Another Night, Another Day

  Karen nods. I’ve seen therapy sessions in films and on telly, she thinks. And Lou works with troubled schoolchildren, so I know something of the process from her. I suppose I could have talked to Lou about how I was feeling. But Lou’s job is tough enough and her baby’s due any moment. I didn’t want to stress her further.

  ‘So, Karen.’ Johnnie interrupts her thoughts. ‘Perhaps, to help me get a fuller picture, you could tell me a little about your background, and if there were any particular events or experiences that led you to spend some time here.’

  Johnnie’s fringe falls as he looks down at a file on his lap. That must contain my notes – they probably say I’m a total nutcase, worries Karen. And I don’t know if he means to begin with my life story, or Simon’s death, or the fact I can’t stop crying . . .

  ‘I’m not sure what you know about me already,’ she says.

  ‘Well, I know what you shared in group this morning.’ But this wasn’t what Karen was driving at, and Johnnie seems to pick this up. ‘Other than that, all I have is a brief letter of referral from your GP, so you can assume I know very little and begin wherever you want.’

  Help, thinks Karen. There’s so much to say, but she’s not sure she’s ready to reveal any of it. Still, most therapists seem keen to believe that problems tend to stem from childhood, so she plucks something that isn’t too raw and seems apt. ‘Well, I grew up in Reading, in Berkshire . . . and I’m one of two siblings . . . though my brother lives in Australia now, so we’ve not seen him in a long while . . . and my parents . . . um . . . my dad and mum were . . .’ It’s no good, the mere mention of her father triggers tears. I miss him so much, she thinks, remembering being his little girl once more. ‘I shouldn’t be doing this again.’ She reaches for a tissue. ‘Sorry. I didn’t expect all this to come out quite so . . . so . . . fast.’

  ‘Crying can be a really good thing,’ says Johnnie.

  Karen isn’t so certain. Is it really productive to be weeping so much of the time?

  ‘Maybe your tears are a sign that something’s being released, or possibly shifting?’

  ‘I suppose.’ Considering how young he is, Johnnie seems astute. Karen lets out a long breath. ‘My father died six weeks ago.’

  It’s as if she’s at the hospital in Worthing all over again, running down the corridor, frantically looking for her mother, then finding her, ashen-faced and distraught, outside the Intensive Care Unit . . .

  ‘He was in a care home,’ Karen tells Johnnie. ‘We don’t know exactly what happened, but the nurse said she went to his room to give him his night-time pills and found him sitting in his chair, unable to move. She asked him if he was OK, and he couldn’t reply. The thing about my dad was, if he was awake, he’d normally say something, even if it was “fuck off”.’ Karen laughs ruefully. ‘He’d had a stroke.’

  Johnnie nods in understanding.

  ‘He never regained consciousness.’ She dabs her eyes with a tissue. ‘He lasted a week, in the end . . .’ Although she’d been able to see her father, hold his hand, feel the warmth of his skin and listen to him breathing, he’d never woken up again.

  ‘I’m so sorry for your loss,’ says Johnnie.

  ‘It’s OK,’ she says, then reproaches herself for using such a nondescript word. Is a death ever “OK”? And she doesn’t want Johnnie to think she didn’t love her dad. ‘He was in his eighties, he’d had Alzheimer’s for several years . . .’

  ‘That must have been difficult.’

  ‘Yes, it was . . . Though before, well . . . We were very close.’ She looks up – Johnnie’s expression is full of sympathy – and she’s sobbing again. It’s as if she’s a soap bubble, held together only by tension; all it takes is a few kind words and pop! she bursts. The tears make it hard to speak. ‘I . . . haven’t managed it so well this time. I can’t seem to keep it together, and, um, my friend Anna suggested I go to my GP and the doctor said . . . he said that it wasn’t surprising I was finding things difficult, and, er . . . he suggested antidepressants, but I’m not happy taking medication . . . I don’t want to not be myself any more – they might change my personality – and I don’t want to get addicted . . .’

  ‘I doubt very much that would happen,’ says Johnnie. ‘And some people do find them helpful.’

  ‘Really?’

  ‘They can help lift mood and, although I wouldn’t advocate their use on their own, it has been shown that, along with therapy, antidepressants can provide good results.’

  ‘Oh.’

