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Day 812

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The boundaries between ‘sanity’ and ‘insanity’ are elastic. Each one of us has a place on the spectrum and it constantly shifts and shuffles depending upon the changes in our outer and inner landscapes. Each of us with our own fears, anxieties, sadnesses, communication problems and struggles to fit in move up and down that range.

“The world is but a great Bedlam, where those that are more mad, lock up those who are less.” -Thomas Tryon (1689)

“Surely we’re all mad people, and they, whom we think are, are not.” -Thomas Middleton, The Revenger’s Tragedy (1606)

Some days are impossible. I have to roll as a stone on the road, slither on sharp stairs, climb up through a lift shaft, squeeze under the door to the room and then at the end, to finally assemble myself on a chair to make a complete feeling. Today, the feeling is of nothingness. All I feel are my empty arms. The air between them is painful. The arms ache. They stretch out, crying, wanting to hold him. They hate it but they are… empty.

My heart and soul are empty. This house is empty. This whole world is empty. Reality is not what it seems to be. Nor is it otherwise. Am I now bordering on the insane? Am I always like this, but covering it up? Who is to decide what is what? No one knows. No one has ever known.  A rock is just a rock. A river is just a river. Misfortune is just bad luck! It is just what it is – the experience of being human. It is absolute. It does not need validation. It does not need a name.

(Inspired by an exhibition at the Wellcome Collection: Bedlam- the asylum and beyond)

Day 811

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Her Voice – a short story

‘I hear her. Her voice is in my head’ says Joe.
“How long has the voice been there?” asks the trainee psychiatrist.
‘Since I was 12.’
“And you are now 18.”
‘Yes.’
“Is it really upsetting for you?”
‘Yes. Distressing. I feel terrible.’
“What does the voice say?”
‘Different things. Often cries desperately.’
“How often does this happen?”
‘At least 3-4 times every day. It’s painful.’
“Hmmm. Let me speak to my senior and come back to you in a few minutes.”

A few minutes later.

“We think you might have Schizophrenia. Let’s start you on Quetiapine and see how it goes.”
‘Okay.’

Joe waits at the pharmacy to collect his medication. A trainee nurse is also waiting there to collect some meds for a patient on the ward. They talk. He tells her why he’s there. She asks him who is ‘she’? Whose voice does he hear?

‘She is my little sister. When we were kids we shared a bedroom. At night, my mum’s boy friend would come into our room and trouble my little sister behind a curtain. She cried. I could hear her but I was powerless. I could hear her then. I can hear her now.’

‘Do you think these pills will work?’

Day 810

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Left the massive, fire-walled monster of a building, feeling as tired as a rag. Stood on the covered walkway looking at vertical lines of water heavily following gravity, falling like a velvet curtain, making the darkness darker. Couldn’t gather enough courage to step into it. No rush. No one waiting at home. Cold hands in pockets, frozen tips of noses and ear-lobes. Cool, moisture-laden air flooding the balloon-bags in the chest and leaving with a tiny bit of fatigue. Even though the jungle is concrete, it offers some respite.

While I stand at the edge of this temperate downpour, tiny deflected reflected droplets find my face and keep me awake. The noisy business of clanking rain adds to the drama.

Over the next few minutes the drops become grainy. Splat! They shatter on flat surfaces of windscreens and pavements, leaving a little residue, a trace of things to come.

The noise suddenly vanishes, as if the conductor of an orchestra has indicated a pause. The air changes form. Little white flakes completely defy gravity and dance gracefully in all directions, seemingly weightless. The darkness lifts into soundless brilliance. Streetlights exaggerate these elegant movements. I bounce onto the road and walk under this light white flurry. My feet land on softness. The whiteness starts to make little homes  on hedges, fences and chimneys. I am transported into a world of lightness and joy.

For a few moments, all is right with the world.

Day 809

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Recently I came face to face with my own subconscious biases. They came as a surprise but were interesting to watch once I became aware of them. I was faced with a series of people who were to be evaluated as objectively as possible by a colleague and I. They walked into the room and talked to us one by one. Some men, some women, some from abroad, some very well dressed, some with an accent, some with facial hair, some suave, some with a lot of hand movements, some hiding their nerves behind an overconfident exterior…

We made evaluations and discussed the interviewees. It was apparent that those who presented themselves well and appeared relaxed made a good impression. We reminded ourselves that even if someone spoke well, our focus must be on the content rather than the delivery. We picked up on body language clues like a mild trembling of the fingers and periodic clearing of the throat.

Couldn’t help thinking back. Saagar spoke well. He had an endearing and calm demeanor. He was clever. He was also a good mimic and actor. He could have easily made his assessors believe whatever he wanted them to, unless they were aware of their own biases and could read his non-verbal language – things that come with years of practice and experience!

 

 

Day 808

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Yesterday our Prime Minister put Mental health at the top of the national agenda. Great to have these focussed conversations in prominent places with special emphasis on schools and work places being equipped to intervene early for children and young people with difficulties. These announcements are welcome but are also met with a slow applause as this government does not have a great track record with the NHS.

Relevant tweets:

“Schools will be linked to local NHS #mentalhealth services to support early intervention for Children and Young People” in PM speech.

“You can make the promises, but you need the workforce to deliver them.”

“Biggest challenge PM faces -getting funding to the front line. Services over-pressed, under-staffed + facing even more demands.” – President of the Royal College of Psychiatrists.

In my opinion, as long as we stick strictly to the medical model of mental illness we will never get it right as it does not put enough emphasis on prevention. We need to start with educating young parents about the family, environmental, individual and social factors that contribute to the mental well being of a child.

Thereafter the schools need to be aware that if a child is happy, he or she is more likely to perform well. Hence putting them under academic pressure can be counterproductive. Bullying policies must be strictly implemented. Kids must be allowed to fail sometimes. There is grace and learning in defeat.

By no means do I claim to have all the answers but this would be a good start. Prevention is better than cure.