by AB Morgan
The document was signed with Dr Sharman’s usual flourish, ‘Dr Giles Sharman’, and was timed and dated.
I was stunned and confused by what I had read. I checked the name on the paper, and it stated Mr Trainman (real name unknown) and yet Dr Sharman had written that this was a known patient with a diagnosis.
If that was the case then how does he know him?
Does he really know him from his previous hospital?
Why doesn’t he know his name?
And if Charming is acquainted with him, but does not know his name, then how can he know that he has an established diagnosis?
What was old Charming thinking, because obviously his recommendation would be markedly different from the approved social worker’s, and from Dr Siddiqui’s, written only the day before?
I needed to find out who reviewed these Section papers and checked their validity, apart from staff in the Mental Health Act office at Hollberry Hospital Psychiatric Unit. The recommendation for Mr Trainman was worse than a bit half-hearted or sloppy. It was a deliberate set of false statements written to validate Dr Charming Sharman’s decision to place a man on Section 3 out of spite. I was no expert on the law, and particularly vague about Section 4. I didn’t think I had ever come across its use. Either way, what Charming had written was a lie, blatant lies.
As a result of this torturous mystery, I had a sleepless night, despite the wine. Most of the wee small hours were spent dreaming up various ghastly punishments and murderous endings for Dr Sharman. A few of my ideas were really inventive, and others were a respectful reinvention of Roald Dahl’s Tales of the Unexpected, with Sharman as the victim in each case.
My favourite was the tale in which the murder weapon is a frozen leg of lamb, which is then fed to the police who are sent to investigate. Genius though that idea was, I couldn’t remember how the body of the victim was hidden or disposed of, and I wondered how I would hatch a plot that would put old Charming in my vicinity while I was holding a frozen leg of lamb. He tended to avoid me as if I deeply offended him in some way.
12
Appealing
Mark saw nothing of Monica until the afternoon of the following day, by which time he had been given prescribed medication. In the morning, on the first occasion, he had used his tongue to divert the tablets into his cheek to avoid swallowing them. Despite the endless rehearsals at home, this had been trickier than anticipated. He was nervous and this hampered him significantly. Mark had also been ignorant of the fact that the whole process was overseen by the administrating staff nurse, from within a medication room, through a hatch. That particular nurse watched his every move. He was also keenly observed by one of the healthcare assistants who was standing within feet of him. The set-up ensured that everyone who was prescribed medication, arrived to receive it. In his head, Mark was struggling with a constant replay of the ‘medication time’ scene from the unforgettable film ‘One Flew Over the Cuckoo’s Nest’. That’s me, stuck in the loony bin, God knows how long for.
Despite this pessimistic review of his circumstances, Mark was fascinated by the thoroughness of the ward teamwork. His name ‘Mr Trainman’ was checked against the drug chart, and the nurse who did not resemble Nurse Ratched from the film, confirmed what was written down as the prescription. Mark found her to be thoughtful and gentle in her approach as she went out of the way to explain what the medication was, and what possible side effects there might be from taking the tablets.
Why hadn’t the consultant been this thorough and informative when he prescribed it in the first place? Mark wondered.
The staff nurse then told Mark when his next dose would be due. Having thoroughly assured herself that full advice had been given, she encouraged him to take the tablets in front of her, before she then signed the drug chart. Mark followed the instructions, then left the area promptly, ensuring that he spat the tablets into his hand, well out of sight of anyone. He also made sure that he did not head immediately towards a toilet, convinced that would arouse suspicion. He repeated the same process again after supper when his second dose was due.
Having been downstairs in the art group for part of the morning, he looked forward to more activities in the afternoon of the next day. Being occupied was a far better way to pass the time than remaining on the ward where the clocks ran painfully slowly. Monica had sent a message to the OT department requesting to see Mark on the ward as soon as the relaxation group had finished.
Feeling suitably relaxed, he found her in the ward office. All in all he had quite enjoyed the freedom of the OT department, and his second day in a mental hospital was so far proving to be much less stressful than his first.
I would love to say that I managed to warn Jesus not to take the medication, or that I persuaded the doctors to change their minds about prescribing any, but that did not happen. By the time I next saw Jesus, he had already been given two doses of medication, and appeared slower in his movements. Not as overly sedated as I had feared.
He seemed pleased to see me. Relieved even. I had arranged to catch up with him personally in order to help hasten his right to appeal against his Section. I suppose it was my way of trying to right a wrong. Maybe he wasn’t sedated, just relaxed.
No, he wasn’t. There was something wrong. Jesus took a seat opposite me in the small office, and when his bright blue eyes caught mine, they betrayed a certain degree of trepidation on his part, I thought. He then passed me a piece of paper with the words, ‘My name is Mark. Please help me’, written on it in spidery scrawling handwriting.
I must have appeared shocked because he put his finger to his lips to indicate for me to keep quiet. While my brain computed the possibilities contained within this brief but poignant written request, I hesitated in my response. Was he trying to tell me that he was struggling with a real mental health problem? Unlikely. Was he trying to get me on side to collude with a plan to escape from the ward? Possibly. Had he realised that he could be in all sorts of trouble because he was on Section 3? More than likely.
