The Girl Behind the Gates

by Brenda Davies

  Dale leans against the door frame, watching silently. ‘Want to talk about it?’

  ‘No point,’ she says.

  Janet sits cross-legged in jeans and an old jersey, her hair looking as though she forgot to brush it this morning – which wouldn’t be entirely wrong. A pastel palette has been applied to the heavens this Sunday afternoon, a wash of soft grey, mauve and peach, with the odd gold highlight for effect. She watches a grey squirrel making its way down the branch of a huge elm whose trunk supports a whole universe of lichens.

  Scattered around her on the carpet are the back-ward patient files that she’s trying to arrange in some kind of order. She’s been at it for hours and feels pretty overwhelmed. No real patient notes, just individual sentences, often separated by bald patches where nothing at all was recorded, as though the patient simply stopped existing for months at a time. Brief diagnostic and medication notes here and there. ‘Septic foot. Bathe with iodine.’ ‘Impetigo. Paint with gentian.’ Dosage details are encoded in Latin, which her tired brain struggles to remember.

  How could anyone pull together a person’s life from this? Sore throats and coughs, swollen ankles and ingrown toenails; the odd hallucination and a bit of difficult behaviour. But nothing that says anything about who this person really is – what they think, feel, do; where they came from, what hopes and aspirations they may have had, and may even still have. Years and years of signs and symptoms and nothing else. Is that all these people have become?

  Janet stretches her neck and rubs her eyes. Perhaps she could review a couple of them each week . . . Even that, though, will take months. She sighs and makes her own brief notes in a bid to figure out where to start.

  A man who tried to kill himself by lying on a railway line. Two traumatic amputations. Been here more than forty years. Oh, hang on – he was discharged years ago.

  A woman from Auschwitz. Strange for her to be here. Ah . . . sent by the court. It appears she murdered a Mrs Müller in 1954.

  A girl who was admitted at seventeen. It seems she was pregnant – a ‘moral defective’. Though Janet remembers this term from her days as a medical student, she never imagined she’d actually see it written on a patient’s notes these days. God – she’s been here since 1939. Janet pulls the file out and puts it to one side, making a mental note to look up the legality around the incarceration of so-called moral defectives.

  A man with an IQ of forty-nine, who seems to have had an unlikely number of injuries – ‘fell in the bathroom’, ‘bumped into a door’, ‘fell out of bed’ – also, seems to have spent long periods in seclusion . . .

  She also jots down the ‘treatments’ mentioned here and there. Cold baths, wet wraps, straitjackets, restraints, insulin therapy, sterilisation, unmodified ECT, continuous narcosis, psychosurgery – leucotomy, trepanning . . . on and on . . . She’s never heard of some of it, although she does recall that someone in the USA in those days did psychosurgery almost as a travelling road show – lobotomy on demand in the back of a motor trailer. She shivers at the thought. She’ll have to do some research. Even more time I don’t have . . .

  Hopelessness radiates from every yellowed page. She shuts the last file and slams it onto the pile. How can she even face these people who’ve been so abused and neglected in the name of medicine, let alone ask them to trust her? She stares out of the window again, unconsciously tapping on the sill. To be fair, what else could the doctors have done back then? What resources did they have? None of the medication available now. At least they were trying to do something at a time when many people just wanted the psychiatrically ill to disappear – or be euthanised. Anything to prevent them from being an embarrassment or their behaviour to cause a disturbance. Although, what do we do now? Mostly just ‘straitjacket’ them with medication instead. And we still have psychosurgery . . .

  She leans back against the sofa, her eyes mindlessly following the progress of a robin around the garden, wondering what on earth she can do with all of this, when the door opens. Her husband, Ian, steps in and surveys the scene, his green eyes sparkling with irritation.

  ‘Sunday afternoon and you’re still working. I thought we were going out for a walk?’

  Somewhere, at a distance, Janet is aware of his voice, but is still lost in her thoughts and continues to stare out of the window.

  ‘Janet?’ Ian raises his voice impatiently.

  She snaps away from the window and looks first at Ian and then at her watch. ‘Oh, sorry. The time ran away with me.’

