Madness (12 page)

Money is a real problem. Some of us with long-term mental illness are lucky enough to be financially supported or assisted by family and friends. My parents are paying the mortgage and most of my bills and I don't know how I'd manage without them. The fortnightly government allowance is swallowed up by food and groceries and cat food and the occasional book. I haven't walked into a clothing shop or a shoe shop or a department store for months. Hiring a DVD once a week is cheaper than the cinema.

To save money I pare my diet down to raw carrots, mandarins, spinach leaves and steamed rice with chilli. I drink black coffee instead of whisky. I lose a lot of weight. My blood glucose and cholesterol normalise after the years of subsisting on chocolate. Sometimes I faint if I stand up too quickly.

When one of my former colleagues in cancer research goes on long service leave, I'm offered a job as her replacement for three months. I feel somewhat re-born just at the thought of being involved in something that matters, in having a sense of purpose, in contributing. I'm also nervous; scared of performing poorly or making mistakes or of it somehow being obvious to others that I've once or twice gone mad.

I suspect that most of my workmates know I've been in a psychiatric institution, because that kind of gossip travels and I've never asked those who know me well to keep it secret. It is painful that I can't discuss what happened (whatever it was) frankly, like I would a hip replacement or even a hysterectomy. It is painful and somewhat awkward – this thing left unsaid yet present.

But I settle in uneventfully and I work hard and the best parts of the day become the times a group of us hang out together and relax – morning coffee, lunch, drinks on a Friday night at a bar up the road.

‘Whatcha doing on the weekend?' we ask each other after the third beer.

‘Alpine hiking,' says Deborah.

We groan in admiration.

‘Sleeping,' says Jess.

‘Strip club,' says Adrian.

‘Adrian's horny,' we say, slapping his shoulders and knees. As the only man in a sea of women, he loves teasing us, and we him.

‘Let's all go!' I say.

Adrian laughs . . . blushes.

‘Gross,' say Jess.

‘Why?' I say.

She frowns, mocking shock. ‘Watch it.'

Later in the evening I settle into a state of nice, warm, alcohol-fuelled disinhibition. We're mulling over religion and science. ‘Purring, for example,' I say randomly. ‘What evolutionary benefit does purring have?'

‘What?' says Jess.

‘Seriously.'

‘Dunno. You're weird.'

‘Am so not. Am. Yeah.'

Jess gets up for another round of drinks. ‘Hey,' she says, turning back to me. ‘Love ya.'

‘Love ya,' I say, thrilled. Quietly.

My work portfolio covers clinical trials of new and hopefully better therapeutics in leukaemia, lung cancer, breast cancer and prostate cancer. Some of the novel agents are drugs, others involve a new radiotherapy technique or a new surgical technique or a combination. We educate patients and families, provide support and collect clinical data. Obviously, the ability of a new therapy to treat or cure cancer is paramount, but we spend a lot of time assessing adverse events as well as efficacies. That is, talking with, and examining patients to see if the new treatments are affecting them adversely, and if so, what action we can take.

One of my patients is a young woman with breast cancer concerned about her fertility after chemotherapy. There's a mother of three young children who can't get out of bed in the morning because her haemoglobin is so low and a twenty-one-year old who has devastatingly relapsed after a bone marrow transplant. Some days at work are uplifting and others bring great sadness.

Richard was on his second honeymoon when he noticed blood in the toilet. He didn't tell his new wife, didn't want to worry her. Didn't tell her that he had booked in for a colonoscopy when they got home. Didn't know how to tell her when the biopsy result came back as cancer. Richard's wife hates hospitals – both her parents died in a hospital – so Richard attends his weekly appointments for chemotherapy alone.

Richard is forty-nine. He has a full time job, a new wife and two teenage sons. He has bowel cancer that has spread to his liver and lungs.

Every Wednesday at nine in the morning, Richard is sitting up straight in his chemotherapy chair with the newspaper and a cup of tea.

‘Morning Kate,' he says brightly.

‘Morning Richard. How are you?'

‘Excellent.'

‘Yeah?' I sit down beside his chemo chair.

‘Yeah.' His face is more grey than pale. Exhausted.

I learn forward just a little.

‘Well . . . you know how it is . . .' he says.

‘How are the nights?'

He folds up his newspaper and looks at me. After a while, he says, ‘Long.'

‘How much sleep are you getting?'

‘Not much.'

‘Pain?'

‘Yep.'

‘Where?'

‘Back, tummy, lower down.'

‘Worse that last week?'

‘Yeah.'

‘What else?'

‘Oh, the usual. Nausea.'

‘Anything else?'

‘Just can't get off to sleep.'

‘How about in yourself . . . how are you feeling?'

He looks away. Looks back at me. ‘It's rough.'

‘It sounds rough.'

He smiles.

‘Okay,' I say. ‘Let's talk to your oncologist about your pain medication. And we'll get you something stronger for the nausea. What else can we do to help, Richard?'

At the end of the three months, almost as if heaven and angels exist, one of our work team hands in her resignation and I'm offered a permanent full-time position and I take it without hesitation and for a further six months I work hard and practice yoga and visit Winsome once a week and life smooths out like an estuary nearing the sea.

‘It's such a god damn relief,' I say to Winsome, breathing so deep and fast I'm dizzy, ‘to be financially responsible. I think being reliant on the government for a fortnightly pittance – sickness benefit, disability support – is also a kind of straightjacket. Like being hospitalised and medicated and told you're not . . . you're just not . . .'

‘I see that,' Winsome says, quietly. ‘But you're making wonderful progress. It's a delight to see.'

‘Really?'

‘Yes. Really.'

‘Thank you, Winsome. That means . . .'

real connection kind of love gratefulness smallness strength hope

‘. . . that means a lot.'

