Mad Worlds (25 page)

“Our consultant's a-comin' tomorrow – especially to see you,” said Charge Williams, the boss white-coat.

Consultant – at last! John could feel the shiver of excitement. “Ah – the god?” he half joked.

“Our consultant's the god, right enough. He says what treatment our patients are to have.”

Hell. This charge nurse was an earnest fellow. Dead earnest. And this was leuco heaven? “That monster nearly crucified me. Must I see him? I want home.”

The Charge's face had reddened. “Our patients stay here and we looks after them for all their days.”

He'd joined the lifers.

John had just finished breakfast when Charge Williams called him into the office.

“This is John Chisholm, Doctor,” the Charge said to a man seated behind the desk, and went to stand in the far corner.

This white-haired weather-beaten guy behind the desk was not the god.

“Mr Chisholm, I'm Dr Kenney, Consultant Psychiatrist.” The man smiled, then glanced down at a file spread open on the desk.

A different kind of god? “Hello, Dr Kenney.”

“I'm sorry not to see you for a chat before now, Mr Chisholm.”

Hey, a consultant psychiatrist apologising to him. “Okay.” But – beware of Mister Nice Guy. Could be even meaner than Mister Nasty?

“How are you feeling now?”

“Great, by comparison with how I was.”

“Right. I see that in January, you reported memory loss.”

“After the Shocker. I began remembering things sooner than I expected. The trouble is I've no idea what I've forgotten.”

“Hm. We can't monitor any memory loss properly.” The doctor closed the file. “I'd like us to consider your mental state when you came into Springwell. There's not much in our records. You hated your wife?”

“No. I was convinced she had a lover.”

“On what basis?”

A voyeur? “She'd been distant toward me since Becky's birth. And my suspicion grew. Any man near her – I thought there there was something between them.”

“Now, what do you believe?” Not a ‘dirty old guy' question!

“I don't think there was a third party.”

“And I read in your file that your thinking started bothering you?”

“Thoughts came and went.”

“What do you mean?”

This didn't feel like any kind of grilling. Nice Guy looked earnest. Really wanting to know. “My head would get crammed with negative thoughts that'd vanish, like they'd been snatched.”

“And now?”

“No such problems. I think clearly without interference. Oh, another funny thing hasn't happened for ages. I thought sometimes people were reading my mind.”

“And the notes say you were depressed.”

“Yes, I had thoughts of suicide. These haven't been around for ages either.”

“Good. What troubles you now?”

“No leucotomy?”

“Heavens, no.” Doctor looked shocked.

A genuine nice guy, who cared. “I can go home then?”

“No, it's not –”

“Why ?”

The doctor rose suddenly and threw out a hand. “Just noticed the time. See you next week.”

John sat, seeing the hand dangle a moment then withdraw as the doctor breezed past him and exited. What? Did he scare this decent consultant?

Charge Williams escorted him out to the ward.

John sat with Dr Kenney in the Charge's office; a one-to-one in easy chairs. No desk barrier. And the Charge had, at Kenney's request, left them alone.

“Sorry I left abruptly last time. I remembered I should be elsewhere. And today must be brief, as I've squeezed in your session. We'll have longer next time.”

“It's okay.” Time to make his move. “Why can't I go home?”

“I have to be satisfied you're ready. And your wife…”

“I'm ready. And I'm sure my wife will want me.”

“We'll see. Any more questions?”

“Why was I diagnosed schizophrenic?”

“There's little in the notes. Your beliefs about your wife were seen as delusional – fixed and without foundation. But they sound like over-valued ideas – that are common in the general population and don't indicate schizophrenia.”

“So I've not had schizophrenia.”

“Well, it's possible you have. Thoughts crowding into your head and being stolen, and believing others can read your mind, could be diagnostic. But I'd have needed to see you clinically at the time.”

The doctor looked at the notes again. “There's no record of you hearing voices you couldn't account for. True?”

