This Too Shall Pass (5 page)

As we tried to undo this concept – touting that our cases were unique and complicated – all we managed to do, according to our critics, was back up their claims. Our methodology alone – labelling, sectioning off, medicating – was a crime, they said, especially when most kids had good reason for their troubles: growing up poor, witnessing violence, suffering sexual abuse, and all of this was perpetuated by a lack of good policy, and laws that did not adequately deal with perpetrators. (Psychiatry wasn't going to help!)

In fact, the view of those working in the community, in charitable organisations and in foster care, those whose caseloads teemed with kids and adolescents needing our services, was that the only thing going on at Marlowe Downs was the reinforcing of the status quo of children and women as being of zero value. Instead of taking the reality of their situations into account, we were bandaiding, even joining with the oppressor, both individual and state. Added to that, our out-of-date methods were offensive. In short, we were carrying out systemic abuse.

The subject of our reputation among both government and non-government organisations – not to mention a considerable number of disgruntled parents who saw our shortcomings firsthand – was taboo inside the walls of Marlowe Downs. The clinicians were, according to our PR press club, beyond reproach. With the shutters closed tightly and the walls and roof insulated well, we were to be protected from having to listen and if we did happen to hear, we were to take no notice. As long as it didn't get into the papers, we could stay out of reach and out of range. But that, in itself, was just another thing the critics were accusing us of.

So how did I know this? I lived in a world between two worlds. A politically vivid, if not radical, women's feminist perspective was fed to me via Renny and her peers who worked in the area of domestic violence. They had been perfecting the art of lobbying. To them the tenets of Freud, Jung, Lacan and all who followed in their footsteps, were skewed, and dangerously so. It didn't help that Anna Freud, Sigmund's daughter, and other female analysts like Melanie Klein, had become involved. Freud and his cronies should have been hung, drawn and quartered, their theories and following disbanded.

‘There are things we don't accept now,' was my point to Renny (a point I never succeeded in making, but which I also never gave up on) ‘but that doesn't mean
all
of it's useless.'

I know
why
the distrust existed: a lot of bad things have been done in the name of Freud – were done even by the hand of Freud. And Jung, having entered into unethical relations with the women he treated, would be struck from today's medical registers if he was still practising. But apart from the obvious argument that there's no point in reading theorists out of the context of their times, it is also true to say that they came up with the most plausible model of an individual's psyche we have to date.

This, however, is a spurious discussion. The truth is that many psychiatrists know next to nothing about Freud's theories; everything is all about the brain these days, as in neurons and synapses and chemical imbalances. Nerve activity. Mental illness
really is
mental illness, not the fault or fancy of an individual (a wonderful thing for all those who've ever been accused of “malingering”). But humans are not simply conglomerations of their hardware. It might be easier if we were, if the mind could be quantified in some physiological computation. And that's what first caught my attention with regard to Nigel Pathmana-than – excuse me,
Doctor
Nigel Pathmanathan. From his point of view, life could be perfectly abstracted into an equation. Children were like little machines. If you had a manual and followed the steps, you could fix them.

TWELVE

I
t should be said that I liked the good psychiatrist who was part of the team I was assigned to. Doctor Nigel Pathmanathan was a gentle person. His demeanour meant he was approachable. It was after these first impressions, though, that I began to understand a little of what was going on for him professionally, which I tried, unquestioningly at first, to take at face value.

The doctor dieted on kinesiology. This crossing of the brain's hemispheres through activity was the way, according to him, to fix all ills from severe intellectual disability to cerebral palsy, not to mention everything in between. He defended the hours it took to complete the complicated exercise regimes – hours out of a child's day – and persisted drawing complex diagrams for mothers so they could instruct their children in the art – and it was a kind of art – of performing the routine. Don't get me wrong: it's a lovely idea. But this neatly dressed Sri Lankan-born man – unusually tall with a round face and large green eyes and long lashes – was kidding himself. There had been no trials and little clinical opinion to back up his extraordinary claims – a consideration he didn't seem concerned about. Doctor Nigel Pathmanathan was writing a book about his theories, incomprehensible excerpts of which he willingly handed out for us to read. They made little sense and overlooked many practicalities.

