by Fiona Neill
‘Can you talk?’ I ask, trying to sound businesslike.
‘Sort of. Is there something wrong?’ Her voice is muffled and I guess she is in a meeting and has cupped her hand around the phone so no one else can hear.
‘Kit and I were wondering if you’re coming straight home after work?’
‘Not sure. It depends on my list this afternoon.’ I hear someone laughing in the background and it sounds like Ed Gilmour.
‘I saw the old man from opposite and he was wondering if anyone has Zika at your hospital?’
‘No.’ I can tell she is distracted. ‘Are you okay, Daisy?’
‘I’m fine. Don’t forget Kit and I are going out tonight to meet Max and his mystery girlfriend.’
‘That sounds fun. I might be back late.’
My heart sinks. ‘Who are you meeting?’
‘A colleague,’ she says vaguely. ‘Don’t wait up.’
I open up the computer screen again. The same helter-skelter of anxiety spins round my body. But this time I realize not only what is triggering it but come up with an antidote. I find some sticky white labels in the drawer of the desk where I’m sitting and cover the letters A, S, I and L on the keyboard in small squares.
I decide to run through every routine one more time before I start work, just to be triple sure, even though my shoulders are red raw from tapping myself and Kit will come home soon and ask me if I have finished my essay and will realize I’m lying when I say I’m still re-jigging the conclusion. There is a new look he gives me now, somewhere between mistrust and disdain, as he discovers that I am none of the things that he wanted me to be while he is still everything I ever wanted.
Two hours later I’ve finished. I haven’t written a single word and I’m counting the minutes again until I can call Mum. I’m at my lowest ebb.
A moment of clarity: it dawns on me that if I beat this illness once before, there’s a small chance I could do it again. Impulsively I book an Uber (Addison Lee has all the bad letters) to take me to Geeta’s office. It isn’t far, but I want to hit the road before my old adversary realizes and tries to talk me out of it. OCD finds spontaneity very threatening.
I keep the driver waiting in the street while I run up and down the stairs, checking the sockets, switches and knife drawer three times and see him eyeing me warily as I keep going back to make sure the front door is locked. He interrupts me once to tell me to please hurry up, which means I have to check the door three times all over again. I know I look mad. I am mad.
The big difference with my illness this time is that in an adult the rituals appear even more absurd. My 22-year-old self can’t tell the Uber driver that I have to do all this to prevent a burglar getting into the house and lying in wait for my mum when she gets home. Or that this is the reason I avoid going out any more. Whereas when I was fourteen this explanation might have sounded kookily protective. When I finally sit down in the back of his car my sweaty body is so heavy with exhaustion that I’m tempted to ask him to drive me aimlessly around London just so I can sleep.
The one thing that keeps me going is the prospect of seeing Geeta. She is the only person in the world who can help me right now. I calculate that it is exactly forty-five months since I last saw her. We draw up outside the building where she works. It occurs to me that she might be in the middle of a session with another patient, or taking a day off or even have moved offices.
The driver asks me if I’m okay. I’m startled by his kindness. I could cry with relief when the woman on reception confirms that Geeta is not only still working at the mental health centre but is with a patient right now. I ask if I can see her right away and the receptionist doesn’t look remotely fazed, even when I realize that my T-shirt has slid down to reveal the sores on my shoulders.
‘Do you have an appointment?’ she asks.
I shake my head.
‘Take a seat. I’ll see what Geeta suggests.’
I sit down as far from the exit as possible to make it more difficult for the illness to make me leave. I look around. The waiting room hasn’t changed much. There are a couple of new posters on the wall.
Myths About OCD reads one: ‘OCD is no joking matter. The D in OCD means it is a disorder, which means it causes great DISTRESS and DISRUPTION to a person’s life.’
The posters of famous people who suffered from OCD are still there although their compulsions aren’t listed in case they are triggers for patients. But I know them all: Charlize Theron – contamination issues – washes her hands all the time; Billy Bob Thornton – thing about good and bad numbers representing certain people – wrote a song called ‘Always Countin’’; Daniel Radcliffe – got over a compulsion to repeat every sentence he ever said under his breath – not a good trait in an actor; Julianne Moore – used to leave her house at a certain time, at a certain pace so the traffic lights would always be green at pedestrian crossings. I have a real affinity with Nikola Tesla, an American inventor who did things in threes or numbers divisible by three.
A woman and a young girl who I guess is her daughter sit opposite. Judging by the state of her hands, the girl surely has contamination issues. Her mum smiles at me and I try to reciprocate. I remember how one of the boys at my OCD support group was so worried he would catch germs that he had to wash all his cutlery and plates five times before every meal, which meant he couldn’t even eat school dinners or go out to a restaurant.
Geeta comes out of her office. Her hair is much longer and several shades lighter and she is wearing glasses but apart from this she hasn’t changed. The receptionist hands her an embarrassingly thick file of notes with Daisy Rankin written on the front. She walks over to me, hand outstretched as if she was expecting me.
‘Daisy. How nice to see you. I’ve got an appointment right now but if you would like to wait I can see you for a quick chat before my next patient. Sound good?’
