‘There’s nothing to prevent me visiting my patient in hospital, and I also intend to follow up the matter of the tests I asked for, none of which have been carried out, perhaps needless to say, or at least I haven’t been told of the results. And then you see I can suggest things to the doctor in charge of his case. And as regards medical etiquette, allow me to tell you, Mr Duke, I’m too old and rich and powerful and fed-up to be unduly swayed by that. You can go straight from here to the Collings woman and tell her I have told you I consider her to be a disgrace to her profession, which incidentally would be saying something, and I won’t turn a hair. Not that you would of course.’ He had got up as he spoke and stood now over his desk with his knuckles resting on its top, as though he expected to have his photograph taken. ‘Would you care for a glass of sherry? Mrs Duke?’
‘Well, yes, thank you very much, Dr Nash,’ said Susan, sounding slightly astonished as well as pleased.
‘Mr Duke?’
What Mr Duke would have cared for at this stage was a small tumbler of absolute alcohol, but he had the sense to see that it would not be available and said Yes to the sherry instead. This came out of a cut-glass decanter that came out of an expensive rosewood cabinet with an inlaid top. Some digestive biscuits came too, in a silver-bound barrel, but there Nash must have been joking. Now the room seemed like a don’s study in one of the snootier colleges at Oxford or Cambridge. There were certainly plenty of books. Most of them were across the room from me and the light was none too marvellous, but from the look of their jackets a lot of them were not on psychiatry. I saw Susan giving them a good going-over during the sherry production.
By the time we got to my turn what had been a consultation or something like that had started to turn into something else. Before it could finish doing so I said, ‘If my son gets taken off the drug he’s on, what sort of happens after that?’
‘Of course. Oh, he goes on to another tranquillizing drug that doesn’t have the effects you saw but works in the same general way, acting on the so-called neuro-transmitter system in the brain and in a great many cases, as I told you, bringing about positive improvement, it’s not known how or why. But it does frequently happen.’
I tried to take this in. ‘So Dr Collings is aiming in the right direction, so to speak, but so far she’s missed the bull’s-eye.’
Nash nodded, swallowing sherry. ‘Broadly, yes. There’s not a great deal of choice in the matter. Electro-convulsive treatment — not much help to us, except with patients so far gone in withdrawal that they’re in danger of dying of hunger and thirst because they can’t be bothered to eat or drink anything. Neurosurgery — obsolete. Psychotherapy, which is talking to the patient and getting him to talk — appallingly difficult, with the risk of encouraging him to elaborate and naturalize his fantasies. Troublesome, too. Group therapy — useless in my view, likely to be popular with Collings, no matter, harmless as well as useless. Anyway, drugs are easiest and most effective. There we are.
‘But she has all these terrible ideas,’ I said.
‘Has she? I mean I too think they’re terrible, perhaps even more … passionately than you do, Mr Duke, but I wonder to what degree she can be said to have them, to hold them. They’re to her taste all right, obviously, but then she must hold some ideas or views, or must seem to, to, to do so. It would be virtually impossible for a woman, an individual of that type to say to you, “Your son has schizophrenia, just as that old man said and as any qualified observer could have seen. I’m giving him a lot of drugs to try to make him better. And that’s that.” Wouldn’t it? Be … So she told you your son was trying to find out who he is and a great deal more in the same strain.’ He spread his hands in the air.
Susan gave me a cheerful look that said she and I had never thought of that. I wondered.
‘There’s also the point,’ said Nash, ‘that, assuming she takes a similar line when talking to your son, going on about his efforts to surmount the difficulties imposed on him by other people, all that, she’ll be likely to acquire his confidence, which will tend to reduce his anxiety. However unfortunately in other respects, she is, well, on his side. A supportive approach, as the trade odiously calls it.’
Susan was showing more signs of relief. ‘I see that, yes.’
