by David Roland
‘I’m just doing what I’ve been told.’
‘But that’s silly. I don’t see the point. I’m not giving any more blood.’ I rest my head back on the pillow. I don’t like her. Doesn’t she know what it’s like to be prodded and examined every day?
She steps away from me with a sneer, the skin around her nose tightening, as if I am a piece of talking dung. Then she picks up her case, turns, and leaves.
When I’m up, I tell Julia what happened. She says that she will check on the previous blood results.
After breakfast, I catch up with Peter. He’s easy to talk to. ‘One way of keeping a lid on your panic is to do controlled breathing,’ he says. ‘Are you familiar with that?’
‘Ah, could you go through it?’
‘Breathe in to the diaphragm, counting in … two … three, hold … out, relax… two, relax … three, relax.’
It’s as if I am hearing this for the first time, even though I’ve taught breathing techniques to hundreds of others before. He gives me self-soothing statements that I can say: ‘I can start again’ and ‘Anna and I have each other.’
I have made another human connection in the hospital, and my sense of aloneness diminishes a little more. I resolve to use Peter’s techniques; I’m sure they’ll help.
I just have time to attend a session on ‘reasons for change’ before lunch. But as I make my way there, I see Alan. I recognise him immediately. He was an ex-policeman, running his own gardening business, when he came to see me a few years before, for help with anxiety. He would come to our sessions with a small notebook in his top pocket, having written down his worrying thoughts as he went about his jobs during the day. He practised the exercises I gave him. I sensed that he had issues from his police career that he hadn’t resolved, but he didn’t want to look at these — just at how he was managing day-to-day. He made good progress.
Today he is looking calm — still athletic, the same boyish face. I haven’t seen him in the ward before, so I guess he must be attending the clinic for a day program. The fact that he is here probably means he had a relapse. Did I fail him?
Alan sees me across the crowd of people milling in the corridor, waiting to go into the various group-activity rooms, and our eyes lock briefly. It is a blowtorch on my sense of shame. I panic. I’m carrying a red clipboard with notepaper, and I quickly bring it up to my chest — trying to look like a busy staff member. It’s an automatic response. I back off around the corner and wait for the noise of the crowd to die out. To stop my chest heaving, I count my breaths, like Peter told me.
When it goes quiet, I peer around the corner: he’s gone. I think I know what room he went into, and I hurry past it, thankful that there is no window in the door. I’ll need to watch out for other former patients who might know me. This mustn’t happen again.
TODAY IS ALSO the day of my consultation with Doctor Franklin, when I’ll find out what hope there is for me, and why I’m like this. After lunch, I’m back in the characterless waiting room I sat in with Anna on admission. This time, I’m near the door of Doctor Franklin’s office. It’s very quiet, as if the carpet is soaking up all the sound.
I can’t work out what is happening to me. Will I become a nervous wreck, unable to function ever again? Is it my fault that I’ve ended up here? If so, I can’t trust my judgement anymore. Who, or what, do I hold on to? Julia’s words, ‘Did you know that Doctor Franklin also worked with your mum?’ tumble over and over in my mind, becoming solid and polished. I ache for Doctor Franklin to say something about Mum when we meet; it would be a connection, a consoling hand on the shoulder.
The door opens. A man wearing a black suit and a pale-coloured tie emerges. ‘Mr Roland?’ he says.
‘Yes.’
He motions, directing me into his office. ‘Please come in.’ His face is inscrutable.
I go into a small, square room, ordered and uncluttered. Framed prints of sailing ships hang on the walls — a nautical theme that’s incongruous with the setting.
Doctor Franklin looks to be in his fifties, with a thin, youthful face, and hair in need of a trim. He’s wearing nerdy spectacles. He sits down behind a gleaming wooden desk, clear except for a computer off to his left and some notepaper before him. I sit opposite, the desk a barrier between us. Behind him is a low bookcase filled with reference titles. There is only one personal item: a photograph of someone sitting at a camp table, silhouetted by the setting sun. I’d like to know who this person is, but Doctor Franklin’s facial expression doesn’t invite such frivolous enquiries.