John nodded. A pity the doctor was rising to signal an end to a useful dialogue.

John sat with Dr Kenney – in easy chairs, as last time.

“And how's life on this ward?”

An opening he hadn't expected. “I feel so young, Doctor! But I'm grabbed by older men's tales. Anecdotal history. And it's nice to wear clothes that fit.”

“Happy staying here forever?”

He searched the doctor's face. Not even a twinkle. “No!”

“I don't want misery here, young man.” The doctor rose, his face crinkling into a smile. “John Chisholm, you are fit for discharge.”

What? He grasped Dr Kenney's hand and crushed the man in a hug.

He stepped back. “Sorry.” The doctor smiled and straightened his tie. “That's okay. You'll be free to go once arrangements are made. This'll take time, as your wife needs consulting. I'll ask our new psychiatric social worker to contact you about this.”

The doctor sat down again. “Take a seat. We've a few more minutes for questions if you want.”

“If it was schizophrenia, could it come back?”

The doctor scratched in his hair. “I don't know. There's reason to hope not. It doesn't seem to recur in a fair proportion of younger folk.”

“And maybe you guys got the diagnosis wrong?”

The doctor shrugged. “Maybe. In psychiatry we're uncovering the tip of the iceberg. We rarely speak of curing, or having answers. Oh, and your depressed state might have indicated a schizo-affective disorder.”

More jargon. “What on earth's that?”

“A state that doesn't present firmly as schizophrenia, and where your mood is abnormally exaggerated – in your case, depressed. As for the depression – broadly speaking, did this come out of the blue, or were there things you felt caused it?”

“Definitely the latter. I was pretty stressed, both at work and at home.”

“Again, reason for optimism. Sounds like the stress triggered your breakdown – and indeed your troubling experiences could have been an understandable though exaggerated reaction to severe stress.” Dr Kenny smiled. “Enough psycho-babble!”

John shook the proffered hand as they rose. He leapt out into the ward. And the rest of the day he kept whistling his favourite tune, the Song of Liberty.

*

After a brisk walk in the sunshine and a celebratory coffee at The Stars – a new cafe at the top of Hospital Lane – John got back to a message from the staff nurse.

“A nice-looking woman called after you.” Staff chuckled. “Says she's Maggie Lee, the new psychiatric social worker. I'll ring and tell her you're back.”

So this woman would be the crucial link for him.

*

A few minutes later, a fair-haired young woman appeared, spoke to the staff nurse, and came his direction. “John Chisholm?”

“Yes, hello.”

She was good-looking when she smiled. “Maggie Lee, PSW – stands for psychiatric social worker. You can call me Maggie. Let's go to my office for a chat.”

D-Day. Yes, Discharge Day. And now, nine a.m., he was en route home in Maggie's car. “The road needs all my attention,” she said. “I haven't long passed my test.”

She was crawling along, and kept hitting the brake. He stayed quiet!

Wednesday evening at half-past eight, Maggie had come to the ward. “I've just visited Heather and we had a long chat. The way's clear to go home this Friday.”

He'd nearly hugged her. Clouds of doubt over whether he'd be welcome home had gathered. Though he and Heather hugged warmly on her fortnightly visits, and talked together so much – mainly her telling him about Becky, the nursery, her friends Elsie and Mattie and Moira – they hadn't touched on him coming home. Even on her last visit, he'd been pessimistic about his chances of discharge. And her response to his mention of shacking up with another guy had left him wondering.

Yesterday had been a tying-up-of-the-ends day. Dr Kenney made an outpatient appointment at Aversham clinic and showed him the discharge letter for his GP.

“One last tip, John,” said Dr Kenney. “If you get over-stressed, try and find somebody you can trust to talk with about what's bugging you. But if that doesn't work, ring and I'll fit you in at outpatients.”

He'd asked about Ginger. “Discharged. And the Baron insisted on taking, as companion, Mackay – the man you'd know as Kong, who sadly was like an automaton after a leucotomy – back to live on his estate.”