  ‘Something did, but I don’t think it was just the time. You always find enough time for your patients.’

  ‘Ian, don’t st—’

  ‘I’m not starting anything. Just wishing my wife would like to spend some time with me on the only day of the week we’re both at home together. You’ve had two call-outs till God knows what hours this week – though how on earth that happens I don’t know.’

  She feels heat creeping up her neck. ‘The SHO wasn’t available.’

  Ian’s lip curls. ‘Seems like he’s often “not available”.’

  She sighs. ‘Give me half an hour.’

  ‘Just forget it. I’ve been waiting for hours already. I’ll catch you later.’ He turns and sweeps out of the room without another word, the collar-length hair she loves streaming like a lion’s mane behind him. She hears rustling as he grabs his anorak from the hallstand and then the slam of the front door.

  She closes her eyes and takes a few deep breaths, then stares into the space he just vacated and runs a frustrated hand through her dark hair, feeling unusually defeated. She sits up straight and sighs deeply. What am I doing? I can’t let this happen to us.

  But still she stares out of the window, biting her bottom lip, then her hand almost involuntarily wanders back to the notes of the woman who was admitted because she was pregnant and unmarried. She flicks through the notes again. Forty-two years of this woman’s life in her hand. She pauses. Her heart hurts. She knows full well why this woman’s plight has called to her.

  She sighs again and places the file to one side. What she needs most, she thinks, is a strong cup of tea. And she’ll call Martin. She misses him now he’s at university. Nineteen. Where did all those years go? She wanders off into the kitchen and puts on the kettle, leaning heavily on her hands as she waits for it to boil. Her head droops forward as Ian creeps back into her mind, but the welcome bubbling of the kettle as it starts to boil rescues her and she breathes heavily and straightens up, reaching for the tea caddy. She swills boiling water round the pot to warm it and makes the tea, putting a tea-cosy over the pot to keep it hot, then stands still for a long moment, her own past bleeding into the present.

  There but for the grace of God . . .

  She rubs her neck and shakes her head, dislodging the uncomfortable thoughts. She checks the time and heads for the sitting room with her tea tray.

  Janet is awoken by the slam of the front door. She glances at her watch as she pulls herself up to a sitting position and pushes back the throw she’d pulled over herself on the sofa. Ten thirty. The files are in a stack at her feet. She looks around, confused, just as the sitting-room door opens.

  ‘Janet, we need to talk,’ Ian says, sitting down beside her.

  A shiver runs through her. ‘It’s late, Ian. Not now.’

  ‘Not now? It’s always “not now”. You’re busy with this, tied up with that. There’s never time for us.’ He takes her hand. ‘We don’t even make love any more. I wonder if you even care.’

  ‘I’m—’

  ‘I know. You’re busy. You’re tired. But we have to make some time for us – some time to talk.’ He glances at the stack of notes. ‘I’m off to bed. Don’t work too late, eh?’ He kisses her cheek and turns to leave.

  She grabs his hand. ‘Ian, do you love me?’

  ‘You know I do. But what’s more to the point is, do you love me? If there’s something that’s bothering you, just tell me. We can work it out. Come to bed. Please.’r />
  But she drops her head and avoids his eyes. ‘Sleep well. I won’t be long. I promise.’

  Monday morning arrives after a restless night. The light edging its way round the curtains is flat and distinctly autumnal. Ian’s arm is looped over her and Janet shifts a little, looking over her shoulder at her sleeping husband. Sadness engulfs her and she thinks, Please don’t let me hurt him. She inches her way out from under his arm, trying not to wake him, and turns to really look at him, her heart aching. ‘It’ll be all right,’ she whispers. ‘I promise, I’ll make it right.’ But even as she makes the promise, she feels her mind drifting to her work.

  She’s in and out of the shower and part way through her breakfast before Ian emerges. She attempts a smile but his eyes slide over her as though she is just another appliance. He heads straight to the fridge, scratching his chin. Her eyes follow him as he takes out the orange juice, butter and milk. He grabs the marmalade from a cupboard and a couple of slices of bread, puts the bread in the toaster, pours the juice and takes a swig.

