- -
- 100%
- +
Morgan turned to me with a grin and a lift of the eyebrows, by which I understood him to mean that now I saw the necessity of removing my jacket.
The woman in the bath twisted around to get onto her back and lifted her head spluttering from the water. She tried to get up, but O’Reilly had a hand on her chest holding her down.
‘Get the cover!’ she said to the other women.
They reached under the bath and pulled out a rolled-up length of canvas. The patient tried to scream again but it came out as a wounded-animal whimper that pierced both my ears and my heart.
‘Let me up, for the love of God,’ she begged. ‘The water is freezing. I cannot take a bath in this!’
O’Reilly grabbed the woman’s wrist with her free hand and placed it in a leather strap fixed to the side of the bath. One of the other women let go the canvas and repeated the operation on the other side, so that the woman was now firmly held in a sitting position. Then the attendant returned to the canvas, taking one side of it while her colleague took the other. I saw it had a number of holes ringed with brass along each edge. The woman stopped her screaming and watched wild-eyed as the attendants stretched it over the top of the bath, beginning at the end where her feet were, putting the rings over a series of hooks which I now saw were fixed along the bath under the outside rim. The woman was fighting frantically, trying to get up, but of course she couldn’t because of the wrist restraints, and when this proved to no avail she began thrashing about with her legs, which were under the canvas and merely kicked uselessly against it. O’Reilly stood back now, arms folded, on her face the grim satisfied smile of the practised sadist. In a matter of half a minute the canvas was secured snugly over the top of the bath, the edges so tight it would have been impossible for the woman to get a hand through even if they had not been shackled. At the very top end there was a little half circle cut into the canvas and from this the patient’s head protruded, but the opening was so tight she could not pull her head back down into the water and drown herself.
While this was happening the noise in the room was hellish, the woman’s screams and curses alternating with bouts of calm, when she sobbed and pleaded first with O’Reilly, then the other women and finally with Morgan. ‘Please, doctor, let me out, I beg you. Let me out and I promise I will be a good girl.’
This all came out staccato, for her teeth were chattering, leaving me in no doubt that the water was indeed as freezing as she claimed. When these appeals fell upon deaf ears, she began screaming again and pushing her knees vainly against the canvas, which was so tightly secured it moved scarcely at all.
One of the women went to a cupboard, took out a towel and gave it to Morgan. He dried his face and hands and tossed the towel to me and I did the same. Then he shrugged. ‘We may as well go now, nothing more to be done here.’
He strolled over to where our jackets hung, and began putting his on and I followed suit. I must have looked puzzled and he said something that I could not catch because of the screams of the woman echoing around the room. He rolled his eyes and motioned toward the door. O’Reilly strode over to it and unlocked and opened it and we passed through. The door clanged shut behind us with a finality that made me shiver and I thanked my lucky star that I was not on the wrong side of it, or one like it. The cries of the woman were instantly muffled and Morgan said, ‘She will soon quiet down. The water is icy cold and rapidly calms the hot blood that causes these outbursts.’
‘She seemed calm enough before she was put into the bath,’ I said, forgetting myself and then realising I had perhaps sounded a note of protest.
He began walking swiftly, so that again I had trouble keeping up. ‘Momentarily, yes, but she has been given to fits of violence, such as you witnessed a little of, ever since she arrived here a week ago. The hydrotherapy has a wonderfully quiescent effect. Another three hours in there and—’
‘Three hours!’
I could not help myself. It was unthinkable to me that you could put someone in freezing cold water in the fall and leave them like that for three hours.
He stopped and looked at me, taken aback by my tone. Before I had time to think about it, I raised my hand to cover the bruise and was suddenly conscious of how I must appear to him, with my too-small jacket and my bashed-about face.
‘I know it may seem harsh to the untrained spectator,’ he said, ‘but believe me it works ninety-nine per cent of the time. She’ll be as meek as a newborn lamb after this, I assure you. And I’d go so far as to wager that after another three or four such treatments there will be no more violent fits. We will have her under control.’
