Among the Mad

  Doreen stopped struggling and began to weep, tears falling across her face. “It’s bad, Billy. It’s bad here. Take me home, please, Billy. I want my boys, I want my Lizzie, take me home.”

  “We’ll get you out of here, don’t you worry. It won’t be long now.”

  “Don’t let them put them needles in me again, don’t let them do it.” Her breath came in short, rapid gasps, and her chest rose as she struggled for air.

  A staff nurse entered and stepped across to the opposite side of the bed. “Now then, Mrs. Beale, you don’t want any more injections, do you? Take a deep breath, come on, Mrs. Beale.”

  “I can look after my wife while I’m here, Nurse. Please leave us.”

  “Now, look here—”

  Maisie moved toward the woman. “I can be of assistance while you are out of the room, Staff Nurse. I am sure Mrs. Beale will settle in a minute or two—and I was a nurse in a secure institution, so I understand the importance of summoning you if help is required.”

  Doreen calmed as she listened to the exchange, and the rhythm of her breathing slowed as Billy stroked her brow to settle her.

  “Ten minutes, that’s all you’ve got.” The staff nurse shook her head and left the room.

  “Who does she think she is—ten minutes, my eye!”

  “Billy, you’re not helping Doreen,” Maisie whispered, as she came to the opposite side of the bed. She took a clean linen handkerchief from her pocket and wiped saliva from the sides of Doreen’s mouth, then turned toward the side-table, where a pitcher and bowl had been placed, along with a square of clean white muslin. Maisie poured cold water into the ewer, then steeped the cloth into the water and squeezed out the excess. Shaking out the fabric, she folded it horizontally and smiled at Doreen. “Now if Billy will just lift his hand for a minute, let’s cool you down a bit.”

  Doreen nodded, and looked at Billy, who was trying to release the straps that held her hands in place. And as Maisie wiped her face with soft strokes, then rinsed the cloth and swabbed her neck, she began to weep again.

  “I want my boys, I want my little girl.”

  “Love, Lizzie’s gone now, she’s gone. That’s why you’ve come here, so they can help you get over it.”

  Doreen began to gasp again, and Maisie shook her head at Billy. “Let’s just keep her calm. If we can get her transferred to the Clifton, Dr. Masters will know exactly how to approach her treatment. Let’s just settle her so they’ll release her from the straps and take her back to the women’s ward.”

  “I don’t want them doing this to her again.”

  Maisie continued to draw the cool cloth back and forth across Doreen’s forehead, and soon her eyes were heavy, her breathing became more shallow and she began to fall asleep.

  “Poor love, look at her, there’s nothing of her. She looks barely more than a child herself.” Tears welled in Billy’s eyes.

  “They’ll work through a standard set of treatments, trying to find something that works,” whispered Maisie. “I am sure she has had some kind of Faradism, and as for this insulin treatment—” She said no more, but gave silent thanks for the fact that removal of the ovaries, the fashionable treatment for melancholia in women some thirty years earlier, had long been abandoned.

  “What do you think will help her, Miss?” Billy rested his hand on his wife’s forehead once again, as Maisie ran the cloth down her arms and into her palms, removing the sticky sweat of fear from the exposed parts of her body.

  Maisie did not speak for some seconds, instead stroking the cloth back and forth along the inside of Doreen’s left arm, her eyes fixed on the thick leather strap and buckle that secured the sick woman to her bed. “Time is the great healer. I once knew a doctor who said that his real job was to keep the patient occupied while time and nature did their work. Doreen’s grief has run so deep that it now colors every waking and sleeping moment. It has leached down into the fibers of her being, so there are physical as well as mental disturbances and consequences.” She paused. “I do not want to preempt a doctor, however, I would imagine she will need a period of time in hospital, to stabilize her melancholia—the fatigue, anxiety, depression. She has doubtless suffered from the headaches and neuralgia that accompany her condition, so the doctors will want to get her on an even keel, alleviate her physical suffering to the point where they can address the deep-seated grief that has led to her malaise, her instability. She needs good nutrition, she needs to be calmed. And she needs to talk, but not to you or me or someone close to her. She needs to shed her sadness, like a snake sheds its skin, and that can be a troubling process, for a snake is at its most vulnerable at such a time.”

