by M. J. Cates
“Well, he’s thirty-two and he can’t get work, even though there’s lots of jobs around, so that should tell you something.”
“He’s been home now for five years, is that correct?”
“That’s right.”
“And how was he when he first came home?”
“He still wasn’t right—in the head, I mean. But much better than he was when he went in. He wasn’t seeing and hearing things that aren’t there, for one thing. He wasn’t muttering to himself all the time. And he could manage a good night’s sleep.”
“But he was unable to find work?”
“Oh, he tried, he really did. He’s very handy with tools and things. He made those tables,” she said, pointing, “and that box over there for our scarves and mittens and so on. He’s not a master carpenter, but quite capable of putting things together. He’d always worked before he went off.”
“If he was so much better, why do you think he was unable to get work?”
“Because he’s got no teeth, of course. They pulled ’em all out at Trenton, on account of they was all infected and causing his brain to go wrong. Well, people put two and two together, you know. They see a man of thirty with no teeth and they know where he’s been, doesn’t matter how sane he might look at the moment. Everyone knows they yank your teeth out at Trenton. So anybody’s got no teeth they know right off.”
“The records show he had extensive dental surgery.”
“He’s toothless. Completely toothless.”
“Was he not fitted for dentures?”
“Hah. A full set of dentures? You know how much they cost? We haven’t got that kind of money.”
“How does he eat?”
“I chop everything up small. And give him lots of mashed potatoes and such. It’s not his fault. People just see you got no teeth they think you’re…” She made a circling gesture next to her temple.
“I see.”
Mrs. Trout pulled a handkerchief from her sleeve and dabbed at her eyes.
“May I see him now?”
She nodded. “You’ll have to visit in his room. He don’t come out of there, not anymore. Except to use the bathroom. Hasn’t set foot outside that room for months and months. You’ll have to forgive the smell. It’s hard to get him to bathe—well, he won’t bathe—but most days I can get him to wash his face. The bathtub talks to him, see? The pipes, the drains.”
Mrs. Trout led Imogen down a short dark hall. A stench of old sweat and filthy socks emanated from a room on the left. She rapped crisply on the door.
“Ronnie?”
“Come in!”
She opened the door, and the smell made Imogen gag.
“Ronnie, this is Dr. Lang. She’s come all the way from Baltimore to see how you’re doing.”
He was standing about twelve inches from a wall that was covered, floor to ceiling, with handwriting, block printing, and strange symbols in many different shades of ink.
“Baltimore,” he said, then muttered it several times. His speech was remarkably clear, considering his toothless state, but he didn’t turn to look at Imogen, just kept staring at the wall.
“Thanks,” Imogen said to Mrs. Trout. “I’ll talk to him alone, if I may.”
“Suit yourself,” Mrs. Trout said, adding, “You’ll be polite, won’t you, Ronnie?” She withdrew, closing the door behind her.
“Hello, Ronnie. Is it all right if we talk for a while?”
“Talk away,” he said, still without looking at her.
“Perhaps you could sit on the bed and I could sit on the chair.”
“You can sit. I can’t sit right now. You can sit.”
He gripped a thick pencil in his right hand, squeezing it so that his knuckles whitened.
“Will you tell me what you’re working on?”
“Yes. It’s a reality map. Realities, I should say.”
He flexed and unflexed the fingers gripping the pencil.
“Tell me more,” Imogen said, looking at the wall. “That central circle, is that the earth?”
“Yes.”
“And you have another circle around it.”
“The reality that encloses our reality. The one we only sometimes see. When we’re really happy. Or really sad. It can be happy or sad. It’s weather. Well, not weather.”
“And you have another line much higher.”
“I’m not supposed to talk about that.”
“Why not?”
“It’s Ercaluit. It’s where the Ercalui live. Well, not live. I’m not sure if it’s a separate reality, or an element in this one. They’re like fish in water there. I think it’s a separate reality.”
“What are they like?”
