It would be fair to say that I have no physical concerns, other than his being underweight for his age, and his inability to make eye contact or walk with his arms straight at his sides, or with his feet flat on the ground.
It was difficult to assess the apathy about which you are concerned, as Nicholas was in a highly agitated state due to his anxiety at being in a strange environment with a group of people with whom he was unfamiliar. He seemed genuinely baffled by the series of questions regarding personal attachments and emotions, and was unable to answer most of them. He seemed unable to empathise; even with hypothetical situations where it was suggested that harm befall you, or his grandfather, he seemed solely concerned with practical considerations such as who would then do the shopping. He showed no emotion when I asked him about the death of his brother.
I concur with your suspicions of autism, although I feel there is something else at play here. What would have started as Asperger’s Syndrome, borne out by Nick’s high functioning at school in mathematics and science subjects, now seems to have been exacerbated by something, perhaps a psychotic break or early trauma, which could account for the sudden worsening of his condition. If there is anything that you are aware of that could have triggered such a reaction, it would be very helpful to know. Otherwise, I think for now careful monitoring is in order.
Nick needs a lot of support, consistent home life, and a gentle unpressured routine which should lessen his anxiety. I would suggest another assessment in a year’s time, when we could also consider the use of Prozac or antipsychotic drugs, which I know you are resistant to, but I have had very good results with other patients who have similar symptoms to Nick. Let us hope that the situation improves or at least settles over the next twelve months and that we can then see where exactly on the autistic spectrum he fits.
Kind regards,
Stephen Stanniforth
I remember now, looking in the hall mirror, my head spinning, trying to see what the doctor had seen. I didn’t like the letter and I remember thinking that the doctor and his chaperone nurse hadn’t understood me at all.
And here I was back at the hospital and it had started again. The panic I had felt that other time was even worse now, and I was a grown-up who should use coping strategies, but I couldn’t make them work. I scratched at one arm with the other, wondering whether I should go back down to the morgue; I must be late by now. I looked at my watch and it was half-past eleven. I had got to work early and so they shouldn’t have shouted at me. Now they had wasted my morning and it wasn’t my fault. I wanted to shout at the statue of Jesus in front of me, and ask him why he had made everyone so different and messy and demanding. I had good qualities, I was very clean, and very quiet and very neat. It was lucky for me that I didn’t need to earn money; my mother had enough for both of us. I was not demanding, and I didn’t need anything from anyone else.
The big problem for everyone else seems to be feelings. I know I laughed sometimes when people fell down, or when they cried. Mother was upset when I did that. Everyone has a good side and a bad side, Grandpa always says. I think he is right but I am not laughing because I am bad, I am just laughing.
At ten to twelve I went to the lift, and when the doors opened the floor was clean and dry. I went to the freezer room and put on my apron. This was better. I went to find Mark and Pete to ask them what they wanted me to do. My heart had slowed down, and I felt ready for the day ahead.
When I came into the rest area Karen was sitting there with Mark and Pete. I didn’t like her being down here.
‘Nick, are you alright?’
I decided to ignore her and talk to Pete instead. He is the person in charge of me. I asked him what I should do.
He didn’t reply. She did.
‘Nick, do you remember I told you that you would be on a trial for the first couple of weeks down here?’
My heart sped up, and I found a loose piece of thread on the arm of my jumper. I pulled it.
‘Nick? This morning, when you arrived early, there was a family waiting in the room to see their daughter’s body. Do you remember, you helped get her ready yesterday? When you came in you were upset. Do you remember screaming, and kicking the bucket of water down the corridor? You were shouting, Nick, and everyone could hear you and they got quite scared and upset.’
‘No one should have shouted at me. I didn’t shout first, I was cleaning up the blood on the floor. Germs. I was early and now I’m late because they shouted.’
I tried to remember earlier. I couldn’t remember screaming, I couldn’t remember anything now. All I knew was that I didn’t want to be here. I needed to go home.
