The Sleep Room (5 page)

‘Where’s what?’ he responded.

‘You know very well, Mr Foster.’ I coughed to attract her attention. ‘My ring,’ she said, ‘I took off my ring and left it here on the bedside cabinet before going to the sink to wash my hands. And now it’s gone.’

‘Mr Foster,’ I said gravely, ‘please give Sister Jenkins her ring back.’

‘I haven’t touched her ring!’ he replied, opening his hands to show me that they were empty.

‘It was there!’ Sister Jenkins brought a rigid finger down on the cabinet. ‘Right there!’

‘Come now, Mr Foster,’ I said. ‘You really must cooperate.’

He continued to declare his innocence. I beckoned Sister Jenkins to my side and whispered, ‘Are you quite sure about this?’

She bristled and replied, ‘Yes, Dr Richardson. I am absolutely sure! Mr Foster is fond of doing things which he later says were nothing to do with him. It’s always because of . . .’ she rolled her eyes at the ceiling. ‘Them!’

‘Ah yes, of course,’ I sighed, recalling the nature of Mr Foster’s condition.

Addressing him sternly, I said, ‘Now, Mr Foster. I’m afraid if you don’t return Sister Jenkins’s ring this instant we will have to search you.’

And that – in the end – was exactly what we had to do. We stripped Mr Foster and then his bed. Nothing. Finally, I looked inside his mouth. Still nothing.

‘He’s swallowed it!’ said Sister Jenkins.

‘Oh dear,’ I said, nodding sympathetically. ‘I think you may be right. Was it a very expensive ring?’

‘It was my wedding ring.’

I turned to Mr Foster and said, ‘I’m afraid you won’t be allowed use of the toilet for a few days. When you need to pass stools, you must use a chamber pot.’

‘But why?’ he asked.

‘Because that is where, in due course, we’re bound to find Sister Jenkins’s ring.’

‘But I didn’t swallow her ring!’ Mr Foster cried, exasperated. Then, by slow degrees, certainty was replaced with doubt. ‘Not unless . . .’ His eyes caught the light and glinted. ‘Not unless
they
made me.’

Sister Jenkins’s expression hardened. She took a deep breath and her ample bosom lifted. It was not necessary for her to say, ‘There, I told you so!’

‘Perhaps we need to increase his medication,’ I said drily.

‘That would certainly meet with Dr Maitland’s approval,’ Sister Jenkins replied, glaring at Mr Foster.

At midday, lunch was served in the dining room, and it was there that I got to know all the nurses. Jane Turner was usually sitting with Lillian Gray, a colleague with whom she had trained at St Thomas’s. They were old friends and in the habit of exchanging complicit, sideways glances. This tendency to exclude would have become quite irritating, if their expressions – girlish and mischievous – hadn’t aroused in me certain questionable sensations of pleasure.

Our conversations were relatively superficial. We talked about films we had seen –
Three Cases of Murder
,
Doctor at Sea
,
A Kid for Two Farthings
– popular comedy programmes on the wireless, and places to go dancing in London. I was surprised to discover that Jane and Lillian had been to most of the jazz clubs in Soho. Unlike my predecessor, neither of them seemed to have found adjusting to life at Wyldehope problematic, and I mentioned in passing what Maitland had said about Palmer. Lillian shrugged and said, ‘He was very serious. You know the type. His suit was rather shabby and he smoked a pipe.’ Her hand came up to her mouth as she cupped an imaginary bowl. She made some puffing sounds and adopted an intense, slightly deranged expression. The parody was cruelly funny and made Jane and me laugh. ‘And he didn’t get out very much. Even on weekends, when the sun was shining, he used to stay cooped up in his rooms.’ She shrugged a second time. ‘We enjoyed ourselves over the summer.’

‘Where did you go?’ I asked.

‘We went cycling,’ Jane replied. ‘The hospital has three bicycles. If you want to use one, just ask Mr Hartley – the caretaker. Have you met him? He always says yes. The land’s very flat around here, so you can go for miles without getting tired.’

Lillian chased some peas around her plate with a fork: ‘And we went to Southwold.’

‘Southwold?’

‘It’s a little seaside resort,’ Jane cut in. ‘There’s a beach there that’s good for swimming – or paddling, at any rate: the North Sea is always a bit chilly. It’s got a promenade, shops and a pier. Although you can’t walk very far along the pier because it’s been damaged.’

