The Avignon Quintet (141 page)

“Thank you, anyway,” said Affad. “I see no undue cause for worry. But of course once a woman disturbs a sequence of events by a rash act …”

“Exactly,” said the Prince. “It always makes me nervous when a woman intervenes. Things usually get into a tangle. At any rate, for the moment there is no undue cause for our fears. Have you made any plans yourself?”

“I haven’t yet said goodbye in Cairo so I plan to spend a few days there this week. Back Saturday.”

THREE

Inner Worlds

A
S FOR CONSTANCE
,
SHE HAD AT LAST TAKEN THE ADVICE
of Schwarz and left for the little lake house which they used for weekends of leave. It lay in a sunken garden and was built over a boat-house containing the precious motor-boat of Schwarz, which he had christened
Freud
. There was also a tiny skiff which they used when they wished to sunbathe on the lake or to visit the local
auberge
for lunch or dinner. It was a delectable corner and there was no telephone – a fact which set off its quality of seclusion and quiet. As ideal for work as for rest, then.

But in her present disturbed mood it would have been hard to think of rest, so she had done what she had so often done before, namely taken her work with her in the form of the medical dossier which the central clinic had built up out of their investigations of Affad’s son; a document which depressingly reflected the objective medical view of the child as “a case”. It lay before her on the rough deal table together with her typewriter and a cluster of pencils and notebooks. She shrank from it somehow, for she could foresee its dispiriting evaluations of human misery, and the inflated vocabulary which could hardly disguise the almost total ignorance in which their science lay shrouded. Nevertheless. One must begin somewhere, one must make an effort to understand, the hunt for exact observation was their only
raison d’être
. She could hear the cautious voice of Schwarz cutting into her thoughts to warn her, “Yes, but method, while desirable, must remain an art and not dwindle into a barren theology – the sort of superstition upon which dead universities exist!”

Okay. Okay. Symbiotic child psychosis with marked
autistic traits
. As she read the portrait of the small staring face in the sailor hat, fervent in its withdrawn impavidness, gazed out upon her from the slowly gliding limousine. It was of course the face of Affad in miniature that she watched.

The child was referred by a hospital where he had been kept under observation for three weeks of tests at the request of his father and the child’s grandmother; the mother, who had a long record of psychic upheavals punctuated by ordinary periods during which she resumed her responsibilities, exhibiting a normal but hypertense relationship to the family circle when she was at home. But during periods of collapse or stress she herself returned to her home in Egypt and had herself committed as a voluntary patient for rest and treatment. The evolution of the boy’s childhood seems to have been normal and regular, but after the mother’s first disappearance for long from the scene during his sixth year, he fell ill with a fever which resisted accurate diagnosis, but which kept him in bed for several months during which the present traits slowly evolved. The behaviour pattern was sufficiently striking to prompt parental anxiety and the father sought medical aid. The case was referred to my care and a fairly detailed and intensive period of observation and evaluation followed, during which I saw the child for several hours a day. His grandmother was permitted to stay in the hospital with him, though he himself exhibited neither alarm nor curiosity and stayed sunk in the apathy of his condition.

The report had been written by an old friend and fellow-student of Constance, a wise and experienced neurologist not lacking in insight and affection, with children of her own; and it was extremely detailed, though as always with such a subject, consistently tentative. She heard Schwarz again: “Despite such a river of verbiage we know damn all about the human condition either in health or in sickness. Yet we must slog along.” Slog was the word! Constance made herself some tea and returned to the thoughtful and painstaking document of her friend.

The standard preliminary tests showed no trace of anything pathological. There seemed to be no history of lues or any other family illness in the background. Cerebral computer tomography registered normal states.

Up till the time of his illness which could have been touched off by the crisis of his mother’s departure, his development had been somewhat retarded as to speech and the making of sounds; but not sufficiently marked to warrant real anxiety – some children are slow to learn to speak. But from the illness onwards his autistic behaviour grew so marked as to prompt a question as to whether he were not actually deaf and not responsive to sound-signals. Yet this did not seem to be the case for at some loud noises he turned the head, but very slowly, and his look was blank and incurious. Sometimes he stood quite still with eyes narrowed as if he were listening to some inner noise, though his reactions remained expressionless and stony. He submitted to caresses with equal indifference, and if a human face approached his would look away or look through it into some imaginary place, as if something or someone were waiting for him there. His great physical beauty makes it easy to be fanciful about him. But he was like a mechanism which proves defective, had stuck definitively at a certain stage in the building. With both eye-contact and physical contact lost one became somewhat hesitant about an explicit diagnosis of the case. I myself alternated between notions of cerebral damage, pure autism, shock and hyperkinetic syndrome: since whenever he did move the procedure was almost ataxic in its lack of coordination, though always violent and directed towards some inanimate object around him, into which he often sank his teeth before dropping it and then standing still, to stare at a wall or door with total expressionlessness. He did not behave destructively with his hands, tearing things apart, but simply sank his teeth into them, and then dropped them.

His grandmother with whom he lived was herself a somewhat dramatic old lady, and seemed disposed to help, but owing to her defective French and Italian did not seem able to provide much understanding which might be of medical aid to a would-be physician. The boy was named Affad after his father, a businessman who came frequently to see him but lived in semi-permanence in Egypt and did not reside in Geneva. The old lady lived in great luxury in her own lakehouse with several servants, a large private limousine as well as an expensive motor-boat for outings, on which the little boy always accompanied her after being carefully dressed for the occasion in true Levantine style. The family came originally from Alexandria in Egypt.

