A Little Bit of Me

Jottings and Writing, miscellanous misgivings

Archive for madness

Scenes from someones childhood

He had always been different. I remembered him from primary school. A ‘

weedy little chap’ was how I heard the teacher confiding to her trainee. ‘Problems at home’ and they nodded wisely, in unison and said no more. I thought his home life was fantastic. We would go there after school and with the innocence of youth I failed to recognise the peeling walls, the broken floors, the weed-choked lawns. His father was always there, sitting in an old chair in front of the empty fireplace and I never questioned why he was not at work like my Dad. Or why he was so old. Art was different in so much as he sucked his thumb, wet his pants, was always in trouble. But he also was a marvel at making things, at marbles, great at sports, and he was a fighter. No-one would pick a fight with Art because he would fight with a determination and with such endurance that you would literally have to kill him to win. Then his mother disappeared. She, who had provided us with so much amusement, just went from our after school games. Everyone said that she was a loony. At the time I was told that Arts mother had an ‘accident’, and that Art was going to live with his much older brother and his new wife. Art seemed happy enough with the arrangement. Years later the story unfolded in a form that I could understand. The family was dirt poor. But when you are young you don’t recognise these things. Arts father had not worked for years and they lived on a measly benefit that could not possibly provided for the family. To make matters worse, Arts father was a drunk and a gambler. What little money did come in disappeared down his throat or into the hand of Ray the barber who was also a bookie. Ray took money off all the watersiders and unfortunates who thought they could end their miserable existence with a win on the ponies. Arts father was also a wife and child beater, but that was only to emerge many years later when Arts tragic life was made semi-public.  Anyway to get back to Art and his story. The family had been struggling more than was usual for them. The beatings had multiplied and Arts mother had reached the end of her tether. There was no food to go on the table. Desperate, and at the end of her tether, she set the table and cut photographs of food from old magazines. After placing the photographs on the plates, she sat the children down and sobbed hysterically while they looked at her, wondering what they should do. She suddenly shrieked and rose up from the table and ran outside. They remained behind contemplating what it was that was bothering mother, and what to do with the photo’s in front of them. She, meanwhile, single-mindedly made her way down to the wharf and without hesitation, jumped in. No-one saw her go, and her body was only discovered later that evening when the father finally alerted the police to his wife’s failure to return and provide him with supper.

I lost touch with Art after we left primary school. He followed his brothers and started work on the wharves. I made my way up the academic and professional ladder and ended up, first, in medicine, and then psychiatry. And that is where Arts story was played out. I was at a case presentation at a conference and a psychiatrist from my old home town was making much of a unique diagnosis that he had attached to one of his long term patients. The more I heard, the more I knew it must be Art.

Art had not worked for long. He seemed to gravitate toward drugs and drink, much like his now long-dead father. He left the wharves and worked or roamed overseas for several years before ending back in our hometown, and with the older brother. The older brother recognised that there was something terribly wrong with Art when he tried to set himself on fire. He had poured a can of petrol over himself as he sat in the very same chair that his father had spent so much time in. He then calmly lit a cigarette and if it wasn’t for the brothers hasty intervention the burning to his face and body would have been much worse. His brother said that Art had become so depressed that he literally couldn’t move. He had been amazed that he had managed to purchase the petrol and make the effort to kill himself. Art was hospitalised for the first of many times. Once in hospital he made significant progress so that he was back out in the ‘world’ again within a month. Then started the familiar routine (to a psychiatrist) of acute admissions followed by lengthy stays and then discharge to a series of placements that rapidly got worse and worse. During his second long hospitalisation, at the age of 25, while he was taking antipsychotic medication, he made his first serious suicide attempt. He had obtained a pass to attend the wedding of a woman whom he had always wanted to date, and several days after the ceremony he took an overdose of Paracetemol and drank a quart of brandy. Art later told his therapist that he was neither depressed nor manic at that time and that he had been taking his medicine while in the hospital.

