Bloodletting (3 page)

The clinic normally didn’t admit people on the weekends, which was why the downstairs reception was closed. I was expected though. I bit the inside of my cheek and followed a friendly nurse to a room with four beds, each with its own chest of drawers, bedside table and curtain that could be pulled around for privacy. I was to discover that while the curtain hid you, it didn’t offer any protection from the people who talked constantly, in their sleep as well as in their waking hours. Nor did it protect you from those who were simply curious.

I was asked the usual health questions. Had I had any major operations? Was I allergic to anything? Had I had any infectious diseases? They asked for my medication. I was also asked if I’d brought in any sharp implements.Why would I do that? I thought, I’m trying to get away from those things. They know that. A psychiatrist who would assess me more fully would be coming in later. In the meantime, I was told to stay on the ward, either in my corner of the room—a space of about one and a half by two metres—or in the common area.

Contrary to what I had imaged, the common area wasn’t filled with people dribbling and muttering to themselves. Instead, five or six women sat on plastic-covered chairs and sofas.They watched television in a rather half-hearted way, read old copies of women’s magazines and
Reader’s Digest
s, and talked quietly in a manner that suggested they didn’t want to disturb anyone else. Most of the women in this peach-coloured room with its matching floral curtains were in their sixties. It was strange to see them, dressed and looking perfectly well, sitting patiently inside on a cloudless, sunny morning.

This wasn’t what I had expected. My immediate reaction was, I’m going to be really bored. It hadn’t occurred to me to think about how I’d fill my time once I signed in.

I was also trapped. I was now, of my own volition, locked up. I was not to leave the ward, let alone the floor or the building. I wasn’t allowed to duck down to the shops. I couldn’t go for a walk.This was particularly galling as exercise was probably my only ‘appropriate’ way of coping with stress. I’d never quite been able to get rid of the idea— which first surfaced when I stopped eating as a teenager—that if you didn’t exercise every day you’d get fat. Just like that. Sometimes I could ignore it but the more unhappy I was, the more it recurred.

It was strange being in a hospital where you could get out of bed— indeed where you were expected to do so—but where you had nowhere to go and nothing to do. On Monday, I was to find that there was plenty to do.There were groups to attend on anger management, medications, coping with depression, dealing with anxiety. But on the weekend most people, if they could, would get overnight leave and spend the time with their families, or at least arrange to go out for a meal. For those who stayed behind, the two days dragged on endlessly.

What had I done? I still didn’t believe I was sick. I was perfectly healthy, just unhappy.What was I doing in this place full of sad, lonely old women? How had this happened?

Late in the day, the consulting psychiatrist turned up. The doctor who had arranged for me to be admitted wasn’t taking on new patients, nor was she a visiting specialist at this hospital. I couldn’t imagine how she’d got me in. Now this slight, well-dressed man in his fifties, Dr G, was going to take over my treatment.

Dr G asked me to tell him about myself. As usual, I left out the bits I didn’t consider anyone else’s business, such as my love life and my mistrust of the medical profession. I was too embarrassed to talk about sex or relationships, and only touched on drug use. I circled around issues and expected him to read my mind, pick up on clues. He scribbled down notes but didn’t make any comments.

At the end of our session, he asked me to sign a contract: a list of ten points, things that I would agree not to do during my‘stay’.These points included not harming myself, either with a blade or in any other way. I wasn’t to harm anyone else, nor was I to leave the ward without permission.There were other requirements but they seemed unimportant. It was a boilerplate contract, designed to cover a range of patients. Dr G highlighted the clauses relevant to me.Were I to break the terms of this contract it would give him, as my specialist, the authority to ask me to leave or,chillingly,to have me ‘scheduled’.To be scheduled is to be placed, involuntarily, in a state mental hospital (in some states this is called ‘being sectioned’). Once there, only your doctor or a mental health review board can decide when you leave.The doors are locked, the windows are barred and the patients can be violent and psychotic. Understaffing and underfunding mean that these places can be more akin to jails than hospitals.

