Sometimes, she thought ruefully, the world is so much sicker than the inmates of its institutions. She remembered Tilda, in the hospital in Germany, at a time when Hitler was on the other side of its walls and not even she could say which side was sane. Tilda’s murderous hate, bound down on beds, tube-fed, and drugged into submission, could still fade long enough to let the light in now and then. She remembered Tilda looking up at her, smiling in a travesty of genteel politeness from the canvas-bound bed, and saying, “Oh, do come in, dear Doctor. You are just in time for the patient’s soothing tea and the end of the world.”
Tilda and Hitler were both gone and now there was more and more to tell the younger doctors who were coming out of the schools with too little experience of life. Is it fair to take private patients when any real improvement may take years, and when thousands and tens of thousands are clamoring, writing, phoning, and begging for help? She laughed, catching in herself the vanity she had once called the doctor’s greatest enemy next to his patient’s illness. If one by one was good enough for God, it would have to do for her.
She sat down with the folder, opened it, and read it through:
BLAU, DEBORAH F. 16 yrs. Prev. Hosp: None
INITIAL DIAG: SCHIZOPHRENIA.
Testing: Tests show high (140-150) intelligence, but patterns disturbed by illness. Many questions misinterpreted and overpersonalized. Entire subjective reaction to interview and testing. Personality tests show typically schizophrenic pattern with compulsive and masochistic component.
Interview (Initial): On admission patient appeared well oriented and logical in her thinking, but as the interview went on, bits of the logic began to fall away and at anything which could be construed as correction or criticism, she showed extreme anxiety. She did everything she could to impress her examiner with her wit, using it as a formidable defense. On three occasions she laughed inappropriately: once when she claimed that the hospitalization had been brought about by a suicide attempt, twice with reference to questions about the date of the month. As the interview proceeded her attitude changed and she began to speak loudly, giving random happenings in her life which she thought to be the cause of her illness. She mentioned an operation at the age of five, the effects of which were traumatic, a cruel babysitter, etc. The incidents were unrelated, and no pattern appeared in them. Suddenly, in the middle of recounting an incident, the patient started forward and said accusingly, “I told you the truth about these things—now are you going to help me?” It was considered advisable to terminate the interview.
Family History: Born Chicago, Ill. October, 1932. Breast-fed 8 mos. One sibling, Susan, born 1937. Father, Jacob Blau, an accountant whose family had emigrated from Poland 1913. Birth normal. At age 5 patient had two operations for removal of tumor in urethra. Difficult financial situation made family move in with grandparents in suburb of Chicago. Situation improved, but father became ill with ulcer and hypertension. In 1942 war caused move to city. Patient made poor adjustment and was taunted by schoolmates. Puberty normal physically, but at age 16 patient attempted suicide. There is a long history of hypochondria, but outside of tumor the physical health has been good.
She turned the page and glanced at the various statistical measurements of personality factors and test scores. Sixteen was younger than any patient she had ever had. Leaving aside consideration of the person herself, it might be good to find out if someone with so little life experience could benefit from therapy and if she would be easier or harder to work with.
In the end it was the girl’s age that decided her, and made the report weigh more heavily than the commitment of doctors’ meetings to be attended and articles to be written.
“ Aber wenn wir … If we succeed …” she murmured, forcing herself away from her native tongue, “the good years yet to live …”
Again she looked at the facts and the numbers. A report like this had once made her remark to the hospital psychologist, “We must someday make a test to show us where the health is as well as the illness.”
The psychologist had answered that with hypnotism and the ametyls and pentothals such information could be obtained more easily.
“I do not think so,” Dr. Fried had answered. “The hidden strength is too deep a secret. But in the end … in the end it is our only ally.”
For a time—how long by Earth’s reckoning Deborah did not know—it was peaceful. The world made few demands so that it seemed once more as if it had been the world’s pressures that had caused so much of the agony in Yr. Sometimes she was able to see “reality” from Yr as if the partition between them were only gauze. On such occasions her name became Januce, because she felt like two-faced Janus—with a face on each world. It had been her letting slip this name which had caused the first trouble in school. She had been living by the Secret Calendar (Yr did not measure time as the world did) and had returned to the Heavy Calendar in the middle of the day, and having then that wonderful and omniscient feeling of changing, she had headed a class paper: NOW JANUCE. The teacher had said, “Deborah, what is this mark on your paper? What is this word, Januce?”
And, as the teacher stood by her desk, some nightmare terror coming to life had risen in the day-sane schoolroom. Deborah had looked about and found that she could not see except in outlines, gray against gray, and with no depth, but flatly, like a picture. The mark on the paper was the emblem of coming from Yr’s time to Earth’s, but, being caught while still in transition, she had to answer for both of them. Such an answer would have been the unveiling of a horror—a horror from which she would not have awakened rationally; and so she had lied and dissembled, with her heart choking her. Such a danger must no more be allowed, and so that night the whole Great Collect had come crowding into the Midworld: gods and demons from Yr and shades from Earth, and they had set up over their kingdoms a Censor to stand between Deborah’s speech and actions and to guard the secret of Yr’s existence.
Over the years the power of the Censor had grown greater and greater, and it was he who had lately thrust himself into both worlds, so that sometimes no speech and no action escaped him. One whisper of a secret name, one sign written, one slip of light could break into the hidden place and destroy her and both the worlds forever.
On Earth the life of the hospital moved on. Deborah worked in the craft shop, grateful that the world also offered its hiding places. She learned to do basketwork, accepting the instruction in her acerbic and impatient way. She knew that none of the workers liked her. People never had. On the ward a large girl had asked her to play tennis and the shock had sounded down to the last level of Yr. She saw the pencil-doctor a few more times and learned that he was “ward administrator” and the one who gave permission for “privileges”—steps in similitude to the normal world—to get up and go out on the ward, to go to dinner, on the grounds, then out of the hospital itself to the movie or store. Each was a privilege and had a certain connotation of approval that seemed to be expressed in distances. To Deborah he gave permission to walk unrestricted on the grounds, but not outside. Deborah said to the large girl, whose name was Carla, “Well, I’m a hundred square yards sane.” If there were such things as man-hours and light-years, surely there was foot-sanity.
Carla said, “Don’t worry. You’ll get more privileges soon. If you work hard with your doctor, they ease up a little. I just wonder how long I’ll have to stay here. It’s been three months already.” They both thought of the women at the far end of the ward. All of them had been in the hospital for over two years.
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