In Two Minds

by Gordon Parker

  As he felt ill, he went and sat on a chair on the lawn. A few minutes later a woman came across, dragging a chair and sat opposite him.

  ‘Can I join you? You have such a kind face. I was told your name was Martin.’

  Martin nodded. She was fortyish and, unlike all the other patients in the ward, she was well groomed although wearing somewhat too much make up.

  ‘I’m Clarissa,’ she said quietly.

  ‘Mrs Dalloway?’ queried Martin.

  She looked puzzled. ‘No, I never married. One of the many sorrows of my life. Thank God I have my bipolar, it gives me times when I’m better than fine, full of zest and life’s possibilities, and don’t have to think about my life failures.’

  Martin queried her. ‘Are you in here because of it?’

  ‘My sixth admission in ten years. Came in last week. And you?’

  Martin was not sure how to answer, wishing to avoid any self-disclosure. They were interrupted by a man in his forties, unshaven and missing his front teeth, who squatted down in front of them.

  ‘Got a cigarette. A real one. No ifs and butts, doc.’

  ‘Doc?’ inquired Martin.

  Clarissa intervened. ‘He’s not a doctor, Freddie. He’s a patient like us.’

  ‘No, he’s a doc. I know. Doc, I’m dying. I died today and I want to stay there. In the bath I was relaxed and I knew I’d died. Something to do with the change in the government. Or maybe something I did. Or my ancestrals. Perhaps my grandfather. He died. He had bat ears you know. Gave him too much latitude but not enough gratitude. They’ll take me to a church. It’ll be very quiet till the resurrection. I’ll come back as a work of art though. You know, my mother died. So have you got a cigarette?’

  Martin apologised and Freddie wandered off. Clarissa said, ‘I think he made a good case that he’s dying for a cigarette, Martin.’

  ‘Poor bastard,’ muttered Martin.

  ‘We think so but he’s actually quite happy. He’s chronically schizophrenic but, every now and again, it becomes quite florid and the community team bring him in for a few weeks until he settles down again and they have had time to clean his place up.’

  ‘He doesn’t look after himself well?’

  ‘He’s a hoarder. Apparently every room in his house is chockers with stuff, up to the roof. Living room, bedroom, kitchen, everywhere. He even filled up the shower. Began to sleep outside his flat on the landing. But happy as Larry most of the time. Shows the advantages of not having a private school education.’

  Martin did not want to contemplate Freddie’s existence. He turned back to Clarissa. ‘You said this was your sixth admission?’

  ‘My parents called the crisis team. Said I’d gone manic, having travelled around the world and spent lots of money. Factually correct apart from me being manic.’

  She was keen to tell her story and Martin thought listening to it might break the monotony of the morning. Clarissa’s family had a preoccupation with money and it was a riches to rags in three generations saga. Her great-grandfather made a fortune, her grandparents saved it, and her parents gambled it away so that her own childhood had been impoverished. The family meme was money – she and her brother were dirt poor, poverty bound, wastrels, spendthrifts, gamblers or feckless, hopeless with money and unable to be trusted with it. Money was to be saved and coveted, while excesses were viewed with contempt. Clarissa had been in the A class at school but, when her mood problems commenced at eighteen, she had been hospitalised for three months, given a diagnosis of schizophrenia and trialled on many inappropriate medications for two decades until the correct diagnosis had been made. As a consequence of the initial incorrect management, she had not been able to continue her education or hold down a job, had had only one boyfriend for three months before he had left her as a consequence of her illness, and had no close friends. In recent years she had spent her days doing chores for her parents and daydreaming as to how she might escape. Manic episodes provided a release. At those times she would stay up all night and write letters to her favourite current film star, buy cheap jewellery on a free-to-air television show that relied on buypolar manic customers, fill her bedroom with knickknacks bought at Vinnies and exsanguinate her carefully saved disability pension money in a day or two – sometimes dressing in a clown suit she had bought during an earlier episode – and often prune the rose bushes at three a.m., feeling as if she was the Queen of the Universe, bursting with happiness and euphoria.