  ‘Ian, I’m sorry – I just wasn’t in the mood,’ she says, but he leaves the kitchen, having successfully avoided meeting her eyes even once. Irritation now rises in Janet. Well, two can play at that game. She scoops the last few mouthfuls of her porridge into her mouth in double-quick time so that she can leave the room before his toast pops up.

  They pass each other again in the bathroom as she cleans her teeth and he mops his face after his shave, then they head in different directions without a word.

  They climb into separate cars with hardly a glance, then Janet rolls down her window. ‘This is a stupid game,’ she calls to him as he shifts into gear and starts to move off. He brakes and looks at her, his eyes empty.

  ‘Then stop playing it,’ he says.

  Janet gives a wan smile. ‘Don’t work too hard.’

  Ian doesn’t smile, but at least he holds her eyes. ‘You’re a right one to talk,’ he says. ‘What time are you going to honour me with your presence tonight?’

  ‘Six,’ she says brightly, ignoring the burning sarcasm.

  As he thrusts the car back into gear, he shouts back. ‘I’ll expect you at eight, then.’

  Before Janet can respond, he drives off in a squeal of tyres. Janet hits the steering wheel and curses. She knows it’s childish, but she hates it when he steals the last word like that. The whole way to work she is seething quietly; even the soothing tones of her favourite Bread track are unable to break through her mood. In fact, the lyrics just inflame her more and she slams off the radio.

  She pulls into her parking space and turns off the engine, sighing into the sudden silence. There’s no way she can go in feeling like she does now. She closes her eyes and forces herself to take deep, calming breaths until she feels ready.

  Chapter Two

  As Janet locks her car she glances up at the impressive Victorian façade of Hillinghurst Hospital. The September wind skirmishes with the crisp brown and gold leaves and abruptly changes, teasing her hair and snatching at the papers she hauls from the boot of the car so that she has to grip them extra tight. Weighed down with the files, she walks across to the annexe known as Rowan. Although this will be the first time she has entered this part of the hospital, since she started here she’s wondered at the identity of the man – of course, it would have been a man – who named this beige relic from the post-war prefab era after the beautiful tree that produces dense clusters of cream flowers in May and scarlet berries in September. The door needs painting and the windows could do with some putty. It has the appearance of a hapless, neglected child standing alongside its ornate, stern Victorian mother. Janet takes a long breath and determines to feel hopeful about what she might find in there.

  Her shoulder bag is caught in the crook of her arm and she tuts, backing up against the door, protecting her precarious cargo with both arms. But the door is lighter than she imagined and gives way, so that she almost falls inside, diving head-first into the familiar smells of urine, bleach and polish. A woman in a grey flared skirt and a pale green blouse approaches, hands outstretched. She’s mid-forties, Janet reckons, with her mouse-brown hair short and well-behaved, her cheekbones high. She looks newly washed and shiny and her hazel eyes seem to dance. Her left hand bears a simple gold wedding ring and her face a welcoming smile. Her name tag states ‘Ellen Saunders, Sister’.

  ‘D’you need a hand?’ she says cheerily and without waiting for a reply, Ellen expertly slices off the top two-thirds of Janet’s pile of notes and moves towards another door. ‘Dr Humphreys, is it?’ she asks over her shoulder. ‘Tea or coffee?’

  Ah, hospital hospitality. ‘Tea would be great, please. Milk, no sugar. And it’s Janet.’

  ‘Perfect,’ says Ellen, handing Janet a steaming mug. ‘Shall we get straight to it, then?’

  ‘That would be great,’ says Janet, then takes a sip of her drink and is pleasantly surprised at how good it is. Ellen must bring in her own teabags.

  ‘It’s hard to know where to start, so please tell me if I’m boring you,’ says Ellen with a smile. ‘Things have changed a lot over the years, with health-service reforms and such, but all of it too little too late for a lot of them. They’re just burnt out, heaven help them. They couldn’t exist outside now.’

  ‘Is that the case for all of them?’ Janet asks.

