The Quantity Theory of Insanity: Reissued

by Will Self

  A short corridor led from the mouth of the lift to the central association area of the ward. This was a roughly oblong space with the glassed-off cabinet of the nurses’ station on the short lift side; a dining area to the right looking out through a long strip of windows over the city; to the left were the doors to various offices and one-to-one treatment rooms; and straight ahead another short corridor led to the two dormitories.

  Every attempt had been made to present Ward 9 as an ordinary sort of place where people were treated for mental illnesses. There were bulletin boards positioned around the association area festooned with notices, small ads, flyers for theatrical performances by groups of hospital staff, clippings from newspapers, drawings and cartoons by the patients. Over in the dining area a few of the tables had rough clay sculptures blobbed on them, left there like psychotic turds. I assumed that they were the products of my predecessor’s last art therapy session. Around the open part of the area there were scattered chairs, the short-legged, upholstered kind you only find in institutions. And everywhere the eye alighted – the dining area, the nurses’ station, dotted in the open area – were ashtrays. Ashtrays on stands, cut-glass ashtrays, lopsided spiral clay ashtrays, ashtrays bearing the names of famous beers; all of them overflowing with butts.

  There are two kinds of institution that stand alone on the issue of smoking. Whereas everywhere else you go you encounter barrages of signs enjoining you to desist, slashing your cigarette through with imperious red lines, in psychiatric wards and police stations the whole atmosphere positively cries out to you, ‘Smoke! Smoke! We don’t mind, we understand, we like smoking!’ Ward 9 was no exception to this rule. Empty at this hour (the patients had no reason to get up, they didn’t roll over in their beds at 8.00 sharp and think to themselves, ‘Ooh! I must get up quickly and have my shot of thorazine …’), the whole ward still whirled and eddied with last night’s acrid work.

  I walked down the short corridor to the nurses’ station. A young man sat behind the desk completely absorbed in a dogeared paperback. He wore a black sweat shirt and black Levis; his sneakered feet, propped on the cluttered shelf of clipboards and Biros, pushed the rest of him back and up on two wheels of his swivel chair. As I stood and observed him, he rocked gently from side to side, his body unconsciously mirroring the short, tight arcs that his eyes made across the page.

  I shuffled my feet a little on the linoleum to warn him that he was no longer alone. ‘Good morning.’

  He looked up from his book with a smile. ‘Hi. What can I do you for?’

  ‘I’m Misha Gurney, the new art therapist, I start on the ward today and Dr Busner asked me to come in early to get a feel for things.’

  ‘Well, hello Misha Gurney, I’m Tom.’ Tom swung his feet off the ledge and proffered a hand. It was a slim, white hand, prominently bony at the wrist with long, tapering fingers. His handshake was light and dry but firm. His voice had the contrived mellowness of some Hollywood pilgrim paterfamilias. There was something unsettling in the contrast between this and his beautiful face: sandalwood skin and violet eyes. The body, under the stretchy black clothes, moved in an epicene, undulant way. ‘Well, there’s not a lot to see at this time. Zack isn’t even in yet. He’s probably just getting out of bed.’ Tom rolled his lovely eyes back in their soft, scented sockets as if picturing the psychiatrist’s matitudinal routine. ‘How about some tea?’

  ‘Yeah, great.’

  ‘How do you take it?’

  ‘Brown – no sugar.’

  I followed Tom down the corridor that led to the staff offices and the consultation rooms. There was a small kitchenette off to one side. Tom hit the lights, which flickered once and then sprang into a hard, flat, neon glare. He squeaked around the lino in his sneakers. I examined the handwritten notices carefully taped to the kitchen cabinets. After a while I said, ‘What do you do here, Tom?’

  ‘Oh, I’m a patient.’

  ‘I assume you’re not on a section?’

  He laughed. ‘Oh, no. No, of course not, I’m a voluntary committal. A first-class volunteer, exemplary courage, first in line to be called for the mental health wars.’ Again the light mocking irony, but not mad in any way, without the fateful snicker-snack of true schizo-talk.

  ‘You don’t seem too disturbed.’

