The Little Stranger (22 page)

T
here have been many times in my medical career when, on examining a patient or on seeing the result of some test or other, it has gradually but ineluctably broken upon me that the case before me is a desperate one. I can think, for example, of a young married woman, just pregnant, who came to see me with a summer cough: I remember very vividly setting the stethoscope to her breast and hearing the first faint but devastating indications of tuberculosis. I can recall a handsome, talented boy brought to me with ‘growing pains’—actually, the onset of a muscle-wasting illness which, within five years, was to take his life. The thickening tumour, the spreading cancer, the clouding eye: they are part of a family doctor’s case-load alongside the rashes and the sprains, but I have never got used to them, never caught my first certain glimpse of them without the heaviest feeling of impotence and dismay.

Something like that dismay began to creep upon me as I sat listening to Rod tell his extraordinary story. How long it took him, I’m not sure, for he spoke with a certain brokenness, a hesitation and reluctance, a shrinking from the ghastliness of the details of the tale. I kept silent for the most part, and when he had finished we sat together in that quiet room, and I glanced about me at the safe, familiar, fathomable world—the stove, the counter, the instruments and jars, old Gill’s hand on their faded labels,
Mist. Scillae
,
Pot. Iod.
—and seemed to see it all grown slightly strange to me, all knocked slightly askew.

Rod was watching me. He wiped his face, then made a ball of his handkerchief and worked it with his fingers and said, ‘You wanted to know. I warned you what a filthy thing it was.’

I cleared my throat. ‘I’m very glad you told me.’

‘You are?’

‘Of course. I only wish you’d done it sooner. It breaks my heart to think of you having gone through this alone, Rod.’

‘I had to, you see. For the sake of the family.’

‘Yes, I see that.’

‘And you don’t judge me too badly, over the girl? I swear to God, if I had known—’

‘No, no. No one could blame you for that. There’s just one thing I’d like to do now. I’d like to examine you, if I may.’

‘Examine me? Why?’

‘I think you’re pretty tired, aren’t you?’

‘Tired? God, I’m out on my feet! I hardly dare close my eyes at night. I’m frightened this
thing
will return if I do.’

I had risen to fetch my bag, and, as if in obedience to a signal, he began to draw off his sweater and shirt. He stood on the hearth-rug in his vest and trousers, with that dirty bandage on his wrist, rubbing his arms against the chill and looking shockingly thin and vulnerable and young; and I made a brief, basic examination, listening at his chest, reading his blood-pressure, and so on. But I did it, to be honest, mainly to buy myself a little time, for I could see—anyone could have seen—what the real nature of his trouble was. What he had told me, in fact, had pretty well shaken me to the core, and I needed to think about how to proceed with him.

As I’d guessed, there was nothing obviously wrong with him beyond the fact that he was underfed and overtired; and that was true of half my neighbours. I took my time putting my instruments away, still thinking. He stood buttoning up his shirt.

‘Well?’

‘You said it yourself, Rod: you’re exhausted. And exhaustion—well, it does odd things to us, plays odd tricks.’

He frowned. ‘Tricks?’

‘Listen,’ I said. ‘I can’t pretend to you that what you’ve told me has made me anything but extremely alarmed. I don’t want to mince words with you. I think your problem is a mental one. I think—Listen to me, Rod.’ He’d begun to turn away, in disappointment and anger. ‘I think that what you’ve been experiencing can best be described as a sort of nerve-storm. They’re more common than you might think, in certain over-stressed people. And let’s face it, you’ve been under an enormous pressure ever since you came out of the Air Force. I think that that pressure, combined with war-shock—’

‘War-shock!’ he said scornfully.

‘Delayed war-shock. That’s more common than you would think, too.’

He shook his head, saying firmly, ‘I know what I know. I know what I saw.’

‘You know what you
think
you saw. What your tired and overstretched nerves persuaded you to see.’

‘It wasn’t like that! Don’t you understand? God, I wish I’d said nothing. You asked me to tell you. I didn’t want to, but you made me. Now you throw it back at me like this, making me out to be some sort of loony!’

‘If you could just get a good night’s sleep.’

‘I told you: the thing will come back if I do.’

‘No, Rod. I promise you, it will only return if you
don’t
, because it’s a delusion—’

‘A
delusion
? That’s what you think?’

