Maitland nodded. ‘And how long do you think you’ll keep them under this time?’
‘As long as it takes,’ Rosenberg replied. ‘I’ll let you know how things are progressing.’
When the patients were all back in their beds and asleep, Maitland congratulated Sister Jenkins. ‘Well done,’ he said softly. Again, his attitude reminded me of a military man. The Americans accompanied Maitland back to his office and I returned to the sleep room. Before parting, Rosenberg had seized my arm and said, ‘If you ever come over to New York, be sure to call me up.’ His eyes were bright with raw intelligence.
I thanked him for the invitation.
The Jaguar was still parked outside Wyldehope at half past three. When I looked out of a window two hours later, both vehicles – the Jaguar and the Bentley – were gone.
That evening I sat at the bureau and added a few more paragraphs to my unfinished paper, but I wasn’t satisfied with what I had written. The language was too dense and the sentences didn’t flow. Forcing myself to concentrate was giving me a headache. I smoked a cigarette and thought about Jane. When I closed my eyes, the recollection of her kiss became so vivid it was like a repetition of the actual experience. I could feel the pressure of her lips against mine and their slow parting; I could detect a trace of her perfume in the air.
Since returning from our trip to Southwold, only a single opportunity had arisen for private conversation. I had said that I wanted to see her again, preferably alone, the following weekend, but she had already made arrangements to visit her mother in London. She had squeezed my hand and said: ‘Never mind. We’ll sort something out.’ I wasn’t sure what she had in mind.
A blast of wind shook the windowpane and its loud rattle disturbed my musings. I drew diagonal lines across the two paragraphs I had just written. It simply wasn’t good enough. I stubbed out my cigarette, tidied up my notes and put them in the bottom drawer. The Reserpine was still there. I hadn’t bothered throwing it away. I picked up the container, looked at the wastepaper basket, but found myself oddly disinclined to complete the action I had started. Instead, I put the container back in its usual place. Consulting my watch, I noted that it was eleven thirty.
I shuffled along the hallway, yawning, until I came to my bedroom door. Reaching into the darkness, I slid my hand along the wall until I felt the light switch. It emitted a soft ‘click’ and the room instantly materialized: the large iron bedstead, the chest of drawers, the bulky wardrobe. In the middle of the carpet, about a yard or so in front of me, a metallic gleam caught my attention. I crouched down to take a closer look.
‘It can’t be . . .’ I was conscious of my words as if they had been spoken by someone else. They sounded abnormally loud.
I picked up the object and let it roll into the palm of my hand. It was a wedding ring. I tried to slide it onto my index finger and found that it was too small to get past my knuckle. Without doubt, it belonged to a woman.
Was I the victim of a prank? Hartley possessed a spare key, identical to my own, but it was patently absurd (I realized after a moment’s reflection) to suppose that he and Sister Jenkins shared a common interest in playing practical jokes. Had Hartley been persuaded then by Sister Jenkins to plant the ring in my bedroom in order to accuse me of theft? Again, the idea was totally absurd. My brain generated a number of equally unsatisfactory theories, which I promptly rejected on account of their utter implausibility, until only one remained: Alan Foster must have slipped Sister Jenkins’s ring into the back pocket of my trousers, and it must have fallen out while I was getting dressed that morning. The fact that I had not detected its presence earlier was perhaps a measure of how distracted I had become.
I was about to call Sister Jenkins on the telephone, in order to inform her that I had recovered her ring, when it occurred to me that telling her the truth might not be such a good idea. She would think me unobservant or, even worse, absent-minded, and very likely share her views with Maitland. After giving the matter some thought, I decided that I would invent a harmless lie, something that would clear me of any fault or blame. I placed the ring on my bedside cabinet and pulled back the cover and blanket.
As I was falling asleep, listening to the sound of the sea, the memory of Jane’s kiss returned. Great black waves rolled through the room and I was carried out across a vast ocean of forgetfulness.