  ‘No, I’m not, that’s why they let me go pretty much where I please and do pretty much what I want, as long as I live on the ward. You see, I’m a rare bird.’ A downward twist of the corner of a sculpted mouth, ‘The medication actually works for me. Zack doesn’t really like it, but it’s true. As long as I take it consistently I’m fine, but every time they’ve discharged me in the past, somehow I’ve managed to forget and then all hell breaks loose.’

  ‘Meaning …?’

  ‘Oh, fits, delusions, hypermania, the usual sorts of things. I carry the Bible around with me and try and arrange spontaneous exegetical seminars in the street. You know, you’ve seen plenty of crazies, I’ll bet.’

  ‘But … but, you’ll forgive me, but I’m not altogether convinced. If you’re on any quantity of medication …’

  ‘I know, I should be a little more slowed down, a little fuzzier around the edges, un peu absent. Like I say, I’m an exception, a one-off, an abiding proof of the efficacy of Hoffman La Roche’s products. Zack doesn’t like it at all.’

  The kettle whistled and Tom poured the water into two styrofoam cups. We mucked around with plastic dipsticks and extracted the distended bags of tea, then wandered back to the association area. Tom led me over to the windows. The lower decks of the hospital poked out below us. Up here on the ninth floor, more than ever, one could appreciate the total shape of the building – a steeply sloping bullion bar, each ascending storey slightly smaller than the one below it. On the wide balcony beneath us figures were wafting about, clad in hospital clothing, green smocks and blue striped nightdresses, all bound on with tapes. The figures moved with infinite diffidence, as if wishing to offer no offence to the atmosphere. They trundled in slow eddies towards the edge of the balcony and stood rocking from heel to toe, or from side to side, and then moved back below us and out of sight again.

  ‘Chronics,’ said Tom, savouring the word as he slurped his tea. ‘There’s at least sixty of them down there. Quite a different ball game. Not a lot of use for your clay and sticky-backed paper down there. There’s a fat ham of a man down there who went mad one day and drank some bleach. They replaced his oesophagus with a section cut from his intestine. On a quiet night you can hear him farting through his mouth. That’s a strange sound, Misha.’

  I remained silent, there was nothing to say. Behind me I could hear the ward beginning to wake up and start the day. There were footsteps and brisk salutations. An auxiliary came into the association area from the lift and began to mop the floor with studious inefficiency, pushing the zinc bucket around with a rubber foot. We stood and drank tea and looked out over the chronics’ balcony to the Heath beyond, which rose up, mounded and green, with the sun shining on it, while the hospital remained in shadow. It was like some separate arcadia glimpsed down a long corridor. I fancied I could see the park bench I’d passed some forty minutes earlier and on it a blue speck: the tonsured idiot, still rocking, still free.

  Zack Busner came hurrying in from the lift. He was a plump, fiftyish sort of man, with iron-grey hair brushed back in a widow’s peak. He carried a bulging briefcase, the soft kind fastened with two straps. The straps were undone, because the case contained too many files, too many instruments, too many journals, too many books and a couple of unwrapped, fresh, cream-cheese bagels. Busner affected striped linen or poplin suits and open-necked shirts; his shoes were anomalous – black, steel-capped, policeman’s shit kickers. He spotted me over by the window with Tom and, turning towards his office, gestured to me to follow him, with a quick, flicking kind of movement. I dropped my foam beaker into a bin, smiled at Tom and walked after the consultant.

  ‘Well Misha, I see you’ve found a friend alrea
dy.’ Busner smiled at me quizzically and ushered me to the chair that faced his across the desk. We sat. His office was tiny, barely larger than a cubicle, and quite bare apart from a few textbooks and four artworks. Most psychiatrists try to humanise their offices with such pieces. They think that even the most awful rubbish somehow indicates that they have ‘the finer feelings’. Busner’s artworks were unusually dominant, four large clay bas-reliefs, one on each wall. These rectangular slabs of miniature upheaval, earth-coloured and unglazed, seemed to depict imaginary topographies.

  ‘Yes, he’s personable enough. What’s the matter with him?’

  ‘Actually, Tom’s quite interesting.’ Busner said this without a trace of irony and began fiddling around on the surface of his desk, as if looking for a tobacco pipe. ‘He’s subject to what I’d call a mimetic psychosis …’

  ‘Meaning?’

