Madness

by Roald Dahl

  Slowly she reached into her handbag and took out her spectacles and put them on. Then, holding the pages up high in front of her so that they caught the late afternoon light from the window behind, she started to read:

  This note, my dear Mary, is entirely for you, and will be given you shortly after I am gone.

  Do not be alarmed by the sight of all this writing. It is nothing but an attempt on my part to explain to you precisely what Landy is going to do to me, and why I have agreed that he should do it, and what are his theories and his hopes. You are my wife and you have a right to know these things. In fact you must know them. During the past few days I have tried very hard to speak with you about Landy, but you have steadfastly refused to give me a hearing. This, as I have already told you, is a very foolish attitude to take, and I find it not entirely an unselfish one either. It stems mostly from ignorance, and I am absolutely convinced that if only you were made aware of all the facts, you would immediately change your view. That is why I am hoping that when I am no longer with you, and your mind is less distracted, you will consent to listen to me more carefully through these pages. I swear to you that when you have read my story, your sense of antipathy will vanish, and enthusiasm will take its place. I even dare to hope that you will become a little proud of what I have done.

  As you read on, you must forgive me, if you will, for the coolness of my style, but this is the only way I know of getting my message over to you clearly. You see, as my time draws near, it is natural that I begin to brim with every kind of sentimentality under the sun. Each day I grow more extravagantly wistful, especially in the evenings, and unless I watch myself closely my emotions will be overflowing on to these pages.

  I have a wish, for example, to write something about you and what a satisfactory wife you have been to me through the years, and I am promising myself that if there is time, and I still have the strength, I shall do that next.

  I have a yearning also to speak about this Oxford of mine where I have been living and teaching for the past seventeen years, to tell something about the glory of the place and to explain, if I can, a little of what it has meant to have been allowed to work in its midst. All the things and places that I loved so well keep crowding in on me now in this gloomy bedroom. They are bright and beautiful as they always were, and today, for some reason, I can see them more clearly than ever. The path around the lake in the gardens of Worcester College, where Lovelace used to walk. The gateway at Pembroke. The view westward over the town from Magdalen Tower. The great hall at Christ Church. The little rockery at St John’s where I have counted more than a dozen varieties of campanula, including the rare and dainty C. waldsteiniana. But there, you see! I haven’t even begun and already I’m falling into the trap. So let me get started now; and let you read it slowly, my dear, without any of that sense of sorrow or disapproval that might otherwise embarrass your understanding. Promise me now that you will read it slowly, and that you will put yourself in a cool and patient frame of mind before you begin.

  The details of the illness that struck me down so suddenly in my middle life are known to you. I need not waste time upon them – except to admit at once how foolish I was not to have gone earlier to my doctor. Cancer is one of the few remaining diseases that these modern drugs cannot cure. A surgeon can operate if it has not spread too far; but with me, not only did I leave it too late, but the thing had the effrontery to attack me in the pancreas, making both surgery and survival equally impossible.

  So here I was with somewhere between one and six months left to live, growing more melancholy every hour – and then, all of a sudden, in comes Landy.

  That was six weeks ago, on a Tuesday morning, very early, long before your visiting time, and the moment he entered I knew there was some sort of madness in the wind. He didn’t creep in on his toes, sheepish and embarrassed, not knowing what to say, like all my other visitors. He came in strong and smiling, and he strode up to the bed and stood there looking down at me with a wild bright glimmer in his eyes, and he said, ‘William, my boy, this is perfect. You’re just the one I want!’

  Perhaps I should explain to you here that although John Landy has never been to our house, and you have seldom if ever met him, I myself have been friendly with him for at least nine years. I am, of course, primarily a teacher of philosophy, but as you know I’ve lately been dabbling a good deal in psychology as well. Landy’s interests and mine have therefore slightly overlapped. He is a magnificent neurosurgeon, one of the finest, and recently he has been kind enough to let me study the results of some of his work, especially the varying effects of prefrontal lobotomies upon different types of psychopath. So you can see that when he suddenly burst in on me Tuesday morning, we were by no means strangers to one another.

