**Author's Note: I'm sorry for the delay. I'm having some issues with my computer, so the next chapters may come inconsistently. I will do the best I can to get things up in a timely fashion :)
Chapter Five:
Thomas was deeply miserable, trying unsuccessfully not to shudder beneath the icy touch of the stethoscope.
"Is this really necessary?" he asked rather sharply, irritated at having to sit in the cold of the hospital without his shirt.
Dr Clarkson stood up straight and removed the stethoscope. "I would rather be certain of the status of your entire bodily health than leave certain areas unchecked and, therefore, uncertain. But you can put your clothes back on."
Thomas quickly obeyed. "I have sleeping problems, though," he explained, his words muffled by the fabric of his undershirt as he pulled it over his head. "Why do you need to check my lungs?"
Dr Clarkson wrote something down on the clipboard he carried with him and said, "Because you never know what you may find; and because you smoke far too much."
Thomas craned his neck to see what the doctor was writing, but the clipboard was moved away, out of range of Thomas's prying eyes. "I will explain everything once I am finished, Mr Barrow. It will be easier that way."
The rest of the examination was performed quietly, with Dr Clarkson only speaking now and then to request that Thomas move in this way or that. He would write down anything that interested him, then continue on in persistent silence.
"Now," he declared once he had satisfied himself as to the state of Thomas's physiological health, "do you know what is the cause of your sleep deprivation?" He sat in front of Thomas, his hands folded on his lap, observing Thomas intently. "What keeps you awake at night? Do you have nightmares?"
Thomas shook his head. "Not nightmares, exactly. Memories."
"Memories? Of what?"
Thomas opened his mouth to speak, but then faltered and turned pale. To Dr Clarkson, it was immediately obvious that Thomas was struggling internally with some difficult decision, so he waited patiently; and eventually Thomas divulged the facts.
"Of the war. You know, all the blood and the screams and the mud. And the stench."
"Any particular memory of the war?" Dr Clarkson's gaze flickered to Thomas's left hand.
Unconsciously, Thomas began to rub the thumb of his good hand over the bullet scar, as if massaging away a remembered pain. When he realized what he was doing, he quickly stopped and gave Dr Clarkson a frail smile.
"This one, yes. But it's not the only memory."
"Tell me."
Thomas held his tongue.
Dr Clarkson leaned towards him in confidence. "Mr Barrow...Thomas, I can't help you if you won't talk to me."
But Thomas had turned his attention away from the doctor, toward the distant door surrounded by walls of dingy white. For a long time he didn't speak. Dr Clarkson was beginning to think they would get nowhere at all, when Thomas suddenly turned back and said, "Do you remember one patient you had during the war, a young man blinded by mustard gas? He killed himself–slit his wrists open–when you told him he needed to leave Downton? Lieutenant Edward Courtenay."
Dr Clarkson signified that he did remember the man.
"I keep seeing him in my head, you know. The scars on his face, his blind eyes. He's right in here." Thomas jabbed a finger into his temple, his mouth a tense line. "Same as the rest of them."
"The rest of who?"
But‒now caught up in a rapid flow of remembrances‒Thomas didn't hear Dr Clarkson, and talked on, a slight frenzied air to him now. "He didn't need to die, you know. If we had let him stay instead of sending him to Farley Hall, he wouldn't have done it."
"You don't know that, Thomas."
"I do! I do know it! He didn't want to go!"
"Many didn't want to go," Dr Clarkson explained gingerly, though he was vaguely surprised at Thomas's sudden emotional outburst. "But they had to. We didn't have the space or the resources to keep them. What happened to Lieutenant Courtenay was not your fault. Nor was it mine, or Mrs Crawley's, or anyone else's. We did the best we could with what we had."
Thomas nodded reluctantly, but Dr Clarkson noted that Thomas's eyes were unusually glassy.
Dr Clarkson leaned back in his chair and observed Thomas. He remembered the man Thomas had been once: devious, insincere, intelligent, and proud. This man before him bore little resemblance to the former one. This man was nervous, weak, and timid. Something had to happen to have caused such a drastic change of character in a man such as Thomas.
"What else do you remember?"
"Being in the trenches."
"Specifics?"
Thomas shifted on the bed, lacing his fingers together on his thighs. "The men I knew, sometimes. How they'd be alive–and we'd be having a laugh or talking–one day; and the next they'd be lying there, a bullet in their brains or their legs blown off."
"You felt powerless to help them."
Thomas snorted in condescension. "No one feels powerful in the trenches. Everyday you're confronted with your own limitations, and you know that the only reason you're alive has nothing to do with your courage, but because you're actually a coward who hides behind sandbag walls; and because the enemy decided not to bomb you to Hell."
Dr Clarkson nodded his head slowly. But there was something about everything Thomas had said that perplexed him.
"What you are describing sounds to me almost like shell shock."
Thomas frowned intently and repeated, "Shell shock?"
"Yes. This is by no means a definitive diagnosis. We've not nearly enough information for that yet. But what with your atrocious memories of the war and your inability to sleep due to these memories, it does seem to be somewhat likely. I'd say it is at least a contributing factor to whatever the larger issue–if there is one–may be." He paused, unsure how to voice what puzzled him.
Thomas sat silent, watching Dr Clarkson.
"What I am confused about, Thomas, is the fact that this stress is so greatly delayed. The war was some years ago, and you have never showed symptoms of shell shock prior to this. Has something else happened, something to trigger the resurgence of these memories?"
He noticed that Thomas had instantly tensed up. His fingers were digging into the bed, his brows were lifted, and his shoulders were taut. He suddenly seemed much like a cornered fox: frightened, but prepared to attack if provoked. This was the thing–whatever it was–that was the real issue.
"You don't have to tell me if you don't want to," Dr Clarkson reassured. "But I do truly want to help you, and without all the information, I can't."
Thomas didn't speak, didn't try to explain; and though he knew there was much, much more than what Thomas had said, Dr Clarkson also knew he would get no more from Thomas today. He had shut down. "All right," he said as he got up from his chair, "I think that is enough for today. But Thomas, I hope you know you can trust me, if you ever need to talk. About anything."
Thomas climbed off the hospital bed and went to get his coat.
"I would like to see you again."
He turned to look at Dr Clarkson. "Is that necessary?"
"You doubt the necessity of many things today, it seems. But I think it is. We've not found a solution to your sleeping problem."
Thomas pursed his lips, but grudgingly agreed to another appointment. "I didn't even want to come today, did you know? I only came because Lord Crawley–according to Mr Carson–was most insistent that I come."
Dr Clarkson chuckled. "I am sure. But this is serious, Thomas. Sleep deprivation can kill you. You've already felt the effects on your health: you're much weaker, your heart rate is elevated, your ability to retain information is decreasing, you're experiencing depression, and you're irritable. It's only going to get worse if we don't find a solution. I'm almost tempted to send you to a psychiatrist."
"A psychiatrist? I don't want to see a psychiatrist."
"You may need to. But we haven't determined that yet. I will come see you at Downton next Thursday afternoon."
Thomas shook the hand that Dr Clarkson proffered, then hurriedly left the hospital.
It was a cold wind outside, and the village was quiet. A single car rumbled slowly down the street, the man inside smoking a leisurely cigarette. Three girls were walking on the opposite side of the street, talking and giggling, purchased items in their hands, and their eyes slanting sideways every so often to catch Thomas's gaze. Thomas turned from them and pulled up his coat collar against the wind, and made the cold journey back to Downton, wondering all the while whether he had said too much.