All in the Mind (5 page)

‘So,’ Sturrock said, realising that his first ‘So?’ had not worked, ‘how has your week been?’

‘OK.’

‘Really?’

‘No, not really.’ She smiled.

‘How did you get on with your homework?’ he asked.

He had given her a book to read at the end of their last consultation, an anthology of stories of survival from around the world which the publishers had sent to him because he had treated one of the cases featured. He read widely and was always looking to find ways of sharing what he read with patients and colleagues. He had hoped Emily might get some kind of solace from learning about people who had suffered even worse injuries than hers, but who had gone on to rebuild their lives, one of them becoming a celebrated poet, another running a small bank in Illinois. Part of his assessment of trauma victims was that they needed to know there were others like them.

‘I’m afraid I didn’t really get into it. I will try, I promise.’

‘Only if you want to,’ he said. ‘There’s no pressure. I thought it might help to read of others who have gone through something similar.’

‘Sorry.’

‘Not a problem. What about the raisins?’

He had asked her to study a box of raisins as part of a cognitive therapy designed to change the way people think about the world around them and, hopefully, their own lives.

‘Sorry. I will, I promise.’

There was a pause. Then Emily broke the silence.

‘I spent a lot of time looking in the mirror.’

‘And what did you see?’

‘I covered the bad side of my face with a towel, and stared, just stared at the good side.’

‘And saw …?’

‘Pretty. Saw that I was pretty. Clear blue eye. Nice high-set cheekbone. Nice ear. I remembered how Patrick used to nibble it when we
made
love. Then I stared into the good eye for as long as I could and tried to remember what it was like when all of me was like that. I tried to smile but half a smile looks odd. You need the whole face for a smile to work. So I tried to imagine the mirror changing shape so that instead of half a face looking out at me, the good side was reflected and the face became whole again.’

‘And how did it feel to imagine your face whole?’

‘I don’t know because then I dropped the towel and the ugliness came back.’

‘And how did that feel?’

‘Disgusting. And I thought if
I
feel disgusted by what I see, why shouldn’t others?’

She had been in her second year as a primary-school teacher when she was burnt. He had no doubt she was good with the children, and though she said some were cheeky from time to time, they adored her. She loved the work. The day before the fire, she said, she felt she would teach for the rest of her life. Today, she couldn’t see herself ever being inside a classroom again. The children would not be able to look at her. As for having children of her own, even if it was physically possible, which seemed to be doubtful, she didn’t believe it would happen.

‘Children can be very understanding,’ said Sturrock. ‘They might surprise you. They might just see you as the same person they knew before.’

‘But I’m not.’

‘I think you are. All that’s changed is how you look, and that changes how you feel.’

‘But what I feel dictates what I am,’ she said. ‘I don’t feel like I used to feel because I am not who I was.’

‘I think you are
who
you were. You’re not
what
you were in that you look different, but what has happened to you is part of who you are.’

‘I was happy,’ she said, ‘and now I’m not. I was pretty, and now I’m not. I was confident, I was whole, and now I’m not. I wasn’t scared, and now I am. I wasn’t angry, and now I am.’

‘And that anger is part of who you are.’

‘What good does it do me?’

‘What harm does it do you if it helps you come to terms with what’s happened?’

‘I don’t know that I can ever come to terms with what’s happened.’

‘You might, Emily, we just don’t know. You thought you were going to die, didn’t you? Yet here you are. Not long ago, I had to come to your parents’ home to see you because you wouldn’t go out in daylight, but here you are. And you’re living on your own now. This may not seem much to you, but it’s progress, I promise you.’

Sturrock was never afraid of silence. He often used it to let a point sink in. He used it too to let the patient take that point wherever they wanted to in their minds, and then say whatever they wanted to say once their mind had played with it. He assumed Emily was reflecting on what he had just said, and would come back at him in a softer, mellower way. He was wrong.

‘What are you thinking?’ he asked.

