Mad Worlds (24 page)

Heather tucked Becky into her cot, waited till she'd dozed off, came back to the living room and put on Elvis's
Golden Album
. She picked up the library book on child development and stretched out on the settee. In nursery work, she'd found her vocation. Now she wanted a refresher on theoretical thinking about the significance in later life of how toilet training and temper tantrums were handled. Vital for Becky – and her.

A faint knocking on the door? “It's Sam” through the letterbox. Swinging off the settee, she shouted “Coming,” paused by the hallway mirror to touch up her hair and adjust her skirt, and flung the door open.

Sam, minus briefcase. “Sam, come in.”

The aroma she'd come to like – of Brylcreem. She led the way to the living room and motioned to the table. “Sit down.”

But he remained standing, his arms outstretched. “Happy new year, Heather.”

“Happy new year, Sam.” She opened her arms and stepped into an embrace. She was being drawn into him, and oh, the warm insistence of his body. She felt a kiss on the cheek; then his tongue was in her mouth. This excitement and longing for something she was starved of.

He was pressing her backward, toward the settee, and she felt his full arousal. “No, Sam.” She wasn't ready for this. His grip slackened and she moved out of the clinch. His tanned face was red.

“Sorry. I thought that was what you wanted. I love you, Heather.”

“You're attractive, Sam, but I still have feelings for John. And he's my husband.” All true. “Let's just sit at the table and talk.” She motioned to a chair.

Yes, she had wanted it. But deep in her being, shame had won the battle with arousal.
Cool down.

“Okay, Heather.” They sat down opposite each other.

“Have you news for me, Sam?”

“Yes. Your husband's been moved to the Annex and he's allowed a visitor. The next date's 19
^th
January, a Saturday. I could, unless something blows up, take you there. I'd stay out of sight.”

“Thanks, but I'd like to try the bus.”

“Well – I hope the visit goes okay.”

“So do I. Last time was so horrible.”

“He was a swine to you. Look, Heather, I doubt they'll ever release him, with his mental condition.”

Exactly what she feared. Was Sam going somewhere with this? “Really?”

“Yes, from my knowledge of Springwell, I'm certain. It's sad for you, and for Becky.” He paused, gazing at her. “You could have grounds for divorce.”

“Could I?”

“Yes. If John's ‘of unsound mind' for long enough. I'd then want to propose marriage – but any romance with a patient or spouse means the sack.”

“So?”

“Heather, I love you enough to risk my career. If we can express our feelings towards each other fully, here, without anyone else knowing – well, I'd want that.” He stood up. “I have to go. Think about what I've said.”

Stunning, what he was suggesting. An affair! She rose. “Thanks Sam. I will. Remember what I've said too.”

She hung back from the doorway while he said good-bye. She didn't trust her feelings with another hug.

Heather leapt off the bus and walked briskly down Springwell's Hospital Lane. The last few days, a powerful urge to take up Sam's offer had been vying with a longing for the John she'd married. Maybe this visit could help calm her inner maelstrom.

Keys clanked as the imposing front door opened to reveal a familiar face. Jock Mackenzie, whom Sam had called ‘one of the good guys'.

“Hurry in lass, out o' the cold. I remember you, Missus Chisholm, from when you came to see your man.”

“That's right, Mr Mackenzie. I'm told John's on the Annex.”

She followed him to the desk, where the visitors' book lay. They went through the formalities – again irritating, as this swallowed precious visiting time.

Mackenzie showed her to a seat. “I'll ring, and your man'll be brought down.”

The hall was no longer spooky! They'd painted the walls in brighter colours and hung pictures. And there was a buzz of conversation – seemed like patients having visitors.

A door at the far end slammed. She looked up. A white-coated man was pointing her way. John was striding towards her. She got up, smiling, but stood waiting, uncertain of how he'd be. Only another few steps. He looked thinner, fitter, and more smartly dressed than before.

He stood facing her, his arms spread wide. “Heather, come here.”

Wrapping her arms round his neck, she felt his reassuring strength enfold her. Her lips found his. She stood savouring his intimacy. He was rocking her from side to side, like he used to do. That this would last.

