Mesmerised (10 page)

It is a miserable night. I toss and turn and watch the shadows of carriages become grotesque upon the ceiling. The street lamp flickers and distorts the image. I haemorrhage again, this time, from my back passage. I am afraid of homeopathy’s other worldliness and its power is humbling. It is loneliness that stifles me. Not complications. Not Paris. I know if Blanche were with me, I would not feel like this. Strange, amongst all of this melancholy uncertainty I feel the need to have her nakedness against my skin. I have the desire to make love.

When I awake I feel wretched but I have learned something. As I make my ablutions, I realise that I could recognise the need for
Phosphorus in a patient without ever having to look in a textbook again, for I have lived the experience twice now – once before I’d even ingested a dose. You can’t explain that to anyone. It is like when someone speaks of messages from the dead or strange objects in the sky.

I also know
Blanche’s remedy is not Phosphorus. It is close but it is not exactly right. Her wanderlust is too essential to her character for her most similar remedy not to mirror this. I have a nagging suspicion that my love’s cough has abated for now but is nowhere near cured.

Suzanne’s Consultation

May 15th

‘Even in a high potency, Ignatia is a main remedy in cases of vexation in subjects who have no tendency to break out violently or to revenge themselves, but who keep their annoyance to themselves; in whom, in a word, the resemblance of the vexatious occurrence is wont to dwell in the mind, and so also especially in morbid states which are produced by occurrences that cause grief.’

Samuel
Hahenmann,
Materia Medica Pura.

‘Suzanne,’ I say, pumping her hand over-zealously. She is still in her nightdress, rubbing her eyes. It appears that the boy Leon has gone to visit family in Holland. The soiree finished long after midnight. She apologises, she has woken up late.

‘That’s fine,’ I say. ‘Don’t worry about any of it. Where do you want us to conduct the consultation?’

‘In the drawing room?’ she asks.

‘Yes,’ I say. ‘That’ll do fine.’

I sit down and start pulling out writing paper and a pen from my bag. She sits opposite on the edge of her seat. My pen is poised and ready to go to work, I look up into her face and say, ‘Tell me about your cough. When did it start?’

Suzanne hesitates
. ‘Actually, it started a while ago but recently it’s got worse.’

‘Was anything stressful happening immediately before the cough came or around that time?’

‘No, nothing stressful.’

‘Then tell me about the cough itself. When does it come on?
Is there anything that initiates it?’

‘Talking
, but if I consciously suppress it, it’s better.’

‘How do you do that?’

‘I swallow, you know,’ she says, with fingers resting against her throat and conspicuously swallowing to demonstrate what she means.

‘Tell me more about the cough
.’

‘Well, it is a lump in my throat as well. This is how it comes. It starts with a lump
and I have to cough to dislodge … it’s the phlegm, I suppose. Doctor, would you like a coffee? I am so rude I haven’t thought to offer you … .’

‘No, I’m fine, thank you.’

‘Do you know what remedy I can take to get rid of my cough?’

‘I have my suspicions as to what you might need, but I wouldn’t be happy to prescribe for you straight away.’

Cough better for not coughing, worse for talking, and sensation of a lump in the throat are all symptoms of
Ignatia
.
Ignatia
is a grief remedy. Is this a case of grief? My training forbids me to assume that it is. ‘Tell me a little bit about yourself first?’

‘I don’t know what to say.’

‘Tell me anything. What do you find difficult, stressful?’

‘I’m sorry,’ she says, leaping out of her seat and hastily leaving the room. When she comes back
she is dabbing a handkerchief to the corners of her eyes. I wait for her to settle in her chair.

‘Are you
all right to go on?’ I ask.

She
nods briefly.

‘Please, I don’t mean to pry, but in order to find your correct remedy I’m going to have to understand just a little bit more.’

At which point, the dam breaks and she cries hysterically, loudly, taking in huge gulps of air between sobs and I do something that I don’t normally do. I rise to go and sit on the arm of her chair, take her hand in mine and wait for her to calm. Then I speak again.

‘This is obviously very difficult for
you and I understand if you prefer me to come back another day but in my opinion whatever is making you so upset is what is causing the stress in your body, which in turn, is what provokes the symptom of a cough. Do you follow?’

Once again she signals the affirmative with her head bowed.
Simultaneously her hand pulls away from mine. She places it in her lap on top of the other one. I return to my chair. It isn’t long before she speaks and I try to write down every word without looking away from her face.

‘This cough began some time ago. It’s hard to say exactly when. But you are right
Doctor Gachet, I have stress in my life.’

‘Go on.’

