Asylum

Book by Patrick McGrath

1

The catastrophic love affair characterized by sexual obsession has been a professional interest of mine for many years now. Such relationships vary widely in duration and intensity but tend to pass through the same stages. Recognition. Identification. Assignation. Structure. Complication. And so on. Stella Raphael's story is one of the saddest I know. A deeply frustrated woman, she suffered the predictable consequences of a long denial collapsing in the face of sudden overwhelming temptation. And she was a romantic. She translated her experience with Edgar Stark into the stuff of melodrama, she made of it a tale of outcast lovers braving the world's contempt for the sake of a great passion. Four lives were destroyed in the process, but whatever remorse she may have felt she clung to her illusions to the end. I tried to help but she deflected me from the truth until it was too late. She had to. She couldn't afford to let me see it clearly, it would have been the ruin of the few flimsy psychic structures she had left.

Stella was married to a forensic psychiatrist called Max Raphael and they had a son, Charlie, aged ten when all this happened. She was the daughter of a diplomat who'd been disgraced in a scandal years before. Both her parents were dead now. She was barely out of her teens when she married Max. He was a reserved, rather melancholy man, a competent administrator but weak; and he lacked imagination. It was obvious to me the first time I met them that he wasn't the type to satisfy a woman like Stella. They were living in London when he applied for the position of deputy superintendent. He came down for an interview, impressed the board and, more important, impressed the superintendent, Jack Straffen. Against my advice Jack offered him the job, and a few weeks later the Raphaels arrived at the hospital. It was the summer of 1959 and the Mental Health Act had just been passed into law.

This is a desolate sort of a place, though God knows it's had the best years of my life. It is maximum-security, a walled city that rises from a high ridge to dominate the surrounding country: dense pine forest to the north and west, low-lying marshland to the south. It is built on the standard Victorian linear model, with wings radiating off the main blocks so that all the wards have an unobstructed view across the terraces to the open country beyond the Wall. This is a moral architecture, it embodies regularity, discipline, and organization. All doors open outward to make them impossible to barricade. All windows are barred. Only the terraces, descending by flights of stone steps to the perimeter wall at the foot of the hill, and planted with trees, grassy banks, and flower gardens, soften and civilize the grim carceral architecture standing over them.

The deputy superintendent's house is just a hundred yards from the Main Gate. It is a large dark house of the same gray stone as the hospital, set back from the estate road and hidden by pine trees. It was much too big for the Raphaels, having been built at a time when doctors came with large families and at least two servants. For several years before their arrival it had stood empty, and the garden was neglected and wild. To my surprise Max took an immediate interest in its rehabilitation. He had the goldfish pond at the back of the house cleaned out and restocked, and the rhododendron bushes around the edge of the lawn cut back and made to flower.

The project that most interested him however was the restoration of an old conservatory at the far end of the vegetable garden. This was a large ornate glasshouse built in the last century for the cultivation of orchids and lilies and other delicate tropical plants. In its time it had been an imposing, airy structure, but when Max and Stella arrived it was in a state of such disrepair there was talk of pulling it down. Much of the glass was broken and what panes remained were thick with dust and cobwebs. The paintwork had flaked off and the woodwork in places was rotted and splitting. Birds had nested inside it, mice and spiders had made their home there, weeds had sprouted through the cracks in the stone floor.

But Max Raphael had an affection for all things Victorian, and the exotic architecture of this garden conservatory, with its intricate glazing and joinery, and the graceful Romanesque arches of its windows, all this gave him peculiar delight. He was fortunate that among the hospital's parole patients was a man confident that he could do the work of restoring the conservatory. This was the sculptor Edgar Stark.

Edgar was one of mine. I have always been fascinated by the artistic personality, I think because the creative impulse is so vital a quality in psychiatry; certainly it is in my own clinical work. Edgar Stark was already influential in the art world when he came to us, though what we first saw was a confused and very shaky man who shuffled into the hospital like a wounded bear and sat hunched on a bench for hours with his head in his hands. He intrigued me from the start, and once I'd settled him down and got him talking I discovered him to be a forceful individual with an original mind, and I also realized that he was possessed of considerable charm, when he chose to use it. He and I quickly came to enjoy a warmly combative relationship, which I encouraged, up to a point; I wanted him to feel he had a special relationship with his doctor.

At the same time I was wary of him, for his was a restless, devious intelligence. He was quick to grasp the workings of the hospital and always alert to his own interest. I knew I could rely on him to exploit any situation to his own advantage.

Oddly enough I saw him with Stella only once, and that was at a hospital dance, a year after the Raphaels arrived here and just three weeks after he began working for Max in his garden, around the beginning of June. Dances are important events in the hospital calendar and there is always much excitement beforehand. They take place in the Central Hall, a spacious high-ceilinged room in the Administration Block with a stage at one end, a line of pillars down the middle, and casement windows opening onto the top terrace. Soft drinks and sandwiches are spread on long trestle tables at the back, and the band sets up onstage. Parole patients from both the male and female wings of the hospital may attend, and for this one evening they and the staff become an extended family without distinction of rank or status.

This at least is the idea. The truth is, the mentally ill are not at their best at a dance. Our patients dress eccentrically and move awkwardly, handicapped as much by the medication they take as by the illnesses that make the medication necessary. Despite the energetic efforts of the hospital band, and the contrived high spirits of the staff, I have always found it a poignant affair, and attend out of duty rather than in anticipation of any pleasure. That night, as I watched the proceedings from the shadow of a pillar at the rear of the Hall, I was not surprised to see Edgar Stark approach the deputy superintendent's wife, nor to see her step out onto the floor with him. The band went into something quick and Latin and she darted away in his arms.

