Caroline Graham - A Ghost in the Machine

“Where would you like to sit, Karen?”

Dr. Lester didn’t look much like a doctor either. It wasn’t just that she didn’t have a white coat or a thing round her neck for listening to your chest, she looked, well…a bit like Karen’s PE teacher. She’d got quite a short denim skirt on and one of those shirts that tied up in a knot round your waist. Her bare feet were in white sandals. She was already sitting down, on the puffy yellow sofa. Karen sat in the nearest armchair, which had a large box of tissues balanced on one of the arms.

“Can I put this on the floor?”

“Of course you can.”

“Only my cold’s better now.”

Karen watched intently as the doctor put some glasses on and took a folder from a briefcase resting on the carpet nearby. There didn’t seem to be much in the folder. She read it in what Ernest would call “the shake of a lamb’s tail.”

Dr. Lester was rather surprised at the picture the little girl presented. Having been a child psychiatrist for thirteen years she had come across every attitude in the book and quite a few others you wouldn’t believe but Karen’s was most unusual. In the first place, her expression was totally unworried. She appeared confident, happy even, sitting forwards eagerly on the edge of her seat, as if expecting some entertainment to begin.

“I’ve been waiting ever such a long while to see you.”

You and a hundred others, dear. And already the clock was ticking their time together away. The doctor’s notes told a familiar story. Physical neglect, psychological abuse, no love to speak of. And unfortunately no grandparents to buffer sorrow. But now the mother had died and the child was being fostered, very successfully, by all accounts. She suffered constantly from noises and chattering and pains in her head.

Dr. Lester was not surprised to note the GP’s suspicions of early schizophrenia. Even laypeople jumped to this conclusion, given such symptoms. However, there were other early signs and these were not present. One also had to make allowances for the imagination. Wretched and lonely children will struggle to conjure alternative worlds in an attempt to escape the horrors of the real one. Karen’s fantasies were incredibly inventive.

Dr. Lester smiled, offered some sweets from a glass bowl, suggested Karen called her Barbara. They talked for a few minutes about the successful present. How kind Aunty Doris was. Uncle Ernest’s birds. Roy’s beautiful new dog, Dancer.

“And I’m in a higher class at school. We’re going to talk French.”

“You like school?”

“It’s great. I was in the Christmas play.”

“I played Aladdin once – in a hospital pantomime. How did you get on?”

“I couldn’t really learn it very well.”

“Because of your headaches?”

“That’s right. It’s hard when everyone’s talking at once.”

“I believe they started just after your mother died?”

“That’s why they started. I explained to Dr. Dickenson.”

“Yes. But there can be other reasons for headaches, Karen. For instance, if we cry a lot—”

“And she didn’t just die. Someone gave her poison.”

“Really?”

“Like Snow White.”

“That’s a fairy story, isn’t it?” Dr. Lester paused, waited. “Do you like fairy stories?”

“No.” Karen remembered pricking her finger and waking up without a prince. “They’re all lies.”

“Do you find it difficult to tell the difference?” Karen looked puzzled. “Between what’s true and what we make up.”

Karen shook her head and the gossamer hair lifted and floated in slow motion, like thistledown.

“I’d like to talk about when you were little, if that’s all right?” Karen shrugged. “How far back do you remember?”

“For ever.”

“Tell me the first thing.”

“You mean when I was born?”

“A bit further on. Playgroup, say.”

“What’s a playgroup?”

“OK, when you went to primary school. Did you make friends there?”

“I’ve never had a friend.” This was delivered without a trace of self-pity. She could have been saying: I’ve never had a mobile. Or a bicycle.

“What about imaginary friends?”

Karen stared at Dr. Lester in amazement. She couldn’t help thinking that it wasn’t herself who didn’t know the difference between what was true and what people make up. Then she wondered if it was a trick question. Or perhaps a joke. It was certainly pretty funny. She said politely: “You can’t have imaginary friends, Doctor…um…Barbara.”

“Why not?”

“Because you couldn’t play with them or go for walks or round to their house or anything.”

“You can do all those things in your imagination.”

Karen frowned. She was beginning to look anxious. “I don’t understand.”

“The mind can fool us in all sorts of ways, Karen. And one of its tricks is the ability to make things that don’t exist seem totally real.”

Karen’s air of bright confidence was dimming by the minute.

“Look…” Dr. Lester glanced down at her notes. “How would it be if we—”

“I thought you were going to help me.”

“Before anyone can help you your illness has to be diagnosed. Seeing me is just the first step.”

“I’m not ill.”

Define illness. Not always easy on the physical level, mentally you were in a minefield. Take out the unmistakably mad and there still remained thousands of afflicted souls suffering from simple depression, if it ever was, through to torment so wild and strong that the sufferers had to be confined for their own safety and that of others.

Having read the report on Karen, Dr. Lester was pretty sure that the headaches were psychosomatic and directly linked to the extraordinary fantasy that the child had woven about herself. Not that these imaginings were in themselves harmful – far from it. If you don’t have a dream, as the song says, how you gonna have a dream come true? Dr. Lester had come across several adults admitting to a very freaky fantasy life, which hadn’t stopped them going successfully about their daily business and harming no one. Alas, Karen didn’t fall into this category.

At this early stage there was little point in challenging her story. The way forward was gradually to lead her to a place where she would be secure and confident enough to begin to dismantle the whole structure, eventually accepting that none of it was true. There were various techniques that could be used to bring such an understanding about. It was just unfortunate that the scenario was so grotesque and frightening. No wonder she had headaches. The miracle was she had so far avoided a breakdown.

Dr. Lester glanced at the Mickey Mouse clock over the door. Ten minutes to go. Suddenly she shivered. A breeze seemed to be flowing directly through the open window, cooling her neck and arms. She got up to close it and the metal latch was clammy to her touch. Fastening it securely she noticed a butterfly clinging to the curtains and stood on tiptoe to get a closer look. It was extraordinary. Totally black; not just the velvety wings but even its body and antennae. Surprised and delighted, Barbara studied it for several seconds, even agitating the fabric gently to see if it would fly. When she sat down again Karen regarded her with a mixture of apprehension and yearning.

“So, Karen – these people you told Dr. Dickenson about. What are they like?”

“Ordinary.”

“When did you first see them?”

“I’ve always seen them.”

“Where?”

“Everywhere. Well, not in the house. At the shops, on the bus, just walking about.”

“And have you always talked to them?”

“Only if they talk to me. It got me into trouble, though.”