by M. J. Cates
“Lunch is ready,” she called for the second time, when she and the children were seated.
“I want to finish this,” Carl said, banging at something with a wrench. “I don’t want to freeze like last winter.”
“You could fix it later,” Imogen said. “I have to catch my train soon.”
“I’m not stopping you.”
The children ate quietly, tired after their morning out, and no doubt a little disheartened at their mother’s imminent departure. When they were done, Imogen sent them off to their room.
“Please don’t stay angry with me,” she said quietly. “I thought you’d gotten over it. It can’t do any of us any good.”
“You’re doing what you wanted to do. I react how I react.”
“Carl, please. It’s hard enough without this.”
“Hard, is it?” He put aside the wrench and turned to face her, still sitting on the floor. “Then why are you doing it, Imogen? Why are you depriving the kids of their mother? Why deprive me of my wife?”
“Carl, we’ve been over this. You know why—the chance of publication, advancement. I’ll be bringing in more money. That’s for all of us. Why does it have to be a source of friction?”
“Because it’s not what women do.”
“You don’t mean that.”
“It’s not what wives do. Mothers. You should be here, Imogen. With your family. You know it and I know it.”
“Carl, it’s not like I hid anything from you. You always knew I wanted to keep working. Why is it suddenly a problem now?”
He turned back to the radiator, wrench in hand.
“Carl, please don’t be like this.”
“Just go and catch your damn train.”
* * *
—
The Clocker was crowded, and the woman seated next to Imogen smelled strongly of lily of the valley, a scent that never failed to give her a headache. Before they had gone very far, Imogen took out her new Jeremy West novel.
She was disappointed to discover that it was not in fact a novel but a collection of short stories. She found novels as a rule more absorbing, and she had hoped it would take her mind off Carl.
The first story was narrated by a man who has nothing but contempt for the “gamine little flapper” who lives in the rooming house next door to his Village townhouse. He has an acerbic wit that he deploys to describe the young woman, an actress struggling to make it on Broadway. She has the looks for it, he allows, but also points out that “like all flappers” she is dim-witted, conceited, and promiscuous. He knows this because she is beautiful and because she is an actress—and everyone knows what actresses are like. He does not say so, but he is clearly counting on that well-known promiscuity to make his day when he asks her to have dinner with him.
He takes her to a fashionable restaurant on Fifth Avenue and orders an expensive bottle of Bordeaux, “not that she was capable of appreciating it,” and “stokes her vanity” by asking questions about her experiences onstage. The young woman is sharply critical of her own skills, and full of praise not just for the current stars but for her colleagues in the rooming house, most of whom are theatre people. The narrator sees this “fake humility” as just another actressy tactic to make herself superior.
As he is walking her home, they pass a dog walker with a long-haired dachshund straining at the leash. The young woman suddenly becomes very quiet, and the narrator asks her what’s wrong. She explains that her dog, also a long-haired dachshund, died not long ago. It’s a warm night, and they sit on a bench in Washington Square and she begins to tell him about Timmy.
At this point West’s story swerved in a new direction, much as his novels did. It became about the dog.
The girl talks about Timmy’s affectionate character, his love of play, his canine obsession with sticks and balls, his catholic taste in food, his Lothario tendencies toward female dogs five times his size, and above all his bottomless capacity for love and loyalty.
All very sentimental, one might think (the impatient narrator certainly does), except that it is the girl’s character that West illumines through her description of her pet. She comes across as a creature of infinite loyalty herself, loving and gentle, as she nurses Timmy through a long and debilitating illness until finally he has to be put down.
Her description of the dog’s last days brought tears to Imogen’s eyes and, indeed, when the girl finishes her story she cries and cries and the narrator holds her close. As he offers her this comfort, he slips his hand inside her coat and fondles her breast. The girl says nothing but soon gets up from the bench and dries her eyes. They finish the walk to the door of her rooming house on Waverley Place. She thanks the narrator and says good night.
But when he asks her to dinner again, she makes excuses—as she does when he asks her again. And again. The story closes with his fulminating, in his bitter yet amusing way, on the “secret contempt that beautiful women harbour for every other member of the human race.”
Imogen closed the book, keeping her place with an index finger, and thought about what she had read. A portrayal of self-delusion, to be sure, but what had moved her more than anything was the “dim-witted flapper’s” description of the death of her dog. Her vulnerability, her grief, and her discovery of the ineffable sadness of life contrasted powerfully with the scheming narrator—though even he, by the end of the story, becomes quite sympathetic, his prejudice and resentment all but guaranteeing him a life of misery. A sad story, all in all, but not a depressing one.
She glanced outside at the telegraph wires as they rose and fell from pole to pole. The soft light of early evening gleamed on a swamp, green with lily pads, and illumined the backs of houses and their tiny yards criss-crossed with washing lines. Lamps were beginning to come on in some of the houses.
She read several more of the West stories before reluctantly putting the book into her bag; saving a few would draw out the pleasure. The lily-of-the-valley lady was gone—Imogen had been too absorbed to notice her departure—and the train now smelled only of oil and steel. Her mind turned to the conversation she had had with Mrs. Boxer before leaving for Baltimore the previous week.
