by Will Self
‘I thought a lot of anorexics and bulimics grew out of it?’
‘To some extent, but there’s always a hard core and at the moment it seems to be growing. These long-term anorexics are different, they’re placid, resigned and apparently unconscious of any motivation. The temporaries tend to be wilful, obstinate and obviously powerfully neurotic. These hard-cores, like Hilary, could almost be psychologically blameless. Some of them even have fairly stable relationships. They’re at a loss to explain what comes over them, it seems to be somehow external, imposed from elsewhere.’
I should have been paying attention to what Busner was saying, but I couldn’t concentrate. For a start there was the strangeness of the situation – I’d only ever spent isolated periods of a few minutes on psychiatric wards before. I had known what to expect in broad terms, but it was the relentlessness of the ambience that was beginning to get to me. There was something cloacal about the atmosphere in the women’s ward. None of the patients seemed to have bothered to dress, they sat here and there talking, wearing combinations of night and day clothes. There was a preponderance of brushed cotton. I sensed damp, and smelt oatmeal, porridge, canteen; indefinable, closed-in odours.
I could walk away from the tonsured idiot on the Heath, but inside Ward 9 I was trapped. And these people weren’t pretending. They weren’t closet neurotics or posing eccentrics, Bohemians. They were the real thing. Real loss of equilibrium, real confusion, real sadness, that wells up from inside like an unstaunchable flow of blood from a severed artery. I felt my gorge rising. I felt my forehead, it was sandpaper-dry. Busner was neglecting me and talking to a pneumatic nurse. The nurses on Ward 9 didn’t wear a uniform as such, rather they affected various items of medical garb: tunics, coats and smocks, nameplates and watches pinned at the breast. This nurse had a man’s Ingersoll attached by a safety-pin to her jacket lapel. She had blonde baby curls, bee-stung lips and the creamy, slightly spongy complexion that invariably goes with acrid coital sweats. I forced myself to listen to what they were saying, and fought down nausea with concentration.
‘Take her out to the optician then, Mimi, if she has to go.’
‘Oh, she does, Zack, she can barely see a yard in front of herself. She can’t be expected to deal with reality if she can’t see it.’ The voluptuous Mimi was squidged on to the corner of the table. Behind her stood a short woman in her thirties with the hydrocephalic brow and oblique domed crop of an intelligent child. She stared at me with sightless eyes.
‘Rachel shouldn’t really be off the ward, considering the medication she’s on.’
‘But Zack, it’s a walk down to the parade, ten minutes at most. Give her a break.’
‘Oh, all right.’
‘Come on then, Rachel, get your coat on.’ Rachel bounced away into one of the bays. Mimi lifted herself off the edge of the table and winked at me in a languid way.
‘Come on, Misha, we’ve got an admission for you to see. I’ll leave you at the front desk. Anthony Valuam will pick you up and take you down to casualty.’ We walked out of the women’s dormitory and back to the association area. Tom, my friend from the earlier part of the morning, was back behind the nurses’ station, reading his dog-eared Penguin. Busner despatched me to wait with him by giving me a gentle shove in the small of my back, then he crooked his finger at a scrofulous youth in a tattered sharkskin suit who sat smoking and disappeared with him towards his office. Tom put down his book and treated me to another little conspiratorial exchange.
‘Has the good doctor given you a little tour?’
‘We’ve been round the ward, yes.’
‘Beginning to catch on yet?’
‘What do you mean?’
‘Well, who did you get introduced to? No, don’t tell me. Let me guess. You talked to Clive and then you saw a lot of other male patients quite quickly until you ended up scrutinising Hilary’s watercolours.’
‘Err … yes.’
‘And did Zack come out with his catch-phrase?’
‘Yes, when we were talking to Jane Bowen.’
‘Thought so. He’s so predictable. That’s one of the truly therapeutic aspects of this place, the unfailing regularity of Dr Busner. What are you doing now?’
‘I’m meant to be going down to casualty to sit in on an admission with a Dr Valuam.’