‘Very good.’
The girl and her mother follow her into the treatment room. Feeling over-confident, I rashly google the BBC, on the basis it contains none of the letters that might make me anxious. The main headline is about Ebola. My body tenses. On an intellectual level I understand the chances of Mum catching Ebola in the UK are negligible. But instead of thinking about the 99.99 per cent of people who won’t get ill, I fixate on the 0.01 per cent who might and the certainty that Mum will be one of them because she sometimes has meetings at the hospital where victims are treated. I see her lying semi-unconscious in a hospital bed after contracting the virus. I see the cells multiplying in her body every twenty minutes. I imagine her holding the letter from Lisa and crying tears of blood because she is so upset about what she has told her.
As soon as I have a bad thought about Mum I have to neutralize it by making myself have the opposite thought. So I visualize her on the beach in Norfolk wearing her wide-brimmed hat and the baggy purple swimsuit that highlights her flaws although she thinks it hides them. I imagine her shoulders burnt from the sun because she doesn’t have skin that tans easily, all easy smiles as Max turns his trunks into a thong to make her laugh. It almost works. But then I see Lisa sitting beside her and imagine her telling Mum that I saw her and Dad having sex long before the truth came out, and I start to feel anxious all over again. Sometimes it feels as though the worry will only end if I die. I run through a few foot-and-shoulder-tapping sequences. Geeta’s waiting room is one place you can get away with this without anyone thinking you’re a freak.
‘Would you like to come in, Daisy?’
The warm, smooth tone of Geeta’s voice is instantly soothing. I follow her into her office and she closes the door. She sits down in her armchair in the corner of the room and indicates I should take up my old position on the sofa. I thought coming back might feel like failure but it feels closer to coming home after a long journey.
Geeta explains that she doesn’t have time for a full session but will try to cover as much ground as possible and book me in for a follow-up appointment in three weeks.
/> ‘I’m sorry I can’t see you sooner.’
‘It’s fine. Three is a good and safe number,’ I mutter under my breath.
‘Do you remember we discussed how there is no good evidence that any number is lucky or unlucky, Daisy?’ She says this brightly in a way that doesn’t make me feel like an idiot and gives me a copy of research from a scientific journal that proves this. ‘OCD hates empirical evidence.’
‘I’m having a relapse,’ I blurt out as I stuff the paper in my bag. ‘I thought it might go away on its own or that I could get away with doing just a few rituals but it’s taken over again.’
‘Can you talk about the intrusive thoughts or are you worried that if you do they might come true?’
I nod.
She flicks through my notes and peers over her glasses. ‘Are they the same as last time?’
‘I won’t win any prizes for originality,’ I say.
‘So you’re worried about something bad happening to your mum and brother, Max? Are you still ruminating about them being harmed during a burglary?’
Now she’s articulated my fears, I can talk about them without worrying this will make them happen.
‘Mostly Mum. I imagine terrible things happening to her all the time, like a horror movie on repeat in my head. I’m spending all my time doing the rituals.’
‘How many hours a day would you estimate?’
‘Around eight.’
‘Just because you think something doesn’t make it happen,’ says Geeta. ‘Try to make me pick up my file by using your thoughts.’
I try. Her arms stay in her lap.
She makes careful notes on lined paper and pulls out some worksheets from one of her files.
‘Homework,’ she smiles. ‘I want you to list all your obsessions in the left-hand column and your compulsions in the right-hand column. If you’re feeling strong enough maybe you could try to reduce the number of times you perform a ritual. Limit the sequences, for example. The OCD will try and stop you from making changes.’
I take the piece of paper from her.
‘Don’t fold it into three.’ She understands me too well.
I fold the piece of paper in half. She gives me an OCD diary where I have to note what the OCD makes me do, when it happens and how long it lasts.
‘Do you have any idea what might have triggered your relapse, Daisy?’ she asks. ‘Are you feeling anxious about anything in particular?’
Bizarrely, I haven’t really considered this. The strangest thing about an illness that involves so much thinking is that you don’t necessarily think about the right things.
‘It has a tendency to sneak back during times of stress.’
‘Lisa sent Mum a letter. I read it.’
‘So? What’s wrong with a letter?’
‘She’s dying and wants to see Mum one last time.’
‘Why is that so bad?’
‘It might set Mum back.’ I like the way there’s no recrimination for reading a letter that wasn’t meant for me.
‘She might want to make peace with her old friend before she dies. OCD encourages you to overestimate the likelihood and extent of danger. Try to see it from your mum’s perspective. Don’t catastrophize.’
‘Lisa says there’s something she needs to tell Mum before she dies. I’ve got a bad feeling about what she’s going to say and the effect it might have on Mum. There are some things she can’t ever know.’
‘You can’t control the outcome of events with your thoughts, Daisy. It’s a trick the OCD is playing on you. Your mum will decide whether she wants to see Lisa or not. And you have no control over what Lisa wants to tell her. Can you give me one example from your life where your thoughts have ever prevented something bad from happening?’
‘There was one time when I didn’t do my rituals and something happened to Mum.’
