‘You’re hurt,’ she says as she pulls away. ‘Someone hit you.’
I open my mouth, close it again, then just shrug and nod.
‘It’s okay. You don’t have to tell me now. Tell me in the car. We need to get you home.’
‘I don’t think I can go home.’ My voice is still a cold monotone. ‘Not yet.’
‘My home, Abby. I’m taking you back to mine. For now.’
‘Thank you.’ My eyes prickle. ‘I need to return my key.’
‘Give it to me.’
I do as instructed, and Dr Barbara strides over to the desk and hands the key to the receptionist, touching him briefly on the arm. In anyone else, it would seem overfriendly, a breach of etiquette; but Dr Barbara does it with such a calm and kind authority that it looks the most natural thing in the world.
‘My bill,’ I say when she comes back. ‘I think I need to check about my bill.’
‘Don’t worry.’ She’s already ushering me out. The doorman nods politely as we pass. ‘It’s taken care of.’
‘Thank you. That’s . . . I’ll pay you back, I promise. As soon as I can.’
‘Abby, you’re not to worry. There isn’t going to be a bill. I explained the situation. The staff were very understanding.’
‘Oh.’ I don’t know what else to say.
Dr Barbara gives me a tight-lipped smile and guides me to where her car is parked, in the drop-off zone. It’s a Prius, charcoal grey and shiny as a bullet. She gestures to the passenger door and I get in. The interior is spotless, as if it’s just been valeted.
She doesn’t start the engine immediately. She flips on the interior light and looks at me again, her eyes lingering on my left cheek. ‘Abby, I’d like to call Beck if that’s all right? Just to let him know you’re okay.’
My stomach drops a little. I close my eyes and nod. It’s a phone call that has to be made, but there’s no way I could make it – not right now. Dr Barbara, it seems, has understood this without having to ask.
The call lasts only a couple of minutes, but even this is close to unbearable. All I can think about is burying something sharp or hot in my flesh.
When it’s finally over, Dr Barbara slips her phone into the side compartment and turns back to me. ‘Abby, I want you to tell me exactly what has happened today. Bits of it I know already; Beck phoned me soon after you left. He was . . . worried, understandably. But I’d like to hear it in your own words. Can you manage that?’
‘Is it okay if I smoke?’
‘If you absolutely must.’
‘I think I must.’
‘Okay then.’ She starts the engine and rolls down both of the front windows. There is classical music playing quietly on the stereo, something soft and intricate.
It takes me most of the fifteen-minute journey to explain everything to Dr Barbara. I start from the previous morning, with the journey to Oxford to see Professor Caborn, since that seems the place to begin. It’s difficult to find the words, and already I think there must be bits I have forgotten; everything happened so quickly, and every minute was packed with too many thoughts and feelings and actions. Now that I’m coming down – now that alcohol and exhaustion are finally taking their toll – it’s all too much for me to process. And yet I struggle through somehow, managing to reconstruct most of the story, even if it comes across as a series of poorly drawn incidents, the gossamer logic that connected them now in tatters. Dr Barbara helps me: she prompts occasionally, or asks for clarification when I stop making any kind of sense. But mostly, she stays quiet, lets me find my own circuitous path.
She stays silent afterwards, too, but when I look across, her brow is deeply creased. There are dark crescents under her eyes; and without make-up, wearing a slightly tatty cardigan and jeans in place of her usual office wear, she looks older than I’ve ever seen her. It feels as if I’ve aged her – by at least a decade.
‘I’m sorry,’ I say. ‘For making you come out in the middle of the night.’
She doesn’t look across, but she gives a shrug and a wry smile. ‘A hazard of my job. You’re not the first, and you certainly won’t be the last.’
‘Still. Thank you. I don’t know what I would have done.’
She shushes me, reaching over momentarily to rest her fingers on my arm. ‘Abby, you did the right thing calling me. You’re okay. You don’t need to think about anything else right now. We’re almost home.’
