Human Traces (30 page)

rather than be ensnared." "I did not have you marked down as a coward." "She would have derailed my life. She had already awoken in me emotions I did not wish to see through." "I have heard many reports of the morality of young nurses. Something about their daily closeness to death makes them eager to seize the minute." Thomas laughed. "The study was exhausting. I dare say that for some there were consolations." "It would suit you to have a wife now, would it not?" "Perhaps. I seldom think of it. Young women come and go here all the time. Some of them are my patients. Many of them are insane. So in either case, I remain detached." Thomas feltValade looking at him curiously. "And are you happy here, Doctor?" Thomas loved the Schloss Seeblick and he loved his work there. At the age of thirty-three, he had become, he supposed, a rather serious man, aware through the lives of those he treated how capricious to put it no more strongly human life could be, and unwilling to risk his own contentment. He looked at Sonia and how she had blossomed in the Carinthian air, at Daisy and Mary, his cuttings from foreign rootstock, who were unrecognisable as the sad creatures he had first encountered in the asylum. He had reason to be pleased with them and with the way the schloss was going. At the same time as watching over them and treating his patients, he worked hard to develop his own concerns, aware that his interests were diverging from Jacques's and anxious that he himself seemed so far from being able to produce anything original or worth publishing. He was stuck with the alieni st perennial problem: human mind-sickness was impossible to understand. They converted the cellars into laboratories with overhead electric light (keeping back one room for wine) and hired a third psychiatrist to help them with the growing number of patients. He was a young man from the local district called Franz Bernthaler, whose intellect had made him precociously famous as a prize-winning student. He had recently returned from studying at the asylum in Frankfurt, where he had been taught new ways of looking at cell layers of the cerebral cortex by two eccentrically industrious men, Franz Nissl and Alois Alzheimer. Sections of brain tissue were taken from patients who had died or were brought in from local hospitals; Franz instructed Thomas in the newest histology and staining techniques and together they bent over the microscope until their backs and eyes ached, when Thomas would go through to the end room of the cellar to select a bottle, over which they then discussed what they had seen. Thomas liked Franz, though he felt a little daunted by the younger man's expertise at the microscope. "I am not at root a scientist, you see, Franz," he said one evening, sipping a glass of hock. "My first interest was in poetry and drama and I have this weakness that makes me always want to see things in large human terms rather than through a magnifying lens. I want great theories and connections, though I know perfectly well that that is not how real scientific progress is made." "I think that is a preference you may share with Dr. Rebière, if I may say so," said Franz. He was sometimes critical of his employers, but always spoke respectfully, aware that they had dealt with far more patients than he had. "Oh, no, Jacques is a proper scientist," said Thomas. "The gentlemen of the Salpetriere rose to applaud him. He is entitled now to talk in larger abstract terms because he has mastered the chemistry. I began with... Oh God, I can barely remember where I began. With some poetic abstract. Humanity. Hope. Some such thing." "Did you see the obituary of Professor Charcot in the newspaper?" "Yes, I did. It was very florid, I thought. It had little understanding of his important early work. It was all about his later fame." "Indeed," said Franz, removing his spectacles and holding them up to the electric light to polish them. "It will be interesting to see what happens to his disciples now that the master is dead." "I count myself a disciple," said Thomas. "His legacy is secure, I would have thought. Though I suppose you mean the way in which others have developed his work." "Yes. In Vienna," said Franz. "And Dr. Rebière himself "The evil that men do..." "What do you mean?" "I think that Charcot's best work may be overlooked, "interred with his bones", as Shakespeare might have said. I have doubts about his legacy. I think perhaps it is as well that he died when he did and I suspect that after a respectful pause, some of the avenues he opened will be... I have lost my figure of speech here... Abandoned. I am not sure they lead anywhere." "A mercy, then," said Franz, resettling his glasses. "How will Dr. Rebière proceed?" "He was thinking of returning to Paris for the funeral, but I dissuaded him. Jacques's work has its own momentum now. He read a paper in Vienna last winter which was a development of one he read to us here in the spring. It was well received. There are a number of people in Vienna who are thinking in the same way, but they do not all have his authority as a clinical neurologist. That is why people respect him, not as a psychologist, where it is so hard to establish a position, but because he can explain in detail the love life of the eel. And because he is so eloquent, damn it!" Franz laughed. "And German is not even his native language. Imagine what he must be like in French." "Not nearly so persuasive, oddly enough," said Thomas. "I think he feels that French was the language of his restricted childhood, English for romance and happiness but German for science and intellectual freedom." "Do you have misgivings about his