by Bev Thomas
There’s a silence. She takes a breath. ‘When Samira came the following week, her daughter was still wearing that old vest and skirt.’ She fiddles with her pen. ‘All those new clothes in the bedroom – and she’s dressed in the same dirty outfit.’
I say nothing. We sit for a moment in silence.
Stephanie goes to speak, but her voice falters. She starts to cry.
I sit with her quietly, passing her the box of tissues. She’s embarrassed by this unexpected show of emotion. I wait for her to collect herself.
‘Doing this – day in, day out,’ she says, ‘all these dreadful lives. It’s grim. How do you bear it? Don’t you just want to do something,’ she says angrily, ‘something to take it all away?’ She stops and reaches for another tissue.
When I ask her about the session, she says Samira told her about getting the new clothes and the baby things, ‘but she also told me more about what happened to her in Somalia. What those men did to her.’
Stephanie closes her eyes briefly. ‘It was awful,’ she whispers. ‘But the way she told me – it was like a shopping list. Like it had happened to someone else. No emotion. No anger. No sadness. Nothing.’ She shakes her head. ‘As I listened, I felt full up with it all. Helpless – and so sad. But I couldn’t find any words.’
I think for a moment.
‘Have you ever seen a snake eat a rat?’ I ask. ‘In a zoo? Or on television? They swallow the rat whole. It sits in their body. A perfect rat-shape under the skin of the snake. It’s like a cartoon.’
She nods.
‘Then gradually over time, it regurgitates bits at a time. Crushing the bones of the rat, reducing the body into smaller digestible pieces.’
Stephanie blinks back at me.
‘Sometimes the things that have happened to our patients are too awful. Too shocking to digest.’ I tell her about one of the first patients I ever saw as a trainee.
‘Mr Begum was a small dignified Bengali man who ran a fruit and veg stall in Whitechapel market. He’d been badly burned in a house fire. Had to have a leg amputated after the building collapsed on him. His two young daughters died in the blaze.’
Stephanie is listening intently.
‘We saw him in hospital. I was struck by how calm he was as he carefully detailed the events of that evening. While he remained detached, I felt engulfed by the horror of what he was describing. Then after a while, he reached for his watch on the bedside table, and looked up at us. “I’m terribly sorry,” he said politely, “but you must excuse me. I have to go and collect my daughters from school,” and with that, he began to shuffle his bandaged leg to the edge of the bed—’
Stephanie gasps.
‘The nurses rushed forwards, stopped him, just in time.’
Stephanie is wide-eyed.
‘The event for Mr Begum was like the rat in the snake. Simply too big to digest. It was going to take him time to swallow the news, piece by piece. The emotions had been split off, projected on to us. They were simply too painful.’
‘Do you think that’s what happened with Samira?’
‘She’s in shock,’ I say. ‘It’s too overwhelming. She has to cut it off, disassociate from it all. It helps her survive, get up in the morning, take care of the baby.’
She nods.
‘The other thing to remember,’ I say, ‘is that she’s a refugee. She’s holding a real sense of displacement. While she’s safe here, physically – her safety comes at a price of alienation.’
I tell her about an Iranian I once saw who had fled his country. Many of his extended family were tortured and didn’t make it out alive, but his wife and children were safe. ‘He talked about the violence he’d witnessed, but he also talked about everyone telling him how lucky he was. He felt conflicted. Grateful, yet preoccupied with a feeling of wistfulness, a sense of longing he couldn’t really put into words. “The smell of my own country,” was the thing he missed the most.’
‘So you’re saying the things I think Samira will like, might actually make her feel more alienated from her country?’
‘It’s possible,’ I shrug. ‘But tell me what happened, after Samira told you her story.’
‘I just felt really sad. I didn’t know what to say. What you said about the rat? – it’s weird, because I felt like I couldn’t swallow. That something was stuck in my throat. I said it was a very sad story and that it was brave of her to tell it to me. That I was very sorry that these things had happened to her.’
‘And then?’
