At eight I tell Emmie to rouse Master Tommy. This morning there was, as always, a brouhaha. The child had had bad dreams, he wanted to stay in bed and did not like the way Cook had made his porridge. As I prepared our lessons in the nursery, which is now the schoolroom, I distinctly heard him say to Emmie, ‘I don’t want beastly lessons. Why can’t you teach me?’
And Emmie’s voice, ‘I am not clever like your aunt.’
‘Auntie Hen smells of old rice pudding, and she’s always cross, and she doesn’t like me.’
The child’s ingratitude is a cross I must bear, for he is your child, although, alas, he grows more like his mama every day.
At nine I began my daily battle.
‘Have you learned the poem I set you, Tommy?’
Silence.
‘Tommy, I asked you a question.’
‘It’s a horrid, gloomy poem, and I don’t want to say it.’
‘Soon you will go away to school where you will have to do many things you do not want to do. You know what will happen if our lessons go badly. Emmie will not take you to see the ostrich race at Batty’s Royal Hippodrome this afternoon.’ I confess that I have taken to offering sensual rewards to make our lessons go more smoothly.
At this he stood up, held his hands behind his back, pouted and gabbled:
‘The coffin by the cradle
Told the struggle that was o’er
Hope whispered in the Mother’s ear
‘Tis but an angel more.’
‘Rather mangled, Tommy. We do not have to catch an express train. Now say it again, more slowly. Try to put some passion into the beautiful words.’
But Tommy is only passionate when passion is not required. After three attempts I sighed and turned to our little catechism. ‘What causes the rain?’
‘Papa says it’s when clouds bump together and water spills out.’
‘And a more spiritual answer?’
‘Oh, I can’t remember. Something about angels.’
‘The drops of rain are the tears shed by angels over the sins of the world.’
‘Why do angels cry all the time if it’s so wonderful in Heaven?’
‘It is not for us to try to imagine Heaven.’
‘I bet I can. Heaven’s the steamboat wharf near London Bridge. When are we going to Ramsgate?’
‘There will be no summer holiday this year, Tommy.’
‘But we always go to Ramsgate!’
His face was red and contorted with rage. I hurried on with our lesson, trying to distract him.
‘What is the date of the invention of paper?’
‘I don’t care. Why aren’t we going to Ramsgate?’
‘What is the longitude and latitude of Calcutta?’
‘I don’t want to go to rotten old Calcutta. I want to go to Ramsgate!’ Tommy bellowed so loudly that I am sure the patients in your waiting-room must have heard and have thought you had a lunatic in your attic.
Emmie knocked on the door and pretended she had to tidy his clothes. He ran to her and sobbed in her arms, making me feel as if I had whipped him when I had merely asked a harmless question.
When the child was calm again I resumed my fight to save his soul. I fear that he may die young like his sister, and, as I frequently tell him, he will not enter the Kingdom of Heaven in his present state. ‘Tommy, have you thought any more upon our little plan?’ He glared at me sullenly. ‘I mean, dear, our uplifting idea that you should renounce your baby books and toys?’
‘It wasn’t my idea.’
‘But when I suggested it you seemed so eager to make the sacrifice.’
‘You said you’d give me a tin of Everton Toffee.’
I sighed. I have attempted to explain to my nephew that virtue is its own reward, but he is a very greedy, sensual child. ‘And have you made the sacrificial heap, as we agreed?’
‘I’ll do it now, shall I? Where’s the toffee?’
‘I shall buy it this afternoon. And tomorrow we will go together to distribute your gifts to a poor family who live near by. I want you to see how children less fortunate than you live.’
He raced around the nursery in his usual fever. ‘Now, Tommy, this is not a steeplechase.’
When he had thrown books and toys all over the floor I examined them. ‘And have you given away all your baby things? I do not see Bertie here.’
He was silent. I knew that he is very fond of Bertie, his toy rabbit, for he takes it to bed with him and even carries it with him during the day. Once, when I was attempting to explain the Holy Trinity and the concept that GOD is in everything, always, he facetiously asked, ‘Will He come back as Bertie?’ Naturally I was obliged to punish his blasphemy.
