‘Um, fine, I think,’ I said. Grace had schizophrenia, and a history of hearing persecutory voices. ‘I’ve read Grace’s case notes and chatted to people. I’m looking forward to meeting her. I think we’ll get on.’
Jeremy nodded and excavated a bit of egg sandwich from his back molar.
‘You know, she has got a challenging background, although nothing out of the ordinary: years of sexual abuse by her stepfather sent her over the edge – nasty piece of work by all accounts, he was. She was brought up in a hotel, and the stepfather was the manager, apparently. Used to abuse her in the guest bedrooms.’ He made a face, as if he was describing a disgusting meal he’d had.
‘Horrible,’ I said. Jeremy was harmless and also quite passionate about his job in his own (his
very own
) way. But there was sometimes a salacious tone in his voice, when he talked about patients, that didn’t sit well with me, like he enjoyed the drama.
‘You do know she’s
had three CPNs beforehand who she’s not got on with?’ he said (you had to love his management style – so encouraging).
‘Yes. I think I did know that.’
‘Although, she’s particularly requested a woman this time, so, you know, you might be okay.’
He told me how he’d been Grace’s CPN for years; that they went back to the year 2003, when she had her breakdown and came into the system.
‘Oh, so you know her well, then?’ I said.
‘Yes. And I can tell you, she has a very definite cycle.’
I laughed. ‘A cycle? That makes her sound like a washing machine.’
He frowned, a bit affronted.
‘What I
meant
was, if you would just let me finish
,
is that she runs like clockwork. She has …’ He paused, belching quietly into his hand. ‘And no, I won’t make any apologies for this, ’cause it’s true. She has a very definite “cycle” of behaviour.’
‘Okay,’ I said. ‘So what does this cycle consist of?’
‘Well, she has an episode every May, without fail, like we’ve just seen now, when she’s generally found wandering the streets at night, starts hearing voices, saying people have broken into her flat at night. Then June, we’re not usually too bad, but come August and we’re downhill again. Always mid-August. Always the same time.’
‘Is she not on a CTO this time?’ I asked. It would make sense after so many admissions. A Community Treatment Order meant she’d have to sign a form to say she’d come into hospital for an injection, because she couldn’t be relied upon to take her medication herself.
‘I don’t know,’ Jeremy said, a bit defensively, like I was trying to get one up on him, which I wasn’t. ‘But this will be something you can discuss up at the hospital.’
He bit into his sandwich and chewed, breathing noisily through his nose. ‘Sorry, you don’t mind if I eat this now, do you? Molls is potty training – we had several accidents this morning, including a number two, and I didn’t get time for breakfast.’
‘No, not at all,’ I said, although ‘breakfast’ and ‘number two’ in the same sentence made me gag.
‘So, has anyone got to the bottom of Grace’s … “cycle”? Why episodes happen at certain times?’ I asked.
Jeremy carried on chewing. ‘Well, it’s obvious, isn’t it? I mean, the summer – like Christmas – can be a very alienating time for people like Grace. Everyone’s having barbecues, going on holidays …’
This seemed tangential but I nodded anyway.
‘And also she’s got this thing with taking people’s photos – I’m sure they’ll fill you in when you get there. Needless to say, it gets her into trouble on the ward. She’s got no idea of personal boundaries.’
Having finished his sandwich, he started applying some cream to a flaky red patch on his elbow.
‘Sorry,’ he said. He made a wincing noise as the cream touched his skin. ‘Psoriasis. It’s really flared recently.’
I couldn’t wait to meet Grace now. I’d read her case notes and there were things that chimed with me, things people had said to me about her, that reminded me of things people said about me, when I was younger, before Mum happened and that summer happened, and I probably grew up ten years in one: ‘She’s a handful, that Robyn King’; ‘She’s not at
all
as sensible as her big sister.’ It made me want to rise to the challenge of her. To show Grace what I was made of.
When a patient was about to be discharged to the homecare team, us CPNs often went along to the hospital for ward round and what was called a ‘discharge planning meeting’, so we could meet the patient beforehand. As discharge planning meetings went, Grace’s was pretty painless. Dr Manoor was Grace’s consultant, which made things easy, because we’ve got quite a rapport going now, Dr Manoor and I. Whenever he calls me up to come in and assess, we always have a joke: ‘Who’ve you got for me this time, Ramesh?’; ‘Are we going to need a stiff drink after this?’
