Asylum Page 9

  I shift awkwardly in my seat. "I'm sure that you and Dr. Campbell have an understanding," I say.

  "We do," he replies. "We certainly do. He does his work, and I do mine. We don't interfere with one another very much. I keep my equipment in the basement, so he doesn't have to see it. Out of sight, out of mind, that sort of thing. He knows about my 'special treatment' ideas, of course, and he sometimes sees the results. But I've yet to convince him that what I'm doing is worthwhile. That's why I need to keep going until I have irrefutable proof. And for that, I need an assistant."

  I stare at him. I understand what he's offering, but I can't work out why he's chosen me. It's my first day here, and I feel like I'm coming across as a rather clumsy and naive girl. I know my strengths and I know my weaknesses, though, and I'm the last person anyone would ever expect to take part in the kind of work that Andrew is suggesting. I just want a normal environment.

  "What do you think?" he asks. "Are you interested?"

  I take a deep breath. "I'm quite happy with my work as it is," I say, trying to be diplomatic. "I feel that it would be impractical for me to take on any extra duties at this time."

  "You're turning me down?"

  "I'm very grateful that you thought of me," I continue, "but I don't think I have the capability of devoting myself to the work in a manner that would be required. Perhaps you would be better off looking for someone else."

  "One night," he says. He's remarkably persistent, which suggests that he's somewhat desperate. Perhaps no-one else has ever agreed to take part in his 'special treatment' experiments before. "Join me for one night," he continues, "and I'll show you the kind of work I do. I'm convinced that once you see it in action, you'll understand how useful it could be if we pursue my ideas to their logical conclusion."

  "I really don't -"

  "One night," he insists. "Just one night. And if you decide to withdraw after that, I'll never mention it again." He pauses. "One night isn't a lot to ask when the future of psychiatric medicine is at stake."

  I pause, uncertain as to how I should respond. I'm quite certain that I don't want anything to do with Andrew's work, because it sounds like an unnecessary complication in my life at a time when I really just want to keep my head down. But I feel that he's putting considerable pressure on me, and it might be better if I simply agree to help him for one night and then withdraw the following morning. So long as he keeps his promise not to push me any further, I feel that this might be a compromise that will allow me to get out of the situation with relative ease.

  "I can see that you're thinking about it," he says.

  I nod. "I'll help you for one night," I reply, "but only on the condition that you promise you'll honor your word. If I decide to withdraw after that initial night, you'll never pressure me to participate again, is that clear?"

  "Crystal," he says, smiling.

  "And I reserve the right to leave at any time during the night if I decide that I don't want to take part any longer," I say.

  "Of course," he replies. "I have no desire to keep you there against your will."

  I stand up. This meeting is over, and I'm tired. "You must let me know when you're ready for me," I say.

  "There's no time like the present!" he says, getting to his feet and heading over to the door.

  "Tonight?" I ask, somewhat shocked. "I can't possibly. I've just finished my shift, and I must be back on the ward at 8am."

  "We'll only need a couple of hours," he says. "I usually work from 11pm through to a little after 1am."

  "Still," I say, "I'm not sure that I -"

  "You promised," he interrupts.

  "Fine," I say, dreading the thought of staying up for a few more hours. My perception of Andrew has changed rapidly since I entered his office: whereas before I thought he was a handsome, attractive man, now I find him to be irritating. It's one thing to be passionate about your work, but it's quite another to force that passion onto your co-workers, especially when they've only just arrived. I can't help feeling that he's trying to take advantage of me, trying to mold me so that I help him. Unfortunately for him, this only strengthens my resolve to resist his attention. I shall simply learn the nature of his 'special treatment' program, and then get back to my regular work.

  Dr. Lava

  Today

  "Sometimes it feels like my head is so full of voices, it's gonna burst," says Errol, sitting in my office as the early evening light floods through the large windows. A well-built, late-middle-aged African American male with a history of psycho-sexual abnormalities, Errol has been at Lakehurst for five years and, according to his files, he has made very little progress in that time. Blood trickles from his cut lip as he speaks, and his restless hands constantly fiddle with the buttons on his jacket.

  "Do you think your head might actually burst?" I ask.

  "No, Sir," he says. "I know that's impossible. But -" He pauses to wipe blood from his chin. "I don't know, it's just like there's so many voices in there, and they're all jostling for attention, and I don't know how to give it to them. Do you know what I mean?"

  I take a deep breath. "I've never experienced auditory hallucinations myself," I say eventually, "but I've read a great deal about them, and I've worked with a lot of patients who have had the same kind of problems that you describe, Errol. The key is to overcome your fear of those voices. Don't try to bottle them up. Let them out. Listen to what they have to say."

  He shakes his head, a look of fear in his eyes.

  "Why not?" I ask.

  "I'm scared of what they'll say," he replies. "I'm scared they'll tell me to do something and I'll..." He holds out his hands, as if he's imagining the power he could wield. He's certainly a strong-looking guy, and I imagine he could more than hold his own in any kind of physical struggle.

