Among the Mad

by Jacqueline Winspear

  Now, still staring into the rasping white-hot gas jets, she saw once more the twisted bodies, muscular responses not to physical injury but to mental anguish. She saw the eyes rolled back or staring into the distance, the constant weeping, the uncontrolled reflexes. There were men who cried, those who could not eat, those who would cause themselves injury, as if to feel, physically, the wounds that lay in their souls. And there were those who would sit alongside a wall, banging their heads against the hard surface again and again and again while saliva streamed from their open mouths, as if to mirror the cavernous hell they looked into from the time consciousness claimed them in the morning, until nightfall, when a sedative would send them into oblivion.

  Maisie came to her feet and walked across the room to a chest of small drawers that resembled something one might find in a pharmacy. She opened a drawer and flicked through the cards until she found the one she wanted. Tapping it against her hand, she walked back to the desk, picked up the telephone receiver and dialed one of two numbers listed on the card. She continued looking at the card until her call was answered. Only someone close to her would have heard her whispering, Please be there, please be there, please be there . . .

  Maisie started when the telephone was answered. “Yes, is Dr. Anthony Lawrence on duty today, by any slight chance? Oh, good. May I speak to him, please?”

  Maisie waited while the doctor was summoned, running the telephone cord through her fingers as the seconds ticked by.

  “Lawrence here.”

  “Oh, Dr. Lawrence, I’m glad I’ve caught you, especially on Boxing Day. I don’t know if you remember me, my name is Maisie Dobbs—I was a staff nurse on Oak ward at the Clifton Hospital in 1918, then sister on Ash, and—”

  “You’re the one who left to go back to Cambridge. Sustained a nasty head wound in France, if I remember correctly.”

  “Yes, that’s right.”

  “What can I do for you, Miss Dobbs?”

  “It’s rather difficult to explain on the telephone, but it is urgent, and confidential—would you spare me about twenty minutes this afternoon, say about half past one?”

  “I have to leave to keep an appointment at approximately two o’clock, so . . . well, all right, yes, but perhaps you could come along to my office a bit earlier—one o’clock?”

  “Yes, thank you, Dr. Lawrence. I look forward to seeing you at one.”

  “And you, Miss Dobbs.”

  Maisie smiled as she replaced the telephone receiver in its cradle. There was something that Anthony Lawrence and Robert MacFarlane had in common—they were both honest, no-nonsense men dedicated to their respective professions. But with Lawrence, now considered an expert in the treatment of psychological trauma, she had observed his compassion when they had both worked at Clifton, had seen him square up against pension authorities who tried to label mind-wounded men as malingerers, and had seen him spend hours with one man simply to try to get him to speak his own name out loud. She didn’t hold out hope for a breakthrough in the meeting, but if a conversation with Lawrence helped to crack into the frozen lock on this case, it would be more than worth the time.

  ARRIVING AT THE Princess Victoria Hospital by half-past twelve, Maisie went first to the porters’ office, whereupon her name was verified and a porter picked up a hefty bunch of keys attached to a bracelet-sized brass ring and instructed Maisie to follow him. The hospital where Lawrence now worked was much like other institutional buildings constructed in the heyday of Victoria’s reign, with a certain flourish to the red-brick design signifying the industrial and commercial wealth of her Empire and a legacy for the people. The wooden banister was buffed to a shine, as was every brass fixture and fitting, and as they made their way toward the doctors’ offices, a lavender fragrance wafted from just-polished floorboards. Maisie wondered if Sheila Kennedy, the hospital’s almost legendary matron, was still in charge—certainly the level of order suggested that she remained at the helm. It was an order that belied the name accorded the hospital by the locals, who referred to it as “the Bin.” First built as an asylum, it had been turned over to military cases of neurasthenia and other neuroses during the war, as had the Clifton Hospital. Although many of those wartime patients had been discharged over the years, some after just a few weeks of care, the hospital remained more or less full, with an increasing number of patients starting to be admitted in recent years whose mental anguish was rooted in an inability to deal with the ordinary and extraordinary in everyday life, rather than battles on foreign soil.