He made a reasonable recovery and his elder brother, now divorced and living with his defacto partner agreed to take Art in. The defacto partner turned out to be a mixed blessing. Although she was kind to Art, he developed an obsessive attraction to her. He was getting very little sleep, feeling “oppressed” by the intense heat, and started complaining that there was “no privacy” in his brother home. This apparently started after the defacto walked unexpectedly into his room and discovered him masturbating to a picture of her. This triggered a response from the brother to the effect that Art’s time in his house would be curtailed unless he ‘pulled himself together’. Art responded to this by walking into the kitchen and picking up a very sharp knife that the object of his affections had been using to cut tomatoes. He took the knife into the bathroom, and, in his words, “I looked into the mirror and prayed for God to forgive me.” He proceeded to inflict a number of wounds on himself, beginning with his right arm. He reported that the first cut severed his hand. A second slash, to his mid-forearm, was reportedly deep enough to leave the distal end of his arm hanging. A third cut to his upper right shoulder was more superficial. He made a fourth wound by stabbing himself in the bladder, then superficially lacerated his genitals and gouged his right leg. Art reported later that he did not recall feeling any pain while inflicting these wounds.

His brother only visited once in his subsequent hospitalisation, but during that visit Mr. A told him that all he wanted to do was go to sleep and never wake up. His brother looked down at him and replied, “But we were so kind to you and you go and repay us by your filthy behaviour”. Art lost his right arm and walked with a pronounced limp from that day. The medical staff had no explanation for the limp, as he had not damaged any organs that would cause this.

Art deteriorated further. He basically was now living on the streets. After a hospitalisation he would be discharged to a halfway house but he would abscond within a week and he became a feature about the city. He was often found sweeping the streets, directing neighbourhood traffic, attempting to organise a rock concert on the sidewalk, or donating his meagre belongings to passerbys. Often the police would be called out because Art was walking around nude and quoting scripture. It was during one of these episodes that Art made his second sacrifice to what he had started calling ‘His Saviour’. The tragedy for Art was that he performed this amputation in a very public place, so public, that the local authorities called for an investigation of psychiatric outpatient services in the city. Art had wandered down to the wharves, which were undergoing a transformation since the tourist industry had daily cruise ships from al around the globe calling in. Disgustingly wealthy patrons alighted from their berths in the morning and spent huge amounts of money looking around each port and then, returned to the ship and trundled to another port for the next day and a repeat of the same routine. I don’t doubt that there was some significance in choosing the wharf to carry out this deed but Art was so far gone that it could have been pure coincidence. He sat on the edge of the wharf and removed the shoe from his right leg. Before any of the onlooking elite of the planet could stop him he produced a small tomahawk from his coat pocket and with one amazingly anatomically aware blow severed his foot from his leg. He then slumped forward and pitched headlong into the oily waters between the ship and the dock. Unlike his mother he was fished out immediately, the bleeding stemmed, and again hospitalised. This hospitalisation was all the more dramatic as his face and deed appeared in the local press for the duration of the enquiry which, of course, concluded that this was an atypical incident and in no way representative of the excellent services provided by the local health authority.

After the furore died down Art was not much seen in public for a number of years. The presenting psychiatrist described a more sober and discrete lifestyle. Art would occasionally be seen being wheeled into the outpatient department of the psychiatric unit but his behaviour was under much better control.  The next time Art did come to the attention of the therapist was when he presented with profuse bleeding from an eye socket in May1997. He had seen an attractive woman in the street and felt guilty about his “lustful thoughts” about her. He had stuck a thumbtack in his right eyelid more than 50 times, completely annihilating the eyeball. When he was asked about this incident, Art replied, “The Bible says that if the eye offends you, then you must pluck it out.”

I approached my colleague after he had summed up the case as an example of predicting self-mutilative behaviour by a combination of behavioural sign and medication compliance. I enquired as to the whereabouts of Art.

