‘Up her dose?’
‘Maybe. I don’t know. We had her father in last week and then her husband as well. They’ve got no idea what’s triggered all this. The main message I got from them is this is a total bolt out of the blue.’
‘What’s her husband like? ’
‘Seems a nice enough guy from what I could see in the short time he was with me. He kept saying I thought a baby was what she wanted. The thing is, what I’m struggling with here is that there’s been no suggestion of anything wrong up until now and, if you can believe what her father and husband are saying, and the notes I’ve got from her GP seem to confirm it, her health is good, the marriage is stable and the pregnancy was planned.
Then whammo she goes off and has an abortion and tries to kill herself.’
‘Wasn’t there some family history of depression?’
‘Yes, her mother but that’s quite different, really. When her father came in for the conference I asked him about it. According to him, Elisabeth’s mother had a long history of mild to severe depression dating back from early adolescence. But he said as well as that there was a family tragedy which triggered a much worse condition which was, basically, chronically depressed, barely functioning at all.’
‘What happened?’
‘He wouldn’t elaborate.’
‘How’s Elisabeth’s mother now?’
‘She died.’
Wanda filled their wine glasses. ‘Well, I think you’ve got some answers. Depressed mother, family tragedy whatever that was, mother dying, that’s a lot for anyone to deal with. Stephanie, I can see this is worrying you. You just can’t let it get to you and I don’t think it would if you weren’t so worn out. You’re obviously doing your best. Everything’s being done for her that can be.’
‘I’m not letting it get to me.’ Stephanie heard her voice sharpen and she tried to soften it, ‘I don’t want her to slip any further down. I feel if I could make some sort of contact with her I could help.’
‘You know, in this game there are times you just have to accept that a patient won’t get better.’
‘I know that.’
‘Where’s Mark this weekend? Is he away?’
‘Maybe.’
‘Has something happened?’ Wanda’s eyebrows were slightly raised.
‘I guess so. Possibly we won’t be seeing each other any more.’
‘Why not? I thought you two were getting along really well.’
‘We were, I suppose. But I was feeling stretched. I haven’t got time for all that now.’
Wanda sighed and shook her head. ‘Everyone I know is trying to find a man who’ll make some sort of commitment and you get one and don’t want it.’
‘Oh well.’
‘Oh well, indeed.’ Wanda finished her coffee. ‘You ready to go?’
‘Yes. Think I’ll have an early night.’
Wanda looked thoughtfully at her. ‘Just another thing, though. About Elisabeth Clark. That time she was so beside herself, there was a name she said a few times. Tracy. Something like that. She said she wanted to be with Tracy.’
‘Tracy?’
‘Mmm. But like I said, get a bit of rest and don’t let this get to you.’
‘Hi, Elisabeth.’
The blank, resistant stare. The measured shutting of eyes, deliberate turning of the body towards the wall.
On the surface everything is normal: temperature, blood pressure, pulse, heart. She eats what is placed in front of her, takes her medication without complaint. But she won’t speak.
Why has this patient got to her? She rarely thinks about the others, leaves them behind as she drives out onto the main road towards her flat. But she’s far too preoccupied with this one and that worries her. Sometimes she’s caught herself thinking in a way she should never think, in a way that goes against all her training and experience. What is it with you? You’re pretty, young, intelligent, got people around who love you. For God’s sake, you’re alive, aren’t you?
Maybe this intense concern she has with Elisabeth is preventing her from feeling disappointed about Mark. Maybe unconsciously she’s obsessing about this patient to stop herself thinking about him. He hasn’t phoned, hasn’t emailed or texted, even though she has books and a DVD which belong to him. He’s acting like some put-out adolescent. Totally infantile behaviour. You’d expect better from a 32-year-old adult. They’d been seeing each other for almost six months and now, because he was a little miffed she was busy and didn’t want to eat with him, he’s completely withdrawn.
