"Yes." Alsop nodded slowly once, and said again, "Ye-es. . . . Well, there's nothing to be ashamed of in feeling the strain. This isn't the easiest of hospitals to work in, despite its size. But it'd be damned silly if you let yourself crack up under the petty kind of pressure Chent can generate. So you ought to take precautions while there's time."
-- Like what? Cultivate Holinshed and lick his boots a bit? Tell Iris to go to hell?
"However," Alsop went on briskly, "the schedule's too full this morning to worry about healing the physicians. Fuller than you appear to realise. I asked you to add Mrs Chancery to the roster for today, and you didn't."
Paul started. "I'm sorry! It quite slipped my mind."
"Papa Freud he say . . ." Alsop drew a large black arrow to exchange the order of two patients on the list. "You don't like the Chancery woman, I know. No more do I, but at least I remember to hide the fact. And who in the world is this 'Urchin' I see mentioned?"
"You should have the admission report on her. We brought her in last night -- emergency."
Alsop rifled papers. "Not here. Holinshed must be sitting on it. Lots of gory details in it? I find that kind usually take longest to get out of your boss's clutches."
-- What am I to make of cracks like that? Is it camaraderie or an assertion of superiority over Holinshed? You're fine, how am I?
Paul summed up the story as concisely as he could.
"And you find this dreadfully puzzling," Alsop commented. "I'm surprised. Female exhibitionism is rarer than male because it has more . . . ah . . . institutionalised outlets, like strip-tease dancing, but it does exist and can generally be fitted into a coherent diagnosis. I'd hypothesise an excessively restricted childhood with so much stress laid on bodily exposure that the mind just" -- he pantomimed crumpling a sheet of paper -- "folds up under the pressure. Did you tranquillise her on admission?"
"No, I gave her no medication at all."
"Therapeutic nihilism is an obsolete standpoint even in psychiatry, young fellow! I worked under a medical superintendent who suffered from it, but I thought he was the last surviving dinosaurian exponent of the notion. Why not?"
"Well . . ." Paul fumbled for words. "Because she came quietly, I suppose you'd say."
"The fact remains, she had a mere hour or so earlier broken a man's arm with her bare hands. You say she's a tiny little thing. Well, a black widow spider isn't exactly a ferocious great monster, but I wouldn't start keeping one as a pet."
-- Stuff the sarcasm, for heaven's sake!
"But how about what's happened this morning? I never heard of a case of hysterical aphasia where the patient set about getting the doctor to teach her English. Besides which, she isn't aphasic."
"All right, what's she suffering from, then?" Alsop waited with a triumphant air, expecting and receiving no answer. He sighed at length.
"I have this nasty suspicion you're convincing yourself you've run across a brand-new subspecies of mental disorder which you can write up for publication, talk about at the next congress you go to, and ultimately name after yourself."
-- Sounds like a capsule version of your life story!
And a tacit admission of the truth of that followed.
"Fell into the same trap myself when I was your age or a bit younger. Remind me to dig out the case-notes sometime. They're . . . well . . . illuminating. Reserve judgment, young fellow, and then hang on a bit longer still. There's nothing so damaging to your opinion of your own competence as having to climb down in public from some limb you've wandered out on. Brrr!"
He acted a fit of the shivers and laughed without humour.
"Let's settle the matter, shall we? Deal with her first. Charrington's not going to cut his throat while he waits."
At first Paul was gratified by the thoroughness with which Alsop set about double-checking the results of last night's examination of Urchin, first by satisfying himself that the girl didn't understand English yet was capable of talking some language of her own, then by repeating the physical examination with a running commentary.
"Get me a urine sample, Nurse -- first thing tomorrow morning, please. . . . We should have a blood sample too. Ought to type every patient who comes in and give them a card showing it on discharge. Might save lives later, case of accident. . . . Curious facial structure! Nothing Asiatic about it whatever except this very marked epicanthic fold. . . . I think you should book her an appointment for a skull X-ray, young fellow. I agree she's quite fluent in this odd language of hers -- which I imagine you'll check up on, won't you? -- but she could hardly have got to the middle of England on Upper Slobovian or whatever unless somebody brought her here, so injury may have caused her to revert, say to a childhood language. . . ."
-- Admirably comprehensive. And yet there's a false note. I'm damned certain there's a false note.
Abruptly, with a stab of dismay, he decided he knew the nature of it.
-- The bastard! He thinks I might be right in calling this an anomalous condition not in the literature; he won't admit it, but he's making damned sure he doesn't let slip the chance of reporting it before I manage to!
*12*
The clock was marking a quarter to two with the inevitable bang boom and clink as Alsop climbed into his Vanden Plas Princess R and Paul turned wearily towards the mess.
