’s, the hospital in Haywards Heath, was to monitor the patients who had been inmates so long that the hospital had become their only home. Among those whom it was my melancholy business to oversee, one case especially troubled me: a man who suffered from the unshakeable conviction that he had a wolf lodged in the upper portion of his skull. His behaviour was always perfectly docile but to his perturbed mind this phantom, to which he was the unwilling host, was a threat not to himself but to the world at large. In fact, as I had said in my report when he first became my responsibility, in my view he was now too institutionalised for the world to be anything but a far more serious menace to him.
Not long after my first encounter with this unfortunate, I found myself, due to some delayed appointment, killing time by
visiting Whipsnade Zoo. It was a filthy November day and, walking briskly to keep my circulation moving, I landed up at the far corner of the zoo, by the enclosure which houses the wolves.
I was at once drawn by their lean shadowy forms and their long-legged stilted gait. But what held my attention most was the way their narrow, vigilant muzzles and haunted eyes put me in mind of this man, so much so that I began to speculate whether the captive creatures mightn’t suffer from the fantasy that they had a desperate human being trapped inside their skulls. Whenever I saw this patient now, I thought of those penned-in wolves. I could never decide whether it was the influence of the delusion or being confined like a beast which had rendered him so visibly lupine.
But that he was a harmless, docile wolf, I was convinced, and for more years than I could bear to calculate, he had been stashed away in the upper storeys of the hospital which had originally served as one of the big Victorian asylums.
St Stephen’s had retained in its running a remnant of the asylum policy wherein the madder the inmate, the higher up the large mock-Gothic pile they were placed; and, in the cases of the potentially violent, in locked wards, with confining cells, and with nurses trained to deal with any dangerous outbreaks. We even had restraining jackets, based on the old ‘strait’ kind, though as Gus once said, why a ‘restraining’ jacket was deemed to be less offensive than a ‘strait’ one, beat him. He and I agreed one evening, over a whisky or two, that if we were ever forcibly confined we would rather be straitened than restrained. (‘And while we’re at it,’ Gus had added, ‘what in God’s name is wrong with the old word “asylum”?’)
My purpose in visiting St Stephen’s was to conduct the long-term patients’ annual review, which had been scheduled for the following day. For the most part this meeting was a mere routine of briefly reviewing, and then renewing, existing measures—security levels, medication, treatment plans—but when the wolf man’s name came up I found myself asking, ‘Why, as a matter of interest, do we keep him on level five?’ Five was St Stephen’s top security ward.
I was the consultant and the person who’d known the wolf man longest and, as I had expected, no one had any answer to this question.
‘Have we any evidence of violence?’
Level five’s charge nurse, an Irishman with bad skin and reddish hair, said that, as far as he knew, we didn’t.
‘Has he been any trouble at all, Sean? Anything not on the record we should know about?’
‘Nothing, Dr McBride, so far as I’m aware. Though…’
‘What?’
‘He’s always saying he
might
do something. Or so I’m led to believe. Can’t say he lets on to any of us.’
‘But that’s his delusion, isn’t it? My point is, why are we pandering to it? We’ve never had the smallest peep out of him in all the time I’ve been here. I think we should try him out on level four, or even three, see how he goes. Anyone got any objections?’
I knew they wouldn’t have. And I caught the train to London with the self-satisfied feeling that I’d performed at least one valuable action that day.
The reason the meeting at St Stephen’s had had to be brought forward was because I was obliged to be in London the following day. I was to appear as an expert witness in a medical case, which gave me an opportunity to visit Gus.
Gus lived in prodigal squalor in a cramped, snuff-coloured flat on Marylebone High Street. I’d never had much clue about Gus’s private life. I gathered from some source, not Gus himself, that he had been married. Signs of various involvements were occasionally discernible though I never met Gus in the company of a woman with whom, so far as I could judge, he had any close tie. I saw him once coming down Shaftesbury Avenue with a tall, elegantly dressed, striking-looking older woman. There was a Russian air about her—she had a dancer’s bones and deportment—but if Gus noticed me he concealed the fact and something in his manner kept me from making my presence known. I thought afterwards that he had looked vulnerable with the woman on his arm.
But no woman I’ve ever known could have managed more than a night or two at Gus’s flat. To this day, I couldn’t say whether the nicotine-coloured walls were that shade to blend in with or as a result of his addiction. I removed a plate of what looked to have been egg and beans and brown sauce and settled into a peeling leather armchair that put me in mind of a rhinoceros with dermatitis.
