by Sarah Moss
She turns back towards the house. She must do something, get something done. She has been speaking of writing a paper, perhaps something for the new British Journal of Asylum Medicine, but the truth is that so far she has not even a title, only the vague idea that there is a widely recognised category of patients who appear to pass their entire adult lives recovering when confined and relapsing upon release. She wonders if anyone has tried to invent at least a temporary refuge from both the madhouse and the mad home, a compromise between an institution and a family. A place where people chose to be, not a place of confinement. A convent, an Oxford college, only with a less formal hierarchy, without vows. A place of healing, for those who know where to go afterwards, but perhaps also a permanent abode without the stigma of an asylum for those whose need for a sanctuary will not pass. And if asylum medicine is beginning to concern itself with treatment as well as containment, it is time to learn what makes people sane as well as what makes them mad. Mad-doctors must question their assumption that sanity is obvious, requiring no study. There are few settings less appropriate for scientific experiment than a county asylum, where the variables are beyond anyone’s control, but a smaller setting, with a few carefully selected patients . . . An institution where the damage of homes, of domestic life, can be undone, or at least healed. A place where the shape of sanity might emerge. It’s an idea, not an essay, and claiming to be thinking about writing hardly qualifies as work. She needs a job, a position with set hours and a salary. She needs time to pass without having to push every minute up a hill.
Really, Alethea, you dare to complain of inactivity when you know the deadly overwork of your fellow beings, treated as no more than beasts of burden to keep the looms and spinners working? You who have witnessed children sick and dying because their fathers have no work can yet bemoan your own boredom?
Oh, stop. Go away. She finds herself sometimes wishing Mamma dead, going even so far as to imagine poison or, more satisfactorily, a knife to the heart, blood spreading like spilt milk across the floor, but increasingly she is just tired of Mamma. Bored by her. Tom’s latest letter says that Japanese peasants believe that the symptoms of madness result from possession by demonic foxes. It is in some ways an appealing idea, to blame the foxes, to imagine demons in one’s head. But she must not make Mamma into a demon, nor allow herself to fall prey to any form of superstition. The clock downstairs whirs as it does before striking. It is almost time for tea.
She opens the door to hear laughter from the drawing room, and to see Annie’s coat and hat on the stand. Annie must be back from Bath, where she has been covering the absence of another doctor at the Lying-In Hospital. Annie has always liked the slow chattiness of Obstetrics, the narratives sustained over weeks and months and the frequent happy endings. Annie doesn’t worry that female obstetricians are just glorified midwives, their acceptance a way of making sure that women doctors don’t threaten the central expertise of men. Naturally a woman doctor will be especially suited to the crises of women’s lives, Annie says, and anyway if one obtains a family’s trust at the birth of the first child one is almost guaranteed the role of their primary physician; it is an excellent beginning to a practice of one’s own. But Annie does not seem to want a practice.
Ally hangs up her coat beside Annie’s and rubs her cold hands.
‘Ally?’ calls Aunt Mary.
The door opens and there is Annie, all shiny hair and blue gown and skin that looks powdered whether it is or not. She kisses Ally’s cheek; the drift of floral scent and the brush of warm lips on a cold face.
‘Ally! How are you?’
Annie stands back and looks Ally up and down, sees her three-year-old skirt and jacket showing signs of wear, her blouse with its dated frilled collar.
‘I’m well, Annie. And you?’
‘Tired. I don’t wonder Dr. Kerry went away for a month. But there were some good cases. Triplets, Al, can you believe? The smallest one a good four pounds, and all doing well.’
She’s studying Ally as she speaks.
‘The poor mother,’ Ally says.
Annie holds out her hand, inviting Ally in. ‘She came through it nicely. The tea’s just made. And there are crumpets.’
Aunt Mary, nursing a cup of tea on a saucer in her lap, a gilt-edged plate holding a slice of sponge cake on the occasional table beside her chair, smiles up at Ally. ‘There you are. A nice walk? It’s getting chilly out there.’
Ally sometimes thinks Aunt Mary and Annie would get along beautifully without her. Buttered crumpets to ward off an early nightfall.
She sits down. ‘There are snowdrops. In the square.’
Annie pours a cup of tea and hands it to her, remembering lemon-not-milk and no sugar. ‘They were out in Brighton. And there are palm trees! From certain angles one could think oneself in France.’
Annie and her family have been to France several times, to the Normandy coast in summer and once to Paris, where Annie’s father offered each of his daughters an evening gown from an atelier of which even Ally has heard.
‘There are palm trees in Falmouth,’ Ally says. She cups her hands around the porcelain tea cup and lets the heat sear her fingers. ‘I think I know what you mean, Annie. It doesn’t feel quite like England either, not until you notice the red-brick houses behind the bougainvillea. And it’s so far away. Further than France.’
She remembers flowers like scarlet irises that grow in the corner of the stone wall and the garden path, the profusion of the fuchsia’s magenta bells cascading through cast-iron fences along the terraces high on the hill, and beyond the town gorse flaming along the cliff tops and upland heath. She remembers the woods that in a few weeks will be dusted and then blanketed with bluebells. The bluebells are quite startling, said Tom, and when you see them you will know that I am on my way home. She sips her tea, feels the heat trace her oesophagus. She needs to go back, she thinks. It will be better there.