-- I suppose he's right about these courses I ought to go on, but why can't the damned things crop up at a convenient time, while Iris is away? Just see her face when I say hullo darling nice to have you home I'm off tomorrow for a course and I'll be back in a fortnight. On the other hand, maybe I should try it. Declaration of independence.
He felt a stir of vague puzzlement. The proprietary attitude regarding Urchin which had come on him unbidden, because he felt his own long-standing nightmare of waking into a "wrong" world gave him special insight into her condition, had made him speak more sharply to Alsop this morning than he would normally have dared, culminating with a ten-minute argument about one of the patients due for discharge today. To his surprise, far from being annoyed Alsop had been positively cordial; for the first time in two months he had volunteered suggestions about some courses Paul might attend.
-- I'll . . . think about it.
Ferdie Silva was leaving the mess as he entered; neither Phil Kerans nor Natalie was present -- only Mirza, distastefully examining a plate of stewed apples and custard which Lil had just placed before him.
"Has Natalie gone?" Paul demanded.
"I saw her go off with Rosh Hashanah, the Newish Jew Here," said Mirza, touching a spoonful of the dessert with the tip of his tongue on the last word and pulling a face. "Lil dear, lose this somewhere, would you? And give me a piece of cheese if we have any fit for human consumption. The soup is ghastly too, Paul, in case you were thinking of trying it."
"I must eat something," Paul sighed. But Mirza was quite right: the soup was half cold with patches of grease floating in it. At least the bread-rolls were today's delivery. He munched on one of them.
"Why did you want our golden-hearted Dr-rudge, anyhow?" Mirza inquired, making a mouthful of the rolled r's.
"Oh, she asked to be kept informed about Urchin."
"She'll get it all on the grapevine, I imagine. I've been hearing about no one else all morning."
"Why in the world?" Paul put down his spoon, staring.
"You mean you haven't realised that no remotely identical case has arrived at Chent since the year dot or the birth of Holy Joe whichever is the earlier?" Mirza sliced his cheese with rapid elegant motions and laid it out tidily on a biscuit. "The patients know, the staff know, how is it you don't?"
"Pretty sure of the patients' diagnostic ability, aren't you?" Paul snapped.
Mirza gave him an astonished glance. "Paul, I thought a night's good sleep would have cured you of yesterday's fit of grumps! I'm sorry if I trod on your corns."
Paul controlled himself with an effort. "No, I'm the one who should say sorry. Go on with what you were saying."
r /> "About the patients' diagnostic ability, you mean?" Reassured, Mirza reverted to his habitual mocking lightness. "Actually I have enormous faith in it. How else do you think I could get along in England?"
"If you're making a serious point, make it seriously. Otherwise shut up. I'm not in a joking mood."
"Yes, I am serious." Obediently Mirza put on voice and expression to match. "Bear in mind, Paul, I come from a country which is" -- he raised fingers to count off the successive items -- "Moslem, underdeveloped, recently ex-colonial, predominantly rural, different in just about every possible way from industrialised, citified, nominally Christian Britain. And here I am pretending to tinker with precisely that aspect of a human being which is affected most by cultural conditioning. So I was sent to an English-speaking school and an English university -- so what? This is merely a late gloss on my basic orientation. I haven't been inside a mosque since I was eighteen, but the mosque is inside me. Your cracked bell up there in the tower" -- a jerk of his thumb towards the ceiling -- "bothers you at least partly because this is a country of Sunday morning church-bells. To me it has no cultural associations. But when that fellow in Disturbed has a bad spell and starts wailing at the top of his voice -- do you know the one I mean? -- I jerk like a frog's leg on a galvanic plate, because to begin with he hits the same three notes as I used to hear every sunrise during my childhood and before I can remember where I am my mind has already completed the call in anticipation: Ya-Allah il-Allah . . . . The muezzin was stone-blind and about ninety, but he used to climb forty feet of stairs before sunrise every day."
Reminiscently he paused, eyes focused on some faraway spot beyond the wall of the room.
-- I ought to be ashamed of myself, thinking that struggling against this damned silly British class set-up is bad. How'd I make out with Mirza's problems of adjustment? Culture shock.
-- Culture shock!
The idea was so dazzling he completely lost the thread of what Mirza was saying, and was only recalled a minute later by the Pakistani's offended question about being bored.
"Sorry, Mirza I" Paul recovered hastily. "Something just hit me. Tell you about it in a second. Go on -- this is very interesting."
