This Too Shall Pass (14 page)

‘Is everything okay?' she inquired, genuinely concerned.

‘Just time squeezing me like I'm a love heart.'

‘You are a love heart,' she said in her brisk tone.

I tilted my head, not quite able to accept the compliment.

‘Perhaps I should come back?'

‘No, really. I can cry about one thing, think about another.'

‘I wondered if you would see the brother of one of my clients? He's got learning difficulties, isn't socialising at school. We can organise for them to come together. Once a fortnight.'

‘I don't understand. Is he living in my team's catchment?' (Celia wasn't in my team and our clients were designated to one or the other team by postcode.)

‘Yes. At least now he is. One reason I'm asking. The boys were living in mine when I took the case.'

‘Would have said yes anyway.' I smiled weakly.

I wouldn't have turned down an opportunity to work with Celia and because we were in different teams it was a rarity.

‘Oh,' she had begun to leave but turned back around, her impetuous rapid movements making the moment pressed and a little awkward, as usual. ‘You're going to have to mark out your diary. This place will suck the fat out of you otherwise.' Her suggestion fired like a barrage of tiny bullets. ‘In regard to your past life, Renny will come round in time.'

I looked at her, a beleaguered expression on my face because of the shock of thinking she had said something that was both prophetic and utterly confusing. I nodded. ‘Thanks,' I said, weariness laced in my tone.

An hour later, still feeling like a dead sea was sloshing around inside my stomach, I went to the afternoon sessions with the students. They sat in a big semi-circle. I wheeled a whiteboard in front of them and, with limbs as heavy as steel cranes, I drew what we referred to as a "genogram" – a basic family map - pertaining to my client. Patty was a young woman of Chinese descent. She'd lived in Australia since she was six months old, was a bright but cynical student - I had learnt that the two can easily go hand in hand - attending a Catholic college that was enforcing the rule that all pupils had to participate in sports. The problem was that Patty didn't want to play sport at all. Her individual style and her determination to stick up for what she wanted set her apart from the other students. Some teachers feared she would commit suicide and indeed, there was a lot of existential rhetoric in Patty's head that would have led most people to believe it, rhetoric that depicted a young woman isolated from the great Australian supposition that everybody should be happy in this lucky country.

When I went to get Patty from the foyer, she immediately said to me, ‘Are you alright? You look terrible. Nothing's wrong is it?'

‘I'm fine,' I assured her. ‘Are you nervous?'

‘No, why would I be nervous? Bunch of blowflies would bother me more.'

Patty was beyond her years. She also, at least from outside appearances, had an indestructible ego, both dangerous and self-preserving. When she wasn't wearing me out, she was entertaining me. I was, however, rattled that she'd picked up on the fact I'd been crying, and I made an effort to buck up.

The students were full of comment and conclusion when Patty left. We discussed the therapy they'd observed, the trajectory and journey Patty was on. Their faces, eager to begin with, were now on fire at the possibilities and power they thought was going to be theirs if they were ever lucky enough – they cautioned themselves – to end up working at a place like Marlowe Downs.
Was I perpetuating the ivory tower concept?

Alice, my next client, was nervous and had considered not coming. (The half an hour excuse thing had been an attempt to cancel.) Alice, now fifteen, had lived in foster homes since she was twelve. Every professional involved in her life had an instinctual sense that she had been sexually abused by her father prior to the foster care and at twelve she was, or so we surmised, too old for his taste so had been thrown out (possibly because she actually wanted the sexual attention she'd always been given). If this hadn't happened, there was no doubt that something strange had gone on in that family house.

The session was low-key. I didn't push Alice. She knew that twenty students were looking at her from behind the huge reflection in front of her, and it would have been better if she'd agreed to meet them first, as most clients did. (It is always better to see than not, the imagination an unruly force at the best of times.)