‘When you and Tom are settled again, may I come and visit?’ asks Annie. ‘Cornwall always sounds so romantic.’
She and Annie could walk on the coast path while Tom is out at work. In summer, they could picnic on the rocks of Castle Beach and perhaps take the train to St Ives where Annie would enjoy the cobbled lanes and the ancient chapel on the hilltop.
‘It can rain for weeks. And some of those picturesque fishermen are desperately poor. But I’d love you to visit, Annie, truly.’
She will return to Falmouth, and the summer will come again and the sea sparkle in the early mornings. She has not thought properly of Tom, of his body and his smile, for a long time. She must write to him, now he is settled in Kyoto, and describe the snowdrops and the news of George’s success at Cambridge. For the first time in weeks, she thinks of the globe, of Tom there on the other side of it. There is snow in Kyoto still, but the days are lengthening as they are here and the skies are blue over the white mountains. She turns the ring on her left hand, which fits better than it did a few weeks ago. With this ring, I thee wed. With my body, I thee worship. Really, Alethea, are you fallen so far as to find justification in your marital relations?
‘Are you quite well, Ally?’
Aunt Mary sets down her cup and lifts her feet from her footstool. ‘I believe I forgot to ask Mrs. Hayfield about the soufflé. Do excuse me, girls.’
Girls no more, Ally thinks. They watch Aunt Mary’s upright back, her bustled green skirt, cross the room.
Annie sits forward. ‘Ally? You looked suddenly pained.’
Ally closes her eyes. Annie won’t question her sanity, won’t send her to the asylum. Probably.
‘It is Mamma’s voice. Her remarks. It’s not an auditory hallucination, I don’t imagine that her voice makes sound, but she is always in my thoughts. Questioning my motives. I cannot decide to go for a walk without reflecting that perhaps it is an act of self-indulgence to fritter away my time so, or then to remain at home without
reproaching myself for idleness. If I do not eat I think that perhaps I am seeking attention and excuse for inactivity by remaining weakened and thin, but if I enjoy Aunt Mary’s table I am guilty of sensual indulgence. And I cannot tell any longer which thoughts are mine and which hers.’ Which reason and which madness, or whether it is her own ideas or Mamma’s that represent a rational mind.
Annie reaches for Ally’s hand and then thinks better of it, but Ally wouldn’t mind, not just now. ‘She is a terrible woman.’
Ally shakes her head. ‘No, Annie. She is capable of great kindness and endless, selfless work for the good of those who receive nothing from anyone else. She has given her whole life to the untiring service of the most degraded women and looked for nothing, no gratitude or appreciation, in return.’
‘I know. But it seems that the cost of such dedication has been paid by you and May, and your Papa.’
Ally’s throat hurts. ‘No. No, we must not say that. That a woman must choose between her work and her family obligations. That she must devote herself first and always to her husband and children. No-one says that of men. She has a right to her work.’
Annie shrugs. ‘To be sure. But also an obligation to her children, and indeed the obligation that we all share: to be kind to each other. There is no exemption, short of insanity, from kindness. Tell me, Ally, do you intend a large family?’
‘No. You know that.’
‘If you have a child, will you employ a nurse?’
‘You know that too. But Annie, our work is paid. It allows for the employment of nurses. And May and I had Jenny, and then went to school. Mamma was not neglectful.’
Not yet, it isn’t paid. Not in Ally’s case.
‘Oh, Al. She was negligent. At best, negligent. Whatever her virtues elsewhere. It isn’t the point, the politics of women’s pay. Tell me more about hearing her voice.’
But it is the point, Ally thinks. Annie is able to say otherwise only because her domestic life is easy, because her parents appear to live without recrimination. There is no separation between what Annie calls the politics of women’s pay and the formation of women’s minds. Mamma was trained to philanthropy, not to a professional life. Mamma was taught to set no price or value on her own time and effort, to understand her own labours merely as the justification of her existence. The labourer is worthy of her hire, Ally thinks, though she wishes her mind would not produce a Biblical text as the last word on any given subject. It is not as if Mamma’s own girlhood equipped her with the opportunities she made sure to give to Ally and May. It is not as if Mamma had the choices, or indeed the Dutch rubber device, available to Ally. Mamma also is a creature of circumstance, of history and location, as are we all. Mamma works, Ally sees, because she does not believe that she deserves to live. Mamma justifies herself by work. And so does Ally. There must be better metaphors for life than money, than numbers. Consider the lilies of the field, Mamma. How they grow, they toil not, neither do they spin.
‘Her voice is disabling. It makes any action impossible. If I read, I am guilty of indolence but if I do not read I reveal the trivial mind she always feared for me. If I take tea with Aunt Mary I am indulging in gossip and gluttony but if I keep to my room it is because I wish to draw attention to myself. I think I need something to do. Some work, something real. I have too much time for self-reflection and self-questioning.’
