Authors: Kate Richards
The sun stirs on my face, its warmth slides across the divide in my head: a connection. I am out of seclusion, having been locked in for two days and two nights in a white gown in a white room with no socks. The white fluorescent light has mottled my skin and the people in my head are quiet. Staff have given back my glasses. The world is at once closer, sharper, more insistent, and with a combination of venlafaxine and lithium and diazepam it opens up even further, but with fewer teeth. I breathe, there are muted voices inside and outside, there is sunshine, cool wind, and I notice the way the leaves on the trees in the courtyard move in the wind.
The main ward is vinyl and concrete and perspex windows looking out onto the courtyard. Grey vinyl chairs, grey carpet, equally grey walls. Staff are kept safe from patients in a glass room in the centre of the unit, backing onto HDU. There is a television and a broken exercise bike and a broken rocking chair and an art room with a radio.
My mum and dad visit. Because the door to the ward is locked, they have to ring a bell and wait to be admitted by a member of staff. I'm on one side of the glass door, waiting, and they are on the other â the outside-world-side of the door, the normal side.
We don't talk much. We sit on the bed, me in the middle, and hold hands and their hands are strong and warm and they hold me for a moment together.
Later Hana and I drink coffee. Hana is a spoken word poet and musician, with a magnificent sense of rhythm. Her friends have brought in her guitar. She plays Elliott SmithÂ .Â .Â . picking every note perfectly.
I take out one of my scruffy notebooks and write.
Rachel, one of the other women on the ward, gives us a foot spa in an old blue paint bucket. The smell of sandalwood and jasmine is finished off with lime; the warm oil-infused water feels like silk. I look at my naked legs in the water. The scars on my legs are pink and dark red and blue-grey â new skin, a fragile sleeve of skin that has crept over the little stories, little souls, little griefs that populate my insides.
My skin is too pure a cover for what lies underneath; I can't bear touch. There is something about the pureness of touch â skin to skin â that is intolerable. I shrink, flinch, cower, forget to breathe. Touch is a tiny request for opening up, for presenting one's underside for a shared second. Instead my hands do a kind of dance away from each other; there is a gap in my consciousness and I fall through it.
âI'm going home today,' Rachel says. I raise my eyebrows. Rachel still looks wild. She's thirty-one. This is her fifteenth hospitalisation. Her long brown hair is plaited with strips of purple cotton and piled up in a bun on top of her head.
âThank God. I want to go to New York.'
âOh, yeah, me too,' says Hana. We laugh.
âHave you met my daughter?' Rachel asks.
âNot yet,' I reply.
âIt's her birthday tomorrow.' She pauses. âShe's the most beautiful thing in the world. The most beautiful.' We nod.
âI would be dead without her. D'you know?'
We nod. Rachel's eyes grow luminous in the fluorescent overhead light.
She stands up suddenly, walks over to a man in a long black leather coat with hair reaching far out from the sides of his face and head. Rachel kisses him and runs her hands lightly down his cheeks. He smiles at her, all encompassing. I look away.
Staff give me a battery of neurocognitive tests on computer: attention, immediate recall, short-term memory, concentration, learning and executive function. I tap my head and shake it side to side like a dog, twist my scarf around my good hand, the pale blue chenille soft against my skin. My right arm lies heavy in its sling, the skin under the plaster itches, the fingers like worms move without purpose. Press the yes key when the card displayed is red.
Though the door is shut people periodically walk in. An elderly lady, who won't give her name, sits down on the floor in the corner and dozes off.
âWhat does all that glitters is not gold mean?' asks the registrar.
âSurface beauty doesn't equal inner substance,' I reply.
âMmm,' he says. âWhat about a fish out of water?'
âAnd how are you today?'
âYour bloods are good.'
âTerrific. Am I cured then?'
âDo you still want to die?'
âI still want to die.'
He walks away, I walk away.
Lisa B takes us for a walk under the trees in the park. Moving with anything like a purpose feels odd. We are bats suddenly blinded by light, we are awkward in the open space, unsure of the intent of our feet, except one young man, who takes off with the wind, running across the spiky grass in his big army boots, his arms stretched out toward the horizon either side of the sky.
Lisa B calls to him.
âFuck off!' he shouts. He's tall and young and strong and he covers the ground at speed. Now Lisa's running too, lightly and fast, while the rest of us stand in an uncertain gaggle, bemused, shivering in spite of the sun.
