The Boy Who Could See Demons (3 page)

There are many who feel intimidated by Ursula. At forty-three, I like to think I am past such things as an inferiority complex, and in any case the staggering reality of Poppy’s fourth anniversary already had me on the verge of tears. I took a deep breath and informed Ursula in my most professional voice that I would gladly meet with the rest of the Child and Mental Health Services team first thing tomorrow morning.

And then something happened that I still can’t explain, something that has happened only a few times before and which is so unlike any other feeling that I’ve named it, quite simply, The Feeling. It defies words, but if I’m to attempt to verbalise it, it goes like this: deep in my solar plexus, there’s at first a warmth, and then a fire, though not a sensation of heat or pain, that creeps up my neck and jaw, right into my scalp until my hair stands on end, and at the same time I feel it in my knees, my ankles, even my sacrum, until I am so conscious of every part of my body that I feel like I’m about to lift off. It’s like my soul is trying to tell me something, an urgent, tingling message that so fills my capillaries and cells that it threatens to burst if I don’t listen.

‘Are you all right?’ Ursula asked, and I told her to give me a moment. I set the receiver on my dresser and wiped my face. In ten years of training I have never come across a single piece of literature to inform me why this thing happens to me sometimes, nor why it tends to happen on the most significant of occasions. I only know that I have to listen. Last time I didn’t, my daughter decided to end her life and I was not able to stop her.

‘OK,’ I told her. ‘I’ll be there this morning.’

‘Appreciate it, Anya. I know you’ll be wonderful on this case.’

She told me she would contact the boy’s social worker, Michael Jones, and have him meet me at the reception of MacNeice House in two hours. I ended the call and glanced in the mirror. One of the effects of Poppy’s death is that I now wake frequently during the night, resulting in sallow patches beneath my eyes for which no make-up seems to compensate. I looked over the jagged white scar on my face, the flat of my cheek there sucked inward by the ribbed pattern of dead tissue. Usually I spend a considerable amount of time each morning arranging my long black hair in a way that shields this ugliness. I made do with sweeping my hair into a chignon spiked by a biro and threw on the only item of clothing that I’d unpacked – a black trouser suit with a crumpled white shirt. Finally, of course, I draped my silver talisman around my neck. Then I left a note for the friends who would come and find, to their astonishment and fear, that I had actually crossed the threshold of my home on the anniversary of Poppy’s death.

I took the coastal road instead of the motorway in a bid to distract myself from thoughts of Poppy. Maybe it’s a consequence of approaching middle age, but my memories of her these days are not visual, rendered instead by sounds. Her laughter, light and infectious. The melodies she used to make up on my old Steinway in our Morningside flat in Edinburgh, using one finger. The phrases she’d use to describe her condition.
It’s like … it’s like a hole, Mum. No, like I am one. A hole. Like I’m swallowing darkness
.

MacNeice House is an old Victorian mansion located in an acre of wilderness, high in the hills that look down on Belfast’s bridges named after British monarchs. Recently refurbished, the unit offers inpatient and day-patient treatment for children and young people between the ages of four and fifteen suffering from any mental illness noted in textbooks – anxiety disorders, autism spectrum disorders, behavioural disorders, depressive disorders, obsessive compulsive disorder, psychotic disorders, and then some. There are ten bedrooms, a common room with computers, an art room, an interview or therapy room, a toy room, a dining room, a swimming pool, a small apartment for parents who need to stay over occasionally, and a restraining room – strictly referred to in-house as ‘the quiet room’. Inpatients require education, and so an onsite school is available and provided by specialist teaching staff. After completing my training at Edinburgh University I worked at a similar unit there for two years, but the reputation of MacNeice House attracted me back home to Northern Ireland – a move I am still tentative about.

I spotted a new vehicle parked beside Ursula’s gleaming black Lexus in the car park – a battered bottle-green Volvo with a 1990 registration plate – and I wondered if Alex’s social worker, Michael Jones, had already arrived. I raced across the gravel car park using my briefcase as protection against the pouring rain, when a tall man in a navy suit stepped out from behind the stone pillars, opening a golf umbrella in my direction.