‘Tony, yeah. Well, he’s my kind of a shrink, not like Dr B; more practical like, more chemical.’
A door opened to the right of the nurses’ station which I hadn’t noticed before. A very short man came out of it and with neat movements locked it behind him, using a key that was on an extremely large gaoler’s bunch. He turned to face me. He was a funny little specimen. He had wispy fair hair teased ineffectually around his bare scalp. It wasn’t as if he was going bald, it was more as if he’d never grown any hair to begin with. This impression was supported by the watery blue eyes, and the nose and chin which were soft and seemingly boneless. He wore a stiff blue synthetic suit of Seventies cut and vinyl shoes.
‘You must be Misha Gurney. I’m Anthony Valuam.’ His handshake was twisted and rubberised, like holding a retort clamp in a laboratory, but his voice was absurdly mellow and basso. A voice-over rather than a real voice. His foetal face registered and then dismissed my surprise; he must have been used to it. Tom was stifling an obvious giggle behind his paperback. Valuam ignored him and I followed suit. We walked off down the short corridor to the lift. Valuam launched into an introduction.
‘It’s very unusual to have an admission through casualty at this time of day. On this ward we deal almost exclusively with referrals, but we know this particular young man and there are very good reasons why he should be treated on Ward 9.’
‘And they are …?’
‘I don’t wish to be enigmatic, but you’ll see.’
Valuam fell silent. We waited for the lift, which arrived and slid open and closed and then dropped us down through the hospital to casualty, which was situated in the first sub-basement. The lift stopped on every floor, to take on and drop passengers.
The architects, interior designers and colour consultants who had made the hospital were not insensitive to the difficulties posed by such a project, they had earnestly striven to make this vast, labyrinthine structure seem habitable and human in scale. To this end each floor had been given slightly different wall and floor coverings, slightly different-shaped neon strip-light covers, slightly different concrete cornicing, slightly different steel ventilation-unit housings and slightly different colourings: virology an emphatic pale blue, urology a teasing (but tasteful) green, surgery and cardiology a resilient pink and so on. At each floor the patients and their orderlies were also different colours. The faces and hands of the patients as they were transferred from ward to ward, on steel trolleys, in wheelchairs as heavy as siege engines, were stained with disease, as vividly as a pickled specimen injected with dye.
The orderlies were violently offhand; they manhandled the patients into the lifts like awkward, fifty-kilo bags of Spanish onions. Then they stood menacingly in the corners, lowering over their livid charges, their temples pulsing with insulting health. Occasionally a patient would be wheeled into the lift who was clearly the wrong colour for the direction we were headed in (this was evident as soon as the lift reached the next floor) and the orderly would back the chair or table out of the lift again, the faces of both porter and cargo registering careful weariness at the prospect of another purgatorial wait.
We reached the sub-basement. Valuam turned to the left outside of the lift and led me along the corridor. Down here the colour scheme was a muted beige. The persistent susurration of the air-conditioning was louder than on the ninth floor and was backed up by a deeper throb of generators. The industrial ambience was further underscored by the pieces of equipment which stood at intervals along the corridor, their steel rods, rubber wheels, plastic cylinders and dependant ganglia of electric wiring betrayed no utility.
The beige-tiled floor was scarred with dirty
wheel tracks. We whipped past doors with cryptic signs on them: ‘Hal-G Cupboard’, ‘Ex-Offex.Con’, ‘Broom Station’. The corridor now petered out into a series of partitioned walkways which Valuam picked his way through with complete assurance. We entered a wide area, although the ceiling here was no higher than in the corridor. On either side were soft-sided booths, curtained off with beige plastic sheeting. The beige lights overhead sub-sonically wittered. We passed stooped personnel – health miners who laboured here with heavy equipment to extract the diseased seam. They were directed by taller foremen, recognisable by their white coats, worn like flapping parodies. Valuam turned to the right, to the left, to the left again. In the unnatural light I felt terribly sensitive as we passed booths where figures lay humped in pain. I felt the tearing, cutting and mashing of tissue and bone like an electrified cotton-wool pad clamped across my mouth and nose.
