It is difficult to describe what my feelings were as I drove between the old gateposts. Two mutually exclusive states of mind, excitement and a kind of numbness, vied for supremacy. Looking to my left, I saw an expanse of purple heather. The sun was a pale, floating disc; however, from time to time it would discover a small breach in the quilt of clouds and a thin, coppery light would pour through.
I stopped the car and the engine fell silent. Peering through the windscreen, I gazed at what was left of the hospital. The central tower had collapsed, the roof had fallen in, and rectangular portions of the eastern sky were visible through the upper windows. Parts of the brickwork were blackened, debris was scattered in front of the facade and a shaggy moss had started growing on the sills. I pushed the car door open against a sudden blast of wind. After getting out, I cupped my hands around a cigarette and lit it. The reed beds shimmered and I heard, once again, their distinctive sound. Ripples spread across pools of silver water and a flock of birds ascended vertically in the distance.
The outbuildings were clearly uninhabited. Mr and Mrs Hartley’s cottage had all of its windows boarded up and the paintwork was peeling badly. The area in front of the bicycle shed was overgrown with weeds. When I had finished the cigarette, I dropped the filter onto the gravel and flattened it beneath the sole of my shoe.
I set off down the drive, all the time keeping my eyes on the hospital. As I advanced I succumbed to a curious illusion. It seemed to me that I was walking on the same spot, not progressing, and that the diminishing distance between myself and the hospital was the result of Wyldehope gliding forwards. Somewhat sooner than I had expected, I found myself facing the porch, deliberating whether or not to enter. I doubted very much that the structure would be safe, but curiosity got the better of me and I stepped inside. There was no floor – only exposed beams covered in rubble and broken slate. The vestibule, with its faded wallpaper, grand staircase and suit of armour, was entirely gone, and in its place was a bomb-site enclosed by four high walls. Some seagulls, disturbed by my arrival, fluttered across the big, open space, exchanging a low perch at one end of the building for a high perch at the other.
The stairs leading down to the sleep room had been destroyed and all that remained of the basement was a depression in the debris. I cautiously stepped over the wreckage and, as I moved forward, the bottom of the hollow came into view. Among the rubble and slate I saw a twisted, rusting bedpost. I then noticed something among the scorched bricks and detritus that made my heart jump. The pounding in my ears was loud and furious. I was looking at a miniature doll: one of the Christmas tree decorations that Hartley had found in the tower attic. From my vantage point, the doll looked completely undamaged.
How could that be?
I wondered.
Surely, it should have been reduced to ashes by the fire?
The seagulls flapped their wings and emitted harsh calls. Another bird was wheeling high overhead. I edged down the slope, but the rubble beneath my feet began to shift, and I had to scramble back up to the lip. In doing so, I created an avalanche of broken bricks, and when I looked back down the doll had been completely buried. I knew exactly what I had seen, but even so, the indefatigable voice of reason had already started to suggest that perhaps I had seen nothing at all.
I stood very still, listening to the sound of my breathing. In spite of this reminder of my own physicality, the sensation of my lungs working like bellows in my chest, I felt like a ghost, a fragile assembly of motes, floating in the air and easily dispersed. The close transit of a moth would threaten my integrity. I left the hospital and took the path that led down to the sea. For a long time, I sat among the dunes, watching the dun-coloured waves crashing on the shore. A tear trickled down my cheek, but it did not come with a note attached, explaining the reason for its existence. Was I crying for Chapman? Mary Williams? The sleep-room patients? Maitland? Was I crying because I had lost Jane, or was I crying because, somewhere along the line, I had lost myself? I wiped the tear off my face and studied the tip of my finger. Moisture on skin. I had no sense of ownership. I had shed a tear, but it seemed to belong to a stranger.
In due course, I walked back to the car. I looked at the hospital for the last time, knowing that I would never return. Clouds glided past the sun, dappling the front elevation with patches of light and shadow. It was then that I noticed the figure, framed by one of the upper windows. A small figure, no bigger than a child, looking out across the heath, in my direction. The light changed and a moment later, she was gone.
That night, I dreamt of the lighthouse: an oil-black sea, a starless sky, and a yellow beam sweeping across the sluggish waves. As usual, each revolution of the lamp was accompanied by a sound that evoked heavy industry. The roar of a furnace, the scrape of metal against metal. But then the scene began to fade, until all that remained was the sweeping beam, which shrank and became a blinking light embedded in a grey metal box. At the same time, the mechanical sound softened and became an electronic pulse, repeating on a single pitch.