‘And there are some quaint pubs,’ Lillian added.

‘How far is it?’ I enquired.

‘Not far,’ Jane answered. ‘Although it’s probably best to go by bus.’

Sister Jenkins entered the dining room and scanned the tables. Jane looked at her watch and said, ‘Oops! We’d better get going.’ The two friends stood up together and marched off. Their coordinated step, the synchronized sway of their hips, and the sight of their shapely calves captured and held my attention for far too long. When they were gone, I became self-conscious and looked around the room so as to make sure that no one had observed my impropriety. It was my good fortune that Sister Jenkins had been wholly occupied by her own concerns.

Maitland was true to his word. He visited Wyldehope at least once a week and occasionally we spoke on the telephone. I didn’t feel as though he was checking up on me – quite the contrary; my impression was that he was calling only to make sure that I was settling in all right and had no complaints. On the second Friday after my arrival I awoke to find a note on the floor. It had been slipped beneath the door that separated my quarters from the landing. I recognized the cream laid paper and the bold handwriting: ‘I’m in my office. Come down when you’re ready. Hugh.’ He must have left London at some unspeakably early hour. I entered one of the empty rooms and looked out of the window. The Bentley was parked outside, partially obscured by blankets of mist. It looked slightly surreal – a displaced exotic object.

I skipped breakfast and went directly to Maitland’s office. He seemed delighted to see me and we sat together on the Chesterfield, discussing medicine like colleagues who had known each other not for weeks, but for decades. Maitland poured me a cup of tea and asked if I had read his manuscript. I had read it – and very thoroughly too.

The precise mechanisms underlying the beneficial effects of narcosis were not understood; however, in his paper, Maitland had proposed that prolonged sleep might result in the disintegration of personality, allowing – at some later stage – for a healthier reconstitution. He likened the process to breaking and re-setting a leg. His advocacy of ECT as an additional component of treatment was based on the idea that it could hasten recovery by obliterating unpleasant memories.

Extending his arms out along the backrest, Maitland seemed to occupy a physical space disproportionately greater than his actual size: ‘There are those who say that ECT should be abolished, that it is associated with memory loss and must cause significant brain damage. But what if those memories are painful? What if those memories are distressing or traumatic? Getting rid of them can only be a good thing, surely? Who would choose torment over tranquillity, suffering over the chance to begin afresh?’

I offered Maitland a few tentative criticisms, which he took in good part. He tested each argument with a counter-argument and I was thankful that the atmosphere remained friendly. When there was nothing more to discuss, he said, ‘Thank you so much for your comments.’ He wasn’t, as far as I could make out, being disingenuous.

The rest of the morning was spent on the wards, and after lunch we made our way to the sleep room. I could now identify all six patients: Sarah Blake, Elizabeth Mason, Marian Powell, Kathy Webb, Isobelle Stevens and Celia Jones. Apart from their names, dates of birth and diagnoses I knew nothing else about them. Their notes contained pages of blood-pressure readings, pulse-rates and drug dosages, but no biographical details. I wanted to know more about these women, as individuals, as living, breathing human beings. In effect, I wanted to know who they were, but when I pressed Maitland for more information, he was, once again, quite evasive. A shade of irritation had entered his voice and I thought it best to let the matter rest. As far as Maitland was concerned, case histories were entirely irrelevant. The only thing that mattered was treatment.

In those post-war years, men like Maitland wanted to distance themselves from the past: the personal past as well as the historical. They didn’t want to grub around in the unconscious, looking for horrors. They had seen enough of them already.

One of the women, Elizabeth Mason, had been talking in her sleep, and the night nurse had jotted down some of the things that she, Elizabeth, had said
: I won’t take it off. No, I shan’t. He’s on his way.
None of these utterances made any sense. Even so, I couldn’t help wondering whether such disconnected phrases might become more intelligible, if I only knew a little of her case history. Maitland wrote ‘Sodium Amylobarbitone 400 mg’ on the chart, and then pointed at Elizabeth Mason’s face. ‘See here,’ he said, ‘cracks in the skin, spreading out from each corner of her mouth. Angular stomatitis. A common complication of narcosis, but easily rectified with a B vitamin supplement.’ Before leaving, Maitland paused at the door and emitted a soft grumble, as one might after a particularly satisfying meal. He turned to me and said, ‘Cigarette?’

