Will Self - The Quantity Theory of Insanity - Reissued

‘I thought a lot of anorexics and bulimics grew out of it?’

‘To some extent, but there’s always a hard core and at the moment it seems to be growing. These long-term anorexics are different, they’re placid, resigned and apparently unconscious of any motivation. The temporaries tend to be wilful, obstinate and obviously powerfully neurotic. These hard-cores, like Hilary, could almost be psychologically blameless. Some of them even have fairly stable relationships. They’re at a loss to explain what comes over them, it seems to be somehow external, imposed from elsewhere.’

I should have been paying attention to what Busner was saying, but I couldn’t concentrate. For a start there was the strangeness of the situation — I’d only ever spent isolated periods of a few minutes on psychiatric wards before. I had known what to expect in broad terms, but it was the relentlessness of the ambience that was beginning to get to me. There was something cloacal about the atmosphere in the women’s ward. None of the patients seemed to have bothered to dress, they sat here and there talking, wearing combinations of night and day clothes. There was a preponderance of brushed cotton. I sensed damp, and smelt oatmeal, porridge, canteen; indefinable, closed-in odours.

I could walk away from the tonsured idiot on the Heath, but inside Ward 9 I was trapped. And these people weren’t pretending. They weren’t closet neurotics or posing eccentrics, Bohemians. They were the real thing. Real loss of equilibrium, real confusion, real sadness, that wells up from inside like an unstaunchable flow of blood from a severed artery. I felt my gorge rising. I felt my forehead, it was sandpaper-dry. Busner was neglecting me and talking to a pneumatic nurse. The nurses on Ward 9 didn’t wear a uniform as such, rather they affected various items of medical garb: tunics, coats and smocks, nameplates and watches pinned at the breast. This nurse had a man’s Ingersoll attached by a safety-pin to her jacket lapel. She had blonde baby curls, bee-stung lips and the creamy, slightly spongy complexion that invariably goes with acrid coital sweats. I forced myself to listen to what they were saying, and fought down nausea with concentration.

‘Take her out to the optician then, Mimi, if she has to go.’

‘Oh, she does, Zack, she can barely see a yard in front of herself. She can’t be expected to deal with reality if she can’t see it.’ The voluptuous Mimi was squidged on to the corner of the table. Behind her stood a short woman in her thirties with the hydrocephalic brow and oblique domed crop of an intelligent child. She stared at me with sightless eyes.

‘Rachel shouldn’t really be off the ward, considering the medication she’s on.’

‘But Zack, it’s a walk down to the parade, ten minutes at most. Give her a break.’

‘Oh, all right.’

‘Come on then, Rachel, get your coat on.’ Rachel bounced away into one of the bays. Mimi lifted herself off the edge of the table and winked at me in a languid way.

‘Come on, Misha, we’ve got an admission for you to see. I’ll leave you at the front desk. Anthony Valuam will pick you up and take you down to casualty.’ We walked out of the women’s dormitory and back to the association area. Tom, my friend from the earlier part of the morning, was back behind the nurses’ station, reading his dog-eared Penguin. Busner despatched me to wait with him by giving me a gentle shove in the small of my back, then he crooked his finger at a scrofulous youth in a tattered sharkskin suit who sat smoking and disappeared with him towards his office. Tom put down his book and treated me to another little conspiratorial exchange.

‘Has the good doctor given you a little tour?’

‘We’ve been round the ward, yes.’

‘Beginning to catch on yet?’

‘What do you mean?’

‘Well, who did you get introduced to? No, don’t tell me. Let me guess. You talked to Clive and then you saw a lot of other male patients quite quickly until you ended up scrutinising Hilary’s watercolours.’

‘Err … yes.’

‘And did Zack come out with his catch-phrase?’

‘Yes, when we were talking to Jane Bowen.’

‘Thought so. He’s so predictable. That’s one of the truly therapeutic aspects of this place, the unfailing regularity of Dr Busner. What are you doing now?’

‘I’m meant to be going down to casualty to sit in on an admission with a Dr Valuam.’

‘Tony, yeah. Well, he’s my kind of a shrink, not like Dr B; more practical like, more chemical.’

A door opened to the right of the nurses’ station which I hadn’t noticed before. A very short man came out of it and with neat movements locked it behind him, using a key that was on an extremely large gaoler’s bunch. He turned to face me. He was a funny little specimen. He had wispy fair hair teased ineffectually around his bare scalp. It wasn’t as if he was going bald, it was more as if he’d never grown any hair to begin with. This impression was supported by the watery blue eyes, and the nose and chin which were soft and seemingly boneless. He wore a stiff blue synthetic suit of Seventies cut and vinyl shoes.

‘You must be Misha Gurney. I’m Anthony Valuam.’ His handshake was twisted and rubberised, like holding a retort clamp in a laboratory, but his voice was absurdly mellow and basso. A voice-over rather than a real voice. His foetal face registered and then dismissed my surprise; he must have been used to it. Tom was stifling an obvious giggle behind his paperback. Valuam ignored him and I followed suit. We walked off down the short corridor to the lift. Valuam launched into an introduction.

‘It’s very unusual to have an admission through casualty at this time of day. On this ward we deal almost exclusively with referrals, but we know this particular young man and there are very good reasons why he should be treated on Ward 9.’

‘And they are …?’

‘I don’t wish to be enigmatic, but you’ll see.’

Valuam fell silent. We waited for the lift, which arrived and slid open and closed and then dropped us down through the hospital to casualty, which was situated in the first sub-basement. The lift stopped on every floor, to take on and drop passengers.

The architects, interior designers and colour consultants who had made the hospital were not insensitive to the difficulties posed by such a project, they had earnestly striven to make this vast, labyrinthine structure seem habitable and human in scale. To this end each floor had been given slightly different wall and floor coverings, slightly different-shaped neon strip-light covers, slightly different concrete cornicing, slightly different steel ventilation-unit housings and slightly different colourings: virology an emphatic pale blue, urology a teasing (but tasteful) green, surgery and cardiology a resilient pink and so on. At each floor the patients and their orderlies were also different colours. The faces and hands of the patients as they were transferred from ward to ward, on steel trolleys, in wheelchairs as heavy as siege engines, were stained with disease, as vividly as a pickled specimen injected with dye.

The orderlies were violently offhand; they manhandled the patients into the lifts like awkward, fifty-kilo bags of Spanish onions. Then they stood menacingly in the corners, lowering over their livid charges, their temples pulsing with insulting health. Occasionally a patient would be wheeled into the lift who was clearly the wrong colour for the direction we were headed in (this was evident as soon as the lift reached the next floor) and the orderly would back the chair or table out of the lift again, the faces of both porter and cargo registering careful weariness at the prospect of another purgatorial wait.