‘It was quiet,’ she hesitates, ‘I didn’t really do anything. Didn’t know what to do. My mind went blank. We just sat together. I really wanted to say something – something helpful?’
‘You did something very important,’ I say. ‘You were bearing it with her. You stayed with it. It’s our job to connect people with their feelings. If we run away from them, they will too. You didn’t run away. You did well.’
I expect Stephanie to bloom under the compliment, but she simply shifts in her seat.
‘But you know,’ she says slowly, ‘I’m not sure I really see the point—’
She bites her lip, blinking away the tears.
‘The point of what?’
‘Doing this. This type of therapy. I don’t feel I’m making a difference.’
‘Making a difference?’
‘Helping. Doing something. It’s what I’m used to. What I’m good at.’ She looks away.
‘All this emphasis on feelings – I mean,’ and then it comes, the question I’ve somehow been waiting for, ‘does any of it actually help?’
I listen as she tells me about her family. She’s pragmatic with the details. The oldest of four. The only girl. A younger brother born with cerebral palsy. ‘Dylan,’ she says fondly, ‘he’s such a character.’ She tells me he was very sick when he was small, in and out of hospital for months at a time, ‘difficulty breathing,’ she says. As he got older she explains they had a family rota; for feeding, for physiotherapy, and for the exercises to prevent infections. ‘My other brothers were pretty hopeless,’ she laughs, ‘but I did what I could. Tried to fix things. I just got on with it,’ she says briskly. I think about the symmetrical bob. The colour-coded ring binder. The first from Oxford. And I see that somewhere underneath all that perfection was a world of mess and chaos. And of loss.
‘So, all this staying with the feelings,’ she says, ‘I’m just not sure I really see the point – or even want to.’
I nod.
I tell Stephanie that I don’t know if this model of therapy is right for her. Or if trauma work is going to be the right fit either. ‘It’s way too early to tell, and only you can make that decision.’
Yet I can’t stop thinking about a childhood where her own needs and feelings were lost under a rota of practical tasks. Being good. Being helpful. Trying to fix the unfixable. I want to remind her that something drew her to this unit.
‘You fought hard to do this placement,’ I say. ‘I think there was something you wanted to learn.’
*
After she’s gone, I think about those pretty Boden dresses. The toddler bed, the high chair. I think about all the items from our own baby years: the bath toys, the mobiles for the car seats and the brightly coloured play mats. My mother fed into all of this. By way of compensation for her erratic grandparenting, she showered them with expensive gifts and toys. ‘I know you’ll say I shouldn’t have – but I just couldn’t resist them,’ she’d say, as she staggered in laden with bags. One time, she brought two enormous stuffed animals, a tiger and zebra that she’d spotted in the window of Selfridges. ‘Too big to get on the tube,’ she laughed, ‘I had to get a cab for the three of us.’ And on subsequent visits, her eyes would greedily seek the furry creatures out, as if successful sightings, or flickers of interest from the children, were a confirmation of their love for her.
We too bought into the consumer pressure to buy the trappings of family life. The covert message being that if you buy the best,
you’ll be the best, as if somehow, this would be a ticket through. A way of ensuring the smoothest and best possible childhood. We knew it was rubbish, but we were sucked right in. And so, it continued for us, the bunk beds, the connected desks that sat side by side, the matching satchels when they went to school. The meaninglessness of all these things in the end. Gloss that covers the rotting wood underneath. There was a time, in his early teens, when Tom would only wear Adidas and Nike. Only to eschew these, and all labels, in later life when he turned his attention to globalisation and the destruction of the planet.
‘All brands are feeding the devil,’ he said, ‘a step into the big wide jaws of consumerism.’ Shortly after, he exchanged everything for some old jeans, plain t-shirts and that green Fruit of the Loom sweatshirt that he picked up in a charity shop.