Linda is my second roommate.
âHave you got a cigarette?' she asks, and gives me a toothless smile.
âNo,' I say. âSorry.'
âCan I have your jumper then?'
âUmÂ .Â .Â . no.' I say. âSorry. I've got some coffee, if you'd like.'
âAre you married?' she asks.
âI am. Yesterday I was going to marry Peter, but today I'm in love with Darren.' She takes the coffee in a paper cup and disappears up the corridor. Later I return to our room to find all my clothes missing from the wardrobe. I sigh.
âI've washed them,' Linda says. Lying on the shower floor are indeed all my clothes â bras, knickers, socks, jeansâ in a sodden, soapy pile. I'm back to the orange hospital pyjamas.
âDarren's taking me out tonight,' Linda says, sitting on my bed. âWe're gonna do it, you knowÂ .Â .Â . sexÂ .Â .Â . there's this aura above us, sparkling, that's why it's gonna be tonight.' She starts to cry. I move over to her, almost touching her, we sit in the silence, quite still. She sniffs, âI need him.' Linda leaves the curtain open while she undresses. Her belly is round as a cantaloupe and the skin of her torso and limbs is crazed, dusky pink as though minute rivers have eroded away its softness. Immolation?
I work with the ward psychologist on the tenets of cognitive-behavioural therapy: cognitions, assumptions, beliefs and behaviours. We discuss body image, I tell her my theory of the floating consciousness â freed from the body, free to inhabit the expanse of the universe much as a gas expands into the entire space in which it finds itself. She looks faintly troubled. Her hair is shining, it matches her eyes.
âThere are some blank spaces,' I tell her, âin my head.'
âClose your eyes,' she says. âConcentrate on your breathing. Feel your feet on the floor. Now feel your calves, your thighs as they touch the seat. Your stomach, your back, your neck, your arms and hands, your fingers.' Her voice is soft. In the quiet the world reaches in from the outside. There is space around her words, for a moment I feel whole.
Then I meet a new patient at breakfast.
âAll the usual suspects,' he says.
âThat was a rhetorical statement, bitch.'
I look up at him. âOh.' I say, confused.
âListen,' he grabs my hair and leans into my face. âI'm going to get my shotgun and shove it up your arse.' He says it very quietly, very intently.
I believe him.
âKeep away from me,' he hisses, letting me go.
I walk outside. Linda is talking on her mobile. She's wearing a long skirt, black and red, shimmery. On top she has a super tight skivvy to show off her belly. Rachel is talking with people from the Mental Health Review Board. âNo, I'm completely cured,' she says. âActually, I was never sick in the first place, just overwrought.'
âDo you think the medication helps?'
âIt makes me dopey. I can't think straight. I friggn' keep falling asleep!'
âAre you going to take it when you go home?'
âNo way. Like I said, I can't keep my eyes open. I have to look after my daughter. I can't do that if I'm half asleep all day.' They nod up and down in unison and take copious notes.
Hana comes at me with a mouth full of chocolate. âKiss me,' she says. I kiss her. Her lips are soft as clouds. Simon laughs and makes a whooping noise; I punch him lightly in the ribs.
âThat good?' he asks. âWish it were me.'
The ward courtyard has a garden containing a miniature Japanese maple with a curved trunk and several flowering gum trees. There's also a gnarled plane tree bereft of its leaves, the lower branches having been sawn off to prevent people climbing it. We sit in a circle by its trunk, drinking de-caffeinated coffee, watching the light change light grey to dark as the sun moves across the sky. I can't always make out who is talking.
Two weeks after admission, the unit social worker helps me complete forms to claim Sickness Allowance: $453.30 a fortnight. I can't tell if this is a lot of money or a pittance, the numbers sit unprocessed in my brain. And I have an appointment with the Plastic Surgery people. They remove the plaster cast on my arm with an electric saw. The stitches are ready to come out â a cut above the knot, a soft pull through skin â the wavery black string lying innocuous on stainless steel once held me together.
âECT,' says the psychiatrist one morning. âElectroconvulsive therapy.' She accentuates convulsive.
âFabulous,' I say. My heart is loud, my breathing roughens, I twist my fingers into fists.
âRead this and you can sign it tomorrow.' She gives me an information sheet. âIf you don't sign it we'll have to make you involuntary.'