‘—a delusion which is feeding on your own tiredness. I think you should get away from the Hall for a while. Right away, on some sort of holiday.’

He was pulling on his sweater, and when his face emerged from the neck of it he looked at me in disbelief. ‘Go away? Haven’t you been listening to a single thing I’ve said? If I were to leave, who knows what would happen!’ He hastily smoothed down his hair and started putting on his overcoat. He’d caught sight of the clock. ‘I’ve been away too long already. That’s your fault, too. I must get back.’

‘At least let me give you some Luminal.’

‘Dope?’ he said. ‘You think that’ll help me?’ And then, with an edge to his voice, seeing me go to a shelf and bring down a tub of tablets: ‘No. I mean it. They pumped me full of those after my smash. I don’t want them. Don’t give them to me, I’ll throw the damn things away.’

‘You might change your mind.’

‘I won’t.’

I came back around the counter empty-handed. ‘Rod, please. Listen to me. If I can’t persuade you to leave the house, well, there’s a man I know, a good physician. He has a clinic, in Birmingham, for cases like yours. Let me bring him in to talk to you; to listen to you. That’s all he’ll want to do: just listen to you while you talk to him as you spoke, just now, to me.’

His face had set. ‘A mental doctor, you mean. A psychiatrist, or psychologist, or whatever the hell you call them. That’s not my trouble. The trouble isn’t mine at all. The trouble’s at Hundreds. Can’t you see? I don’t need a doctor so much as a,’ he groped for a word, ‘a
vicar
or something. If you’d felt what I had—’

I said on impulse, ‘Let me come with you, then! Let me spend some time in your room, and see if this thing appears!’

He hesitated, thinking it over; and the sight of him doing that, treating the idea as if it were possible, sensible,
reasonable
, was almost more disturbing than anything else. But then he shook his head and spoke coldly again.

‘No. I can’t risk it. I won’t tempt it. It wouldn’t like that.’ He put on his cap. ‘I have to go. I’m sorry I told you any of this. I should have known you wouldn’t understand.’

‘Please listen to me, Rod.’ The thought of losing him, now, was dreadful. ‘I can’t let you go in this state of mind! Have you forgotten how you were just now? That dreadful panic? Suppose that comes over you again?’

He said, ‘It won’t. You caught me off-guard, that’s all. I shouldn’t have come here in the first place. I’m needed at home.’

‘At least talk to your mother, then. Or let me talk to her for you.’

‘No,’ he said sharply. He had moved to the door but now turned back to me, and, as once before, I was disconcerted to see real anger in his eyes. ‘She mustn’t know about any of this. Nor my sister. You’re not to tell them. You said you wouldn’t. You gave me your word, and I trusted you. You’re not to talk to that doctor friend of yours, either. You say I’m going crazy. All right, go ahead and believe that, if it makes you feel better; if you’re too much of a coward to face the truth. But at least have the decency to let me go crazy all by myself.’

His tone was hard and level, and absurdly rational-sounding. He put the strap of his satchel over his shoulder and drew together the lapels of his coat, and only the paleness of his face and the slight redness of his eyes hinted at the fantastic delusion that had him in its grip; apart from that he looked, as he’d looked before, like a youthful country squire. I knew there was no keeping him now. He had moved back to the dispensary door, but it was clear, from sounds beyond it, that the first of my evening patients were arriving, so he gestured impatiently to my consulting-room and I took him in there, to let him out into the garden. But I did it with a very heavy heart, and a dreadful sense of frustration; and as soon as the door was closed I went back to the dispensary window and stood at the dusty net curtain to watch him reappear from around the side of the house and make his rapid, limping way along the High Street to his car.

D
hat was I to do? It was clear to me—horribly clear—that over the past few weeks Rod had been the victim of some very powerful hallucinations. That, in a sense, was hardly to be wondered at, given the dreadful mix of burdens he’d recently had to bear. Evidently the sense of threat and strain had overspilled in his mind, to the extent that even ‘ordinary things’, as he’d repeatedly put it, seemed to be rising up against him. That the delusion had first struck on the night he was meant to host a party for his more successful neighbour was perhaps no surprise; and I thought it sadly significant, too, that the worst of his experience had centred on a
mirror
—which, before it had started on its ‘walk’, had been reflecting his scarred face, and had ended up shattered. All this, as I say, was shocking enough, but could be explained away as the product of stress and nerve-strain. More upsetting and worrying, to my mind, was the fact that he was still so attached to the delusion he had produced this logical-seeming fear that his mother and sister would be ‘infected’ by whatever diabolical thing had supposedly invaded his room, unless he was there to ward it off.