  When an aunt died, Clarissa had inherited 50,000 dollars. It was enough to send her manic but Clarissa experienced a different high. The agent of an American film star whom she had written to the month previously had sent her an invitation with a version of a silent auction. A dinner evening under the stars with a star. Whoever bid the largest amount would be able to have a three-hour dinner with the Hollywood luminary at one of the most expensive restaurants in Los Angeles. Clarissa bid 40,000 dollars, allowing the remainder for travel expenses. Her bid won! It was only later – and via the star’s agent – that Clarissa learned that the next closest bid had been 350 dollars. She had relayed her excitement to her psychiatrist who had been quite alarmed and warned her not to proceed. He suggested that she tell the star’s agent that she had a bipolar condition and was unable to afford such a large amount. He, the psychiatrist, would write a supportive letter if she so wished. And what if she went? The excitement of the event would ensure a severe manic episode, probably requiring hospitalisation. And then how would she afford the hospital bills as any travel insurance company would almost certainly reject her claim? Clarissa thanked her psychiatrist for his advice and support and indicated that she would respect it.

  Another patient came rushing over. Clarissa warned Martin, ‘Here comes Clive. He’ll carry on a bit but don’t be worried.’ Clive was wearing a turban and his shirt was unbuttoned. He was talking before he reached Clarissa and Martin, words tumbling out in rapid-fire staccato sentences. Clive looked at Martin and pointed to another patient in the corner of the court.

  ‘Sir, sir, he’s got a brain tumour. I’m the only person listening to him. Freddie says you’re a doctor. You, doctor, should perform a brain operation. I’ll ring Emergency now. Haven’t you taken the Hippocratic Oath? I said if it gets worse give me a tap. And he just gave me ten. He was not joking. Pressure on the brain. I beg of you. Just give him an MRI. This man is serious. He’s just hanging on. I know. I’ve had fifteen bags of blood put into me. Please stretcher him. I’ve had friends die, especially when I prayed and hoped. He needs an operation to save his life. He needs to be brainwashed. My grief comes out verbally. They try to give me drugs but I’m a medaphobe. You need a derivative. I don’t see myself as a victim. I’m very big on boundaries. I can tell you one thing. I’ve lost my thread. I’ve learned a lot about the brain through damage. It needs a lot of inhibitors. You know with a swimming pool you can create a biosphere. The brain’s just like that. Drugs just bash you on the head. Don’t effect the natural inhibitors. Giving me drugs weakens my natural inhibitors. My brain waves are too slow. They’re in sleep mode. So I’m not dead but I don’t know I’m here. You know Bach’s music helps you study so it must slow down the brainwaves. So I need different music to speed it up. Or a laser. Or a vibration. Remember, cats purr to heal themselves. I make noises when I’m sick. Uuuhhhh…ooohhhh…oohhhh. That’s my molecules vibrating to heal myself. It’s in the Bible. That’s the voice of God. That’s a vibration. Get it? That should be a therapy…to change the crystallisations. If there’s anything you want to know I’ve got a brain. You know this is something that is true. The analytical part of the brain is the last thing to go. The brain part for kindness, compassion, spirituality, aptitude, subtlety. I’ve trained myself. Don’t be disappointed if I haven’t got all the answers. Our brain hasn’t got the capacity of a computer. And that’s the puzzle. Whoever created us gave us this subtlety. I don’t believe if you don’t believe in God.’ He looked enigmatically at them. ‘You know, God is “dog�
� spelled backwards. If we had a dog here there’d be more religion, and by God we need it.’ And then he became angry. ‘Well, if you’re not going to help him, I’ll organise a craniotomy myself.’ Clive ran off to the nurses station.

  Clarissa reassured Martin. ‘He’ll be like that for a few days, then the meds will bring him down. Mania, of course. Not rhyming though. I love manic rhyming.’

  Martin smiled to himself and made a brief response to Clarissa. ‘Mania. Really. I’ve often wondered what it must be like.’

  Clarissa smiled and then returned to her story. She had proceeded to Los Angeles and the special dinner. Against expectations, it was not a tête-à-tête occasion. The star was accompanied by his agent, his wife, his principal public relations officer and six old friends.

