Seeing the psychiatrist

SEEING THE PSYCHIATRIST

Left to herself by Cathy, Alice meets new people and they are competitive, always asking what do you do? If you haven't a job you can see in their eyes their immediate assumption you've no status worth bothering with and they extricate themselves and go away. Alice doesn't mention her illness, not since the wife of a colleague of her husband's seemed sympathetic so she mentioned it, the wife stared at Alice in horror then picked up her drink and abruptly, without a word, ran away. Alice has had several poems accepted for publication by the editors of magazines she's tried, if she proudly claims that as status people don't understand, never having heard of poetry magazines. If she explains she's competing with the whole of the English speaking world moreover only 2% of submissions are successful, her husband says she is intimidating and frightens people off. Nobody ever asks to read her work, indeed, they look alarmed when Alice announces she writes, as if they expect her next move will be to thrust a dog-eared manuscript under their noses just like that.

Alice wishes she could tell someone what she endures during evenings out, claiming status and being goggled at like a codfish on a slab then being left to herself, or worse, trying honesty and finding she terrifies people. Perhaps she could tell the psychiatrist at her next appointment? Her loneliness and isolation are persistent problems that she finds herself incapable of solving, her sisters have said join a support group for “people like you” but Alice doesn't find evenings spent playing bingo or trying to get a conversation out of very ill people satisfying, it neither gives her a feeling of belonging in society nor is it a venue for literary and philosophical discussion. With that her sisters washed their hands of her, like Cathy they have their own lives to lead and Alice is a “problem” therefore someone else's, she is forced onto the verges and margins.

Your next appointment to see the psychiatrist will be on:

Tuesday 21st May at 11am

Psychiatric Outpatients Clinic, Claybury Hospital, Woodford Bridge.

Please bring this card with you to your appointment.

WAITING

The waiting room is shabby, it is a temporary, wayside place in a hospital being run down prior to closure and demolition. Psychiatric medicine is the Cinderella of the NHS so patients it exists to help and heal are at the very bottom of the NHS heap, people who are too ill to cope are being discharged every day and nothing the psychiatrists and nurses say makes a blind bit of difference. The hospital is to be emptied so its valuable site can be sold off, wealth realised which will never find its way back into psychiatric care. Alice is anxious.

FAUST IN A CAFE

What is the point of Alice in her black coat

cramped on a hard wooden chair? She's been put there

to come to the point and there's neither help nor escape.

She dreads the thoughts her brains are pregnant with, she dreads

the psychiatrist's demands they be made real in breath and sounds.

The ashtray is navy glass and peppered with her ash

but she won't realise her wait as pertinent.

She has a toxaemia of the brain, she sobs and catches her breath

for nobody is gentle, although she needs careful nursing

and she mustn't explain, but sit tight, however ill her thoughts.

If Alice opened her mouth to deliver

the bony head and spine of what she knows, she'd be so weak

that first it would tear her into dark and bloody shreds

then it would blow her into nothingness like cobweb.

She knows she'd never live to see the clean, evening light of afterwards.

Her name is called, she gets up and knocks on the door.

This psychiatrist is friendly and well turned out in a silvery grey suit and white ironed shirt. Alice always sees someone different who hasn't read her notes so must start from scratch, this one smiles and chats so it's easy enough. But this is beside the point, Alice has pressing questions of her own but the psychiatrist is so much in control there are no openings, Alice is carried on the flow and feels more and more unreal and unlike “normal” people. What's really the matter is her loneliness, her isolation and the terror she seems to induce in other people, but it seems to be impossible to get onto the subject and say something real and pertinent to herself.

NIGHT DRIVE THROUGH FRANCE

These red reflector studded sticks are absorbed

in guiding the road whilst she is being driven

on the wrong side through blackest night.

The red reflectors veer off fast

to left or right. She doesn't know the driver's

destination, though she ought help out, she can't.

Strange to see oncoming headlights on the left.

What's total to Alice, is to the driver incidental,

he has an overview but she is immersed in detail.

He asks: “How are you feeling?” She replies: “Ashamed.”

“Ashamed”, heavily iambic, blurts like a sneeze:

he stares. She'd like to say everything that could be said

about the red reflectors, the car, the drive

into nowhere but she cannot manage that much,

it's all subsumed, compressed into “ashamed”.

“Ashamed” lights her red face. The driver

wants to establish a very different agenda

and she knows that “ashamed” is no help whatsoever.

The “a” is vulnerable, he cannot understand

that “shamed” is like copious and overflowing tears:

she's fucked as, professionally, he reiterates his superficial queries.

Alice knows from Cathy's friends, and the new people she meets, that you're a poor thing if you are without a job and she doesn't want “poor thing” status, so when the psychiatrist asks if she works Alice says: “Yes, I'm a writer.” This is a starting point, it is real and actually pertinent to Alice, but a gleam has come into his eye, he fires out a pet hobby horse in a series of bullet point questions:

“Have you published a collection of poems?”

