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Authors: Jean Davison

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When I opened my eyes the ward had emptied.

‘Why aren't you at OT?' a stern voice demanded to know.

‘OT?'

‘Occupational Therapy,' Sister Grayston informed me. ‘Where the other patients are and where you should be too. Off you go.'

The OT building was a place where male and female patients from the various wards came together to engage in activities such as Debbie had described. Miss Burton, the Head Therapist, introduced me to a therapist called Tina, a small, auburn-haired young woman with an old-fashioned beehive hairstyle, who seemed to be attempting something a little more stimulating with a group of about seven teenage patients; it looked like a discussion had been taking place.

Tina pulled a pen and paper from the top pocket of her stiff white overall and added my name to a list.

‘This is Jean,' Tina said, addressing the group and motioning me forward. ‘Now, Jean, I want you to do some role-play with Peter.'

She placed two chairs in the centre for Peter and me while the rest of the group formed a semi-circle round us.

‘What I want you to do, Jean, is to pretend Peter is your fiancé and you've just found out he's a drug addict. OK?'

Peter, a shy-looking, painfully thin, pimply youth of about nineteen looked heavily drugged anyway, which added a touch of reality. He was slouching forward in his chair staring at his shoes. After an awkward silence, I said, ‘So you're a drug addict?'

‘Yeah,' he replied, without looking up.

‘What kind of drugs?'

No reply.

‘Well, is it something you swallow or are you injecting?'

Still no reply.

‘How long have you been on drugs?'

He shrugged his shoulders.

‘Why did you start taking drugs?'

Tina said, ‘That's a good question. Now come on, Peter. Tell her why.'

‘I … I don't know,' he said, raising his head just enough for me to see he'd turned crimson. My heart went out to him; he was shyer than I was.

‘Do you
want
to come off drugs, Peter?' I asked. ‘Are you willing to see a doctor and try to come off them?'

‘I don't know,' said Peter. And then we both lapsed into silence. End of act.

Tina clapped her hands.

‘That was very good. Tell me, Jean. If he wouldn't come off drugs, would you break off the engagement with him?'

‘Yes,' I replied, not giving it much thought. I couldn't imagine being told by someone I knew well and loved that he was a drug addict, and not having had the slightest idea until then.

‘Very good,' Tina said again. ‘So would I. You'd be well rid of him if he was on drugs.'

Next came a quiz. I was surprised to find that the teenage girl who appeared to be the most severely disturbed patient in our group, Joan, knew more of the answers than any of us. But her answers were interspersed with senseless laughter, tears, screaming, rocking back and forth, asking everyone silly questions and hitting those of us who didn't answer her. This fair-haired, blue-eyed teenager was the disruptive element in the group. The joker was Raymond, aged about eighteen, who kept everyone amused with his own bubbly brand of humour.

‘Joan was at grammar school not long ago doing A levels,' Raymond told me at break when we sat together in a corner of the noisy hall sipping stewed tea from badly stained plastic cups. ‘She got meningitis. Left her with permanent brain damage.'

‘Oh, isn't it sad?'

‘Yes, it's sad but that's life,' he said matter-of-factly. ‘Anyway, what about you? Can I ask the old corny question: what's a nice girl like you doing in a place like this?'

‘Well, I think the diagnosis is acute depression,' I said. ‘So perhaps they believe giving me a dose of this dismal place will make me realise I'd got nowt to be sad about before.'

Raymond grinned. He offered me a cigarette.

‘No thanks. Tried smoking but gave up while stopping was still easy.'

‘Very sensible,' he said, lighting up.

‘And you?' I asked. ‘Why are you here?'

‘Oh, I'm a really bad case.' His dark eyes twinkled. ‘I've been here a year.'

‘A year!'

‘Yeah, well, it's somewhere to live, isn't it? I suppose if I'm a good boy and don't talk as if I might cut my wrists again, I'll eventually return to the big bad world and then …' His smile faded. ‘And then I can do what I want to do with my rotten, lousy, fucked-up life.'

‘And what's that?'

‘End it.'

‘But that wouldn't solve owt, would it?' I put to him hesitantly, aware of the need to tread carefully now that his cheerful mask had slipped.

‘It would solve
everything
. But let's quit this morbid talk.' His painted grin returned. ‘Do you know any good jokes?'

