Andante Cantabile Con Moto
- What did she say? asked the man.
- She said she felt depressed.
The man frowned, the young woman began to flick through her notes, hurriedly, as if she had lost a page.
- And what else did she say?
- She said she was feeling low – in her spirits.
- Go on.
- She said she couldn’t do anything.
An emergency vehicle came and went, its siren fading in the distance.
- She said she was off her food.
- What did she have for breakfast?
- I didn’t ask.
Kona McClean shifted her weight in the chair, sighed inwardly, adjusted her strappy top.
- Could you just give me a thumbnail sketch. I’m trying to get a picture. What was she wearing? How did she relate to you? said Dr Flink. The word depression doesn’t tell you much. I mean she could be one of a thousand patients, clients I mean, and they’d all say they were depressed. You couldn’t tell the difference between them. It doesn’t tell you a thing about her as an individual.
- I thought it was significant.
- It is. But only a beginning.
- She seemed irritated, almost aggressive. Didn’t seem to want to tell me about herself. She said wasn’t it all in the referral letter? She didn’t make eye contact. She was in her mid thirties wearing jeans and a short coat that she didn’t take off, with no make-up.
Another siren dopplered down the High Road. The sky was clouding up. It was a cold Spring day. A gust of wind caused the branches of a silver birch to tap on the window, like a bird attacking its own reflection. Kona McClean looked through the tree at the garden framed in the window-sash. A lilac was budding up.
- I thought people liked to talk about themselves, she said, tugging at her short skirt.
- Some people don’t, said Dr Flink, we have to open them up. It’s like a kind of psychological operation. You can’t do that by asking the standard questions. What time they wake in the morning? Whether there’s any diurnal variation?
A helicopter thrummed overhead. Kona McClean raised her voice.
- She said her GP put her on to SSRIs. And had referred her for CBT, but there was a long waiting list.
- Depressed people are walking clichés, we have to declichéfy them, make them see themselves as interesting.
- If they could do that they wouldn’t be depressed would they?
- So she decided to try you out?
-Yes. Well she said her friend insisted. Somebody she knew at work told her about the Counselling Service.
The afternoon darkened. Unseasonable hail began to fall in large icy lumps. McClean’s i-phone played the first few bars of Beethoven’s ‘Ode to Joy’. She lent forward to pick up her bag, disturbing a polished stone pendant which swung away from her cleavage.
- Sorry, I forgot to switch it off.
- No problem.
She replaced the phone in her bag. The pendant swung forward again.
- According to the letter she’s having problems at work. Can’t face going in. Apparently her Head of Department is a bully.
- What does she do?
- She’s an English teacher. She works in the University Language Centre giving courses to foreign students.
The hail began to ease off. The helicopter seemed to be circling.
- Apparently her boss is always checking up. E-mailed, accusing her of taking personal calls during work.
- Has she been to her union? They’ll probably advise her to claim sexual harassment.
- Her boss is female. She’s on sick leave though, with work-related stress.
- I wonder if she’s reading anything at the moment?
- Is that relevant?
- Everything’s relevant, said Dr Flink, the best way to really get to know her is to ask an unexpected question, take an interest in an apparently trivial detail. That way you break through her defences.
Flink rotated his left wrist, glanced at his watch in a matter-of-fact way. Kona McClean gathered her things together and began to get up.
- I should have put on warmer clothes. It was sunny this morning. Something must be going on. I got stuck in a long tailback. It’s probably total gridlock out there.
Outside the room, the front door opened and the sound of heavy shoes being wiped on the mat filtered in.
- So I’ll see you next week then.
- Yes, hope you get back OK.
- Sit down anywhere you like. You can put your coat over there.
Alison Brockbank chose the chair nearest the door. She was wearing thick framed spectacles, and had dark hair pulled back tight in a bun. She undid the buttons of her coat, keeping it on. Kona McClean got up from the desk and walked over to the other arm-chair. There was a filing cabinet in one corner of the room. A standard lamp in another. A small circular coffee-table in light wood-effect veneer separated the two chairs. A Paul Klee print of camels hung on the wall. Alison Brockbank pulled a tissue from the box on the table and wiped her nose. She pulled another tissue and wiped again, sniffing. She held her body forward in the chair, her back unsupported.