“We are having fantastic success with this patient since the case notes I described concluded”, he replied, neither confirming or denying that his patient was Art. “Since his last self mutilation episode he has become very compliant. At the moment we are working through his request to be castrated.” I must have telegraphed my incredulity at this remark more obviously than I thought.

“I am completely comfortable with it. The patients wish for castration is authentic, long-standing, and nonpsychotic in nature. Although the request was thought to be unrelated to delusional beliefs, his overvalued ideas regarding the relationship between sexuality and spirituality seemed unusual, rigid, and intractable. No symptoms of a current, full psychiatric syndrome are present. In explaining his wishes, the patient referred to two scripture passages: ‘If your right hand offends you, cut it off” and “there be eunuchs, which have made themselves eunuchs for the Kingdom of Heaven’s sake. He that is able to receive it, let him receive it.’ The patient has shown mutulative behaviour in his past, but I consider this to be a genuine desire to move out of the trap that he has been in for most of his life. He wishes to become completely asexual and feels that castration will remove temptation from his life. If you recall from my talk, temptation has played a large part in his self mutilations.”

I asked if the doctor was actually going to go through with the castration.

“Oh no! We are working through the issues but it would be ethically and morally impossible for me to actually let the patient be castrated. “

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Francine

THE OBLIGATION

a constraining power of law, duty or contract; a duty, a burdensome task; a binding agreement especially one enforceable under legal penalty; a service or benefit

He shuffled down the long corridor that led from his bedroom to the girl Yvette’s room at the eastern end of the apartment. Hopefully she would be gone. The sunlight streamed through the open window as he surveyed her room for any sign of where she might have gone. Were her schoolbooks still there? School – it was University now wasn’t it. Same with Sophie. His beloved Sophie who was following in his footsteps. She would make a fine doctor just as he had made a fine anaesthetist. Maybe Sophie would follow that particular medical speciality? Unlike Yvette who was nothing but trouble. Always asking questions. Sullen, moody, frequently bored or uncontactable. It looked like she was out to University. How she was going to pass was anyone’s guess. She certainly wasn’t smart like Sophie. Yvette was just like her mother. Dumb and difficult.

He moved downstairs through the massive house. There were only four of them living here but his previous affluent lifestyle had demanded that they buy this huge, two-storied house in the city’s wealthiest suburb. He didn’t notice how dusty and shabby things were or the strong smell of urine that pervaded every crevice of the house. No one did any cleaning except for his or her own bedrooms. The living areas, apart from the kitchen, had not been cleaned since they moved in at the beginning of the year. Since the divorce. He moved into the kitchen that was immaculate. He demanded that it be kept so. He did all the cooking. In one of the sinks was a cabbage he had bought yesterday and which now lay soaking to get rid of those pesky worms which were in all the supermarket vegetables and fruit now. Another sink held a massive mound of peeled potatoes. He peeled a sack at the beginning of each week and left them soaking in water and then used what he needed each day. He had his methods to make cooking not so much a chore as an exercise in planned management. His former wife could never accuse him of abusing his daughters. He opened the refrigerator which contained fourteen bottles of milk, two large pails of shrimp, butter, and a jar of hosein sauce. His speciality this month was shrimp, cabbage and potato curry and that is what he cooked every night until all the shrimp had been used up. Then he would master another dish and make that for another month. It took the chore out of deciding what to cook every night and having to have hundreds of ingredients and spices and herbs to assemble those dishes. Pick one dish, make it simple, buy in bulk, and then cook it until it was completely mastered. He had to admit to himself that occasionally he broke his own rule. He had lately taken to buying biscuits in bulk and some days, he lived on biscuits for breakfast, lunch, and sometimes dinner if the monthly dish was starting to become monotonous. The girls never seemed to grow tired of this routine. He thought that it bought some regularity into their lives that they needed after their bloody mother had left.