  ‘You can always discuss it with Dr Kasdan – he’s the psychiatrist here – if you decide you would like to explore it further. Why don’t you see how you go over the next week or so coming to groups and seeing me, and review it then?’

  ‘That sounds like a good idea.’

  ‘Anyway, I interrupted. You were saying?’

  Karen hesitates, struggling to pick up her thread. ‘Yes, so, um, I decided that . . . Well, my friend suggested that maybe my health insurance might cover something else, you know, something like this, so I looked and I saw that yes, I had cover . . . so . . .’

  ‘Perhaps we don’t need to go into all these details now,’ says Johnnie. ‘Can I bring you back a moment to your father?’

  ‘Oh, of course.’ Karen is thrown. I must be boring him, she thinks, going into such minutiae.

  ‘You said “this time” . . . “I haven’t managed it as well, this time.” Might I ask . . . have you experienced the loss of someone close to you before?’

  ‘Yes.’ She pauses, then says, ‘My husband.’

  ‘Your husband?’ Johnnie is taken aback – Karen can tell. He hadn’t expected her to be a widow. People don’t. She’s got used to this reaction, but still she finds it hard. She ends up holding back from going into detail to lessen their upset, and the fact that Johnnie is young makes her feel especially protective. She reaches for another tissue and says, ‘He had a heart attack, out of the blue . . . It was just over two years ago . . .’ Her voice cracks. Johnnie is a therapist, she reminds herself. He’ll be able to handle it. ‘My husband’s name was Simon.’

  ‘That must have been a terrible shock.’

  ‘It was. But I seemed OK . . . I mean, I’m not saying it didn’t affect me; obviously it did, horribly, it was a dreadful time, awful . . .’ A flashback of Simon collapsing on the train makes her shudder. She gulps. ‘But I managed: I had to, you know, because of the children, and I kept going. Yet now, with my dad, I can’t seem to hold it together. The last few weeks – since he died – I’ve been crying all the time, every day, several times a day. And it’s like . . . I don’t know what’s wrong with me. Some days I feel miserable, but other days I feel ghastly in a different way. It’s as if someone else has taken over my body and I’m not my normal self at all.’

  ‘Would you say these are physical symptoms?’

  Karen frowns. ‘It’s hard to separate them. I get these headaches, as if someone’s wrapped a metal band tight around my forehead – sometimes it feels so real I’m surprised I can’t see it . . . like I’ve been wearing a hat, and when you take it off, it’s left a mark, and you can still feel it.’

  Johnnie nods. ‘That’s a good description.’

  ‘But why now? Why could I handle Simon’s death better, when it was so unexpected, and not my father’s . . . when I should have known – I did know – it was coming? My dad was in his eighties; he’d been ill for ages.’

  ‘Well, it sounds like you’re experiencing depression. You’ve had a huge amount to deal with in a relatively short time, so to have some sort of reaction is completely natural.’

  ‘It was such a stress for my mum looking after him . . . so, in a way this is a blessing, a relief for her . . . I wish I could see it that way, too, but now I can’t stop worrying about her either, and what she’s going to do . . . I guess she should move in with us, but I’m not sure I can cope with that right now, not when I’m such a wreck . . .’ Karen stops and looks up, then says, ‘Sorry.?
??

  ‘There’s no need to be sorry.’

  ‘No, I guess not. Sorry.’ Karen realizes what she’s done and laughs.

  Johnnie smiles. ‘You seem to be beating yourself up a lot.’

  ‘Oh?’

  ‘It sounds as if you believe you should be feeling one way about your father’s death, and because you’re not, you’re getting angry with yourself. I’m hearing the word “should” a lot in what you’re saying – you should have foreseen your father’s stroke, you should ask your mother to move in, you shouldn’t be crying so much.’

  ‘I suppose I do think a bit like that . . .’

  ‘When something painful happens, we sometimes feel that we have failed in our response to it.’ Johnnie glances at the clock. ‘I’m afraid we’ve only a couple of minutes left, just so you are aware.’

  ‘I can’t understand why I seem more upset than when Simon died,’ says Karen. ‘Don’t you think it’s odd?’

  ‘Well . . . it sounds to me as if you’ve probably experienced what is often called cumulative trauma. It can happen when you’ve been through one distressing event after another.’