I decided to accept the words on the paper at face value, and as usual to do the right thing. ‘You need to appeal to the hospital managers and the formal appeal tribunal, then they will listen to your case and decide if you should remain detained in hospital under the Mental Health Act.’
He nodded and I therefore continued.
‘When you appeal it’s best to have a solicitor to represent you, and they can be the most helpful people in these circumstances.’ Which was true. ‘I have a list of solicitors here. I can contact one for you, if you give me your consent.’
Jesus Trainman, now known to be called Mark, looked down the list and shrugged with a questioning expression on his face.
‘These people have been recommended by other patients,’ I said pointing about halfway down the list. ‘They seem to be thorough and work really hard to challenge any detention. Section, detention, formal admissions are all the same thing by the way. Do you want me to phone for you and explain the situation? You may need to write down relevant information for them though.’
Mr Mark Trainman shook his head at the offer of pen and paper, which I found annoyingly obstructive. However, I had his permission, via a clear nod, to contact solicitors and this was good news all round because I had steered him towards a local firm that I had become familiar with in the past three years or so.
Huntley and Greaves were well respected, and one of their younger partners, Richard, son of Huntley senior, was often seen at the hospital, and he was the firm’s expert in the Mental Health Act. He was a fine competitive adversary in any tribunal hearing, and we both seemed to relish our written and verbal sparring rounds, where he would attempt to pick the tiniest hole in my nursing report. Richard would use any error or contradiction in support of his argument against the detention of his client, whoever it was. In turn I would try to write the tightest of reports giving him no scope for debate. As a result, it was usually the consultant psychiatrists who took the brunt of a grilling
from the tribunal, thinking their reports were beyond criticism, and yet they were generally found wanting. At times they were made to squirm in their seats when they failed miserably to answer the questions either from the tribunal or the solicitor. Those were my favourite moments, where I could shine purely by doing my job well.
I phoned the offices of Huntley and Greaves where I spoke to Cheryl, the most efficient of administrators. She knew who I was immediately, and guessed that I was asking for representation for an appeal against a Section. She was amused by the information I gave when she asked for the ‘Name of the client please, Monica.’
‘Mr Trainman.’
‘First name?’
‘Sorry, we don’t know yet,’ I lied. ‘He doesn’t speak and he hasn’t given us any written information either, but he may well give details to Richard in confidence,’ I prompted.
‘Oh yes, this one sounds right up Richard’s street. He’s busy this afternoon, but I’ll get a message to him, and hopefully he’ll make arrangements to visit the ward tomorrow if he can. It’s still Pargiter Ward, Monica, isn’t it?’
‘Yes, Cheryl. Thanks a lot. Could you see to it that Richard asks for me to be available because I’m the mystery gentleman’s named nurse, and I need to ensure that Richard has the relevant details? This is potentially tricky, and I can’t explain over the phone. Sorry.’
‘That’s okay. No problem. Will do. Speak to you soon. Bye now.’
That was excellent news. It had occurred to me that Richard might have been on paternity leave, and I couldn’t for the life of me remember what he’d said about when the baby was due. I trusted Richard’s judgement, and planned to give him the ins and outs of Dr Sharman’s unfathomable decision-making in this case. I was convinced that there was something fishy about the decision to use Section 3, and about what was written on the Section paper. Relieved that Richard was available to represent him, I went to find Mr Trainman to give him the update.
I chose to keep referring to him as Mr Trainman in case I slipped up and called him Mark. I still don’t know why I was keeping this so secret. On reflection, I think it was intuitive on my part not to reveal his name to anyone at that particular time, as I had been considering the possibility that Mr Trainman could be taking advantage of me for his own ends, whatever they were.
He had been consistent in his presentation the whole time he had been on the ward. Not once had he spoken to anyone, nor had he become restless agitated, or angry. Indeed he stuck out because he behaved more like a seasoned member of staff, spending much of his time sitting with the other patients on the ward listening to them or silently joining in with cards or games. He even helped with the giant blackboard crossword puzzle that we’d put in the main lounge for everyone to have a go at solving.
I was puzzled myself. Who was he and what was he doing here?
Why did he simply not tell the charming Dr Sharman his name and who he was? He would stand a good chance of being discharged on the basis that Dr Sharman could claim that the treatment had worked its magic. Mind you if I was he, I might worry that whatever I told Dr Sharman he would assume that I was delusional and would keep me locked up and treated for the hell of it.
Why was Mr Trainman choosing not to speak? If it was a trauma related reaction then where was the rest of the evidence for distress? What’s he hiding and why was he not demanding to be let out?
Emma had her own Sherlock Holmes versus Moriarty theory and maybe she was correct. Was it the case that our Jesus lookalike was a bigger and more devious psychopath than Dr Sharman himself, and was in fact a cold-blooded killer? Was I now implicated in colluding with him? If so, I could lose my job and my registration if I was not careful.
