The psychiatric halfway house was a place where people with problems could go to spend their day. They could sit around drinking tea, playing pool and join in organised outings run by the two women who worked there. The women were trained nurses, with many years of psychiatric experience behind them. As well as providing a place for people to hang out, they offered counselling and provided a community monitoring service for the local hospital psychiatric unit. They could see who was deteriorating, or not taking medicines, and refer patients to the psychiatrist.
I was next introduced to the other nurse who worked there, Mrs Kelly Scott, and was again surprised to find her easily in her early fifties.
I was wondering where the muscle was around this place surely they needed the use of a strong man occasionally, to control those patients that became violent. Mrs Scott led me to the lounge where I met Peter, Ben, James and Allan; all local users of the house.
They got up out of their seats to shake my hand and soon had me ensconced in a small circle and Mrs Scott decided it was time to leave.
Im sure you boys will have plenty to talk about. Ill catch up with you later.
I am sure this was a strategy that was used often leave the new student and see if they sink or swim.
What exactly does one say to a group of psychiatric patients?
What brings you here? certainly didnt seem appropriate, nor did, How are you?
Thankfully, James took the lead and instead asked me what I was doing there. I was wondering that myself. Before I could think of a safe answer, they started laughing. The beggars were having a joke at my expense.
Allan invited me to the pool room and so our small contingent headed upstairs. The pool room was to turn into the most interesting room in the building. I was told that I would be teamed up with Peter against James and Allan.
As the game got underway Peter began to talk about himself.
I have schizophrenia, so I dont usually need a partner.
Again, there was a round of chuckles from the rest of the boys. Peter then explained that he was always hearing voices, he was never alone. He could cope with the voices, as long as they were not too loud and as long as they were not saying anything bad. They didnt seem to affect his pool playing as he sank two balls in a row.
When Allan went to take a shot, he said that he had bipolar disorder, but his medicine was working well at the moment. He sank two balls. When it was Jamess turn to shoot, he said that he had been an alcoholic and it had affected his brain. He said he was not as sharp as he used to be, as he sank three balls. It seemed the pool table acted almost like some sort of therapy couch, as it gave them an excuse to talk, although I was a bit taken aback at how open and blunt they were. It was also becoming obvious that I would never beat any of them at pool.
Their openness gave me a chance to ask some questions of my own; the first of which was how they could be so open about their problems with a complete stranger.
Were not all open, Peter said. This is my life. I can either get on with it or spend it trying to hide my problems. That can get a bit tiring.
Unlike physical medical conditions where there is sometimes a cure, a course of antibiotics or even surgery to solve a problem, mental illness often has no cure.
But what about your medicine? I asked.
Peter said his medicine helped reduce the volume and violence of his voices, but they were always there and always would be. He added that at least he didnt look like he had a problem. Surprisingly, this drew another round of laughter.
Aside from joking, I had never before given serious thought as to what a psychiatric patient might look like, but I swear Peter looked like one. He was a small, emaciated looking fellow with big bulging eyes and a large forehead, accentuated by his baldness. He had scraggly, dirty looking shoulder-length hair and an equally scraggly goatee. He was the sort of person whom if you saw in the street, you would make sure to leave a wide berth.
Feeling emboldened by such openness, I asked Peter when he first knew he had a problem. His bulging eyes locked on to mine, and he just stared and did not say a word. I was taken aback, thinking Id offended him.
When he finally did speak, he spoke with an intensity that made everyone look up and pay attention.
I knew I had a problem when I found myself standing at the foot of my parents bed one night with a kitchen knife in my hand.
I felt a shiver go down my spine. The laughter we had shared earlier now seemed absurd in the context of such a very sobering comment. The lads were still all smiles, but I could feel their eyes looking at me, questioning me, wondering how I would react to such a comment.
Ah, so what happened? I asked nervously.
He shrugged his shoulders.
Theyre fine, he said, I didnt kill them yet.
The rest of the group burst into another round of laughter. I tried to join in, as I felt that it was expected of me, but I felt lost. I couldnt figure out what was real and what was not; I guess I must be really fitting in.
