THE PAST

I cannot believe it, I just cannot believe it. I have again succumbed to it, to her, to something, and I do not know why. Perhaps I am a victim – sometimes I feel that it may be so – but if so I am victim of something I do not understand, some eddy of fate that is outside my comprehension but whose ripples nonetheless disturb my life. And if I am a victim, why is my victimisation tinctured with guilt? Why does the shape of whatever it is I do not understand sometimes materialise close to my consciousness and hover there, tantalising, haunting, mocking? I cannot grasp it, try as I might. It is as visible but as insubstantial as one’s breath on a cold morning.

Today I even had an inkling that something would happen and like a fool chose to ignore it, although I cannot think what else I might have done. It began as a typical weekday morning for me. I arose at 5.30am for my run, as I always do, and ran my usual seven-kilometre course despite the cold and some black ice that made parts of the footpath hazardous in the dark. It gave me a good feeling – not so much the run itself, although that was part of it, as the satisfaction of adhering to my invariable regimen despite the winter temptation to stay in bed. I thrive on self-discipline, you see; it prepares me psychologically for the day, just as my run prepares me physically.

After running, and still in a good state of mind, I shaved and showered and took my usual care selecting what I would wear. As a physician I spend a lot of time just sitting, and it would be easy – too easy – to dress casually or even carelessly, as many of my colleagues do. No one would think any the less of me, I suppose, but I have my own standards and refuse to let them slip. I selected a pale grey suit, a midblue shirt, and a silvergrey silk tie. I was knotting the tie and considering the neatness of my hair and the efficacy of the shave I had given myself when the thought suddenly came to me, out of nowhere, just like that, and my day was ruined.

Understand that I am not a superstitious man. I am well educated and, if I may be permitted a little hubris, well read in a number of disciplines besides my own. I believe in science and in the power of reason, not in soothsayers and crystal balls. Moreover, I am a practical man, as a good physician must be. When one deals daily with life and death, hope and disappointment, it is necessary to be practical. Not that I am without sympathy for those who are genuinely ill. I very much like the feeling of being able to help them, whether with sympathy or advice or, if strictly necessary, medication. It is sympathy or understanding that most need, I believe, although it is most often some form of chemical panacea they seek, presumably because that would be easier for them than the changes to their lifestyles that most need. For many of my patients, perhaps most of them, are victims of no more than their own lack of self-discipline. They smoke, they drink too much alcohol, they eat the wrong foods, they never exercise. So I try to instil in them the need to change, to be disciplined about the way they live, to be in control, but they do not want that. They prefer some modern pharmaceutical magic because it is easier, requiring little or no effort on their part. Nevertheless, and often to their surprise and chagrin, I am reluctant to provide it except in genuine cases where I know it will be efficacious. Mostly I prefer to encourage them to take responsibility for their own treatment rather than have them rely on my providing script after script for some chemical palliative while they do nothing to help themselves. They need to be goaded into standing on their own feet, into taking control of their own erratic lives. That is the secret of good health – indeed, it is the secret of good living: self-control. I am evidence enough of that; strict adherence to my own regimen ensures that I am in excellent health and that my days pass pleasantly enough to give me the equilibrium that tells me my regimen works.

So I was not at all pleased, as I was knotting my tie, to have that equilibrium completely shattered by the sudden arrival of the wildly irrational notion that she – I must in all honesty call Mrs Hannah Rosen my least favourite patient – would consult me today. The thought ruined my day before it had really begun.

As I have said, I am not a superstitious man. I believe reason is the effective antidote to all mankind’s fears and delusions, just as self-control is essential to good health, which in turn is essential to good living. Yet the mere thought that Mrs Hannah Rosen might have a consultation with me today instantly flattened the battery that my satisfaction with my life normally keeps fully charged. Walking towards the breakfast room, I tried to reason with myself. First, I did not know for sure that she would be there today; it was simply an inexplicable and undoubtedly stupid and unfounded notion. Second, surely my education, my intelligence, my nine years’ experience as a practising physician were sufficient to enable me to deal with her in a professional manner if she did come. As I am with all my patients, with her I would be helpful, sympathetic, but firm. She would put nothing over on me. Nothing! That made me feel a little better, but not much. Somehow I still felt irremediably deflated despite the pleasing discipline of my run and the considerable care I took with my toilet.

So it was without any pleasure at all that I ate my usual light breakfast

– fresh fruit, unsweetened muesli, wholemeal toast, and a small cup of excellent coffee – and swallowed my usual vitamin and mineral supple-ments. At my wife I smiled a smile that I did not really feel but did not fool her.

‘Is something the matter, sweetheart?’ she asked.

I shook my head. I could not tell her what was wrong because I myself hardly knew. So I kissed her on the cheek and said goodbye.