After tea break I was sent to the therapy workshop where patients were sitting in rows at long workbenches. Here, I was shown how to make an ashtray with small coloured square tiles by tearing off the gauzy backing material which kept the tiles together and then gluing each tile to a metal base. It was dreadfully boring, but there were distractions. Enid, the stout, elderly woman on my right, kept talking to herself. Mary, on my left, shuffled about in her seat, sometimes clapping her hands while she laughed and laughed.

Occasionally I glanced at Fred opposite to see if he still kept breaking off from the basket he was making to pull faces or wink at me. Only a few days ago I'd been laughing with Jackie when we'd joked about me sitting ‘basket-making with the loonies'. It didn't seem funny now. Nothing seemed funny now.

CASE NO. 10826

Mental state
:

Young apprehensive girl, reasonably well dressed and co-operative and pleasant.

Capable of holding good stream of conversation. Finds it difficult to express herself of the thought disorder – as she cannot express the feelings in words.

Thought disorder of bizarre in[sic] nature
:

‘I am confused with so many different ideas.' ‘Heaven and hell confuses me very much.' ‘I do not know
what
I am at times,' etc. Expresses these thoughts with particular reference to religion – ‘I want to be a good Christian.'

Perceptual disturbance
:

Absent.

Passivity feeling perhaps present
:

Not deluded with depersonalisation.

Orientation: full. Memory – Intact.

General Informations
:

Intact.

Schizophrenia (Simplex) in a young girl with ? family history.

Dr Prior

CHAPTER THREE

T
HE FIRST FEW DAYS
in High Royds passed in a blur. My thoughts became fuzzy as the drugs took a firm hold, and I sank into the regimented routine of the institution. Up at seven. Bed at nine. And in between, a drowsy dream-state of longing for bedtime. I would wake in the morning to face another day stretching ahead of me like an endless, gloomy tunnel.

At OT, I sometimes escaped from the monotony of knitting dishcloths and making ashtrays by lingering in the toilet. The door wouldn't lock but a measure of privacy for writing could be achieved by sitting on the floor with knees to chest, feet against the base of the pot and back against the door holding it firmly shut. This was where I sat, scribbling copious notes for my diary, pouring my heart out on wads of toilet paper.

I was standing alone among the crowd of patients in the therapy hall at tea break watching a tall, wiry woman with a ‘basin' haircut on what seemed to be her daily scrounge for cigarettes.

‘Have you got a cig?' she asked.

I shook my head. ‘I don't smoke.'

She eyed me up and down whilst nervously twisting a lock of hair around her shaky, nicotine-stained fingers, with nails bitten to the quick.

‘I'm Beryl. What's your name?'

‘Jean.'

‘How old are you?'

‘Eighteen.'

‘Oh dear, oh dear, I thought so. I knew it,' she said, frowning. ‘I can see it all again now.'

The way she was staring at me and shaking her head mournfully made me feel uncomfortable.

‘You remind me of myself about thirty years ago. This is your first time in a mental hospital, isn't it?'

I nodded.

‘Yes, like me. I was eighteen. I've been in and out ever since and I expect I'll be a permanent resident now. It all starts when you first come in. Once you're in, they've got you.'

This reminded me of my mother's warning that you'd never get away once they got their clutches on you. But what did my mother know about it? As for Beryl, well, surely this was her illness talking, and of course it was completely different for me.

Beryl's eyes darted back and forth like a trapped animal. ‘It's like being in prison, only worse. You'll see.'

‘I'm a voluntary patient,' I informed her.

‘Voluntary. Ah, yes,' she said with a strange, crooked smile. ‘What does that word mean in here?' Her breath was coming out in noisy puffs; she seemed very agitated. ‘Have they given you any treatment yet?'

‘Just drugs.'

‘Yes, like me. First the pills. Lots of pills. Make you very sleepy, don't they? Have they given you electric shock treatment yet?'

‘Electric shock treatment?'

‘Yes. They zap your brain with electric.' She pointed a finger to her head like a gun. ‘Pow! It's supposed to shock you back into sanity by destroying your brain cells.'

‘No, I'm not having that. I only came in for about a week, so I'll be going home in a couple of days.'

‘Oh, sure you will. Is that what they told you? They told me that, too. I was only eighteen. You're only eighteen. It's terribly sad. I hope you'll be OK but I know how it can happen and …' She bent her face near to my mine. ‘I'm scared for you, Jean. Really scared for you.'

My God, what a Job's comforter, I thought as I watched her shuffling away, stopping every now and then to rummage through ashtrays for tab ends.

When Dr Prior asked to see me in the Quiet Room I thought it must be for the ‘good talk' he'd promised, but he said, ‘I'll only keep you a moment. First, how are you?'

