Postcards From Berlin (16 page)

“That doesn’t work,” I tell her.

There’s an edge to my voice, perhaps. A slight frown creases the skin between her eyes. She’s looking at the letter.

“I need to tell you what it says in here,” she says. “I’m afraid he does mention …” She hesitates. “He does say that he thought
you were quite demanding.”

I hate that word: It triggers a brief, wild rage. I’m the girl in the ad, who could be rather demanding, the girl that nobody
wanted, although she smiled and smiled.

“That’s utterly unfair.”

She gives me a wary look from under her eyelashes. She’s flushed as though she’s nervous.

“And that you wouldn’t let Daisy speak for herself.”

“She was really scared. She was trembling. Of course I would speak for her.”

She shakes her head a little. “Children of eight are perfectly capable of speaking for themselves.”

It’s happening again: The consultation is slipping away from me.

“But doesn’t he say anything else — you know, about the illness?”

She’s wearing a low-cut T-shirt under the jacket. There are weird red blotches on her neck and chest.

“I was coming to that,” she says.

She clears her throat, an abrupt, sharp sound, as though she’s making a speech.

“Tell me, Mrs. Lydgate, have you ever heard of Munchausen syndrome by proxy?”

“Kind of.” Magazines articles skimmed through come back to me. “You mean, like Beverly Allitt — that nurse who killed those
children?”

She moves her mouth a little, as though she’s trying to smile.

“Well, it’s nothing like that usually,” she says. “It’s usually in the family.”

“Like when people poison their children?”

“There are some terribly disturbed mothers who do behave like that,” she says. “It’s a very strange condition. But there are
also mothers who perhaps exaggerate their child’s illness, or do odd things like putting blood in the child’s urine sample,
so the children end up having lots of unnecessary investigations.” She’s straightening Daisy’s notes between her hands, as
though this is important, to have them exactly aligned with the edge of the desk. “Sometimes today we call it fabricated illness.”

I shrug. “I’ve never heard of it,” I tell her. I don’t know why she’s saying all these things when time is short and we haven’t
started talking about Daisy.

Her throat moves as she swallows. “Dr. McGuire says that Munchausen syndrome by proxy is one diagnosis that he’s considering
here.”

For a moment the words don’t make any sense: as though she’s speaking in a different language. A kind of mirthless laughter
starts to move through me.

“This can’t be true.”

She shakes her head; “I’m serious, Mrs. Lydgate. This is about you and Daisy.”

I’m in a looking-glass world; this is all so crazy, so bizarre. But I feel how my pulse is skittering in my wrist.

“He thinks I’m like that? He thinks I’m making it up?”

She moves her head; it might be yes or no. The blushing deepens on her throat, the blotches red as peonies.

“It’s just one of the things they’re considering,” she says. She’s looking down at the letter, not meeting my eye.

“But why on earth would I do that? Why would I make it up, or hurt her, or do any of those things?”

“I guess he’s got to cover ail the bases. He’s got to consider everything,” she says. She’s careful, cautious, moving a word
at a time. “When the illness is quite confusing, and the child doesn’t seem to be responding to treatment.”

“But what do you think?” I’m pleading, trying to reach her. “You don’t believe him, do you?”

She hesitates. Some anxiety or uncertainty flickers across her face. I sense the conflict in her, that there’s part of her
that wants to stay on my side.

“He
is
a very respected physician,” she says. “But, to be honest, I do think this is a rather strange suggestion. From everything
I’ve read, we tend to find mothers who do these things will be people who’ve had very disturbed childhoods — really quite
damaged people.” She smiles at me, a warm, inclusive smile, a smile that says how very undamaged we are, Dr. Carey and me,
how very undisturbed our childhoods have plainly been. “Nothing like what we’re dealing with here.”

I’m worried she will hear the thud of my heart.

“As you know,” she goes on, “I do think that there may well be a psychological element to Daisy’s illness. But that’s a different
thing.”

The nurse in the treatment room next door is saying good-bye to someone. Her voice is vivid, cheerful; it resonates in the
corridor. From the waiting room I hear a child shouting. It amazes me that all these ordinary things are still happening.

