Death in the heart

If only he was less intense, less serious all the time. If only he worried less and didn’t get so wound up. If only he wasn’t so pessimistic. If only he was less angry. If only he could be more fun. If only he could be more gentle and romantic. If only….she had made her decision. She had met him when she was an idealistic nineteen-year old and fallen deeply in love with him. She knew what he was like and she believed she could change him. She plucked him from a desperate marriage that had failed years before hand. He came willingly to her. She rescued him from misery, although the marriage was already over, and she had nursed him, cared for him and tried to heal him.

 

She remembered the days as a student nurse in Southwest London on her psychiatric placement. It had been during Christmas week in 1981 that she had been with him. Three students allocated in the same week to the small team of three Community Psychiatric Nurses was quite unusual. His colleagues had made excuses and he had ended up taking all three students out with him on several days. She recalled the snow on the ground. She remembered his silver Mini Clubman. She recalled visiting the reclusive schizophrenic lady living in the rambling big house in the centre of Putney who had plied them with sherry. He had tried to refuse but the patient had insisted, so when she turned her back he switched his glass with her empty one. She ended up drinking four glasses of sherry in a short space of time. She fancied him and when she told her friends they had laughed at her. She remembered the other sad lady they had visited who complained of “shaky” legs and had said that he had “come to bed eyes”.

He was a charge nurse who visited psychiatric patients in their own homes. He and his two colleagues covered an area that took in Parts of Wimbledon, Putney, Roehampton Barnes and some of Richmond. She found it very interesting and had written an essay at the end of the placement which he had made comment upon.

The next week the three students had moved to the day hospital, downstairs from McPerson’s office.  On New Years Eve there was a party in the tiny office used by the three community nurses. She made sure that all three girls attended. The room was getting fuller by the minute and the noise was building. He was busy trying to get his case records up to date before the holiday began. One of his fellow charge nurses had been trying to chat her up and was becoming quite insistent. He kept asking her out for New Years Eve and invited her back to his place. Suddenly John McPherson spoke up

“She can’t." he stated with conviction, "……….She’s busy” he said. And that was that.

 

They had met up for a drink and stayed at a local pub together watching the merriment and people in fancy dress but only interested in each other. They stayed for the New Year bells before going back to the nurse’s home and her room where they made love. She remembered telling him that she didn’t usually kiss on the first date. She felt so thrilled. She was so in love. She recalled being on holiday in Lanzarotte having put him under pressure to make a decision about leaving his wife. And she recalled the joy she felt on finding that he had done it, for her. But that was in the past and she had suddenly realised three years ago that she wasn’t in love with him. She had made a mistake; she was tired of trying to change him and getting little in return. She was tired of doing things for others. She made her decision. She would stop trying to please others and would think only of herself. Even the children didn’t matter. It was not worth staying just for them. That would be wrong; denying her the chance of a happier existence. She had seen the possibilities now. Her move to start her own business and her early success had opened her eyes. Anything was possible. Bloody hell everything she touched was affected, a sort of Midas touch. She had always made a difference but she was now excelling and doing just what she wanted. She was making a difference and within high powered organisations. She had made a difference within the umbrella group she had joined as an independent management consultant. Considering her lack of experience, she was one of the most successful. One of the only women to have survived the demands of being a consultant and having a family, she was also the youngest consultant by far and very good at it. She could see herself running her own consultancy group. Anything was possible, but not with him. He had always held her back. He was too cautious, never taking risks. Kept the mortgage low, didn’t spend money. Never went anywhere. He was boring. The neighbours were all small-minded boring people. In fact she had recently been to her fathers retirement do at the school in Leicester where he had worked part-time for the last few years and had found all the people there so boring. No it was time to move on; time to forge her own passage amongst far more dynamic people and to take on more challenges, time for Alice to rise from the smothering cloak of little people devoid of ambition. Now she had found herself nothing would stop her. Especially as she had the man she wanted too. Their affair had started because she was so miserable at home. A bit of fun; she had not meant to fall in love with him but it had happened. He knew how to make her feel good.

 

She did after all at thirty-six years of age have her whole life in front of her. With him it would be so ordinary and devoid of happiness. With the new him it would be warm, interesting and exciting. He too had needed rescuing. His marriage was also over when she met him and he too needed her to nurse him, care for him and heal him. The difference was he could show her such tenderness. She had always found older, distinguished men attractive, Michael Parkinson, Dave Allen the comedian and Robert Redford in his later years. He was greying and distinguished. He was more refined and interesting. He was a gentle man, so different to John. The John she no longer felt she loved.

