The Quick

For Richard

1

Patient DL had already been in the hospital ten years before I discovered her. She occupied a small room at the end of a corridor on the top floor, forgotten by all except her visitors and the staff who cared for her. There had been no change in her condition in a decade, no deterioration towards death nor stirring of life. It was a sad case, because she was quite a young woman, and it was the opinion of her doctors that she would remain that way until her natural death, or until someone put an end to her life – whichever happened first.

I arrived at the hospital seven years after DL. I brought with me quite a reputation, and by the time I took up my post it was understood that I would see only the most difficult cases. It was therefore only a matter of time before I came across her, she who was to become my obsession, the most tantalising and elusive of my patients. She had already been there so long she was considered a part of the fabric of the place, as essential to it as the lift shafts, operating theatres and incinerators. It was as if Patient DL, or someone like her, had always occupied that small room at the end of the corridor on the fifth floor.

Sooner or later, then, I would find my way to her. And yet for three long years I managed to avoid it. No whisper of her ever reached me, even though I must have passed people in the corridors, or nodded to them in the lifts, who had seen her with their own eyes. How could that be? I can’t explain, except to say that in some strange way, I feel it could only have happened in that place.

After DL entered the hospital, the city underwent a period of rapid change. It was the first decade of a new millennium, some said the dawn of a new enlightenment, and the poli -t icians were in empire-building mood. They gave the architects free rein, and the architects played with the skyline like plasticine. Their techniques and materials had advanced to such a level that they could afford to have a little fun at last. I would glance upwards and laugh – I admired their playfulness. But the hospital was older, more earthbound. It wasn’t designed to draw attention to itself, but to shelter, or to hide, the most fragile of our brethren. It squatted at the heart of this giddy, gaudy construction site, like a trapdoor you might stumble through by chance.

Everybody knew about that grand old hospital, with its historic reputation: backdrop to some of the greatest discoveries in medicine. But ask them to point to it on a map, and they would shrug their shoulders and grin. It was all but invisible to the untrained eye, and this invisibility was only partly an accident of town planning. The front of the hospital, the tip of the iceberg, occupied one side of a pretty Georgian square which was reached by several cobbled alleyways. These narrow openings – just wide enough to admit an ambulance – were easy to miss. If you peered into them from the busy street outside, they looked dark and uninviting. So people carried on walking into the brightly lit theatre district, or in the other direction, to the museums and restaurants. They rarely came to the square without an appointment, unless they arrived by ambulance, or fell in drunk. And so it was cut off from the city that encircled and pressed in on it, like an eddy in a fastflowing river.

On passing through one of the narrow alleyways, and emerging into this peaceful backwater, the newcomer would be presented with a red-brick, rather austere building, with a gabled roof and regimented rows of small windows. In fact, that façade was deceptive, because grey, military-style blocks stretched back for some distance behind it, fanning out in all directions. There was a wide entrance with a flight of shallow steps leading up to it, a long ramp for wheelchair users and an ambulance bay on the street. Nowhere on the front of the building would you find the word ‘hospital’, something the reader might find hard to believe, until I explain that it had no emergency department, and the administration wished to discourage the scourge of every casualty room – the hospital tourist – from dropping in. Even the ambulances that served it lacked the usual characteristic markings. So it was only when you entered the building, and sometimes not even then, that you realised what kind of a place you had come to.

What was that place? To those in the know, it was the country’s leading authority on the treatment of brain disease. That was its reputation at the time I’m writing about, the beginning of the new millennium, but originally its purpose was to treat psychiatric patients – those suffering from disorders of the mind. The distinction has now largely lost its signi ficance – the mind being considered a product of the brain, not able to exist separately from it – but the outdated ideas persisted in bricks and mortar, and many new visitors remarked, on gazing up at the façade, that the hospital had the look and feel of an asylum about it.