Goldblatt’s Descent

‘DR GOLDBLATT,’ THE PROF said, taking a deep breath, ‘let’s start again.’

Andrea Small gathered her thoughts. She hadn’t expected this to be an easy conversation, but she thought she was prepared for it. Yet it was turning out to be worse than she had imagined. Far worse. In fact, it was beginning to feel like a cruel joke that she had played on herself. The boy seemed unable to understand what she was talking about. Or unwilling, more likely. He refused to take a hint. Almost as if he were going to force her – force her – to come out and say exactly what she meant.

On the other side of the desk, Goldblatt smiled at her patiently, trying to work out what on earth she had been endeavouring to say for the previous five minutes. They were in her office. The Prof had bleeped him and asked him to come down, but to be honest, after she started talking, his mind had wandered, and not for the first time that morning. What had happened with Ludo last night? And what had almost happened? He told Lesley he had been kept late at the hospital. It was the first lie of that sort – or half-lie, because he had been kept late there, but not that late – that he had ever told her. What was the next lie going to be? Where was it leading?

Goldblatt nodded. As a doctor, he knew how important a simple expression of empathy can be in alleviating another person’s discomfort, even if you have no idea what is causing it.

‘I just don’t know what to do,’ she said at last, shaking her head a number of times as if she were trying to dislodge something from her ear. ‘On the one hand, it would be easier in many ways if the situation was resolved. But on the other hand, that means I’ll have to find someone else. That can be very troublesome. Very disruptive for everyone.’

Goldblatt nodded again. It was a terrible dilemma that the Prof had just outlined to him. He could well understand her perplexity. On the other hand, he would have liked to know what on earth she was trying to say.

Like Dr Morris, Goldblatt was nothing but a fusty old traditionalist who associated the notion of one doctor kicking another out only with the most severe breaches of medical ethics or the most abject acts of incompetence. He was guilty of neither, as far as he knew. He had shrugged off Ludo’s warning in the pub as a combination of Emma’s penchant for malice and Ludo’s penchant for exaggeration. That, together with his own preoccupation and the Prof’s excruciating circumlocutions, and he really hadn’t latched on to what was going on in her head.

The Prof, for her part, having failed to be fully reassured by her conversation with Dr Morris about getting rid of Goldblatt, had spent a lot of time trying to think of someone else whom she might safely ask for the opinion she needed. But she couldn’t think of anyone – until it occurred to her to ask the boy himself. She could certainly ask him. And somehow, when she thought about it... well, somehow it had seemed to make sense. It wouldn’t really be asking an opinion of him, it would be more in the nature of a warning. But in the guise of asking an opinion. It had made perfect sense. Then. But now, when she actually had the boy in front of her, it made no sense at all. Sense? It had never made any sense. What on earth had she been thinking?

‘Which people?’ asked Goldblatt, thinking it might help them both if the Prof could be more specific.

‘More than ten?’ Goldblatt enquired, giving the Prof a lead. He waited. ‘More than eight?’

‘Was it the lady in clinic, is that who you’re talking about? The Armenian lady?’

‘The one in clinic,’ said Goldblatt. A couple of weeks earlier an Armenian lady he was seeing in clinic for knee pain had threatened to put in a complaint when he declined to check her blood pressure. According to her notes, the Armenian lady went to five different clinics for eight different conditions. One of these was high blood pressure, for which she had been on the same dose of the same medication for eleven years, and she was accustomed to having a cuff put on her by every doctor she saw, not even excepting dermatologists. Goldblatt thought it was unhealthy, all this taking of blood pressures, and had thought it important to tell her so. All that could come of it was obsessionalism and anxiety, and everyone knows what that does to your blood pressure.

‘Unnecessary disclosure,’ replied Goldblatt. ‘I can’t disclose patient details unless there’s a valid medical reason.’

‘Dr Goldblatt, I am the head of this unit!’ said the Prof, blinking rapidly.

‘Well, since you are the head of the unit, I suppose I could give you her name.’

‘I don’t!’ shrieked the Prof. She was blinking and shaking her head like a mechanical doll that somebody had overwound. She took a deep breath. She was getting bogged down. How did the boy always manage to discompose her? Where had the Armenian lady come from? Who had mentioned an Armenian lady? The Prof didn’t care about any Armenian lady. She just wanted to know whether she should fire him, and unless the Armenian lady could give her the answer, she didn’t want to hear any more about her.

‘Dr Goldblatt,’ she said in barely a whisper, ‘let’s forget about the Armenian lady, shall we?’

The Prof took another deep breath. She looked down at the front cover of the diary on her desk and ran her fingers carefully along the sides of it. She examined the front cover for a long time.

Goldblatt’s head shot up at the Prof’s surprise move to his first name. This was a startling tactic but one that he seemed to recall she had used before, in one of her first conversations with him. In any case, she had certainly succeeded in putting him on the back foot for a second.