She felt him withdraw and she did likewise. She sat on a chair and he drew up one beside her. She dabbed her face with her sleeve. “How are you, John?”

“Chuffed at your visit.” He was frowning? “But I won't blame you if you've shacked up with somebody else.”

Telepathy? Her cheeks felt warm. He was waiting for her reply. “No. When I wanted to visit before, they said you were having shock treatment.”

“The Shocker – a kind of punishment. Yes, that finished before Christmas. I couldn't remember much after – your name, or Becky's. My memory's gradually come back, though there might be things I'll never remember.” He looked sad, lost.

She put her hand in his and was rewarded with a gentle squeeze. “Gosh, you've been going through it, John.”

“I've had one or two adventures, but I won't bore you with these.” The frown had gone. “It's been okay since I was moved to the Annex. That's a long-stay ward, and I must be twenty years younger than any of the others. A lot look senile or doped, but I hear some interesting tales.”

“Do you think there's a prospect of discharge yet?”

The frown was back. “Nobody's mentioned that. And –” John paused, the furrow on his brow deepening, “they say patients are in the Annex for life.”

What she'd feared. “Oh, John.” He looked so miserable.

“Apparently only a consultant psychiatrist can discharge a patient – and I've not seen one on this ward yet. They say he's very busy. When I do see him, I'll ask.” He bent forward and his face brightened. “Enough of me. How have you been, and Becky?”

She told him about Becky's progress and her work at the nursery. He kept nodding, with a dreamy faraway look she scarcely recognised. Mildly worrying, somehow. She began to speak more rapidly. There was so much to tell.

Mid-sentence, a bell rang. She paused. “Fire alarm?”

“I'll find out.” John rose and went to ask a white-coat.

“To let us know to wind up. We've about five minutes.” He sat down again.

This awful place! “I've so much to tell you.”

He stretched forward, and took her hand again. “Heather, I must have been more unhinged than I realised and had terrible unwanted thoughts. I'm through that, and I pine for you and Becky.” He stood up. “Please come again.”

Her face awash, she hugged him. “John, I will.”

But on the journey home, she still agonised. Had John properly recovered from his breakdown? His eyes lacked that vital spark, so characteristic when he was fit. Maybe they'd never release him anyway. If so, she'd always visit when she could. He was her true love. Yet the lure of Sam's insistence remained strong, nagging away at a primal level. And he too had shown he loved her. Could she go along with Sam's proposal – for now?

It came as a shock. Heather was confiding in Moira about her liking for Sam, and what he'd suggested.

“Mr Newman's married, with a daughter,” Moira stated. “At least he was when I was still working. Sad – his wife had a long-term illness. Unless she's died. I'll find out for you.”

Next day, Moira was back on the doorstep. “Me again, Heather. More news.”

“Come in, Moira.”

“I'll just step inside. Can't stop.” Moira pushed the door to. “I've checked on Sam. He lives in a council house with his wife and teenage daughter.”

What! “You're sure?” This decent caring man had misled her?

“Absolutely. He's been something of a lad, you know – had other women.”

Heather had just put Becky to rest. The knocking on the door was faint, gentle. She opened the door and peered round it. Yes, it was Sam Newman.

“How did your visit go, Heather?”

“Okay thanks, Sam. Look, I won't invite you in.” She gulped. She'd rehearsed for this moment. “About your proposition, the answer's a definite ‘no'.”

“Why, Heather?” He looked puzzled, deflated.

“I love John. And I know you're a married man with a family.”

“But –” He gesticulated with his hand.

“Thanks for all your help, Sam. But there'll be no romance. And it's better you don't come round here again.”

“But –” Was he going to cry? And was she?

“I must go. 'Bye, Sam.” He was still standing there. She closed the door, then ran to the living room and, weeping silently, threw herself into the armchair.

*

Sam Newman limped into his car and sat in the dim lamplight, fumbling for his fags and lighter. Hell of a shock. And she'd shut the door in his face! He looked back at the door. He felt like going and banging on it, breaking it down. After all he'd done for the bitch. And she'd led him on! How did she know he was married?

Blowing smoke rings, he calmed. Maybe in a month or two he'd go round, try persuading her to change her mind about an affair. The husband wouldn't ever get home anyway. He started up and moved off slowly, back to Ella and Helen.

