Looking Through the Windows of Madness
Leo Vine-Knight
Copyright 2009 Leo Vine-Knight
Smashwords Edition
Steven is a psychiatric nurse with an attitude problem, as well as one or two embarrassing secrets. Close to burn out, he struggles through a maze of flashbacks, rebellious impulses and mind-numbing events, gradually revealing a story of insidious madness. Not just a story, but also a heartfelt critique of modern values - seen through the comic lens of a profession on the brink.
The author has worked for over twelve years in mental health units around the U.K. He has a Ph.D. in Mental Health Studies and now lives in the North of England with his wife and two children. He has published work in a number of international journals.
Author’s Note
Although this book is based on the author’s experiences as a psychiatric nurse, it is a fictional account. The characters and situations which appear in the work are synthesised from a large number of observations made during a twelve year clinical career. The author makes no attempt to factually report the actions of any particular person (living or dead), or to factually represent the structure and processes of any particular mental health unit. Similarity is therefore coincidental.
The author acknowledges that the challenging assertions made in this book are based on his personal views and subjective experience, rather than the objective truth. He accepts that the background events which inspired this novel, as well as the fictional world created, may not be typical of mental health units around the U.K.
He also acknowledges the serious nature of mental disorder itself, and realises that satire may be considered a strange form of analysis. But for those who have worked through the tragedies and comedies of a psychiatric setting, the choice may be easier to understand. They will have learnt that people often overlook significant issues until they are uncomfortably amplified.
Above all, the author asserts his right to express an honest opinion on matters of public interest.
I wandered along to the bathroom in a grateful daze, and locked the door behind me. Hot water soon filled the tub, and a wan face gazed crookedly back from the chrome taps. My mind was made up and very still; but first it opened windows.
Nephelokokkygia
Some enlightened citizens once asked the birds to build a wonderful walled city in the air. In this place, a person could be removed from the evils of society, and made safe from the wrath of the Gods. The city was called Nephelokokkygia.
Cloud Cuckoo Land.
Ornithes
A Play by Aristophanes 414 B.C.
Prologue
1990
The Victorian mansion stood eerily in the mist, its perpendicular windows and scarred oak doors sitting in Gothic relief amongst the vast grit-stone walls. Nearby, the little chapel tolled its bell, and a crocodile of grey shapes meandered slowly down the gravel drive. Past the high privet hedges, the old crooked birch trees, the huge gateposts capped with carved eagles, and on towards the waiting coach. Here, one or two white faces turned around to look at the place some called home.
It was the day that eight people left the regional asylum to ‘rejoin’ society.
And this is the story of what happened.
2007
We adjourned to the back of the car and sumo wrestled into an uncomfortably exciting position across the leather. The thin straps of Carol’s silk dress fell away and I circled her white orbs with hot lips and poetic sighs, while she quietly inspected my credentials with a languid, vermilion tipped hand. Patiently, I wandered along the perfumed curves of her trunk, until her legs divided around me and my tongue licked rapturously along the lacy top of her right stocking. With a husky voice she gasped,
“Please…..please…..
“ Bang!”
“Wake up, you lazy pig!” she screamed from the kitchen.
I would probably have woken up anyway because the neighbours had left their halogen security light trained on our bedroom window again, like a Colditz search light probing around for unauthorised activity across the compound. There was certainly a din going on downstairs, and this turned out to be a dropped bowl of corn flakes on the lounge carpet, followed by loud recriminations and protracted sobbing. I hated great shows of emotion, and yet this seemed to be the primary method of communication in our house, as people swung freely from delirious mirth to cold silence without a second thought, or probably a first.
“Will you please eat your breakfast!” my wife implored.
“It’s my turn on the piano!” my youngest answered.
“….grandmother strangled in her own home…” contributed the man on T.V.
“Where’s Dad?” said my eldest, followed by the sound of scampering footsteps coming up the stairs, and what sounded like a mumbled insult from my spouse in the background.
“Crash!” went the door as it bounced off the wall, and I received a loving hug, followed by a garrulous report of current domestic disputes downstairs.
“Okay petal, I’ll be down in a minute” I said, trying to gather my wits together, as my sinuses tightened their hold on my forehead, and my rumbling bowels notified me of their overnight load. With little option, I swung my spindly legs over the side of the bed, inadvertently broke wind, and spotted the old ‘Triang’ toy crane sat on top of the wardrobe; its black bucket hanging over the side like a man on the gallows.
Yawn, belch, fart.
A short history of humanity.
I hadn’t been sleeping well for weeks, going to bed dead beat, waking up in the early hours, and then remaining awake until four or five o’clock, when I would descend into a feverish stupor until the alarm went. I was constantly tired, sluggish and irritable, finding it harder than usual to concentrate, and carrying around a variety of aches and pains as I waded through the day like a Great War soldier waist dip in mud. At different times over the last six months, I’d had colds, aching joints, upset stomachs, sore throats, a vague dizziness and a woolly headed tendency to forget messages, or acquaintances’ names, or the toast. Some days I would have to write out a list of reminders in the morning, to ensure that I didn’t overlook something important, and even then I would occasionally mix up my shifts at work, or forget to attend a meeting. Worse than that, I’d sometimes experienced strangely delirious thoughts as I’d drifted off to sleep, or when I’d woken up in the middle of the night; something which altered the shadows and forms in the room and took a whip to my imagination. Something like acid flashbacks.
I couldn’t put my finger on any one reason why my health was deteriorating, largely because there was a variety of leading contenders. For a start, my mother had died earlier in the year at the age of 79, and this had opened up a Pandora’s box of conflicting emotions. We’d been reconciled for the last few years and there’d been regular visits, outings and set-piece celebrations which had brought us closer together as a family, but the past had been a long hard road. It was impossible to abolish history and no matter how generous and attentive my mother was towards the end, I simply couldn’t throw off my old attitudes of resentment, wariness and distantly recalled pain. I was caught hopelessly between the present and the past; an inward struggle with no winners.
