The Other Side of You. Salley Vickers

       9

      CIRCUMSTANCES AROSE WHICH MEANT THAT I WAS OBLIGED to postpone my next appointment with Elizabeth Cruikshank.

      In the days when social policy over the treatment of the mentally ill was more conservative, many hundreds of men and women in Britain had been confined to ‘care’ for the bulk of their adult lives. One of my duties at St Stephen’s, the hospital in Haywards Heath, was to monitor the patients who had been inmates so long that the hospital had become their only home. Among those whom it was my melancholy business to oversee, one case especially troubled me: a man who suffered from the unshakeable conviction that he had a wolf lodged in the upper portion of his skull. His behaviour was always perfectly docile but to his perturbed mind this phantom, to which he was the unwilling host, was a threat not to himself but to the world at large. In fact, as I had said in my report when he first became my responsibility, in my view he was now too institutionalised for the world to be anything but a far more serious menace to him.

      Not long after my first encounter with this unfortunate, I found myself, due to some delayed appointment, killing time by visiting Whipsnade Zoo. It was a filthy November day and, walking briskly to keep my circulation moving, I landed up at the far corner of the zoo, by the enclosure which houses the wolves.

      I was at once drawn by their lean shadowy forms and their long-legged stilted gait. But what held my attention most was the way their narrow, vigilant muzzles and haunted eyes put me in mind of this man, so much so that I began to speculate whether the captive creatures mightn’t suffer from the fantasy that they had a desperate human being trapped inside their skulls. Whenever I saw this patient now, I thought of those penned-in wolves. I could never decide whether it was the influence of the delusion or being confined like a beast which had rendered him so visibly lupine.

      But that he was a harmless, docile wolf, I was convinced, and for more years than I could bear to calculate, he had been stashed away in the upper storeys of the hospital which had originally served as one of the big Victorian asylums.

      St Stephen’s had retained in its running a remnant of the asylum policy wherein the madder the inmate, the higher up the large mock-Gothic pile they were placed; and, in the cases of the potentially violent, in locked wards, with confining cells, and with nurses trained to deal with any dangerous outbreaks. We even had restraining jackets, based on the old ‘strait’ kind, though as Gus once said, why a ‘restraining’ jacket was deemed to be less offensive than a ‘strait’ one, beat him. He and I agreed one evening, over a whisky or two, that if we were ever forcibly confined we would rather be straitened than restrained. (‘And while we’re at it,’ Gus had added, ‘what in God’s name is wrong with the old word “asylum”?’)

      My purpose in visiting St Stephen’s was to conduct the long-term patients’ annual review, which had been scheduled for the following day. For the most part this meeting was a mere routine of briefly reviewing, and then renewing, existing measures—security levels, medication, treatment plans—but when the wolf man’s name came up I found myself asking, ‘Why, as a matter of interest, do we keep him on level five?’ Five was St Stephen’s top security ward.

      I was the consultant and the person who’d known the wolf man longest and, as I had expected, no one had any answer to this question.

      ‘Have we any evidence of violence?’

      Level five’s charge nurse, an Irishman with bad skin and reddish hair, said that, as far as he knew, we didn’t.

      ‘Has he been any trouble at all, Sean? Anything not on the record we should know about?’

      ‘Nothing, Dr McBride, so far as I’m aware. Though…’

      ‘What?’

      ‘He’s always saying he might do something. Or so I’m led to believe. Can’t say he lets on to any of us.’

      ‘But that’s his delusion, isn’t it? My point is, why are we pandering to it? We’ve never had the smallest peep out of him in all the time I’ve been here. I think we should try him out on level four, or even three, see how he goes. Anyone got any objections?’

      I knew they wouldn’t have. And I caught the train to London with the self-satisfied feeling that I’d performed at least one valuable action that day.

      The reason the meeting at St Stephen’s had had to be brought forward was because I was obliged to be in London the following day. I was to appear as an expert witness in a medical case, which gave me an opportunity to visit Gus.