Chapter 32
Quality of Life
Elizabeth removed the stack of journals and a sheaf of papers with her notes.
Anne started, but Elizabeth fixed her with a stare she knew was unnerving, until Anne acquiesced with a nod for her to proceed.
This was the moment of truth. Anne had to make a hard decision.
Without it, Elizabeth would have been wasting her time; with permission granted, some possibility of progress remained.
“Pray keep in mind that Anne asked me to intervene. I feel honour bound to do my best, which requires speaking clearly and frankly. May I proceed?”
Both ladies nodded.
“These are Anne’s secret journals. I have no idea if they are actually secret, but Anne presented them to me as such and asked me to analyse them mathematically.”
Less shocked than Elizabeth expected, Lady Catherine asked, “Why you? Why mathematically?”
“Let us say that I have some talent in dealing with other people’s…
difficulties. I use mathematics as a handle to pry into things that should not be my business, so I might extract some rough approximation of truth.
As to why me, I have a history of successful interventions, though whether that is luck or skill is anybody’s guess. ”
Lady Catherine studied her. “It sounds like you have been in some awkward conversations.”
Surprised at how quickly the lady arrived at that conclusion, Elizabeth nodded.
“And this is yet one more? I take it you do not particularly enjoy these activities; at least by your demeanour.”
“I do not. I am, however, honour bound to help as I am asked, whether it is a good idea or not.”
“Duty is not always enjoyable, so I applaud your intentions. Might you answer the first question? Why mathematics?”
“Because it is my particular skill, and in many cases, the clarity of the mathematical expressions helps me think. You probably know it has nearly infinitely precision, but its application is highly variable and error prone. You can determine with perfect clarity whether an apple is larger or denser than a pear, and, given enough information about the markets, you might determine their relative values with some precision. You cannot, however, tell if a person prefers one over the other, or why; but, given enough information, you could determine the preferences of the average Englishman or Irishman. Its application I can manage well enough to suit my purposes. The tools of mathematics help bring clarity, though the clarity may be as wrong as right, because everything depends on how well you map reality to the mathematical world—a task rife with for error.”
“Carry on.”
Elizabeth opened the first notebook. “This journal begins on Anne’s 15th birthday, when she was absolutely certain she was unlikely to survive another day, let alone another year.”
Lady Catherine gasped and turned to Anne, who stared at her hands. “Is this true?”
Anne snapped, “It is, and you cannot deny you thought the same.”
Ignoring Anne’s peevish tone, Lady Catherine leaned forward to take her hands. “I admit I had such dark thoughts. We all tried to hide them from you, but we were clearly unsuccessful.”
Anne sighed and squeezed her mother’s hands. “You did your best. I cannot fault you.”
“May I continue?” Elizabeth asked. Perhaps she should have let the discussion go on longer, but it seemed unlikely to produce the results she wanted.
“3 times Anne was absolutely certain she would die in the month before she started writing, 5 the next month, then back to 3, and so forth. Each time, it was either because the pain was so intense she was not certain she wanted to survive, because the clues from her caregivers were overly pessimistic, or some combination.”
Elizabeth took out a chart showing the incidents in a line graph. “As you can see, for the first year of the journal, these incidents rose and fell, varying between 2-5 incidents per month, but finally dropping to 0 the last month of the year.”
Anne and Lady Catherine studied the chart.
“That is very interesting,” Lady Catherine said, “but you could have concluded that easily enough without the graph.”
“Of course. Sometimes mathematics adds clarity; sometimes it restates the obvious; sometimes it is harmful, giving a veneer of respectability to a mistake or falsehood. In this case, it let me see the pattern. That was only the beginning, though. There is more.”
“Pray continue,” Anne said, looking more interested.
“I noticed the feelings of despair and fear ebbed and flowed, and sometimes they did not correlate with her condition. Sometimes Anne felt worse than objective evidence suggested; sometimes the converse.”
Anne asked, “What do you mean by objective?”
“Those are scientific terms. Subjective means matters subject to interpretation or opinion, while objective means measures true in themselves. Of course, there is dispute about what is subjective and what is objective.”
Anne laughed. “You suggest the difference between subjective, and objective is subjective?”
Elizabeth laughed along. “Very clever.”
Lady Catherine said, “Are we to spend the entire time discussing vocabulary?”
“My apologies. The point is that the tools of mathematics are not completely appropriate here, because while it is objective, the inputs are subjective and highly due to interpretation. However, I still believe it might be useful, so long as you admit that the analysis is considerably less exact than it might appear. I tried to map all the different feelings in Anne’s diaries into a graph independently, so I could see the relationships between them, but it became hopelessly muddled. ”
“And yet, here you are with more notes and graphs.”
“Allow me to explain. I made up a new measure, which I shall call Quality of Life[xxi], to map a person’s life experience.
It is obviously terribly imprecise, but I tried to take everything I could read in each month and give it a numerical value.
I accounted, as far as I could, for health, wealth, comfort, and general feelings of happiness.
The scale runs from 0-100. 90 would be a loving, happy, and healthy person, free from want and strife, surrounded by loving children sitting before a warm fire.
10 would be a miserable life—someone sick, in pain, and desperate.
I presumed most people muddle along somewhere around 50 and tried mapping people’s lives onto this scale.
By this measure, my aunt and uncle would spend most of their lives around 80, while my parents would be lucky to break 50 on a good week, and mostly hover around 35.
I next tried mapping Anne’s life similarly.
It is rough, approximate, probably incorrect, and in all ways insufficient, but I hope you might find it enlightening. ”
Lady Catherine leaned forward with some interest. “Fascinating.”
Elizabeth showed them another line graph, much like the first.
