The Four-Gated City

  ‘And Paul, ’ said Martha.

  ‘Yes.’

  ‘I think you should come home and try.’

  ‘Will you ask Mark first? I mean Mark might not…’

  Lynda collapsed back on her bed and lay weeping, a handkerchief clenched in her fist, which was pressed to her cheek.

  Oh, don’t take any notice, ’ she muttered. ‘I cry and cry, I don’t know what for.’

  The nurse came back, smiled at Martha, and stood quietly by Lynda’s bed.

  ‘Mrs. Coldridge, ’ she said, ‘would you like to get up now and come down for supper?’

  ‘No, ’ said Lynda.

  ‘I think you should try. You’ve lost far too much weight, you know. You don’t want us to have to give you insulin, do you?’

  ‘Give me arsenic if you like, ’ said Lynda.

  ‘Now, Mrs. Coldridge, ’ said the nurse.

  ‘Oh all right, I’ll come in a minute.’

  The nurse lingered, left. Lynda sat up.

  ‘Talk to Mark, ’ she said. Sitting on the bed, she stripped off her gown. She was certainly very thin, her collar bones stuck out, her shoulders showed blades of bone. She leaned over, pulled a roll of pink out of her locker, drew it over her head, slid down to the floor with a bump, and unrolled the pink downwards on to her. It was, when pressed and looked after, a very pretty dress. Lynda stood, with rumpled pink hanging on her, running her grubby hand through lank hair.

  ‘I’ll get some food inside me, ’ she muttered. ‘Talk to Mark.’

  Martha kissed her and left, through flowerbeds and shrubs and trees.

  She went to see Dr Lamb.

  About a week before Dorothy slashed her wrists, Martha had seen, among the pictures that moved in her inner eye (very numerous these days), a scene of Dorothy, in a lacy black petticoat, that had a rip in the lace under the left arm, leaning over the basin in the downstairs bathroom. Martha saw this from the back, and slightly to one side. Dorothy turned, blood running from one wrist. In the hand whose wrist was running blood, she held a razor blade, and was sawing at the other. What impressed Martha about this was the care with which Dorothy did it. Her face, vindictive, was frowning with concentration. There was a smudge of blood on her cheek-bone.

  When Martha went down to the basement on the morning this scene took place (in life), because of the screams of the cleaning woman, Dorothy had fainted. She wore a black lace petticoat, ripped under the arm, and had blood on her face and on both wrists.

  This was by no means the first time this kind of thing had happened, but Martha was now brooding about possible responsibility. Should she have gone down to Dorothy and said:’ Excuse me, but you are going to slash your wrists, please don’t! That is, unless you have already done it at some time? You will be wearing a black lace petticoat, ’ etc.

  Or she could have rung up Dr Lamb: Dorothy is going to slash her wrists, she might have said. Oughtn’t she to be persuaded not to? Yes, I know she has taken overdoses in the past, but this time, it will be her wrists.

  To Dorothy she might even have said, entering the persona of a Rosa Mellendip: Beware of a black lace petticoat that has a rip under one arm!

  The thing was, she had a great reluctance to think about it at all: cowardice. She knew perfectly well it was cowardice; and she approached Dr Lamb as it were with a sideways crab scuttle, trying to think out ways to ask questions and not expose herself. She was afraid of Dr Lamb-of the machinery.

  There was no one else to ask: that was the point. Very strange that, when you came to think of it. She was afraid of Dr Lamb, and of the power that he had, yet, with a certain kind of question there was nobody in this complex and so-sophisticated society, that she could ask.

  There was nobody, ever, who could approach Dr Lamb without a certain kind of tremor. When he spoke to law courts, or advised policemen, or sat in judgement about this sick person or that: when a mortally confused human being sat before him, what Dr Lamb said was the truth. Very, very strange, no matter how one looked at it.

  Apart from Dr Iamb’s wife, or mistress, or child, or close friend, there was nobody who could approach him without this tremor, the slave’s silent withdrawal behind defences.

