ONE FLEW UNDER THE CUCKOO'S NEST (2007) takes place in New Hope Hospital, England. Dominic's head is full of voices, Lisa is in a daze and Nathan is twitching. Together they rock back and forth, holding themselves tightly because no one else will hold them. They are alone together. Jason visits his schizophrenic wife, Bernie. She's been moved to the locked ward. He finds her curled up on the floor in a catatonic state. Hard as he tries, he is unable to reach her. He desperately wants to help but at the same time he can't cope. Together, they both feel so alone. After the advent of 'Care in the Community' Jason feels totally imprisoned. Faced with a Hobson's choice, he starts to go under. He is now expected to look after Bernie 24-7. Heading for burnout, with no one to turn to, he sees no future. There is no exit from his hell. No one seems to care about the carer!
alonetogether
they tried to survive
Sample
3. The Ward
‘The body is a house of many windows;
there we all sit, showing ourselves and crying
on the passers-by to come and love us.’
(Robert Louis Stevenson)
Ward 7 was filling up fast,
not unusual for the time of year with Christmas just round the corner.
Christmas was unavoidable; you could not erase it from the calendar. Even if
you could, it was virtually impossible to ignore the tinsel decorated streets
and the carol singing wherever you went. This festive season always came too
soon for the troubled and the disturbed, the rejected and estranged misfits of
society. Little wonder that the number of suicide attempts increased notably at
this time of year. Little wonder, too, that many suffered breakdowns or were
admitted to psychiatric hospitals where they were offered refuge and protection
from the menacing season of goodwill.
These patients were oblivious of reality,
lost in unreality. They had escaped to captivity, forced by society to opt-out,
forced by parents to break down, or self-motivated, to break-through the
role-playing, the false selves, so tired were they of 'being-for-others'.
The patients in Ward 7 were strangers to one
another. They did not share the same state of aloneness even though they might
have shared a common label. Together they found themselves for a short or long
span of their lives in Ward 7 - a microcosm of the real world. They were life's
casualties though there was nothing casual about them. Instead, their
conditions were ones of edginess, urgency and desperation to find the right
path and make progress, even recover.
Whereas some of them were anxious to 'get
better' the rest were caught up in the turmoil of coming to terms with an illness
such as schizophrenia and panicking about the implications of such an
acceptance. For them, life was a kind of death - a life founded on injustice,
knowledge of innocence that they would never claim since they were cursed; 'it'
had happened to them. They were wrongly and unfairly punished and tormented by
their cruel lives, yet they were not guilty of any crime. Instead, they were
doomed to inhabit bodies that they would never feel, doomed and dominated by
minds they did not comprehend. And worse of all, they were rejected by their
families and friends and forgotten by society. Through its ignorance and fear,
society stigmatised and alienated them, making them outcasts: the forgotten
ones. Now that Bernie was locked away, she, too, was forgotten. Bernie was out
of sight and out of mind!
Ward 7 seemed very quiet
without Bernie. After the patients had had their bedtime tea or milky drinks,
the medication trolley did the rounds once more: yellow pills for some, red for
others, or dark syrupy substances for the more agitated cases.
Staff nurses Kris and Zoe were in charge
again, assisted by Robin. Zoe was a warm, middle-aged nurse who freely gave of
her time. She was so unlike nurse Jodi who always avoided those patients who
needed someone to talk to. Kris and Robin settled in for the night.
Kris sipped his coffee and said as he put
his feet up: 'I think it's going to be quiet tonight.’
'What about Dominic?' asked Robin. 'He was
very restless earlier. He kept pacing up and down the corridor... must have
gone through two packets of cigarettes...'
'Oh! Forget about Dominic! We don't have to
worry about him any more; he'll be sleeping with the angels tonight... floating
on a cloud. Dr Foster changed his medication, he's on Largactil now, joined the top league has our Dominic.'
With these words Kris took out his
newspaper.
'Shall I check on them now?' Robin asked as
he raised himself from his chair.
Kris responded abruptly: 'Look Rob, don't
take your job so seriously. Relax man! It's just a job and an underpaid one at
that. Enjoy your coffee! I've had a hard day... nag, nag, nag from the wife
since I got out of bed. She's been complaining about us never going out, not
having enough money... problems she expects me to listen to. And then I come to
work and all I want is a little bit of peace and quiet. The last thing I want
to hear about tonight are problems from any of that crowd,' pointing to the
communal area.
