The Sleep Room Page 21

  ‘This situation will be very difficult to manage.’

  ‘Don’t worry. I don’t expect you to handle things on your own, James. This is an emergency. I’m staying.’ He offered me a tight smile. I sensed that he was expecting me to respond with an expression of gratitude, but all I could do was return an economic nod. He registered my reticence, and became magnanimous. ‘You look tired, James. Take a break. I’ll see you after supper.’

  Outside, the air was fresh and cool. I smoked a cigarette and watched a thin crescent moon becoming periodically dim, and then bright, as a train of small clouds passed in front of it. The sea was calm. A bat flew past, sensed more than observed.

  After I had eaten a light meal in the dining room, I went down to the sleep room again. Maitland had switched all the lights on: nine hanging bulbs, hidden within conical shades and projecting interlocking circles of luminescence onto the tiles. I could see the ceiling properly for the first time. It consisted of unvarnished planks, supported by massive, transverse beams. Deprived of its dark recesses and shadowy boundary, the sleep room looked smaller than usual. The alignment and orientation of the six beds no longer evoked sympathetic images of underground temples or standing stones. The atmosphere of enchantment had been dispelled and something more mundane had taken its place.

  Maitland was on his own. I could only assume he had dismissed the nurses. He was walking from bed to bed, taking blood pressures, pulses, temperatures, and making notes on the charts. Celia Jones was connected to the EEG machine, and Maitland would occasionally return to her bedside in order to scrutinize the traces on the scrolling paper.

  Eventually, he saw me standing by the door and said, ‘Ah, James. Come over here. Celia Jones is producing some interesting spindles. My guess is that they are connected with the inhibitory processes that are preserving sleep.’ I went over and examined the patterns, which were indeed interesting. Maitland continued to busy himself. He did not seem in the least bit anxious, and his eyes shone with a kind of fevered excitement. His absorption was total and I very much doubted that he had spared a single thought for his wife since his arrival.

  It occurred to me that only hours before I had decided to resign; however, that decision now seemed to have lost much of its emotional urgency. I couldn’t raise the difficult subject of my departure in the middle of a crisis. Maitland would be furious, and rightly so. I hadn’t changed my mind. I still accepted that I would have to leave – and as soon as realistically possible – but it wasn’t the right time to hand in my notice. Furthermore, I have to admit (with no small amount of attendant shame) that I was curious to see what would happen next.

  When I retired for the evening, Maitland was still freely associating ideas, and making notes with purposeful energy. ‘This is fascinating, isn’t it?’ he said. Then more softly, ‘Quite fascinating.’

  I ascended the stairs and passed Hartley, who was working an oily substance into the banisters. It was an activity that I had seen him engage in many times before. He looked up from his work and nodded. I almost stopped to ask him if he had seen the blackened carving. What did he make of it, I wondered? But I had too much on my mind, and Hartley had never been very talkative.

  On entering my apartment, I went straight to the study. Sitting at the bureau, I toyed with a pen and thought about the sleep-room patients. I remembered their sad histories of abuse and abandonment. They were not merely brains, collections of cells, suspended in communal oblivion, but people.

  What if they didn’t wake up? I asked myself. Tomorrow. Or the day after – or the day after that. What if they couldn’t be roused after weeks, months, or years? What would happen to them? Heart failure? Infections? Stroke? The appropriate course of action would be to transfer them all to Ipswich, a general hospital, somewhere properly equipped to deal with life-threatening medical emergencies. But Maitland wouldn’t agree to such a suggestion. He wanted to observe, test and monitor outcomes. He was conducting an experiment now. In fact, he always had been. I should have realized that as soon as I saw the letters ‘CIA’ on the memorandum in Marian Powell’s notes.

  I wanted to work through my thoughts on paper, and searched through the bottom drawer of the bureau for a writing pad. The drawer had become quite cluttered and I had to remove several objects, including Palmer’s Reserpine. As soon as I picked up the container, I knew that something had changed. It didn’t rattle. I prised the lid off and looked inside. There was nothing there. The three white tablets, with their distinctive scored surfaces, had disappeared.

