There is the sound of the front door opening. It is too early for my father, so I know it must be one of my grandparents, Gran or Gramps. And it is indeed Billy, retired from baking now and with too much time on his hands. Still, it is unusual for him to come around by himself without Grace.
He walks into the kitchen, too fast, as if there is something that must urgently be done. What is left of his silver hair is uncombed. He seems terribly old to me, but he is only in his sixties, neat and apparently healthy. He is mouthing something that at first I cannot make out. It sounds like Chisgorn.
He is repeating this phrase wildly. I cannot make sense of it. He is shaking his head, as if something quite infuriating has happened. I can see that my mother is also confused, but senses that what he is saying is important, vital.
Chisgorn. Chisgorn.
My mother puts her arms around Billy, who has begun to shake. I stand up from my chair, as if to do something, although I cannot imagine what it should be. I have understood suddenly what it is Billy is saying.
She’s gone. She’s gone.
I realize that what he means is that Grace, my grandmother, has died. Something goes still within me, as if resting before some great activity. Neither my mother nor Billy is crying, but the way they hold each other appears to form a support arch, to prevent each slipping down. I feel the overwhelming need to do something, while realizing that there is nothing to do.
After a while they separate and Billy sits down next to me. My mother remains standing and starts to make tea, to soak and soften things. As Billy talks, he does not meet anyone’s eye, as though he is ashamed of what has happened. He concentrates on the surface of the table, occasionally raising his eyes to dart a look at my mother, who is stiff with something now, grief or forbearance.
Went out, me and Alan. An hour or two. Needed some milk. She wasn’t there. I called out, but – We had the milk. The Co-Op was closed so we – Anyway, it was raining. She wouldn’t have – She was in the toilet. I knew right away. Had a turn. Alan went round to Dr Smith, but I knew. Oh, chisgorn. Face all purple. Heart attack, it was. Well, she was a big woman. Oh, God. What am I going to do?
My mother began to cry, and went on more or less continuously for three or four hours.
She was more controlled when Billy himself died, two years later. This time, it had been expected. From the moment Grace had been cremated, he had begun to erode. This disintegration found its expression in lung cancer, which began to consume him particle by particle. He now lived in the house with just Alan, who was well into middle age, more eccentric than ever and working as a park keeper, mocked and ridiculed by local schoolboys. Alan and Billy fought bitterly; Grace had been the buffer and with her gone they collided.
Billy was terrified of dying. I would take his dinners round to him sometimes and he would prop himself up on his pillow, muttering.
Timmy. Timmy, I’m so scared.
I would not answer at first. This was not how dying was meant to be. My mother always told me that as you grew older, you ‘adjusted’ to the idea of dying, you accepted it. But the fear that spread from Billy’s bed was thick as dust. It made me uneasy. It was embarrassing.
Timmy, I’m –
You’ll be OK, Grandpa. You’ll be up in no time.
Nah. Nah. I’m dying, son. I’m going to die.
He would begin to cry. I was shocked.
You’ll be up in no time.
Nah.
Billy finally died, in King Edward’s Hospital, a few months later. My mother seemed to accept it. The death of Grace had prepared her and the grieving seemed brief, restrained. For me also, I had somehow become accustomed to the idea of this impossible absence, this ridiculous hole in life. When Grace died I was, more than anything, incredulous that such a thing was possible. But now I got it, now I understood. One day, sooner or later, people simply disappeared.
It became clear after the deaths of Billy and Grace that Alan, hitherto thought of as merely ‘a little simple’, had more complex problems. At the funerals of both his mother and his father, he gave the impression that he was attending a party rather than a wake. Chattering non-stop, and at ten or fifteen decibels above a normal level, he grinned and nodded as the cortège pulled up outside Rosecroft. In the slow haul of the cars towards the crematorium, the stream of chat – about his model boats, which he sailed on the Serpentine, his Airfix aircraft, his minor health problems – went on without pause. Even as the doors opened and each coffin began to slip into the flames, as his mother and father, his only protectors, disappeared for ever, Alan muttered and called out, a grin pasted on his face. At no time did he cry. No one had ever seen Alan cry.
