Jumpers

As the ward manager left the staff room, Andy found himself staring, somewhat blankly, into the 18 inch high strip of wall ahead of him. He was hunched over, sat on a cushioned, low back stool to the left side of the galley office. Looking down the office from the doorway, early morning October light entering through the small, high window at the far end was illuminating his back and right side. He leant, both arms in front of his face, sweeping an oval on the work surface, palms down. Nursing files, copy books and procedure manuals were in the cupboards over his head. The safe was on the floor to his right and two filing cabinets bursting with assorted stationery were on the floor to his left. There was just room for his legs between the two.

His arms came to rest in the shape of a pointed steeple. He observed, in the meeting of his hands, the shape of prayer. He drew his hands towards him pushing the walls of the steeple out into a mosque, then let his hands part, only the fingertips now touching, into a rather flat dome, his eyes half closed, feeling now, not seeing, until the touch of a sharp edge of plastic slows the movement, the hands pull gently, the file squeezes between hands and chest. Relax.

Listen.

Next weekend Steve is coming down from Liverpool and Jenny and Francis are coming up from Brighton. Everyone is going to be staying the weekend. We'll get drunk and get into old times. When I talk about old times now, I am talking fifteen years back, a decade and a half history. Mark is part of our group of friends so that makes it, for me, twenty two years history to these relationships.

How will it be when I can look back on half a century of friendship with someone?

As I think of Billy last night, it all feels fragile as gossamer.

'Don't fuck about with this anymore,' I said. 'You will die in the end. What have you got - at the most, the longest likely, say sixty more years. With the damage you've already done to your body, with the overdoses, say fifty years.

Andy had been shouting. He got up, stood across the dining table, grabbed Billy's shoulders and shook him.

'You're going to die anyway, sometime between now and then. Why are you so keen to bring the date forward? All you have to do is wait.'

Steps, running, down the ward.

'What's happening?'

'Billy. You're cutting your wrists with knives, you're tying the sweatshirt around your neck and trying to light it. You're either trying to kill yourself or you're not. If you're not, STOP PLAYING WITH THIS STUFF. Just stop it. Its not funny to play with death.

'If you really are trying, you'll manage in the end. But why? DEATH WILL COME ANYWAY. ALL YOU HAVE TO DO IS WAIT.'

The other nurses were standing in the doorway. Andy spared them the embarrassment of dealing with the situation. Not quite shouting, but loud, firm, precise:

'I'm sorry to cause embarrassment. But what I say is true and Billy needs to hear it.'

He was forcing out the words past tears, forcing down the choking sensation with sheer, angry strength.

And then to Billy, sharp and bellowing, 'Now get out. Just get out of my sight. Go to your room and think about what I've said.'

As soon as Billy had stomped out, head bowed, Andy spared himself and his colleagues any embarrassment once again. He got up, mumbled 'Sorry', and walked out of the dining room, up the corridor and into the staff rest room where he pulled the door to in anticipation of at least a few minutes solitude.

Billy must have decided just about immediately. One of the nurses had apparently gone to him soon after to make sure he was OK. Knowing who it was, thinks Andy, she probably even sensed something different about his conduct. Probably. Something moving beneath the melodrama. The penny finally dropping. That click. Points, making contact.

Sometimes, Andy thinks, he tries to start his car in the morning and it backfires. The electricity is there, the spark, the fuel, the compression. But it does not turn over more than twice before an enormous backfire resounds against the three walls forming an end to the cul-de-sac by his house.

The most enormous backfire.

Billy went to his room.

They talk to me about acting, melodrama, but show me one thing that isn't false. The room, for example. The room which I have been sent to is a bed with a curtain around it, and just by it, the other side of the curtain, another madman. Another man with mental illness. He thinks he is important. He is always talking about meeting the queen and the chancellor of Germany as he tips his head back knowingly and looks over his glasses at you, grinning.

Opposite? A thin gangly man, scrawny as an underfed hen. He is a 2nd dan blackbelt in karate. He once nearly killed someone in a fight, smashed their skull and broke their back; he's macheted someone else. He is angry right now because his cousin has made a mess in the seventh floor council flat where he lives. He had an accompanied visit there today. You know what? He couldn't get through to his mother on the phone to sort it out because she goes out on Sundays, and so he has been shaking with rage. But they have tranquillised him and so now the violence is turned in on itself and brewing. He is quiet now.

The fourth man in our dormitory frets. He has been sitting on the edge of his bed worrying all night and half the day. He is there now. Why, you ask me? He is not sure whether his wife will find him on the ward when she visits later this evening. He's overwhelmed by anxiety. That's what I think.

