‘Really?’
‘Yes, I believe so.’
‘You have to say that.’
‘I don’t, in fact. And I don’t, knowingly anyway, lie to my patients.’ Deliberately, I introduced a note of coolness into my voice.
‘I’m sure you don’t.’
‘There are as many misconceptions about shrinks as there are about—’
‘Their patients? What are the “misconceptions” about your patients, Dr McBride?’
‘That because they have had the misfortune to end up somewhere like this hospital they cannot therefore also be rather bright, for one, Mrs Cruikshank. That they aren’t able to give us the run-around!’
We stared at each other.
‘Do you think I’m giving you “the run-around”, Dr McBride?’
‘I think you are giving yourself the run-around, if you really want to know,’ I said. And then, more gently, after another longish pause, ‘But that’s all right. It’s your prerogative.’
The people who landed up with me were mostly in a state of terror, and one element in it was the fear that I possessed some professional means forcibly to overcome the complex safeguards erected to protect their secret worlds. I didn’t want anyone imagining that, especially not this patient.
‘You don’t, you know, with me, anyway, have to say or do anything you don’t want to say or do.’
6 (#ulink_e41c37ec-90f7-5a14-bf4d-c0a4b268fbe3)
THE FIRST DREAM I HAD WHEN I STARTED MY ANALYTICAL training took place by the sea and I can recall it as if it were yesterday.
I was walking on a pebbled beach when a man dressed in a loud turquoise shirt accosted me. He had in his hand a lump of sea-smoothed stone and he was shoving it in my face demanding to know what it was. I said, ‘You should ask the archaeologist fellow.’ Then the scene moved inland and I found myself on a steep hillside, by a small church, or chapel, cut out of the rock face. But when I entered the building it proved not to be a church at all but a zoo. There was a skinny-looking puma restlessly prowling up and down the cage, its paces marking the limits of its confinement. In the same enclosure, a huge white barn owl was flying against the high fence, beating its wings frantically on the restraining wires.
When I mentioned the dream to Gus Galen he said that if he had a tenner for every dream he’d heard that began ‘I was walking by the sea’, he would be able to reduce substantially his charges. He was fond of quoting ‘God cures; and the physician takes the fee’, but as with everything about Gus in practice his billing methods were eccentric. A woman I sent him once, the wife of a colleague, said she had to stop seeing Dr Galen because he never sent her a bill and it made her feel guilty. ‘I went to see him because I felt guilty in the first place,’ she pointed out. I sent her, finally, to a less unworldly colleague, who charged a king’s ransom.
Anyhow, in those days I was glad to have the sea on my doorstep so that when I needed to mull anything I could walk along the beach and listen to the tread of the waves, and puzzle over my thoughts by puzzling out, at the same time, what principle enables you to tell where the water ends and the horizon begins, and observe the dark shapes of boats against the sky. Or if I’d got my rubber boots out of the boot of the car, wade through the dirty-cream foam.
Walking is a famous loosener of thoughts. Although I had many other patients in my charge, looking back now it seems it was always Elizabeth Cruikshank I was thinking about when I walked by the sea’s edge, and her story I kept trying to piece together in my mind.
Perhaps it was the reassurance that there would be no compulsion on her to disclose, or perhaps it was the tincture of chilliness with which I prefaced my absolving words, because after that last meeting my patient did yield up a few grudging facts.
After leaving school, with reasonable but unremarkable O levels, she took a job at a local library. From her father she had acquired an appetite for reading and in those days there wasn’t the current mania for formal qualifications, so she went quite a way up the librarianship ladder before deciding to get herself some proper qualifications. By this time, she’d cut loose from her parents and taken a flat in Camden Town.
‘Any boyfriends?’ I asked.
‘I don’t care for the word.’
‘Did you go out with anyone?’
‘I don’t like that phrase much either.’
‘Fine,’ I said, cheerily refusing to be diverted. ‘How about lovers? Are you happy with that term?’
She touched the leather bag she always had beside her in the chair and said, vaguely, ‘Oh, you know, I never really expected anyone to want me.’
I pictured her, as she might have looked then, underweight, unfashionably dressed, a pale young woman. When I met her she still gave an impression of pallor and plainness, though no one looks their best in the aftermath of a suicide attempt and it was a while before I saw Elizabeth Cruikshank smile. When she did I was reminded of an expression of my mother’s: ‘It was as if the moon had taken off her clothes and gone dancing.’