 

They had decided to move in together. She would need to tell John sometime soon. Her new man’s wife had found out and had been making mischief. They would need to get it into the open before word got around. She would need to tell him. The affair had gone on for five months now, and he didn’t even notice, not even when she had waved him under his nose and brought him home to stay over. He was so insensitive. He had not noticed on those two occasions when he had sat at their dinning table and they had eaten together. The first was a matter of days after their affair began. Although John had made it plain that he didn’t like him being there because it was another work intrusion in their lives.  If only he knew how much of an intrusion. She had made up her mind. There was more to life and she knew it. What was more it was within her grasp.

***

Maureen Auld was not herself. Their aspiration that Boddington would join them in their fight to put the medics in their place had been smashed. It was becoming clear that despite his nursing background he had made deals with the key doctors in return for his own success and possibly the prize of being given the substantive post as Chief Executive of the new merged Trust. He needed to secure the post to get a foothold, he would not achieve that if he did battle with the doctors. The Region and the Department would not allow it.

 

“He’s made it clear that he won’t allow me to challenge either him or the doctors” Auld said shaking her head in disbelief.

 

“But Maureen, he must realise that you were the only Director to stand up and be counted when the heat was on” He reassured.

 

“The agenda has moved on John.” She said pointedly, “We’ve lost the opportunity. He has his own goals and he has no stomach for a fight. He’s got a job to do and he’ll do it. He’s made it plain he wants me out.”

 

He looked at her in stunned silence then began clutching desperately.

 

“What about the non execs?” He queried.

 

“Not a hope; most don’t have a clue and the two that do, and support me, don’t have the bottle to stand up and do so in public or at the Board.” she said with resignation. “He’s offered me a secondment. He wants me out but with the merger on the cards he cannot offer me severance.” She continued.

 

“I can’t believe this after the four years of hell that we’ve been through.” he said with pain “all that we’ve done….the risks we’ve taken and the evidence time and time again of such gross intransigence.”

 

They sat in silence for a moment, before he stood and put on his jacket. He put his papers in his briefcase and clicked the catches shut. She stood up to see him out; he walked round the table and gave her a hug.

 

“I’m not going to lose this one Maureen; maybe its time to regroup like any good commander who loses a battle. The war goes on. There are a growing number of disaffected senior nurses around the country who feel as I do. All they lack is leadership. You are their natural leader. Think about it-we’ll speak again soon.” He soothed.

He felt so isolated, alone and vulnerable. Carole had sold out. Maureen was being pushed out and John Boddington was not interested in the real issues. He felt angry. He felt saddened and guilty about Maureen whom he felt he had pushed into exposing herself. He felt despair at the injustice and the crushing power of the organisation. No one seemed to care about the real issues. Issues of life and death and misery for thousands of people exposed to the weakness of present day psychiatric practice, dominated by the outdated and invalid medical model. No one wanted to deal with the doctors. All they wanted was an easy time and to avoid conflict at all costs; even if it meant ethical and moral complicity. It was like one of those exposé movies, usually American, where the lone reporter or housewife in the case of Erin Brochavich, fights the power of the system and wins. Except in this case he felt that they had lost. He felt vulnerable and very exposed.

***

He felt aroused. He wasn’t quite awake yet but he was aware of the stirrings. The bursting throbbing feeling as his stiffness forced itself up the front of his boxer shorts. They rarely made love these days although he hadn’t noticed just how rare it had become over the last few months. Over the years he had begun to feel that he had to make all the moves in bed. He had told her of his perception but she made some excuse and the point was lost. It was important to him to be wanted and desired. In fact it was his raison d’être. He didn’t need clothes or other material possessions; he didn’t need an active social life. He needed to be with his family and needed to be her desire.

 

He watched her dress so exquisitely for work. He had commented on just how wonderful she looked. She had worked at loosing weight over the past year and she looked fantastic. He couldn’t believe that she had stayed with it. She dressed very sexily, not tarty but very sexy. Alice knew the art of dressing. Alice knew the art of living. She was a sort of Ian Botham of Superwomen-an all rounder. He had asked her why she dressed so sexily for work and not for him. Her answers were always vague.

