in the account of the case which follows it is better that i allow the patient to speak for herself.

i am a neurotic woman. in that capacity i have been the subject of much criticism and much counsel. i have been both talked to and talked at. on the other hand i have detailed my unhappy symptoms to many in the hope of securing consolation, but with indefinite success. i am afraid i have often been a bore; for a bore, i am told, is a person who will talk of herself when you want to talk of yourself.

my husband says that there is nothing the matter with me, that my ailments are all imaginary and unreasonable. he becomes very cross when i talk of my wretched state and considers my ill-health as a grievance personal to himself. he says—when he is very irritated—that he is sick of my moanings, that i look well, eat well, sleep well, and so must be as sound as a woman can be. if i have a headache and cannot go out he70 is more annoyed than if he had the headache himself, which seems to me irrational. he is often very sarcastic about my symptoms, and this makes me worse. once or twice he has been sympathetic and i have felt better, but he says that sympathy will do me harm and cause me to give way more. i suppose he knows because he is always so certain. he says all i have to do is to cheer up, to rouse myself, to pull myself together. he slaps himself on the chest and, in a voice that makes my head crack, says, “look at me! i am not nervous, why should you be?” i don’t know why i am nervous and so i never try to answer the question. from the way my husband talks i feel that he must regard me as an impostor. if we have a few friends to dinner he is sure to say something about “the deplorable flabbiness of the minds of some women.” i know he is addressing himself to me and so do the others, but i can only smile and feel uncomfortable.

i have no wish to be nervous. it is miserable enough, heaven knows. i would give worlds to be free of all my miseries and be quite sound again. if i wished to adopt a complaint i should choose one less hideously distressing than “nerves.” i have often thought i would sooner be blind than nervous, and that then my husband71 would be really sorry for me; but i should be terribly frightened to be always in the dark.

i get a good deal of comfort from many of my women friends. they at least are sympathetic; they believe in me, know that my complaints are real and that what i say is true. unfortunately, when i have described certain of my symptoms—such as one of my gasping attacks—they say that they have just such attacks themselves, only worse. they are so sorry for me; but then they will go on and tell me the exact circumstances under which they have had their last bouts. i am anxious to tell them of my other curious symptoms, but they say that it does them so much good to pour out their hearts to someone, and i, being very meek, let them go on, only wishing that they would listen to me as i listen to them.

i notice that their husbands have for the most part just the same erroneous views about nerves that mine has. some of them say that they would like to make their menfolk suffer as they do themselves. one lady i know always ends with the reflection: “ah, well! i shall not be long here, and when i am dead and under the daisies he will be sorry he was not more appreciative. he will then know, when it is too late, that my symptoms were genuine enough.” i must say that i have72 never gone to the extreme of wishing to die for the mere sake of convincing my husband of obstinate stupidity. i should like to go into a death-like trance and frighten him, for then i should be able to hear what he said when he thought i was gone and remind him of it afterwards whenever he became cynical.

it is in the morning that i feel so bad. i am really ghastly then. i wake up with the awful presentiment that something dreadful is going to happen. i don’t know what it is, yet i feel i could sink through the bed. i imagine the waking moments of the poor wretch who has been condemned to death and who is said to have “slept well” on the night before his execution. he will probably awake slowly and will feel at first hazily happy and content, will yawn and smile, until there creeps up the horrible recollection of the judge and the sentence, of the gallows and the hanging by the neck. i know the cold sweat that breaks over the whole body and the sickly clutching about the heart that attend such an awakening, but doubt if any emerging from sleep can be really worse than many i have experienced.

i can do so little in the day-time. i soon get exhausted and so utterly done up that i can only lie still in a dark room. when i am like that the73 least noise worries me and even tortures me almost out of my mind. if someone starts strumming the piano, or if a servant persistently walks about with creaky boots, or if my husband bursts in and tries to be hearty, i feel compelled to scream, it is so unbearable.