Normally the drive along the Derwent foreshore to my consulting rooms gives me great pleasure, for Hobart is a safe, beautiful place far from the strife that seems endemic in the greater world. The sun was beginning to appear above the eastern shore and to illuminate the crystalline Tasmanian sky that reminds me so much of Europe’s, but my pleasure this morning was blighted by my irrational notion that Mrs Hannah Rosen would present herself at my surgery today. I cursed myself for a fool, but some doppelganger of her was my passenger all the way into town.

I walked into my consulting rooms precisely at 8.25 and greeted my receptionist. We exchanged the usual pleasantries and chitchat about the weather and the quantity of snow on the mountain, after which I intended to ask her whether Mrs Rosen had such an appointment with me today. But I hesitated, torn between wanting to know and the knowledge that if I knew for certain she did, it would ruin my whole day. Best not to know, to subsume the absurd, irrational notion in work.

My first patient was a young man whom I had not treated before; he had a ring in each ear and a bizarre hairstyle and presented with a typical winter viral infection. The symptoms were unmistakable, so I prescribed three days’ bed rest and told him to drink plenty of fluids.

‘Is that all?’ he asked, his voice a pitiful whine. I knew what was coming. ‘You can take two aspirin every four hours if you feel any pain in the joints,’ I said, ‘and use an inhalant three times a day if congestion is a problem.’

‘Aren’t you gunna gimme anything for it?’

‘Some medication, you mean? I’m afraid there’s nothing I could prescribe that would help you.’

‘What about an antibiotic? I usually get an antibiotic when I’ve got the flu.’

‘An antibiotic would be of no use to you at all. Your ailment is caused by a virus, and medical science regrettably has no treatment for a nonspecific virus. Antibiotics will destroy only bacteria, which are a different lifeform altogether.’ He scowled at me, obviously too stupid to comprehend reason, so I thought to disarm him with a little humour. ‘My prescribing an antibiotic for what afflicts you would be rather like your hunting a lion with a flyswatter,’ I said. ‘Being armed with something might make you a little happier, but it would have no effect whatsoever if the lion attacked you.’

He seemed unamused by my joke and slammed the door as he went out.

After him it was a busy morning. A similar viral infection was epidemic in the city and my receptionist was coping with it by squeezing in extra appointments. Thus busy, by late morning I had quite forgotten my preoccupation with Mrs Hannah Rosen until, suddenly, there she was, limping into my surgery, although to the best of my professional knowledge there is nothing wrong with her legs, feet, or hips to make her limp. My heart sinking, I rose to greet her as she slumped into a chair, and in a moment of sheer stupidity I decided to tackle her head-on with levity.

‘Mrs Rosen,’ I said with deliberate but feigned cheer, ‘I’m surprised to see you. What could possibly be wrong with a strong, healthy lady like you on such a beautiful sunny morning?’

She gave me such a look of contempt that, feeling like a child whose hand has been slapped for reaching without permission for a biscuit, I sat down abashed and assumed my usual serious but friendly professional mien. As another gambit, I tried remaining silent, waiting to see what she had to say, but she matched my silence with her own. I could hear the telephone ringing in the reception area. Mrs Rosen is a plain woman

– but, then, most old women are at best plain, perhaps because they think the need for good grooming is past. It is possible that she was once attractive, but a lifetime without discipline had shrunk and spread and bent her even as time and gravity had done their relentless work on her features, which sagged and drooped like melted wax. Her spirits drooped also; in the months she had been my patient she had never risen above desolation. She was wearing the only outfit I had seen her wear: a faded reddish-purple overcoat and a sort of knitted hat, like a teacosy, in more or less the same colour, that more or less covered her ears and her colourless thinning hair. She emanated a faint sour smell of mothballs and bodily neglect. Pouchy bloodhound eyes that I always found difficult to meet were her most pronounced facial feature.

They gazed steadily at me now. I was determined to make her speak first, to make her come to me, but her stare was unnerving. To give myself an excuse for looking away I glanced at my watch and found myself saying that time was short and my appointment list long. Still she did not speak. I controlled the testiness I was beginning to feel and forced myself to sound businesslike.

‘How may I help you, Mrs Rosen?’

She made no response, just kept that sorrowful gaze on me. I forced myself to lock my own gaze with it, trying to plumb it, analyse it, but found that as impossible as trying to hold it. I was about to repeat the question, this time with a measured tincture of testiness, when she muttered something, at the same time shrugging in a worldweary way with her hands extended slightly, palms up, briefly revealing on one wrist the dull blue stigmata of her generation.

‘I beg your pardon, Mrs Rosen, I did not hear what you said.’

Again she muttered, and I was about to ask her yet again to repeat herself when she muttered some more, this time almost audibly.

‘Who can help?’ was what I think she said – the shrug, the palms raised heavenwards again.

‘I am a physician,’ I said. ‘If I can help you I will.’