 

He could sense her warmth and could hear her breathing gently. He didn’t want to disturb her so he lay for some time on his back with his hand over the front of his shorts trying to gain some comfort. The throbbing didn’t go away. It must have been the build up of weeks without. The pressure of work and looking after the kids made life between them a passing event, especially as she was away so often nowadays. He looked at her in the little light provided by the orange halogen street lamp as it seeped in through the gap in the curtain. He saw the soft warm form of the woman he loved deeply. Alice was the woman he wanted to grow old with. He regretted his coldness towards her, which was his expression of his unhappiness at her being away overnight and chasing her career so avidly. He reached out a hand tentatively and felt the rounded warmth of her right breast. He squeezed gently and feeling the n****e with his thumb and forefinger. She stirred and rolled further onto her back. He climbed on top of her and kissed her mouth. Her smell, softness and warmth was so enticing.  She held his penis tightly, guiding him inside and drawing up her legs so that he could go deep. She had started to do that recently. It must have been the loss of weight and the fact that she felt better about herself. It really felt fantastic. He always felt like he was entering a special sanctuary when he went inside her. It was like a cathedral to him. A heavenly place of angels; “Angel” was what he called her, a place of deep devotion and worship. He could not understand how he could be so hurtful and cold towards her at times but he knew his love for her was so deep and that their love was so complete that it would survive. He trusted in it; put all his faith in it. When they had finished he stayed on top of her as he soaked up the smell of her skin and hair, bathing in her soft warmth. He made sure that he took most of his weight on his knees and elbows so as not to squash her. He thought her almost perfect in every way. Her skin was soft and unblemished. He loved her so much that it sometimes felt painful. He loved her deeply for the children she had given birth to. He didn’t understand why therefore it seemed there was a veil between them, something getting in the way of her giving herself to him and as a consequence their closeness had disappeared over the years. It seemed to have started to drift after the death of their first baby, Ann, in her womb. He wasn’t sure that she had ever resolved her grief from that terrible trauma. But he preferred to put the drift down to life, the jobs, study and the kids. He felt it would right itself as Jason got older and went to school. They had both completed the study they felt they needed to do and now he felt they would be entering a phase when they could concentrate on themselves. He wanted it to get warm again. She asked for the tissues. He apologised and reached them from the dressing table for her before climbing out of bed to go to the bathroom.

***

He was having a reasonable week at work. With The new trust Chief Executive in post things were improved. He didn’t feel that every day was like living on a knife-edge. He didn’t agree with Boddinton”s approach but he could work with him, he found him less supercilious than Brady, much more approachable. He was relieved that Brady was no longer around. With Jim McKay now in Arthur Lodge he knew that was in safe hands. The new Clinical Director at the lodge, a straight talking Irishman, and McKay had hit it off and looked like becoming a dynamic team. Work had started at a frenetic pace to implement the recommendations from the Independent Review-all one hundred and one of them. The erection of a 5.4 metres high fence with additional CCTV was in progress and a range of more secure windows were being tested.

 

Dave Sowden had been moved to take charge of the next most risky part of the trust, Adult Psychiatry. He was another safe pair of hands, although very different in approach to McKay, much less challenging and confrontational but he had a keen appreciation of what needed doing and he would move matters forward as long as the resistance wasn’t too strong. McPherson had a good rapport with them and a healthy respect for them too. They were both trust-worthy although he knew it was McKay he would want behind him if it came to a fight of any description. McKay like Auld was a courageous leader who was not afraid to get his hands dirty or to speak the truth even if it brought the roof down on his head.

 

Despite feeling an element of relief, McPherson was saddened that Maureen had been forced to move and accept the secondment. He had spoken to her and he knew she was devastated. She put on a brave face for the outside world but she was a broken woman. To be so powerless while someone else destroys the world you have built around you and to be unable to resist was the worst kind of hell for a leader like her. It made McPherson feel more exposed and vulnerable. The bottom line was that it was so very, very wrong; a sad state of affairs.  The power organisations and the powerful elements within them had over individuals was frightening. He was learning that much but it only made him more determined to resist. He would not become complicit, he would not bend and he certainly would not be threatened and bullied by anyone. The issues were too important. No he would be slightly more cautious, if he could, but he would continue the battle. He had in recent times decided to fight on a wider front and had published about fifteen articles in professional journals over the previous two years. Most were controversial as they challenged accepted wisdom and the assumptions widely held by others in the field of mental health care. He was now working on even more challenging articles that would hit at the heart of the issues and possibly attract considerable unfriendly fire his way. He was determined to continue to resist but he would need to move to guerrilla tactics over a wider front. He could not accept that with so many highly placed and experienced nurses feeling the same oppression and disempowerment that they were impotent to resist. Power was the people’s he believed. But only if the people had leadership, faith in themselves and their abilities and were strong enough to take the risks involved in joining the fray.