  ‘Look,’ he said, pulling up a chair beside the bed. ‘In a few weeks you’re going to be dead. Correct?’

  Coming from Landy, the question didn’t seem especially unkind. In a way it was refreshing to have a visitor brave enough to touch upon the forbidden subject.

  ‘You’re going to expire right here in this room, and then they’ll take you out and cremate you.’

  ‘Bury me,’ I said.

  ‘That’s even worse. And then what? Do you believe you’ll go to heaven?’

  ‘I doubt it,’ I said, ‘though it would be comforting to think so.’

  ‘Or hell, perhaps?’

  ‘I don’t really see why they should send me there.’

  ‘You never know, my dear William.’

  ‘What’s all this about?’ I asked.

  ‘Well,’ he said, and I could see him watching me carefully, ‘personally, I don’t believe that after you’re dead you’ll ever hear of yourself again – unless …’ and here he paused and smiled and leaned closer ‘… unless, of course, you have the sense to put yourself into my hands. Would you care to consider a proposition?’

  The way he was staring at me, and studying me, and appraising me with a queer kind of hungriness, I might have been a piece of prime beef on the counter and he had bought it and was waiting for them to wrap it up.

  ‘I’m really serious about it, William. Would you care to consider a proposition?’

  ‘I don’t know what you’re talking about.’

  ‘Then listen and I’ll tell you. Will you listen to me?’

  ‘Go on then, if you like. I doubt I’ve got very much to lose by hearing it.’

  ‘On the contrary, you have a great deal to gain – especially after you’re dead.’

  I am sure he was expecting me to jump when he said this, but for some reason I was ready for it. I lay quite still, watching his face and that slow white smile of his that always revealed the gold clasp of an upper denture curled round the canine on the left side of his mouth.

  ‘This is a thing, William, that I’ve been working on quietly for some years. One or two others here at the hospital have been helping me, especially Morrison, and we’ve completed a number of fairly successful trials with laboratory animals. I’m at the stage now where I’m ready to have a go with a man. It’s a big idea, and it may sound a bit far-fetched at first, but from a surgical point of view there doesn’t seem to be any reason why it shouldn’t be more or less practicable.’

  Landy leaned forward and placed both his hands on the edge of my bed. He has a good face, handsome in a bony sort of way, and with none of the usual doctor’s look about it. You know that look, most of them have it. It glimmers at you out of their eyeballs like a dull electric sign and it reads ONLY I CAN SAVE YOU. But John Landy’s eyes were wide and bright and little sparks of excitement were dancing in the centres of them.

  ‘Quite a long time ago,’ he said, ‘I saw a short medical film that had been brought over from Russia. It was a rather gruesome thing, but interesting. It showed a dog’s head completely severed from the body, but with the normal blood supply being maintained through the arteries and veins by means of an artificial heart. Now the thing is this: that dog’s head, sitting there
all alone on a sort of tray, was alive. The brain was functioning. They proved it by several tests. For example, when food was smeared on the dog’s lips, the tongue would come out and lick it away; and the eyes would follow a person moving across the room.

  ‘It seemed reasonable to conclude from this that the head and the brain did not need to be attached to the rest of the body in order to remain alive – provided, of course, that a supply of properly oxygenated blood could be maintained.

  ‘Now then. My own thought, which grew out of seeing this film, was to remove the brain from the skull of a human and keep it alive and functioning as an independent unit for an unlimited period after he is dead. Your brain, for example, after you are dead.’

  ‘I don’t like that,’ I said.

  ‘Don’t interrupt, William. Let me finish. So far as I can tell from subsequent experiments, the brain is a peculiarly self-supporting object. It manufactures its own cerebrospinal fluid. The magic processes of thought and memory which go on inside it are manifestly not impaired by the absence of limbs or trunk or even of skull, provided, as I say, that you keep pumping in the right kind of oxygenated blood under the proper conditions.