ideas?" "Misgivings, yes. I would put it no more strongly than that. I would not wish to see him develop a complete psychological theory on the basis of what he learned from one neurological illness a mysterious and not fully understood one, at that. And I think he would find it extremely difficult to move outward from that base into psychiatry, where the different illnesses may have their own singular organic nature. I think what he has done is wonderful, and I do see why he wants to learn from it and extend it. It looks like a cure and a breakthrough and it is so philanthropic in its application. A cure! Happiness! And yet..." "You have doubts?" "Yes. I do not believe you will ever cure severe psychiatric illness by the application of psychological theory and what at the Salpetriere they now call "psychotherapy" talking to the patient however complete your model and whatever your gifts of understanding. He has not yet established the physiology of this process either how an idea becomes a seizure. He cannot say in exact terms how it works." Franz smiled. "When I was in Frankfurt, a visiting professor told me the story of a man he knew whose wife had endured an agonising labour. The husband was present throughout, greatly anguished by what his wife went through. At the end she was delivered of a healthy boy and suffered no after-effects. After two days at the hospital, the father went home elated. Two days later, when his wife and child had returned home, he went to open his bowels, something he had done every day of his life after breakfast. On this occasion, however, something went wrong. The matter he was trying to evacuate got stuck. His sphincter kept contracting, but what it was trying to expel was too big. It was enormous. He began to cry out in pain. "I can't bear it, I can't bear it." His wife heard him and came to help. Somewhat shamefaced, he explained the problem. He was in agony, pouring sweat. She went to fetch him a suppository her doctor had given her for the likelihood of constipation in late pregnancy. He inserted it, the contractions increased and eventually this enormous thing was expelled. He expected there to be damage and bleeding to the rectum, but in fact, as soon as it was done, he felt completely normal. He inspected this freak of nature in the water, shook his head in wonder, then disposed of it. It was only a week or so later when he heard his wife describing her childbirth to her sister that he suddenly remembered the words of hers that had so upset him at the time. "I can't bear it," she had screamed. "I can't bear it." But now it appeared that he had taken over a part of her pain, he had done the proper thing and experienced a version of it for himself Thomas laughed. "Did he weigh it?" "I think he was pleased to see it go! But although there is a practice in certain primitive tribes it is called couvade, I believe when the men go through rituals of shutting themselves away in sympathy or strapping weights to their bellies, that is all a conscious performance. They feel no pain. But this man... Something happened. The idea of sympathy was converted by his brain, through the operation of his nervous system into a somatic offering." "Unarguably somatic by the sound of it," said Thomas. "But you might suggest a quite prosaic explanation. He had late nights at the hospital, he did not have his normal diet. In his care to bring water to his wife he probably neglected to drink enough himself. All available energy was diverted into remaining alert; little was left over for the normal process of digestion." "Is that what you think?" said Franz. "It seems probable. At any rate, it provides a plausible account of how the body worked, even if there was also an emotional motivation." "That is not how our professor interpreted it," said Franz. "His view was that either it happened as you describe or as I describe. There can be no mixture. Either it was a simple change of dietary habit and it was an utter coincidence that his cri de coeur used the same words as his wife's; or his subconscious mind entirely took over the working of his body for its own ends." Thomas smiled. "It need not be a choice. Take the phenomenon of temporary impotence. A man is ready to perform, then lacks confidence, and suddenly the blood drains away. The draining mechanism can be activated chemically, by the effects of alcohol, for instance, or simply by an idea: I am not worthy. So, you would say, this collapse might be caused by the chemical content of wine or the mental content of a man's timidity: either, or. Yet in fact, I would suggest the mechanism is the same. Increased blood flow depends on a degree of relaxation. Both alcohol and fear can affect that degree of relaxation through their own separate accesses to the operation of the central nervous system. A room with two doors, but the same room." Franz put his wineglass down beside the microscope. "Dr. Rebière tells me you are much interested in your fellow-countryman, Mr. Darwin. What would he have to say about this mechanism of temporary impotence, do you suppose?" "I think he might argue that it is an advantage for the less self-confident male not to reproduce. By revealing his lack of fitness at the vital moment, he demonstrates to the female that he is to some extent an impostor and she had better mate elsewhere. Though I must say I do not personally believe that every embarrassment, every tiny experience in life is the selected best outcome of a billion previous experiments. There is still chance. As for the drunkard... I am not sure he serves a high purpose in the process of "descent with modification"." "And what about your demented patients? What would he say