‘I’m wondering how different you would look if you had all these scars. And I’m wondering if you’d still feel you were the same person.’

‘The you I see is the only you I know, and it is a full you, a real you,’ he said. She nodded but in an unyielding manner that said to him he was failing. He felt the failure deeply, felt it was his fault, something he was doing wrong. How could he convince her she was making progress if he didn’t even believe it himself, or believe that he knew how to help her?

‘But there is a difference with me,’ she said. ‘I have seen a different me. The one that was pretty and whole. The one whose only scar was a tiny little mark below my ear, hidden away by my hair and so small it was hardly noticeable anyway. You can imagine the other me, can’t you? But could you really imagine yourself looking like this? Do you really think you would still be saying I’m the same me?’

There was a short silence.

‘I don’t know,’ he said. ‘You’re right. I don’t know.’

He felt even more stuck with her now. The only good thing had been to see her showing a bit of fight and spirit. But he knew he was clutching at straws. They wrapped up early. As she pulled her
headscarf
tightly around her face, she said, ‘Thank you,’ as she always did, and left.

Sturrock went back to his desk, and sat motionless for several minutes. He felt almost numb. He couldn’t recall the last time he had experienced a collapse of confidence like that during a consultation. Not since his student days. Usually, no matter how low the patient might be, he was able to come up with an idea, a strategy, something to help. But today he had been weak, drained of inspiration. As he tried to think what else he could have done, he reflected that Emily had lost her health, her looks, her confidence, her job, her sense of belonging and her boyfriend. It was hardly surprising she failed to buy into his assertion that she was the same Emily as before.

He had a spare ten minutes. He edged his hand towards the mouse of his computer. As happened far too often when he was low, he thought of Hafsatu, and felt an overwhelming urge to see her. A few months ago, she’d told him how her captors had posted videos of her on the Internet. She had described them in detail. How they had forced her to have sex with three white men, filmed her, shouted at her to look like she was enjoying it, then sold them to a company that specialised in interracial sex websites. Ever since then, he’d been looking for the videos. Even though it meant sifting through thousands of pornographic images, even though he felt sick with himself for doing so, he couldn’t stop himself: he needed to see them. But just as he was about to open a new site he had not known about till now, Phyllis came in with messages.

With her usual efficiency, she went through her list. The organisers of last night’s dinner called to thank him for going. Could he phone his research director about a couple of fund-raising leads they had? Next Wednesday’s budget meeting was being moved. And his wife had called.

The message that his wife had called was one that Phyllis conveyed often. She always did so in a totally deadpan manner, as if it was entirely usual for a wife to make so many calls to her husband at work. Sturrock wondered if she even noticed the way his face fell a little each time she said the words. He suspected not. For a secretary to a psychiatrist, she showed a remarkable lack of interest in human nature.

He and Stella had been married for so long, and spoken by phone
so
often, that Stella liked to say she always knew when it was her husband calling. Statistically, that was a fair bet. She phoned him at least four times a day, sometimes half a dozen, and very occasionally the number of calls to poor Phyllis would reach double figures. He almost always called back. There was a time, just after the texting craze began to catch on among the older generation, when she got into the habit of sending messages to his mobile saying ‘please call’. But it led to so many consultations being interrupted by the pinging sound of a message coming in that he’d had to turn off the phone and ask Stella to go through Phyllis like everyone else. Needless to say she was aggrieved that yet again, in her mind, he was putting his care for his patients ahead of his care for her.

He still had a bit of time before David was due to arrive – if he decided to come. He picked up the phone, and dialled home.

Stella answered after one ring, which meant she had been sitting there waiting, phone in hand. There was no hello from either of them. There rarely was.

‘It’s me,’ he said. ‘Phyllis said you called.’

‘It’s Jack’s birthday on Sunday. Have you remembered?’

‘Oh yes, of course it is. Twenty-eight, isn’t he?’

‘Will you get a card on the way home? We can talk about a present tonight.’

‘Fine, yes, OK,’ he said.