Like an obedient child, I signed on the dotted line and promised to behave myself.This was the beginning of a period of learned helplessness. Suddenly, after a long struggle to maintain the appearance of coping, I didn’t have to look after myself. Someone would remind me to take my medication. I would be given afternoon tea, morning tea and supper, as well as cooked meals. Dinner was at 5.40 pm in the dining room, so supper at 8 pm was a necessity. Breakfast was between

7.30 and 8 am.The only people allowed meals in bed were those too unwell to get up. I wasn’t considered one of them.

Over the next few weeks my days were filled with group therapy, which I grew to hate. I really wasn’t interested in the other patients. I wanted my problem solved; I didn’t care about theirs. I began to behave like a fourteen-year-old, alternately giggling and sullen.The environment seemed to encourage this behaviour.

I discovered that three of us in the Acute Ward had problems with self-mutilation and were there for observation and our own protection. What we had in common was gender, age and no confirmed psychiatric diagnosis.Annabel,Jessica and I were simply unhappy.Selfharm, or specifically self-mutilation, isn’t classified as a disorder in itself. It is seen as part of something else, such as depressive disorder, an eating disorder, or some kind of personality disorder.

The women I’d seen on that first Saturday weren’t really representative of those on the ward.They were just the ones who didn’t have anywhere to go. In Acute—where I’d been placed—people suffered from a range of conditions, most with frightening names and very specific treatment regimes. Some patients had severe clinical depression, others were changing medication, and there were also those who were waiting for medication to kick in. There were those with bipolar disorder who were in the manic phase and had to be sedated to curb their behaviour which could be extremely damaging. Some believed they could fly, or were extremely promiscuous. Others had delusions of enormous power. Given this mix of patients, the ward was surprisingly quiet. I don’t think this was just a result of the sound-absorbent carpet.

The girls and women who suffered from eating disorders were on the floor upstairs.There were no men up there. I watched them walk into the dining room, accompanied by nurses who made sure they didn’t hide the food in their pockets or under the plates. After meals they were made to lie down to let the food digest.Those who had been there for some time looked healthy—not exactly plump, but no longer thin. Others, newly arrived, did not look like young women. Their hair was lank, their features gaunt and their posture stooped. One girl could no longer walk and instead sat motionlessly in a wheelchair. Looking at them, I knew I’d had a close call.

But then I’d chosen another fork in the road to self-destruction.

There were only two places you could meet people from the other wards: the dining room and the recreation room downstairs.While people didn’t tend to socialise when eating, they did chat as they played pool or smoked. Smoking was the norm; if people didn’t when they came in, there was a fair chance they would when they went out. In the recreation room,those from Acute could beg cigarettes from Eating Disorders who could be sure to get them from the Alcohol and Drug Addictions crowd.

It was down there too, out of the way of the hospital staff, that you’d hear other people’s stories. Some were horrific and some, like mine, were disturbingly mundane.There was a hierarchy of disorders, and I’d regularly hear:

‘You’re not really in danger, it’s not like cutting your arm will kill you, is it? None of those scars are real suicide attempts are they? You’re just playing. If you wanted to kill yourself you’d try some other way.’

We self-mutilators had no real tag but quickly began to want one. We wanted a name for our problem, a clear-cut category and label. That would give us an explanation and, no doubt, a quick drug-based cure.We didn’t want to hear that we had borderline personality disorder, or any other personality disorders. These were too intangible and, worse, there would be no quick solution with that diagnosis. But it wasn’t straightforward, and my treatment program highlighted this.

My new psychiatrist, Dr G, believed my urge to self-harm was exacerbated by depression,so he ‘put’me on Prozac,as the Prothiaden clearly hadn’t worked.An antidepressant was necessary if I wanted to feel better, I was told. He also prescribed Stelazine, which I was to take to calm me down if I felt that I needed to harm myself.

Psychotherapy wasn’t, at that point, seen as a way to solve my problems.The argument went that even if I delved back into my past and found something monstrous, knowing about it, and discussing it, wasn’t necessarily going to stop the urge to self-harm. Dr G, having decided that there wasn’t anything obvious causing my problem, decided to focus on the immediate issue: how to stop me cutting myself.The key seemed to be in breaking the pattern. I had told him how it worked.