Jean knew now that the responsibility for Alan remained with her. Norman, who had married and then been abandoned with his three daughters, did not have the time, or much inclination, to help. To leave Alan to his own devices was not an option. Jean’s sense of duty to her family, being the greatest part of what she was, could not be avoided.
After Billy’s funeral, Jean took Alan under her wing. He was an essentially good man, although eccentric and, in some ways, faintly autistic. Every night he would come around for dinner, despite the fact that he was vexatious company. Smoking non-stop, his voice would somehow get louder by degrees, running like a tape-loop of static, incessant and deeply banal. He would repeat himself constantly. When the TV was on and we were trying to watch Morecambe and Wise or The Good Life or Harry Worth, he would carry on his monologue, interrupting it only for laughter that was idiotic and cacophonous, blotting out everything else. The laughter was always in the wrong place. His voice was rough as ground pepper and cast a harsh light, like a probe into the hidden root of family.
I ’ad a job in Sowfall Pahk, right? They give me the push for skiving. Fell asleep in the bleedin’ wheelbarrer, didn’t I? Then it was the council. A right con. Doing the verges and that. Got off on the sick. I got piles, see? Then I got this, what is it? Ulcer. Half me gut hanging out. I just lay in the ahse not doing nothink. Well, that was that.
And so on.
Then Jean began to notice that Alan was becoming gradually more dishevelled and indifferent to himself. His complaining – about his health, his doctor, the dole office, the weather, anything at all – was becoming more relentless. After a while he stopped coming round to dinner.
Alan had gone to bed and would not get out. As if his body was grieving on his behalf, the skin opened and wept. He developed large, plate-sized sores all over his body and face. Soon he could not even be bothered to go upstairs to bed. He lay on filthy rags in the back room. The chaise-longue had gone now, but the record player was still there, and a Rayburn fire, and a bookshelf with unread copies of Zane Grey on it.
Jean began to take his dinner round to him, to clean and tidy the house, to sponge-bath and shave him. Nothing made any difference. In a strange echo of my grandfather’s breakdown in 1939, my Uncle Alan had, through grief, withdrawn from the world.
The house, once neat and meticulously ordered, its step bleached white, began, despite Jean’s efforts, to crumble under the force of entropy and indifference. The front garden became overgrown with weeds and inside there were grease marks on the disarranged furniture. Alan’s abandoned train sets and Airfix models dominated the rooms, while he lay motionless, apart from a soft, endless picking at his skin that made the sores larger and deeper.
The sight of Alan tormented Jean. She had made a promise to her mother she would look after her simple brother whatever happened, but it was a promise she did not know how to fulfil. She considered bringing him into her own house, but feared it would damage her marriage. Instead she visited every day, bathing his sores in salt water and bringing hot food, which he would often leave untouched, declaring openly his wish to die.
I’ll stick my head in the gas oven. I’ll do meself in.
Meals on Wheels began to visit. For the first time, the social security blanket descended on the family. It was a kind of shame, but Jean c
ould not look after Alan single-handed. Jack took him to the family doctor, Falconer Smith, in Allenby Road, and Alan was prescribed an assortment of sleeping pills, since he complained of insomnia. The pills, which he took overlarge doses of, seemed to crush him further. He took an overdose, a whole bottle of phenobarbitone, only to sleep for thirty-six hours and wake with a cracking headache. Now he would not even get out of his rancid pyjamas or shave.
One day Jean went round to take his dinner. Alan was outside the house, in his pyjama bottoms, his buttons undone, his cock and balls visible. He had dropped his plate from Meals on Wheels and was scraping the food off the pavement. His torso was bare, pitted with red welts. It was as if he were decomposing. Jean tried to lead him back inside, but a neighbour, a recently arrived Ugandan Asian, who worked for the health service as a nurse, intervened.
