The Other Side of You

5

WHEN I SAW ELIZABETH CRUIKSHANK NEXT, THE LATE-afternoon sun was streaming through the window and lighting up my room. It was a big room, with high ceilings, and one weekend, when Olivia had a friend staying, I’d gone in and painted it white because I couldn’t look a day longer at the existing institutional pale blue and cream. I’d also brought from home some paintings which I’d acquired before Olivia and I lived together. ‘Horrible gloomy thing,’ she’d said of the Orpen, a portrait of a sad-faced clown, I’d picked up at Kettle’s Yard.

I have a bee in my bonnet about pictures being crooked on the wall and one thing Lennie failed at was setting them straight. More often than not his big presence disrupted the paintings so, as my patient was settling in the chair, I walked across and adjusted the clown. I felt her eyes on my back and when I returned to my seat she asked, ‘Who is it?’

‘The painter or the portrait?’

‘The clown.’

I could have responded with, ‘Do you feel like that yourself?’ or something equally alienating but more by luck than judgement I chose to answer the question.

‘I’ve always felt it must be an aspect of the artist. What do you think?’ I never told Olivia this but I’d bought the painting because it reminded me of Jonny.

‘You’d need to know sadness to paint that.’

Something I’d picked up from Dan was that he almost never mentioned food to his anorexic patients. ‘Drives them nuts,’ he used to say. ‘They’ve been questioned till they’re blue in the face about their eating habits, having their food weighed to the last ounce, and God knows what, and when I don’t broach the subject at all they get confused. Breaks their control, see.’

‘Do you like art?’ I enquired.

I didn’t want to confuse Elizabeth Cruikshank or break her control but I didn’t want to go head on again into what had brought her to me. The strategy worked because something rigid about her shoulders relaxed.

‘Some.’

‘Any special artist?’ She appeared to frown so I added, ‘It’s not a trick question.’

‘It’s not that.’

‘Oh, yes,’ I said, imagining she didn’t know how to choose. ‘For me, some days it’s Rembrandt, some days Cezanne, or sometimes, you know, it’s Titian.’

The light was partly obscuring her face—I should really have had blinds but I hate to keep out the sun.

‘I used to like Caravaggio.’

That was a coincidence, though nowadays, of course, plenty of people admire the Italian painter. He was Gus Galen’s favourite. In fact, it was Gus who introduced me to Caravaggio that time when we first met.

‘Come, dear boy,’ he said, pushing me along with his hand on my elbow, after a session on anxiety, ‘I need to walk off some of my own anxiety after hearing those baboons.’

Gus walked faster than any man I knew and he was a terror with traffic. Why his life hadn’t ended under somebody’s wheels I’ll never know. He stepped off the pavement without a thought for the oncoming cars so that to accompany him on the streets was like a cue in a comic film for vehicles filled with swearing drivers to come to a screeching halt. A walk with Gus was a definition of a mixed blessing—his company was to die for, and there was always the possibility that one might.

By the time we got to Trafalgar Square I felt that had I been at all of a religious disposition I might have slipped into St Martin-in-the-Fields to light a candle in gratitude for having reached it in one piece. But Gus, still insistently shoving my elbow, steered me up the steep stone steps of the gallery and navigated us rapidly through its rooms, till we stopped in front of a painting I’d not seen before.

Here Gus let out an explosive snort so that the drowsing attendant’s head started up, fearful that this might herald some act of vandalism. But if the sigh expressed violence it was violence of a harmless sort—that of the innate passion which in Gus was always searching for a suitable object.

The picture he showed me was of a young beardless man, seated in darkness, at a table laid with food. Framing him, on either side, their backs half turned to us, were two seated companions. You could see from their posture that the central figure had just revealed something remarkable. The big-boned man to the left of him was caught, dramatically, in the act of rising to his feet, and his astonished elbow was poking through the torn sleeve of his green jerkin. His raw-nosed companion, to the right, had flung his spread arms wide, so that the large left hand seemed to shoot dangerously out of the frame and almost to poke me in the eye.

‘Who are they?’ I asked, though it was clear who the man at the centre of the table was. As I say, I wasn’t too keen on religion, or its art.

Gus stood looking at the painting as if too preoccupied to have heard me so I read the inscription aloud. ‘The Supper at Emmaus.’

‘What d’you think?’ asked Gus, as if he’d produced a gold coin from my nose or a pair of doves from my ears. ‘Marvellous, isn’t it? Beats having to listen to the babble of those baboons.’

At the time, I didn’t marvel. But it would have been rude to say so, especially at a first meeting. But also something of Gus’s passion rubbed off on me. I didn’t like the painting—I didn’t understand it—but what I did like was Gus’s liking for it. His passion bred passion: that he could so openly avow his own love for it made me love him. And now this painting, which I had encountered so many years earlier, gave me my first glimmer of insight into Elizabeth Cruikshank. Beneath that pallid exterior there must be passion too, however carefully concealed. But all I said was, ‘A dear friend of mine, Dr Galen, loves Caravaggio’s work. He’s an analyst, too. A very original one. It’s he who says there’s no cure for being alive.’

‘That’s what you said last time.’

So she had taken it in. ‘Yes. Gus’s words. I’m afraid I’m not original. He feels that people aren’t ill so much as lacking a meaning to live. He thinks our job is to help them to find it.’

‘That might be rather a tall order.’ There was the ghost of a smile in her voice.

‘Yes. And possibly arrogant, you may be thinking?’

‘No, I wasn’t thinking that.’

She lapsed back into silence and I dropped into a reverie.

Some patients, however little they say, keep your attention tied to them so that the silence is an effort. I’ve learned that this is anger. Angry people press on you, hold you down to keep you with them. But it was easy to drift off with Elizabeth Cruikshank. She didn’t mug you with her presence; she let you go as lightly as a dandelion seed.

