A Justifiable Madness

by AB Morgan

  ‘Crikey, what have I done to deserve such attention?’ Mark greeted them with a polite grin. Assuming that their mistake had been realised, he was expecting their announcement that he was no longer under a Section.

  The group did not smile in return. Dr Sharman, who approached the meeting with a professional but amiable air, took the lead role. His whole attitude was most unlike the man that Mark had seen in action during the ward round the previous Tuesday. This friendly version of the consultant psychiatrist unnerved Mark. He listened attentively as Dr Sharman explained. ‘The hospital have now confirmed your name, address, and other details, which we were previously were unaware of. Therefore we are obliged to review your status under the Mental Health Act.’

  This seemed to Mark, to be a reasonable explanation, on the surface. However, knowing that Richard Huntley had revealed a discrepancy in the Section paperwork, he was immediately suspicious of Dr Sharman’s justification for yet another assessment under the Mental Health Act. He’d had one in A+E the previous week, another in ward round the day after that, and now he was being subjected to another assessment.

  Never mind, he thought, let’s see where this is going. If all is well, I could be a free man very shortly. He nodded to Dr Sharman, who proceeded to ask a series of relatively superficial questions about Mark’s mental health. Mark was content to oblige with carefully considered answers. ‘Look, I shouldn’t be kept in hospital. There’s no need, you see. My mental health is fine now. I’m feeling a bit embarrassed about all the fuss actually. I must have hit my head when the train pulled into the station. I don’t even remember what happened exactly,’ Mark assured the three assessors who maintained poker faces.

  Dr Sharman asked him about whether he had ever heard voices when there was nobody around. Mark, in the same way that he had when Monica asked the same questions, denied any such experiences. ‘No, never have. Nothing unusual.’

  ‘Do you ever see, feel, or smell unusual things?’ he was asked and again he gave a factual answer.

  ‘No, never,’ he lied, determined not to mention the flashbacks. Mark had said roughly the same to Monica when she had assessed him.

  Then there appeared from nowhere, an inner voice that popped into Mark’s head. Not an hallucination, no, this was the voice that we experience when we realise that we may have done something wrong, or thoughtlessly uttered words without due consideration for the consequences. The little voice, like our conscience, niggles and nags, rebuking us for not using the brains we were born with.

  Mark’s inner voice treated him to a proper scolding for his stupidity, and as result, he became incredibly irritated with himself for being so open with Monica. Monica had told him that in her opinion he did not have psychosis, but the man in front of him was determined to prove that he did. Mark recognised far too late that he had freely given Dr Sharman the ammunition needed to keep him detained in hospital. It was in the notes that Monica had written. Dr Sharman had her report in his hands.

  ‘It says here that you have night terrors and have reported experiencing flashbacks. Would this report be inaccurate?’

  ‘No. I mean yes. I mean, I do get flashbacks, but I’m not psychotic.’

  Mark tried in vain to close the metaphorical door on the stable from where the verbal horse had bolted. ‘I lived in the Middle East when I was a child and our family was caught up in the fighting. I witnessed terrifying acts of terrorism, so I have flashbacks sometimes, but I know what they are and I have learnt to live with them.’

  Mark prayed that this background information would result in a better level of understanding, by Dr Sharman in particular, and with any luck there would be a change of mind about the Section. He would agree to stay in hospital as an informal patient, if offered the chance, and Mark didn’t even mind if they wanted to put him on different tablets; he wasn’t taking the ones they were already giving him.

  The poker faces remained in place, as Dr Sharman continued. ‘We believe you are suffering from schizophrenia.’

  ‘So I heard,’ Mark countered. ‘Although I’m not sure how you came to that conclusion. I don’t have schizophrenia.’

  ‘You are to continue your treatment, and when you are better you can be discharged to get back to your usual life … what is it? Oh yes, studying for a PhD. It appears your specialist subject continues to be the Middle East according to this.’ Dr Sharman was again reading from Monica’s assessment report. He chose to ignore Mark’s challenge. ‘I have made it abundantly clear that you remain under a Section of the Mental Health Act. Therefore you must comply with the treatment plans that I have determined. I will increase the dose of your Haloperidol and you will soon be on the mend.’