Afterwards, even though I had told the group the facts about Alice's history while leaving out our speculations, they insisted she behaved in a sexualised manner and, because of that, she had been sexually abused. I wasn't sure whether to be impressed or disturbed. The tendency to label and categorise, even to pathologise, is alive and well and way too robust. It wasn't that they were wrong. It was their enthusiasm to treat Alice as a sum of her problems that didn't sit well and, because of the clinical setting, the dry, perhaps incisive way I had delivered Alice's story, I felt partly responsible. I finished the session with a caution.

‘Helping isn't only about identifying problems. More often than not it means clearing a path, so someone can proceed. Without being able to go forwards, problems get stuck in dark corners. You're right, Alice will probably be able to admit, if things go well for her, to having been abused. But if you see your clients as problems and not as people with possibilities then you'll tend to miss opportunities for them to find their potential. You must respect the problems they present to you as theirs. It's not your job to hang them up, to see people as the things that have been done to them. If you walk with them while they make their way over things, which is often time consuming, they will do their own healing.'

They looked at me, dumbfounded. I guessed they had always been told to be active and alert, to search for problems, to tease them out and attack them head on, to problem-solve. If they had argued the point, I may have capitulated. They didn't. I nodded, wishing them the best of luck, and started to mutter TS again, like a child with a favourite nursery rhyme.

Rubbing its back along the window-panes;

There will be time, there will be time.

THIRTY-TWO

T
here were other words that kept me going in those days, when moments of calm in my routine at Marlowe Downs sent me slightly adrift, causing me to ponder what it was I was doing.

When I became worried of obsessive adherence to Tom Eliot, I remembered something of Borges.

Let no one fear in the bewildering night

that I will lose my way among the borders

The workload was growing to gargantuan proportions. Drowning not waving. A lifebuoy was of no help. I didn't need to float, I needed to be hoicked out of a rolling swell. At times like these there was only bravado to rest against. I kept a smiling face even as a monster wave was looming.

I had forty-eight open cases. I was meant to be – under our new rapid-response, which had received a huge rap from the audit team – taking in one new case a week, and closing one to keep everything evened out. I decided to close five a week until everything was more manageable. Easier said than executed. When I contacted people to say I was closing their file, they came up with more problems. I regretted having embarked on the exercise and considered closing cases without informing the clients. I knew this wasn't an option and went back to closing those I could and not worrying about the rest.

I began to turn down offers to sit on committees. Extra curricula activities were out. I was starting to harden.

One day, Eddy rang me, begging me to fill in for someone who had pulled out from being on a panel in a hypothetical. The occasion was the Annual General Meeting of the hospital's psychiatry department and they wanted a representative from every discipline. I was to hold the flag for social workers. I reluctantly agreed, as I owed Eddy for small favours incurred over the two years I'd worked in the place.

He wasn't there. In fact, I knew very few of the people gathered in the Milly Logan Lecture hall - the room I'd seen Celia come to grief in on my first day. What's more, the women looked like headmistresses from the fifties, and the men like ancient cricket players. But I guessed they were all ex-mental health aficionados. The only person I did recognise in the audience, let alone on the panel, was a psychiatrist from another hospital whom I'd come to loggerheads with over a diagnosis they had given a child I'd been working with, when he'd been treated in their inpatient unit.

They had anointed the kid in question as having attention deficit hyperactivity disorder – not uncommon for a nine-year-old boy, especially one I'd had to catch and peel from his school roof one day. This overrode my diagnosis of adjustment disorder – a diagnosis I'd chosen because his mother had, I suspected, an undiagnosed personality disorder. (See how complicated psychiatry can be! And was I "mother blaming", I had to ask myself.) I was arguing that the adjustment disorder was in response to the mother's personality disorder. But really the label of adjustment disorder – given that we were required to diagnose every kid we saw – was a ruse on my part to choose the lesser of the diagnoses and to treat the kid rather than just medicate him, as is what ended up happening. Tagged ADHD, he'd been medicated and, since his behaviour had improved – the seemingly obvious fact that he wasn't in his mother's company when he was in their inpatient unit not having occurred to them – he'd been returned home after two weeks, only for his behaviour, despite the medication, to have returned to its previous level of naughtiness. Finally, another clinician had labelled him conduct disordered.