  “When you say, ‘talking,’ do you mean like Dr. Blanche did with me, when I went through my bad turn, a couple of years ago? And like you do with the people what come to you?”

  “That’s more or less what I mean.” Maisie wondered how to express her frustrations without upsetting Billy. “The trouble is, it’s always been those of a higher station in life than either you or I who could afford the sort of therapeutic process that Doreen needs. And progress must be accompanied by direction from a clinician such as Dr. Masters.”

  “Bleedin’ typical, ain’t it—about the toffs getting the best treatments, while the likes of us are packed away in nuthouses?”

  “You could say that. Frankly, it stems from a belief that the lower classes—and that means both of us—do not think and feel in the same way as our betters. Times are changing, though.”

  “But not fast enough, eh?”

  “No, not fast enough.”

  Billy and Maisie remained with Doreen until the staff nurse returned, and as she strode into the room, Maisie lifted a finger to her lips.

  “Mrs. Beale is resting now,” she whispered. “May we leave Mr. Beale alone with his wife for a moment?” She stood up and moved toward the nurse, taking her by the arm. “Perhaps you and I can have a word outside, while he says his good-bye.”

  The nurse frowned, but acquiesced, allowing Maisie to lead her from the room.

  “She’s a right nutter, that one,” said the nurse, as Maisie closed the door without a sound.

  “I beg to disagree with you, Staff Nurse. She is a woman who is wracked with grief, a woman who has buckled under the weight of losing a child. We now have to help her to her feet again, though that loss will always be with her.”

  “But thousands have lost, haven’t they? They don’t all end up inside, though, eh? Made of stronger stuff, that’s what they are.” The nurse tensed her jaw, and Maisie noticed the way she rubbed her hand back and forth across her abdomen as she spoke.

  “Mrs. Beale’s husband took her to the doctor, which is why she is here now.”

  “I don’t know, I think she’s had some mollycoddling, that’s what it is. I mean, when I lost my—” The staff nurse paused, clutched her hands together, then released them to reach for the door handle. “It’s time for him to go now. If she remains calm like this for the afternoon, then she’ll be back on the main ward by evening.”

  Maisie looked on as Billy lingered with his wife a moment longer, then she reached forward and set her hand upon his shoulder.

  “Better be off now.”

  Billy nodded, kissed Doreen on the cheek, and walked from the room without looking back.

  “I do hope you can get her out of here, Miss. I’d discharge her, if I could.”

  “I know, Billy, I know. She won’t be here for long.”

  And as they left the building, she thought of her father, and his words echoed once again: this was another desperate sort of place.

  MAISIE DROPPED BILLY at Fitzroy Square and made her way directly to Camberwell and the Clifton Hospital. When Maisie was shown into her office, Dr. Elsbeth Masters looked up over her tortoiseshell spectacles, smiled broadly, and reached across the desk to shake her hand.

  “Maisie Dobbs. I haven’t seen you since you worked for dear Maurice—how is he?”

  “In his mind, s
till very busy, but slowing down in his body—he’s getting on now.”

  Masters held out her hand for Maisie to be seated, then sat down herself, moving a patient file to one side as she spoke. She leaned forward, hands clasped, as they exchanged pleasantries and caught up on Maisie’s progression from Blanche’s assistant to proprietress of her own business. When Maisie first came to work at the Clifton, it did not surprise her in the least to meet someone who knew Maurice. There always seemed to be someone, somewhere in her life, who was acquainted with her longtime mentor.

  “Frankly, Maisie, I always hoped you would move into the clinical arena—we could do with more women doctors in the care of the mentally ill, you know, and things have moved on since my early days at the Royal Free. But I am sure your work is more than satisfying.”

  “Yes, it is—very much so.”

  “Now then, tell me what I can do for you.”