Richard has come into hospital by ambulance with a bowel obstruction. I go up to the oncology ward to see him.

‘Dr T and I had the big talk,' Richard says. ‘To keep going with the chemo . . . or not. I've decided not.'

‘Okay,' I say. And then I get up from the chair and kneel down next to the bed so our eyes are at the same level and I hold his thin, dry hand. ‘Bloody hard decision.'

He huffs, grins, frowns. There are tears in his eyes.

‘So. This is it,' he says.

‘Is your family here?' I ask.

‘Yeah, they've gone to get me some stuff from home. They'll be back.'

‘Good.'

‘I've been wondering . . . what happens now?'

‘Do you mean about palliative care?'

‘Yes. And about . . . you know . . .'

‘About dying?'

‘Yes.'

I nod, hold his hand. There are tears in his eyes.

‘At night I keep thinking . . .' he says.

‘Ah huh?'

‘How do you die?' he asks. ‘I mean . . . how do you actually . . . die?'

I take a breath and think about how to reply. I want to be honest. I don't want to scare him. I'm scared that he'll see I'm scared (to talk honestly about dying to a man who is dying).

‘I can talk with you from my knowledge and experience Richard, but I don't know everything – far from it – and I might be wrong. I mean there are only a few set truths and so much of what happens will be very personal to you . . . okay?'

‘Please . . .'

‘First, there's a physical process . . . of the body slowing down and then shutting down. So people usually rest more and sleep more and more and often don't feel hungry. And then you may have times of not being conscious to most things, but you may still hear music and the voices of people talking with you. Your breathing changes, it may get faster for a time and then much slower. Sometimes people feel restless and sometimes people wake up for a while and then fall back into a very deep sleep. The right medication for pain and for feeling restless is so important and the palliative care team will make sure of that.'

We sit in silence for a few minutes.

‘You know,' I say quietly. ‘Whatever is important to you, whatever is sacred, whatever feels right for you and your family . . . so long as you are comfortable in your body . . . there aren't any rules.'

We sit in silence, holding hands.

Then he says thanks and I squeeze his hands and go back to the stairs and whisper, oh fuck, with each step down, tears blurring the stairs and stairwell and the people striding past with purpose, on and up.

One day, walking down a quiet street with a park at the end of it, I pass an apartment for sale that is open – right now – for inspection. I go in. The main bedroom upstairs has large windows overlooking mature oak and silver birch trees. The kitchen is old and the carpet is bile-green shag but the living area is big enough for books and music with adequate wall space for etchings and linocuts, posters and paintings and photographs. There's a spare bedroom for friends and a separate toilet and a courtyard with high walls covered in ivy.

I turn up to the auction alone, wearing old track-pants and a bright orange, crocheted beanie. At the end of the auction the apartment is passed in, but I'm the highest bidder so we enter ‘negotiations.' The estate agent trips back and forth between the owners and me.

‘You must be so nervous!' she says, standing well inside my personal space, breathing fast. ‘I'm nervous, and it's not even going to be my new home.'

I frown.

She smiles, red lips and teeth.

‘There are more important things,' I say.

She frowns.

I sniff.

After half an hour, the owners agree to my price, which is actually my parents' price. Though I've saved enough to pay the deposit on the mortgage, they are financial guarantors and without their support I couldn't afford anything like this place.

My father builds a red gum bookcase that spans nearly the length and height of the living room. It is the centrepiece of the apartment. The cats stalk through the new rooms like they're prowling in the jungle. At the end of each day I ask what it is they have discovered. We all sleep on the big bed with the windows wide open to the air and the darkness and the creeping of the ivy and the brimming silver birches.

‘I've booked a flight to New York,' I say to Zoë one Sunday evening, sitting in the courtyard, watching the light fade, artery to vein.

‘What?'

‘Manhattan, Queens—'

‘Duh. I do know that. Are you manic?'

‘I am not.'

‘Have you told Winsome?'

‘She's cautiously positive.'

‘Why now?'

‘I've been thinking that I might always have a fits and starts kind of life. Able, unable. Sick, well,' I lean forward, clasp my hands. ‘I'd like the well bits to be meaningful, I'd like to experience stuff and explore, meet people, learn. Manage better.'

Zoë nods but she doesn't look convinced. ‘I get that,' she says. ‘And New York sounds . . . fantastic, bloody hell, it really does, but . . . I dunno . . . have you thought it through?'

‘Yes.'

‘Have you?'

‘Yes.'

Of course I have. The Met! The Guggenheim, Central Park! The world.

Zoë tips her head to the right. Her eyes search for mine.

Oh. Now I get it.

‘Oh,' I say.

‘You bought this flat, what . . . three months ago?'

‘Yeah,' I say. ‘But I've saved hard for this. The mortgage isn't going anywhere.'

Zoë crosses her legs, uncrosses them. Crosses them. Looks at me.

I say.

I have not thought this through. It was so clear and so right a minute ago. So easy.

I close my eyes. ‘I'm such a stupid fuck.'

‘Hey?'

‘Me.'

‘I'm not saying give it up, I'm saying be careful. I mean . . . be careful with your money. And think about what could happen if you don't get enough sleep over there, or you get mega-obsessed with something.'

‘Yeah. You're right. You're just like Winsome. Too bloody rational. But thanks Zo. God. Seriously. Thanks.'

‘Take your meds.'

‘Every single morning and every single night.'

‘No exceptions.'

‘No exceptions.'

‘And for God's sake don't take too much spending money!'

I laugh.

‘And call me or call Winsome if you think you're not doing well.'

‘Thanks, honey.'

‘I mean it.'

We smile at each other across the fur of sleeping cats.