Asylum Part 1

Asylum.

by Patrick McGrath.

ACKNOWLEDGMENTS.

For all her help and support in the writing of this, my love and grat.i.tude to my wife, Maria; and for his a.s.sistance with matters of psychiatry my warmest thanks to Dr. Brian O'Connell.

CHAPTER ...

The catastrophic love affair characterized by s.e.xual obsession has been a professional interest of mine for many years now. Such relationships vary widely in duration and intensity but tend to pa.s.s through the same stages. Recognition. Identification. a.s.signation. Structure. Complication. And so on. Stella Raphael's story is one of the saddest I know. A deeply frustrated woman, she suffered the predictable consequences of a long denial collapsing in the face of sudden overwhelming temptation. And she was a romantic. She translated her experience with Edgar Stark into the stuff of melodrama, she made of it a tale of outcast lovers braving the world's contempt for the sake of a great pa.s.sion. Four lives were destroyed in the process, but whatever remorse she may have felt she clung to her illusions to the end. I tried to help but she deflected me from the truth until it was too late. She had to. She couldn't afford to let me see it clearly, it would have been the ruin of the few flimsy psychic structures she had left.

Stella was married to a forensic psychiatrist called Max Raphael and they had a son, Charlie, aged ten when all this happened. She was the daughter of a diplomat who'd been disgraced in a scandal years before. Both her parents were dead now. She was barely out of her teens when she married Max. He was a reserved, rather melancholy man, a competent administrator but weak; and he lacked imagination. It was obvious to me the first time I met them that he wasn't the type to satisfy a woman like Stella. They were living in London when he applied for the position of deputy superintendent. He came down for an interview, impressed the board and, more important, impressed the superintendent, Jack Straffen. Against my advice Jack offered him the job, and a few weeks later the Raphaels arrived at the hospital. It was the summer of 1959 and the Mental Health Act had just been pa.s.sed into law.

This is a desolate sort of a place, though G.o.d knows it's had the best years of my life. It is maximum-security, a walled city that rises from a high ridge to dominate the surrounding country: dense pine forest to the north and west, low-lying marshland to the south. It is built on the standard Victorian linear model, with wings radiating off the main blocks so that all the wards have an un.o.bstructed view across the terraces to the open country beyond the Wall. This is a moral architecture, it embodies regularity, discipline, and organization. All doors open outward to make them impossible to barricade. All windows are barred. Only the terraces, descending by flights of stone steps to the perimeter wall at the foot of the hill, and planted with trees, gra.s.sy banks, and flower gardens, soften and civilize the grim carceral architecture standing over them.

The deputy superintendent's house is just a hundred yards from the Main Gate. It is a large dark house of the same gray stone as the hospital, set back from the estate road and hidden by pine trees. It was much too big for the Raphaels, having been built at a time when doctors came with large families and at least two servants. For several years before their arrival it had stood empty, and the garden was neglected and wild. To my surprise Max took an immediate interest in its rehabilitation. He had the goldfish pond at the back of the house cleaned out and restocked, and the rhododendron bushes around the edge of the lawn cut back and made to flower.

The project that most interested him however was the restoration of an old conservatory at the far end of the vegetable garden. This was a large ornate gla.s.shouse built in the last century for the cultivation of orchids and lilies and other delicate tropical plants. In its time it had been an imposing, airy structure, but when Max and Stella arrived it was in a state of such disrepair there was talk of pulling it down. Much of the gla.s.s was broken and what panes remained were thick with dust and cobwebs. The paintwork had flaked off and the woodwork in places was rotted and splitting. Birds had nested inside it, mice and spiders had made their home there, weeds had sprouted through the cracks in the stone floor.

But Max Raphael had an affection for all things Victorian, and the exotic architecture of this garden conservatory, with its intricate glazing and joinery, and the graceful Romanesque arches of its windows, all this gave him peculiar delight. He was fortunate that among the hospital's parole patients was a man confident that he could do the work of restoring the conservatory. This was the sculptor Edgar Stark.