  Where there might have been double doors that flapped open in hospitals for the physically infirm, the porter at the Princess Victoria Hospital unlocked each door and took care to secure it again as they passed through. Soon they reached the upward spiraling back staircase flanked by cream-painted walls with maroon and cream tiles at the base. The staircase opened onto a corridor with offices on both sides, each with a heavy oak door. In this part of the hospital there was not the same level of security, though the porter remained with Maisie at all times. He stopped at the door to Dr. Lawrence’s office and knocked, only opening the door when a voice boomed, “Come!”

  “A Miss Dobbs to see you, sir.”

  “Ah, yes, of course—oh, and I’ll see Miss Dobbs out again later when I leave.”

  “Right you are, sir—but she will have to sign out.”

  “Not to worry, I’ll ensure she stops at the office.”

  The porter stepped aside to allow Maisie into the room, then touched his forehead as if in salute and backed out into the corridor while closing the door as he went.

  Maisie shook hands with Dr. Lawrence. His hair was combed to either side from the same center parting he favored as a younger man, though it was now gray, and not the coal black Maisie remembered when they both worked at the Clifton Hospital. His moustache seemed longer than it had once been, and Maisie noticed the ends were waxed, giving him something of a haughty appearance, though she could not recall such a character flaw. He wore round wire spectacles, and his skin bore the lines and folds of one who worked instead of slept over many nights, suggesting that worry and concern were elements he could never escape. His collar was tight around the neck, his tie pulled almost to his Adam’s apple, and he was still wearing his white coat, which indicated that he had just finished his rounds.

  “Please, take a seat, Miss Dobbs.” He held out his hand toward a plain wooden chair.

  “It was good of you to see me, Dr. Lawrence, especially at such short notice.”

  “Think nothing of it, glad to assist, if I can. You were a fine nurse, Miss Dobbs. I always thought you might enter medical school yourself—women seem to be turning their hands to everything nowadays, don’t they? I suppose it’s a case of ‘needs must,’ what with so many remaining spinsters, eh? Certainly we don’t have so many nurses leaving to get married, because there’s not enough men to go around!” He smiled briefly as he took his seat on the other side of the desk. Maisie noticed that his chair had two flat and worn cushions on the seat, probably brought from home in an attempt at creating more comfort. “And what have you been doing with yourself since you returned to Cambridge?”

  As Maisie began to describe her life over the past twelve years, she took account of her surroundings. Lawrence’s office was neat and tidy, with books shelved according to subject matter and a general sense of order. It was something that Maisie had liked about the doctor, that sense of order. He always counted instruments before and after procedures, always made legible notes immediately following each patient consultation, while thoughts were still fresh in his mind. But that was ten years ago. Now, as she spoke, she noticed he absently corrected the pile of papers and files on his desk, making sure that each was only so far from the edge, and never more than two inches apart. He reached forward and lined up his pens and pencils, then took a clean handkerchief from his pocket and wiped it back and forth across the wood.

  “ . . . so, when Dr. Blanche retired, I took over the business and set
up on my own. I now have an office in Fitzroy Square.”

  “Hmm, impressive, Miss Dobbs, impressive.” He looked up and returned the handkerchief to his pocket, pulled out a fob-watch from his waistcoat and checked the time before replacing the watch once more. “Mind you, we always hate to lose a good nurse.” He cleared his throat. “So, what can I do for you—you said it was urgent.”

  “Yes, indeed—and confidential.”

  “Of course. As you know, we’re used to keeping a confidence here, so do bear that in mind.”

  Maisie sighed. “The fact is, I do not have very specific questions, but I am anxious to make a dent in a very serious investigation. Suffice it to say that I am working on secondment to Scotland Yard on a sensitive case.”

  “Go on . . .”

  “Did you read about the man who committed suicide on Charlotte Street on Christmas Eve?”