‘Welcome,’ he called. I stepped underneath the umbrella and he shielded me until we were well inside, where Ursula was waiting at reception. She is tall with an imperial air, her red suit, thick black Diana-Ross mane streaked with grey and handsome Greek bone structure more suggestive of a high-profile businesswoman than a clinical psychologist. She was also one of the panel members at my interview for this post, and it was because of her that I was sure I hadn’t got the job.

You originally trained to become a GP. Why the shift into child psychiatry
?

At the interview I had slipped my right hand beneath my thigh, looking over the faces of the panel – three male psychiatrists and Ursula, internationally renowned as much for her developments in child psychology as for her boorishness.

My original interest lay in psychiatry
, I had replied.
My mother had a long battle with mental illness, and I had a desire to find answers to the riddles posed by such illnesses
. If anyone knew the devastation caused by mental illness – its social taboos, disgraces; its ancient, fearful association with shame at just how far the human mind can plummet into itself – it was me.

Ursula had watched me carefully from behind the panel desk.
I thought the cardinal sin of any psychiatrist was to suppose that all the answers can be found
, she had offered lightly – a joke with a jag. The panel Chair – John Kind, Head of the Psychiatry Department at Queen’s University – had glanced uncomfortably from Ursula to me and attempted to forge a question out of Ursula’s thinly veiled joke.

Do you believe you’ve found all the answers, Anya? Or is that your intent by taking up this post
?

My heart said
yes
. But, at the time, I smiled and gave the answer they were looking for.

My intent is to make a difference
.

At reception, Ursula gave me an overly wide smile, then extended a hand and shook mine firmly for the first time since my interview. It is not entirely uncommon for psychiatrists to clash with psychologists, given the disparity in our approaches, though I assumed from her phonecall that whatever issue she had with me at the interview had been resolved. She turned from me to Michael, who was shaking out the umbrella and slotting it into the coatstand.

‘Anya, this is Michael, Alex’s social worker. He works for the local authority.’

Michael turned and flashed a crooked smile. ‘Yes,’ he said. ‘Someone has to.’

Ursula regarded him through heavy eyelids before facing me. ‘Michael will talk you through the details. I’ll meet with you later to discuss management of the case.’ She nodded curtly at Michael before walking back down the corridor.

Michael held his hand out for a shake. ‘Thanks for coming in on your day off,’ he said. I wanted to tell him it was more than a day off – it was the anniversary of my daughter’s death – but found a lump forming of its own accord in my throat. I busied myself with signing my name into the register.

‘You know, we’ve already met,’ he told me as he took the pen from my hand.

‘We have?’

He signed his name with an illegible flourish. ‘At the Child Psychiatry conference in Dublin in 2001.’

The conference was six years ago. I had no memory of him at all. I saw he was rangy and wide-shouldered, with steely green eyes that held a stare several seconds longer than was comfortable. I guessed him to be in his late thirties, and there was a weariness about him that I’d encountered many times with social workers, a cynicism detectable in his body language, the slightness of his smile. His voice bore the rough edge of too many cigarettes and from the cut of his suit and the shine of his shoes I suspected that he had no children. His blond hair was worn messy and long over his collar, but a scent of hair gel told me this was deliberate.

‘What was a social worker doing at a child psychiatry conference?’ I turned towards the corridor behind us that led to my office.

‘Psychiatry was my original discipline, after a spell studying for the priesthood.’

‘The priesthood?’

‘Family tradition. I liked your paper, by the way. “Addressing the need for psychosis intervention in Northern Ireland,” wasn’t that it? It struck me that you’re passionate about changing things around here.’

‘Change is probably a bit ambitious,’ I said. ‘But I’d like to look at the way we handle younger cases of psychosis.’

‘How so?’

I cleared my throat, feeling an old defensiveness rise up. ‘I think we’re missing too many signs of psychosis and even early onset schizophrenia, allowing these kids to flail and even harm themselves when treatment could very easily help them live normal lives.’ My voice had started to wobble. I heard Poppy’s efforts on our piano in my head, her voice softly humming the melody she was trying to match on the keys. When I looked back at him I noticed he was staring at the scar on my face.
I should have worn my hair long
, I thought.