‘Tommy? Where is Bertie?’
‘He’s in hospital.’
‘Don’t be foolish. You must give him away, too. There is no virtue in renouncing only the things you do not care for.’ Silence. ‘Very well, if you refuse to tell me where he is I shall go and look for him in the night nursery.’
Tommy flung himself at my legs and screamed, ‘No! He’s gone to hospital like Mama.’
‘Now you know that is not true. You have told me a lie, haven’t you, Tommy? I am anxious for your eternal welfare, for this may be only the first of a series of evils. Do not break your father’s heart. Now, give me the rabbit.’
The sacrifice was made. I forgave Tommy, and Emmie has taken him to the ostrich races.
I sit in my pleasant room and gird my loins for tomorrow morning’s battle. I am helping Tommy to become a new person in Christ, and I am helping you, too. How rich my life has become and how thankful I am that I have found my vocation at last, not in Africa but toiling in the spiritual fields of my own family. I no longer fear the future, for I shall not after all be a reduced gentlewoman, eating the bread of charity. I know that I have valuable work to do here, and my reward is to see you every day. How happy I would be to spend the rest of my life beside you.
DR HOOD’S
NOCTURNAL
ILEAVE MY dear Jane sleeping and pass through the door to my other family. Our own children lie peacefully, surrendering themselves to the loving darkness; but for these bigger, older children each night is a monster to be fought. Not with swords but with groans, sighs, mutters, snores, grunts and screams.
I take my candle and move through the long galleries, locking and unlocking doors with my master key. Sleep will not come to me until I have patrolled these other sleepers and made sure that they are as safe as the shipwrecked can be.
Here in the basement lie the most desperate and violent. They are no longer in cages or chained to beds of filthy straw, as in the all too recent Monro past, but lie in cells padded with cotton where they may not harm themselves or others. These suffering ones are given harmless morphine to help them sleep, and I almost envy them the deep ocean of dreams in which they bathe.
My insomnia began when I was a young doctor, on call day and night, and my years in asylums have not eased my condition. I have so much work to do, I cannot waste time sleeping. When I do, for a few hours each night, my slumbers are punctuated by tables of statistics and ranting voices. I hear these lost souls call my name and summon me back to my duties. My Jane says that to lie beside me in bed is as restful as taking a nap at Paddington Station. She calls me her Puffing Billy and says I charge through sleep at fifty miles an hour, in such a hurry to reach morning that I hardly close my eyes. But she does lie beside me, thank Heaven, and in her arms I know my only rest.
Here on the ground floor are the new admissions, with whom I converse at length. I like to hear them tell their own stories and do not accept what families and so-called friends say about them. If we knew more of their real lives many of their delusions would not seem so absurd. We all have our deranged intervals, and I believe that most of my charges may be cured within a year. Otherwise, what is the difference between a certificate of lunacy and a lettre de cachet?
Our patients have separate apartments at night, with a keepe
r to watch over them and to make sure that they do not abuse themselves or others. One of my colleagues, Stephen Wheeler, performs cliterodectomies on women who persistently indulge in manualization. In my opinion female masturbation is not a cause but a consequence of insanity, and it is most painful to witness the frenzied, almost convulsive transports of these benighted creatures, who frequently become epileptics, nymphomaniacs, hysterics or prostitutes. How noisy they are tonight. These corridors echo with their paroxysms, moans and soliloquies, which are frequently indecent, quarrelsome or both.
I love to watch their sleeping faces as I try to solve the mystery of consciousness. The sleeping may resemble the dead, but they are very much alive, vulnerable and open. My fellow insomniacs open their eyes as I walk past, and I glimpse their secret lives like clouds scudding across their inner skies. Others toss on their pillows in that enigmatic state between waking and sleeping. Sleep is a great leveller, melting distinctions of class and time. I have always believed that Shakespeare must have observed the insane, perhaps in this very hospital when it stood at Bishopsgate. Hamlet, Macbeth, Ophelia and King Lear are observed with such truth and accuracy that I often expect to meet them on my nightly rambles. Indeed we have many Ophelias here.
