A Justifiable Madness

by AB Morgan

  Monica? He never called me Monica. This charm offensive was most disconcerting, and to make matters worse, in the Twilight Zone of Gordon Bygraves’ office, both Gordon and Harriet were hanging on his every word, with the occasional pitying glance in my direction. It was bad enough that Sharman loved himself so much, let alone everyone else swooning over the man.

  ‘Let me explain,’ he condescendingly offered. ‘You put in a request for an appeal on behalf of Mr Trainman as he was known at the time. An appeal against Section 3, when in fact he was detained under Section 2, or would have been if I had noticed that you had given me the incorrect recommendation form. I do hold my hands up here everyone, to be clear … I should have noticed this at the time. However it is common knowledge that a patient initially detained under emergency Section 4 should be transferred onto Section 2 by the completion of the second medical recommendation. Not onto a Section 3.’

  ‘I didn’t know that,’ I whispered.

  In my head I was still trying to work out what on earth was going on. Mark had been admitted under a Section 4. Dr Charming Sharman had definitely transferred Mark onto Section 3 the next day. He had said it out loud, and I didn’t even recall that I had sorted out the recommendation form for him during that ward round the previous Tuesday.

  I still had a photocopy of that form in my flat.

  I didn’t question the version of events as told by Dr Sharman. I stood there, stumped.

  ‘Not to worry. There has been a second assessment under the Mental Health Act this morning, which was highly informative. It appears our man is now talking unhindered. It is a shame Monica, that you didn’t let me know that he had been in full verbal communication with ward staff since Friday. Nor did you inform me that you had submitted appeal paperwork on the patient’s behalf, last Wednesday I believe? Tell me how did you do that when, at the time he remained mute?’

  ‘He wrote a note,’ I replied.

  ‘Yes, he did,’ Dr Sharman said, looking reminiscent of a grinning shark about to launch an attack. ‘But that note, which you neatly and efficiently filed in the patient notes, did not make any reference to a request for an appeal against his Section, did it? And to put yourself in an even more precarious position, you contacted the solicitors on his behalf. Did you choose them for him too? I’m not suggesting coercion, you understand, but the Mental Health Act Commission may see it that way. They won’t actually, you will be pleased to hear … because Harriet has not yet sent that appeal request.’

  Oh my God. What’s going on? I thought as I experienced a dreadful heavy sinking feeling with cold and jelly-like legs into the bargain. That request should have been posted straight away. I daren’t ask why it had been delayed.

  ‘That was an unfortunate oversight,’ Dr Sharman said, helpfully answering my unspoken question.

  I didn’t believe him.

  ‘Now that our patient is officially on Section 3, he can re-appeal as of today.’ He grinned at the two managers next to him. ‘Our most pressing issue is to ensure that the patient is properly treated, and I shall see him in ward round tomorrow. I suggest that you re-read him his rights under the Act, using the correct leaflet, Monica, please. The same one you mistakenly used on the last occasion, and you will not need to apologise for the confusion. He has already been told that the reassessment had to take place this morning because he had disclosed to us his true identity. I believe we also have a GP identified, and that his parents have been looking for him. They live in Australia, so they are not in a position to see him but there is a family friend that we have details for, I believe.

  ‘Don’t worry, Monica. As I said, I’m sure it won’t be long before the appeal can be set up, and your misdemeanours will soon be forgotten. At least we did not get so far as wasting solicitors expensive time …’

  He generated a sickly grimace, which seemed to linger in suspended animation on his face, and yet it was not the sort of smile that was ever reflected in his eyes. I allowed myself a small shiver in response.

  Oh shit, I thought, as it occurred to me in one thud of apprehension, that they obviously had no inkling that Richard Huntley had already been to the ward. He had scrutinised the notes, and what’s more he was on a mission about unlawful Section papers.

  In that moment, I couldn’t remember if I had written anything in the notes about Richard’s visit to the ward on Friday. I frantically searched my memory library and was able to reassure myself that, no I hadn’t written anything because Richard still had the notes with him in the small office at the end of the day. I didn’t even see him leave; therefore another nurse must have put the notes away.

