The Sleep Room Page 13

  She had raced up the basement stairs and exited the building without pausing to lock the door. She had scrambled down a steep bank, tearing her clothes and losing her shoes. In absolute darkness, she had attempted to cross the reed beds, running, blindly, until she had tripped and fallen into deep, freezing cold water. Every night, as I passed from wakefulness into the shallows of sleep, I asked myself the same question: what had Mary Williams been running away from?

  11

  Maitland handed me the referral letter as we were leaving his office. ‘I wonder if you would be so kind as to assess this gentleman for me?’ His manner was casual, almost careless, but I wasn’t fooled. He was keen to repair any damage done to our reputation by the Mary Williams affair. The provision of outpatient services at Wyldehope was long overdue, and if we offered them now this would not only improve our standing among local GPs but it would also mollify the Health Board.

  Our new patient’s name was Edward Burgess. During the war he had spent four years as an army driver and had never reported sick. He then became an infantryman and was sent to the front line, where he and his comrades came under fire. Heavy shelling and mortar bombs precipitated a rapid mental collapse, and he was transported to an aid post on the Normandy beachhead. In due course he was evacuated to England and given various treatments. Although outwardly he appeared to improve, he was constantly on edge and prone to attacks of anxiety. He was allocated a desk job and after being demobbed he started a haulage business in Lowestoft that subsequently became very lucrative. Within a relatively short period of time he had become a well-respected member of a regional trade association and his contribution was recognized when he was voted its president. Yet he continued to be tormented by traumatic memories and his sleep was disturbed by vivid nightmares of the battlefield and all of its attendant horrors. He would wake up, several times a week, screaming and drenched with perspiration. Occasionally, he would be crippled by a loss of sensation in his legs. His nervous condition was placing a considerable strain on his marriage, and after years of resistance and procrastination he was finally persuaded by his wife to consult his GP.

  I was waiting for Mr Burgess in one of the first-floor outpatient rooms, reading and rereading the referral letter. A nurse had been instructed to receive him in the vestibule, and I knew that he had arrived when I heard the heavy iron knocker sounding downstairs, three unhurried strikes that were amplified by the resonant space of the vestibule. Shortly after, there were footsteps in the corridor and Mr Burgess was ushered in. I recognized his face at once – the sloping brow, sunken eyes and lean features – but it took me a few moments to establish where, exactly, I had seen that grim, haunted visage before.

  ‘Doctor,’ he said, offering me his hand.

  ‘Mr Burgess.’ And then it came to me. ‘I believe we’ve already met.’

  ‘Briefly, yes. We shared a train compartment.’

  I recalled my first, interminable journey to Wyldehope: the man sitting opposite, gripping his kneecaps. Folk ’round here didn’t want a madhouse on their doorstep. I had misunderstood him completely. Mr Burgess had not been expressing his own view but, rather, forewarning me of local hostility.

  ‘Please,’ I gestured, indicating an empty seat.

  ‘I’m still not sure whether I’ve done the right thing, coming here today.’

  ‘Why’s that?’

  ‘There are others who have far greater need of your help than me.’

  ‘Suffering is not easily quantified, Mr Burgess. I make no such distinctions.’

  He considered my words, nodded, and sat down without removing his coat.

  After some preliminary discussion, I encouraged him to talk about his wartime experiences, and discovered that when Burgess had joined the front line the shelling and mortar fire had lasted continuously for eight days. He was then ordered to cross a river and mount an attack on the enemy in a densely wooded forest.

  ‘My friends were falling all around me. I remember the noise, the cries and the explosions. I lost my voice, started to sob, and my legs stopped working. Two chaps got me back to an ambulance, but I was stunned, and just lay there, gibbering.’

  ‘You must have been very frightened.’

  ‘I’m not sure what I felt. In a way, it was like I wasn’t there.’ Later he sighed and said, ‘Doctor, I did a lot of talking when I got back to England. I was admitted to a hospital down in Surrey, where they made me go over what had happened every day. It didn’t do me any good then, and I don’t think it’ll do me any good now.’