Gus poured me a whisky, picked up a half-smoked cheroot from the ashtray, stubbed it out absent-mindedly, lit a fresh one and stretched out a leg on the sofa. Watching him, I was aware of a sensation which often visited me when I saw Gus, which was that with him I was safe from harm.
I don’t know when I first began to ask myself, at some point in any association, whether or not this person would be likely to shop me to the Nazis. I’m not even sure what this question means since I’m not a Jew, a Gypsy, nor, so far as I know, homosexual. I dare say it has something to do with losing my mother’s unquestioning support. If push came to shove, my mother would probably have shopped me because she would have judged it right to save her own skin for the girls’ sake, or my father’s. Perhaps I’m being mean, but Olivia, I often felt, might shop me for a couple of pretty dresses. I couldn’t have told you how Dan would stand this test. He might have proved the staunchest of allies but I wouldn’t be sure until an occasion to test it arose, which summed up some crucial element in my relationship with Dan. Bar—I didn’t have even to consider it—would never betray me, however I might have betrayed her—and I was never too sure about my own potential behaviour in this hypothetical situation—and Gus, I was entirely confident, without a thought to his own safety, would lead a Resistance force to rescue me.
For Gus the fearful things which lurk for most of us at the ragged edges of consciousness were mere flimflam rubbish and piffle before the wind. With an agile innocence, he simply stepped over them or swept them aside. This, it came to me, in an access of gratitude—as I drank a generous measure of his excellent single malt, in the smoky, familiar room, and felt the muscles in my neck and shoulders begin to ease—was why I loved him. It was also why it was easy to tell him when I was afraid.
The court case that had brought me to London concerned a twenty-year-old female student’s suicide. The family was attributing the tragedy to the negligence of the consultant, a Dr
Hannan, and I was an expert witness for the defence. From what I could tell, the case had been conducted with due professional propriety but it brought up inevitable anxieties. There but for the grace of some god or other went I. Any of us who did this work could find ourselves in poor Hannan’s shoes.
Elizabeth Cruikshank was more than usually on my mind because of the postponement of our appointment, and the relaxing effect of the whisky, and the sense of security which Gus induced, prompted me to ask, ‘Would you mind if I talk to you about somebody?’
Gus, the most voluble of men, had also the gift of listening deeply. He listened now, only getting up to refill my glass as I struggled to summarise the state of affairs with Elizabeth Cruikshank.
One asset of an analyst’s training is that it teaches you pretty effective recall. Not that in this case there was much to remember. What, when you came down to it, did I really know about my contained, grey-eyed patient after all these weeks apart from a succession of refractory silences? That she had been a librarian; that she had married; that she had two children, who, so far as I was aware, were not close enough to have visited; that she refused medication; that she always had with her a brown leather bag; that she appeared fascinated by the quince tree in the hospital garden; these, and my sense of some mortally dangerous secret, squirrelled away beneath that politely occluding veneer, were the sum of what I had to report.
‘She’s got under your skin,’ Gus observed when my sketchy account petered out. ‘Is she a burden? That you mind about her is obvious, but does she weigh on you, get you down?’
I considered this. ‘No, to a surprising extent she doesn’t. I rather enjoy her presence.’
‘That’s good. When all bets are off theoretical statements about “therapeutic commitment” are daylight rubbish. You might as well lean on air.’
‘For what it’s worth, I do mind about her. I mind rather a lot.’ For the first time, it struck me that I was anxious about this.
‘Yes, you do,’ said Gus firmly. ‘Thank goodness.’ Probably he had sensed my unease. One of the things I liked in Gus was that he could pick up one’s state of mind without the need to comment on it. ‘Have you noticed how no one thanks “goodness” any more? Goodness is out of fashion. So is minding. Minding’s considered bad form. God knows why. You must mind. You have to love them—I don’t mean go to bed with them, I don’t have to tell you that, but need them, need them to live, for your sake, too.’
‘“It’s in giving yourself that you possess yourself”?’
‘Who said that?’
‘Lou Andeas-Salome.’ One of Freud’s first disciples.
