The Illness Lesson

by Clare Beams

  “Hawkins,” Samuel said, from his desk. “I know you’re mostly jesting about the book. But as I began to say before, we have been thinking the trouble might lie somehow in the girls’ thinking. And perhaps after all part of it is their exposure to that—that story—and its atmosphere. It might have disarranged them in some way their previous lives haven’t equipped them to handle.”

  “Yes. It’s what seems to make the most sense,” David said.

  “Our suspicion that it’s their minds that are somehow injured is actually why we decided to keep them here,” Samuel added. “Instead of sending them all home, where the physicians who’d treat them wouldn’t have the first idea what they were even seeing. We thought that here, where we could find the true trouble, we might be better able to help them.”

  “Is that why,” Hawkins said.

  “What if it isn’t their minds?” Sophia said. She flushed, but having begun to speak, she seemed to decide to finish, and instead of shrinking she stood. She lifted her chin. “What if it’s—”

  David made a small involuntary-looking movement, as if he’d almost put out a hand to tug her back down and only just stopped himself. “Sophia, please.”

  “What if it’s spiritual?” she insisted.

  “Whatever do you mean by that?” said Samuel.

  David strode away to the window. Sophia’s body reoriented itself toward him, but she turned her face to Hawkins and kept talking. “I’ve seen God visit people before. I have. And when Miss Bell had her fit, it looked like—”

  Hawkins barked a laugh.

  Samuel squinted at her. “Sophia, why would God ever want to do this to these girls?” he said.

  “We aren’t meant to understand His plans.”

  “I don’t think this situation is quite what that sentiment refers to.”

  Hawkins held up a hand. “Let’s just proceed with the examinations, shall we? And we’ll see, Mrs. Moore, if I can discern any signs of divine visitation. Or if it’s some obscure physical malady or—what did you say, gentlemen?—their thinking that’s doing this to them. Or if it’s as I’m expecting.” He turned to go, taking pleasure in his withholding. Samuel followed him.

  The two men climbed the stairs: the familiar sound of Samuel’s tread, broken by Hawkins’s heavier one.

  “Why did you say that,” David said, low-voiced, to Sophia, “after I’d asked you not to?”

  Sophia fixed teary eyes on his face. “I’ll say what I want.”

  Caroline’s fingers felt full of wires. She rose from her chair. She didn’t have to listen to this argument. She had no particular joy, it turned out, in hearing it.

  Sophia watched her leave the room with reproach.

  After Caroline closed the study door behind her, she lingered in the entryway, at the base of the staircase. She heard footsteps, the opening of a door. Creak, creak. Hawkins was in one of the girls’ rooms now, and whoever it was, he was peering into her mouth, pulling back her eyelids, while Samuel sat on the desk chair and looked at the wall. Hawkins pressing the girl’s belly, lifting her arms at the wrists, assessing parts and sums.

  Caroline hadn’t really thought before about what it meant that Hawkins was a doctor. She’d been aware of his profession only in how it supplied him with impressive dense texts to trot out in discussions with Samuel, who was not scientific in his reading habits, and with fine food and expensive jackets in the years after Birch Hill. But now she considered: Hawkins as a physician, with patients. Hawkins as healer. Hawkins tending to flesh with the round, warm pads of his fingers.

  She couldn’t believe those thick fingers would be able to feel the pulse of what ailed these girls. His eyes were so full of what he expected to see that he wouldn’t really look at them. It would seem impossible to him that such small bodies might contain depths.

  Caroline sat down on the bottom step, guard on her battlement, to listen to the sounds of the progress through the rooms. She let her fingers patter atop her knees because somehow they felt more usual, more her own, when she wasn’t trying to keep them still.

  (This perhaps was how every girl felt too. All just alike. Herein the question that attended what her father had told them about themselves, and told Caroline first of all—if he thought they were all special, did he think they were therefore all the same?)

  A few more minutes and a door above her opened, and the tread this time progressed toward her. She turned to find Hawkins coming down the stairs.

  “Not done already?” she said, rising.

  “No, I need something from my bag.”

  Caroline backed against the wall to let him pass, imagining some metal tool he could want for setting to work on the girls. “What are you finding so far?” she asked. Her hands she put behind her again.

  He tsked. “So impatient, Caroline!”

  She boiled at that reprimanding finger held aloft in her face. “Dr. Hawkins, this isn’t a joke,” she said.

  “Did I call it a joke?”

  “Everything about you has been calling it that since you arrived.”

  Hawkins leaned back against the opposite wall and regarded her. “I must say, you seem…different, somehow, Caroline, than when I was here last.”

  “I don’t know what you mean.” She thought her hands might ignite.

  “Back in the summer you wouldn’t have said such a thing. The influence of becoming a teacher, perhaps.”

  “It isn’t so uncommon a profession.” For a woman, she meant.

  “You must be making very fine use now of that mind he gave you.”

  “Just as you always have.”

  This seemed to irritate him. “All right, there’s something to that, I suppose. Sam always did see further than the rest of us. I must say, though, sometimes I have wondered what he’s about. With you, for instance. You interest me, Caroline—wouldn’t you rather be doing other things? All these years here with him. You and now all these girls.”