Until recently I didn't learn precisely what happened next. Perhaps I should have guessed that something was wrong, for I noticed her becoming slightly flushed. I watched them move briskly across the floor, passing directly in front of the superintendent's table, and it is only now that I recognize just how bold, and bald, and reckless was the insult Edgar flung in our faces that night.

The dance ended promptly at ten and the patients filed out noisily. Jack asked those of his senior staff remaining in the Hall to come back for a drink. I strolled along the top terrace with Max, both of us in dinner jackets and both smoking good cigars as we chatted about various of our patients. The sky was clear, the breeze warm, and the world spread beneath us, the terraces, the Wall, the marsh beyond, all was dim and still in the moonlight.

Stella's voice drifted clearly back to us on the warm night air. Oh, I have known many elegant and lovely women, but none matched Stella that night. She was in a low-cut black evening dress of coarse ribbed silk, an exquisite grosgrain I had never seen before. The neckline was square and showed the curve of her breasts. It clung to her body then belled from the waist, scooped in a fold over each knee like a tulip, with a split between. She was wearing very high heels and a wrap thrown loosely about her shoulders. She was asking Jack about her last dance partner, and as I heard my patient's name I glimpsed again in my mind's eye the shuffling men and women in their ill-fitting clothes, something subtly askew about all of them except him.

Jack was standing at the end of the terrace, holding open the gate for Max and me. Stella was clearly amused at the sight of two consultant psychiatrists in dinner jackets hurrying so as not to keep their superintendent waiting. A minute or two later we were in the Straffens' drawing room and the phone was ringing. It was the chief attendant, to tell the super that everyone was present and accounted for and the hospital was safely locked up for the night.

I am not a gregarious man, and at social gatherings I tend to stay in the background. I let others come to me, it is a privilege of seniority. I stood by the window in the Straffens' drawing room and murmured small talk to the wives of my colleagues as they each in turn drifted over. I watched Stella listening to Jack tell a story about something that had happened at a hospital dance twenty years before. Jack liked Stella for the same reasons I did, for her wit, her composure, and her striking looks. I know she was considered beautiful: her eyes were much remarked on, and she had a pale, almost translucent complexion and thick blond hair, almost white, cut rather short, which she brushed straight back off her forehead. She was rather a fleshy, full-breasted woman, taller than the average, and that night she was wearing a single string of pearls that nicely set off the whiteness of her neck and shoulders and bosom. In those days I considered her a friend, and often wondered about her unconscious life. I asked myself was there peace and order beneath that demure exterior, or did she simply control her neuroses better than other women? A stranger, I reflected, would take her self-possession for aloofness, or even indifference, and in fact when she first arrived at the hospital she encountered resistance and hostility for this very reason.

But most of the women accepted her now. She had made an effort to join several of the hospital committees and generally to pull her weight as senior staff wives are supposed to. As for Max, he stood there with his glass of dry sherry, listening with a half-smile of slightly distracted indulgence as various horror stories were told by the women about their misadventures on the dance floor with patients of such clumsiness that they put last year's plodders and stampers to shame.

Stella did talk about Edgar Stark that night, but not to the company at large, and certainly without any mention of what he'd done in the Hall. It was when she reached my side that she told me the man danced like a dream-wasn't he a patient of mine?

Oh yes, he was one of mine all right. I suppose it was with a sort of affectionate cynicism that I said this, for I seem to remember that she peered at me closely as though it were important.

"He works in the garden," she said. "I often see him. I won't ask you what you think of him, because I know you won't tell me."

"As you saw yourself," I protested. "An extroverted man, well liked, and possessed of a certain, oh, animal vitality."

"Animal vitality," said Stella. "Yes, he has that all right. Is he very sick?"

"Pretty sick," I said.

"You wouldn't know it," she said, "from talking to him."

She turned and glanced at the party, the little clusters of those old familiars, each one distinct and idiosyncratic as tends to be the case in psychiatric communities. "We are more eccentric than the general population, aren't we?" she murmured, her eyes on the crowd.

"Undoubtedly."

"Max says psychiatry attracts people with high anxiety about going mad."

"Max must speak for himself."

This elicited a sidelong glance from those large sleepy eyes.

"I noticed you didn't dance once," she said.

"You know I'm hopeless at this sort of thing."

"But the ladies enjoy it so. You should, for their sake."

"How saintly you're becoming, my dear."

At this she turned and gazed at me. She hitched up the strap of her dress, which had slipped off her shoulder. "Saintly?" she said, and I saw Max looking in our direction, absently polishing his spectacles, his mournful demeanor faltering not a jot. She noticed him too and, turning away, murmured, "And my reward, I suppose, will be in heaven."

Later that evening I returned to my office to write up my observations. I had been impressed with Edgar's behavior. Watching him dance with Stella it was hard to believe that he suffered a disorder involving severe disturbance in his relationships with women. He had been a working sculptor for some years before he came to us, and was, as such, subject to the unique pressures that a life in art imposes. About a year before his admission he became obsessed with the idea that his wife, Ruth, was having an affair with another man. By all accounts Ruth Stark was a quiet, sensible woman; she modeled for Edgar and supported him financially much of the time. But as a result of his wild and violent accusations the marriage became severely strained and she threatened to leave him.

One night after they'd been drinking there was a terrible quarrel and he bludgeoned her to death with a hammer. What he did to her after that indicated to us how very disturbed he was. No one came to help Ruth Stark though her screams were heard the length of the street. Edgar was in a profound state of shock when he reached us. I tidied him up and then prepared to see him through the inevitable reaction of grief and guilt. But to my concern there was no grief or guilt; he regained his equilibrium after a few weeks and was soon involved in a variety of hospital activities.