  "We all have those fears, Errol," I say. "Why, sometimes I see a pretty girl out in a cafe, and I find myself wondering what it would be like to just grab her, force her down and do whatever I want to her. Or I see an old lady on a deserted street, and I realize that I could just bash her head in and leave her there to die. But what separates me from you, Errol, is that I know I wouldn't act on those impulses. They're chaotic. They're destructive. You have to let yourself free a little, so you can have confidence in how you react."

  He nods. "I know you're right," he continues, "but it's so hard. What if the voices tell me to kill someone?"

  I shrug. "Well? What if they did? Would you do it?"

  "I don't know," he says. "I hurt those women..."

  "That was a long time ago," I say. "A very, very long time ago. You're better now, much better. I really think that we're entering the phase of your time here that's going to start preparing you for a return to the real world." I wait for him to respond, but he just stares straight ahead. "That's what you want, isn't it, Errol? To go back to the real world so you can be a productive and constructive member of society?"

  "I guess so," Errol says, but it doesn't sound as if he entirely believes what he's saying. This is a common problem: the patient says what he thinks he's 'supposed ' to say rather than what he really believes, and the entire therapist-patient relationship breaks down into a series of self-congratulatory platitudes. It's precisely this kind of feedback loop that I'm determined to erase.

  "You guess so?" I say, disappointed by his lack of commitment. "You guess so?" I stand up and walk around the desk until I'm standing behind his chair. "If that's your attitude, Errol, I don't see why any of us are bothering to try to help you. Unless you're really determined to make this treatment work, we might as well just stop now, cut your throat and leave you out so the crows can pick at your meat. Is that what you want?"

  "No," he mutters.

  "Is that what you want?" I shout.

  "No!" he says, louder this time.

  "I can't hear you!" I shout.

  "No!" he shouts.

  "Better!" I shout, stepping away and kicking the back of his chair so hard that he's launched forward
against my desk. He crumples off the chair and lands on the floor. "I want to know that you give a damn, Errol," I say, stepping around him. "You might have folded up pathetically when you gave into your demons before, but I'm damn well gonna make sure you stand up and take control of your life now, do you hear me?"

  He nods.

  I kick him in the face, my shoe knocking out several of his teeth. He hauls himself back up onto the chair and sits there, pathetically out of breath and slouching like a sack of potatoes. The room falls silent for a moment as I stare at the back of his head. There's a part of me that wants to break his pathetic head open and end his miserable life. What good is he, if he can't even fight back?

  "Are you scared of me?" I ask him.

  There's a pause, and then he shakes his head.

  "You're not?" I ask, surprised but also a little impressed.

  He shakes his head again.

  "Then what are you scared of?" I ask, leaning close to him and whispering in his ear.

  "Don't send me for special treatment," he says immediately.

  "Why not?" I ask. "What's so special about special treatment?"

  "Please don't," he says, sounding almost as if he's begging. "Don't tell Nurse Winter anything. Don't even mention my name. Don't make her even think about me for a second."

  I pause. This man, like all the others I've encountered since I arrived here, seems to be terrified of Nurse Winter and her 'special treatment'. I have no idea what the woman is doing, but whatever it is, it seems to have had a powerful psychological impact on these poor bastards. They live in constant fear of even catching her eye, lest she might decide that it's their turn to go for this 'special treatment'. Since so many of the patients seem to be deteriorating mentally, rather than getting better, I can only conclude that 'special treatment' is something rather damaging.

  "Tell me about special treatment," I say eventually. "Tell me what it entails."

  "I don't know," he says.

  "Bullshit," I spit back, leaning even closer to his ear. "Tell me!"

  "I don't know!" he insists. "I swear! But I've heard people talk about it, and I've seen what people look like when they come back. It's like someone's stripped out their soul."

  "And then what happens?" I ask. "What happens to them next?"

  "Some of them have to go back for more special treatment," he says. "Once they get you, they keep their claws in you. That's why it's so important to make sure they don't notice you in the first place."

  "They?" I ask. "Who are they?"

  "Nurse Winter and the others."

  "What others?"

  He pauses. "I don't know," he says, "but I've heard people mention that there are others." Suddenly, and a little alarmingly, Errol turns to face me. His eyes are wide open, with madness burning in his pupils. "There's a doctor down there who never comes up here. The only people who see him are the ones who go down to the basement."

  I consider what Errol's saying. "And Nurse Winter is in charge?" I ask.

  He nods. "She's the one who decides who goes down for special treatment. She doesn't usually go down with them. She lets the others do the dirty work."

  It's clear that I'm going to have to pay a lot more attention to Nurse Winter. "If you're lying to me, Errol," I say, determined to make sure he's not trying to trick me, "I'll kill you. Do you understand? I'll bring you into my office for another session, and I'll beat you to death. Do you understand?"

  He nods.

  "Now get the fuck out," I continue, pushing him off the chair again and sending him sprawling across the floor. "Get out!" I shout, and then I watch as he stumbles to his feet and runs over to the door.

  Once he's gone, I sit back at my desk and check my watch. It's just past 5pm, which means the evening shift will be beginning. Nurse Winter has been working all day, so she's due to go off duty right about now. I guess my best option would be to end my day as well, and head to my new apartment in the east wing of the building. I'll wait a while, and then I'll come back down to the ward tonight and see if anything interesting is happening. If anyone's getting any 'special treatment' tonight, I want to know exactly what happens.

