by M. J. Cates
They leaned toward each other and in the fragile warmth of mutual forgiveness kissed and lay quiet in each other’s arms.
* * *
—
“Well, you’re in for it now,” Laura remarked. She had not shown up for some time, but trains and trams offered broad dark windows, where Imogen’s ghostly twin could travel beside her, dressed like her, with Imogen’s features, Imogen’s face. She could lean her translucent head with comely weariness against the pane, never mind the landscape rippling by at forty-five miles an hour if you were taking the Clocker from Baltimore.
“Who was it who said she never wanted to be apart from her husband? And abandoning her children,” Laura went on in her breathy voice. “What kind of feckless mother does such a thing?”
The connecting door rattled open and the conductor came through announcing Trenton in ten minutes. Imogen sat up and rubbed her head where it had been resting against the glass. She was already missing her children, Aubrey with his endless questions, and Charlotte so serious and cautious and sensitive.
Laura was still lingering in the window—faint, but with impish smile intact.
“I don’t see why you’d want to upset a husband who is not only supremely talented at his work, but also makes you feel positively glorious in bed.”
As the train began to slow for Trenton’s Penn Station, Imogen was remembering Carl’s touch, his muscles, the way he held her. Whatever else her feelings about this trip, she was not looking forward to lying by herself in a cold bed.
* * *
—
She took a cab from the train station to Trenton State Hospital. They had to stop at the gatehouse and wait for an attendant. He duly consulted a list on a clipboard, made a check mark, and opened the gate. As the gatehouse receded behind them, Imogen’s heart began to lift. The hospital’s driveway curved through an alley of oak trees and emerged into beautifully landscaped grounds—almost a park. It was a warm fall day, and the trees were bright gold and rusty red, the grass brilliant green.
The main building was massive, the front door guarded by six Corinthian columns. The cab stopped between the fountain and the front steps, and the driver held the car door open for her. Imogen paid him and reached for her suitcase, but he insisted on carrying it up the stairs—a welcome kindness, since she counted thirty-six of them on the way up.
The interior was grand in the neoclassical style, with much marble and stone and a sense of rock-solid stability—not the worst environment for people with a shaky sense of reality. She pushed open the door to the medical director’s office and introduced herself to the receptionist.
“I’m Dr. Lang—I’ve just arrived from Baltimore. Dr. Bingham is expecting me.”
“Yes, yes. He’ll be right with you. Please have a seat.”
Imogen was not sure what would constitute a proper reception. She was, after all, a kind of independent auditor. One should not, she supposed, expect too much warmth. She sat in a hard oak chair that offered a view of the oak counter and the huge oak clock that indicated she was exactly on time. Ten minutes went by, during which she began to feel rather oakish herself, thick and heavy with the fatigue of travel. It was only four o’clock but all she wanted was dinner and a book and bed.
After fifteen minutes she got up and asked the receptionist if Dr. Bingham had been made aware of her arrival.
“He’s expecting you. I’m sure he’ll be along any minute.”
Imogen waited until he was half an hour late before speaking to the receptionist once more. “It appears the director has been detained. I wonder if perhaps someone else could show me where I’ll be staying?”
The receptionist scanned Imogen’s features as if trying to organize them into a face. Finally she said, “Dr. Bingham will be here any minute. Let’s just be calm and wait for him, shall we?”
“I have been waiting. I’ve been travelling most of the day, and I—”
The door banged open and Dr. Bingham came in, greeting the receptionist but not Imogen. “Iris—any messages?”
The receptionist got up and followed him into his private office, closing the door behind them. Imogen felt the heat of anger rising in her neck and face. She took a deep breath and told herself to remain calm.
The door opened and the receptionist came out. “You can go in now.”
Imogen dithered a moment about what to do with her suitcase before deciding to take it in with her.
Rupert Bingham’s office was three times the size of Dr. Ganz’s, brightly lit by tall windows. The walls were lined with fat volumes of medical texts, mostly on surgery. Bingham sat at a massive, extremely neat desk, examining some papers. He put them aside when Imogen entered, and came around the desk to shake her hand.