It was Jamie Macdonald's second morning in the job. And this was a vital meeting, with key folk that he needed to go along with him.

“There'll be a bloody revolution,” said Davies.

“Yes – bloody, literally,” added Cope.

Macdonald decided not to break the silence. This response to the vision he'd outlined – of a caring institution, without locked doors or padded cells or barriers to community involvement – was expected. He'd figured neither the HMC Chairman nor the Secretary would embrace radical change.

Chief Macnamara came in. “Sure, there needs to be a revolution in patient care. Some of our practices are from a bygone era, before we had the chemical cosh and effective anti-psychotic drugs.”

“Blind us with jargon if you like. It's not safe,” said Davies.

Matron Caroline spoke. “I understand your fears. We'll have to go carefully, and staff will need a lot of reassurance. But let's remember that we're a hospital, to treat and care for our mentally afflicted fellows. Any one of us” – she looked round the room – “could have a breakdown. Would we want to be cooped up, imprisoned, and thrown into isolation if we behaved oddly?”

The debate ran on. With solid backing from his two Heads of Nursing and Kenney, he secured the reluctant cooperation of the two doubters.

Wards would be unlocked from Monday 4
^th
March. Seclusion in padded cells was to be used only for patients likely to harm themselves. And he'd bring proposals to Committee for refurbishment to transform them into small single rooms. Here again, the support of his three allies would be vital in swaying the lay members – and the Chairman and Secretary agreed not to vote against the changes in Committee.

Another critical meeting – for all staff this time – in the Main Hall. Macdonald outlined his proposals to abolish pillars of the old regime – the locked wards, the padded cells and the airing courts. Then, from the platform, he and his three lieutenants – Kenney, Matron Caroline and Chief Macnamara – listened to comment and joined in the (often heated) debate. It was memorable, atmospheric and, for much of the time, uncomfortable.

Unlocking of wards went down like a blunt knife on granite. Reactions ranged from disbelief and ridicule (with one male nurse saying, too audibly, “Guy's a nutter” – and getting a ripple of laughter), to more rational objections: “Impractical for us to keep control” and “unsafe – for the patients, us, and the outside world.”

Abandoning padded cells was marginally less controversial. “Mayhem,” “needed for violent lunatics to let out their madness,” and “vital to cool the bad boys and teach them a lesson,” were among the comments.

The phasing out of airing courts wasn't too popular either. “How will they get their exercise?” and “it'll be murder for the lot of us – having them cooped up all day,” were two of the comments.

The loudest protest came from the COHSE branch chairman. “I am astounded by this madness. This is the lunatics running the asylum.” The man, a pompous nursing assistant with powers of oratory, added, “Chaos and murder will ensue. Our Union will support any members in industrial action.” The applause was roof-challenging.

Matron Caroline spoke quietly, passionately. “Working with mentally afflicted folk in here is one of the toughest and most worthwhile jobs anywhere. Remember, for long enough we've had the chemical cosh to subdue the violence – as a last resort, when somebody's out of control. Physical restraints of the past have no place in modern psychiatry.” She got mild applause. Was this a measure of support for the changes, or a spontaneous response to Caroline's charming eloquence?

Joe Macnamara said, “And the phenothiazines herald a pharmacological revolution that gives real hope in treating psychoses.”

Macdonald went on to outline his vision. Springwell would evolve into a truly caring community. Occupational therapists and art therapists would be appointed, to provide helpful activity for patients. Barriers to the world outside would be lowered and community involvement encouraged. And psychiatric social workers would be appointed to work with patients and families, and help rehabilitate patients identified for discharge. The change process would extend over months, years.

At the end of the meeting, he'd been encouraged to hear some applause. Polite and mild, but better than the boos and catcalls he'd feared.

Macdonald had remained firm through lobbying and protests. All wards must be unlocked as from today.

Morning, he toured the male wards with Macnamara, speaking with the charge nurses, listening, supporting, debating – and on Refractory, having to insist the ward door be unlocked. Matron and Kenney toured the female wards – and their cautiously optimistic report indicated less resistance there.