about them?" Thomas sighed. "You may say that they are misfits who should be bred out of the human strain. That is the dominant view of European psychiatry, that they are degenerate and part of a doomed process. Yet I cannot accept that. My instincts tell me it cannot be so, partly because they are so numerous. I believe as many as one man in a hundred may have this disease Dr. Rebière's own brother, for instance. My feeling is that the root of this illness lies very close to the mental faculty that first made us human. It is a relatively new ability, and as a wonderful doctor called Hughlings Jackson the English Charcot, you might call him has pointed out, those neural circuits which have most recently evolved are those which are most likely to go wrong. I do not see men like Olivier as degenerates, as simple idiots but with more florid symptoms. I think what they suffer from is a problem in awareness and making connections in the brain. Mr. Darwin's great collaborator Alfred Russell Wallace believes that God has been present at various moments in human development, principally the one at which we gained this consciousness of being alive. I strongly sense that at that crucial chemical moment, when one mutation was "selected" and the first Homo sapiens was born, a certain instability came into the neuronal circuits of the brain. If God was present, you might argue that He was also for a moment absent. Homer nods. One day, this instability may regulate itself through successful transmutation. Until then, I do not see men like Olivier as being degenerate or retarded; I see them rather as at the forefront, in the vanguard of what it means to be a human." "But they suffer," said Franz. "My God, they suffer. I think they suffer for all of us. It is almost as though they bear the burden of our sins. It is scarcely too much to say that they pay the price for the rest of us to be human." "And how do you treat them?" "I talk to them," said Thomas. "I listen and I try to learn. It is how I treat Dr. Rebière's own brother, though I am aware that I probably take more from it than he does. But, frankly, I have little else to offer him." Franz smiled. "It is an adventure." "Yes," said Thomas. "One must always see it in that way. Sometimes I feel such a fool. How can I possibly know these things which are of their nature unknowable? What mad arrogance keeps me hitting my skull against the wall? These are mysteries which no man can know. But there is something of Don Quixote in me, I suppose. Where I see a windmill, I will take my lance and saddle up. I dread growing older because one day I will think that I can no longer be bothered." Franz took the glasses to the sink to wash. "We must all try to keep the quixotic element," said Thomas. "Throw the old knight a pie. Give oats to Rosinante." Later that year Thomas read the new edition of Emil Kraepelin's Handbook of Psychiatry. Kraepelin had suffered a frustrating exile in Estonia, where his inability to speak the language had prevented him from making progress; on his return to Germany, however, he had gone to Heidelberg, where he continued to study the long-term course of severe illness. With the help of an enormous card-index, he had begun to identify two repeating patterns of psychosis. The first had been baptised 'circular insanity' by doctors at the Salpetriere, because periods of high elation and mania alternated with passages of profound depression; Kraepelin developed the idea and went on to call it' manic-depressive illness'. The second category of psychosis
he called 'premature dementia' or dementia praecox. Reading the definition in Kraepelin, Thomas recognised it immediately as Olivier's disease. Its basis, Kraepelin stated, was a 'psychopathic predisposition'; in other words, it was a biological brain disease. Thomas was moved by the intentions that lay behind the monumental industry of Kraepelin's research: he wanted to be able, as a doctor, to help the woman who asked, "Will my husband recover from his illness? What will happen to him now?" About three quarters of those suffering from dementia praecox grew steadily worse, Kraepelin concluded; but the remainder might grow well again. Thomas enthusiastically pointed out the passage in Kraepelin to Jacques, thinking he would be encouraged to know that his brother's illness finally had a name; but Jacques said the term had been coined by a Frenchman called Morel some years before, and did not seem able to share Thomas's enthusiasm. To Thomas, it did look like progress. He remembered the ledgers in the asylum, and the multiplicity of colourful and unscientific diagnoses: old maid's insanity, honeymoon psychosis, moon madness. In the older books, causes of insanity were divided into moral and physical, the former including 'loss of several cows' and over excitement at the Great Exhibition'. He saw the faces, grey and dirty, of the urban poor who came to stand in front of his trestle table in the hall, waiting to be assigned a ward number, waiting for an instant name for their distress, then set to vanish down the shrinking corridor. Kraepelin had divided psychoses into those with violent swings of mood, and those without. From the former, patients tended to emerge, from the latter they were unlikely to. He had established patterns, something close to a nosology, and surely this progress at least gave grounds for hope? What he described to Franz as the 'quixotic' element survived in Thomas because he found there were still enough things for him to despise or rebel against. In the summer of the following year, his father died and he returned to Torrington with Sonia for the funeral. His brother Edgar told him he would be