  ‘Is that why my reaction is so out of balance?’

  ‘Perhaps it would help to look at it not as a balance like this—’ Johnnie cups his palms before him on a level as if he were a weighing scale, ‘ – where one grief is heavier than the other.’ He drops one hand down and the other up. ‘Perhaps it’s more like this—’ He puts one cupped palm on top of the other, ‘ – where you could bear one heavy weight, but not two.’ He drops both hands.

  ‘Oh. I hadn’t seen it like that . . .’

  ‘I’m not saying it’s entirely the case, but it might help you be kinder to yourself.’

  Karen nods.

  ‘I’m afraid we are going to have to stop now, but you might like to think about that a little before next time.’

  ‘Sure.’

  ‘And enjoy your lunch,’ says Johnnie.

  16

  Oh no, thinks Michael, entering the dining room. Most of the chairs are taken; he’s going to have to share a table with other patients. There’s space beside Rita and she seemed harmless enough, but she’s sitting with Troy, and Troy seems in as dark a mood as he is, so is probably best avoided. Michael looks around for Karen – he’s more inclined to chat with her if he’s got to talk to anyone, because she’s new, too. But then he remembers that Johnnie waylaid her as they were leaving.

  There are only two seats free in the corner by the French windows. The other chairs at the table are occupied by the guy with the Mohican who gave Michael the tip-off about the coffee machine, and another young man in glasses whose colourful tattoos appear to run right up both arms and across the back of his neck. Michael squeezes through to reach them and is just saying, ‘Do you mind if I join you?’ when there’s a waft of scent and he feels hair brush against his arm.

  ‘Hi guys!’ It’s Lillie. ‘You OK with me sitting here?’

  ‘Of course,’ say the two men.

  No surprises there, thinks Michael.

  ‘Come on, Michael, park your bum with me,’ says Lillie, patting the red-cushioned seat of the chair next to her.

  Michael does as he’s bid.

  ‘Michael’s new,’ Lillie explains.

  ‘We met this morning,’ nods the Mohican. He stretches out an arm. ‘I’m Karl.’ Michael shakes his hand. ‘And this is Lansky.’ Lansky looks up from his plate – he’s already been served with a burger and chips – and nods.

  ‘That’s an unusual name,’ says Michael, then kicks himself for stating the obvious and adds, ‘You probably get that all the time.’

  ‘No,’ says Lansky. ‘It’s what they call me in here. It’s my surname – my first name’s Paul, but there are two Pauls in ATP.’

  ‘The addiction therapy programme,’ explains Lillie, reading Michael’s confused expression.

  ‘So, what you in for?’ asks Lansky.

  ‘Oh, he’s a Sad,’ says Lillie.

  ‘Whereas we’re Bad,’ Karl winks; his pierced eyebrow seems to emphasize the gesture.

  ‘Very Bad,’ Lillie nods. She turns to Michael. ‘Karl was into cocaine.’

  ‘And speed,’ says Karl.

  ‘With me, it’s booze,’ says Lansky.

  I can tell, thinks Michael. Behind large, black-framed glasses, Lansky’s cheeks are threaded with broken blood vessels.

  There’s a jug in the middle of the table. Lillie reaches to fill up her glass with juice and says, ‘In here, we like to say there are the Mads, Bads and Sads.’

  Michael feels his face crack into a smile at the notion. ‘So if we’re the Sads and the Bads, who are the Mads . . . ?’

  ‘Oh, there aren’t too many of them in here at the moment,’ says Karl. ‘But they’re – you know, the psychotic ones, the total nutters, people who’ve really lost it.’

  ‘I lost it before coming in,’ says Lillie. Her frankness is disarming, but Michael is rapidly learning that small talk is rare in Moreland’s Place. ‘I’m BP.’ She smiles at him brightly.

  ‘What’s that?’ asks Michael.

  ‘Bipolar,’ says Lansky, and takes a large bite of his burger. Ketchup squidges out and plops onto his plate.

  Lillie looks up at a woman bringing in their food. The woman hands Michael a plate with a baked potato filled with tuna and sweetcorn; he now recollects ordering it earlier. ‘You got mine, Sally?’

  Bit strange to be on first-name terms with the staff as well as the other patients, thinks Michael. Though I guess it’s good to be friendly.