Beep. Beep. Beep.
I was lying in a bed, and when I rolled my head on the pillow to look in the opposite direction I discovered that there were other beds, close to mine, and beyond them a desk, behind which a nurse was sitting. All of the other patients were asleep. The nearest was Celia Jones. My mouth was dry and I felt very hot. Curiously, even though I was dreaming, I seemed to lose consciousness, and only woke again when someone rocked my body. I opened my eyes and saw Maitland and Jane gazing down at me. Although I recognized Jane, she looked very different. Her hair was much longer and parted in the middle. She was wearing a short orange jacket, a frilly blouse and a necklace which seemed to be made from wooden beads. Maitland also looked different. His complexion was tanned and he had grown a peculiar, drooping moustache.
Jane pressed her palms together beneath her chin, as if in prayer, and I noticed that she was wearing a wedding ring. I could smell her perfume. It was Chanel No 5.
‘James,’ said Maitland. ‘Wake up. Wake up. Your wife is here to see you.’ But I could not respond. My tongue was stuck to the roof of my mouth.
‘What happened to his hand?’ Jane asked.
‘An accident, I’m afraid,’ Maitland replied. ‘One of the trainee nurses was careless and he slipped over. The cut was quite deep. I’ll get one of the nightingales to change the dressing this afternoon.’
Their eyes met. Maitland’s brow creased and his expression communicated deep concern. But the longer they looked at each other the more I detected other registers of feeling. Tenderness, self-interest, guilt and desire.
‘James?’ said Jane, rocking me gently again. ‘It’s me.’
Maitland stepped to the end of the bed and examined a chart. ‘I’m sorry. He’s only just been medicated.’
‘I should have let you know I was coming.’ She bent her knees and lowered herself to my level. ‘James? Can you hear me?’ I wanted to reply, but my eyelids felt heavy and closed over my pupils.
‘He’ll be like this for some time.’
‘I should have called,’ Jane repeated.
‘It’s all right. I wanted to see you anyway.’ There was a long pause. ‘Have you decided?’ Maitland’s voice contained a suggestion of eagerness. Hope?
‘You’re right, of course,’ Jane replied, obliquely.
Maitland made a noise, a sudden release of breath that I was sure – if only I could have seen his face – must be accompanied by a smile of satisfaction. ‘It’s for the best. You can’t . . .’ He hesitated, and Jane finished his sentence for him: ‘Go on. Yes. I can see that now.’
‘Shall we go to my office? There are some papers you should sign.’ When Maitland spoke again, he sounded less confident. ‘Although, you don’t have to do the paperwork
right
now. If you want to spend some time with him, on your own I mean—’
‘No,’ Jane cut in. Then, more firmly: ‘No. That won’t be necessary. I have many faults, but hypocrisy isn’t one of them.’
Maitland lowered his voice to a whisper. ‘Jane. Not here.’
‘I’m sorry,’ she replied. ‘It’s just, sometimes . . .’
‘You don’t have to explain. Really. Come on. Let’s go to my office.’
I could hear Jane’s wooden beads rattling as she moved away. With considerable effort, I was able to raise my eyelids again. Jane was wearing trousers that were very wide at the bottom. Maitland’s arm was extended, horizontally, behind her. It would have been an innocent gesture – and one much favoured by paternal physicians – had his fingers not made contact with her waist. Jane did not protest, and the last thing I saw was the nurse’s private scowl of disapproval.
When I surfaced from the dream, it was as though I had been drowning. I awoke, gasping for air, and kicking wildly. It was some time before I calmed down.
I sat up in bed and lit a cigarette. Through the net curtains I could see the sulphurous luminescence of a street light. I remembered Chapman’s Chinese conundrum: ‘A man dreams that he is a butterfly, and in the dream he has no knowledge of his life as a human being. When he wakes up, he asks himself two questions: am I a man, who has just dreamed that he was a butterfly? Or am I really a butterfly, now dreaming that I am a man?’ I pinched myself. And then I pinched myself again.