The ward alarm had sounded briefly, a few seconds after I had finished on the phone to Cheryl at Huntley and Greaves, but by the time I arrived on scene, order had been restored. A minor skirmish had erupted between two of the male patients. One had apparently stolen the other one’s Toblerone chocolate bar, and the accusations had resulted in a physical push me pull you. The nearest staff member to the kerfuffle had needed brief backup to settle the argument, but this did not take long and no damage was done, other than to the Toblerone itself which received a battering when used in self-defence. The incident became affectionately known as the First Battle of the Chocolate Wars. There were indeed a number of such battles over the ensuing days, and they invariably involved the same two people and bars of chocolate.
I eventually found Mr Trainman, who looked for all intents and purposes to be secretively making copious notes using his bedside locker as a table. He had pulled the curtains around his bed space, and appeared as if he was not expecting to be disturbed as he sat on the edge of the mattress. The dormitory door was slightly ajar, and as I made my usual silent approach, I caught a glimpse of him through a gap in the curtains, writing furiously. I watched noiselessly for several minutes before deciding to knock the dormitory door and call out, ‘Mr Trainman? Are you about?’
That was a bit thoughtless of me, because he hadn’t replied to anyone since his arrival on Pargiter Ward, but I needed a reason to approach the bed space and pull back the curtains to check his whereabouts. In those few seconds, he had miraculously made the notes disappear, and was sitting on the edge of his bed pretending to read a tatty old magazine. I knew he had heard me calling him. He was mute, not deaf.
I couldn’t quite work out where he had rapidly hidden the notes he was making, but I was certain that I would be searching for them when I had the opportunity.
‘Oh hello, there you are. I’ve come to let you know that I’ve called the solicitors and they are arranging for one of the partners called Richard Huntley to act on your behalf at your appeal. He’s usually really thorough and his secretary hopes he can be here to see you tomorrow. If not, then definitely on Friday. It can take a week or two for appeal tribunal hearings to be set up, so try to be patient. Oops, pardon the pun!’ I have a way with words. I had also seriously underestimated. It often took more than three weeks for a tribunal to be arranged.
‘This is the NHS,’ I reminded Mr Trainman, with a note of apology in my voice,‘ and the legal wheels of the Mental Health Act do turn quite slowly, I’m afraid. Perhaps you can join more of the groups downstairs to keep you occupied. They do a creative writing session which you may like,’ I added, for my own amusement.
Mr Trainman looked deflated, but nodded to confirm he had understood and agreed. That was a standard response to the news that the Mental Health Act Commission was lacking in urgency. On the whole, we had disappointment as a reaction, with a general look of deflation, or lots of tears and wailing, or the destructive violent response, all of which I found understandable.
Two weeks! Two whole weeks! Mark screamed inside. He couldn’t wait that long. What was he supposed to do in the meantime? Fester? Still it could have been worse. Could it? He had to firmly convince himself that he could easily manage two more weeks if the end result was to be worth the effort.
13
A Little Clue
I was missing my good friend and colleague, Emma, who was away for a couple of days with her boyfriend Jake. The two of them had gone mud wrestling or dyke jumping, or an activity equally as ridiculous, I can’t remember exactly. She breezed back onto the ward on the Friday, bursting with renewed energy, and I couldn’t wait to update her with the latest.
‘We have part of a name,’ I proudly announced when she enquired about progress with Jesus Trainman. ‘I say that, but I don’t mean we, I mean me, because I haven’t told anyone else yet.’
‘Why not, you twerp?’ Emma asked with a bemused look on her face.
‘I don’t know exactly,’ I replied, subdued. ‘I’m a bit wary of how Charming will react, and also I’m not sure about Jesus. Something is decidedly not right, but not in a mental way. More in an unsettling, dodgy, underhand way.’
‘Good God, you sound like me, and you’re usually the sensible one. Why don’t you show Charming the
note and let events take their course? What’s the worst that can happen?’
‘That’s my point, Em. At the moment, I don’t seem to be able to predict what could be the worst thing. Poor Greg has ended up chemically coshed by injection, looking like a zombie. Everyone else is relieved because he doesn’t need close obs anymore and the doctors are calling that an improvement, would you believe. If I tell Charming that we have a note saying ‘my name is Mark, please help me,’ he will more than likely see it as irrefutable evidence that Jesus is psychotic.’
‘Yes, but he thinks that anyway, and the man is already being treated with medication and on a Section 3, so it can’t do any harm to have a first name.’
When I told Emma about the issue with the Section papers, she went straight to the shelves and pulled out the ward file containing the copies of every Section paper for patients on Pargiter Ward. Judging by her expression, she was as dumbfounded as I was when she read what Dr Charming Sharman had written on Mr Trainman’s Section 3 recommendation.
‘He can’t write that, surely? He doesn’t know him, does he? That settles it,’ she announced. ‘You give Charming the note, and if he knows Jesus, he should simply recall his full name once he’s given the first part of the riddle.’
‘Good plan. How far away is the next ward round? Or … I tell you what, shall I phone his secretary? Yes, that’s a better idea. I can tell him over the phone, that way he can’t see my facial expressions. You stay here so you can hear what he says.’
