The Skeleton Cupboard (9 page)

As I got nearer, I could hear the noise of car and truck horns. People had spotted this little girl and stopped to jump out and call up to her. I saw two men leap out of a van and begin running up the embankment, someone else on the hard shoulder was talking frantically into a mobile phone.

As I approached her, I instinctively slowed down: Run at a person ready to leap, then leap they will. My feet were sore, my muscles ached, and my lungs felt near to explosion, so I stopped and stood still.

Imogen, on the barrier, turned to look at me; all noise was gone. She was calm; she smiled at me. I was soaking wet from rain and sweat, and panting harder than I ever had. I wanted to bend forward, put my hands on my knees and recover after my marathon, but I couldn't look away.

Imogen broke our gaze. She and her dead sister's stinky rag doll looked over the edge of the barrier and into the road below, gridlocked with vehicles. In the distance, a siren was wailing. I started to walk slowly toward her.

“Imogen, shall I pull you out of the bottom of the deep blue sea, sea, sea?”

I felt calm; I was back in my grandmother's front room staring at her bloodstained carpet.

She looked at me again, her mouth moving and her wrists circling. She was deciding what was about to happen. I willed her into my arms.

And she came.

I held Imogen, locking my arms around her and pulling her into my body as we both flopped onto the oily, wet tarmac. I felt light, as if I were floating. And then there was a thud on top of me as we both ended up under male bodies, sweating and panting from their sprint up the highway embankment, wrapping their arms around us.

*   *   *

Life continued. Young people came and went on the unit. Imogen and I carried on with therapy—I was the only person she would talk to. And talk she did.

Over time she joined the unit school and after using the “sliding-in technique”—where a teacher would sit in a room while Imogen talked to me, getting closer and closer over days and weeks until our little charge felt comfortable enough to let him join our conversation—I was able to leave her with others, chatting confidently and engaging in lessons; she was a bright little button.

The skipping and counting stopped almost completely, reappearing only occasionally to remind us that we had missed something she was still struggling with. Self-harm became a thing of the past. Imogen put on weight. Eventually she was able to wear her sneakers done up with their laces, and a dressing gown secured by its cord. It was time to plan her discharge from the unit.

Coming into an inpatient psychiatric unit is hideous for anyone, but leaving it can be even worse. As a team, we would spend months talking to the kids about leaving, giving them weekend leave, introducing their outpatient team to them and beginning to integrate them back into mainstream school. We told them that this process needed to be lengthy because there was so much to organize, and we needed to give them the chance to disengage slowly, to say good-bye to us. The truth also was that we took so long because we were reluctant to let them go.

We expected all young people to act out a bit before they left us—they were anxious and wanted to find a way to stay because the outside world felt too scary. Institutionalized children are difficult to support because their anxiety triggers a sense of protectiveness in us and we had to work hard not to collude with their need to remain with us. We wanted to keep them with us—to keep them safe.

If you know you've turned a kid's life around and she wants to live, how hard would you find it to send her back to the shitty world that made her want to die in the first place?

Imogen was dealing well with the discharge planning; in fact, she was managing it
too
well, and it spooked me. My colleagues, however, were careful to help me challenge my own reluctance to let her go, and so the frequency of my individual sessions with Imogen decreased. Soon I was just another member of the staff team preparing her to leave us.

But this pissed me off big-time.

At this point I got the news that Chris would be off work for an “indeterminate” time; the rumor was she was in rehab. It was bad timing: I needed guidance. I resented the fact that I didn't have a way of getting in touch with her.

When I told my colleagues that I instinctively felt there was something that Imogen hadn't told us, they were kindly patronizing in expressing the need for me to “distance” myself from her; I was being told that these were my issues, not hers.

Since the mirror incident, everything had felt too smooth. Meetings with Imogen and her family were calm: Imogen talked more, her mother listened, and her beautiful stepfather stopped sobbing. Everything, like the mirror, was getting fixed.

So why did I feel uneasy?