He leans forward, forearms on the desk, silver pen poised. ‘We know someone in common, I believe?’ he says, without a smile.
‘Yes,’ I say.
And, as if that subject is now out of the way, he asks, ‘Tell me, how are you feeling right now?’
‘Oh, well — I’m in a daze. I’m not my usual self … my concentration’s not good.’
‘Can you tell me what day of the week it is?’ he asks, and I answer.
The familiar questions unroll; his gaze is intense and enquiring. He asks about my psychiatric history, work history, drug and alcohol use, medical history, family history, life stresses, suicidal thoughts … I see, upside down, my answers turn into indecipherable squiggles on his notepaper. My experiences are being squeezed into the boxes of his psychiatric protocol. It doesn’t seem right, summing up rich and ragged life pieces and squaring them away like this. Yet, I remember, it’s what I used to do.
Doctor Franklin doesn’t always let me finish answering each question before he moves on. I am a small child, hand firmly gripped, unable to keep up with him, an adult striding on. My brain is hurting. I try to slow down the pace with pauses and comments: ‘I’m becoming foggy’ or ‘Can you say that question again?’ It feels relentless.
After the questions stop, he leans back in his chair; his face relaxes. He pushes a blank piece of paper across the desk and proffers a pen. ‘I’d like you to draw a bicycle for me,’ he says.
I know this test from my neuropsychology training. It’s a measure of some aspect of brain function, but I can’t remember what exactly, right now. I draw it hurriedly, my right hand strangely clumsy.
He asks me to name in a minute as many things as I can beginning with the letter ‘s’, and then to name as many animals as I can. These are word-fluency tests, and I notice how slowly my words seem to come. He doesn’t give much away, so I’m not sure how I’m doing. Finally, I am to repeat the sentence ‘Tom and Bill went fishing and caught three brown trout.’ With a huge amount of concentration, I pull the words out of the fog. I think I get it right, but Doctor Franklin only nods and says he will ask me to recall it again later. I try to rehearse the sentence in my mind, in preparation.
We talk about medication. He doesn’t recommend anti-depressants, but sees no need to stop taking St John’s wort. However, he wants me to take Remotiv. ‘It is the only formulation that guarantees a correct dose of the active ingredient,’ he says, making a note to ask the nursing staff to order it in for me.
Doctor Franklin wants to conduct an EEG to rule out epilepsy, and an MRI to have a closer look at my brain. The first will reveal my brainwave patterns, and the second will reveal something important that he does not elaborate on. ‘I want the results of these tests before I can be confident of what is going on,’ he concludes.
When I ask him how long I’ll need to stay in Seaview, he says he’ll review this at our next meeting, and if I’m doing well, I could be discharged as early as Saturday.
Anna would like to visit on Thursday evening, I say, and he agrees to let me have dinner with her at a local restaurant.
After this consultation, I’m not left with much of a warm feeling, and my brain is in a serious fog. But I sense thoroughness in his approach about reaching a diagnosis, and I have some hope of release from this place. I don
’t anticipate that the new tests will show much. I’ve had a mental breakdown; what else is there to find out?
SEAVIEW IS UNSETTLING and confining. The place is like a drug, slowly immersing me into an addiction to passivity: the inevitable outcome of things being done for you. The next morning, a pathology nurse comes into my room at a reasonable hour and says, in a pleasant manner, that all the tests were done at Lismore except for the HIV/AIDS test, and so into the arm the syringe must go. I accept my fate.
After this is breakfast. I take my food outside, into the warmth of the sun. The garden is dotted with small melaleuca trees with slender, scented leaves. There are no flowerbeds. The few plastic chairs — some cracked with age — are highly prized.
On the lawn I spot Glenys, a patient in her late fifties. I’ve met her briefly before. I’ve also seen her from afar.