Edgar was one of mine. I have always been fascinated by the artistic personality, I think because the creative impulse is so vital a quality in psychiatry; certainly it is in my own clinical work. Edgar Stark was already influential in the art world when he came to us, though what we first saw was a confused and very shaky man who shuffled into the hospital like a wounded bear and sat hunched on a bench for hours with his head in his hands. He intrigued me from the start, and once I'd settled him down and got him talking I discovered him to be a forceful individual with an original mind, and I also realized that he was possessed of considerable charm, when he chose to use it. He and I quickly came to enjoy a warmly combative relationship, which I encouraged, up to a point; I wanted him to feel he had a special relationship with his doctor.

At the same time I was wary of him, for his was a restless, devious intelligence. He was quick to grasp the workings of the hospital and always alert to his own interest. I knew I could rely on him to exploit any situation to his own advantage.

Oddly enough I saw him with Stella only once, and that was at a hospital dance, a year after the Raphaels arrived here and just three weeks after he began working for Max in his garden, around the beginning of June. Dances are important events in the hospital calendar and there is always much excitement beforehand. They take place in the Central Hall, a s.p.a.cious high-ceilinged room in the Administration Block with a stage at one end, a line of pillars down the middle, and cas.e.m.e.nt windows opening onto the top terrace. Soft drinks and sandwiches are spread on long trestle tables at the back, and the band sets up onstage. Parole patients from both the male and female wings of the hospital may attend, and for this one evening they and the staff become an extended family without distinction of rank or status.

This at least is the idea. The truth is, the mentally ill are not at their best at a dance. Our patients dress eccentrically and move awkwardly, handicapped as much by the medication they take as by the illnesses that make the medication necessary. Despite the energetic efforts of the hospital band, and the contrived high spirits of the staff, I have always found it a poignant affair, and attend out of duty rather than in antic.i.p.ation of any pleasure. That night, as I watched the proceedings from the shadow of a pillar at the rear of the Hall, I was not surprised to see Edgar Stark approach the deputy superintendent's wife, nor to see her step out onto the floor with him. The band went into something quick and Latin and she darted away in his arms.

Until recently I didn't learn precisely what happened next. Perhaps I should have guessed that something was wrong, for I noticed her becoming slightly flushed. I watched them move briskly across the floor, pa.s.sing directly in front of the superintendent's table, and it is only now that I recognize just how bold, and bald, and reckless was the insult Edgar flung in our faces that night.

The dance ended promptly at ten and the patients filed out noisily. Jack asked those of his senior staff remaining in the Hall to come back for a drink. I strolled along the top terrace with Max, both of us in dinner jackets and both smoking good cigars as we chatted about various of our patients. The sky was clear, the breeze warm, and the world spread beneath us, the terraces, the Wall, the marsh beyond, all was dim and still in the moonlight.

Stella's voice drifted clearly back to us on the warm night air. Oh, I have known many elegant and lovely women, but none matched Stella that night. She was in a low-cut black evening dress of coa.r.s.e ribbed silk, an exquisite grosgrain I had never seen before. The neckline was square and showed the curve of her b.r.e.a.s.t.s. It clung to her body then belled from the waist, scooped in a fold over each knee like a tulip, with a split between. She was wearing very high heels and a wrap thrown loosely about her shoulders. She was asking Jack about her last dance partner, and as I heard my patient's name I glimpsed again in my mind's eye the shuffling men and women in their ill-fitting clothes, something subtly askew about all of them except him.

Jack was standing at the end of the terrace, holding open the gate for Max and me. Stella was clearly amused at the sight of two consultant psychiatrists in dinner jackets hurrying so as not to keep their superintendent waiting. A minute or two later we were in the Straffens' drawing room and the phone was ringing. It was the chief attendant, to tell the super that everyone was present and accounted for and the hospital was safely locked up for the night.

I am not a gregarious man, and at social gatherings I tend to stay in the background. I let others come to me, it is a privilege of seniority. I stood by the window in the Straffens' drawing room and murmured small talk to the wives of my colleagues as they each in turn drifted over. I watched Stella listening to Jack tell a story about something that had happened at a hospital dance twenty years before. Jack liked Stella for the same reasons I did, for her wit, her composure, and her striking looks. I know she was considered beautiful: her eyes were much remarked on, and she had a pale, almost translucent complexion and thick blond hair, almost white, cut rather short, which she brushed straight back off her forehead. She was rather a fleshy, full-breasted woman, taller than the average, and that night she was wearing a single string of pearls that nicely set off the whiteness of her neck and shoulders and bosom. In those days I considered her a friend, and often wondered about her unconscious life. I asked myself was there peace and order beneath that demure exterior, or did she simply control her neuroses better than other women? A stranger, I reflected, would take her self-possession for aloofness, or even indifference, and in fact when she first arrived at the hospital she encountered resistance and hostility for this very reason.