  “There are two reasons for my visit—the first is regarding the wife of my employee. I am close to the family and want to see an end to a difficult situation.”

  “Go on.” Masters took off her spectacles and leaned forward as Maisie continued.

  “Last year their young daughter died of diphtheria. They have two boys as well, but Lizzie was the apple of her mother’s eye, and such a dear, dear child.” Maisie bit her lip and paused. She felt quite ready to weep, an emotion that gripped her with such suddenness that she fought to stem the tears. “Since their loss the parents have struggled to come to terms with the fact that Lizzie is no longer there, but Doreen, my employee’s wife, has taken a downward spiral. She had been under the care of a doctor for some months—the child died last February—when it was decided to section her and she was sent to Wychett Hill a couple of days ago with a diagnosis of melancholia and hysteria.”

  “Oh, dear . . . ” Masters shook her head.

  “They have already proceeded with insulin shock and changes of diet, and I can see—we visited her this morning—that she has been sedated with narcotics. When we arrived she had been strapped to a bed and left alone in a room. I think the treatment is rather harsh, and that she would do better closer to home and under your care, if it were possible to effect a transfer.”

  “I see.” Masters tapped the desk with her long fingers, the backs of her hands embossed with a mesh of veins and dotted with liver spots. “Certainly, I believe we could make more progress with such a patient here. Let me make some inquiries—who was the admitting doctor, do you know?”

  Maisie reached into her document case, brought out a sheet of paper and handed it to the doctor. “You’ll find all the information you require here.”

  “Ah, as efficient as ever, Maisie.” She took the page of notes and slipped it into a fresh file, which she then marked with Doreen Beale’s name. “I take it I could telephone Mr. Beale at your office, if I need to reach him as a matter of urgency?”

  “Yes, of course. However, we are out of the office a great deal, so if you do not receive an answer, please send a telegram or postcard.”

  “Right. Leave it with me. I’ll see what I can do.” She scraped back her chair as if to stand.

  “Dr. Masters, there is one more thing, if you have a moment or two.”

  Masters looked at the wall-mounted clock. “Yes, of course. I’ve a few minutes.” She smiled and leaned forward again, her hands once more resting on the desk.

  “I know you were in France, during the war, and you were involved in the treatment of men with war neuroses of one kind or another.”

  “Well, eventually I was in France. At first, as you know, they told us women doctors that we should go back to our kitchens, but I joined one of the all-women medical units set up by Dr. Elsie Inglis—there was an indomitable woman for you—and was privileged to work with a truly dedicated and professional group of nurses and doctors. Before long my presence was requested by the boys at the top when shell-shock cases began coming through thick and fast, and I was able to work alongside men. And yes, it was my background in neurology and psychiatry that they were interested in.”

  “I am familiar with the different levels of war neuroses, Dr. Masters, the distinctions between neurasthenia, battle fatigue, soldier’s heart and hysteria, but I am involved in a case at the moment that demands—I believe—a deeper understanding of the mind of a man who has seen battle at close quarters and is afflicted mentally and emotionally by that experience.”

  Masters tapped the desk again. “Remember, there were many cases of shell-shock recorded where the patient had been nowhere near a detonated shell, nowhere near the front line of battle. Simply anticipating a move up to the front could turn some men. Unfortunately, despite the best efforts of myself and others with specific training in dealing with injury to the mind of a man, the army doctors—and the brass, I might add—wanted clean-cut delineations between wounded and sick, between shell-shocked and malingering. Wounded and shell-shocked would be granted the ‘W’ armband—and the pension that went with it. Simply being an ‘S’ case—sick—meant you were turned around and sent back up the line at the earliest possible opportunity.”

  “I understand. I’ve also been speaking to Dr. Anthony Lawrence—do you remember, he was here for a while, then moved to the Princess Victoria? He has said much the same thing. Anyway, I simply wanted to get some sort of . . . ” Maisie looked out of the window as she considered her words with care. “Some sort of reflection from you, as to what it was like to treat such an affliction.”

