I believe that Bea’s intentions, in taking me to the fourth floor first may have been calculated, for on leaving the relative order and normality of the second, which we visited last, I had regained my composure to a passable extent. Here the rooms were furnished in a perfectly orthodox manner, simply but cheerfully, with curtained windows, vanity stands, chintz-covered chairs and all the ordinary appurtenances of a woman’s boudoir. There was a common room, as well, with an old upright piano, a writing desk, bridge tables, playing boards and racks of tattered magazines. The patients were neatly dressed and groomed and exhibited at least a social degree of self-control. Several of them asked me intelligent and courteous questions and expressed their pleasure at meeting me.
When we stepped out of the building into the bright morning sunlight I felt exhausted. Bea made us a cup of powdered coffee in her office, and we chatted for a while. I was not very attentive, and I think she must have sensed this, for her conversation was very general and untechnical, as if her purpose was not to equip me with any more information for the moment but to study my reactions to the morning. She said that she would see me again after the evening O. T. meeting.
I spent the afternoon with Bob, working, to my great relief, with second-floor patients. I found this so absorbing that my apprehensions of the morning disappeared very shortly into my fascination with the work. Our first patient was a Miss Behrendt, a slender, intense, darkly pretty girl of about twenty-two, with a sullen manner and enormous energy. She asked to be taken walking, and we accompanied her at her own ferocious pace up the back road past Doctors’ House (the big old farm building where many of the resident doctors live), Crowfields, and the pond. She strode with her fists in the pockets of her poplin jacket, her chin held very high with a look of contempt for us and our obvious difficulty in keeping abreast of her. Beyond the pond the road turns to the left, continuing on out of the hospital grounds and joining the state highway which runs adjacent to them; she made directly for it. When we were within a few yards of the road Bob stopped and said, “We’ll have to go back now, Miss Behrendt.”
“Why?” she asked indignantly.
“I’m sorry, but you’re not allowed out of the grounds.”
“I went to the movies in Stonemont just two nights ago.”
“You had town privileges then, but they’ve been revoked since.”
She stared at him for a moment, her face growing pale with rage, and advanced one foot slowly in front of her. Her socks and shoelaces were plastered with little green “beggar lice” pods from the weeds that grew along the roads.
“There are burs in my shoelaces,” she said. “Take them out for me, please.”
“We’re your attendants, not your servants, Miss Behrendt,” Bob said easily.
“Take them out immediately.”
“This isn’t a very good way of getting your privileges restored.”
“What do you mean by that?”
“I mean that I’ll have to report your behavior, and if it doesn’t improve you stand a very poor chance of getting your privileges back very soon.”
“Are you trying to bribe me?”
“No.”
“I’m going to report that you attempted to bribe me.”
“Just as you like. Now let’s go back to the Lodge.”
She stood staring at him, her nostrils whitening with tension, and said shrilly, “This is outrageous. Outrageous!”
“Are you ready to go now?” Bob said.
She turned swiftly and walked back, at an even faster pace than we had come, toward the Lodge. When we had returned her to the floor, Bob took me into the office. The charge nurse here is Miss Jackson, a younger woman than most of the charge nurses, with red hair and a droll and melancholy face.
“How was Behrendt?” she asked.
“Pretty nasty,” Bob said.
“She’s been getting high for the last couple of days. You’d better write it up.”
“Yes.”
She handed him a report form, which he explained to me as he filled it in, writing the patient’s name, the date and the time of the contact. Below, he wrote a brief summary of her activities and behavior: Patient asked permission to go walking. Surly and uncommunicative. Attempted to leave hospital grounds by entering state highway. When detained became hostile and defiant. Threatened to report being bribed. No physical violence.
He signed the report, Robert Clayfield, O. T., and returned it to the nurse.
“We make these reports after every contact,” he said. “They’re very useful to the doctors. They can be pretty brief, but they ought to include anything unusual that happens.”
“I see.”
“What else can we do for you?” he asked Miss Jackson.
“I’d like to get Meaghan out, if I can. She hasn’t been out of the building for days. See what you can do with her.”
“All right.”
We knocked at Mrs. Meaghan’s door and were admitted by a cool, cultured voice, slightly European in quality. Mrs. Meaghan sat by her window reading a paper-bound French novel which she lowered into her lap, her forefinger dividing the leaves, and smiled at us formally. She is a slight, fastidious, Latin-looking woman in her middle thirties, with very fine features, a mass of black, severely styled hair and a constant controlled expression of pain. She said it was “very kind of us to call” but could not be persuaded to leave the building, as she was sure she would be done harm to. “I have many enemies,” she explained to me gently.
“I’m sure you’d find it was perfectly safe,” Bob said. “In any case, we’d be more than capable of protecting you.”
“It is very kind of you. Perhaps another day. I would enjoy playing cards for a while, though, if you have the time.”
“Yes, of course,” Bob said. “Shall we go in the common room?”
“Yes, perhaps we would be more comfortable.”