“You’ve been kept waiting,” he said blandly. “I apologize. Surgery went longer than expected.”
His handshake was limp, damp, cool—as bland as his features, which showed no trace of any current, or for that matter historical, emotion.
“We’d thought it was a simple bowel resection, you know, a couple of punched-out ulcerations, but it turned out to be a diffuse folliculitis, involving the entire mucous lining.”
“A dangerous procedure then.”
“Not as dangerous as leaving it untreated. But, come—let me show you around—or are you too tired? Would you rather rest?”
“No, no—a tour sounds just the thing after sitting all day. What about my suitcase?”
“You can leave it here. I’ll have it sent to your quarters.”
* * *
—
Bingham led her along the echoing marble hall to a rear exit. The grounds, beautifully landscaped in the Romantic style with curving paths and shady ponds, looked tranquil in the low September sun.
They walked down a winding, rustic lane lined with elms, oaks, and maples, and Bingham pointed to an elegant stone house, set all by itself on a small hill. It had a circular drive and an ornate veranda. “The medical director’s house,” Bingham said, as if referring to someone other than himself.
“How lovely. That veranda must be heaven on hot summer days.”
“My wife enjoys the house very much, and it’s been a healthy environment for the boys to grow up in. That big building coming up on the right is where the attendants live. We have apartments for the married couples, of course, but mostly it’s much like a school dormitory. Then we have the nurses’ homes.”
“The grounds are so beautiful.”
“You can thank Dorothea Dix for that. Trenton State was the first hospital built when her reforms came in. That way are the doctors’ houses,” he added, pointing. “We have nine psychiatrists on staff at the moment.”
The houses were charming, cottage-like affairs, with tiled roofs that seemed optimistic considering the New Jersey climate.
Bingham led her back toward the building where most of the wards were located.
“How is Dr. Ganz doing these days? He seemed a little subdued when he visited here last month.”
“Oh, the chief’s fine. He’s always fine, you know.”
“Yes, he was a great inspiration to me,” Bingham said without enthusiasm. “I don’t think I’d have got half as far if I hadn’t had Jonas Ganz to guide me.”
Dr. Ganz had felt it was incumbent upon him to make a preliminary journey to New Jersey to get a quick look at the site of Imogen’s investigations. He’d told her that his glance into the surgical records had been anything but reassuring. Although he was satisfied that every measure was taken to keep the operating room antiseptic, operations on the bowel, even by the finest surgeons, remained extremely risky. A few of the numbers had stuck in Imogen’s head, bright as crossing lights: Of 133 total colectomies, 44 had died. Of 148 patients who had had their colons reconstructed, 55 had died.
“I think it’s wonderful what Dr. Ganz has done for psychiatry in general,” Bingham was saying. “I hope to do the same or better for asylums.” He stopped on the path and waited for Imogen to c
atch up. “We’re not a warehouse. Trenton State Hospital is just that—a hospital. People get better here, as your survey will show.”
The path curled around a copse of trees and then a vista of sky and hill opened up, with a row of small, red-brick buildings on one side and, on the other, a large, dark structure that abutted the stone wall surrounding the grounds. Bingham pointed to the smaller buildings.
“That’s our butcher. Then the baker, the shoemaker. That’s the laundry over there, and the one with the smokestack is our powerhouse.”
“Such a vast enterprise,” Imogen said. “Don’t you get overwhelmed by it all?”
“I’m solely the medical director. Another man is in charge of the physical plant.”
She detected a note of annoyance in his response. Normally the medical director was in charge of every aspect of an asylum, no matter how large. It was unusual to have two directors.