I’ve never been to Dr Barbara’s flat before, but it’s nice. It’s in Notting Hill, and seems to take up an entire floor in a huge five-storey house. Nothing like my flat, of course – two bedrooms and a study, a large lounge and separate kitchen. It must be worth a million – possibly millions, plural. But I know that Dr Barbara has been living in central London for over two decades. She probably bought it before property prices went completely fucking crazy. I try to imagine what it would be like to live somewhere like this, but I can’t. That is, I can’t imagine myself living somewhere like this. It’s ridiculously implausible, a bright boulevard I’m not allowed into. Not unaccompanied, anyway.
Dr Barbara asks me to keep the noise down when we enter, as Graham is sleeping. This information comes as a shock to me. Not the fact that Graham is asleep; it’s around two in the morning – this is when the sane people sleep. The shock is the simpler fact of Graham, his existence.
‘I didn’t know you were seeing anyone,’ I whisper.
‘I’m not a nun, Abby,’ Dr Barbara replies.
‘No, of course not. It’s just . . . well, you’ve never mentioned him.’
Dr Barbara shrugs as she places her keys in a bowl on a sideboard. ‘It’s relatively recent, and it never came up. The main concern of our sessions is talking about what’s happening in your life, not mine.’
‘Yes, but still . . .’ I trail off. Eight months of intense and intimate conversation has made me assume that I know Dr Barbara pretty well – certainly better than I know most of the people in my life. I know all about her messy divorce fifteen years ago. I know about her early career as a GP. I know that she can read Latin and has twice run the London Marathon. But here is something significant that has slipped me by, and as we creep through to her spacious, stand-alone kitchen, there are other signs of a life I know little about: photos of foreign landscapes and mystery children – nephews and nieces? – morphing into young adults; a bookcase crammed with cookery books; a surprisingly extensive collection of fridge magnets. We’ve talked about sex and death and drugs and orgasms, about love and guilt and humiliation and shame – and yet it appears, now, that Dr Barbara’s is just one more life I’ve failed to imagine in any real detail.
She gestures for me to sit at a sturdy, circular table. Four chairs, completely free of clutter. ‘Can I get you a drink? Coffee?’
‘Water. Just water, please.’
‘And what about food? Have you eaten?’
The question confuses me. ‘When?’
‘Recently!’
I look at the wall clock, which, it transpires, has no numbers. Just the hands, like some sort of ongoing spatial awareness test. ‘I had half a pizza thirteen hours ago, and two, maybe three canapés at the Dorchester Bar.’
‘What can I get you?’
My hesitation is long enough that Dr Barbara decides to stop asking questions and just take charge. She gets two bananas from the fruit bowl and watches me eat both. I’m not hungry, and they don’t taste of anything, but at least they don’t require much chewing, and Dr Barbara tells me they contain a lot of potassium, which will help settle my stomach when my inevitable hangover kicks in. She sits opposite, nursing a cup of tea in both hands and regarding me in silence for a few moments. I know that the serious conversation is coming, the one where we talk about what happens next. But I have no idea what happens next. I still can’t bring myself to think about that yet. Looking even ten seconds ahead causes a queasy lurch in the pit of my stomach, and anything beyond that is like the uncharted territory on an ancient map – the bit where
it’s quite possible to slip off the edge of the world and never stop falling.
I don’t want to think. I just want to sit here in Dr Barbara’s immaculate kitchen, with its concealed lighting and fridge magnets and clock with no numbers. I want to sit here and pretend that it’s a normal day and I’m a normal friend who has just popped over for a glass of water and a couple of bananas.
Luckily, Dr Barbara is much better at handling this situation. She has had the practice, and accelerates through the professional gears, getting swiftly to the crux of the matter.
There’s a diagnostic test that GPs use to assess the mental health of their patients – the PHQ-9 questionnaire. It’s a checklist I know so well I can recite it by heart, with more feeling and fluency than any poem. Question One: Over the past two weeks have you felt little pleasure or interest in doing things you usually enjoy? (Not at all/some days/many days/every day.) Question Three: Have you had trouble falling or staying asleep, or sleeping too much? For each of the nine questions, you score a mark out of three, and this gives a total out of twenty-seven, from which the doctor can objectively quantify how nuts you are, zero being fine, twenty-seven being fetch the straitjacket. This is the only test in which I have ever achieved perfection, twenty-seven out of twenty-seven – and on more than one occasion.