‘You mean she will be cured?’
He pursed his lips and moved his head from side to side, weighing up his reply. ‘Well, not exactly. Not as you probably mean.’ He began walking again, but this time slowly, as though the need to choose his words carefully forced him to slacken his pace. ‘We must be sure of our terms here, Shepherd. Now, she will not be cured in the sense that she can be released and live a normal and productive life. Immersing her in cold water will not repair a damaged brain. So from that point of view, no, not cured. But think of what madness involves. Who is most inconvenienced by mental affliction?’
‘Why, the sufferer, of course.’
‘Not so, or rather not necessarily so. Often the patient is in a world of her own, living a fantasy existence, in a complete fog, and does not even know where she is or that the mental confusion she feels is not the normal state of all mankind. No, in many – I would even go so far as to say most – cases, it is the people around her who endure far more hardship. The family whose life is disrupted. The children who are forced to put up with bouts of abuse and violence. The poor husband whose wife tries to hurt him or turns the home into a place of fear. The parents who are too old to restrain a daughter undergoing a violent episode. And, not least, us, the doctors and attendants whose duty it is to care for these unfortunate beings. So not a cure for the patient, but one for everyone else, whose lives are made better because the illness is being managed.’
We continued walking in silence for a minute or so.
‘So the patient can never resume her place in society, then?’ I asked at last.
‘I would not say never, no. After a period of restraint, of being shown again and again that making a nuisance or herself will gain her nothing, a patient will often become subdued. It is the same process as training an animal. The fear of more treatment leads to compliance. In the best cases it becomes the normal habit. Oh, I know some may not like to admit it, but it’s a tried and tested regimen. It worked for King George III of England, you know. He went mad, but after a course of such treatment the merest hint of restraint would cool his intemperance and he was able to take up the reins of government again for another twenty years.’
2
After our visit to the hydrotherapy room, Morgan took me on a brief tour of the institution. We began on the second floor, where the dormitories were arranged along a long corridor that must have run a good deal of the length of the building. Most of the women slept in large rooms accommodating twenty or so beds, although some were in smaller rooms, and a few were in isolation.
‘It may be that they are violent or that there is something about them, some habit or tic that is a nuisance to others that makes them a victim of violence, or simply that they continually make a racket and keep everyone else awake,’ Morgan explained. ‘We try to keep things as peaceful as possible.’
Each sleeping area had a room nearby where two attendants alternately slept and kept watch. ‘Is this to prevent the patients escaping?’ I asked.
‘Escaping? Escaping?’ He looked askance at me. ‘Good God, man, they cannot escape, because in order to do so they would first have to be prisoners. They are not; they are patients. They do not escape; they abscond. Or would do if we were to let them. Anyway, the sleeping quarters are locked at night so they cannot wander.’
I surveyed the length of the corridor and the many doors. ‘What about the risk of fire? Surely if one broke out, there would not be time to unlock all these doors?’
He sighed. ‘You may well be right. I have my doubts about some of the women we are forced to employ and fear that in such a case they would think only of saving themselves rather than chance their own lives getting the patients out.’
‘I’ve seen a system where the doors in a corridor are linked and locked by a device at the end of the row that secures or releases them all at once.’
He stopped and stared at me. ‘I know of only one institution that has such a system. Sing Sing prison. How came you to see it?’
I could only hope he didn’t notice my momentary hesitation before replying. ‘I didn’t mean I’d actually seen it, sir. I meant that I had seen there is such a system. I think I read about it in the Clarion or some other newspaper.’
He resumed walking. ‘I’m sure we cannot afford such luxuries. The state will fund these things for lawbreakers, but not, alas, for lunatics.’
I could not help clenching my fists at the idea that prevention from being burned to death in a locked room should be considered a luxury, but said nothing. I was not here, after all, to take up the cause of the lunatics.