Carol and I had also provisionally agreed to divorce, although we both seemed reluctant to take practical steps towards it. We had never recovered the romance of those years before the interloper appeared, and had gradually replaced love, friendship and trust with the soft cement of parenthood, financial partnership and inertia. Most of the time we rubbed along together, but we were both sensitive to anything that reminded us of the year we separated, and the ugly issues which were then exposed forever. Relationships seem to thrive on a mutual ignorance (or disregard) of each other’s weaknesses, and this was no longer the case for us, as we fenced and boxed through the days, strangely uneasy in our nearness, like familiar strangers.
We were basically very different in our outlooks now, with my wife becoming a fully paid up consumerist, while I maintained an interest in ‘down shifting’ and a simpler lifestyle. She was theatrically sociable to gain supportive friends, while I was studiously anti-social to preserve independence and fleeting quietude. She was a happy-clappy born again Christian buying a stairway to heaven, and I was an inveterate cynic critiquing the world with monotonous grumpy old man intensity. We quarrelled incessantly yet avoided one another where possible, and when we agreed to approach the solicitors one day, we probably knew we wouldn’t the next. Family visits to stately homes alternated with personal visits to estate agents, while heated exchanges vied with electrical silences to see which could have the more stressful effect. My wife spoke more to the guinea pigs than me, and I thanked them for the distraction. The only thing that remained of our hippy heydays, was a split cane rubbish basket next to the toilet.
Still, continuing romance had its price too and I cheered myself up by remembering the man who told his wife to excrete daily in the public lavatories rather than the domestic loo, because her bathroom activities were spoiling his idyllic view of sex.
“Morning” I said, when I arrived downstairs.
“Hi” said two out of the three present.
“Mum’s going to take us to see ‘The Three Tenors’ tonight” said my daughter.
“Oh, we’re not that poor” I quipped. “I’ve already got four twenties and a fiver in my wallet, if you want to see them.”
(silence).
“And I’m doing a presentation at school today”.
“A presentation!”
“Yes, a presentation on ‘what it’s like to be a child in the 21st century’.”
“But I thought everybody was an expert on that these days. Surely we don’t need any further explanation. Ha ha …..ha……er…...”
(silence)
I shook the debris out of the long-suffering toaster, took a lung full of lingering smoke, noted that we’d had cabbage the previous evening, and watched the guinea pigs watching me from their luxury winter cage. Seeing some bills hiding behind the ornamental lighthouse, I involuntarily reviewed the household budget which was written in red ink and permanently stapled to the back of my mind. We weren’t heavily in debt by any means, but we had a steadily growing overdraft and I was having to run faster and faster on the overtime treadmill, with cramp setting in. I was happy enough with our detached house, black second hand sporty hatchback with pop up headlights, pine furniture, basic computer and weekends away. But Carol wanted a third child, foreign holidays, bulging wardrobes and state of the art gismos at every turn in the house. I counselled restraint, and she ordered store credit cards and mail order catalogues. I avoided shopping centres like the plague, and she treated them as blessed havens of modernity.
This led to extra shifts and plenty of night duties, and for a while I coped well while many of my colleagues just reported sick and ordered ‘The Oxford Medical Encyclopaedia’ to research their excuses. But then the poor quality interrupted sleep began to wear me down, my chronic sinus problems got worse and I started picking up colds and stomach upsets. I contracted a chest infection and had my first time off work for three years, coughing up bottled fruit phlegm and taking antibiotic bombers, while Carol accused me of malingering and went to see one of my work mates who’d been sick for four months with a ‘backache’ of uncertain origins. I’d never really pulled clear of that, and for two weeks I’d been waiting in freezing school yards, taking the kids to Beavers, Brownies, Scottish dancing and piano lessons in a daze of vagueness, irritability and febrile distraction. One night, I’d even turned back to philosophy for guidance, only to find that postmodernists were now as certain of uncertainty as I was.
In a whole life, we don’t understand a single moment.
An Apocryphal Story:
The Future of Madness
1964
Tarp was always a bit headstrong and self-centred, but the impact of school left him in no doubt that the ordinary conventions of life were not for him. He regularly played truant, and was often seen hanging around kiddies play equipment in parks, or listening to rock and roll in the public library. Nevertheless, his egalitarian schoolteachers were quite happy to award him his 12-plus examination (even though his scores plumbed new minima), just to make sure he didn’t feel a failure and to give him every possible chance in life. So, at 16 he left the local Grammar with ten (grade 1) ‘O’ levels, masses of confidence and oceans of self-belief; as well as a noticeable inability to read, write or talk coherently.
While his contemporaries started work, or began A level courses, he opted instead for sitting at home watching ‘Rag, Tag and Bobtail’ on his mum’s telly, or sniffing old balls of plasticine, to see if he could get high. He told the neighbours that he wasn’t interested in work, and that he expected to be paid by the government for doing exactly what he wanted for the next fifty years, because that was his basic human right. In the early hours, he was usually seen with a tin of gloss paint and a 4” brush, embellishing the nearby police station with union jacks and pictures of genitalia. The police sometimes came out and had a quiet word, but it was “only natural” for lads to behave that way - what else could young people do? It was 1964 after all.
At the age of 20, he put his football kit on every morning and played with his hoop and stick or marbles in the back alley until lunch was ready, after which he would ride his little red tricycle on the pavements into town, where he would shoplift and swagger. The local university heard about his maverick behaviour and soon identified it as a worthy expression of ‘inarticulate social critique’; later offering him an honorary place on their sociology degree course. He refused in fine four-letter fashion, but was less pleased a year later, when his mother died.
Although he didn’t bother going to the funeral, he soon noticed her absence by the proliferation of dust and bills in the house, as well as his own unaccountable malnutrition. Passing the big hospital on his roller skates one day, he had a flash of inspiration, and decided to go in and ask for help. The bearded doctor welcomed him onto the couch with open arms, and then began a detailed, trail-blazing psychiatric assessment. At the end of it, he said:
“So, you say you’re “dyslergic” to work and responsibility, Tarp?”
“Fucking right, I do.”