Afternoon, they all toured again. A fight on Male Refractory had been diffused via the chemical cosh. A couple of wandering patients from Male Annex were found in the corridors and escorted back. Maybe there was a case for locking the Annex wards to keep senile patients secure?

It was now evening on this momentous day.

The internal phone startled him. “Jamie Macdonald.”

“Caroline.” Matron. “Trouble, Jamie. Sister on our Annex has reported a patient with senile dementia, Nellie Morgan, missing from the ward. She was last seen about two hours ago. My Assistants and I have searched the building and walked round the outside, with no joy. Sister blames the unlocking of doors, and says this would never happen in the old days.”

Blast. Resistance from nurses, backed by COHSE, could derail his plans. “We'd better inform the police.”

“I can contact them if you like?”

“Aye. Thanks.” Made sense, as Caroline would have the patient's details.

“I'll keep you posted and send you a report about the incident. And I propose no disciplinary action against Sister or her staff – unless any are found to be deliberately negligent. They've been short-staffed today.”

This Matron was outstanding – not only ready to take things on, but a brilliant ally in reforming. She had, with Kenney's backing, begun the change process before he arrived. And the tour round with her on his first day was a heartening experience.

The internal phone again. He snatched the receiver. “Jamie Macdonald.”

“Caroline, Jamie. Police with dogs are on their way. They're coming to my office for details. I'll bring them straight over.”

He sat waiting.

He'd known it wouldn't be easy. Mac Bell had made bold moves in the right therapeutic direction by unlocking Dingleton for the world's first open-door mental hospital, and trying to involve the community in its life. But the changes had inevitably brought difficulties, which Mac was honest about in last year's paper for the
International Journal of Social Psychiatry
.

Matron appeared, with two great-coated policemen and their dogs. “Matron's briefed us, Sir,” the sergeant declared. “We've each got a lamp and a torch.” They set off.

“I'll stay in my office for news, Jamie.”

An unusually strained expression on her finely-cut features reflected the seriousness of this situation. “Thanks, Caroline.”

Again, he sat waiting.

Thank God Caroline was Matron. With her talents and passion, she'd have been effective in the skin of a monster. She was also so damned attractive. If he'd been single… Wed to her profession.

“An unclaimed treasure,” Uncle Frank would have said. A phrase the young Jamie had unthinkingly taken as a tribute to an unmarried woman's beauty.

He remembered the moment of enlightenment. Sitting in a quiet corner of Mackie's in Princes Street with fellow student Gill, meaning to sympathise with her over the death of her unmarried great aunt, the phrase slipped out.

Gill had stood up. “What patronising bilge,” she hissed, her cheeks colouring. “You profess to support women's rights and equality. Back to claiming goods and chattels, are we?” She stomped off to the ladies' lav.

Stunned, he'd sat in silence, eyeing the table, feeling the stare of Edinburgh's tongue-waggers, realising everything he'd heard was true, hoping this woman he fancied would come back to join him.

She did. And, leaving the café together without ordering, they apologised to each other (he for a naivety that didn't reflect how he saw women, she for a rash public outburst that didn't reflect how she saw him) as they walked hand-in-hand along Princes Street.

That had been make-or-break with Gill, and the frankness drew them closer.

Maybe he'd write up his experiences at Springwell after a few years. The psychiatric community was too damned conservative. And the legal framework needed a drastic overhaul. As in Scotland, where the main substantive law was Victorian, in England the 1890 Lunacy Act still applied. Ludicrous!

Aye, the 1930 Mental Treatment Act had re-named asylums, advocated setting up outpatient clinics, and introduced a ‘voluntary patient' category. Folk could go into a mental hospital without having to be certified. Big deal. Most institutions had kept harsh stigmatising regimes, and voluntary patients bold enough to try leaving without psychiatrist blessing often found themselves certified and detained.

In Melrose, he'd looked impatiently to a committee being set up to recommend a new legal framework for Scotland. And here in England it was a Royal Commission, set up in 1954. Subsequent law should sweep away anachronisms and improve the lot of the mentally distressed. But he wasn't waiting for that.

Someone was knocking on his door. The police or Caroline? He leapt to his feet. “Come in.” It was the sergeant, with dog on leash.