‘No, I cannot say. It’s too difficult. If you cannot give me a remedy now then I sincerely understand. But I cannot speak of what you ask me to and I think I would rather live with my cough.’

I sit in my chair for some time staring out ahead of me. Hysterical weeping is another symptom of
Ignatia
. But is this grief? I have to complete the symptom picture. Right now, I am just assuming that it is. I can hear Clemens’s words to me:

‘Don’t assume anything Paul. You are not the patient. Only the patient knows what he thinks and feels. You may think at some point, because you are making all of these beautiful cures, that you are a god and know better than your patients about themselves. Forget it. Do you understand? You’re a man. We are both men. Ordinary men with an extraordinary job, maybe. But if you ever take the path of bringing conjecture into your prescribing, I hope that one day you will be wise enough to realise, through experience as I have done, where you have gone wrong.

And don’t be fooled. Whatever they say …
whatever they say
… it is about themselves. If they say, ‘she is a very jealous woman’ they mean ‘I am sensitive to jealousy; jealousy is in my nature’. If they deny something – ‘I’m not a jealous person’ – again you know they are sensitive to jealousy and it is a characteristic that is in their nature.’

‘Suzanne, w
ould you be willing to talk more about your cough? In that way we might be able to avoid talking about your stress. For instance, when it happens, how would you describe it?’

‘I think I have told you everything.’

‘Please tell me again. Humour me. What is the effect that this cough has on you?’

‘
Doctor Gachet, it tears me to pieces, if you must know.’

‘And how would you describe being torn to pieces? Tell me more about the experience of being torn to pieces?’

‘It’s shattering.’

‘Suzanne, I’m so sorry. You probably don’t understand why I am asking you these inane questions, but it is important to me that you tell me everything and that I don’t guess even one thing as to how you are feeling. So, if you were to write a dictionary, how would you describe the word
“shattering”?’

‘It is like an earthquake. I
f you are its victim you feel shattered. It was exactly the same way when Edouard’s father died. Everyone felt shattered.’

I notice she is biting the inside of her cheek as she speaks.

‘Surely, after all that speaking, you must need something to wet your throat?’ she asks, with a brave smile.

Rapid change of mental condition.
Hysterical weeping alternating with great emotional control and wanting to look after others
. She acts out more symptoms from the homeopathic proving of St Ignatius Bean. From the
loganiaceae
plant family. I have a botanist friend who informed me of the other plants we use homeopathically that belong to the same family. If you study homeopathic
Materia Medica
you will find that all of these plants have symptoms in common. Patients who need them all suffer from shock, disappointment and sometimes deception. The nerves of the patient are affected, suggesting to me that Suzanne’s is a nervous, hysterical cough.

I prepare a small vial of
Ignatia
200c and ask her to take the remedy one a day for five days.

‘I’d like to come back next week to see how you’re getting on.’

‘It’s not necessary, please.’

‘If you take the med
icine, I’m sure it will help. The most difficult part of being a homeopathic patient is now over. I am sorry to have caused you distress. I won’t ask you these things again. I will only ask about the cough. May I come by on my way home from the hospital next week?

And there it is again, that slight nod of her head that speaks to me of powerlessness to do anything about her situation. It will be
interesting to observe how much the effect of the remedy will help her.

When I arrive home to my private practice, the same long line of sufferers greets me on the stairs. My creaking footsteps groan. There are times when my mind and heart become so overloaded that my head buzzes with the problems that have landed at my door. I long for peace and quiet. My footsteps are heavy as I climb the stairs. When I let myself in I don’t invite anyone to follow me.

‘I’m sorry,’ I say over my shoulder.

I go to stand by the window. There are two labourers staggering across the road, no doubt playing truant from work. One whistles at a woman whose hair is too blonde, lips too red. I acknowledge that I am suffering from the symptom of having women on my mind.

Clouds like those in the paintings of the old masters sail past buildings through the sky. I will walk to Blanche’s house uninvited this e
vening and ask her what’s wrong. I’ll try to make amends, but will leave if she wishes it. On the way I’ll walk past La Salpêtrière and administer Bella’s remedy, Platinum(
Platina
) 1M, a prescription I am now convinced will not provoke a spontaneous remission … but what about Suzanne?

‘Whatever they say,
whatever they say
, is about themselves,’ Clemens said.

Do I understand right? That she is grieving for
Auguste Manet, Edouard’s old man, whilst she lives with Edouard? I only learned recently that the judge died last year. Edouard pursues a bachelor’s lifestyle. Perhaps Suzanne is his housekeeper after all and the boy Leon his half-brother. So, why does he sleep in his ancestral home at least three nights a week? The dynamic is confusing and most interesting but I am starting to feel glad that Edouard is a patient of Georges. The remedy must mirror the motives of the man and this man is proving difficult to work out. I look at my watch. I have stood here too long. It is time to invite my first patient into my consulting room.

