Casebook
(Eventually all of the casebook will be up here)
RULEDGE PRIVATE CLINIC AND ASYLUM
CASEBOOK
Patient: Alice
Date admitted: 4 November 1864
Physician: Heironymous Q. Wilson
4 November 1864
Received confirmation from the Superintendent that I will be given of the opportunity to treat a very troubled and difficult patient. Dubious honor! Her name is Alice, and her prognosis is not promising. After looking at her file, I’m astonished she has survived this long. She has been nearly comatose for a year.
-Would I have admitted her had I known then what I know now? 13/10/73
11 November 1864
Mute on a stretcher, with her head curiously bandaged, Alice seems to cling precariously to life. Her burns have healed remarkably in the year since the fire, but she languishes in a deep trance-like dementia. It’s as if the blaze consumed her senses. Deaf, dumb, and blind to all stimulation, she’s a fair match for the infirmary’s gloom.
In a forward instant, a cankered feline pounced on Alice while she was about to be carried inside. Startled by the cat’s yowl, the bearers lost their grip and dropped the wretched girl to the ground. Most curious to behold, the cat stood atop Alice as if claming territorial rights, or as If defending a rodent captured in the day’s hunt from other hungry predators. Only when an orderly threatened it with a stick did the creature scamper into a nearby hedge. Even then the cat crouched beneath the shrubbery. With eyes agape, it fixed on Alice as if it had some vital interest in our proceedings.
-It pays to heed the feline – something I’ve learned over the years. –21/10/73
13 November 1864
In the twelvemonth since the conflagration, Alice has dropped further into a grim and darkly quiet abyss. It's a wonder the Superintendent didn't bury her deep within the Bedlam catacombs. The surgeons were able to cure the flesh, but they've done nothing to treat the inflammation of her brain. It's not sure what he expects me to accomplish with her. I suppose he thinks that in my twenty-three years within these troubled walls I've mastered a curriculum not taught in Oxford classrooms.
14 November 1864
Her one possession is a toy - a sooty, stuffed rabbit whose single button-eye dangles from a loose thread. Plaything from her time of innocence, and her only link to life before the fire, the rabbit is now sentinel to Alice's deepening dementia.
-The rabbit may prove valuable instrument for shock therapy. I should have noticed is sooner.. - 21/10/73
8 December 1864
When I hold a flame to her eye, nothing in her vacuous gaze betrays the faintest glimmer of response. I clap a pair of blocks at her ear. Nothing. Neither her sight nor her hearing appear to be damaged; still she registers nothing at all. The rumor (passed on by Reverend Mottle amongst others) alleges that she feels nothing - not pain, or fear or other torments - is neither credible nor kind. Still, she is far, far gone, this one.
9 December 1864
In many ways it's as if she is in the grave already; her countenance so still she appears to be in training for the coffin. Indeed, if she were to die today in this old hospital, nary a person would take note other than those few who recall her name from the papers. Those few who'd mutter to themselves "ah, that's a shame - the poor girl," and then turn the page to learn more of the recent stabbings in Notting Hill.
-So quiet she appeared. Was the deep madness already coursing itself through her mind? - 23/10/73
10 December 1864
Though she appears weak, she must have a strong constitution to survive until now. Her fever persists, her breathing heaves violently at times and, even after more than a year of healing, burns so massive commonly cause great discomfort. You'd never imagine she is in any distress, though, the way she's stretched, as lifeless as a British Museum mummy. I daresay, however, that I'll stir her from her dreamery, even if the response is involuntary. I'll begin tomorrow with a steady treatment of cold plasters and bloodletting. The blooding might cause some relief to her dementia. I also have a new shock apparatus that I'd like to try on her. I'm curious to see how she reacts to this treatment.
14 December 1864
The physicians who treated her burns reported that she barely noticed when they debrided and dressed her wounds. Indeed, she rarely showed any agitation at all when they examined her over the months. They also report, however, that on some nights, she howled like a banshee. When the nurses responded to the screams, Alice would hush, as if magically released from her demons. Eventually, they stopped responding to these outbursts. And, after a short while, she stopped uttering any noise whatsoever.
6 January 1865
Another patient died in the night. I'd been treating her with the same potion I intend for Alice. I had been quite certain she was improving with each subsequent vial, so this development is quite vexing. Perhaps the stronger mixture was too much for her chronically weak chest. A little more experimental is in order before I feed this serum to Alice.
-A little less Laudanum and a little more camphor might have spared her.
13/12/73
22 January 1865
The bleeding doesn't appear to be causing a significant change except for the increased pallor of her complexion. Contrasted against her drab rags, she's turned an uncanny shade of ivory. The bloodletting will prime her constitution for my restoration potion.
18 February 1865
Three
amputations in a week- that's a high number, for any hospital. I dream of
wiggling stumps and splintery crutches. I mumble a prayer of thanks to
Napoleon's surgeon- how terrible the screams must have been before he discovered
the technique for painless amputio amputation.
