The Proper Procedure and Other Stories

by Theodore Dalrymple

  Reluctantly, then, she turned to the computer to enter the man’s details. Her hands hovered over the keyboard.

  ‘Name?’ she said.

  ‘That’s just it,’ said the man. ‘I don’t know.’

  The woman let out an exasperated sigh. How could he be fully conscious and yet not know his own name? She accepted, of course, that an unconscious man, knocked over in the street, might be brought to hospital without any identifying documents on him. Such a man could be recorded as ‘Unknown Male,’ and given a letter of the alphabet according to how many such unknown males had been found or picked up that day, though she had never known it get beyond the letter C because no one remained unidentified for long. Either the relatives or the police would claim the Unknown Male as their own; but it was clearly ridiculous to call a man standing upright before her, taking normally, Unknown Male B. Nevertheless, faced with no other choice, that is what she did.

  ‘Date of birth?’ she asked.

  ‘I don’t know that either,’ said the man.

  ‘Address?’

  ‘I don’t know,’ said the man, adding by way of explanation that he couldn’t remember anything until he woke up that morning.

  ‘What do you mean, you can’t remember anything?’ said the receptionist. ‘How did you get here?’

  ‘I walked.’

  ‘Where from?’

  ‘I woke up in a cinema. I didn’t know who I was or how I got there.’

  The woman snorted in disapproval.

  ‘Well, what do you want us to do about it?’ she said. ‘I have to put something down on the computer, otherwise you can’t be seen.’

  ‘I want to know who I am and where I came from,’ said the man.

  ‘This isn’t a lost and found department, it’s a hospital. Perhaps you should go to a lost property office, someone might be looking for you there.’ She smiled at her own joke.

  ‘I know,’ said the man, ‘but there must be something wrong with me if I can’t remember nowt.’

  ‘But what?’ she replied. ‘I have to put something down in writing.’

  ‘Memory problems?’ suggested the man in an almost supplicatory way.

  ‘That’s not on the system,’ she snapped. ‘It has to be something that’s on the system, otherwise it won’t record it.’

  ‘I’m sorry,’ said the man, but she did not accept his apology.

  ‘You’ve given me a real problem,’ she said. ‘I’ll have to think of something.’ She stared ahead of her, as if trying to pluck a diagnosis from the void. ‘Ah, that’s it,’ she said. ‘Dementia, unspecified type.’

  Her mood improved with the solution that she had found. Sometimes, after all, her job was rewarding.

  ‘Go and sit over there,’ she said, pointing to a waiting area. ‘A doctor or nurse will be with you as soon as possible.’

  The man went over to the waiting area and sat down. There was only one other person waiting there, a woman not yet old but with a face as wizened as a walnut. She smiled at the man as if welcoming him to a religious fellowship. Above them was a television screen, on which a sun-tanned man in his thirties, in a buttoned-up suit and a broad sky-blue tie, was speaking.

  ‘Did the operation go badly?’ he asked. ‘Were you badly treated? Why not contact us? Remember, there’s no fee to pay unless we win, so you have nothing to lose. Don’t delay, contact us today.’

  Another voice urged viewers to call o-eight-hundred, one three one three one four. Then a man appeared, dressed as a judge, and sang, with a ticker-tape of his words below him, ‘Remember, where there’s blame, there’s a claim.’

  Then the football resumed, as if it were a service essential to the running of the hospital. The commentator’s words could not quite be made out, but his intonation was that of excitement, like a lunatic in a locked room.

  ‘I don’t really like this hospital,’ said the woman to the man who was waiting with her. ‘But it’s the nearest.’

  The man, now officially Unknown Male B, nodded.

  ‘Most of the doctors are foreign. Sometimes you can’t even understand what they’re saying.’

  The man nodded again.

  ‘I’ve got a lump on my leg. What you here for?’ asked the woman, who was clearly a regular.

  ‘I don’t know who I am,’ said the man.

  ‘You what?’ she asked.

  ‘I don’t remember nowt from before this morning.’

  The woman looked around her quickly.

