by Will Self
until now. Well, she’s never in the way, Always something nice to say, Oh what a blessing. I can leave her on her own, Knowing she’s okay alone, and there’s no messing. She’s a lady, Whoa, whoa, she’s a lady! I presume that you and, um, these others – Miss Deerth, Miss Deeth, Miss Death and, er, Miss De’Ath – that you are . . . one and the same? Busner leans into the headrest as far as he dare, entangling his hair with hers – there’s nothing to hear beyond the pigeon burble of fluid respiration. He tries another tack: On your notes . . . Miss Dearth . . . You were seen by various doctors over the years . . . Do you recall Doctor Hood? Nothing. Or maybe Doctor Hayman? Nothing again. A trolley comes wheedling along stacked with aluminium-lidded plates, the sulphurous stench of overcooked Brussels sprouts rolls over the trench where he hunches – other patients rise to fetch trays and there is a modest cacophony. Frustrated, Busner rears up. Mboya has gone – there are only orderlies in blue-and-green-cheque nylon housecoats passing out the featherweight cutlery, handing over the scratched-opaque plastic beakers. Oh what a blessing – there’s no messing . . . He tries again: How about Doctor Cummins – or Doctor Marcus? This last name is his trump card, surely it will elicit a response, surely? Sjoo-shjoob. I’m sorry? He tucks his ear in still further – her cheek is deeply creased, she has been sleeping on sheets of disordered time. Sjhoo-shoob. Or is it jujube? His ear brushes her purse lips, Please, he says, please Miss Dearth or whatever your fucking name is, please try again . . . the wishbone jaw articulates, releasing foul breath and two pellets of sense: Jew-boy. For a moment Busner imagines she has roused only to insult him, then two more pellets follow: he . . . was, before she falls silent. Of course! It is not in Busner’s nature or deportment to become a whirl of activity, yet this, he thinks, is what I am. His springing up releases her flywheel – and so her hands go to it again: the right rotating, the left adjusting, while he grips his clipboard and plunges straight through the row of chairs. Oi! Garvey leers at him dying Pakistani a cuspid of mash in his otherwise toothless mouth – Busner sheds sorries as he sees that someone has switched the television back on, although it like me lacks vertical hold: jagged compartments going up and up, a Brucie in every one. He slaps the set’s wood veneer cheek once, twice, hard and Fanks, Doc, follows him and his stinging palm – but he doesn’t look back. It’s the Saturday evening before Easter Sunday, he should be at home with my wife and kids, with Miriam, Mark, Daniel and the baby – not here, where in the intensifying gloom the Austin’s headlights sweep across the trompe-l’œil façade of the hospital, It’s a fake, because, while it looks like a hospital on this holiday weekend, there won’t be a single doctor in the entire asylum, the three thousand or so lunatics prevented from taking it over only by their own institutionalised inertia. — The vulnerable prey of his own soaring enthusiasm, Busner wrestles the car around the ornamental flowerbed, past the lodge and turns left on to Friern Barnet Road. Settling down into the cold, damp vinyl odour of the car, merging my own foam rubber with its, he sets course for St John’s Wood through another spring squall. He had telephoned again from the nurses’ station to confirm that he was coming and Marcus’s voice – clipped, bored and nasal – said: I thought I made it clear to you when we spoke yesterday evening, Doctor Busner, come whenever you like – there’s nothing else to do. And to Busner, despite Miriam’s censure, it also feels that there’s nothing else to do . . . An ultimatum had been set when they quit the Concept House the previous year: No more enthusiasm – enthusiasm almost got you bloody struck off! Now it has him in its talons again, gripping him as tightly as he grips the kyphotic steering wheel and directs the Austin’s blunt nose to part the rainy spangles that trail across the carriageway. Last night Miriam had taken the children to Seder at her parents’ without him – it was the first time this had happened since she laid down the law. He remained poring over Audrey Dearth’s notes at the kneehole desk he had installed in the corner of their bedroom, having failed in his attempt to enthuse her too by showing Miriam the entries made by Doctor A. Marcus that began in 1931 with him effectively dissenting from his colleague’s diagnosis of schizophrenia, and ended in 1941 when, Busner assumed, he had been called up. You see – he had grasped her elbow – here he’s written Enc. Leth. And here he expands on this: I consider it likely this patient may in fact be suffering from the somnolent-ophthalmologic form of encephalitis lethargica. Then here . . . he riffled . . . here, here, here and here! Every time he sees her over the next decade he’s moved to write something – he scrawls across her drug card when she’s been given paraldehyde Not Required. He writes next to another doctor’s observation that her oculogyric crises – whatever they may be – are functional: Nonsense. See, see! Miriam, who has a dip’ psych. of her own, wouldn’t see, she only echoed the baby’s full-throated protest from the next-door room: See what? She pulled away from him and said, What is this encephalitis lethargica anyway? Believing he had her hooked, Busner had begun hauling on the cuff of her cardigan, dragging her towards the entry in the musty Britannica he had inherited from Maurice: There – he’d glossed it – end of the First War . . . Came before the Spanish Flu epidemic – maybe a precursor? Thing is, onset Parkinsonian – fevers, night sweats, swoons – but then paradoxical: some lapse into comas, others the reverse, suffering sleeplessness to the point of agrypnia! Maybe a third of ’em died, another third recovered completely, and a further third seemed to get better, but then a year, three – perhaps as many as five later they relap—. She took back her arm, saying, Zack, the baby is crying, she can’t sleep right now. Miriam’s freshly sculpted bob was polished ebony in the sharp light of the Anglepoise, Mary Cunt, he thought, then said: Don’t you see? This patient of mine at Friern, she’s just one of scores in the hospital I’ve identified – there must be hundreds more still scattered throughout the big asylums, possibly thousands. Don’t you see, there’s nothing at all wrong with them psychologically – or at least there wasn’t to begin with, now . . . who knows – this was a virus that attacked the brain stem. Miriam had been arrested in the open doorway, her fingers rubbing her own shaven nape in sympathy? her hip still boyish nudging the wicker laundry basket from which dripped a pair of his own underpants piping hot. I tell you what I see, she said. I see the same sort of pathetic reductionism at work here that was operating when you fell under your pal Ronnie’s influence . . . that voice banishes my concentration . . . Then there was no mental illness to speak of, only different ways of looking at the world. Different – she spat individual syllabic seeds – ex-i-sten-tial phe-nom-en-olo-gies. And now, again, there’s no mental illness – hey presto! All gone! All better! And in its place this encepho-thing. I wonder, Zack – really, I wonder when it’ll occur to you . . . this had been her parting shot, and he the dumb dog sat there obediently waiting for it . . . that simply wishing madness away won’t make anyone regain their sanity – nobody at all. Soon enough the baby’s crying shuddered to a halt, stoppered by a bottle. He could hear Miriam calling to the boys to get their coats – then car keys jangled, the front door slammed, the starter motor of the Austin coughed and whined, coughed and whined again. He sat there worried she would return to upbraid him some more until, eventually, he heard the car accelerate away – then he began to worry she would never return at all. Now, the same engine fulminating by the lights at Henley’s Corner, Busner sits waiting in the clammy day that Henry carefully removed all the polythene from their uncle’s dry-cleaned suits, then, taking the wire coat hangers, bent them to form the framework upon which the filmy stuff could be stretched. These strange blooms of the future were finished off with large amounts of Sellotape before being planted in between the delphiniums in the – at that time – sterile and ordered front garden of the Redington Road house. He was always good with his hands – still is. Zack already knew better than to interfere, although it can only have been a few weeks since Henry had returned unexpectedly, mid-term, from Cambridge, filthy, unshaven, his knuckles scabbed, and told his younger brother that th
e Authorities had concealed an intercontinental ballistic missile silo beneath the quadrangle of his college. His plastic flowers planted, Henry got out the hose and stood there drenching the same spot for an hour, then a second, then a third. He drenched it until the earth liquefied and flowed down the path, out the gate and down the road, bearing privet leaves, twigs and blades of cut grass on its thick and sinuous back. He drenched it until their uncle returned home to find him standing there, his kaleidoscope eyes on the marmalade sky, his trousers soaked and mud-spotted. Then Henry began to water Maurice. Soon enough there was a clangorous police Rover – soon after that an ambulance. Uncle Maurice, with his interest in the Elstree Studios and his brittle-coiffed friends, had had a flare for dramatics — although to be fair he had tried persuasion before, many times.
