The receptionist triggers a switch to open the security door and we summon a lift. Fenwick examines himself in the internal mirrors, brushing specks of dandruff from the bunched shoulders of an expensive suit. It says something about Fenwick’s body when a hand-tailored suit doesn’t fit him.
“Still consorting with prostitutes?” he asks.
“I give talks.”
“Is
He won’t believe me if I tell him I do it for nothing. “They give me vouchers. I can redeem them for blow jobs later. I have a whole drawer full of them.”
He almost chokes and blushes furiously. I have to stop myself from laughing.
Fenwick, for all his obvious success as a doctor, is one of those people who tries desperately hard to be somebody else. That’s why he looks vaguely ridiculous behind the wheel of a sports car. It’s like seeing Bill Gates in running shorts or George W. Bush in the White House. It just doesn’t look right.
“How’s the you-know-what?” he asks.
“Fine.”
“I haven’t noticed it at all, old boy. Come to think of it, Pfizer has a new drug cocktail undergoing clinical trials. Drop by and I’ll give you the literature…”
Fenwick’s contacts with drug companies are renowned. His office is a shrine to Pfizer, Novartis and Hoffmann-La Roche; almost every item donated, from the fountain pens to the espresso machine. The same is true of his social life— sailing in Cowes, salmon fishing in Scotland and grouse shooting in Northumberland.
We turn the corner and Fenwick glances inside my office. A middle-aged woman sits in the waiting room clutching an orange torpedo-shaped life buoy.
“I don’t know how you do it, old boy,” Fenwick mutters.
“Do what?”
“
“That’s how I find out what’s wrong.”
“Why bother? Dish out some antidepressants and send her home.”
Fenwick doesn’t believe there are psychological or social factors in mental illness. He claims it is completely biological and therefore, by definition, treatable with drugs. It is just a matter of finding the right combination.
Every afternoon (he doesn’t work before midday) patients march one by one into his office, answer a few perfunctory questions before Fenwick hands them a scrip and bills them ?140. If they want to talk symptoms, he wants to talk drugs. If they mention side effects, he changes the dosage.
The strange thing is that his patients love him. They come in
Listening to people is considered to be old-fashioned nowadays. Patients expect me to produce a magic pill that cures everything. When I tell them that I just want to talk they look disappointed.
“Good afternoon, Margaret. Glad to see you made it.”
She holds up the life buoy.
“Which way did you come?”
“Putney Bridge.”
“It’s a good solid bridge that one. Been around for years.”
She suffers from gephyrophobia— a fear of crossing bridges. To make matters worse she lives south of the river and has to walk her twins to school across the Thames every day. She carries the life buoy just in case the bridge falls down or is swept away by a tidal wave. I know that sounds irrational, but simple phobias are like that.
“I should have gone to live in the Sahara,” she says, only half joking.
I tell her about eremikophobia, the fear of sand or deserts. She thinks I’m making it up.
Three months ago Margaret panicked halfway across Putney Bridge. It took an hour before anybody realized. The children were crying, still clutching her hands. She was frozen by fear, unable to speak or nod. Passersby thought she might be a jumper. In reality Margaret was holding up that bridge with sheer willpower.
We’ve done a lot of work since then. She carried the life buoy and has tried to break the thought loop that accompanies her irrational fear.
“What do you believe is going to happen if you cross the bridge?”
“It’s going to fall down.”
“Why would it fall down?”
“I don’t know.”
“What is the bridge made of?”
“Steel and rivets and concrete.”
“How long has it been there?”
“Years and years.”
“Has it ever fallen down?”
“No.”
Each session lasts fifty minutes and I have ten minutes to write up my notes before my next patient arrives. Meena, my secretary, is like an atomic clock, accurate to the last second.
“A minute lost is a minute gone forever,” she says, tapping the watch pinned to her breast.
Anglo-Indian, but more English than strawberries and cream, she dresses in knee-length skirts, sensible shoes and cardigans. And she reminds me of the girls I knew at school who were addicted to Jane Austen novels and always daydreaming about meeting their Mr. Darcy.
She’s been with me since I left the Royal Marsden and started in private practice, but I’m losing her soon. She and her cats are off to open a bed-and-breakfast in Bath. I can just imagine the place— lace doilies under every vase, cat figurines and the toast soldiers in neat ranks beside every three-minute egg.
Meena is organizing the interviews for a new secretary. She has narrowed them down to a short list, but I know I’ll have trouble deciding. I keep hoping that she’ll change her mind. If only I could purr.
At three o’clock I glance around the waiting room.
“Where’s Bobby?”
“He hasn’t arrived.”
“Did he call?”
“No.” She tries not to meet my eyes.
“Can you try to find him? It’s been two weeks.”
I know she doesn’t want to make the call. She doesn’t like Bobby. At first I thought it was because he didn’t turn up for appointments, but it’s more than that. He makes her nervous. Maybe it’s his size or the bad haircut or the chip on his shoulder. She doesn’t really know him. Then again, who does?
Almost on cue, he appears in the doorway, with his odd-legged shuffle and an anxious expression. Tall and overweight, with flax-brown hair and metal-framed glasses, his great pudding of a body is trying to burst out of a long overcoat made shapeless by its bulging pockets.
“Sorry I’m late. Something came up.” He glances around the waiting room, still unsure whether to step inside.
“Something came up for two weeks?”
He makes eye contact with me and then turns his face away.
I’m used to Bobby being defensive and enclosed, but this is different. Instead of keeping secrets he’s telling lies. It’s like closing the shutters in front of someone and then trying to deny they exist.
I take a quick inventory— his shoes are polished and his hair is combed. He shaved this morning, but the dark shadow has returned. His cheeks are red from the cold, but at the same time he’s perspiring. I wonder how long he spent outside, trying to get up the courage to come and see me.
He walks into my office and stands in front of my bookshelves, perusing the titles. Most of them are reference books on psychology and animal behavior. Eventually he stops and taps the spine of a book,
“I thought Freud’s views had been pretty much discredited these days.” He has the faintest hint of a northern accent. “He couldn’t tell the difference between hysteria and epilepsy.”