She has to admit she misses him. She liked the quirky texts while she was working. Liked the feel of his body up against hers waking on a Saturday or Sunday with the morning ahead of them. Making a plunger of coffee, him going out for fresh, warm bread and reading the paper together. Had she loved him? Had she been in love with him? Certainly not in the way she’s read about. Falling in love. Falling. She’s mistrustful of the idea; of being so helplessly caught up, so utterly enthralled you may lose yourself. She’s never felt like that, suspects that such emotion is largely delusional. Anyway, she doesn’t want it.
‘Elisabeth? How are you today?’
‘Fuck off, Stephanie.’
The light sifts through the blinds harshly illuminating Elisabeth’s face and the sound of her voice is so abrasive, so jarring that Stephanie recoils, almost cries out. She stands for a moment, shocked into silence.
But it’s a response. At least it’s something.
‘Do you want to talk?’
Her eyes close. She turns her body to face the wall.
In the end she phones him.
‘Mark? We haven’t seen each other for quite a while and I was wondering if—’
His voice is clipped and distant. ‘I’m seeing someone else.’
‘Oh. Okay, then.’
‘You’re not surprised, are you?’
‘Well, I—’
‘Oh come on, Stephanie. You never really wanted me around, did you?’
‘I liked being with you, Mark. I thought you knew that.’
‘No, I didn’t know that.’
She hears the phone click.
Fuck off, Stephanie.
Every day she’s spending longer in her office; getting there earlier, staying later. The cleaner came in the night before, looked surprised to see her still there at seven-thirty. Joked that she’d have to start bringing her sleeping bag in. But she prefers to be here. She can hear voices, sense movement in the corridors and rooms just a few metres away. At first she’d liked her flat, liked the austerity and the silence. Now she feels restless and cramped when she’s there.
Sometimes when Stephanie goes over to the house Mary-Anne and Kevin own in a new subdivision in Abbotsford, she can’t help but marvel at it all. There’s the new leather lounge suite and the curtains Mary-Anne made even though she always said sewing was so boring and she was never ever going to get into all that housewife crap. They’re painting the baby’s room bright yellow which is a positive colour Mary-Anne says and there’s new curtains up: blue with ducks along the border. Mary-Anne’s having a natural birth, her midwife’s booked the birthing pool, and she’s bought pure cotton clothes for the baby and using cloth nappies because they’re better for the environment. She’ll have a two-year gap and then they’ll start trying for another, this one’s a boy and she’d like a girl next time but she doesn’t really mind so long as it’s healthy.
Where is the Mary-Anne who liked boys and laughed out loud, that great belly-laugh Stephanie remembers? Where’s the Mary-Anne with the fat knees and spiky hair? This Mary-Anne is slim and sleek apart from the protruding belly. This Mary-Anne does yoga every day and goes to Mediterranean cooking classes and her life seems planned and foreseeable. She’s so sure of everything, so surrounded by the trappings and concerns of adulthood that Stephanie sometimes feels like a child in comparison. Stephanie owns nothing significant, has consciously avoided collecting all that clutter of partners and belongings, so why doe
s she feel dissatisfied all of a sudden?
Maybe she should find another place to live in, somewhere tranquil and restful just out of town. She could rent a little cottage by the beach at Warrington or Waikouaiti where she’d have that sweep of coastline to look forward to at the end of each day. Or she could look for something out on the peninsula: Macandrew Bay, Broad Bay, Portobello. Somewhere where she could wake and look out across the harbour. Watch the boats, watch the wind churn up the water, the sky change colour, the sun tip behind hills in the evenings. Though how would she feel facing that great expanse of water each day? On a clear, fine day the harbour is like a lake. Fathomless in some places. Glittering blue. Beautiful and treacherous.
She could get a pet. Dogs are great company though they don’t like being on their own, they’re more trouble than cats. Cats are more independent. A cat would be okay left alone all day and if she got two they’d be companions for each other. Maybe Burmese; she read somewhere that Burmese cats are affectionate.