  As for the people who actually became Dr Lamb’s patients, and must submit to this or that treatment, they were all there as a result of force, or pressure, direct or subtle-that of society, their families, an ordinary doctor who was out of his depth. Or Lamb, whether benign, cruel, a secret lover of power, or a man gifted with insight, was always in a position of strength. Because it was he who knew-society had said he did-everything that could be known about the human soul. Or rather, while he would be the first to concede that his knowledge was merely provisional, this was not reflected in the way patients were treated.

  This was the central, the key fact, about this great machinery of psychiatrists, psychoanalysts, psychologists, social workers, clinics, mental hospitals, which dealt with what they referred to as the mental health of the country. In any situation, anywhere, there is always a key fact, the essence. But it is usually every other fact, thousands of facts, that are seen, discussed, dealt with. The central fact is usually ignored, or not seen.

  The central fact here was that nobody approached Dr Lamb unless he had to. In approaching Dr Lamb one approached power. It was hard to think of a power like it, in its inclusiveness, its arbitrariness, its freedom to behave as it wished, without checks from other places or powers.

  There was in fact only one check: was Or Lamb by nature a man who had some kind of humility about this position he held, which was an almost unlimited power based on an admitted ignorance?

  Dr Lamb was not sitting in his chair; but at the end of the room where two small easy chairs were by the window. Martha had said on the telephone that this visit was not on her own account: he was showing tact, delicacy. This was going to be treated almost as a social occasion. In a few moments a small tray appeared with tea.

  ‘I saw Lynda, ’ said Martha. ‘I went to the hospital.’

  ‘Ah, ’ said Dr Lamb. ‘I tried to get her into another, but at such notice, there wasn’t a choice.’

  He was apologizing for the hospital.

  ‘Would you say that Lynda was worse than she was?’

  ‘Of course, I’m not dealing with her personally. But I spoke to the doctor who is handling her, over the telephone, this morning.’ He took off his glasses, and laid them aside. He looked very tired.

  ‘Of course you visited Mrs. Coldridge before, in the private hospital? You know, those enormous fees relatives pay, it’s not for better treatment, on the contrary, it is often worse.’

  ‘I suppose they feel they are more in control of what goes on, ’ said Martha. ‘If they are paying …’

  He looked at her-acute, but he did not see her point. ‘Waste of money, ’ he said. ‘Unless, of course, relatives just want to get rid of somebody and pay to have them kept comfortably-conscience money. But for someone really ill, I’d never advise it.’

  ‘Lynda wants to come home, ’ said Martha.

  ‘She asked to go in. She can leave when she wants. But if she is returning into the situation which if you like, triggered her off, then…’

  This was a question. He wanted to know what had triggered Lynda off. This meant the doctor who dealt with Lynda did not know; or that Dr Lamb did not think much of that doctor; or that Dr Lamb was trying to find out something about her, Martha.

  Martha said:’ Lynda gave up the drugs about a year ago. That was one thing. And then, her son decided to-come closer. Two things. And then Dorothy-three things.’

  He looked at her. Then:’ Her son decided?’

  Panic began to rise in Martha. She said:’ Mark and I talked about it-well, for years we’ve been talking about it. You know-Paul and Francis. Francis is never at home because of Paul. Paul is going to be at home all the time. We thought

  ‘It was Mark’s idea?’

  Guilt almost overwhelmed Martha: it was her fault. She
fought it back.

  ‘It was as much his idea-but it was I who suggested we should actually try to make Francis be at home more.’

  He remained silent.

  ‘Well, was that the wrong thing to do?’

  ‘Not if she can stand it.’

  ‘I think she would have stood it if she hadn’t been fighting the drugs. And if Dorothy wasn’t jealous.’

  Martha sat thinking: within five minutes, I sit overwhelmed with guilt. Why? Should I be? Did he mean to make me? For two pins I’d rush out now and not say what I want to say … She made herself sit quiet.

  ‘About Dorothy, you’ll have to deal with that when it arises. She’s definitely not well enough to leave hospital at the moment. There’s been another suicide attempt. About the drugs: when patients in Mrs. Coldridge’s condition give up the pills, then they usually land back in hospital pretty fast.’

  ‘Well now, that’s what I wanted to ask. Suppose Lynda had arrived in hospital and had not been given pills, what then?’

  He said nothing: he looked inquiring.