On the ground floor we visited a long bleak room with bare wooden benches around the walls, bolted to them, all occupied by inmates, and in the centre a table covered by a shining white cloth, around which sat half a dozen attendants. The entire room was as spotless as the tablecloth and I thought what a good job the attendants must do to keep it so clean. I would later mock my own stupidity for this assumption. At either end of the table were two potbelly stoves, whose heat I could only feel from a few feet away when we approached them, but even if my own experience hadn’t told me they were inadequate to the task of heating such a large room, I would have known because the women on the benches were shivering and hugging themselves for warmth. The backs of the benches were perfectly straight and you could tell they were uncomfortable from the way the inmates were forced to sit upright upon them, the seats being so narrow the sitter would simply slide off if she slouched. Each bench looked as if it would accommodate five people, which I could tell from the fact that every one had six women sitting on it and looked unpleasantly crowded. These inmates were all clad in the same coarse, drab calico garment I had seen on the woman in the hydrotherapy room. On one side of the room were three barred windows set at more than five feet from the ground, so that even standing, let alone sitting, it was impossible for any but an exceptionally tall woman to see out of them.
When I mentioned this to Morgan, thinking, but not saying, that it was a poor piece of design, he said, ‘That’s the idea. We do not want them looking out – it would be a distraction.’
I had to bite my tongue not to ask distraction from what, since the women had absolutely nothing to occupy them. There was no sound from any of them and they all seemed subdued, staring blankly into space, or down at the floor or even sitting with their eyes closed and possibly dozing, until they became aware of us, whereupon I sensed a ripple of excitement pass around the room.
A woman stood up and approached Morgan. She stretched out a hand and tugged his sleeve. ‘Doctor, doctor, have you come to sign my release?’ she said. She was old, perhaps sixty or so, with a bent back and a brown wizened walnut of a face.
Carefully, he lifted her hand from his arm as if it had been some delicate inanimate object and let it drop gently by her side. ‘Not today, Sarah, not today,’ he told her. ‘Now be a good girl and sit down, for you know we have to see you can behave properly before there can be any talk of release.’
I was impressed he knew her by name – he’d told me there were some four hundred patients in the hospital – which made him smile. ‘She’s been here thirty years, since long before my time. She asks me the same thing on every occasion she sets eyes on me; she does not realise she will never go home.’
While this had been going on, other patients had taken their lead from Sarah and risen from their seats and a great hubbub of chatter had sprung up. In response to this disturbance the attendants rose from the table and busied themselves taking hold of those who were walking about and leading them back to the benches and where necessary pushing them down onto them. ‘Now behave!’ I heard one attendant snap at a young woman. ‘Or you’ll be for it later.’ Instantly the woman turned pale and meekly went back to her place.
Eventually all the patients were seated again and after a few more stern words from the attendants, the chatter died down and silence reigned once more. Some still looked at us, with what seemed like great interest, but most resumed their earlier pose, and simply sat and stared empty-eyed straight ahead, not even making eye contact with the women sitting opposite them on the other side of the room.
‘What are they doing here?’ I whispered to Morgan.
‘Doing? Doing? Why, man, you see for yourself, they are not doing anything. This is the day room, where they spend much of the day. They will sit like this until it is time for their evening meal.’
‘When do they have that?’
‘At six o’clock.’
It was presently only four o’clock. I could not help thinking that if I were made to sit in total silence with nothing at all to occupy me, even if I were not off my head to begin with, I soon would be.
Morgan looked at me angrily, and I wondered for a moment whether I’d actually spoken my thoughts aloud, but being sure I hadn’t, I saw I had irritated him by the tone of my questions. He took my queries as criticism of the regime, which, I began to see, they were, since I was so appalled by what I was seeing that I could not prevent a certain disbelief creeping into my tone.
