A short time later I was vomiting a good deal. I had finished the course of antidepressants, but felt no more cheerful, and my GP did what you do when someone says she is vomiting: send her to a psychiatrist. I should like to say I protested, but I was willing enough. I thought perhaps I was a fascinating case. I had been tested for anemia, but I wasn’t iron deficient. No one seemed to be able to think of another disorder to test me for, and if my body was not the problem it must be my mind that was acting up; I could believe this, and wanted my mind fixed. “Psychosomatic” was the buzz word. Properly understood, the term suggests a subtle interaction between mind and body, between the brain and the endocrine system. Improperly understood, it means, “it’s all in the mind”—that is to say, your symptoms are invented. You’ve nothing better to do with your time. You’re seeking attention.
Dr. G., the psychiatrist, was remote and bald. He had as much chance of understanding a girl like me as he had of rising from his desk and skimming from the window on silver pinions. He soon diagnosed my problem: stress, caused by overambition. This was a female complaint, one which people believed in, in those years, just as the Greeks believed that women were made ill by their wombs cutting loose and wandering about their bodies. I had told Dr. G., in response to his questions about my family, that my mother was a fashion buyer in a large department store; it was true, for at the end of the sixties she had reinvented herself as a blond, bought herself some new clothes, and taken up a career. Oh really, said Dr. G.: how interesting. Thereafter, he referred to her place of work as “the dress shop.” If I were honest with myself, he asked, wouldn’t I rather have a job in my mother’s dress shop than study law? Wouldn’t the dress shop, when all’s said and done, be more in my line?
I saw Dr. G. once a week. He must have obtained reports about me from my tutors, for he said, conscientious, hm, it says you’re very conscientious.
Was I? I only turned in the work asked for. Didn’t other people bother?
“And a mind for detail,” Dr. G. said, “you have that.” I tried to imagine the other kind of law student, the kind who favored the broad-brush approach, who took on the law of trusts, for example, with a grand generalist’s sweep and dash. “Tell me,” said Dr. G., “if you were a doctor, what kind would you be?”
I said politely that to be a psychiatrist must be interesting. No, pick something else, he said, something less close to home. I’d often thought, I said, that GPs had a challenging job, the variety of people and problems, the need for quick thinking—but no, I could see by his face that wasn’t the answer required. Dr. G. sat back in his chair. I see you as a medical researcher, he said, one of those quiet invaluable people in the back room, unseen, industrious, unsung—a mind for detail, you see. And wasn’t it the same, he asked, with law? If I did go on with my studies, wouldn’t the niche for me be in a solicitor’s office, conveying clients’ houses—wasn’t it just what people needed, at such a stressful time in their lives, to have the services of someone very conscientious, like me?
I could see her: a clerk very conscientious and quiet and dull, who wore snuff-colored garb and filed herself in a cabinet every night and whose narrow heart fluttered when anyone mentioned a flying freehold or an ancient right of way. But you’re not looking at me, I thought. I was quite thin; nausea was wearing me away. I left G.’s consulting room and stood on the pavement to consider this new version of myself. I felt as if I had been dealt a dull blow, but I didn’t know which part of me ached.
The next time I went to Dr. G.’s office I sat and wept. It was as if a dam had burst. I must have worked through a box of tissues, and no doubt it was his upset-girl ration for the whole month. Dr. G. spoke kindly to me; said gravely he had not known that things were so bad. I had better have some stronger pills. And maybe a spell in the university clinic? I trucked off there, with my textbooks. At least now my husband would be able to study in peace for his finals. I wasn’t easy company; I was laboring under a violent sense of injustice that may have seemed unreasonable to the people around me; I was angry, tearful, and despairing, and I still had pains in my legs.