In the afternoons, I like to shorten my walk and stop for coffee at one of the cafes along the beachfront. Across the road from where I sit, a grass verge drops away, becoming the yellow sand of the beach. Along the verge are needle-leafed she-oaks and squat palms with shredded, plate-sized leaves, filtering the view of the ocean. Pedestrians cruise the footpath before me. I envy them their normality and their freedom, which they seem to take for granted. The cafe’s coffee is usually a little disappointing, but for as long as it lasts, I can be a normal person. For as long as I can stare out to sea, before I trudge back to the hospital, I am free too.
Yesterday I saw Glenys. She was walking on the beach side of the road, a takeaway coffee in hand, jauntily attempting to look at ease with herself. The sight cheered me; I wasn’t the only one trying to appear normal.
Today Glenys tells me that the patients in the addictions ward, where she is staying, were reprimanded last night for buying coffee outside the hospital. ‘Apparently it goes against the program,’ she says. ‘I don’t see what harm it does.’
There’s no such restriction in the general psychiatric ward. Even at this low stratum of society, it seems, there are first- and second-class citizens.
Glenys has a straight-backed posture and an educated way of speaking. She looks fit, with an open, tanned face. In the world outside, she runs a dance school. She smiles easily as she tells me her stories, and grimaces when they reach the inevitable sting. ‘I can’t seem to stop after one or two drinks. I’m having a good time, and by the end of it, I’ve made a fool of myself,’ she says.
I feel the urge to ask probing questions and give advice, but instead, I listen — one confused human being to another.
I’VE DECIDED TO stick with the non-talking groups; the talking variety is too unsettling for me. I’ve already missed the art-therapy class, but after breakfast I make it to the weekly yoga class in the big common room downstairs. As we recline over the bolsters placed on the floor and wait to begin, I immediately feel as if I’m in the right place.
The yoga is undemanding, and when I tell the teacher afterwards that I’ve been a regular practitioner, he says that he scales down the intensity because many of the patients are not up to much exertion. Nevertheless, I wish we could do this every day.
Later that day, I learn that the brain MRI that Doctor Franklin has ordered is to be conducted at an outside radiology facility, but the appointment is not for two weeks. However, a young EEG technician arrives. She brings out a white skullcap, with multiple eyelets to poke electrodes through and a tight elastic band around the rim. The contraption reminds me of pictures from the days of lunatic asylums, which I’d seen in my psychology textbooks. She fastens it onto my head and glues the electrodes to my scalp, attaching the wires. These are gathered together at the back of my neck and run down to a battery source attached to my waist. I will need to wear this for at least twenty-four hours; she will come tomorrow to remove it.
A look in the mirror reveals hideous multicoloured growths sprouting out of my head, like an absurd Einstein hairdo. How am I going to walk around looking like this? I saw a young man on my first day here wearing the same contraption and felt sorry for him.
It’s imperative that I go for a walk today, as usual. To disguise my head and hide the wires running down my neck, I pull on a beanie and turn up the collar of my jacket. I don’t want to freak anyone out.
Alone on the shore, I can forget about my cap. The waves dump on the slanting beach, sending white foam scurrying in cauliflower-like florets. I am barefoot. I’m hungry for the sensation of wet sand pressing through my toes, and the last gasps of the waves slapping my ankles. I’m doing a walking meditation. I need to be anchored. But daggers of thought skewer my attention — lifting it away from my feet and tossing it about. My mind wrests it back to my feet again. It’s a tussle, and early in the week there was no clear winner. But with each walk I’ve taken since, the feet have gained ascendancy.
I return in time for dinner. The dining room has long, coral-coloured tables with matching vinyl chairs. Floor-to-ceiling windows look out over the garden. A wide photograph, one of those typical images of rows of beach boxes, hangs on the end wall. A sign above the entrance says NO STAFF ALLOWED. There is an openness among the patients: no hierarchies here.
Tonight, an obese man with a walking stick spreads three foil-wrapped butter portions on each half of his bread bun. It is difficult either to watch him or to look away, but I don’t say anything.