Kris's attitude astonished Robin who after
some hesitation spoke: 'I went into psychiatric nursing because I care about
these people. I'm interested in their problems and I want to try and help them.
I really do.'
'When you've been in nursing for as long as
I have Rob, you won't be so keen to help them. You'll learn to switch off as
I've done, otherwise you'll go round the bend. I've seen hundreds of mental
cases with their strange mannerisms, their stiff walk...
‘Be warned Rob or you'll end up twitching
like Nathan out there, or shuffling like Penny and then it will be you who
needs to be nursed. Eh?'
Robin smiled and left the office to check on
the patients, concerned about Kris's attitude, fervently hoping that he would
never be as blasé as Kris had become. He could not understand how Kris seemed
so totally immune to the pain and suffering of patients. Kris and Robin
differed - Kris was much older and viewed all the in-patients as problems,
whereas Robin viewed them as human beings first and foremost. They were persons
with problems.
The last two patients came back on time
minutes before Robin locked the main door.
'Did you have a good walk?' inquired Robin.
Jade and Mara nodded their heads, smiling.
They had a good walk as well as a good drink.
The staff knew the local pub was often
crowded with in-patients, but unless they returned to hospital in a drunken
state, staff members normally turned a blind eye, as long as the patients
weren’t alcoholics, of course.
By 11 pm the lounge and communal area were
deserted except for Lyndsey, the young anorexic girl. By this time patients had
usually retired to their rooms, leaving scattered ashtrays which were full to
the brim, in a thick, smoky atmosphere. Behind them they also left their
presences - ones of discordant thoughts and mixed feelings - a cluttered atmosphere
of confusion and hope, 'lostness' and survival.
Lyndsey usually telephoned her mother at
this time. She never went to bed without reporting in minute details what she
had eaten:
'I had one and a quarter slices of toast for
breakfast, Mummy, four spoonfuls of baked beans and fish for dinner. I even had
two spoonfuls of sugar in my tea today.'
She ended the call seeking approval as
usual: 'I did well, didn't I, Mummy? But I prefer your cooking, Mummy. I love
you. Bye!'
Lyndsey ended up in hospital after
persistently refusing to eat what her mother had cooked for her. She was
painfully thin. The habit of phoning her mother was followed by a second habit,
a determination to make herself sick. When she didn’t have the opportunity to
be sick, she took laxatives instead. Twenty-four hour supervision was unheard
of at
Lyndsey had a long way to go in her
recovery. In bed, tightly holding her teddy bear she looked about twelve years
old. She tried to sleep but couldn't. She tried not to think about anything but
her mother's recent vehement treatment kept her awake. Not only did she deny
herself nourishment but was made to feel guilty for doing it. The previous day
her mother had accused her of being selfish and ungrateful. In bed, she
replayed the scene in her mind:
'Your Dad and I, haven't we given you
everything, haven't we Lyndsey? All you've had to do is ask for something and
we bought it, didn't we? You've had the best of everything - toys, clothes, expensive
bicycles, holidays abroad every year. You never went without, did you Lyndsey?
Answer me!'
Lyndsey was unable to answer her mother.
What she said was true. Her parents had given her everything and she was
grateful for that. Yet she felt she had nothing. Instead, she felt she was of
no value whatsoever. The abundance of material possessions in her bedroom at
home: her books, TV, music system, computer etc all provided for her by her
parents, contrasted sharply to her own inner emptiness.
Lyndsey sobbed heavily the day her mother
had scolded her for deliberately hurting her through her continual refusal to
eat:
'How long is this going to go on for,
Lyndsey? Why are you hurting your Dad and I? He's sick with worry. You're not a
child any more. Why are you doing this to us? I'm tired of this game. Lyndsey, stop being a silly little girl and
just start eating.
‘Before I leave you're going to do what
you're told,’ she had said.
That day, from her handbag she produced a
bar of chocolate, and then unwrapped it. She cut the block into pieces and
handed the chocolate to Lyndsey.
'Eat it now! I'm not asking you, I'm telling
you. Eat it!' she said in an extremely angry voice.