Jesus. What’s she turning into? A spinster who keeps pedigree cats? She has to get a hold of herself. She doesn’t want her life cluttered with cottages and cats. The way things are is fine.
But she’s thirty-one. She has two friends, a few books, a bed, a desk, a table, two chairs, a sofa, a coffee table, clothes. Brothers she rarely sees, a father she never visits. No real home though sometimes she dreams it. Silken tussock, the tang of thyme and lavender, a sky like rippling silk. Sun gleaming on water.
A child holding out her arms before she jumps.
Even though you know it’s wrong to repress pain, even though you know it’s wrong to work so hard you have no room for anything or anyone else, even though you understand you cannot ignore the mourning process without consequences, still you’ve done everything you can to disregard it. You guide others towards retrieving past hurts and confronting them. This is what you ask of your patients. Never yourself.
Never yourself.
Get on with it. There’s a pile of papers to go through. Get your head down, just get on with it. There’s a knock at the door.
Will Ryan pokes his head in.
‘Have you got a minute?’
‘Yes. There’s coffee. I just made it.’
‘Thanks.’ He pours a mug and sits opposite her. ‘I was wondering if you’d looked at last night’s ward notes yet.’
‘Not yet. Was there a problem?’
‘Amy was fairly shaken up when I came in this morning. She was on last night. Elisabeth Clark wasn’t in her bed around midnight so Amy went looking for her. She was in the bathroom having a go at her wrist with a bread knife.’
‘How the hell did she get a bread knife? ’
‘She must have got into the kitchen somehow. I don’t know. But there was blood everywhere and when Amy took the knife off her she started screaming and the other patients woke up and there was general chaos.’
‘Where is she now?’
‘In bed sedated. She had to be taken into A & E to get her wrist seen to. We’ve got Jan sitting with her to make sure she doesn’t try to open up the wound.’
‘How are the other patients?’
‘Disturbed.’
‘I’ll look into it and talk with Amy. Thanks for letting me know.’
‘Thing is.’ He looks at her. ‘Thing is. Well, I know it’s not really my place to say but you do ask nurses to contribute. Anyway, what I want you to know is Elisabeth is upsetting the other patients. They get the message all the time that this place is about being responsible for yourself and contributing to what’s going on but Elisabeth hasn’t even spoken to any of them. She’s started having meals with the others but she kind of spooks them, stares at them like she hates them. That’s what Rowan says anyway. So this latest thing, well, there’ll be complaints.’
‘Right. I’ll be aware of that, then.’
‘Just for the record, what some of the patients are saying is Elisabeth’s presence here is affecting them.’
‘Okay. Thanks for that, Will.’
There’s a meeting called in the afternoon. The medical director, Stewart Carter, is chairing and Elisabeth’s overseeing psychiatrist, Anne Hurst, is there. Ian Donovan the physio, Elsie Drummond the ward sister and Amy Bell are around the table as well.
Stewart looks over at Amy. ‘Perhaps you could start, Amy, by going over what happened last night.’
Amy reads her report, then looks up.
‘And Elsie, how has Elisabeth been today?’
‘Not responding. She’s slept most of the day.’
‘Did anything happen yesterday that appeared to have upset Elisabeth?’
‘Nothing that anyone noticed.’
He looks back at Amy. ‘Did you observe anything? ’
‘That could have upset her? No, she had a hot drink around nine-thirty and went to bed.’
He looks across the table at Stephanie, ‘Stephanie, you’ve seen her most days. Has there been any progress?’
‘I have been concerned about her lack of response to treatment.’
‘How about the other patients? Does she respond to them?’
‘Not yet.’
‘How are the other patients? They were disturbed last night I understand.’
Elsie speaks. ‘Quite upset, today, I’m afraid. There was quite a lot of noise and blood. Amy handled a difficult situation very well.’
Stewart looks towards Anne. ‘Any comments, Anne?’
‘I haven’t got much to add. I have considered changing or increasing her medication but I’ve been unsure if that’s the right approach.’
‘Ian?’