Emily had left early. She got up before everyone else and left the house to avoid having to spend any more time than was absolutely necessary with her family. The house itself was not welcoming. It was cold, the old man refused to have central heating and would not allow heaters on before the sun went down; it smelled, the old man never flushed the toilet after he had used it and it was usually left to one of the girls to do so when they returned each evening; and it was dirty. Emily had plans to leave on a more permanent basis as soon as she could get some finances sorted out and make the break. Unlike her two sisters she felt no ties to her father and mother any more. As long as she could remember they had been at each other’s and their throats. Mother would come in from work each night and criticise and pick until everyone gulped down their meals and retired to their rooms, the study or just out. Only Francine, poor dumb Francine, who ate so slowly and would never do anything to offend anyone, suffered her mother’s wrath as all other targets disappeared. Then Mother would leave. Where she went was one of lives mysteries. Emily doubted that she had a lover. It was probably to some women friends or perhaps back to work. Although Father said she was dumb she had manage to amass a small fortune buying second hand goods and selling the back to the public as antiques or memorabilia. As more and more people wanted to recapture the past and nostalgia from it, such things as cereal packets, soaps, toys, cookbooks, furniture, radios and TV’s, music, and other valuable accruements to daily living. She probably was out buying or maybe finding potential goldmines. Emily didn’t really care and she suspected that no one in the family did either. Anything that got Mother out of the way went unmentioned, unchallenged, and profusely thanked in prayers. She could never understand why they had stayed together. A marriage that the wife was forced into by an ambitious but poor father and a husband had agreed to because he was unable to attract anyone despite his wealth and prestige as a practising specialist. As the girls had grown up they came to realise that their family was held together by obligations, commitments, loyalties, and guilt. Those loyalties had shifted constantly over the years but one thing was usually permanent through all the changes. Francine was always the target for everyone’s misery.

Lately he had been dreaming. Well he hoped it was dreams and not the start of that terrible Alzheimer disease that had stricken his own mother a few years past. She had gone from an intelligent, forthright women totally in control of her own and others world to a bent, feather duster image of her former self. When she did recognise him now when he infrequently visited the nursing home, she called him Dimmy or imagined him to be some past lover. He retched at the thought of some of the things she had said and done to him on those visits. To have your mother whisper foul obscenities to you while contorting her ravaged old body was beyond a son’s obligation to his parents. He had been dreaming that the house was filled with guests and throughout the day he wandered from room to room and held interesting conversations with these people. One room would be filled with former colleagues who would discuss medical issues of the day, another room would be sombre and one or two beautiful people would be holding elegantly cut crystal glasses, eating fine delicate food, and be listening to beautiful jazz music. The kitchen would be abuzz with dishes from around the worlds busily being prepared. One cook would be putting the finishing touched to a Rojan Gosh with wild and basmati rice and saffron, another moroccan chicken with an orange and almond salad, another two cooks concocting an exotic dish of calves liver marinated and cooked in Noilly Pratt and lime juice with delicately grilled onion, and yet another a lamb and onion tart with a tandoori marinade on the lamb. The smells were delicious and the sounds of the cooks enjoying their craft, mingled with the bustle of people being busy made him feel as though he as on a cloud. He would then float into another room where his united family was. Elegantly dressed, behaving civilly to each other, and waiting on whatever whim he may have to start their interaction.

A LETTER FROM Francine TO ANYONE LISTENING

I can’t seem to say what I want to say. I wander off the track and mess up my thinking with little sayings from books and movies I have been seeing. At the moment I am keen on China. Those bound feet. I read about a women who when she went to live with her daughter her daughter noticed that she was always wearing the same shoes. Her mother had polio when she was a child and wore an elaborate leg brace and one leg was shorter than the other. The daughter said that her mother always loathed her body and that she thought of it as dead. The daughter found out that the mother was sleeping in her shoes and had not taken them off for over six months. They went to a doctor and the doctor refused to let the mother take her shoes off in his surgery. When they eventually removed the shoes, in the doctor’s presence, at home the room was filled with the gagging smell of rotting flesh. The doctor said that if they had waited much longer gangrene would have set in. The mother was drunk for three days and refused to talk. I wanted to say some things so that I won’ get off the track.