As well as Dr Manoor, there was Michelle, the OT – occupational therapist – who never seems as frazzled as the rest of us. I like Michelle. It was the senior nurse I didn’t take to – someone called Brian Hillgarth, who I’d never dealt with before. He had dandruff and this off-putting habit of never meeting your gaze when he was talking to you. I didn’t like the way he spoke about Grace either. He kept saying things like, ‘Like all chronic schizophrenics, she has fixations about things …’ What did he mean, ‘Like
all
schizophrenics?’ (
Like all people called Brian
,
you never meet people’s eyes when you’re talking to them.
) I felt like he spoke about her as if she was beyond help, beyond hope.
There was also this matter of her taking photographs.
‘The problem is, she was putting that camera in patients’
faces,’ Hillgarth was saying. (I couldn’t help thinking there were worse places she could have been putting her camera.) ‘Taking pictures of them brushing their teeth, or in the art room. I mean, these patients are paranoid enough.’ There was a pause during which everybody looked at one another as if to say,
We know, Brian, it’s a mental hospital
.
‘So, can I ask, what’s with the photography in the first place?’ I said. I was curious. ‘Is Grace generally interested in photography? Is it something she does as a hobby?’
This seemed to completely confuse Brian, who said, ‘I think my point is, she’s abusive with it.’
‘Abusive? What, with a camera? How do you mean?’ Everyone sort of looked at the floor. As CPNs went, I was probably quite outspoken.
‘She gets a bit upset, I think,’ said Michelle, ‘when people don’t want their photo taken, you know.’ Michelle was such a softy; if Grace had been beating people over the head with a mallet, she’d have put it down to her just being ‘a bit upset’.
‘No, I’d definitely say, she’s abusive,’ Brian said. ‘Personal and insulting when people don’t want their picture taken. She told one rather large patient that they were supposed to “eat what’s in the fridge, not the fridge itself”.’ I had to bite my lip so I didn’t laugh. I’ve always liked the naughty ones.
The meeting went on for forty-five minutes. It seemed Jeremy was right about one thing at least: there was a pattern to Grace’s admissions (May and August figuring strongly), but nobody had got to the bottom of why.
‘So she’s not on a CTO?’ I asked.
‘She was trialled,’ said Dr Manoor. ‘But there were side effects with the injections: tremors, weight gain …’ Often the side effects were worse than the mental illness itself but, without the CTO ensuring Grace would agree to come into hospital to have her injections, I’d have to work hard to keep her compliant.
Eventually, they called Grace in. She was
tiny
and ever so sweet-looking, with this delicate, fawn-like face and these big brown eyes shining out from beneath the Yankees baseball cap she was wearing. The skin on her face had been ravaged by fags and booze and emotional pain, but there was still a girlishness to her; then, she spoke.
‘Wotcha?’ she stuck a tiny hand out and I shook it. ‘I’m Grace, and you are …?’
‘Robyn.’
‘Robyn,’ she said, screwing her tiny nose up. ‘Isn’t that a boy’s name?’
‘And a girl’s,’ I said. ‘Although, my theory is, my parents wanted a boy and so didn’t really have any proper girls’ names on their list.’
She laughed, but like it was an afterthought, then carried on staring at me, quite intently.
‘You’re pretty, ain’t ya?’ she said, eventually. ‘She is, she’s pretty, i’n’t she?’ she said to the rest of the room. I could feel myself glowing beetroot. ‘It’s the eyes – you’ve got lovely brown eyes. And great bone structure. Have you got Slavic in your blood?’
‘I’ve got Cumbrian, does that count?’ I said, and everyone including Grace laughed – although Grace a little later than everyone else. She swung a leg over the chair and almost bounced into the seat. She was wearing a grey poncho with reindeers on it, rust-coloured trousers, white trainers and the cap.
‘I’m glad I demanded a girl,’ she said. ‘They normally give me smelly old men to look after me. One before last, looked like a massive strawberry,’ and I smirked, because I knew exactly who she meant (Jezza – Jeremy), and he did, he looked
exactly
like a massive strawberry. ‘He had this big fat red face with pits all over it, and this hair, sitting like a toupee on top …’
‘
Grace
…’ Michelle was laughing too but had her hand over her eyes, shaking her head. ‘We’ve talked about being personal, haven’t we? Sometimes you’ve got to
think before you speak
.’
‘Oh, I know, I know,’ Grace said, ‘That’s my problem, innit?’ I never think before I open my big mouth.’