‘It is, as I said,’ he paused to let go a sigh of exasperation, ‘a question of management. If they were all doing something, they would be more difficult to manage. Any activity would have to involve something to do it with. If you allowed them books, for example, some of them would damage the books, or they would throw them at the attendants, or use them as weapons against their neighbours. And even if they simply read them it would not be good, for it would give them ideas. They have too many ideas already. It would be the same with sewing or knitting. Can you imagine the possible consequences of handing them needles? So removing potentially dangerous objects and maintaining an air of calm is essential for control. But also it is therapeutic. They acquire through practice the ability to sit and do nothing. It teaches them to be calm. If they can do this, then both their lives and ours are made easier.’
After this he took me outside via a rear entrance to show me the grounds. There were extensive lawns and an ornamental pond and beyond this some woodland. I felt a great relief to be out in the open air. I looked back at the hospital. It was a forbidding sight and I could not help thinking how daunting the first approach to it must be for a new patient. The style was gothic, with a fake medieval tower at one end and a round turret at the other. Much of it was strangled by ivy. The windows were small, which accounted for the gloom within, many of them merely narrow openings to imitate the arrow slits of an ancient castle.
Once again Morgan must have read my thoughts. ‘Dismal-looking edifice, isn’t it?’
I turned away from it. ‘I fear no one could say otherwise. It looks as if it ought to be haunted.’
He began to walk away and I heard him mutter something that sounded like, ‘Oh it is, my boy, believe me, it is.’ I had the sense that he was talking to himself and did not think I could hear him.
I caught up with him just as we came upon a group of lunatics out for their daily walk. Still clad in their same worn calico dresses, each woman now had a woollen shawl and, bizarrely, a straw hat, such as you might wear on a day out on Coney Island, making the overall impression strangely comic. The women were lined up in twos, guarded by attendants.
As they passed us, a shiver of horror crept through me. My gaze was met with vacant eyes and inexpressive faces, while many of them jabbered away, seemingly holding conversations with themselves, or sometimes leaning toward their partners and talking animatedly, although in most cases the other woman appeared not to be listening, either staring mutely ahead or muttering away herself, lost in a conversation of her own. I saw too that these women were under restraint. Wide leather belts were locked around their waists and attached to a long cable rope, so that they were all linked to one another, a sight that reminded me of old illustrations I had seen of slaves being led from their African villages to the slavers’ ships. I did a rough count and estimated there must have been around twenty women roped together in this fashion.
We stood aside to let them pass and I could see many of them had dirty noses, unkempt hair and grimy skin. My own nostrils attested that they were not clean, whereas I hadn’t noticed any unpleasant smells amongst the other women in the day room and was surprised that there should be any now we were in the fresh air.
‘Who are these women?’ I asked Morgan.
‘They’re the most violent on the island,’ he replied. ‘They are kept on the third floor, separate from the rest. They are all extremely disturbed and their presence would not be compatible with the treatment of the others.’
As if to verify this, one of them began to yell, which sparked off a reaction in another, who commenced to sing, in a strangely beautiful and haunting voice, the old song ‘Barbara Allen’, and for a moment it felt as if the sadness of the song was a reflection of her state, but then others broke out in a discordant caterwauling, raucous stuff such as you hear in low taverns, and one woman added to the cacophony by mumbling prayers, while others stuck to simple cursing, casting oaths defiantly into the air seemingly at nothing or no one in particular, but to the world in general and what it had done to them.
The women were forced to keep to the footpaths and I thought how they must have longed to kick off their shoes and run barefoot across the soft, elegantly coiffed grass. Every so often one of them would bend and pick up something, a leaf or nut or fallen twig, but immediately an attendant would be upon her and force her to discard it.
‘They are not allowed possessions,’ Morgan observed to me.
Possessions! What kind of hell was this where a fallen leaf was counted a possession? I could not help but be reminded of Lear, in which I had once played Edmund – who else? – and the old king’s speech: ‘Oh, reason not the need, our basest beggars are in the poorest thing superfluous.’
Following in the wake of this miserable spectacle of humanity, we passed a small pavilion, no doubt a vestige from the days when the asylum had been a private residence. On the wall was painted in elegant script ‘While I live, I hope.’ I shook my head at the irony of this; you only had to look at these poor women shuffling along to see there was no truth in it.
