These Good Hands

by Carol Bruneau

  II

  … AND WILL NOT TAKE OR KNOWINGLY ADMINISTER ANY HARMFUL DRUG …

  MONTDEVERGUES ASYLUM

  MONTFAVET, VAUCLUSE

  11 SEPTEMBER 1943

  “Doctor says you’ve made nice things with clay,” was how I broached it. Be subtle, never too obvious, Sister always said.

  I set the pail in the middle of the floor, having hauled it up to Mademoiselle’s room from where the farmer had deposited it in the refectory. Escorting Simone’s replacement had provided the opportunity for me to collect it. When I had mentioned Simone to Head Nurse, I was told, “That poor creature? Don’t give her another thought. She’s gone to her family in Nice. Sometimes, if rarely, cures can happen, you know.” She had spoken with such conviction — why, she’d signed the release herself! — which only added to my unease.

  Mademoiselle eyed the bucket. She didn’t make a peep as she watched me transfer her jottings to the bed, but when I spread the tabletop with newspaper she ground the stumps of her teeth. I found it impossible not to dwell on a note scribbled in her file, regarding a self-made remark about her caprice and inconstancy. The contents leaving the bucket made a disgusting plop.

  The patient sat on her hands. “To think I modelled the most exquisite mother and child out of such shit.”

  No need for foul talk, I bit my tongue to keep from saying. The muck was dug and delivered that morning, the fellow had said. A greyish brown, it smelled of dung. I prodded it with the stick I’d used earlier depressing her tongue, a routine oral check. “Something to keep you busy, love. The merits of recreation can’t be overstated.”

  She gave the mound a poke using her index finger. For one indelicate moment she looked about to taste it.

  “It’s not chocolate, dear.”

  But she seemed to have another beef. “You don’t expect me to knead it, surely? Criteur! I need my assistant, Criteur.” That small, plaintive voice suddenly haughty, insulted. “You can’t expect me to work without a model.”

  Be kind, be patient. Be willing to play along. So I struck a pose: chin up, chest out, perfect posture if I do say so. But Mademoiselle glowered and stubbornly folded her arms.

  “If you would be so good, give me my pencils. I prefer not to soil my hands.”

  After the trouble I’d gone to — not to mention that of my accomplice, who supposedly raised pigs but hedged, very conveniently, on the location of his or any farm. “Come now. So much brooding on paper, Mademoiselle!” I suppose I spoke from experience. “Making something nice will do you good and pass the time.”

  “Writing doesn’t?”

  For someone inconstant and capricious, my goodness, the guest was obtuse, constant in her self-absorption. More writing would produce more letters, more pressure to flout hospital policy. And Head had just reminded me at the start of shift that no matter what the directeur said — “his laxness notwithstanding,” as she put it — the rules on sequestration were to be obeyed. Unswervingly.

  Sighing, Mademoiselle timidly pinched off a bit of the stuff, rolled it between her trembling palms. The effort couldn’t have been all bad: a faint smile curled her lip. Closing her eyes, she caressed the mud, stroking, squeezing it, pulling and stretching it. What she laid upon the newsprint made me blush, I must say. Quite a specimen — that aspect of male anatomy the nuns deemed unmentionable, but we’d all seen our share of, though in my case, only a couple of times intimately, truth be told. Textbook illustrations hardly count.

  “From memory,” the patient cackled, taking obvious delight in my reaction.

  “Well. You have a good one, then. Memory, I mean. Though I’m not sure what the orderlies will make of this.” My best attempt at humour.

  Not that she noticed or was even listening. “Criteur?” she addressed nobody, or nobody visible, then eyed me squarely. “He had the patience to pose. But not the physique, alas. Though it’s spiritual substance we look for. So you, Soitier Polange … you needn’t bother posing.” Grimacing as if it pained her, she closed her fist around her handiwork. Greenish slime oozed from between her fingers. She let the thing fall to the floor, then, quite innocently, held out both palms stained that foul colour. “It’s useless, don’t you know? When one can’t see properly — a torture, to lose one’s gift. You have no idea, do you, do you, how desperate it feels being blind.”

  Patience, patience, I could almost hear Sister Ursula’s voice. Deep breath in, deep breath out. “Now, now. That speck above your bed, Mademoiselle? You see it, yes? Tell me what it is.”

  “A fly. Of course.” But her eyes had a dewy look.

