For fifteen years he scarcely emerged from the house, ostensibly because of ‘intractable seizures’, his mother maintaining she dared not take him out, otherwise he would have twenty or thirty seizures in the street every day. All sorts of anticonvulsants were tried, but his epilepsy seemed ‘untreatable’: this, at least, was the stated opinion in his chart. There were older brothers and sisters, but Jose was much the youngest—the ‘big baby’ of a woman approaching fifty.
We have far too little information about these intervening years. Jose, in effect, disappeared from the world, was ‘lost to follow-up’, not only medically but generally, and might have been lost forever, confined and convulsing in his cellar room, had he not ‘blown up’ violently very recently and been taken to the hospital for the first time. He was not entirely without inner life, in the cellar. He showed a passion for pictorial magazines, especially of natural history, of the National Geographic type, and when he was able, between seizures and scoldings, would find stumps of pencil and draw what he saw.
These drawings were perhaps his only link with the outside world, and especially the world of animals and plants, of nature, which he had so loved as a child, especially when he went out sketching with his father. This, and this only, he was permitted to retain, his one remaining link with reality.
This, then, was the tale I received, or, rather, put together from his chart or charts, documents as remarkable for what they lacked as for what they contained—the documentation, through default, of a fifteen-year ‘gap’: from a social worker who had visited the house, taken an interest in him, but could do nothing; and from his now aged and ailing parents as well. But none of this would have come to light had there not been a rage of sudden, unprecedented, and frightening violence—a fit in which objects were smashed—which brought Jose to a state hospital for the first time.
It was far from clear what had caused this rage, whether it was an eruption of epileptic violence (such as one may see, on rare occasions, with very severe temporal-lobe seizures), or whether it was, in the simplistic terms of his admission note, simply ‘a psychosis’, or whether it represented some final, desperate call for help, from a tortured soul who was mute and had no direct way of expressing his predicament, his needs.
What was clear was that coming to the hospital and having his seizures ‘controlled’ by powerful new drugs, for the first time, gave him some space and freedom, a ‘release’, both physiological and psychological, of a sort he had not known since the age of eight.
Hospitals, state hospitals, are often seen as ‘total institutions’ in Erving Goffman’s sense, geared mainly to the degradation of patients. Doubtless this happens, and on a vast scale. But they may also be ‘asylums’ in the best sense of the word, a sense perhaps scarcely allowed by Goffman: places that provide a refuge for the tormented, storm-tossed soul, provide it with just that mixture of order and freedom of which it stands in such need. Jose had suffered from confusion and chaos—partly organic epilepsy, partly the disorder of his life—and from confinement and bondage, also both epileptic and existential. Hospital was good for Jose, perhaps lifesaving, at this point in his life, and there is no doubt that he himself felt this fully.
Suddenly too, after the moral closeness, the febrile intimacy of his house, he now found others, found a world, both ‘professional’ and concerned: unjudging, unmoralistic, unaccusing, detached, but at the same time with a real feeling both for him and for his problems. At this point, therefore (he had now been in hospital for four weeks), he started to have hope; to become more animated, to turn to others as he had never done before—not, at least, since the onset of autism, when he was eight.
But hope, turning to others, interaction, was ‘forbidden’, and no doubt frighteningly complex and ‘dangerous’ as well. Jose had lived for fifteen years in a guarded, closed world—in what Bruno Bettelheim in his book on autism called the ‘empty fortress’. But it was not, it had never been, for him, entirely empty; there had always been his love for nature, for animals and plants. This part of him, this door, had always remained open. But now there was temptation, and pressure, to ‘interact’, pressure that was often too much, came too soon. And precisely at such time Jose would ‘relapse’, would turn again, as if for comfort and security, to the isolation, to the primitive rocking movements, he had at first shown.
The third time I saw Jose, I did not send for him in the clinic, but went up, without warning, to the admission ward. He was sitting, rocking, in the frightful day room, his face and eyes closed, a picture of regression. I had a qualm of horror when I saw him like this, for I had imagined, had indulged, the notion of ‘a steady recovery’. I had to see Jose in a regressed condition (as I was to do again and again) to see that there was no simple ‘awakening’ for him, but a path fraught with a sense of danger, double jeopardy, terrifying as well as exciting—because he had come to love his prison bars.
As soon as I called him, he jumped up, and eagerly, hungrily, followed me to the art room. Once more I took a fine pen from my pocket, for he seemed to have an aversion to crayons, which was all they used on the ward. ‘That fish you drew,’ I hinted it with a gesture in the air, not knowing how much of my words he might understand, ‘that fish, can you remember it, can you draw it again?’ He nodded eagerly, and took the pen from my hands. It was three weeks since he had seen it. What would he draw now?
He closed his eyes for a moment—summoning an image?— and then drew. It was still a trout, rainbow-spotted, with fringy fins and a forked tail, but, this time, with egregiously human features, an odd nostril (what fish has nostrils?), and a pair of ripely human lips. I was about to take the pen, but, no, he was not finished. What had he in mind? The image was complete. The image, perhaps, but not the scene. The fish before had existed— as an icon—in isolation: now it was to become part of a world, a scene. Rapidly he sketched in a little fish, a companion, swooping into the water, gambolling, obviously in play. And then the surface of the water was sketched in, rising to a sudden, tumultuous wave. As he drew the wave, he became excited, and emitted a strange, mysterious cry.
I couldn’t avoid the feeling, perhaps a facile one, that this drawing was symbolic—the little fish and the big fish, perhaps him and me? But what was so important and exciting was the spontaneous representation, the impulse, not my suggestion, entirely from himself, to introduce this new element—a living interplay in what he drew. In his drawings as in his life hitherto, interaction had always been absent. Now, if only in play, in symbol, it was allowed back. Or was it? What was that angry, avenging wave?
Best to go back to safe ground, I felt; no more free association. I had seen potential, but I had seen, and heard, danger too. Back to safe, Edenic, prelapsarian Mother Nature. I found a Christmas card lying on the table, a robin redbreast on a tree trunk, snow and stark twigs all around. I gestured to the bird, and gave Jose the pen. The bird was finely drawn, and he used a red pen for the breast. The feet were somewhat taloned, grasping the bark (I was struck, here and later, by his need to emphasise the grasping power of hands and feet, to make contact sure, almost gripping, obsessed). But—what was happening?—the dry winter twiglet, next to the tree trunk, had shot up in his drawing, expanded into florid open bloom. There were other things that were perhaps symbolic, although I could not be sure. But the salient and exciting and most significant transformation was this: that Jose had changed winter into spring.