You will have a general anaesthetic.
A small electric current is passed between two electrodes on your scalp.
When you wake up, you will have no memory of the procedure.
It is completely painless.
While I wait for the first session of ECT I seek out Coby on the couch.
âHave you been to the Philippines?' he asks, his eyes are so blue they might have been scooped out of the sky. âIt's not just the islands. It's the people. And the jungle. Want to listen to some music?' Coby has earphones and a portable CD player. He lends me the left earpiece and we sit together on the couch listening to Chinese opera.
âChen Shu Liang,' he says, pointing at his cd player.
âYou have beautiful eyes Coby,' I say suddenly. He stares at me.
âLaughter always was the best medicine,' he replies, gets up and walks away, earphones trailing behind him. I can't tell if he thinks I'm mocking him.
The ECT room has a trolley bed in the centre, a mobile cupboard full of medication, a defibrillator and a view over the road to the park. I lie down on the bed face up. There's a picture of a forest on the roof. The anaesthetics registrar puts an IV needle in the back of my left hand. The ECT nurse, Anna, lifts up my gown and places ECG markers down the centre of my chest and under my left breast. I feel horribly exposed. Then she puts dobs of Vaseline on my scalp where the electrodes will go; it's cold and sticky. Bernice is talking on her mobile in the corner of the room.
âReady?' asks Anna.
I nod. Ready to die.
The anaesthetic registrar attaches a syringe to the IV line and begins to push through a white liquid â I can feel it running up the cephalic vein in my arm, heavier than blood, then my head is assaulted with a huge buzzing and the world goes white.
âKate,' a voice is speaking from far above me. I have no idea where I am; I am not even sure who I am. The room is all white â walls, floor, beds, curtains. If this is death, it's whiter than I imagined it.
âYou've just had ECT,' says the voice.
âWhy am I here?' I ask.
âKate, you've just had your first ECT.'
I sit up, rip the IV line out of my arm and try to get out of bed over the railings. I struggle with the sheets, I can't feel my feet, I can't remember why I've been arrested, âWhat have I done?' I shout. People appear from various directions. âDon't touch me! Please! No! I haven't done anything wrong.' The world is turning too fast, I am back down on the bed and injected with something that makes everything peculiar and fuzzy.
âYou were very confused, we've had to give you some midazolam,' says Anna when I wake up again. I'm still confused. A few hot tears ooze their way out of my red, hot eyes. I am numbed so effectively by the midazolam that I understand why they call it a chemical restraint.
âDo you have a faith?' Anna asks.
âDo you believe in God?'
âHow are you going to heal?' she asks.
âHammer and nails,' I answer. She takes my hand.
Back on the ward, the music therapist has come in with his guitar for a sing-along. We sit around him in a circle and sing Crowded House, Cat Stevens, Bob Dylan and Gary JulesÂ .Â .Â . mad worldÂ .Â .Â . Linda walks into the room and attempts to sit on his knee.
âLinda, I can't play like this,' he says. âSit down over there.'
Linda makes kissing noises, âOoh, you're hot!' she says.
The music opens up a kind of conduit between my brain and heart. Even though my back and arms and legs feel like they've been put on the rack and it takes me a whole minute to stand up because of post-ECT muscle spasms, the music â guitar notes and the act of singing â is a flash, then a ray, warm like bath water, almost human.
âWhere's your shirt, Coby?' asks Lisa B later, in the main room. He ignores her.
âCoby, you can't walk around without a shirt.' She takes him by the arm and walks him down the corridor to the bedrooms. In the courtyard someone has strung the inside tape of a cassette across the trees from one end of the courtyard to the other. It shimmers and shivers in the breeze like a sudden sculpture. I walk outside slowly and raise my hands in the air in homage.
âCoby and Hana,' says a nurse, walking past fast with a large pair of scissors. It takes them over an hour to get it down; despite their best efforts strings of tape are taken up by the wind, drawn heavenward, are flying; the clouds make a superb backdrop.
Evenings I curl into one of the grey vinyl chairs in front of the TV. Nothing on the television looks familiar. I can't remember ever having seen the newsreaders, I can't understand the news, the stories are foreign and confusing, my eyes won't focus. This is life without punctuation. This is a commentary of rappers whose dance I barely keep up with, round and about they go free as air, they do not acknowledge, but rather breeze through and past and between as though nothing else exists, their hair in my head is quite red, tangled, curling at the ends, mixed with air and light it shimmers. I can't quite grasp them, rein them in, slow them down, they are turning, looking at me, laughing, are gone.