In these circumstances the child lived a strange non-life, or a life of total non-cooperation despite the presence of kindly servants. His vast playroom was full of toys which he ignored, even the musical ones, like the toy piano and drum and xylophone which would normally tempt a child. Of course with both father and mother absent there was a lack of family atmosphere about his life, but many children suffer such conditions without becoming ill. This could be a subsidiary reason but did not seem to be central. Nor could his father offer any clues; he was a somewhat effete and withdrawn figure, fashionably and even elegantly dressed, but overcame the first impression of insipidity and proved extremely articulate, though of course completely in the dark as to the child. His own medical history offered none either, and he seemed depressed and concerned about this highly intractable condition which had, as he put it, rendered his child as silent as a mummy. I obtained his active agreement to venture upon a series of tentative visits to the child with a view to trying to penetrate this mask of impassivity, or at least come to a definite conclusion as to the causes. I spent over an hour in his presence about three times a week, just to observe his habits, however passive they might be. He was taken out on the lake sometimes in the big motorlaunch, dressed up and clean. He liked to sit and trail one hand in the water, though without any evident pleasure. The other excursion was in the limousine which went slowly along the lakeside for an hour or so. He sat looking at the passers-by and the houses, but saying nothing, impassive.

He does not refuse food but he has still to be fed, although old enough to feed himself; nor does he show any preference as to dishes. He goes through the actions of eating with indifference. He sleeps restlessly and sometimes groans in his sleep or whimpers and has been known to suck his sheet – but this is a fairly normal suckling hangover like thumb-sucking; one is tempted to think that it would be too easy to assume his condition to be the result of shock at his mother’s departure. I would say rather that the shock touched off a more deeply based anxiety historically situated in the remoter past, and was concerned with his suckling problems. I suspected that the mother might have been guilty of depriving the child of its milk either from distaste for the whole business, like so many mothers; or simply had broken off the suckling period in favour of the bottle at too early a stage. Of course this is a traditional view after Klein, yet it is rather puzzling that he showed no disturbances over eating now, that his whole condition seemed to be independent of a food problem.

Here the dossier came to an end and there followed some notes in the hand of Schwarz which began:

By ill luck this unsatisfactory preliminary sketch could not be amplified as the therapist was forced to return to Canada on duty and owing to staff shortages we could not allocate another for many months, so that the situation was allowed to drift and at the time of writing has not markedly changed. All the elements described here remain constant, and the life led by the child maintains its steady rhythm. I think it desirable that we try and penetrate a little further into the obscurity of his condition. There are a number of things which have not been tried; for example a pet, say a kitten. It is hard to resist a kitten playing with wool or a rolling ping-pong ball. Harder to resist the advances of a puppy. Then, what effect if any have images? Images projected on the nursery wall could be tried, just to see whether they raise the tone of his response. What about music while he sleeps…? I throw out these suggestions at random. I think, however, that since you have gone as far as to promise your friend a consultation you should perhaps take the place of the therapist and continue the portrait of this (in my own view, looking in from the outside) classical autism!

The dossier was marked in her name and with the classification numeral of her post-office box. What should be done, she wondered, that had not already been done by her more experienced colleague?

Wind rose off the lake and whirled the shutters closed; she set them to rights and after checking the moorings of the skiff set about cooking her frugal dinner in the cosy kitchen with its wooden walls and waterscape. The moralist in her frowned a little at herself, at her eagerness to come to the rescue of the child, for she felt her intention to be not quite pure, not quite disinterested. After all, had it not been the child of Affad … what would she have done? Most likely deserted it in favour of more interesting cases? Perhaps. “You are still showing your vulnerability,” she told herself, and with the thought a wave of hatred swept over her – hatred for Affad and the appalling game of cat’s cradle he was playing with her attachment. Damn him! And damn that collection of dismal death-worshippers projecting their infantile death-wish out of a ruined Egypt! “I thought the Germans were infantile enough,” she said to herself, “and that the Mediterranean races were older and wiser … what a fool! How naive can you be?”

All this self-recrimination did not however help her to come to a decision about her clinical role in the affair of the child. She would sleep on it and decide in the morning whether to go through with it or simply to pass it to some other therapist. There were several skilful and devoted people she could think of who were quite as capable as she was, and would be glad to round off the portrait of the robot-child. It cost her a pang to think this, however, and she slept badly, dreaming of him with a fervent sadness.

In the morning she woke and at once recalled the description of Affad as a “somewhat effete and withdrawn figure”. This annoyed her, though the feeling was, she knew, utterly irrational. But her own new appearance was pleasing, it was part of the attempt to rehabilitate herself in her own eyes, to rise phoenix-wise from the ashes of this destructive and barren attachment. She had bought the fur coat and some handsome winter gear, she had changed her perfume and she had allowed her hairdresser to alter the style of her hair and wave it differently. It really became her very well – and here there was nobody to see it, to admire it! “Serve you right,” she said vindictively to the shade of the departed “effete and withdrawn” one. But she had not been able to resist dropping into the office to seek the approval of her colleague. His reaction was most stimulating. “God! Constance, you look ten years younger and just fallen in love again – how I wish
that
were true!”