  ‘What I ask specifically is this: do you know the effect on someone if for years and years-in Lynda’s case, getting on for fifteen years, they are always full of some kind of drug?’

  ‘I see.’

  He did.

  There was a considerable silence. ‘Mrs. Hesse, I don’t think there’s a doctor in England who is satisfied with what he’s got to work in. If we had ideal conditions then-but we haven’t. In Mrs. Coldridge’s case I can say definitely yes, she ought to take what we prescribe for her.’

  Dr Lamb had withdrawn from responsibility, as of course he had the right to do.

  Some years before, an Act of Parliament had been passed, which had taken bars off windows, unlocked doors, made strait-jackets and padded cells things of the past, created hospitals that were civilized. Well, not quite. Because, for this bit of legal well-wishing to work, it needed that a great deal of money should be spent on new buildings, doctors, nurses. This money was not being spent. (It was being spent on war, the central fact of our time which is taken for granted.)

  Inside the dozens of mental hospitals scattered up and down the country, built like prisons, were many thousands of people who had been strait-jacketed, forcibly fed, kept in padded cells, beaten (in fact, the central fact, had had their wills broken), and were now derelict, ‘deteriorated’. This was not Dr Lamb’s fault, who administered machinery he had not invented. Like the educators, and the ordinary doctor, and like everything else-he was part of a bit of machinery which was supposed to be working to a blueprint which in fact had never been put into operation, because there was never money for schools, hospitals, mental hospitals. The money was spent on war. Thousands and thousands of people all over the country could look forward only to death, they were the victims and the casualties of the past. Meanwhile, all over the country, hundreds and thousands of people, more and more every day, were in conditions which Dr Lamb wished were much better, but it was not his fault if they were not.

  At this point Martha nearly left-out of cowardice.

  She said: ‘I want to find out something. I’m trying to find out-you say Lynda is schizophrenic.’

  ‘Yes.’ He smiled. ‘You are not, Mrs. Hesse.’

  ‘Do you know what schizophrenia is?’

  ‘No, but there are different theories. And we are treating it better than we did.’

  ‘Supposing I came to see you and said I hear voices, would I be schizophrenic?’

  He said easily:’ It depends. What kind of voices?’

  ‘And pictures, before my eyes?’

  ‘A great many people see pictures before their eyes, usually before they go to sleep, and as they wake up. And hear voices.’

  ‘That’s normal, not schizophrenic?’

  ‘Quite normal.’

  ‘If I said to you …’ Martha began, and changed it. ‘No, I am saying to you: I saw a scene, a vision if you like, of Dorothy slashing her wrists before she did it.’

  He remained where he was, not moving. But the muscles of his face tightened slightly: she knew it was a waste of time, because now what he said would be measured, would be diagnostic questions only.

  ‘Have you ever heard of déjà vu? ’

  ‘Yes. And read it up.’

  ‘Dorothy has made suicide attempts before, ’ he said. ‘You knew that?’

  ‘Yes. She has taken overdoses of pills, hasn’t she?’

  ‘Yes. She is a suicidal type.’

  ‘I saw something I was predisposed to see?’

  ‘Yes. You imagined it.’

  ‘Dr Lamb, what is imagination?’

  He hesitated now, then gave her a charming gentle smile, almost teasing. ‘Mrs. Hesse, you aren’t ill, I can assure you.’

  Oh. You think I’m upset because of Lynda and Dorothy both landing back in hospital?’

  ‘Are you sure you are not?’

  ‘Well then … no, I want to go on. If someone sat here and said to you, Dr Lamb, I hear voices-no, no, don’t smile. I want to know, what would be the thing they said, they did, which would make you say “schizophrenic” and not just, oh well, everyone does that?’

  ‘I’d ask them, do you imagine it? And the reply will be no, I hear voices. Real ones. Like yours or mine, Mrs. Hesse.’ He emphasized this, meeting her eyes, half in inquiry, half to make it sink in.

  ‘An imaginary voice then is fantasy-one sits and has a sort of day-dream-that’s imagination?’

  ‘Yes.’

  ‘But a real voice, that’s serious?’

  ‘A typical reply will be: everyone is talking about me, everyone is jeering at me. They want to kill me.’