“Well, this is what we call a ‘neologism’ in our business. It means that you are creating new words as part of your delusion about life.”
“Whatever you say, Doc, as long as I can stay in here for a bit.”
“Yes, you can certainly stay. In fact you can stay indefinitely.”
“Fucking brilliant – cheers mate!”
With that, Tarp was shown to the bed he would sleep in for the next twenty-five years, while the psychiatrist massaged a braless bust of Sigmund Freud and carefully placed a piece of pink water-marked paper on his leather topped desk. A man born before his time, and a regular contributor to the ‘Lancet’, he wrote:
Responsibility phobia: the first case in a modern epidemic?
Yes (he thought) the world is going into reverse. Good old Tarp.
“Time to go!”
So, we piled into the car still chewing our bacon gristle, shuddered over the traffic calming humps and joined the other grey-faced parents sitting uncomfortably at the semi-permanent temporary traffic lights on both sides of a big deserted hole. All around us there were children in blue, green and red uniforms traipsing along with dull bestial looks and vast rucksacks stuffed with key stage hieroglyphics, while mouth-frothing trolls hurled obscenities from the side roads; their ways barred by stone age rivals. Thirty minutes and two miles later we were at the school, where the usual collection of thick-skinned narcissists were parked once again on zigzag lines in front of the gates, their eyes glinting with gunslinger venom at my well-practiced slow motion ironic applause, while a procession of cold, scantily clad young mothers sashayed by, modelling their latest catalogue purchases. It was here that Carol smiled for the first time today, as she blended seamlessly with the crowd, flicked a switch, and started chattering gaily.
Sidling through a tight opening in the twelve-foot high mesh fence which had been erected to discourage some local ‘high spirited young men’, we entered the school yard and Carol curtsied in the direction of a smirking parent-governor who was thrilling his twittering fan club with tales of valiant deeds down at the rugby club where he wore hipster shorts. I openly stifled a yawn, said farewell to the disappearing children and retired to the car, where I played Jimi Hendrix on the dusty stereo and waited for my wife to return.
“That was rude “ she said, apparently referring to my lack of hero worship for the parent-governor.
“Agreeably so” I remarked with undisguised satisfaction.
“At least he knows how to put a tie on” she taunted.
“It’s just a pity it wasn’t three inches tighter” I rejoined.
To think that many years ago I used to give Carol her breakfast in bed on Sundays (although it was later revealed that she preferred it on a plate like everyone else).
We spent the rest of the journey in strained silence, as cars veered towards us like heat-seeking missiles, and the sky got another shade darker. For the first time in two years the car radio mysteriously crackled into life, and somebody commented:
“A man recently killed his wife for her life assurance, only to discover that she had already cashed it in to spend on her lover.”
I couldn’t help noticing that Carol’s eyes were like the cross hairs on the sights of a sniper’s rifle, but I was by now absolutely immune to any amount of sulking, and my mind wandered, not for the first time, into a reverie of paranoid self-analysis. I was getting old, and all around me deceit, excess and spin seemed to be turning mockingly orthodox, while my own values and beliefs lay buried under an avalanche of 21st. century sleaze.
Yes, ‘sleaze’ was just the right word for it.
When I first started working at the unit, it was only a degenerate minority who regularly used their elephant hides and mercenary natures to exploit the system, but now a majority of staff had joined the bandwagon and the protesting few could only stand by as managers and abusers cutely turned the tables. Staff members who regularly drew attention to the excesses and deficiencies were at first cleverly humoured and given empty promises, but then gradually marginalized by counterattacking challenges, jokes about their ‘obsessions’, and ostracising acts. I had now almost entered this final phase, and I could feel the crowded ranks closing against me, as my naïve advocacy on behalf of the taxpayer was routinely reviled by the collusive ‘closed shop’. Farce, travesty and collective delusion had become so deep-seated in our local psychiatric services, there was literally nobody left to complain to.
“You don’t seem to think much of our management skills, Steven?” the Locality Director once said.
“Well, I know one manager who can render the first line of ‘Old Man River’ as a continuous belch, but apart from that………No.” I replied.
‘Patient rights’ on the unit had also set me apart from my more enlightened colleagues, who had joined with the massed bands of relatives, professional advocates, inspectors, consumer groups, public relations managers and health trust solicitors to ensure that people with even the most dubious ‘mental disorders’ were insulated from the irksome risks and obligations of life like a protected species. I perceived work as the first therapy, not the final illusive goal, and could not accept that maximising rights whilst minimising responsibilities could possibly provide successful rehabilitation within a society allegedly based on ‘give and take’ principles.
This had recently brought me into conflict with one irate relative who frequently berated staff for failing to improve the condition of her brother, but at the same time banned us from exerting the slightest pressure on him to even get up in the morning. I had pointed out the self-contradiction of this position, and asked her if she would like to assume responsibility for his care herself, if our approach was so clearly deficient.
“No I bloody wouldn’t!” she squawked “That’s your job! What do you think we pay our taxes for?”
I then pointed out that she had been on income support and other benefits herself since leaving school, so her contribution to the taxation fund was also somewhat questionable.
“What!! You bloody cheeky devil! My life’s absolutely impossible and now you’re making it even more difficult!”
“Could the Job Centre provide a solution” I had recklessly continued.
This naturally landed me in hot water with management and I now had a disciplinary ‘investigation’ hanging over my head, with a guaranteed Judge Jeffries outcome. In a world held to ransom by career victims, ambulance followers and politically correct officialdom, my fate was hermetically sealed. I was marooned in a deviant organisation held together by shirkers, bureaucrats and drones, making my own deviant status absolutely inevitable; either by adaptation to the prevailing deviant culture (he’s now like us), or by disaffection from the prevailing culture and resultant labelling (he’s deviant because he’s not like us). I was truly in the jaws of a ‘vice’.
Yes, my old mum had the greatest difficulty understanding prize-winning books by “Simon Rusty”, but even her most dogmatic opinions now stood loud and proud above the sound-bite hypocrisies of our Age.
A monument in a desert.
