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Through the Cracks: Home… Sweet Home

What’s it like to be in a mental hospital? In the introduction to this series, Phill offers an empathetic yet unflinching first-hand account, leaving labels, preconceptions and prejudices at the door.

Through the Cracks: Home... Sweet Home

This feature is Part 1 of a series.

My room is a single room with an ensuite bathroom. Newcomers, I’m told, temporarily occupy these rooms until a decision is made regarding our mental state. Soon we will be moved, either to single rooms with shared bathrooms or four-bed dormitory rooms. Another patient, unhappy about being moved into a dormitory where his unsettlingly-vacant neighbour openly masturbates to vocalised violent fantasies involving minors, has told the nurses that I’ve agreed to swap with him. I am asked only once if I have indeed agreed to swap rooms. My terror must be evident; my room remains my home.

My room itself is a curious statement. There is a single bed, much like any cheap motel room but with its comfort hindered further by a thick vinyl bed protector. The walls are a powdery blue and the carpet is a hard-worn, grey-blue loop-pile. The spartan furniture — a desk, bedside table, chair and wardrobe — would have been understated two decades ago. The print which depicts a city scene, somehow aptly, in the rain, is firmly fixed to the wall, its glass removed. There are two impenetrable layers of steel bars on the outside of the building and the floor-to-ceiling windows are no longer able to be opened. All the same, I am glad for the small patch of blue sky I can see through the bars, past the large tree growing in front of my room and out over the tops of the surrounding houses.

There are pictures on the walls, and flowers in the halls, but everywhere the air is stale with a too-easily avoided truth.

Aesthetically, the room is unashamed of its intended utility — to minimise opportunity for self-harm. The wardrobe has no handles and no rail. Clothes are instead hung on weakened hangers which are unable to be removed from an odd, folded-metal channel. This works for hanging clothes on, but nothing else. In the ensuite there is no traditional shower rose. In its stead, a smoothly rounded nub with holes in it. It works, but only for showering.

When you are forced to consider the effort which has been expended in conceiving of and then preventing opportunities to do yourself in, you seem to look all the more for possibilities not yet imagined or prevented. For example, the building is old and my door swings inward, not hung on safety hinges allowing it to be removed in the event of my blockading it. There is enough furniture in the room to lock myself in quite effectively. I won’t recount all of the possibilities I’ve imagined, but I know I’m not the only one spending tortured hours staring at my four walls through these clouded eyes.

Many patients here will say they don’t want to die, if only to be spared the shame and humiliation which inevitably follows their expressing how they really feel. It’s unfair to misunderstand the will to life expressed in this self-effacement, though. Of course, there are those who tell the most chilling truth and openly wish for death – some here have lived on borrowed time for too long – but a great majority of patients are not particularly different, especially visibly, to you or I. The daily lives of many suffering psychiatric malady are not lived far beyond diagnosis and symptom, and I suppose even the strongest of flames at times burn low and flicker. I am in a hospital, but death wears different colours within these walls, a more familiar cut of cloth. One is not loose with one’s words to another under his ominous presence.

On admission all patients are assigned a Category 4 rating, which mandates half-hourly sightings and no possibility of exiting the building. The institution is built on a quadrangle and has a pleasantly landscaped internal courtyard, so being locked down isn’t so bad, at least in this regard. A Category 3 rating means that you only need hourly sighting – though your door is still opened every half hour regardless. Category 2 means that you can go outside the building with a responsible family member or friend for up to two hours. Category 1 means that you can sign yourself out for up to two hours. Changes in rating are effected upon doctor’s orders, and there is no negotiation of ratings in their absence. In emergencies, all of your belongings are removed from your room and you are placed under constant, physical observation. It is rumoured that there are two padded cells in the basement where patients can be held until police escort them to the nearest public hospital where forced sedation can be administered. There are pictures on the walls, and flowers in the halls, but everywhere the air is stale with a too-easily avoided truth.

Now that I’m deemed to be a Category 1 patient, I take the opportunity most days to sign myself out to explore the local area and escape the conspicuously-discreet observation. It is wonderful to feel the sense of freedom in walking the streets and browsing the shops of the precinct. It is also disarming to find myself at the same time unavoidably aware of a reality best voiced by one particular Welshman: “All the world old is queer save thee and me, and even thou art a little queer.” The cross-dressing hippy who walks the footpath barefoot while smoking a joint isn’t in the mad-house, and nor is the man who lies in hiding, quite naked, in the mounded beds of the nearby public rose garden. But I am.

It has been challenging seeing a head poke around my door every half-hour of the clock, a flashlight insensitively beaming in my eyes during the dark hours. Even more confronting have been the psychiatric nurses asking me every hour or so, in slow, deliberate tones, “How are you feeling?” They ask this expectantly, as if I will surely need to make some confession at every opportunity, as most patients do. The nurses write volumes on how we behave and interact – even at dinner they observe from the edges of the room, writing continuously.

