This Too Shall Pass

by S. J. Finn

  This, however, is a spurious discussion. The truth is that many psychiatrists know next to nothing about Freud’s theories; everything is all about the brain these days, as in neurons and synapses and chemical imbalances. Nerve activity. Mental illness really is mental illness, not the fault or fancy of an individual (a wonderful thing for all those who’ve ever been accused of “malingering”). But humans are not simply conglomerations of their hardware. It might be easier if we were, if the mind could be quantified in some physiological computation. And that’s what first caught my attention with regard to Nigel Pathmana-than – excuse me, Doctor Nigel Pathmanathan. From his point of view, life could be perfectly abstracted into an equation. Children were like little machines. If you had a manual and followed the steps, you could fix them.

  TWELVE

  It should be said that I liked the good psychiatrist who was part of the team I was assigned to. Doctor Nigel Pathmanathan was a gentle person. His demeanour meant he was approachable. It was after these first impressions, though, that I began to understand a little of what was going on for him professionally, which I tried, unquestioningly at first, to take at face value.

  The doctor dieted on kinesiology. This crossing of the brain’s hemispheres through activity was the way, according to him, to fix all ills from severe intellectual disability to cerebral palsy, not to mention everything in between. He defended the hours it took to complete the complicated exercise regimes – hours out of a child’s day – and persisted drawing complex diagrams for mothers so they could instruct their children in the art – and it was a kind of art – of performing the routine. Don’t get me wrong: it’s a lovely idea. But this neatly dressed Sri Lankan-born man – unusually tall with a round face and large green eyes and long lashes – was kidding himself. There had been no trials and little clinical opinion to back up his extraordinary claims – a consideration he didn’t seem concerned about. Doctor Nigel Pathmanathan was writing a book about his theories, incomprehensible excerpts of which he willingly handed out for us to read. They made little sense and overlooked many practicalities.

  He talked about being offered a publishing deal. Collectively – there were about twelve people in our team – our blank faces said: You can’t be serious! and, our second thought, The publishers can’t be serious!

  Still, in what became a kind of ritualised response, we’d smile and say it sounded good.

  Added to this, Nigel wrote notes that he regularly delivered into our pigeonholes. He had a habit of putting a smiley face – a circle with dots for eyes and a curve for a mouth – on everything. My immediate reaction to this was that twelve-year-old girls had done it en masse for a couple of years in the early nineties – a fad a whole generation grew out of quickly. The smiley face, however, adorned the page regardless of whether it was a paper discussing the count of Rapid Eye Movement a child suffering night terrors has, or a yellow sticker slapped on the flyer advertising a church meeting.

  And there, since I’ve alluded to it I might as well let another detail fall upon the page: Nigel Pathm-anathan was a born-again Christian – a fundamentalist, in fact.

  In the church Nigel was a member of, recruiting others into the fold wasn’t just encouraged, it was expected. He was required to try to transform those who were tainted – by definition, heathens. His church ignored "disinterest" in Christianity, preferring to call it "waiting". According to Nigel, every disbeliever was waiting in a line outside God’s door, and all it took was for their number to be called and BINGO, they’d want to proceed inside. Nudging the process along, though, Nigel would post notices in our pigeonholes inviting us to hear his local preacher or to gatherings for visiting American evangelists – the sort seen on late-night television.

  ‘While it’s well-known,’ I told Renny in a heartfelt address one evening, ‘that people’s pigeonholes shouldn’t be violated, certainly that nothing should be taken from them, the same cannot be said for what is put inside them.’

  ‘You should say something,’ she said.

  Nigel waggled his head when I approached him. The flyers stopped for two weeks. When they started again the only defence, for a relative newcomer like myself, was to take the path of ignoring them. What else could I do? In a psychiatric setting, psychiatrists are indispensable. Further to that, I was beginning to understand that – often regardless of their merit -psychiatrists wielded significant power. Anyway, there were more serious problems with Nigel Pathmana-than, problems that weren’t so easy to turn the other cheek to. Could there be something to squeeze in beside the kinesiology, the religiosity?