it is on such an occasion as this that my husband is apt to beg me “to pull myself together.” he quite maddens me when he says this. i feel as full of terror, awfulness and distress as a drowning man, and how silly it would be to lean over a harbour wall and tell a drowning man in comfortable tones that he should “pull himself together.” yet that is what my husband says to me, with the irritating conviction that he is being intelligent and practical.

i cannot walk out alone. if i attempt it i am soon panic-stricken. i become hot all over, very faint, and so giddy that i reel and have to keep to the railings of the houses. i am seized with the hideous feeling that i can neither get on nor get back. i am not disturbed by the mere possibility of falling down on the pavement, but by the paralysing nightmare that i cannot take another step.

if anyone were to put me down in the middle of a great square, like the pra?o de dom pedro74 at lisbon, and leave me there alone, i think i should die or lose my reason. i know i should be unable to get out. i should fall in a heap, shut my eyes and try to crawl to the edge on my hands and knees, filled all the time with a panting terror. a man who finds himself compelled to cross a glassy ice slope which, twenty feet below, drops over a precipice, could not feel worse than i do if left adrift, nor pray more fervently to be clear of the abhorred space and safe. my husband says that this is all nonsense. i suppose it is, but it is such nonsense as would be sense if the jester were death.

the knowledge that i have to go to a dinner party fills me with unutterable alarm. by the time i am dressed and ready to start i am chilled, shaking all over and gasping for breath. the drive to the house is almost as full of horror as the drive of the tumbril to the guillotine. by the time i arrive i am so ill i can hardly speak and am convinced that i shall fall down, or be sick, or shall have to cry out. more than once i have insisted upon being driven home again, and my husband has gone to the dinner alone after much outpouring of language.

possibly my most direful experiments have been at the theatre, to which i have been taken on75 the ground that my mind needed change and that a cheerful play would “take me out of myself.” my worst terrors have come upon me when i have chanced to sit in the centre of the stalls with people packed in all around me. i have then felt as if i was imprisoned and have been filled by one intense overwhelming desire—the passion to get out. i have passed through all the horrors of suffocation, have felt that i must stand up, must lift up my arms and gasp. i have looked at the door only to feel that escape was as impossible as it would be to an entrapped miner about whom the walls of a shaft had fallen.

it is useless for my husband to nudge me and tell me not to make a fool of myself. if i did want to make a fool of myself i should select some more agreeable way of doing it. it is useless, moreover, to argue. no argument can dispel the ever-present sense of panic, of being buried alive, or relieve the hopeless feeling of inability to escape. i have sat out a play undergoing tortures beyond expression, until i have become collapsed and until my lip had been almost bitten through in the effort not to scream. no one would believe that i—a healthy-looking woman in a new paris dress, sitting among a company of smiling folk—could be enduring as much agony as if i were76 lodged in an iron cell the walls of which were gradually closing in around me.

i am very fond of my clothes when i am well, but there are certain frocks i have come to loathe because they recall times when i have nearly gasped out my life in them.

i have taken much medicine but with no apparent good. i envy the woman who believes in her nerve tonic, since such faith must be a great comfort to her. i knew a poor girl who became for a time a mental wreck, owing to her engagement having been broken off. she refused food and lived for a week—so she told me—on her mother’s nerve tonic. she declared that it saved her reason. i tried it, but it only brought me out in spots. i have seen a good many doctors, but although they are all very kind, they seem to be dense and to have but the one idea of treating the neurotic woman as they would treat a frightened child or a lost dog.

i was taken to one doctor because he had the reputation of being very sensible and outspoken. my husband said there was no nonsense about him. he certainly made no effort to be entertaining. after he had examined me he said that all my organs were perfectly sound. he then began to address me as “my dear lady,” and at once i77 knew what was coming. it was to tell me that i wanted rousing and that all i had to do was to get out of myself. he said i was not to think about myself at all, which is very good advice to a person who feels on the point of dissolution. he told my husband afterwards, in strict confidence, that if i was a poor woman and had to work for my living i should be well directly. he went farther and said that what would cure me would be a week at the washing tub—at a laundry, i suppose. my husband imparted these confidences to me as we drove home from the doctor’s and said what a shrewd, common-sense man he was. my husband quite liked him.