He gave a deep sigh, folded his arms across his chest, and bowed his head.
Imogen didn’t want to lose him. “They make you sad?”
He nodded.
“Are they mean?”
He nodded again. “Beautiful. Imagine the most beautiful woman you have ever seen, the most beautiful angel. That’s how beautiful they are. Just to see them is to want to be with them. But they’re cruel as well. Beautiful and cruel. They invite me in and then tell me I’m not worthy. Of course, they’re right. I’m not worthy.”
“Not worthy?”
“They put it stronger than that—a lot stronger. If I told you what they say, it would burn your ears. I am filth to them.”
As he talked more, the damage to his speech became more obvious. A prospective employer might easily mistake him for an imbecile. “Why are you not worthy?”
“I can’t talk about it.” He shook his head and choked back a sob.
“All right. I notice you’re not looking at me. Do you find it hard to face people?”
“Some people. Sometimes. I mean, I can look a little.”
He jerked his head in her direction and looked away again. His face had the collapsed, elderly look of the patients Imogen had observed at Trenton.
“How was that?” Imogen asked. “Was that difficult?”
“I can’t look at you. I can glimpse you but I can’t look. I’m sorry.”
“That’s all right. Why can’t you look? You can tell me, I won’t be mad or upset.”
“Your eyes would suck my soul out of my body.” He said it simply, as if stating an allergy to pollen.
“Do a lot of people have that effect?”
“No. Some. I saw a wedding ring. You’re a happy woman, I can tell.”
So much for “the wisdom of the mad,” Imogen thought. No one who actually knew any psychotics thought they had any special insight; mostly their preoccupations made them dumb as bricks.
“Your mother tells me, and I can’t help but notice myself, Ronnie, that you refuse to bathe.”
“The Ercalui scream at me if I try. They say I don’t deserve to be clean. That I can’t be clean. You can’t clean shit, you know. You can clean shit off but you can’t clean shit itself.”
“Since you know they are cruel, Ronnie, do you think perhaps you could learn to disbelieve what they say?”
Ronnie did not respond, but reached up the wall and waved his hand from side to side. “Macrocosm. Up here? That’s macrocosm.” He glanced back over his shoulder at Imogen, then away. “You see? Macrocosm.”
“All right.”
“And down here…” He squatted and pointed to something written in tiny letters. “Microcosm.”
“You feel that’s significant?”
“Microcosm.” He slapped the wall. “Microcosm.”
“Do you think you’ll be going outside anytime soon? Will you leave the house at all?”
He shook his head.
“You mean not anytime soon? Or never?”
“Can’t. Can’t.”
“Why is that, Ronnie? Why can’t you?”
“They scream at me. They tell me to do terrible things. Horrible things.”
“And in this room they don’t?”
“Not as loud. Not as often.”
“Wha
t sorts of things do they tell you to do?”
Instead of answering, he stood up and started writing on the wall, squeezing letters between lines of larger words: Earth, Fire, Universal Key. Imogen got up from the chair, and he whirled around with a look of terror. He smelled awful—a mixture of death and charred meat.
“It’s all right, Ronnie. I won’t come any closer.”
“No. Please.” His eyes were shut tight.
“I’ll leave you alone,” Imogen said. “I don’t want to upset you—I just came to see how you’re doing. But I’d like to ask you just one more question, if I may.”
He turned his back to her, and she could see him trembling from across the room.
“Will you think about the possibility of going back to a hospital?”
“Why? I’m all out of teeth.”
“It wouldn’t have to be Trenton, necessarily. There are other places you can go. Places where they don’t pull teeth.”
He inscribed a symbol at the exact height of his forehead—a circle enclosing a triangle, which in turn enclosed a minus sign.
“What does it mean?”
“It’s Ercaluit.”
“Will you tell me what it means?”
“Yes. It means…” He leaned close to the wall so that his nose was almost touching it. “It means—there’s no one here.”
“In this room, you mean?”
“No. No, it means there’s no one here.” He tapped the wall three times with his forehead. “In this body.”