Events like this keep reminding me that I’m a patient. I realise now that in the past I’ve felt superior to mental-health sufferers. I would say things like, ‘It’s nothing to be ashamed of. Everyone, sometime in his or her life, will be affected by mental illness,’ and then rattle off some statistic about the condition my client was suffering from to reassure them. Well, I am one of those affected now, and I do feel ashamed. I was complacent in my bubble of competency. Now, wherever I look there’s a billboard in my face, bellowing: ‘Guess what: you’re one of us now, boy!’
Although I’m a voluntary patient, I’m worried that I might slip up somehow — show obvious signs of depression, or even suicidal tendencies — and be sent away to a locked ward where I’ll have no say: none of the temporary freedom of walks to the beach or coffees. I need to be vigilant as to how I present myself to staff, if I am to get out of here soon.
PRIOR TO MY mental breakdown, I had begun to wonder what my brain was doing to me. How did it create the panic, the sharp oscillations of mood, the suicidal thoughts, the nightmares, and the hovering sense of dread? On Thursday, I attend a talk given by a visiting neuropsychiatrist on neuroplasticity in the brain. He is holding up the man who layered butter on his bread as an example of neuroplasticity. The man tells us how he had to learn to walk and talk again after a stroke.
The neuropsychiatrist tells us about the role of the amygdala in triggering anxiety. I ask him if there is a difference between fear and anxiety, and the role of the amygdala in this. ‘There is no physiological distinction between them,’ he says.
Then I catch up with Doctor Franklin for my second consultation. I feel self-conscious talking to him with my stupid cap on. But he is less demanding this time, and chats with me like a colleague about his recent adoption of self-report questionnaires: the type routinely used by most psychologists. He says that he will repeat the speech and memory tests from the first session, and if I do well — and the results of the EEG tests are normal — he’s happy for me to be discharged on Saturday.
I’m still concerned about being made an involuntary patient. I try hard to remember the sentence — Bill and Tom went fishing and caught three brown trout — when Doctor Franklin asks me to repeat it straight after him, and then to recall it later. It’s a little easier this time. He gives me a questionnaire that I recognise as a measure of depression. I complete it, careful not to overstate any of my symptoms.
Late in the afternoon, the technician returns and takes the skullcap off. I tell her that the night before was terrible. The elastic band around my
head was torturous. I could only lie on my back because of the battery pack. And I don’t say it, but to make things worse, Simon was farting and snoring noisily; deadly pongs drifted over me like rain clouds. I doubt I slept at all. Dawn, when it came, was a wonderful relief.
As soon as I can, I lay clothes, a towel, and conditioner out on the floor in the white bathroom and wash the glue patches out of my hair, free again.
THAT NIGHT, ANNA and Amelia arrive. We go to the cafe where I’ve been stopping during my afternoon walks. The atmosphere is cosier after dark, with candles, and plastic screens shutting out the ocean wind.
Anna has good news. Doom and Gloom told her today that the developer is going to accept our latest cash offer — he thinks they’re in a desperate financial position themselves. This is incredible. Something is going right for a change; there is some light at last.
Our meal together is lovely. I’m glad to be with my family, and so grateful to Anna for keeping things going while I have been out of circulation. Amelia found a blue dog coat in the hospital car park on the way in, with no one around to ask about it. She’s still excited. ‘Mummy says I can keep it. I’m going to give it to Boo. It will keep him warm.’ Boo is the brown, big-eyed stuffed dog that sleeps with her in bed. Her joy over Boo’s new coat touches my heart, giving me greater perspective on what matters.
When I get back to the ward, I learn that Doctor Franklin has agreed for me to be discharged the next day, Friday. But Anna had planned for Saturday, and says that she won’t be able to pick me up until late Friday afternoon.
The next day, I’m formally discharged in the morning, and, with my bags packed, am free to do as I please. After lunch, I join a youngish and enthusiastic teacher who conducts a tai chi class outside in the sun. I’ve never done tai chi before. With our bare feet planted in the grass, he guides us through the movements. I notice how uncoordinated many of the other patients are; their stiffness and gaits remind me of the patients in the psychiatric hospital where Mum worked. But I enjoy the session. It’s physical, it’s outdoors — and I’m now a free man.