The Silent Patient (9 page)

Yuri was tending to my bleeding scratches in the goldfish bowl. He opened the bottle of antiseptic and applied it to a swab. The medicinal odor transported me to the sick bay at school, conjuring up memories of playground battle scars, grazed knees and scratched elbows. I remembered the warm, cozy feeling of being taken care of by Matron, bandaged and rewarded for my bravery with a boiled sweet. Then the sting of the antiseptic on my skin brought me back sharply to the present, where the injuries I presented were not so easily remedied. I winced.

“My head feels like she hit me with a fucking hammer.”

“It’s a nasty bruise. You’ll have a lump tomorrow. We’d better keep an eye on it.” Yuri shook his head. “I never should have left you alone with her.”

“I didn’t give you a choice.”

He grunted. “That’s true enough.”

“Thanks for not saying, ‘I told you so.’ It’s noted and appreciated.”

Yuri shrugged. “I don’t need to, mate. The professor will say it for me. He’s asked to see you in his office.”

“Ah.”

“Rather you than me, by the look of him.”

I started getting up.

Yuri watched me carefully. “Don’t rush. Take a minute. Make sure you’re ready. Any dizziness or headaches, let me know.”

“I’m fine. Honestly.”

That wasn’t strictly true, but I didn’t feel as bad as I looked. Bloody scratches, and black bruises around my throat where she’d tried to strangle me—she’d dug so deep with her fingers, she’d drawn blood.

I knocked on the professor’s door. Diomedes’s eyes widened when he saw me. He tutted. “Po po po. Did you need stitches?”

“No, no, of course not. I’m fine.”

Diomedes gave me a disbelieving look and ushered me inside. “Come in, Theo. Sit down.”

The others were already there. Christian and Stephanie were standing. Indira was sitting by the window. It felt like a formal reception, and I wondered if I was about to get fired.

Diomedes sat behind his desk. He gestured to me to sit in the remaining empty chair. I sat. He stared at me in silence for a moment, drumming his fingers, deliberating what to say, or how to say it. But before he could make up his mind, he was beaten to it by Stephanie.

“This is an unfortunate incident. Extremely unfortunate.” She turned to me. “Obviously we’re all relieved you’re still in one piece. But that doesn’t alter the fact that it raises all kinds of questions. And the first is, what were you doing alone with Alicia?”

“It was my fault. I asked Yuri to leave. I take full responsibility.”

“On whose authority did you make that decision? If either of you had been seriously injured—”

Diomedes interrupted. “Please don’t let’s get dramatic. Thankfully neither was hurt.” He gestured at me dismissively. “A few scratches are hardly grounds for a court-martial.”

Stephanie pulled a face. “I don’t think jokes are really appropriate, Professor. I really don’t.”

“Who’s joking?” Diomedes turned to me. “I’m deadly serious. Tell us, Theo. What happened?”

I felt all their eyes on me; I addressed myself to Diomedes. I chose my words carefully. “Well, she attacked me. That’s what happened.”

“That much is obvious. But why? I take it was unprovoked?”

“Yes. At least, consciously.”

“And unconsciously?”

“Well, obviously Alicia was reacting to me on some level. I believe it shows us how much she wants to communicate.”

Christian laughed. “You call that communication?”

“Yes, I do. Rage is a powerful communication. The other patients—the zombies who just sit there, vacant, empty—they’ve given up. Alicia hasn’t. Her attack tells us something she can’t articulate directly—about her pain, her desperation, her anguish. She was telling me not to give up on her. Not yet.”

Christian rolled his eyes. “A less poetic interpretation might be that she was off her meds and out of her mind.” He turned to Diomedes. “I told you this would happen, Professor. I warned you about lowering the dose.”

“Really, Christian?” I said. “I thought it was your idea.”

Christian dismissed me with a roll of his eyes. He was a psychiatrist through and through, I thought. By that I mean psychiatrists tend to be wary of psychodynamic thinking. They favor a more biological, chemical, and, above all, practical approach—such as the cup of pills Alicia was handed at every meal. Christian’s unfriendly, narrow gaze told me that there was nothing I could contribute.

Diomedes, however, eyed me more thoughtfully. “It hasn’t put you off, Theo, what happened?”