“Sir, we've found the body of an elderly female floating in your pond.”

Alas. He dialled Caroline. “Bad news. Come to my office.”

*

At midnight, Jamie dragged his weary frame out of the office. For the first time in many years, he'd felt like drowning himself in whisky. It was a blessing that his desk drawer did not (unlike that in Manchester) conceal a half-bottle. Now, in his emotionally flat state, the yearnings for that instant solace tugged compellingly at him.

Nearly home. He hoped Gill was awake so that he could unwind with her. Up north she too had enthused about unlocking wards, and she'd been active in encouraging the local community's involvement in the hospital. At some point, she would set about doing for Springwell what she'd done for Dingleton. Her GP work was only two days a week.

The lights were on downstairs. She'd be up. Nonetheless, he tiptoed in.

“What the hell have you been up to, Jamie?” Gill was dressing-gowned and unsmiling.

He'd forgotten to ring, keep her posted. “I was winding up, when Matron rang me.”

“So? Confession time, laddie. You didn't think to ring me, did you?”

“No. Sorry.” He needed a tirade like a bullet through his head. But he must tread carefully, as Gill's sadness at the latest miscarriage had verged on depression. And she too had probably noted Caroline's good looks and charm. “I didn't think.”

“You didn't think!”

No welcoming cocoa – just a grilling. He didn't feel like apologising. “Okay, thoughtless! But you could have rung me.”

“I did – after being sick with worry – and they told me you were in conference with Matron. I told the man who I was. But he said it was a confidential matter, an emergency. You'd left orders not to be disturbed by anyone. I slammed the phone down. Confession time!”

He'd told switchboard: ‘No more calls, except the police'. Couldn't risk the media or anyone else nosing. Gill thought he was having an affair with Caroline!

“Well?” She was scowling at him.

“Matron reported a female patient missing. The police came, and found her dead – drowned in the pond.”

Gill was looking intent, and her expression changed.

“I've had to deal with this. And I'm to blame for insisting all doors be unlocked, without giving thought to the frail, elderly wanderers in the Annex.”

“Goodness, Jamie!” She hugged him. “The kettle's boiled. I'll get the cocoa.”

Minutes later, sipping from a steaming mug and holding Gill close on the settee, he continued his sad tale. “It's grim. Poor Nellie Morgan – she was so emaciated. The fence was down at one end; we assume that's how she got into the pond. There'll be a post-mortem and an inquest.”

“Had she family?”

“None recorded, Matron says. Apparently Nellie'd been here over forty years. She came in depressed after a stillbirth.”

“Tragic.”

“Aye. And I feel damn guilty. Ready for bed?”

She acquiesced and they went upstairs. In bed, they prayed – he saying the words. “Almighty God, I'm sorry for the death of Nellie Morgan. May she rest in peace. And be with all affected by her death – ward staff, fellow patients, Matron. And give each of us strength to face this coming day…” He pondered adding a prayer for the success of his policies, but that didn't seem right.

They kissed and said goodnight. He felt calmer, but his mind stayed alert. Matron had said the ward sister was distraught – blaming herself for the death of “A sweet lady, a trusty for years.”

He'd agreed to go onto the ward with Caroline tomorrow. They'd seek out anyone affected and try to help with their distress. He'd insist the blame lay with him. And he'd agree to both Annex wards being locked pro tem.

The pond was a place of beauty, and now of death. He'd talk with Cope and the Chief Engineer, and have it drained.

Ammo for the old guard. Could derail his plans. If there was a big enough outcry… But he'd push ahead, monitoring the ‘open door' progress and difficulties. The first psychiatric social worker and occupational therapist appointments would be made next week. And he had plans to start involving the community.

The press! He'd no experience dealing with them. The police sergeant had warned him. “Bloodhounds'll love this and yap at your heels.” Terrible publicity.

“No such thing as bad publicity,” Mac Bell would say.

Well, the media would give him hell. But he could get from this an airing on the dire state of provision and the need for reform.

He'd take the initiative, ring the local paper and offer a world exclusive.

He began formulating how to approach this, what messages to give. Next thing, he was being shaken.

Gill was stretching across their bed. “Jamie, it's 5.30. The alarm's gone off.”