  ‘There were a lot more people than I expected, but perhaps it was always going to be that way and they just didn’t tell me in advance. But they were all so friendly and welcoming. And to spend time with my favourite actor was wonderful. He was very kind and friendly and thanked and hugged me a lot. His agent told me that I would have an allocated time to be with him and I’m sure he went over that time. And when he looked into my eyes I felt he was looking into my soul. He was very sincere and genuine. Being with him went past all my expectations.’

  ‘And you weren’t overwhelmed?’ Martin asked.

  ‘I went a bit blank at times. Meeting your favourite person in the whole world is daunting, but it made me develop a sense of self-acceptance. It counteracted all the self-hate I’ve felt over the years. As I flew back, I was in a peaceful state, certainly not manic. And, while the forty thousand was a lot of money, I had no regrets. People spend forty thousand on a car or a wedding or a cruise. I don’t need a car, I don’t want to travel the world and I learned years ago that I couldn’t handle the stress of a relationship. And how many people get to have dinner with their favourite person in the whole world? I felt there was no price you could put on the happiness that evening gave me.’

  Martin mused. Clarissa’s family narrative was one of money, and with the money distortions compromising her view of reality. But her bid had made real something that had previously only been fanciful. Never believing that money should be her servant she had chosen to give herself one big thing. He spoke gently to her.

  ‘That’s a wonderful story.’

  Clarissa shrugged her shoulders. ‘Thank you.’

  ‘How did your parents respond?’

  ‘As I said, they called the crisis team, told them I’d had manic depression for two decades and that I’d just spent forty thousand to fly to Los Angeles to have dinner. That I’d become infatuated and that the next predictable step was that I would engage on a spiritual quest to save the world.’ She shrugged her shoulders. ‘So the crisis team brought me in here a week ago and the admitting doctor diagnosed me as manic.’ She laughed. ‘I haven’t had a manic episode for a year.’

  ‘So have you explained all this to your doctor?’

  ‘No. I’m better off here. If I was at home my parents would be criticising me incessantly about the money. Better they think I’m ill. And better that I’m here. There’s always something interesting about a psych ward. Hard not to be spotted when you’re quite sane. So I recite my favourite poems aloud to make them think I’m talking to my voices. And I’m very effusive with everyone.’ She laughed.

  Martin mused. What an extraordinary woman. Something of great value had come to pass in her real world, and yet the rest of the world would probably never understand or appreciate it. And he, in turn, failed to recognise that his empathy had returned.

  Freddie appeared before them. ‘You sure you haven’t got a cigarette, doc? Or are you Jesus Christ? If you are, how about a miracle? I’ll get you some fishes and you can turn them into packets of cigs?’

  HIDING AND SEEKING

  Professor Marshall met Sarah in the unit’s waiting room, introduced himself (‘Call me Saxon’) and said he would appreciate her observations and that, unless Martin had any concerns, he would prefer both of them to be present at the interview. He then escorted Sarah through to Martin’s room. Martin was lying on the bed and Marshall noted he was somewhat slow as he sat up and edged to sit on the side of his bed. Both his hands were shaking mildly and his shoulders were slightly stooped.

  ‘Martin, I’m Saxon Marshall.’

  ‘I’ve heard of you and I appreciate you giving your time.’

  ‘All fine. I’ve been asked to review some of the diagnostic and management issues. OK by you?’

  ‘Absolutely.’

  ‘So it all started with depression, I understand. A month or two back.’

  Martin nodded. ‘Yes.’ It was not his style of interview. Cut to the action was this man’s strategy. There was no attempt to establish a rapport with Martin, perhaps discussing whether Marshall was also a Wallabies tragic. No bonhomie. Marshall was going to be more like a barrister than your friendly barista. Martin anticipated a staccato closed-question interview and one that would evoke monosyllabic responses from him.

  ‘First episode ever?’

  ‘Yes.’

  ‘Did it come out of the blue or were there some stressors?’

  ‘My mother died.’

  ‘I’m sorry,’ Marshall offered briefly. ‘Of what?’

  ‘Cancer of the pancreas.’

  ‘A bugger of a disease. Any other stressors around that time?’

  ‘None that were unusual.’