  Masters ran her hands through her short, bobbed gray-flecked hair. “That’s an interesting question. I don’t think anyone’s ever put it like that.” She sat back, then forward again, having considered the question. “I don’t know whether you know this, but I was born and grew up in British East Africa. My father had a coffee farm—it’s now run by my younger brother—so we had a very different childhood in comparison with our peers here. We were rather wild, if I may admit such a thing. We were both sent to school in England at age eleven, and although I returned briefly prior to commencing my studies at medical school, it is those early years that defined me, defined my sense of what I could do—I wasn’t used to anyone telling me that a girl couldn’t do this, or that. But here’s something that struck me in France. It was the memory of something I’d seen as a child.”

  Elsbeth Masters pushed back her chair and walked to the window behind her, where she placed her hands on the bulbous radiator as if to cleave from it a warmth she had known at another time. She turned to Maisie and continued, now leaning back against the source of heat. “I remember going off one day with my friend, a young Masai boy, the son of one of our servants. No one seemed to mind us playing together, out and about for hours until sundown, following the men when they hunted. On this particular jaunt we saw a lion take down a gazelle—and I mean at close quarters. It quite took my breath away. It was as if something happened to the gazelle at the moment of capture, something awe-inspiringly terrible and wonderful at the same time—as if, in knowing the gazelle was to die a dreadful death, ripped apart by the jaws of the lion, the Creator had given the captive a reprieve by taking her soul before she was dead, so that no pain would be felt because the essence had gone already.”

  Maisie nodded, able to see the scene in her mind’s eye, so charged was the doctor’s description.

  “And I saw the eyes of the gazelle again in France, and it struck me that perhaps a heartsick God had looked down and taken up a soul, leaving only the shell of a man.” She shook her head as if to extinguish the recollection, and brought her attention back to her visitor. “I sometimes thought that, in my work, I was really trying to create the conditions whereby a soul might be persuaded to join a man’s body once again, thus making him whole.”

  Maisie nodded.

  “You’re probably thinking, ‘Physician, heal thyself.’”

  “No, not at all, not at all.” Maisie smiled. “I was just thinking back to the days when I worked as a nurse with shell-shocked men at this hospital
—looking into their eyes and knowing that part of them was lost. Perhaps to return, perhaps not.”

  “Now, do you have any more questions for me?”

  “Just a couple. Do you know Dr. Lawrence well?”

  “Curious that you mention him again, because I hadn’t heard from him in years, yet I received a letter from him this morning, wondering if we might meet.” She shrugged. “I suspect he has a paper he’d like me to review before he reveals it to a wider peer group.”

  “How are you acquainted?”

  “Funnily enough, it wasn’t directly to do with our regular work with the insane, but years ago, in connection with patients who had suffered in gas attacks.”

  “I see.”

  “Yes. There was a team of boffins—you know, scientists, physicists, that sort of person—working in Berkshire on antidotes to gas. There was some experimentation, I think you would call it, and they were interested in having a degree of neurological and psychological assessment as part of their research.”

  “Did you work for them?”

  “For a very short time. I wasn’t sure if it was a command or request, to tell you the truth, but I didn’t like what was going on. I looked into it, you see, and realized that they were—if you’ll forgive the phrase—playing fast and loose with the health of anyone and everyone who worked there. Anyone or thing who breathed could be dragged in for an experiment or test. I could just imagine it: ‘Just put down the teapot, Mrs. Smith—breathe through this mask and tell us how you feel.’”

  “And Dr. Lawrence? Did he continue?”

  “I believe he did, for a while.”

  Maisie nodded and looked at the clock. “Thank you so much for seeing me—and for anything you can do for Mrs. Beale. She is in a desperate situation.”

  “Yes, I understand. I’ll take this along to admissions now—we could have her transferred within the next four or five days if all goes well.”

  Maisie stood up to leave, and as she held out her hand to Elsbeth Masters, the doctor stepped from behind her desk. It was only then that Maisie realized the woman was not wearing shoes, and stood before her with bare feet.