‘Is it okay if I smoke?’
‘If you absolutely must.’
‘I think I must.’
‘Okay then.’ She starts the engine and rolls down both of the front windows. There is classical music playing quietly on the stereo, something soft and intricate.
It takes me most of the fifteen-minute journey to explain everything to Dr Barbara. I start from the previous morning, with the journey to Oxford to see Professor Caborn, since that seems the place to begin. It’s difficult to find the words, and already I think there must be bits I have forgotten; everything happened so quickly, and every minute was packed with too many thoughts and feelings and actions. Now that I’m coming down – now that alcohol and exhaustion are finally taking their toll – it’s all too much for me to process. And yet I struggle through somehow, managing to reconstruct most of the story, even if it comes across as a series of poorly drawn incidents, the gossamer logic that connected them now in tatters. Dr Barbara helps me: she prompts occasionally, or asks for clarification when I stop making any kind of sense. But mostly, she stays quiet, lets me find my own circuitous path.
She stays silent afterwards, too, but when I look across, her brow is deeply creased. There are dark crescents under her eyes; and without make-up, wearing a slightly tatty cardigan and jeans in place of her usual office wear, she looks older than I’ve ever seen her. It feels as if I’ve aged her – by at least a decade.
‘I’m sorry,’ I say. ‘For making you come out in the middle of the night.’
She doesn’t look across, but she gives a shrug and a wry smile. ‘A hazard of my job. You’re not the first, and you certainly won’t be the last.’
‘Still. Thank you. I don’t know what I would have done.’
She shushes me, reaching over momentarily to rest her fingers on my arm. ‘Abby, you did the right thing calling me. You’re okay. You don’t need to think about anything else right now. We’re almost home.’
I’ve never been to Dr Barbara’s flat before, but it’s nice. It’s in Notting Hill, and seems to take up an entire floor in a huge five-storey house. Nothing like my flat, of course – two bedrooms and a study, a large lounge and separate kitchen. It must be worth a million – possibly millions, plural. But I know that Dr Barbara has been living in central London for over two decades. She probably bought it before property prices went completely fucking crazy. I try to imagine what it would be like to live somewhere like this, but I can’t. That is, I can’t imagine myself living somewhere like this. It’s ridiculously implausible, a bright boulevard I’m not allowed into. Not unaccompanied, anyway.
Dr Barbara asks me to keep the noise down when we enter, as Graham is sleeping. This information comes as a shock to me. Not the fact that Graham is asleep; it’s around two in the morning – this is when the sane people sleep. The shock is the simpler fact of Graham, his existence.
‘I didn’t know you were seeing anyone,’ I whisper.
‘I’m not a nun, Abby,’ Dr Barbara replies.
‘No, of course not. It’s just . . . well, you’ve never mentioned him.’
Dr Barbara shrugs as she places her keys in a bowl on a sideboard. ‘It’s relatively recent, and it never came up. The main concern of our sessions is talking about what’s happening in your life, not mine.’
‘Yes, but still . . .’ I trail off. Eight months of intense and intimate conversation has made me assume that I know Dr Barbara pretty well – certainly better than I know most of the people in my life. I know all about her messy divorce fifteen years ago. I know about her early career as a GP. I know that she can read Latin and has twice run the London Marathon. But here is something significant that has slipped me by, and as we creep through to her spacious, stand-alone kitchen, there are other signs of a life I know little about: photos of foreign landscapes and mystery children – nephews and nieces? – morphing into young adults; a bookcase crammed with cookery books; a surprisingly extensive collection of fridge magnets. We’ve talked about sex and death and drugs and orgasms, about love and guilt and humiliation and shame – and yet it appears, now, that Dr Barbara’s is just one more life I’ve failed to imagine in any real detail.
She gestures for me to sit at a sturdy, circular table. Four chairs, completely free of clutter. ‘Can I get you a drink? Coffee?’
‘Water. Just water, please.’
‘And what about food? Have you eaten?’
The question confuses me. ‘When?’
‘Recently!’
I look at the wall clock, which, it transpires, has no numbers. Just the hands, like some sort of ongoing spatial awareness test. ‘I had half a pizza thirteen hours ago, and two, maybe three canapés at the Dorchester Bar.’
‘What can I get you?’
My hesitation is long enough that Dr Barbara decides to stop asking questions and just take charge. She gets two bananas from the fruit bowl and watches me eat both. I’m not hungry, and they don’t taste of anything, but at least they don’t require much chewing, and Dr Barbara tells me they contain a lot of potassium, which will help settle my stomach when my inevitable hangover kicks in. She sits opposite, nursing a cup of tea in both hands and regarding me in silence for a few moments. I know that the serious conversation is coming, the one where we talk about what happens next. But I have no idea what happens next. I still can’t bring myself to think about that yet. Looking even ten seconds ahead causes a queasy lurch in the pit of my stomach, and anything beyond that is like the uncharted territory on an ancient map – the bit where it’s quite possible to slip off the edge of the world and never stop falling.
I don’t want to think. I just want to sit here in Dr Barbara’s immaculate kitchen, with its concealed lighting and fridge magnets and clock with no numbers. I want to sit here and pretend that it’s a normal day and I’m a normal friend who has just popped over for a glass of water and a couple of bananas.
Luckily, Dr Barbara is much better at handling this situation. She has had the practice, and accelerates through the professional gears, getting swiftly to the crux of the matter.
There’s a diagnostic test that GPs use to assess the mental health of their patients – the PHQ-9 questionnaire. It’s a checklist I know so well I can recite it by heart, with more feeling and fluency than any poem. Question One: Over the past two weeks have you felt little pleasure or interest in doing things you usually enjoy? (Not at all/some days/many days/every day.) Question Three: Have you had trouble falling or staying asleep, or sleeping too much? For each of the nine questions, you score a mark out of three, and this gives a total out of twenty-seven, from which the doctor can objectively quantify how nuts you are, zero being fine, twenty-seven being fetch the straitjacket. This is the only test in which I have ever achieved perfection, twenty-seven out of twenty-seven – and on more than one occasion.
But Dr Barbara doesn’t bother with this test today; she goes straight to question nine, or a simplified version of question nine, which is the only question she really needs to ask right now.
‘Abby, are you having thoughts of hurting yourself?’
‘Yes.’
That’s all I need to say. I could elaborate and tell her that’s all I can think about – the only possibility I can see if I allow myself to look beyond the next ten seconds – but what would be the point? A simple yes will suffice.
Dr Barbara nods, and it’s like we’re shaking hands to seal a deal. ‘With your permission, I’d like to have you admitted to hospital.’
I attempt a hollow laugh, but it turns out that even the hollowest of laughs is beyond me. ‘What if I don’t give you my permission?’