‘That’s what you said last time.’
So she had taken it in. ‘Yes. Gus’s words. I’m afraid I’m not original. He feels that people aren’t ill so much as lacking a meaning to live. He thinks our job is to help them to find it.’
‘That might be rather a tall order.’ There was the ghost of a smile in her voice.
‘Yes. And possibly arrogant, you may be thinking?’
‘No, I wasn’t thinking that.’
She lapsed back into silence and I dropped into a reverie.
Some patients, however little they say, keep your attention tied to them so that the silence is an effort. I’ve learned that this is anger. Angry people press on you, hold you down to keep you with them. But it was easy to drift off with Elizabeth Cruikshank. She didn’t mug you with her presence; she let you go as lightly as a dandelion seed.
I was contemplating this when she spoke again. ‘Why on earth would anyone want to bother with people like us?’
For a second I supposed she was referring to the two of us. Then, with a sense of slight shock, I recovered myself and recognised her allusion was to me as doctor and herself as patient.
‘What are people like “us” like?’
She gave one of her little dismissive shrugs. ‘People like me, then.’
‘And what would you say you were like?’
The ginger tom was back balancing on the fence outside. It had an air of entitlement which in a human would be psychopathic. Perhaps that was why I so disliked it. It took for granted something I could never take.
‘Oh, I don’t know,’ she said, listlessly. ‘Not very interesting.’
‘Well,’ I said, ‘I don’t know that anyone is uninteresting once you get to know them.’
‘Really?’
‘Yes, I believe so.’
‘You have to say that.’
‘I don’t, in fact. And I don’t, knowingly anyway, lie to my patients.’ Deliberately, I introduced a note of coolness into my voice.
‘I’m sure you don’t.’
‘There are as many misconceptions about shrinks as there are about—’
‘Their patients? What are the “misconceptions” about your patients, Dr McBride?’
‘That because they have had the misfortune to end up somewhere like this hospital they cannot therefore also be rather bright, for one, Mrs Cruikshank. That they aren’t able to give us the run-around!’
We stared at each other.
‘Do you think I’m giving you “the run-around”, Dr McBride?’
‘I think you are giving yourself the run-around, if you really want to know,’ I said. And then, more gently, after another longish pause, ‘But that’s all right. It’s your prerogative.’
The people who landed up with me were mostly in a state of terror, and one element in it was the fear that I possessed some professional means forcibly to overcome the complex safeguards erected to protect their secret worlds. I didn’t want anyone imagining that, especially not this patient.
‘You don’t, you know, with me, anyway, have to say or do anything you don’t want to say or do.’
THE FIRST DREAM I HAD WHEN I STARTED MY ANALYTICAL training took place by the sea and I can recall it as if it were yesterday.
I was walking on a pebbled beach when a man dressed in a loud turquoise shirt accosted me. He had in his hand a lump of sea-smoothed stone and he was shoving it in my face demanding to know what it was. I said, ‘You should ask the archaeologist fellow.’ Then the scene moved inland and I found myself on a steep hillside, by a small church, or chapel, cut out of the rock face. But when I entered the building it proved not to be a church at all but a zoo. There was a skinny-looking puma restlessly prowling up and down the cage, its paces marking the limits of its confinement. In the same enclosure, a huge white barn owl was flying against the high fence, beating its wings frantically on the restraining wires.
When I mentioned the dream to Gus Galen he said that if he had a tenner for every dream he’d heard that began ‘I was walking by the sea’, he would be able to reduce substantially his charges. He was fond of quoting ‘God cures; and the physician takes the fee’, but as with everything about Gus in practice his billing methods were eccentric. A woman I sent him once, the wife of a colleague, said she had to stop seeing Dr Galen because he never sent her a bill and it made her feel guilty. ‘I went to see him because I felt guilty in the first place,’ she pointed out. I sent her, finally, to a less unworldly colleague, who charged a king’s ransom.
Anyhow, in those days I was glad to have the sea on my doorstep so that when I needed to mull anything I could walk along the beach and listen to the tread of the waves, and puzzle over my thoughts by puzzling out, at the same time, what principle enables you to tell where the water ends and the horizon begins, and observe the dark shapes of boats against the sky. Or if I’d got my rubber boots out of the boot of the car, wade through the dirty-cream foam.
Walking is a famous loosener of thoughts. Although I had many other patients in my charge, looking back now it seems it was always Elizabeth Cruikshank I was thinking about when I walked by the sea’s edge, and her story I kept trying to piece together in my mind.
Perhaps it was the reassurance that there would be no compulsion on her to disclose, or perhaps it was the tincture of chilliness with which I prefaced my absolving words, because after that last meeting my patient did yield up a few grudging facts.
After leaving school, with reasonable but unremarkable O levels, she took a job at a local library. From her father she had acquired an appetite for reading and in those days there wasn’t the current mania for formal qualifications, so she went quite a way up the librarianship ladder before deciding to get herself some proper qualifications. By this time, she’d cut loose from her parents and taken a flat in Camden Town.
‘Any boyfriends?’ I asked.
‘I don’t care for the word.’
‘Did you go out with anyone?’
‘I don’t like that phrase much either.’
‘Fine,’ I said, cheerily refusing to be diverted. ‘How about lovers? Are you happy with that term?’
She touched the leather bag she always had beside her in the chair and said, vaguely, ‘Oh, you know, I never really expected anyone to want me.’
I pictured her, as she might have looked then, underweight, unfashionably dressed, a pale young woman. When I met her she still gave an impression of pallor and plainness, though no one looks their best in the aftermath of a suicide attempt and it was a while before I saw Elizabeth Cruikshank smile. When she did I was reminded of an expression of my mother’s: ‘It was as if the moon had taken off her clothes and gone dancing.’
‘But you married?’
‘I married,’ she assented. She gave an impression that if she could she would have denied it.
To augment her library studies, she explained, she enrolled on an art history course, which in those days was run at the old North London Poly.