“Not at all.”
I went back out of the building, past the spectral passengers staring out from their sunken, exotic porch, and walked toward the tiny cottage to which she had directed me. As I approached it I saw a young woman in a white blouse and woolen skirt, clutching against her hip a stack of books and a large Manila folder, coming toward it also along the asphalt drive from the rear of the grounds. She stopped in front of the door and, supporting the pile of books with her lifted thigh, began searching awkwardly through her pocketbook, apparently for a key.
“Can I help you?” I asked.
“Oh. Yes, thank you. If you could hold these books for a minute it would be a great help.”
I took them from her, and while she found her key and unlocked the cottage door I said, “I’m looking for Miss Brice. Miss Crowe said there might be a job available in the Occupational Therapy department.”
“Yes, that’s me. Would you like to come in and talk about it?”
“Yes. Thank you.”
Her office, in contrast to the main building and to the plain clapboard exterior of the cottage which it entirely occupied, was furnished and decorated in a very modern style, with steel-and-leather sling seats, a blond-oak desk and sectional bookcase and a large Gauguin print on the wall. I set her books on the desk, and she asked me to sit, which I did, obliquely facing her, in one of the sling seats, having time, while she arranged some papers and made a call on the white telephone, to observe her manner and appearance. She was very little older than I, a fact which, combined with her easy, intelligent and incisive air of authority, I found oddly disconcerting; for young, poised, well-educated professional women of this type—as her telephone conversation revealed her to be—were unknown to me and made me feel uncomfortably provincial. But there was about her a quality of sincerity and sympathy—of genuine, personal, more than professional interest in one—which was very reassuring; and after talking to her for a very few minutes, I felt entirely at ease. Perhaps I should set down our interview in some detail, for it will tell a good deal not only about Bea—as I shall call her now—but about the Lodge as well, more briefly than would otherwise be possible.
When she had replaced the receiver and sighed cheerfully in the manner of one who is used to, and pretends a genial regret for, responsibilities which actually are dear to him, she smiled at me and said, “Well, we could either begin with you telling me all about yourself, or me telling you all about us. Which would you rather do?”
“I’d better tell you about myself,” I said. “Then you may not have to bother with the rest of it.”
“All right.”
“There isn’t really very much to tell. I’m twenty-two years old and just got out of the army. I’ve never had a job before, except part-time work—you know, like mowing lawns and delivering groceries—and I’ve never been to college. I went into the army right after I got out of high school. I’ve lived here in Stonemont all my life, and I’ve always been kind of curious about this place; so I thought it might be interesting to work here.”
“Do you mean a permanent job, or just summer work of some kind?”
“No, I mean a permanent job.”
“Because if you just got out of the army you’ll have the G. I. Bill, won’t you? Don’t you want to go to college now?”
“No.” After a pause in which she seemed to anticipate some further explanation I added, “I’m not really very ambitious. Or maybe I’m too restless, or something. I’ve never been able to think very far ahead, I guess. But I feel as if I want to go to work right away. I want to learn something about life from experience, not just from books.” I stared for a few moments at the Gauguin print on the wall, silently considering how I might better express the reasons for my application. She did not interrupt, and in a moment I went on. “My grandfather owns the Dangerford Tavern here in town. I could go to work for him—I think he really wants me to—but I don’t want to. I want to do some kind of work that would be a direct help to people. I suppose that’s the only real ambition I have. That’s really why I decided to come here.”
“But don’t you feel that you could help people just as well—much better, even, in more important ways, like medicine or science—if you were better educated, better equipped to help them?”
“Yes, I suppose so. But those are pretty big things for me to try; I’m not sure at all that I could do them well. And anyway, they take too long. I don’t think I could wait that long. I might die, or something, before I ever finished getting ready—before I even got to work. And then I’d never get it done. I just want to do some simple thing that I feel pretty sure about, while I can.”
“It doesn’t sound as if you trust the future very much,” she said.
