A slow death

John McPherson sat on the low armchair; one of the only chairs in the room whose springs were not breached in some shape or form and consequently a sought after chair.  After the early evening meal was served patients would make their way to the lounge to get a seat they favoured. For some it was by a selected window where they could gaze across the wide playing field with its secure perimeter fence.  For others it was a seat in view of the Philips TV that had seen better days, or in a quiet corner where they could sit in private with their thoughts. The favoured seats, the few fully sprung ones upon which only the toughest or most favoured dared sit, were sparse; probably only four in total.  They had raised it at the community meeting and had discussed it with the new Patient Advocacy and Liaison Officer (PALs for short) who had direct access-at least in theory-to the Trust Chief Executive.

 

There was a pecking order among patients on the ward with a subculture the staff rarely experienced.  Top of the tree was John Donnelly a six foot Belfast man who as a UDF member had spent time in the Maze Prison for a series of sectarian attacks on Catholics. He had moved to the mainland after his release and had worked on building sites in London and the South before moving to Yorkshire.  He had ended up at Newtown Lodge after stamping a man to death outside a night-club in Harrogate where he had been working as a bouncer. The man had been drunk and refused entry in reaction to which he produced a knife and stabbed Donnelly in the back.  Donnelly although bleeding heavily from a deep wound that punctured his left lung had turned on the man in a rage, had punched him to the ground and stamped on his head so viciously that two witnesses needed post trauma counselling to deal with recurrent flashbacks. Donnelly had been assessed as having a psychopathic personality disorder and was ordered to be detained at Newtown Lodge rather than going to prison. His reputation and size alone placed him at the top of the pecking order and he rarely had to assert himself.  After several weeks McPherson had established himself in the unit.  Not because of his physique, not because of a propensity for violence but because his knowledge of the system gave him power.  He was in great demand by his fellow patients who came to him for advice on all manner of matters.  He never abused his acquired power and kept a low, quiet but friendly and co-operative profile with staff and fellow patients alike.  He was careful with the advice he gave lest it cause upset and a knock on effect on the staff management of a patient.  Thus he avoided being seen as manipulative and in particular being seen by staff as a threat.  In fact he was just as much in demand with staff who sought him out for his views on the technical side of care.  In particular his help was recently enlisted when a purchaser visit to gauge the quality of the unit was about to take place.

The ward manager came to him one morning after breakfast and asked if he minded missing his occupational therapy session and wondered if he would look at the purchaser programme and give him some advice about what they would be looking for.  McPherson agreed readily.  It gave him a feeling that all of his years in the job had not totally gone to waste and that he still had some respect.

 

The ward had 15 beds according to the contract with the purchaser, nine heath authorities across Trent region, through a lead purchasing arrangement contracted for beds at the unit.  Only twelve of the beds were in use however. Following a number of incidents and escapes and in an attempt to lessen the pressure that can build up in such units when highly disturbed individuals are forced to spend much of their waking hours with strangers they have not chosen to be with.  The unit was built following the style of the day, which was to accommodate eighteen month to a maximum of two-year stays.  Over the intervening three decades this had lengthened considerably across the country with many patient's stay being somewhere between three to four years.  The unit like many others build between the early seventies and the early nineties was not spacious enough for lengthy stays.

 

McPherson knew the routine of the unit inside out.  Routine was what made these places tick. Shifts, routines, staff rotas, therapeutic programme schedules and the human reliance on filling space between waking and sleeping with certainty and 'meaningful activity'.  Often there was no activity to speak of for patients while the staff seemed to sit around the office for hours on end. This would lead to boredom for many, frustration and outbreaks of disharmony or violence for others. 

 

He knew all of the staff, their grades, habits, likes and dislikes, family situation and most of all he knew their characters.  He had time on his hands and between formal 'treatment' sessions with his Named Nurse and forensic psychologist. He watched, listened and noted.  He knew which staff got on well with each other and which related well to the patients. 

