As I slumped up the long path to Hoadley Manor, feeling unequal to the task that lay before me, rain thrummed off my umbrella and bolts of lightning electrified the late afternoon sky. What would this uncle I'd never met be like? And how would I, a fresh new medical school graduate, stand up to this position as assistant director of an insane asylum?
Hoadley, a turreted Victorian mansion of crumbling brick, was hardly a welcoming sight. Its physical plant was obviously in ill repair, and strange cries of human agony escaped from its dark walls like wailing from a human zoo.
Eventually I reached the porch and lowering my umbrella, stomped my feet to knock the water off my rubbers and macintosh. As I did so, an ugly smell, perhaps feces, perhaps vomit, or perhaps some unappetizing combination of both of those plus institutional food and stale air, tormented my nostrils.
Well, there was no turning back. Dr. Angus Cruikshank, my distant uncle, had been so kind as to give me my first position out of medical school, and I was in no financial condition to be choosy. With a heavy load of tuition debt and the driving determination that I would eventually start a practice in London, there was nothing for it, but to grit my teeth and learn to love Hoadley Manor.
As soon as I pounded on the door, a feeble woman, whom I assumed was the housekeeper, limped to the door and admitted me.
"Dr. Cruikshank will be right with you," she said angrily as a peculiar crouching fellow with no trousers on stared at me from the top of the stairs as though I were a creature from another planet.
I stood dripping in the fetid hallway for a minute or two, and then Dr. Cruikshank emerged from down a dark corridor. Even at first glance, he was a prepossessing fellow. A head taller than I, with shaggy, iron-gray eyebrows, gigantic feet, and huge hands with knuckles like walnuts, he was obviously no one to be fooled with. But it was only as he drew closer that I realized he had but one eye; the missing eye was a pink crater with a knot sewn into it where the eyeball had once lodged.
"Jimmy, get back to your room, and get your pants on!" Dr. Cruikshank commanded as he glanced upwards and saw his patient beginning to play with himself.
Without a word of protest, Jimmy turned and scampered back away from the head of the stairs as Dr. Cruikshank extended his mighty hand towards me.
"So you're Thomas Brown, my nephew. Just call me uncle," Dr. Cruikshank said, without the hint of a smile as he pumped my hand in a grasp that was at both powerful and intimidating.
"My pleasure to meet you, sir."
"I think you'll find Hoadley Manor a quite interesting place to begin your medical career," my uncle said, staring disapprovingly with his one eye at my sopping clothing.
"Oh, I'm sorry about the water on the carpeting," I stammered. "It rained all the way from the train station, and I couldn't find a carriage."
"No matter, Brown. Now let me show you around the premises, for you'll soon be in charge here yourself on days I'm away in London; and the sooner you come to know the lay of the land the better."
"Excellent."
At that my new uncle led me down the hallway from whence he had emerged. We had not gone far when we encountered an obese woman, with sparse gray hair, sprawling in a corner, jabbing at her belly with a sharpened pencil. She had succeeded in opening wounds and her filthy dress was stained with blood.
"Here, Nellie, where did you get that pencil?" Dr. Cruikshank bellowed. "Take it from her at once, Brown."
My uncle's command had amazing authority, and I found myself pleading with the woman to hand me the pencil, which she steadfastly insisted in jabbing into her abdomen.
"Not like that, Brown. Take it! These crazy people must be protected from themselves." With that Dr. Cruikshank seized the pencil from Nellie's hand, giving her the back of his own fist to the jaw almost all in one motion. In response the demented woman began to cackle as though the most hilarious event in the world had just occurred.
I was staggered. I really didn't know what to expect at Hoadley. My medical training had only involved one brief course on psychological pathology, the mysterious split personality, the intractable and incurable manias and obsessions, the ravages of minds damaged by syphilis, but again and again the bottom line had been-no known treatment available, institutionalization the only answer.
"Is she always like that, sir?" I asked as we moved away from Nellie, and a titanic boom of thunder rattled the window panes.
"Always and eternally unless she can steal a sharper object and seriously damage herself."
We had just reached the end of the hallway and were opening the door to a locked ward when suddenly a bald-headed fellow sprang out from a dark corner and tried to strangle my uncle. I was so taken aback I could hardly react, but it was no matter. Dr. Cruikshank threw off his attacker as easily as a man throttles a child.
"You cruel son of a bitch I'll kill you some day," the attacker, whom I could now see was tattooed from head to fingertip, bellowed as my uncle held him to the floor with one huge, dark foot on the attacker's neck.
"Barnicus, if you don't improve your behavior we're going to lock you up again," my uncle said in a firm voice that left no doubt about his veracity.