“As you see, in her 15th year—her life bounced up and down between 10-20 on this scale. It is almost the inverse of the previous graph, but with added factors, and in the last month she did not think herself likely to die even once.”
Lady Catherine studied the paper. “I remember that year. To be honest, the first graph could probably be measured in the volume of my tears. This tells the same story.”
“This is interesting, Lizzy,” Anne said after a good look. “To tell the truth, I can hardly remember that year myself, and I never had the courage to read the journal. You know my words better than I do.”
Elizabeth pulled out another graph.
“Let us look at your 16th year. You started about 20—a considerable improvement—then you bounced up and down between 20-30, much like the previous year. You ended your 16th year around 30, which did not seem particularly wonderful, but it was a clear improvement over your 15th.”
Both ladies examined the graph carefully, and Anne said, “I remember approaching my 17th birthday feeling life had slightly improved, so that correlates with what you said, but I would have thought it a very minor improvement.”
“Let us look at that year. You somehow clawed your way up from the low to the upper 30s by the end of the year, and things seemed to improve. You were not by any stretch of the imagination healthy and happy, but you were improving.”
“Out of curiosity, where do you generally fall on this scale, Miss Bennet? Have you done the exercise on yourself?” Lady Catherine asked.
“To be honest, for most of my youth, I would have been in the 30-40 range, but that was mostly because of self-inflicted wounds. My own behaviour both disturbed my equanimity and drove people away, leaving me lonely and brittle, even though my own actions caused the problems. A good friend helped me overcome them, and I feel as if I have lived in the 60-70 range these last few years. I am generally healthy and happy.”
“I envy that,” Anne sighed.
Elizabeth refrained from comment. “Shall we continue?”
“By all means.”
Elizabeth uncovered another graph. “Let us look at your 20th year. As you can see, you were floating around between 30-50, but here it falls sharply.”
“That was the year I caught a terrible cold in the winter, and it lasted for months.”
“Exactly. I have so far not really told you anything a little reasoning would not divulge. The interesting point, though, is that you were down for a few months, and climbed back to your accustomed level of around 40 very quickly. You see it here? See how steep the line is, indicating rapid improvement. Those are the insights a graph helps you see.”
The ladies examined the graph, and Lady Catherine ventured, “Your charts show that that if you get sick, then get well, your life improves.”
“Correct! But let us look here, a few months later. You had a long, mostly flat period, much as in the previous year—the status quo, correct?”
Both ladies nodded.
“It took a dramatic turn for the better just here, a few months before your 21st birthday. It may not have seemed dramatic, but it rose as high as 55 over just 3 months, a score you had never previously achieved.”
Anne looked carefully at the graph. “I do not remember that period as being particularly happier than any before it, but I will take your word for it.”
“No, you shall not. I am the mirror, remember. You must do your own thinking.”
Anne stared at it for a while. “I can remember that period gradually becoming better and better if I put my mind to it. Can you account for it?”
Elizabeth trod carefully. “I shall not attempt a scientific explanation, but I can point to a correlation—though I caution you that correlation is not causation. The upturn in your fortunes happened immediately after Dr Choak died.”
Anne and her mother gasped, and demanded to see the entry. They had never put the two incidents together, since they both thought of one physician as much like another; and Anne had been sickly both before and after the doctor’s demise.
Elizabeth continued as if anxious to get the miserable chore over.
“He conveniently died when you were in a relatively good place. He was still treating you at his death, but… well, let me ask this outright. Did he have you taking treatments, even though by any objective measure you were not terribly unhealthy, though you had been for some time?”
Both ladies considered it, and Lady Catherine said, “It seemed prudent, after so many years of illness, and all the physicians agreed.”
“But his death corresponded with a time when you were not particularly unhealthy, so I surmise you took your time finding another physician.”
“I suppose so. We had a flood that year. Anne seemed all right, so I did not prioritise it.”
“In fact, you never got a physician until that winter, when Anne once again got a nasty cold, correct?”
“Correct.”
“Was there something different about this new physician?”
Anne looked embarrassed. “I would prefer not to say.”
Lady Catherine asked. “Why not?”
“When you stand in front of a mirror, you may not pick and choose what the mirror sees, Anne. Answer your mother.”
“By then I was no longer accustomed to holding my nose and taking vile concoctions, so—”
She stared at her hands in embarrassment, and her mother gently asked, “So?”
“I disposed of most of them. I worked out a way to dump the bulk of them into the chamber pot.”
Lady Catherine looked appalled, and Elizabeth jumped in.
“I do not oppose physicians, or at least not all of them, but if you look at the slope of this line, you will see Anne recovered much more quickly than at any time in the past. She went from 30-60 in 2 months. Still not the most robust recovery in human history, but doing extremely well by her standards.”
Lady Catherine said, “Say it plainly.”
Elizabeth laughed. “I do not believe the concoctions were helpful, and they may even have been harmful. Or perhaps Dr Choak’s were helpful and the new physicians’ harmful, or the reverse, or none of them did anything at all.
We will never know, but I can see that at that particular point in her life, she recovered quickly. ”
Both ladies looked at the graphs, and at last Lady Catherine said, “I can see the reason for your style. I might never have worked it out just from reading the journals.”
“Perhaps, and perhaps not. Sometimes all you need is to have someone unaffected examine a story to get more meaning. It probably matters little that I use mathematics and graphs. A good storyteller might just lay out the plot and come to the same conclusion, or a painter might have tried to paint the scenes to bring them to life. I suspect that if you had handed the journals over to either of your nephews, they would have come to the same conclusion.”
Lady Catherine nodded, and Anne said, “Perhaps, Lizzy. It all seems so obvious in retrospect.”
“Things usually do. That is what mirrors are for… apparently.”