I shook my head. “On the contrary, I’m encouraged.”

Diomedes nodded, looking pleased. “Good. I agree, such an intense reaction to you is certainly worth investigating. I think you should keep going.”

At this Stephanie could restrain herself no longer. “That’s absolutely out of the question.”

Diomedes kept talking as if she hadn’t spoken. He kept looking at me. “You think you can get her to talk?”

Before I could reply, a voice said from behind me, “I believe he can, yes.”

It was Indira. I’d almost forgotten she was there. I turned around.

“And in a way,” Indira said, “Alicia has begun to talk. She’s communicating through Theo—he is her advocate. It’s already happening.”

Diomedes nodded. He looked pensive for a moment. I knew what was on his mind—Alicia Berenson was a famous patient, and a powerful bargaining tool with the Trust. If we could make demonstrable progress with her, we’d have a much stronger hand in saving the Grove from closure.

“How long to see results?” Diomedes asked.

“I can’t answer that,” I said. “You know that as well as I do. It takes as long as it takes. Six months. A year. Probably longer—it could be years.”

“You have six weeks.”

Stephanie drew herself up and crossed her arms. “I am the manager of this unit, and I simply cannot allow—”

“I am clinical director of the Grove. This is my decision, not yours. I take full responsibility for any injuries incurred upon our long-suffering therapist here,” Diomedes said, winking at me.

Stephanie didn’t say anything further. She glared at Diomedes, then at me. She turned and walked out.

“Oh, dear,” Diomedes said. “You appear to have made an enemy of Stephanie. How unfortunate.” He shared a smile with Indira, then gave me a serious look. “Six weeks. Under my supervision. Understand?”

I agreed—I had no choice but to agree. “Six weeks.”

“Good.”

Christian stood up, visibly annoyed. “Alicia won’t talk in six weeks, or sixty years. You’re wasting your time.”

He walked out. I wondered why Christian was so positive I would fail.

But it made me even more determined to succeed.

CHAPTER SIX

I ARRIVED HOME, FEELING EXHAUSTED
. Force of habit made me flick on the light in the hallway, even though the bulb had gone. We’d been meaning to replace it but kept forgetting.

I knew at once that Kathy wasn’t there. It was too quiet; she was incapable of quiet. She wasn’t noisy but her world was full of sound—talking on the phone, reciting lines, watching movies, singing, humming, listening to bands I’d never heard of. But now the flat was silent as a tomb. I called her name. Force of habit, again—or a guilty conscience, perhaps, wanting to make sure I was alone before I transgressed?

“Kathy?”

No reply.

I fumbled my way through the dark into the living room. I turned on the light.

The room leaped out at me in the way new furniture always does until you’re used to it: new chairs, new cushions; new colors, reds and yellows, where there once had been black and white. A vase of pink lilies—Kathy’s favorite flowers—was on the table; their strong musky scent made the air thick and hard to breathe.

What time was it? Eight-thirty. Where was she? Rehearsal? She was in a new production of
Othello
at the RSC, and it wasn’t going particularly well. Endless rehearsals had been taking their toll. She seemed visibly tired, pale, thinner than usual, fighting a cold. “I’m so fucking sick all the time,” she said. “I’m exhausted.”

It was true; she’d come back from rehearsal later and later each night, looking terrible; she’d yawn and stumble straight into bed. So she probably wouldn’t be home for a couple of hours at the earliest. I decided to risk it.

I took the jar of weed from its hiding place and started rolling a joint.

I’d been smoking marijuana since university. I first encountered it during my first term, alone and friendless at a fresher party, too paralyzed with fear to initiate a conversation with any of the good-looking and confident young people around me. I was planning my escape when the girl standing next to me offered me something. I thought it was a cigarette until I smelled the spicy, pungent, curling black smoke. Too shy to refuse, I accepted it and brought the joint to my lips. It was badly rolled and coming unstuck, unraveling at the end. The tip was wet and stained red from her lipstick. It tasted different from a cigarette; it was richer, rawer, more exotic. I swallowed down the thick smoke and tried not to cough. Initially all I felt was a little light on my feet. Like sex, clearly more fuss was made over marijuana than it merited. Then—a minute or so later—something happened. Something incredible. It was like being drenched in an enormous wave of well-being. I felt safe, relaxed, totally at ease, silly and unself-conscious.