  With his office being three down from mine on the same side of the corridor, I saw many a disgruntled mother leave his room. Red-faced, stormy with umbrage, dragging on her child’s arm – or scuttling away as quickly as possible, ripe with upset and not trusting herself to hold off from bursting into tears – she (collectively) was the one “blamed’” the one our critics were hearing from, and I know there were many more than did complain. I heard about affronts from Nigel, sometimes first-hand. Things such as: If you’re undisciplined, and I can tell you are by your weight, then your child will see you as ineffectual! would drill uncompromisingly into women who were already feeling inadequate. Sotto voce, he would hammer the nail in further with something like: Why would he take notice of someone who watches television all day?

  But even I underestimated his capacity for sideswiping women until a mother complained to me about recommendations he’d made in regard to her child. I asked him openly what he’d been thinking when he’d suggested the father – a man we both knew, a man who’d been violent to the mother – take over the parenting of their son.

  ‘The mother’s unable to discipline the child,’ Nigel said.

  ‘His father’s violent.’

  ‘Only towards her,’ he replied. ‘Not to the boy.’

  It was the tone of his voice, the sureness in it, combined with the fact that I’d chosen an informal setting (in the hallway a few minutes before our team meeting) that stumped me. Never one to carry an arsenal of comebacks, I remained dumbstruck – and left standing alone in the corridor, I felt decidedly ill. The critics were right. I should be better prepared next time; in the future I’d go to his office and flesh out the conversation.

  I don’t remember there being another situation, certainly in those initial months, that gave me such clear grounds to challenge him on this particular issue. I knew that his effrontery was still being played out behind closed doors – it was there in his language when he talked about patients. Undermining women: it went on, and it was something I had to resign my self to.

  Despite this, unable to let it go completely, I always had an ear out, as if waiting on the sidelines to catch him. My eagerness may have alerted him to be more careful – although he never acted as if I was someone to be careful of. Still, either he was subtler after that, or the women were too afraid of upsetting him, because I didn’t hear anything more along those lines, certainly not directly. Perhaps it was a combination of being female and not medically trained, but I was never more than a hillock on an Everest-sized mountain to Nigel.

  Mind you, Nigel wasn’t as powerful in the scheme of things as I’d first imagined. He was just one in a line of puffed-up figureheads at Marlowe Downs vying for ultimate authority.

  THIRTEEN

  Up that rungless ladder was my team leader, Elliot Burton, a man who had moments of brilliance and moments of bust. He was, as some in the organisation described, a cowboy, someone who shoots from the hip. This was a criticism, of course, but to me, in the short-term at least, shooting from anywhere had a charming, if not intellectually stimulating, resonance. At least he was alive and had something to say. And, although some of what he came out with, despite him thinking it brilliant, was just post-feminist (now there’s a fallacy) rhetoric, I still found it attractive and worth listening to.

  Elliot, who moved in frenetic fits of absent-mindedness, would lumber up the corridors as if his
limbs might suddenly fly from his torso and continue on without him. He needed all the breadth the wide hallways offered, as he was usually juggling several reams of loose notes, academic papers and journals, as well as assorted bags full of the same. Elliot listened intensely to anyone addressing him, gave merit enthusiastically when it was due and if not, made scathingly accusing responses on the spot – hence the shooting analogy. This applied to worker and service-user alike, even the hoi polloi at the top. He had no time for power mongering and, unlike Nigel, remained clear about what he thought were injustices upon children. At every opportunity he’d leap up to vociferate his opinions, and systemic abuses -especially in government-run services, like schools or child protection – were high on his list.

  ‘Humiliation,’ he’d inure. ‘If they refuse to listen to the client, we’ll take it to the papers, make them feel ashamed.’