I saw it too, and tried to feel relief, but mostly what I felt was a slight sense of being conned. I realized I had hoped, and almost expected, that after listening to my tale with mounting horror Nash would grab the phone or even go tearing out of the building as the first step towards getting Steve out of Collings’s clutches and under the care of Dr Stone or some other angel of mercy. All right, not on, but I found it hard to swallow the idea of Collings as a well-meaning blunderer with a duff line in conjuror’s patter. At the same time I was reflecting that here I was after twelve years’ marriage to Nowell still assuming that unless people were actually lying they meant what they said.
‘Is that all?’ I asked Nash.
He gave me a sharp look. ‘Nearly all of this section, Mr Duke. For the moment I’ve only one more question for you. Which of the following, if any, would you apply to your son’s disposition? Cut off, dreamy, diffident, unintimate, unsociable, solitary, moody, touchy, uncommunicative?’
‘Diffident,’ I said. ‘And a tendency to be dreamy.’
‘None of the others?’
‘No .’
‘Not uncommunicative?’
‘No.’
When appealed to, Susan agreed that that was fair. There was no sign that this registered with Nash, but he did come round again with the sherry, which she turned down and I accepted. When he had finished with that he half-sat, half-leant on the side of his desk. I thought he looked clever, grim and crafty, also upper-crust.
‘The trouble with discussing schizophrenia,’ he began — he was obviously just beginning, ‘is that almost nothing is known about it after seventy years of study by some very intelligent men, and a great pack of blithering idiots too, of course. Some of what is known isn’t very helpful, for instance you’re more likely to develop it if you were born early in the year. North of the equator, that is. The helpful parts are elementary and mostly negative. Schizophrenia is an illness, one in which the brain becomes disordered. The cause has not yet been established, though there’s quite a long list of things that don’t cause it, like cell senility as I suppose they have to call it, and food allergy and any sort of virus, and anything to do with society. For a time it was thought to be tied up with unhappy families, until someone noticed that there were lots of unhappy families in which nobody had schizophrenia. Heredity comes into it, though it’s not known where or how.
‘As I told you, Mr Duke, the subject fascinates me, but not as anything but itself. It leads nowhere. All schizophrenia patients are mad, and none are sane. Their behaviour is incomprehensible. It tells us nothing about what they do in the rest of their lives, gives no insight into the human condition and has no lesson for sane people except how sane they are. There’s nothing profound about it. Schizophrenics aren’t clever or wise or witty — they may make some very odd remarks but that’s because they’re mad, and there’s nothing to be got out of what they say. When they laugh at things the rest of us don’t think are funny, like the death of a parent, they’re not being penetrating and on other occasions they’re not wryly amused at the simplicity and stupidity of the psychiatrist, however well justified that might be in many cases. They’re laughing because they’re mad, too mad to be able to tell what’s funny any more. The rewards for being sane may not be very many but knowing what’s funny is one of them. And that’s an end of the matter.
‘I consider you should know of these matters. Think of your son’s illness like a physical illness of the dullest and most obvious kind, after which he may be restored to you undiminished, healed, healthy, or he may be more or less impaired, and the process may be a long one. Meanwhile I’ll see to what has to be seen to.’
‘Thank you, doctor,’ I said, and stood up. At
the same moment he looked at his watch and then at Susan.
‘I was thinking, if you’re not doing anything special for lunch,’ he said, looking at me now, ‘you might let me take you round the corner to my local, my local restaurant. It isn’t awfully good but at least it’s pretentious, with the added merit that at this sort of time of day you can just walk in. And from here you can walk to it as well. Two minutes away. It’s stopped raining.’
Not for me, in line for a couple of stiff quick ones and a sandwich in Fleet Street followed by a slog in the office. I drew in my breath to explain some of this, caught Susan’s eye and said, ‘That’s very kind of you, we’d love to.’
Nash was delighted. He went and helped her on with her mack as though nobody else knew how to handle a thing like that. She played up to him about the proper amount.
‘I see you’re an Anthony Burgess fan, Dr Nash.’
‘Yes. I find him a very interesting writer.’