another doctor i went to was very sympathetic. he patted my hand and was so kind that he almost made me cry. he said he understood how real and intense my sufferings were. he knew i must have gone through tortures. he gave me a great many particulars as to how i was to live and said i was never to do anything i did not like. i wanted to come and see him again, but he insisted that i must go abroad at once to break with my sad associations and afford my shattered nerves a complete rest. he gave me a letter to a doctor abroad which he said contained a very full and particular account of my case.

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something happened to prevent me from leaving england, but six months later i came across the letter and, feeling it was no longer of use, opened it. it began, “my dear harry,” and contained a great deal about their respective handicaps at golf and their plans for the summer. the kind doctor ended in this wise in a postscript: “the lady who brings this is mrs. ——. she is a terrible woman, a deplorable neurotic. i need say no more about her, but i hope you won’t mind my burdening you with her, for she is the kind of tedious person who bores me to death. however she pays her fees.” my husband sent the letter back to the doctor who wrote it, because he thought the memoranda about the golf handicaps would be interesting for him to keep.

as i made no progress and as my friends were getting as tired of me as i was of myself, it was resolved that i should be taken “seriously in hand.” i was therefore sent to a nursing home to undergo the rest cure. i had to lie in bed, be stuffed with food and be massaged daily. i was cut off from all communion with the familiar world and was allowed to receive neither letters nor newspapers.

the idea underlying this measure is, i think, a little silly. it is in the main an attempt to cure79 a patient by enforced boredom. the inducement offered is crudely this: “you can go home as soon as you think fit to be well.” i did not mind the quiet nor the lying in bed. the excessive feeding merely made me uncomfortable. the massage was a form of torture that i viewed with great loathing. the absence of news from home kept me in a state of unrest and apprehension. it was the continued speculation as to what was going on in my household which prevented me from sleeping at night.

the withdrawal of all newspapers was evidently a punishment devised by a man. it was no punishment to me nor would it be to the average woman. the nurse, of course, kept me informed of current events as she was extremely fond of talking and thereby rendered a newspaper unnecessary. she told me of the occasions when my husband called to inquire and always said that he looked very well and remarkably cheerful. she walked past my house once and came back with the information that the drawing-room blinds were up and that the sun was streaming into the room. this worried me a great deal as i don’t like faded carpets and silks and am very fond of my furniture.

after i had been in the home a few days i discovered that the institution was not wholly80 devoted to rest-cure cases, but that it was also a surgical home where many operations were performed. this frightened me terribly because i began to wonder whether an operation had been an item of the programme when i was taken seriously in hand. i arrived at the conclusion that i was being “prepared for operation,” that i was being “built up,” with the result that i was prostrated by alarm. i felt that at any moment a man with a black bag might enter the room and proceed to chloroform me. there came upon me a conviction that i was being imprisoned, that i had been duped and trapped. above all was the awful feeling, which nearly suffocated me, that i was powerless to escape. i thought my husband had been most base to desert me like this and hand me over, as it were, to unknown executioners.

i have a dread of operations which is beyond expression. the mere thinking of the process of being chloroformed makes me sick and faint. you are held down on a table, i believe, and then deliberately suffocated. it must be as if a man knelt upon your chest and strangled you by gripping your throat with his hands. when i was a small girl i saw a cook dispose of a live mouse by sinking the mouse-trap in which it was imprisoned in a bucket of water. i remember that81 the struggles of the mouse, as seen under water, were horrible to witness. when i grew up and was told about people being chloroformed for operation i always imagined that their feelings would be as hideous as those of the drowning mouse in a trap.

