In Two Minds

by Gordon Parker

  Prior to Edina’s death Martin had read widely about pancreatic cancer, being preoccupied by how its diagnosis was usually too late as it was so hard to detect. And, reading more widely on cancer detection, he had learned about ‘diagnostic dogs’. That trained dogs could sniff out cancer, be it prostate, breast, ovary or lung cancer, by recognising an ‘odour signature’ in urine, faeces, breath, sweat or even blood. If they could do that, he had mused, why could they not be trained to detect pancreatic cancer? He would pursue this inquiry. And then he would be atoned for not detecting her cancer. He had forgotten about this project during his week with Bella but Edina had not. And she had worked out the next step. No point in trying for a research grant in Australia. Martin needed to go straight to the world heartland of cancer research, the NIH at Bethesda, just out of Washington, and see the director. And so Martin left his room to scout the observation ward, and to examine the doors and walls for means of escape. It would not be too difficult, people were always escaping from psychiatric units and Edina would have the car waiting.

  As he entered the dining room a male patient walked slowly towards him. He appeared somewhat presidential, a pasha of the psychiatric unit, thought Martin.

  ‘Welcome, young man, to my kingdom,’ his voice boomed pontifically, ‘I’m Jesus Christ.’

  Another patient, who was seated at the dining table, jumped up, rushed across and tried to push the patient aside.

  ‘No, he’s not. You can tell. He’s not wearing sandals. And he can’t be. I’m Jesus Christ. He’s an imposter.’

  The first patient looked dismissively at the second. ‘But whosoever shall deny me before men, him will I also deny.’

  ‘If you’re Jesus, where are your disciples, mate?’

  ‘You doubt me, Thomas?’

  ‘So, no disciples, eh? I bet, verily, you couldn’t even name them. Go on, name three. No, four.’

  Jesus the First looked imperiously and dismissively at Jesus the Second.

  ‘He that is not with me is against me. Get thee behind me.’ He turned to Martin.

  ‘You look heavy-laden, my son. Come unto me and I will give you rest. Here, the blind receive their sight, the lame walk, the lepers are cleansed, the deaf hear and the dead are raised up.’

  Jesus the Second gave Jesus the First an all-knowing look. ‘So if you’re omnipotent, tell us how we can get the hell out of here, you pontificating prick.’

  Jesus the First evidenced resignation. ‘It is easier for a camel to go through the eye of a needle.’

  Martin hesitated. It seemed absurd but perhaps Jesus the First could assist him in some way. He asked tentatively, ‘Could you help me in getting one of the doctors?’

  Jesus the First responded dismissively. ‘They that are whole need not a physician. But…’ And he raised his hand as if to give a benediction… ‘I say to you. Ask and it will be given to you; search and you will find; knock and the door will be opened to you.’

  ‘Wow,’ said Jesus the Second. ‘If I knock and all the obs ward doors open, that would be a miracle. I can feel all my bum hairs standing erect.’ He was quivering as Jesus the First moved to the nurses station and rapped on the door. He turned to the two watchers. ‘Behold, I stand at the door and knock…’

  A nurse’s face appeared at the window. ‘Barney. Settle down. Go and work out in the gym. We’re too busy right now.’

  Jesus the Second turned to Martin. ‘Barney, huh! Told you barmy Barney wasn’t Jesus. But then I ain’t either. The clue, mate, is in Mark Knoffler’s Industrial Disease, but I’ll let you work that one out.’ Martin looked blankly at him. ‘I’m Fred Quinn, mate, and I work for the Federal Police. They – like God – move in mysterious ways. They’ve sent me in here on a special mission. My lips are sealed but if you’ve got a cigarette or three I’m prepared to take you into my confidence.’

  Fred looked at Martin with amusement. And then glared at him. ‘You don’t believe me, do you?’

  Martin pulled back. ‘Why would you think that?’

  Fred stepped closer to Martin and glared. ‘The next thing is you’ll be asking for identification.’

  A threatened and bewildered Martin noticed the nurse move quickly towards them and then slide between them. The nurse suggested Fred might have a game of table tennis with him.