One patient is arguing with another in the hall. âJust give me a fuckin' cigarette,' the new patient says. âJust one.'
âGet your own,' the other says.
âFuckin' bitch.' The new patient walks towards me up the corridor. She's wearing hospital pyjamas several sizes too small, the fat around her hips and abdomen is leaking over the sides, she smells musty, like the aftermath of sex. Her face is large and round and her eyes show sorrow to their very depths and something else â a labyrinthine bewilderment. When she leers at me, she has no teeth.
For the next four weeks, three times a week, the ECT procedure repeats itself: up on the bed, lie down, ECG leads, Vaseline, needle in vein, injection, the cold, the rush, the falling. I hang suspended; I am disembodied; I am nowhere. I am transient as shadow, soon fading and dying, bereft of sun. The kabbalah says âwhen a person stands in the light but does not give out light, a shadow is created'.
It's my twenty-sixth birthday. Friends from school, Tanya and Penny, bring red and orange gerberas â small suns in a vase in the sunlight. My parents bring roses and chocolate and books. We sit together in the day room, hunched up on a couch that has long ago lost its stuffing.
âAre you okay?' they ask. My mother looks thinner, my father's hair is greyer and I'm culpable.
âIt'll be okay,' I try a creaky smile. An old man with white hair sticking out all over his head and a long white beard sprints the length of the ward stark naked. Three staff are after him, âFuck you!' he shouts, disappearing into the courtyard.
Thanks to ECT, memory has left me a soggy trail, mired with half-truths and confusion. Whole days are black holes â the normal neuronal connections that forge new memory stagnate, and with a loss of emotional breadth the entire world encapsulates into the boxy rooms of the ward. I have shed my brain.
In an attempt to make sense of things, I write scratchy notes in the notebooks that I carry everywhere. The notebooks are unlined; writing tracks across the pages like trails of ants in search of food. Some mornings I sit with my dear friend, Tan Ying, in the courtyard and it is all I can do to pronounce her name. I'm astonished that she puts up with me.
The consultant psychiatrist suggests I apply for the Disability Support Pension. âBest you face facts, Kate,' she says. âYour sort of illness doesn't go away. It's very unlikely you'll be able to work.'
I stare at her.
âHey!' Someone shouts outside the consulting room door. âHDU's on fire!'
I turn slowly just as the sonorous fire alarm sounds. Everyone is milling around the nurses station. The HDU patients are being walked out into the main ward, a nurse at each arm. Most of them are so heavily medicated with phenothiazines that they mince with Parkinsonian steps, arms dead at their sides. We're herded out the front of the psychiatric unit while the fire alarm changes to a more insistent whoop, lingering on the last note. The fire trucks arrive, then the police. There's a vague smell of smoke but no flames. Coby is brought out last between two nurses and two security guards. He looks frail but his eyes are lit with the light of epiphany.
âFlorid,' says one of the nurses holding him up. Coby folds onto the ground in his orange flannel pyjamas, his black hair slicked back with brilliantine, his patent leather shoes still on.
Coming back into self after a crisis is as slow as mending bone. Psychiatric illness affects the deep centres of the brain that govern perception, emotion, behaviour and personality. These areas â the prefrontal cortex, the thalamus and limbic system manifest the hidden experience of the mind as opposed to the core motor and sensory functions of the brain.
In the night I slip past the night staff and go out into the courtyard, lie down on a bench and look up at the sky. The night air ripples. According to Scottish mathematician J.S. Haldane, âthe universe is not only queerer than we suppose, but queerer than we can suppose.' This gives me comfort. The stars are out â gleaming cantos of space. In the wide, wide night, there is only the essential smallness of self and the tiny equilibrium of earth and air on which we exist.
Anna finds me occasionally on the ward and we sit side by side on the wooden seats in the courtyard. She has a beautiful face â rich brown eyes that have a depth and an intelligence, liquid soul. She is wise. The people in my head don't know quite what to make of her, they mutter together and flitter, they are edgy.
Another appointment with the plastics people. They take the splint and bandages off. It is odd to see that skin again, the raised dark pink scar like a thick, oily snake, almost circumferential. Disgusting. I go for a walk in the park.
