All in the Mind (4 page)

He had often wondered, as he stood in the newsagent’s deciding which golf magazine to buy, who were the millions who sustained such a massive market in top-shelf literature? But although he had occasionally taken a glimpse at the covers, and even more occasionally looked inside, he had never felt tempted to buy one. Yet there they were, in shops up and down the land, presumably being purchased regularly or else the shops wouldn’t bother stocking them. And, as Celia had been discovering, the Internet had seen the market expand beyond the wildest pornographer’s wildest dreams; in cyberspace, a vast army of men and women indulged in any and every sexual practice for the titillation of a vast global army of consumers. Just not Matthew.

His problem was that he was currently powerless within the relationship. He was the one who had strayed. He was the one begging for forgiveness, desperate to stay in the marital home, and so avoid the anger of his children and the laughter of his colleagues. Celia would never be in a stronger position and he felt his weakness every time she came out with yet another Web-based assertion to back her basic case that he had a problem which ‘together’ they could solve. This was why he had no way of wriggling out when, to his considerable but unspoken annoyance, Celia said she was worried he would not tell Professor Sturrock the full story if he saw him on his own, so she was coming too.

4

It was 9.20 before Sturrock before Sturrock was ready to see Emily Parks. He hated running late so early in the day. He viewed his meticulous punctuality as one of the few positive qualities he had inherited from his father. But this morning, events were against him. He had been held up by a call on his mobile from Ralph Hall, the government’s Health Secretary and the only senior politician he had ever treated. Hall had sounded hung-over, and panicky. He asked if Sturrock might be able to come and see him that afternoon, even though their next appointment wasn’t until Tuesday. For obvious reasons, Hall didn’t like to visit the hospital.

‘Today is difficult,’ Sturrock had said. ‘I have patients most of the day, and budget meetings later. It’s tricky.’

Hall seemed desperate. ‘I wouldn’t call if it wasn’t important, Martin. It’s just that I’m not sure I’m going to hold it together.’

In his head, Sturrock ran over his schedule again. His only options were to skip one of the budget meetings, or reschedule his afternoon appointment with Hafsatu, which cut both ways. Part of him was longing to see her, part of him dreading it.

‘Look, Ralph, it is not impossible one of my patients won’t show. It happens a fair bit. I’ll call you later whatever happens, but if a gap appears, I’ll find a way to get to Westminster.’

He walked over to the windows to rearrange the blinds. Though the sky was grey, the rain was holding off and there was even a bit of sun struggling to get through the clouds. He liked light, and when the sun was out, he preferred to have the blinds up and the sun streaming in. But Emily’s sensitivity about her appearance seemed to
be
exacerbated by light. On her last visit, she had clearly been troubled by the sun, shielding her face from it and wincing, as if in pain. He had interrupted their conversation to lower the blinds, but this had made her more than usually self-conscious and they hadn’t made much progress after that. So today he left two of the blinds up, lowering the one that would place her chair in shade. Then he went to the door to call her in. He always called the patients in himself. It was one of those little touches he prided himself on.

‘Hello, Emily, would you like to come in?’ He waited at the door, stepped back to allow her in, then watched as she walked to the soft leather armchair in the far corner of the room in her usual timid, hunched way. She stared into her lap while Sturrock gathered up a brown folder from his desk, and went to sit in his chair, a few yards from her. He smiled, waited to see if she had anything to say, and when it was clear she hadn’t, he said simply, in as friendly a manner as he could: ‘So?’

Sometimes, that simple little question was sufficient to get the patient to open up with a general assessment of their current mood, what they had been feeling, and what had been happening in their lives. Once or twice, that had worked with Emily. Today, she smiled weakly, but said nothing.