But Dr Barbara doesn’t bother with this test today; she goes straight to question nine, or a simplified version of question nine, which is the only question she really needs to ask right now.
‘Abby, are you having thoughts of hurting yourself?’
‘Yes.’
That’s all I need to say. I could elaborate and tell her that’s all I can think about – the only possibility I can see if I allow myself to look beyond the next ten seconds – but what would be the point? A simple yes will suffice.
Dr Barbara nods, and it’s like we’re shaking hands to seal a deal. ‘With your permission, I’d like to have you admitted to hospital.’
I attempt a hollow laugh, but it turns out that even the hollowest of laughs is beyond me. ‘What if I don’t give you my permission?’
Dr Barbara sips her tea. ‘Well, I think I’d have a job forcing you. I could wake Graham, I suppose, but I’d rather not.’ Then she smiles, a smile that’s somehow warm and sad at the same time. ‘Do you want me to wake up Graham?’
I’m not even aware that I’ve started crying again, not until I feel the tears trickling down my cheeks. ‘I don’t want you to wake Graham,’ I tell her. ‘You have my permission to take me to hospital.’
So that’s it. A few minutes later I’m back in Dr Barbara’s car and heading west to the twenty-four-hour emergency unit.
That’s what happens next.
Hammersmith Hospital is not a reassuring place to be visiting at three o’clock in the morning in a fragile state. It has an imposing Victorian façade of dark red brick and dozens of windows staring like latticed spider eyes. It sits behind wrought-iron gates and is crowned by a starkly lit clock tower. Its closest neighbour, just to the west, is Wormwood Scrubs.
We walk through an elaborate entranceway bordered with cornices and columns, through lobbies and winding corridors, and it all feels like a hideous parody of my experience at the Dorchester, only nine hours ago. Everything is white again, but it’s no longer the dazzling white of marble floors and crystal chandeliers: it’s the bleached-out white of fluorescent strips and rooms without texture. Rich mahogany is now laminate worktop, and the soft aroma of bath oils and freshly washed cotton has become starch and antiseptic.
Dr Barbara has phoned ahead, and once we arrive it doesn’t take long to get me formally assessed. We sit in a consultation room with a small, bespectacled psychiatrist who listens attentively as Dr Barbara runs through my medical history. She tells him I’m having a mixed-state hypomanic episode, which has been ongoing for the past forty-eight hours, possibly much longer. The hypomanic part means that I’ve gone a little crazy but it could be worse: I’ve been running amok – impulsive actions, reckless spending, promiscuity – but I’m not delusional; I don’t think I’m Joan of Arc or an alien visitor or Christ reincarnated in female form. The mixed-state means that I’m simultaneously displaying signs of depression: weeping, despondency, despair; wanting to kill myself.
I sit and listen to the medicalese version of this while staring numbly at a filing cabinet. I’m still wearing my beautiful blue dress, though Dr Barbara has also lent me one of her cardigans to wear over it. It’s slightly too big; the sleeves hang a couple of inches past my wrists. And it’s camel-coloured, which is a shocking clash with cobalt blue. All in all, I’m not sure it makes me look any saner. Plus it’s still a stupidly hot night, and the windowless consultation room feels tight and stuffy. After a couple of minutes, I remove the cardigan and hand it wordlessly to Dr Barbara, who folds it in her lap.
My talk with the psychiatrist lasts no time at all. He asks me a dozen questions and I reply with monosyllables wherever I can. Sometimes, I’m forced to speak a full sentence, but anything more than that seems an insurmountable effort. I tell him I just want to sleep, and soon enough my wish is granted. I sign my own committal form – the one that says the hospital can keep me until such a time as they deem me ready for release – and then I’m led by a nurse to a single room on an unremarkable ward a couple of floors up. It would be too disruptive to put me anywhere else for the moment.