  He was the lone, if not largely chaotic, voice inside the place touting rights for individuals. I was impressed but it remained to be seen how much he actually did to ameliorate wrongs. I had been warned that he was bluster without a flame.

  Elliot, like Nigel, was also a writer; however, his results were of considerable quality. With ease he produced long therapeutic letters to clients, often full of complicated compound verbs and circular questions. The best of these were addressed to violent men whose children he was treating for one reason or another. Elliot worked hard to bring these men into the service, to educate them about their behaviour and its effect. I’m not sure how successful he was in his endeavours, but it was impressive that he put in the effort. We needed more of his ilk, more men who were at least speaking up. An occupational therapist by trade – that incarnation having long left him, despite being his ticket into child psychiatry – we had much in common and spoke in a close language when it came to our work. I liked Elliot – his intense and rapid speech, the unafraid way he’d deconstruct a situation by pointing out inconsistencies and power imbalances. It was always good to have someone ready to be a rebel. And although his manner had a sting in it, sometimes closing doors for more meaningful discourse – which is also why others wiser than I called him a cowboy – I’d still opt to have someone to liven up proceedings than not. Added to this, I admit, he saved the egg from falling on my face more than once.

  In this rickety ascent of domination there is one more necessary individual to describe. Anton – or Antwerp as I called him – Pilsner. Antwerp had come from the private sector, specialising in hospital management and integrated systems (whatever they are). He’d been employed by the hospital to use his entrepreneurial skills to turn the preciousness of our ivory tower into a corporate concern, complete with units of measure and customer responsiveness. Antwerp was just the person for the job. You could see it from a hundred paces. He had all the corporate meanness it takes to execute such a thing. And it wasn’t long after his arrival – a little before mine – that the catchcry "bottom line" was being chorused with cheer-squad pomp into our otherwise hierarchically-laden system, which had previously had nothing to do with monetary efficiency. Since when did health, especially mental health, fit between those dictums? Since the modern era began. Academia move over, the burden of fiscal reality is about to take front row.

  Apart from Antwerp being way too slick and smarmy, shallow and dictatorial, and apart from the whole hideous notion of the dollar deciding health outcomes for people, the effect his presence had on the service meant that clinicians had to look at the way they worked. Everything had to be overhauled, streamlined and pared down. Things like waiting lists and throughput indicators needed, in the case of the former, to be reduced, and, in the latter, to be increased. The reality was that clinicians needed to find new ways to be responsive without lowering the quality of service. That was the theory, at any rate. The antidote, or so it had been posed, was to become accessible. Now that sent a shiver down everyone’s vertebrae. Child psychiatry had kept inaccessibility in high regard and would have clearly marked it on a coat of arms if there had been such a thing.

  Along with the state’s other child and adolescent mental health services, at Marlowe Downs thorough examinations, laborious assessments and encumbered processes were the cult of the day. And, now, the board of directors was stamping the hard cold fact of the dollar value onto previously untouchable public programming. The corridors were abuzz. Everyone was loading their carts with suspicions and theories of Big Brother cost cuts and the effects of a government’s leverage that was finally taking hold.

  A newcomer, I sat somewhere in the middle – not on the fence but gladly jumping from side to side. I wanted to soak up as much educational experience as I could from the thickly cushioned brains of the long-term, deeply immersed, analytical practitioners, while at the same time – having come from a position in the country in which I’d been everything to everyone – be as accessible and responsive as I could. I had a great belief in help for all.

  At night, when I got on the tram to head home, I’d almost collapse with the head-spin of this convergence. The day would strike like a hot mix turning to cold hard bitumen. I’d struggle through the crowds in the city and, if I was lucky, find a seat on the number 96 to St Kilda. There, squashed in, I’d feel as if my head had shifted to Angola while my body had stayed on the tram. That’s when the loneliness and regret of a failed marriage would return. Any failed marriage, even the most horrendous, has a lingering sadness. Difficult to account for or not, there’s a malaise. And, sometimes, I felt so submerged and alone without Marcus, that the weight of things seemed suffocating. I missed him especially before and immediately after my weekends with him, which were still occurring at a rate of two out of three.