He was feeling stuck with her, a feeling not helped by the lack of time for preparation. Yet they had made good progress when she was first referred to him. So phobic was she of being seen in public that his first four visits had been to her parents’ house, where she had been staying after the fire, ‘OTOs’ as Phyllis called them: out-of-the-office consultations. Sturrock had introduced her to strategies for coping in the street and now, though she still found it difficult, at least she could make it to the hospital. She always asked for the first appointment of the morning. It meant there were fewer people around to see her, fewer people coming and going in the little waiting room. Her mother would drop her as close to the hospital entrance as she could, then wait in the underground car park listening, as she did all day, according to Emily, to Classic FM. Sturrock knew that Emily found the journey agony. She would arrive in a state of distress, only calming down once
they
began talking over how she felt. In order to soothe her, he’d developed the tactic of asking after her friend Sami. He’d noticed that the only time she really lost her inhibition was when she talked about Sami, the Muslim owner of the twenty-four-hour corner shop where, once darkness fell, she would do her shopping.

Shopping was a huge challenge for Emily. When she had been staying in Hendon with her parents, it hadn’t been a problem because her mother had done it all. But when Emily decided to move out and try to live on her own again, in a flat just off the Caledonian Road, she’d been forced to shop for herself. Since the nearest grocery was Sami’s, she’d ventured in and immediately been struck by the warmth with which he’d greeted her. She felt as though he was not even conscious of her appearance. When he talked to her, he looked straight into her eyes. After that she did all her shopping at Sami’s and he made it clear to other customers that, no matter what she looked like, she was a valued and respected customer. He had even intervened when Emily ran into trouble outside his shop one evening. She wore a dark headscarf to hide her disfigurement and once or twice, she was mistaken for a Muslim woman. A group of kids hanging around outside the shop had started jeering at her, shouting things like, ‘Go back to Somalia!’ then, ‘Show us your tits, Muslim tart!’ Sami had rushed out to defend her and had even closed up his shop so he could walk her home.

Sturrock liked the sound of Sami and saw him as a useful ally. He had recently set Emily the homework test of ensuring five new people saw her face each day, so he had been particularly pleased to hear that Sami had suggested she might help out in the shop from time to time, in order to get used to people looking at her. Emily’s immediate reaction had been to say thank you, but no. But Sturrock hoped that, given time and Sami’s encouragement, she might change her mind.

He knew that Emily’s personality made it particularly difficult for her to deal with negative reactions to her condition. She was so fundamentally decent a person that she simply couldn’t understand why one human being would abuse another, purely because of their appearance. She’d talked about her schooldays and how, even though there was
plenty
of bitchiness among some of her friends, it had never occurred to her to pick on someone because they were fat, or thin, or black, or Asian, or Irish. She was always the one who, rather than joining in with the taunts, would tell her friends off for making disparaging remarks. When, at one consultation, he’d asked her to bring with her the following week something she was particularly proud of, she’d come bearing a school report, at the bottom of which her form teacher had written, ‘
Emily is a strong role model for other girls. On more than one occasion, I have had Emily to thank for helping me to deal with unpleasant behaviour. She has a strong sense of right and wrong and a very clear moral compass. You should be very proud of the person she is becoming
.’ So proud were her parents that they’d had the report framed, and hung it on the wall in the hallway.

The challenge was to persuade Emily she was the same person, despite what had happened to her, and to get her back to seeing the world as a benign place.

Sturrock had had a lot of experience of burns victims. He had been the duty psychiatrist on the day of one of London’s worst industrial blazes, in which thirteen people had died, and many more had been seriously injured. It was then that his interest in the lasting psychiatric impact of trauma had been aroused sufficiently for him to decide to write a book on the subject, the first he wrote. So for a year or two he had specialised in that field, the fire victims and the emergency workers who had tried to rescue them providing a huge resource for his research and his care for them, hopefully, doing some good. It was this work that first caught the eye of senior people in government, who put him on the list of likely contenders when outside experts were required for policy review groups.