  “Yes, of course—nasty, nasty business. It’s a miracle he didn’t take anyone with him, though according to the press, there were wounded.”

  “Thankfully, nothing too serious—though, as we both know, to witness such a thing scars the mind forever.”

  Lawrence ran his fingers along the sides of a pile of folders as he nodded. “Indeed. I take it the suicide is connected with your current work?”

  “It is a distinct, but not confirmed possibility. I believe the man had been a soldier in the war. I was walking along Charlotte Street at the time, and was close enough to him to see that one leg was crippled in some way, perhaps an inability to bend at the knee, while the other leg was either amputated at the knee, or bent backward. I would say there had been an amputation. His remains would support such a conclusion. And though I was not able to speak to him—had I been any closer, I might not be here today—I observed movement of the head and hands that might suggest a shell-shock case.”

  “How can I help?”

  “Dr. Lawrence, there are a considerable number of men who have remained locked away in institutions since the war and who are still suffering from war neurosis. And many more have been discharged in recent years, possibly to relatives, or to live in a hostel. Our man may have been one of them.”

  Lawrence sighed, rubbing his chin. “Miss Dobbs, the truth regarding this country’s treatment of its shell-shocked soldiers is harrowing, and to someone like yourself—trying to discover the dead man’s identity, for I imagine that must be of prime importance—it presents an obstacle of considerable proportions.” He sighed again, picked up a pen and put it down, ensuring that the writing instruments remained parallel to one another. “There were approximately, say, seventy-five to eighty thousand men diagnosed with shell-shock during and immediately after the war. These were the cases that could be easily identified, corroborated and signed off to return to England or to receive treatment.” He looked at Maisie with eyes the color of slate that reminded her of the sky on a bitterly cold day. “In my estimation—and I could be taken to task by the authorities for such comments, so please reflect upon this conversation with care—the numbers of shell-shocked men ran into the hundreds of thousands. And, arguably, there is no man”—he held Maisie’s eyes with his own—“or woman, who returned from Flanders unscathed in the mind.”

  “I know.”

  “Yes, you do. However, I wonder if you know what pressures were brought to bear on doctors during and after the war?” He did not wait for an answer before continuing. “Not only were we pressed to declare a man fit for duty as soon as any physical wounds were healed, but in all but the most obvious cases—and here’s my personal experience—our instructions, perhaps to send a man to a secure institution for additional care, were overruled by senior military staff who would label a man as a lazy item, or with low moral fiber. And off they would be sent, back onto the battlefield with their minds half destroyed.” He shrugged. “Of course, there was another reason—pensions. If a man is physically wounded in battle, there is a small pension allowance. With increasing numbers of men suffering mentally from the effects of war, the government was becoming queasier and queasier about having to pay pensions it would never be able to afford—so those men were discharged at the earliest possible opportunity, because for many, there was no bleeding, no physical wound or scarring. Miss Dobbs, if you haven’t realized it already, you must be aware that you are looking for a needle in a haystack. You could go through every record of every patient suffering from neurasthenia, war neurosis, melancholia and hysteria, and you will have touched only the tip of the iceberg.”

  “You are very frank, Dr. Lawrence.”

  “For every man on our wards who will never see the outside of an institution, there are five, six, seven out there”—he pointed at the window—“who are in a cell in their mind. They are trying to find work, trying to live from one day to the next. Some might have families or children, but they are ticking away inside, so that one day, when the baby wails in a certain way, the man will end up cowering in the corner or, worse, inflicting harm. And some take a deep breath every day, working, living, eating, breathing, holding all the components of life together in a vise-like grip so that no one will ever know they are broken as much as if their bodies had been crushed.”

  “I’m sorry if—”

  Lawrence held up one hand. “Please, don’t. You came to ask a question or two and you got more than you bargained for.” He reached for a folder, taking care to pull it toward him without disturbing the rest of the pile. He tapped the top of the folder. “This is a collection of letters from the powers-that-be instructing me to decrease numbers of soldiers from the war still held here. They are to be sent out into the raw reality of London in the midst of winter, and with no prospects of work or any sort of support. Where will they go? Who will care for them? This is the sort of battle I have on my hands—now everyone wants to forget the war.”