Don’t take him back inside. They won’t do anything if he’s indoors. If you take responsibility, they will not. Leave him. Call an ambulance.
And so it was that Alan was admitted to St Bernard’s Hospital. Jeff and I had sniggered, as children, as we passed it on the way to Aunty Olive’s in Brentford.
That’s where the loonies are.
We would whisper, half in mockery, half afraid, staring at the barred windows with a thrill. And now Alan had been admitted into one of the long wards, where men in dressing gowns sat for hours, staring into air smelling of paraldehyde and pissed-on sheets.
Each time Jean went to visit, she left in shame and despair, horrified at the parade of sadness that was arrayed inside the walls.
How can they live like that? People just standing around. Not doing anything. It’s terrible. Terrible. Poor Alan. If only I could –
But there was nothing she could do. It was for the doctors to sort out, those shrunken, infallible gods.
*
Around this time, the time my uncle, with his bog-brush hair and busted-klaxon voice, was admitted to what I then still cheerfully referred to as the loony bin, two obliquely connected events took place. First, I went to see a particular movie at the Ealing AB C with Debbie. Her perfume was Rive Gauche. Her hair was cut in a soul-girl bob and she wore a velvet choker and hoop earrings. Second, two patients at a hospital in Stockholm committed suicide.
The film was sharp and affecting, one of the best of that decade – better even, I thought, than Emmanuelle or The Exorcist. Since I had pretty much given up reading books, the movies and TV were the main part of the flickering hypermarket where I picked up information about, well, more or less everything, I suppose. I didn’t see them at the time as forming my beliefs, because I wasn’t aware of having any beliefs. I didn’t believe in them, you might say. I didn’t understand then that you have to have them, one way or another. You don’t have a choice. It’s really just a question of acknowledgement. And films fed them, if anything did. Fed, frame after frame, those unstated, unacknowledged beliefs – ‘overbeliefs’ someone smarter than me once called them. What I thought about Vietnam was what I took away from Apocalypse Now. What I thought about social workers was what I picked up from Cathy Come Home. And what I thought about mental illness was lifted raw from One Flew Over the Cuckoo’s Nest.
It was this film that I went to see in 1975 with Debbie. As I say, it was a good movie; at the time, I thought it a great one. I was moved, I think, to tears of pity and rage. I found the movie deeply cathartic. The picture it presented of a mental hospital imprinted itself indelibly on my mind, as much a matter of poetic fact as of fiction.
One Flew Over the Cuckoo’s Nest tells the story of how a ‘free spirit’, R. P. McMurphy – played by Jack Nicholson – is crushed and destroyed by a hostile, almost psychotic medical establishment. He is drugged, shocked and finally lobotomized into submission and conformity. When I left the cinema, I had several impressions formed, or perhaps they were existing impressions reinforced. First, I thought that mental handicap and mental illness were much the same: types of craziness personified by staring eyes, stutters, jitters, mutism. Second, paradoxically, was the idea that mental illness was not anything real, but an individual weakness promoted to ‘illness’ by a whole profession of middle-class control freaks. Third was the idea that the medical treatment of mental illness, by drugs, electric shock or surgery, was worse than unhelpful – it was barbaric, cruel and dangerous.
I did have another, more direct source of information about the subject of depression and madness: Uncle Alan’s hospital treatment. Unlike my mother, I did not visit every week; in fact, I remember going only once. It didn’t seem too bad to me at the time. His room was light and airy, and his terrible, self-inflicted sores seemed to be recovering. He moaned and complained when I went to see him, but Alan always moaned, it was a sort of hobby. There were, as my mother had told me, abstracted-looking men shuffling around the corridors in soiled pyjamas, but I didn’t pay it much mind. The mental agony my mother was going through seeing her brother in an institution was invisible to me. I was nineteen and as selfish as a newborn baby. Also she hid it, for if there was one thing Jean knew about, it was concealment.