I decided to consult my girls, my three closest friends, in the pub. I could always rely on them for support. Since I started my training I needed them more than ever.

Ali, whom I'd known since university, was an HR manager and asked, “Why, when you have a good outcome, with all family communication intact, would you doubt what you see before you? Discharge the girl—let her get on with her life.”

The brilliant Megan, a research scientist, said, “This little girl has been in your unit, supported mostly by you, for months. Her symptomatic behavior has decreased to virtually nothing, she now understands the links between her thoughts, feelings and behaviors, and is choosing to engage with life. What's not to celebrate? Move on to the next patient—you've done your job here.”

My oldest friend from primary school, the lovely, kind Rosie, who was doing her second degree while waiting tables, said, “If this doesn't feel right, then get some bloody advice.”

But where the hell was I supposed to go? I felt abandoned, and angry with Chris for suddenly disappearing. I had not seen anything coming—she was odd, but nothing had led me to believe that she needed rehab. God, just how shit was I at this job? I couldn't even spot my supervisor having a breakdown.

The university administrators were being very tight-lipped about where Chris was and, because it was coming to the end of this placement, they felt there wasn't time to get another supervisor set up for me. It was suggested that I look within the unit team for some one-to-one supervision.

And so I did.

*   *   *

The room still smelled dusty, the majority of book spines were still unbroken, but actually it felt good to stretch out on the couch underneath Frida Kahlo.

“She's not ready to go.”

Silence.

“It's too easy.”

More silence.

I picked at my nail varnish and then bit my cuticles. “Oh, come on. Please talk here. We both know that this sudden recovery is weirder than an angry kid leaving us and getting on with their life to prove our rejection wrong.” I tugged at my sleeves—I'd bitten my nails to the quick. “I need to find out why she has bounced back. She was so … broken. There has to be a bigger narrative.”

I realized suddenly that the analyst's silence had helped me understand that we didn't know Imogen's backstory. She had been silent about everything before her sister's death. We'd examined and controlled her behavior, but we still didn't really know what caused that behavior in the first place. We didn't know the end of that story I'd tried to tell her on day one.

And then he spoke.

“I think her story is bigger than the grief of losing her sister.”

No shit, Sigmund. That's what I was saying.

“What else have you experienced with this child?” he asked.

I knew what I had to say, but I couldn't—it felt too clichéd to say while lying on a couch with an analyst.

“There was a ‘moment' with her stepfather in the meeting before she ran.”

I felt beyond foolish. He said nothing.

“OK,” I backpedaled. “That was too much information. Irrelevant. Just tell me, what do I do?”

And then the pale, self-contained, silent, God-like analyst shocked me.

“Just bloody find out what this is all about, before it's too late.”

*   *   *

Imogen was leaving in a week's time and I was under pressure. I hated psychoanalysts, but suddenly this one was my best friend at work. My head was a mess. I met with him again, but he'd reverted to mostly silence; I felt stupid for having brought up the moment of frisson with Imogen's stepfather.

Imogen's mother, Mary, and her stepfather, Jake, were happy. Mary was pregnant again and life held hope for Imogen after the freak accident that took her half sister: Here's a replacement puppy! Everyone be happy!

And why wouldn't they be? I was being selfish: I couldn't let go of a happy, healthy girl ready to move on.

I decided to stop the self-pity and we all prepared for the unit's summer fete on the hospital grounds, which was when I found her staring into the pond.

“Hey,” I said.

She didn't reply.

“Imogen, come get some cotton candy.”

She crouched down.

Imogen and water. Oh God, should I be scared? No, get a grip—evidence-base this girl's progress. She knows how to handle herself. Be calm.

“Hey, Imogen. What's up? Come on, cotton candy is beckoning! Race you to the stall.”

She pulled the rag doll from under her arm, then threw it into the pond. I reached in, lifted the smelly rag doll from the water and handed her back.

“C'mon, sweetheart. Are you angry about leaving the unit? Tell me about it. Don't take it out on Rag Doll!”