Emily’s fire had been far less dramatic and was deemed to merit just two paragraphs in the local paper headlined ‘WOMAN HURT IN BLAZE’, in which she was wrongly named as Emily Parker, and her age given as twenty-two when in fact she was twenty-four. But although it wasn’t front-page news, the fire had left terrible scars, both physical and psychological, and the more Sturrock saw of Emily, the less sure he was that, despite all his experience, he was going to be able to help her. Though Emily’s parents had been stalwart in their support for
her
, shocking themselves at how quickly they had grown to accept her disfigurement, her boyfriend of three years, Patrick, had been far less understanding, perhaps planting the seed of Emily’s belief that she had changed beyond recognition.

Nine months after the fire, as she was preparing for yet another skin-graft operation, Patrick had written her a letter. Sturrock had a copy of the letter in his brown folder.

‘
I will always love you
,’ it had said, ‘
but – and I know how cruel this will seem given all you have to face – I cannot cope with what is happening to us. I thought our life would be together, that we would raise a family. But we both know it cannot be. Yours is the pain and the suffering, I know that. For you, there is no escape. It will be with you for the rest of your life. For the rest of mine, I will curse myself that I am too weak to see it through, or even to give you this message face to face. But that is the reality. I do not have the strength to see you suffer like this. I do not have the strength to stay by you and help you to recover. I cannot bear your pain, nor my inability to deal with it
.’

In the first months after the fire, Emily had been forced to wear pressure garments, including a mask. To look at, the mask was less alarming than the scarred face it hid, but she complained it was tight and sometimes sore, and it drew glances from virtually everyone she passed. Sturrock had pressed her on their reactions, and why they mattered to her. Most had reacted with studied neutrality, she’d said, and a number of people had even given an intimation of warmth, like a nod or a smile. But some looked away, unable to conceal shock or disgust. He urged her to try to enjoy the intimations of warmth, and appreciate the fact that this was the way most people reacted. But it only took one bad incident to set her back. The worst had occurred as she was being dropped off at the hospital one day. Three men in the cab of a filthy lorry trailing a cement mixer had spotted her getting out of her mother’s car. She was in tears as she recounted the story to Sturrock just moments later. The young man in the middle of the cab saw her first, and pointed. Then the driver honked his horn, so loudly it startled her. She looked up to see the three men now gesticulating and laughing. Her meekness vanished, and before she knew it, she was
striding
over to the lorry and ordering the driver to open the window. He did so, and the laughter calmed.

‘Do you have children?’ she asked. ‘Do you have brothers and sisters? Do you have a heart?’

She said the man in the middle sniggered, but she could see her point had hit home with the driver, who was silent.

‘When you go home tonight,’ she said, ‘ask your children to google “burns victims”. Look at the pictures. Then imagine it’s them, not me.’ And with that, she turned and went into the hospital.

‘How did you feel?’ Sturrock asked. It was one of his favourite questions.

‘I felt strong. I felt I was making a point I had to make. But then as I came up the stairs, I could feel myself collapsing inside. Why should I have to put up with that? What have I done in my life to deserve what has happened to me?’ She was sobbing so heavily that Sturrock felt he had to get up from his chair and go to console her. In her diary of emotions which she submitted the following week, she said she sobbed in similar fashion on and off for three days.

Emily’s mask was now a thing of the past, so it was the reality of the scarred face beneath it that she sought to hide from passers-by. She was a little out of breath as the consultation began because she preferred the breathlessness and the intense pain in her left thigh from climbing six flights of stairs to the feeling of being trapped in the corner of a crowded lift, with people pretending not to look at her, but sneaking glances in one of the tinted mirrored walls.

Sturrock felt that he’d made little headway with Emily in recent months. In fact, the only real progress was that she now removed her scarf when she sat down in the leather armchair. Once someone was used to her appearance, as he was, or Sami the shopkeeper, or Phyllis, Emily could cope more easily. But he was desperate for her to overcome her fear of strangers and that just wasn’t happening. In general, she hated being seen, and devoted much of her energy to preventing it. That meant staying in during daylight hours, even though she knew that wasn’t helping address what her GP called ‘the underlying issue’. To her, there was no underlying issue. The issue was there for all to
see
, her face a hotchpotch of the skin she was born with, scar tissue and grafts from other parts of her body.