Alan did appear to recover after three months, but then he relapsed and was taken back into hospital. Released again, he relapsed once more. Eventually, it was becoming clear that Alan was dependent on the hospital care and the drugs, mostly tranquillizers, that were being prescribed. Tranquillizers – Valium, Mogadon, Librium – were as much a 1970s fashion for doctors as loon pants were for me, and Alan had a medicine cabinet full of them. By the end of the decade one in ten men and one in five women had been prescribed them. In 1975, the year I went to see Cuckoo’s Nest, there were 20 million prescriptions for Valium alone in America. There were epidemics of tranquillizer overdoses across Britain.
It was Jack who decided, after talking with doctors, that Alan had to be left, effectively, to go to the wall. Jean, always more delicate than my father, found this a terrible decision to take. The threats that Alan continually made to end his life fell upon her like blows, but what, Jack, always the realist, continually asked, could they do? The doctors, those gods, who had put Alan on tranquillizers in the first place, had got him addicted. Now they said he had to stop, and in the stopping he might kill himself.
Jean and Jack told Alan that he could no longer come round for dinner. Jean, struggling against her deepest instinct, did not go to help him, or clear up his house, or bathe his always reopening wounds. Effectively, he was ignored. Either he pulled himself together or he died. Jean sat at home, drinking tea, thinking of her brother a few hundred yards away, lying on blood-soaked sheets, wasting away, filthy.
You don’t know how I suffer, she said to me once, but only when pushed, for my mother tried her best not to be a martyr, always strived to reject that most maternal basic power-play.
Almost miraculously, the cold-turkey approach worked. After attempting an overdose and practically starving, Alan, quite of his own volition, was forced into a decision. He took responsibility for himself. He flushed all his tablets down the lavatory. He began to recover, slowly at first, then more quickly. He started to sleep upstairs in the bedroom instead of on rags on the back-room floor. He put on weight. His sores started to clear up. After a while, he began to dress and shave, and go back to the Serpentine to sail his boats. He had been cured, cured of self-pity and dependence, and the curing had been his own doing.
I thought of Alan, I thought of R. P. McMurphy. It was clear to me that depression – if such a thing, separate from unhappiness, existed, which I heartily doubted – was simply an expression of weakness, or botched medicine. Alan had not been mature enough to deal with his grief and had looked for pity, from Jean, from the system, and for medicines to blot out his pain. The road of the doctors was the road to complete degradation and sapping dependence.
No, there was no depression; it was all bollocks. There were only forms and varieties of unhappiness, and the consequences of personal failure. Anything else was just excuses. Margaret Thatcher had in this year, 1975, been made le
ader of the Conservative Party, and our class – the respectable, upwardly clambering subtopians – were always Thatcherite in this respect at least: do it yourself, because no one was going to do it for you.
Of course I did not know about the other thing that happened in 1975 in Stockholm, because it took place in academic circles which were as alien to me as Papuan tribal life. It was an experiment in neurology, and it followed, as I say, on the suicide of two patients.
A researcher called Marie Asberg decided to examine the chemical compositions of fluids from the brain cavities of the suicides, the cerebrospinal fluid. She discovered that this fluid had low levels of a substance called 5H1AA. Further investigation revealed that more than twice as many depressed patients with low 5H1AA levels had attempted or committed suicide than those with normal levels. Those with the lowest levels killed themselves by the most violent methods. Every study since has confirmed the results of this experiment.
This was the clearest evidence yet that there was something distinct from unhappiness called depressive illness, and that its roots were organic. It was a deeply unfashionable view in 1975, a decade still in thrall to the ideas of anti-psychiatry expressed in Cuckoo’s Nest, at least among intellectuals (doctors, as the tranquillizer epidemic attested, were often of a different opinion).
The idea of depression as an illness had fallen out of favour with good reason. After the war the first real systematic study of ‘mood disorders’ took place. This was, as in the nineteenth century, overwhelmingly biased towards an organic, ‘scientific’ view of what more romantic individuals – most people, I suppose – like to think of as the human spirit.