Imogen said goodbye to him then, apologizing for upsetting him and thanking him for his time. She told his mother before she left that Ronnie could well be a danger to himself and others, that he should be examined by an asylum psychiatrist.
“I seen him worse,” Mrs. Trout said. “Way worse.”
Over the next few weeks, Imogen crisscrossed the entire state of New Jersey. The first snow flurries twirled over small towns, cities, and villages that were little more than a general store and a couple of houses at a crossroads. She visited patients in Lumberville and Raven Rock, in Yardley and Clarksburg, in Nelsonville, Englishtown, and Freneau. She drove highways 1 and 2 and 13. She drove the Lee Highway, the Lincoln Highway, the Victory Highway, and the Lackawanna Trail. She drove south as far as beautiful Spring Lake, home of a chronic depressive who killed herself between the time Mrs. Boxer located her and the day Imogen managed to visit. She saw the not-so-beautiful Belmar and the gorgeous Jersey Shore and the thundering Atlantic on a stormy day that whipped up stormy emotions in the chambers of her heart. She drove upstate almost to the New York border and saw patients in Sussex and Vernon, Campgaw and Oak Ridge. And of course there were patients much closer to Trenton. In fact she discovered that, owing to lax record-keeping, four patients discharged as “cured” were actually inmates in the back wards of the hospital itself.
Every week she summarized her findings in brief patient reports and sent copies to Dr. Ganz and to Dr. Bingham’s office, keeping the originals for herself. Dr. Ganz quickly realized the import of her research. “God in heaven,” he said, “this is not what we’d hoped for at all. Not at all.”
Dr. Bingham, however, seemed bizarrely oblivious of her findings, even happy with her work. He took a more friendly attitude toward her, greeting her in the hallways and every now and again stopping by her office for a quick word.
“Morning, Doctor. How is everything going?”
“Fine, Dr. Bingham.”
“Making progress?”
“Oh, yes. Good progress.”
“Need anything?”
“No, I believe everything’s well in hand.”
“Excellent report on Tadeusz Retkowski.”
Tadeusz Retkowski was a former patient, discharged as “improved,” who had been repeatedly warned by state police over the past few months to stop impeding traffic by walking out half-naked onto the road and shouting at cars, drivers, and horses. He had attacked a local bank manager with a slingshot and was more than likely to find himself back in hospital within months if not weeks.
“Keep up the good work,” Bingham said, slapped the door frame, and bid her good day.
Imogen found it peculiar, and entertained the thought that Dr. Bingham might be helping himself to pharmaceutical supplies. He did not even comment on her discovery of the four “missing” patients in his back ward. To be sure, her overview was not yet complete, but nothing now could make Bingham’s work on focal infections appear anything more than a complete failure—at best.
His wife seemed similarly impervious to reality. Abigail Bingham was a Southern lady through and through, with a Southerner’s veneration of family, loyalty, and tradition. She seemed to be under the impression that Imogen was working with her husband, and made a great fuss when Bingham introduced her. Imogen had been dropping off reports in his office and had been hoping to sneak away unnoticed—the reports once again being far from flattering—when the inner door opened and the two of them emerged dressed up for an evening out. (Imogen had noticed that the couple appeared regularly in the pages of the Trenton Chronicle, attending one charitable function after another.)
“My deah,” Mrs. Bingham said, “you simply must come and have suppah with us one of these nights.”
“Thank you. That’s very kind of you.”
“Nonsense, it’s nothing but the merest good mannahs! You’ll have to forgive the Director. His head is always on such lofty mattahs as scientific research, and simple mattahs like food and good company simply escape his notice.”
“Well, thank you. If I would not be imposing…”
“Of course not—the very ideah. Now I know you only grace our hallways toward the beginnin’ of each week. How would next Tuesday suit? Would Tuesday be convenient for you?”
“Yes. Tuesday would be fine. What time should I come?”