"That's all right I'll kill you from a locked ward," Barnicus screeched as my uncle released a foot from the attacker's neck, and we plodded on.
"Paranoid schizophrenic," Uncle Cruikshank murmured as we moved past Barnicus. "He killed his wife and children before being committed here."
"I see," I said, realizing for the first time that I had begun to sweat even though the mansion was chilly and dank.
The rest of the tour was uneventful if a constant panorama of what amounted to a human freak show could be called uneventful. There was a naked man eating his own feces, a boy of sixteen who sat in a corner beating his own head against the wall, a toothless woman who sat rocking herself while emitting a horrible keening moan that suggested she was in terrible grief.
In short, the tour was a vista of human wreckage that I had had little idea existed. However, as we reached the end of the tour, my uncle unlocked a room near the front of the manor.
To my surprise, a delicate, flaxen-headed girl of perhaps one and twenty sat quietly in a rocking chair, doing needle point. She looked up in obvious fear as we entered her room without warning.
"And how are you today, Elena?" my uncle said.
"The days are all alike. Life creeps in this petty pace from day to day to the last syllable of recorded time. And who is it kills the mocking birds?"
Having started to become accustomed to the strange, far away stare in the eyes of the other inmates, there was something troubling in the keen, intelligent eyes of this young lady.
"I see you've been doing needlepoint," my uncle said. "What's that design?"
"We design our lives but with little effect," Elena said, staring out the window.
"I want you to meet Dr. Brown. He'll be assisting me as director of the hospital." My uncle towered over the girl.
"There are those who direct and those who are directed," Elena said, extending her hand shyly towards me as she stared out the window. "The strange thing that elicits pity is that those who are directed are often the most sane."
A smile curled around my uncle's thick lips. "From the mouth of babes," he murmured.
"And who stole my baby and crushed its pretty skull?" Elena said, her face clouding with sudden fury.
Dr. Cruikshank winked at me. "You didn't have a baby, Elena."
Suddenly, the pretty thing rushed at my uncle who seized her forearms before she could gouge at his face. "I'll take that other eye of yours, liar," she cried.
"Now sit down, Elena," my uncle commanded, throwing the girl back into her chair where she immediately seized her needle point and began furiously knitting as though we were not there.
When we were outside in the hall, my uncle began to explain. "Elena has been with us for two years now. Her father is a nobleman from the north country. He had the child committed after she ran off to Birmingham and began to sell herself as a prostitute. Drugs are suspected, but she has obviously lost contact with reality."
"Yes," I murmured, trying to understand how such a physically perfect specimen could have gone so far over the brink. My heart reached out to Elena.
"And that concludes the tour," Dr. Cruikshank announced. "You'll need to unpack your things no doubt. Then this evening you can sit in on therapy sessions and begin to learn techniques."
With that he snapped his fingers and the feeble housekeeper emerged from the shadows.
"Lucy, will show you to your room. And, Brown, one important thing. Be sure to keep the safety bolt on your room latched at all times."
I swallowed hard. My uncle's words hinted at something I hadn't considered when I agreed to accept the job, Hoadley Manor might be dangerous.
"And why is it I must keep my door locked?" I asked.
"Because these patients are beyond total control, my friend. One never knows what diabolical scheme one of them might come up with."
My room was a barren eight by ten chamber with a huge dead bolt lock, a steamer trunk, and what appeared to be an army cot for a bed. After a dismal meal shared with patients in a foul-smelling communal dining hall, I read in my monastic cell for a time and eventually fell into an uneasy sleep.
I awakened with a start a short time later, for though the driving rain had abated, something was beating at the heavy, metal mesh of my window. Heart in mouth, I staggered to the window, but could see nothing in the black gloom. Then at length, the beating began again, and I saw what was tormenting me. A deathly black crow was pecking at the glass as though it were determined to smash its way into my cell.
"Go away," I cried, waving my arms at the intruder, but the bird continued its strange behavior until I gave up resisting at last and fell into an uneasy slumber.
Several hours later I was awakened from a nightmare, in which I was being strangled, by insistent knocking at my door. Barefoot, I staggered across the cold stone floor and called out, "Who's there?"
"It's your uncle," a guttural voice replied. "Wake up, Brown, it's time for therapy sessions."
I looked around in confusion. What in God's name was my uncle talking about? It had to be approximately three in the morning. What kind of therapy sessions took place in the dead of night? However, I didn't want to jeopardize my new position with any untoward questions.
"I'll be there in a moment, sir."
As soon as I was dressed, I followed my uncle, who was now wearing a broad-brimmed black hat and a dark suit, down the dimly-lit passage way.
"Therapy sessions are in the basement," he intoned in a sepulchral voice.