There is a second part of the dormitory, another two beds, opening from here, and then the grotty bathroom and showers opening off from there.

A door to the other side of me, left as I look down the bed, divides the room here from the dining room. I think Andy has left the dining room now and gone off somewhere. Some other nurses are hanging around, watching the ripples die down.

Andy is right. Quite right. Just because all the rest is acting too, does not excuse anything. All I've been doing is play- acting.

As he ruminates, Billy is rummaging through the sports bag at his side. The sheet is twisted up with the duvet, and they trail together off the edge of the bed. The muddy edge of his left shoe leaves a crumbling mess on the mattress. Stale, sweaty clothes stink into the space around him.

Just as he reaches the source of nourishment he is fumbling for, a nurse pushes aside the curtain. It is Annie, the short red- head with the smile.

Billy reaches in with his other hand, pulls out a packet of chocolate digestives, and taking two which he sandwiches together and pushes into his mouth, he offers the packet to Annie.

'No, Billy, thanks; I'm OK. I'm wondering how you are after Andy shouting at you just now.' Annie trusts Andy but he is, after all, only a student, even if a mature one. She has a right and a duty overtly to scrutinise his clinical practice and its effects.

'Well, the thing is Annie, the way I see it, Andy's got a point. It may be difficult for me to hear, but, I have to say, he has a valid point. If you've said it to me once, you've said it to me a thousand times. And I'm grateful. I should talk about my feelings rather than act on them and my behaviour this evening was inexcusable. What more can I say? Will you have a chocolate digestive?'

Annie catches herself. She has been quite impressed with Andy's intuitions about how Billy play-acts all the time and was just about to say something of her impression that he is putting her on, his expression is unauthentic. But no. It suddenly occurs to her that if you deconstruct someone's whole way of being for them you have to have something to replace it with. She has nothing just now to hand that seems adequate for the job. In the circumstances, Billy's play-acting appears to her quite reassuring and so she excuses herself, promising to return soon. Her thoughts are already back with Andy, her student supervisee, and the distressed state he is in. Why has he ended up shouting and losing his rag?

As Billy pulls open the sports bag to find the electrical flex, he sees a bunch of sheets of paper folded in four and with a vague sense of interest, he pulls them into view.

Tom strides, chest forward, back up the corridor from the staff room. Into his office he retreats, his own yale key opening the lock, the only yale on the ward. All the other rooms are entered by a heavy, five inch steel key, silver turned gunmetal grey.

Although his desk is under the window, it is too dark to view the print clearly. Nevertheless the light remains off. This is the centre of Tom's mandala.

'Bloody Monday mornings. Shit!'

He has to get back up and move to the door to answer the knock.

'I heard the news about our dear Billy. I'm just going over to deal with it now. Thought I'd let you know first. These self- harmers become so very trying after a while, don't they.'

The registrar was bad enough to work with six months back, but at least then he had the humility appropriate to someone new in his job. Now, his plummy, ponderous voice and his grandiose manner in holding forth are unbearable.

'Thanks for letting me know, Robert. If you need the medical notes I've got them here, and I'll have the nursing notes as soon as Andy has finished writing up the report of what happened.'

'Oh, I heard it was after the evening staff had gone home that it all happened, about 10.30. Am I wrong then?'

'It was. I asked Andy to write it out though, in more detail, what he could remember of the precipitating events, from before he went off duty. I'll have both files in here when you get back. I'll be writing up an incident report.'

'Precipitating events were his being born, weren't they? Prognosis very poor, these self-harmers, little we can do to treat them. I'll be getting along.'

Robert shut the door behind him.

'Yeah, great. You do that. Pompous arsehole.'

Tom looked back to his papers, still there from Friday and due another two hours work.

'Bloody budget overspend.'

To the left of his desk, just at the edge of the blotting sheet, a buff folder rested on a pink medical file. On top of the buff folder five sheets folded over together, and folded again into quarters, slowly opened, now that they were no longer sandwiched between the pages of Billy's pictorial account of second world war fighter aircraft.

Annie raised her eyebrows, set her head slightly sideways and down, and held a gently quizzical expression long enough to force Andy to reflect. He knew her eyes were on him, awaiting an explanation.

He looked up sheepishly. She had perhaps heard the click at the other end of the phone preceding his gesture of lifting the receiver high before clattering it contemptuously back down into the cradle.

'What did he say?'

'Self-harmers have a very poor prognosis and we shouldn't blame ourselves. That's what he said. Smug, self-satisfied bastard.'

