Til Morning Comes

by Lisa Ann Harper

  Following the procedural examination:- No attempts at murder. No evidence of sexual assault. The woman was a virgin. Already she was forming her own opinions on this case, but the age was not right, she was too old. Well, it was getting late and she had much to do. There was little more this file could tell her, so she thanked the night nurse who had come on duty whilst she had been so totally engrossed and headed for the university reference library.

  Since her return, Mallory had staked out a corner for herself by the medical stacks and often would spend another two or three hours at the books. Now she googled for references on amnesia, which led her to two dense tomes, both containing fairly hefty chapters on brain trauma and its various consequences. Time sped by as she absorbed what she could from the reported case histories, medical experiments and specialists’ reports. When the words on the page began to jumble and her writing slithered away, it was time to quit.

  Back at the residence she heated a packet of noodles and took the bowl, with a banana, to her room. At the coffee table, which did service for many functions, she looked over her notes again. Her heart raced as it had not done in a long time. She took herself back to that weird episode in her life – her life as a man which, after so long she had begun to believe was all in her head. She had attempted to block out these thoughts, had avoided the term ‘memories’, and now here she was, trying to retrieve them. Searching for dates, she realised she had previously ignored this information, but she needed to know the exact day and year of their discovery. The time line would make or break. She grimaced at the impact of this significance.

  * * *

  Mallory had to wait until the week-end to allocate time for her personal pursuits. First she returned to Lychette St. Agnes, explaining to another supervisor that she had been there earlier. The waiting stretched out. It looked like this next hurdle was going to be too high. Stonewalled so soon! After verification she was allowed to continue. Relief flowed liberally as she let out her breath and moved on.

  Today turned out to be positive all the way. The month and day put Faith in the right place at the right time. Just those two facts raised her spirits. Hold on … don’t get carried away Blockhead, one step at a time. There’s still her age.

  Saturday was a better day to return to the QEH. The routines were less pressured with the teaching side of things on hold. She wanted some uninterrupted time with Faith’s new chart and was able to sequester herself in the Residents’ study room from where, one hour later, she emerged with a fairly detailed construct of how this woman’s life had unfolded over the past two years. It was not a pretty story.

  i. Inflammation between the Dura Mater and Arachnoid Mater has resulted in excessive pressure on sensitive brain tissue. Until this subsides, the patient will be subject to sudden and violent episodes.

  ii. Recommended experimentation with different drugs to control irrational outbursts.

  iii. Over the two years, there has been a steady progression towards deep melancholia, interspersed with transient, episodic bouts of delusional behaviour.

  iv. There has been no way of assessing the degree of internal scarring that could have taken place.

  v. Final result:- Total withdrawal of all activity.

  “Until now,” Mallory exclaimed. It appeared Faith was living a closed life, lost inside herself. Decreasing interaction with people had resulted in an escalating alienation, followed by a progressive detachment from reality. She was no longer violent, but this degree of passivity had gone to the other extreme. She needed more detail on the patient’s so called delusions. The consulting psychiatrist would have this information in his own clinical notes. It would be tricky.

  She was sitting in the cafeteria with a coffee, trying to work out a plan. It was quiet, between meal-times and although there were some post-grads she knew she did not go over, just waved. She needed to think.

  How could she access private reports? Perhaps go through her own department, if she explained she had to conduct a feasibility assessment or a ‘follow up’ with mental health services. No, that would not work. There would be a check with the Department and they would discover there had been no such request.

  Wait! She sat back. There was already a legitimate case. Desmond was on her list and he and Faith had the same specialist. At his Rooms, engaged in researching Desmond’s background, could she casually ask for Faith’s file? Worth a try. If she could not pull it off, she would just have to think of some other strategy. One way or another she had to get to the root of it all. It was beginning to feel like her whole future depended on the outcome of this scheme. Was she becoming compulsive? She did know she was beginning to feel like her old self, before – before – before what? Don’t go there Mal. You’ve got more urgent matters. Anyway, it was the weekend so no good trying for more today, but Monday she would ’phone Doctor Jamieson’s receptionist and set it up.