i told all my suspicions and alarms to the nurse, who laughed at me contemptuously. she said: “you are merely a nerve case.” (“merely,” thought i.) “no surgeon ever thinks of operating on a nerve case. the greater number of the patients here come for very serious operations. they are real patients.” as she conversed further i must confess that my pride began to be touched. i had supposed that my case was the most important and most interesting in the establishment. i had the largest room in the house while the fussing over me had been considerable. i now began to learn that there were others who were in worse plight than myself. i, on the one hand, had merely to lie in bed and sleep. they, on the other, came to the home with their lives in their hands to confront an appalling ordeal. i was haunted by indefinite alarms; they had to submit to the tangible steel of the surgeon’s knife. i began to be a little ashamed of myself and of the trouble i had occasioned. compared with me82 these women were heroines. they had something to fuss about, for they had to walk alone into the valley of the shadow of death. i had many times said that i wished i was dead, but a little reflection on the modes of dying made me keep that wish ever after unexpressed.

my nurse deplored that she was not a surgical nurse. “to nurse an operation case is real nursing,” she said. “there is something satisfactory in work like that. i am only a mental nurse, you see”—a confession which humbled me still further.

it was in september that i entered the home, and as the leading surgeons were still out of london there were no operations. when october came the gruesome work was resumed. the house was set vibrating with excitement. in this i shared as soon as i discovered that the operating theatre was immediately over my bedroom. almost the first operation happened to be a particularly momentous one, concerned with which was none other than the great surgeon of the day. his coming was anticipated with a buzz of interest by the nurses, an interest which was even shared by the mental nurse in whose charge i was.

i could learn very little about this great case83 save that it was desperate and the victim a woman. i know that she entered the home the night before, for my nurse planned to meet her on her way to her room. i know also that just before the hour of closing the house i heard sobbing on the staircase as two people slowly made their way down. i came to know afterwards that one was the husband, the other the daughter.

the operation was to be at nine in the morning. by 6 a.m. the whole house was astir. there was much running up and down stairs. everybody was occupied. my morning toilet and breakfast were hurried through with little ceremony. the nurse was excited, absent-minded and disinclined to answer questions. after my breakfast was cleared away she vanished—it was supposed that i was never to be left alone—and did not appear again until noon. when she did come back she found me an altered woman.

i lay in bed in the solitary room with my eyes fixed upon the white ceiling over my head. i was terrified beyond all reason. there was everywhere the sense of an overstrung activity, hushed and ominous, which was leading on to tragedy. i knew that in the room above me was about to be enacted a drama in which one of the actors was death.

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there was considerable bustle in the room in question. they were moving something very heavy into the middle of the floor. it was, i am sure, the operation table. other tables were dragged about and adjusted with precision. above the ceaseless patter of feet i could hear the pouring of water into basins.

i knew when the surgeon and his assistants arrived, for i heard his voice on the stair. it was clear and unconcerned, the one strong and confident thing among all these portentous preparations. heavy bags were carried up from the hall to be deposited on the floor above. i could hear the surgeon’s firm foot overhead and noticed a further moving of tables. there came now a clatter of steel in metal dishes which made me shiver.

i looked at the clock on my table. it was three minutes to nine.

what of the poor soul who was waiting? she also would be looking at the clock. three minutes more and she would be led in her nightdress into this chamber of horrors. the very idea paralysed one. if i were in her place i should scream until i roused the street. i should struggle with every fibre of my body. i should cling to the door until my arms were pulled out of their sockets.85 a barrel-organ in the road was playing a trivial waltz, a boy was going by whistling, the world was cheerfully indifferent, while the loneliness of the stricken woman was horrible beyond words.

as the church clock struck nine i knew that the patient was entering the room. i fancied i could hear the shuffle of her slippers and the closing of the door—the last hope of escape—behind her. a chair was moved into position. she was stepping on to the table.

