No Way to Say Goodbye

by Rod Madocks

  His transfer to the special unit was accepted in early December and a little while later I found myself walking the main block corridor on a chill day, the boiler house at full stretch with wet sleet mixed with sooty particles falling from the long silver chimney. I saw a shambling line of patients with their escorts approaching along the corridor. My usual vigilance was a little relaxed and I was surprised to see Lynch suddenly swing out of the line and lunge at me despite the yells of the escorts. His face was contorted with rage as he growled, “You fucker, fuck you, with your lies about me, I will get you, you will pay for it, that’s a promise.” He then spat at me before the staff hustled him away. I brushed his spittle off me and continued down the corridor where, beyond the portholed windows, I could still see the grey flakes continuing to stream down as I went into the canteen for the staff Christmas dinner. Those lines from Lombroso that I used to love came back to me: Quand le neige tombe noir, B ... sortira de ma memoire.

  Chapter Five

  Black Doll

  I did not then realise all that Max would mean to me when I first saw his sweaty broad face in the review meeting. He had been recently transferred to Alder Villa and now stood his ground. His feet were planted a little apart to steady himself as he swayed about in the review room, holding onto the back of the chair keeping us at bay with his angry protestations.

  Alder was a quiet annexe in the hospital, with a long balcony area attached to it surrounded by a few, straggly viburnum shrubs. In the 1920s the tubercular patients were left out in their beds there in the belief that fresh air would clear their clotted lungs. It had remained as an invalids’ villa in the hospital ever since, inhabited by elderly patients and by the chronically sick. Max was newly placed there because of his diagnosis. The registrar to Dr Reed — a bluff young Irishman with a rugby club tie — walked along with me, briefing me about Max and his illness as we passed the seated patients in the day rooms. We were interrupted for a moment by a thin, elderly man who had spotted me as a newcomer, got up, took a few wavering paces towards me, and announced with quiet pride in a high, clear voice, “Good morning sir! I am the oldest patient in the hospital! I am eighty-two!”

  He proffered his tremulous hand to me which I ignored. I never shook hands with the patients now, having learned the games of dominance that they so often played. The registrar commented, “That’s Ernie. He is our oldest, but by no means the least dangerous. Hit a woman with a sock that he had filled with rocks. He had followed her in a public park, two days after we last let him out to a probation hostel at the age of seventy-six.”

  We both chuckled and shook our heads with grim professional humour as we threaded our way through the clatter and bustle of the morning shift; the sound of music from the patients’ radios and the whistling of the cleaning staff as they buffed the floors.

  “Now our friend Max here,” continued the registrar as we manoeuvred along through the throng, “well, he was set for a career on the PD units, an out-and-out psychopath you know, but began to cough you see, and sweated and had lower back pain, hid it doggedly-like, until he couldn’t hide it any more. Well now, no surprise when he came out with an abnormal radiograph and the lung section proved it, stage four, undifferentiated, large cell carcinoma of the lungs, our boyo has got three months tops. That’s why we want you. We need to decide what to do with him.”

  We sat facing him in the review rooms as a thick February mist rubbed itself up against the barred windows. Max remained on his feet, twisting about and refusing our offers to sit and make himself comfortable. He was clad in a blue cotton shirt, his sleeves rolled up from the institutional heat of the villas, with a rose-shaped tattoo showing on his left forearm with the characters LL inked in above. He still looked so strong, so alive; there was a real vigour to him. I imagined the blood pumping the proteins that fed the abnormal cells deep in his lungs. There was also something familiar about him which I couldn’t quite place, something in the deep-set hooded eyes and down-curving mouth. Not an unpleasant face when seen in repose, but as he yelled and snarled at us, I saw something that could be much more frightening. I continued gazing at him as I sat in the review rooms with Tina Reed, the registrar and nursing staff. We were also accompanied by the physician from the patient treatment centre as we tried to explain his diagnosis to him and its implications.

  “Perhaps we need the chaplain,” murmured Dr Reed as Max began to yell at us.