- So how are you?
- Do you really want to know?
- Of course I do.
-You’re paid to ask how I am.
The door to the consulting room half-opened, someone said ‘Oh, Sorry’ and quickly withdrew.
- Let’s try again. I understand you’ve been having some problems at work?
- Oh, what’s the point. I can’t go back there. I feel shaky just walking past the place. I can’t work with that woman.
She took another tissue with difficulty, as if the box wanted to withhold it.
- I’m sure she stole my memory stick.
- I left it on a desk by the computer while I was teaching a class, and when I came back it wasn’t there. She was the only other person in the Department that afternoon. I know she’s got it in for me. I don’t know why. I haven’t done anything wrong.
The engine of a car started up. It crunched gravel outside the building. Kona McClean put her hands together.
- You teach English don’t you. I’m wondering if you’re reading anything right now?
- What’s that got to do with it?
- Just wondering.
- Actually I’ve been re-reading an old novel by Marguerite Duras, Moderato Cantabile, from the nineteen-fifties. I found it in the French section at work.
- What do you think?
- It’s slow going with my dictionary. There’s this child who’s learning the piano and won’t cooperate. There’s this mother who’s an alcoholic. There’s this man she meets in a bar. They just keep pouring out wine. Actually nothing happens. It’s good. Somehow, I like it.
She began to warm to her subject, almost against her will.
- It’s wrong to say nothing happens. There’s a crime of passion. A murder at the beginning. A woman gets killed. But you don’t know anything about it. You never find out what it was about.
A fire-alarm began to ring in a corridor. Alison suddenly stopped talking. Kona clicked her tongue.
- Sorry about that. It’s just a practice. They do it every Monday at this time. It’ll go off in a minute.
The alarm continued. Both women sat in silence, looking down, waiting. There were footsteps in the corridor. The sound of hurried conversation. A magpie flew past the window, flashing black and white like a nun hurrying to mass on a windy day. Peoples’ voices accumulated in the grounds outside.
- I think, perhaps, we do need to evacuate the building, Kona McClean said.
-Would everybody make sure they’ve charged their glasses.
Ladies and gentlemen, friends and colleagues,
In present company, I’m a relative newcomer to this hospital. When I first began to work here Kojo had already been at St Lukes for six years, completed his training, and been appointed to the post of Charge Nurse at the Carrington Clinic, just a few months before I arrived.
I must have been born under a lucky star, for I couldn’t have chosen a more congenial colleague, nor could I have known that our careers would be intertwined for the following twenty years.
Looking back on those days, memory seems to colour them with a rosy hue. They were the days, of course, when hospital managers were like friendly uncles, when inter-professional relationships were infused with harmony, and even the starched white-coats of Drs Daneman, Davis and Moorfield, now appear as images of swan-like purity, flapping in the breeze as they walked between the wards.
Conflict, of course, was not entirely unknown to us, and sometimes reached surprising proportions. It happened that a psychiatric registrar and a clinical psychologist were collaborating with one another on a research project. Kojo was standing in the corridor of the Carrington Clinic talking, when he heard a bit of a commotion coming from the other end. Suddenly the door of the psychologist's office opened and the research psychiatrist came flying out, landing rather heavily on the floor. Being a trained psychiatric nurse, Kojo was not fazed by this – and since he had no emergency bleep or alarm button – contented himself with a Freudian response, "interposing thought between impulse and action".
Those who have worked closely with Kojo have come to appreciate his calming presence, his wisdom and tact, his professional skill, and above all his warmth and generosity in listening to and supporting his colleagues. It might be thought that this wisdom derived from his later training as a psychotherapist, or his knowledge of anthropology, or that it was just innately given – but I believe there is also a deeper cultural root. The Asante of Ghana, are renowned for the richness of their wit and poetry, and the subtlety of their proverbs and discourse. Among the Asante, it is apparently usual to approach delicate and emotionally charged situations, by way of indirect allusions, thus softening the pain of confrontation, but at the same time giving rise to some degree of ambiguity.