I walk faster.
In the park there are leaves forming on the plane trees, shining with newness. I lie down on the grass, put my face as close to the grass as I can. A small black beetle, brilliant as a mirror is crawling about down there. I watch it travel several centimetres â up over the green stems, falling back down, finding a new way.
Back on the ward Rachel and Simon are playing basketball in the courtyard. The new patient has urinated all over the courtyard bench.
âIf she was my dog, I'd shoot her,' says Simon.
She shuffles in her stained pants, asking for cigarettes, picks through the butts on the ground, finds one with a bit of tobacco, asks for a light. No one will give her one.
âYou're all mad,' she says. âMad.'
Tan Ying brings in my cello and some sheet music. I take the cello out of its case slowly and stroke the brown wood with the back of my hand. It is cool and smooth. I take out the bow with its clean smell of resin. White resin dust gets on my clothes and sticks there like dandruff. I pluck the C string. It resonates even without the bow. I place the cello between my legs and rock back and forth a little and tighten the bow and play an open A and smile. I pick up the sheet music: Bach's first suite for solo violoncello. The music is notes crawling all over the paper, black on white, like ants. I squint, shake my head, turn the page upside down.
âI can't read it,' I say. âMy brain's fried.' Tan Ying offers me comfort; she holds my hand and rubs my back.
The next day I wake up and know immediately I've had enough. There are new cameras in the ceiling â several of them in the air conditioning vents and behind the sprinklers. There may be more. I can't be sure any longer about the motives of staff â if they have been trying to kill me with ECT, with the drugs, the food, for some reason I'm still alive. Do I want to die? If I don't want to die, I have to leave. I stand in the corner of the room â I must be reasonable. The rain runs down the window, gets caught in the throats of the calla lilies. I pack my bag, strip the bed and wait at the nurses' station.
Lisa B listens to my request. I try to speak politely, my hands flutter. âCan you wait till after the morning meeting?' she asks. âI need to talk to your doctor.'
âNo,' I say, looking up at the cameras. âI'm ready to go now.'
âAre you voluntary?' she asks.
âHow are you feeling?'
âOh, good, really good. Much better.' I smile.
âOkay, give me a minute.' Lisa B disappears into the staff area, speaks to the psych reg, walks back out to me. âYou're not on a treatment order, are you?'
âHave you got enough medication?'
âPlenty of everything,' I say.
âThanks, Lisa,' I say.
She locks the door behind me.
When I get home there's a message on the answering machine from Anna. I call her, and agree to complete the ECT program as an outpatient, Mondays, Wednesdays, Fridays. I am under no illusion that ECT actually works; I catch the tram to the hospital in the mornings to see Anna and to have a few minutes of oblivion under the anaesthetic. Waking from the anaesthetic I rise up from deep under water and gasp, mouth wide open like a fish, lose all sense of my body, become the floating consciousness. I tell Anna I'm made of bad DNA. She says we all have something that makes us beautiful; we all have a right to be alive. I smile. I don't believe her.
Li, phen, pen, thio, tem, tram. This could be a poem or a piece of music whose notes intone my death. â.Â .Â .Â Send not to know for whom the bell tolls; it tolls for thee.' It tolls for me. I take all of the tablets into the living room and line the bottles and the blister packs up on the floor. My head is clear as water. Bach's fourth cello suite fills the room with sound that is as reassuring as it is magnificent. This is my death. I put on appropriate clothing: jeans, shirt, jumper, socks, no need for shoes. I fill up big bowls of water and food for the cats and give them a kiss on the top of their heads; their fur like silk threads comes away in my mouth.
It is evening. The last lengths of sun are deeply pink on the right of the sky. There is a half moon in the bottom of the sky. I have a jug of water and a glass by the couch and my eyes are full of music and the softness of the sky. Breathing is sweet but finite. The people in my head are quiet, we are all in agreement: it is the right time to die.
I sit on the grey carpet, cross-legged, with my back to the couch. I start with the half bottle of white, coffin-shaped tablets. I take them carefully, two at a time. Then I take the blue ones, the white ones, the yellow ones, the orange ones, the other white ones. It takes about five minutes. I lie on the couch and pull a clean white sheet over me. The phone is off the hook, the lights are out, all the windows are open to let in the fresh air â a room gets very cloying with a dead body in it. I close my eyes and fold my hands neatly over my abdomen.