“But I don’t understand,” I tell her. “Why do they do it? The women you were talking about, who make their children have all
these investigations?”

She considers. “It’s thought to be attention-seeking behavior. For some people, being a mother of a sick child makes them
feel needed and admired. As a society, we tend to view mothers of sick children as rather heroic and special.”

I think of the school gate — Daisy crying; me, frantic and somehow ashamed, peeling her fingers from my wrist like sticking
plasters.

“I don’t feel special,” I tell her.

She shrugs a little. “That’s how it’s generally understood.”

I’m trying to find a way through the maze in my mind.

“What happens to these women? What happens to their children?”

The blotches are dark on her throat.

“Well, in extreme cases the children have to be taken into Care. In extreme cases. To be protected from their mothers.”

This is all so stupid, laughable, nothing to do with me. But the inside of my mouth has turned to blotting paper.

She pushes back the cuff of her jacket and looks at her watch rather pointedly. The consultation is nearly over, and still
I haven’t said what I need to say.

“This isn’t what I came for,” I tell her. “I came to ask to be referred to somebody — you know, a specialist. Someone who
will be able to work out what’s wrong.”

She shakes her head a little. “I just don’t think that’s how we should go about things,” she says. “I really think that for
now we’d do best to go along with what’s been recommended. We don’t want to keep chopping and changing. All he’s asking is
for you to see a psychiatrist — just to check some of this out.”

“But I don’t want to see this psychiatrist — I want to stop all this right now. It’s mad; it won’t help Daisy.”

“Mrs. Lydgate, I don’t think you understand,” she says. “I’m trying to help you here.” She leans toward me across the desk.
Her breath smells of spearmint, and her teeth are very white. “And my advice would be that you should go along with this.
You see, if you don’t cooperate, it’ll only make him more certain he’s onto something. It’s up to you, of course. No one can
make you do it, not at this stage. But I really think you should.”

“What d’you mean, not at this stage? Is there a stage when they can make me?”

She ignores this.

“Listen,” she says. “Just go and see the psychiatrist — and I’m sure this will all blow over. Dr. McGuire will have his assessment
and that’ll reassure him. And hopefully it will help us find out what’s really going on with Daisy.”

She folds up the letter, pressing on the creases so it’s really neat: She’s going to tuck it back in Daisy’s folder. The consultation
is over.

“Could I see that?”

She hesitates.

I have some vague sense that patients have rights, that there’s a charter or something.

“I think I have the right to read the letter, don’t I? To see my daughter’s notes?”

She raises an eyebrow; she wasn’t expecting this.

“Well, yes, you do,” she says.

It surprises me how readily she acquiesces.

She hands it across to me. I unfold it. There are two pages stapled together.

“Not here,” she says. She looks again at her watch. “D’you mind? I’m running out of time. Could I ask you to read it in reception?”

“Of course.”

“Just give it to Sheryl at the desk when you’ve finished.”

“Yes. Thank you.”

I go out to the waiting room, holding the letter with care, as though it could hurt my hand.

There are only two people waiting: a bleary, huddled woman, coughing over a copy of
Hello!
and a mother with a baby in a sling. The mother is preoccupied with the baby, pressing her lips to his head. I know how that
feels, the sensuous simplicity of it, the tender heat of a baby’s hairless head. I envy her. There are two receptionists:
one in a blue cardigan who’s hunting around in the filing cabinet, the other on the phone.

I sit down and reach for a magazine and open it, to shield the letter from view.

It starts with a paragraph about the results of the tests on Daisy. I skim through this, not really understanding.

On the next page, the tone of the letter changes.

“After I had explained the results to the parents, I broached the possibility that their daughter’s illness might have a psychological
cause, and suggested that this possibility should be further investigated. The mother immediately became extremely hostile
and aggressive, and adamantly refused to consider this possibility. This reaction concerned me a great deal, and in view of
this concern, I would suggest that Munchausen syndrome by proxy or fabricated illness should be part of the differential diagnosis.

