From a Safe Distance (27 page)

The students were back.

“Anyone heard of Maslow's Hierarchy of Needs?” The spotlight is on him.

The student doctors mumble their ignorance.

“I'm not that surprised. It's mostly for psychology students and nurses. But it does help to put things into perspective. Maslow starts with basic human needs, ie food, safety, shelter, warmth and companionship, shown here along the widest part at the bottom, and moves up, like this – ” Max is drawing a large triangle on the board and filling in the horizontal strata, writing in the levels of need across it, working his way upwards, “to the pinnacle of achievement for any individual, which Maslow calls ‘self-actualisation.' Now the majority of us in Western societies take for granted the fulfilment of the most basic needs. But I think it's important to bear two things in mind: one, the triangular shape implies that not everybody fulfils every need, and two, a person's level of need can change – which is where you and I come in. When a person develops a mental illness, however high their place on this triangle may be, suddenly” – he drops his hand – “the most basic needs become the priority, which is why help is needed.”

“Are you saying, then, Dr Greenwood, that someone who is ill cannot reach the pinnacle?” Mr Phillips asks. His light clicks off.

“Not during their illness, no. When they return to normal functioning, they can usually look after their own physical needs, so that the focus shifts to more advanced, even what you might call abstract needs.”

“Can you give us an example of this process?” Mr Flint takes his turn.

“Yes. I knew a woman who, when she was well, wrote as a way of finding self-fulfilment. She had food, warmth, clothing etc. in her everyday life and didn't need to worry about these things. But when she became ill, her writing became a series of desperate messages until, in the grip of psychosis, she couldn't write at all. More significantly, nor could she walk, speak, eat or wash herself, so her physical needs became the most important for her survival.”

“So when well, she had everything she needed?” Mr Jones has to ask. Click.

“No, that's not what I mean. There were certainly things she did lack when well, but they were not necessarily physical things. Companionship, a relationship perhaps – they were the holes in her triangular cheese, if you like, and it's possible that they contributed to her becoming unwell.”

Max knew that, in Maslow's terms, the need for a safe environment was denied to Vee by Sandra …

Suddenly there was a crash in the kitchen and Max rushed downstairs to investigate. Helen had her back to him and was crying quietly, her arms stretched out on either side as she gripped the work surface, her head down. On the tiles lay the broken remains of the porcelain dish her mother had bought her.

‘Oh, darling. Don't cry! We can replace it.' He picked his way over to her and took her in his arms.

‘It's not that, Max … ' She was still sobbing. ‘I think there must be something wrong with me … I keep dropping things and … I get pins and needles.'

‘Have you got a headache again today?' He had to hide his own anxiety.

‘Yes. Well, it comes and goes.'

‘Would you like to see the doctor?'

She pulled away from him and crouched down, picking up some larger pieces. ‘I don't know. Max, I'll be OK. It's probably nothing. What with work and the business with Jackson, I … I'm just tired.'

‘If you're sure. Hey, I'll cook tonight. One of my pasta specials, yes? You're on at one, aren't you?'

She nodded. ‘Half day, til six.'

‘So go up and have a lie down for an hour or so. I'll clear this up.'

She slept for two hours. Max returned to his work in the attic:

“I regarded Sandra as representative of a regime whose darker side was only revealed to me as a consequence of my involvement with Vee, but whose behaviour seemed to be a contributory factor in her death. As a result of this suspicion, I have more than once considered terminating my contract with Squaremile. Then, while Helen was talking about Sandra recently, I realised that things were happening behind the scenes which suggested that the enemy was not the Centre as a whole, but Sandra in particular, who must have hoodwinked the management into following her lead with Vee, and was making the most of her position.

“While this would still prove they didn't care what happened to Vee, it also shows how Sandra could get away with treating her badly. So even if the seniors didn't know exactly what she was doing, as long as she appeared to be ticking all the boxes, they turned a blind eye. Promotion off the house was presumably the management's way of removing Sandra from the front line, as it were, once Vee was out of the picture. Job done. They must have thought highly of her though, to take this expensive route.”

