Growing Into Medicine (30 page)

Ralph was not naturally gregarious. Once I was alone I could take chances. I was more hospitable and invited people to stay with less caution. If they were not congenial I was the only person who had to tolerate the discomfort. These varied visitors have enriched my life. My younger American nephew, Will, is a maths professor who took a while to get his PhD, for his passion lay elsewhere. He put me in touch with his amazing world of jugglers. If any of them want a bed, in any town in the world, they ask on the net and someone responds. He sent four to stay with me. They arrived on bicycles from Heathrow, their juggling clubs on trailers behind. They had camped on the way and arrived in the pouring rain, grateful for my hot soup and cheese. Although they were all charming they were very different characters, held together by their dedication to their craft. I was astonished that they had no idea Will was a professor. They knew nothing of his family or background but admired him because he could juggle six clubs. It is the most classless society I have ever encountered, its hierarchy determined by nothing but the skill of its members.

For a fortnight, in three consecutive years, I hosted a different Spanish teacher. The organiser of the trips was born in Leicester of Cypriot extraction, and now lives in Pamplona teaching English. He brings groups of children on exchange visits to a school near my home. The children lodge with the families of their exchange partners, while the staff find other accommodation. I have delighted in the company of these teachers and hope to make a return visit.

I have also hosted various interns working in the Liberal Democrat office. Living in Bath, where the Labour party is very small, the Liberal Democrats offer the only challenge to the Conservatives. Although I am not very politically active I am a member of the Liberal party. My sympathies have never been as left wing as my mother’s in her early days, but like her I have, during the ageing process, swung slightly to the right – but I have never voted Conservative. Within any capitalist system the population as a whole is
said to become wealthier, but whichever party has been in power in this country during my lifetime, they have not been able to prevent the gap between rich and poor becoming wider. In a world with finite resources, any system based on continued growth will be unsustainable. My hope is that, as this realisation spreads, a more egalitarian system will emerge without excessive or heavy-handed state control. Probably a vain hope, but I am an optimist. Meanwhile, despite its weakness, I remain loyal to a party that attempts to follow a rational, middle way. I am frightened by the extremes of both left and right to which, in an uncertain world, more people turn.

My varied visitors have been stimulating, but thinking back I see that my belief that I am freer now I live alone is flawed. On at least two occasions during our marriage we invited young people to lodge with us for several months. When we were in Maidstone, the daughter of a medical colleague got a job in the area and Ralph encouraged me to invite her to stay until she found somewhere to live. Earlier, during our second stay at Pollington, one of the prison officers was moved away. His son stayed with us until he had taken his O levels (GCSEs for today’s reader). The boy had lived a fairly restricted life but when he was offered a chance to camp for a weekend on the Yorkshire moors, Ralph encouraged him to go. We were both amazed at the changes when he returned full of excitement. His world had been transformed by his taste of the wild countryside. Ever since, I have subscribed to an organisation called CHICKS – Country Holidays for Inner City Kids.

Ralph had been aware of my need for company since the early days of our marriage. Christmas in the prison service could be difficult for families. We could never go back to our parents for Ralph was always on duty. At the time when family ties are most keenly felt, he was especially concerned for the men and tended to bring their misery home. He was aware of my loneliness and encouraged me to invite a young French woman, living in Britain but alone over the holidays, to stay for the festivities. Marie Therese came many times, bringing her husband with her after her
marriage. Helen’s first trip abroad without us was spent with them in Paris.

After Ralph died I spent one Christmas in that city with my friend Elizabeth Forsythe. We stayed in a hotel near the Gare du Nord, sharing a small double bedroom. We were not used to such close contact and we pushed the beds apart.

‘How will we know when it is morning time?’ she asked.

‘That won’t be a problem,’ I assured her.

In the event, it was. I woke in the dark, excited for her to open the small stocking of presents I had brought. I went into the en-suite bathroom to turn on the light without waking her, only to find I had shut the door with the light switch on the outside. To try and see my watch by the glimmer from a high window I stood on the toilet seat – which broke.