‘If that happened, it is nothing more than coincidence. There are many reasons why things go wrong and none of them have anything to do with you. When you come next time, we’ll talk about this further.’ She looks at her watch and then down at her notes again. ‘Lisa was a trigger for the illness last time as well, wasn’t she? You told me it all started after your dad left your mum for her.’
‘This was all a long time ago so I might have some of it wrong.’ I apologize to Kazuo Ishiguro for quoting him out of context.
‘It’s hard work confronting OCD, Daisy. There are no short cuts.’
‘There is one.’
She looks interested.
‘If Lisa dies it will go away forever. You said it yourself. She was the trigger.’
14
Max
My heart sinks when I get to the pub and see through the window that Daisy is alone. She was meant to be coming with Kit. If it weren’t so cold I’d wait outside until Connie gets here but she’s always late. I glance at Daisy’s feet through the window. Old reflex. She’s wearing the expensive R. Soles cowboy boots that Dad gave her the first Christmas after he left Mum. There were some good presents that year: I became the first boy in Year Seven to get a Wii. But every time I played Super Mario it made me miss Dad.
I watch as Daisy taps the toecap on the floor three times, followed by the heel and finally the worn side where the embroidered cactuses unravelled long ago. I count to three and, sure enough, she starts up again. When I look closely I notice her lips moving as she mutters silent incantations. Textbook.
I suddenly remember how Daisy used to read Dr Seuss to me when I was little and made me count exactly how many Bee-Watcher-Watchers there were on each page of Did I Ever Tell You How Lucky You Are? If I made a mistake I had to start all over again. Then she copied out all the words in her insanely neat handwriting and tried to make me do the same and got cross with me when I couldn’t. Maybe her illness was always lurking in the shadows.
She tried hard to persuade me to come to Mum’s tonight instead of going out but I insisted we stick to the plan to meet at the pub because she’s spending more and more time at home, and her illness feeds off isolation. The bad part of me – the part that wants an easy life, and wishes I didn’t have a sister like this – was hoping she’d cancel. I sigh and the window fogs up with my breath.
I slump against the wall of the pub with my eyes closed. I can’t face seeing her alone. Without thinking it through, I send a Snapchat to Carlo and ask him to come along too. Safety in numbers. He gets back right away. B there in 5. He’s always reliable if it involves meeting a new girl. The fact that Daisy has a boyfriend won’t put him off. In fact, the evidence would suggest the opposite. At least in Daisy’s current state he doesn’t stand a chance of getting with her, even if he pulls out all the stops – which, knowing Carlo, he will.
I take a deep breath and go into the pub. Daisy looks really pleased to see me, which makes me feel really bad. I watch the rise and fall of her chest and realize she’s doing the breathing thing to try and keep herself calm. She manages a quick brave smile. She looks so vulnerable that I just want to throw my arms around her, but then I’ll crack and we’ll go straight back into the old unhealthy habits. The headshrinkers call it ‘accommodation’.
Ironically – there are a lot of ironies in this story – I’m in the middle of a mental health component on anxiety disorders so I only get time off from thinking about Daisy when I’m with Connie. I pissed off Carlo by getting the highest score in the group in our most recent test. So I know everything there is to know about how fear and stress reactions are essential for human survival and help healthy people pursue goals and respond to danger. Fight, fright or flight. The body makes three choices before the mind has a chance to think. Daisy would like that. But the threats to Mum that Daisy perceives are not genuine and in her less anxious moments she realizes her worries are excessive. I learnt this week that if she truly believed what she thought all the time (her worst fear was Mum being stabbed by a burglar) the diagnosis would be psychosis. I have always had faith in the power of knowledge. But sometimes you can under
stand everything and do nothing. It makes me feel so impotent.
‘Drink?’ I ask casually. I want to keep everything on the level.
‘Large white wine, please.’
I look at her empty glass. Always a mistake to neutralize anxiety with alcohol. It actually raises the production of stress hormones. Good observation, Dr Rankin. I wonder if I should try and explain to Daisy but I don’t think she would listen and I don’t want to draw attention to her illness in case she tries to get me involved. I go up to the bar, hoping that by the time they serve me Carlo will have made an appearance, but when I get back to the table she is still alone. ‘Did you get your essay done?’ I ask.
‘Just re-jigging the ending.’
She has given the same answer for the past month.
‘So how’s life, Maxi?’
I can tell by the way she grips her glass that she’s making an effort not to tap her foot, count in her head, or do the magical thinking. Last time she was ill I was so young that part of me really wanted to believe that she could control what was going on with her superpowers. This time I understand only too well the delusion of the disease.
‘All good.’
‘How’s it going with Connie?’
‘Unpredictable in a more settled way. I think.’
‘Sounds like progress.’
I would like to explain to her that Connie is the first thing I think about when I wake up in the morning and the last thing before I go to sleep. That sometimes I miss her so much that it physically aches, and when she leaves my flat I lie on my bed and try to find the imprint of her body and musky scent on my sheets. But I have already lost Daisy’s attention. She’s in retreat from the world again. The illness is stronger than me, stronger than her. It’s like watching the tide carry someone you love out to sea.