  Maisie nodded. “Dr. Lawrence, you have been most kind to spare me so much of your time. However, I wonder if I can just ask one or two questions. Are there any behaviors common among men who are discharged? Do they remain close to the hospital? Do they go further afield?” She breathed deeply. “You see—and it’s my turn to remind you of my need for confidentiality now—to give you more of an idea of the situation, there has been a threat received by a high-ranking government official. While others are working to see if the demands of the person who issued the threat could be met in some way that might placate him and give us time, my task is to try to find him. I have said the words needle in a haystack myself—I know from my war experience and my work at the Clifton how difficult that task might be. But I must continue, and in a short time follow any lead that presents itself to me. So, clutching at straws—if I take a gamble and assume the man who took his life on Christmas Eve was released from a secure institution at some point in the past couple of years, how might I find him?”

  Lawrence replaced the folder and ran his fingers along the sides once more to align the pile. “You could start with the pensions people, but I can tell you now, that door is indubitably locked shut. I will try to gain permission for you to view the records held here of former patients. And I can give you an introduction to other secure hospitals. When people leave an institution—be it a hospital or prison—there is sometimes a need to retain a sort of relationship with that place. They might find digs with a view of the hospital chimneys, they might need to come back for outpatient examinations or medication. They might just want to know that the nest, even if it was the most dreadful place they had ever known, is still close. But that’s just my opinion. My peers might suggest otherwise.”

  Maisie gathered up her gloves and scarf. “Thank you, Dr. Lawrence.” She looked at the clock on the wall. “I had better be off now.” She took a card from her black document case and put it on the desk in front of Lawrence, who had pushed back his chair. “Please send word as soon as you have permission for me to view the records. I hate to say this, but to gain informal access to the files would be so much better than having a warrant issued. I am sure Matr
on would walk on hot coals rather than have that sort of thing going on in her hospital.”

  Lawrence laughed. “I will be in touch. Now then, I’d better escort you to the porters’ office.”

  As they made their way down the staircase, Lawrence and Maisie spoke of times past, of improvements to the Clifton Hospital since she relinquished her nursing position, and of the doctor’s children, who were now grown. He unlocked doors and locked them again as they passed through the lower corridors, and soon they had reached the entrance.

  “Here we are.” Lawrence stopped alongside the porters’ office and knocked on the door. “Please let me know if I can be of any further assistance to you, Miss Dobbs.”

  Maisie shook his proffered hand, and turned to the porter who had just opened the door.

  “Will you be back today, Dr. Lawrence?” The porter inquired, while holding the ledger for Maisie to sign out.

  “Yes I will,” replied the doctor. “See that Miss Dobbs doesn’t have to wait too long for a taxi-cab, there’s a good chap, Croucher.”

  “Right you are, Dr. Lawrence. I’ll make sure she gets on her way.” He turned to Maisie and smiled.

  FOUR

  The man opened his eyes and waited for a moment or two while sleep ebbed from his mind, in the way that the sea recedes from the shore, going back a little, then returning, going back, then returning. It was in the first few seconds of waking that he sometimes panicked and was paralyzed by fear, for there were times when he took to his bed, not because it was night and therefore time to rest, but because being awake—even in daytime—was more than he could bear. His body was always chilled, and though the room was dry enough, his clothes felt damp, and his toes were bitten with cold. He pulled the blanket up over his coat-clad body and closed his eyes, smacking his lips as if to soothe his jaw so that sleep would come again and he could be delivered from his waking nightmares, which always seemed worse than those inflicted upon him in slumber. There were times when he woke and held his breath, for he couldn’t remember why he was steeped in melancholy, why his heart ached and his body hurt. Then the pictures began to play in his mind’s eye again, and the sounds tormented him so that he would clutch his head as if to rip it from his shoulders. Those were the times when he would have welcomed death, if only to be cast free.