"Well, there's no need to shout at me," Alsop said, glancing up.
"Candidly -- mind if I speak straight out?"
"Of course not," Paul muttered.
"I think you're letting things get on top of you. Bad. Mustn't do it.
If you try and identify with these unfortunates all around us you're
much too liable to wind up joining them. You had some psychotherapy once,
didn't you?"
"A course of analysis," Paul said. And repeated his habitual cover-story:
"Thought it was the simplest way of getting a patient's-eye view of
psychiatry."
"Yes." Alsop nodded slowly once, and said again, "Ye-es. . . . Well,
there's nothing to be ashamed of in feeling the strain. This isn't the
easiest of hospitals to work in, despite its size. But it'd be damned
silly if you let yourself crack up under the petty kind of pressure
Chent can generate. So you ought to take precautions while there's time."
-- Like what? Cultivate Holinshed and lick his boots a bit?
Tell Iris to go to hell?
"However," Alsop went on briskly, "the schedule's too full this morning to
worry about healing the physicians. Fuller than you appear to realise.
I asked you to add Mrs Chancery to the roster for today, and you didn't."
Paul started. "I'm sorry! It quite slipped my mind."
"Papa Freud he say . . ." Alsop drew a large black arrow to exchange the
order of two patients on the list. "You don't like the Chancery woman,
I know. No more do I, but at least I remember to hide the fact. And who
in the world is this 'Urchin' I see mentioned?"
"You should have the admission report on her. We brought her in last night
-- emergency."
Alsop rifled papers. "Not here. Holinshed must be sitting on it. Lots of
gory details in it? I find that kind usually take longest to get out of
your boss's clutches."
-- What am I to make of cracks like that? Is it camaraderie or an assertion
of superiority over Holinshed? You're fine, how am I?
Paul summed up the story as concisely as he could.
"And you find this dreadfully puzzling," Alsop commented. "I'm surprised.
Female exhibitionism is rarer than male because it has more . . . ah . . .
institutionalised outlets, like strip-tease dancing, but it does exist
and can generally be fitted into a coherent diagnosis. I'd hypothesise
an excessively restricted childhood with so much stress laid on bodily
exposure that the mind just" -- he pantomimed crumpling a sheet of paper
-- "folds up under the pressure. Did you tranquillise her on admission?"
"No, I gave her no medication at all."
"Therapeutic nihilism is an obsolete standpoint even in psychiatry,
young fellow! I worked under a medical superintendent who suffered from
it, but I thought he was the last surviving dinosaurian exponent of the
notion. Why not?"
"Well . . ." Paul fumbled for words. "Because she came quietly, I suppose
you'd say."
"The fact remains, she had a mere hour or so earlier broken a man's arm
with her bare hands. You say she's a tiny little thing. Well, a black
widow spider isn't exactly a ferocious great monster, but I wouldn't
start keeping one as a pet."
-- Stuff the sarcasm, for heaven's sake!
"But how about what's happened this morning? I never heard of a case
of hysterical aphasia where the patient set about getting the doctor to
teach her English. Besides which, she isn't aphasic."
"All right, what's she suffering from, then?" Alsop waited with a triumphant
air, expecting and receiving no answer. He sighed at length.
"I have this nasty suspicion you're convincing yourself you've run across
a brand-new subspecies of mental disorder which you can write up for
publication, talk about at the next congress you go to, and ultimately
name after yourself."
-- Sounds like a capsule version of your life story!
And a tacit admission of the truth of that followed.
"Fell into the same trap myself when I was your age or a bit younger.
Remind me to dig out the case-notes sometime. They're . . . well . . .
illuminating. Reserve judgment, young fellow, and then hang on a bit
longer still. There's nothing so damaging to your opinion of your own
competence as having to climb down in public from some limb you've
wandered out on. Brrr!"
He acted a fit of the shivers and laughed without humour.
"Let's settle the matter, shall we? Deal with her first. Charrington's not
going to cut his throat while he waits."
At first Paul was gratified by the thoroughness with which Alsop set about
double-checking the results of last night's examination of Urchin, first by
satisfying himself that the girl didn't understand English yet was capable
of talking some language of her own, then by repeating the physical
examination with a running commentary.
"Get me a urine sample, Nurse -- first thing tomorrow morning, please. . . .
We should have a blood sample too. Ought to type every patient who comes
in and give them a card showing it on discharge. Might save lives later,
case of accident. . . . Curious facial structure! Nothing Asiatic about
it whatever except this very marked epicanthic fold. . . . I think you
should book her an appointment for a skull X-ray, young fellow. I agree
she's quite fluent in this odd language of hers -- which I imagine you'll
check up on, won't you? -- but she could hardly have got to the middle of
England on Upper Slobovian or whatever unless somebody brought her here,
so injury may have caused her to revert, say to a childhood language. . . ."
-- Admirably comprehensive. And yet there's a false note. I'm damned certain
there's a false note.
Abruptly, with a stab of dismay, he decided he knew the nature of it.
-- The bastard! He thinks I might be right in calling this an anomalous
condition not in the literature; he won't admit it, but he's making damned
sure he doesn't let slip the chance of reporting it before I manage to!
*12*
The clock was marking a quarter to two with the inevitable bang boom
and
clink
as Alsop climbed into his Vanden Plas Princess R and Paul
turned wearily towards the mess.
-- I suppose he's right about these courses I ought to go on, but why
can't the damned things crop up at a convenient time, while Iris is away?
Just see her face when I say hullo darling nice to have you home I'm off
tomorrow for a course and I'll be back in a fortnight. On the other hand,
maybe I should try it. Declaration of independence.