Sturrock suspected Stella’s next call would be about what present to buy for Jack. He tried to say goodbye but she went into a long explanation of the comings and goings – or rather non-comings and goings – of a delivery man who was supposed to be bringing the new lawnmower she had ordered. He let her roll out every inconsequential detail, quelling with difficulty the urge to shout out that he had just spent an hour with a woman almost burnt to death, he was about to spend an hour with a chronic depressive, then see a woman who had been raped with a knife at her throat, and did she ever think that she went a bit over the top in complaining about her lot?

‘I’d better go,’ he said. ‘I have a patient coming. I’ll get the card.’ And he hung up.

5

Phyllis was close to sarcasm when she buzzed through to say that David had arrived.

‘He’s here, lo and behold,’ she whispered, and Sturrock hoped she wasn’t pitching her voice just loud enough for David to hear.

‘Good,’ he replied. ‘Excellent.’ The relief was as much for himself as it was for David’s well-being or Phyllis’s schedule.

He walked over to his door. Through the frosted glass he could just make out the form of David, slumped in one of the chairs outside his consulting room. He smiled on seeing the familiar blue coat, hands plunged into side pockets. It was his first smile of the day. He smiled again to himself, thinking that it was a depressive who was making him happy.

On the surface, there was little in David’s background to explain why Sturrock had so taken to him. David came from a broken home from which the father had fled when his son was just five, leaving his Irish mother, Nora, to cope alone with financial hardship and, as David grew older, her son’s evident psychological problems. He, on the other hand, came from a well-off, middle-class background which, if unloving, had been comfortable and stable. Sturrock was a husband and a father. David had difficulty forming any sort of relationship. Sturrock was a highly educated, well-paid, respected professional. David earned seven pence above the minimum wage in a packaging warehouse in Dalston, which took a quota of ‘disabled’ people as part of its social responsibility programme.

Secretly, though, Sturrock knew that as well as treating David, he used him to deal with his own depression. In his behaviour and
his
words, David articulated a lot that he himself was forced to suppress.

So whenever David didn’t show up, Sturrock knew why. Often he too felt like not turning up, but he was the doctor, and he had to. Only twice in his career had he missed a consultation because he felt psychologically unable to face it. He’d told Phyllis he had a migraine and she’d told his two patients he had food poisoning. It was the closest he’d got to asking for help. He’d sat with the phone in his lap, and begun to call his former colleague, Michael Wells, who had recently retired and was living in Bath. He got as far as the 01225, then stared at the keypad for a while, and pressed the red button. He could just about bear to admit to a general feeling of being beleaguered. He could not bear to admit all the reasons though.

It was one of the great ironies of his life that he urged his patients, and friends in his own circle, to be open about their own feelings and experiences, yet remained so closed about his own. Several times in the past, he had been asked to examine fellow psychiatrists who had either developed a particular condition that worried them or, more likely, who just felt life and the pressures of work getting on top of them. They were all encouraged to ask for help if they felt they needed it. Perhaps that was why the suicide rates among psychiatrists had fallen substantially since the days when Sturrock started his career. But he never felt able to follow their example. There were depressives who scored four or five who were under regular care and yet he, sometimes self-analysed as a six, had always resisted doing what he knew he should. It was partly the fear of damaging his own reputation inside the profession, or within the politics of the hospital. There was also a little arrogance in there, the belief he could analyse himself better than others could.

In truth, it was often David who provided the analysis. Sturrock was constantly amazed by the way he managed to describe with such vividness the knots, the chasms, the spaces, the voids and the vacuums that tormented him.

There had been several moments when he had wanted to tell
David
that he experienced something very similar, but that he had learned how to hide it from others. He wanted to say it not in any ‘I feel your pain’ kind of way, but so that David might take some pride in his feelings and his ability to articulate them. David had never felt special about anything. He had been a failure at school and in work, and a failure in relationships. Yet he had a very special way of describing his depressions once he had left them, or they had left him, and Sturrock experienced a profound empathy.