* * *
The car careered on through the dismal streets, stampeding cocky sixth formers into the gutters as their gang mentality and instilled insolence gave way for the first time to primordial fear. Carol defended their youthful exuberance and misunderstood charms, while I prosecuted their arrogant disrespect and herd instincts, and we sped towards her workplace as two enemies in the same tank. She left the car without a word, clicked her neck like Mike Tyson going into the first round of a championship bout, and prepared her public self for a captive audience of blue-collar admirers.
“Isn’t that the bloke who gave you a lift home the other night?” I said, nodding towards a smart, urbane young man in the well-cut linen jacket of a solicitor on holiday.
“Yes” she cooed, swivelling her eyes between his chinos and my battle-scarred jeans, and back again.
“He’s the factory van driver isn’t he?” I commented.
“So what?” she snapped, and marched off.
Arriving back home, I observed a police car outside our house and an irate looking troglodyte stomping up and down the street as though he owned it. Two policemen and the troglodyte converged on me when I parked in the driveway, and I soon deduced that all was not well. I recalled the previous evening when I had disturbed two hooded youths wandering about our garden with spray canisters, and knew instantly that I had somehow offended their delicate sensibilities, exposing me to the full weight of the law. They had certainly looked rather surprised when their spotty behinds were been assisted up the street with the parting message:
“You are a pair of completely useless tossers going nowhere in life, and if I catch you down here again I’m going to deliver you back to your brain-dead parents in meat chunks.”
Clearly, the troglodyte was one of the brain-dead parents, and now he danced in front of me, beating his chest and snorting like a gorilla about to charge, while I could only stare with forensic interest at his bulging neck.
“You assaulted my boy last night, and now you’re in real trouble pal!”
“Would that be the hooded vandal boy with the graffiti paint?” I enquired.
“That’s nothing to do with it pal! He was just having a laugh and you had no right attacking him!”
“You’re keen on peoples’ rights are you? How about mine?”
“Oi! Watch yourself smart arse. My lad’s just a bit legally challenged that’s all. Any more of your prejudice and I’ll give you a smack!”
“It’s the little parasites with the aerosols that should have been given the smacks you repulsive oaf” I replied “And could you please refrain from power washing my glasses with your rank spittle?”
At this point the rabid ape launched himself across the driveway with a primeval roar which brought the neighbours to their windows like iron filings to a magnet, but the constables grasped him before his large hirsute fists could do any damage and I continued to smile amiably as his red face swung in front of me like a sun in nova.
“You’re going to be paying me and my lad compensation!” he spat.
“Would you like your blood pressure taking?” I asked in way of reconciliation.
The policemen eventually interrupted his robust reply and persuaded him to go home, but only after he had received their reassurance that I was going to be interviewed down at the station. An hour and a half later I returned home wondering if a prosecution would follow, while two hooded forms scuttled about at the top of the street, grinning delightedly at my brake lights.
“The whole count…..country is wet” said a stuttering, liberal weather forecaster.
The lunatics had not only taken over the asylum, they had taken over the other institutions of society too, and I dropped onto the sofa as if a giant boot was relentlessly stamping me into the bloody dust. Our T.V. spluttered into life, and I watched the continuous flow of inane adverts, smirking contestants on multi-coloured quiz shows, drunken louts in Ibiza, chuckling adults in Disneyland and (on tape) mono-syllabic bald men in soap operas shouting for their next T.V. award. A world of toys, infantilism and futility bore down on me. Hard.
In urgent need of escape, I walked to the computer workstation and picked up a hardcopy of the cathartic, whistle-blowing book I’d been working on for three years (‘Inside the Cuckoo Clock’). Like an episode of ‘Casualty’, the unrelenting horror nearly always cheered me up.
Especially this part.
The ‘phone rang while I was switching the T.V. off. It was Kate – one of our many ex-nursing assistants.
But a special one.
This was ‘kiss me’ Kate, a wonderful flaxen-haired, 24-caret beauty with sapphire eyes, serpentine curves, Nordic directness, sugar, spice and all things nice.
“Hi Steve” she said “A few of us are meeting up at the ‘Tar and Feathers’ on Saturday night. Do you want to come along?”
“ Yeah, why not” I replied casually, my mind extrapolating wildly.
“Great. You could bring a bottle back to my place afterwards too, if you like.”
“I’ll do that. Thanks a lot.”
“See you then. 8 o’clock at the Tar and Feathers.”
“’Bye Kate.”
I was already in the pub, cutting an elegant but mysterious figure in my Oswald Moseley black shirt, suede winkle-pickers and fashionable wrap-round sunglasses. I exuded an easy confidence as I strolled towards Kate and her perfectly irrelevant friends, whom she had invited merely as a cover for her assignation with me. She was dressed in an ivory-coloured silk blouse, black pencil skirt and sheer tights, with her legs crossed cleverly to exhibit two gorgeous thighs. We chatted amiably about a variety of profound subjects, laughed hilariously at each other’s jokes, and exchanged beautifully synchronised non-verbal cues, before making independent excuses and adjourning to her flat for three hours of blissful sexual congress.
Naturally, our trysts would quickly become a passionate affaire, and we would often venture out from our love nest to dine in palatial surroundings, walk silently in Northumbria, or water-ski in the tropics. As an intellectual nymphomaniac, she would be my soul mate for eternity, and it would only remain for me to break the news to a sobbing, heartbroken Carol who would wisely hand over the children to me. They would naturally take this in their stride, live happy successful lives, and be more than pleased to wipe my bottom when the time eventually came.
I wish.
But sometimes wishes can come true, I thought.
Carol
1980
When I met Carol it was really love at first ‘site’, because we were both in a rock club we liked, listening to music we liked, drinking lager we liked, talking about subjects we liked, with friends that we liked. When you added up all the likes, they seemed to almost equal love, so we started going out together and soon shared a flat in a terraced house with buckets for the leaks, traps for the mice, and a massive electricity bill we had to pay in 24 equal instalments. The shower flooded the downstairs neighbours’ flat, and their motorbike filled ours with carbon monoxide when it was warming up, so we had a close organic relationship for six months before moving up to a rented Victorian cottage in a local village. Carol had long, dark brown hair parted in the middle, a serene face, artistic leanings and small pointed breasts with fabulously erectile tips. I was no oil painting, but I had a good head of hair, unrealistic ambitions and a thin sinuous body with phallic intent, so she wasn’t short-changed too much. We rolled experimentally in front of the condemned gas fire and when her thighs became a necklace, the spider was happy with her fly.