  ‘I think I’ll just go and have a cup of tea,’ she said, and moved away to the far side of a partition where he could not see her.

  Two hours later a nurse emerged from somewhere in the interior of the hospital and, referring to a clipboard, called out ‘Unknown Male B.’ The man stood up.

  ‘This way,’ she said, and led him into a cubicle with a thin floral curtain around it and an examination within.

  ‘Get undressed down to your underpants and the doctor will be with you shortly,’ she said. ‘Here’s a gown for you.’

  She handed him a flimsy gown that could be tied up at the back with bows, but not by the person wearing it.

  About half an hour later the doctor entered the cubicle. He was concentrating intently on the documents he was holding as he entered. He put them aside after a short while.

  ‘So you’re the Unknown Mr B?’ he said jocularly.

  ‘That’s what they call me.’

  ‘Now why is that?’ asked the doctor.

  ‘I can’t remember nowt until I woke up this morning. I don’t even remember who I am.’

  ‘Well, you’re not from round here, to judge by your accent,’ said the doctor. ‘Let’s take a good look at you.’

  The doctor examined the man from head to foot, tapping his elbows, his knees and his ankles, shining a light in both his eyes, standing him upright with his eyes open and shut, and performing various other tests upon him. Having done all this, the doctor told him he could get dressed again.

  ‘I can’t find anything wrong with you,’ said the doctor.

  ‘There must be something,’ said the man. ‘I mean…’

  ‘Anything physical,’ said the doctor, unsure what to do next. He looked bemused, for he could hardly claim there was nothing at all wrong with a man who couldn’t remember who he was. ‘Are you sure you haven’t had an accident, a bang on the head or something like that?’

  The man repeated that he couldn’t remember anything.

  ‘I’m going to have to call someone else to examine you,’ said the doctor. ‘You’ll have to wait here.’

  The man waited for another two hours. He heard cries and groans coming from other cubicles. Young children wailed and a confused old lady cried ‘No!’ when the doctor did something to her that she didn’t like. All this held no interest for him, however; it passed over him like a mist; but when a nurse put her head through the curtains that surrounded his cubicle, he mentioned that he was hungry.

  ‘There’s a vending machine on the other side,’ she said.

  ‘I haven’t got no money,’ the man said.

  ‘I’m afraid that’s too bad,’ said the nurse. ‘You’ll have to wait till you’re admitted. We don’t give out meals in A and E.’

  At the end of the two hours, another doctor entered the cubicle. He was casually, even shabbily dressed, and looked as though the cares of the world weighed heavily on him.

  ‘I’m a psychiatrist,’ he said.

  The man did not react as so many patients did, with surprise or shock. A man who is interested in nothing cannot be surprised or shocked. His face registered no emotion.

  The psychiatrist asked him a lot of questions, but he responded them like a man who has been arrested by the police and stands on his right to remain silent. He didn’t know when or where he was born, who his parents were, where he went to school, what his work was, if any, whether he was married and had children, what his hobbies were, whether he had ever had any illnesses or took medication, how much he dran
k or whether he smoked cannabis. When the psychiatrist asked him how old he was, he looked in the glass in the cubicle and said, ‘I look about forty.’ He was trying to be helpful and co-operative, not clever or cheeky; he did not want to appear deliberately obstructive.

  ‘From your accent,’ said the psychiatrist, ‘you sound as if you are from the North of England.’

  But even this information evoked no response from the man, to whom it meant nothing and for whom it jogged no memory. He continued to look blankly at the psychiatrist.

  ‘If you can’t remember who you are,’ said the psychiatrist, ‘we’ll have to admit you temporarily to the ward.’

  The man looked neither pleased nor displeased. He seemed detached from the world and even from his own life.

  ‘I’ll arrange for you to be transferred,’ said the psychiatrist, ‘and I’ll see you later.’