‘Don’t know that one,’ said Gus. ‘But she’s right. The thing is, Freud never intended his ideas to be taken as a recipe for bogus detachment. You know, the Greek potters could tell the very second at which a glaze turned in a kiln from red to black. They didn’t need a thermometer. They trusted the blink of an eye. The same’s true of the heart. The heart can register true or fake before the theorist can say “knife!” Freud, for all his other nonsense, knew that. Naturally, others’ll tell you otherwise.’
‘Oh, “others”…!’ I said. ‘You mean like Jeffries?’
‘Jeffries wouldn’t save his own mother if she were drowning in her bath. The only reason he’d cite the Oedipus complex is
as a valid excuse for refusing to see her naked. You must plunge into it with them. You have to—stand, or sit, splash your feet in it—it doesn’t matter as long as you’re there too. Show them you can bear it, and you’re willing to bear it with them.’
‘But can you bear anything for anyone else, really?’
‘No,’ said Gus. ‘You can’t. But you can let them know you’ll try. And that, very likely, you can’t bear it either but—’
‘In saying so show you are bearing it?’
‘Exactly,’ said Gus, again, approvingly, and poured me another large Scotch presumably as a reward. I’d drunk the first one pretty rapidly. It tended to be like that with Gus, I’m afraid.
‘The Stoics had the right idea,’ Gus resumed. ‘Trouble with this age is it’s got hold of the crackpot notion you can do away with suffering. Jeffries and his type are responsible for that kind of babyish attitude. Someone says, “Help, help, it hurts,” and they hand out a bloody drug, and say, “There, there, this’ll make it better.” That’s sticking-plaster mentality. It doesn’t make the bloody awfulness go away. It just covers it up. Pathology. The logos of suffering, or the word on suffering. Well, the “word” on suffering is it has to be bloody well suffered, not covered up.’
I thought of Mrs Beet saying to me they had taken all the sorrow as well as the joy out of her husband when they lobotomised him.
‘So how do we help the suffering suffer bearably?’
‘The word patient comes from the same root as suffer. Patient: one who suffers patiently.’
‘It’s rather a tall order,’ I suggested, nursing my whisky glass. I wasn’t unaware that I used alcohol to make the unbearable bearable.
‘Yes, it is,’ Gus agreed. He sounded mournful. I’d never fathomed what his own brand of suffering consisted of. ‘And of course some can’t take it. Like your patient. They want to bale out. You can’t blame them.’
We sat awhile consumed with our own thoughts. I was reflecting how frequently I wanted to bale out myself.
‘What is suicide, Gus? What are people up to, really, when they seriously try to kill themselves?’ You’d be surprised how little my profession generally considers these questions. I suppose it’s because we are kept so busy dealing with the consequences.
Gus lit another cheroot. ‘Acceleration of life, perhaps? A suicide is someone who wants to take a short cut to one of the only certainties: death and taxes. Only taxes aren’t as sexy as death. You could argue that a suicide is getting straight to the point: it’s a fast-track method of transportation from one realm to another.’
‘But there isn’t a place you can be transported to behind the scenes, is there? Another country called “Death”?’
‘The ancients thought so,’ Gus said. ‘I trust them. They’d a feel for the mysteries. Hades, for instance. Mind you, it was a pale sort of a place. Achilles hated it. When Odysseus visited Hades, Achilles told him he would rather be the meanest ploughboy alive than the great Achilles deprived of life.’
‘But there was Socrates,’ I said. ‘What about him? He chose suicide, didn’t he?’
‘Yes, but for the Greeks suicide was always linked with courage. It takes courage not to be defined by life and courage consciously to enter the biggest of all unknowns. Socrates was
using his life, sacrificing it, you could say, to make a point to the Athenians about their law. He was insisting that they act rationally, put their money where their mouth was and apply the law’s sentence for the crime he had not been acquitted of committing. It wasn’t that he wasn’t able to bear life. Quite the contrary. He was so unfussed about it he knew how to play with it! He could have escaped the sentence, and it was clear they were keen as mustard that he should. That was the correct form: you applied the death sentence, the culprit made appropriate arrangements with his chums and tactfully buggered off. The last thing the authorities wanted was Socrates’ death on their hands. But he wasn’t having it. He put the frighteners on them by not caring enough about saving his own skin. You see, Socrates knew something else. His last request before he downed the hemlock, which incidentally wasn’t such a jolly way to depart as people suggest—it would have given him shocking stomach pains—was that a cock be sacrificed to Asclepius. One of his better jokes.’