Max was too worried about Helen to spend long writing. After waking her at twelve, he went down and ate a sandwich with her.

‘Darling, why don't you take a week's leave – they'll just have to manage without you.'

‘I can't just drop everything – sorry. I mean, there's too much to do. And don't you want evidence against Sandra? I've had an idea about that. We'll talk it over this evening. I'll be back by seven.'

‘Are you sure you're OK to drive?'

‘I'll be fine. I've got some painkillers to see me through at
work. I'll see you tonight then, Max,' said Helen, putting on her coat and gloves.

‘I'm looking forward to hearing this idea.'

She blew him a kiss from the front door.

Back home, Helen seemed fine.

‘I found out why I was the one chosen to look after Grove – to go back there, I mean. I had the most experience. Jean is leaving at the end of the week and Sandra's in Portugal until she takes up her new post. She's got two weeks left of her month away; I'd love to know how she wangled a month at once. I can guess, but anyway, they said there was nobody else they could really call on or trust. I do feel a bit used, though, Max. Moved around as it suits them. And I feel … trapped. But there's something else, Max.'

He took the few steps from the kitchen to the dining area, with two bowls of pasta, then switched off the television. ‘You were saying?'

‘Whenever Sandra's been in charge of a house – oh, but hey', she paused to savour the mouthful, ‘nice sauce Max. No, but she leaves a trail! Residents' folders get tatty and aren't repaired, the office gets in a mess, some My Life meetings are missed, which reflects badly on the Centre, and shopping trips to get new clothes for some of the people in her care aren't arranged. God alone knows what state Alder was in before the fire. But worst of all, Max,' Helen frowned briefly, ‘I had to send two residents to hospital last week. They had been badly neglected. Can you believe it?'

‘Yes, actually.'

‘Oh, Max. Now I've read her book, I wish I hadn't left Vee on Grove with that woman. I could've picked her to come with me to Birch after the fire, but I had been told to avoid her. I hope I didn't contribute … '

‘I doubt it. Anyway, why were you told to avoid her?'

‘They said … '

‘Who said?'

‘Jack Marshall I think. Yes, he said she was not suitable for further promotion or moving to another house because
she was disruptive and kept taking time off sick. I remember now – he tapped the side of his head to show she had mental problems.'

Max's face darkened. ‘God, that makes me so angry!'

‘Hey, calm down Max. I don't want to get into another ambulance with you. Where's your medication?'

‘I'm alright.' He sat back. ‘I'm more worried about you. How have you been today, in yourself?'

‘Not too bad.' Helen cleared away the pasta dishes and fetched two yoghurts. ‘Vanilla or strawberry?'

‘Vanilla please. Come on then, my love, I'm itching to know what your idea is!'

She took a deep breath, and announced that they should prepare a document, a report, covering the goings-on in Grove as well as Vee's treatment. Then they could present it to senior management. They both knew that she was in the perfect position.

‘I think that's a brilliant idea! In fact, I think it's really the only way forward!'

So gripped were they by the excitement of having a definite plan that they stayed at the table for the rest of the evening discussing strategy. Max was interested in what the junior staff might have to say, like a fly on the wall. Helen had already thought of this and was planning to talk to them individually, and tape them. With their consent, of course, and anonymously, because any methods she and Max used must be beyond reproach. Max could see problems with this; for example the first one might talk about it to the others. Again, Helen countered this by saying that she had got to know these people, so knew who got on with whom and who was likely to cause trouble; based on this, she had already decided who the first person would be.