  She finished off her coffee and thought about what else she had to do. There was the seminar in her third module coming up next week: Social Work in a Global Environment. She had better move on to what she was supposed to be studying. If there was one thing she hated, it was not being sufficiently prepared. Checking the big clock she saw it was still early and on the spur of the moment, changed her mind and decided there was time to pop into the gym. The trainers were pleased to see her and asked where she had been hiding. Her replies were non-committal and eventually they dispersed. She went through a warm up on the bike feeling exhilarated. Enthusiasm was back in her life. She had taken the first, tentative steps on the winding path of hope. It felt good.

  The weight had dropped off considerably since being in regular attendance, but her conviction was positive, it would not take long to regain her former fitness. All she needed was to apply herself reasonably diligently, on a consistent basis. She had done it before, she could do it again. For the first time in a long time she felt ‘body-alive’ and fired with genuine commitment. Moving round the circuit, she re-acquainted herself with the Bench Press: Lat. Pull: the Pec. Deck: and some of her other old friends. By the end she was ready to get back to the pressing assignments.

  * * *

  Bettina, Dr. Jamieson’s receptionist saw no problem with Mallory’s request. She worked ’til six o’clock. Surgery finished at four on Mondays, so any time in there was fine. Kylie had hoped they could get together that afternoon and was crestfallen. She had to be content with tomorrow. Mallory promised.

  Obtaining Faith’s file was easy. She slipped it inside Desmond’s folder, then sat in full view of Bettina’s desk and quickly began to flip the pages. Her note pad filled rapidly and soon she had everything she needed. Elated, she dutifully returned the files with appreciative thanks.

  That evening, supper out of the way, she sorted the information she had gathered and was preparing to see how the pieces would fit when there was a light tap at her door. Opening it she saw Kylie on the threshold a case of stubbies in one hand, briefcase in the other. She held up the beers: “Thought we could mix business with pleasure,” and smiled as she entered. Not pleased, Mallory put on a good face as she gathered up her private notes before Kylie could become curious. “OK Ky, you didn’t want to wait ’til tomorrow? Is there a problem?”

  “No, no problem.” She sat herself down on the floor and proceeded to pop the tops. “I felt like company and since we’ve got to get Mrs. Thompson done up and out of the way, I thought we could do it together.” She looked up brightly as she handed the bottle across the table. Mallory accepted it, resigned to putting her own interests on hold and prepared to get stuck in.

  “In a moment Mal, let’s get a bit lubricated first,” Kylie insisted. She looked conspiratorial. “A little bird told me you were back at the gym Saturday. That makes a change from the library, eh?”

  Mallory laughed as she began searching through her stuff for Mrs. Thompson’s particulars. “Bloody Nora, news travels fast around here. Who was it?” She sat on the couch and picked up the Services Manual for the West
Midlands Region.

  “No matter, it’s true then?” She cocked an eyebrow. “What brought this on?”

  “Nothing special, it was about time I guess.” She began to check the index.

  “Wait Mal,” she stretched out her hand: “Have you met someone?” She looked hard into the other woman’s eyes and Mallory discerned the intensity behind the scrutiny.

  Crikey! What is this?

  She laughed again in an attempt to lighten the mood. “Come on Kylie, there doesn’t have to be another person just because I go back to something. Anyway, where do I go where I’d meet anybody? Everyone I see is already busy studying, just like us.” She chuckled. “Well, like me anyway,” she amended. “I don’t know how you fit in all those parties, you hoping to meet a nice doctor?” She tipped her hand.

  Kylie watched the exposed neck muscles as the liquid was swallowed: When Mal gets her physique back … she’ll be irresistible. “No. All work and no play … you know about Jane?”

  “Well, I think it’s time we got started. I don’t like late nights even if you do.”