Lyndsey lightly held the broken pieces in
her hands, afraid of them, afraid that the unwanted substance might contaminate
her, staring at it with enmity, suspicious of it poisoning her. Tension filled
the air as each second ticked by, slowly, painfully. When her mother refused to
wait any longer she shouted at Lyndsey and moved forward.
'Damn you child, eat the damned chocolate!'
At this point, her mother grabbed one of the
pieces and tried to force it into Lyndsey's mouth. Lyndsey struggled and pushed
her mother away from her, shouting 'No, I don’t want it! No!
'I
can't eat it, I can't. Get away from me!' Then she burst into tears and ran
away from her mother who stood exhausted, shaking - her hand covered with the
melted chocolate, the floor strewn with broken and crushed pieces.
After reliving that dreadful episode Lyndsey
eventually fell asleep, mentally exhausted by the encounter, physically weak -
her body sore from retching and emotionally drained.
Robin looked in on Dominic. He was
twenty-one and had been admitted twice this year. The first admission took
place only a few weeks after his father's short illness and sudden death. There
was, however, no end to his grief, a grief that was accompanied by strange
behaviour when Dominic began talking to himself and experiencing hallucinations
- both auditory and visual. Following this development, he became
self-destructive and was found on several occasions slashing his arms, his
legs, and even his face.
Dominic was fast asleep and snoring heavily.
Such stillness disguised the daily torment apparent to all. Robin observed him,
hoping that the medication had brought him a little peace, wondering whether he
was disturbed by nightmares or genuinely enjoying a brief respite from the
demons that haunted him unceasingly. Asleep, he looked ordinary, even normal,
apart from the inescapable evidence disclosed by fresh scarring on his cheek.
No, he had not been scratched by a cat or an animal, not even by a woman; he
had disfigured himself and insisted that voices had commanded him to do so.
Jon who shared a room with Dominic
interrupted Robin’s thoughts and observations. As Robin left he asked Jon who
was about to retire to bed, how he was feeling? They exchanged a few words
outside the door in order not to waken Dominic. Jon forced a half-smile and
said: 'Things are looking up. I'm beginning to feel better. I hope it lasts.'
'That's good to hear, Jon. Take it easy.
You're doing fine. The only way now is up!'
Jon smiled again wishing him goodnight
before they parted. As Jon moved away from him Robin noted his posture - his
head was lowered, his shoulders hunched projecting shame more than
embarrassment.
He had been in hospital for a few weeks
after trying to kill himself; his wrists were still bandaged. Life had suddenly
overwhelmed Jon, a church minister in his late thirties. Unbeknown to Jon his
wife had been having an affair and one day announced that she was leaving him.
On top of this devastating news, that same
week, his parents were killed in a car crash. Up until then life had run
smoothly until suddenly everything was taken from him. Without warning and
almost overnight he lost his faith. He no longer felt able to help others
pastorally; he no longer wanted to live.
However, now that he had gained a measure of
distance between these cruel events and himself he was again learning to cope,
helping others on the ward at the same time. He was still astonished that he
had actually attempted suicide, shocked at his butchered wrists - so messy and
out-of-character for Jon. No wonder he felt ashamed, stupid even when he looked
at the bandages. He tried to conceal his shame by ensuring his sleeves were
pulled down over them at all times.
Nathan was a sad figure. Even fast asleep,
Robin saw him twitching, a nervous habit that he had for as long as the staff
could remember. Nathan, however, denied this, and blamed it on the medication.
He had put on three stone in weight since first being prescribed Modecate. In time, however, he had
stopped complaining and obediently took the medication though he hated taking
it. His doctors all said the same thing to him:
'You must understand Nathan that we are
concerned about your mental state. If you don't take your medication, you know
what will happen. You'll become unwell again, won’t you Nathan?'
Nathan failing so often to make himself
heard finally stopped trying. The doctors refused to see his point of view. (Dr
Halliwell he found especially exasperating.)
'I don't want this twitch, doctor. People
make fun of me. I know they're talking about me and the kids imitate me too.
Can you not give me something else, a drug without side effects?' he had said
many times.
'Unfortunately Nathan, all these drugs have
side effects. But you are exaggerating! It's just a little twitch which we're
sure will disappear in time. And I wouldn't worry about putting on weight. As
I've said, Nathan, it's your mind we're concerned about, not your body.'
