Tollesbury Time Forever (20 page)

Pleadle plaudle with your dove-like hands good doctor. You can vious your ob any way you like and plore your imp to all that will listen. ‘Tis your frightful right good sir!

PETER MIDDLETON
- And whose reality is that, Dr Weepy, to which you seek to bring my client? Your reality or his?

Dun dun daaar!

IRIS PEARSON
- Dr Weepy?

Well, well, weeeeellll?!

DR WEEPY
- Well, I don’t think it is actually that helpful to labour this point. The fact is that if somebody thinks they have gone back in time then, to me, and to society at large, that is surely the product of a mental illness and it is my duty as a Consultant Psychiatrist to lead that person back to the real world. It would be cruel not to do so, wouldn’t you agree?

PETER MIDDLETON
- I wonder if you could tell me at what point, Dr Weepy, you would consider my client to have gained sufficient insight to warrant you discharging him from Section 3? Assuming of course he is not discharged by the panel today.

Puppy dog eyes my Peter to cajole and shlurp the spaniel paniel. Ah but the eyebrow of the lady jerks and jumps over the
hurdle of her eye and her chin sinks into swampy pulpy neck flesh. No dice, man. No dice.

DR WEEPY
- Insight is a key component, maybe the key component of any patient’s recovery. Without insight, a patient may discontinue medication which will in turn lead to a relapse. Without insight, a patient may neglect to meet up with their Community Nurse or Social Worker. They may even refuse to attend Outpatient Appointments with the Consultant Psychiatrist. In short, without insight, a patient will inevitably disengage from all attempts to help maintain them in the Community with, just as inevitably, disastrous consequences.

PETER MIDDLETON
- So if I understand you correctly, Dr Weepy, insight is gained when a patient does what the mental health system tells him or her to do, without question. Is that what you are saying?

DR WEEPY
- Let us not be trite Mr Middleton.

PETER MIDDLETON
- Please forgive me. I am just trying to ascertain as to what, in your opinion, my client needs to do to prove to you that he has, as you call it, developed insight.

DR WEEPY
- Well, he would need to understand that he suffers from Schizophrenia and that he needs to take medication. He will also need to assure me that he understands the need for community care and to show sufficient commitment to engage with community services.

PETER MIDDLETON
- Not an easy task, I’m sure. Could you please tell me briefly how the medication works? I would just like to understand it a little bit more.

DR WEEPY
- Anti-psychotics work by increasing or reducing the effects of natural chemicals (called neurotransmitters) in the brain, including dopamine, serotonin, noradrenalin and acetylcholine. These neurotransmitters regulate numerous aspects of behaviour including mood and emotions, control of sleeping and wakefulness and control of feeding.

PETER MIDDLETON
- Thank you. I think. Is it true that one view would be that such medication dulls the emotions and impulses of an individual to the point where they
no longer have the motivation or energy, mental or otherwise, to do anything other than the most basic of daily tasks? And that’s without even considering the side-effects of such medication. And furthermore, could that reduction in energy, emotion and motivation then perhaps limit the opportunity for others to be aware of the thoughts someone such as my client may have purely because one such as my client would be spending the majority of his time, well, asleep.

IRIS PEARSON
- I think, Mr Middleton, that such a debate could go on indefinitely. If we could just stick to why we are here today, namely whether Mr Anthony warrants continued detention under Section 3, then I would be much obliged.

PETER MIDDLETON
- I’m sorry. It is not my intention to keep the panel here any longer than is necessary. I would just like to make the point that the fact that my client is currently complying with medication is evidence alone of a degree of insight into his condition and that surely he does not need to complete a test in physiology to prove that. When my GP tells me I have a chest infection, I do not ask the ins and outs of how it develops and he does not grill me as to whether or not I understand what is wrong with me or whether I will comply with treatment. I just take the antibiotics and hope things improve. And my GP trusts me to do so.

DR WEEPY
- My point exactly.

Plinky plonk ker-plunk. Pull your straws and lose your marbles. Tickety, tickety BOO!

PETER MIDDLETON
- But we are not talking about mere chest infections, are we Dr Weepy? We are talking about a man’s thoughts, his emotions, his moods, his connection to society, indeed to the world. We are talking about the sensory experience a man has of his life - and if that experience is too dissimilar to that of the rest of us then we call it an illness - and the cure for that illness is to subject the transmitters or whatever they may be to drugs which debilitate the workings of the mind to the extent that a fog, a vacuum, develops; the only way out being to agree that you are mad and that the venerable Dr Weepy is right.

Sigh miles high Mr Peterman and raise your hands to the venerable amongst us. Tolerate their frown with a stoic tinge and seek not to vanish into the antiquity of it all.

IRIS PEARSON
- Thank you Mr Middleton. And thank you Dr Weepy.

Nodding head Weepy wibbly wobbly leaning back recline and sink into the form of all our souls the power turning twixt and thus into the spirals of my mind.

IRIS PEARSON
- Are you ok, Mr Anthony? We can stop for a moment if you like?

In the name of love! Before you break my heart - think it oh oh ver.

SIMON ANTHONY
- I am fine thank you. Well, in a manner of speaking, of course.

IRIS PEARSON
- That’s good. I am aware that these kind of things can be very stressful so please do let me know if things are becoming too much.

SIMON ANTHONY
- Thank you. I will.

IRIS PEARSON
- Now, if we could come to you please Miss Shoraton. A summary of your Nursing Report if you please.