  Mark shook his head, baffled. What is the pompous psycho-pillock getting out of this? ‘Dr Sharman, I don’t have schizophrenia, and I’m not suffering from anything other than a bit of insomnia. I therefore object to having to take any increase in the dose of the tablets you are prescribing, as quite clearly I can’t be on the mend from something which is not broken in the first place, namely my sanity. I don’t see what there is to gain from keeping me here on a Section.’ Mark was firm but polite. Assertive. Stick that in your po-face! He thought.

  ‘I’m afraid these decisions are out of your hands, Mr El Amin,’ came the riposte from Dr Sharman. ‘You have the right to appeal, and we shall take this up again in ward round. Am I seeing you today or tomorrow?’ Dr Sharman asked, seemingly unaware of the upset he had caused.

  Dr Siddiqui answered the question on Mark’s behalf, and then the trio of mental health professionals dismissed Mark to think about the consequences of all that had been said in the previous ten minutes or so. As far as Mark was concerned, he had made no progress.

  ‘Still on Section 3 … still in hospital … still pissed off,’ he concluded aloud.

  He was determined to make the most of his difficult circumstances rather than cave in to self-pity, so Mark set himself a target. This week he would be on a special assignment to find out what more Welsh Phil might know about Dr Sharman’s past. Mark hoped that Lewis would be getting the wheels in motion from the outside too, in order for the scandal to be revealed in all its glory, and the sooner the better. ‘That bastard deserves to be exposed for what he is. Stand by, Dr Sharman. The pen is mightier than the medication. I’m on a mission now, so bollocks to you,’ Mark muttered, striding down the corridor.

  He headed to morning groups on the ground floor, with his new smaller notepad and a pen tucked in the back pocket of his clean Levi jeans. Meanwhile, Dr Sharman, Dr Siddiqui, and Mrs Brown completed the paperwork for the most recent of Mark’s detentions. Section 3. Dr Sharman wrote almost exactly what he had done previously.

  Dr Siddiqui, on the other hand, wrote a vague description, which tallied with what Dr Sharman had concluded. He was too scared not to.

  Mrs Anna Brown, beige and square, was clearly just along for the ride, having left her backbone at home again. She did not question one single point that was discussed or written down. She merely confirmed with Mark, when she found him downstairs in Creative Writing for Beginners, that he was now on Section 3.

  He was mildly amused.

  He’d been on Section 3 before so there was nothing new in what she was telling him, as far as he knew.

  ‘I have a duty to inform your nearest relatives.’

  ‘Good luck with that,’ Mark said, knowing that his pretend parents were in Australia and could not be contacted.

  With a sinking feeling, Mark realised that the whole system was shambolic.

  27

  Backed into a Corner

  As Emma escorted Mark into the large room for his second ward round, Dr Sharman was preening himself for the umpteenth time so far that day. Mark noticed how weary Emma had appeared. He thought perhaps the day was taking its toll on her usual chirpy good humour as ward round had dragged on past lunchtime, yet again. Mark could tell that Dr Sharman was holding court, when he heard the consultant detail the rationale
behind his earlier decisions, and by going to extreme lengths to describe the pharmacological actions of the medication he had prescribed.

  Mark slowly crossed the room and took his seat, and as he settled into the upright uncomfortable chair, he found that he was now party to the great man discussing ‘this interesting case’ with his acolytes. Pleased to hear that he was considered to be an interesting case, Mark listened carefully to every word. He also took out his pen and writing pad, and wrote down verbatim all that was said, without Dr Sharman even noticing. The noble consultant was far too full of his own importance to look at the patient to whom he was referring, and he pontificated on the subject for several minutes.

  ‘… was reassessed yesterday under the Mental Health Act 1983, and he’s now on a Section 3 as a result. He reported on-going auditory and olfactory hallucinations. The voices were in the third person, commanding in nature and this in itself is an indicator for schizophrenia. He displays no insight into his illness …’

  What the hell is the idiot talking about? I never said anything about hearing voices, thought Mark.