  ‘Pretty nigh. Maybe one or two might still have a chance, but not many. This is their home now and most of them will be here till they die or until the government in its wisdom closes us down.’ Ellen sighs regretfully. ‘There was a big push to discharge people about ten years ago. Some were readmitted in a dreadful state, but so many of them just died – or committed suicide. It was a nightmare for all of us.’

  ‘I bet,’ says Janet.

  They walk on, pausing every now and then for Ellen to greet one of the nurses and introduce Janet, then make their way to Ellen’s office. Small and cramped, it houses a desk, one end of which is pushed against the wall to leave enough space for Ellen to squeeze between it, the filing cabinet, the medicine trolley and her chair. They both dump their piles of notes on the desk. The usual board with its safety notices, fire drill in pictures, staff holiday sheet and a variety of leaflets hangs on the wall next to the large clock.

  ‘How are you settling in?’ Ellen asks her as they sit themselves down.

  ‘It’s early days yet,’ Janet tells her, ‘and there’s a lot to absorb between here and acute, but I’m sure I’ll feel more at home soon.’ Ellen gives her a commiserative look, and Janet pushes on. ‘I was going through the patients’ notes,’ she says, ‘but it’s hard to tell what’s going on with some of them.’

  ‘At least you’ve looked at the notes – that’s more than most people do. I know it’s more interesting on acute for you doctors, but it’s a shame that our lot are always at the end of the queue and rarely get more than five minutes of anybody’s time. I know, we’re not doing heroics here, but we’re doing our best to keep them steady and give them a bit of pleasure if we can.’

  ‘Maybe we could go through the notes together some time?’

  ‘Wow,’ Ellen says, looking at Janet with wide-eyed wonder. ‘That would be fabulous. It’ll be like a breath of fresh air to have somebody give a damn. Have you got time to meet some of them now?’

  Janet smiles at Ellen’s eagerness, but also feels a stab of sadness that a doctor showing interest in these patients is such big news. ‘Absolutely,’ she says warmly, getting to her feet.

  ‘Great, let me show you around.’ Ellen leads Janet out into the day room, where plastic flowers and crocheted blankets and cushion covers try valiantly to lift the air of resignation by injecting some colour and hope. Janet stops in her tracks as she looks around at the shells of women in the chairs that line the perimeter of the room, some tied down with restraints camouflaged as bandages. Most have bibs to collect dribbling saliva, their heads nodding, mouths chewing, eyes wandering or staring blankly. They’re all wearing ankle soc
ks that make them look like very old little girls; Janet feels her lips purse in irritation and wonders whose idea that was and what the hell they were thinking. She makes a mental note to confront that sometime, but not today.

  Ellen leads her over to a white-haired woman who is picking at her skirt with one hand while rolling the fingers of the other in small circles, her eyes downcast. ‘This is Elsie. Apparently, she suffered from a “nervous illness” since childhood, though what that was exactly, we’ll never know,’ Ellen says, her voice soft. ‘She was diagnosed as “psychotic” and admitted here when she was sixteen. She had insulin shock therapy and repeated ECT. She rarely speaks, does exactly as she’s told – never more nor less – and sits waiting for the next command: “pick up your spoon”, “go to the toilet”, “go to bed”. She goes to art therapy but always just paints brushstroke after brushstroke in dark blue.’

  Janet wonders what would happen if Elsie were instructed to use yellow, or red.

  ‘And this is our Nora, Nora Jennings. She’s been here for over forty years. Sectioned because she was pregnant and unmarried – diagnosed as moral defective.’

  Janet stands perfectly still, aware of a lump in her throat as she looks at this small, shrivelled woman. Over forty years . . . Longer than Janet has been alive.

  She blinks and forces her attention back to Ellen. ‘Moral defective . . . Yes, I remember seeing it in her notes. I meant to look and remind myself of what that meant specifically, but didn’t have time.’

  ‘Alcoholics, prostitutes, unmarried mothers – that kind of thing,’ Ellen says. ‘They could all be detained indefinitely under the 1913 Mental Deficiency Act. It was only abolished in 1959. Can you believe it?’