  Did that nurse write in the notes that Richard had been to the ward to see Mark El Amin?

  I was brought back from my fraught recollections of Friday, to the painful present by Gordon Bygraves who was speaking to me intently.

  ‘… so we shall say no more about this, to anyone, Monica. As far as those of us in this room are concerned, the matter is dealt with. Your thanks should go to Giles and to Harriet for being so observant. We could have found ourselves in extremely hot water, but we are lucky to have such an eminent consultant on the team. Our bed situation is much improved and we have patients being discharged relatively swiftly. What with the National Psychopharmacology Conference coming up in London shortly, we shall be making a name for ourselves as a centre of excellence, certainly in respect of the quality of care and treatment …’

  Gordon Bygraves rambled on.

  Fleetingly I had wondered what eminent consultant he was talking about, but as he was still gazing lovingly towards Dr Giles Sharman, there was little doubt, and I again felt nauseous.

  ‘Thank you,’ I muttered as I turned to leave the office with my mind in a whirl and my stomach churning. I was attempting to come to terms with the realisation that Dr Charming Sharman had put himself in an unassailable position in the eyes of the hospital managers, meaning that nurses making a further complaint against him could easily be discredited.

  23

  A Disappearance

  Once back on the ward, my first priority was to check the nursing notes to see if there was any reference to Richard Huntley being on the ward on Friday.

  No. Nothing. Good.

  My second priority was to phone Huntley and Greaves, and speak to Richard. I found a moment to use the small office, the same one that Richard had used on Friday. I succeeded in getting through to Cheryl without delay, and she was happy to put my call straight through. I didn’t know how to broach the subject with him other than to be truthful.

  ‘Richard, I’m so sorry to bother you. I’m not sure that I should be making this call, but there is an issue with Mark El Amin’s Section paperwork.’

  ‘You’re not kidding!’ came the reply. ‘It’s hard to fathom why he was put on a Section 4, let alone a Section 3, which should have been a Section 2 by the way, but the main point is, that the information contained in that recommendation is a work of fiction as far as I can see. I too am not sure that I should be telling you this, but I believe the detention of your patient to be invalid, and therefore illegal.’

  ‘Richard,’ I was gabbling desperately, ‘did you know Mark was re-assessed under the Mental Health Act again today? And he’s on Section 3. Again. Apparently I gave Dr Sharman the wrong form last week, even though I didn’t, and Mark should have been on a Section 2. I didn’t know that. Although I don’t think I’ve done anything wrong, earlier I was given a right royal bollocking for what I’m sure I didn’t do, and for requesting an appeal against Section 3 on Mark’s behalf. But it hasn’t been sent to the commission and it’s my fault, and what’s more, the managers don’t know that you have already been to see Mark and that you have seen his notes and his Section papers, well, old Section papers … God this is such a mess and I don’t understand any of it.’

  ‘Good grief! Monica, slow down!’

  I duly obeyed, and went through step-by-step, slowly, what had occurred that morning. Richard arran
ged to come to the ward without delay to see Mark, explain the issues, and to do so while making out that he was accessing the notes and meeting Mark for the first time. He had convinced himself that I was being made a scapegoat for hospital cock-ups, and he said so. However he needed facts prior to acting.

  I was supposed to be seeing Mark to advise him as to his rights, again, but I had to give myself time to think before I made my next move. Mark had been assessed for Section 3 again that morning and had been successfully detained under the Mental Health Act. How on earth could that have happened? He didn’t appear to have any mental illness, so what did they find that I had not? I went back to the notes, but there was nothing of any help in there, only brief confirmation of the outcome of the assessment that morning.

  Section Papers. Copies. Where were they? No. Not in the ward copy file.

  In fact there were no copies of any Section papers pertaining to Mark to be found on the ward. Not even in his notes, where the previous ones should have been filed as historical information.

  After I had a slight brainwave, I phoned down to Harriet Morris on the pretext that I needed to see the information on the recommendations before I could read through Mark’s rights with him again. ‘After all I don’t want to get it wrong this time,’ I said to her, almost believing myself.