moving into the house with Lucy and their five children; he asked if Thomas would like to join him in the family grain business and promised him a farmhouse. Edgar seemed bemused when Thomas explained that he had a profession and a life in Carinthia; it was, as though' Thomas thought, Edgar believed that he was in some obscure way joking. "Write and let me know if you change your mind," Edgar said, his hand on Thomas's shoulder when the time came to say goodbye. "I will always try to keep a place open for you. "Thomas wondered if it was just that Edgar felt he had taken Sonia away from England and that if he returned, she might follow. It was certainly true that without her Torrington was not the same. His mother was bewildered by her husband's death, was herself growing old and had lost some of the self-belief necessary to make such a household seem worthwhile; Lucy was a kind enough girl, he thought, but overwhelmed by children. At least their noise made the old house feel inhabited, and Sonia could not be in two places at once. Back at the schloss, he learned that Olivier had been found one night in the city, hiding naked in an alleyway. No one was certain how he had got into town in the first place presumably he had gone with one of the tradesmen who came to deliver each day but it had been difficult to reassure the police who took him into a cell that he posed no danger to the public or to himself. Jacques enlisted colleagues from the hospital, where he and Thomas still had a clinic, to vouch for their qualifications and good standing. He undertook to make certain there would be no recurrence of the incident, and Olivier was released into his care. The policeman's major concern, it appeared to them, had been that Olivier's nakedness might have affronted people who happened to be walking by. The next morning, Olivier came down to Thomas's consulting room as usual. He had been at the schloss for four years, and they had grown close to one another. The warmth was manifest in an exasperated affection on Thomas's side, a sort of habitual and frustrated brotherly love, and, on Olivier's, by a manifest anxiety and bizarre behaviour if ever Thomas went away. Thomas always spoke gently, but he had learned that he could also be direct and that, provided he was not alarmed, Olivier often responded well to a kind of bluntness. "Would you like some of the drink that makes you feel drowsy?" Olivier did not answer. He touched each arm of the chair, then put his fingers soundlessly together, then each hand back to the chair arm, back together and so on without interruption. This was a sequence of movements he seemed frightened to abandon at any time. "How do you feel, Olivier? Do you feel better today? Do you feel better now that we are all back?" Olivier glanced up over his left shoulder. His lips moved, though as far as Thomas was aware he did not speak, at least not to him. It would be one of those days on which it was going to be difficult to engage his attention, but this was often the case. "Olivier, do you remember what happened? Do you remember being taken into a cell by the police?" Still there was no answer, though Thomas was not surprised, since this was not something Olivier would wish to confront. "Who told you to take your clothes off?" "What did you say?" "Who told you to take your clothes off?" "The Sovereign." Thomas leaned forward; at last he had Olivier's attention. "The Sovereign? You've told me about him before, haven't you? But he doesn't speak to you often himself, does he?" Olivier shrugged. "Sometimes. There are a number of people. The Carver comes. Or the Seamstress. Sometimes there are more." "What determines if there is to be more than one?" Olivier shrugged, not really interested by the question. "It depends if the message is important." "And are they here now? Is the Seamstress here now?" Olivier looked up over his left shoulder. "Yes, she's here now. I won't go to market, I won't go back there. They are all foreigners and they have read the books. So why should I lend them to ' "Olivier." Thomas regretted mentioning the Seamstress, because now Olivier was talking to her instead of him. He stood up. "Talk to me." He felt himself appraised by Olivier's gaze; it was clearly a reasonable choice for him which one to address. "Last time we met," said Thomas,"you told me something of your thoughts, how they are shared with other people. Do you remember?" "Yes, of course. What I think can be seen by the Sovereign and by the President of the Republic. I have no need to write to him." "Which Republic?" "The Republic of France." "What is the President's name?" "The President." "Do you live in France?" "Of course." Olivier was unruffled by the question. "There are five or six people who have a list of traitors. They have a list of all the illnesses in the world and they have the cures. It is a very well kept secret." "How do you know about it?" "I just know. I receive messages. Sometimes the Carver tells me. Or I can read it in books, you see. It is not in the lines, not in the printed lines. No, no, you would not open the book and just see it there. It is between the lines, that is where I can see it. The Monarchy will return. I have been informed." "But how?" Olivier gave him a curious look. Thomas was sometimes reminded of one of the fellows of his old college at Cambridge, a man so secure in his superior knowledge that he seemed reluctant to impart it to anyone of lesser intellectual standing; he responded to questions with the same slightly pitying expression that Olivier now directed at him. Then Olivier spoke quite calmly, something which Thomas always took to be a good sign. He liked watching him, this