He felt a stir of vague puzzlement. The proprietary attitude regarding
Urchin which had come on him unbidden, because he felt his own long-standing
nightmare of waking into a "wrong" world gave him special insight into
her condition, had made him speak more sharply to Alsop this morning than
he would normally have dared, culminating with a ten-minute argument
about one of the patients due for discharge today. To his surprise,
far from being annoyed Alsop had been positively cordial; for the first
time in two months he had volunteered suggestions about some courses
Paul might attend.
-- I'll . . . think about it.
Ferdie Silva was leaving the mess as he entered; neither Phil Kerans
nor Natalie was present -- only Mirza, distastefully examining a plate
of stewed apples and custard which Lil had just placed before him.
"Has Natalie gone?" Paul demanded.
"I saw her go off with Rosh Hashanah, the Newish Jew Here," said Mirza,
touching a spoonful of the dessert with the tip of his tongue on the last
word and pulling a face. "Lil dear, lose this somewhere, would you? And
give me a piece of cheese if we have any fit for human consumption. The
soup is ghastly too, Paul, in case you were thinking of trying it."
"I must eat something," Paul sighed. But Mirza was quite right: the soup
was half cold with patches of grease floating in it. At least the
bread-rolls were today's delivery. He munched on one of them.
"Why did you want our golden-hearted Dr-rudge, anyhow?" Mirza inquired,
making a mouthful of the rolled r's.
"Oh, she asked to be kept informed about Urchin."
"She'll get it all on the grapevine, I imagine. I've been hearing about
no one else all morning."
"Why in the world?" Paul put down his spoon, staring.
"You mean you haven't realised that no remotely identical case has
arrived at Chent since the year dot or the birth of Holy Joe whichever
is the earlier?" Mirza sliced his cheese with rapid elegant motions and
laid it out tidily on a biscuit. "The patients know, the staff know,
how is it you don't?"
"Pretty sure of the patients' diagnostic ability, aren't you?" Paul snapped.
Mirza gave him an astonished glance. "Paul, I thought a night's good sleep
would have cured you of yesterday's fit of grumps! I'm sorry if I trod
on your corns."
Paul controlled himself with an effort. "No, I'm the one who should say
sorry. Go on with what you were saying."
"About the patients' diagnostic ability, you mean?" Reassured, Mirza
reverted to his habitual mocking lightness. "Actually I have enormous
faith in it. How else do you think I could get along in England?"
"If you're making a serious point, make it seriously. Otherwise shut up.
I'm not in a joking mood."
"Yes, I
am
serious." Obediently Mirza put on voice and expression to
match. "Bear in mind, Paul, I come from a country which is" -- he raised
fingers to count off the successive items -- "Moslem, underdeveloped,
recently ex-colonial, predominantly rural, different in just about
every possible way from industrialised, citified, nominally Christian
Britain. And here I am pretending to tinker with precisely that aspect
of a human being which is affected most by cultural conditioning. So I
was sent to an English-speaking school and an English university -- so
what? This is merely a late gloss on my basic orientation. I haven't been
inside a mosque since I was eighteen, but the mosque is inside me. Your
cracked bell up there in the tower" -- a jerk of his thumb towards the
ceiling -- "bothers you at least partly because this is a country of
Sunday morning church-bells. To me it has no cultural associations. But
when that fellow in Disturbed has a bad spell and starts wailing at the
top of his voice -- do you know the one I mean? -- I jerk like a frog's
leg on a galvanic plate, because to begin with he hits the same three
notes as I used to hear every sunrise during my childhood and before
I can remember where I am my mind has already completed the call in
anticipation:
Ya-Allah il-Allah
. . . . The muezzin was stone-blind and
about ninety, but he used to climb forty feet of stairs before sunrise
every day."
Reminiscently he paused, eyes focused on some faraway spot beyond the
wall of the room.
-- I ought to be ashamed of myself, thinking that struggling against
this damned silly British class set-up is bad. How'd I make out with
Mirza's problems of adjustment? Culture shock.
--
Culture shock!
The idea was so dazzling he completely lost the thread of what Mirza was
saying, and was only recalled a minute later by the Pakistani's offended
question about being bored.
"Sorry, Mirza I" Paul recovered hastily. "Something just hit me. Tell you
about it in a second. Go on -- this is very interesting."
"Wouldn't have thought so from the blank look on your face just now,"
Mirza grunted. "I was saying that in my view no patient here is
entirely
insane. Even the ones out of reach of communication probably aren't --
a few of them do occasionally come back with memories of the disturbed
phase, incomplete though the memories may be. Or incommunicable, which I
suspect is nearer the truth. But the milder ones, suffering from things
like compulsion neurosis and in here more because they get on their
families' nerves than because they're overtly dangerous to themselves
or society, do retain huge areas of relative sanity. Day and night
they associate with their fellow patients, and though they lack the
professional background required to organise their observations into
the basis for a diagnosis, that doesn't prevent the sheer volume of
what they see and hear from distilling into clear patterns. I've often
had a patient say to me about a new admission, 'Ah, that's another of
them like Mr So-and-so!' And when I looked up Mr So-and-so's case-notes,
damned if they weren't right. Do you follow me?"
Paul abandoned his soup and Lil exchanged it for a plate of macaroni
cheese and chipped potatoes.
"Ought to have a resident dietician," Mirza said sourly. "Do you know I've
put on two inches around the waist since I came to Chent? Disgusting!"
"I see what you mean now," Paul said, having tasted this course and found
it at least edible. "Once when I was a student I was told to write up a
new admission to see if what I said matched the real admission report,
and I was completely muddled until one of the other patients made a
comment that set me on the right lines."