I think, in retrospect, that it would have been better if I had denied that I had pains in my legs, if I had taken it all back, or brightly said that I was well now. But because I didn’t, the whole business began to spiral out of control. I still believed that honesty was the best policy; but the brute fact was, I was an invalid now, and I wasn’t entitled to a policy, not a policy of my own. I feared that if I didn’t tell the strict truth, my integrity would be eroded; I would have nothing then, no place to stand. The more I said that I had a physical illness, the more they said I had a mental illness. The more I questioned the nature, the reality of the mental illness, the more I was found to be in denial, deluded. I was confused; when I spoke of my confusion, my speech turned into a symptom. No one ventured a diagnosis: not out loud. It was in the nature of educated young women, it was believed, to be hysterical, neurotic, difficult, and out of control, and the object was to get them back under control, not by helping them examine their lives, or fix their practical problems—in my case, silverfish, sulking family, poverty, cold—but by giving them drugs which would make them indifferent to their mental pain—and in my case, indifferent to physical pain too.
The first line of medication, in those days, were the group of drugs called tricyclic antidepressants—which I had already sampled—and also what were then called “minor tranquilizers”; the pills marketed as Valium were the most famous example of the type. Highly popular in those days among overworked GPs, the minor tranquilizers are central-nervous-system depressants. They impair mental alertness and physical coordination. They dull anxiety. They are habit-forming and addictive.
The antidepressants didn’t seem to be having much effect on me—or not the wanted effects, anyway, only the effects of making me unable to grapple with the written word, of making print slide sideways and fall out of the book. It didn’t seem as if I would be able to sit my finals, Dr. G. said, but never mind: in view of my good work record, the university would grant me an aegrotat degree. Did I understand aegrotat? It meant “he was sick.” I muttered “he, not she?” It would have been much healthier for me if I had stopped muttering, and kept smiling.
Valium, however, did work; it worked to damage me. Some people, given tranquilizers of this type, experience what is called a “paradoxical reaction.” Instead of being soothed, they are enraged. One day I sat by the hearth at Roebuck Road and imagined myself starting fires—not in my own chimney, but fires in the houses of strangers, fires in the streets. Somewhere along the line, I seemed to have been damaged; I imagined myself doing damage, in my turn. I knew these thoughts were not rational, but I was obliged to entertain them; day by day I smoldered in a sullen fury, and when I saw a carving knife I looked at it with a new interest. I agreed to the clinic because I thought that, if I were to act on my impulses, someone would see me and stop me—before, at least, it got to arson and stabbing, and the deaths of strangers who had never harmed me at all.
After a day or two in the clinic I felt a little calmer. No one saw me as a danger; the danger was all in my own head. At first I came and went; I would go back to Roebuck Road during the day and do the cleaning. One day I went down to town to buy myself a nightdress. But because my vision was blurred, I misread the label, and came back with a size 16 instead of a size 10. “Look at this monster garment!” I cried gaily to the nurses; I was having one of my less murderous days, and trying to lighten the tone. “Look what I bought!”
My nightdress, I found, was viewed in a grave light. Why had I bought it? It was a mistake, I said, you see I … Didn’t you hold it up? they asked me. Well, no, I, I just liked the pattern, I … Didn’t you remember what size you were? Did you feel you didn’t know? Yes, I know my size, but you see, my eyesight, it’s misty, it’s because of the drugs I … oh, never mind.
But they wouldn’t drop the topic. It was obviously characteristic of mad girls to buy big ni
ghtdresses. Every time I spoke I dug myself into a deeper hole.
Dr. G. came to see me. Well, and what was I doing with myself now that I was free from my struggles with my textbooks? I have written a story, I offered brightly. It was a long story—that is to say, a short story, but long as these things go. Short but long, said Dr. G. Hm. And what was it about? A changeling, I said. A woman who believes her baby has been taken away, and a substitute provided in its place. I see, said Dr. G., and where and when did this occur? In rural Wales, I said, funnily enough. (I’d never been to Wales.) I don’t have to say the date, but it feels like the early 1920s. I mean, judging by their furniture and clothes. Does it? said Dr. G. It’s a time well before social insurance, anyway, I said. The doctor won’t come up the mountain to see them because they can’t pay. I see, said Dr. G. And how does it end? Oh, badly.