In the cottage there were antlers over the fireplace, chintz-patterned chairs with broken webbing, rampant silver fish in the kitchen and a damp patch in the main bedroom which was so attractive it had been colonised by a family of slugs. There was a long rear garden which had turned into a tropical rainforest of gigantic thistles and looping dog roses - once trapping our next-door neighbour for ten minutes, as two thorny vines snarled her fur coat on the way back from the Women’s Institute.
“Our bubble almost burst then” Carol said.
Bubble was right. We were inseparably close; fifty miles away from all our friends, and viewing life through the glass with Alice, amidst the herbal tobacco, vegetarian stews and Jack Kerouac novels. We rowed and made up with childlike zeal, discussed the psychedelic philosophy of Timothy Leary and planned a future of paid art and sociology (sic). We missed each other when rarely apart, and I concluded that love was the most solid principle of all.
But good things always come to an end, and as the years slowly trickled by, I began to realise that I’d lost my momentum, lost my sense of balance, and failed to see the fading light. My thirst for knowledge and self-discovery hadn’t made me particularly employable in a world that preferred its slaves pre-packaged and uncritical, and I found myself over-qualified, unorthodox and under attack. In 1988 Carol declared a growing interest in children and mortgages, and when I took the ‘golden’ opportunity to do some research at Cambridge, the proverbial camel’s back broke. I came back to discover a more practical man warming my slippers, and the past forgotten.
This was partly predictable, but nevertheless devastating, and I spent many gloomy months in penance, as I pined, planned and manoeuvred to recover my errant love. Carol’s sudden indifference was sadistically augmented with cruel jibes or manipulative endearments as she kept both men dancing, and for six months or so I slowly turned on the Devil’s spit. In the end, my patience was rewarded when the slipper-warmer rolled into oblivion with a series of self-inflicted wounds, and my ‘romance’ was miraculously rescued from the brink. But love and trust were now as dead as the grave, and another idol had demonstrated the foolishness of my worship.
Nevertheless, our relationship eventually recovered to about half of what it was, and in 1990 I began training as a psychiatric nurse. This helped pay the bills, and soon our lives were conforming to the Western template as we applied for our mortgage, got married and started our first child. Mental health nursing had never been a key part of my grand vision at university, but it was nevertheless an eye-opening experience, and I soon started to appreciate the distance between my firm theoretical assumptions and the weird realities behind many closed doors.
Some of the patients were almost extraterrestrial in their appearance and behaviour, and the amount of body fluids, violence and dependency we had to deal with was staggering in the extreme. It was the back of beyond in the here and now; a medieval society on an alien planet, and a curious self-contradiction of rarefied professional policies and continuing traditional practices. My qualifications were worth nothing, and I rediscovered all sorts of personal weaknesses which I’d despatched to the back of my mind during the halcyon days of self-flattery at college. I had difficulty juggling all the little demands on my time because I was used to blinkered concentration, and my introverted personality shied away from clamour and confusion. I had trouble dealing with authority figures because I was used to reason not power, and I was timorous in large groups because of my nervous and gauche nature. My artistic indifference to mega-bites, CD-Rom drives and floppy disks was becoming unsustainable, and modern technology quickly swept me aside.
The theoretical elements of psychiatric nursing were taught at the local college of health studies and this turned out to be largely fatuous, time-wasting tomfoolery designed to keep the Americanised lecturers insulated from anything remotely didactic, plus a heavy dose of theatrical sanctimony from my esteemed peers. But I qualified in due course, got a local job, and sired a little boy to join the little girl in our 1970’s semi-detached bungalow with ‘Georgian’ style bow window, gardens to three sides, and a concrete and asbestos underwater garage. We had the garden vandalised every Saturday night, bump-started our old Renault Fuego down the hill every morning, and forgot our wedding anniversary every year (both of us).
By 1992 we were rich enough to buy a 1930’s detached house with the roof falling off, and I spent a hundred hours or so improving the kitchen, refinishing Art Deco furniture, and dodging rogue roof tiles in high winds as they scythed through the air like Odd Job’s bowler. We turned the rooms into a pre-war museum, with tin plate toys, cast iron fireplaces, wood and Bakelite cased H.M.V. radios, ancient tomes and Tiffany style lamps. Later, we discovered woodworm, snails under the stairs, a damp spot near the chimney, how cold it was without central heating, and a toilet which used gallons of water, but still left bran bulked stools floating on top after three flushes.
But I contented myself that I had firmly relinquished the bohemia of motorbikes, sociology and hippy values, in favour of average wage packets, status improving cars, reasonably impressive houses, upward mobility and parenthood. Surely, with my new credentials as a completely ‘normal’, decent, hard-working fellow, I could look forward to a fruitful, harmonious future, with few problems and plenty of solutions?
But when the momentum stopped, I began to suspect that things weren’t quite what they seemed, and that there might be a heavy price to pay for this wonderful orthodoxy; just like everything else. And this time I was right.
The Channel Tunnel opened in 1994, and I was soon disappearing down my own hole.
Daily Post, 30th. June 1990.
New Mental Health Act
A Government spokesman has assured people that the new ‘NHS and Community Care Act’ will not lead to significantly greater risks for either mental patients or the public. The new legislation is intended to ensure the delivery of widespread community based mental health services, and to counter the negative effects of traditional regional asylums. It is hoped that ‘home like’ surroundings and individual cares will help people return to a more normal way of life, away from the ‘institutionalisation’ and isolation which often prevails in large psychiatric hospitals.