At breakfast I apologised to Madame in my inadequate French. She shook her head as, with a serious expression, a stream of words that I could not follow flowed out.

Elizabeth translated. ‘On Christmas morning, in France, we only dance on the toilet seats in the country, never in Paris.’

Madame would accept no money for its repair. The story served to break the ice at the lunch party to which Marie Therese had invited us.

But this freedom to travel was nothing new. Ralph had been happy for me to go to Greece for a week with the Matthews, while he stayed to manage the house, Helen and the animals. He never tried to influence my actions. He believed in individual autonomy and I can still hear him saying, ‘You must do what you want.’ My problem was that I seldom knew what I wanted, or if I did, I could see no way to fit it in with my first concern – to keep him happy. I am convinced that this feeling was not culturally determined, but an inner need. My mood went up and down with his happiness or misery. At the same time I wanted the impossible, for him to realise what I wanted and bend to my unspoken wishes with enthusiasm.

Looking back I find the psychological concept of projection helps me to understand my sense of being to some extent fettered. From a
distance I can see that I pushed some of my internal constraints onto Ralph and resented them in him. But the one area where I felt completely free was in my professional life. The messages imparted by my parents, about the importance of training to work in a profession, had been built into my psyche with enough force to withstand all uncertainty. I always chose when to work and in what field of medicine. Although, in keeping with the values of those times, Ralph expected me to run the house, he supported every decision I made about the balance between my domestic and professional life. Only now is it clear that, when I was certain what I wanted, he did everything in his power to help me obtain it.

In John Daniels’ book
Looking After
he says, ‘Memory is not a record of the past, but an evolving myth of understanding the psyche, which spins from its engagement with the world.’ My thoughts about the restrictions and freedoms in my marriage feel like an evolving explanation of the truth of the love that grew between us.

Very late in our life together – for the first and only time in the whole marriage – I lost my temper. I learned then that when I could voice my own needs Ralph was freed to be different.

Being a diabetic he had occasional attacks of hypoglycaemia, ‘hypos’ we called them, when his blood sugar dropped too low. It happened if he did not balance his insulin with enough food or if he had taken an unusual amount of exercise. Personality changes are known to occur and a story is told of how a loving man killed his wife when he was in this state. When Ralph became hypo his normal wit took on a sarcastic, almost cruel edge. The change was subtle, not usually noticed by strangers. But Helen and I knew; and both hated it. This was not the man we loved. I was frightened, not because I thought he would be violent but just by his strangeness. I sometimes wondered if he did it on purpose so that he could let out some of the negative feelings towards me that he never showed.

On two occasions he needed intravenous glucose and I had to send for the emergency doctor, for I never gave him an injection myself. The first time was after playing cricket all afternoon and
evening with his borstal boys. He was too tired to eat much and became unconscious during the night. On the other occasion he had been travelling up to London from Coulsdon and somehow forgot to eat. Again, he became restless during the night and I could not rouse him.

The day I lost my temper was after we had retired to Bath. I found him slumped in his car, but managed to get him into the house where he collapsed onto the floor in the corner of the dining room. He could still swallow so I fed him peppermint creams, a form of glucose that he enjoyed, followed by tea laced with sugar. Once he was almost back to normal I looked down at him in fury and shouted, ‘I cannot bear it any longer. You
frighten
me when you’re hypo.’

He made no response and I had no idea whether he had registered my anger. But something changed. He continued to get occasional hypos but after that explosion his behaviour was different when they occurred. Either he realised that he needed sugar sooner or he controlled his speech and behaviour more carefully. Whatever the mechanism of the change, he never frightened me again. We did not talk about it, but both of us had discovered that if I could allow my real feelings to show he could change, even when he was in the altered mental state caused by low blood sugar.