And you believe, Alethea, that you should work not for the good of others but because it will be of benefit to you? For amusement, for diversion from the burdens of leisure? Think then of all those women laboured to exhaustion and looking only to death for release and say again that you want work as a rest from self-reflection.
It doesn’t matter, she thinks. It doesn’t matter why I work, if the work is in itself useful. It doesn’t really matter whether I take a walk out of boredom with the comfort of the fireside or because physical exercise is healthful; there is no recording angel, Mamma, noting each cup of tea not taken, each skirt patched and dragged out another season. Denying myself butter on my bread, even if I go out that very morning and give the butter to the nearest soup kitchen, will do nothing to alter the fate of all the children of this country born and yet to be born into grinding poverty. For that one would need a different kind of change, a revolution. For that one would need to turn the nation upside down, and perhaps that is what Mamma should be doing, if the hungry are to be fed, the children of the masses educated and the stain of poverty wiped from the land. But that is not what Mamma wants. As the nurses could not bear to see that the mad are just like us, only sadder, so Mamma cannot bear to see that the poor are just like us, only poorer.
‘Ally?’
Ally meets Annie’s eyes. Dear Annie, who is able to accept her manifest blessings without opening an existential account, and to do the work to which she is called without holding a running trial in her head.
‘I was thinking about Mamma, and my patients in the asylum. I was thinking that everything could be different.’
Annie reaches towards her again. ‘Many things could be different. But Ally, are you sure you want to stay in mad-doctoring? Forgive me, but it does not always seem perhaps the best line for you. To be so constantly exposed to such distress, to pass your days among those who—well—’
‘Those who hear voices?’ Ally asks. ‘Those who cannot tell their own minds, who cannot walk but cannot be still, cannot work and cannot bear idleness?’
Annie gasps. ‘No, Ally. Please. I did not say that. Dear Al. I did not.’
Ally looks up at her. ‘And you did not think it? Come, Annie. Do you think I have not questioned my own reason? I found myself hiding in the bushes in the park on Christmas Day for fear of my parents’ pursuit. I wept in the corridors of the asylum and shouted at the nurses that we are all more like the patients than we know. A mind can be aware of its own danger. I have perhaps not been mad but we cannot say that I have been without the symptoms of a deranged mind.’
And I hurt myself, she thinks, I remembered that only pain sings louder in my head than Mamma’s voice. I remembered that sometimes the pain I cause myself can eclipse the harm she does to me. But also that I hurt myself for her, because I do as she wishes and she wishes me harm.
This time Annie takes her hand. ‘Very few of us reach the ends of our lives without times of derangement. Through grief, or rage, or encounters with the spite or ill-will of others. I did visit the asylum, you know, last summer after you said it was every physician’s obligation to know what they are like. The saddest cases were not the most mad. There were those to whom delusion would be a blessed release, who were tormented by the knowledge of their own damaged intellects. But you did leave. You came here, and now you are better, I think? It was a breakdown of the sort to which fine minds are subject.’
Ally squeezes the hand.
If she were to be confined, she thinks, Annie would still visit her.
If she were to be discharged, Aunt Mary would still take her in.
There are people who like her whether she walks or reads, takes tea or stays upstairs. They do not love her for her work, or for her prize, but for herself. She cannot see why but she can see that it is true.
‘I dare say they didn’t show you the back wards?’ she asks.
‘I am ashamed to say I didn’t ask. I wanted to get out. The smell, and all those locks. I couldn’t work in such a place. I like to be with women having babies, and I’ll keep working in the lying-in hospitals but I like it when they have flowers in their rooms afterwards and a good fire and everyone happy that they are doing well.’
‘And when they don’t do well? Or the babies die?’
Annie looks down at their linked hands. ‘Then I do my best. I try to say the right words and I go home and tell Papa what happened. Sometimes he tells me his cases too.’ She looks up. ‘Papa and Henry have asked if I would join their practice. Henry says if they cannot beat wo
men doctors they must join them.’
Henry is Annie’s brother-in-law, Ally remembers. He used to work at St Michael’s hospital and never liked the idea of women doctors.
‘You will accept?’
Annie nods. ‘I can keep on living at home. No worries about house-keeping or anything. I will be quite free to work. And of course to go to the theatre and see my friends. I have spent quite enough nights in boarding houses and hospital bedrooms.’
And what when your parents die, Ally thinks. What when there is no longer anyone to look after you, to see to the laundry and the cooking, the cleaning and the chimney-sweeping and the paying of bills so that you can attend the rich of West London in their pleasant homes and go to the opera in the evenings? But then Annie, probably, will move in with her sister and brother-in-law and be welcome there. Envy is corrosive. Annie is her friend. And Annie has chosen—several times—not to marry, to remain unentangled, to depend as she so easily does upon her family and her friends for company and affection. If therefore thine eye be single, thy whole body shall be full of light. We make our choices and then we live with them, but nothing that we can choose exonerates us from the need for kindness. Ally draws a deep breath.
‘I’m very happy for you,’ she says. ‘It is just right. A perfect plan. Your Papa must be delighted.’