We wandered the grounds for the best part of an hour, during which I had several uncomfortable moments, as every now and then Morgan attempted to quiz me on my ideas for the treatment of lunatics, while at the same time ridiculing them without managing to convey any clue as to what these ideas actually were. I began to feel quite aggrieved that he should patronise me so and frustrated that I could not produce any counter-argument, and sensed myself losing control, which of course would have ruined everything. I held my tongue only with the greatest difficulty.
Morgan pulled out his watch. ‘Dinner in six minutes. You may as well observe the dining hall.’
Back inside the hospital we looked on as the more violent inmates, still in twos, were marched through a doorway in shambling parody of a military manoeuvre. They were taken off to a separate dining room, Morgan told me, for they needed careful supervision while they ate. After they had gone, I followed him into the long, narrow dining hall where the rest of the patients were standing, behind backless benches on either side of plain deal tables that ran almost the entire length of the hall’s centre. At a word from one of the attendants the inmates began to scramble over the benches and take their places upon them in such a disorderly fashion I couldn’t help thinking of pigs at the trough.
All along the tables were bowls filled with a dirty-looking liquid that Morgan assured me was tea. By each was a piece of bread, cut thick and buttered. Beside that was a small saucer that, as I peered more closely, proved to contain prunes. I counted five on each, no more no less. As I watched, one woman grabbed several saucers, one after the other, and emptied the prunes into her own. Then, holding tight to her own bowl of tea, she stole that of the woman next to her and gulped it down.
Morgan watched and, when I glanced at him, lifted his eyebrow and said, ‘Survival of the fittest,’ and smiled.
Looking around the tables, I saw women snatching other people’s bread and others left with nothing at all. All this Morgan viewed with such complete indifference that I began to despair of humanity, until I noticed one inmate, a young woman, not much more than a girl really, with long dark hair that fell down over her face, half veiling it, tear her own slice of bread in two and pass one portion to the woman next to her, who had been robbed of her own and who accepted it eagerly, showing her gratitude with a smile, the first I had seen in this place. At this moment, as if feeling the weight of my eyes upon her, the girl who had given away her own bread lifted her head and stared straight at me with a look that chilled me to the bone. It had a knowingness in it, as if she saw right through me and recognised what I was and observed something in me that enabled her to claim kinship. I was only able to hold her gaze for a short time before I had to look away. A minute or so later, I glanced back at her and, finding her eyes still fastened upon me, had to turn away and walk to the other end of the room.
While all this scramble for food was going on, attendants prowled up and down behind the women, not bothering to stop the petty larcenies, but tossing an extra slice of bread here and there when they saw someone going without.
When the bread and prunes had been consumed, which in truth didn’t take long, for there was not much of it and the women were obviously ravenous, the attendants fetched large metal cans from which they dispensed onto each of the women’s now empty plates a small lump of grey meat, fatty and unappetising, and a single boiled potato. You’d have thought a dog would have baulked at it, and indeed I don’t think I ever saw a dog so poorly fed, but the women fell upon it as if it was the most sumptuous feast. A few, I noticed, grimaced as they bit into the meat, showing it to be as rancid as it looked, but managed to swallow it nonetheless. Everyone else devoured it as fast as they could chew it – and it was evidently so tough, this was no easy thing – and, when it and the potato were done, looked balefully at their plates as though they could not believe the meagre offering was already gone.
Afterwards Morgan and I had our dinner in the doctors’ dining room. Although the dining table would have accommodated six people, there were only the two of us. I asked how many other physicians there were, at which Morgan shrugged. ‘We do not have unlimited resources, you know. The state does not set great store on treating the mentally ill. We cannot afford to employ more staff or anyone more experienced than you. Which is fortunate for you. Normally someone just starting out upon a career as a psychiatric doctor might wait years for an opportunity such as you have here.’