But most of the women accepted her now. She had made an effort to join several of the hospital committees and generally to pull her weight as senior staff wives are supposed to. As for Max, he stood there with his gla.s.s of dry sherry, listening with a half-smile of slightly distracted indulgence as various horror stories were told by the women about their misadventures on the dance floor with patients of such clumsiness that they put last year's plodders and stampers to shame.

Stella did talk about Edgar Stark that night, but not to the company at large, and certainly without any mention of what he'd done in the Hall. It was when she reached my side that she told me the man danced like a dream-wasn't he a patient of mine?

Oh yes, he was one of mine all right. I suppose it was with a sort of affectionate cynicism that I said this, for I seem to remember that she peered at me closely as though it were important.

"He works in the garden," she said. "I often see him. I won't ask you what you think of him, because I know you won't tell me."

"As you saw yourself," I protested. "An extroverted man, well liked, and possessed of a certain, oh, animal vitality."

"Animal vitality," said Stella. "Yes, he has that all right. Is he very sick?"

"Pretty sick," I said.

"You wouldn't know it," she said, "from talking to him."

She turned and glanced at the party, the little cl.u.s.ters of those old familiars, each one distinct and idiosyncratic as tends to be the case in psychiatric communities. "We are are more eccentric than the general population, aren't we?" she murmured, her eyes on the crowd. more eccentric than the general population, aren't we?" she murmured, her eyes on the crowd.

"Undoubtedly."

"Max says psychiatry attracts people with high anxiety about going mad."

"Max must speak for himself."

This elicited a sidelong glance from those large sleepy eyes.

"I noticed you didn't dance once," she said.

"You know I'm hopeless at this sort of thing."

"But the ladies enjoy it so. You should, for their sake."

"How saintly you're becoming, my dear."

At this she turned and gazed at me. She hitched up the strap of her dress, which had slipped off her shoulder. "Saintly?" she said, and I saw Max looking in our direction, absently polishing his spectacles, his mournful demeanor faltering not a jot. She noticed him too and, turning away, murmured, "And my reward, I suppose, will be in heaven."

Later that evening I returned to my office to write up my observations. I had been impressed with Edgar's behavior. Watching him dance with Stella it was hard to believe that he suffered a disorder involving severe disturbance in his relationships with women. He had been a working sculptor for some years before he came to us, and was, as such, subject to the unique pressures that a life in art imposes. About a year before his admission he became obsessed with the idea that his wife, Ruth, was having an affair with another man. By all accounts Ruth Stark was a quiet, sensible woman; she modeled for Edgar and supported him financially much of the time. But as a result of his wild and violent accusations the marriage became severely strained and she threatened to leave him.

One night after they'd been drinking there was a terrible quarrel and he bludgeoned her to death with a hammer. What he did to her after after that indicated to us how very disturbed he was. No one came to help Ruth Stark though her screams were heard the length of the street. Edgar was in a profound state of shock when he reached us. I tidied him up and then prepared to see him through the inevitable reaction of grief and guilt. But to my concern there was no grief or guilt; he regained his equilibrium after a few weeks and was soon involved in a variety of hospital activities. that indicated to us how very disturbed he was. No one came to help Ruth Stark though her screams were heard the length of the street. Edgar was in a profound state of shock when he reached us. I tidied him up and then prepared to see him through the inevitable reaction of grief and guilt. But to my concern there was no grief or guilt; he regained his equilibrium after a few weeks and was soon involved in a variety of hospital activities.