  She let it go and they worked on Mrs. Thompson until they were satisfied they could do no more for her. Nonetheless, their supervising liaison officer could probably come up with something they had overlooked. When Kylie left it was too late for Mallory to take on anything else, especially as she had determined to go to the gym before her workday started. She felt this would be the best way to maintain a routine.

  * * *

  The week she put in flew with hardly any time left over, but before Grand Rounds on Friday, she had been able to positively collate her data on Faith. Deep inside she felt a well-spring of conviction that Faith would turn out to be Nigella. Everything seemed to be coming together. They had only estimated her age, but all she needed was some personal contact for proof conclusive. She could not claim to be a relative, so what to do?

  Waiting for Dr. Stubbs with eager anticipation, she observed everyone’s arrival, laughing and chatting; some were complaining, but she was impatient to get on.

  “We missed you at lunch,” Kylie admitted.

  “I wanted to check a patient’s file before we got started.”

  There were some new admissions since last week so Rounds took even longer. Dr. Stubbs fired off his usual barrage of questions and it seemed the usual students responded. This week his theme was addressing the moral issues involved in the practice of Psychiatry: the four main principles which should concern the therapist, whatever his respective discipline. After a rather protracted question period, he finally got what he wanted.

  1. Respect Autonomy – the brain state could result in incapacity.

  2. Beneficence – do good.

  3. Non-beneficence – do no harm.

  4. Justice – the virtuous position of the practitioner.

  This last proved to be more knotty than at first appeared and the topic of virtuous ethics stumbled to a halt. The professor declared they would return to this discussion at a later date.

  When they reached Faith’s bedside it was not possible to detect any change, she was just as lethargic as before. Again Dr. Stubbs requested suggestions. He was not in favour of shock therapy. They went through her drug program. Obviously this was having minimal impact. Mallory thought back to their analysis of Autonomy and Justice and saw her chance.

  “Dr. Stubbs, may I make a suggestion?”

  All eyes turned to this tall, slim woman in the rear and Dr. Stubbs nodded his approval.

  “I was thinking along the lines of possibly CBT. If we could find some form of occupation or entertaining diversion, perhaps her mind could be stimulated to interact? This could provide her with a means of involvement and in turn accommodate the need to show respect.”

  Staff Nurse checked her board and reported that the occupational therapist had been in, but no activity had prompted a response.

  Dr. Stubbs looked back at Mallory enquiringly, “Miss …?”

  “Mason Sir,” Mallory supplied.

  “Yes Miss Mason. Have you any specific ideas?” His thing was the appropriate application of pharmacology, not cognitive behaviour therapy which may never evolve from the level of airy-fairy nonsense. However, this brought into question the ethics of prescription which must be observed.

  “Perhaps some form of art therapy? I have read it can be a powerful tool in helping to uncover the workings of a disturbed mind.” She stopped and now everyone turned to look at the Prof. His response was measured.

  “There have been numerous studies into the efficacy of self-expression through art, as a disturbed diagnostic accessory: A conduit of emotional expression from the head to the brush. It can be a liberating experience for the patient, releasing them from the constraints of rationality. It has been used as an aid to understanding what the patient finds difficult to express.” Dr. Stubbs looked around, having delivered himself of these pedagogic principles and appreciated the agreement of the nodding heads.

  Quickly, Mallory interjected that she would be interested in taking on this case. “It could provide me with a clinical aspect to my thesis,” she explained: “‘Art as a persuasive agent in opening up a dialogue in the non-verbal situation’. I’m interested in observing if there could be acceptable outcomes from this trial.” Again everyone regarded her curiously, but said nothing.

  “I too, would be interested to see if there would be any merit in this form of visionary lens. Set it up Miss Mason and report your results to me. I expect nothing less than full academic rigour to this trial. Shall we allow, say … three weeks?” Although he regarded her critically, it was with a new interest. Mm…m not just a follower!

  Grand Rounds completed, the fourth year Social Sciences students returned to the pokey room assigned to their use in the welfare agency section of the hospital. The space was cramped with all of them, but usually it was only one or two at a time. Jason wanted to know what Mallory was up to: “Where did this ‘art therapy’ bizzo come from Mal? You never mentioned it before.”

