At the same time I’m grateful because Liverpool taught me where I belong. For the first time London felt like home. And ever since then, as much as I moan about congestion charges, crowded Tube trains and the ubiquitous queues, I have never once felt any desire to leave the capital.
So who is Florence and why is she writing to me? The idea that I might have a secret admirer is a little perturbing, especially now. She writes of being “rejected again.” Catherine McBride came from Liverpool. The idea is absurd, of course, and I’m about to move on when I turn the page over and notice a telephone number.
A young woman answers.
“I’d like to speak to Florence, please.”
“You have the wrong number,” she says, sounding upset. She’s about to hang up.
“Listen, I’m sorry to bother you, but I’ve received a letter from someone called Florence. I don’t know who she is. She gave this phone number.”
“There’s nobody called Florence here.”
I blurt out, “What about a Catherine?”
Silence. I begin to wonder if she’s still listening.
“Are you a friend of Catherine’s?”
I’m not sure if we’re talking about the same person. She doesn’t wait for me to answer. “In case you haven’t read the newspapers, I think you should know that Catherine is dead. If you have any questions, you should talk to her family or the police.” She’s on the verge of tears.
With a rushing sense of depleted reality I apologize and end the call. The implications keep unfolding in my head, one after the other, until they are so labyrinthine I can’t find objectivity. Catherine is Florence. Perhaps it’s a pet name. Florence Nightingale. A nurse.
Why would she be writing to me after five years of silence? I study the postmark again. How could a letter arrive weeks after her death? Someone must have mailed it for her.
In one corner of the attic I find what I’m looking for— boxes containing my old case notes. The notebooks are labeled with a month and year. Two in particular interest me, with dark green covers and mottled spines.
Back downstairs in the study, I turn on the desk lamp and begin reading the notes. The A4 pages are neatly ruled, with a wide margin showing the date and time of each appointment. Catherine McBride’s name is in the top right-hand corner. Assessment details, medical notes and observations are all here.
I don’t know what I’m looking for. Maybe I’m hoping I can bring her back to life so I can ask her questions.
How do I remember her? I see her walking down the corridor of the Marsden, dressed in a light blue uniform with dark blue trim on the collar and sleeves. She waves to me and smiles. She has a key chain on her belt. Most nurses have short-sleeved tunics, but Catherine wore hers long.
In the beginning she was just another face in the corridor or in the cafeteria. She was pretty in a genderless way, with her boyish haircut, high forehead and full lips. She nervously cocked her head from one side to the other, never looking at me with both eyes at once. I seemed to bump into her a lot— often just as I was leaving the hospital. Only later did I suspect that she was orchestrating this.
Eventually, she asked if she could talk to me. It took me a few minutes to realize that she meant professionally. I made an appointment for her and she arrived the next day.
From then on she came to see me once a week. She would put a bar of chocolate on my desk and break up the pieces on the silver foil, like a child divvying up sweets. And in between smoking menthol cigarettes, she would let the chocolate melt under her tongue.
“Do you know this is the only office in the entire hospital where you can smoke?” she told me.
“I guess that’s why I get so many visitors.”
She was twenty, materialistic, sensible and having an affair with someone on staff. I don’t know who it was, but I suspect he was married. Occasionally, she would say “we” and then, realizing her mistake, change to the singular.
Very rarely did she smile. She would cock her head and look at me with one eye or the other.
I also suspected she had seen someone like me before. Her questions were so precise. She knew about history taking and cognitive therapy. She was too young to have studied psychology, so she must have been a patient.
She talked of feeling worthless and insignificant. Estranged from her family, she had tried to mend fences but feared that she would “poison their perfect lives.”
As she spoke and sucked pieces of chocolate, she sometimes rubbed her forearms through her buttoned- down sleeves. I thought that she was hiding something, but waited for her to find the confidence to tell me.
During our fourth session she slowly wound up the sleeves. Part of her was embarrassed to show me the scars, but I also sensed defiance and a hint of self-satisfaction. She wanted me to be impressed by the severity of her wounds. They were like a life map that I could read.
Catherine had first cut herself when she was twelve. Her parents were going through a hate-filled divorce. She felt caught in the middle, like a rag doll being pulled apart by two warring children.
She wrapped a hand mirror inside a towel and smashed it against the corner of her desk. She used a shard to open up her wrist. The blood gave her a sense of well-being. She was no longer helpless.
Her parents bundled her into the car and drove her to hospital. Throughout the entire journey they argued over who was to blame. Catherine felt peaceful and calm. She was admitted to hospital overnight. Her cuts had stopped bleeding. She fingered her wrist lovingly and kissed her cuts good night.
“I had found something I could control,” she told me. “I could decide how many times I cut, how deep I would go. I liked the pain. I craved the pain. I deserved it. I know I must have masochistic tendencies. You should see the men I end up with. You should hear about some of my dreams…”
She never admitted spending time in a psychiatric hospital or in group therapy. Much of her past she kept hidden, particularly if it involved her family. For long periods she managed to stop herself from cutting. But with each relapse she punished herself by cutting even deeper. She concentrated on her arms and thighs, where she could hide the wounds under her clothing. She also discovered which creams and bandages helped minimize scarring.
When she needed stitches she chose accident and emergency centers away from the Marsden. She couldn’t risk losing her job. She would give a false name to the triage nurse and sometimes pretend to be foreign and unable to speak English.
She knew from past experience how nurses and doctors regard self-mutilators— as attention seekers and time wasters. Often they get stitched without anesthetic. “If you enjoy pain so much, have a little more,” is the attitude.
None of this changed Catherine’s behavior. When she bled she escaped the numbness. My notebooks repeat her words, “I feel alive. Soothed. In control.”
Dark brown flecks of chocolate are stuck between the pages. She would break off pieces and drop them on the page. She didn’t like me writing. She wanted me to listen.
To break the cycle of blood, I gave her alternative strategies. Instead of reaching for a blade I told her to squeeze a piece of ice in her hand, bite down on a hot chili or rub liniment on her genitals. This was pain without the scarring or the guilt. Once we broke into her thought loop, it was possible to find new coping mechanisms, less physical and violent.
A few days later Catherine found me in the oncology ward. She had a bundle of sheets in her arms and was looking anxiously from side to side. I saw something in her eyes that I couldn’t recognize.
She motioned me to follow her into an alcove and then dropped the sheets. It took me a few moments to notice the sleeves of her cardigan. They were stuffed with paper towels and tissues. Blood leaked through the layers of paper and fabric.
“Please don’t let them find out,” she said. “I’m so sorry.”
“You have to go to casualty.”
“No! Please! I need this job.”
A thousand voices inside my head were telling me what I should do. I ignored every one of them. I sent Catherine ahead to my office, while I collected sutures, needles and butterfly clips, bandages and antibiotic ointment. Behind drawn blinds and a locked door I stitched up her forearms.
