Once when I had shown him out I noticed that my hands were shaking; I was quite distraught.
“Who is that man?” my wife said.
We were sitting, about to have lunch, in our dining room, which looks out across the front garden onto the road. On the opposite side of the road is a bus-stop where sometimes, after I have finished surgeries, my last visitors can still be seen waiting for their buses. My wife sees my patients come and go. She asks about them. Sometimes I think she is jealous of them.
M. was there, in his crumpled blue raincoat. My wife must have noticed him before.
“That’s M.” I said. “He’s a damn nuisance.” And then I added in a sudden defensive, possesive way—I don’t know why: “There’s nothing wrong with him! Nothing wrong with him at all!”—so that my wife looked back at me in a startled fashion.
This was a short while before Christmas. My wife’s pregnancy was now quite visible. I have helped countless women through their pregnancies. This has given me satisfaction. But this baby, inside my wife, was like a barrier between us.
I said to M. about a week later (we were back to headaches and miscellaneous complaints, the jumbled up symptoms of half a dozen nervous disorders): “You know just as well as I do that you’re perfectly fine, don’t you? Why do you do it?”
It was a raw, foggy day in November. On such a day my surgery can seem cosy, a place of sanctuary. I have a fine oak desk with a roll top, a dark green carpet, a gas fire that fizzes gently; pictures on the wall—still-lifes of flowers and fruit.
I had put my pen down on my desk and leant back in my chair. I was ready to talk frankly.
“I am not well, Doctor—I come to you.”
There was sometimes something foreign about M.’s voice, his accent, his choice of phrase, his looks.
I sighed and swivelled slowly in my revolving chair.
“Tell me about yourself. What do you do? You’re some sort of clerk aren’t you?”
“Life insurance.”
This amused me. I didn’t show it.
“But what about your evenings? Weekends?”
He said nothing. He looked uneasily at my desk. He was like a schoolboy who clams up when the master becomes friendly.
“Don’t you have friends? A girlfriend?”
No answer.
“Family?”
He shook his head.
His expression was empty and opaque. Without pressing him further I could see the whole picture: filing and entering figures all day; a bed-sit somewhere, evenings spent alone. At night he would lie awake listening to his heart-beat, the suction of his lungs, the gurgling of his alimentary canal.
I thought of myself when I was twenty. I had pored over textbooks in the Medical School library. I had played Rugby for Guy’s; dated a girl from the Dental School.
“Well—” I began.
“Doctor,” he interrupted as if impatient with my digression. He had this way, despite his reticence, of suddenly pulling you up. “You are going to tell me what’s wrong?”
“Well, I was about to say that if you lead a fuller—”
“No, I mean what’s wrong with me.” He patted his chest. Sometimes he spoke as if I were withholding from him some awful truth. “Please tell me.”
“The same as usual—nothing,” I said crossly.
“You know that?”
“Yes.”
“How can you know?”
This was like a game of bluff in some interrogation.
“It’s my job, for goodness sake.”
He drew his face a little closer to mine. It had the same sheepish look it perpetually wore, but there was something insistent, arresting about it.
“Doctor, you have to relieve pain. Do you know what pain is?”
I should have blown up at an absurd comment like this, gently spoken though it was. But I didn’t. I noticed I was swivelling quite compulsively from side to side in my chair. I had taken up the fountain pen from the desk and was rolling it between my fingers.
“Look, all this is rather pointless, don’t you think? We don’t seem to be any help to each other. Shall we call an end to the game now? Don’t you think it’s gone far enough?”
He blinked.
“Come on, off with you.”
He got up. I was stern. But, in speaking to him in that confiding way, I realized that I had admitted that he had got under my skin, that he affected me, that my relations with him were different—more intimate and involved—from my relations with other patients. At the door he looked up, almost with satisfaction. My palms sweated. His features had this flat quality, as if there was nothing behind them. And suddenly I knew why he fostered and cherished his “pains,” why he manufactured little upheavals and crises in his body, why he needed these amateur dramatics in my surgery: He was getting his experience.
That night my wife could not sleep. She had a mild pregnancy ailment for which I had had tablets prescribed. We lay awake in the dark. I said to her (this was a question I had been asking her, silently, ever since we knew she was pregnant, but now I spoke it aloud): “Whose child is it?” “How do I know?” she said. And yet I knew she knew. Perhaps she was not saying, to protect me, to propitiate me; or—if it was my child—to punish me. She turned onto her side. I put my hand gently on her belly.
I met my wife when she was twenty-two and I was forty-one and had just become a partner in the practice which I run now by myself. I had trained and worked for twenty years in the hectic world of hospitals and acquired something of a reputation; but it was never my aim to become eminent in medicine, to devote myself exclusively or academically. One day I wanted to take up a practice which I could manage without hardship, where I would be free to enjoy life. I would enjoy life. I had a taste, a zest for it. My medical knowledge would ensure this—you see, it was always for me a matter of health, of happiness. And when I took up this practice it would be time for me to marry. My wife would be young, sensual, free, full of life. She would make up for some of the sacrifices, for some of the constraints that go with serving medicine.