‘Will you cut down me drugs?' I begged him. ‘They're making me too drowsy.'

‘Drowsiness is not a serious side effect,' he said, lighting a cigarette.

‘But it's
awful
being so tired,' I pointed out, exasperated.

‘Well, just lie on your bed for a while when you feel tired.'

How I wished I could. He obviously wasn't aware of the rules.

‘Do you enjoy going to OT?' he asked, changing the subject.

‘I'm so tired and bored there. Do I
have
to go?'

‘No, not if you don't want to.'

‘Oh, thank you,' I said, grateful for small mercies. Sitting in rows at the therapy workbenches reminded me of the factory assembly line, except it was even worse. In the factory each minute had passed, albeit slowly, but at OT it was as if time just hung about sleepily and lingered in the air mingling with the atmosphere of deep gloom that clung to the walls and ceiling, enfolded us like a shroud and dampened at source any spark of humour. It was the same in the ward to some extent, but nowhere had I experienced it more keenly than in the OT department.

‘Now, listen to me, Jean,' Dr Prior was saying. ‘I'd like you to have a course of about six to eight applications of electric shock treatment. Don't let the term “electric shock” frighten you. It's a safe, simple procedure. A small electric current is passed through your brain but it's all done under anaesthetic so you won't feel a thing.'

It was a bit better than Beryl's version, but I still didn't like the sound of it.

‘We don't know how it works,' he said. ‘Only that somehow it shakes the mind up, lifting depression and enabling a patient to think clearly.'

But I needed to think clearly now, so that I could understand what he was suggesting. And thinking clearly was far from easy when I was heavily drugged.

‘I can't see how it could help me,' I said, feeling puzzled.

‘Well, I think we should at least give it a try. Now if you'll just sign this, please.'

He produced a printed form from his briefcase and handed it to me with a pen. I read: ‘As this form of treatment is not without an element of risk we should like to have your consent to employ it …'

As I tried to decide what to do, Dr Prior waved his hand. ‘This paper's just a formality: there's really no need to read it.'

‘What's the risk?' I asked, as this was not explained on the form.

‘There is no risk,' he replied.

I felt decidedly uneasy. He was telling me that the form did not mean what it said, was unimportant, and that it was unnecessary for me even to read it – but nonetheless my signature was required on it. I began reading it again while trying to ignore Dr Prior who kept impatiently pointing to the space at the bottom where he wanted me to sign.
As this form of treatment is not without an element of risk
…

‘Why does it say there is a risk if there isn't?' I persisted.

‘It says what? Let me see that form.' He looked at it and frowned. ‘Oh, damn! I've given you the wrong one,' he said. ‘Not to worry though. I'll just amend it slightly then you can sign it.'

He made some minor adjustments, as the form had obviously been designed for someone to sign on behalf of the patient, then he handed it back to me.

‘What's the risk?' I asked again. ‘It says there is an element of risk.'

He drew heavily on his cigarette, and sighed. ‘The risk is in the anaesthetic, not the treatment,' he said, ‘and all anaesthetics carry an element of risk but it's so slight that it's not worth worrying about. You don't worry each time you cross a road but there's far more risk in that. Now, just sign it there.'

I studied his face carefully, wondering why he seemed impatient and evasive. I looked back down at the form. The words were blurred; my eyesight, previously excellent, had deteriorated rapidly in the few days since my admission, presumably due to the drugs. And I was so, so tired. In this strange mental hospital world, one's self-determination and resistance could easily become dangerously low.

‘I only want to help you,' Dr Prior was saying. ‘You do trust me, Jean, don't you?'

I still didn't understand. But surely I could trust professional medical staff who wanted to help me.

‘Yes, I trust you,' I said weakly, as he pushed the pen into my hand.

I no longer trusted God. I no longer trusted my own thoughts and feelings. I supposed I had to trust somebody. So I signed.

‘That's a good girl,' Dr Prior said, smiling.

Good girl? Naughty girl? It didn't matter whether a patient was thirteen or seventy-plus or anything in between, psychiatric staff still persisted in talking to us in those terms.

Many years later I saw again the consent form I'd signed and remembered how Dr Prior, before realising he'd given me the wrong form, had said emphatically: ‘There is no risk.' There was also a form signed by another patient that day which had obviously been filed into my case notes by mistake. On this, there was no mention of ‘risk'. Instead, it emphasised that an assurance had ‘NOT' been given that the treatment would be administered by a specific practitioner (surely ironically irrelevant to most patients in the circumstances).