then came an absolute silence. i knew they were chloroforming her. i fancied that the vapour of that sickly drug was oozing through the ceiling into my room. i was suffocated. i gasped until i thought my chest would burst. the silence was awful. i dared not scream. i would have rung my bell but the thought of the noise it would make held me back.

i lay glaring at the ceiling, my forehead covered with drops of cold sweat. i wrung my fingers together lest all sensation should go out of them.

in a while there came three awful moans from the room above and then once more the moving, of feet was to be heard, whereby i felt that the operation had begun. i could picture the knife, the great cut, the cold callousness of it all. for86 what seemed to me to be interminable hours i gazed at the ceiling. how long was this murdering to go on! how could the poor moaning soul be tortured all this while and endure another minute!

suddenly there was a great commotion in the room above. the table was dragged round rapidly. there were footsteps everywhere. was the operation over? no. something had gone wrong. a man dashed downstairs calling for a cab. in a moment i could hear the wheels tear along the street and then return. he had gone to fetch something and rushed upstairs with it.

this made me wonder for a moment what had happened to the husband and daughter who were waiting in a room off the hall. had they died of the suspense? why did they not burst into the room and drag her away while there was yet time? the lower part of the house was practically empty and i was conscious that two or three times the trembling couple had crept up the stairs to the level of my room to listen. i could hear the daughter say, “what shall we do! what shall we do!” and then the two would stumble down the stairs again to the empty room.

i still glared at the ceiling like one in a trance. i had forgotten about myself, although there was87 such a sinking at my heart that i could only breathe in gasps. the loathsome bustle in the room above continued.

now, as i gazed upwards, i noticed to my expressionless horror a small round patch of red appear on the white ceiling. i knew it was blood. the spot was as large as a five-shilling piece. it grew until it had become the size of a plate.

it burnt into my vision as if it had been a red-hot disk. it became a deeper crimson until at last one awful drop fell upon the white coverlet of my bed. it came down with the weight of lead. the impact went through me like an electric shock. i could hardly breathe. i was bathed with perspiration and was as wet and as cold as if i had been dragged out of a winter’s river.

another drop fell with a thud like a stone. i would have hidden my head under the bedclothes but i dared not stir. as each drop fell on the bed the interval came quicker until there was a scarlet patch on the white quilt that grew and grew and grew. i felt that the evil stain would come through the coverings, hot and wet, to my clenched hands which were just beneath, but i was unable to move them. my sight was now almost gone. there was nothing but a red haze filling the room,88 a beating sound in my ears and the drop recurring like the ticking of some awful clock.

i must have become unconscious for i cannot remember the nurse entering the room. when i realized once more where i was i found that the bedclothes had been changed. there was still the round red mark on the ceiling but it was now dry.

as soon as i could speak i asked, “is she dead?” the nurse answered “no.” “will she live?” “yes, i hope she will, but it has been a fearful business. the operation lasted two and a quarter hours, and when the great blood vessel gave way they thought it was all over.” “was she frightened?” i asked. “no; she walked into the room, erect and smiling, and said in a jesting voice, ‘i hope i have not kept you waiting, gentlemen, as i know you cannot begin without me.’”

in a week i returned home cured. my “nerves” were gone. it was absurd to say that i could not walk in the street when that brave woman had walked, smiling, into that place of gags and steel. when i thought of the trouble i had made about going to the play i recalled what had passed in that upper room. i began to think less of my “case” when i thought of hers.

the doctor was extremely pleased with my89 recovery; while his belief in the efficacy of the rest cure became unbounded. i did not trouble to tell him that i owed my recovery not to his tiresome physic and ridiculous massage but to that red patch on the ceiling.

the lady of the upper room got well. through the instrumentality of the nurse i was able to catch sight of her when she was taking her first walk abroad after the operation. i expected to see a goddess. i saw only a plain little woman with gentle eyes and a very white face. i knew that those eyes had peered into eternity.

some years have now passed by, but still whenever i falter the recollection of that face makes me strong.