Cupid is a knavish lad,
Thus to make poor females mad.
Tonight I start on the women’s side of the building. We have always more women than men, for mental alienation is of more frequent occurrence among females than among men. I believe there are a variety of causes for this: disorders of the menstrual function, pregnancy, parturition. In the male sex the active pursuits of business or pleasure more quickly supplant tender impressions. The development and decline of the ovarian and uterine functions at the two great epochs of a woman’s life affect her mental and moral condition. Men and women do not experience madness in the same way, and females are more subject to a monomania of vanity: they crave praise, attention, admiration and homage.
Marriage is for women the point at which all future and past hopes congregate. For us men, marriage is a shield against ourselves and our passions, but for women it is all. Their susceptibility of mind and delicacy of frame make them tragically vulnerable to disappointment, and their education arrests the development of their bodies, leaving their mental powers untaught. It encourages sordid and selfish feelings and vapid sentimentalism instead of a realistic view of life. I have told Jane that I want little Louisa and our own daughters, if we have any, to have a rational and thorough education.
Most of my women patients have been maids or governesses, like dear Jane. She calls me her Perseus and says I rescued her. The fate that was nearly hers, to rot for the rest of her life in a squalid private asylum because a cynical young man took advantage of her, is never far from my mind. Many of these women have similar stories: they are all Jane. When I enter these wards during the day I am thronged by women who press my hand, ask my advice and whisper to me. I do not tell Jane that several of them are convinced I am their husband.
Here on the ground floor are the women who have recently been admitted and those who have been promoted from the basement. The structure of our hospital is a little like Dante’s cosmology, although I like to think that we have no Hell. No, that is not true. Our inferno is in the criminal blocks beyond, and I have no control over them. But here inside the main building real progress is possible. By their own efforts my patients move upwards until they are ready to leave us.
I observe these new admissions, interview and examine them, trying to identify their secret past life, the real cause of their disease. In the document Jane and I are preparing for Lord Palmerston my patients are reduced to initials. But as I wander here among them in the shadows of the night I call each one by name, silently, hoping to protect them from any more evil than has already befallen them.
Ann Wells is mild in manner with a round face and gentle brown eyes. Now, as I watch her sleep, she looks like any other plump woman of forty. Her prevalent delusion is that the Pope follows her about and harasses her. She recognizes in many strangers, including myself and the butcher’s boy, a likeness to His Holiness. She is quiet, industrious, attentive to all the requests of her nurses and thankful for every kindness. However, the delusions still continue, and whenever she speaks of the Pope I observe her eyeballs roll, and she stutters. Her husband, a carpenter, brought her here three weeks ago and assured me she had always been mad as a hatter and there was nothing more he could do for her.
But Mrs Wells has confided in me that her husband ill treated her, beating her and going with other women when drunk. As a young girl she worked as a maid in a convent in Brompton and became very fond of the nuns, who were kind to her and gave her some education. I believe some half-digested idea of an all-powerful male has fused with the husband she is terrified of.
Elizabeth Thompson is an imaginary thief with an imaginary fever with which she is afraid of infecting others. Now she is sleeping and looks calm, but during the day she will not employ herself in any way and sits before the fire with her hands covering her face, lamenting her miserable existence and all the trouble she has caused. She would be a pretty girl were it not for the cloud of shame and guilt that envelops her. Although she is only nineteen she is convinced she will meet some horrible death, either by fire or devoured by animals. This is to be her punishment for the sins she imagines she has committed. She is in the best of health and as far as I can discover has never stolen anything, but her self-belief has been stolen from her. Every day she tearfully begs to be allowed to remain one more night here. She is always on the look-out for cats, and when she sees one she goes and talks to it as if it was human. I have tried to discover more, but she is rambling in her ideas, constantly muttering.
Elizabeth was brought here by her father, a respectable-looking carter. Her mother died when she was very small. I have offered her the chance to visit her father at home, accompanied by a nurse, but she will not go.