  If necessary, count. Slowly, while breathing. Running my tongue over my bottom molars, I counted these, while bending to scoop up the offending object. Its mud felt warmed by her touch. It felt vaguely improper, too, and I dropped it quickly into the pail, as if it were a real appendage that deserved a proper disposal.

  Fortunately I’d had Novice drop off a supply of good hot water. I cleaned off our hands — the patient’s, then mine — and set about straightening the bed. It meant tiptoeing around the guest, because once more she was engrossed. She had retrieved another blob of mud, prodding and pinching it into something like a face — recognizably human, with a nose so lifelike I blinked. What Mademoiselle accomplished was rather remarkable, really.

  “The orderly will come to tidy things up. I asked him to, once you’re done.”

  She barely glanced up.

  This business was a lot messier than jigsaw puzzles or crocheting, but at least it didn’t involve dangerous tools, thank my lucky stars. Not too much harm could be done by an aliénée using her bare fingers. “There, dear — see what you can do without fussing over anything sharp?” Like a nib, I meant — and better had kept to myself, I realized too late.

  “Sharp!” she lit into me. “Lunatics screaming and laughing! Blades slicing up my heart, my mind. These aren’t sharp?” Then her voice dipped. “Scrapers, rifflers, chisels …” She continued rhyming something off, half under her breath.

  Save for the racket from the hallway, the only other sound was the feline licking itself. An inspiration. “Maybe you could make a cat? No trouble getting it to pose, Mademoiselle. Seeing how it likes to sleep.”

  She gnawed her lip, weighing the pros and cons of divulging some dreadful secret? “Once, if you are at all interested … if you care to know … I could sculpt the human form to make a man weep. My mother and child was every mother and child ever born in the world.” She gave the mud a vicious shove.

  Novice couldn’t have picked a better moment to arrive. The patient three doors down, “the one whose fever didn’t take last time,” was prepped for a second treatment. Cadieu expected me to start it. As if I’d forgotten.

  “Fever!” Mademoiselle was quaking. “Boiling a person like a lobster! You, Nurse” — those eyes bored into mine — “that someone who pretends to be so sweet could be a torturer!” Shaking her head, blocking her ears to any protests, she spat, “Isn’t that what you are?”

  ***

  IT IS A well-known fact that the success of fever therapy hinges on the nurse’s skill. Novice had everything ready — pressure cuff, stethoscope, thermometer, washcloths. No fever cabinets available, unfortunately, so treatment had to be given the old-fashioned way. I was relieved that today’s recipient wasn’t Mademoiselle.

  Steam rose from the tub; this in combination with the room temp soon accelerated my pulse rate, a sure sign the procedure would go off effectively. The guest, a girl suffering from hysteria, squirmed a little — “No one enjoys having this done, dear” — when we got her into the tub. It took both orderlies to apply the restraints. I pumped up the cuff — “Pay attention now, Novice” — and noted the pulse rate: steady and smooth. Testing the water temp, I admit I winced. It was hotter than hot, scalding. Within minutes — “Excellent, love” — sweat beaded the patient’s face. She kept keening. One orderly helped hold her under while the other augmented the hot. The patient stopped shrieking
enough to ask how long the treatment would take. “Only five or six hours,” I said. Optimum results required up to twelve, but no point upsetting her.

  It took Novice, plus an orderly borrowed from Men’s, running back and forth to replenish the bath at optimum temp. One hour in, the patient’s temp remained steady, despite her racing pulse. Her blood pressure dropped abruptly — very good, and critical for sending the body into its restorative state of shock. Fever is gentler than coma therapy, I repeatedly told myself, fighting the patient’s thrashing. It would’ve been much easier, a lot more efficient, with a cabinet, designed to raise and maintain body temp significantly higher and equipped to spray hot or cold water as needed.

  After two more hours, body temp at 40º Celsius, the treatment began to take effect. The patient stopped fighting and her eyes became filmy. Her skin, red earlier, now appeared colourless. It might’ve been cause for alarm, but the textbook and Dr. Cadieu agreed that a body temp of 41º is vital for success. The duration of the febrile period depends on the disease, the patient’s condition and the physician’s judgment, I recited to myself. The utmost care must be taken to observe minute changes in vital signs.