'I know Dr Halliwell but I hate being fat.
It makes me feel bad. I'm depressed about being fat. I look disgusting and feel
disgusted with myself.'
Dr Halliwell refused to make any connections
- holistic treatment was irrelevant and unheard of when dealing with
schizophrenic patients.
He continued: 'You must agree Nathan that
the Modecate controls your symptoms.
You haven't heard voices for some time, have you? You're not as disturbed as
you were a few months ago. You're sleeping better. So Nathan, I really wouldn't
worry about the way you look. Keep taking the medication and you'll stay well.
If you stop it - then we all know what will happen next, don't we Nathan?'
Nathan was forced to accept his situation
for now, though unwillingly.
Further down the corridor Robin heard Jake
and Mal's conversation, one that was interspersed with laughter. They were two
of a kind, making light of problems, denying the serious nature of their
situations, by and large wasting their time in hospital.
Jake, an overworked doctor had turned to
alcohol to ease some of the pressures he was feeling. When his problem came to
light, his superiors threatened to strike him off the register - unless he
agreed to undergo therapy. Mal was about Jake's age, in his late twenties, a
highly paid executive - always immaculately dressed who, after being caught
shop-lifting was referred by the Court to the New Hope for treatment.
Robin, dedicated as he was to psychiatric
nursing couldn’t relate to them. No matter how hard he tried he had no sympathy
for them.
'Is everything fine with you both?' Try and
get to sleep soon! Goodnight!' said Robin.
After closing the door behind him Jake
mimicked Robin's voice:
'Is everything fine with you both?' Bloody
fool, what kind of a stupid question is that when we're in a loony bin drinking
orange juice!'
Mal laughed aloud. Jake needed an audience
and Mal, light-heartedness - someone to trivialise his problems, and therefore
keep anxiety at bay. There was complicity in their self-denial.
The laughter annoyed Robin who was irritated
by them maybe because they were middle-class people, though generally he had
more difficulty relating to men than women. Perhaps that's what the problem was
again. He never felt totally comfortable with male patients, finding them hard
to support, yet he got on famously with the women - both young and old. He felt
sorry for them and helped them as best he could. Though Robin was only
twenty-eight years old, he came across in a warm, paternal way, expressing
genuine caring, freely offering his help and carefully choosing his words
slowly, as if from a fount of wisdom.
His advice was often practical and always
sensible though idealistic. Frequently, he wished he could wave a magic wand to
make others' problems disappear, instead of watching them suffer; other times
he expressed anger on behalf of the patients - so moved and angry did he feel
at their predicament, at certain injustices or parental treatment. He felt this
way particularly about patients diagnosed with schizophrenia, and there were
many of them. In his dealings with them he felt least useful, powerless, in
fact. With them, his advice counted for nothing. These people, however, he
befriended, treating them gently and compassionately each time their familiar
faces reappeared at the hospital. He couldn't offer them hope of a cure, as
that would have been a cruel lie - even though he often felt tempted. As long
as research hadn't found a cure for the illness the most he could offer was
friendship and understanding. That support was invaluable when so many of them
had been rejected or forgotten by their nearest and dearest.
How many cases had he known in his short
nursing career? Too many! How much help did they receive? Too little, he
thought! And the tragedy of schizophrenia as he saw it lay in the way life
seemed to stand still, without a future. He was well aware of their
predicament. Without a glimmer of light darkness becomes unbearable and he
empathised with their journey, a journey through an endless tunnel feeling
isolated and frightened.
Little wonder, he thought, that some of them
- tired of going nowhere, dizzy of going round and round in circles, filled
with pain, yet forever denied peace - made the sane decision to end their
lives. Robin understood their viewpoint yet had to disagree with it. His job
dictated encouragement and support. 'Life must go on' is the rule in a
civilised society - the quality of life is irrelevant! But he knew that life
for the schizophrenic is not really a life at all, unless he or she is expected
to value undeserved torture and undergo endless torment.
'Shuffling Penny', the patient Kris mocked
earlier, had spent the last thirty odd years of her life in and out of
hospital.
'What's the point of going on?' she often
asked Robin, ‘when every day is a struggle to get through, and for what? Nobody
cares about me! No one can help me. I'm ignored because I look normal. I
haven't got any visible scars. If I had cancer then I'd be treated differently
but this illness is like a cancer, it's devouring me and I can't do anything
about it. I've been trying to accept it for thirty years now and look at me.