At length Valuam reached the right booth. He swept aside the curtain. A youth of twenty or twenty-one cowered in a plastic scoop chair at the back of the oblong curtained area. On the left a fiercely preserved woman leant against the edge of the examination couch. On the right stood a wheeled aluminium table. Laid out on it were tissues, a kidney dish of tongue depressors, and a strip of disposable hypodermics wound out of a dispenser box.
Valuam pushed a sickly yellow sharps disposal bin to one side with his blue foot and pulled out another plastic chair. He stretched and shook hands with the woman, who murmured ‘Anthony’. Valuam sat down facing the youth and untucked his clipboard from the crook of his arm. It was left for me to lean awkwardly in the opening, looming over the gathering like a malevolent interloper. I was conspicuously ignored.
‘Good morning, Simon,’ said Valuam. Simon drew a frond of wool out from the cuff of his pullover and let it ping inaudibly back into a tight spiral. Simon was wearing a very handsome pullover, made up of twenty or so irregular wool panels in shades of beige, grey and black. He pinged the thread again and fell to worrying a bloody stalk of cuticle that had detached itself from his gnawed paw.
‘Simon and I felt it would be a good idea if he came to stay on the ward with you for a while, Anthony.’ The woman uncrossed her ankles and hopped up on to the examination table. Her steely hair was sharply bobbed, one bang pointed at the youth who was her indigent son. She took a shiny clutch bag from under her arm, popped it open and withdrew a tube of mints which she aimed at me.
‘Polo?’
‘Err … thanks.’ I took one. She smiled faintly and took one herself.
‘How do you feel about that, Simon?’ Valuam held his foetal face on one side, his basso voice sounding concerned.
‘S’alright.’ Simon was rotating the cuticle stalk with the tip of a finger. He was also starting to rock back and forth.
Valuam consulted the papers attached to his clipboard. ‘Mmm … mm …’ He snuffled and ruffled the case notes while the steely-haired woman and I regarded one another peripherally. She really was pretty chic. At neck and wrist she was encircled with linked silver platelets cut into shapes; her clothes were made out of varieties of vicuna and rabbit; her stockings were so pure you could see the mulberry in them. I couldn’t quite get the measure of why she was so blasé about Simon’s voluntary committal. Genuine lack of caring? A defence mechanism? Something more sinister?
‘You were discharged last October, Simon,’ Valuam had found the right place, ‘and went to the Galston Work Scheme. How did that go?’
‘Oh, OK, I guess. I did some good things; worked on some of my constructions. I enjoyed it.’ Simon had given up on the cuticle, he looked up at Valuam and spoke with some animation. His face was quite green in hue and distorted by weeping infections. It was like watching a colour screen where the tube has started to pack up.
‘But now you’re in pretty bad shape again, aren’t you?’
‘Yeah, I guess. I’m fed up with living with the bitch.’ Simon’s mother winced. ‘She puts me under pressure the whole time. Do this, do that. It’s no wonder I start to freak out.’
‘I see. And freaking out means stopping your medication and stopping going to the Galston and stopping your therapy and ending up looking like this.’
Simon had relapsed into torpor before Valuam had finished speaking. The cuticle had claimed his whole attention again. We were left regarding the top of his unruly head.
Valuam sighed. He ticked some boxes on the sheet uppermost on the clipboard and twisted sideways on his plastic chair to face the woman. ‘Well, I suppose he’d better come in for a few weeks then.’
‘I’m glad you see it that way, Anthony.’ She eased herself off the examination couch with a whoosh of wool and silk and patted herself down. ‘Well, goodbye then, Simon. I’ll come and see you at the weekend.’
‘Bye, Mum, take it easy.’ Simon didn’t look up, he’d found some antiseptic and fell to swabbing his bleeding finger with tight little arcs. His mother smiled absently at Valuam as if acknowledging his sartorial failure. I stood to one side and she nodded at me as she swished out of the cubicle and away.