He talked about being offered a publishing deal. Collectively – there were about twelve people in our team – our blank faces said:
You can't be serious!
and, our second thought,
The publishers can't be serious!

Still, in what became a kind of ritualised response, we'd smile and say it sounded good.

Added to this, Nigel wrote notes that he regularly delivered into our pigeonholes. He had a habit of putting a smiley face – a circle with dots for eyes and a curve for a mouth – on everything. My immediate reaction to this was that twelve-year-old girls had done it en masse for a couple of years in the early nineties – a fad a whole generation grew out of quickly. The smiley face, however, adorned the page regardless of whether it was a paper discussing the count of Rapid Eye Movement a child suffering night terrors has, or a yellow sticker slapped on the flyer advertising a church meeting.

And there, since I've alluded to it I might as well let another detail fall upon the page: Nigel Pathm-anathan was a born-again Christian – a fundamentalist, in fact.

In the church Nigel was a member of, recruiting others into the fold wasn't just encouraged, it was expected. He was required to try to transform those who were tainted – by definition, heathens. His church ignored "disinterest" in Christianity, preferring to call it "waiting". According to Nigel, every disbeliever was waiting in a line outside God's door, and all it took was for their number to be called and BINGO, they'd want to proceed inside. Nudging the process along, though, Nigel would post notices in our pigeonholes inviting us to hear his local preacher or to gatherings for visiting American evangelists – the sort seen on late-night television.

‘While it's well-known,' I told Renny in a heartfelt address one evening, ‘that people's pigeonholes shouldn't be violated, certainly that nothing should be taken from them, the same cannot be said for what is put inside them.'

‘You should say something,' she said.

Nigel waggled his head when I approached him. The flyers stopped for two weeks. When they started again the only defence, for a relative newcomer like myself, was to take the path of ignoring them.
What else could I do?
In a psychiatric setting, psychiatrists are indispensable. Further to that, I was beginning to understand that – often regardless of their merit -psychiatrists wielded significant power. Anyway, there were more serious problems with Nigel Pathmana-than, problems that weren't so easy to turn the other cheek to.
Could there be something to squeeze in beside the kinesiology, the religiosity?

With his office being three down from mine on the same side of the corridor, I saw many a disgruntled mother leave his room. Red-faced, stormy with umbrage, dragging on her child's arm – or scuttling away as quickly as possible, ripe with upset and not trusting herself to hold off from bursting into tears – she (collectively) was the one “blamed'” the one our critics were hearing from, and I know there were many more than
did
complain. I heard about affronts from Nigel, sometimes first-hand. Things such as:
If you're undisciplined, and I can tell you are by your weight, then your child will see you as ineffectual!
would drill uncompromisingly into women who were already feeling inadequate. Sotto voce, he would hammer the nail in further with something like:
Why would he take notice of someone who watches television all day?

But even I underestimated his capacity for sideswiping women until a mother complained to me about recommendations he'd made in regard to her child. I asked him openly what he'd been thinking when he'd suggested the father – a man we both knew, a man who'd been violent to the mother – take over the parenting of their son.

‘The mother's unable to discipline the child,' Nigel said.

‘His father's violent.'

‘Only towards her,' he replied. ‘Not to the boy.'

It was the tone of his voice, the sureness in it, combined with the fact that I'd chosen an informal setting (in the hallway a few minutes before our team meeting) that stumped me. Never one to carry an arsenal of comebacks, I remained dumbstruck – and left standing alone in the corridor, I felt decidedly ill. The critics were right. I should be better prepared next time; in the future I'd go to his office and flesh out the conversation.

I don't remember there being another situation, certainly in those initial months, that gave me such clear grounds to challenge him on this particular issue. I knew that his effrontery was still being played out behind closed doors – it was there in his language when he talked about patients. Undermining women: it went on, and it was something I had to resign my self to.