Quivering quaking in your shakings redden up as your lamp arises bringing forth the fundamental shift of the soul to the surface, breaking the mighty tensions with which the gentle of heart must forever contend. The beat of my heartness, the heart of my beatness and the twanging of your memory strings combines to fill the VOID with musical delights and absent smitings that behold nothing but the glory of the future and the nebulous hammerings of the past.

PENNY SHORATON
- Thank you. I have known Simon for about four years. In that time, he has had three admissions to Crimson Ward. On the current admission, I have been his Keyworker. He was admitted informally having just tried to drown himself in the marshes in Tollesbury, where he lives. When he was admitted, he was disorientated in time, place and person. He walked around the ward constantly with little communication to others. He was noted to be responding to auditory hallucinations whilst in his bedroom. It wasn’t
clear as to whether he was experiencing visual hallucinations as well.

Simon initially complied with oral medication which was given in liquid form due to him having secreted tablets during previous admissions. He took his depot from one of our student nurses but continued to present as confused and disorientated. There were initially no signs of him being a suicide risk or a risk to others.

When Simon was seen in ward review by Dr Weepy and Dr Nardy, he became distressed and was placed on continuous observation. This was mainly due to the fact that on previous admissions he has attempted to harm himself when distressed. It was the following day that he absconded from the ward. He was found after three days, asleep in a field near Tollesbury. It seemed he had cut a narrow strip of grass about a foot long and placed matchsticks in the ground at each end. According to the police, it looked like some kind of miniature cricket pitch.

When Simon returned from AWOL, he was taken first to the Section 136 Suite and then to his room. It was there that he tried to hang himself and I was one of those who found him. In his pocket, there was a selection of scrabble letters - nine of them from what I remember although I can‘t remember which ones they were. I think there was an F and a Y and perhaps a G.

IRIS PEARSON
- I am not sure we expect you to remember such unnecessary detail, Miss Shoraton. Do go on.

PENNY SHORATON
- Sorry. Thank you. Well when Simon returned from A&E he was placed again on continuous observations and began to comply with his medication. Over the last few weeks, he has become orientated to reality and there has been no evidence of responding to visual or auditory hallucinations. He is now on intermittent observations. He hasn’t had any periods of unescorted leave but does currently have one hour escorted leave per day around the grounds.

Beauty is as beauty does and we all stand together! The lady of all our wonders sighs and touches so gently her own cream hands and her eyes enter mine with the gargantuan fullness of the steamer departing from the shores of Albion’s
purity. There is nothing like the deep ocean look of the majestic love that throbs within a fairy woman’s soul and the splendour of its radiance when it encompasses your whole entire earth. Penny Shoraton you are not only my angel but the fulfilment of all my misshapen logic and blunders. You stream into me and take apart all that is treacherous in the mountainous regime of my powerless worth. I am yours, in madness, your friend and your lover - Simon Anthony.

IRIS PEARSON
- Thank you. Are you ok to continue Mr Anthony?

SIMON ANTHONY
- If it’s alright with you, I would like to just take a breath in the garden. Only if that’s alright, of course?

IRIS PEARSON
- In that case, we will adjourn for, say ten minutes? Thank you everybody.

The leaves depart and the light ascends
,
flowers pulsing through the veins of time. The breath of all is upon me now weaving and meandering in and out of my mighty heart and dishevelled mind. The arras awaits to save me once more. Falling apart is so much harder than keeping it together, the crimble crumble of my stony pony brings about a gathering of unfortunate miasma that can lead only to a debacle from which there is no escape. But I know all that and knowledge alone is what will keep me strong. It’s a quarter to four and the bell doth ring clanging me home from school into the greasy arm slithering dreams of a grim decaying monster.

Love me do, people. Love me do!

Well, from behind the arras I do now reveal myself and once more am I to be subjected to the jestery tinklings of adultspeak; but, ah, the light in which I will submerge my fine self is that which gushes forth from the angel of all my heavens and pours over my big old aching soul. All else is but shadow to me now.

IRIS PEARSON
- Thank you for returning on time everybody. So, if we can continue? Before we adjourned we had just heard the evidence of the nursing team. Now I will ask the panel if they have any questions.

DR KHAN
- Do you consider, Miss Shoraton, that Mr Anthony is currently a danger to himself?

PENNY SHORATON
- I don’t think so, though it’s difficult to say. He has obviously tried to kill himself in the recent past and you can’t rule out him trying to kill himself in the future I suppose. But right now, he is really well - probably as well as I have seen him for a long time.

Love is in the air! Every time I look around it seems I’m bound to have found the sound that leads ever to the ground, that deep dark bass that throbs and fathoms the ultimate assuaging of the tortuous rhythms of my heart. I love you, Penny Shoraton.

DR KHAN
- Well, going on from there, do you consider that Mr Anthony warrants continued detention under the Mental Health Act?

PENNY SHORATON
- That’s not really for me to say, I don’t think. All I’m saying is that Simon has been very unwell and now he’s getting better. Whether he needs to stay on a Section is really up to you. And the others of course.

DR KHAN
- Thank you.

IRIS PEARSON
- Raymond?

RAYMOND LISTER
- Could you please explain to me what you mean by Mr Anthony being ‘well’?

PENNY SHORATON
- When Simon first gets admitted, he is always very deluded in terms of time and place. This is the first admission where he has not worn sunglasses the entire time. When he is unwell, he can be very unpredictable. When he is well, he seems just like me or you. You can have a normal conversation with him and you wouldn’t know there had ever been anything wrong with him. He really does go between being incredibly ill to more or less fine.

RAYMOND LISTER
- So it is your professional opinion that he is now, as you call it, more or less fine?