  ‘Meaning he literally mimics the symptoms of all sorts of other mental illnesses, at least those that have any kind of defined pathology: schizophrenia, chronic depression, hypermania, depressive psychosis. The thing about Tom’s impersonations, or should I say the impersonations of his disease, is that they’re bad performances. Tom carefully reiterates every recorded detail of aberrant behaviour, but with a singular lack of conviction; it’s wooden and unconvincing. Your father would have found it fascinating to watch.’

  ‘Well, I find it pretty fascinating myself, even if I don’t have quite the same professional involvement. What phase is Tom in now?’

  ‘You tell me.’

  ‘Well, he seems to be playing the “Knowing Patient Introduces Naive Art Therapist to Hell of Ward” role.’

  ‘And how well is he doing it?’

  ‘Well, now you mention it, not too convincingly.’

  Busner had abandoned his search for a pipe, if that’s what it had been. He now turned and presented me with his outline set against the window. In profile I could see that he was in reality rather eroded, and that the impression of barely contained energy which he seemed determined to project was an illusion as well. Busner sat talking to me, rolling and then unrolling the brown tongue of a knitted tie he wore yanked around his neck. Overall, he reminded me of nothing so much as a giant frog.

  Behind him light and then shadow moved across the face of the hospital at a jerky, unnatural speed. The clouds were whipping away overhead, out of sight. All I could see was their reflection on the hospital’s rough, grey, barnacle-pitted skin.

  The hospital was big. Truly big. With its winking lights, belching vents and tangled antennae, it slid away beneath the cloudscape. Its bulk was such that it suggested to the viewer the possibility of spaceships (or hospitals) larger still, which might engulf it, whole, through some docking port. The hospital was like this. I couldn’t judge whether the rectangles I saw outlined on the protruding corner opposite Dr Busner’s office were glass bricks or windows two storeys high. The street lay too far below to give me a sense of scale. I was left just with the hospital and the scudding shadows of the racing clouds.

  Busner had given up his tie-rolling and taken up with an ashtray on his desk. This was crudely fashioned out of a spiralled snake of clay, varnished and painted with a bilious yellow glaze. Busner ran his fleshy digit around and around the rim as he said, ‘I’d like you to stick close to me this morning, Misha. If you are to have any real impact on what we’re trying to do here you need to be properly acquainted with the whole process of the ward: how we assess patients, how we book them in, how we decide on treatment. If you shadow me this morning, you can then get to know some of the patients informally this afternoon.’

  ‘That sounds OK.’

  ‘We’ve also got a ward meeting at noon which will give you an opportunity to get to know all your fellow workers and appreciate how they fit into the scheme of things.’

  Busner set down the turd of clay on his desk with a clack and stood up. I stepped back to allow him to get round the desk and to the door. Despite being the senior consultant in the psychiatric department, Busner had about as much office space as a postroom boy. I followed him back down the short corridor to the association area. By now the sun had risen up behind the clouds and the bank of windows on the far side of the dining area shone brightly. Silhouetted against them was a slow line of patients, shuffling towards the nurses’ station where they were picking up their morning medication.

  The patients were like piles of empty clothes, held upright by some static charge. Behind the double sliding panes of glass which fronted the nurses’ station sat two young people. One consulted a chart, the other selected pills and capsules from compartments in a moulded plastic tray. They then handed these over to the patient at the head of the queue, together with a paper beaker of water, which had a pointed base, rendering it unputdownable, like a best seller.

  ‘Not ideal, but necessary.’ Busner cupped his right hand as if to encapsulate the queue. ‘We have to give medication. Why? Because without it we couldn’t calm down our patients enough to actually talk to them and find out what the matter is. However, once we’ve medicated them they’re often too displaced to be able to tell us anything useful. Catch-22.’

  Busner cut through the queue to the dining area, muttering a few good mornings as he gently pushed aside his flock. We sat down at a table where a young woman in a frayed white coat was sipping a muddy Nescafe. Busner introduced us.

  ‘Jane, this is Misha Gurney, Misha, Jane Bowen – Jane is the senior registrar here. Misha is joining us to manage art therapy – quite a coup, I think. His father, you know, was a friend of mine, a close contemporary.’