“This mother does in several respects fit the stereotype that is described in cases of MSBP. She presents, as these mothers
usually do, as very nurturing and concerned, and is also somewhat overprotective — for instance, not allowing her daughter
to speak for herself, in a way that is quite inappropriate with an eight-year-old child. She is very demanding of medical
staff, and appears excessively knowledgeable about and preoccupied with her daughter’s illness — flourishing a sheaf of detailed
notes on the girl’s symptoms during the conversation — but has nonetheless failed to comply with the recommended treatment.

“In view of these concerns, as well as the shifting and elusive nature of Daisy’s illness, I am referring the family to child
psychiatry for an in-depth assessment. In the meantime, I have suggested that Daisy continue with the prescribed medication,
though I am not over-optimistic about the mother’s willingness to comply.”

Tears start in my eyes.

I glance round the waiting room. The other patients are lost in their worlds, the mother murmuring to the baby, the coughing
woman intent on her magazine. One receptionist has her back turned, and the other is still on the phone, talking in her brisk
Glaswegian accent, explaining something to somebody down the line who keeps interrupting; her head is turned away. I fold
the letter and tuck it in my pocket and walk briskly through the door.

H
E COMES STRAIGHT TO ME
where I’m sitting on the sofa, under the masks from Venice. He’s home quite early tonight, for his string quartet rehearsal.
He kisses the top of my head, then moves a little away. He’s leaning against the windowsill, looking at me. Behind him, there’s
an operatic sunset, a wash of apricot light, and the new leaves of the birch tree are sharp, as though cut with a blade against
the florid sky.

“What’s the matter?” he asks. “Is something wrong? What’s happened?”

I put my glass of wine on the side table, moving slowly, carefully: It could so easily spill.

“I went to see Dr. Carey.” I can’t breathe; there’s a constriction in my chest. “She showed me this letter.… She says one
of the things they’re considering, to explain Daisy’s illness … it’s called Munchausen by proxy.” The awkward words are like
solid things in my mouth; it’s hard to spit them out.

He raises an eyebrow. “Like that nurse who killed all those children? Someone’s getting a bit carried away there,” he says
dryly.

“No, not like that. Dr. Carey says it’s when mothers make their children’s symptoms worse, or exaggerate them, or invent their
children’s illnesses. Like it’s the mother who’s actually causing the illness …”

I put out my hand to pick up my glass, but I can’t — my hand is shaking.

His eyes are narrow, watching me.

“What are we going to do, Richard? Should we make a complaint? D’you know how to do that? D’you think we should do that? Isn’t
there a committee or something we could go to?”

“Darling, hang on a minute,” he says. “Let’s just try and sort this out.” He’s leaning back against the window sill. He’s
dark with the light behind him, his face in shadow; I can’t see his expression. “I don’t suppose for a moment we need to do
anything drastic. It’s probably just that some medical student’s out to impress the consultant — had this bright idea. Coming
up with something really obscure.”

I shake my head. “No, it was him, it was Dr. McGuire.”

He frowns a little. “Anyway, didn’t you say it was just one of the things they were considering?”

“Yes.”

“Well then. Maybe it’s something they always consider with sick children. I mean, they’ve got to be on the alert — there are
some very weird people out there.”

“No,” I say, “it’s not like that. It’s not something they always think of. It’s about me. There’s this letter about me. About
how aggressive I am.”

He thinks about this. “To be fair to Dr. McGuire,” he says, “you did get rather upset. I mean, I’m just trying to see both
sides of the picture. I know he was tactless, but you did rather lose your cool.”

“Anyone would; he was foul.” There’s a splinter of rage in my voice.

He shrugs, moves his hand a little: as though his point is made.

I was going to show him the letter. It’s there in the hall, in the pocket of my jacket. I had some kind of inchoate notion
that he could copy it before we took it back to the surgery, and we could take the copy to show someone. There are surely
people who will help you — advisers, advocates, local councillors — people to advise you if you want to make a complaint:
There must be; I’m sure I’ve read about these things. All I have to do is to get up and go to the hall and take the letter
from my pocket. But my body is slow and heavy, as though my limbs are drenched.