Bedlam Read online

“No, of course not—” Now, still in shadow, his back to the window, which was half shuttered, he said in a reflective tone, “These assertions, Haslam, coming from one in a position of public responsibility I confess I find astonishing. Tell me this. What if he does recover? What then?”

  “Then we’ve got a Ministry that would keep a sane man locked up in a madhouse. But if you want him lucid, my Lord, you should know his recovery will be likelier out of Bethlem than in.”

  “Will it? In that case, sir—” and he started out in such a slow, quiet voice I thought, At last, accession to my request. Birth will out. This gruffness has been my trial by fire, the resentment what any practised politician must feel at acceding to anything. It’s only a facet of his strength. The plain fact is, if he wants to know what Matthews knows, he wants him lucid.

  Alas, I was mistaken. “I ask myself—” he continued, his voice rising steadily in volume and temper, “when patients are likelier to get better out of it than in—” shouting now—“if Bethlem should be a public hospital at all!”

  In the silence that followed this outburst, he lurched sideways to wipe spittle from his chin with shaking fingers.

  “If I might, my Lord, be permitted—”

  I was not. A flick of his glistening hand and I was dismissed.

  IN THE DEAD HOUSE

  In the carriage back to Moorfields, still a-tremble, I fell into reflection. If this was a war of worlds, which side was I on? The one I was leaving or returning to? The noble or the lunatic? Bethlem was a hospital, not a gaol. Any approbation I had won from the right side of town I had won by knowing what was what on the wrong side. If Liverpool and the government had their priorities, I had mine. This was a case of differing professional judgments. The politicians only wanted the nation safe, I only wanted justice for my patient.

  I was not on both sides but could see both.

  Yet, what if Matthews was in all but name a Green Cloth case like Peg Nicholson, only happening to come into our care before that provision was formally in place? How did I know the government lacked excellent cause to believe he was a threat to the King? Why should I take offence that my expert opinion counted for nothing in the matter? What can a nobleman and politician be expected to understand of madness, even if he has read my little book? What Liverpool did seem to know was Matthews posed a danger, which would suggest, as Sarah warned me, he knew something I didn’t. Matthews must have the equivalent of pulled a knife on the King. Who could blame Liverpool for thinking he might again?

  The carriage stopping, I looked out to see if we were out of the Strand yet and was amazed to see my own door. Time passes quick when you’re at a loss. Home again reminded me I had things to do: On top of three hundred other patients to worry about, a tour of the premises by Pinel was fast approaching. I had tried Liverpool; I’d remove Matthews’ chains; I’d have him learn engraving if he would. What more I could do for him I didn’t know, only that I had no more time to think on it now.

  Young John was sitting crossed-legged in the middle of the front hallway, awaiting my return, his little bow and arrow across his knees.

  “What’s this, lad?” I greeted him. “Are you powwowing?”

  “I made Hetty a paper canoe, but she crushed it. Did you see Lord Liverpool?”

  “I did.”

  “Did he give off light?”

  “Light?”

  “You said they call him The Dark Lanthorn because he gives off no light.”

  “Ah, light. No. None.” I was hanging up my coat.

  “But you thought he would—”

  “Yes, I did. I underestimated him.”

  “Did he mention America?”

  “Yes, he spoke with grave eloquence on that subject.”

  “What did he say?”

  “He said we should not have wasted the resources we did on the place.”

  “He said that? Does he think it was not worth the fight? How does he know? Has he been there?”

  “Liverpool? No, I don’t think he ever—”

  “I’m going, Father. I’ll be joining a hearty band of Indians and paddling down the Mississippi.”

  “Do you need to be an Indian to paddle down the Mississippi?”

  “Pardon?”

  He was following me to my office.

  “Does an English boy become a Red Indian, just like that?”

  “Well, he can live with them—they’re not brutes, Father—and grow his hair long and wear buckskin and smear himself all over with bear grease and grow dusky in the sun—”

  “Did you know, John, some say the Indians of North America are the Lost Tribes of Israel?”