In 1881, when the British Governor came to negotiate a peace with senior members of the Asante, he attempted to adopt their style. The senior Asante began by saying "I have come down to stop all those small leaks in the roof which have been giving trouble of late. If I cannot do this, we must have a new roof ", which was interpreted as "I have come for peace ". The Governor then replied in like manner, ending up by declaring – "I am not a mud-fish ". An Asante proverb which is easier to interpret states the following: "Only a bad crocodile eats the creature which shares the same hole in the river bed. "
I would like to say, on behalf of us all, what a privilege it has been to share the same hole as Kojo, and to express our gratitude to him for having kept so well to the proverb's message. There have been one or two occasions over the years when I had thought that we were about to lose Kojo, and had prepared myself with anticipatory grief, but this never happened and so I had been lulled into a sort of false sense of security – one might say, the manner of his going was slow – and so it is difficult to believe that it is really happening. You will not be surprised to discover that the Asante have a proverb that also gives graphic expression to this situation –
"The tortoise goes off in a laughable manner, but he can escape all the same."
In this case, Kojo has very wisely escaped to be Principal Adult Psychotherapist in one of the few London Teaching Hospitals whose future is assured. On behalf of all your friends and colleagues here, I would like to wish you every happiness for the future and a long and fruitful association with your new place of work. Would you please raise your glasses and drink a toast to Kojo.
- Good speech Dr Flink, Kona said, squeezing his arm lightly.
- It’s great to see everybody in party mode, outside working hours. I’d’ve fancied working here then. Sounds fun. Did they really wear white coats in those days?
She was wearing a sleeveless short black dress, slashed low at the back, heels and dangly earrings. Her blond hair was cropped short and highlighted. There was a tattoo on her left upper arm, a kind of abstract design of reedy leaves. Her eyes were sparkly as the wine.
- They were anachronisms. Old School organic psychiatrists. They thought talking to the patient was best left to social workers. Well, their ideas seem to be getting a new lease of life. I guess it’s me that’s the anachronism nowadays. Young psychiatrists look to neuroscience.
- And it’s people like me who do the talking, Kona said.
- They think they’ll always be needed to review drug prescriptions and police society. It’s sad, Flink added.
The Carrington Clinic was a single storey building put up at the end of the fifties. The leaving party was in a large space at the far end of the Clinic, accessed through a set of double doors. It had previously been used as an anaesthetic recovery room for patients having ECT. Now there were naive paintings on the wall, done by those having Art Therapy. There were stacking chairs around the edges and strip lights created an atmosphere unconducive to social events. Down one side a table was covered with cardboard plates, used glasses and screwed up napkins. A few tired looking sausage rolls and left over Wonderloaf sandwich quarters remained, a tumbler with some twiglets and bowls containing small numbers of salt peanuts and cashews. The buzz of conversation was diminishing. It was dark outside. Clumps of people were beginning to disperse. Kona and Flink walked down the corridor toward the plate-glass front doors, chatting. Flink’s ten-year-old BMW was parked nearby.
- I’m car-less, she said. It failed its MOT and they’re waiting for a part.
- If you need a lift home, you’d be welcome.
- There seem to be a lot of flies in the waiting area, Alison Brockbank said.
- Yes, I’m sorry. We’ve called the Works Department and they’re coming to deal with them. People were complaining about squirrels scratching on the ceiling during Group Therapy sessions. They put poison up in the roof a week or so ago, but I’m afraid they forgot to come back.
- You’ve been poisoning squirrels!
The Counselling Service was located in a house in the grounds of St Lukes, not far from the Carrington Clinic. It had previously been occupied by the Physician Superintendent. The outside wall was covered in Wisteria. There were Axminster carpets on the polished wood floor and velvet curtains, rather than blinds on the windows. Several rooms were set aside as offices and there was a larger meeting room. Its attempt at a non-institutional atmosphere was gradually being eroded by signs and fire doors. A manager had put up a notice in the waiting area saying THIEVES OPERATE IN THIS BUILDING.
- So how are things with you?
There was a prolonged silence.
- The same I suppose.
Another long silence.
- I’m OK as long as I don’t have to go into work.
- What have you been doing with yourself?
I’ve been trying to write my feelings down, Alison Brockbank said quietly.
- Good idea. I’d be interested to hear what you’ve written. Why don’t you read it out to me?
- It’s embarrassing. You’ll think it’s stupid.
- I won’t. Why don’t you try me?