That was it. Before long I was smoking weed every day. It became my best friend, my inspiration, my solace. An endless ritual of rolling, licking, lighting. I would get stoned just from the rustling of rolling papers and the anticipation of the warm, intoxicating high.

All kinds of theories have been put forward about the origins of addiction. It could be genetic; it could be chemical; it could be psychological. But marijuana was doing something much more than soothing me: crucially, it altered the way I experienced my emotions; it cradled me and held me safe like a well-loved child.

In other words, it contained me.

The psychoanalyst W. R. Bion came up with the term
containment
to describe a mother’s ability to manage her baby’s pain. Remember, babyhood is not a time of bliss; it’s one of terror. As babies we are trapped in a strange, alien world, unable to see properly, constantly surprised at our bodies, alarmed by hunger and wind and bowel movements, overwhelmed by our feelings. We are quite literally under attack. We need our mother to soothe our distress and make sense of our experience. As she does so, we slowly learn how to manage our physical and emotional states on our own. But our ability to contain ourselves directly depends on our mother’s ability to contain us—if she had never experienced containment by her own mother, how could she teach us what she did not know? Someone who has never learned to contain himself is plagued by anxious feelings for the rest of his life, feelings that Bion aptly titled
nameless dread
. Such a person endlessly seeks this unquenchable containment from external sources—he needs a drink or a joint to “take the edge off” this endless anxiety. Hence my addiction to marijuana.

I talked a lot about marijuana in therapy. I wrestled with the idea of giving it up and wondered why the prospect scared me so much. Ruth said that enforcement and constraint never produced anything good, and that, rather than force myself to live without weed, a better starting place might be to acknowledge that I was now dependent on it, and unwilling or unable to abandon it. Whatever marijuana did for me was still working, Ruth argued—until the day it would outlive its usefulness, when I would probably relinquish it with ease.

Ruth was right. When I met Kathy and fell in love, marijuana faded into the background. I was naturally high on love, with no need to artificially induce a good mood. It helped that Kathy didn’t smoke it. Stoners, in her opinion, were weak willed and lazy and lived in slow motion—you pricked them and six days later they’d say, “Ouch.” I stopped smoking weed the day Kathy moved into my flat. And—as Ruth had predicted—once I was secure and happy, the habit fell away from me quite naturally, like dry caked mud from a boot.

I might never have smoked it again if we hadn’t gone to a leaving party for Kathy’s friend Nicole, who was moving to New York. Kathy was monopolized by all her actor friends, and I found myself alone. A short, stubby man, wearing a pair of neon-pink glasses, nudged me and said, “Want some?” I was about to refuse the joint between his fingers, when something stopped me. I’m not sure what. A momentary whim? Or an unconscious attack on Kathy for forcing me to come to this horrible party and then abandoning me? I looked around, and she was nowhere to be seen. Fuck it, I thought. I brought the joint to my lips and inhaled.

Just like that, I was back where I had started, as if there had been no break. My addiction had been patiently waiting for me all this time, like a faithful dog. I didn’t tell Kathy what I had done, and I put it out of my mind. In fact I was waiting for an opportunity, and six weeks later, it presented itself. Kathy went to New York for a week, to visit Nicole. Without Kathy’s influence, lonely and bored, I gave in to temptation. I didn’t have a dealer anymore, so I did what I had done as a student—and made my way to Camden Town market.

As I left the station, I could smell marijuana in the air, mingled with the scent of incense and food stalls frying onions. I walked over to the bridge by Camden Lock. I stood there awkwardly, pushed and nudged by an endless stream of tourists and teenagers trudging back and forth across the bridge.

I scanned the crowd. There was no sign of any of the dealers who used to line the bridge, calling out to you as you passed. I spotted a couple of police officers, unmissable in their bright yellow jackets, patrolling the crowd. They walked away from the bridge, toward the station. Then I heard a low voice by my side:

“Want some green, mate?”

I looked down and there was a small man. I thought he was a child at first, he was so slight and slender. But his face was a road map of rugged terrain, lined and crossed, like a boy prematurely aged. He was missing his two front teeth, giving his words a slight whistle. “Green?” he repeated.

I nodded.