For days or weeks, I would resist the urge to hurt myself, and then, for some reason, I would be unable to do so any longer. I’d walk to the nearest chemist and buy a new packet of razor blades. I’d use one and then throw the rest out, horrified by what I’d done.While the wound healed I’d feel better.And then the cycle would start all over again. Dr G’s suggestions included calling someone before I went to the chemist, or walking to the nearest café instead of buying blades.

It was apparent that he really had no idea how best to treat me.

At the end of the first week, my risk assessment was changed, and I was allowed to go for walks. Administratively, this meant that I graduated from a blue to a red dot on the large whiteboard that was fixed to the wall opposite the nurses’ station.This board listed the first name of every patient in Acute,their room number and their bed number.The coloured sticker indicated how sick (or dangerous) the patient was. Blue meant that you were confined to the ward, orange that you could leave if escorted by a nurse or family member, and red was for those who were allowed out for limited periods of time unaccompanied. It was, in theory, a sensible system but in practice it had its problems—it was easy to switch the stickers around when the nurses weren’t looking.

With the notable exception of those who were manic, most of the other patients were polite and quiet—an effect, I guess, of both their illness and their medication. Occasionally there were disturbances. One male patient liked to sit in his tracksuit in the common room masturbating while watching television. Many of us had reported this, but it wasn’t until he attacked a nurse that he was moved, we assumed, to a more secure location. Jessica, who had signed a contract like mine, broke it when she managed to create two sets of raw red scratch marks on the inner side of both arms, using her fingernails which she’d carefully filed.Within ten minutes of these marks being noticed, she was assessed and scheduled. She was distraught.

First the police turned up, motorbike helmets under their arms, followed by ambulance officers carrying a stretcher.Technically, Jessica was now under government ‘protection’ and proper procedures had to be followed. This meant that she had to have a police escort. But Jessica wasn’t mad or dangerous. She was just miserable and expressing it. It seemed to us that her behaviour had been seen by hospital authorities as attention-seeking and she was being punished for it. I heard later that she was spending her days curled up in the corner of a large common room like a scared animal. It was a warning for those of us who had signed the same agreements.

It didn’t take more than a few days for the outside world to recede. I didn’t watch the news or listen to the radio or read any newspapers. I didn’t read at all, in fact. I couldn’t concentrate enough to do so. I gave up after the fourth attempt at the first chapter of a Jackie Collins novel. I felt as though I were in a bubble.We could have been on Mars for all that normal life mattered.

There were few visitors. Rodney didn’t call,Alex didn’t call.Only Peter, one of the few people I was still in touch with from uni, dropped in. When I rang him to let him know where I was he wasn’t really surprised. Instead, he sounded relieved. He knew that things had been difficult for me, and had been doing his best to help. I didn’t tell him much about what was going on in my head but he guessed a lot of it, and was as supportive as I’d let him be. This meant that sometimes Iwould ring him at ten at night, frightened I’d use the fresh blade sitting on my desk. He’d always come over when I called. Often I didn’t ring him though. I couldn’t, or didn’t want to.

Peter thought hospital sounded like an excellent place for me.

I still remember him walking into the common room; it must have been on a Saturday afternoon because he was wearing tennis gear. He sat down on the plastic-coated couch and started chatting to the person next to him, gradually including others in the conversation. Everyone was charmed of course, and I was really pleased. It was the first sign of normality I’d seen for a while. He was behaving as if he’d been invited to afternoon tea at an aunt’s house. He was being considerate—which was more than I could say for my parents.

My mother visited me once while I was in hospital. While she brought flowers and a pair of new pyjamas as a peace offering, we had little to say to each other. My admission to hospital was just another example of how weak I was.Hadn’t they taught me how to ‘rise above it’? Hadn’t they shown me how to hide and ignore my problems? My mother believed that I was choosing to be like this. Choosing not to cheer up, not to make an effort, and, finally, choosing to hurt myself.