“Maybe not. I don’t ever think about it very much. I don’t particularly like to.”
She folded over the corner of a sheet of paper, creasing it thoroughly into a small triangle with her finger tip, as if considering a further question on this subject, which in a moment she appeared to abandon, however, for a more practical one.
“Are you good at sports?”
“A few of them. I play individual sports pretty well—like tennis and swimming. And I’m a good rider. That’s the thing I can do best. I guess that’s the only thing I can do really well.” She smiled at this confession in a way that made me like her very much.
“Do you have any hobbies?”
“Yes. Well, I used to have, before the war; I used to collect folk-music records and make model airplanes.”
“Oh, that would be useful, because we do a lot of crafts, you know—weaving and woodwork and that kind of thing. Are you a good dancer?”
“No. I can’t dance at all.”
“Really? Do you mean you never have, or you can’t?”
“I can’t. I’ve tried to learn, but I just can’t get anywhere. I don’t think I’ll ever be able to dance.”
“Oh.” She stared at me thoughtfully for a moment, as if summarizing these things in her mind, and then leaned forward across her desk, spreading her fingers on her cheeks casually, while she told me about the Lodge.
“This is a private hospital,” she said. “You may know that, but many people don’t. That means it’s very different from state institutions, both in the type and number of patients and the kind of treatment they’re given. We have only thirty-five patients here; they’re mostly young people, between sixteen and forty, and all schizophrenics. They are all considered curable, and each one of them has an analyst working with him. That’s the only kind of treatment given at the Lodge, and it’s very expensive. These people are all from very wealthy families who pay several thousand dollars a month to keep them here. That means they have superior backgrounds—economically superior, anyway—private schools, travel, and so on. Most of them are also of superior intelligence, and many of them were people of considerable distinction in the outside world.” She paused for a moment and asked, “Do you know anything about mental illness?”
“Not very much, no.”
“Well, schizophrenia is one of the most common and difficult kinds of illness to treat. There is a popular conception that it means ‘split personality,’ and that all schizophrenics are clear-cut cases of a Jekyll-and-Hyde personality; but that isn’t true at all. Schizophrenia is much more complicated than that. People with this disease can have just about every manifestation of mental abnormality there is—there are catatonics, paranoics, hypomanics, and so on. They have the most complex and bewildering syndromes—mixtures of associated symptoms—in the world, which makes their treatment very difficult. The patients here are in all different states of disturbance and deterioration; some of them have been rigid and speechless for months, some of them talk nothing but garbled nonsense and can’t feed, clothe or bathe themselves. Others seem to be such assured, vigorous, intelligent people that you wonder what on earth they’re doing here. They seem much saner than we do, sometimes. But they’re not stable; they move through manic cycles of behavior, and sooner or later they break down. They may be discussing Kant or Shaw with you one afternoon, in the most profound and witty way in the world, and the next morning be rolling and screaming on the floor, completely out of contact.”
She paused to examine the effect of this upon me—it was one of genuine fascination—and then went on: “There are different theories about the causes of schizophrenia and the most effective way to treat it. Some people feel that it’s an organic disease—that is, that there’s something actually physically or chemically wrong with the structure of the brain—and that it can be treated like any other physical illness. Other doctors believe that it’s a functional ailment—that there’s no actual physical damage or deficiency—but that the mind has become deranged functionally, through acute emotional problems, tensions, conflicts and so on. We tend toward the last interpretation, here; and also we only use classical therapy—that is, analysis. This is so expensive, and usually so prolonged, that most state institutions can’t afford it. They do a great deal with shock—electrical or insulin shock—and with drugs and surgery. But we don’t feel that those methods are as thorough or permanent. May I ask what you know about psychoanalysis?”
“Almost nothing,” I said.
“Well, it means curing by analyzing. Talking with the patient, encouraging him to talk through free association, leading him to discover and examine the causes of his illness. Going back to the old conflicts and tensions, and exploring them until he begins to gain insight into them. This takes years sometimes and requires enormous skill and experience on the part of the analyst. You can see how limited it is, too, because the patient must be in contact before you can communicate with him effectively, and schizophrenics very often aren’t. Now, what do you think about all this?”