  After undertaking the assessment, I wasn’t at all sure how to proceed. Mr Burgess was not only disenchanted with talking cures, but also medication. The barbiturates his GP had prescribed were equally ineffective. I discussed our new patient with Maitland, who recommended ‘excitatory abreaction’, a treatment that he had developed during the war precisely for veterans like Mr Burgess, that is to say men suffering from nervous shock. I had, of course, read about this procedure; however, I had no direct experience of carrying it out myself. The opportunity had never arisen. Maitland detected my hesitancy, and said, ‘Perhaps I should conduct the session.’ I was grateful that he was willing to do so and eager to learn from example.

  The following week, Mr Burgess returned. I introduced him to Maitland, who sat by his side and explained in layman’s terms how the treatment was going to work.

  ‘Your symptoms are caused by pent-up emotions, a blockage if you like, but a blockage that can be removed. To this end, we must get you into the right state of mind, and we’ll achieve this by giving you some ether to inhale. It’s quite harmless and you have no need to worry. You’ll feel light-headed and a little intoxicated, but the ether will also increase the clarity of your memories. It is essential for us to arouse strong feelings, particularly those associated with your experiences in Normandy, if the treatment is to succeed.’ Maitland asked Burgess to remove his jacket and his tie and to unfasten the top button of his shirt. He then poured some ether onto a mask and helped Burgess to put it on. ‘Breathe normally,’ said Maitland, resting a reassuring hand on the man’s shoulder. The strong, chemical smell filled the room, and I began to feel a dull ache behind my eyes. ‘Now,’ Maitland continued, ‘I want you to tell me about what transpired on the front line?’

  Burgess told his story again. As he spoke, his delivery gathered momentum and he became more and more agitated. The words tumbled out of his mouth, his eyes darted around the room, and his index finger wound around a phantom trigger. At one point he began to panic and he tried to tear off his mask. Maitland took a firm hold of Burgess’s wrist, looked him in the eye, and barked, ‘No!’ Burgess seemed to come to his senses and fell back in his chair. ‘You are in the forest,’ Maitland continued, ‘there are loud detonations, screams and shouts. What do you see ahead of you, Mr Burgess? Tell me? What do you see?’

  ‘Jack!’ said Burgess, his eyes swelling out of their sockets in terror. He raised his hand and pointed. ‘I can see Jack. He’s standing there, right in front of me, and I can see straight through his head.’

  ‘How is that possible, Mr Burgess?’

  ‘There’s a hole, a big one, big enough to put your arm through – and a red mist in the air that tastes of iron – and his brains are on my face.’ Burgess was hyperventilating and his forehead was beaded with perspiration. ‘Harry turns round and he hasn’t got a chin any more, but he’s still making sounds, horrible sounds. He wants me to advance, but I can’t – my legs won’t move. Blood is dripping on me and when I look up I see soldiers hiding in the trees. But they aren’t hiding and they’re not really soldiers. What I’m seeing is parts of soldiers – arms, legs, torsos – and I think to myself, this isn’t happening. This can’t be happening.’

  ‘But it is happening,’ Maitland interjected.

  ‘No. It isn’t real.’

  ‘Oh, but it is real,’ Maitland insisted with stern authority. ‘And there is no escape.’

  Burgess started to beat the air
wildly and he pitched forward onto the floor. I immediately leapt to his assistance, but Maitland barred my way; he looked at me severely and shook his head. Burgess had curled up into a ball and tears were streaming down his cheeks. He was producing an infantile, mewling noise.

  ‘Bombs are exploding,’ Maitland intoned, exploiting the deeper registers of his voice with plangent theatricality, ‘and the ground beneath your feet is trembling and shaking.’ Burgess moaned and thrashed about from side to side, throwing gangly, uncoordinated punches and kicking without purpose. Maitland caught my attention and mimed a pinning down action. Our patient was enfeebled by a combination of ether and exhaustion and it was relatively easy to restrict his movements. ‘It does not end,’ Maitland continued. ‘The earth is convulsing and you are being showered with dirt and rock. You can smell burnt flesh, gunpowder. All around you, men are dead or dying.’