Marcus’s address in 1941 had been given up grudgingly by Missus Jarvis of Records. There was still a Doctor A. Marcus listed in St John’s Wood, yet Busner hadn’t been convinced he had the right man until, upon apologising for calling on the evening of Good Friday, the pre-war voice on the end of the line said: We Jews also celebrate the death of Christ y’know – an outrageous statement, presumably intended to drive away callers, but which in this instance had the opposite effect. Busner had the unnerving sensation – so clearly did he hear the other man’s voice inside his head – that they were only two hemispheres of the same brain, yoked together by the citywide stretching of the corpus callosum phone line. He’s the one, Busner had thought, and now, having been buzzed in to the mansion block on Abbey Road, he climbs the wide and shallow treads of the stairs to see a Jew with a military bearing – he’s definitely the one. Of course I remember Miss Deerth, Marcus says before anything else. He stands: a tall, stooped figure Stravinsky ugly with a pot-belly and a large nose with a broad, flat tip duck-billed, his bifocals pushed up high on a balding cranium. I saw her at least monthly, if not more often, for getting on for ten years, why shouldn’t I remember her? There’re members of my immediate family I’ve seen less of – and found less, ah, congenial. In the twitch of the bill towards a mousy wife who stands in the tenebrous corridor, there is a nasty implication, one confirmed when Marcus ushers Busner on without making an introduction and she withdraws, presumably to a kitchen. They breast smelly vapours of chopped liver and frying potatoes, their feet crackling on a plastic strip laid over the carpet, before entering a weird chamber. Can I offer you a sherry? Marcus asks, as he points to one of a pair of club chairs of thirties vintage with burled walnut sides like the dashboard of the Austin that face one another over a nest of red lacquered tables. The sherry is Cypriot – incredibly sweet. Marcus un-nests one table, a second and then a third to accommodate all of the case notes Busner withdraws from his briefcase. A frosted bulb of high wattage is exposed in a perverted way by the scalloped edge of its paper shade and the mean white light strikes Marcus’s face – a face that, as is so often the case with the ageing male, has been inefficiently shaved, leaving bristly crests on either cheekbone and along the line of the resolute jaw. You have to understand, he says, that it was all too common in the first wave of the epidemic to have one patient correctly diagnosed with encephalitis lethargica and sent to a fever hospital, but for his as it were twin in every symptomatic respect to be diagnosed with dementia praecox and sent to a mental one. This . . . he dips for his sherry . . . happened all the time – and it went on into the twenties, when the second wave of the epidemic felled many more of those who it’d been thought had fully recovered. Still, to be fair to the doctors of that era –. Marcus interrupts himself: But why? Why be fair to ’em! Sherry spittles on my precious notes! Some of ’em were outright bloody pervs – it’s a fact. Marcus shudders. Feelin’ up the patients – having intercourse with ’em if they were biddable, or sedated with opium, hyoscine – henbane even. They gave sex hormones to schizophrenics – I expect they were swallowing them as well! There were sadists too – but then I daresay there still are. Those who take sheer bloody delight in applying restraints – or ordering it done –. The outburst suddenly stops: Is he guilty himself – or sly? Of course, Marcus runs on dismissively: these were the exceptions, the bad apples . . . Or simply touched? . . . the vast majority of the staff were as responsible as they could be in the circumstances – if a trifle, um, unempathetic –. She creeps in from the soundlessly opened door, one shoulder raised, To ward off his blows? with an oblong blue Tupperware platter upon which are lined up shield bosses Ritz crackers, each meticulously coated with chopped liver. She un-nests a still littler red lacquered table, sets down the platter and retreats under the cover of her rigid perm’ is it a wig? At once there is an avalanche of crumbs that scatters between the cable-knit ridges of the old man’s cardigan as his lips purse about a cracker, his dentures fiddling in their skin bag. Help yourself, he says a little grudgingly – then: You cannot be so wet behind the ears that you don’t know that diagnostics were in their infancy. Besides, you can have no idea of the caseload and what a bloody caseload! Even in the early thirties there were still plenty of inmates at the Hatch with TB – and fresh cases coming in every week. They all had to wear a caution card on a ribbon round their necks – yellow for TB, red for diphtheria, green for . . . something else, I forget. I said help yourself. Busner does mm . . . crunchy, creamy, salty – surprisingly . . . tasty. We considered pulmonary TB to be the twin of insanity, so closely were they associated. In my time there I had plenty of colleagues who, I knew for a fact, still believed that one caused the other, although not altogether certain – euch, euch! – which. Marcus makes a conductor’s gesture, the long fingers of both hands spatulate, duck-billed