“Oh, the Director is an early risah so we take a early suppah. It’s uncivilized but science ignores so many of the social niceties. You come at seven, and we’ll have time to enjoy a propah visit before we dine.”
“Seven o’clock. Tuesday.”
“We’ll be lookin’ forward to it, Dr. Lang, we most surely will.” Throughout this exchange, Dr. Bingham stood in his wife’s shadow, an ambiguous grin on his pink round face.
* * *
—
To visit the Binghams—at least to visit the Binghams knowing what Imogen knew about the medical director’s treatments and his outcomes—was to visit a reality as separate as that of toothless Ronnie Trout and his wall maps. Their home was majestic compared with any other residence on the hospital grounds. The interior, with its burnished oak and walnut, its ornate mouldings and heroic fireplaces, was an asylum within the asylum. Imogen hadn’t realized how used she had become to the clamour and wail of the criminal wing until she found herself wrapped in the quiet of the Bingham residence.
Before dinner they sat in the drawing room and Imogen answered the many questions of Abigail Bingham. She found herself captivated by the older woman’s manners. Mrs. Bingham presented each question as if it were a little gift—a bonbon to be unwrapped at your leisure. “You have an eldah sistah? And what is her age and station, if one may inquiah? A lawyah! Heavens, you are an accomplished family of fine women, are you not? I feel an absolute slugabed by comparison—an absolute slugabed.”
Rupert Bingham took on a glow as she talked, smiled her way, and nodded silent agreement with her observations. Imogen was struck by how shy he seemed. It was not what she had expected in a man who had pursued such bold, even radical treatments, and promoted them with unabashed vigour in such unscientific journals as the Saturday Evening Post.
At the supper table he came into his own. They were served by an Irish maid who stood, attentive and motionless until called on, by the sideboard. From the moment the opening course of French onion soup appeared the tone of the evening changed, with Mrs. Bingham now adopting the role of her husband’s Boswell. She would broach a topic in a way that invited an expa
nsive response from “the Directah,” allowing Bingham to slip into an anecdote like a flattering self-portrait into a frame.
“My deah, tell Doctah Lang about your arrival at this august institution. Tell her the first thing you did. He’s so modest, you see, I have to prod him.”
“The first thing I did? The first thing I did was to hold a bonfire. It was at the far edge of the grounds, towards Stuyvesant. I had the staff empty the basement, empty the wards, and empty the storage rooms of all restraint devices. There must have been a dozen Utica cribs but also manacles, straitjackets, and bed cuffs. We had the patients help carry them out in a fantastic parade and toss them into a huge pile. Doused the whole thing with kerosene and set it ablaze. That was 1916. I was determined to drag this place out of the Dark Ages and into the light.”
“And the second thing you did?” Here Mrs. Bingham turned once again to Imogen and added, “The Directah can’t beah the slightest indignity toward people under his care.”
“The second thing I did was to close these grounds to the public. Do you know what the locals were doing? Every Sunday they would show up, toting their picnic baskets and their blankets and their children, and they would set up under the elms or in a patch of sun and watch the patients as if they were at the zoo! You’d see children—and even some adults—mimicking the spastics and so on. It was an absolute disgrace. I told the commissioner we’re an asylum not a circus. We house people here—not livestock—people.”
“You were a real reformer then,” Imogen said.
“I have devoted my life to it,” he said. “My sole ambition is to put psychiatric treatment firmly on a foundation of rock-solid science.” For the rest of the evening Bingham overcame the modesty his wife had attributed to him and talked as if he were speaking for the ages. After they had finished their beef Wellington and their peach Melba, he pushed back his chair and folded his arms across his stomach and delivered himself of remarks that he clearly considered penetrating, pausing only when his wife lobbed him another softball. Later, in her room, Imogen wrote down the comments she could remember.
Dentists in this country have a lot to answer for. A lot to answer for.
I am sick of the view—ever more current—that certain mental disorders can occur independent of any changes in the brain. From this view we unhesitatingly dissent.