Deviant, Victoria thinks. It’s always about deviations. A person is only deviant if there’s a predetermined scale. And psychiatry is subsidised by the state. So, in practice, politicians decide what is sick and what isn’t. But surely things ought to be different within psychology? There are no clear boundaries there, and if there’s one thing that she knows for sure, it’s that everyone is deviant and non-deviant at the same time.
‘In Sweden, and of course even in Denmark, where the procedure was carried out, we have a long history of dubious interventions with people who have been regarded as having learning difficulties, or are otherwise aberrant. I remember one case where a fourteen-year-old boy was given electric shock treatment for six weeks because his devoutly Christian parents found him masturbating. In their world, that was deviant behaviour.’
Victoria finds herself wondering how people like that even have the right to vote.
‘Being religious ought to be regarded as deviant,’ she says.
Sofia smiles briefly, then sits in silence for a while, and Victoria listens to the sound of the old woman breathing. It’s quick and shallow, just like it was twenty years ago, and when she finally speaks again, her voice is more serious. ‘To get back to the point,’ she says quietly, but in a sharp tone. ‘As you know, frontal lobotomy was an operation on the frontal lobe of the brains of people demonstrating deviant behaviour. The connection between the lower part of the brain and the frontal lobe was severed, and approximately one in every six patients died. The Medical Council knew the risks but never intervened. I started my professional career in the early 1950s, and I’ve seen a lot of terrible things over the years. The majority of lobotomy patients in Sweden were women. They were described as dissolute, aggressive or hysterical. And they were made to pay a very high price.’
Taliban politics, Victoria thinks. She’s listening attentively to Sofia, still with her eyes closed, and she realises that this is the first time she’s ever heard even a hint of anger in the old woman’s voice. It feels good. Alleviates her own fury.
‘Unlike lobotomy, capsulotomy isn’t a fatal intervention, as far as we know, and that’s why they decided to use the procedure on Madeleine. They cut through the nerves in her capsula interna, the inner capsule of the brain, in the hope that her mental health problems – compulsive disorder and disruptive behaviour – would abate. But it was a complete failure, and actually had the opposite effect.’
Victoria can no longer keep her eyes shut or stay quiet. ‘What happened to her?’
Sofia looks angry. ‘Her lack of inhibitions got worse, her impulse control vanished more or less entirely, while at the same time her intellectual ability actually seemed to get sharper, oddly enough.’
Victoria doesn’t understand. ‘That sounds like a contradiction.’
‘Yes, maybe …’ Sofia blows out a large smoke ring that sails above the table and breaks against the glass of the window. ‘The brain is fascinating. Not just each separate part and function in itself, but also the interplay between them. In this instance you might compare the procedure to building a dam across a river to block the flow. But the result was that the river found new ways around the dam, and grew in strength.’
Victoria picks up the bag containing her notepad.
Denmark, 2002
And that’s why, Mama says, I’m nearly always happy and gay.
I think the whole of life is like a sunshiny day.
THE HOSPITAL ENVIRONMENT didn’t scare her, because she’d spent large parts of her childhood being treated for one thing or another. If it wasn’t stomach aches, which it almost always was, it was feeling sick or dizzy, or bad headaches.
The worst thing was when she was alone with P-O in the big house with all the toys.
P-O, the man she had never called her father, who had taken pity on her but then discarded her when she was no longer good enough to be his daughter.
Everything around her had had a name, but was always something else. Daddy wasn’t Daddy and Mummy wasn’t Mummy. Home was actually somewhere else, and being ill was like being well. When someone said yes it meant no, and she could remember how confused she had been.
The brain is the only organ in the human body that has no feeling, and can therefore be operated on even while the patient is conscious.
And goodness, how cross they were when she went to the police and told them what P-O and his so-called friends got up to in the shed that was meant for pigs, not young boys who were angry with each other. Screaming and crying and punches left and right, before they sent her away to a new place that they told her she should call home from now on. But there it was just dark and silent and her arms were strapped down, just like they were now.
The doctor had said that if they just did a bit of cutting inside her head, she would no longer think everything was so complicated. She wouldn’t have violent outbursts, and the hope was that she would be able to take care of herself. If only they could snip through a few unhelpful connections in her head, everything would be fine.
Daddy would mean Daddy in the same way that Mummy would mean Mummy.
She was woken from her thoughts by someone lifting her up in bed. But she kept her eyes shut because she didn’t want to see the knife that was going to cut her.
Admittedly, they had actually said that they didn’t use knives any more, because times had changed and they had more refined methods now. Something to do with electricity that she didn’t quite understand, but she had nodded when they asked if she did, because she hadn’t wanted to cause any more trouble than she already had.
Trouble, trouble, trouble, that’s all you are. That’s what Charlotte, the woman she had never called Mother, had always said whenever anything broke or fell on the floor. And it often did. If it wasn’t wobbly glasses full of milk, it was slippery plates, or windows that were so thin that you couldn’t see them until they were lying in pieces on the floor.
Someone took hold of her head and she felt the cold steel of a razor blade.
First the scraping sound as they shaved off the hair at the back of her head, then the pain, and finally the sound of the electric knife.
The future of the procedure was decided when Christian Rück, a psychiatrist at the Karolinska Institute, demonstrated that a combination of the negative side effects of treatment, as well as difficulties with its practical implementation, meant that it should not be used for anything other than strictly controlled experiments.
It’s going to be fine, she thought. Now I’m going to be well, just like everyone else.
Rosenlund Hospital
NOT VICTORIA BERGMAN, Hurtig thinks. Why not?
All the other names from Sigtuna are written on the notepad in front of him.
‘But you did know Victoria?’
‘Only from school,’ Annette says. ‘She wasn’t part of our group.’
‘Your group?’
The woman squirms. For the first time in their conversation a flicker of awareness appears in her eyes. ‘I don’t know if they’d want me to say,’ she eventually says.
Hurtig has to make an effort to keep his voice sounding calm and friendly. ‘Who wouldn’t want you to?’