That was it. Susan said, ‘I didn’t notice a copy of Don Juan and the Lunatics.’
‘Oh, that,’ said Nash, pretending not at all strenuously to have nearly forgotten what I took to be the great work on madness in literature, its title now successfully researched. ‘Out of print for many years.
‘I’m ashamed to say I’ve never read it. In fact I don’t think I’ve ever set eyes on it. I suppose there isn’t a copy I could borrow?’
‘I may have a spare somewhere, I’ll have a look. But, er, you mustn’t expect too much, you know. I’m afraid you’d find some of the literary judgements ill considered. Where they’re not painfully obvious.’
‘Oh, I doubt it.’ She seemed to think he was a tremendous old tease to say that, then immediately went serious. ‘But after what you said just now about mad people being incomprehensible and madness not telling us anything about the human condition, which I thought was absolutely fascinating, well, I just wonder what’s left, what you found to say in your book.’
‘Internally, in itself, madness is an artistic desert. Nothing of any general interest can be said about it. Like sex. But the effects it has on the world outside it can be very interesting indeed. It has no other valid literary use. But that’s by the way. My subject was just how well or, mostly, how badly writers have described madness. As a gardener or a cook might with their speciality. A medical doctor.’
‘Mostly badly?’ asked Susan in a companionable way.
‘Yes. A fellow wants to put some madness into his novel because it’s strange and frightening and quite popular. But if he bothers to go into the reality he finds it’s largely unsuitable, an unsuitable topic for his purposes. So he gets hold of a pamphlet by some charlatan or crank propounding a suitably colourful fantasy and makes a character kill his wife because he’s got an Oedipus complex, or find he’s strangled a prostitute while under the impression he was a Victorian sex murderer. Which may be great fun but makes it hard to take the thing seriously. I mean you wouldn’t have much confidence in Graham Greene if he tried to tell you Haiti was in the Mediterranean. Good morning.’
The last bit was said to a waiter, because here we were in the restaurant, which at this first sight looked quite modest to me, but then probably Nash was better at detecting pretentiousness than I was. I rather handed it to him for making no bones about enjoying the way the head waiter and the manager practically carried him to his seat at the best table in the place. He had put my mind at rest here and there, and I reckoned I bought his general approach, but I would have had a little more time for him if he had gone pounding off to see after a patient of his in some distress instead of going out to an elaborate lunch and flirting mildly with the patient’s stepmother. Still, that part was very likely just me being mildly jealous. And I could see a large whisky coming straight at me.
‘Hasn’t anybody got it right?’ asked Susan when we had ordered. ‘Describing madness.’
‘Shakespeare got it right. Lear, of course. Cerebral atherosclerosis, a senile organic disease of the brain. Quite common in old age. Periods of mania followed by amnesia. Rational episodes marked by great fear of what he might have done while manic and great dread of the onset or renewed onset of mania. That way madness lies — let me shun that — no more of that. Perhaps even more striking — Ophelia. A particular form of acute schizophrenia, very thoroughly set up — young girl of a timid, meek disposition, no mother, no sister, the brother she depends on not available, lover apparently gone mad, mad enough anyway to kill her father. Entirely characteristic that a girl with her sort of upbringing should go round spouting little giggling harmless obscenities when mad. In fact it’s such a good description that this … subdivision of schizophrenia is known as the Ophelia Syndrome even to those many psychiatrists who have never seen or read the play. He was content just to describe it, you see. No theories or interpretations. Oh, she says and does plenty of things that mean a great deal to the other characters and to the audience, but she doesn’t know what she’s saying or doing or who anyone is, because she’s mad.’
Our starters came then and I thought we might have heard the last of the topic, but not a bleeding bit of it. I had no great objection to Shakespeare as an author — it was just that I thought he was rather far back as something to talk about over lunch. Also I reckoned I had learnt enough about schizophrenia for one day. Anyhow, in less than a minute and without waiting to be asked Nash was off again.