  At the end of the agreed weeks, Renny and I would travel back to have him. We had negotiated to pay my friend Ange a reduced amount of rent for the use of two rooms and a bathroom at the back of her large house. As things went, while not ideal, we managed to create some sense of normality for Marcus and maintain some privacy for ourselves. It couldn’t go on forever but until Dave and I could sort out a settlement, it would have to do. ‘These things take time,’ I told Renny, who would have preferred we had our own place. ‘These things take time.’

  Returning from these weekends, the memory of his spindly clinging monkey body, his smiling requests and his gurgling laugh planted in me, there would begin a process of tearing away, as, in painfully slow increments, the images and sensations dissolved.

  It wasn’t that I didn’t love Renny. I’ve never not loved her. But in those early days of work, coming home amidst a flock of people rushing to their own piece of privacy, I felt like a displaced person. The crowd, its uncaring throb, only increased the feeling. Renny, who worked much closer to home, would be waiting for me at the tram stop or sitting at a bar we used to drink in regularly. She was always so positive and I would arrive like a scared cat, misery and wretchedness rising in me. I wanted to be better for her, but something else always emerged. I would well up with tears of sadness and exhaustion. I particularly cried if she made me laugh. I was prone to anguish and an act of tenderness from her was enough to open all sorts of cathartic outpourings. Alcohol was the good oil for this and we’d often walk home, her carrying my satchel over one shoulder and me under the other, a pain the size of a small country for Marcus lodged in my heart.

  I was waiting, without knowing how long it would take, to feel better.

  FOURTEEN

  I ‘ve come to think there’s a protective mechanism in humans that – excluding traumatic events – causes us to remember things in a more positive light than was actually the case. In some instances we completely erase sourness from our recall. In keeping with this, certain incidents that occurred prior to our moving to the city seemed to have passed out of my consciousness. These were things I needed to remember when I was blaming myself for deserting Marcus.

  Renny, a memory like an elephant, would tell me in soft tones what some of those things were. One rose in my mind with clarity. It had
made our leaving undeniably necessary.

  The precursor to the actual event had occurred when Renny and I went to a pub one evening in what was, for the town, quite a big night. A friend had organised a band from the city to play. I even remember the band’s name: the Jaynes. They were an energetic band, fun, but the atmosphere lacked a little depth charge and consequently Renny and I started to have our own depth charges at the bar. The atmosphere improved and so did our mood. We kissed. I don’t think it was too much of a kiss, but then I was on the inside of it, not the outside.

  However, when I’d gone to pick Marcus up from gymnastics at the end of the week, Dave met me outside, prickly with the news of it.

  ‘I want to talk to you about last Saturday night.’ His lips were drawn back as if he was a father about to deliver an unpleasant but necessary communique with a wayward child. Cars were pulling into the car park and sneakers were twisting noisily on the concrete path around us. I, not wanting to get too close, had my head perched forward in an exaggerated act of paying attention. I was balanced in the stance of sarcastic listener, perhaps thinking that if he wanted to talk, looking at me may have quelled the inclination. But – like many other things – I was wrong.

  ‘You were seen at the pub, Renny’s tongue stuck down your throat.’

  ‘Who said that?’ Deflection, Margaret Thatcher style.

  ‘It’s not important who said it.’

  ‘Yes it is.’

  ‘Well, I’m not saying.’

  ‘I bet they wouldn’t have commented if we’d been heterosexual.’

  ‘That’s not the point.’

  ‘It’s certainly my point.’

  ‘You’ve got to understand,’ Dave said, ‘this is Marcus’s and my town. We live here.’

  ‘I live here too!’