  Jane Bowen extended her hand with an overarm gesture that told me she couldn’t have cared less about me, or my antecedents, but because she thought of herself as an essentially open-minded and kind person she was going to show me a welcoming smile. I clasped her hand briefly and looked at her. She was slight, with one of those bodies that seemed to be all concavities – her cheeks were hollowed, her eyes scooped, her neck centrally cratered. Under her loose coat I sensed her body as an absence, her breasts as inversions. Her hair was tied back in one long plait, held by an ethnic leather clasp. Her top lip quested towards her styrofoam beaker. The unrolled, frayed ends of her stretchy pullover protruded beyond the frayed cuffs of her cotton coat. Her pockets were stuffed full. They overflowed with pens, thermometers, syringes, watches, stethoscopes, packets of tobacco and boxes of matches. The lapels of the coat were festooned with name badges, homemade badges, political badges and badges of cutout cartoon characters: Roadrunner, Tweetypie, Bugs Bunny and Scooby Doo.

  ‘Well, Misha, any ideas on how your participation in the ward’s creative life will help to break the mould?’ She gestured towards an adjacent table, where several misshapen clay vessels leant against one another like drunken Rotarians.

  ‘Well, if the patients want to make clay ashtrays, let them make clay ashtrays.’ I lit a cigarette and squinted at her through the smoke.

  ‘Of course they could always try and solve The Riddle.’

  I hadn’t noticed as I sat down, but now I saw that she was shifting the four pieces of a portable version of The Riddle around on the melamine surface in front of her. Her fingers were bitten to the quick and beyond. Busner flushed and shifted uneasily in his chair.

  ‘Erumph! Well… bankrupt stock and all that. We have rather a lot of The Riddle sets around the ward. I err … bought them up for a pittance, you know. At any rate, I still have some faith in them and the patients seem to like them.’

  Busner had been responsible for designing, or ‘posing’, The Riddle in the early Seventies. It was one of those pop psychological devices that had had a brief vogue. Busner himself had been forging a modest career as a kind of media psychologist with a neat line in attacking the mores of conventional society. The Riddle tied in with this and with the work that Busner was doing at his revolutionary Concept House in Willesden. His involvement with the early development of the Quantity Theory also dated from that period.
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br />   Busner was a frequent trespasser on the telly screens of my childhood. Always interviewing, being interviewed, discussing an interview that had just been re-screened, or appearing in those discussion programmes where paunchy people sat on uncomfortable steel rack-type chairs in front of a woven backdrop. Busner’s media activities had dropped away as he grew paunchier. He was now remembered, if at all, as the poser of The Riddle – and that chiefly because the short-lived popularity of this ‘enquire-within tool’ had spawned millions of square acrylic slabs of just the right size to get lost and turn up in idiosyncratic places around the house, along with spillikins, Lego blocks and hairpins. In fact it had become something of a catch-phrase to cry as you dug a tile out from between the carpet and the underlay, or from behind a radiator, ‘I’m solving The Riddle!’ Eventually The Riddle itself – what you were actually meant to do with the four square slabs in bright pastel shades, which you got with The Riddle set – was entirely forgotten.

  ‘I’m sorry Zack, I didn’t mean to sound caustic.’ Jane Bowen placed a surprisingly tender hand on Busner’s poplin sleeve.

  ‘That’s all right, I think I still deserve it, even after all these years. The funny thing is that I did believe in The Riddle. I suppose a cynic would say that anyone would believe in something that brought in enough income to buy a four-bedroom house in Redington Road.’

  ‘Even shrinks have to have somewhere to live,’ said Jane Bowen. The two of them smiled wryly over this comment – a little more wryly than it strictly merited.

  ‘Well, we’re not helping anybody sitting here, are we?’ said Busner. Once again this was a key motif. It had been his catchphrase on all those discussion and interview programmes – always delivered with falsetto emphasis on the ‘helping’. The catch-phrase, like The Riddle, outlived Busner’s own popularity. I remember seeing him towards the very end of his TV sojourn, when he was reduced to going on one of those ‘celebrity’ gameshows where the celebrities sit in a rack of cubicles. Zack trotted out his obligatory line and the contestant dutifully pushed the button on the tape machine – as I recall, she ended up winning a suite of patio furniture. It was really quite a long way from the spirit of radical psychology. Now Busner was using the phrase again, clearly with a sense of irony – but somehow not altogether; there was also something else there, a strange kind of pride almost.