Despite this, unable to let it go completely, I always had an ear out, as if waiting on the sidelines to catch him. My eagerness may have alerted him to be more careful – although he never acted as if I was someone to be careful of. Still, either he was subtler after that, or the women were too afraid of upsetting him, because I didn't hear anything more along those lines, certainly not directly. Perhaps it was a combination of being female and not medically trained, but I was never more than a hillock on an Everest-sized mountain to Nigel.

Mind you, Nigel wasn't as powerful in the scheme of things as I'd first imagined. He was just one in a line of puffed-up figureheads at Marlowe Downs vying for ultimate authority.

THIRTEEN

U
p that rungless ladder was my team leader, Elliot Burton, a man who had moments of brilliance and moments of bust. He was, as some in the organisation described, a cowboy, someone who shoots from the hip. This was a criticism, of course, but to me, in the short-term at least, shooting from anywhere had a charming, if not intellectually stimulating, resonance. At least he was alive and had something to say. And, although some of what he came out with, despite
him
thinking it brilliant, was just post-feminist (now there's a fallacy) rhetoric, I still found it attractive and worth listening to.

Elliot, who moved in frenetic fits of absent-mindedness, would lumber up the corridors as if his limbs might suddenly fly from his torso and continue on without him. He needed all the breadth the wide hallways offered, as he was usually juggling several reams of loose notes, academic papers and journals, as well as assorted bags full of the same. Elliot listened intensely to anyone addressing him, gave merit enthusiastically when it was due and if not, made scathingly accusing responses on the spot – hence the shooting analogy. This applied to worker and service-user alike, even the hoi polloi at the top. He had no time for power mongering and, unlike Nigel, remained clear about what he thought were injustices upon children. At every opportunity he'd leap up to vociferate his opinions, and systemic abuses -especially in government-run services, like schools or child protection – were high on his list.

‘Humiliation,' he'd inure. ‘If they refuse to listen to the client, we'll take it to the papers, make them feel ashamed.'

He was the lone, if not largely chaotic, voice inside the place touting rights for individuals. I was impressed but it remained to be seen how much he actually did to ameliorate wrongs. I had been warned that he was bluster without a flame.

Elliot, like Nigel, was also a writer; however, his results were of considerable quality. With ease he produced long therapeutic letters to clients, often full of complicated compound verbs and circular questions. The best of these were addressed to violent men whose children he was treating for one reason or another. Elliot worked hard to bring these men into the service, to educate them about their behaviour and its effect. I'm not sure how successful he was in his endeavours, but it was impressive that he put in the effort. We needed more of his ilk, more men who were at least speaking up. An occupational therapist by trade – that incarnation having long left him, despite being his ticket into child psychiatry – we had much in common and spoke in a close language when it came to our work. I liked Elliot – his intense and rapid speech, the unafraid way he'd deconstruct a situation by pointing out inconsistencies and power imbalances. It was always good to have someone ready to be a rebel. And although his manner had a sting in it, sometimes closing doors for more meaningful discourse – which is also why others wiser than I called him a cowboy – I'd still opt to have someone to liven up proceedings than not. Added to this, I admit, he saved the egg from falling on my face more than once.

In this rickety ascent of domination there is one more necessary individual to describe. Anton – or Antwerp as I called him – Pilsner. Antwerp had come from the private sector, specialising in hospital management and integrated systems (whatever they are). He'd been employed by the hospital to use his entrepreneurial skills to turn the preciousness of our ivory tower into a corporate concern, complete with units of measure and customer responsiveness. Antwerp was just the person for the job. You could see it from a hundred paces. He had all the corporate meanness it takes to execute such a thing. And it wasn't long after his arrival – a little before mine – that the catchcry "bottom line" was being chorused with cheer-squad pomp into our otherwise hierarchically-laden system, which had previously had nothing to do with monetary efficiency.
Since when did health, especially mental health, fit between those dictums? Since the modern era began. Academia move over, the burden of fiscal reality is about to take front row.