Alison produced a small notebook from her coat pocket. It had a beige velour cover and was filled with tiny writing in pencil.
- Can’t I just leave it with you?
- It’d be better if you tried to read it out, then we can talk about it.
Alison clutched the notebook and curled round in the chair so that she was facing away from her counsellor. She began to read in an almost imperceptible babyish voice. Kona strained to hear what she was saying.
- Alison Brockbank is off sick and we need someone to cover her classes. I was wondering whether you might be able to help out, said Mary Hinshelwood.
- Again! said David Oakthorpe. The beginning of a wry smile flickered on his face.
- I know it’s a lot to ask. I’m only thinking of the Tuesday intermediate session 1pm – 3pm. I’ll try to find someone else for the others.
- Your wish is always my command, Mary. Actually I saw her in the cinema last week with another woman. They had plenty of popcorn, seemed to be having a good time.
A strong scent of lilac filled the garden. Two gold finches arrived on a branch and quickly disappeared, a chaffinch was nibbling the droppings under a bird-feeder. The lawn was newly mown. A thick growth of Clematis Montana decorated the back boundary wall, in front of which some early orange poppies were in flower. A damsel fly settled on a large elephant ear leaf. Sap was rising everywhere. It was a sunny day. Jeremy Flink had put on a polo shirt and cotton trousers. He was gazing out of the window of his private consulting room when Kona McClean arrived for her supervision.
- Sorry to be late.
- You’re not late, you’re on time.
She was wearing a light grey jogging suit and trainers. The top was one third zipped down. She radiated energy.
- I’ve been out running and didn’t have time to change. Sorry if I’m a bit sweaty.
- Sit down and get your breath.
- I’ve just been preparing a paper for the Occupational Health Group, Flink said.
- You studied history, what do you think of Thomas Carlyle? ‘The blessed glow of Labour…a purifying fire, wherein all poison is burnt up, and of sour smoke itself there is made bright blessed flame!’
- Ask Alison Brockbank!
- Well, has she opened up?
- I wouldn’t exactly say so. I thought we were getting somewhere but then she scarcely speaks. I’m never quite sure whether to interrupt her silences or not. When she does speak, I can hardly hear a word. She’s terrified of having to go back to work, worried that they’ll fire her if she doesn’t. I try to feel sympathetic but she makes me angry. Last week I couldn’t get her out of the room when the session ended. She made me late for my next client. She’s behaving like a manipulative child.
Kona seemed comfortable talking to Flink. His office was lined with books. A Victorian landscape hung above a Carrera marble fireplace, a stone-built bridge spanning a narrow river running through a meadow where cattle grazed. It had a calming effect. There were two brown leather arm-chairs. He had pulled one of them over from its normal place behind the couch. He was an old-fashioned psychoanalyst.
- We need to try and keep our psychological perspective. Look, if she makes you feel like that, she probably makes her colleagues at work feel the same way. What we need to ask is what’s being re-enacted here? You know you can see the work-place as a kind of theatre in which people unconsciously cast each other in different roles. People reproduce their personal emotional history over and again. There’s never a shortage of actors to play their allotted parts. That’s what I’m going to say in my presentation.
Kona looked thoughtful.
- But isn’t there an objective reality? ‘La théorie c’est bien mais ça n’empêche pas d’exister’?
- Ah Yes, you weren’t at Oxford for nothing.
- Or should it be, ‘Psychoanalysis is fine but it doesn’t stop old men lusting after young women’, she added, looking Flink in the eye. Her boss sounds awful, she quickly continued, apparently she’s always down on her for taking too long comfort breaks.
- And does she?
- I don’t know. She’s been accused of starting late and finishing early. Some of the students have been complaining that they don’t get their money’s-worth.
- OK. There’s always some kind of bedrock of reality, but the psychological templates are superimposed on it. It’s never difficult to find someone whom the cap fits. We need to know more about her.
- Thanks, that’s helpful.
Some mail dropped through the letterbox in the hall outside. Kona became aware of the time.
- Gosh, that went by quickly, she said, packing up her notes.
Flink opened the white panelled door to show her out. She bent down to pick the letters off the mat and handed them to him, grasped the polished brass door-knob and pulled the front door open, went to leave and half-turned toward him.
- Oh and thanks for Tuesday, she said, smiling playfully.