  ‘My dear William, just think for a moment of your own brain. It is in perfect shape. It is crammed full of a lifetime of learning. It has taken you years of work to make it what it is. It is just beginning to give out some first-rate original ideas. Yet soon it is going to have to die along with the rest of your body simply because your silly little pancreas is lousy with cancer.’

  ‘No thank you,’ I said to him. ‘You can stop there. It’s a repulsive idea, and even if you could do it, which I doubt, it would be quite pointless. What possible use is there in keeping my brain alive if I couldn’t talk or see or hear or feel? Personally, I can think of nothing more unpleasant.’

  ‘I believe that you would be able to communicate with us,’ Landy said. ‘And we might even succeed in giving you a certain amount of vision. But let’s take this slowly. I’ll come to all that later on. The fact remains that you’re going to die fairly soon whatever happens; and my plans would not involve touching you at all until after you are dead. Come now, William. No true philosopher could object to lending his dead body to the cause of science.’

  ‘That’s not putting it quite straight,’ I answered. ‘It seems to me there’d be some doubt as to whether I were dead or alive by the time you’d finished with me.’

  ‘Well,’ he said, smiling a little, ‘I suppose you’re right about that. But I don’t think you ought to turn me down quite so quickly, before you know a bit more about it.’

  ‘I said I don’t want to hear it.’

  ‘Have a cigarette,’ he said, holding out his case.

  ‘I don’t smoke, you know that.’

  He took one himself and lit it with a tiny silver lighter that was no bigger than a shilling piece. ‘A present from the people who make my instruments,’ he said. ‘Ingenious, isn’t it?’

  I examined the lighter, then handed it back.

  ‘May I go on?’ he asked.

  ‘I’d rather you didn’t.’

  ‘Just lie still and listen. I think you’ll find it quite interesting.’

  There were some blue grapes on a plate beside my bed. I put the plate on my chest and began eating the grapes.

  ‘At the very moment of death,’ Landy said, ‘I should have to be standing by so that I could step in immediately and try to keep your brain alive.’

  ‘You mean leaving it in the head?’

  ‘To start with, yes. I’d have to.’

  ‘And where would you put it after that?’

  ‘If you want to know, in a sort of basin.’

  ‘Are you really serious about this?’

  ‘Certainly I’m serious.’

  ‘All right. Go on.’

  ‘I suppose you know that when the heart stops and the brain is deprived of fresh blood and oxygen, its tissues die very rapidly. Anything from four to six minutes and the whole thing’s dead. Even after three minutes you may get a certain amount of damage. So I should have to work rapidly to prevent this from happening. But with the help of the machine, it should all be quite simple.’

  ‘What machine?’

  ‘The artificial heart. We’ve got a nice adaptation here of the one originally devised by Alexis Carrel and Lindbergh. It oxygenates the blood, keeps it at the right temperature, pumps it in at the right pressure, and does a number of other little necessary things. It’s really not at all complicated.’

  ‘Tell me what you would do at the moment of death,’ I said. ‘What is the first thing you would do?’

  ‘Do you know anything about the vascular and venous arrangements of the brain?’

  ‘No.’

  ‘Then listen. It’s not difficult. The blood supply to the brain is derived from two main sources, the internal carotid arteries and the vertebral arteries. There are two of each, making four arteries in all. Got that?’

  ‘Yes.’

  ‘And the return system is even simpler. The blood is drained away by only two large veins, the internal jugulars. So you have four arteries going up – they go up the neck, of course – and two veins coming down. Around the brain itself they naturally branch out into other channels, but those don’t concern us. We never touch them.’

  ‘All right,’ I said. ‘Imagine that I’ve just died. Now what would you do?’

  ‘I should immediately open your neck and locate the four arteries, the carotids and the vertebrals. I should then perfuse them, which means that I’d stick a large hollow needle into each. These four needles would be connected by tubes to the artificial heart.

