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There is no cause for alarm. I certainly cannot question the quintessential character of the stairwell. There is no denying its objective status. Thick bars of unpainted concrete punched through with four-inch bolts. The handrail a fire-engine red bar, as thick as an acroprop. Parstelin is a drug — I realise — that makes you acutely aware of things-in-themselves. Their standing into existence is no longer nauseous, but splendidly replete. That said, I gag a little and cough up a whitey dollop, somewhere between sputum and vomit, which plops into the drift of fluff wedged at the back of the stair I stand on.

Among the scraps of silver paper, safety-pins and nameless bits of detritus, a part of me. The fugue is broken by a whoosh of dead air that gusts up the well from below. Someone else has entered the staircase, pushed hard on a pneumatic door, maybe three flights down. The windows on the stairway are cut at oblique angles into the outer wall of the hospital. It is clear from the view, which affords me no sight of the huge bulk that contains me, that the staircase runs down the outer edge of the ziggurat’s sloping wall.

I pick my way down, pausing from time to time to cock an ear and listen for sounds of pursuit, but there are none. It is plain to me now that I have been suffering from a delusion, that the ward has overtaken me in part. I never denied that I was highly strung. I need some bed rest and the opportunity to read the papers. The lower I get the freer I feel. I know I haven’t really escaped from anything — and yet there’s the temptation to laugh and skip, to strike some attitudes.

I calculate that I am still two floors above ground level when the staircase blocks off its own windows. Light is now supplied by yellow discs that shine on the walls. The yellow light disorientates me. It must have done. I can genuinely no longer tell whether I am above or below ground level. The doors that lead off the staircase are blank oblongs. I panic and push at one, it wheezes under my palm and I tumble out into a corridor.

It is immediately clear that the stairway has diverged significantly in its path, that it hasn’t followed the lift shaft and deposited me in one of the open areas that form a natural reception concourse for each floor. Instead, it has thrown me off to one side, into the hinterland of the hospital, added to which I’m not on the mezzanine floor, I’m on the lower ground floor. I recognise where I am. I’m somewhere along the route Simon took me on my first day. I’m on the way to see the giant obsolete machine. I am in the same wetly shining concrete corridor. In either direction the naked neon tubes dash away; even they are hurrying off from this crushing place.

Which way? Whoever entered the stairwell while I was coming down is now on their way up. I can hear the cold slap of feet ascending and this hastens my decision. I turn to the left and start off down the corridor, trusting to my intuition to find my way to casualty and out of the hospital. As I walk I am aware that I’m positioned chemically at the eye of the storm. I no longer feel muzzy; I know that my body is saturated with Parstelin, but I’ve swum into a bubble of clarity. Nevertheless, I still don’t seem able to gain a definitive view of Busner and his ward. What has been happening? Those patients — with their madness — as stylised as a ballet. Were they the logical result of Busner’s philosophy? Were theirs the performances of madmen-as-idealists? Or just idealists? Their symptoms … was it true that they genuinely caricatured the recorded pathologies, all of them, not just Tom, or was my perception of them a function of the Parstelin?

These speculations give me heart. I feel my old self. I pause and look in a stainless steel panel screwed to a door. My reflection, dimpled here and there by the metal, looks back at me, amused, diffident. I feel cosy with my self-observation and immensely reassured by this moment of ordinary, unthinking vanity.

But where am I? No nearer casualty. The corridor has not swapped its concrete floor for tiling, there is no paint on the walls. I have turned the wrong way. Twenty feet ahead I can see the two swing-doors that lead to the conservatory. What the hell. I’ll pop in and have a look; it will be the last time I come near the hospital for a while. The doors whicker apart on their rusty rails and as I turn and pull them shut behind me they cut out the steady undertow of thrum that powers the hospital. The light in the high-domed room is the same as before and the obscure machine with its cream bakelite surfaces projects up above me, inviolate.

Tom and Jim step out from behind its flanged base, they move quite unaffectedly into my sight, as if expecting no particular reaction. I am very frightened.

‘Misha, where are you going?’ says Tom. Jim is casting his eyes about with rapid jerks of his head. He keeps flexing and rolling his arms back and forth, opening the palm forwards to disclose plastic mouth tubes — the kind used to stop people who are fitting from biting their tongues off — which he has adapted to some manual exercise routine.

‘I’m going off for the rest of the day, Tom, I came here by accident. I was looking for casualty.’

Tom listens to me, nodding, and then gestures for me to join him and Jim. The three of us then squat down between the outstretched paws of the great instrument, which are bolted heavily to the floor. We are like Africans under some fat-trunked tree, timelessly talking, until Jim drops his adapted muscle expanders on to the cracked tiles of the floor with a clatter.

‘I’m glad you listened to my advice, Misha. You’re leaving, aren’t you?’

‘Just for a couple of days. I … I need a rest. The atmosphere on the ward is quite overwhelming.’

‘Yes, it can be, can’t it. That’s why Jim and I like to come down here and play with the machine, it’s peaceful down here, quiet. Do you think I’m mad, Misha?’

‘What about me, am I mad too?’ Jim chimes in as well. I find myself embarrassed, which is absurd. To be frightened seems right, but to be embarrassed as well, that’s ridiculous.

‘Does the question embarrass you?’ Tom is rolling a cigarette with deft fingers. He flicks over the lip of paper and raises it to his budding, sensual mouth.

‘I hadn’t thought about it in those terms.’

‘Oh, oh, I see, you are a disciple of good Dr Zee, so we’re just behaving in a way which others choose to describe as mad. We’re simply non-conformists.’

‘I think you’re simplifying his position a little.’

‘Of course, of course. Are you mad, Misha?’ Jim snickers and rakes the tiles with long, cracked nails.

I can’t answer. My eyes cast up to the ceiling some twenty feet away. The conservatory is roofed with a glass cupola, the inside of which seems dirtied as if by soot. Beneath this a complete circle of dirty dormer windows lets in the grey light. From the very centre hangs a flex — which dangles a cluster of naked bulbs just above the highest shoulder of the machine.

After a while, Tom reaches out from where he squats and touches me lightly on the arm. ‘I’m sorry Misha, come on, let’s climb.’

‘Yeah, let’s.’ Jim is on his feet in one bound, a foot already on the kidney-shaped step, which is set two feet up into the base of the machine. In turn we haul ourselves up. Tom comes last. The machine is designed to be climbed; we ascend to a horizontal platform about seven feet up. This is girded with massive gimbals, the purpose of which is to tilt the platform under the main barrel of the contraption. What the machine ever did to the patients who were lain out on the platform is obscure. Perhaps it projected something through them: radiation; ultrasound; a light beam, or even something solid … The barrel itself has been de-cored; all that’s left is a hank of plaited black wires, spilling from its mouth.

The three of us then sit in a row on the platform, passing back and forth the wet end of tobacco. The curved well of dead light that falls on to us and the heavy machinery we sit on conspire to effect timelessness. Jews about to be shot or gassed are caught against the straight rod and round wheel of a railway engine. Crash survivors crawl from buckled aluminium sections rammed into the compost earth of the rainforest. We sit and smoke and I hear the ‘peep-peep’ of a small bird, outside the hospital, sounding like a doctor’s pager. It completes the dead finality of my situation. My neck, rigid with absorbed tension, mushy with tranquillisers, feels as if it is welling up over my head to form a fleshly cowl.