  The man waited another couple of hours in the cubicle. Eventually a porter arrived with a wheelchair. The porter was in a uniform that he had disarranged somewhat to demonstrate his individuality and to enter his protest against regimentation. His tie, loosened at his undone collar, hung at an angle to the vertical and displayed a rich pattern of stains. He wore running shoes that were out of keeping with the uniform, but which were not intended to convey an impression of expeditiousness, let alone athleticism. On the contrary, he moved as through an atmosphere that he found almost gelatinous. He had a rolled-up tabloid newspaper in the back pocket of his trousers.

  He looked at the man and saw that he was not of the difficult, complaining or socially superior type.

  ‘Come on mate,’ he said, ‘hop in.’

  The man climbed down obediently from the examination couch. Apart from the fact that the flimsy gown was open at the back and it revealed his buttock, there was no reason why he could not have walked and had to be moved in a wheelchair.

  The porter wheeled him along the corridor with his clothes piled on his lap. The passing parade of invalids, visitors, doctors in green gowns, nurses, patients pushing drip-stands, did not interest him.

  ‘Are you a racing man?’ asked the porter.

  ‘A what?’ said the man.

  ‘A racing man. Do you follow the horses? The gee-gees?’

  ‘I don’t know.’

  ‘You don’t know?’ The answer was so unexpected that the porter stopped pushing the wheelchair for a moment. ‘You must know. I mean, either you do or you don’t.’

  ‘I can’t remember nowt from this morning,’ said the man.

  The porter rolled his eyes heavenwards.

  ‘Pity,’ he said. ‘I’ve got a dead cert for the 3.30 at Cheltenham.’

  They reached the ward. A nurse in a dark uniform stood at the entrance.

  ‘Put him in the end room,’ she said to the porter.

  The porter wheeled him through the ward, suddenly accelerating for no obvious reason. The other patients stared at him inquisitively. Those who were not too ill themselves took a lively interest in the illness of others, and perhaps even hoped for a tragedy, or at least a drama.

  ‘I’m hungry,’ said the man to a nurse who had come to take his details, having followed him the last few yards. ‘Can I have something to eat?’

  ‘It’s too late now,’ she said, as if he had dawdled on his way and had therefore to pay the price. ‘There’ll be something this evening.’

  ‘Get up on the bed mate,’ said the porter, and pulled the chair away from him as soon as he had stood up. ‘See you.’ And he went out, using the chair as a battering ram to open the swing doors.

  The man got up on to his bed. A television at the end of an articulated arm like a spider-crab’s limb hung over it, and relayed soundless images of a man in a leotard performing energetic callisthenics and obviously inviting the viewers to join in. The man pushed the screen away; then laid down on the bed, staring up at the ceiling composed of white polystyrene squares, one of which was coming loose and might suddenly fall on the bed. But the man was not frightened by the possibility.

  He was left alone in the room for the rest of the day. The meal he had been promised turned out to be a couple of thin sandwiches, compressed as if by heavy weight, and a fibrous tangerine with a thick skin. The man felt by no means satisfied, and asked a cheerful Nigerian nurse who came in to take his pulse whether he could have a piece of toast.

  ‘I’m sorry, my darling,’ she said. ‘I’m the only one on for the whole ward, and I don’t have the time.’

  So saying, she went to the ward office where she spoke on the telephone to a friend for half an hour about a party next week-end, and whether the handsome Dr Olugunde would go to it.

  Somewhere in the ward a very old woman was crying out ‘Nurse! Nurse! Help me! Help me!’ But experience had shown that helping such old women did not stop them from crying out, and therefore she was ignored.

  The psychiatrist came to the man’s room the following day.

  ‘How are you?’’ he asked. ‘Remember anything yet?’

  The man shook his head.

  ‘I still can’t remember nowt,’ he said. ‘I still don’t know who I am.’

  He seemed remarkably untroubled by his ignorance.

  ‘We’ll have to try to find out,’ said the psychiatrist.

  ‘How?’ asked the man, a hint of anxiety entering his otherwise indifferent manner, as if the enquiry into his identity were a matter of mere academic interest.

  ‘I want to try an injection,’ said the psychiatrist. ‘Of course, you have to agree to it.’