I pulled my gloves off and dropped them on the floor and wanted to go and say goodbye to the bodies, but I knew that no one would understand that. I realised I was crying again and my nose was running and usually, except this week, I didn’t cry. I hadn’t cried for a long time. I was wailing, and no one was here to make me be quiet, not my mother, not Grandpa. I had seen the sign for stairs next to the lift, and I ran from side to side but towards it, on my tiptoes, arms waving.
Before I could get there, Pete and Mark caught me from behind, and I screamed.
‘Come on, Nick, it’s fine. Let’s just have a cup of tea and talk about it.’
I screamed again, I remember that.
‘Nick, if you can’t calm down, we are going to have to call upstairs and see if a doctor can come and help. Take some deep breaths.’
I didn’t want a doctor, and I knew what would happen if one came. I tried to listen to my own sounds and make them still. I needed to go home. I took the tea. Three tries to get it to my mouth, and then I took a gulp which burnt me. I nearly threw the cup across the room, but I grabbed my hand with my other hand. Steady.
After ten minutes, they were still talking, and I began to remember the rules. Make eye contact – that wasn’t working. Nod. I could manage that. Breathe. I sipped and I nodded and I breathed and I blew my nose. My heart was banging in my chest, but they couldn’t see that. When Karen offered to order me a taxi I nodded. When she took me upstairs and after Mark and Pete had said their goodbyes and said sorry, and what a good worker I had been, and I bit hard on my cheek to stop myself from crying again and tasted blood but I didn’t shout at them, I got into the taxi and went home. Pete told me to take a couple of days at home and calm down, but I was so tired I never wanted to go out again.
I was looking forward to just being on the path leading to my own front door. It was nice not to have to smell people, and be squashed on the Tube, or in a car that smelt of curry like the one I was in now. I got out of the car and took out my wallet with my allowance in it but I didn’t even have to pay, and I went towards the front door past the bins on my right. It was familiar. So much had happened and now I was just going to sleep. I had wondered if the police would come to see if it was me who had taught the couple in the park a lesson, but they hadn’t. If they were going to come it would have been by now.
I went inside, and tried to breathe. It wasn’t calming me down. I needed a paper bag like Grandpa brought me sometimes when I got very upset. I straightened the letters on the table. I took down my note about a job. I couldn’t get the letters straight and the note was making me want to cry, again. I went up the stairs, pulling myself upwards with one hand while my feet refused to behave and my other arm waved around and my face was scrunched up so tight I could hardly get my key in the lock even though usually it was easy. I looked at my list, but it was no help. It was supposed to be work, and Grandpa was crossed out, and now I would have to cross work out. My hands were shaking too much to do it. I had a glass of water in case I was dehydrated and went past the window, covering my face with my hand so that I couldn’t see the litter tray. I made it to my bed and I lay down under the covers with all my clothes still on. I had never done that before, either. I would wait for the day to be over, and tomorrow would be another day.
The house was completely quiet. My whole week had b
een filled with unexpected noises, but now there was nothing. The front door closed, I heard it through my pillow, but no one came in, and no children arrived. I was usually happy when the house was quiet, but even under the covers my legs were jiggling and my heart was racing. I did all my coping strategies but nothing worked. If I could go to sleep I knew I would feel better, but as I tried to think of something happy to dream about I heard banging, on the front door. Grandpa wasn’t coming, and no one was supposed to be here. My neighbours have keys, the doctor’s children have keys. No one should be outside, but someone was. I opened the door of my flat, and I looked down into the hall. There was a figure outside. I waited – they would go away – but they didn’t, they pulled up the letterbox and shouted in, then banged again, then shouted, and the voice was a girl. I had to make it stop and make them leave me alone. I twisted and weaved my way to the door, and I opened it. This was probably what hell was like.