  Here he halted and clapped his forehead in a droll stagger of surprise. “Not red-skinned Hebrews!?”

  “Aye. Why don’t you convert, get snipped, and save a voyage—”

  “But I want to paddle down the Mississippi—”

  I sat at my desk. He climbed into the chair opposite.

  “If you were a Jew,” I said, “you could paddle down the Nile, in a bulrush ark—Mind you, some people say Moses was Egyptian.”

  He gripped his chair arms in a clench of astonishment. “Not Moses an Egyptian!? An Egyptian Jew, I hope!” Growing serious he added, “Father, I do want to paddle down the Mississippi.”

  “Yes, and a dozen other ippi’s, -assi’s, and -gumi’s. Why not? But you must carry a life-buoy, write often, and solemnly promise to pay a visit now and then to your aged parents, who will be thinking of you every day.”

  He nodded, not listening. He was waiting for something. I looked at him. What a boy I had. “Father?”

  “Yes, my intrepid voyager?”

  “You said when you came back from seeing if The Dark Lanthorn gave off light you’d show me how you look inside a dead person’s head.”

  But of course. This was why he’d waited and followed me so expectant.

  Together we took the back way, through the Laundry House, past the maids with their arms plunged in steaming tubs, calling out endearments to their favourite, then down the side steps into the yard, his play ground, a strip of toy-littered lawn between the east wing and the Infirmary (the sod-ceiling part, now I think of it, of our Black Hole of Calcutta), and into the Dead House, which comprised on its main level the carpentry shop for coffin-making, etc., with downstairs the dissecting room, a usually-frigid half-cellar with open gratings for the longer preservation of the deceased, not the comfort of the anatomist. This was a Bethlem building John had never entered, and as we left the yard, he slipped his hand into mine, and as we descended the stairs, he squeezed hard at my fingers.

  The dead person’s head I had promised to show him was Mary Creed’s, prepared by me that morning before I left to see Liverpool. Mary was a good-natured woman deserted by her husband after he defrauded her of a small inheritance. When her four children were took from her she went out of her senses, imagining herself a boy (Matron White dotingly called her my beauty) and would bow and scrape like a footman to everybody and took humble delight in offering assistance to all, cheerfully attending the sick and suffering with a benevolence that made her loved from one end of the women’s wing to the other. Generally, the patients have a sympathetic compassion for their sick companions that the keepers can’t or don’t, but what Mary felt and did was exceptional. Yet she could never help others enough not to blame herself for losing her children and would tell you smiling she could hear the workmen under the window, erecting the scaffolding for her execution on the morrow. The day before her death she stole a patient’s wooden leg and mounted it in an attempt to hatch it like an egg to a limb of flesh and blood, and when she failed to effect that miracle blamed it on the misery of her sex and hanged herself with a strip of her blanket-gown.

  Now Mary lay on one of our slabs, that entire world of goodness contracted to what might have been a buckle in the fabric of a canvas sheet. Setting John on a stool by the head, I asked if he was sure about this and receiving a vigorous though wordless nod that he was,
lifted away the canvas to reveal the shaved cranium I had already slit across the crown, from ear to ear. Now I wondered what I was doing. It wouldn’t be the first time my boy’s preco-ciousness had me thinking he was older than he was. As I peeled down the skin of the forehead and folded it over the face far enough to expose the bone, my doubts did not diminish. But it was too late. All I could do now was act the man of science.

  Saying, “Here you see, John, where earlier today I cut the skull—” I easily lifted out the segmented plates, having spent twenty minutes that morning scraping the pericranium and dura mater from the interior of the bone, not wanting him to sit through that.

  Glancing at him, I saw his eyes directed where I indicated, but he was not leaning in for a better view. “And there it is—” I said.

  He made no answer.

  “The brain of Mary Creed,” I added, and looked at it. “This depression you see here, John, is called the lateral ventrical. This is where fluid from the spine collects. I mention it because it’s larger in maniacs. I found that out by spooning water into it—”

  I looked at him; he looked at me. He seemed a little pale.