  ‘And what did the depression feel like when it became established?’

  ‘Amotivated. Black. Bleak. And a sense of doom.’

  ‘Could you be cheered up? Get pleasure out of things you’d normally find pleasurable?’

  ‘Not really.’

  ‘How about your energy? Hard to get out of bed and get going?’

  ‘Absolutely.’

  ‘Any diurnal variation? Worse in mornings or evenings?’

  ‘Much worse in the morning.’

  ‘Any appetite or weight change?’

  ‘Not much appetite. Not sure about my weight.’

  Sarah cut in. ‘His pants sagged. He definitely lost weight.’

  ‘And sleep?’

  ‘Very poor.’

  ‘Initial, middle or terminal?’

  ‘All. I’d sleep fitfully till the early morning and then sleep was impossible after a certain time.’

  ‘Three ten a.m.?’

  ‘Pretty much around then.’ Martin viewed his question as cogent but also demonstrating a level of self-conceit by Marshall.

  ‘And your concentration?’

  ‘Not good.’

  ‘Lots of distractible thoughts or, instead, more foggy. Hard to take things in.’

  ‘Foggy.’

  ‘Did you feel slowed down or agitated?’

  ‘Both at different times.’

  Sarah cut in again. ‘Mostly he was very slow. Like an old man…’

  Marshall nodded. ‘Did he lose the light in his eyes at those times?’

  She smiled with recognition. ‘Absolutely. And would keep to himself.’

  Marshall smiled. ‘Became insular then. Very appropriate symptom descriptor when this type of depression reflects disconnections in the insula cortex of the brain.’ He pressed on quickly. ‘Any psychotic features, delusions or hallucinations?’ Martin was again struck by Marshall’s directness and avoidance of euphemisms.

  Sarah had a query. ‘Delusions?’

  Marshall responded quickly. ‘Believing he was in penury, had done something that evoked disproportionate guilt, judged he deserved to be punished, thought his life was at danger, that the TV was bugged…’

  Sarah shook her head twice. ‘I didn’t observe anything like that.’

  Martin shook his head a few times.

  Marshall turned back to Martin. ‘Any suicidal thoughts?’ Martin was again struck by Marshall’s directness. No gentle introduction to the domain, perhaps by asking if he had felt worthless, or whether he had thought that life was
not worth living. Not wanting to worry Sarah, he responded, ‘None.’

  ‘And you worked during this time. You didn’t think you were impaired?’

  Martin shrugged. ‘It distracted me. Gave me a structure. But when it got worse, I took some leave.’

  ‘Why? What changed?’

  ‘I lost my capacity to make decisions, to feel for people and I became even indifferent to my own actions.’

  Marshall turned to Sarah. ‘Abulia. Like being stuck in a block of ice.’ He turned back to Martin. ‘And then you apparently went high. Did you feel more energised and wired?’

  ‘Absolutely. Initially, I thought it was just a rebound from the depression but then it became excessive.’

  ‘Talk more and over people?’

  ‘Absolutely.’

  ‘Loud?’

  ‘I don’t think so.’

  ‘Feel more creative?’

  ‘Indeed.’

  ‘Feel bulletproof and invincible? Have your day-to-day worries disappear?’

  Martin decided he would offer rapid responses too. Qualifiers, exemplars and elaborate descriptors were not the order of the day. ‘All of the above.’

  ‘Decreased sleep and not feel tired?’

  ‘I could run on two or three hours.’

  ‘Did things seem interconnected to each other?’

  ‘Some of the time.’

  ‘Buy things you didn’t really need or couldn’t afford?’

  ‘To some degree.’ Marshall noted Martin’s hesitancy and suspected its origin.

  ‘Would you like Sarah to leave the room?’ Martin felt caught. If he asked her to leave she would know he was hiding things from her. Had Marshall contrived this risk? He responded quickly.

  ‘No, I’d like Sarah to stay.’ As he said those few words he recognised that, if there was any chance of repairing his marriage, he had to be as he had always tried to be with Sarah. Open. Although it might risk irreparable damage to their relationship, the process had to begin. Edina’s Lao Tzu quote, The journey of a thousand miles begins with one step, would guide him.