  ‘What was it?’ asks Sally.

  ‘Omelette,’ Lillie replies. ‘I have a wheat allergy,’ she tells Michael. She lowers her voice to say this, as if it’s a more personal revelation than her previous confession.

  ‘So . . .’ Michael isn’t usually nosy, but this is fascinating. It’s making him feel less weird, and he’s been sensing himself as cut off from others for a long while. For the first time in months, he feels something faintly approaching cheeriness. ‘When you say “lost it”, how do you mean?’

  ‘Oh, I tried to stab my sister,’ says Lillie.

  Michael nearly chokes on his baked potato.

  ‘You must have seen it,’ says Lansky. ‘It was in all the papers.’

  Just as he’s saying this Michael cottons on. So that’s where I know Lillie from, he realizes. Stone me! She and her sister present that TV programme my kids are into, Street Dance Live. I bloody hate it – it’s the music I can’t stand – but still. Imagine me, he thinks, pausing for a moment to swallow his mouthful, having lunch with someone famous. Ryan and Kelly will be dead impressed.

  ‘I had a psychotic episode,’ says Lillie, adjusting her top so that once more Michael has to tell himself not to stare. ‘But I’m all right now.’

  Hence the meds, thinks Michael. Maybe for some patients they’re not such a bad idea. ‘What about your sister?’

  ‘Oh, she’s used to me,’ Lillie smiles. ‘And I did think she was the daughter of the devil at the time.’

  ‘Mad, you see.’ Lansky taps his temple, but he’s grinning.

  ‘So, you insurance or what?’ asks Karl.

  It takes Michael a moment to gather what he must be referring to. ‘You mean, how am I paying to be here?’

  ‘Yeah,’ says Karl. ‘She’s private, obviously—’ A jerk towards Lillie. ‘So’s Lansky here—’

  ‘My dad’s paying,’ says Lansky. He looks sheepish.

  ‘And my work have sponsored me. How about you?’

  ‘Oh,’ says Michael, still assimilating. ‘I’m NHS.’

  ‘NHS?’ Lillie and Karl are agog.

  Michael nods. I didn’t realize it was that unusual, he thinks. Not that he’s thought much about his admission. It’s a blur.

  ‘You lucky bugger,’ says Karl.

  First time anyone’s called me lucky in a long time, thinks Michael. ‘Why?’

  ‘Costs a fortune to be in here otherwise.’ K
arl turns to Lillie. ‘How much is it again?’

  ‘You’re an inpatient, aren’t you?’ says Lillie.

  Michael nods, though he’s no idea how long he’s supposed to be here for.

  ‘Like us then. Nearly a grand a night.’

  For a second time, Michael has to stop himself from spluttering. He reaches for his glass and takes a sip of juice.

  ‘So how come the NHS sent you here?’ asks Karl.

  ‘No beds anywhere else,’ he says.

  ‘Don’t you remember?’ says Lansky. ‘That other guy – in a few weeks ago – Matt? Always had his nose in a book? Scrabble buff? He was NHS too.’

  ‘Was he?’ says Lillie.

  ‘Yeah. They’ve been cutting beds in mental health wards, apparently. So now they ring round all the psychiatric hospitals, and if there aren’t any spaces free, the overflow patients end up in clinics like here.’

  ‘I didn’t know that,’ says Karl.

  I don’t get why they’re so surprised, thinks Michael, there’s a lot of pressure on public resources. Then he realizes the significance of what they’re saying. ‘So if a bed becomes available, will they move me, do you think?’ He fights to control his panic. He’s a keen supporter of the public sector, but he’s just beginning to settle in, and the idea of being transferred to an NHS psychiatric ward fills him with dread. Images of straitjackets and patients chained to bedposts spring to mind. Don’t be ridiculous, he tells himself. This isn’t Victorian England. Still, he can’t shake his horror at the prospect. There won’t be original watercolour paintings on the walls, he’s almost certain, but he can live without those. Worse by far is the idea that he might not have his own bedroom.

  ‘No, now you’re in here, you’ll be fine. I’m sure it’ll be way too complicated to shift you,’ says Lansky.

  Thank God for that, thinks Michael. Sharing a ward with people as nuts as I am – I can’t imagine anything worse.