  Martin walked away quickly to inspect the airing court. Three other patients were pacing up and down in the courtyard. They ignored Martin and he ignored them.

  The wall was high but capable of being scaled, particularly if Martin could drag his bed out and place it vertically against it. He was confident he had the strength. Timing was the key. He would wait until all the staff were in the nursing station and then clamber over the wall. They might have to be distracted. Perhaps if he set off the fire alarm? But when he inspected the ward there was none. But perhaps if he could get a lighter and hold it near the smoke detector? It might need some time to find one but Edina would keep the car waiting. He had total confidence in her.

  ‘Martin.’ A male voice. He turned around.

  A nurse was approaching, holding two paper cups. ‘Medication time, Martin. Just one tablet now and a couple before you go to bed.’ He held out one cup, indicating that Martin should take it. Martin questioned him sullenly and the nurse told him it was his olanzapine.

  ‘My olanzapine! I have my job, I have my wife, I have many things but this drug is not mine and not me. I want to see my doctor. Don’t you know who I am? If you don’t do what I say, I’ll have your job.’

  The nurse appeared not to hear. Martin would write a complaint about him once other priorities had been addressed.

  Martin pointed enigmatically towards the TV, desperate to distract the nurse. But the nurse remained phlegmatically attentive. Martin knew if he took the tablet it would become harder to later climb the wall. But he suspected that, if he refused the tablet, the staff would almost certainly give him an injection. He picked the tablet out of the cup, but was unable to palm it, and instead locked it under his tongue. He heard Jesus the First call out ‘Whosoever drinketh of this water shall thirst again.’ The nurse grinned as he handed Martin a water-filled cup. Martin drank the water slowly. Jesus the First called out again. ‘If you bring forth what’s within you, what you bring forth will save you.’ The nurse ceased grinning when he asked Martin to open his mouth and was quick to find the tablet. ‘Come on, Martin. No diverting. I’ll give you some more water and I want you to keep your head back and mouth open.’ Martin felt the tablet pause momentarily in his upper gullet – where he knew he could regurgitate it–but then it was gone. Swallowed. Martin felt disconsolate. He may not be able to escape this night. The car would just have to wait.

  Over the next few hours Martin oscillated between his room and the nurses station. In his room he read and re-read the schedule, and idly flicked through some magazines that had been in the dining room. At the station he asked to see a doctor, but when asked why, he refused to offer a reason. He would explain to the doctor. He demanded his mobile phone back but was told that patients were not allowed a phone on the ward. He asked for access to the hospital phone and was told he could make one call only and for no longer than five minutes.

  When Sarah answered he spoke tersely. ‘You disappeared on me.’

  Sarah spoke slowly and in a constrained voice. ‘That was the doctor’s advice, Martin.’

  ‘But you haven’t rung me.’

  ‘I rang the ward and talked to a nurse. She thought it best to let you settle in first.’

  ‘Have you got me a barrister?’

  Her voice dropped. ‘I thought we might sit on that option for a day, Martin.’

  ‘Sarah! If you’re not for me, you’re against me.’ He slammed the phone down and swore several times – including at each Jesus.

  Over the next hour Martin started to feel somewhat sedated. He no longer had the energy to move his bed out of the room. He oscillated between his bedroom and the dining room, trying to read a newspap
er, watching television for a few minutes, brooding about how he might get out of the hospital and trying to avoid the other patients who were all quite mad. He also avoided the nurses, even their attempts to have a chat with him. He knew they were seeking information to keep him locked up. After a desultory dinner at five o’clock, during which Jesus the First reminded everyone that ‘Man should not live by bread alone,’ he was given more medication to take. On querying he was told it was another dose of olanzapine and a starting dose of lithium. He put each in his mouth and told the nurse he had to go to the toilet. The nurse smiled. ‘Let’s just sit here together till you swallow and I have a look in your mouth. Toilet after that.’

  After dinner and watching several boresome programs on the small television set – with threats by two of the patients, rather than democracy, determining the selection – Martin went to his room and lay down.