After he died I learned that he had said to a friend, ‘I give my wife a hard time, but she understands me.’ He cannot have felt very comfortable, knowing he gave me a hard time. I wish I could have been more demanding, but something in me needed to do all the giving. Even writing the word ‘demanding’ makes me feel insatiable, as if however much he had given I would only have wanted more. I am reminded of my mother’s style of breast-feeding, using the scales to stop each feed as soon as possible. Again I can imagine her distaste when my small fingers wanted to play with her breast, to delay the moment of parting – to grasp and cling, only to be rejected.

During my analysis I bought many books by analysts and psychotherapists of various schools. Stuffed with knowledge, these
books crowded my shelves. I dipped into them but reached the end of very few. Any attempt to integrate the ideas into my ongoing experience was unproductive. I remember, from early chemistry lessons, the definition of osmosis,
the passage of liquid from a weaker to a stronger solution through a semi-permeable membrane
. My purchases were fuelled, not just by the intention to read them, but by the vain hope that the reverse process, where the wisdom in the books would filter through my skin into my brain, would take place.

Once I reached the end of my analysis I lost interest in theories. Within a year or two I donated almost all the books to the IPM and concentrated on the rewards of writing. As I try to assimilate the experience of writing this memoir a flicker of interest stirs again – but in a different form. My analyst described himself as eclectic. I had the sense that he was sympathetic to the views of Melanie Klein (which might account for the connection I have made about the origin of my insatiable needs). But one of his strengths was that he never used any specialist language – there was no psychobabble. His comment on any dream was always the same, ‘What do you connect with?’ He never put his own interpretation on the material or tried to link it to a general idea of what a dream might mean. I understood he had been working to help me ‘free associate’, to say the first thing that came into my mind as a way of exploring the unconscious, a technique I found incredibly difficult. If I try the exercise by myself my mind races past any first thought to comment or wonder about its meaning. I do not find the occupation very illuminating, but during the sessions it was different.

At the time I was particularly glad he was not a Jungian. I had sensed that those theories would be too vague for my practical way of seeing the world. I was not interested in the universal unconscious, in archetypes or the search for deeper understanding of the soul. I thought that what I was looking for was a way to deal with the grief of Ralph’s death, while being aware that I also needed to escape from some of the legacies of the childhood that had confined me to particular ways of being. When writing about Jung, Anthony Storr says, ‘. . . the patient. . . might not have any associations at all
[to dreams with mythological content]. Jung did not hesitate to supply his own associations, culled from his own extensive knowledge of mythology.’

My own dreams may lack mythological content because I am ignorant of the stories. One example of a response to my silence on the couch followed a vivid dream in which I was at the tiller of a small dingy, rushing down a river with the wind behind me. I could make no connections. Eventually my analyst said, ‘You are travelling very fast. I wonder what is passing on the banks as you speed along?’ I was filled with the warmth of his whole attention. This concentrated regard is a love unlike any other, for it is contracted, paid for, confined within the time of the session and without the need for some adaptation of the self demanded of normal love. Books such as
Care of the Soul
by Thomas Moore arouse my suspicion that Jungians may refract the beam of concern by reference to universal archetypes and mysteries. Vibrant colours of the imagination might be released by such an approach, but for me the feeling of being ‘special’ was the experience that allowed me to live more fully. My belief is that the healing properties of all therapies probably depend on the ability to provide a feeling of empathy rather than on the analyst’s particular intellectual approach.

As part of my quest to understand my marriage I have recently read Deirdre Johnson’s book
Love: Bondage or Liberation?
I was alerted to this publication by a notice of a meeting in Bristol about love in the psychosexual clinic. Alas I saw the notice too late to attend, but I have spoken to the organiser, Cathy Coulson, an IPM doctor I have known and admired for many years. She gave one of the lectures, which was about the absence of the concept of love, however one defines it, in our work. This observation is striking. I cannot remember the word in any of the books I have edited or in my professional writing. Cathy explored the idea that when sexual intimacy is lost the playfulness and creativity of the relationship is also lost. She suggested that in those couples where the bond could be repaired, early attachments for both of them might have been stronger.