I’m given a hospital gown and some disposable underwear to change into, and Dr Barbara sits with me while the nurse asks questions about my recent alcohol consumption – what, when and how much. Once she’s satisfied that it’s safe, she brings me a tiny beaker containing two diazepam.
‘Dr Barbara?’
It’s the first time in about an hour that I’ve spoken without being asked a direct question, and my voice sounds like it’s coming from far, far away.
‘Yes, Abby?’
‘I know I have no right to ask . . .’
‘Go ahead and ask.’
‘Would you stay with me? Just until I fall asleep. I don’t think it will be very long.’
Dr Barbara smiles and places her hand on mine. ‘Of course. And I’ll be back in the evening. I don’t know if you’ll be awake by then, but I’ll be back.’
‘Thank you.’
There’s nothing else to say. I take my diazepam, and not long after, I drop into a black, bottomless sleep.
15
SHARPS
I was awoken around midday, groggy and disorientated. A nurse was tapping me on my shoulder, long after most would have given up. She told me that she’d also been in at eight, with breakfast, but it had proven impossible to rouse me. ‘Dead to the world, you were.’
I didn’t reply. The comment was pointless. I didn’t want to get involved in a pointless conversation.
‘Still, lunch soon,’ she went on. ‘Can’t have you missing a second meal.’
‘I’m not hungry,’ I said. ‘I just want to sleep.’
The nurse tutted in a way that suggested what I wanted was no longer relevant. ‘Doctors’ orders,’ she insisted. ‘I’m to make sure you eat before we move you.’
I shrugged – or tried to shrug – my heavy shoulders to let her know that I wasn’t going to play her ridiculous game. I had no curiosity about what the doctors had planned for the next twenty-four hours. I told her that if they wanted to move me to another ward, they could just as well do it while I slept. I had no intention of getting up.
‘You’re not going to a different ward,’ the nurse countered. ‘You’re going to a different hospital. St Charles. It’s all been arranged. They’re expecting you mid-afternoon.’
‘I can’t walk,’ I persisted. ‘I’m too tired.’
The nurse smiled benevolently. ‘You don’t have to walk. One of the porters will be very happy to take you down to the ambulance in a wheelchair. After lunch.’
‘I’m too tired to chew,’ I told her. It was childish but I didn’t care. The thought of food made me sick.
> ‘It’s soup,’ the nurse said. ‘You don’t have to chew, either.’
Someone from the psychiatric liaison team came in immediately after lunch. He told me I was being moved to St Charles because it had a specialized mental health unit and would provide a much more suitable environment for my recovery. But I knew this was just a euphemism. What he really meant was that they had locked wards there. That was why it would be more suitable.
At two o’clock, with my blue dress and my handbag and my Harvey Nichols underwear heaped in my lap, I was wheeled down to the ambulance and driven a couple of miles across west London to another imposing Victorian hospital. Same stained brickwork and turrets and daunting iron gates. The only difference was that it was in a nicer part of the city. Instead of a maximum-security prison next door, there was a Carmelite monastery.
The ambulance passed through the open gates and followed a small road to the back of the hospital complex, where the mental health unit was housed in its own three-storey annexe. In contrast to its almost Gothic surroundings, the mental health unit was as modern and nondescript as a newly built block of flats, the sort of building you’d pass on the street without a second glance. Inside, it was obvious that every element of the décor – from the bright blue carpets to the potted rubber plants – had been chosen to reinforce the impression that this was not a hospital at all. The only thing that gave the game away was the doors. Past reception, they were all magnetically locked and could only be opened with staff key cards.
They took me through to a ward called Nile. The wards were all named after rivers for some reason. There was also Amazon, Danube, Ganges and Thames. I never found out why. Maybe it was another way to make the mental unit seem less institutional. Maybe there was some other hidden significance. All I found out, upon my admission, was that Nile was the psychiatric intensive care ward. It was a closed ward housing the psychotics, the suicidal and those deemed at high risk of absconding. It should have been called Styx.
The Mirror World of Melody Black Page 13