  Nurse Winter

  1999

  "You see?" Andrew says as we step out of the elevator and into the large basement area beneath the hospital. "There's nothing too strange going on down here."

  At first glance, it would appear that he's telling the truth. The basement has been divided up into a series of smaller rooms, with wall-mounted lights struggling to keep the place well-lit. In this room, there are banks of computers, all of which seem to be linked up to a series of chairs dotted about the place. The chairs themselves have various wires attached to them, and it's quite clear that Andrew is placing patients in these contraptions and then... Well, I'm not sure what he does at that point, but I can see why this kind of work might be considered controversial. Direct experimentation on patients is frowned upon by the medical community. This kind of thing could lead to Andrew getting his license revoked, in which case I'm more certain than ever that I want nothing to do with whatever's going on down here. I've made enough bad decisions in my life already.

  "This kind of special treatment is designed to help the patients," Andrew says, switching on a couple of machines over by the far wall. "You have to keep that in mind at all times. The patients are the focus. Everything we do down here is to help them. But there's an important caveat." He pauses. "When I talk about the patients, I'm talking about them as a group. If I can help the majority, then I might be willing to do things to the minority that aren't immediately beneficial. Do you understand what I'm saying?"

  I feel a strange sense of unease as I look at the wires running between the computers and the chairs. "You're saying that you can't make an omelet without breaking a few eggs," I reply.

  "That's a good way to put it," Andrew says. He logs into the computers and sets various programs running. "If I have a hundred patients, and I can help ninety of them by running experiments on the remaining ten, shouldn't I consider that a worthy gamble? What's the alternative? Trying to protect all hundred, and ending up never really helping any of them?"

  I glance over at the elevator door. How long should I give Andrew before I tell him that I'm not interested in any of this? I need him to believe that I've given him a fair chance, so I guess I have to wait half an hour or so before I tell him I'm going back upstairs.

  "Sacrifice shouldn't be a dirty word," he says as he continues to fiddle with machines and settings. "Sacrificing a few people in order to save the rest is not a bad thing. It's celebrated in the military. It's seen as a sign of honor. These experiments are going to help a lot of people one day, and those who are used in the name of progress will be remembered." He smiles. "Am I scaring you, Nurse Winter?"

  "Of course not," I reply. "It's fascinating." The truth, though, is that I'm very uneasy down here. I don't know exactly what Andrew is doing, but I don't want any part of it.

  "There!" he says, looking at the computers. "We're ready!"

  "Ready for what?" I ask.

  At that moment, the elevator doors open and I turn to see one of the guards leading Rolf into the room. Rolf is still in his pajamas, and he looks not only tired but also a little groggy, as if perhaps he's been drugged. He shuffles forward, barely even acknowledging my presence in the room as the guard leads him over to one of the chairs.

  "What are you going to do?" I ask, shocked to see the way Rolf obediently sits while the guard straps him into the chair.

  "I've been working on Rolf for a while now," Andrew says. "He's showing real progress. I decided I wanted to demonstrate the special treatment on Rolf because I think you'll be able to see how my work is going to help people. Rolf isn't a victim. He's a pioneer. He's benefiting as much as anyone. More than anyone, perhaps, since he's getting to receive the special treatment first."

  "Did he give his permission to take part in this test?" I ask.

  "He's insane," Andrew says bluntly.
"He's incapable of giving permission for such a thing. I could sit and explain everything to him for a week non-stop, and he still wouldn't understand."

  "He might refuse his consent," I reply.

  Andrew shrugs. "And if he agreed, would that satisfy you? He's not capable of making a rational decision." He turns to the guard. "Eddie, make sure he's properly secured this time. We don't want a repeat of what happened with Samantha."

  I watch as Eddie finishes restraining Rolf. The leather straps look so brutal, and Rolf keeps falling asleep. Whatever was in those pills that Andrew gave him earlier, it seems to have knocked him out completely. Maybe it's better this way, so he doesn't know what's happening to him, but I feel uneasy about this whole thing. Back at college, we were all repeatedly warned about the importance of enabling patients to give informed consent. I've only been down in the basement with Andrew for a few minutes, and already the ethics violations are piling up.

  "I need to warn you," Andrew says as Eddie steps back and joins us over by the computers, "Rolf will seem to be in pain during the treatment. It's an uncomfortable process, but it works and you'll see that the overall benefit makes any discomfort worthwhile." His finger hovers over a button next to one of the computers. "Tonight I'm increasing the duration of the treatment from five to seven seconds. It's a bit of a risk, but I think it's worthwhile. If I don't get results, I'll have to rethink the whole concept. No-one could handle more than seven seconds, it'd be cruel and inhumane." He pauses. "See? I do think about that kind of thing."

  I don't say anything. I'm starting to feel nauseous. Rolf looks like he's strapped into an electric chair, even though I'm quite certain that whatever Andrew is doing is far more sophisticated and cutting-edge.