On the doorstep, just standing there, was the girl from the Pure Girls website, or I thought it was her. She even had the same pigtails. I stood in the doorway and closed my eyes. When I opened them again she was still there and she said hello. ‘Are you Tam?’
She had an accent, but I think that is what she said. I am not Tam, I am Nick, so I said no.
‘I am looking for Tam, about the cleaning job.’
Clear your head, and think about nothing. It was my most extreme way of dealing with things, but this had been a very extreme day. It didn’t work. I stood still but she walked towards me, pigtails swinging back and forwards and a big smile on her face.
‘Do you know Tam?’
‘What is his address?
She told me, and it was the right house. I wondered if it was the policeman, but he was called Thomas, I had seen it on his envelopes when I put them in order.
‘I can’t help. I don’t know him. You need to go away.’
‘Shit, I was counting on this job. Do you need cleaner? I am very good, and very quick, and we can be friends. How old are you? We must be same age, and I just arrive in London.’
She carried on talking, but I could only hear the general tune of it now, and she didn’t seem to need an answer to any of her questions, so when she followed me into the hall and up to my flat I couldn’t do anything. I opened my door and quickly tried to shut it, but she was behind me.
‘Come on, be nice. Let me clean your flat, only ten pounds an hour and I will be quick. Let me see.’
The energy had drained from my body. More things had happened in one day than usually happened in a month. Worse, Mother and Grandpa were coming in two days, and the flat was not up to its usual standard and I had no job, or cat.
The girl with the pigtails stuck out her hand and said, ‘My name is Marta, what is your name?’
My head was buzzing, but I managed to say Nick. That was all I managed to say before she started opening and closing doors, looking into my bathroom, lifting up the toilet lid, opening the kitchen cupboards. I was unable to move.
‘You relax, you want cup of coffee? Ah, I find the bucket and mop here, you very organised man. You have lots of cleaning products, I love these wipes, I can use them? I can put on radio? I clean quicker that way.’
I felt invisible, and went into the bedroom while she twiddled the knob of the Philips radio I never used, and came up with a song which seemed to be mostly a drum that was banging in unison with my head.
‘You like rock? You ever hear Polish rock? You can show me nice place to go dance in London? This place won’t take more than two hours, then clean.’
I sat on the edge of my bed and put on my slippers. My heart was racing, but my mind was empty now. I watched her through my bedroom door, dancing and cleaning while she sang along and the radio pounded, and every time she bent down to wring out the mop her jeans stretched over her bottom, and her jumper fell away from her breasts. She wasn’t wearing a bra, and I liked her body; it was neat and she had looked after it, there was no fat and no blemishes.
She was on her knees now, scrubbing the floor and wiping over the skirting boards with my cleaning wipes, which I usually rationed to three a day. She was taking handfuls, and would have to start another packet if she carried on like this. She was sort of dancing on her hands and knees now, and her pigtails were near the bleachy water in the bucket.
‘In Poland I think we say you have zaburzenia obsesyjno-kompulsywne. You don’t know what I mean, do you? It’s when you hate mess. I can see from your neat clothes, and your neat hair, and your neat cupboards. I love to clean houses for people like that.’
It was true I hated mess, but I also hated to feel taken over, and invaded. I hated being given labels, and most of all I hated being teased. I thought about the quiet of the morgue and I wanted to cry again. The girl I had liked there had been so peaceful that I could have spent all day just sitting next to her.
I sat on the sofa, but five minutes later the hoover was on, and she was bumping into the legs of my chair. ‘Lift up, I have to get all the dust and then I will be out of your way.’ I didn’t have strong muscles in my tummy and lifting my legs straight up was difficult for me. I swung them round and she laughed.
I stood up, and all I could think about was stopping the noise in the flat. I was so close that I could feel her breath and she stopped laughing then. Her last laugh had left a bit of spit on my cheek and I wiped it off with my handkerchief. ‘You OK?’