Dr Joseph Grayson
Department of Psychological Medicine
London Hospital
Whitechapel
London E1
23rd June 1955
Dr Hugh Maitland
Department of Psychological Medicine
St Thomas’s Hospital
London SE1
Dear Dr Maitland,
Re: Miss Isobelle Joyce Stevens (d.o.b. 12.10.1929)
The Old Alms House, 28 Rope Street E2
Thank you for agreeing to see the above patient, who we discussed today on the telephone. She has been in my care now for fifteen months and I would value your opinion with respect to her future treatment. She is twenty-six years of age and in her relatively short life she has managed to collect several diagnoses, some of which are rather exotic. These include
folie circulaire
, melancholy and catoptrophobia. My own view is that she suffers from a severe manic depressive illness with pronounced psychotic features.
Her background is as follows: her father cannot work on account of a major injury he sustained during the war, and her mother is a seamstress who is employed by a clothes’ manufacturer in Bethnal Green. She has one sibling, Maude, who is her junior by three years. Miss Stevens was a premature baby and slow to develop. She did not talk or crawl until quite late and she missed much of her early schooling because of a recurrent chest complaint. Be that as it may, she eventually caught up with her peers and on leaving school she was able to get a job as a waitress in a cafe.
Soon after her nineteenth birthday she is said to have gone through a change of character, becoming, in turns, increasingly indolent and impulsive. She also became fearful of mirrors and insisted that her parents cover all reflective surfaces in the house. When asked what she was afraid of, her responses were nonsensical. She was attended by her family doctor, Dr Fletcher, a man sympathetic to Freud and psychoanalysis, who attempted a talking cure which was, as one would expect, wholly ineffective. Miss Stevens’s behaviour became increasingly erratic and she lost her job as a consequence.
After a period of several months, during which she hardly stirred from her bed, Miss Stevens’s mood improved and her fear of mirrors remitted; however, one set of symptoms was immediately replaced by another. Miss Stevens could not sleep, she became garrulous, and she began to express grandiose ideas: for example, that she had been in conversation with a representative from a New York casting agency and that she was going to be a successful actress in Hollywood. She took to wearing flamboyant clothes and frequented local public houses, where she received a great deal of attention from men. Needless to say, she became the subject of much gossip and when her parents learned of her behaviour there were heated arguments at home. Some of these altercations must have been quite ugly, because Dr Fletcher noted the appearance of bruises on her face and a swollen, twisted ankle. At last, recognizing the limitations of his chosen method, Dr Fletcher referred Miss Stevens to my predecessor, Dr Meadows, who admitted her to the Royal London for a period of two months and treated her with bromides. This approach was successful, insofar as she became less agitated and expansive, but a depression followed, and thereafter this pattern of alternating mood states was repeated, usually resulting in an admission during the manic phase of her illness.
At the age of twenty-three, Miss Stevens became pregnant and she was not able to identify the father (although it seems very likely that he was one of her drinking companions). This proved to be the final straw for her parents, who subsequently threw her out of their home. Miss Stevens was taken in by a women’s refuge and the baby was removed for fostering three weeks after its birth. The sad consequence of this was a severe depression, which culminated in a suicide attempt by overdosing. Fortunately, Miss Stevens was discovered in the act and immediately given an emetic.
Since that time, Miss Stevens’s condition has not improved. Indeed, I regret to say that (in spite of my own best efforts), if anything, her symptoms have got worse. During manic episodes, her delusions are more florid than ever – she talks incessantly about how beautiful she is and how she is destined to be an international starlet – and when she is low she feels utterly useless and wishes that she were dead.
When I took over the case from Dr Meadows, I discontinued her bromides and replaced them with lithium carbonate. This was very effective and her mood swings flattened out but, sadly, she developed several side effects – nausea, tinnitus, blurred vision and, more alarmingly, attacks of arm hyperextension. I was forced to reduce the dose from 1200 mg to 800 mg daily. The side effects disappeared but, alas, so did the benefit.
Once again, I am most grateful for your assistance. Miss Stevens is an interesting example of cyclical mood disturbance with accompanying delusions and I very much look forward to receiving your advice concerning her management.
Yours sincerely,
Joseph Grayson
Dr Joseph Grayson
MB BChir., MRCP., D.P.M.
6
I discovered Sister Jenkins in the sleep room. She was sitting behind the desk, scrutinizing a rota. One of the bathroom doors was ajar and I could see Mary Williams, through the opening, energetically mopping the tiles. The air smelled of disinfectant.