and raised up – if he could see himself, Busner thinks, he’d diagnose acute chorea – then brought down once, twice and a third time, so that cracker crumbs and pâté blobs are left in suspension, flickering in the bright light – a meteor shower the old alienist thrusts himself through to spit: I doubt you’ve ever seen a case of lupis vulgaris outside of a textbook . . . and Busner, confronted by nostrils eaten away at by sharp shadows, thinks, I could be looking at one right now, but only confirms: You’re right there. Marcus next asks, More sherry? although this inquiry post-dates the unscrewing, the pouring and the re-sealing of the bottle. Last December, Marcus continues, when we had candles in here and got out the old Tilley lamp, it made me think of my first years at the Hatch – those endless bloody corridors, a gas-bracket only every thirty yards or so. D’you know, there was a neurologist who came up a few times from Queen Square to do some encephalograms with one of the first portable machines – and that was before they’d fully installed electrical light in that mausoleum, so he could scarcely see well enough to take the readings of the electrical activity in the patients’ brains! Marcus has fallen back once more, but now he comes once again unto the light: What I’m driving at here is that we’d patients with diphtheria, who’d had typhoid – with dia-bloody-betes, not forgetting . . . a duckbill speared into the air . . . ones poisoned by lead or arsenic or alcohol. All of ’em would exhibit peripheral neuropathy so all of ’em would be given the catch-all: hysteric. Busner says nothing, Say nothing, for as it is to the patient, so it is to the physician: if you want them to talk say nothing . . . Look – at what, your bill, those crumbs? – the enkies were merely another group of patients for whom there was neither the conceptual apparatus nor the resources to disentangle the physiological from the psychological. With the enkies one neurologist’s catalepsy was another psychiatrist’s catatonia – but, anyway, it’s progress that’s the real delusion. You, young man, might like to believe that there’s no turning back – the Wasserman test and so forth . . . the replacement of diseased types by disease processes . . . but really this is utter bosh, because, after all, what’ve you got now with your so-called personality disorders – it’s only types all over again, denigrating the poor bloody patient by saying he’s got a bad character. That reminds me of something . . . Marcus pours himself another sherry to aid the process of recall, this time forgetting to impose a
refill on his guest . . . there used to be a statue in the grounds, ragged-arsed Victorian kid, the Hatch’s own Madness and Melancholy – y’know, the Bedlam statues – he had a plaque on his plinth that read, Monument to the Unknown Pauper Lunatic. Still there is he, in the shrubbery by the big villa off Eastern Avenue? Busner thinks for a moment, and for some reason decides to spare Marcus the ugly truth. No, he says, no, I believe he was, um, discharged a couple of years ago. I understand the feeling was at the Health Authority that he sent a rather negative message to the patients . . . and Marcus crows, See, see! They got rid of him because he represented the truth: that the patients are poor, and they’re mad – and indeed that many of ’em are mad precisely because they’re poor. That’s the reality all their borderline-this and histrionic-that balderdash covers up! Busner, however, doesn’t wish to pursue this line, no matter the extent to which it speaks to my condition. Instead: Enkies? he queries. They had a nickname? Marcus snorts, Naturally! After all, they were simply another feature of the post-war scene – along with limbless ex-servicemen and economic stagnation. I remember as a young man going to the cinema and seeing newsreels of enkies – quite a lot was made of ’em in their hyperkinetic phase, and you could understand why because they had a strange sort of physical genius, able to make sudden moves that were deft – but zany and prankish, y’know, juggling lots of balls, chucking stuff, leaping and skipping. Marcus, in attempting to illustrate this physical genius, makes a wild sweep of his arm, knocking another table out of the nest and scattering the notes, he juggles none of them. He is dismayed by his own clumsiness: I don’t know . . . I daresay you wouldn’t be able to spot it if you saw those films now – I mean, in films from that era everyone looks like a Chaplin or a Buster Keaton – even Lloyd George – something to do with way they hand-cranked the cameras, I s’pose. The liverish pucks are all gone – a lot of the sherry too. Busner says, And what of Miss Dearth – as she is now? Marcus spends a while surveying the room, squinting at the spreading behind of his young colleague, who, as he gathers the scattered sheets from the carpet, takes in the bookcases densely packed with decades-old professional journals and Roneographed papers that he’ll probably never pick up again, let alone read. Well . . . he drawls at last . . . what of her? Busner persists: I mean, you thought it worthwhile putting things in her notes, making your own tentative diagnosis . . . Marcus shrugs. – It was a jape, I s’pose – I mean, it was clear to me that she was post-encephalitic, and