  ‘No more,’ gasped Burgess. He wrenched one of his hands free and clawed at the mask. ‘Please. No more.’

  ‘There is no escape,’ Maitland repeated.

  I recovered Burgess’s flailing arm and crossed it over the other, which I was already holding against his chest. He tried to heave me off, but the effort seemed to drain some last reserve of strength, and suddenly he became limp and his eyes closed. We lifted him up from the floor and carried him over to a rest bed, where we tried to make him comfortable by supporting his head on some pillows. Maitland removed the mask and wiped away two threads of mucous from beneath Burgess’s nose.

  ‘Typically, patients lie quietly for one or two minutes, and when they come round their manner is composed and rational and there are no signs of persisting excitement or intoxication. If the treatment has been successful, Mr Burgess will be able to tell us immediately.’ Maitland adopted a more familiar tone of voice, ‘James, would you mind awfully if I asked you to fetch some tea from the kitchen?’ When I returned Burgess had regained consciousness. He looked very tired but his manner was curiously calm and untroubled.

  ‘How are you feeling?’ Maitland enquired.

  ‘Better. More myself.’ Burgess looked puzzled, perplexed. ‘Everything feels different.’

  ‘Do you remember what happened on the front line?’

  ‘Yes, of course. Jack – the hole in his head – and Harry – the legs and arms in the trees. Even so . . .’ He produced a lengthy sigh. ‘It’s sort of lifted. It’s lighter. I feel unburdened.’

  ‘Good,’ said Maitland, ‘very good.’ He was smiling, but his smile was a little too self-satisfied to give off any warmth. ‘I want you to rest for a couple of hours. Then, if Dr Richardson has no objection, you’ll be free to go home.’

  After lunch, I found Burgess standing by the window. He had put on his tie and jacket and he was looking up into a sky of bright white cloud. He glanced at his wrist-watch. ‘Half past one already. I came with a driver. He’s been waiting for me outside.’

  ‘Perhaps we could meet again in a fortnight?’

  ‘Thank you,’ said Burgess, studying his reflection and tightening the knot of his tie.

  Later that same day, I encountered Maitland in the vestibule. He was carrying a briefcase and I guessed from his ink-stained fingers that he had been writing. We swapped a few remarks about Mr Burgess and then I accompanied Maitland outside. The heath was unusually still. Dusk had decanted pools of darkness into the hollows and even the sea was silent. Maitland opened the nearside door of his car and tossed the briefcase onto the passenger seat. Looking at me across the roof, he said, ‘James, I’d like to propose something. You don’t have to give me an answer now. Obviously, you’ll want to think about it first. The second edition of my textbook was published in the spring, but Churchill-Livingstone are already asking me when they can expect the third. Producing such a comprehensive review of the literature is very time-consuming – too much really for one man. I was wondering, would you be interested in helping out with the next edition? Naturally, you’d be credited. You would be joint-author.’

  It was an extraordinary offer.

  ‘Why, yes, of course I’d be interested.’

  ‘It’s a considerable undertaking.’

  ‘Indeed, but I can tell you right now, even after I’ve thought about it, my answer will be yes.’

  Maitland walked around the front of the car and said, ‘Excellent.’ Before I could express my gratitude he was behind the steering wheel and the engine had begun to purr. I watched him drive off, and as was his custom he hooted his horn just before the road descended and the Bentley disappeared from view.

  I was due to drop in on the sleep room, but instead I ascended the stairs to my apartment and found my copy of Maitland’s textbook in the bureau. Sitting down, I balanced it on my knees and stroked the dust jacket. I formed a mental image of how the cover would appear in future, the simple black font on the pale-blue background: An Introduction to Physical Methods of Treatment in Psychiatry, Third Edition, by Hugh Maitland and James Richardson. Something like an electric charge of excitement seemed to travel up and down my spine. In another few years I could reasonably expect offers of employment from prestigious institutions, early promotion and a much better salary. Life would be very different.