We were worried about him. Although he functioned at a high level of intelligence he never showed any insight into why he had killed his wife. What troubled me was not just the persistence of his delusions, it was their intrinsic absurdity. He claimed to have a wealth of evidence of Ruth's infidelity, but when asked for it he produced only trivial everyday occurrences, into which he read bizarre, extravagant meanings. A flushing toilet, a stain on the floor, the placement of a box of washing powder on a windowsill, these were the sorts of things that signified. He had otherwise fully recovered his sanity and was ready to be released, but he remained on this one point unshakable, that the murder was justified. Oh, he agreed it shouldn't have happened, and he regretted drinking so much, but he insisted that he'd been driven to it by her taunts and insults. I didn't feel we should let him out yet, and nor did anyone else. He'd been with us for five years, and it looked to me as though he'd be with us another five at least. This was how things stood when he was given the job of restoring Max Raphael's conservatory.

Every morning that summer several parties of parole patients, each under the supervision of an attendant, and all dressed in baggy yellow corduroy trousers and blue shirts, with white canvas jackets slung over their shoulders, emerged from the Main Gate to maintain the grounds of the estate. Edgar was one of the group a.s.signed to the deputy superintendent's garden. Stella often saw him when she went out to pick vegetables or flowers, and if there was no sign of the attendant, a senior man called John Archer, she would sit for a few minutes and they would talk. She admitted she was attracted to him almost from the start. For obvious reasons she tried to ignore the feeling, but his presence out there every day made it easy for her to invent pretexts for seeing him. Though what harm was there in befriending a patient? This is what she said to herself, in justification of her behavior.

How had it happened?

On this point she couldn't at first give me any sort of satisfactory answer. She avoided my eyes, she became vague. Perhaps it was just a case of household l.u.s.t, easily enough aroused, just as easily crushed out, but when I suggested this the dreamy abstraction vanished and for a moment I felt a flare of spirited hostility from her. Then it faded. She was already deeply depressed; she could not sustain affect. She mentioned something he'd done one day that expressed, oh, strength, tenderness ...

Perhaps. I let it pa.s.s.

Then in a later conversation she described it more fully, what it was he'd done that had so charmed and attracted her at the beginning. She'd gone into the vegetable garden one warm afternoon to pick some lettuce, and saw Charlie down at the far end with a patient, the big black-haired man she had been aware of simply as the one working on Max's conservatory, she didn't even know his name; this was a couple of weeks before the dance. Curious to see what the boy was up to, she wandered down the path and he shouted to her that he'd invented a test of strength, and that she should come and see. Charlie Raphael was an overweight little boy with pale skin like his mother's, which in the summer became lightly freckled. He had dark brown hair that fell over his forehead in a thick fringe, and when he grinned you could see the gap between his two rabbity front teeth. That summer he invariably wore a short-sleeved cotton shirt, baggy shorts, and sandals, and his legs were always scratched and muddy from his various outdoor projects.

Stella sat on the bench by the wall, in the shade, and watched as Charlie made the patient stand there on the path holding a spade horizontally with a hand at either end of the shaft, then, with his knees bent, ducked underneath and grasped the middle of the shaft.

"Lift!" he cried.

The patient glanced at Stella and lifted, and Charlie rose slowly off the ground, his face screwed up with concentration and his knees drawn up beneath him as he clung with both hands to the spade. "I'm counting!" he shouted. "One, two, three, four ..."

He hung from the spade to a count of twenty, at which point Stella, laughing, begged him please to allow the poor man to put him down. "Down!" shouted Charlie, and was gently lowered onto the path. "You're a strong man," he said, gazing with admiration at Edgar, who seemed not at all strained by the ordeal. Stella told me that it was while Charlie was clinging like a monkey to the shaft of the spade that she felt the first stirring of interest in the man. He had good hands, she noticed, long, slender, delicate hands, and she wondered what his work was, on the outside.

The next day she again went down to the conservatory to see what he was doing. She freely chose to do so, nothing can excuse or obscure this fact. She found him up a ladder, removing broken gla.s.s from the frame of the structure, carefully working it free of the crumbling putty. He was dropping it into a dustbin beside the ladder, and every few moments the drowsy stillness of the afternoon was shattered by breaking gla.s.s. When he saw her approaching he came down the ladder and pulled off his heavy gloves.