He shrugs. ‘Nothing. I’ve tried to involve her in some of the activities but she won’t have a bar of it.’
Stewart looks around the table. ‘The problem I think we must deal with immediately is last night’s suicide attempt, which suggests to me that we’re not able to meet Elisabeth’s present requirements. It may be best to transfer her to a more secure unit at the public hospital, at least until she presents as making progress.’
Elsie nods. ‘She obviously needs constant supervision.’
Anne is also nodding. ‘This is her fourth suicide attempt. We have to consider both Elisabeth’s needs and those of the other patients.’
‘Stephanie?’
She hesitates. ‘She didn’t make any progress at all in the public hospital. At least here we’ve got her out of bed. She’s been into the gardens for the odd walk and she’s eating with the other patients. I know it’s not much but I’m concerned that transferring her back there will set back any progress, however negligible, that she’s made. Couldn’t we give her a little more time?’
‘She would have to have a full-time carer.’ Stewart looks at Elsie.
‘I could get one of our regulars in.’
‘Anne? What are your feelings on keeping her here under strict supervision?’
‘I agree with Stephanie that she may make better progress here and transferring her back to Public could be distressing for her. At the same time we can’t provide supervision indefinitely to a patient who’s at risk and having a negative effect on other patients.’
‘So?’
‘My recommendation is we give her a set period here and if she doesn’t show signs of improvement during that time we arrange the transfer.’
‘All right. I’ll go along with that. We’ll give it another two weeks and meet again after that. Another incident, though, and we’ll have no choice.’
Two weeks. Stephanie walks down the passage to Elisabeth’s room. She’s propped up on the pillows. Marie Tyler is sitting on the chair beside the window. Stephanie nods at her and she leaves.
‘Elisabeth? How are you feeling?’
Calm face. Gentle voice. Stephanie sits on the chair nearest to the bed.
Elisabeth picks at the bandage on her wrist.
‘Does your hand hurt?’ Stephanie asks gently, ‘I can give you painkillers.’
‘Painkillers?’
&
nbsp; Her voice is harsh and incredulous, her face slightly contorted. She shuffles down in the bed, turns away.
Gemma would have been just about your age, pretty and young like you, everything ahead of her. Would her voice still be husky and soft, would she look up when I came into the room, her eyes brightening?
How much do you love me, Gemmy? Up to the sky.
Goddammit, you have your life, why don’t you use it?
Stephanie sits on the seat beside the bed, closes her eyes, almost drifts off into sleep. There’s the hum of the TV coming from the patients’ lounge, someone laughing.
Maybe she should call Liam and Jonny, ask them around for pizza and she could get in some beer. She should phone Dave. Have a chat. Maybe he’ll come down. Maybe he’ll bring Esther and Greg with him, stay a weekend.
She feels so unutterably alone just now.
14.
She looks over last night’s ward notes. No incidents. At least that’s something.
She reads through the notes on Elisabeth. Patient quiet. No response. She calls the ward.
‘Will? It’s Stephanie. Is Amy on right now?’
‘She’s just leaving.’
‘Could you ask her to pop into my office for a moment on her way out?’
‘Sure.’
Amy knocks at the door. Stephanie opens it, ushers her in.
‘Coffee?’
‘No thanks. When I’m on night duty I sleep most of the day. Coffee keeps me awake.’
‘Amy, I wanted to check in with you over the incident with Elisabeth. I see in your report that Elisabeth continued to scream for some time after you found her. Was is just incoherent screaming or was she using words?’
‘Incoherent but mixed up with words as well.’
‘Could you make any sense out of it?’
‘I wasn’t listening all that hard. What I was trying to do was get the knife off her without hurting her or me and then getting her cleaned up and calmed down. I had to get help fairly quickly and there were the other patients to see to.’
‘Yes, I understand. So you can’t remember any words she may have said? Anything at all?’
‘Not really.’
‘Nothing like— Like Tracy?’
Hunting BLind: It's Every Family's Deepest Fear Page 10