  “Are you surprised the cerebrum’s not pink?” I asked.

  He shook his head.

  “Alive it wouldn’t look so pasty—There’s copious blood, only no longer at the surface. Observe—” With my scalpel I sliced into the pia mater. The blood welled up like quality red port, as it next did from the medullary substance. “D’you see—?” Awaiting his response, I idly palpated the brain and was astonished how doughy it was. “John—?” I had never felt a brain so impressionable. Could doughiness, I half wondered, be the key to benevolence, to generosity, to goodness itself? Is it possible a person’s nature is nothing other than their brain state metaphorized? “John, feel this—”

  When there was still only silence, I glanced round. He was clutching the edge of his stool, swaying, eyes squeezed shut. I put down the scalpel and swept him into my arms. Immediately he threw his own around my neck and held on like a drowning boy. With my free hand I re-covered Mary Creed, and we climbed the stairs. Outside, I set him on the grass. He put out a foot for balance, gazing about at his toys as if they were contraptions fallen from the moon. Then he walked over and picked up a ball and looked at it and took a deep breath, and said, “Dad, will you play catch with me?”

  Thank God I said yes, because he threw himself into seizing out of the air and returning my gentle lobs with such wild, earnest energy that I have never experienced love of any human being, no, not even of his own mother, as fierce as I loved my little man then.

  CROWTHER

  That night late I was back again in the Dead House carpentry shop at work on my mouth-key—to have it ready to show Pinel, so he could know that in England what we do for our patients is more than symbolical—when Bryan Crowther wandered through on his way to the basement dissecting room to start his day. He liked to have his post-mortem examinations out of the way earlier than the two or three hours before breakfast when he saw to the living, as he resignedly called them, as if the root of their afflictions was their reluctance to be dead. Once Crowther told me weepily of a brave eulogy for a lunatic spoke by the lunatic’s daughter, a girl only eight or nine, mentioning her beautiful long grey hair when he meant blonde, and that macabre little slip summed him up pretty well.

  Sarah used to tell me I only despised Crowther so much because he was what I lived in fear of becoming, were I ever to let down my guard. This was why I never gave him the chance he needed to do enough around the place to maintain his self-respect. I would say there was something in what she said. In light of how things turned out, there’s not a day I don’t regret how hard I was on him. Yet, at the time, I didn’t know what to do about it, when I could hardly bring myself to look at him.

  In appearance he resembled a slug that had staggered to its footpads after ten hours under a rock. Not so much fat as soft. Hair close-cropt, short almost as our inmates’, short enough to show the scar that wound from behind his left ear to the top of his head where I sewed him up the year before when he tumbled down a flight of stairs after he was kicked in the head drunk by a patient. He was in every sense a creature of the place. Sunlight excruciated his eyes. In them you saw the same swollen, muzzy look as entered any keeper’s after a few years of working and living in the galleries. It was the miserable, complacent gaze of a man the terms of whose employment allowed no life beyond the workplace except what could be guzzled from the beer tap. But Crowther lacked the stolid menace of a keeper, having more in common with the patients. His physiognomy betrayed the same twitching, beleaguered irresolution as theirs, his body the same absence of definition. He wasn’t mad though, Crowther, at least not yet, and not a fool either. And totally incompetent only when he swilled like a tinker, which was not every day.

  Sober, our surgeon showed a pathetic eagerness to be part of things, and that night he took an immediate interest in my mouth-key, though when he first detoured from his usual path to the dissecting-room stairs to stand and watch as I pondered a better shape for the handle, he had no idea what he was looking at. But soon as I explained the purpose of the key, which is simply to open the patient’s mouth, he understood, assuring me how painful he found it to consider the number of teeth he’d seen smashed and mouths lacerated because patients refused to eat or take their medicine. On this point we were in perfect agreement. Too many of our patients, especially the female, and among them the more interesting, left us to be restored to their friends without a front tooth in either jaw. I don’t suppose there had been a Bethlem keeper on the job more than four years who hadn’t lost a patient under his hand in the act of what is called spouting, or force-feeding by knocking out the teeth. When Mrs. Hodges, wife of the vestry clerk of St. Andrews, Holborn, had died that way two years before, I made a personal vow to him I’d discover a way to avoid this dreadful practice.