‘But you married?’
‘I married,’ she assented. She gave an impression that if she could she would have denied it.
To augment her library studies, she explained, she enrolled on an art history course, which in those days was run at the old North London Poly. She met her future husband in the polytechnic canteen where she was in the habit of going for a supper before the evening lectures. She’d queued up for her usual soup and bread roll, being economical with her rations, and, searching in her bag for her purse, accidentally tipped the tray so that the plate slid, spilling soup over the man before her in the queue.
‘He was nice about it, though it ruined his jacket. It was light-coloured and the soup was tomato and I was mortified. But he laughed and when I asked how I could make it up to him he said I could come to the pub. So I went. He seemed to like me.’ She sounded apologetic.
‘And you liked that?’
‘I liked being the centre of someone’s attention.’
Up till now, she’d barely held my glance, her eyes always flickering off to the quince tree, or to some point in her imagination projected on to the glass. But now she looked at me with a fierce directness that almost made me smile.
‘Not everyone wants attention,’ I said, and regretted it because she took it as criticism, which I should have foreseen.
‘Yes, wishing to die is seen as attention-seeking, I know.’ Her voice was low and she hardly raised it but at moments of tension I noticed that her diction became precise.
‘I didn’t mean that,’ I said. ‘I’m sorry.’
It bothers me how infrequently people in my profession apologise. Everyone makes mistakes, why would a psychiatrist or an analyst be different? ‘We should learn to make the mistakes as fast as possible,’ Gus says. ‘It’s mistakes that let the light in.’
‘I’m sorry,’ I said again. ‘That was stupid of me. Of course everyone wants attention, provided it’s the right kind.’
She laughed, none too cheerfully. ‘Who knows if this was the “right kind”? It was enough that I was paid any attention by anyone, let alone a man.’
While I was a medical student, I took this tall, thin girl called Wanda Williams out on a date. Because it seemed expected of me, I put my arm round her at the cinema and afterwards she invited me back to her room, in a dismal part of London. When we got in she put on the kettle and then excused herself to go to the bathroom. I was sitting on the bed, leafing through a magazine and wondering when I could decently say I was leaving, when she came back into the room. She’d taken off all her clothes and there was a line round the middle of her waist, where the elastic from her knickers had left a red mark, and another higher up where her bra had cut. I remember that the sight of these cruel-looking red impressions dividing up her pale flesh filled me with pity and dismay. I couldn’t leave after that, so I went to bed with her and watched my unenthusiastic but polite performance with the inner imager I rarely manage to switch off. It would have seemed rude to do otherwise but it depressed me no end.
Several men to whom I’ve confided this story have revealed that they’ve found themselves in similar situations. There was desperation about Wanda Williams and I found myself hoping that it had not been like that for Elizabeth Cruikshank. Somehow I didn’t think it had been. Her despair felt of a different order.
Neil Cruikshank, it turned out, was an engineer, with a research fellowship at Imperial College, employed by the polytechnic to do some external examining. A stocky, squareshouldered, fair-haired man, with a moustache.
‘I should never have married a moustache, Doctor. I might have guessed I wouldn’t get on with one.’
She gave me my title with that faint edge, which seemed to imply: Yes, I know you are a doctor, but somewhere I know, too, that underneath all this, the hospital, the consulting room, the professional qualifications, you are no different from me.
We are most of us badly cracked and afraid that if we do not guard them with our lives the cracks will show, and show us up, which is why we are all more or less in a state of vigilance against one another. Although I paid lip-service to this idea I hadn’t properly acknowledged it in those days. It was Elizabeth Cruikshank who showed me the truth of it. She had a faculty of divination which is not uncommon among psychiatric patients but in her case it was developed to a degree which enabled her to see through to the back of one’s mind. But that was a recognition I had yet to reach, so when she added, ‘You know, don’t you, in advance, I mean, when you do something you’ll regret, like marry someone you shouldn’t?’ I took refuge in a doctorly, ‘Go on,’ that being one of many such mindless phrases I hid behind.
‘But you do, don’t you?’ she persisted, and made a quizzical movement with her hands, which made me think of the wings of a wounded bird.
‘I’m not sure I do,’ I said, being a practised coward.
A few haphazard fruits, which had ripened on the quince, were still hanging, gold and knobbly, on the branches outside. My mother was brought up in India and she used to tell us how if a mango tree didn’t bear fruit they would pierce the trunk with a nail to make it fructify.