  “No, doctors, you have got it wrong. There is nowt wrong with me that a bit of building up won’t cure.”

  Eventually his rage subsided and he stumbled forward to sit in his chair, putting his head in his hands, and then looking up to glare at us from time to time, “My God! No. I do not want to hear this!” he suddenly erupted again. “I’ll have my solicitor on you, torturing me like this. I have ’ad too much to cope with as it is.” He muttered into his hands for a while then lapsed into an unresponsive silence.

  After a while, it was clear that we had reached an impasse and we dismissed him. “OK, Max, you can go,” said Dr Reed. He stomped out and went off to crouch in the lounge day room where we could still see him, through the translucent panel in the review room door, furiously rolling a cig and shaking his head to himself. We remained in discussion.

  The registrar asked, “What’s the prognosis?” as if he did not know, directing the question at the physician who looked after the primary care unit.

  “And shouldn’t we stop him smoking?” added Dr Reed.

  “Well, it won’t make much difference,” said the young brusque physician. “He is end stage really. X rays show that it’s in his lymph nodes and in his bones. It will usually show in the legs and hips next. He will get sicker quite soon and he won’t be very mobile. We can start giving some chemo to slow the process but really it will be palliative care that he needs.”

  Dr Reed said, “The hospital is not really equipped to look after him but where could he go? We have already had to shift him with escorts back and forth from the local hospital. It’s a strain on staff resources. He should really go into some sort of hospice. We will have to sort out the legalities of it, but what about the risk? Jack, could you look at his notes and give us an informed view about him and his risk, what we would have to think about? I guess security will have to be involved. He would also have to be conditionally discharged by a tribunal.”

  “Sure, I’ll check on him,” I agreed, and walked away from the villa into the mist.

  As I strode off down the path between the villas I could hear the rooks making a muted cawing somewhere in the murk beyond the perimeter wire. My mood was lowered, whatever he had done it was grim to see such a distracted and doomed man, although a thought kept nagging at me. I could not make out where it was that I had seen him before. I am sure I had passed him on the blocks corridors a few times over the last years. Max was one of many out of the hundreds penned up here with whom I had no direct dealings, although I tried to scan most of them. No, it was something more specific that nagged at me.

  At the next opportunity I went to the records rooms above the blocks and waited impatiently for the gurney to come trundling along bearing his close-packed notes. The large, buff ledgers fell open to form the usual archaeological layers depicting a patient’s career through the system. Max had come in to the hospital by court process in 1988; he would have been twenty-four or twenty-five then. Interestingly, he came from the city and was originally arrested there. He must have been swilling around the detention system at the same time that I was trying to track Kress. The index offence was attempted murder.

  One hot August afternoon he had presented to the casualty department of the main city hospital, asking for help, saying that he had head problems, wanted a rest, and wanted to be helped because he could not control himself. He was seen and screened and then turned away by junior staff. There were the original Accident and Emergency flimsy contact sheets in fading violet ink in the notes, with the diagnosis written in: acute situational reaction then in la
rger slanting capitals in a different hand NPD. NPD stood for No Psychiatric Diagnosis. It meant that this man had no definable or treatable mental illness in the opinion of the junior, or his registrar. Max was just one of hundreds of the disturbed, the damaged and the angry who washed through A & E’s doors.

  He left a quite detailed account of what happened after that with later clinicians, which was easy to reconstruct as I turned the brittle pages in the large files. After he had been turned away from the hospital he returned to wandering in the city centre, drinking from a bottle of White Lightning. It had been a sunny Saturday afternoon during an August heat wave. He finished the bottle and walked down past the strolling crowds and the rattling fountains with empty drink cans floating in the green water. Buses full of weekend shoppers drew up and departed in a haze of diesel fumes; pigeons scurried in droves, looking for discarded scraps and shop girls swung their legs on the council house steps. A gang of punks were laughing, perhaps they were laughing at him. On the studded leather of their coats, he read emblems of his own demise. One had the message “Why?” picked out in stud heads. The word “Why” turned in his head.