  “What’s your procedure with the key, then?” Crowther was curious to know.

  I explained to him how, if a patient insisted on keeping her teeth shut, we restricted her movements and blindfolded her, then squeezed her jaw, or used snuff to make her sneeze, or tickled her nose with a feather. Anything to get the teeth apart long enough to slip in the key. Then, the instrument consisting of an ovoid of flattened metal with a wood handle, all you did was depress the patient’s tongue, or with a turn of the wrist force her mouth open, for the insertion of food or physic as required.

  It so happened (Crowther now told me) he’d himself for some time been considering what material might be sufficiently flexible to make a hollow tube that could be fed in through the nose and thereby a nourishing wine posset, say, passed direct down the throat of patients who refused to unclench. Leather, he’d been thinking, lubricated with olive oil. But to his credit he immediately appreciated the genius of my key and right away was making suggestions for improving the handle, on the model of a simple corkscrew, the principles being similar: firmness of grip and ease of rotation.

  As we worked together on a drawing, the two of us looking at the paper and not at each other, we went on to talk, by way of the subject of forcing, about the general lot of the keepers, and he readily agreed when I said they didn’t have an easy life, always needing to compel and coerce individuals who were not only disposed to recalcitrance but capable within seconds of overwhelming violence. Combine this with daily exposure to madness on all sides, no life outside these walls, a steady diet of beer, the creeping infirmities of age, low pay, and no pension, and it was no surprise an observant patient like Matthews was kept busy recording daily abuses. What we ask of warders of lunatics is more than is expected of the most brutalized foot soldier, galley slave, or workgang convict, and nobody would think of putting tormented unfortunates at the mercy of them. You don’t call in hardened killers to keep the peace.

  But I went too far, frankly confessing I agreed with William Battie when he argued keepers ought to be properly trained, at least in order to a
cquaint them with certain elementary principles in the humane treatment of those in a condition of mental suffering. The instant these words were out of my mouth, I regretted them. Praising Battie with qualification to Monro’s face in order to let him think he’d caught a true glimpse of the limits of my position was one thing. Concurring with Battie in the presence of an uncertain quantity like Crowther was quite another, and very likely to mean my view would reach Monro by a route that made it appear subversion. First a book, now this.

  Right away, as if eager to confirm my worst fears, Crowther replied, with a knowing look, “Battie got more than that right.”

  And thinking, There’s candour, and then there’s the naked intemperance of a Bryan Crowther, I said, “What do you mean,” in a flat tone intended to warn against any real answer.

  At first he made no reply, and I thought he’d taken the hint. Then he said, “There’s more to madness than was ever dreamt of in the Monro philosophy.”

  “I daresay,” I muttered, and thought, For God’s sake, man, shut it now.

  But no, he pressed on. “What Reverend Willis did to cure the King of his insanity, whether you agree with his methods or not—The thing is, it looked to everybody like they worked.”

  “Not to me,” I said flatly. “The King came round by himself and could relapse at any time. The nine-out-of-ten success rate Willis boasts of has made him the laughing-stock of the profession. Everybody knows the man is a mountebank.”

  “But so does everybody imagine the King has been cured. I’m saying Battie’s optimism has not gone away. It’s in the air we breathe.”

  “Somewhere out there somebody’s curing madness? Is that what you think?”

  “I don’t know if they are or aren’t,” he replied. “I just know the time’s ripe for different approaches. People now have it in their minds that if the King can go mad, anybody can, at any time, and they’re asking themselves, How would I like to be treated if it happened to me?”