  He slept fitfully during the night but more than he had in previous weeks. He was aware of nurses checking on him every hour, of the noise of other patients unable to sleep and one who paced the corridor, sometimes banging on his and every door.

  One patient could be heard as he walked up and down the corridor. It sounded like Barney. ‘Do not be anxious about tomorrow, for tomorrow will be anxious for itself. Grow from adversity. Act with a pure heart. Feel the love. Find joy in the moment.’ And perhaps it was Fred who shouted back ‘Shut the fuck up or I’ll put a joystick up your Khyber.’

  Barney maintained his discourse. ‘Remember. This too will pass.’

  ‘The joystick certainly won’t.’

  ‘Ask not what the world had done to you but what you can do for the world. And know that I am with you always.’

  ‘Not if I can get to you, you weird sicko psycho, if you don’t piss off. You’ve got ten seconds or I’ll belt the bejus out of you.’

  The ward went quiet for a period. But shortly, Martin heard the sounds of a fight, a nurse’s duress alarm going off and a number of people – presumably nurses – running down the corridor.

  A nurse woke him at eight. ‘Could I suggest you get up, Martin? You’ll feel better.’

  Martin felt horrible and was aware of a dull headache. He felt even worse when he stood up. He was unsteady on his feet. And sweating. He went to the bathroom and noted that he now had diarrhoea. It was that bloody lithium. He was not able to tolerate it – physiologically or psychologically.

  After dressing in the same clothes as the day before – damn Sarah for not bringing him some clothes – he went to the dining room and ate a typical hospital breakfast. As each of the day nurses passed him Martin would complain about the lithium side-effects and demand to see his doctor, only to be told that the consultant was not scheduled to undertake his ward round till the afternoon.

  As he found the other patients disturbed and disturbing, Martin retreated to his room with a morning paper. It was impossible for him to concentrate on it, needing to lie down for periods and then, feeling incredibly agitated, having to get up and pace. He called out to Edina but she failed to respond. He knew that the car would no longer be there. Everyone had deserted him.

  At mid-morning he was escorted to the Medical Imaging Department by two nurses to have a MRI. He was warned that lying in the machine might be somewhat claustrophobic and given a buzzer to press if he could stand it no longer, but he actually found the confined space peaceful – despite the tapping, knocking, chirping and squeaking acoustic noises made by the scanner.

  He was even more unsteady as he walked back to the ward and his sweating was more severe. Again he asked the escorting nurses to get him his doctor and again they indicated that his doctor would review him in the afternoon. ‘Bugger the lot of you,’ Martin yelled through the nurses station window.

  At two, there was a knock on his door and Sarah appeared. She smiled tentatively but looked wan. She was carrying a bag. Presumably spare clothes. ‘Sunny, how are you?’

  ‘This is the pits, Sarah. You must get me out. It’s Monday. I need to be at work.’

  ‘Dave and I have talked, Martin. He’s cancelled your shifts for this week.’

  ‘Week!?’

  ‘We just don’t know how things are going to progress, Martin.’

  ‘So what excuse is Dave going to give?’

  ‘The staff and the patients will simply be told that you are unwell and not able to get to work. Nothing specific. No mention that you are in hospital.’

  ‘And have you organised the barrister?’

  ‘Not yet, Sunny. I was rung by your consultant. He suggested I come in and that we’d all meet together and work out a plan.’

  There was a knock at the door. Sarah opened it and three people entered.

  ‘Hello Martin, I’m Don Fielding, your consultant, and this is my registrar, Doctor Hilary Johnston.’ The male nurse leant back on the closed door, his arms folded.

  Martin inspected his consultant. Young, perhaps mid-thirties, tieless, casually dressed and with a cultivated scruffy unshaven beard. So he was the enemy out to trap him. Fielding sought to establish some commonalities, by asking which medical school Martin had attended, and had Martin come across his uncle, who was also a North Shore general practitioner? Martin simply stared back at the consultant.

  ‘So Martin, how are you feeling?’

  ‘Crap. I’ve got a headache, I’m sweating. I have a severe tremor and loose bowels. The lithium you put me on is poisoning me. I don’t want to take any more of it.’