  Why do they have to be such sticky beaks? Jackass!

  “You know our Mal, always going off on her tangents,” Kylie supplied. She too was intrigued, but she wanted to get Mallory on her own. In front of everyone she would only make up some story.

  “I have many interests Jason that you don’t know about.” Mallory’s response was terse and impatient: “And Kylie, get back in your box. You don’t know me.” This was delivered through gritted teeth, a veiled, obscure light glimmering in the cold, blue eyes that turned fiercely on the unsuspecting young woman. She nailed her with a penetrating stare. “You know nothing about me.” With this last shot she collected her backpack of books and made for the door, leaving a circle of astounded and bemused stares in her wake. They looked wordlessly at each other as the door slammed.

  Why can’t they mind their own business? On reflection, perhaps she had been too unsparing, but now she had a plan and only weeks to show results. She had no time for their probing curiosity. The Occupational Therapy Department was located on the ground floor to provide easy access to out-patients. Cynthia Lewis was the supervising therapist, an amazingly tall, thin woman of mature years. No lab coats here – multi coloured shirts matched with a plain grey skirt gave just the right impression of friendly efficiency. Having listened to her request Mrs. Lewis saw no impediments to the proposal.

  “We have a corner in the crafts’ room. Patients have access to pots of bright poster paints; large boards for spray-can expression and of course oil paints for those who are more vivacious.”

  “Thank you Mrs. Lewis. I’ll set up a time with the ward staff and bring the patient down myself and let you know when we’ll begin.”

  “That’s good. There should be no problem with availability of materials. We don’t have much demand on our supplies at the moment.”

  “Oh, as to materials, the paints will have to be water colours,” Mallory hastened to clarify: “And possibly charcoal for sketching.”

  “Water
colours, we don’t use them for therapy or craft.” Mrs. Lewis shook her head. “That technique’s no longer popular,” she declared, wondering if this smart young student was really as smart as she looked. “We may have some charcoal sticks lying around though.”

  “They have to be water colours Mrs. Lewis or the medium won’t work.” She was adamant.

  “In that case you’ll have to supply the materials yourself.” The supervisor looked dubiously over the top of her glasses.

  “No worries. I’ll get everything together and set up a time as soon as I can.” Mallory knew exactly what she wanted and was determined to find it. “Thank you again Mrs. Lewis. I’ll see you next week.”

  Although her student’s stipend was not large, during the past two years she had not indulged herself and still had funds in the bank. She would afford whatever was needed. She tried the artist supply shops, but there was nothing. Next it was the second-hand outlets, but still no success. Saturday afternoon she began to comb the antique stores not far from the jewellery precinct, on the northern side of the city. Two hours later and almost resigned to giving up, she was explaining once again what she was after and not expecting any help. Surprisingly, the elderly gentleman who was about to close up directed her to a ‘collectables’ shop, down the road. He thought old Arthur might have what she wanted. Arthur did indeed. He had to wade across, through and under a mountain of bric-a-brac, but buried deep beneath the most unlikely assortment of what Mallory classified as junk, he found it; a rectangular, wooden box, very worn, but obviously of good quality. She reckoned with a little French polish, some Linseed oil and enough elbow grease, she could bring it back to its previous life. Opened up, inside were spaces for two glass pots for clean and dirty water: pots missing. There was the tray for the various bristle brushes, also gone. What pleased her most were the paints themselves, dried-out cakes, but not too much used. The closed lid must have maintained an airtight seal. Careful re-hydration should bring back the re-colouration. From her diligent searches, she knew which artist suppliers had what she required in the way of brushes and paper. Fish paste pots, when cleaned up, would be just the right size for the water. Tomorrow she would buy the easel and folding stool. Everything must be just like before. Hurrying back to the bus stop with her purchase tucked under her arm she repeated to herself, over and over like a mantra: “Please let this work. Oh please, let it be right.”