I wrote it down partly to twit my colleagues, partly simply to show that I knew . . . perhaps, pah! for posterity . . . perhaps to fish you from the future – I hardly know any more, it was a long time ago. I can tell you one thing, though . . . The notes are all reassembled on one of the red lacquered tables and Marcus cants forward to leaf through them, stopping from time to time to bring one up to his face so he may examine his younger self’s handwriting with lenses clawed down from his forehead . . . It certainly wasn’t with any intention of helping her – there was no cure, she’d no one to look after her that we were aware of. It mattered not one jot which sort of institution she was confined to, given how profoundly ill she was – and you say still is? Busner assents, then outlines the condition of his patient: her long periods of catatonia interspersed by manic episodes and still stranger phases when – he screws his features into an approximation of Audrey Dearth’s crises of fixed regard – She has her attention, her gaze . . . compelled by some invisible object up above her and to the left. Marcus is himself compelled. – Yes, yes . . . His watery eyes fix on a threadbare pelmet, its flaking brocade indistinguishable from smears of cobweb . . . this is entirely typical of post-encephalitics. Still – he snaps out of it – I’m surprised she’s still with us, she must be very elderly by now. You might’ve thought the enkies would’ve been altogether worn down by their illness, plenty died in all the usual ways, of course, but I also recognised that there were these others – like her – who were almost preserved by the sleepy-sickness, as if it were a kind of suspended animation. Sometimes . . . but this is fanciful! Busner almost shouts: No, no! It’s not fanciful at all – how could anything connected with these astonishing patients be fanciful? So please – please give full rein to your thoughts! He has, he realises, succumbed to the old man’s very lack of charm, Marcus’s abruptness, a stop-and-start that recalls the paradoxical condition of those others with their veined, dry-leaf skin . . . who blow in drifts along the endless corridor, for the end of time has come . . . and the campanile has collapsed . . . rain falls through the broken ceiling of the pharmacy . . . blue-and-yellow capsules swirl in a clear glass bowl, schizophrenics bob for them – dipping birds . . . — They must have reached some sort of conclusion, risen from their burled walnut caskets and got out from under that harsh white light, for here they are: the old man standing erect in the hallway, Busner already outside the heavy front door and embarrassed for the Marcuses, whose Jewfoody stench can still be detected a floor down from their flat, and which seems to him to sully the deep-piled purple carpets and smirch the brass nameplate of the mansion block. Busner cannot contain his thoughts — they fly to be with squatters sitting grouped on tea chests, one of whom licks a Rizla and attaches it to two others . . . and in another place there are disco lights making thighs blood-red . . . the horror, the horror is that this, of all the possible times and places, feels willed. His hand ivy on the doorjamb, his carpet slippers mossy on the mat, Marcus says: I enlisted as a general physician, but when they discovered I was a psychiatrist I was seconded at once to the field hospitals set up in the beachhead immediately after the landings. It was very abrupt – one week the dark corridors of Colney Hatch, the next these equally oppressive Normandy hedgerows, and pitched right beside them army canvas tents . . . When I’d first been at the Hatch inmates who repeatedly soiled themselves, or those put in the padded cells, were forced into canvas tunics . . . Every time there was a show more and more boys were brought into the tents, white as . . . white as . . . They’d never seen action before – their training had consisted only of robotic drills. They’d soiled themselves – plenty had thrown away their rifles . . . by far the majority hadn’t fired a shot. They sat in their own mess ticcing, and we shrinks joked – gallows humour, d’you see – that it was a busman’s holiday. Chap I knew – before the war he’d been at Napsbury – he went over with the Yanks and they did some sort of a study, very hush-hush. Turned out only one in ten of their infantry ever shot with lethal intent and I can’t imagine it was any different with our boys. Where’s he going on his busman’s holiday? Odd, isn’t it, to think of all that mayhem, all that killing – now too in Pakistan – and yet the vast bulk of it is perpetrated by a mere handful of psychopathic personalities, the rest being there to, euch-euch, make up the numbers. They have been standing like this for so long that it would seem appropriate for Marcus to invite Busner back in, but instead he looks critically at the younger man’s fat knot of woolly tie and the plump hand that fidgets with it, and says, I’ve enjoyed talking at you – will you come again? Busner laughs, I’d like to – and I’d like to come with news of a . . . positive nature. I mean to say, if this is Parkinsonian . . . well, there’re terrific strides being made just now with chemical therapies, I’ve read an article in the Lancet –. The Lancet! the old man yelps, How very quaint!