The basement? I hadn't till then realized there was a cellar beneath the manor. However, we now passed through a number of heavily locked doors and soon descended via a narrow, twisting passageway of steps into a greenish series of chilly tunnels that sent shivers of apprehension down my spine.
"This is where we keep our hard cases," Doctor Cruikshank said as I gazed at hordes of human wreckage lying in foul tangles of human waste that made me gag.
"These are the ones beyond hope." He gestured to our right and left at emaciated, naked bodies that seemed to have lost all semblance of humanity. The stench was overpowering as my uncle took out his keys and unlocked a padded door that admitted us to a dimly-lit cell ten times the size of my room.
He, then, walked directly to a series of what can only be described as Medieval instruments of torture that were affixed to the far wall.
"You know what these are for, of course?" he said.
I shook my head.
"Instruments of therapy and behavior modification," he said knowingly. Before I could protest, he pushed a button.
A moment later two husky attendants wrestled a pathetic-looking naked young creature into the room.
"Ah, it's you, Sedley," my uncle murmured. "You've had a number of demerits this week, including eating your own feces. Bend over, my friend, and take your punishment."
With that Doctor Cruikshank took a fierce looking whip from the wall and administered a series of blows to Sedley's back.
As I watched in horror, my uncle stopped at the fourth stroke and said to me, "That's four, Brown. He's to get six more. It's your turn. My arm has grown tired."
"Nay, Uncle, I can not do that." I held my hands up to block passage of the whip.
"Can not do that? What kind of a physician are you? What are they teaching at medical school these days?" It was obvious that my uncle's tone brooked no disagreement. I didn't know what to do. The job was important to me, and had been offered to me as a favor. Now how was I, despite my moral scruples, to resist what I'd been told to do by a senior physician?
I wavered for an instant, and then I took the whip and struck.
"And that's all the harder you wish to strike?" my uncle said. "With blows like that, this place will be a seething volcano of rebellion within a week."
Stung by my uncle's criticism, I struck harder, eliciting cries of agony from the hapless creature whose back had begun to seep blood. Three blows later I lowered the whip.
"Good, Brown. You'll make a fine physician one of these days. Now let's see the next of our therapy cases."
And so went that nightmare that introduced me to the routine "therapy" procedures of Hoadley Manor. My next unpleasant surprise arrived as I lay in a feverish sleep, wrestling with my conscience over the pain I'd inflicted, when a feeble knock awakened me.
"Who's there?" I cried, uneasily.
"Elena Maupin, a patient," came the timid response.
Striding to the heavy door, I unbolted it, and peered into the darkened hall. By the pale light of a flickering candle, I recognized the attractive flaxen-haired woman my uncle and I had visited that afternoon. Her delicate features were finely-chiseled, and her tiny hands fluttered like frightened birds.
"Won't you come in?" I said.
"Thank you." Elena tiptoed into my tiny room and looked about in fear. I gestured for her to sit, but she remained standing. Finally she squared her shoulders and said, "I've come to warn you."
"To warn me?"
Her manner of speech, so fragmented and strange that morning, had changed completely. "Yes, about your uncle. He is a sadistic madman, a confederate of my father who has committed me here with a tissue of lies."
I listened carefully as I was fully aware of the devious workings of the paranoid mind. Was I to believe what she said? Could I believe a word this child uttered?
"But you were obviously incoherent this morning when we visited you?"
"A ruse," Elena replied. "My father intended to use me as a prostitute to enhance his dwindling fortune. My only way out was to pretend insanity."
Something about the girl's intense stare made me certain she was telling the truth.
"And you've chosen a life in this madhouse in preference to your father's evil domination?"
"Yes, he's a vicious man."
"But you make the same charge against Doctor Cruikshank?"
"Yes, he and my father are the best of friends, a loathsome pair of co-conspirators."
I took the poor child's hand, for she was trembling like a feeble branch in the wind.
"And you say Doctor Cruikshank is a sadist?" Remembering the spectacle in the "therapy" chamber, I was now willing to give credence to the girl's charges.
"Yes, you must leave here at once, or he will ensnare you in his web of evil."
The words were barely out of Elena's mouth when lights came on in the hall, and the gaunt figure of my uncle filled the doorway.
"Doctor Brown," he cried, "what sort of violation of medical ethics do we have here? Certainly you're aware that staff is not permitted to entertain patients in their private quarters."
I hesitated. Was I to believe the charges that Elena had lodged against my uncle and thereby jeopardize the progress of my medical career? Or was I to assume the girl was a devious paranoid bent on assassinating the character of my uncle? I was unsure how to respond.
