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‘I want you to shadow me while I do the ward round.’ Busner guided me by placing his palm on my shoulder. We both nodded to Jane Bowen, who had forgotten us already and fallen into conversation with a nurse. Busner stashed his bursting briefcase behind the nurses’ station, after extracting from it with difficulty a clipboard and some sheets of blank paper. We walked side by side down the short corridor that led to the entrance to the two wards. For some reason Busner and I were unwilling to precede one another, and as a result people coming in the other direction had to crush up against the walls to get around us. We were like a teenage couple — desperate to avoid any break in contact that might let in indifference.

The dormitories were laid out in a series of bays, four beds in each bay and four bays to the dormitory. Each bay was about the size of an average room, the beds laid out so as to provide the maximum surrounding space for each occupant to turn into their own private space. Some of the patients had stuck photographs and posters up on the walls with masking tape, some had placed knick-knacks on the shelves, and others had done nothing and lay on their beds, motionless, like ascetics or prisoners.

Busner kept up a commentary for my benefit as we stopped and consulted with each patient. The first one we came to was a pop-eyed man in his mid-thirties. He was wearing a decrepit Burton suit which was worn to a shine at knee and elbow. He was sitting on the easy chair by his bed and staring straight ahead. His shoulder-length hair was scraped down from a severe central parting. His eyes weren’t just popping, they were half out of their sockets, resembling ping-pong balls with the pupils painted on to them like black spots.

‘Clive is prone to bouts of mania, aren’t you, Clive?’

‘Good morning, Dr Busner.’

‘How are you feeling, Clive?’

‘Fine, thank you, Doctor.’

‘Any problems with your medication? You’ll be leaving us soon, won’t you?’

‘In answer to your first question, no. In answer to your second, yes.’

‘Clive likes everything to be stated clearly, don’t you, Clive?’

At the time I thought Busner was being sarcastic. In fact — as I realised later — this wasn’t the case. If anything, Busner was being solicitous. He knew that Clive liked to expatiate on his attitudes and methods; Busner was providing him with the opportunity.

‘You’re staring very fixedly at the opposite wall, Clive, would you like to tell Misha why this is?’

I followed his line of sight; he was looking at a poster which showed two furry little kittens both dangling by their paws from the handle of a straw basket. The slogan underneath in curly script proclaimed, ‘Faith isn’t Faith until it’s all you’re hanging on to.’

‘The kitten is powerful.’ Clive smiled enigmatically and pointed with a dirt-rimmed nail, ‘That kitten holds in its paws the balance, the egg of creation and more.’ Having pronounced he lapsed back into a rigid silence. Busner and I left him.

Although there were only thirty or so patients on the ward they soon resolved themselves, not into names or individuals, but into distinct groups. Busner’s catchment area for his ward was an L-shaped zone that extended from the hospital in one dog-leg into the very centre of the city. The hospital pulled in its sustenance from every conceivable level of society. But on Ward 9 insanity had proved a great leveller. A refugee sometimes seems to have no class. The English depend on class, to the extent that whenever two English people meet, they spend nano-seconds in high-speed calculation. Every nuance of accent, every detail of apparel, every implication of vocabulary, is analysed to produce the final formula. This in turn provides the coordinates that will locate the individual and determine the Attitude. The patients on Ward 9 had distanced themselves from this. They could not be gauged in such a fashion. Instead, I divided them up mentally into the following groups: thinnie-pukies, junkies, sads, schizes and maniacs. The first four groups were all represented about equally, whilst the fifth group was definitely in the ascendant; there were lots of maniacs on Ward 9 and by maniacs I mean not the culturally popular homicidal maniac, but his distant herbivorous cousin, hyper, rather than homicidal, and manic, rather than maniacal.

As Tom had already characterised himself earlier that morning, hypermanic types are lecturers; extramural, al fresco professors, who, like increasingly undulant or syncopated Wittgensteins, address the world at large on a patchwork syllabus made up of Kabbalah, astrology, tarot, numerology and Bible (specifically Revelation) study. They are sad-mad, they know they are ill, they have periods of conformity, but they are always somehow out of joint.

‘Art therapy is very popular here, Misha.’ Busner detained me in the vestibule between the two wards. ‘We can’t keep the patients sufficiently occupied, they have treatment sessions of various kinds in the mornings, but in the afternoons you’ll be all they have to look forward to. Sometimes we can arrange an outing of some kind, or a friend or relative will be allowed to take them out on the Heath, but otherwise they’re cooped up here in a fuddled daze.’

We went on into the women’s dormitory. Here things seemed, at first, different. On the men’s dormitory Busner and I had spoken with a few isolated individuals, backed off into their individual bays. But here the patients seemed to be associating with one another. They reclined on beds chatting, or sat round the formica-topped tables which formed a central reservation.

A skeleton with long, lush hair rocked on a bed in the bay to our right, an obscenely large catheter protruding out of her lolly-stick arm. Busner took me in under tow and introduced us.

‘Hilary isn’t that keen on eating — or at least she is sometimes, but she doesn’t really like the nutritional side-effects of food. Hilary, this is Misha Gurney, he’s our new art therapist.’ Hilary stopped rocking and gave me a level smile from underneath neatly coiffed chestnut bangs.

‘Hello. I’ll look forward to this afternoon. I like to paint, I like watercolours. These are some of mine.’ She gestured towards the wall at the head of the bed, where an area about a foot square was tiled with tiny watercolours, terribly painfully precise little paintings — all portraits, apparently of young women. Busner wandered off, but I remained and walked to the head of the bed, so that I could examine the pictures thoroughly. They had been executed with a fanatical attention to the detail of make-up and hair which made them almost grotesque. Hilary and I sat sideways to each other. With her neck canted around so that she could face me, Hilary’s greaseproof-paper skin stretched, until I could see the twisted, knotted coils of tendon and artery that lay within.

‘They’re very good. Who are all these people?’

‘They’re my friends. I paint them from photographs.’

‘Your pictures are very detailed. How do you manage it?’

‘Oh, I have special pens and brushes. I’ll show you later.’

I left Hilary and went over to where Busner was sitting at one of the tables in the central area of the dormitory.