A gang of starlings was pecking about in the shade of an elm and making clicking sounds, as if they were cracking jokes about the food. As Imogen walked with Bingham toward the large building, she became aware of a background noise, an aural blur that became more distinct in its components as they approached the stone façade. These were the wails of men, groans and cries in every register. Some were singing, most were yelling, several haranguing. Someone was crying, “Pardonna me! Pardonna me!” Another sounded as if he had his lips right up against one of the barred windows, shouting individual words in a clipped, clear voice as if teaching an unseen crowd English from the dictionary, one word at a time. “Crack! Crackpot! Crack shot! Crack corn! Craft! Crafty!”
Bingham took no notice. He started up the steps as if they were heading into a library. “Our home for the criminally insane. I needn’t take you into the cell area.”
“Are any of your surgical subjects drawn from this pool?”
“Not possible. There’s no way to secure informed consent from someone who has been ruled not responsible for criminal actions.”
They entered the building and proceeded along a hallway. About halfway down, Bingham pointed to a pair of heavy doors at the end. “Criminal wards are beyond. Don’t worry—there’s always an attendant controlling the door on the other side. No one gets out who shouldn’t.”
His words echoed against the tiled walls.
“This is your room.” Bingham took a key out of his pocket and opened a door numbered C106. “It’s pretty spartan, but you should be comfortable enough. We have the odd medical resident stay here and no one’s ever complained.”
The room contained a narrow bed, an armoire, and a dresser much scarred with cigarette burns. The dimensions were those of a cleaning supplies closet, which it clearly once had been. No windows.
Imogen said nothing. Her suitcase was already parked beside the bed.
“Facilities are just down the hall. Don’t worry—you’ll have the place entirely to yourself, but do be sure to keep the door locked at all times.”
He handed her the key, which Imogen accepted numbly, and led her back outside. All the way back across the grounds he talked about the money his procedures were saving the state, but she didn’t take any of it in. She could still hear the howling. She was still seeing that room.
Bingham took her through the rear entrance of the ward building, shepherding her along one floor after another. He introduced her quickly to each ward nurse, who in turn introduced her to a patient or two. The wards were neither better nor worse than those she’d seen at Byberry. They smelled of urine and floor polish, nicotine and paraldehyde.
A highly animated patient, a man of about sixty with a perfectly bald head, fired questions at Imogen. She could tell they were questions by the interrogative lilt, but his speech was so impaired she couldn’t understand the words. She smiled and said, “Perhaps I’ll see you again,” as they moved on.
Another man, impeccably dressed in what had once been an expensive pinstripe, sidled up to her, gripping a newspaper. He looked about to deliver a political comment, perhaps a diatribe about state funding, but he too had impaired speech. Having suffered from being tongue-tied herself, Imogen was sympathetic to speech problems, but simply could not make out what he was saying.
On another ward, a young patient waved to her the moment she entered, a look of recognition lighting his eyes. Imogen was sure she had never seen him before. He had the dark hair and clear eyes of a young person—perhaps twenty-five or twenty-six—but his cheeks were sunken like those of a moribund eighty-year-old.
He jumped up and started talking as he crossed the room. “Dokser Lang! Dokser Lang! Is me! Jimmy! Jimmy Worse!”
This, she realized with a shock, was Jimmy Worth.
“Why, hello, Jimmy. I haven’t seen you for a long time.” She would never have recognized the caved-in face. Twenty-five, and he looked ancient. “I thought you lived in Baltimore.”
“No!” Jimmy said. “I got sick again! Sick! Sick! Sick!” He gave her a great wide grin that showed raw red gums and not a single tooth.
They have no teeth, Imogen nearly said aloud. None of them have any teeth.
“Former patient of yours?” Bingham said when they were outside again.
“Yes. He was extremely bright—doing advanced mathematics at Johns Hopkins—when he suffered his first attack. The delusions calmed down after a few weeks, but I can’t claim it was in response to any treatment I gave him.”
“No, it wouldn’t be—because his problems are not psychogenic. He had massive dental infections and pyorrhea of long standing. We pulled all the teeth and cleared all that up.”
“He still seems rather florid, don’t you think?”