“It sounds very interesting,” I said.
“Really?”
“Yes.”
“All right, let me tell you about my department. A very important part of the treatment is to keep the patient engaged in normal and interesting activities; it keeps them in touch with reality, gives them recreation and physical exercise and creative expression. So occupational therapy is a most important part of it. It includes all kinds of things: crafts, like rug-weaving, leather-work and so on, gardening, sports, music, social activities—we have a tea dance once a week, which is why I asked if you could dance—occasional automobile trips, hiking, bird-watching, picknicking—anything that falls outside of actual clinical treatment. Which means that we actually spend a great deal more time with the patients than the doctors do. All of these activities are voluntary, but we encourage patients to participate in as many of them as they can without becoming confused or anxious. Naturally, some of them are in better shape to do these things than others and require much less attention and supervision; and individual patients will vary from day to day in their interest and ability to concentrate. Some patients have “privileges”—which means that they can walk about the grounds or engage in activities unattended—but most of them must be accompanied and supervised by an assigned attendant who is personally responsible for them any time they are outside their actual quarters. This means that we have to maintain a fairly large staff, although the nurses help out a great deal. We usually have three or four students here on rotation, from colleges like Antioch, and others—people who are majoring in O. T. and have to do some practical training as part of their course—but I still have to keep a basic permanent staff of at least six, if I can; and right now I only have five.
“The work, as you can see, is difficult, nerve-wracking and sometimes dangerous. It requires a great deal of intelligence, patience, skill at manual crafts, personal authority and integrity, and—oh, heavens, all sorts of things. The ideal O. T. worker has never been born yet. But most of all it requires sympathy, I think—a real interest in these people. Workers who come here just out of curiosity, or on a temporary basis, are never really successful, because they can’t endure the abuse they get from the patients, the constant tension, the occasional violence and the—well, the unpleasantness of working in a mental hospital. Because there
is
something unpleasant about spending most of your life with people who are willful, slovenly, abusive, violent and sometimes physically repulsive. Now—” she leaned back in her chair and smiled, brushing her hair with a frank and feminine gesture—“do you still feel the same about working here?”
“Yes.”
“You do?”
“Yes, I’m more interested than ever, as a matter of fact.”
She laughed. “All right. Then come and have a look around, and I’ll show you some of the things we’ve been talking about.”
For the next hour, while we toured the grounds and buildings of the Lodge, there grew in me a strong and positive sense of joy—a feeling of identity and of metier, so long anticipated and so often despaired of that, in being recognized at last, it created in me an almost festive feeling, a kind of jubilation which, although it resembled other, transient, sensations of the kind which I had had before—on winning the tournament, on leaving for the war—I was able to distinguish from these less durable experiences by the more profound, more tranquil thing which accompanied, or perhaps, indeed, produced it: a stilling and quieting, a glowing process of composure, like the formation of a crystal in my spirit. I took a great pleasure and pride in everything—in the grounds themselves, with their gracious landscaping, the great-leaved oaks and poplars casting pearl shadow on the walks, the espaliered apples against the rose-brick walls, the tennis courts and playing fields, with long morning shadows on the velvet grass, the craft shop with its fresh, clean-scented lumber, its great tan-colored rolls of cowhide, bundles of raffia and sheaths of bright, lithe, virgin wicker—as well as the attendants whom we passed sometimes, strolling with patients about the grounds or conducting games or classes, whom I felt to be people of extraordinary sympathy and intelligence and with whom I felt an immediate and profound fraternity. Since my employment here seemed now, so far as Bea was concerned, to be foregone and to depend only upon my own inclination, I was able to presume, without fear of disappointment, my accession to them and to take in them the mystic, proud delight which a devoted novice feels in the paraphernalia of his profession.