‘The play’s full of interesting remarks about madness, among other things, yes. Polonius. A rather underrated fellow in my opinion. To define true madness, what is it but to be nothing else but mad? Not bad. Not bad at all. Not a complete definition, but an essential part, excluding north-north-west madness. Later in the same scene, you remember, he has a chat with Hamlet, the fishmonger conversation, and is made a fool of — the very model of a dialogue between stupid questioner and clever madman as seen by that, er, that, er, that unusual person R. D. Laing — you know, The Divided Self and all that.
‘But actually Hamlet’s only pretending to be mad, isn’t he? No problem scoring off the other chap if that’s what you’re up to. Polonius gets halfway to the point. How pregnant sometimes his replies are, he says, a happiness that often madness hits on, which reason and sanity could not so prosperously be delivered of — a remarkably twentieth-century view. If he’d paused to think he might have found it just a bit suspect. But Hamlet in general very cleverly behaves in a way that lay people who’ve never seen a madman expect a madman to behave. Ophelia doesn’t go mad till Act IV.’
The two of them went on having the time of their lives, working their way through Gothic novels and then Dickens, who either left mad people out altogether or was no good at them, though evidently terrific on neurosis. There was something about King Charles’s head.
‘Penangan High Commission, good afternoon.’
‘Good afternoon,’ I said, and went on to say who I was. ‘May I speak to the Commercial Attaché?’
After a moment I heard the dying-away of a phone bell and after a longer moment a hollow voice that said, ‘Yes, hallo, yes?’
I said who I was again, but there followed only a rumble that might or might not have been human, followed by more silence. ‘Hallo?’
The man — I assumed it was a man — at the other end breathed out heavily a couple of times. ‘What … do you want?’ I could not help being impressed by the quantity of both fear and menace he managed to pack into those four simple words, with a bit of despair added on.
A certain amount of despair came over me as I sweated away at explaining what I wanted, talking about report, supplement, feature, advertisement, publicity in the hope of grazing the target with one of them. Eventually I just ran out.
Another rumble. Then, ‘When were you speaking of this before?’ I gave the exact date and had hardly got it out when he came back, ‘No no, finish, all done, cancelled, cancelled.’
‘Does that mean your Minister of Trade has —’
Dialling tone. I rang the High Commission swit
chboard again and established quite easily that, as I suspected, I had been talking not to my pal Mr One but to his rival or replacement, Mr Two. Mr One had presumably returned to Penang, then. Not yet, said someone on an extension, he was in consultation with Mr Two but was not available.
Cheers most awfully, I thought. Win some, lose some. Well, lose some, certainly. Not that it really mattered, but it would be nice to have something go right for a change. I hoped slightly that it had been panic rather than fury that had made Mr Two bang down the receiver on me.
It was quite late and I was quite tired. I had had another early morning over at St Kevin’s, where Steve had turned out to be in more comfortable shape, true to Nash’s report the previous day that he fancied he had put the hospital on the right track. Good, but all the same I had found him, Steve, no more responsive than last Thursday, not really. He lay on rather than in his bed and now and then sat up on the edge of it while I talked, but that was all. Already, not nine hours later, I had a pretty poor hold on what I had taken quite a long time telling him, rambling recollections of holidays, places where we had lived or stayed, bits of school, that type of thing interspersed with even less reliable stuff about how nice the hospital seemed and the great strides made in medical science since the war. At just three moments altogether I thought he looked at me properly and perhaps recognized me, but they were only moments. In the room when I arrived, and still there when I left, there had been a small prematurely white-haired man in his forties looking out of the window and making the sort of little grunting, moaning, wincing noises that might have come from a chap watching something like a fist fight in which a friend of his was rather getting the worst of it.
I had made no move to see Trish Collings during my visit, in fact on my way back to the car park I hurried past Rorschach House with my head down. Not much digging inside it was needed to show me that I was afraid that, if I had happened to run into her, she would tick me off for having complained about her to Nash, or for perhaps having done that, which of course was just as bad. Old Don Barley up to his tricks again.
Stanley and the Women Page 16