I was contemplating this when she spoke again. ‘Why on earth would anyone want to bother with people like us?’

For a second I supposed she was referring to the two of us. Then, with a sense of slight shock, I recovered myself and recognised her allusion was to me as doctor and herself as patient.

‘What are people like “us” like?’

She gave one of her little dismissive shrugs. ‘People like me, then.’

‘And what would you say you were like?’

The ginger tom was back balancing on the fence outside. It had an air of entitlement which in a human would be psychopathic. Perhaps that was why I so disliked it. It took for granted something I could never take.

‘Oh, I don’t know,’ she said, listlessly. ‘Not very interesting.’

‘Well,’ I said, ‘I don’t know that anyone is uninteresting once you get to know them.’

‘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

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.

‘You could make jelly with those,’ Elizabeth Cruikshank suggested, looking away from me to the garden. ‘It makes good jelly, quince.’

I dropped by Cath Maguire’s office later on my way home.

Maguire was a lesbian but not the sort that doesn’t get on with men. I had occasionally speculated what had made Maguire prefer her own sex. She was an attractive, sparky woman and while not my type exactly certainly could have been many men’s. But when I once tentatively started on this line, she shut me up by saying, ‘You’re not suggesting that women are second best or anything, are you, Dr McBride?’

But one lucky consequence of Maguire’s preference was that we had the kind of good-natured intimacy which is only possible between a man and a woman where sex will never be a factor. And I’d long given over questioning the whys and wherefores of Maguire’s sexuality. What mattered to me was that I trusted her instincts and depended on them to fill out my own.

‘How’re you getting on with Mrs Cruikshank?’ I asked.

‘Elizabeth? I like her. Quiet, like I said. Doesn’t make demands. Probably doesn’t make enough. Always very polite.’

‘Any visitors?’

‘None I’ve seen, anyway. A couple of phone enquiries from her children but so far as I know they haven’t visited.’

So she had children. I wouldn’t have guessed this and there was no mention of them on her record. She looked almost too girlish to have given birth. ‘How many?’

‘Two, I gather. A boy and a girl. The girl was a bit, you know, stand-offish but the boy sounded nice.’

By the phone in her room was a book squashed face down. Maguire read two or three books a week.

‘Does she read?’

‘She’s got a couple of books out of the library, but now you come to mention it, I’ve not seen her read them, unless she keeps them for nights.’

‘What are they? Did you see?’

Maguire screwed up her face as she did when trying to concentrate. It gave her a look of a small girl which always made me feel warm towards her.

‘Not fiction anyway.’

Maguire devoured fiction. Her favourite author was Ruth Rendell but I’d noticed some surprising ones too. For a time she seemed to be reading her way through Proust.

‘She used to be a librarian.’

‘Really? I wouldn’t mind that job myself.’

‘Too late,’ I said. ‘I need your help here.’

‘You know, I don’t know if in the long run a really great story isn’t more help.’

7

THAT AUTUMN, OLIVIA HAD DECIDED TO ENROL IN SOME evening classes and she was out at one of them when I got home. She had a tendency to these sudden enthusiasms. They rarely lasted, and I therefore hadn’t bothered to ask much about this latest. I was never quite abreast of which class was when, partly because I was glad to have an hour or two to myself. Olivia never forbade me anything openly but it’s not so agreeable to listen to Schubert, or Bach, when the person with you would rather hear The Archers. Not that I’ve anything against The Archers—it was more that Olivia had something against Schubert: she assumed respect for my tastes but somehow it had the discouraging effect of dislike.

I had a deadline for a paper I was reviewing for a clinical journal, which was an added reason for preferring my own thoughts. So when the phone rang and interrupted them I was put out till I heard Gus Galen’s voice.

‘Can you beat it?’ Gus was one of those people who never announce themselves, as if one spent one’s time simply waiting to hear from them alone. ‘They’ve got that baboon Jeffries giving the keynote address. What the hell is a “keynote” anyway, when it’s at home?’

‘I don’t know,’ I said. ‘A musical metaphor maybe?’

Gus was referring to the international conference on anxiety and depression which was to take place the following year.

‘Nothing melodious about Jeffries’ approach. It wasn’t so long ago he was advocating bloody lobotomies.’

Lobotomy, or leucotomy, the surgical severance of the frontal lobe of the brain from the subcortical area, became fashionable as a remedy for intractable depression in the late thirties and during the forties and fifties something like 80,000 such surgical operations were performed before it dropped out of style again. But since 1970 there had been a revival of interest in the procedure.

Gus was one of the first modern neurological experts to query the wisdom of this, which, as with everything else, he did vociferously.

‘They claim it worked on monkeys but I wonder what the poor beasts would say about it if they could speak,’ he said, not long after our first encounter. ‘Those baboons haven’t a bloody clue how it works on humans, if it works at all, which I doubt. Monkeying about with the brain like that as if they were God All Bloody Mighty, though God would have more sense than to be so interfering.’ As with many of his other associations, Gus appeared to have some informal access to the mind of God.

There was, and still is, a political division in our profession between an interventionist approach, which roughly speaking means drugs and ECT, and the so-called ‘talking cure’. Most psychiatrists practised a largely unconsidered mixture of the two, but Gus was passionately against the hard-line attitude and his training in neurology combined with his forceful personality gave him clout.

There’s a place for drugs, and with schizophrenia or bipolar states only a fool or a miracle worker would attempt to manage without them. But, by and large, I was of Gus’s mind. In fact—and of course he knew this—it was as a result of seeing the consequences of a lobotomy that I began my analytic training.