“Oh, there’s a lot more work to be done. We’ll be putting him through all the tests and I’ve no doubt we’ll find focal infection in the bowel. Perhaps even endocrine involvement. He gets headaches, you know—headaches are always a sure sign.”
* * *
—
That first day at Trenton was as anxious and lonely as any Imogen could remember. She had dinner in the staff cafeteria, and the nurses and physicians were friendly enough. They were impressed, even intimidated, that she was a staff psychiatrist at the Phipps. (“You work with Jonas Ganz? What’s he like?”) They expressed cautious interest in the eventual outcome of her study and wished her well with it.
“You’ll have a hard time tracking down some of the patients,” one nurse said.
“Oh, you mean the follow-ups? I’ll have the assistance of two social workers for that.”
“Which social workers—did he tell you?”
“I’m to meet them tomorrow.”
“I’m sure they’ll be very good. That’ll make all the difference.”
Imogen tried to keep up polite conversation but found herself yearning to be home at her kitchen table having dinner with the twins. She missed their chatter about all the newsworthy events of their day. Myra took us here! Myra told us this! Myra said cough drops are bad for you, is that true? She wanted to be reading them to sleep and listening for Carl’s key in the door. My God, she thought, as the nurses talked on, I’m not a professional person at all.
If dinner was uncomfortable, sitting alone in her grey little chamber was worse. Having the whole corridor to herself did nothing to make her feel secure. Every so often would come a piteous cry, or a howl, or a wail—Pardonna me! Pardonna me!—followed by suggestions, expressed in the harshest terms, that the howler immediately kill himself. Other cries were not words at all.
She tried to read to distract herself, but the words on the page of her novel refused to form sentences. She put the book aside and switched out the light and tried not to mind the creak of the springs, the sag of the mattress, the desperate cries of the mad.
* * *
—
An office had been set aside for her, just off the records room, and it was a definite improvement over her sleeping arrangements. A wide window offered a view of brilliantly coloured maples, where black and grey squirrels spiralled and
somersaulted.
Imogen had her own lockable file cabinet, a good-sized desk, and even a typing table complete with a shining new Underwood and reams of paper.
“This is Mrs. Boxer,” Dr. Bingham said, as he ushered in a roly-poly woman in a rumpled brown suit. “Our statistician.”
The woman smiled at her, displaying a palisade of snow-white teeth.
“Feel free to call on her for anything you need.” Bingham handed Imogen a thin file, tied with black ribbon. “In the meantime, Mrs. Boxer has put these figures together. They should give you a good grounding.”
When he had gone, Mrs. Boxer showed her the layout of the records room, the protocol for signing out files, and handed her the key to her office. She was a cheerful, bustling sort of woman, the kind of person you’d want to look after children. Imogen asked her if she had any.
“Two girls, twelve and fourteen. And you, Doctor?”
“I have a boy and a girl, five years old. Twins.”
“Mother of twins and a doctor too. You must be a very special person.” Mrs. Boxer closed a file drawer and blew some invisible dust off the top. “Dr. Bingham is a very special person too, as I’m sure you know. A brilliant, brilliant man. I was in a terrible state. Not fit for anything. I’d seen a nerve specialist for months—couldn’t do a thing for me. I come here, Dr. Bingham takes one look at me and says, Well, it’s no mystery why the neurologist can’t help you. What you need is the dentist. Before you know it he’s pulled out must be I don’t know how many teeth—a dozen or more—and I haven’t had a problem since. Discharged me a few weeks later.”
She clacked her dentures together—clack, clack, clack—by way of proof.
“And here I am. Started in the front office, filing and so on. I’m just a natural for filing—I like things shipshape—and then eventually they put me back here looking after all the files and keeping track. I could not be happier, and here I’d been so sick you’ve no idea and it was such a relief to realize it was all my teeth and not my head. Or not just my head, anyway. Goodness me, I’ve talked your ear off—you’re going to think I’m still a lunatic.”