Instead of setting off for OT the next day, I remained in the day room and started writing a letter to Mandy.

‘What do you think you're doing?' You should be at OT,' Sister Oldroyd snapped at me.

‘Dr Prior says I don't have to go to OT,' I said innocently.

I could never have guessed the effect of these words. She actually shook with anger and her voice rose to a shriek as she informed me it made no difference what Dr Prior had said: it was none of his business! It was what Dr Sugden said that counted and he would listen to her about what she thought was good for me, and how dare I sit there and be cheeky enough to say I didn't have to go? If I didn't get out of her sight this minute and off to the OT block, she wouldn't be held responsible for what she'd do to me. Who did the little madam think she was to expect special treatment compared to other patients?

I stood up immediately to fetch my coat. And off the little madam went to OT.

I woke up early the next morning despite the drugs and, fixing my eyes on the green light above, I thought: Today they are going to shoot electric currents into my brain. Why?

I had to get up at seven but remain in my dressing-gown and have nothing to eat or drink. The next three hours were spent sitting in the day room silently waiting, and wishing the sky would fall to stop the day.

The ambulance to take me to the ECT Unit arrived at ten. Inside were six women from other wards wearing dressing-gowns, and two young nurses. As we rode across the broken tarmac in the grounds the two nurses joked with each other while we, the victims of God knew what, sat silently, squashed together, alone with our ‘sick' thoughts.

We jerked to a stop outside a heavy wooden door and were ushered into the building. One sharp breath of fresh, winter air and then a stuffy warmth again with a faint smell of the now familiar cleaning fluid. I tried to understand this ‘sickness' of mine. Was I a troubled teenager or a hard-core psychotic? In this mental hospital there was, apparently, no distinction. We were heavily drugged, categorised as ‘sick', sat side by side making ashtrays and knitting dishcloths. Perhaps, too, we were all experiencing the same naked fear as we sat together on the wooden bench in this small, oblong waiting area.

The elderly and most confused patients were frisked to check that all hairgrips, false teeth, glasses and anything with metal fasteners had been removed. A nurse appeared with a syringe to give us an injection in the arm; a procedure which proved difficult since some of the patients chose to engage her in a cat-and-mouse game. I was one of the good, co-operative patients who smiled for the benefit of some frightened patients who were studying my face as she pushed the needle in.

‘What's the injection for?' someone asked.

‘It's to dry your mouth so you don't swallow your tongue and choke to death while you're having a fit,' the nurse explained coolly. ‘So if you don't let me give you it you might die.'

‘Do you think that bothers us, you fool? We all want to die.'

I tried to say, ‘No, not all of us. I don't want to die,' but the words froze on my lips and I couldn't speak.

After the injection came a half-hour anxiety-filled period of waiting, during which time there was nothing to do but sit and think. I thought about how my hospital stay was meant to be for a week. In my sleepy state it was hard to keep pace with what was happening to me. Without protest, or even much thought about it, I had resigned myself to a longer stay.

And then my thoughts travelled back to what I was doing a thousand years ago. No, wait a minute; it wasn't really long ago. Today was Thursday and a week last Saturday I was dancing at the Mecca with Danny, then on the Sunday afternoon Danny and I went to the bowling alley with Mandy and Pete and, on the Sunday night, we were dancing at the Mecca again. Then on the Tuesday, the evening before my admission, I was at the bowling alley with Danny. So that must have been … I counted the days backwards on my fingers … Nine days ago! How could that be? Only nine days ago. Another place. Another world.

As the time for ‘treatment' drew near we took turns to go to the toilets in the wooden cubicles with three-quarter-length doors that wouldn't lock, and then a nurse passed a hot-water bottle round which was placed on the back of our hand to try to get the vein to stand out clearly. By this time my tongue felt too big to fit properly inside my dry mouth, my throat was parched, and I could hardly swallow.

Another nurse appeared with a sheet of paper. She gave us each a number, arranging us to sit in a certain order. I was Number Seven. I used to think seven was a lucky number when I was a little girl. I remembered how it had once won me a huge box of chocolates tied with a red ribbon in a raffle. Strange how often irrelevant thoughts intrude at moments of crisis in our lives. All Number Seven meant to me now was that my agony of waiting was to be prolonged because I was the last in the queue.

The nurse escorted Number One away. They disappeared through a double door. Silence fell over the waiting group, then someone said: ‘Oh God, we're lined up like sheep for the slaughter!'

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