Ah, so what happened? I asked nervously.
He shrugged his shoulders.
Theyre fine, he said, I didnt kill them yet.
The rest of the group burst into another round of laughter. I tried to join in, as I felt that it was expected of me, but I felt lost. I couldnt figure out what was real and what was not; I guess I must be really fitting in.
I asked him what stopped him and he leant forward, his face close to mine. He had caught me off guard and I didnt have a chance to move away.
Its as if I had a moment of truth, as if God had given me an instant of clarity, another chance, at the last second.
It certainly gave me some perspective on all the joking around that had gone on before.
Ben said he suffered from depression and had recently been discharged from hospital, although it wasnt his first time there. He added that he also got a bit excited at times.
The doctor says Ive got a mild case of bipolar disorder, but Im not so sure, he said.
Why do you say that? I asked reluctantly.
My mind still had an image of Peter standing with a knife at the foot of his parents bed and I was worried what horror stories Ben had to share.
Well, it sure doesnt seem minor to me, because Ive lost my job, my wife has left me and the only friends I have left are the people in this room.
He then explained that he blamed everything on one night out on the town several years ago, when he had dressed in womens underwear and gone to the local nightclub, and ended up being arrested by the police.
Many of the people here were like Ben, because they had lost their friends, their wives and children and had nowhere else to go. None of the people here worked, because no employer would take them on. This was their world now and these were their friends.
Spotter
After returning back home from London I didnt want to go back to a regular ward just yet. But I wasnt sure exactly what I wanted to do. I signed on to the hospital register to work as a casual nurse, until I made up my mind about a more permanent role. My first line of work came from the local psychiatric unit.
I had the option of working in a general medical/surgical unit, but I was curious about what it would be like to work in such an unusual area of nursing. At Waverly House I had been a naïve student, and now I was an experienced nurse, but I was still fairly ignorant of things psychiatric, and very curious. My interest was only made greater when other nurses said things like:
Its not just the patients that are mad; the staff arent quite right either.
Or
It isnt safe and Watch your back.
The general consensus was that I was making a big mistake.
As the new casual member on the team, I was technically the most junior, but since I had five years nursing practice behind me, I was actually a lot more experienced than a fair number of the nurses on the ward. There were a lot of graduate nurses, straight from training, many of them with less than six months experience.
Still, I didnt mind starting at the bottom. This meant being a spotter. I wasnt allocated my own patients yet, and so didnt have to be responsible for anyone. As a spotter, my task was to wander the ward every five, ten or 15 minutes, trying to locate where all the at risk patients were. At risk meant that these people had either harmed themselves, threatened to harm themselves, or were acutely unwell because of their various psychiatric problems. It was a brainless but vital job, and I ended up finding it rather ironic that this often life-saving job was mainly given to all the new, junior staff.
Armed with a clipboard and a list of patients, I would stroll the corridors, hoping like hell that no one on my list went missing. But, of course, occasionally they did. My first missing person was on ten-minute observations and was still absent after 15 minutes. What happens next? Well, you begin by feeling sick to the core of your stomach. You assume the worst. You imagine your patient stiff but not yet cold lying in a pool of blood. You frantically begin searching every corner of the building, the bedrooms, the living rooms, the dining room, the pool room, the toilets, and worst of all the showers. Your heart pounding in your chest as you open the door to the showers, a large, bare space with five closed doors facing you, desperately hoping your missing patient is not hanging around in one of the cubicles. Opening each shower door is like a terrible lottery: And behind door number three is Mr Smith, freshly hanged and still warm to touch.
I found the patient half an hour later. One of the new graduate nurses had foolishly taken him outside for a breath of fresh air. Not only was he not supposed to be outside, she had not told anyone that she was taking him.
But it can go other ways.
One patient, who I came to know reasonably well during my 18 months in the psychiatric unit, had made eight attempts to kill herself, two of those in the previous 12 months. After eight attempts, you might think she wasnt quite sincere about wanting to finish her life, but she was, she was just plain unlucky (or lucky, depending on your point of view).