‘Hah!’ – not loudly, barely audibly, not really offensively, but unmistakably derisorily. She removed her gaze from me and slowly looked around my surgery, I thought with a certain condescension, although since by now I was quite irritable it may have been my imagination. A ship hooted on the river. I waited. Slightly shifting her amorphous bulk in the chair, she brought her gaze back to me and waited too. We both waited. She had now been in my surgery for nearly five minutes, ample time, in most cases, for a consultation. Still she did not speak. Then, abruptly, she shrugged again. It was hardly a motion at all, just sufficient movement to imply – what? Contempt? Weariness? Pain? Despite the brevity of the movement, it seemed to contain something of all three. I felt uneasy, unexpectedly out of control of things, even the first faint tremors of panic. I thought I knew what would come next and tried to prepare myself for it.

‘Mrs Rosen – ‘

She was standing now, smoothing the front of her grubby overcoat with all her attention. At my pronouncing her name she again caught my eyes with her sad, heavy gaze. I could feel myself becoming agitated.

‘Mrs Rosen, what have you come here for? Are you ill? If you are, tell me and I will try to help you.’

For a moment she did not move. Then she gave me that shrug again

– that hopeless, worldweary shrug, as worn as an old doormat – and turned towards the surgery door.

‘Mrs Rosen – ’

Her hand on the doorknob, she paused as if considering an important decision, although she did not turn around.

I pitched my voice a little lower, coaxing, cajoling. ‘Mrs Rosen – ’

You might ask what else I could have done, and I would be forced to answer that I do not know. I knew what was coming, was sure by now of what was coming, but I am a physician, and a dedicated one if I may say so, and I could not bring myself to turn away a possibly sick woman, not even Mrs Hannah Rosen. Not that I believed she was really sick, for in the past months I had sent her for a great many tests – more than were strictly necessary, I must reluctantly admit – and none of my specialist colleagues had been able to find any trace of somatic illness other than the usual niggles of old age and years of self-indulgence.

She was coming slowly back into the surgery, limping towards me, sinking into the chair. I smiled reassuringly. She sighed and fixed those great disconsolate eyes on me again.

‘Mrs Rosen – ‘

Now she was shaking her head in sad, slow movements. I felt like a child eavesdropping on some arcane adult conversation, knowing that it was important but unable to understand it. ‘The pain,’ she said plaintively, so softly that it was little more than a thought made manifest.

‘Are you in pain, Mrs Rosen?’ I asked, seizing on what she had said and thinking that I had at last broken through to her but then immediately feeling that somehow she had turned the tables in her favour. Nevertheless, I was determined to win this time, determined to beat her. I was sure I knew all her gambits and ploys by now and was certain of my ability to counter them with reason and professionalism. ‘If you are genuinely in pain, then I will be able to help you.’

To my astonishment she briefly smiled – hardly a smile, really, more like a blink of the lips – but it was sardonic and mocking and emphasised by her nodding her head incredulously. What would you know? it seemed to say, and I was eighteen and gauche again. I decided to regain the upper hand with a short and rather savage thrust that, if nothing else, would cut this painful consultation short.

‘Mrs Rosen, let us jump quickly to what I believe to be the point of your coming here. I cannot and will not prescribe you any more medication. It is a very powerful and potentially dangerous amphetamine, one that is not meant to be taken long-term. It would be personally remiss, professionally unethical, and perhaps criminally culpable of me to prescribe you any more of it.’ I glanced at her file on my computer screen. ‘What’s more, you cannot possibly have taken all that I prescribed for you at your last consultation, certainly not at the prescribed dosage. The answer is no, Mrs Rosen.’

I felt better for that salvo, felt myself briefly in command of the situation again, but her expression did not change – or did it? I could almost swear that her eyes momentarily gleamed: sudden brief supernovae in a dark, sad sky. Was she playing me as a skilled angler plays a fish? I felt my anger begin to surge even as my sense of control started to skid. I fought vainly to stop it, feeling myself, my professionalism, my will slide into an abyss of helplessness despite my determination that this should not happen.

‘No, Mrs Rosen!’

She closed her eyes and began to rock slowly in the chair, as someone mourning might, softly, almost inaudibly moaning or keening. Briefly, I thought I had won. For a few seconds she continued to rock back and forth with her eyes closed, as if gathering strength from something unseen; then she stopped and looked at me, into me, through me. Her eyes were moist. ‘Doctor Schlegel,’ she said in a soft, melancholy voice still leaden with accent, ‘I am old woman, born Poland 1919. What these eyes have seen – ’ She sadly shook her head and shrugged helplessly. Our eyes locked; they remained locked for perhaps five seconds, but I could hold neither her gaze nor my resolve. Angry, shattered, hollow, feeling again that I was being victimised for something I did not understand, I printed out the prescription she desired and flung it across the desk to her as I shoved back my chair and fled to the window, to stare emptily out at the tantalising, haunting, mocking patterns of winter sunlight on the river until I heard the door close behind her.

ROBERT COX’s latest book is Steps to the Scaffold: the Untold Story of Tasmania’s Black Bushrangers (Cornhill Publishing, 2004).