 

David Moore, a heavily built 39-year-old South Yorkshire man with a beer gut that heaved over his thick leather belt, ran the ward.  He came to the unit after six years at Rampton high security hospital in Nottinghamshire.   Three 'F' Grade staff nurses who covered day and night shifts supported David.  Melanie Stoker, who had crossed the Pennines and moved from her home in Manchester two years previous, she was an academically bright, attractive slim woman of twenty eight with deep auburn hair.  She was good with patients and in great demand.  She handled innuendo well and loved her work.  Simon Anderson a single, twenty-six year old Londoner who had moved to Yorkshire to gain promotion after his first staff nurse job at the Three Bridges medium secure unit.  Simon guarded his private life well.  He enjoyed being single as it allowed him to do as he pleased.  He was very selfish and chose not to share more permanence with his string of boyfriends. He was stimulated by the thrill of the chase and capture; so he changed them almost as frequently as his Kalvin Cline underpants.  He had a reputation for being a change agent in his chosen career and kept himself networking in order to trawl for ideas and share his own experiences.  He loved travel and chose exotic locations for his twice-yearly jaunts. 

 

 McPherson felt more at peace than he had ever done.  He felt in control, not rushed but somehow calm.  He watched and waited.  He did not know what he waited for although he still felt tortured that his children were not with him and he knew they were suffering because of his actions. Despite which, he had a feeling of control and contentment.  The pressures of life had been removed.  He knew from experience that not everyone who ended up in such a place as this felt like he did.  He could not explain the feeling but it was as if he was absolved from responsibility for anything other than getting himself through the daily routine.  It felt good.  In contrast the days, not so far in his memory, when he was struggling to stay afloat as an NHS senior manager seemed so alien and fruitless.

 

Sonia was Jamaican by decent but born in Birmingham in 1965. She had gone into mental health nursing aged twenty-four and qualified, at the end of a four year degree course, as a Registered Mental Nurse She had staffed for three years in a community unit run by the North Birmingham Mental Health NHS Trust before moving to the medium secure Reaside Clinic in Birmingham where she spent three years, prior to moving to Newtown Lodge .  She had been promoted to Deputy Ward Manager, which attracted an 'F' Grade.  She enjoyed her work and was seen as a bright intelligent, forward thinking nurse.  She was 5' 4'' tall, with a slim but curvaceous figure and clean sharp features, an aquiline nose and full lips.  She was full of life and fun and was always laughing. 

Over the months as McPherson watched and listened he noticed that although seemingly full of the joys she was not entirely happy.   Sonia found it difficult to secure a regular boyfriend.  He heard the regret in her words even when she was joking with patients and staff about men being a waste of time.  She lived alone in a rented flat with her three ex sanctuary cats.  Peach, a tabby getting on in cat years and who had failing eyesight, could not go out anymore as she could not hunt and found it difficult to move as agilely as she did when she was younger.  She would not have been able to defend herself should she be attacked and certainly would be too late to spot any potential danger before it was upon her. Hermione Granger, after J.K. Rowling's classmate of Harry Potter, was only just a cat having left kitten-hood recently. She was full of mischief and loved to chase sunbeams and tear at flowing curtains or anything else that moved.  Colonel Mustard, a large tomcat who was in fact black, suffered the cat equivalent of agoraphobia and never left the flat.

 

Sonia spoke of them as her children and McPherson listened.  He liked Sonia. She was the sort of nurse who preferred to be with the patients, unlike many of her colleagues who spent an inordinate amount of time in the office doing paper work or moving around the site on the pretext of this errand or that.  Sonia was happiest when involved with the patients and they responded to her lively nature.  She was often to be found playing board games with groups of patients or organising some other activity with them singly or in small groups.  McPherson admired her attention to basic nursing.  She liked to keep the place tidy and where other nurses ignored the untidiness of the individual rooms of the patients (especially the male patients) Sonia would encourage the making of beds, tidying of rooms and laundry management. 

She spoke to McPherson with respect and viewed him as a colleague.  She had often been criticised for being too close to the patients but she rejected this as the defensive moans of colleagues who were too detached and lacking in humanity.  She saw them put their effort into processes rather than relationships and she resented them for it.  She completed her own paperwork to an average standard and kept it reasonably updated. Her care plans reflected her humanistic, as opposed to medical, orientation.  On the occasions she had sessions with her clinical supervisor they explored this aspect of Sonia's professional persona. But despite being encouraged to become more process and medically oriented she found herself unable to do so and was relieved that supervision sessions were not as regular as they were supposed to be.