I'm old.'
She looked as if she was in her late
sixties, yet she was only fifty-two.
'Look at me, Robin, why should I accept it
anyway? I did nothing to deserve it. What have I got to look back on? No happy
memories that's for sure. People think that I'm crazy... and sometimes maybe I
act in a crazy sort of way. But they don't realise how much I've suffered.
They're not interested and they don't care.
'I've lost count of the number of
admissions. I've forgotten how many times I've flipped but I haven't forgotten
the pain. Nobody wants to know about that, do they? Sometimes I even think I'd
be better off if I didn't come out of a psychotic episode, especially during
the episodes when I feel alive and powerful. Then I'm somebody: a person who
can feel. I must say that sometimes when I'm on a high, un-self-conscious and
elated, well that state - what you call psychotic - is better than the deadness
I'm used to, after you and your lot have given me your injections and got me
under control again. The medication starts working, the numbness takes over and
I'm a zombie again. I can't feel anything except emptiness. And then my whole
body is heavy, slowed-down, walking is difficult because my feet feel as if
they're dragging a heavy iron ball and chain.
'But that's how you prefer us
schizophrenics, isn't it Robin, drugged to the eyeballs, controlled, manageable
and therefore less trouble to everyone? I know I've been a nuisance many times
but what right have you to extinguish my life-spark? What right have you to
blow it out so efficiently - as if you were blowing out a candle-flame? Phew!
I'm alone! No one gives a damn about me, nobody cares.' Penny was often upset.
Robin always listened to her, patiently
trying to understand what she was saying, wanting to share his perceptions of
Penny, his understanding of her history. When Penny was so downhearted, Robin
faced a challenging task. He had to choose his words with great care and
respond tactfully.
'It is untrue to say that nobody cares about
you Penny,’ he would say. ‘I, for one, care about you. And I do know what
you've gone through, what you're still going through. Any illness is
unpleasant, but the nature of schizophrenia is so horrible and unpredictable
that I really do feel for you. It's so unfair!
'But don't dwell too much on the point of
carrying on the struggle, Penny, that won't help you. To ask the question is
unhelpful even to people who don’t have schizophrenia. Just think of all the
so-called 'normal' people in the world who ask the same question over and over
again. The majority don't get an answer, but they don't give up, do they? They
keep going. I'm not minimising your difficulties Penny but you must keep
living.'
'What for?' she would say.
Robin stumbled for a moment, not knowing
what to say. His nursing training had not prepared him for this existential
moment. Robin was honest with her:
'I really don't know what to say Penny
except that if you decided to kill yourself then I would miss you.'
She looked surprised at first and then Robin
saw a little smile forming on her lips. They had made a connection. He had
managed to reach out and the lifeline he had thrown her now connected them.
'You would miss me?' Penny asked, her smile
broadening.
'Yes! I would.'
Robin knew that he didn't need to say
anything else... for the moment. He hadn't answered her questions nor had he
been able to give her a purpose to go on living - anyway he knew fine well that
no one could! But he had given her enough through listening, treating her as
caringly and respectfully as he would treat others. And in that exchange she
was comforted.
Robin also knew a similar conversation would
take place in the not too distant future but for now, his basic appreciation of
her, the simple few words he had said had given her strength – maybe just a
little strength but enough to help her carry on.
Before returning to the office Robin checked
the last bedroom inhabited by three women. Jocelyn and Mara were both nineteen
and Lisa was forty-five. They were sleeping deeply, these three women with
their personal histories and different sets of problems.
Jocelyn, a bulimic, looked very different
from the previous year when she had weighed only six stones; now she weighed
over eleven. Mara had a different sort of compulsive disorder, obsessed with
hygiene and cleanliness and without supervision was to be found washing her
hands hundreds of times a day.
And then there was Lisa, still in a state of
shock, unable to function in the present - her mind blown apart by her
husband's suicide. Most of the time she walked in a daze, and when she wasn’t
walking she sat on her bed staring at the nothingness.
That night, Robin did not have to check on
Bernadette, or Bernie as she was always called. Bernie was in her thirties,
attractive and intelligent. She was re-admitted only a few days ago.