Valuam got up and scraped the chair back against the wall.
‘I have someone to see here, Misha, would you mind taking Simon up to the ward?’
‘I’m, er, not sure I’ll be able to find my way back.’
‘Oh, that’s OK, Simon knows the layout of the hospital far better than he knows his own mind.’
I wasn’t sure whether I was meant to share in this sick irony – but looking at Valuam’s miscarried countenance I could see that he wasn’t joking. Simon seemed not to have noticed.
I followed the abstraction of Simon’s pullover back through the twisting lanes of the casualty examination area. Even before we’d gained the corridor I found that I’d completely lost my bearings. Simon, however, didn’t hesitate, he plunged on unswervingly, walking with long fluid strides. We travelled like a couple arguing; he would make gains on me of some twenty yards and then I’d have to put on a spurt to catch up with him. To begin with I feared that he was actually trying to lose me, but whenever there was a choice of directions and he was some way ahead he waited until I was close enough to see which way he went.
The nature of the corridors we bowled along was perceptibly changing. The machines that stood at intervals against the corridor walls were becoming more obviously utilitarian – parts were now painted black rather than chromed or rubberised – they had petrol engines rather than electric pumps. The walls themselves were changing, they were losing their therapeutic hue and reverting to concrete colour, as was the floor. Lights were becoming exposed, first the odd neon tube was naked and then all of them.
This part of the hospital was beyond the world of work, it was a secret underworld. From time to time we would pass workers clad in strange suits of protective clothing: wearing rubberised aprons, or plastic face masks, or Wellington boots, or leather shoulder pads. They looked at us inscrutably. It was clear that they were intent on their jobs; maintaining the whine, stoking the hum, directing the howl. It was also clear that Simon wasn’t taking me back to the ward, he had business here. I caught him on a corner.
‘Where are we going, Simon?’
‘To see something, something worth seeing. I promise you won’t be angry.’
‘Can you tell me what it is?’
‘No.’ He wheeled away, calling over his shoulder, ‘Come on, it’s not much further.’
The corridor walls gave way to sections of masonry. Embedded in them were the filled-in remains of long-dead windows. I realised that we had reached the place where the new hospital had been grafted on to its predecessor. There were the marks of cast-iron railings, pressed and faint, like fossilised grass stems. More than ever I sensed the great weight of the hospital crouching overhead. A dankness entered the air; at intervals trickling pools of water seeped up on to the floor. Eventually Simon stopped by a set of double doors, old doors belonging to the former hospital, the top halves glassed with many small panes. He pushed them apart on failing rails.<
br />
We were in some sort of conservatory. Round, twenty-five feet across, fifteen feet up the walls gave way to a dirty glass dome, which arched overhead, almost out of sight in the gloom. There was daylight here, filtering down weakly through the tarnished panes. Water dripped audibly. In the centre of the room stood a giant machine for doing things to people. This much was clear from the canted couch positioned halfway up its flank. Otherwise it resembled a giant microscope, the barrel obliquely filling the uncertain volume of the room, the lens pointing directly at the couch. The whole thing was festooned with hydraulic cabling. It had originally been painted a kitchen-cream colour but now it was corroded, atrophied.
Simon and I stood and looked.
‘Good, isn’t it.’ His voice was full and resonant. He’d lost his sullen edge.
‘Yes, very striking. What was it for?’
‘Oh, I’ve no idea. I got left alone one night in casualty and just started wandering about, I found this. I don’t think anyone’s been here for years. Funny, really, because it’s right in back of the MDR.’
‘MDR?’
Simon beckoned me over to the grey-filmed window opposite the door we’d entered by. I circled the giant machine, stepping over the edge of the vast plate that riveted it to the floor. Bits had fallen off the machine – bolts, braces, other small components – but given the scale of the thing, they were large enough to bruise your shins if you knocked against them. Simon was vigorously rubbing the windowpane.