Goldblatt shrugged. They could start again if the Prof wanted, but that would mean wasting all the ground they had already covered. And it would be the second time they were starting again, which would make three starts in total. That was a lot of starts for one meeting. Personally, if it were him, and he needed so many starts, he’d probably want to reconsider whether it had really been a good idea to start at all.

The Prof smiled nervously. She blinked. ‘It’s just that... I wonder sometimes if you wouldn’t be happier doing something else.’

Goldblatt wondered sometimes as well. Theoretically, one could always be happier doing something else. Existentially, the Prof’s question was virtually meaningless, and he didn’t see why he should bother answering it. Anyway, who was she? His mother?

‘We always wonder about things, Professor Small,’ said Goldblatt. ‘I see it as part of the human condition. Ontologically, we’re wonderers.’

The Prof gazed at Goldblatt in a state of apparent paralysis. She wasn’t shaking her head now, not even a bit. Or blinking. Her facial muscles must have stopped working. Myasthenia gravis, thought Goldblatt, always keen to hone his diagnostic skills: the disease of muscle fatigueability. The Prof had blinked so much that now her periorbital muscles were too weak to blink any more. Goldblatt scrutinized the Prof’s eyes surreptitiously to see whether she was developing a divergence in their direction of gaze, a common finding in patients with myasthenia gravis that usually occurs towards the end of the day when muscle fatigue is most pronounced.

No, no hint of divergence, Goldblatt concluded reluctantly. Both her eyes were gazing in exactly the same direction. A little manic in intensity, but straight, definitely. One couldn’t ask for a better example of coaxial coordination. But it was only ten in the morning. Goldblatt made a mental note to look for divergence the next time he saw the Prof late in the day.

The Prof stared for so long that Goldblatt began to feel uncomfortable. He had been a lot more comfortable when the Prof wasn’t in suspended animation and was attempting to ambush him by using his first name.

‘It’s an ontological proposition,’ he said, to see whether that would reanimate her. ‘But you can dispute it if you like.’

‘I mean it, Malcolm. We have to be understanding. She’s not the most confident girl.’

‘It can be hard for women,’ said the Prof, looking straight at Goldblatt, as if she were someone who should know.

Goldblatt nodded. The Prof seemed to expect him to nod, and he would nod to anything if only she would get to the end of this nauseating sexist blackmail.

‘Sometimes women don’t say things as openly as they should, especially to men. It can be hard for women to deal with that. It’s easier for men.’

Goldblatt stared past the Prof at the wall behind her, desperately trying to distract himself from her voice. His gaze fixed on the Scale. He wondered what kind of a mind could have conceived of it and what kind of a hand could have wrought it. What would Blake have made of it? Probably would have written some stirring masterpiece on human insanity. How would it start?

Scyle! Scyle! red and bright

In the Fuertler of the night,

What demented brain or eye

Could frame you on the wall so high?

What mad doctor? what crazed witch?

What sad sour sulking—

‘Couldn’t you go to Emma’s ward rounds, Malcolm? Couldn’t you do that? For me?’

‘Yes,’ said Goldblatt, ‘I could go to her ward rounds. I should, shouldn’t I?’

‘Yes, you should. That would be very good,’ said the Prof brightly. ‘I’m sure that would help.’

‘Emma,’ said the Prof. ‘I’m sure that would help with her confidence.’

Suddenly he realized what all that muddy verbiage at the start had been about. She really did feel she had a dilemma. And the dilemma was whether getting rid of him was more trouble for her than it was worth.

Goldblatt could feel a certain tightening of his chest. He tried to quell his anger.

‘Well, what did you think I was going to do, Professor Small? You’re seriously telling me you’re thinking about firing me. Isn’t that what you just did? How badly do you think I need this job?’ Badly. Very badly. But he couldn’t stop himself. ‘How long do you thing I’m going to go on working in this atmosphere? How long do you think I’m going to put up with it? Surely you thought about that before you decided to speak to me.’

‘I... What atmosphere?’ asked the Prof timidly. She thought the atmosphere had become very pleasant in the last few minutes, and when Goldblatt said he would go to Emma’s ward rounds – for her – she had almost convinced herself that deep down Goldblatt really did respect her, proving that Emma knew nothing – absolutely nothing – about what people thought of her.

‘People telling me I’m difficult. The SR going behind my back and crying to the professor. The professor patting the SR on the back instead of telling her to grow up. It’s difficult for me too.’ Goldblatt felt a wave of foamy, artificial passion sweeping him away and decided that he may as well see where it took him. ‘It can be difficult for men, you know. We don’t open up enough. We’re not in touch with our feelings. Many of us find it difficult to say what we think, especially to women. I just wish people would remember that sometimes!’

Goldblatt got up. ‘I’ll think about it. I’ll let you know. Right now, that’s all I can say.’