  19

  The following morning I was summoned to Maitland’s office. He was seated behind his desk, the surface of which was completely covered with EEG read-outs, statistical manuals, and sheets of paper covered in his distinctive hand. The folders that I had surreptitiously examined – the ones from the grey cabinet containing the referral letters and documentation for the sleep-room patients – were piled on top of each other next to the telephone.

  ‘Have you been working all night?’ I asked.

  ‘More or less. Although I think I managed to get some sleep at about three. Thirty minutes, perhaps.’ He pointed to the Chesterfield and then tidied up some of his papers. I would have expected him to show more signs of fatigue, but he was well groomed and looked positively cheerful. He had recently shaved – the smell of his cologne was strong – and his hair glistened with a fresh application of pomade. ‘Please,’ he boomed hospitably, ‘do sit down.’

  ‘How are they?’ I asked.

  ‘No change,’ he replied.

  ‘Extraordinary.’

  ‘Indeed.’ Maitland drew my attention to some unusual wave patterns that he had circled in black ink. He asked me for an opinion, and then informed me that he had already arranged for another EEG machine to be transported from London. ‘We can expect it to arrive by mid-afternoon. I have a suspicion,’ he continued, tapping the red traces with his finger, ‘that these will prove to be significant. If identical spindles are produced by different patients, at the exact same time, then we will have taken the first step towards establishing the physiological basis of this curious phenomenon.’

  He continued to speculate, talking at speed, and stopping only occasionally to check that I was keeping up with his arguments. At one point, he suggested (rather wildly, I thought) that synchronous dreaming might be therapeutic. ‘What if they woke up and all of them were cured?’ Even in the middle of a crisis, Maitland was willing to entertain the possibility that a medical breakthrough could be snatched from the jaws of an impending disaster.

  After listening to him enlarging upon his themes for an hour or so, I found the courage to remind him of the question that he had been assiduously avoiding. ‘What if they don’t wake up?’ I asked.

  Maitland pushed his expensive fountain pen forward on the desk, and it came to rest parallel with the edge of my chair. The manoeuvre appeared oddly defensive, as if his intention had been to create a physical divide that would clarify our respective positions on opposite sides of a territorial boundary.

  ‘It’s early days. And they aren’t in any immediate danger.’

  ‘Aren’t they?’

  He smiled. A smile that carried a subtext of disbelief and mild disappointment. ‘Whatever do you mean by that?’

  ‘Well . . .’ I paused, my resolve faltered and I almost chose to say something less contentious. But instead, I looked at the files, remembered what I had read, the sorry tales of abuse and loss, and decided that there was a substantial matter of principle at issue. ‘Are we really set up to deal with this contingency? I mean . . . do we have the facilities?’

  ‘Facilities?’

  ‘This condition that the patients are in. We don’t know what it is, or the risks that might be associated with its continuation.’

  ‘The patients are dreaming. That’s all. There are no risks associated with dreaming.’

  ‘With respect, Hugh, they aren’t just dreaming. They have entered a state that, even accepting the
anomalous EEG, appears to closely resemble a coma.’

  Maitland shook his head. ‘I do not believe that these patients are in any danger.’

  The silence that settled around us was tense and layered with unease.

  ‘If they were transferred to Ipswich—’

  ‘That is out of the question,’ Maitland cut in. ‘They don’t have experience of running a sleep room at Ipswich. What on earth are you thinking? We have Sister Jenkins here, the nightingales. How could such a transfer possibly best serve the interests of my patients.’ His use of the emphatic possessive was ominous.

  ‘I’m not sure, Hugh. If something untoward were to happen, the sleepers would be more likely to get good emergency support in a general hospital setting.’

  Maitland’s face was like alabaster. ‘Nothing untoward will happen,’ he said softly.

  I was not going to be cowed. ‘What are our objectives, Hugh?’

  ‘To keep the patients alive, and comfortable, until such time as they spontaneously wake, or are chemically stimulated into wakefulness.’

  ‘Those objectives could be achieved just as easily at Ipswich.’