  He went into a sports goods store and bought a knife, a lock knife with a bone handle, quite expensive, with an engraved blade showing the image of a leaping salmon. He stepped from the store and took a taxi through the crowded streets. He asked to be dropped at the railway station — it was only a five minute journey. He paid his fare with his last £5 note and as the driver leaned forward to find change from a bag under his seat Max thumped the knife into the taxi man’s back between the shoulder blades, the point of the blade wedging in the fifth lumbar vertebra. He left the knife wagging there as the driver slumped forward. Max rummaged under his victim’s legs as he choked and gasped and he took the hidden money wallet from under the seat, then wandered away casually into the nearby railway station. He bought a platform ticket and sat ostentatiously eating sandwiches and drinking bottled beer at the railway buffet while speckles of blood gleamed on his shoes. He was arrested soon by transport police after he was pointed out to them by passengers also waiting on the platform, and who had sensed the menacing strangeness of the man.

  It had been a pointless crime. A decompensatory act as the psychiatrists identified it, borrowing from cardiology the concept of decompensation, the temporary scrambling of the balancing systems of the body. This decompensation had engendered an act that had ensured his removal to a secure place. He was also identified as a dissocial personality disorder and by that label they incorporated all the nameless hurts, abruptions and losses that had gone to create that envelope of emptiness that was Max.

  There was little in his notes to explain the development of that personality. He had been born in the northern suburbs of the city. His father was a textile worker. He had died when Max was sixteen, of lung disease caused by dust from the work fabrics. His mother developed an anxiety disorder which prevented her from venturing out of doors very much. She coped by taking the new-fangled diazepine doled out by her family doctor and by drinking sherry in the afternoons before Max got back from school. His younger sister Theresa kept the family going by her selfless care and support. Young Max was a sour, isolated adolescent with a poor concentration span and a disconnection from the feelings of others. He hurt the family cat; he attended school rarely and hung around the local woods, starting fires there, watching them blaze all day. He was no good at games. One day the school sports pavilion burned down. Max was questioned but nothing was proved. He used to steal pointless items from his friends and family. His mother eventually kicked him out and he drifted among the drinkers and the vagrants of the city.

  Then we know less about him. He was convicted of the statutory rape of a thirteen year old girl when he was eighteen, did three years in young offenders’ prison then was back out in the city, labouring on building sites, doing van deliveries and some cabling work for a phone company. As I mused over the case, I reflected that he was just like the older Kress; really they were brothers, sembables. Their mutual denials and lack of connection with people linked them. I found a comment scribbled in the margin of one of Max’s reports “this is a man without conscience” written by a medic or forensic psychologist.

  Yet, still, I did not see it. I turned to other tasks, helping the staff on Alder Villa prepare for his removal to a hospice. I even went to the women’s villas at his request to explain his illness to his girl friend Maeve, who was another patient in the hospital. She was an arsonist, one from the small contingent of women detained in that male environment. They used to hold hands at the dances at the Blue K, the patients’ social club. I also supervised the packing-up of his belongings from the block ward where he was kept before his diagnosis. I was approached there by Mattie Dread, a young patient who sauntered up as I watched the nursing auxiliaries heaving the heavy cardboard boxes filled with his scrap books and old newspaper clippings.

  “What up wit’ Maxie sah?” asked Mattie.

  “Maxie is not well and will not return to this ward. That is all I can say,” I replied,

  The auxiliaries laughed and one said, “He is even sicker than you, Mattie, and that’s saying something.” Mattie made no reply, just making a clicking noise of disapproval in the Caribbean fashion.