‘Yes. Why not?’

‘Let’s go outside.’ The fetor of the sleep room was tenacious: it clung to one’s clothing, lingered in the nostrils, and made the prospect of a cleansing draught of fresh air most welcome.

Standing beside the Bentley, we smoked and admired the desolate landscape. Some distance away, a solitary doe appeared in a patch of dead fern. She stood very still, determining whether we represented a threat to her safety, then cantered down the incline that swept off to the marshes.

‘I’ve been meaning to ask,’ said Maitland. ‘Would you mind doing an assessment?’

‘Not at all.’

‘It won’t be for a while yet. I’ll tell you when. The only snag is that you’ll have to give up one of your weekends. There’s a woman who lives down in the village’ – he gestured towards Dunwich – ‘Hilda Wright: a catatonic schizophrenic. She hasn’t got out of bed or said a single word in years. Up until July she was being cared for in a private convalescent home, but the family can’t afford the fees any more. Her sister looks after her now, with a little help from a nurse.’ Maitland blew a stream of smoke into the air and his expression became contemplative. ‘There were a lot of dissenting voices when it became known that Wyldehope was to become a mental hospital. If – pending the result of your assessment – we accepted this patient into our care, that would be good for our reputation.’

I remembered the man who had shared my carriage on the evening of my arrival, and his reference to people not wanting a ‘madhouse’ on their doorstep.

‘The patient sounds very . . . appropriate.’

Maitland dropped his cigarette and crushed it with his heel. ‘I knew you would appreciate the importance of good community relations.’

On the men’s ward, everyone was comfortable apart from Michael Chapman, who was experiencing one of his agitated episodes. All psychiatric patients have sad histories, but Chapman’s was, at least in my estimation, sadder than most. Although his origins were humble, he had possessed a natural gift for mathematics. He was awarded a scholarship and subsequently went to Cambridge, where, while preparing for his final examinations, he had suffered the first of several ‘nervous breakdowns’. He was overwhelmed by dark thoughts and believed that one of his tutors, a renowned logician, was stealing his ideas. The college doctor made a diagnosis of monomania and Chapman was sent home, where he was treated at a local hospital as an outpatient. His recovery was slow and this period of ill health left him with significantly impaired powers of concentration. He was unable to return to Cambridge and instead found employment as a clerk in an accountant’s office. Within a year he had started behaving strangely once again and was dismissed: a notebook had been discovered in which he had recorded the movements and whereabouts of his work associates in minute detail. Thereafter, the poor man was never able to hold down a job for more than a few weeks, for he was always convinced that his colleagues were conspiring against him, and the rest of his life was spent in hospitals or hostels.

Chapman’s promising youth and descent into madness evoked in me a very particular sympathy. It was my good fortune to have been born with chemicals benignly balanced in my brain, otherwise my Cambridge career might have ended just as ignominiously. Individuals like Chapman demonstrated all too clearly the moral indifference of fate. Accidents of biology, rather than brilliance or hard work, are the real and haphazard determinants of success or failure.

I could have given Chapman more sodium amytal, but he had had so much of late, I decided not to. Instead, I tried to calm him down with common sense and good humour, two practical expedients that all hospital doctors rely upon from time to time.

Chapman was breathing heavily and beads of perspiration were visible on his brow. ‘Am I going to be punished?’ he demanded.

‘No,’ I replied. ‘Whatever makes you say such a thing?’

He ignored my question and, wringing his hands, repeated the same phrase over and over again, until it dwindled to a whisper: ‘What have I done? Oh, what have I done?’

‘Certainly nothing that deserves punishment,’ I said, affecting a jovial manner. He started biting his nails. ‘What are you so worried about?’

Chapman spun around on his heels, reached the window in two long strides and pressed his forehead against the iron bars. ‘I don’t like it here.’

‘Perhaps we could play a game of chess? Do you play chess, Mr Chapman?’

He sighed, a massive expulsion of air that seemed to make him shrivel like a collapsed balloon. ‘I used to.’

‘Come on then, let’s go to the recreation area.’

‘I don’t know.’

‘We can start a game and see how it goes, and if you get tired, we’ll stop.’