  ‘Indeed, but there are certain privileges we enjoy at Wyldehope that I am keen to protect.’ He raised his eyebrows, encouraging me to consider the appeal of absolute power. Then he added, with insincere cordiality, ‘I have never been persuaded that clinical responsibility is something that can be practicably shared out. Representatives from different branches of medicine have competing priorities. We don’t want to find ourselves in a situation where we have to argue with a cardiologist every time we want to modify the medication regimen.’

  ‘I’m sorry, Hugh, but I disagree. I think the patients should be transferred, and if we don’t make prompt arrangements, and something goes wrong . . .’ I stopped abruptly.

  ‘What? What do you think will happen?’

  I took a deep breath, and said, ‘I’m not questioning your judgement.’

  ‘Aren’t you?’

  ‘I’m just concerned, that’s all.’

  ‘About the patients?’ he said drily. ‘Or the General Medical Council?’ He saw me start and continued. ‘Well, there was that business with Hilda Wright. The possible arsenic poisoning that you failed to report.’

  ‘What?’

  ‘We discussed the matter as I recall.’

  ‘Yes, and you told me it wasn’t worth pursuing.’

  ‘My dear fellow, I said nothing of the sort. I merely urged you to consider the broader picture. The decision to contact the coroner, or not, was entirely your responsibility. How could it have been otherwise? I never even saw the patient.’ I was flabbergasted. Even more so when he continued, ‘And then there was Chapman. Fortunately, no questions were asked about the straitjacket.’

  I felt a flare of anger and Maitland’s fountain pen rolled forward. He lunged to stop it but it accelerated out of his reach. I watched as it dropped to the floor. For a few moments I stared at the pen, before lowering my upper body, picking the pen up, and returning it to its former position.

  ‘Thank you,’ said Maitland. His eyes fastened on mine. Under any other circumstance, one of us might have commented on this strange occurrence. But Maitland had just issued a threat and my mind was fully occupied with the task of trying to formulate an appropriate response. This concentrated expenditure of mental energy, however, proved unnecessary, because Maitland sighed, made an appeasing gesture with his hands, and said, ‘Look, James, you have a very promising career ahead of you. I think we’ve established a good working relationship and I would like that to continue. Don’t be headstrong. I don’t want it to be like this.’ He was modulating his voice to exploit its attractive tonal qualities, just like he did when he was on the wireless. The sound he produced was melodious, friendly, and above all persuasive. ‘I want you to do something for me. Go upstairs, go for a walk – I don’t care what you do, but find somewhere quiet, a place where you won’t be disturbed and consider, at length, what we’ve been discussing. Try to take a long view. I understand that you have reservations. You’ve made that clear enough. Even so, I hope that, given sufficient opportunity to reflect, you will come round to my way of thinking.’

  He stood up and offered me his hand. I took it warily and matched the determined pressure of his muscular grip. It was one of numerous communications that had not necessitated the crude medium of speech. As I left Maitland’s office I knew full well that the terms of engagement on which my future as a doctor depended had been comprehensively renegotiated. The dilemma that faced me now, as I saw it, was not whether I was prepared to accept those terms, but whether I possessed the courage to reject them.

  I remembered what Palmer had said about his relationship with Maitland, how Maitland had taken a ‘fatherly’ interest in him, and how this had complicated his feelings at the time of his resignation. Perhaps I too had come to see Maitland as a kind of father figure. Because even though he had been manipulative and dishonest, the idea of opposing him churned up a plethora of conflicting Oedipal emotions: principally fear and guilt. I felt that the plan of action that was taking shape in my mind militated against the natural order. Maitland had always mocked ‘couch merchants’ and I had been a willing confederate. Yet as I ascended the stairs to my apartment, the unpalatable precepts of psychoanalysis seemed to have become unassailable truths.

  In my study, I smoked a cigarette and then picked up the telephone. It took me several attempts to find the right official. He was polite but somewhat reserved. After taking down my details he invited me to proceed. On hearing Maitland’s name, he said, ‘I beg your pardon?’

  ‘Dr Hugh Maitland,’ I repeated.