  Then the pulse became almost non-existent and the eyes rolled insensibly. An orderly of all people had the presence to pull the plug and add ice, a bucketful of chipped ice hastily obtained from the refectory. Someone else, Novice perhaps, helped apply cold cloths to the wrists and temples. As the tub drained, a warning — the excessive build-up of fever causes many fatalities — pounded inside my head, as I grappled with the patient’s to hold it up. The same orderly wrested the patient, dripping and unconscious, onto the tiles. Only Novice’s quick action, covering her with towels soaked in ice water, revived her.

  The individual’s tolerance threshold must never be overstepped. Aftercare indicated a cooling sponge bath, an alcohol rub, cold compresses for headache. Check. No such care, however, for rattled, distraught personnel. The only treatment available for us was the quick mental run-through of a checklist, our nurse’s code of conduct:

  1. Like it or not, a nurse is a teacher. Good, average or poor is not an option.

  2. Listen attentively. Engage patients in diversionary conversation as needed. Dead silence frightens or depresses the sick and is especially bad for those requiring distraction.

  3. Cultivate a confident, cheerful manner. A dead, expressionless voice is unattractive and to be avoided.

  4. Never whisper. Never tiptoe. Whispering and tiptoeing are irritating to the healthy and fear-inducing in the sick, inviting anxiety in all but the imbecile who will think their condition has taken a turn for the worst.

  The exercise hardly restored my nerve before I was called to treat another hysteric. I raced to administer Veronal by suppository. A shot of chloral hydrate would have done nicely but for the patient’s automatism — rather violent head-banging — which would’ve snapped the hypodermic in two. It took both of our orderlies to restrain her. After that was a case of nervous exhaustion, which meant employing the crib; it took three of us to subdue this guest on her back in order to secure the lid. “Escape that, Houdini!” Novice said.

  “All in a day’s work,” said Head Nurse.

  The doctor appeared as I was helping myself to a sip of water. “You’re interested in sine-wave therapy, aren’t you? If you hurry, Nurse, they can use you over in Eight — behind Men’s.” Cadieu’s calm, I might add, goes quite a long way, whether she means it to or not. “Head can spell you for an hour or two, I’m sure.”

  In Lyon I had, on a few occasions, assisted with electroencephalograms, at least: shaving patients’ heads, helping the technician fix electrodes to grease-pencilled Xs on their scalps. The jumpy, scratchy noise of the EEG machine tracing their brainwaves had been rather relaxing. I tracked down Cadieu’s colleague in a small, windowless room, where the attending physician merely gave a nod. “Cadieu sent you? That’s good.” The sight of the thin, sallow patient strapped to the gurney made my stomach contract a little, and my throat go slightly dry. On cue I bandaged the guest’s jaw shut. The air’s staleness — yes, better ventilation would certainly help in such situations — made it hard to breathe deeply.

  When I was told to help apply the paddles, I hoped the bandage was tight enough to keep things from breaking. Watching the convulsions, most violent through the extremities, was a bit distressing. The smell of scorched hair and skin, of burns to the patient’s temples from the paddles, made me queasy. It also dispelled the questions I’d formulated, rehearsed even, while looking forward to the present procedure. The treatment was almost over before I could ask, strictly to clarify, “It’s always given without anesthetic?”

  Part of ECT’s desired effect — also a slight drawback, I’d discovered in my reading — is that it mimics that of guzzling copious, near-toxic amounts of icy wine. A freezing effect, if you will, on memories, blotting them out. Could the therapy have a peripheral effect on those applying the shocks? It took my mind off the fever treatment, which I had, despite all precautions, clearly mismanaged.

  “Can you stay for a couple more treatments?” the doctor asked, as soon as the patient was wheeled out.

  I began explaining how short we were in Ten, when a nurse stepped in to relieve me — relief being the operative word.

  ***

  RETURNING TO PAVILION 10 offered a certain reassurance, a sameness. The guests’ automatisms, if not exactly predictable, were at least known.

  Compared to the sine-wave therapy, tidying up from Mademoiselle’s occupational therapy would be a piece of cake. Neither Novice nor the orderlies had thought to do so, I discovered, too hard-pressed to peek in on her till after Quiet Time. She’d shoved the whole mess, clay, newspaper and all, onto the floor, and in the process managed to get the wall, muddy spatters sticking to the plaster. It was enough to give me pause, I must say. Mud also decorated Mademoiselle’s blanket, though her clothing had somehow escaped sullying, not that another layer of dirt would matter. The head and face she’d shaped was now an indeterminate lump.