Barbara was these things. Though she had also, I imagined, an appearance of being vulnerable, of needing to be protected, of being in some ways, despite her twenty-two years, still a child. She worked in the Haematology Unit at St. Leonard’s. I have always had a special interest in haematology. This is because once I was frightened by blood. I used to be scared of the sight of it. Barbara had been at St. Leonard’s for a year, after graduating. Within eighteen months we married. Perhaps I wooed her in an old-fashioned manner. By showing her the solid things I had to offer: the house with its adjoining surgery which Dr. Bailey (a man who had studied under my great-uncle at Bart’s) would offer me when he retired and I took on his practice; the garden with its apple trees; my professional standing; my knowledge. Perhaps it was she who looked to me for a widening of experience. She was playful, energetic, capricious and I wanted to share these things as an equal. But I found myself falling into the role of the older man whose dignity is being teased, tempted. We went on our honeymoon to Italy. We made love in a room with bleached shutters overlooking the Gulf of Sorrento. And yet after this I knew it was not to be as I had foreseen. I did not let this trouble me; I have learnt not to let things trouble me, to accept what is so. I regarded my wife’s youth as perfectly natural, perfectly right, even if I could not wholly reciprocate it. I began to look on her as a father looks on a daughter: Her pleasure was my pleasure; I was there to advise her, to safeguard her pleasure, to protect it from what risks it might incur, to ensure her health. I did not want to restrain her. We started to divide off the surgery and the house as separate territories so as not to impose on each other. Perhaps she became jealous of my patients because the attention I gave them was in a way similar to that I gave her. Yet I believe I was considerate to her, as I was to my patients. I would think of all I had; I had every reason to be thankful. I would look at my wife, as she prepared herself, her hair up, for an evening with friends or as s
he stepped, laden with carrier bags, from the car I bought her (only sometimes would I tell myself, these visions are like photographs whose real subject you do not touch—but I did not let this trouble me), and I would think: I am a happy man, a really happy man. And then I began to want a child.
I knew she was having an affair with Crawford. He was the new head of the Haematology Unit. Only thirty-two. I was not angry, or recriminatory. I don’t believe in making suffering. I thought: This is natural and excusable; she must have this adventure; she must have her experience. The best treatment is to let it run its course. When it is over she will come back to me and our relations will be stronger, more cheerful. I was not even jealous of Crawford. He was a non-medic, like most of the staff in research departments. He had all the non-medic’s sense of a subject seen in academic isolation away from its human bearing. He was a rather slight, unprepossessing man—if sixteen years my younger. His affair with Barbara lasted through that summer, and ended in August. I do not know if he broke it off or whether they put an end to things mutually because they felt guilty at what they were doing to me. Or to Crawford’s wife. Later I learnt that Crawford was accepting a job in Canada in the new year. Barbara took the break-up badly; she even cried in front of me and blamed me. I thought: This is to be expected, it will heal; life begins again. They had terminated the affair just before she and I went on our summer holiday, in the west of Ireland. Often I would leave her in our room and I would go for strolls along the beach or over the golf links, breathing the clean air with gratitude.
Then, when we returned, we learnt that she was pregnant.
I put my hand gingerly on her belly. When you feel the belly of a pregnant woman you can tell all sorts of things about the child she carries. Except whose it is.
“Tell me,” I said.
“I don’t know, I don’t know.”
I thought: All this is perhaps a pretence, to create drama.
“If you tell me, I will understand. Either way.”
She did not answer. It was as though she was far away. She was hunched up beneath the bedclothes, gathered into herself, like the foetus inside her.
After a long pause she said: “What will you understand?”
A few days later, when M. appeared in my surgery, I turned upon him furiously. I refused to treat him. I had not meant to behave like this. But at the sight of his helpless face something exploded inside me. It was no longer a case of professional annoyance. I felt I must be free of him as one feels sometimes one must break off a harmful relationship, sever a tie one should never have begun. “Out!” I said, “I’ve had enough! Out!” He looked at me with a kind of ingenuous disbelief. This made me all the more severe. “Out! I don’t want to see you again!” I could feel my face was flushed and I was losing control. “But—my pain is real, Doctor,” he reiterated his old cry. “No, your pain is not real,” I said emphatically. “If it were real, you would not be concerned whether it were real or not.” This made me feel more in command. One of my hands was on M.’s shoulder pressing him towards the door. I opened it and all but pushed him out. “Go, will you? I don’t want to see you again!”
It was a dark evening in mid-winter. A light over my surgery door lit up the gravel path. He walked away, but paused momentarily, after three or four steps, to look back at me over his shoulder. And as he did so I suddenly had a strange, intense memory from when I was a boy. I was no more than eleven. It was one warm summer Sunday when all the family was in the garden. I had gone indoors into the kitchen for some reason and found our old tom cat Gus dead on the floor. It was lying on the tiles with its legs straight out beside it. I knew it was dead, but I had never encountered death in such a tangible form before. I was frightened. But what frightened me was not so much the dead cat itself but the fact that I was the first to discover it, so that in some way its death was tied up with me, I had responsibilities towards it. I did not know what to do. I simply retreated into the garden, pretending to have seen nothing and trying to hide my state of mind, till someone else made the discovery. But, as I crept out of the kitchen door and down the side path, I had looked back, involuntarily, as if in some way the dead cat might rise up to expose my guilt and cowardice, like the ghost of a murdered corpse.