  ‘The psychiatrist?’

  ‘Yes.’

  ‘The famous psychiatrist.’

  ‘Yes.’

  I described the situation I found myself in and shared my concerns. ‘The patients must be transferred,’ I concluded. ‘Their lives are at risk.’

  ‘You do realize,’ said the official, ‘that you are making a very serious allegation.’

  ‘Yes,’ I replied, ‘I do.’

  The medical profession is notoriously hierarchical and conservative. When I put the telephone down, I did so accepting that I had probably done something very foolish. What could I expect to achieve? In all likelihood the sleepers would remain at Wyldehope, Maitland would be left to his own devices, and I would never work again.

  I spent the rest of the morning on the wards. There was plenty to do, because Maitland had ensconced himself in the sleep room and seemed completely uninterested in the welfare of the other patients. When I went down to consult him about Alan Foster, whose delusions of control were getting much worse, Maitland barely made eye contact. He was standing next to the EEG machine, stroking his chin, bewitched by the movement of the pens. ‘Do what you think is best,’ he said distractedly. Having told me to go off and reflect on our prior altercation, I had supposed that he would show at least some interest in discovering the outcome; however, I was quite wrong. He was simply too engrossed to care.

  The sleepers had not been fed yet; nevertheless, the drips had been attached to their arms. Perhaps it was because I was unaccustomed to the overhead lights but already the supine bodies seemed emaciated. Their interior parts were too visible: bones and shadowy vessels showed beneath transparent skin. When I left the sleep room, I glanced back and felt a preternatural chill. It seemed to pass through my ribcage and freeze my heart. The sensation was profoundly uncomfortable and persisted, albeit less intensely, for some time after.

  It was difficult to work, because I kept on wondering whether or not someone from the Health Board or the General Medical Council would arrive to undertake an inspection; although, in actuality, I knew that such a swift response was unlikely. Maitland would be courteously forewarned by telephone, and I would then have to go to his office and justify myself. I imagined having to stand in front of him, while he expressed incredulity at the magnitude of my betrayal. The p
rospect of what I would have to face made me feel slightly sick. Indeed, it occurred to me that it might be for the best if I simply packed my bags and got Hartley to drive me to the train station. But this felt too cowardly to countenance. I was reminded of men like Burgess: men who belonged to a generation not so very far removed in years from my own, who had had to fight and win a war. Surely I could stand up to Maitland? Surely I had that much courage? The sleep-room patients were in danger and I was the only person in a position to do anything about it. A quote popped into my mind, one that was frequently repeated by my history master at school: ‘All that is necessary for the triumph of evil is that good men do nothing.’ The sentiment was bracing. It revived my spirits and toughened my resolve.

  On returning to the men’s ward I went to see Alan Foster who was still in an anxious state. ‘They’re putting thoughts into my head,’ he said. ‘I don’t know which ones are mine any more.’ I sedated him, tried to make him comfortable, and then went to see some of the other patients: Mr Cook, Mr Murray and Mr Drake. When I had finished, I found myself thinking about Michael Chapman and of our many chess games and conversations. Under the influence of these maudlin recollections, I wandered, without clear purpose, down the corridor and into the recreation room. Jane was sitting on one of the battered armchairs, a handkerchief clutched in her hand.

  ‘Oh, I’m sorry,’ I said, embarrassed. ‘I didn’t realize . . .’ I was about to leave when she looked up at me. She had obviously been crying and I didn’t know what to do. My indecision caused me to vacillate on the threshold; however, there was something about her expression that stopped my confused movements. Her eyes made an arresting appeal that caused an emotion to snag in my chest.

  ‘Must we be like this?’ she said.

  ‘What do you mean?’ I said, rather disingenuously. Then, becoming self-conscious, I turned and looked back down the corridor at the nurses’ station.

  ‘It’s all right,’ Jane said. ‘There’s only me here. Have you got a cigarette?’ I walked across the room and offered her one, which she took and lit herself. ‘Thank you.’ After taking a few puffs she said, ‘What’s going on in the sleep room?’