Annie inhaled noisily through clenched teeth while she shook her head. A mechanic looking sternly over an old wreck of a car beyond repair. Her tone, though, was sympathetic and maternal.

'Andy. What are you like?'

'WHO am I like. When you looked at me then I just caught myself acting like HE would have done. We all do it.'

'What?'

'Make gestures. Role-play rather than just be.

'I know not everyone agreed with me, but the way he could talk, talk about dynamics between him and the rest of the family. He appeared really quite psychologically sophisticated. Or at least he knew the words. I can imagine him now, talking to Robert, making the right noises, nodding his head earnestly in entire, humble agreement. 'Yes, I should have talked to one of the nurses rather than doing what I did. It was just attention- seeking.' And you get more and more frustrated, you want to just grab that pimply face by the cheeks and scream 'GET REAL' at him. And he disarms you with some little phrase like 'I hear what you're saying, Andy.' Christ. I hear what you're saying, Andy. His bushy little eyebrows on that fat head, on that stumpy little body, brows furrowed in serious concern; and he's going to do the same thing the next day. Damn him. And then again he'll tell you exactly why cutting or hanging yourself represents a very poor coping strategy. You know. Like he does.'

'Does? Did.'

There was a long pause.

'Yes.

'Did.'

After a respectful silence, Annie continued, slow and considerate.

'Andy, its OK to talk. You'll have a lot of stuff to get out and I'll be aware of that, and ready. But I want you to start thinking, the relationship's finished. You've got very involved. Now its finished. Sorry if that's callous. I know its hard to let go.'

'The hardest part is the work we were doing. I knew there had to be a way to get through to him. The way he talked, his armour was so well finished, I couldn't see how. The idea of writing was just a shot in the dark. Just something I like doing, so I wondered whether he might find it useful. A distraction as much as anything. Even when he took up the idea I thought it was probably a mistake. And when I saw his first offering I wondered what I was playing at. It was so unformed. It was this eight year old stuff, like 'My dad got up and held the cushion my brother hit him he went across the room I was scared and I think about it now I am in hospital I am looking out the window'. You know, all one sentence. 'And then we went home for tea', like you wrote in primary school.

Andy looked at Annie. She was attentive. They made eye contact.

'So I helped him reconstruct the story for himself in a new way. Or started to. It became a way he might start to see himself clearly and in context. I imagined he might suddenly realise why he was so self-destructive, where it came from, and then get some control over it. It was like his inability to write reflected the fact he just couldn't see himself. So if I helped him to write, all that could change. But I guess if underneath his intelligent, self-aware talk, there's this little boy who doesn't know himself at all and goes running into...'

'Andy; Andy. If he's learnt this self-destructive way of being over twenty five years, you're not going to change it in ten minutes. You may be right in your thinking about him. You're more keyed into this psychodynamic stuff than me and all you say may be spot on. But so what. This is an acute admissions ward and we are here to contain people in crises of one sort or another. The way I see it, Billy had a lot of stress, through bereavement and family strife, debts and the possibility of a spell inside prison. His way of coping with all this shit could well have been different, less destructive, but we are not here to take apart someone's whole way of being and reconstitute them. That's long term. If it wasn't for all the shit he's been going through he wouldn't have been trying to do himself in and he wouldn't even have come to our attention. We contain people here during crises, not change them. We contain them and keep them safe. That's all.'

Annie and Andy looked away from each other. Annie looked at the floor while she turned the gold sleeper through her ear. Andy shifted position back to staring at the strip of wall ahead of him and lifted his pen. The cap remained on as he tapped it against the open pages of the file before him. For a while neither one spoke.

'Annie.'

'Yes,' she sighed.

'So I was pushing too hard. Expecting too much. But didn't you notice anything last night? Didn't he seem different, for Christsake?'

'Maybe he did. I've got to live with that.'

Annie's admission seemed to close the post mortem. A long pause followed. Finally, Andy turned back towards her, speaking in sombre tone.

'I don't want to do it while Robert's there, but I wonder if I should go over to the hospital for a final visit. Later on.'

'Maybe. If you have to. You sure wont be seeing him on the ward again. I'm trying to think whether there's a better way of saying goodbye and putting all this behind you. Learning from it, even.

'Anyway, for the moment I'd like you to sign below what you have written and I'll take the file into Tom. Then go and clear Billy's things and prepare the bed area for this new admission. He'll be here soon. Another cutter, would you believe?'