"Mrs. Raphael," he said, standing squarely in front of her, panting slightly and pushing his hair off his forehead. He produced a red bandanna from his trouser pocket and wiped the sweat from his face and then from his hands, watching her throughout with an expression that she described as affable but at the same time mocking, somehow, or rather challenging, as though he wanted to provoke her to show him who she was.

"You didn't have to stop working," she said, quite at ease with this sort of jousting, and liking the man immediately. "I only wanted to see what you were doing."

"Edgar Stark."

They shook hands. Stella shielded her eyes as she turned away and gazed up at the conservatory. "Is it worth saving?" she said.

"Oh, it's a lovely thing. They built them to last back then. Like that place."

He grinned at her, indicating the Wall, visible through the pine trees on the far side of the garden by the road.

"This won't be quite so grim, I hope."

"It'll be a nice little summerhouse when I'm finished. Settling in all right?"

"We've been here a year."

"Is it that long?"

He took out his tobacco tin and began to roll a cigarette. It smacked of independence, this gesture, and she approved of it. He didn't behave like a patient.

"How long have you been here?" she said.

"Five years now, but I'll be out soon. I killed my wife."

When I heard this I thought, vintage Edgar. But Stella could match his candor.

"Why?"

"She betrayed me."

"I'm sorry."

He was no fool. Here there was tragedy, and she was sympathetic. The wife of a forensic psychiatrist was hardly likely to shrink in horror from such a confession.

"Were you a carpenter on the outside?" she said.

"Artist. Sculptor. Figurative mostly. You like art, Mrs. Raphael?"

"I have so little opportunity down here. In London, yes."

He wasn't at all obsequious, she said, this was her first impression, nor did he condescend to her. She said there was something solid and mature about him, and I couldn't help thinking of all the wildly delusional talk I'd heard on the subject of his late wife. She wouldn't have thought him so solid and mature had she heard any of that, I thought. But she hadn't, and so, the next day, after gathering what she needed from the vegetable garden, she again went down to the conservatory.

He was up his ladder and this time he wasn't wearing a shirt. Charlie was on the garden wall, and Edgar was talking to the boy about football. He was a big man with broad shoulders and a heavy build, well fleshed out on the chest and hips and belly, with soft white skin. There was no hair on his body, and she thought he might be the sort of man who grew fat later in life. She suggested they might like a cold drink.

When she came back out with a jug of lemonade Edgar had his shirt on. She asked would he mind if she sat on the bench in the shade for a while. She enjoyed watching him work, she said, and I thought of Max, cerebral Max, as tall as Edgar but stooped, and pale, and forever polishing his spectacles; Max may have conceived the idea of restoring the conservatory, but it was another man's labor that carried it through. And already his efforts were apparent. Much of the old gla.s.s had gone, and the structure was beginning to a.s.sume a skeletal appearance. It was strangely beautiful, she said, and when she returned to the house this was the image she carried with her, of that big confident man up a ladder with his shirt off, carefully picking broken gla.s.s from the frame of the Victorian conservatory.

She went back the next day, and the day after. He told her about his son, the boy he'd deprived of a mother; Leonard, his name was, he'd be Charlie's age now, though Edgar hadn't seen him for more than five years. His late wife's family were looking after the boy and they were determined, he said, that he should never know who his father was. It was a story guaranteed to arouse a mother's sympathy.

All lies. Edgar had no son.

One day he asked her if he could call her by her first name, and she said yes, but not in front of John Archer or Charlie.

Another time, as he was sketching the design of an iron finial that had rusted badly and would have to be recast, he asked her if he could do her head. She said he could. He had her sit on the bench while he worked, and in a few minutes had produced a strange sketch, all smudged lines, not at all naturalistic, with none of the roundedness and monumentality I saw in Stella, but a curious likeness all the same. She asked if she could keep it and without a word he tore it from the pad and gave it to her.

"But you must sign it," she said.

She kept it in a locked drawer and showed it to n.o.body, for reasons she was reluctant to look at too closely. Nothing improper was occurring, on the surface, but she hadn't said a word about her new friend to Max; and by consistently failing to mention an event of significance in her day she was practicing a form of duplicity. She rationalized it. She should have known that deception eventually eats away all that is wholesome in a marriage, and she should have faced this, but she didn't. She chose not to. From this evasion all else followed.