The Prof nodded speechlessly. Suddenly it seemed that she hadn’t achieved anything at all in this interview. She hadn’t got an answer from the boy about whether she should fire him. She hadn’t even warned him. He had just warned her! He had managed to turn the tables. Now, it seemed, she was waiting for him to tell her whether he was going to leave. Somehow he was threatening her with the very action with which, she thought, she had been threatening him.

Dr Morris bumped into him as he was coming out of the men’s toilets. He grabbed Goldblatt by the shoulders, glanced around shiftily for a second, and then pushed him back inside.

Goldblatt didn’t know what Dr Morris had in mind, but he hoped it wasn’t some kind of male bonding. At best, Goldblatt was ambivalent about male bonding, and he was downright suspicious of it when it took place in a public convenience.

Dr Morris pushed him towards the wall lined with washbasins. At least he wasn’t taking him towards a cubicle.

‘She’s...’ Dr Morris shook his head. ‘You’re in an impossible situation, Malcolm.’

‘You haven’t exactly helped yourself in that department. You know it’s hard for Emma.’

‘Yes,’ said Dr Morris. He looked around for a moment, then went over to one of the urinals.

‘No,’ said Goldblatt to Dr Morris’s back. ‘I don’t care. I don’t care enough to give a fuck about her one way or the other.’

‘This fellow professional is making a profession out of getting compassion from her fellows.’

Dr Morris turned around and stared at Goldblatt. Fortunately, he’d zipped first.

‘Don’t ask me to repeat it,’ Goldblatt said. ‘I don’t think I could.’

‘Yes, it’s one of my toilet jokes. I use it every time I have a discussion with my consultant in the toilet about an SR who’s a pain in the arse.’

Dr Morris washed his hands. ‘What are you going to do?’ he asked as he pulled a couple of paper towels out of the dispenser. ‘Even if you do finish out your contract here...’

‘I once saw a patient who’d burned the retinas of both her eyes skiing,’ said Dr Morris. ‘It was the sunlight off the snow. She’d forgotten her sunglasses, but she skied the whole day anyway. You’ve never seen such oedematous retinas.’

Goldblatt was sure it had been – the thing he wasn’t sure about was what it had to do with him. ‘Anyway, she hasn’t fired me yet. I told her I’d think about whether I wanted to stay.’

Goldblatt nodded. ‘I don’t think I should ask her for a reference, though.’

‘No,’ said Dr Morris. ‘You have to be careful asking her for a reference even when she wants to give you one.’

‘As long as you don’t insult anyone else at interviews,’ he added, only half-jokingly.

‘I try not to,’ said Goldblatt, ‘but they keep asking these dumb questions.’

Goldblatt looked very frankly, almost demandingly, into Dr Morris’s eyes. It was a long time since he had bothered to look so expectantly at a consultant. Not since... well, not since he had looked at Dr Oakley in that way, almost two years before.

Silently, Goldblatt asked the questions. Are you going to do something about this impossible situation I’m in, or are you just going to keep telling me I’m in it? Are you going to stop me getting fired, which will take away whatever last slim chance I have of getting a real job, or are you just going to watch as it happens and then offer to give me a reference?

‘I’ll give you a reference,’ said Dr Morris again. ‘I’ll be glad to Malcolm. Just let me know when you need it.’

‘I mean it. I’ll support you, Malcolm. I’ll do whatever I can to help. Not just for locum jobs, but for substantive jobs as well.’

‘You’re upset. I understand. Remember what I said. I’m behind you, Malcolm. I really am. I’ll support you in whatever way I can.’

Goldblatt stayed there for a moment longer and almost went over to one of the urinals before he remembered that he had actually been leaving the toilets when Dr Morris pushed him in there.

Later that day, the Prof called Dr Morris into her office and told him that she had put Goldblatt on probation for a week. She had sat staring at the Scale after Goldblatt had gone, with no idea what to do next, until the notion of a week’s ‘probation’ slipped into her mind as a fancy name for doing nothing and waiting for the whole thing to go away.

The Prof hoped that Goldblatt would turn up to Emma’s ward round, and that Emma would stop crying about him, and that the whole sorry crew would somehow limp along so that by the end of the week’s probation she could conclude that everything had improved – and that the same sorry crew could then keep limping along until Goldblatt’s contract came to an end – and she could quietly shelve the threat of asking him to leave, which she now was almost too scared to use because she no longer knew whether it was aimed against Goldblatt or herself. But equally deep down, she doubted this would happen. She didn’t really believe she had the makings of a good probation officer.

Incidentally, the Prof had omitted to inform Goldblatt of his week’s probation, since she had decided to put him on it only after he had left, and the last thing she wanted to do was to call him back. As luck would have it, she also omitted to tell Dr Morris – who naturally assumed that she had told Goldblatt – that she had omitted to tell him.

In consequence of all of this, Malcolm Goldblatt ended up in the unusual – and some would say unenviable – situation of being on a week’s probation without even knowing it.

32