  Martha suppressed:’ Perhaps they do!’ She said:’ And what happens then?’

  ‘We treat them.’

  ‘And then the voices and the pictures go away?’

  ‘That is the intention, yes.’

  Or Lamb, if someone is hearing voices, seeing pictures, they must feel abnormal-different. People hate being different from other people. Don’t you think that

  He said:’ It happens two, three times a week. The man who was here before you were, as a matter of fact. I say this: “I know you hear voices. I know you do. You don’t have to convince me of that. But I am a doctor, and a very great number of people sit there and say they hear voices. I tell you, you are deluded. We can treat the condition.” I assure you I don’t, none of my colleagues would, try and make them feel different, or make it worse.’

  ‘You say, “I know you hear voices, I know that, but you are deluded"?’

  ‘Yes. Because they are, ’ he insisted gently.

  ‘Perhaps there are different kinds of voices?’

  ‘Well yes, some say they hear voices in the air, or coming out of walls. Others say the voices are in their heads. Real voices. Like yours or mine.’

  ‘But the real criterion, the test is, whether this person says he does hear voices. If he says yes, he does, he doesn’t imagine it, and you can’t talk him out of it, then that’s it, he’s deluded?’

  ‘Well, yes, that’s about it.’

  ‘So if someone persists, he sticks it out, then he’s likely to be classed as schizophrenic and treated as one. But if he says…’

  ‘Mrs. Hesse.’ he said again. ‘I do promise you, you can take my word for it, you’re not a schizophrenic.’

  ‘Yes, but Dr Lamb, supposing I insisted I had seen Dorothy’s suicide exactly as it was, and I went on insisting, and you said no, I imagined it, and then I got angry and shouted at you, and went on shouting, and called you names, what would you call me then?’

  ‘But you aren’t shouting, ’ he said. ‘You are entirely rational.’

  He was waiting, infinitely ready to be kind, to reassure, and if necessary to-give out pills.

  She said:’ Well thank you. About Lynda-if she comes home, I think you can take it she will try and do without the drugs.’

  ‘Well, it’s up to her of course. But if I were y
ou I’d try to persuade her. I don’t think this spell in hospital has done her much good. She’ll need time to get over it.’

  ‘Will you give instructions that she can leave?’

  ‘Mrs. Hesse, all she has to do is to tell the doctor she wants to leave.’

  ‘I see. Well, thank you. Please send me the account. I came for my own curiosity.’

  ‘Very well. Look after yourself.’

  ‘Yes, I will.’

  ‘And how is your mother?’

  ‘She’s dead. She died less than a year after she went back.’

  He said humorously:’ And that was your fault?’

  ‘When you say it I can’t help feeling it might be-but not when I think it over.’

  Lynda did not come home immediately. It appeared the hospital was very overcrowded, patients did not see doctors ottener than once a week, and one week was missed because a doctor was ill. In the end, Dr Lamb intervened, and she came home. She was very thin indeed, low, inclined to weep and to blame herself for many faults, past and present.

  Meanwhile Paul had gone to school. He went on the first day of term; and returned bitterly, violently complaining. After the freedom of the school he had left, he was going to find this one hard. He was in a class with forty other children, for one thing.

  Suddenly Martha was very busy again. Suddenly there was no time for the sessions when she sat alone in her room. The early mornings were occupied with getting Paul up, fed and to school- an exhausting business, a fight all the way. And Lynda, alone, wanted company and a great deal of reassurance.

  Martha began dreaming. Her nights became filled with fantastic, instinctive or routine dreams. It was as if something in Martha that needed to talk, to express, to speak, to advise, could use this channel or that-pictures, or voices, if she was able to sit quiet in her room, waiting, listening. And if not, was quite prepared to use dreams instead.

  Chapter Two

  A visit to Margaret Patten’s house in the summer of 1958; not a dropping-in, a passing by, a collecting of children, or of plants, but an event which had been built up to, expected, planned for, experienced painfully, or at least vividly, and afterwards remembered. A visit typical of all such occasions in its quality of muddle, confusion, general irritation-for so things continued. It seemed impossible that these people should not be all at cross purposes.