Feature

Stuck inside of hospital with the blues again

How is modern psychiatry treating people in distress? Mo Hutchinson has recently been back in ‘the cuckoo’s nest’. Here is her tale of everyday ward life

Morning — and I struggle to rouse myself from the drug-induced oblivion which has meant that I have had a quiet, if not peaceful, night.

I am in a ward divided into 4-bedded bays Each night I attempt some privacy by drawing the curtains around my bed. Noise, of course, permeates through the curtains but it is not the loud clatter normally associated with a wakening hospital ward — perhaps because this is a psychiatric ward.

Breakfast is a self-service affair and the participants are a mixed bunch. Some have been roaming around for hours, wrestling with the difficulties which brought them into hospital in the first place. They are washed and dressed but seem to be no more ready to face the day than those of us still in night-clothes.

After breakfast it is time to move on to the business of the day and for most patients this starts with medication. Patients are summoned and a queue forms by the drug trolley where some wait patiently for their own particular assortment of drugs prescribed by the doctors. Other patients refuse to take their drugs for one reason or another and the ensuing arguments demonstrate that much of psychiatry remains controversial — it takes a lot more than a spoonful of sugar to make some medicines go down. I insist on knowing what I am prescribed and why — it is the least I should do — but others take their medication without knowing what they are being given. It is hard to tell whether this is out of trust, fear, bored acquiescence, or some other emotion.

Queuing soon becomes a way of life: queues for pills, queues for lunch, supper, cups of tea and everything else. One patient said that she felt like Oliver Twist: ‘Please Sir, can I have some more?’. It is demeaning to be treated in such a way - it establishes more powerfully than anything else that, in this closed world, there are those who ‘do’ and those who are ‘done to’. There must be a more dignified way for us to acquire what we need.

Food and drink punctuate the day and there is little else to do on the ward. The ward consists of a number of 4-bedded bays, a dining room, a lounge with a television quietly talking to itself, a smoking room, a doctor’s room and a larger room used for ward rounds and one-to-one consultations. If you happen to be a smoker you can become part of the smoking clique who occupy the smoking room at any time of the day and (if the door isn’t locked) the night too. One of the main topics of conversation in the smoking room is money — or rather the lack of it — and the consequent lack of cigarettes. The emphasis here is on sharing and sometimes the same cigarette is passed round two or three people.

Alternatively, you can pass the time by taking advantage of the tranquillising effects of many of the drugs and sleep either on the bed or in one of the easy-chairs in the lounge — despite the TV. Of course, some of the drugs make people restless and those affected in such a way prowl around the hospital corridors unable to find any peace for more than a few minutes at a time.

On the floor below our ward is a day centre which some patients attend. There is table tennis, pool, a kitchen, various group rooms, an art room and a woodwork room. Whenever I have visited this place it has seemed dull and lifeless but perhaps I expect too much. After all, this is not the local YMCA but a centre where troubled people gather and for many the day centre is a lifeline which allows them to live at home but maintain contact with the hospital. In fact, I did venture to one group — a music group — on the premise that there was not much you could do wrong with music. Six of us sat on chairs arranged in a circle and the occupational therapist (at least, I assume that was who she was) sat on a mat on the floor. She had a cassette recorder and a number of tapes with her and she played one track from each tape and passed the tape box around so that we could all read who was playing. Conversation was at a minimum — in fact I wondered if we were allowed to speak! After an hour we filed out — slightly bemused and uncertain as to the point of the activity. I suppose, in the simplest analysis, we had ‘occupied’ our time. It is activities like this which give OT a bad name.

And what of the other patients? The first sad observation is that there are many young people on the ward who have been admitted time and time again. The future does not look good for them and they seem destined to live from one giro cheque to the next with little prospect of employment. Although some may receive care in the community it is frequently not enough to enable them to live permanently outside the hospital ward.

There’s Annie, rescued from the back ward of some obsolete asylum to live in a house with other ex-patients and staff. Sometimes she becomes tormented by voices which give her no peace, and is admitted to the ward until she becomes calmer and quieter.

Clare is a fragile-looking young woman who gives the impression that a puff of wind would blow her over. She has regressed to a time in her young life when, presumably, she felt more secure. She seems so very lost that it is tempting to reinforce her regression by taking her hand and leading her around. She repeatedly asks whether she has done something wrong and no reassuring words will convince her that she has not.

Stuart, a young man who rushes around playing his personal stereo at full volume, takes off and spends time either visiting relatives or in his own flat, when the atmosphere on the ward becomes too disturbed. One time he stayed out all night at his flat and police called on him early in the morning to ‘escort’ him back to the hospital. One assumes they have the power to do such things.

And Bill, an older man who has had a severe depressive illness which has disabled him for much of his life. He has been on the ward for some months now but still visits the hospital chapel where he feels certain that he hears the voice of his dead father urging Bill to join him. He has had a multitude of different pills and potions and nearly 40 treatments with electro-convulsive therapy, but nothing seems to alleviate his depressive symptoms.

And so on — the catalogue of misery, confusion or whatever continues and I interact with it as it affects me; I eat the meals, take the medication, sob to the staff, talk to the doctors, laugh and cry with the other patients and try to make some sense of it all. Every weekend I touch base by returning home and reminding myself that I have a life away from the hospital — a husband and three children who greatly miss me.

Together with most patients I am waiting for a time when I can become part of the real world outside, hoping that, as Jean-Paul Sârtre wrote: ‘Life begins on the other side of despair’.