  “You think we’d all rather have husbands, children.”

  “Of course you would,” he said. “But then that’s never been Sam’s strongest suit, the wants of women. Take your mother.” A pause he let linger. “She had a husband and child and yet still felt a need to look…elsewhere.”

  “That’s only a vile rumor.”

  “You might ask your father.”

  She stared at him. “He’s always told me there was no truth to it.”

  “Has he?”

  Caroline’s legs shook; she rested a hand on the wall. She understood now that for all her considering of the possibility of her mother and Miles Pearson, she’d never fully believed it could have happened. Not truly. Imagining it had been an exercise, a restless pushing out of the walls of her world to see how different and new she could make it. To hear that the flesh-and-blood Anna had actually entangled herself with the flesh-and-blood Miles Pearson did not feel like a changing of her world. It felt like a collapse.

  Her mother had been a mother and a wife—the gilded, glorious wife-mother of Samuel’s every story. Who had Anna been, to think she could do such a thing?

  Who had she been?

  And there was Hawkins, watching Caroline, wearing openly his happiness at what he’d done. She was close enough to him to see the heavy dents of his pores.

  There had been a dark well here once, right where they were standing. She had seen the girls floating on it before she followed them into the woods. In retaliation now she wanted to show Hawkins dark water. She wanted to submerge him.

  “Do you know—this is about something quite different,” Caroline said, “but I’ve been meaning to tell you—the birds. I know we thought we’d figured everything out about them.” She emphasized the we.

  “I never claimed that. No one knows what they’re doing here, still.”

  “At any rate, the mystery has deepen
ed, did you know?” She waited now as he had, making him crane forward.

  “If you aren’t going to tell me, Caroline, I need to get back,” Hawkins said.

  “We’ve discovered that they seem to be building nests.”

  Hawkins shrugged. “Birds do.”

  “Now. In winter. And they’re strange nests, a very odd shape. Indescribable. Something for you to put in your next letter when you write to your friend at the Society of Natural History, perhaps. It’s perfectly all right with me if you make it sound as if this is information you discovered yourself.” She pushed off the wall. “I think I’ll go have a cup of tea, while I’m waiting for you to be finished.”

  Let him have one question at least, however small, that he knew he couldn’t answer. Let him hold it too while he held the girls’ fingers, feet.

  Caroline sipped her tea without tasting it. She couldn’t unsee the gleeful look Hawkins had given her as he told her about her mother. He seemed to think he’d bested her in some final way, opened the fingers of one of her hands to show her the sharp humiliation she’d always been clenching there, without her knowledge.

  And she had. The shards of Anna that Samuel had given her to hold—they hadn’t been jagged only because they were partial. Whole, Anna had been jagged too. That jaggedness was Caroline’s inheritance.

  The examinations took another half an hour. The men tromped down. Samuel gathered the others to wait in the study.

  “Papa, what—” Caroline began to ask.

  But Samuel shook his head. “He hasn’t told me anything yet.”

  When Hawkins came in, he took his time. He sat down; he propped one foot on the hassock in front of him. The others arranged themselves in a standing half circle around him, all of them too anxious to sit, a small court fanned out around their king. Hawkins looked delighted, nothing at all like a submerged man. He settled in.

  Then: “It’s as I thought,” he said.

  Was there any line they all loved more to say?

  “This is no sudden plague—not in the customary physical sense, anyway. Nor, Mrs. Moore, is it divine possession. What it is: a case of hysteria. Nervous constitutions foundering under strain and under a certain collective atmosphere.”

  “All the rashes, the muscle spasms—” David said.

  “Hysteria is an astonishingly varied ailment, and often very dramatic in its physical manifestations. But its origins are not directly, simply physical.”

  “All of them? They’re all hysterics?” Caroline said.

  “The phenomenon can be curiously contagious. For it to strike a group is not at all unusual. You get one influential and susceptible girl in the pack—we all know who that is here—and she sets the others off. There’s a substantial history.”

  “We were right then, about what’s causing this. About its origins in strain, mental strain, from that terrible book,” Samuel said.

  Hawkins lifted his palms. “Perhaps. Who can say? The strain can come from many directions.”

  “You aren’t suggesting there’s something about the school itself—”

  “Oh, no particular reason to suspect so,” Hawkins said. “This is common in all kinds of environments. I’ve seen it amongst schoolgirls, old married ladies. In any case, regardless of the cause, the treatment is the same.”

  “What does this treatment involve?” Caroline said. It was a magical word coming from the mouth of a doctor, even this doctor. Somewhere in his medical bag existed a solution.

  “It’s very straightforward. The girls’ affliction is caused by an accumulation of nervous tension. Picture a river blocked by a dam.” Hawkins’s fingers drew a river for them in the air and then rammed into his other palm. “Too much feeling, nowhere for it to go.”

  Nowhere. That was something Caroline understood.

  “To relieve the tension, therefore, we create a release. Simple pelvic manipulation leading to hysterical paroxysm.”

  The rhythm of the word hit Caroline’s ear: par-ox-ysm.