1. I AM STILL IN AN ANGRY FIT. Little things affect me. E.G. I was standing in line at the EFTPOS machine and a member of the bank came out and pushed in front of me and started to operate the machine. I said that this was rude BUT LIKE ALWAYS THEY IGNORED ME. I was too tired to make a complain but the anger fit boiled up inside of me.

2. I am becoming like my family and I don’t want to. I become angry like Mother, I become uncaring like father, I become vengeful like Sophie

3. I DON’T WANT THIS TO HAPPEN – angry fits are wasteful and hurtful. I am so confused. Should I feel like this or is it not normal

4. Things are picking up sometimes. We went out to visit a sick friend the other night and it felt good to be doing something together as a family. They were all nice to me although I can see the strain in Sophie and I know father will be back to his stingy self when a few weeks are past. I remember though when mother left and how I felt then. I felt good when I got back here and the relief of not having to fight with mother but soon I stated to feel bad again. Bad about myself and BAD that I hate both my mother and father for breaking up and making us all unhappy. When I leave home I will try to do it in a nice way. I want to be nice to Sophie and Emily even though I am ANGRY about them. I don’t care if I ever see father again. I still wish him well but would not want to have anything to do with him. Mother left us with him. I feel like I am painting an eggshell which I don’t want to break. Sometimes I can see a balloon filling up with water as my family sits and eats a meal. The balloon gets bigger and bigger, straining with all the water being pumped into it and then it BURSTS. OVER ME.

PS. I want to stay with my father and I want to get away. I want to be with my mother but hate her for running out and leaving us. I want to get on well with my sisters but they are spiteful and vengeful and it makes me angry with them. I put on a happy face because that is what families do. You don’t fight with your family.

Emily was never bothered by what her sisters saw as their duty. As far as she was concerned it was every man for himself. She had grown up fast in her nineteen years of life. She had seen that a mother could be done without. It had only taken her a few months to adopt to life post-mother. In fact it wasn’t too much of an adaptation. A much simpler life. Just avoid too much contact with the others; speak only when the situation cannot avoid total silence, say what you believe the others want to hear. Emily shifted allegiances so often she sometimes forgot what she had said to that person the last time they had been together. Emily had also watched what happened at her workplace. Loyal, trusted, long serving dedicated staff who were irreplaceable. Within a week of them retiring they were forgotten and then they became a mild nuisance when they insisted on coming back to fill in their boring. empty days with idle chatter. By six months they were a definite liability and often had to be asked to limit their visiting to certain times. When Emily retired she would be right out of it. No coming back for her. And she would be out of that family as fast as she could. All that was blocking her at the moment was money. If she just walked pout it would be the sort of excuse that father and mother would take to cut off her allowance. As it was she received a nice little packet of money on top of her wages and although limited, she also had access to two credit cards that they owned and paid for. With those gone she was back to wages and she couldn’t live on them, rent accommodation, pay for food, buy a car……… As she thought about it she became more and more irritated with the unfairness of her life. Unlike Sophie and Francine she didn’t have the fallback of a high paying profession to generate financial independence. In some ways she was like her mother. Forced into entering into a relationship to free herself from family obligation even though it meant adopting a whole new series of obligations. At least mother at used her new situation to become independent. But at what cost? Emily sometimes wondered what her mother thought about as she drifted off to sleep. Was there guilt? Remorse?

ANOTHER LETTER FROM Francine

I only sleep in the same room with others when we go away on trips, but don’t you know that time of communication as you are drifting off to sleep? You talk of things that are so different from when you are normally together. Dreams, hopes, fears. Emily is especially nice then. She and I seem to have some things we share. I think she misses mother like I do and secretly hates father but says things against mother so he will like her.