Great news! He'd also been given the okay to see old pals on Lilac (ex-Refractory) Ward. With each, sadly, he encountered flat rejection. Pat darted glances around and shambled away with his head down, hands in pockets. George whispered protest that being visited would identify him as the famous author.

He jerked forward, bumping his head on the windscreen.

“You're home,” said Maggie. She waved. Heather was in the doorway. “I won't stop. I'll call again soon.”

“Thanks Maggie.” He shut the car door behind him and bounded towards Heather. He'd a lot of catching up to do.

Two-fifty a.m. John lays down his fountain pen. Part One of
Springwell: A Memoir
is nearly completed. This will catalogue his journey through the institution. Identities are disguised through name changes – but the tale is revealed, unexpurgated.

He could continue, finish Part One. At college he'd swot till four a.m. and tackle exam papers later that morning. But now, a librarian facing the public from eight-forty-five a.m., he seeks rest.

He wants to go upstairs and join Heather in their cosy double bed. But no matter how softly he treads, the stairs and upstairs floorboards will creak. Heather mightn't notice – she snored through a thunderstorm the other night – but he'd have to pass the children's bedroom and could waken them. Baby Liam is a particularly light sleeper, with a lusty cry.

He settles in the armchair and closes his eyes. He drowses, but does not sleep. His brain urges him into reflection. He knows resistance will espouse restlessness, and that anyway sleep will eventually prevail.

Part One has, in the writing, proved more harrowing than expected. He knows that writing about traumatic experiences is a tool sometimes used in therapy. The recently qualified PSW Mac (Angus) Macleod, now his closest friend, is encouraging him in this approach, and is helpfully being available to listen and discuss.

Mac (his old acquaintance Browncoat Mac) expresses no regret over having gone into psychiatric social work and not clinical psychology. “I messed up the finals – and am I glad now! Getting around to see folk and the families in their own homes is a heck of a lot more my style than sitting holding hands in therapy.”

It's great to have Mac around, and sometimes they laugh about the dirty laundry and talk about the old days – including the escape. He loves discussing the radical ideas Mac has picked up. “These three guys, John – Ronnie Laing and Thomas Szasz, psychiatrists both, and the Yankee sociologist Erwin Goffman – are like heavyweight nuns in our hallowed psychiatric monastery. Aye, they persuade me that we mental health foot soldiers rely far too much on medical approaches.”

He's considered how such ideas could relate to his own experience. Had he been ill, or was his breakdown a problem of living (in unbearable stresses), to do with events and relationships? Maybe in practice it doesn't matter too much.

Or maybe it does. He agrees with Mac that diagnoses, while essential to the medical approach, can become labels that influence how folk view you socially. He's occasionally been aware that his ‘label' is inhibiting. “Reductionist – how we mental health guys can still talk,” says Mac. “It's our historic culture, and public attitudes.”

He sees very clearly the relevance to Springwell-as-was of Goffman's ‘total institution' concept. In his memoirs, he sometimes refers readers to this and other literature sources.

He's talked with Mac about the suicidal thoughts he had. Thank goodness the means didn't present. Mac reckons that if life gets bad or meaningless enough for anyone, doing themselves in can seem the best move.

He's also read about The Samaritans, a movement started in London by an Anglican priest who believes talking in confidence with somebody can help folk feeling suicidal or upset. He wants to get a similar service going locally.

His anger is often near the surface. The savagery and oppression in a supposedly caring institution with ‘hospital' in its title, the destruction to lives, the waste of talent among his fellow patients. But he no longer feels bitterness on his own account. Without the passage through Springwell, he might still be teaching, with a breakdown about to happen. As it is, he's enjoying work that he's suited to, and that allows him to find time for reading and study.