We reached the door to my office. I tried to remember my entry code, given to me the week before by Ursula’s secretary, Josh. After a few seconds I punched the gold number on the lock. I turned to see Michael looking up and down the corridor, his expression wary.

‘You never been to MacNeice House before?’ I asked lightly.

‘Yes. Too many times, I’m afraid.’

‘You don’t like it?’

‘I don’t agree with psychiatric institutions. Not for kids.’

I opened the door. ‘This isn’t a psychiatric institution, it’s an inpatient unit …’

He grinned. ‘Tomayto, tomato, eh?’

Inside, Michael remained standing until I pointed out two softbacked armchairs at a white coffee table and offered him a drink, which he declined. I poured myself a herbal tea and sat down in the smaller armchair. Michael leaned back in his chair, his gaze turned to a poster on the wall by my bookcase.

‘Suspicion often creates what it suspects,’
he said, reading the poster. There was a question in his tone.

‘C S Lewis,’ I said. ‘From
The Screwtape Letters
. Have you read …?’

‘Yes, I know,’ he said, his face twisting at the sight of my herbal tea. ‘I’m wondering why you framed a quote like that?’

‘I guess it was one of those things that made sense at the time.’

‘I have the T-shirt for that one.’

There was a pause as he pulled out a file from his briefcase. The name at the top read ALEX BROCCOLI.

‘Alex is ten years old,’ Michael told me, his voice softening. ‘He lives in one of the poorest parts of Belfast with his mother Cindy, who is a single parent in her mid-twenties. Cindy has had a hard life herself, though that’s probably a conversation for another time. You’ll know she recently attempted suicide.’

I nodded. ‘Where’s Alex’s father?’

‘We don’t know. There’s no name on Alex’s birth certificate. Cindy’s never been married and refuses to talk about him. He didn’t seem to play much of a role in Alex’s life. What we do know is that Alex is deeply worried about his mother’s health. He acts fatherly towards her, exhibiting all the hallmarks of a child deep in the clutch of the trauma of parental suicide attempt.’

He spun a document around on the table to face me – a compilation of notes from Alex’s consultations with several different paediatric psychiatrists.

‘Interviews with his mother and schoolteachers have flagged multiple psychotic episodes, including violence towards a schoolteacher.’

I looked up. ‘Violence?’

Michael sighed, reluctant to divulge. ‘He lashed out during an outburst in the classroom. He claimed he was provoked by another child and the teacher didn’t wish to make a big deal out of it, but we still record these events.’

A quick scan across the notes told me that Alex had all the classic first-rank symptoms of mild high-functioning ASD – Autism Spectrum Disorder – such as being quite concrete in his thinking, prone to misunderstandings, violent outbursts, language that is slightly more sophisticated for his age, no friends, and eccentricity. I noticed a detail about his claiming to see demons. Then I saw that no medication or treatment had ever been prescribed, and for a moment I was lost for words. I had been warned repeatedly by colleagues in Scotland that
things are different in Northern Ireland
, ‘things’ being the practice of psychiatric intervention. Those words rang in my ears as I scanned the file.

After a few moments I became aware that Michael was watching me. ‘So what brought you back to Northern Ireland?’ he asked when I caught his gaze.

I sat back in my seat and clasped my hands. ‘Short answer, the job.’

‘And the long answer?’

I hesitated. ‘An off-hand remark from a PhD candidate doing a placement at the unit I worked at in Edinburgh. She mentioned that even those kids in Northern Ireland who have never experienced the Troubles, who have never been fished from a swimming pool and wrapped in tin foil during a terrorist threat, who have never measured distance by the sound of a bomb and who have never even seen a gun are experiencing psychological effects because of what the older generation has suffered.’

He cocked his head. ‘“Secondary impact”, isn’t that what it’s called?’

I nodded. For a moment my memory heaved up the muffled thud of a bomb. From my bedroom window in Bangor – a coastal suburb on the fringe of Belfast – I could hear the explosions; sickening, hollow. A memory I have never shaken.