I spent the next few hours turning his condition over and over in my mind. Even as I sat with my other patients, a part of me seemed still to be with Rod, listening in horror and dismay as he told his dreadful story. I don’t think there has ever been a time in my professional life when I have felt at such a loss as to how to proceed. No doubt my relationship with the family was interfering with my judgement. Probably I should have handed the case over, at once, to another man. But then, it what sense
was
it a case? Rod had not come to me that day for a medical opinion. He had, as he himself had pointed out, been unwilling to confide in me at all. And there was certainly no question of me or any other physician being paid for our assistance or advice. I didn’t, at this point, suspect him of being a danger to himself or to others. I thought it much more likely that his delusion would slowly gather strength until it had finally consumed him: that he would wear himself, in other words, into a state of complete mental breakdown.

My biggest dilemma was over what, if anything, to say to Mrs Ayres and Caroline. I had given Rod my word that I would say nothing; and while I had been only half serious in comparing myself to a priest, no doctor takes a promise of secrecy lightly. I passed a terribly fretful evening, deciding now one thing and now another … Finally, at almost ten, I ran over to the Grahams’ house, to talk the matter through with them. I’d been spending less time with them lately, and Graham was surprised to see me. Anne, he said, was upstairs—one of their children was slightly unwell—but he took me into their sitting-room, and heard the story through.

He was as shocked by it as I had been.

‘How on earth did things get so bad? Were there no warnings?’

I said, ‘I knew something wasn’t right; but not like this.’

‘What do you mean to do next?’

‘That’s what I’m trying to work out. I don’t even have a firm diagnosis. ’

He thought it over. ‘You’ve considered epilepsy, I suppose?’

‘It was my very first idea. I still think it might explain some of it. The aura, producing queer sensations—auditory, visual, and so on. The seizure itself, the weariness after; it all fits, to a degree. But I can’t believe it’s the whole story.’

He said, ‘How about myxœdema?’

‘I thought of that, too. But that’s pretty hard to miss, isn’t it? And there are no indications.’

‘Could something be interfering with the brain function? A tumour, for example?’

‘Christ, I hope not! It’s possible, of course. But again, there are no other signs … No, my hunch is it’s purely nervous.’

‘That’s just as bad, in its way.’

I said, ‘I know. And his mother and sister have no idea. Do you think I should tell them? That’s what’s really troubling me.’

He shook his head, blowing out his cheeks. ‘You know them better than I do, now. Roderick certainly won’t thank you for it. On the other hand, it might push him to some sort of crisis.’

‘Or put him completely out of reach.’

‘That’s certainly a risk. Why not take a day or two to think it over?’

‘And meanwhile,’ I said gloomily, ‘things at Hundreds inch further into chaos.’

‘Well that, at least,’ he said, ‘isn’t your problem.’

His tone was rather detached: I could recall it from other conversations of ours about the Ayreses, but it slightly jarred with me now. I finished my drink and went slowly home, grateful to him for having listened, relieved to have shared the details of the case, but no wiser as to how to proceed. And it was only as I stepped into my dark dispensary and saw the two chairs still standing at the stove, and seemed to hear again Rod’s halting, desperate voice, that the full force of his story came back to me; and I realised it was my plain duty to the family to give them at least some inkling of his condition, as soon as I could.

But it was a pretty dismal journey I made out to the house the following day. It seemed that all my business with the Ayreses just now lay either in warning them of something or in carrying out some dreary undertaking on their behalf. With the return of daylight, too, there had come a slight failing in my resolve. I thought again of the promise I’d made, and I drove, if such a thing is possible, in a shrinking, reluctant sort of way, hoping more than anything not to encounter Rod himself, either there in the park or in the house. It was only a few days since my last visit, and neither Mrs Ayres nor Caroline was expecting me; I found them both in the little parlour, but could see at once that, by turning up out of the blue like this, I had rather thrown them.