"Wouldn't have thought so from the blank look on your face just now," Mirza grunted. "I was saying that in my view no patient here is entirely insane. Even the ones out of reach of communication probably aren't -- a few of them do occasionally come back with memories of the disturbed phase, incomplete though the memories may be. Or incommunicable, which I suspect is nearer the truth. But the milder ones, suffering from things like compulsion neurosis and in here more because they get on their families' nerves than because they're overtly dangerous to themselves or society, do retain huge areas of relative sanity. Day and night they associate with their fellow patients, and though they lack the professional background required to organise their observations into the basis for a diagnosis, that doesn't prevent the sheer volume of what they see and hear from distilling into clear patterns. I've often had a patient say to me about a new admission, 'Ah, that's another of them like Mr So-and-so!' And when I looked up Mr So-and-so's case-notes, damned if they weren't right. Do you follow me?"
Paul abandoned his soup and Lil exchanged it for a plate of macaroni cheese and chipped potatoes.
"Ought to have a resident dietician," Mirza said sourly. "Do you know I've put on two inches around the waist since I came to Chent? Disgusting!"
"I see what you mean now," Paul said, having tasted this course and found it at least edible. "Once when I was a student I was told to write up a new admission to see if what I said matched the real admission report, and I was completely muddled until one of the other patients made a comment that set me on the right lines."
"But you haven't inquired what the other patients here think about Urchin? Sorry -- of course: you've had a consultant riding herd on you all morning. You haven't had time."
"Tell me what you've been hearing, anyway."
"Know Miss Browhart? Schoolteacher, keeps her skirt pinned together between her legs because of 'those dirty boys?'"
"And they're behind every bush and around every corner. Yes, I know her."
"She buttonholed me this morning and told me about Urchin in confidential tones. 'Poor thing' -- I quote -- 'she's not crazy, she's just terrified.'" Mirza pulled cigarettes from his pocket. "Mind if I smoke while you're eating?"
"Go ahead." Paul hesitated. "Do you agree with her?"
"Trying to make me commit myself about a patient I haven't even examined? But I heard the same sort of thing from Sister Wells. 'Never had one like her before,' she told me. 'She's not stupid -- in fact she's very bright -- and I can't work out why she has to be shown everything, even which way round to put her dress on.'" Mirza clicked his lighter. "And I furthermore understand she's been getting people to tell her the English names for all the things in the ward."
"Correct. She did that with me this morning."
"To coin a phrase, this strikes me as anomalous. What do you think?"
"Let's hear your view first. I'm busy eating."
"How can you stuff down so much of that slop . . . All right, though I think this is simple cunning on your part." Mirza frowned. "I'll lay a bet that Alsop has been trying to convince you she's suffering from fairly conventional symptoms of hysteria: exhibitionism, hysterical amnesia and all that jazz. While at the same time being perfectly aware that she's way off the beam."
"I wish to God," Paul said with sudden passion, "that I had your gift for predicting people's behaviour."
"It's not a gift. It's a means of intellectualising all the things people in this country take for granted and I've had to learn because they're foreign to me."
"What do you think about culture shock?" Paul demanded.
"What? Oh, you mean this condition that results from being dumped in the middle of China or somewhere and not even being able to read the signposts." Mirza tapped ash from his cigarette. "Well, I suppose a lot of my Pakistani friends in this country are suffering a mild form of it -- after being used to a wealthy family at home, they come here, live like pigs in a slum district, can't be bothered to wash the windows let alone paper their rooms, don't try and make any friends among the local people but just sweat out the course of study or whatever they came here for and go home with a sigh of relief." He paused. "Was that question about anything, incidentally?"
"About Urchin," Paul said reluctantly.
-- It seemed like a paralysing fit of insight when the idea hit me. Spoken aloud it just seems silly.
"I see. You're thinking of her as being -- let's see -- like the illiterate dependants of some of the immigrants I know, haled off to Britain by better-educated relatives without a word of any language but their own. So what was she doing in the woods without clothing? Had some irate husband taken her out after a row and dumped her to teach her a lesson?"
"I wouldn't make guesses as elaborate as that," Paul said, amused. "But at least it may give me a line of attack."
"More power to your elbow. But if you suggest it to Soppy Al, make sure he thinks it's his inspiration, not yours. He is rather intolerant of other people's bright ideas, isn't he?" Mirza glanced at his watch. "Damn, I promised myself ten minutes' reading after lunch and now I must run. . . . What are you going to do about Urchin, anyway?"
"Oh, a string of things Alsop asked for: urinalysis, skull X-ray -- which reminds me, I must book an appointment at Blickham General. And one or two wrinkles I dreamed up myself. By the way, do you happen to know a really good non-verbal intelligence test?"
"No such animal, in my view. But you could ask Barrie Tumbelow."