  “What on earth does that mean?” Sophia said.

  “I brought some literature with me on the subject—case histories, accounts of the long development of the treatment—if you’d like to take a look,” Hawkins said. He went behind Samuel’s desk for his bag, opened it, and began taking out books and piling them.

  “Ah,” Samuel said, greeting the familiar sight of books on his desk. How neatly contained they looked, those books, what precise rectangles.

  “You’ll see,” Hawkins told them. “These girls will soon be quite healthy again. Good as new.”

  As if the only way to be good were to be new, despite all the same flesh, bones, loves, will you had ever had. As if to be healthy meant having no history.

  14.

  AN ANIMAL WITHIN AN ANIMAL

  “You can’t imagine how I feel,” she said, and her mournful eyes implored him for…what?

  —MILES PEARSON, THE DARKENING GLASS (P. 343)

  The teachers took the books, and they began to read.

  The books divided into two camps.

  Large, and old, the body camp:

  Plato and Aretseus knew the womb for “an animal within an animal.”

  Within this camp of physical cause, authors exulted in the ancientness of their precedent but also sought to distinguish themselves.

  While the literature of hysteria dates back thousands of years, few modern physicians would argue that the disease is caused by an actual wandering of the womb. Instead, the modern view is that the symptoms stem from a pelvic congestion.

  Newer, vaguer, and thinner in rank, the mind camp:

  Modern life, with its industry, its bustling streets, its rail travel, its wealth of dramatic incidents, moves at great and startling speed. In such extremity there is strain, and to this strain, the feminine nature, being frailer, proves more vulnerable than the male.

  Both camps offered lists upon lists of symptoms: nervousness, fainting, weeping, painful menstruation, cessation of menstruation, headache, sleeplessness, markings of the skin, muscle spasms, absentmindedness, itching, nausea, ticklishness, worry, anemia, abdominal heaviness, flushing, shortness of breath, coughing, overindulgence in food, refusal to eat.

  They were in agreement upon the treatment: marriage, childbirth.

  They differed, though, in their explanations of why this treatment was effective. Because, said the body camp, the relations of marital life and the ensuing production of offspring serve to relieve the pelvic congestion that produces the distress. Hence the susceptibility of the maiden and the widow.

  Because, said the mind camp, matrimony and motherhood provide the patient with a sure tether amidst the stirrings of the world which proves protective against nervous strain. Hence the susceptibility of the maiden and the widow.

  But these were medical texts, not spiritual ones, and they had more immediate relief to prescribe than matrimony. Both prescribed it the same.

  The tissues may be massaged.

  So as to relieve the tensions, offered one.

  Another: So as to achieve paroxysm.

  The method of this massage is complicated and difficult to learn, and involves a level of detail cumbersome to explicate here: please refer to Galen, Celsus, Boerhaave, Villanova, &c.

  * * *

  *

  The final book Caroline read was a volume of Hawkins’s own medical case notes. He had flagged the relevant entry, but still she thumbed through what preceded it: old men with congestion of the heart, old men with gout, old men with rheumatism.

  On the scrap of paper he had tucked into the appropriate page, Hawkins had written, A representative case.

  The patient, a woman of twenty-one years, presented with initial complaints of fainting spells and odd sensations in the extremities. Her father had been a patient of mine for some years for pleur
isy, and I had treated the girl in her childhood for catarrh and rheumatic fever, but she had been otherwise healthy until some months before this visit.

  The sensations, she said, had been intermittent to begin with, but were becoming more frequent, and were beginning to interfere with ambulation and to distract her during daily tasks (writing, sewing, and so forth). The fainting appeared to cause still greater distress, as she claimed she never knew when a fit would strike, and in a particularly upsetting instance one had come upon her quite suddenly in the midst of a dinner party, making her overturn her plate and raising quite a furor. These attacks were also occurring more often. She denied any particular change in her circumstances or occupations around the outset of this period of increased frequency.

  I examined the patient. Fine tremors in the hands, a rapid heartbeat, and brisk reflexes bilaterally were observed, along with some weakness in the legs.

  All findings were consistent with hysteria.

  I discussed her condition with the patient, informing her of the nature of her ailment and of the usual course of treatment.

  The patient appeared to understand.

  On three separate occasions over the course of a month, manipulation leading to paroxysm was employed. After the third treatment, the patient became busy with her new engagement, and though we had planned treatments for after her marriage, she did not appear for them.

  A year and a half later, I heard that she had been delivered of the couple’s first child, a boy.

  * * *

  *

  The teachers read and skimmed and passed the books one to another without speaking. People left the room and returned to it, bearing books. Caroline walked as she read, into the kitchen, into the alcove of the dining room; she couldn’t seem to stay seated. At one point it seemed to her that she should check on the girls, but when she went up into the hallway there was Mrs. Sanders, sitting in a rocking chair and presiding over the quiet. She gave Caroline a reprimanding look. Caroline considered how they must all seem to Mrs. Sanders—reading and talking downstairs while up here the girls lay on their beds. She felt like an intruder. She returned to the study and read some more, and time passed.