* * *
—
They had been in Imogen’s office in the records department, Imogen seated at her desk, Mrs. Boxer standing nervously in the doorway. Imogen asked her to sit in the only other chair, which she did, perching on the edge, hands clasped primly in her lap.
“Mrs. Boxer,” Imogen began, “in order for this study to have any validity—and in order for it to be of any use to this or any other institution—it must cover a large series of cases. Dr. Ganz and I have agreed that it should consist of the following—and don’t worry, I shall provide you with a typewritten copy of the particulars.
“We want to document the long-term effects of Trenton’s surgical interventions for focal infections, both abdominal and dental. So I’ll need you to supply me with three series of patients who were admitted in 1920.”
“Three series in 1920. I see.”
“Group One must be the first hundred patients, regardless of diagnosis. Group Two will consist of the first hundred functional cases—that is, patients whose trouble had no obvious organic or toxic basis. So, no syphilitics, no epileptics, no one suffering from brain damage, no drug or alcohol cases. If you are in doubt, please ask me.”
Mrs. Boxer nodded. “So, the first hundred patients, regardless of diagnosis.”
“Yes.”
“And then the first hundred functional cases.”
“Correct.”
“I see.”
Imogen consulted her notes. “The third group has to be another hundred patients, but these are to be people who are currently under treatment. Those will show us the immediate effects of surgery.”
“One hundred current patients.”
“Yes. Admitted consecutively. We don’t want to pick and choose among any of these three groups. Selection is strictly consecutive.”
“Strictly consecutive. Yes, I see.”
“Now I want a fourth group: patients who have received all phases of treatment for focal sepsis—in other words, patients for whom the hospital has done everything it could. Every surgery that Dr. Bingham wanted them to have.”
“You want a hundred of these too?”
“Well, there may not be a hundred. As you know, many people find surgery a terrifying prospect. Others may agree to one treatment but not another. You might feel all right about having some molars removed but draw the line at abdominal surgery and so on. So let’s say up to a hundred. Patients who have had every recommended surgery.”
“I’ll do my best.”
“Finally, a special group to be selected by Dr. Bingham himself—patients that he considers have shown the greatest improvement. As many as he likes, up to a hundred.”
“Oh, he’ll have some good ones for you there. You’ll be amazed.”
“Excellent.” Imogen handed her a typewritten sheet. “Here is the summary of what I’ve just told you. I’d like to be able to get started on these when I come back on Monday.”
“I’ll do my best.”
“Any questions?”
Mrs. Boxer put on her glasses and peered at the typesheet.
“This may take some time, all this.”
“It’s a lot of work, I know. As long as I have a good batch to get going with on Monday.”
“Five hundred cases. Five hundred files, my goodness.”
“It may not be five hundred. Because the last two groups—”
“Yes, but still.”
“I don’t need them all on Monday, Mrs. Boxer. Just some.”
“I’ll do my best,” Mrs. Boxer said doubtfully.
“I’m sure that will be more than adequate.”
* * *
—
Mrs. Boxer greeted her cheerily on Monday morning. “Did you have a nice few days with your family?”
“Very nice, thank you. And how have you been, Mrs. Boxer?”
“Oh, my husband is a grumpy sort, especially if he doesn’t get what he wants. Which is most of the time, unless I constantly submit to him. Leonard is a man who suffers from inflamed appetites. Or rather, I suffer from his inflamed appetites.”
“Ah. Well. I hope you managed to enjoy your weekend anyway. Did you have any luck with the files?”
“Oh, yes. First group’s all done.”
“The purely consecutive group from 1920, all diagnoses?”
“That’s the one. On your desk, dear.”
“Excellent. But please call me ‘Doctor.’ ”
“Doctor. Forgive me. Sorry—I’m not used to doctors being young and pretty.”
Imogen went into her office and closed the door. She stood at the window for a moment. The trees had lost more of their leaves, and those that remained were duller than they had been the previous week.
She sat down and opened the first of the boxes labelled Consecutive Cases, 1920. She began to sort them into diagnostic groups: Functional, Organic, Epileptic, or Constitutional (meaning patients whose intellectual development was retarded, no matter the cause). Even using the status cards attached to the top sheets, that took most of the morning.
At noon she walked over to the main building to eat in the doctors’ lunchroom. She approached a communal table with a plate of lamb stew and mashed potatoes. Dr. Roper, a man of about forty with dark hair slicked straight back à la Valentino, had been holding forth, but he went silent as Imogen took her seat. She detected a new coolness in the atmosphere, and folded the Trenton Chronicle beside her plate in case it should be needed to ward off conversation.
Dr. Roper spoke up. “How is the assassination going?”
“Assassination?”
Dr. Roper dug into his stew and surveyed his own folded newspaper. “That’s what you’re here for, isn’t it? To assassinate our director?”
“Actually, no. I’m here at the request of your medical board to do a statistical analysis of your surgical results.”
The sense of being attacked set Imogen’s heart racing.