The place is filled with politely-concealed cameras which are constantly monitored at all three nursing stations. I have located all of these cameras and noticed a place in the courtyard where a tree has grown too large, enabling me to sit behind it and not be visible to camera. I stay there for four hours one afternoon until a nurse finally finds me and says, a bit peevishly, “We’ve been looking everywhere for you.” I say that I’ve been sitting there the whole time, a nothing response. She vengefully ticks her clipboard and offers a pained, “Well, I’m your nurse for this shift, so please come to me if you need anything,” before leaving me, by this time in the darkening twilight. I am cold and have a sore backside from sitting, but I’ve managed to defy their game, even if my rebellion is without warrant, significance or meaning. No doubt this episode, as my doctor will refer to it in the morning, is being indelibly transcribed onto my record at this very moment.

All up, there are perhaps one hundred patients, ranging from ‘normal’ adults to mostly comatose or otherwise demented senior citizens. There is a contingent of patients who seem to be frequent long-term visitors. At five weeks, mine is one of the shorter stays. Doctors visit every morning except Sundays and spend five minutes with each of their patients. I have seen the accounts my private health insurance pays for these consultations. It is staggering, though I don’t begrudge it — the doctors work ceaselessly in the hospital, their private practices and other related projects such as the hospital board, academic research and community work. Most drive expensive cars and dress sharply. My shrink drives a fifteen year-old Toyota hatchback and is unassuming. I don’t know whether to feel proud or short-changed.

Nursing staff are on all three wards in full numbers, right around the clock — there are no gloomy caretakers suckered with the graveyard shift. I know this because I frequently find myself staggering down the long corridor to my nurses station, nauseous and deathly pale with coals where my eyes ought to be, to ask for a medication I’ve been prescribed to prevent me from vomiting. Vomiting that is, of course, induced by the other medications I’m prescribed, which, for four long years, have aged me and left me in many ways a walking corpse.

Medications are kept under lock and key within a secure room on each ward and are dispensed with uniform disregard for any patient’s preference or routine. I usually take one of my tablets before dinner and the rest of them after I eat, because this regime makes me less sick. My pleas are heard in silence with a raised eyebrow, pen and cursed file at the ready. Nurses watch closely to make sure my medications are swallowed at the dispensary door, morning and night. In spite of this seemingly incontrovertible method, there is one kleptomaniac I’ve befriended who is startlingly adept at procuring dexamphetamines, among other inane things. Oddly, it is the constant reoccurrence of her more petty thefts which rankles the on-site hospital manager. As of breakfast this morning (every day so far she has convinced a nurse to microwave her cereal in the staff kitchen), she’s managed to amass over sixty rolls of toilet paper and a dozen towels, though I believe someone has now alerted the nurses again. I’ve spent the past two weeks editing this patient’s Master of Psychology thesis, which she has been granted an extension to complete while hospitalised. She is at once engaging and intriguing, desperate and broken — every frame of reference for her is inadequate.

Any patient not bed-ridden takes meals in the common dining room. The food is prepared fresh for every meal by professional chefs and kitchen-hands. Menus are never terrible, in fact they are often superb. Better than average is about the worst you could say — it is commonly remarked that the last thing the administration wants is for patients to be depressed about food. Certainly it is a favourite feature of the institution among its repeat visitors. The dining experience is not unlike a typical cafeteria. Well, at least any cafeteria at which people line up in pyjamas, dressing gowns and slippers (they aren’t supposed to do this, but the rule isn’t worth enforcing) and with all manner of uncontrollable tics and eccentricities.

I was admitted here on a Saturday afternoon, so my first meal was an evening meal. Mealtimes have been challenging for me from day one. Being alone in this strange social situation is unpleasant and intimidating. I still struggle to merely shuffle through the line, grab a wet plastic tray and procure some food. On that first night though, I take my tray outside to one of the unoccupied picnic tables in the courtyard and begin to eat, glad to be away from the clatter and din of the dining room. Inside and unbeknownst to me, one of the patients has become irritated, or at least something if not that, which causes her to launch a mug with Herculean force at the plate-glass sliding doors which separate the courtyard from the dining room. The mug shatters, as do my nerves. The safety-glass door merely cracks, as she has. Remaining unaware of the situation until the explosion of noise which is the mug hitting the glass, I turn quickly to see three male nurses bodily whisking the flailing patient away. Barely anyone has looked up from their food and certainly no further fuss is being made. The shattered mug lies where it fell, the ever-present nurses watch for any reaction with pens poised. Welcome to mental hospital, I think to myself, and proceed to shake for some time. ◾

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