This memory flashed through my mind as M. departed, but not in the usual way of such memories, as if you see everything again, through your own eyes. I seemed to be looking at myself, from the outside, as a young boy, just as in reality I was now looking at M.
I returned to my desk and sat down. “What on earth was all that about?” said my receptionist, coming in from the little office adjoining my surgery. The shouting must have penetrated almost to the waiting room. “It’s all right Susan. It’s okay. Give me a moment or so, would you, before you send the next one in.” She went out again. I sat at my desk for several minutes with my head in my hands. My surgery is built projecting back from the side of the house so that the rear windows of the house are visible, obliquely, from it. Similarly, by looking from the house one can see the windows of the surgery. I drew back the blinds above my desk and looked at the lit ground floor windows where I knew Barbara would be. I wanted her to appear. Then I drew a breath and pressed the buzzer on my desk which was a signal to call the next patient from the waiting room.
When surgery was over that evening I locked up at once and went straight through to my wife. I wanted to put my arms around her and hold her protectively. But somehow she forestalled me. “What’s the matter?” she said. She was standing in the hallway drying her hands with a kitchen towel. Perhaps I still looked agitated from my outburst with M. She came towards me. She guided me through to the living room. “Here, you sit down for a while, you don’t look so good.” I was so surprised by this that I let myself be led. During the early years of our marriage when it became clear that the difference in our ages would have its effect, my wife had sought a new interpretation of her role. She had seen herself, at some time in the future, as the younger, stronger partner, keeping a watchful, soothing eye over a busy, older husband, guarding him against the strains of over-work. I had resolved that she would never have the opportunity to do this. She motioned me towards a chair. I thought: This is ridiculous, it is some kind of trick. I am the doctor: She is saying I look unwell. It is I who was about to comfort her; it is she who needs rest. As she pressed me to sit down I suddenly thrust her hands off me. “I’m okay, for God’s sake.” She looked at me piercingly. “All right then,” she said, and her expression went grim and hollow.
Later that evening it struck me why it seemed I sometimes recognized M.’s face. His face was like the face of one of the corpses we had dissected in anatomy classes when I was a student. I remembered it because nearly all the corpses used by medical schools are of old people. I did not suffer myself from the attacks of squeamishness which afflict most medical students in the dissecting room. But this corpse, of a young, slim-built man, made me pause. The anatomy lecturer had joked about it. “Your age, eh Collins?”
It’s the same face, I thought. But I dismissed the notion from my mind.
Two or three days after that I received a telephone call which made my heart sink. It was from a young woman who said she was speaking on behalf of M. She said she had a room in the house in which M. lived. M. was ill. He had attracted the attention of other people in the building and given them my number. I thought: Of course, the inevitable ploy. Now he is forbidden my surgery. It was impossible to explain my position over the telephone, impossible, too, to say outright that I had no intention of visiting M. I said that I would try to fit in a call later that afternoon. It was then about eleven in the morning. In my anger I did not even go through the usual practice of asking for a description of symptoms.
“He seems bad, Doctor, don’t you think you should come at once?”
I was tempted to say, “It’s all an act, you stupid girl, don’t let him fool you,” but I didn’t. Her voice seemed genuinely imploring. I said, briskly, instead: “Look, I’m
a busy man, I can’t come before four—all right?” And slammed the receiver down.
I had in fact several calls to make that day. Some were of a quite serious nature, none were, strictly, urgent. I knew I had a duty to deal with an emergency first. Some emergency! My only difficulty lay in deciding whether I should go to M.’s at all. I did not make up my mind until I had finished my other calls. Usually I like to complete my rounds by four so that I can have a moment’s peace before evening surgery at five. It was nearly a quarter past four when I turned the car round and headed in the direction of M.’s. I knew there could be unpleasant consquences for a doctor who refuses a call, even a false alarm, where third parties are concerned. I arrived at M.’s address—one of a row of large, ugly Victorian houses with basements—at about half-past. It was almost dark. More than one person seemed to be waiting for me as the door was opened: a girl with frizzed hair and glasses whom I took to be the telephone caller, a tall, laconic West Indian, a middle-aged man in a blue cardigan who appeared from a room at the rear, another woman, on the stairs, leaning over the banisters. I knew at once they were hostile. The woman on the stairs, who was furthest from view, spoke first:
“You’re too bloody late mate!”
The girl in glasses explained: “We called an ambulance.”
“You did what?”
“It left half an hour ago—we were really worried.”
“Well what was wrong for God’s sake?”
“Now he asks,” said the West Indian, looking me up and down. “Five hours,” he added, “five fuckin’ hours for the doctor to come.”
I stood in the hallway in my overcoat, holding my doctor’s bag. I couldn’t help thinking that all this—even the ambulance—was still some pretence, a hoax, an elaborate conspiracy to continue M.’s fraud. I didn’t want to commit the error of finding it real. The hallway was dimly lit and unheated.