I wasn’t. The park, the night on the floor, the disruption in my house, work and now this. She walked away from me backwards and a new song came on the radio. Bang, bang, and I pushed her backwards. My hands were waving around now, I think, and I could hear the echoes of the laughter of people at school, or on the streets from behind as I walked, head down, on my toes. This was too much and I had to get things back on track. All my rules were falling away, and I tried to remember the list. Make eye contact. I did, and her eyes were scared, and the shape of her body under the jumper was like the girl in the park.
‘Get away from me, you retarded person.’
I didn’t like that word. She must have known it was a bad word and just didn’t care. I walked around the sofa, the picture of the blood matted into the blonde hair of the girl in the park making me upset. I needed to make her quiet and I needed to do it with no mess. I picked up a cushion, and, as I did, she jumped up and ran towards the door.
She got to the handle, but it wasn’t the simplest door to open. I had taken a long time to learn it. You have to undo the latch, then put the handle up, then down, and hold the latch with the other hand. I easily caught her, but now she was really making a lot of noise, and I was glad she was so small.
I got her on the floor easily, and then pushed her towards the sofa so her head didn’t get bruised or cut. I didn’t want a mess. She was against the front of the sofa now, half sitting, and I pushed the cushion towards her, covering her face, but not wanting to get any spit or germs on me.
The problem was that she didn’t stop struggling, and her hands were grabbing at my wrists, then she was digging her nails into my skin. I remembered the screaming into a pillow then, which my grandpa had told me to do if something hurt or when I was agitated or upset. It meant that air could go in and out of a pillow, and I realised I needed something else. The back support cushion on the sofa was harder, and I jammed it over the soft one and straddled her. It was the only way to get her to stop making a noise.
I pushed, and stretched my head back as far as I could to avoid her arms which were now groping for my face, so she could stop me I suppose, and I put all my might into the cushions, without making any sharp movements that might hurt her face. I only wanted her to be quiet and go home, but she wouldn’t stop.
It took a long time, her feet were banging, the radio was banging, and the hoover had somehow come back on and it was loud in my ear. I could hear a muffled noise through the feathers and foam, and then at last her arms dropped and the noise turned into a faraway gurgle and then stopped too. I thought it mig
ht have been a trick so I only let the cushion go little by little to see if she moved, and then in the end I lifted up the edge of the soft one underneath, and I was surprised because her eyes were open.
I watched her the whole time, while I put out my hand and turned off the hoover. Then I got up, slowly, and turned off the radio, and then went back, and lifted her up. There was a wet pool underneath her, but I had seen that once at the morgue. Sometimes people came in wearing the clothes they had died in and they were wet. Peter had told me it was all the waste going out of their bodies so that they were clean like when they were born. I went and got two bin bags, a clean flannel from the bathroom, and I emptied her bleachy water and filled it back up with fresh hot water and a little bit of liquid soap; I had found out at the morgue that if we used too much soap the skin got sticky.
I tried to be as gentle as I could, starting at her feet because I wanted to wash her face last of all. It was a soft flannel, and I put all my skill into making sure she was perfect and washed every inch of her. She seemed much more peaceful now, and much calmer. I cleaned the floor and put her clothes into a bin bag, all of them. I wiped the floor over with the antiseptic that kills ninety-nine per cent of all germs and I felt much better. I rolled her off the bin bags and on to a cashmere throw that my mother had bought and which was the softest thing I had ever felt. I wrapped it round her gently and put her on to the bed, where I had pulled the duvet back. I looked at her: she was totally perfect and a soft scent of lavender was coming off her skin. I bent towards her and gave her a little kiss on her mouth. She had the softest lips. Her whole body was so relaxed, and limp. No tension anywhere; she seemed much better than when she had been shouting and cleaning and singing and being insulting. The whole time in the back of my mind I thought the police might come, or my neighbour because of the noise, but it was as if I was protected. This is exactly how it was with Grandpa: no one ever came.
The Man on the Middle Floor Page 15