If you didn’t respond to the first wave of drugs—if they didn’t fix you, or you wouldn’t take them—the possibility arose that you were not simply neurotic, hypochondriacal, and a bloody nuisance, but heading for a psychotic breakdown, for the badlands of schizophrenia, a career on a back ward. To head off this disaster, doctors would prescribe what were then called the major tranquilizers, a group of drugs intended to combat thought disorder and banish hallucinations and delusions.
The next time I saw Dr. G. he forbade me to write: or, more precisely, he said, “I don’t want you writing.” He put more energy into this statement than any I had heard him make. He seemed as remote as ever, and yet inexpressibly angry. “Because—” he added; and broke off. He was not going to impart to me what came after “because.”
I said to myself, if I think of another story I will write it. In fact, I didn’t think of another story for quite some years—not a story of the long but short type—and when I did I sent it to Punch and what I got back was not a malediction but a check. The changeling too paid off, in time, in a novel published in 1985; the setting was not rural Wales, nor the 1920s, but the present day in a prosperous and dull Midlands town. The novel contained mad people, but no one suggested its author was mad. It’s different, somehow, when you’ve received money for your efforts; once you’ve got an agent, and professionalized the whole thing.
The first drug I was given was called Fentazine. That would do the job, Dr. G. thought.
Do you know about akathisia? It is a condition that develops as a side effect of antipsychotic medication, and the cunning thing about it is that it looks, and it feels, exactly like madness. The patient paces. She is unable to stay still. She wears a look of agitation and terror. She wrings her hands; she says she is in hell.
And from the inside, how does it feel? Akathisia is the worst thing I have ever experienced, the worst single, defined episode of my entire life—if I discount my meeting in the secret garden. No physical pain has ever matched that morning’s uprush of killing fear, the hammering heart. You are impelled to move, to pace in a small room. You force yourself down into a chair, only to jump out of it. You choke; pressure rises inside your skull. Your hands pull at your clothing and tear at your arms. Your breathing becomes ragged. Your voice is like a bird’s cry and your hands flutter like wings. You want to hurl yourself against the windows and the walls. Every fiber of your being is possessed by panic. Every moment endures for an age and yet you are transfixed by the present moment, stabbed by it; there is no sense of time passing, therefore no prospect of deliverance. A desperate feeling of urgency—a need to act—but to do what, and how?—throbs through your whole body, like the pulses of an electric shock.
You run out into the corridor. A man is standing there, gazing dolefully toward you. It is your GP, the man at the Student Health Service, the man with the rimless glasses and the polished brogues. The tension rises in your throat. Speech is dragged and jerked out of you, your ribs heaving. You think you are screaming but you are only whispering. You whisper that you are dying, you are damned, you are already being dipped into hell and you can feel the flames on your face.
And the answer to this? Another antipsychotic. An injection of Largactil knocked me into insensibility. I lay with my face in the pillow as the drug took effect, and sank into darkness; as I ceased to panic and fight, the hospital sheets dampened and wrapped around me like ropes.
After I woke up, I was maintained on Largactil, to combat my madness. It was not a friendly drug; it made my throat jump and close, as if someone were hanging me. This is how a mad person appears to the world—lips trembling, speech fumbling and jerky. You can say, this is the drugs you know, this is not me; I am quite all right, inside myself. They say, yes dear, of course you are; have you taken your pill?
But then it was the end of term, the end of the year. My course of studies was over. The university’s responsibility was ended. I was discharged from the clinic. I went home, and was sane. The drugs wore off; I no longer twitched and jumped. I could have passed for normal in any company. My legs didn’t seem to ache so much; I had more abdominal pain, but I knew better than to mention it. For a time I claimed to be well.
But it was not so easy to shake off the events of the last year. The problem was the names of those drugs I had “needed,” spelled out like evil charms in my medical notes. Fentazine, Largactil, Stelazine. If I set foot in a GP’s surgery—as I did, when I grew increasingly sick—I ran the risk of being prescribed a dose of them that would knock an elephant off its feet. Then there was my old friend Valium, which I knew I shouldn’t go near: not unless I wanted to be arrested.