As Tom pulled his door to, the five sheets slid down the flap of the folder they were resting on and, touching the edge of his desk as they fell, toppled to the floor. They had more than halfway unfolded.

"David's father sat in a chair its a threadbare chair it was second hand", read the uppermost visible lines.

Tom's footsteps receded down the ward.

In black ink was underlined "DAVID AND FATHER WERE IN THE FLAT". Then, in untidy writing, blue biro, "David was in the flat it was his brother's flat his brother came into the room his wife was in the kitchen making the tea".

Light brown, circular stains decorate the page. The fold makes this one appear as an ellipse. Black specks of cigarette ash are stuck to it along the top right as you look at the paper.

The next section is obscured by the fold but it is possible to make out, in black ink, followed by biro:

5 - He got up/he wanted to show who was boss.

 David's 
brother tried to everyone feel small careful to make sure brother was watching 
he walked from the the room he told got up he made cushion again hitting the him 
hard

Black ink strokes delineate where Billy might have finished one sentence and begun another. In one place on the page the stroke is between a heavy, smudged ink full stop and a capital 'H', again in black ink, over the lower register 'h' in blue.

The last lines visible appear where the bottom three inches of the sheet are folded under the other papers and are now exposed to view. The black ink title reads:

I 
think about it ... in hospital ... looking out the window.

In blue biro, beneath: "David stares out of the window immobilised he thinks about what happened six years ago he is on the third floor of the psychiatric hospital he feels scared and alone."

Andy slid the plastic coated duvet through the opening in the cotton cover. In his left hand he held an end corner of the cover and with his right he tried to shuffle the end corner of the duvet between folds to locate it in position by his left hand.

Dirty bed-linen, towels and used tissues rested in a pile adjacent to his left foot on the sticky, drink-stained, lino floor.

How the hell would it feel, wonders Andy, to have a psychopathic brother threaten to break every bone in my body when he gets out of prison, following the mysterious disappearance of œ600 from my father's jacket the day before he died. Scary, I shouldn't wonder. Terror and grief, all in one.

Trying to hang himself and then jumping from the second floor both on one evening, though. That's quite something, even for Billy.

Well the broken bones will mend. And despite the contract promising discharge if he made any more suicide bids or attempts at self-harm, I can't imagine the ward wont relent when Billy comes out of hospital in a few days or weeks. He's got nowhere else to go. They'll have to have him back. And I'll be somewhere else by then, on my next placement.

What will they do with him when he comes back? God knows.

Containment, even assuming it is possible, is unrealistic. (It wasn't even possible, last night.) Billy and every one of the other twenty patients on the ward may be suffering particular crises to be in here, but to end up in this place means, for most of them, their whole lives are ridden with stresses out of which will surely grow plague upon plague of further crises. Contain that? Contain a whole section of the population torn apart by economic forces, social pressures and violence beyond their control?

And as for long term analytic work? There aren't the resources for it. Even if there were, would Billy want it? And even if he did, even if he were to understand himself and his feelings, find a better, more creative way of coping with the stress, what of it? Its still shit.

As Andy continues with the blissfully mundane task of tidying up and bed-making, he recites to himself:

the 
next time you listen to Borodin remember he was just a chemist who wrote music 
to relax; his house was jammed with people: students, artists, drunkards, bums, 
and he never knew how to say: no. the next time you listen to Borodin remember 
his wife used his compositions to line the cat boxes with or to cover jars of 
sour milk; she had asthma and insomnia and fed him soft-boiled eggs and when he 
wanted to cover his head to shut out the sounds of the house she only allowed 
him to use the sheet; besides there was usually somebody in his bed (they slept 
separately when they slept at all) and since all the chairs were usually taken 
he often slept on the stairway wrapped in an old shawl; she told him when to cut 
his nails, not to sing or whistle or put too much lemon in his tea or press it 
with a spoon; Symphony #2, in B Minor Prince Igor On the Steppes of Central Asia 
he could sleep only by putting a piece of dark cloth over his eyes; in 1887 he 
attended a dance at the Medical Academy dressed in a merrymaking national costume; 
at last he seemed exceptionally gay and when he fell to the floor, they thought 
he was clowning. the next time you listen to Borodin, remember...

'Bukowski, 1983. And that's the best case scenario.'

Andy looks at his watch. It reads 10.25am.

'Oh for Christsake. Is that all. Roll on the weekend.'

© The Author

Please let me know what you think.
Also, any enquiries concerning reproduction should be sent either in writing to the following address,
or by E-mail by clicking on my name:

Ben Davidson, 8 Elsie Road, London SE22 8DX., England.