  ‘… and predictably because of the lack of insight he’s not in agreement with remaining in hospital informally …’

  I wasn’t even offered the choice, Mark recalled.

  ‘… is declining treatment …’

  If I don’t have schizophrenia then I don’t need treating for it do I! Mark thought as he shifted forward in his seat tightening the grip on his pen.

  ‘… and we have the significant chain of events that led to him being admitted. The risk to the public must take precedence here gentlemen.’

  What’s that then? The risk of being prayed for, in a made-up language, or the risk of seeing a man the way nature intended. What a complete twat.

  Dr Sharman topped off his observations and personal opinions with the following words to his entourage: ‘We must, as you will no doubt come to appreciate as you progress with your careers, we must ensure that we manage any level of hostility, aggressive behaviour and agitation, and ensure we are treating accordingly. Therefore I increased this man’s medication yesterday,’ he said looking at the drug chart and not at Mark. Mark was not perturbed by the increase in his dose, as he was still not swallowing any of the tablets, and thus it was irrelevant to him how much it was increased by.

  ‘However …’ Dr Sharman said, while pausing for effect, as was his want. ‘I have realised that the requirement here is for more active management, shall we say. Therefore I propose to make use of Droperidol liquid instead. Five milligrams twice a day. Commencing this evening please Nurse Foster with a one off dose of ten milligrams. I take it we have stock?’

  Mark saw Emma’s stunned expression, and realised that he was in for trouble. Emma nodded. Then she shook her head and said, ‘Actually I’m not sure without checking.’

  ‘I have no doubt that the hospital pharmacy will oblige if necessary,’ Dr Sharman responded, with a supercilious grin.

  Mark coughed. ‘Would you mind explaining to me what your intentions are regarding my treatment, Doctor,’ he said, through gritted teeth. ‘I’m quite happy to continue taking the tablets.’ Mark’s mind was whirring away with the possible steps that he might have to take, to avoid accepting the liquid cosh. He had heard enough about it from his fellow patients to know that Droperidol was Haloperidol’s evil twin sister.

  The really ugly one.

  Mark had debated with himself for over a week about whether he should take one tablet of Haloperidol, as an experiment. Now it seemed, he was going to be forced into becoming a human guinea pig, like it or not. The alternative was an injection. Shit. He had to be quite careful what he said next.

  Dr Sharman was astonishingly brusque in his reply to Mark’s request for an explanation. ‘I believe I clarified to you yesterday that you are required to take medication as I decide to prescribe. You will improve and then you can go home.’

  ‘Can I at least have an hours’ escorted leave, Doctor?’ asked Mark in as innocent a voice as he could manage. ‘I need to get out of the hospital for fresh air, I have been here for over a week, and the exercise would be good for me.’

  This was the only thing Mark could think of. He had to find a way of absconding. This was getting too risky. Story or no story, he would go with what information he had already. There was plenty that would keep the public on the edge of their seats when they read about this.

  Buggeration, this is tense, Mark thought.

  Dr Giles Sharman glanced briefly at his entourage and then back at Mark and said patronisingly, ‘And I came up on the down boat, did I? Mr El Amin, if I were to give you leave, the day after you have been placed on a Section 3, and in the full knowledge that you do not wish to accept treatment, then I would be a laughing stock amongst my colleagues. You no doubt, will take your leave and hop back on a train from whence you came. In other words: No.’

  Mark stared in disbelief. Emma remained seated and stunned into silence again. Mark knew that she, like others on the ward, had guessed he was not taking his Haloperidol tablets. He had been credited for his skill in achieving this, because he had not been caught so far, and he always looked as if he had swallowed the damn things. The lack of side effects was the give away. Mark was well aware that Emma was on his side, but he wished Monica had been there.