As I approached the desk, Sister Jenkins altered her position and said, ‘Good morning, Dr Richardson.’
‘Sister Jenkins,’ I responded happily. ‘I have something for you.’
She looked at me askance. ‘Oh?’
I took the ring from my pocket and raised it up for her to see. She permitted herself a faint smile. ‘Did it come out – finally?’
‘No. I found it in Alan Foster’s room.’
‘Where?’
‘Under the radiator.’
‘How strange. I looked there myself.’
‘It was behind the valve. Right in the corner.’
I gave her the ring and I was rather surprised by her reaction. She didn’t put it on immediately, as I had expected. Instead, she extended her arm into the cone of light that spread out beneath the lampshade. She manipulated the ring, turning it over – first one way, then the other. Her eyes showed suspicion and her brow creased. Then, pinching the ring in such a way as to suggest that it might be dirty, or contaminated, she placed it with a precise action on a pad of lined notepaper. Her expression was a combination of disappointment and irritation.
‘Is there something wrong?’ I asked.
‘It isn’t my ring,’ she said bluntly.
‘But it must be.’
‘Dr Richardson, I know what my wedding ring looks like.’ Sister Jenkins realized that I would need some persuading. She reached for the ring and pushed her fourth finger through its centre. It was clearly too tight. ‘See?’ she said. ‘It doesn’t fit. My ring was larger, the gold more yellow. This ring is much smaller and made from gold that is very pale – whitish.’
‘Then whose ring is it?’
She shrugged and said, ‘It doesn’t belong to any of the patients, that’s for sure. Only Mr Cook and Mr Murray are married and they are big, strapping fellows. And none of my nightingales are married – although Sandra Perkins and Margaret Thomas are engaged.’ Her expression became uncharacteristically wistful when she added this afterthought.
For a few seconds I was speechless, but I felt obliged to continue my charade: ‘Then I suppose this ring must have been lying behind the radiator for quite some time.’
‘What an odd coincidence,’ said Sister Jenkins. ‘That I should lose my own ring in the same room.’
‘Yes,’ I replied, feeling distinctly uncomfortable and mindful of the fact that the telling of one lie invariably necessitates the telling of others.
Sister Jenkins shook her head. ‘I can’t believe that I missed it, and how remarkable that none of the nightingales came across it while cleaning?’
I felt the heat of embarrassment on my cheeks and my speech became disjointed. ‘What a shame. I thought I’d sorted everything out. How very annoying. To be frank, Sister Jenkins, I don’t think we’re going to find
your
ring now.’ I looked across the basement in the direction of Mary Williams. ‘The trainee probably did her best, but . . .’ Sister Jenkins gave a curt nod. I picked up the anonymous ring and added, ‘Perhaps I should write to the previous occupants of Mr Foster’s room – to see if I can find out who it belongs to.’
‘There weren’t any previous occupants. The room was empty before Mr Foster’s arrival.’
‘Very well. I shall sell the ring to a jeweller and donate the proceeds to the hospital.’
Again, Sister Jenkins shrugged: an implied ‘As you wish.’
‘How have the patients been?’ I asked, eager to steer the conversation in a different direction.
‘None have required additional drugs. They have all been sleeping very peacefully.’
‘Excellent,’ I said, dropping the ring into my pocket.
I walked off and circled the beds, stopping at the end of each to study the charts. It was difficult to concentrate, because I kept on thinking about the ring and trying to fathom how it had come to be on the floor of my bedroom. In the end, I had to accept that it had always been there, hidden from view, and that some unlikely sequence of events had caused it to suddenly appear. What that sequence of events might be was beyond my powers of deduction. Having reached this reasonable but unsatisfactory conclusion, I dismissed all further thoughts about the ring and got on with my work.
Marian Powell was due to receive ECT. She was one of the younger women, and, like Kathy Webb, still a teenager. There was something about her face – the angularity of the features, the weariness of her expression – that suggested extreme poverty and hardship. I had seen that same type of face many times before, particularly in the East End of London. It was a face that had known hunger, violence and cruel deprivations.