We sat in the common room and embarked upon a game of five-hundred rummy, Mrs. Meaghan manipulating the cards with a graceful shrewdness that reminded me of a countess playing baccarat. It was now about three o’clock in the afternoon and the room was illumined with a soft golden glow from the afternoon sunlight, which fell halfway across the carpet and our table, casting a rime of radiance on motes of dust and strands of hair. The room was full of warm silence, broken only by the occasional creak of our wicker chairs or a murmured comment on the play, and a sense of peace, strangely innocent and nostalgic, like that one experiences in looking at old faded photographs in a family album—of people in straw hats, huge mustaches and ankle-length skirts, gathered about an ancient automobile and smiling into the sunlight of a long-forgotten afternoon—a timeless peace, undarkened by any future or anxiety. We had played for perhaps ten minutes when, stealing tranquilly into the still, archaic climate of the room, as if to furnish it appropriately with music from another time and world, came one of the loveliest sounds I have ever heard: a fragile, plaintive fluting of woodwind notes, ruefully, tenderly unreeling the melody of a folk tune, “The Ash Grove.” I lifted my head to listen, enchanted by the sound.
“What is it?” I asked.
“It’s Miss Arthur,” Bob said. “It’s a little flute she plays that she made herself. It’s very pretty, isn’t it?”
“She plays quite magically,” Mrs. Meaghan said. She turned her head toward the open door, suspending the game for a moment while she listened. I could judge the extent to which she was moved by the fact that she laid down her cards, exposed, upon the table. In a moment, her eyes darkening, she turned to Bob and said, “I understand that you have limited her playing to certain hours. I think that’s monstrous.”
“I haven’t,” Bob said. “It was a staff decision. Some of the patients complained, I believe.”
“Monstrous.”
We resumed the game, rather perfunctorily, and I was scarcely conscious of the play for the next several minutes, listening to the shower of clear cool notes in the still room, stretched out sometimes in a liqui
d tremolo, like the quivering of a drop of water detaching itself from the tip of a leaf, or sprinkled in bright arpeggios, as if shaken from wet branches by the sudden springing of a squirrel. She played another English ballad, “Sweet William,” and then a song that I had never heard, of indescribable beauty. It had much of the quality of a folk tune—the poignant air of melancholy and the same delicate progression of notes—but something far more intense, as well: a kind of barbarous innocence, like that of the most savage Scottish ballads, but strangely notated and unfamiliar in its quality, as if the music had been spun out of some unknown culture, long since forgotten or not yet evolved. It was, as Mrs. Meaghan said, a magic sound. As great an interest as I have in folk music, and as familiar as I am with much of it, I have never heard a melody like this, and find myself extremely eager to meet the performer of it.
Our last contact of the day was with Warren Evshevsky, a tall scholarly-looking boy whom I met yesterday with Bea. Although he has ground privileges, being lodged in Field House, he asked us to play ping-pong with him, and as the rest of the second-floor patients seemed to have been provided for, Bob agreed. There is something very attractive about Warren. He is slow and solemn in speech and movement, and there is a curious shyness and indirection about the quality of his thought, as if he feared to consider anything too categorically. He has long and very beautiful hands, the nails of which are bitten so deeply that I could see tiny clots of dried blood flecking the pink, exposed quicks. He is very conscious of this, and keeps his hands hidden as much as possible, having even developed a Chinese-like habit of walking with the tips of his fingers interlocked, to conceal them. He murmurs to himself almost constantly. Although Bea told me yesterday that he had been a linguistic prodigy, he seems deliberately to avoid all intellectual subjects, and pointedly evaded the early remarks about language with which I had hoped to appeal to his interests. He seems to be obsessed with physical illness; he paused every few minutes as we played to take off or put on again a light woolen jacket that he had brought with him, explaining shyly that he felt either “a little chilly” or a “bit warm.”
The evening O. T. meeting was very interesting. The day’s activities were discussed briefly but comprehensively, with each worker giving a resume of his contacts, elaborating on any unusual behavior or attitude, and offering his opinions as to the progress or decline of his patients, while Bea questioned us and took occasional notes. She asked me to wait after the meeting and we had a bottle of soda together from the dispensing machine inside the shop. She asked how I had got on, and I gave her my reactions as frankly as I could. These, in spite of my general enthusiasm and interest, included the confession that I felt some qualms at the prospect of working alone with patients.
“I would be surprised if you didn’t,” she said. “Even workers who are training for a career in O. T. feel that way in the beginning. After a week or two we’ll know much better what your permanent reactions will be.”
She is a delightful person; not really pretty, but attractive because of her warmth and intelligence. She has soft short brown hair, which she frequently lifts her hand to stroke in a pleasant feminine gesture, not of vanity but of concentration, frowning sometimes while she does so; and gray eyes of slightly different shades of color, which gives her round, rather old-fashioned-looking face a strangely disorganized appearance. I feel that we shall get on very well. She asked if I had formed any preferences among the patients I had worked with, and I said that I had found Warren Evshevsky the most interesting and sympathetic of the few that I had met and Miss Behrendt perhaps the least so.
“Yes, Warren is a very nice person,” she said. “Everyone is fond of him. He’s made a great deal of progress since he’s been here, but for the last few months he’s been in a terrible state. He’s fallen in love with one of the women patients. That happens sometimes, of course, and it’s always very difficult.”
