A Blue Eye

Commentary

‘How do I know what I think until I see what I write?’ W H Auden’s question has always been my guiding principle. For this reason I will admit that I did not do any extensive research before embarking on the subject assigned to me for Writing the Asylum. Rather, as questions were thrown up in the writing, I checked and extended my frames of reference. That said, it was really helpful to be assigned a subject to explore since I would have had no idea where to start otherwise. I was glad too that the subject chosen for me was a set of patient case notes, something I found easy to respond to imaginatively, but not without its problems.

The first task was to decipher the notes, which were written by a medical superintendent. Once I was confident that I had deciphered the neat but not always easily legible handwriting correctly, I read through the notes two or three times. Two themes to emerge from that preliminary reading were first, the marked contrast between the laconic notes of the medical superintendent and the ‘extravagant’ fantasies which the patient entertained, according to those notes; the second, was that the patient was admitted suffering from the effects of general paralysis of the insane, the name then given to neurosyphilis, one possible development of late stage syphilis. It was clear that I had two contrasting voices to explore, the actual notes of the superintendent and the imagined voice of the patient; it was also clear that the life of the imagination would be a narrative theme: syphilis has often been associated with increased creativity (see especially Thomas Mann’s novel Dr Faustus).

I then had to face my first set of choices: would I name the patient and how would I invent his voice? The patient is named at the head of the case notes but not at any point in the record of his behaviour. He owned a glazier’s business in Glasgow and may well have living descendants. I chose not to name him. That also I felt gave me more scope in imagining a voice for him. Though I used specific details from the notes, I saw him as a generic figure not unlike the Tom of Bedlam figure in the ballad of that name, whose wonderfully poetic fantasies are magnificent in their extravagance. I could not hope to emulate the ballad, which can be read at Tom O’ Bedlam’s Song: Anonymous Ballad, circa 1620 (http://www.thehypertexts.com), but I thought it gave me a pointer as to how I might present the patient’s fantasies as an enlargement of his imaginative life, rather than a simple aberration.

To start any piece of writing I need some sort of ‘hook’ to open up possibilities. I was struck by an incident in which the patient was recorded as striking the attendant and ‘inflicting a blue eye’. The ‘blue’ rather than black eye caught my imagination and I suddenly had the first line spoken by my imagined patient: ‘Where is she now my blue-eyed girl?’

A lost or inaccessible lover, real or imagined, became one of the offstage characters as it were and a focus of longing for the central figure, the patient. In a time of restricted sexual freedom for ‘respectable’ women, syphilis was generally acquired through visiting prostitutes, another strand in the story I was building up.

The idea of a walled garden (the one at Gartnavel at this date, 1865, was for the use of the Physician Superintendent) in particular began to assume a central significance, as a symbol both of sanctuary and exclusion. Its biblical origins resonated with the patient’s own dream of having been in the garden of Eden and also with my invented theme of a lost or inaccessible love. I use it also (drawing on the Eden idea) as an emblem of lost innocence.

It was impossible to tell from the case notes how much the patient understood of his situation, but it seemed not implausible, on the evidence of what he did say (for instance about turning pebbles into gold) and his actions (tearing bedclothes, attacking the attendant) that he alternated between a certain grandeur of vision and a fear of being restricted, even imprisoned.

The central structure of my piece is the counterpoint of actual notes and imagined voice until the inevitable conclusion, given the nature of his illness, the patient’s death. I did feel though that I needed at least a third voice, probably more, which would fill in some of the background and hint at some of the questions which further reading and reflection were raising.

The stated principles of the Royal Asylum are admirable; but at no period has it been easy to treat severely ill patients in mental hospitals with complete objectivity and sustained compassion, particularly when, as in the case of the patient I was writing about, their behaviour is uncooperative. Thus the patient in question is described in the notes as ‘troublesome, dangerous and disruptive’; he takes exercise in the ‘airing court’ but such patients did not have access to the wider grounds; he sustains a fractured rib but there is no indication of how he acquired it. How far could the principles be put into practice for such a patient, especially since there was no hope of ‘restoring reason’?

In the finished piece the garden (standing in for the wider grounds of the asylum) is given a voice which invites and excludes. A third person narrative runs parallel with the main theme, setting it in context, and introducing imagery – of windows, mirrors etc – which recurs throughout the piece.

To maintain clarity voices are typographically distinguished: the garden by italics, the third person narrative by the Sans Serif font, the superintendent’s notes by a calligraphical script, the patient by the Serif font. Finally each section of the narrative is prefaced by one of the three aims of the Royal Asylum in capitals, like an inscription over a door.

[Patient record for John Whyte, HB13/5/57]