  ‘Then, working quickly, I would dissect out both the left and right internal jugular veins and hitch these also to the heart machine to complete the circuit. Now switch on the machine, which is already primed with the right type of blood, and there you are. The circulation through your brain would be restored.’

  ‘I’d be like that Russian dog.’

  ‘I don’t think you would. For one thing, you’d certainly lose consciousness when you died, and I very much doubt whether you would come to again for quite a long time – if indeed you came to at all. But, conscious or not, you’d be in a rather interesting position, wouldn’t you? You’d have a cold dead body and a living brain.’

  Landy paused to savour this delightful prospect. The man was so entranced and bemused by the whole idea that he evidently found it impossible to believe I might not be feeling the same way.

  ‘We could now afford to take our time,’ he said. ‘And believe me, we’d need it. The first thing we’d do would be to wheel you to the operating-room, accompanied of course by the machine, which must never stop pumping. The next problem …’

  ‘All right,’ I said. ‘That’s enough. I don’t have to hear the details.’

  ‘Oh but you must,’ he said. ‘It is important that you should know precisely what is going to happen to you all the way through. You see, afterwards, when you regain consciousness, it will be much more satisfactory from your point of view if you are able to remember exactly where you are and how you came to be there. If only for your own peace of mind you should know that. You agree?’

  I lay still on the bed, watching him.

  ‘So the next problem would be to remove your brain, intact and undamaged, from your dead body. The body is useless. In fact it has already started to decay. The skull and the face are also useless. They are both encumbrances and I don’t want them around. All I want is the brain, the clean beautiful brain, alive and perfect. So when I get you on the table I will take a saw, a small oscillating saw, and with this I shall proceed to remove the whole vault of your skull. You’d still be unconscious at that point so I wouldn’t have to bother with anaesthetic.’

  ‘Like hell you wouldn’t,’ I said.

  ‘You’d be out cold, I promise you that, William. Don’t forget you died just a few minutes before.’

  ‘Nobody’s sawing off the top
of my skull without an anaesthetic,’ I said.

  Landy shrugged his shoulders. ‘It makes no difference to me,’ he said. ‘I’ll be glad to give you a little procaine if you want it. If it will make you any happier I’ll infiltrate the whole scalp with procaine, the whole head, from the neck up.’

  ‘Thanks very much,’ I said.

  ‘You know,’ he went on, ‘it’s extraordinary what sometimes happens. Only last week a man was brought in unconscious, and I opened his head without any anaesthetic at all and removed a small blood clot. I was still working inside the skull when he woke up and began talking.

  ‘ “Where am I?” he asked.

  ‘ “You’re in hospital.”

  ‘ “Well,” he said. “Fancy that.”

  ‘ “Tell me,” I asked him, “is this bothering you, what I’m doing?”

  ‘ “No,” he answered. “Not at all. What are you doing?”

  ‘ “I’m just removing a blood clot from your brain.”

  ‘ “You are?”

  ‘ “Just lie still. Don’t move. I’m nearly finished.”

  ‘ “So that’s the bastard been giving me all those headaches,” the man said.’

  Landy paused and smiled, remembering the occasion. ‘That’s word for word what the man said,’ he went on, ‘although the next day he couldn’t even recollect the incident. It’s a funny thing, the brain.’

  ‘I’ll have the procaine,’ I said.

  ‘As you wish, William. And now, as I say, I’d take a small oscillating saw and carefully remove your complete calvarium – the whole vault of the skull. This would expose the top half of the brain, or rather the outer covering in which it is wrapped. You may or may not know that there are three separate coverings round the brain itself – the outer one called the dura mater or dura, the middle one called the arachnoid, and the inner one called the pia mater or pia. Most laymen seem to have the idea that the brain is a naked thing floating around in fluid in your head. But it isn’t. It’s wrapped up neatly in these three strong coverings, and the cerebrospinal fluid actually flows within the little gap between the two inner coverings, known as the subarachnoid space. As I told you before, this fluid is manufactured by the brain, and it drains off into the venous system by osmosis.