Max would still be at the Centre on Tuesday mornings if Helen needed him urgently, but they soon got into a routine. When she was on earlies, she would report back in the evening any developments concerning Sandra or Grove. If she was on a late shift, Max would spend the evening
keeping up with the notes for the report and beginning to put it together. He kept a close watch on Helen to make sure she didn't get too stressed. He was also secretly planning the holiday they would have earned, somewhere nice and warm, which would lift her spirits when this was all over.

They knew that their actions could have an impact on the lives of others. Max thought those two weeks before Sandra's return would be enough to get the information they needed and interview the juniors so they could present the report to the Chief Executive. Better go straight to the top, bypassing Jack Marshall, they thought. Nevertheless, it was possible that the management had moved Helen to Grove for a purpose not dissimilar to theirs, so perhaps Max and Helen would have Jack Marshall's support, especially if he was impressed by Helen's improvements, and even if he didn't know the true motives behind her activities or enquiries. Max recognised, however, that it was important to keep an open mind about the people they were dealing with: in his view, assumptions of any kind were among the most dangerous lapses of mankind, made by those who think they're observant.

For the whole of that first week, Max and Helen devoted their energies to the Vee Project. Not only did Max have the report to prepare, but he also had to write up the discussions he had with Helen. On the second day, he wrote the last piece about Vee herself:

“A textbook definition of prejudice is seen in the way Sandra despised Vee for something she couldn't help. Sandra was the last straw for Vee, the last link in a long chain. Vee grew up with the idea that mental illness was a sign of weakness, then one day she found herself diagnosed with bipolar disorder. Despite the catastrophic effects of this, she retained insight, enough to record what she felt, and she recognised that she was not alone. When she saw those long-stay patients in West Pluting, she was, I think, humbled: they were worse off than she was.

“But I think the most significant effect of her illness was that people started treating her differently. Before diagnosis,
she hadn't needed to prove anything. She just lived; nobody requires a certificate of sanity. Things that had once been easy for her, like getting a job, were suddenly much more difficult, if not impossible. She had to start proving herself now, and there was no script. She encountered stigma and negative assumptions at every turn, even when she got a job at Squaremile. There, she began by assuming, as one might in such a setting, that people were going to be sympathetic. Instead, she had disciplinary hearings and warnings and in the end was sacked because Sandra thought it her duty to discriminate. If you feel that others are suspicious of you, the tendency is to feel guilty.”

Liz was first on the list of junior staff who had to be called over from Birch. As Helen had said, when she had taken up the reins in Birch after Bill's death, she had got to know the different personalities on the staff. She knew Liz to be a bit of a loner, unlikely to say much about what went on today. Helen brought in coffee, and invited Liz to sit down opposite her, so that her face was lit by the window. This was an old trick Max had taught Helen. She tried to make sure they weren't disturbed. She described Liz as being about twenty, of mixed race, with large dark eyes. Helen played Max the first part of the recording, which they would have to edit because of the name.

“‘I've called you in, Liz, to see how you think things are going. Do you like working on the Centre?'

‘Yeah, pretty much.' Her voice was quite deep.

‘Is there anything you want to say about your working conditions?'

‘Don't fink so.'

‘Now, I want to check if you mind me taping our chat. You can refuse. The tape will only be played to senior staff and nothing you say will be held against you, because it will be anonymous. Your name won't appear. So you can say what you really think, and when the tape has served its purpose, it will be wiped, OK?'

‘I don't mind. Got nuffink to ‘ide.'”

Helen proceeded to play the whole interview at home that night. It confirmed what they knew about about Sandra to a certain extent, despite the fact that Liz presented a simplified version. But they needed more. Helen decided she would speak to Sue, Sally and Brian next; they had known Sandra on Alder before the fire. Last of all would come Nat, when she came back from her week's leave. She would have been last in any case, with good reason: she would be the most likely to cause trouble. That said, she would also be the most likely to provide good evidence. Meanwhile Jack Marshall, fresh from his management update course, was interviewing candidates for the manager's post on Grove where Helen was locum; a new manager had taken over in Birch.