We had to get some of the big questions out of the way: likelihood of her topping herself after discharge from hospital, for example (low, she assured us, the council were coming to do up her flat if she could stay out of hospital – and alive – long enough), and whether she promised to stick to taking her medication.: ‘Well if it’s that or a needle in my bum, then I’d better be a good girl, hadn’t I?’
‘And would you like to see one of the crisis team, Grace?’ Dr Manoor asked. ‘For a while, after you’re discharged?’
‘No,’ she said, smiling at me. ‘I just want to see Robyn.’
I felt this little bubble of pride.
Then, the most bizarre thing happened. Brian reached behind him, brought out something and held it out to Grace. ‘My camera!’ she gasped, turning it around in her hand, as though it was her engagement ring that had been found. ‘I thought it was gone forever!’
‘We had to pretend it was lost,’ Brian said to me, like it was a dummy and she was two years old. ‘She was just driving everyone mad.’
‘Got time for a chat, Grace?’ I said, as we were all getting up to leave. ‘Just the two of us?’
She looked at me, a little suspiciously, before breaking into a gap-toothed smile. ‘All right,’ she shrugged. I followed her out of the door.
We went to Grace’s room to collect her cigarettes.
‘We’ll have to freeze our bums off outside,’ she said, rummaging around in her coat pocket. ‘No more smoke rooms. As if they could make these places any more bloody depressing.’
We had to walk around a zigzag of corridors, before we got to the lift that took us to the main entrance outside. The walls were filled with pictures of dodgy, replicated beach landscapes, in an attempt to brighten the place up. Grace gave me the lowdown as we were walking.
‘Room Five. That’s Harry. Hasn’t said a word in two months. Spends all day watching DVDs about polar bears … All right, Harry?’ She popped her head around the door. I could just see a large, white-haired man, sitting in a chair, staring straight ahead. ‘Those polar bears behavin’ themselves?’
I waved at Harry but he didn’t wave back.
‘Room Seven, Winnie – conked up to the eyeballs, bless her. Tried to hang herself on a curtain last week.’
‘I know,’ I said, ‘I heard in the office.’
‘And that’s Rebecca’s room,’ she said as we passed room 10. ‘Now
she’s
a sandwich short of a picnic.
She thinks she’s a millionairess
,’ she whispered as we turned down another corridor.
‘Maybe she is,’ I said. ‘You want to get in with her.’
‘You’re joking, aren’t ya? She lives up at the Elephant in a council one-bed, like me. Day she came in, she’d blown three grand in Harvey Nicks; hired a security team and everything, just in case she was kidnapped, she was so convinced she was loaded.’
‘So what happened?’ I said. ‘In the end?’ This story hadn’t yet made it back to the office, but I knew it would.
‘Driver clocked, didn’t he? Whilst she was having a champers lunch at The Ritz, no less. Story goes, he managed to get hold of her phone, called up her sister, who confirmed she was mad as a box of snakes, and she came to collect her. That was three weeks ago,’ she said, holding the door open so we could go outside.
And that’s the thing about this job, I thought. Just when you think nothing can surprise you, something does. Manic shopping sprees we’d had, but hiring security? This was a league above.
The smoking area’s not such a good place for a ‘private’ chat in a mental hospital, since for 99 per cent of the patients it’s their favourite place on the premises, possibly the world.
We sat together under the plastic shelter. The red-brick chimneys of south London were arranged, against a slate-grey sky, in perfect sloping lines, up in front of us.
I watched as Grace lit a cigarette.
‘That’s a long one,’ I said.
‘Vogues,’ she said. ‘More fag for your money. I may be in the loony bin, Robyn, but you’ve got to retain some of your glamour.’ She inhaled and gave a throaty laugh. I smiled. Grace amused me.
We sat in silence for a while as she smoked. The city looked quite beautiful from up here. I wondered what thoughts had gone through the muddled heads of people sitting in this shelter: what fears, what hopes? How had the world looked to Grace during her months in hospital over the years?
She stuck out the packet of Vogues in my direction.
‘No thanks, Grace. D’you know, it’s one vice that’s never, ever done it for me,’ I said.
‘You’ve more sense than me,’ she sighed, lighting another one. ‘Worst decision I ever made – and I’ve made a few. I bloody well need it here, though.’ I noticed how her fingers were shaking now, with the meds, or anxiety, or the cold – probably a combination of all three. ‘These people don’t help.’