The community care movement has gathered momentum in the last decade, as academics, clinicians and politicians have joined forces to urge a more humanitarian approach. The new system stresses a ‘rehabilitation’ style approach which should enable people with mental health problems to become more independent and self-reliant within mainstream society.
Clive B------
Political Correspondent
The Unit
2007
“Caring for psychiatric patients in the community is a fine and noble idea; unless the community itself is a pathological phenomenon.”
Anon.
“Get up” somebody said in my ear.
One eye opened, but my sticky body glued itself tight to the damp mattress and my mind hung in limbo.
“Get up and go” insisted the unpleasant rasping voice.
Reluctantly, I turned over and looked at the alarm clock which seemed strangely large in the half light, and showed luminous green hands at 20 minutes past late. I yawned until my jaw cracked, then pushed my leaden form onto the edge of the bed, where the whole room whirled reassuringly around me.
“Bloody Hell, I’ll never make it to work like this.”
But the room slowly stabilised, and I started to look for my slippers amongst the debris which seemed to have accumulated in the bedroom overnight. There were magazines and newspapers, cuddly toys with impish faces, lots of pillows, and plates of food with greasy egg patterns strewn around the floor. The whole mess instantly disappeared when I switched on the light, and I cursed the garish carpet and the flickering shadows for playing cruel tricks on me. Yet the room still held an eerie glow under its energy-saver bulb and the pigments swam around like Salvador Dali’s paint palette as I limped towards the bathroom and douched my face with an icy jet from the tap marked ‘hot’. Carol hadn’t stirred, and I showered quickly under a scalding hail of liquid bullets, wondering if I’d eaten something I shouldn’t, or whether I was just drunk from a forgotten night before. The stairs were spongy as I half fell down them, and the moonlight projected jagged silhouettes through the thin gingham curtains, adding to my unease.
There was already an overpowering smell of cooking fat and cabbage in the kitchen, so I decided against the usual burnt toast, and made do with an Argos mug of full strength coffee instead. It was curiously textured as it trickled down my throat and I wasn’t sure if I’d enjoyed it or not, as my nerves twitched under the caffeine flick. Opening the curtains, I gasped at the sight of deep snow covering the roofs and gardens, and a huge full moon suspended above the escarpment like an alien sun, almost blinding me as its rays bounced off the white fairytale landscape and flashed into my blood-shot eyes. I sensed that my reactions were unusually disproportionate, but the scene sent shivers up my spine and riveted me to the window with an overwhelming, transcendental force. Winter was hardly a unique event, yet it assaulted my senses with unbridled power, and I was momentarily transfixed.
There was still just enough time to walk to work, so I pulled myself away from the window, donned my once-a-year Wellingtons and put on the old student great coat. I snapped open the warped door, staggered under a blast of freezing air, pulled on my tea cosy hat and headed up the street, now almost enjoying the bagatelle forces which seemed to be gripping me. There was certainly a weird unreality in the world, as the icy wind warmed my cheeks, the frost crackled loudly underfoot, and the snow blew lazily upwards in concentric circles. I was spellbound, rather like a child walking into a fairground from the pitch black street, and I became aware that my senses were almost penetrating the objects about me, enhancing colours and forms, shadows and perspectives, sounds and smells. Bringing everything alive with magical ease.
But there was a price to be paid for this sensory acuity, and I began to experience an uncomfortable vagueness about my whereabouts and intentions, walking forward automatically, but with little in the way of anticipation. The frozen wastes seemed to float by and I found myself giggling at the sight of smoke coming out of three chimneys on nearby roofs; the whole terrace looking rather like a White Star liner breaking through the ice pack. In fact, I was just expecting to see the infamous iceberg, when I turned the next corner and saw a half-hearted snowman listing badly in somebody’s front garden. There was no joke, but for some reason I found myself howling hysterically at the prospect of the terraced houses crashing into the little snowman and sinking out of sight; until an irritable looking goblin face peered out of the nearest window, and silenced me.
With lightening speed, my euphoria gave way to irrational terror and I found myself running down the slippery path and across the grey spooky park as though the hounds of hell were after me. I ran for half a mile through deserted streets, past the vast, silent, empty office blocks and on towards the three-tier bulk of the hospital, where I finally stumbled to a halt, heart thundering, chest heaving and a staccato pulse beating loudly in my ears. My powers of reflection were clearly dying, and I could only hold on tight as my footsteps now advanced towards the Gothic horror of the hospital with little volition; yet Frankenstein intensity.
Like an image trapped in a can of film, I was being projected.
“Buzzzzzzzzzzzzz!”
“Christ, another bloody nightmare.”
The alarm had shattered my dream world and I gradually adjusted to the twilight, the cold beyond the bedclothes, and the prospect of another early shift on Devil’s Island.
“Stop exaggerating” I croaked.
But I wasn’t exaggerating that much, and for a few precious moments I shrank back into my warm little cocoon and waited for the nagging pains of conscience to grow stronger, while memories of yesterday’s late shift slowly percolated through my brain, and there was another click of the rack’s ratchet.
Cecilia, a rather difficult patient, had arrived back from her father’s house, apparently in quite a good mood, laughing and joking, conversational and basically too good to be true. Inside twenty minutes, she was punching doors, kicking over chairs and telling anybody who came near her to “fuck off”. Another ten to fifteen minutes and she was pounding her bleeding knuckles on the brickwork, depositing a cup through the smoke room window and ripping two toilet seats off their hinges. She refused to talk about it, wouldn’t take any medication, alluded to “voices” and seemed to take a devilish delight in her behaviour, as she continued her systematic demolition of the unit. Being on duty with only one other member of staff – a dear old lady auxiliary nurse who sat petrified in a corner – I decided against any heroics under the common law and instead took the consultant’s advice to ring the police. Two hours later they reluctantly appeared, only to observe the patient enjoying a mug of coffee in the T.V. lounge as she amiably apologised for her loss of control. The bill would be around £250 I suppose, but the cost of such damages was never borne by anyone on the unit so we would never know.