One page in our vast admissions book is never enough for the infinite complexity of an individual, and here we have three hundred and fifty individuals. I must care for them all; I am in a sense their father.
Their delusions cannot be removed by joking or argument. One of Pinel’s patients was convinced he had been guillotined during the Revolution but that judges demanded that his head should be replaced on his shoulders. He had got the wrong one, which he very much disliked. ‘Look at these teeth! Mine were exceedingly handsome. These are rotten and decayed.’
Esquirol, on the other hand, humoured his patients: a woman who suffered from headaches was convinced that animals were burrowing into her head. Esquirol pretended to extract an earthworm from a hole he had made in her forehead. A man who believed he had frogs in his stomach was cured by purgatives and frogs placed in his night stool.
But I think such deceptions are immoral and quackish. I am suspicious of all miracle cures and want to cure my children by kindness and wisdom, not fraud and folly. Like all fathers I have my favourites, and one of the new female patients, Nina Sanderson, fills me with an interest I must hide from all but myself.
When she was first brought here, one night two weeks ago, she was hysterical. She made such a commotion that I heard her from our little house under the portico and came through the door into the entrance hall, where she lay on the carpet writhing and screaming. Our new matron, Mrs Dunn, tried to soothe her, releasing her from her strait-waistcoat and reassuring her, ‘You will be in excellent hands here.’
Most unusually, her husband is a doctor, a handsome fellow of about forty. He and his manservant had brought his wife here in a carriage. I did not like the calm way he handed over Mrs Sanderson and her two certificates of lunacy as if she were a large and vociferous parcel. I returned the strait-waistcoat to him, for we do not allow any instruments of restraint inside our hospital now.
Dr Sanderson completed the necessary paperwork and told me that his wife had been suffering for some months, ever since the death of their daughter, fr
om the delusion that she has travelled through time to the remote future. She actually disappeared for several days, and her husband has reason to suspect that she was abducted and that criminal conversation may have taken place.
He gave me this account in a flat voice as we stood over the prostrate, sobbing form of his wife. It was almost like looking at a mirror image of myself. How often have I taken refuge in professional unfeelingness to escape the painful ravings of patients. But this was his wife - I was reminded, most unpleasantly, of those scenes when I removed my own dear Jane from her incarceration. Having established that there was no history of insanity in Mrs Sanderson’s family and no previous attacks I dismissed him rather curtly and turned my attentions to the poor lady. I administered two grains of acetate of morphia and kept her in my observation ward.
There has been much to observe. As I have always maintained, some of our patients are so reasonable that it is necessary to live with them, to join in their pastimes and talk to them extensively, before pronouncing them mad. I recall Roger Cuthbertson, a solicitor who appeared to be of the most respectable character, until one day he bit me on the nose and screamed, ‘If you don’t discharge me by tomorrow I shall issue a writ against you.’ He proceeded to take off all his clothes and demanded to go out into the street. There are many twists and turns in the dark and disordered mind, and the causes of alienation must be understood before they can be removed.
For the first few days Mrs Sanderson was tearful, restless and fidgety. Then I gained her confidence, and she began to speak to me openly of the tragic loss of her little daughter Bella. She spoke fondly of her husband and then broke off with a puzzled air, as if thoughts had swept away the path of her words. Although no longer young - she is twenty-eight, the same age as I am - she is a woman of considerable charm and beauty (not that I would allow myself to be influenced by that in any way).
As soon as she was well enough to converse she assured me she was not mad. Then she proceeded to talk about and draw London in the year 2006. Her drawings are well executed and so curious that I mean to show them to Haydon and Richard Dadd. It is clear that these strange pictures proceed from an overheated imagination, and yet she is otherwise quite rational. I have told the nurses and attendants that she should be treated with particular tenderness and benevolence, and indeed she is already a great favourite with patients and staff alike. She helps in the women’s garden we are making of the former airing-courts and is clever and industrious. Yet she remains under delusions as to circumstances which could not possibly have happened. Now she sleeps, protected by the arms of Morpheus, whose excellent drug is of such benefit to us.
Nina In Utopia Page 15