I can't seem to escape the chloroform's cloying odor.
23 February 1865
Through the windows of my laboratory, I can glimpse the garden ward. Nurse D is leading a group of children to the airing room. I listen to the great shuffling of feet on the pebble path. Will Alice, I wonder, ever stroll the grounds with the others? Will she ever regain her senses? Or, for the rest of her days will she remain cloistered behind these thick grey walls? Based on her progress so far, it seems futile to hold out much hope for a cure.
-Little could I have imagined her mind would eventually gambol in unimaginable forests and gardens.
21/1/74
24 February 1865
In the finest months of her treatment, a surgeon by the name of Grantham took particular interest in Alice's case. He viewed her early reluctance to rejoin society as quite normal considering what she'd been through. The all-consuming fire. The loss of one's entire family. The shattered and scorched body. It's quite normal for anyone, let alone a child, to give away under such strain.
Yet as the months passed, and as Grantham became more familiar with Alice, he began to comprehend that her problems were a manifestation of a far graver trauma. Bones eventually mended, as did the seared flesh: yet Alice remained locked away in her cocoon.
Unfortunate chap, This Grantham. Seems like he had a collapse of his own. One day he was going about his hospital routine, perambulating against the feeble and infirm. The next day, though no one knows why, he turned up every bit as diseased as one of his patients, speaking gibberish and smashing apothecary jars. I've seen it happen here where doctors pass over to the other side, and, frankly, I'm surprised it doesn't happen more often. At any rate, Grantham's tale concludes with a particularly grisly accident with a surgical implement.
23 March 1865
Nothing seems to aggravate the girl. I've tired restraint - handcuffs, leg-locks and straightjackets. I've tried solitary confinement. On the other hand, I've allowed her to smell freedom, leaving her for hours at a time unattended in the garden. Yet nothing stirs her. I still have a number of methods, some of which I haven't engaged in since the old days, but I'm beginning to doubt anything can bring about a change in this one.
1 April 1865
Each year on this peculiar day I pause - exactly at noon according to my pocket watch - to ponder the absurdity of such a day. Is it not ironic that we here should celebrate a holiday dedicated to fools?
The
girl has shut down completely. If it were possible, I'd say Alice has retreated
even father farther into what the European practitioners of
psychiatry call her "psyche." I'll keep trying different methods, but
unless there's some sort of marked improvement, there's no reson
reason to hope. I'll document progress...if indeed there ever is any progress.
7 September 1873
After years of slumber, she chooses to speak to us with a picture, a drawing of some sort of cat. Really, it's nothing like any cat I've ever seen.
|
Drawing of Cheshire Cat |
Even a drawing so bizarre as this couldn't foreshadow the imaginings to come. -29/3/74
9 September 1873
I admit to a certain amount of excitement over Alice's semi awakening. I have to be careful, though. At this point, it's difficult to tell what this development - what I'm pleased to call her "progress" - signifies.
10 September 1873
While Alice napped following her afternoon sedation, Nurse D- took it upon herself to replace the rabbit's missing eye. Even after living so many years in an infirm population, it can still surprise me when a seemingly trivial act so can trigger such a remarkable reaction.
Alice woke up from her nap and began to sob hysterically. "Tell me child, what's wrong?" pleaded Nurse D-. "What is it, dear?" In an instant of semi-awareness, Alice spoke a sort of poetry.
Into the hole again, we hurried along our way
Into a once glorious garden now seeped in dark decay
She continued to cry, and it was only when Nurse D- plucked the newly-stitched eye from the rabbit's face that Alice fell back into her customary state.
With such behavior, maybe it was a mistake to stir these waters and awaken her. -29/3/74
I compare her response - and my reaction to it - to the person who daily tosses a pebble into a pool of still water. Day after day, the pebble plunges to the murky bottom, causing a few nearly imperceptible ripples. One day, however, the pebble miraculously strikes a fish. What are the odds other than incredible to ponder? And what are the effects - compared to the ripples. Nurse D-, to follow the analogy, struck a fish in the pond today.
I don't know whether to cheer at this response - any response - or grow alarmed over the intensity of her emotional outbursts. At least we discovered one thing: she can speak.
11 September 1873
When she is so inclined, Alice can draw. This memory I was greeted by another of Alice's artistic phantasmagorias. What is it she's rendering? I can only think it's a depiction of her nightmare of Hell.
|
Drawing of landscape |
12 September 1873
Two demented youths hung themselves side by side in the ward last night. As a result, I couldn't devote any time to Alice or any other patients. There was some dissention from the townsfolk about not wanting these suicides to be buried within city limits. After some discussion, they relented. It was agreed to bury the boys separately in a clandestine fashion. One will be buried far behind Ramsbottom church, the other in Ribchester.