Still, Cecilia very rarely misbehaved in the morning, because she was usually too busy making her way through a labyrinth of getting-up routines to worry about violence. I knew she used these obsessive-compulsive rituals to stabilise her troubled mind, and I momentarily reflected on how my own life of ritual work, ritual holidays, ritual meals, and ritual conversation probably served a similar function. It was an irony which rankled, but I completed my ablutions, mouthed a silent farewell to the deeply sleeping forms of my children, ventured downstairs to the kitchen, and flicked on the radio:
“The government is concerned at the number of people killed by ex-mental patients. It is estimated that there have been 100 murders by care in the community patients in the past five years, and that 1,000 have killed themselves over the same period.”
This was just what I wanted to hear (not), so I switched the radio off, parted the gingham curtains and looked out on a row of dead stick trees bending under a heavy frost. There was a solitary sparrow attempting to pierce the rock hard lawn with its beak, a fat black cat lurking under the bramble hedge, and an endless sweep of red brick walls and stained picket fences - as our toy town estate rolled on and out. Not even the greatest romantic poet could infuse this view with any transcendental meaning, yet I knew that by the end of my shift I would be yearning for these same sights with nothing short of rapture.
An amplified trump reverberated around the toilet bowl upstairs, and an invisible hand pushed me to my feet.
It was time to go.
Mutually Assured Destruction (M.A.D.)
In the 1970’s the cold war was still pretty hot, and there were endless news items and documentaries about the proliferation of nuclear weapons. The impotent masses tended to see this practice as dangerous, but a series of governments assured us that the frightful threat of atomic warfare was effectively keeping the peace. This was the policy of Mutually Assured Destruction (MAD).
It was the first official recognition that madness could be a normal state of affairs.
But as community mental health care has proved, not the last.
I opened the side door and was almost blown off my feet by a cannon-like blast of Arctic wind, and saw that a boiling black bank of cloud was rolling across the horizon, with my name on it. Some lights were on in the neighbouring houses, and I was momentarily consoled by the fact that other people were preparing for a working day that they also roundly despised. Even more cursed, I imagined, were those who wore their chains willingly and were actually looking forward to their office gossip, hierarchical positions and new sales targets. They were unlikely to ever look up at the open door, and escape.
Setting off, I assumed the obligatory 45-degree angle walk to counteract the funnelled gale and eventually passed a row of Edwardian houses which seemed to have caught quite a bit of snow in their interesting angles. I reflected on how much I missed our old 1930’s house, even though the tiles were crumbling into dust and the sub-tropical garden had begun to undermine its foundations. I remembered also the G.P. who lived behind us, cutting the edges of his lawn with tailors’ scissors, and weeding the flowerbeds under house floodlights, as half an hour before midnight he fought off the stress of his inner-city surgery.
But working in health care had impacted on me too.
Passing houses and gardens which were once uniquely interesting, but now merged into one amorphous mile of brick and plant because of the two thousand times I’d walked past them on the way to work, I reached the bus shelter. Full of broken cider bottles, covered in artless graffiti and smelling of idiot’s urine, the dilapidated 1970’s structure was hardly sylvan, yet something arrested my attention and this proved to be a black dog huddled in the corner. Conscious that I had not so far talked to another living creature, I said “hello” to the dog in a worldly-wise manner, and the poor thing began to follow me. All the way through the park, with its winding paths and coiled rings of crusty poo, down the narrow terraced streets of Victorian forecourts and high bay windows, past the 1960’s concrete building blocks, and on to the crumbling gates of the old, tired hospital. Here, the black dog looked up, turned around and headed back towards its council estate, showing me a wiry tail trailing in the cutter and a baleful look of psychic certainty. I also looked up at the Gothic masterpiece, with its disused turrets and castellated chimney pots; knowing only too well its inner Dickensian ugliness, and its indestructible black soul.
My eyes drifted across the road to a comforting news board:
“Papergirl stabbed for 50p”
The Sunday Bugle, 9th. May 2003.
Bed Blocking in Psychiatric Units
Crisis looms in mental health units and wards around the country, as community care patients are often unable to move through the system as intended. Beds are blocked for long periods, because patients are not responding to therapy or they cannot get funding to move from one part of the service to another. This is creating a backlog of referrals from the community teams to acute wards, from acute wards to rehabilitation units, and from ‘rehab’ units back to the community. There are also long delays transferring people from the mental health sector to social care and private facilities because of financial difficulties and ‘territorial’ disputes.
At the same time, there are growing numbers of people with drug and alcohol related problems being referred to acute psychiatric wards.
Dick C------
Medical Correspondent
The hospital had been a workhouse in the nineteenth century, but now it was very much the reverse. These days it was populated by a bizarre combination of largely unproductive individuals; managers, clinical staff and patients all circling around in a costly carousel of bureaucracy, political correctness, over-dependence and inertia. But I was part of it, so I ran my eyes over the three tiers of soot ingrained 1860 brickwork and made my way around the back, across the car park and up to a door marked ‘Rehabilitation Unit’, which I found locked from the inside. This was unusual at 7.00a.m., and a variety of intriguing possibilities rushed through my mind as I recalled the tale of two night duty staff sleeping most of their shift and waking up to find that the unit had been burgled. Rumours had always abounded, of course, about staff nurses copulating with students all night, and even though this was generally apocryphal, it did provide me with my first jolly thought of the morning. Indeed, I found myself wishfully musing about alien abduction and mass walkout, but unfortunately the truth was much more prosaic; the staff had simply forgotten to unlock the door.
I was eventually allowed in by a tired and relieved looking agency nurse, and then instantly transported back into the surreal world of mental health nursing, just as though I was in a ‘golden key’ book of the sort my young son was currently reading. People often say that smell is the most redolent and evocative sense, as memories of childhood, holidays and social situations are quickly prompted by a characteristic fragrance from those times. So it was with psychiatric wards, as the hellish combination of stale urine, fresh faeces and rampant body odour never failed to remind the recipient of his or her first wonderful experience of in-patient mental health care. Yet mercifully the mind can often habituate a constant stimulus, and after two or three minutes of nausea and revulsion, the stench miraculously faded (thus ensuring its continuity, I suppose).