 

Boddington had taken the tack of trying to control the medics by putting them into management roles directly accountable to him, with clear objectives for that small part of their role. He talked in a bullish way about this and seemed determined to manage that aspect of the doctors. The more cynical saw it as selling out. They knew the same tack had been tried nationally and had failed because of the astute nature of doctors and their culture, which ensures that they stand outside the circle and only cross into it when it suits them. They wave their shrouds from a detached position and as a body do not allow themselves to be drawn into the true management arena. Admittedly across the country a handful had crossed the Rubicon but they had either had their palms greased with promises of silver or were exceptions. The majority preferred to stand outside the tent and boy could they piss long and straight.

 

His thoughts were interrupted by the ringing of his phone. He picked up the handset, unravelling the twisted chord. He recognised Simon Gill’s voice.

“Have you heard the news” asked Simon

 

“What news” he asked

 

“Janet Brady has just been appointed Chief Executive of a Trust in Cambridgeshire” Simon said with a hint of incredulity in his voice.

 

“This is insane, I know she has connections but how can this sort of thing happen? Why would they take her on knowing her recent history.?……thanks Simon I’ve got a connection at the Oxford Region I’ll give them a ring to see if I can find out any more details.”

 

“Let me know if you discover anything.” Gill asked before McPherson put down the phone and dialled the number from his diary, which he had been flicking through as they spoke.

 

“ Lydia Adkin please” he requested as the phone was answered.

***

McPhail was in her office with Simon Gill. He knocked and stuck his head round the door.

“I’ve spoken to my contact at Oxford.” He said from the doorway “It gets more incredible the more you learn…..apparently it was a close run thing between Brady and a current trust director. I know the director concened from my contract negotiations and she is first class. Apparently they knew Brady had had some recent difficulties but decided on her because of her forensic experience!” He said with scorn. “There is no justice, is there?” he said with finality.

He turned to leave the office.

McPhail called him back.

“John, you will know by now from Kathy about our intention to reorganise.” She paused and stared at him for a second or two before continuing.

“We are slimming down the mental health team.  Kathy is moving to take up a director post at the mental health trust and there is now the opportunity to scale down her post.  We don’t need anyone as senior to continue implementation of the National Service Framework.”  She paused again and waited for McPherson to respond.  He simply looked at her a glazed expression creeping across his face like a man faced with the inevitability of being executed. “The post is being set at SMP 16 and will not have such a wide remit as Kathy currently holds.” She ended

 

“So where does my post fit?” asked McPherson looking pointedly at McPhail before scanning across to meet Simon Gill’s gaze.  Simon looked down at the paper he was holding loosely on his lap.

 

“I think you might consider a move out of mental health. Broaden your experience.  There is a danger in staying too focussed with all the national changes coming about over the next few years.” She advised.

 

“Well” he started taking a deep breath and let out a long sigh “As you know Cathy I have been doing mental health work most on my career.  I have done some work outside mental health with my small community contracts with Derbyshire and Peterborough.  So it’s not as if I have not given it some thought, but no thanks I want to remain in mental health.”

 

“John that may not be the wisest decision…….but let’s talk about it next week when we meet.” Concluded McPhail turning to face Simon Gill.

 

McPherson headed back to his office.  He felt numb.  Nothing had gone his way for quite some time and it felt as if it was going to get worse.  He felt very vulnerable and exposed.

Reviews

[Claire Twinn]

You draw the reader in to the injustices of John's failed marriage, good people being unappreciated and mediocre/poor performers being promoted beyond good sense. Life just makes no sense sometimes.

[John Alexander McFadyen]

Hi Clare, thanks for your kind comments. I have learned that no one really cares. If it gets tough they back off. Something I will never learn to do. Arrogant perhaps.