Bella’s First Remedy

May 16th

‘I am following Nature without being able to grasp her.’

Claude Monet

In the library, the drama is like something out of an
Alexandre Dumas novel. Bella wears the same dress as she wore the very first time I saw her. She walks around like an over-affectionate madam. She places her arm around another patient, kisses their cheek and moves on to the next person. As she moves through the room she swishes the blue cotton folds of her skirt with her arm.

I stand at the entrance and watch her, one hand inside my pocket clutching the bot
tle of
Platina
. A peculiar sensation like a tightening in my diaphragm grabs me, and won’t let me go. I try to ignore it, to physically push it down with a couple of exhalations, but it won’t budge. I know all too well what the feeling is telling me. It is an instinctive reaction to my choice of remedy for Bella. Something is wrong. Bella is acting frivolously; there is a softness to her that is not witnessed in the character of
Platina
.
Platina
is misanthropic, contemptuous and hard. Bella needs a different remedy but I don’t know what it is.

Someone taps my shoulder. At first I think it is Bella
, who a few seconds earlier disappeared behind a column. I turn around and Doctor Ipsen has his face very close to mine. Saliva has accumulated at the corners of his lips and threatens to roll down his chin like a tear. He is unsteady on his feet, no doubt a little hazy from lunch in an inn where he has drunk too much wine. A rank odour blows from his mouth towards mine.

‘Eh Gachet, time to give your patient her remedy.
Exciting times for homeopathy,’ he says, wiping his lips with his sleeve and laughing as if he had just told himself an amusing joke.

In spite of myself, my nerves get the better of me and I stumble over words. ‘I’d really
… rather see her in a … consultation one last time.’

‘I’m not surprised you have cold feet. It’s up to you. We can easily call the whole thing off.’

‘Let’s give her the remedy,’ I say, with what I hope is an assertive nod.

Ipsen
signals to Marguerite Bottard who in turn signals to two other nurses. Within seconds these women are hastening towards Bella. They restrain her. She fights to get away from their grasp and bites one of them on the wrist.

‘The bloody cow,’ the mauled nurse screams across the room, as she alternately shakes and sucks her hand. The scene makes me smile. Too many times I’ve seen patients treated roughly for no reason.
Perhaps true to homeopathy, like will cure like.

‘What is it exactly that amuses you,
Doctor Gachet? You don’t think it is somewhat perverse to be enjoying the painful injury of an on duty nurse?’

This isn’t an argument I want to have, or one I think I can win. I do not enter into the discussion. We follow the nurses, and Bella, out through the corridor to a spare doctor’s office
, a much more sanitised setting for medical staff than the patient’s dank, rat infested bedroom in the basement. I pour one pillule into the cap from the bottle of
Platina
1M.

I want to say, ‘Let her go, let me give it to her straight. I need to build an honest and respectful relationship with my patient.’ But I say nothing because I cannot trust Bella not to tear out my hair.

The matron grabs a lock of Bella’s tresses and pulls her head backwards. Bella screams and I pour the pillule into her mouth. The matron waits a couple of minutes before releasing Bella’s hair. She spits on the floor. Her sputum is clear. The remedy has already dissolved.

‘Is that it, Gachet?’
Ipsen asks.

‘Yes.’

‘And don’t you want to leave that bottle so the nurses can administer the next dose?’

‘There will be no next dose for now
. Maybe not even at the next consultation.’

‘And this will be when?
In a couple of hours? A day, I suppose, at the very most?’

‘Next week. We need to just observe what happens from now until then. How much opiate is she having at present on a daily basis?’

‘Half the amount she was on before,’ the voice comes from behind me. Turning around, I see nurse Morrisot sitting on a chair.

‘Sorry,’ I say. ‘I didn’t see you there.’

‘I’ve made sure your instructions have been adhered to, one spoon of laudanum every other hour. Will we be dropping the dosage again?’

She looks
at me with a defiant stare.

‘No, let’s leave it like it is for now, and Nurse
Morrisot, come and find me if there is anything to report between now and next week.’

‘When I get to my study I will be writing all of this down, Gachet, every
sodding word,’ says Doctor Ipsen.

‘I’ve also recorded every word of this session, as
Doctor Gachet instructed me to do last time,’ counters Nurse Morrisot.

‘I’m very grateful, very grateful indeed and no doubt Doctor
Ipsen is very grateful too because you have saved him a job,’ I say, looking back towards him. But he seems, once again, to have mysteriously disappeared.