This psychiatrist recognised me, but nodded civilly enough. He was a small neat man, dressed in country fair – moleskins and a checked shirt under a conservative blue tie. I remember feeling suddenly on the back foot. He had an air about him – a perched-up-high air, a hawk-looking-down-for-small-prey air.

I tried to forget that he was there as I looked around for Eddy. Cursing his absence, I sat alone through a meeting that meant nothing to me. Although they were attempting to romp quickly down the agenda, the business started to stretch into the hour and I waggled my leg with frustration, my head in my hands, thinking of all the other places I should be (home), all the other things I should be doing (carousing with Renny). And then we were being called to the front.

The panel were introduced, and I put on my ea-ger-to-be-out-of-there-but-nonetheless-eager face. The scenario was presented by a tall gangly psychiatrist also dressed in moleskins – trends are abundant wherever you go – who was suitably quick-witted and handy with the pun. A family had presented themselves at their local mental health service because one of them, an eleven-year-old girl, had stopped talking. Each member of the family was described and the assessment process began. The speech therapist spoke first. She was concerned about neurological problems, she said, and wanted to get the psychologist to test for cognitive functioning, which was duly done. The psychologist, another young woman, who could have found any amount of difficulties, reported finding nothing of significant concern and decided to make a referral to the psychiatrist for a family interview. The psychiatrist – who I had met, I realised then, a couple of times – floored me by saying that he suspected the father was sexually abusing the child. The discussion quickly veered off on a theme about undisclosed sexual abuse. The speechy and psychologist, OT and psych nurse concurred. This was such a leap in judgement I was miffed as to how their thinking had evolved. I began to squirm uncomfortably in my seat and had to stop myself from jumping in. (This was typical of me. I didn't even know if I was right. I held back.)

‘And, Monty,' Andy, the gangly psychiatrist doing the honours, looked at his card that listed the panel's names. I sat up. who is heading up the adolescent inpatient unit, is approached by Maria, the psychologist who's armed with her client's near-perfect cognitive score, to see whether she'll be accepted.' Andy smiled, pausing for effect. ‘There's one problem. Monty's team at the unit is on work bans and their operations are severely curtailed. Monty, what's your response to Maria?'

I gulped. There had been no mention of any union action, or that I was heading up an inpatient unit -something I'd never done. ‘Well,' I fumbled, ‘seeing as it's only work bans and we're not on strike… we're still accepting emergency cases.' (I knew this from that exact situation having been played out at the unit some months earlier.) I went on: ‘And since I classify this as an emergency, seeing the girl's looking down the barrel of selective mutism,' (the words, in one of those truly lucky moments, presenting themselves rather inexplicably) ‘I accept her into the unit.'

‘So,' he continued seamlessly, no flicker of doubt, ‘Catherine is admitted to the adolescent unit, to the great relief of Maria.' There was a titter of amusement from the audience. ‘And. what happens in the adolescent unit?'

‘Even though Catherine,' I said, ‘won't speak, it doesn't mean she can't hear.' (There was a chance this sounded smug, but it came from frustration. There were some people on the panel who seemed to be dallying.) ‘One on one, in a private room, she'd be spoken to about the choices she was making, about what she was hinging those decisions on, about other paths that could be just as provocative if she wanted to make a statement about unfairness or anxiety. She'd hear about how mental illnesses can develop from habits, about how action, or lack of action, can cause physical changes in the brain. She'd be told everything we know about why someone might choose the path she's taken rather than deal with other scarier responses such as anger, sadness, the feeling of being hurt.'

I paused. I had been smart enough, surely.