Oh, but it was so trivial, she told herself, it was absurd to think that talking to a patient in the vegetable garden could amount to anything. But if it was all so trivial, why did she have to conduct this argument with herself? Because of her growing s.e.xual warmth for the man, which she foolishly indulged in this oblique manner, seeking his company, allowing him into her imagination.

It was not easy at first for her to talk about any of this. I know she was tempted to blame fate, or the vagaries of the human heart, for what happened, the tragic outcome of it all. She had a natural impulse to displace responsibility, we all do, but she disliked the idea of making excuses or hiding behind abstractions. Edgar, the one person she might have blamed, instead she defended to the end. Not once did I hear her hold him responsible for what happened.

The first I knew of their growing intimacy was the day Charlie fell off the garden wall. There was an old apple tree beside the conservatory and when Edgar was up his ladder Charlie would scramble onto the wall, and from there climb into the tree. He was a fearless tree-climber but, being plump, not too agile, and one day as he was stepping out of the tree back onto the wall the branch broke-he lost his balance-and with a shout he tumbled onto the path and knocked himself out for a second or two.

Stella was upstairs when Edgar came striding in through the back door with the dazed boy in his arms. Mrs. Bain, the woman who helped with the housework, was sitting at the kitchen table sh.e.l.ling peas. She was the wife of a senior attendant, a man called Alec Bain, and it was he who told me later of his wife's reaction to a patient who came into the house without knocking, shouting for Mrs. Raphael and using her first name. He wanted to lay the boy down on a bed or a couch but Mrs. Bain lacked the presence of mind to direct him to the drawing room, so he pushed past her out through the kitchen and into the hall. She began to shout at him just as Stella came running down the stairs. She cried out in horror.

Charlie was all right. He recovered in a matter of minutes, and Stella didn't feel it necessary to phone Max at the hospital. She held him while Mrs. Bain went for a damp facecloth, showing by the shape of her back what she thought of patients who came barging into the house without being asked and called the doctor's wife by her first name. Charlie tried to get up but Stella told him he must lie still a little longer. She turned to Edgar, who stood there pushing his hands through his hair.

"Thank you for bringing him in," she said. She saw how relieved he was that the boy wasn't hurt. He clearly felt responsible.

"No harm done," he said.

"I don't imagine so. But we'll keep him inside for the rest of the day."

"No!" said Charlie.

"Oh yes," said Stella.

Edgar went out through the kitchen door. Stella knew she should try and explain to Mrs. Bain why he behaved toward her with such familiarity, but her old proud carelessness welled up and she didn't say a word, because she didn't see why she should.

Nothing physical had happened yet, but this incident helped establish a sort of bond between them. It should of course have been severed at this point, as soon as Stella saw that to behave so informally with a patient was bound to cause trouble sooner or later. But it didn't occur to her. At the time she didn't properly a.n.a.lyze why she was amused rather than alarmed by the incident, but later she said she thought it was because she found Mrs. Bain's att.i.tude so ridiculous, as though patients belonged to a lower order.

He began to tell her about life in the hospital, and she was surprised that she had never understood before what went on other than from Max's point of view, the psychiatric perspective. Now she glimpsed a new perspective, she began to see how it was to live, eat, and sleep in an overcrowded ward, sixty men in a dormitory meant for thirty, and to put up with plumbing that dated back to the last century and rarely functioned properly. One story horrified her particularly, about a patient in Block 1 who washed his face in his own urine, then dried himself with the communal towel.

She became involved. Identification, hazy at first, hedged around with friendly detachment, quickened. The idea that this man, this artist artist, should suffer the indignities of primitive plumbing, lack of privacy, bullying, boredom, and utter uncertainty about his future, all this aroused her indignation. He was in Block 3 now, a parole patient with a room of his own, but he still had to tolerate much that, to Stella's sense of justice, was incompatible with the care and treatment of the mentally ill. Though she was starting to doubt that he was was mentally ill. She thought he was guilty of a crime of pa.s.sion; and pa.s.sion, in essence, was good, surely? mentally ill. She thought he was guilty of a crime of pa.s.sion; and pa.s.sion, in essence, was good, surely?