She threw the rag doll back into the pond at my feet. And then she said, quietly and clearly, “I am sorry, but I am not going to save you.”

She was staring intently at her dead sister's doll lying facedown in the pond water. My heart thumped; her face was becoming a mask again, her wrists beginning to rhythmically circle and her mouth twitch with silent counting.
Here comes the grief,
I thought to myself.

I knelt next to my little charge and began to try to soothe her back to me.

“Imogen, I can see that you are having big feelings at the moment. I think that these are about Maisie drowning and this makes you feel very sad and very anxious.”

Without taking her eyes off the drowning rag doll, Imogen shook her head.

“Imogen, why don't we pull the rag doll out of the pond and go inside somewhere quiet where we can have a talk?”

Imogen shook her head again.

“Sweetheart, listen to me. I think it would be so sad for you if we leave Maisie's doll to sink to the bottom of this pond. This is Maisie's doll, isn't it? And now that Maisie isn't here to love her doll, you are doing that really important job for her.”

Finally Imogen turned to me. “I don't want to save her.”

I began to feel very cold. “Why not, darling?” I stooped down to pick up the doll. “Look, we can save her together.”

“No!” Imogen grabbed my arm. She was shaking and beginning to pant. “No. No. No. No. No. No. No. No. No. No.”

She threw herself down on top of me. As I held her, I could feel her heart racing, her entire body shaking. She was sweating.

“OK, sweetheart. Shh, darling. It's OK. I'm sorry, darling. I'm sorry. We will leave Rag Doll there.”

I started to rock her as she sat into my body, her back against my chest, her legs inside mine. We sat like this for a while, both staring ahead at the rag doll swelling with pond water and getting heavier, beginning to sink. Time went by slowly and I began to relax, listening to the sounds of happy children at the party behind us.

But then I felt Imogen twitch and pull away from me.

“What is it, Imogen?”

“It's not fast enough.”

“It's OK, darling—she's beginning to sink.”

“It's not fast enough.”

Imogen jumped out of my arms and waded into the pond. I scrambled forward on hands and knees, trying to catch her and pull her back. I was panicking; was she going to try to drown herself? I crawled into the pond, but then I stopped.

She pushed the doll below the waterline, ever so gently. She was whispering. I struggled to hear what she was saying.

“It's OK now, Maisie. It will all be OK. I love you, Maisie, and you are now safe. Nothing more bad will happen. I promise, Maisie. Immy promises.”

Imogen was drowning her sister.

I felt sick. What was I seeing here? Was this a fantasy reenactment? Was this a reality reenactment? Or simply a way for Imogen to find some closure—to deliver the rag doll back to its rightful owner?

That was it, I told myself. Imogen was drowning the doll slowly and gently, so I had time to think this through.

Rag Doll for Imogen was Maisie, or at the very least a transitional object that connected her to her dead sister. When she came into the unit, she was mute and regressed—a distressed neonate without words, communicating extreme despair and acute distress in her behavior. She suckled the doll at night and held her next to her body by day to comfort her, to keep her sister near.

Over time we helped Imogen heal, right? She had expressed her grief, and her family had come to a new place of understanding and acceptance. They all had a bright future, with a new little baby to come. Life would now move on.

That was it. That made sense. Now I felt back in control. All we needed to do was let Rag Doll sink to the bottom and then Imogen could be at peace.

The rag doll was by now fully submerged and Imogen placed her foot on it. It was time to move on.

“Sweetheart? Is it done? Is Rag Doll with Maisie now?”

Imogen turned to look at me and spoke in a calm, clear voice. “Yes. And now he can't touch her anymore.”

Suddenly she vomited into the pond. She wiped her mouth, and then she began to talk. The rest of the story followed, not clearly, not in the right order, but I understood every word of it.

Imogen had helped Maisie drown when she turned five, the age she herself had been when Jake, her stepfather, had started sexually abusing her.