It was in Year Six that Tom and Carolyn moved into separate rooms. They were ten years old, and I felt sad to sell the bunk beds. To think they would never again giggle and chat together as they went to sleep. Perhaps they hadn’t for a while. Perhaps that was a myth I wanted to keep going. Was it in Year Six that things began to change? At the time, I put it down to gender difference. Carolyn maturing faster than Tom, in the way that girls always did. I convinced myself it was a natural separation between them, and while I felt a sting of sadness, it was, I told myself, entirely normal. I realise, looking back, how frequently I used that phrase, as if it was a kind of mantra.
During the long summer holidays, I enrolled the kids on camps. Carolyn was happy with multi-sports, drama, almost anything I suggested. She made friends easily. Tom would only do the Forest Camps. Days out in the country, running wild. ‘Team games were a challenge,’ they would say at the end of the week, ‘but he’s good with wood. Exceptional.’ The following summer, even these holiday activities became too structured and organised for him.
It was in the early years of secondary school that the bigger differences started to show. Carolyn grew tall and willowy, with long legs and fair wavy hair that cascaded down her back. Tom grew, but he seemed too big for his body. His hair, so gloriously wild as a boy, looked awkward around his adolescent face. He spent hours trying to smooth his hair down, then cutting it short, only to have it bubble up again above his ears. ‘I look ridiculous,’ he said, his hands slapping at the curls. As Carolyn grew older, and became her own person, it left Tom exposed. Wide open. It was only years later I came to see this. She, in her wisdom, had seen it much earlier.
‘Yes, I know he’s having a hard time. It’s not my fault. Why are you taking it out on me?’ she’d ask during one of our many circular nonsensical rows.
‘I’m not,’ I said defensively.
Now I see it. I was angry with her for exposing something I didn’t want to see. I was angry with her for stepping out of the way. For living her own healthy independent life. What kind of a mother resents her daughter for that?
Why didn’t I see it at the time? The truth was, I was good at looking the other way. It was a small muscle that I had worked on and strengthened since childhood. It was a good and hardworking muscle that made me sit neatly and eat my supper after school, as if everything was just fine, as if my mother didn’t drink. Everything was fine and normal. I just never invited any friends round.
With Tom, not only did I look the other way, I went into overdrive to compensate. Gradually, the arranged play dates associated with his younger years all fell away. They were at an age to organise their own socialising. This became effortless for Carolyn, ringing friends, arranging trips to the cinema. For Tom, it was non-existent. Looking back, my involvement was a form of denial. An obsessive need to look away from what was staring me in the face. It was at this point that the strain really began to show with David.
‘Let him be,’ he’d say, ‘let him find his own way,’ was his response to my persistent social organisation.
‘Don’t you think you’re over-attached? Isn’t it all a bit Oedipal?’ he said, wobbling his head from side to side in that irritating way he had of masking a serious point under a jokey façade.
And looking back, if Tom hadn’t been a twin, I’m sure I would have found it easier. Maybe I would have been able to let it be. The fact was, Carolyn was a constant barometer to measure him against – academic success, sociability, friendship – and time after time, he fell short. It was around this time that Carolyn started playing hockey for the Borough. She spent most Saturday mornings at matches. I think I only saw her play three times.
When Tom wanted a dog, we got Hester. When Tom showed a whiff of interest in a football, I got him onto a team. Tom played OK, although he held a slightly vacant presence in a group of other boys. Not unfriendly. Not rude. Just awkward. His absence was a space I quickly rushed to fill. I was like a builder with a fistful of putty, pressing and squeezing to fill the unsightly gaps. I was relentlessly chatty with the other mums. I brought oranges for half time, baked cakes for the end of the match. ‘Is he enjoying it? Does he want to do it?’ David would say. ‘Why are you driving this? This incessant need for control over his life?’ I couldn’t stop myself. My response to feeling out of place has always been denial. Hide behind other people. Find a way to fit in. I didn’t want to see a version of myself in him. Tall and tense. With a small knot of anxiety in my stomach.
Once at the station with Tom, waiting for the train, I spotted someone from the team on the platform. ‘Look!’ I said. ‘There’s Greg. From football.’
Tom nodded, rooted to the spot. I felt his embarrassment, but still I pushed on. It was me who strode ahead. It was only as I’d walked forwards, with Tom shuffling behind, that I saw he was with Finn.