  Fielding ignored Martin’s last statement. ‘Can you tell me what got you into hospital?’

  ‘The police brought me but they didn’t give any reason.’

  ‘I understand you thought you were communicating with your mother?’

  ‘She’s dead.’

  ‘So I understand. But you still felt you could talk to her, I believe. Did you think that the TV was referring to you or are you hearing any voices?’

  ‘Hear voices? Of course, I can hear voices. There are too many voices around here.’

  ‘Voices?’

  ‘Yes, all the patients, especially the two Jesus imitators. They are so loud.’

  Fielding’s voice lifted slightly. ‘Interesting. You think there are people who believe they are Jesus then?’ The nurse leant forward and whispered into Fielding’s ear. ‘Ah, I see.’ He returned to questioning Martin.

  ‘No voices in your head or just outside of it…I mean not from real people…?’ Fielding became disconcerted by Martin’s failure to respond, but recognised that he had not framed his question properly. He changed tack. ‘You don’t feel you are being persecuted, people after you, that sort of thing?’

  ‘Of course I’m being persecuted. I’m locked up here.’

  ‘Quite. So far, I understand you haven’t had any cognitive testing. Do you mind if I ask a few questions?’

  ‘Fire away.’

  ‘I’ll get you to remember this story and repeat it back in three minutes. Tom and Bill went fishing last Saturday and caught two black bass. Can I check you got that?’

  ‘Bats?’

  ‘No bass.’

  ‘Tom and Bill went fishing last Saturday and caught two black bass.’

  ‘Excellent.’

  ‘Unless you wish to use their proper specific Australian name – novemaculeata?’

  ‘No, bass will be fine. I’ll get you to repeat it shortly. And you know the Prime Minister?’

  ‘No. Never met him.’

  ‘I mean his name.’

  ‘Doctor Fielding, this is all very silly. I just want to get out of here.’

  The consultant aborted his cognitive testing. ‘Well, Martin. We can’t let you out, I’m afraid. While we’re not absolutely sure about the diagnosis, all the evidence suggests that you have had a manic episode after a severe depressive period. During manic states people can do things they wouldn’t normally do and they can also put their reputation at risk. We need to treat you until you are out of the episode. It shouldn’t take too long and you’ll do
brilliantly –’

  Martin cut in curtly. ‘How long?’

  ‘The average stay here is two to four weeks…’

  ‘Weeks?’

  ‘Yes, but it can vary a lot.’

  ‘And these drugs that are poisoning me?’

  ‘We have to give you an antipsychotic for a period and it will help you sleep. Adding the lithium will almost certainly get you out of here faster but if the side-effects are troubling you…’

  ‘I’ll take it for the moment.’ Martin reached into his bedside table and took out a sheet of paper. ‘I understand I have the right to appeal to the medical superintendent to get out of hospital. I’ve written the appeal and I want it acted on immediately.’

  Fielding took it. ‘I’ll pass it on. We’ll just have a talk to your wife outside. She can come back shortly.’

  Martin stewed. If Sarah was going to conspire with the staff then he could not trust her at all.

  As the others left the room, Martin’s anger flared up. Said he was testing my memory and he forgot to check it. Who had the memory problem?

  He yelled through the door. ‘Tom and Bill went fishing last Saturday and caught two black members of the Percichthyidae family, you bastards.’

  The others adjourned to the waiting room. Fielding looked more comfortable talking to Sarah.

  ‘Sarah, Martin has almost certainly had a manic episode. His drug screen was negative, all his bloods were normal and his MRI was essentially normal.’

  ‘Essentially?’

  ‘Just some minor hyperintensities. We sometimes call them unidentified bright objects or UBOs. Indicative of small blood vessel changes, usually with age but we do see them more in people with mood disorders. But nothing to worry about. So we will treat him for a bipolar disorder.’

  ‘I hear there are differing types?’

  ‘He’s bipolar one. DSM automatically assigns someone with a bipolar condition if they are hospitalised.’

  ‘DSM?’