On Sunday I went into a bookshop to get something about adopting. I sometimes feel as though I have been adopted. . The sales assistant kept on urging assistance on me and so I

found a book quickly. I might not have been in the shop if the Blamore Centre Clock Tower hadn’t been running 25 mins slow. It had been after

closing time. Metaphorically the clock is being turned back as a new pier

is being built. The clock tower was at the end of the old one. That was

pulled down a long while back. In those days rock’n’roll music was coming

along. I think I thought to `rock around the clock tonight’ meant to dance

around the clock tower. The idea of dancing for 24 hours (around the

clock) didn’t seem to occur to me.  Strange for a toddler who I am told

used to wish `Goodnight children,’ to her sisters as

_they_ went off to bed. I am getting this from the meaning for `waste’ in

life of extravagant or ineffectual use of it. Perhaps dissipated is

another word for it ‑ leading to early death.  It is a different meaning

from that which had been written on the back of that old clock tower

before its coat of paint, `xxx was wasted here.’ That was a bit of a

shuddery feeling, knowing what that might mean, and the feelings going

into it. Why do people want to end the lives of others? They are a bother

to them. Perhaps their lives are hard through lack of work ‑ more so lack

of some sort of identity.

Do you hear the people sing

Lost in the valley of the night?

It is the music of a people

Who are climbing to the light.

For the wretched of the earth

There is a flame that never dies.

Even the darkest night will end

And the sun will rise.

Is there a world you long to see?

Do you hear the people sing?

Say, do you hear the distant drums?

It is the future that they bring

When tomorrow comes!

AM I LOSING TOUCH WITH REALITY???????

PLEASE HELP

PLEASE HELP

PLEASE HELP

He awoke again. He had been dreaming but the dreams quickly blended into a bland series of neutral images.  They hadn’t been positive or negative. He shuffled down the hall again. He could sense that something was not as it should be. For some reason an image flashed through his mind. He saw Francine lying prone on a table with Sophie bent over her. He remembered that this had actually happened. When they were young children Francine had regularly asked her sisters to punish her. One of the more bizarre forms of punishment had been for Sophie to due a crude tattoo on her shoulder with a school compass and a jar of India ink. The area had become badly infected but Francine kept it from her parents and Sophie was too young to recognise the symptoms. She revelled in it, already developing a wish to be a surgeon and thought of herself performing a complex operation. The tattoo has supposed to have been a butterfly but by the time it came to his attention it was a pus filled mess which turned into a horrible scar which only represented an elephant to anyone with any imagination. The moment passed and he opened the door to Francine’s room to find it tidy and empty.

Letter from Francine

I have changed my name. I am now known to you as jasmine. Note that jasmine has a small j. I am saving the big J for when my brilliance and beauty has flowered. I am no longer here to be kicked around. I would rather die than be known as a weakling. Since I spoke to you last I have visited with my mother. She and I got on well. She expects me to sacrifice my life to her needs when I am finished in my training. I went along with her. It is easier that way.

My name is jasmine with a small j.

Francine had to pass this year at her studies and pass well.

She walked down the street that led to her place of study. It was a colourful place to study. When her family had first moved here she was hateful towards the place. It often seemed cold. Always raining or the streets were cold from the bitter wind that blew up the harbour. Summers were usually missed as she travelled north to find seasonal work (well once) or to travel in the warmer climate. But over the years Francine had come to see a kind of beauty and serenity in the place. The street she walked in now was the main artery from the city to the student quarter. It winded down past the last of the retail area and gradually gave away to the training hospital and then the University itself. This was liberally dotted with restaurants, hotels, student flats, and much activity. She passed the clique of ex psychiatric patients who waited in the soon to be demolished bus shelter, adjacent the public toilets. here they gathered from early morning as they waited for their daily appointments for ongoing medication at the nearby acute outpatient ward. A curious group of people who were generally harmless but sometimes could be guaranteed to provide entertainment, especially if they had mixed their medication with alcohol. Some of the students deliberately encouraged them to do so for their entertainment.