‘Hi!’ I said, too brightly. They looked startled by my intrusion. The mumblings of teenage conversation were shattered by my sudden animation. I could feel their surprise. ‘You were robbed last week!’ I ploughed on. ‘That goal should never have been disallowed.’ Momentarily, they look confused. I could see they didn’t quite know what I was talking about. In the life of a thirteen-year-old, last Sunday seemed a very long time ago. Aeons of more important things have happened in their lives. Just not, I realised, in Tom’s. And then I did a dreadful thing. I stepped back. So that Tom was left to finish the conversation, like I was a waiter lifting the lid, handing over my son as a tasty offering.
‘Yeah,’ he muttered. ‘Well played,’ he said, to no one in particular.
He swung his arms back and forth, eyes darting nervously down the platform.
‘Where you off to?’
‘Cinema.’
He nodded eagerly. A pause.
‘What are you going to see?’
It was a beat too late. They’d moved onto something else. An exchange between themselves.
‘What?’ Finn said, turning back towards him.
I could see it – in excruciating clarity – that the harder he tried, the worse it was. The clunky, disjointed conversations. Slightly out of sync. The desperation to please, to be liked. It was painful. And as his back was turned, I saw the exchange of the sad and pitying glances. As they all got older, the looks were more ruthless, more mocking. Harder to ignore. And I’d look away, my face ablaze with a mixture of shame and hatred.
Naturally, the more anxious and uncertain Tom became, the more confident and self-assured Carolyn seemed. I came to expect the best from Carolyn, and understandably, it became a source of exasperation. ‘Tom only so much as has to make his way to school on time, and there’s a bloody fanfare.’
As she got older she had new interests, and more friends; most weekends there was a huddle of girls in her bedroom, flicking through magazines, and making clothes on the sewing machine she’d bought second-hand. All of this seemed to expose Tom’s inadequacies in social situations. The more her confidence grew, the more his eroded and ebbed away. I’m ashamed to say, it irked me. When Carolyn entered a competition, I found myself secretly hoping she wouldn’t win, wouldn’t be on the sports squad, or be picked for the main part in the school play when she
went for her auditions. What kind of a mother thinks that? It wasn’t a feeling I was proud of – and I thought I did my best to conceal it. Though, in the years to come, amidst furious rows with Carolyn, it was clear I hadn’t done as well as I’d imagined.
Ten
I have an unexpected free hour in my day. Hayley’s father had rung on Monday to say they’d had the offer of a friend’s caravan in Hastings for three weeks.
‘Is it OK to have a break?’ he asked. ‘Can we book the other two sessions after she’s back?’ After we scheduled them in the diary, he told me things were a little better.
‘She seems less angry. Been crying a lot, but that feels a big improvement on shouting and shutting herself away in her room. She even watched a film with us last night. Slowly, slowly,’ he said wearily, then thanked me as we ended the call.
The time I would be seeing Hayley I use to catch up on emails and letters to GPs. I’m at my desk by the window when there’s a movement in the corridor. I look up to see Dan in the doorway. He’s leaning against the frame, arms folded, head to one side.
‘Hi,’ he says, then when he registers the surprise on my face, ‘Am I too early?’
His voice is casual. There’s a shy smile. It’s an expression I haven’t seen before. An expression so like my own son that it floors me.
Here you are, I think. Here you are again.
‘I’m sorry,’ he explains, ‘I came a different way around. Up the back stairs. I saw the door open. Shall I wait?’ And he gestures up the corridor.
He’s still smiling, and I feel flustered, wrong-footed again.
‘It’s always better to make your way to the waiting room,’ I say. ‘Then you can let Paula know you’re here.’ I should have left it there, but for some reason, I carry on, I over-explain. ‘I might be on the phone, or with a patient, or colleague,’ and then I make a vague gesture with my hand, ‘so it’s better to let Paula know,’ I say again. I think about the session with Robert. The focus on boundaries. The need to be clear about the rules. To re-align, without sounding judgemental, harsh or persecutory.