  Mark noticed by chance, Dr Siddiqui wearing a sad expression, and he wondered what on earth the doctor was thinking about. Was he feeling guilty regarding how Mark was being dealt with? He had signed the Section papers Mark assumed, and therefore had to take responsibility for his actions. It was of no help him sitting there looking sorrowful. Mark then noticed how Dr Siddiqui had the drug prescription chart in front of him, but that he hadn’t written in it. Dr Sharman had handed it over with the clear expectation that Dr Siddiqui should complete his orders by writing out the prescription.

  Dr Siddiqui closed the unaltered drug chart, and put it down on the pile with the others to go to the pharmacy. Dr Siddiqui caught Emma looking at him and he held her gaze long enough to identify that they were both in agreement and that nothing would be said. Mark caught this exchange, sighing internally with relief at the unexpected reprieve.

  Dr Sharman then interrupted his thoughts by announcing sternly, ‘Dr Siddiqui. You haven’t completed that prescription. Pay attention, man! Just because lunch is late, there is no excuse for dozing. Give it here!’

  Dr Sharman grabbed Mark’s prescription chart and filled in the required areas for Droperidol liquid to be taken as he had instructed and he crossed out the previous prescription for Haloperidol. He launched the drug chart back in the general direction of the pile to go to the pharmacy, leaving Dr Siddiqui to pick it up from the floor and place it neatly on top of the other charts. A little power play for Dr Sharman’s own amusement, Mark realised. Dr Siddiqui seemed as if he was about to cry.

  Short of a miracle, it looks as if I’m cornered, concluded a shaking Mark as he was ushered out of the ward round. Taking the zombie liquid was inevitable. If he refused, then Mark knew he would undoubtedly be forced to have an injection. Anxiety was threatening to turn into panic.

  Christ. Not even Lewis can get me out in time to avoid this unscheduled part of the experiment.

  28

  Descent into Hell

  Mark approached the hatch where Charlotte stood administering prescribed medication to each patient who required it, and she carefully explained to Mark exactly what his new medication was and the possible side effects. She emphasised how important it was to report any ‘unexpected muscle stiffness or any unusual side effects.’

  Mark looked straight into her with his blue eyes and wished she had the courage to pour the syrupy liquid down the sink, right in front of him.

  ‘Any side effects, no matter how insignificant you think they might be, you let us know,’ she said as she handed him the tiny plastic medicine pot. Mark hesitated for a moment or two and then, knowing that he had no choice, slugged it right back, but didn�
�t swallow. He then took a beaker of water and pretended to wash it down as instructed, not actually sipping the water. He looked at Charlotte. She nodded vehemently, willing him on.

  ‘Please, Mark. It’s the safest option. Don’t make him write you up for an injection. That takes forever to work its way out of your system.’

  God, I hadn’t even thought of that. Shit, shit, fuck.

  Mark choked, and in doing so gulped the whole lot. He was trembling as he left the room.

  Mark had one remaining intention. He made certain that he had his pad and pen at the ready to describe everything he was about to experience. He wanted to make this a special piece of personal journalism. What else could he do?

  He felt fine for the first forty minutes or so, maybe a little anxious as would be expected. Insidiously over the next hour, a heavy slowness crept into his every muscle, and his mind became increasingly dulled.

  At first, Mark tried to shake these feelings by having a strong coffee, followed by a second. He had to make do with putting three teaspoons of cheap tasteless coffee in a tall mug in an effort to gain any sort of stimulant effect. He now understood why he saw so many of his fellow patients with caffeine drinks or simply chain smoking. The need to maintain a degree of alertness drove this search for stimulants of any kind.

  ‘Be Alert! Your Country Needs Lerts,’ Mark said out loud as he stirred his coffee, recalling the words on his favourite t-shirt.

  He wrote down, in fine detail, his feelings both physical and emotional, as they arose. As time went on, he was less able to find the vocabulary or formulate descriptions of these internal changes. It was as if he had a gargantuan sized ball of cotton wool being gradually crammed into his head, forcing his cognitive abilities to stagnate. Inexorably, he became incapable of creative thought or undertaking the task of committing descriptions to paper.