  I was stewing away, convinced that I had done nothing wrong the last time I read Mark’s rights to him, and I was appalled that I had been accused of ‘misdemeanours’. Nothing I had actually done was that bad. Not in my book.

  Harriet, being a genuinely kind individual, albeit easily influenced, agreed to get copies of the latest Section papers to me immediately, and she assured me that she had no idea where the old ones had been filed … ‘Sorry.’

  It was a good half an hour later that Harriet brought the most recent Section paper copies to the ward for filing, and as she was leaving again, she met face to face with Richard Huntley on his way in to see his ‘new client’. She chatted amicably with him for a short while. They knew each other professionally because it was Harriet’s job to organise the practicalities of the tribunal hearings held in the hospital. She would normally confirm with solicitors their access requirements to patient case notes and to Section papers. I had undermined standard procedure in Mark’s case and was beginning to regret the fact.

  Harriet ended her brief chat with Richard ‘No problem, I’m glad to be of help.’ She shot me a glance, but I wasn’t confident that I knew what her body language was saying. ‘I’m sure Monica can sort out whatever you need,’ she said as she smiled at Richard pleasantly and headed for the lifts. It turned out that Richard had the foresight to call her before leaving his office to request access to the notes for Mark. Harriet would never know that he had already done so. Clever man.

  Richard then turned to me and said carefully, in hushed tones, ‘Monica, just give me the notes and the copy Section papers and then leave me to it. Whatever happens in future do not get involved in trying to help me. Keep to your usual nursing boundaries and I’ll do the necessary. I think you may be putting yourself in a tenuous position, career-wise, if you are seen to feed information to me. Thanks, and in other words, I’ll take it from here. Don’t worry.’

  The more people around me said the words ‘don’t worry’ the more I worried. Emma caught sight of me as I went in search of the patient rights leaflets, and her first words were, ‘You look worried, or is it a hangover?’

  I had forgotten about my hangover. I was a bit shaky, but that was nervous energy, anger, anxiety, and self-pity rolled into one. I had allowed myself to be bullied spectacularly that morning in Gordon Bygraves’ office.

  ‘What happened with Gordon this morning?’ Emma asked, innocently.

  ‘Oh God, Emma … It’s such a long story, but in short, I’ve been shafted to save Charming. And Mark Jesus Trainman El Amin is still on a Section 3, even though he does not have a mental illness that warrants any admission to hospital. Will that do for starters?’

  ‘Sounds like a normal Monday,’ Emma replied. ‘Did you hear that Mark had a visitor yesterday? He now has clothes that fit him properly. Let me tell you, “fit” is the word. Oh my. A pair of Levi’s maketh the man!’ she exclaimed, revisiting her lustful side briefly. ‘Nice chap by all accounts; the visitor. Margaret was on duty and she reckons he looked like Cary Grant. You remember him. North by Northwest, that Hitchcock film. Margaret was gushing and girlie about him … so it sounds as if you missed out again!’

  I wasn’t actually listening to what Emma was saying, because I was going over and over in my mind the inaccuracies of the conversations in Gordon Bygraves’ office downstairs. Then I tried to analyse what Richard had said. All of which was self-defeating, so I made the decision to keep my head down for now, and get on with my job instead.

  Leaflets. Where was the one I needed?

  When I found the right one, I went in search of Mark, who it turned out, was downstairs in one of the groups again. I left a message with the OT department asking for Mark to find me when he was able. No rush. He wasn’t going anywhere for now, and besides which, he had heard his ‘Rights to Appeal’ information the first time around.

  When I returned to the office Emma collared me again.

  ‘Mon, I forgot to tell you. Laura phoned me late last night. About “you-know-who” and the scandal thing.’ She was speaking in code, as staff members were popping in and out of the office in quick succession.

  ‘She was of no use,’ Emma said. ‘She remembers there being a problem with a drugs trial, and a couple of the patients who were rushed to a general hospital for treatment, but nobody seemed to be blamed at the time. Dr Sharman apparently left to take up a research post somewhere.