"The girl knocked on my door, sir," I said. "Apparently she had gotten lost in a nocturnal ramble."
"Is that so?" My uncle raised his shaggy eyebrows.
"What is and what is not sometimes tangle into terrible knots. One swallows reality, but little knows the truth that lies beneath." Elena's words were as strange once more as they had been that afternoon.
"I think this patient is in need of immediate therapy, Brown. Get dressed, and I'll meet you in the therapy room shortly."
With that my uncle seized Elena by the wrist and dragged her down the hall as she screamed in terror.
Heart thrumming in my throat, I threw on my clothes. What in God's name was Cruikshank about to do to the poor thing? And would I go along with this charade of therapy? And what a lowly thing I would be if I did to further my career.
Minutes later, I stood in the brightly lit therapy room. Two hulking attendants whom I hadn't seen before had strapped Elena to an operating table. A washrag, apparently saturated with ether, had been placed over her nostrils.
Meanwhile my uncle, wearing a mask and a green surgical cap, was rolling up his sleeves as he examined a plate of fearsome looking surgical instruments.
"What are you going to do?" I cried.
"I'm going to do nothing, nephew."
"I don't understand."
"It's quite simple, my boy. It's you who are going to do the procedure."
"The procedure?"
"Yes, trepanning. It's a fine old technique for relieving pressure on the brain. One simply drills into the skull, allowing the brain to expand and thereby relax."
I swallowed hard. "My god, Doctor, trepanning for the mentally ill has been discredited for three hundred years."
"Discredited by quacks and those who are shielded from the realities of mental illness." My uncle stared at me fiercely. For a wavering moment I felt he must be right, his manner was so convincing.
"Now, Doctor Brown, if you'll take this brace and bit and begin to drill into the patient's left temple, I shall instruct you into the intricacies of this forgotten art."
I stared at the sharpened drill bit, suitable for boring holes into solid wood, and then my eyes shifted to Elena, breathing tranquilly on the table. The blood would ooze from the jagged hole in her temple as the bit dug deeper.
And then I understood it all. My uncle's scheme was to involve me so deeply in his nefarious and twisted sadistic schemes that I would not dare to go to the authorities and incriminate him. I would be his slave. In the meantime he wanted Elena, whom he suspected of merely playing insane, either dead or incapacitated mentally.
Still wavering and non-confrontational, for it was not my style to fight, I handed my uncle the drill. "I can't do this," I said.
"I see. You're throwing away your medical career because of a weak stomach. That's fine. In that case I will trepann the girl myself."
With that he lurched towards Elena. Suddenly the veil of timidity lifted from my eyes. A man who refuses to fight for the right is less than a man.
"No!" I sprang towards my uncle and shoved him towards his hulking attendants.
The three of them swarmed towards me at once. There was nothing for it, but the plate of scalpels that lay close at hand. I grabbed the nearest and swung. My appetite for blood is far less than the average man's of that I'm certain, but somehow I realized this was a fight to the death.
Though I'm a small man, I was both young and agile. Using my legs as weapons and slashing with the razor-like blades like a madman myself, I lay open every wrist and hand that came at me.
Soon enough the attendants had had enough of me and fled, leaving my uncle and I to battle it out. Medical school, my career, the ties of family meant nothing now. As adrenaline filled my body with incredible energy, I flailed wildly.
What I had not counted on was the incredible strength of my uncle. He was a man six feet four inches tall. Though I slashed his face and arms to ribbons, he kept coming at me until finally he, too, seized a scalpel and laid open my face from neck to ear.
Such pain was not a thing I'd reckoned with before. I blanched and hesitated, giving my uncle just enough of an opening that he crashed me backwards into a wall of medical cabinets that tumbled onto us with a shower of glass.
With a convulsive thrust of his powerful body, he pinned me to the floor, his powerful hands at my throat, determined to strangle me there and then. I could feel my eyes bulging with the pressure of his gigantic hands. I could smell the rank odor of his pipe-tobacco breath close in my face.
And then there was a wild cry. Whether it was from his lips or from behind him I can not say, but Elena had come off the operating table and seized a scalpel herself.
Though my uncle tried to dodge, it was too late. Elena's tiny hands, wielding the terrible blade, laid open his throat from ear to ear. The mighty pulsing of the jugular sent a shower of scarlet onto my face as with a terrible groan, my uncle reeled sideways and collapsed full-length onto my body.
When it was done, Elena stood frozen in amazement at what she'd done, a tiny waif holding the bloody, incriminating scalpel in her hands as I wrestled myself free of my uncle's weight, knowing that yes Elena and I breathed, but our futures lay muddled before us. For we were now but dark, twisted souls, the shadow of the guillotine looming heavily over our lives.