Francine walked through the archway that led to the noticeboard where the final marks for her exams were posted. This was always a hard time for students. They had some idea whether they had passed or failed but the degree of that pass or fail now became frighteningly clear. She could remember when she new she had failed an earlier paper but was relieved when the failing mark allowed her to sit a new examination which she passed, and went onto the next year of her course. Her number was three down the list 009876-34  –  A+ ( please see Mrs Brighton). What did that mean?? Mrs Brighton was a nice but formidable women who was really the person who ran this training program. Having to see her could mean one of many things. Had she been accused of cheating? was her mark so out of the blue that there were suspicions? Was she to be asked questions about – she could not think what she would be asked.

Surprised and elated – but how could she tell her mother that she had done so well. To be asked to take up a prestigious scholarship over the summer vacation period and to have won two prizes for her years work.  Her mother’s reaction would be ‘ if you did so well this year what happened the other years? or now you will win prizes every year’. Francine could not see how mother could beam with parental pride and shower her with gifts and comment on her intelligence and beauty. This is what she wanted. The world didn’t work in a linear way. You went up and down. Years of struggling suddenly opened up a window through which all fell suddenly into place and a clarity that was not apparent before now beamed like a lighthouse suddenly appearing out of the fog. Francine liked that analogy. She was alike someone who had been at sea for a long time and now was making a landfall. Yes, she could see all sorts of possibilities in this. Stormy seas, weathering storms, making landfalls, swells, ups and downs, smooth then rough, sudden wind shifts, having to shorten sail and then make sail.

Sophie had thought that jasmine had been acting strangely for a long time but the discovery of her letters (to whom?) confirmed the horrible truth. She couldn’t understand a lot of what they said but it seemed obvious that Francine’s (jasmines?) fragile world was rapidly unravelling. What to do? Should she tell father? She had to think what that would mean. It was an unspoken family rule that rooms were personal and sacra cant. Sophie had no right to be prowling in Francine’s room, not to mention in the bottom right hand drawer under a pile of freshly laundered underwear. Sophie thought that father often visited their rooms when they were out of the house but she doubted he rifled through their underwear. What was her duty? As a sister, as a daughter, as a nearly qualified doctor? As a doctor she should get help but as a sister and daughter her duty was less clear. She had seem many times patients admitted to the acute psychiatric wing who were clearly very troubled but parents and siblings had used words like ‘always highly strung’, ‘creative’, ‘under pressure’, and ‘a bit stressed’, when these people had obviously been deeply psychotic for a long period of time.   She would wait. She would wait and see if Francine changed. She would give it a month. No! She owed Francine more than that. She would give her till the end of the year. If she had not shown some improvement by then she would–. The thought stopped there.

Final Chapter

Francine looked down at her elderly patient as she lay on the therapeutic bed. She was a new patient, recently referred from the rehab centre in the centre city after a stoke which had left her paralysed down her right side, unable to communicate, unable tom perform the basic functions of life, but with a wicked look in her eyes which seemed to Francine a signal to some inner secret. The other therapists in the unit had not been able to make much progress and so, after trying for a few weeks, they had given up and the patient had come to Francine like the household cat who is kicked by the child, who has been struck by the older sibling, who has been scolded by the mother, who had been beaten by the father, who had, in turn, been reprimanded by the domineering boss.

Francine sighed and started on the long routine which would, if the patient and her fried brain would allow, restore some of the lost functioning so cruelly taken away by the neurological incident. Francine whispered to her patient as she manipulated the wooden arm – ‘ Obligation – I will stay with you until you can walk, until you can talk, until you can tell these bitches her that they need to understand what the word obligation means.’ Francine almost felt she saw the glint in the eyes take on a new hue as she moved down the old women’s body to the leg.