  “Oh dear. After you did such a lovely job —”

  She turned on me then. “You say you are my friend. But you’re like the others, and I refuse, do you hear, I refuse to help you!” Her voice trailed off, but she was only gathering steam. “That you would use me! Ah — and because my beautiful mother-and-child was stolen you would trick me into making another. All so the scoundrel and his cronies — my jailers! — can profit from this poor old woman’s misfortunes.” She hurled a last bit of mud; the cat, napping atop her papers till then, scurried for cover. “I expected more from you,” she railed, sounding genuinely wounded. “I believed it too, that in your kindness, Miss Poitier, you were a friend. The only one I have in this place willing to help me.”

  A presence breathed behind us: my supervisor, who’d picked now of all times to do her rounds. “What is going on here, Poitier?” Head’s tone would’ve curdled milk.

  I took Mademoiselle’s hands in mine and held them tightly, soothingly. In my steadiest voice, as if Head were far away doing paperwork, I asked about the statue of hers. “Tell me about it, dear — the one that’s of a maman?” I helped the patient to the bed. “I wish I could see it — I’ll bet it’s every bit as nice as you say.”

  From the doorway Head gave a sympathetic cluck. “Clean up here, please, and see me downstairs,” she ordered, went clicking off.

  Now Mademoiselle was crying soundlessly, slumped against my arm. “You could see it — if only you could get it back for me. I mean no harm to anyone, you know, Solange Poitier.”

  “I mean no harm either, love.” Flummoxed, I braced for the request sure to follow.

  “You will find it for me, won’t you.” The patient’s smile showed a strange resolve — perhaps even hope. Perspiration beaded her broad forehead. “Before I die, I would like it back. Then you could see for yourself. Everyone could see, everyone who doesn’t believe that, once, my eyes were wide open … saw what others’
didn’t. Couldn’t.”

  Along with everything else, no one had thought to remove the washbasin. Wringing a cloth, I went to give her brow a quick wipe. She shrank away at first, then yielded — like camembert in my hands, Novice would say. It seemed opportune to ask, “Did they ever try coma therapy on you, Mademoiselle — or fever?” It was the only explanation — logical, maybe — for her aversion to water, but the information wasn’t in her file.

  Gloom filled her eyes. “Where water should be for drinking, Miss Poitier — fresh water and love all the sustenance I ever needed! — here they make it an instrument of torture.”

  “So they did treat you.” I asked very quietly, “Did you feel the benefit?”

  Mademoiselle just gazed back, all brazen and defiant. Her voice was agitated, querulous. “Find my work. Then perhaps you’ll do one more thing? Bring paper, please — and don’t bring more clay. Do not,” she repeated, as if I were stupid or about to argue. “And promise you will not deceive me any more.”

  ***

  DOWNSTAIRS, HEAD WASTED no time confronting me. “You have no business upsetting a guest. Any breaks with procedure must be cleared first with me — understood? I would’ve told you, Cadieu tried — and failed — years ago to interest Mademoiselle in that exercise. Sculpting,” she snorted. “If you’d thought to check, we’d all have been spared grief, not to mention a fine mess and extra work. We’re here not to befriend the guests, Poitier, only to care for them.”

  “Of course,” I said, and hesitated. “Maybe I’m a touch confused. But if protocol’s to be observed, shouldn’t it be consistent? I thought patient release was up to Monsieur Directeur, that he signed …? Granted, in Simone’s case, if we’d all attended to her more closely —”

  She cut me off. “Who?”

  ***

  IN THE QUIET of my room, simply too pooped to undress, I stretched out in my uniform — just till the feeling comes back in your feet, I told myself. I didn’t want varicose veins, a Nightingalian woe for sure, to which the best of us are prone. Then I sat up, with Essentials of Medicine braced against my knees and some graph paper — the back of an electroencephalogram salvaged from the pile on Head’s desk marked “D” for deceased/destroy — for stationery. The peaks and valleys of someone’s brain activity, the brain of a stranger safely dead, formed red zigzags over the blue-checked paper, mimicking some illegible hand. Bound for the dustbin, the paper was perfectly usable and better than nothing, though there’s something slightly creepy about a brain being outlived by its recorded impulses.