handsome man of thirty-eight; his greying hair was trimmer these days, as was his beard. There was something oddly cogent in his understanding of the world; the scheme had a completeness, almost a beauty, and in his better moments Olivier achieved a measure of serenity. His voice was gentle and explanatory, and at such moments Thomas felt overcome by love for him. It was clear to Thomas that Olivier had put a vast amount of emotional energy into understanding the world as it appeared to him; not only energy, but reason and creative intellect as well. These mental faculties were clearly separate from the perceptual area of his brain which told him that there was a woman at his shoulder and a creature on his thigh, where he occasionally made dismissive, brushing movements. '... and I can understand the contents of books I have not read, because I have been chosen," Olivier was saying. "Do you know by whom you have been chosen?" Olivier considered. "Do you know that the fire in the sky is how God cleansed the world of sin?" "No, I did not know that." "Really? It's quite simple. I have the powers of blessing, they were given to me." "By whom?" "By God. You see, when a cloud forms, there is a slow increase of pressure from the vapour gathering inside. If this bears down too hard, you will have thunder. That is how mankind first came down from Heaven." "In a cloud?" "Yes." "Have you been to Heaven?" Olivier's fingers were moving very rapidly through their rhythm. "Yes, I have been to heaven." "What happened there?" "Jesus held me." "Jesus held you?" "Yes. In his arms." Thomas said nothing, hoping Olivier would continue, but then saw him glance up, as though listening to another voice. "What else happened in heaven?" "What?" "You were telling me about heaven. How Jesus took you in his arms. What else happened there?" Olivier rocked slowly backward and forward on his chair. When Thomas had first begun his conversations with him (he hesitated to call it 'treatment'), Olivier had been tirelessly expository, extremely patient in his explanations of the universe he inhabited; often he seemed enthusiastic about it, eager to share with Thomas its wonders and its laws. No one had ever taken the time to ask him before, and he seemed to enjoy talking about it. These days, he was a little less lively, Thomas noticed, and that was something he had observed with patients suffering from the same disease in the county asylum. By the time they reached the age of about forty, they began to lose the fight to make a cogent world; they seemed less able to make even workaday connections. Sometimes Thomas pictured the inside of their brains as being something like the network of twigs and branches in an oak tree, though perhaps a million times more dense. He watched them when their faces grew puzzled and their speech slowed down; the logic became tenuous; the content of the sentences began to loop, repeat and trail off into non-sequiturs. He pictured the mis routing of electrical impulses over all those years, the auditory area chronically aflame with non-existent voices; he imagined the damage done by years of short-circuit in the brain, the build-up and overspill of chemicals at the point of electrical exchange; and in his mind's eye he saw not local 'lesions' but entire pathways burned away, like the landscape after the scorched-earth retreat of a vandal army. "Olivier?" "Yes." "What else happened in Heaven?" Olivier brushed vigorously at his trouser legs. "I was given the powers of speaking languages, the gift of tongues." "And do you speak other languages?" "Yes, I do." "Which languages?" "I speak German. I speak the High German, the proper German. It is called Royal German, not the other one, which is the Nasal German. You know, because that is spoken through the nose. It's a different language. I learned that from my mother." "Your mother?" "Yes. My real mother is Joan of Arc. We are descended from Jesus Christ. The Sovereign has given me the genealogy, I have it all written down." "So are you also related to the Virgin Mary?" "No, no. She was not his mother. No, no. Elisabeth was his real mother, the mother of John the Baptist. Mary was not Jesus s real mother. I can trace my lineage back to Adam." "Have you ever been to the Garden of Eden?" "Eden, eaten. Not eaten." "Would you like to? Is there anything we can do to make you feel happier? Do you like your room in the schloss? It is a good view, isn't it? Across the lake?" Olivier looked puzzled. "Why are you here, Olivier? What are you doing here?" "I have been sent here for some reason." He seemed to regain some of the old enthusiasm, and a little of the donnish quality returned. "You see, there is a formula by which I have worked out the number of cells in my brain and in this way I am unique. My thoughts are in fact recorded for posterity. And I think that is why I am here." "I meant here, in this building, in this part of Austria-Hungary' Olivier said nothing. He was lost again. "How old are you, Olivier?" "I am twenty. I am twenty years old." Thomas knew that this was the age at which he had been removed from home and sent to the asylum by old Rebière. "And do you have any brothers and sisters?" "Yes, I have a brother." "How old is he?" "He is... He is... I don't know how old he is." "Where is he now?" "He is... He is at school." Thomas stood up. "I have spoken to you enough this morning." He laid his hand on Olivier's arm. "I think you should go for a walk in the sunshine and then have something nice to eat at lunch." He escorted Olivier to the door and watched as Daisy took him out beneath the stairs into the cloister, his fingers still fluttering in their rapid pattern of touch.