 

McPherson had never thought of Sonia as attractive until two months previous when he had been asked to stay on the ward to help David prepare for the pending visit by the service commissioners.  He was waiting aimlessly for a ward round to end and David to appear when Sonia came to his room and badgered him into making the bed.  He pretended to be petulant and stubbornly maintained that he had forgotten how to make 'hospital corners'.

He moved the bed from the wall, inserting himself in the gap between the wall and the bed and made a half hearted attempt to fold the sheets under the bottom of the bed as Sonia completed the other side. Sonia in matronly mood marched round the bed to show how it should be done.  She deftly tucked the sheet under the mattress with her right hand, lifted the corner onto the bed with her left and in one sweep folded the trailing sheet edge under the side of the bed allowing the 'ear' of sheeting to fold neatly across the corner.  McPherson feigned amazement and was teasing her on her dexterity. 'What manipulative hands' he joked looking impressed.  'Yeah you should see them in action ' she retorted in a double entendu before she could stop herself.  She was wearing jeans and a tight 't' shirt that stretched across the full roundness of her small firm breasts.  He held his hands up in resignation and looked at her with a knowing grin.  In mock embarrassment she pushed passed him to complete the head of the bed. He felt her stop behind him, hesitate then he felt her hands on his hips and her breasts pushing into his back.  He felt a stirring he had not felt for months and he stiffened his shoulders in pleasure arching back ever so slightly and cushioning himself on her firm bosom.  Sonia breathed heavily but said nothing, he sensed she was afraid, but that she wanted the warmth of the contact. Neither of them knew what to say. Both knew what they were doing was wrong.  He put his arms behind him getting hold of her hips and gently pulled her towards him.  She seemed to relax into him and moved her hands gently round him over his chest. Her head snuggled into his back and he could feel the warmth of her breath and smell the spice of her Opium perfume.  He turned with difficulty in the tight squeeze feeling the fullness of her breasts welcome him as he did so. Her erect n*****s pushing into his chest turned his stomach into a churning raging pit of desire.   He looked down into her brown eyes and moved his face deliberately and slowly towards hers until he could smell her breath.  She looked scared so he gently cupped her face with his hands, moving his fingers across her fresh velvet brown skin and pressed his lips to her full wide mouth.  He felt as if she had suddenly melted as her body relaxed in complete surrender and she moaned slightly as he began to kiss urgently and deeply at her.  She parted her lips slightly, kissed him back with her own urgent passion and he knew she was wet.   Suddenly she drew away a look of horror on her face.  'I'm sorry' she panted as she gently pushed passed him, brushing down her t-shirt and rushing out into the corridor.  He stood for a moment his desire unfulfilled. The thrilling buzz in his head and the overwhelming need to thrust almost choked him. Frustrated but high on his lust he imagined the end game that might have been.  He moved out from behind the bed and kicked the bed with vigour back against the wall. 

 

The day after their encounter in his room Sonia was on a late shift.  He knew the shift pattern and had been frantically anticipating her arrival on the ward. He watched as one-thirty approached and the late shift staff drifted in one by one.  He thought of the smoothness of Sonia's chocolate brown thighs when she wore the fawn corduroy skirt.  He remembered the warmth and comfort of her firm breasts and the sweet smell of her perfume as he tasted her mouth.  But she did not appear.  For days Sonia avoided him. He decided against asking where she was in case he drew the wrong sort of interest and instead kept his ears open to snippets of information from overheard conversations.  He knew she was on sick leave and he felt anxious. For four days he fretted and wandered around morose, making the most during the long soulless nights of the dredged up memories of her touch, of her smell and the promise in her passionate surrender.

 

On the fifth day he had given up any hope of seeing her come on duty.  He still ached to relive the moment when she was wet for him to enter her.   The morning was spent in routine ward activities.  Breakfast, medication round, sitting around, an individual session with his psychologist on anger management, sitting around, a quick ten minute session with David to discuss clinical supervision, lunch, sitting around, medication round.  At hand over he was working on the briefing for David on Clinical Supervision and missed Sonia breeze onto the ward.  He finished the short piece and went to the ward office to give it to David.  As he approached the office hand over had just finished and the nurses were filing out of the office to complete the routine checks on patients.  Suddenly he and Sonia were eye to eye.  'Hi John.' she said with a bland emotionless tone.  She looked passed him and headed to the kitchen to assist with the routine count of cutlery.  The coldness in her voice told him that she regretted what had happened and that she was embarrassed by it.  Her detachment was like a cold shower to him.  He felt quite deflated and an empty hollow feeling swept over him.  He spent the afternoon in a deeply morose mood. He hardly participated in the afternoon activities and kept looking round to get a glance at her when she was around.  She completely ignored him, which was unusual.  He was cut off and it hurt.