At home, he savours being with Heather and their children. Life was unexpectedly rocky at first, and he owes Maggie for her work – listening to him and Heather and helping them sort things. Becky is settling in at school. He'll always carry the pain of missing out on a year of her infancy. Heather says she loves the work at nursery. Now NNEB-qualified and Deputy Matron, this is her career – interrupted only by the births of their two youngest. Her pay's not great, and neither is his, but they manage. And the child benefit's a bit of a life-saver.

Right now's not brilliant for Heather. She's spending a lot of time with Elsie across the road. Mattie has died and the funeral's tomorrow afternoon.

John's not looking forward to it. There's a good chance he'll cry. He liked Mattie, and spent time with the old man in the latter stages of gasping with emphysema.

Perhaps it's this triggering him into melancholic reflection – re-playing his childhood bereavements. And his whole being shakes at re-living the scene of Dave's parting “See ya bruv”. A happy moment preceding unspeakable loss. This is the memory that gets him weeping. He's not told Mac of his intensifying sadness, but he will. Hopefully after tomorrow he'll pick up. And if he's descending into depression, he'll contact Dr Singh, his consultant at outpatient clinic.

After the kids were in bed last night, he and Heather had a weep-in. Not just about Mattie, and Dave. Heather's lamenting Edward, the brother she never knew, and her parents having to move into a home for the elderly mentally infirm in Aversham. He never got on with her folks, but he wouldn't have wished that on them. Heather really feels for Elsie, who befriended her and Becky while he was in Springwell. Elsie dotes on Becky and is great with their other kids. She's like a grandma – and in fact, at Heather's suggestion, they call her Grandma (and Mattie Grandpa). Heather's own parents are Granny and Granddad.

He's studying the history of mental health law and policy as grounding for his MA thesis at Manchester. He learns that in their nineteenth-century conception, the city and county asylums were built to provide a haven (‘asylum' being Latin for ‘place of refuge') for mentally afflicted ‘lunatics'. From 1930, the change of title to ‘mental hospital' signalled the main intended purpose as caring. He notes that sadly, with few exceptions, the institutional emphases were (in line with prevailing public attitudes) on containment – locking eccentricity away from the public and using physical restraints, sometimes brutality, to keep control.

Part Two of his memoirs will focus mainly on the radical changes at Springwell, pioneered by Jamie Macdonald and supported by the Royal Commission findings and the '59 Mental Health Act. As Chairman of the Friends of Springwell Hospital – a group Gill Macdonald set up and is active in – he has periodic meetings with Jamie, Deputy Medical Superintendent Lizzie McVeigh, Matron Caroline Dee and Chief Male Nurse Joe Macnamara, to review how the reforms are working out and discuss initiatives for involving the community. He admires Jamie's dedication to creating a therapeutic environment for the patients, and to schemes ensuring that discharged ex-patients are supported. And Caroline, with her single-minded commitment plus strategic ability and vision of a caring hospital, is also inspirational in the Friends.

On the community schemes, Mac, who with Maggie heads up a department of eight social workers, plays an important part. Through Mac, John hears of Sam Newman, Aversham's Senior Mental Welfare Officer – who, with fellow mental welfare officers from borough and county, goes monthly to the hospital's social work department for training seminars and a review of discharged patients. The mental man! John has no ill feelings now (towards Newman) about being bundled off into Springwell. The man was doing a tough job, and on reflection didn't seem the bullying type. Poor guy – apparently pretty crushed after being widowed recently.

John's work for the National Association for Mental Health – he's on their National Executive – will also feature in Part Two. He plans to continue part-time study for a PhD, surveying ex-patients' experiences of their stays in mental hospitals.

The Macdonalds are now personal friends. He and Heather enjoyed an evening with them last week. A lovely couple, older than they. Jamie told him, over the after-dinner coffee, of their deep sadness at the miscarriages and, with Gill past childbearing age, their application to adopt.

An alarm's going off upstairs. Without sleep, the day ahead – at the library, then the funeral – will be tough. But John knows he will survive.

The End