So when in time I went back to a doctor, I said I had backache, nausea, vomiting, that I was too tired to move. My GPs—to a man, and a woman—suggested a test to see if I was anemic. I never was. They had no other suggestions; except perhaps some Valium: and a little spell away might do me good? By the time I was twenty-four I had learned the hard way that whatever my mental distress—and it does distress one, to be ignored, invalidated, and humiliated—I must never, ever go near a psychiatrist or take a psychotropic drug. My vision blurred, in those days, entirely without the help of the antidepressants. Sometimes there were gaps in the world: I complained one day that the front door had been left open, but the truth was that I just couldn’t see the door. Sometimes it seemed that some rustling, suspicious activity was going on, at the left side of my head, but I couldn’t put a name to what it was. I couldn’t put a name to lots of things, my speech came out muddled: I called a clock’s hands its fingers, and a chair’s arms its sleeves.
I was all right if I stuck with abstractions, ideas, images. And some days I was half-well. I had a job, but I needed a pursuit, I thought. I went to the library and got out a lot of books about the French Revolution. I made some notes and some charts. I went to a bigger library and got more books and began to break down the events of 1789—1794 so that I could put them into a card index. I was very conscientious and with a mind for detail. If you had been having a revolution you would certainly—at such a stressful time in your life—have needed the services of someone as conscientious as me. I began to read about the old regime, its casual cruelties, its heartless style. I thought, but I know this stuff. By nature, I knew about despotism: the unratified decisions, handed down from the top, arbitrarily enforced: the face of strength when it moves in on the weak.
One day, on a escalator in a department store, a man put a hand up my skirt. Enough, enough, I thought. I turned around and punched him in the eye. I got off at the top of the escalator and walked away.
I didn’t like the world I was living in. It didn’t seem too keen on me.
I was too sick to do a responsible job, a professional job. I got a job as a saleswoman, and I thumbed my nose at Dr. G.; I started to write a book. I wrote and wrote it. Time passed. I moved to another country, another continent. Still I wrote it and wrote it.
Christmas week 1979. I was twenty-seven years old. I was in St. George’s Hospital in London having my fertility confiscated and my insides rearranged. When I was admitted, I knew I was very ill, but I didn’t know
quite how bad things might be, and for a time there was no agreement on the nature of what ailed me. Only that it was physical; only that I had a pain and it was real: only that it was a disease Valium wouldn’t cure.
My life had moved on by then, far from its early confines. We had wanted to travel, to see the world; my husband had exchanged carboniferous limestone for the sands of the Kalahari, fossils for diamonds. For three years we had lived in a small town in Botswana, a railway line settlement, where geologists and agriculture specialists rumbled over the unmade roads in four-wheel drives, where ticks and mosquitoes bit, where the days were short and hot and monotonous, and I sat behind the insect mesh of my veranda frowning over my card index, documenting the fall of the French monarchy, the rise of the Committee of Public Safety. I had pressed the juice of meaning from every scrap of paper I had brought with me, every note on every source. The book was finished now. But so, it seemed, was I. When we came home to England on leave, my book went to a publisher who offered to look at it. I went to a consultant who offered to look at me.
In the beds around me were women with complications of pregnancy, who were trying to hang on to their babies; women having abortions; women having their fertility ended by choice. The latter group were two cheerful middle-aged women, a little worn and raddled by life, who complained at the routine discomforts, the marching up and down corridors and waiting in a draft to have blood samples taken; even their complaints were cheerful, and they really amounted to grumbling about the fact that for a couple of days they weren’t in charge, because they were used to a situation where what they say, goes. They had taken this decision, they, for themselves: another baby, no thank you! They called the surgery “having my tubes tied”; I pictured the surgeon hauling ropes, shouting “heave-ho!” and consulting a book of knots. On my right there was a silent Turkish girl in her early twenties, having a termination which she was not, I suppose, discussing with her family; she wanted a cigarette, she said, just a little draw would soothe her. After the operation she appeared to have greenish-dark bruises around her eyes, as if someone had undertaken to knock sense into her. The bruises deepened to caverns, then lightened to a jaundiced tan. Then she was gone, discharged. When she climbed out of bed you saw her vitality, her dark bandy legs, her strength. She would have, you thought, just as many children as she liked.