 

That evening, after tea, a group of patients were playing pool, some were watching television and a small number were in their individual side rooms.  From one of the side-rooms Dido was being pumped out loud and one of the nurses had to go and ask the guy to turn it down. John was making his way from the lounge to his side room when he bumped into Sonia rallying two other patients for a game of Scrabble. 'Come on' she was saying to one patient 'You are good with words' As he walked past them she turned and said 'What about you John?....Want to play?'  He was taken aback but did not want to be seen to be in anyway disaffected lest it be misinterpreted as deterioration in his behaviour.  'Yeah OK' he replied.

 

They played in the dinning area at one of the metal edged, Formica topped tables with their orange 'bucket' chairs.  McPherson was sat opposite Sonia who gave him only cursory recognition.  One patient sat diagonally opposite him, the other beside him.  He had always done well at Scrabble and had enjoyed playing it with his now dead ex wife.  He and Holly had played a few times but she struggled and she did not enjoy it much.  They had played for about three-quarters of an hour.  McPherson was well in front on the score sheet and had just laid down his tiles on a triple word score.   He was trying to relax and to keep Sonia out of his mind.  He found it very difficult as the memory of being pressed up so close to her was at times overwhelming.  He drew six letters from the bag and passed it to his left. He placed the letters on the Scrabble rest in front of him and took in the collection of vowels and consonants before him. He froze suddenly.  Sonia had gripped his left knee between her knees and squeezed his leg hard between her own.  He sat stock still for a few moments, not knowing what to do.  He could feel the sheerness of Sonia's stockings as they rubbed into his legs. He thought it was a dream, an accident but the pressure with which she squeezed told a different tale. He felt the stirring mount in his pants as his months of abstinence caught up with him.  He tried to breathe easy and relax but it was no good.  The memory of Sonia's smell and her breasts pressed against him, and the feel of her knees pressing into his in such a sensual way was overwhelmingly erotic.  

 

She kept her knees pressed into him as the scrabble game moved towards its conclusion.  When it was over she slowly collected all the scrabble tiles.  The two patients playing with them left making their excuses.  He stayed sitting, slowly helping to clear away the spent game. She looked at him with a warm smile and grasped his leg even more firmly.  He dared not move in case it ended.  'Where do we go from here?' he asked hoarsely.  'Wherever you want to take me.' She replied with a warm confident, caressing voice.  'Christ this is impossible' he said in frustration.  'No.... I'll show you' she said in a soft tone.  'I'm on late again tomorrow.'  With that she released his leg, rose, swept the scrabble box off the table and walked to the office.

 

That night McPherson slept fitfully. His mind was tensed with anticipation. He kept flashing back to the events of the evening and fantasised about having Sonia. She felt so close but still so far from him. An impossibility; he did not dare let himself think that it would happen. But he really wanted it to.  He thought of Holly but she seemed so distant and the chances of being with her ever again seemed very remote.  She would not answer his letters nor accept the two phone calls he had attempted to make. He had been told that it would be at least twelve to eighteen months until he would be ready to be considered for a less secure environment.  He felt guilty but strangely detached.  He knew that he had loved Holly and he had spent many lonely hours trying to imagine what it was like for her and what it was like for the kids knowing what had happened and knowing he was locked away branded as a lunatic.

 

Sonia was nothing to do with his life in its widest sense but she had suddenly brought something alive and exciting into his very frightening world.  Something in the back of his mind urged him not to spurn this opportunity and in it he somehow sensed his chance of freedom.

Reviews

[Claire Twinn]

Yet another full circle, it seems that life as a patient in a medium security unit isn't so bad after all. The allure of Opium strikes again...

[John Alexander McFadyen]

life is ful of circles Claire. Opium is sweet. especially when it iws the only drug on offer.