  As spring turned a month later, I had still not recognised Max until one day when I was hurrying to the review rooms on the villa, distracted and late. I rushed in, a little breathless, fidgeting with my keys and joined the review which had already started. He glared at me irritably as I entered. He had visibly begun to decline by then. He had constant pain and night sweats. Chemo had resulted in his hair dropping out in patches. It had then grown again unevenly, long at the sides and thin and wispy on top. He seemed resigned, slouching there in a light-coloured shirt, his thick tattooed left forearm and the metal band of his fake Rolex gleaming in the review room lights. His belly prodded through the shirt and the light reflected on his shiny, sweaty forehead.

  “How are you Max?” said Dr Reed.

  “Alright miss — I mean, doctor. Thank god that chemo has stopped. It played hell with me hair.”

  He drew his fingers through his hair and turned to one side to show his snub-nosed profile. I connected him in that instant. That’s where I had seen those deep set eyes and shiny brow. I sat through the rest of the review looking at him from one side and then another, listening to the account of the legal moves taking place to release him from the hospital on the grounds of his terminal illness. After the review I rushed back to the archives and ordered up a gurney. I carefully checked his year of admission and lifted down the original admissions file and there he was on the front sheet as expected, the image from the plate camera showing Max full face and side view in large definition. Younger, fuller-faced with down-turned mouth and his hair cropped very short to show the gleaming scalp.

  I rocked back on my chair, those files heaped up close to me in that little room next to the roof rafters. I remember looking at my hand as it rested on the file, noticing the slightly puckered skin, the diamond-shaped ridges and the speckling of sun blemishes across the knuckles. So many years had passed, grasping for this moment and even then I could hardly believe it. Could it really be him, sidling up after all this time, ushered in through a back door? The man with the shaved head, caught by the camera in the Paradise Stores, and perhaps the same snarling man seen in a van a little later in his white tee shirt on the night of the 4th September so long ago? The police perhaps not finding him because he was already in their system. And, he had been in the hospital all along while I scented and sniffed around him.

  I drove home quickly that afternoon with the windscreen wipers battering as fierce, spring squalls swept the countryside. Already playing in my mind was the vision of me entering my flat, dragging out the old folders with their rime of dust and unbending the stiff, yellowed newsprint to reveal that security camera image striding back from the past.

  *

  The yellow bars of the ex
ternal vehicle-lock gates opened, accompanied by the whooping noise of a warning klaxon. An atlas grey Mercedes people carrier, with especially strengthened, smoked windows and a meshed, rear cage purred forward then halted. Security gave the exterior of the vehicle a last sweep. Inside the carrier, Hobman sat in a wired enclosure and looked out of the dark windows. He could just see the outside world through the glass and he confronted his own reflection there. His hair was thick and grey now, the nose more bony and pronounced. Images still coiled on each cheek and his temples despite offers of laser removal. His three escorts settled in as the vehicle glided away with Hobman scanning the gate, the wall, the fence, the grass between fence and wall and the swooping ditch beyond that.

  He had not been out these gates in fourteen years and there was an intensity in his gaze not readily apparent to the escorts who looked back at him through the mesh of the cage. He appeared to yawn and then to stretch a little, shifting in his seat in his borrowed Topshop black suit which was a little tight around the chest and shoulders. He continued to view intently the sports field, the white blur of the old score boards, the bowls court and the staff car parks.

  The clinical team had deliberated a long while before making the decision to let Hobman go to the funeral. The older sister of that blighted family had died of breast cancer a week before. Hobman had often tried to contact Fiona over the years, writing her love letters full of fury and regret, which were not allowed to be sent. The delusional intensity of that obsession had seemed to ebb over time and the number of his letters had diminished in recent years. After her initial diagnosis she had several years of life and she tried to build a cautious connection with him, sending him birthday cards and a few simple gifts. Hobman remained quiescent all that time. She eventually arranged to visit him and they met briefly in a hospital review room accompanied by four escorts, her husband and the other remaining younger sister Nikki. The meeting lasted ten minutes. Fiona was already frail and ill. Brother and sister sat with few words between them, they held hands for a while and Hobman gave her a gift he had made in the day workshops. It was a tiny model of a sail boat, a skiff or barque with unfurled sails.