“We are an asylum for the insane, Dr. Lang. Since when are ‘results’ even expected? Surely every result other than early death or lifetime incarceration must be counted a victory.”
Imogen’s mouth had gone dry. She took a sip from her water glass. “My study is for informational purposes. The board—and your legislative funding committee—want to know if their spending is warranted. It’s the same for all state hospitals.”
Roper framed an invisible rectangle in the air, as if picturing a headline. “ ‘The Great Phipps Clinic Speaks.’ I can see it now.”
“You seem to be assuming my findings will reflect badly on your institution.”
“I didn’t say that. You did.”
“You accused me of assassination.”
Roper ate a few mouthfuls of his stew, and dabbed at his mouth with his napkin. “We have figures of our own, you know. We can count, believe it or not. It’s a little unusual to have a Grand Inquisitor come to question our numbers.”
“I’m not here because I question your numbers. I’m here because other hospitals and psychiatrists wonder if your numbers can be accurate. Unfortunately, some quite astonishing figures have been floated in the lay press, but there’ve been no independent studies to confirm them. Perhaps mine will be the first to verify results that sound extremely encouraging.”
“If true.”
“Pardon me?”
“Encouraging numbers, if true.”
“Are you trying to tell me they’re not true?”
“I’m trying to tell you you’re about to do a great deal of damage.” Roper pushed his plate away and stood up. “Tell me, what do they do at the Phipps Clinic for people that smear themselves in their own excrement?”
“I don’t—”
“I’ll tell you what they do. They send them to us—to the state hospitals, the asylums—because chronic schizophrenics are as hopeless as hopeless human beings get. And those asylums lock them up for thirty to forty years. Why? Because there is no treatment, that’s why.”
“We take our share of schizophrenics—”
Roper talked right over her.
“No known treatment. Nobody’s even trying to treat them. Rupert Bingham is the only man brave enough to try something new, rooting out infection in the teeth, the gut, the tonsils, the glands—wherever it may be hiding. He roots it out and these people go home. Yes, Dr. Lang of the Henry Phipps Clinic, Johns Hopkins Hospital and University, we send people home.”
“I know you do. It’s my job to find out what condition they are in five years later—among other parameters. If they are doing well, that will be wonderful news.”
“And if they’re not?”
“And if they’re not, then obviously further studies would have to be done, and different treatment modalities applied.”
“No. If they’re not, you’re going to take away the one thing we give our patients and their families, which is hope.”
“That’s what the spiritualists say, as they empty the pockets of people in mourning.”
“Which is exactly what people in mourning need!”
“But your figures are not claiming hope. They’re claiming cure. Don’t you want to know the truth? Dr. Bingham does. He’s wholeheartedly behind this study.”
“That’s Dr. Bingham. You’ll do what you want, no doubt. But don’t expect me or anybody else in this place to thank you for it.”
* * *
—
Imogen resolved not to let Dr. Roper get to her. She didn’t know him, had no reason to value his opinion. She thought of her medical and scientific heroes—Freud, Pasteur, Semmelweis—and how they had persisted with their studies and experiments despite insults and isolation. Over the next few weeks she bent her mind to the task of further classifying the stacks of cases before her. Her preliminary categories were four: Recovered, Improved, Unimproved (at large), Unimproved (in hospit
al). She had to follow up on the fates of a hundred people admitted to Trenton five years ago—and that was only the first selection.
Just finding out where a former patient was currently living was difficult. People moved—sometimes out of state, leaving little trace behind. The dead were the easiest, since their demise was a matter of public record. More than thirty of the first hundred patients, it turned out, were no longer among the living.
Luckily, Carl seemed to have reconciled himself to her travelling back and forth. He greeted her with a bear hug each time she returned home, told her he missed her (without actually complaining), and engaged her in much-needed sex on Saturday night. When it came time to part on Sunday, he kissed her goodbye. Even the twins seemed to adapt, thanks in large part to the help of Myra and Cynthia.
But Imogen was itching to get on with the job of interviewing former patients and when, after three or four trips, she had just a few remaining files to sort, she telephoned Carl to say that she would have to stay an extra day, perhaps two; there was just so much work.
She had expected him to be annoyed, possibly even angry, but he took it in stride. In fact, he expressed sympathy that she had to face such an arduous task with so little dependable help. She would have liked even more sympathy. She would have liked to tell him how the staff psychiatrists hated her, and how sloppy the record-keeping was, but it was too expensive to do so over the telephone.
“Is everything all right with the twins?”
“Everything’s fine.”
“You must be at your wits’ end.”
“No, Myra and Cynthia have been wonderful. It’s been much easier than I thought it would be and I’m sorry I’ve been such an ass about it.”
His apology soothed Imogen’s wounded heart. She was a lucky woman with a good job, two beautiful children, and a loving husband. Her eyes watered at the sudden uprush of emotion and—not long after she hung up the phone—she changed her mind. She would not stay an extra day; she would catch the four o’clock back to Baltimore.
Her buoyant mood changed her attitude about the work. Instead of feeling it would never end, she could now see that she had made good progress. If she and Mrs. Boxer kept this up they would certainly have a rough itinerary organized by the following Monday.