  The man was in an awkward spot: he didn’t want an injection, but didn’t want to appear difficult either.

  The psychiatrist put a printed form in front of the man. It had a lot of words on it and the man was not a great reader.

  ‘What is it?’ he asked.

  ‘A consent form,’ said the psychiatrist.

  ‘What’s that?’

  ‘It says that I’ve explained everything to you and that you agree to it.’

  He pushed a pen into the man’s right hand – he assumed he was right-handed – and said, pointing to the bottom of the paper, ‘Sign here.’

  ‘But I don’t know who I am,’ said the man.

  ‘Just put an X,’ said the psychiatrist. ‘I’ll get someone to witness it.’

  The man made such a mark.

  ‘Right,’ said the psychiatrist, ‘what I’m going to do is to inject you with a drug that will make you feel very relaxed.’

  ‘Why?’ asked the man.

  ‘Because that’s what we do in cases like yours,’ said the psychiatrist. ‘When they don’t recover spontaneously,’ he added. ‘Now lie back and I’ll just clean your skin with this antiseptic.’

  He wiped the crook of the man’s arm with a little square impregnated with alcohol, the coldness of which made the man start. ‘And now a little pin-prick.’

  The man looked down at what the psychiatrist was doing with a mild detached interest, as if it were being done to someone else, not himself. ‘You might begin to feel a little sleepy,’ said the psychiatrist.

  And indeed he did. His head swam as if he had been suddenly whirled round and round; and his head as heavy as if it had been filled with lead shot, and it now took a supreme effort of will to move it a fraction in any direction. The psychiatrist’s voice came to him as through a curtain of cotton wool.

  ‘What’s your name?’ asked the psychiatrist.

  ‘I... I don’t know,’ said the man, his speech now slurred and indistinct.

  The psychiatrist pushed a little more of the drug into the man’s vein, and his eyelids began to flicker. He was briefly asleep and then woke again.

  The psychiatrist repeated the question a couple of times, but the only words that he could make out in reply were ‘Don’t know.’

  The psychiatrist left off for a while as the man slipped into and out of a light and fitful sleep. Judging his moment, he asked him where he lived. The man muttered something, but so indistinctly that the psychi
atrist did not catch it.

  ‘Say that again,’ he said. ‘Where do you live?’

  ‘Twenty-three...’ muttered the man.

  The psychiatrist’s excitement rose, like a hunter closing in on his prey. He leaned forward, over the man’s bed, so that he might catch every last syllable.

  ‘Twenty-three where?’

  ‘Twenty-three... twenty-three...’ The man’s voice faded, and he fell back into a light sleep.

  The psychiatrist rubbed his forearm rhythmically to rouse waken him. The man came round a little.

  ‘Twenty-three where?’ asked the psychiatrist in a tone that in other circumstances would have been insidious.

  ‘Twenty-three, Willow Street.’

  The psychiatrist controlled himself. He knew that if he were impatient now, all might be lost.

  ‘Twenty-three, Willow Street, where?’ he asked slowly and gently, only just audibly, as if he did not really care if he received an answer.

  ‘Twenty-three, Willow Street...’

  ‘Yes?’ said the psychiatrist.

  ‘Twenty-three, Willow Street, Hindborough,’ said the man, and then feel asleep exhausted by the effort of recollection.

  The psychiatrist leapt to his feet, elated by his triumph. He left the man sleeping on the bed as if he were now surplus to requirement.

  Hindborough, the town where the man lived, meant little to the psychiatrist other than it had a football team that had once been good but was so no longer, despite the town’s fanatical devotion to it. The town, formerly industrial, was also known for its unemployment.

  He was incurious to know more. Instead, he called the town’s police and told the story of Unknown Male B who lived at twenty-three, Willow Street. Was a man known to be missing from there?

  ‘Leave it with us, doctor,’ said the policeman. ‘We’ll find out.’

  The man, recovering quickly from the injection, was now staring up at the ceiling. About an hour later, the Hindborough police called the psychiatrist and told him that no one had been reported missing from that address. However, they would go round in person and check.