Taking note of the assembled staff in the office, I withstood the first wave of playful insults and disingenuous greetings.
“Here he is.”
“Hello, everybody - what an expected displeasure.”
“He used to turn heads when he was younger, you know”
“Yes… but now he turns stomachs”
“Ho ho”
“He’s the life and soul of every party.”
“Especially the Stalinist Party.”
“Ha ha.”
“He’s been tossing and turning all night.”
“Especially tossing.”
“He he.”
(etc. etc. ad nauseum)
The Health Care Assistant sitting at the desk (where the qualified nurse usually sat) was the original poison dwarf; an individual who had to be flattered at all times, otherwise his angry inferiority complex filled the room like a huge inflating lifejacket. But I gazed at the kilogram of chemical scaffolding he used to build up his semi-Mohican haircut, and I just couldn’t resist a dangerous ruse.
“That hairstyle really suits you, Zebulon… It makes you look three inches taller, actually.”
“What…really?” he replied, his face buckling into a wary, hypersensitive scowl.
“Yes, indeed.” I reassured him. “…It must have added a good 10% to your height.”
“Well, I always try to look my best, Steven” he laughed, fully restored to his bumptious norm. “Unlike you.”
I glanced around, and caught a sly acknowledgement from the harassed night nurse who was perched on the windowsill. At least two of us knew what 100% added up to, if 10% was three inches.
And once I had such high hopes for myself.
But the clock was always ticking on a psychiatric nurse, as you wished your life away in the tick tock world of stress and release. Anticipating the end of a shift, craving days off, booking holidays with the drooling relish of a mad dog waiting for the final kick, and absolutely dreaming of retirement. Cottages in Wales, cruises in the Caribbean, fawn jackets and bowling woods, illness and death. A lager at the end of the desert crawl.
So I consoled myself by thinking about my night out ‘with’ Kate on Saturday.
Only two days to go.
Kate
2007
Well, I turned up at the ‘Tar and Feathers’ with my Oswald Moseley black shirt, fashionable wrap-round sunglasses and suede winkle-pickers, but that was where my jolly daydream (previously mentioned) quickly fell apart. Kate just winked at me from the wrestler’s embrace of her Brad Pitt look-alike boyfriend, while the rest of the crew generously made room for me around the corner, amidst the vinegary empties and heaped ashtrays. Even there, I could still observe the wrestler’s hand creeping up Kate’s tights under the distant table, so I glanced away and drank quickly.
I was about two pints behind everybody else and consequently Martian, but I eventually caught up and began to enjoy the general melee. Some of the crowd knew me, which is more than I did, and we exchanged ritual vulgarities until about 10.00 p.m., when I slouched to the bar for my last intended drink. Unfortunately, Brad Pitt was now holding court behind me, and I involuntarily cringed as each of his punch lines reverberated around the room like a dart scorer’s one hundred and eighty and his well-trained audience guffawed and squealed with rapturous delight. A punk rock choir in purgatory would have made a more welcome noise, and I quaffed the frothing beer with grim resignation, ready to leave.
There was an unhealthy collection of vintage whisky bottles running around the top shelf of the bar and I was just about to congratulate the publican on his ingenious wasp trap, when…..
“Hi, Steve.”
It was Kate.
“Hi, Kate. Are you all right?”
“Yes, fine. Sorry we haven’t had a chance to talk, but you were sat so far away I’d have needed a loud hailer.”
“Well, you’ve had one stuck down your throat all night.” (I thought), but instead I said “ Yeah, I was a bit late arriving. But there’ll be other times.”
“Oh…. but I thought you were bringing a bottle back to my place?”
“I’d love to, but it’s getting a bit late now and you’ll probably have a house full anyway.”
“No, most of them are going on to a club. Come on Steve, you’re not getting too old for it are you?”
“Well, if you’re sure?”
“I’m sure.”
“Oh, all right then” I laughed; capitulating too readily.
“Do you know Percy?” she said, pointing to Brad Pitt.
“Not in the biblical sense” I replied with false bonhomie (acknowledging him graciously).
“Ha ha…very good…. I’ll see you later then.”
“Okay.”
So, I bought a bottle of Chateau Shite and followed the crocodile back to Kate’s flat, where Brad Pitt (surprisingly) made his spit and polish farewell, and joined the disco-bound majority. Kate and I sat a lot closer together this time, and as I admired the soft whiteness of her recently licked skin, I wondered whether this would be the ideal opportunity to talk about a variety of profound subjects, laugh hilariously at each other’s jokes, and exchange beautifully synchronised non-verbal cues (as previously imagined).
It wasn’t.
In fact, we were two opposites. She had extremely correct, code of practice-worshiping views about psychiatric nursing, while I was lost on the roundabout somewhere to the right of Genghis Khan, yet well to the left of Karl Marx. She was tender and kind, while I was jaundiced and insensitive. She was occasionally wry and whimsical, while I was constitutionally sardonic. We were both direct. We argued about anything and everything.
We liked each other.
But the evening began to taper off as the loo filled with noodles, Leonard Cohen filled the speakers, one guest fell down the stairs after another…. and my confidence left with them. There was definitely a spark in the air, but I was never a chat-up merchant and didn’t dare fan the flames, so Kate and I lingered on the doorstep for awkward non-committal moments, while the milkman floated by, and the cats howled. Telepathy failed me just when I needed it, and as Kate moved slightly towards me, I simply launched a clumsy kiss at her left cheek, and hoped for the rest. She smiled brightly, and closed the door with a gentle click.
I went home then; with a future as well as a past.
Or so I thought.
The Unit
2007
Another day, another dime.
Thinking nostalgically of the black dog (it had followed me again this morning), I drew up a chair, ensured there was no trace of human excrement on it, and prepared myself for the report, or as it was usually called in this part of the world 'hand over’. The first wails, shouts and coughs of the shift drifted down the staircase, and on this orchestral background we began.
“You look rather fetching in that Womble outfit” I said.
“Yes, I’m going straight from here to the charity walk” replied the night nurse
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