Dr Hugh Maitland
Department of Psychological Medicine
St Thomas’s Hospital
London SE1
12th December 1972
Dr Peter Bevington
Oak Lodge
Nr Biggleswade
Bedfordshire
Dear Peter,
You will forgive, I hope, some lapses of formality in a communication that for all intents and purposes must serve as a letter of referral. But it concerns an individual with whom I have worked closely for two years: my senior registrar, James Richardson. I believe you met him on two occasions, once at the club, and once again when you were visiting our department.
He was, I am sure you will recall, a serious minded and able fellow. Unfortunately, he is now very ill. I have always enjoyed close, almost familial relationships with junior colleagues, and Richardson is no exception: therefore, I find it incredibly hard to write with detachment about an impressive young man who until very recently had everything to live for and now faces an uncertain and very questionable future. Nevertheless, I will endeavour, as best I can, to set out the salient facts.
Richardson comes from a medical family. His father was the Superintendent of Wyldehope, an asylum on the Suffolk coast. I don’t believe it is there any more, not even the building, as it was apparently destroyed by fire. Richardson senior died when James was a boy, and an uncle – the proprietor of a haulage business in Lowestoft – was kind enough to provide the widow and her son with an allowance. Richardson distinguished himself at Cambridge, first as a Rugby Blue, and then as an outstanding member of his college chess team. He went on to conduct some very interesting sleep research in Edinburgh, and just prior to his appointment, here, at St Thomas’s, he was at St George’s and the Royal Free.
About ten months ago, James started to experience episodes of agitated depression. These episodes became increasingly frequent and, over time, were complicated by attacks of morbid sexual jealousy (which is perhaps best understood, I believe, as an atypical instance of paranoia). Apart from being a little less talkative than usual, I can’t say that I noticed anything amiss. He was rather good at concealing his agitation, and, as for his jealousy, there was no reason, one supposes, why this should have surfaced in the workplace. I only learned of his deteriorating health when his wife, Jane Richardson (a nurse at the Royal Free), wrote to me in confidence. She is a very conscientious type and was worried about the welfare of the patients in her husband’s care. It must have been extremely difficult for her to compose such a letter – to go against the grain of spousal loyalty, especially for a woman – and I am much indebted to her. We arranged to meet the following week and she explained that Richardson’s behaviour was becoming increasingly odd at home. He was restless, irritable, and prone to angry outbursts. He was interrogating her for hours (especially when she returned home late) and rummaging through her possessions. She even caught him inspecting her undergarments and the bed sheets for signs that might confirm her alleged infidelity. I felt sorry for her. She had obviously been coping with an extremely trying situation and had had little or no opportunity to unburden herself. I assured her that she had taken the correct course of action and immediately had a frank talk with Richardson. I insisted that he should take some time off work, which he accepted, rather reluctantly, and he voiced no objection when I said that I was willing to advise with respect to medication.
I put him on the usual phenothiazine derivatives, but he was troubled by a number of side effects: low blood pressure, blurred vision, constipation, and pyrexia – to name but a few (all the regimens are detailed in his records). The fact is, I had a great deal of trouble finding anything that he was able to tolerate, and in the end I had to resort to Reserpine (3 mg by mouth, 5 mg intramuscularly). Even then, he still complained of constant headaches and nasal congestion.
I continued to meet with Jane Richardson on a regular basis. Although the Reserpine had had a beneficial effect, the agitated depression and morbid sexual jealousy returned after only three weeks. Poor Mrs Richardson was, by this time, very distraught. Indeed, I began to have very grave concerns for her own mental health. They (that is, Jane and James) had only recently purchased a mansion house flat in Hampstead and the joint mortgage was substantial. Jane was having to work additional shifts to earn more money, but her extended periods of absence were, predictably, making Richardson even more suspicious.
Things came to a head in September. Richardson became fixed on the idea that he must make his wife pregnant in order to save their marriage. Needless to say, Mrs Richardson did not agree. She resisted her husband’s advances but this only seemed to inflame his ardour, and on one occasion, when Jane returned in the early hours of the morning, he attempted to force himself upon her. It was all very unfortunate. I admitted Richardson onto Ward 5 at the Royal Waterloo Hospital a few days later. Narcosis was an attractive treatment option, because I was able to medicate him properly, irrespective of side-effects, and give him a course of 16 ECT. So far, I am sorry to report, there has been no change. His condition remains intractable. When awake, he sometimes refers to the child that he and his wife never had as if it were real.