I asked how such a situation was handled.
“Well, if one of them is indifferent, it isn’t so bad. But if they share the feeling, then it’s much more difficult. We have to chaperone them, of course, if they’re together; but if one or both of them have ground privileges, that isn’t always possible. Usually it means that one of them has to have his privileges limited in order to prevent clandestine meetings. It isn’t fair, but it’s the best we can do. It’s awkward, all around. I’m particularly anxious about Warren because he’s such a sensitive soul and, when he’s depressed, strongly suicidal; and he seems to have it awfully bad. I’ve seen him stand under her window for hours, listening to her play her flute. She plays a little wooden flute that she made.”
“Oh, I heard her this afternoon,” I said. “She plays beautifully.”
“Yes. She’s a fascinating girl—one of the most interesting patients we have, and the most difficult. None of us can do anything with her.”
“Does she feel the same way about him?” I asked.
“No, not at all. I’m afraid it’s going to be very hard on him. She’s not the kind of person it would be much fun to be in love with.”
She locked up the shop and we strolled across the grounds in the warm spring evening.
“Are you going into town?” I asked.
“No, I live here on the grounds, in the dormitory. I only go into Stonemont to the movies once in a while, and about every three months I go into Washington on a real binge and get tighter than a drumhead.” She smiled at me in a professionally intimate way—as if already I shared with her a deep enough mutual feeling about this work to appreciate the feigned irony of her remark—which delighted me. I think it’s fortunate for Bea that she is such a dedicated person, or she would be very lonely; or perhaps it is her loneliness that has made her so. I feel there is a great deal I can learn from her. From everyone here.
I am going to get into bed now and read for a while. I am reading The Red and the Black, which I think is a very powerful book; but I do not have much hope for Julien.
Grandma woke up just now, and I heard her call out in confusion, “Oh, Sonny, are you hurt? Have they wounded you?” I went down the hall and opened the door of her room very quietly and tiptoed in to their bed. She was asleep again, lying with her beautiful old work-worn hands curled up into fists with fear, and I could see the moonlight glinting on the gold band of her wedding ring. I kissed her on the cheek and whispered, “I’m all right now, Grandma,” and she murmured, “Thank the Lord.”
FRI., APRIL 17:
This morning we had Case Histories. These are read to us in the lecture room by Dr. Lavrier, who is a sort of liaison officer between the professional and O. T. staffs. He is a remarkable man—not older than thirty-five, I would guess—whose appearance does not correspond at all with my idea of a psychiatrist’s, as he wears a checkered sports jacket, a pink shirt and a spotted bow tie. He also has an aluminum-stemmed pipe of very complicated design, which looks like a piece of laboratory apparatus and around which he has developed a whole repertoire of manual mannerisms. This very dapper style of dress has been adopted, I think, as concealment for a painful sensitivity which gives his boyish face a strained and rather sorrowful look and invades his voice sometimes in the form of a nervous tremolo. It is an appearance which seems very much at odds with the precision and grasp of his thought, the swiftness and insight with which he understands and replies to inexpertly worded queries, and the expression of essential seriousness—even of severity—of his eyes.
The lectures—one of which is delivered to us every week—are to familiarize the therapy staff with the personal and medical histories of the patients they work with, and are fascinating in themselves. This morning’s history I found particularly interesting, as the subject of it was Mrs. Meaghan, whom I met yesterday. She was the child of an American mining engineer living abroad, and was sent, from the ages of ten to sixteen, to a Catholic boarding school in Belgium. Here she developed a homosexual relationship with a classmate, an English girl of her own age, an affair which went on for nearly two
years. When it was finally discovered, both girls were sent home in disgrace, and Mrs. Meaghan spent the next several years under the very closely confined and troubled surveillance of her parents, who apparently were shocked and embittered by the affair. She became more and more subdued and eccentric, and at twenty-four was married, more or less at her parents’ instigation and in what seems to have been a combined experimental, punitive and precautionary measure, to an English tutor, an ineffectual and complaisant man of thirty-seven who had been engaged to complete her education. The marriage was tacitly subsidized by her parents, and for the next three years the couple lived a retiring life in Berne. Here she renewed her association with the English girl, who had in some way discovered her whereabouts and begun corresponding with her. When the English girl moved, finally, to Berne and took an apartment in their immediate neighborhood, Mrs. Meaghan began very rapidly to deteriorate and had finally to be hospitalized. She does not believe that she has ever been married, although strangely enough she consents to being addressed as “Mrs. Meaghan.” She has also developed “paranoid fantasies” about the Catholic Church, believes that it is conspiring to exterminate her, and has a terrible fear of anyone in clerical clothing. Neither will she recognize her parents or her relationship to them, insisting that she was a Belgian foundling whom they adopted. Her great obsession now is to locate her “true” parents, and to this end she engages in endless correspondence with European orphanages and welfare societies, which she keeps filed carefully in a large cardboard carton in her room. Her illness is also marked by frequent and periodic depression, during which she will not feed or clothe herself. She has an institutional history of three previous hospitals—two European and one American—and is considered to have made considerable progress, particularly within the last eight months of her stay here.
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