  It is a measure of how my feelings towards Jane were deepening that I immediately thought of her. I drifted into a kind of daydream and pictured us living together in London, somewhere genteel, like Hampstead. I saw us ensconced in a spacious mansion flat with tall windows through which the distant city could be seen over tree-tops. I saw us going into town to see films, frequenting jazz clubs and catching the last bus home. And all the while I was conscious of the fact that in this fantasy all of the usual social conventions, such as proposal, engagement and marriage, had already been observed.

  I told Jane about Maitland’s proposition and she was very happy for me. ‘How wonderful,’ she said, squeezing my hand. I explained how joint authorship of the textbook would greatly improve my prospects and I was disappointed when she didn’t reflect on what this might mean for her too. A regrettably mean-spirited response on my part because in actual fact I should have applauded her lack of self-interest.

  It was about this time that a particular issue began to surface during the course of our conversations: whether or not we should make it clear to our colleagues that she and I were going steady. Apart from Lillian, no one was supposed to know, although I was sure that at least two of the nightingales suspected that there was something going on between us. Fortunately, they had chosen to be discreet. I was tiring of all the secrecy and felt that our lives would be a great deal simpler if we were more transparent. Jane was less keen. She was concerned about how Sister Jenkins and the other nurses would react. I didn’t foresee any problems, but Jane was fairly resistant to the idea and I didn’t want to pressure her. It occurred to me, somewhat belatedly, that Jane might have another, quite straightforward reason for being cautious. Men and women are judged according to very different standards of morality and perhaps I was being a little naive. If we made it known that we were a couple then, inevitably, there would be those who would see fit to ask how it was that, under such unpromising conditions, we had found opportunities to become intimate? The thought of clandestine meetings in the hospital would, no doubt, cause some to voice their disapproval. Old slurs were easily aired when it came to the conduct of women.

  The fantasy of our life together in London became a persistent part of my mental activity. I had even begun to calculate the time it would take to make my dreams a reality: a year or two to complete the textbook, then publication, then another six months before taking up a hospital appointment with academic affiliations.

  When I held Jane in my arms and she nestled against my chest, I was tempted to share my thoughts with her, to describe my vision. I had even started to imagine the interior decor of our Hampstead abode: art nouveau lampstands, a rug by the fire, a chintz settee. But I didn’t say a word. I didn’t want to frighten her off.

  Too much, too soon, I chastised
myself. Not yet. Not now.

  It is difficult to account for this failure of confidence. Jane was a demonstrative lover. She would dig her fingers into my flesh and repeat the words ‘I love you’ again and again, until mounting waves of pleasure made her breathy and inarticulate.

  Eventually I would muster enough courage to tell her of my hopes for our future – or so I thought. As it turned out, she never got to hear about the mansion block, the view, or the chintz settee.

  Mrs Matilda Mason

  88 Lordship Road

  Stoke Newington

  London N16

  2nd June 1955

  Dr H. Maitland

  BBC

  Broadcasting House

  Portland Place

  London W1

  Dear Dr Maitland,

  I hope you don’t mind me writing to you like this and I am sorry if I have done the wrong thing. I know you must be a very busy man and that you must get many letters like this one. If you don’t have time to answer then I will understand. I was listening to the wireless last night and you were on a programme called What is Madness? You mentioned a new sleeping cure and I was wondering how I can get this treatment for my daughter, Elizabeth. She hasn’t been well for many years and our doctor, Dr Stott, says she has had a psychotic breakdown. It all started when something terrible happened to her. She was jilted on her wedding day and the man who was going to be her husband ran away and he hasn’t been seen since. Lizzie loved him very much and it’s so sad, because she wanted to get married more than anything and start a family. All she talked about was having kids. Lizzie wouldn’t take off her wedding dress. She kept it on for months. She was like the old lady in that film with John Mills and Jean Simmons. The dress got so dirty we had to cut it off her body when she was asleep. When she woke up she was livid and smashed the furniture in her room. The landlord threatened to throw us out when he saw what had happened and I had to sell my grandmother’s silver brooch to pay for the repairs. I don’t know why Mick, the man Elizabeth was supposed to marry, jilted her. His uncle said it was because he saw some awful things during the war. But we all did. I don’t see what that’s got to do with it. It was probably the usual story and there must have been another woman. My friend Doreen thinks he got someone in the family way.