“Do you attend literary events and festivals?”

“Do you read your work aloud to audiences at venues?”

“Are you regularly in tough with other authors as part of a Writer's Group?”

Alice replies in negatives, feeling unreal again and unlike other people: she has had poems accepted for publication but she is given no chance to say so, she is carried away again, this time by the psychiatrist's enthusiasm in demolishing her claim. Of course she isn't a “real” writer, she is Alice, isolated and different, she can see what he thinks of her, he thinks her claim is ridiculous, she can feel the heavy, sharp edged nuts and bolts digging in of the underside of reality where the service ducts and couplings of the structure are. This, too, is pertinent, she is always feeling or being made to feel like this, but how can she find words to explain to the psychiatrist that he is making her feel as isolated and unreal as everyone else does? She feels tearful at the sheer impossibility but she mustn't cry, he might attack her further if she shows he's got to her, she must keep her feelings tightly unseen and get out of this room in one piece. Unaware and jocular, he winds down the interview and says goodbye, Alice opens the door, she goes through it and out into the shabby slot of the scuff marked, damp stained corridor. Alice walks towards the black rubber swing doors that give onto the fresh air and woods outside.

This is the worst form of the illness, being a codfish on a slab and nothing about her feeling real, she will never be able to feel “normal”. But Alice has had poems accepted! Why didn't he ask, why didn't he give her one little chance of telling him? Should she claw at her skin with her fingernails and draw blood? Strike herself repeatedly on the side of her head? How is she to contain her fury at herself for letting him treat her as if of no account, when she needs to count for something if she is to find healing? Must she be assessed like a wall that needs repointing or a screw that's come loose, not as a living person with feelings? What is the human soul but a quivering dancing candle flame, why didn't he treat her as if she possessed a human soul, why has he made her feel so God forsaken?

Alice slumps onto a fallen tree, crying, but she can cry all she likes, no-one will come to comfort her. This is being treated as if she is well when she's not, she's ill, she's on medication. Alice has been made to feel worse not better, but now she must manage her difficulties by herself without support. Alice lights a cigarette and the nicotine hits her, this is being forced into durance vile, into something she hates because it takes such a terrific effort pretending to be well when she's not well, but she has no choice, Claybury hospital will close just the same. If she sits quietly and smokes she will calm down.

There are horse chestnut candles nodding over head and towering over Alice, there is that sweet scents of growing things and every variety of fresh green in the woods on every side. Alice sits on her fallen tree and smokes, seeing the prone trunk has nevertheless sent up vertical shoots that are green and leafy, the tree is a hornbeam, thinks Alice, looking closely at the veined toothed leaves. Life isn't over for this hornbeam although it has reeled and fallen down, it has quietly entered on another stage in the long life of a tree: Alice has figuratively reeled and fallen down during her illness and breakdown, but despite the unhelpful unreality inducing psychiatrist, she is learning to send up leafy shoots. The sky is overcast with eight eighths of high white cloud but these woods are a “pleasant place”, a “locus amoenus” as the terminology of medieval dream vision poems has it. Alice wipes her eyes and nose on the back of her hand, she's no pearl maiden mediating between God and man but coarse little Alice, she can't provide redemptive visions to order though it is quiet and peaceful in these deserted woods. Alice learned about pearl maidens and dream visions at Oxford, now she thinks she is at least still thinking in these wasteland, wayside woods, already sold off to developers. The developers are going to knock down her hospital, her place of safety and asylum, and tear up the green leaves and burn the sappy branches, and dig deep foundation trenches so they can build a luxury gated residential estate. Alice must manage somehow and of course that psychiatrist wouldn't listen or let her say anything real, he didn't want to hear it, knowing her was sending a sick patient to manage by herself as best or badly as she could. He knows the terror and abuse of the community, thinks Alice, he's as appalled as I am by the lies of community care. Involuntarily, Alice smiles, remembering the black humour of a stand up comedian on TV who joked that hospitals would soon be reduced to money in the slot machines dispensing plasters and aspirin, and a sign would be put over the door reading “Why don't you pull yourselves together?” for the psychiatric patients! Alice sees the point of dark humour, better crack macabre jokes than fly into self destructive rage and cut or punch yourself.

Carefully, Alice crushes and extinguishes the crimson ember of her burned out cigarette beneath one booted foot and checks the time. She has a bus to catch so she retraces her steps, taking care not to trample the delicate Lords and Ladies flower spikes underfoot. After Alice has reached the bus stop the woods are silent and empty as before except for birds, the eight eighths glimmering white sky is changeless, all one high flung cloud that is pearly because it is lit from behind by sunshine.