  ‘It was said to be coincidence that the patients who became ill were on his ward. That was the official line at the time.’

  ‘Is that it?’ I asked, disappointed.

  24

  News from Around the Country

  ‘Lewis! Thank God. Bloody marvellous!’ Mark could not have been more pleased to see Lewis James stroll onto the ward on Sunday. He had not realised who it was at first, as Lewis was casually dressed, and not suited and booted, barrister style, as if for work.

  As he warmly shook Lewis’s hand, grinning widely, Mark took in the smart designer polo shirt – Ralph Lauren, and not one of those snide ones from the market. He envied the dark blue Levi jeans that his visitor was wearing, and as Lewis then smoothly placed his sunglasses on top of his head, Mark spotted the Ray-Ban logo and smiled inwardly.

  ‘You look like a tramp,’ came the brutally honest observation from Lewis as he patted Mark’s back. He couldn’t fail to have noticed the baggy second-hand clothes hanging from Mark’s slim frame. The two men had developed a good bond of friendship since their first meeting at the offices of the Daily Albion weeks earlier, and Mark was genuinely appreciative of the manly hug he received. ‘Is there a place we can talk in private around here?’ Lewis asked. ‘Or shall we go out and get a coffee?’

  ‘God, I’d love to,’ replied Mark, sighing wistfully at the thought of a freshly ground coffee. He could almost smell the magical aroma. Breaking the unhappy news to Lewis that he didn’t have any permission to leave the ward, accompanied or otherwise, they were forced to settle for a mug of rubbish NHS ward coffee. It was the cheap stuff that comes in giant tins, and has no flavour. Mellow was not the word, although insipid was closer to an accurate description.

  ‘Cor, bugger me, Mark, this is crap. How do you put up with it?’

  ‘No choice, mate. I’m sodding-well stuck in here. A Section 3 in case you didn’t know.’

  As it was a Sunday, the ward was almost empty of other patients, giving the pair sole use of the small dayroom, which was not only vacant, but also strangely silent. Unusually, the TV had not yet been switched on. Not a soul walked by or interrupted for the next hour or so.

  ‘Six days in hospital so far, and none of that time has been particularly taxing, just frustra
ting,’ Mark confirmed. ‘In fact, I’m learning to appreciate the change of pace in life. Granted, being stuck in here is not pleasant, but I’ll miss Creative Writing for Beginners, when I leave.’

  ‘You have to be joking! Really? Creative Writing? Now that’s ironic. Well done.’

  ‘Don’t take the piss. It’s therapeutic. No pressure and no deadlines to contend with. Creative writing has turned out to be a huge amount of fun, actually. It was a Godsend when I was still mute.’

  Lewis, had news to impart. He explained to Mark that when he had been in contact with Richard Huntley the solicitor, it had been necessary for him to rustle up a cover story of his own.

  ‘Ah. So you became James Lewis, family solicitor, not to be confused with Lewis James barrister. Of course! … ingenious. No one would ever guess,’ Mark said sarcastically, ‘and, by the way, thanks for giving me parents in Australia, nice touch. Did they send me clothes?’ Mark asked with a nod in the general direction of a carrier bag placed by Lewis’s feet.

  ‘Oh yes, sorry, young man. Nearly forgot. I have clothes and tasty snacks and money for you. Mostly loose change for the phone. I’ve also treated you to a toothbrush, in fact a whole wash kit. You sounded so desperate for basic bathroom essentials.’

  ‘I was desperate. I’ve had to wash and make do with other people’s left over toiletries, would you believe? Quite degrading, even for a scruffy oik like me. Apparently there’s no money in the NHS to have such items supplied by the hospital, so if you arrive on the ward in the clothes you are standing up in, that is all you have. In my case it was a pair of sandals. They gave me these groovy lost property clothes to wear, and that is all I have. Not even any pants! Mind you, I look a lot cleaner than I did. The staff gave me a trim up of the old facial hair on Friday, which I think I can now call “designer Jesus stubble”.’