A Place for Everything

Ten

‘Some A&E departments have a liaison psychiatry team (specialist help for mental health) that you can ask to see. If there isn’t a liaison psychiatry team, A&E staff might contact other local services such as a crisis team (CRHT) to help assess you.’ 10

‘You have to start somewhere,’ as my English teacher used to say.

I start by spending the morning on the phone, trying to find someone who can help. I need advice. I need a professional to take control. It’s all very well saying I must ‘step in’, but what can I do on my own?

I walk up and down the path in the back garden, as much to keep out of Mum’s way as anything. The workmen are back. They watch me pacing outside. They watch Mum pacing inside. What must they be thinking?

When I finally get through the various switchboards, I am always put on hold. After holding I am immediately passed on to someone else who puts me on hold. I hold and I count. I count the red bricks beneath my feet. I count the tiles on the roof. I count and I walk and I talk and I listen.

I have had a habit of counting things for as long as I can remember. Lamp posts between my house and my best friend’s down the road. Flowers on the curtains in my room. Tiles in the shower. Telegraph poles on the way to school. I count to distract myself; to calm myself. It’s not working today. No one wants to be the one to offer help. With each call, feelings of panic increase. With each call I feel myself slipping further and further away from the shore. No one can help us. We are going to be left to drown.

‘You’ve called the Tunbridge Wells number. You’re in Tonbridge – you’re under Sevenoaks, so you should call them.’

‘Your mother’s nearly seventy, in which case she’ll be classed as a geriatric case. You’ll need a different number.’

‘You can’t request a psychiatric assessment without a GP referral.’

I try butting in. I try making our case. I try to sound reasonable.

‘She’s seen a psychiatrist. She’s had an assessment. That isn’t what I’m asking for. I’m asking for help. Right now. She’s raving!’

I repeat myself. Over and over.

No one is listening.

No one wants to help.

I am passed on and on and on.

I drift further and further out to sea.

Even when I say, ‘This is an emergency!’ The answer I receive is, ‘I suggest you call 111.’

I do – and I’m given another list of numbers to try, some of which I’ve already called. I call the rest, 1 by 1 by 1.

Same thing.

Over and over.

I am passed on again

and again

and again.

‘Your mother must be referred through her GP.’

‘She has seen a GP. She can’t wait weeks for a referral!’ I decide to ramp things up. ‘Mum is psychotic – she’s seeing things that aren’t there. She’s talking nonsense and making whooping noises and pacing like a mad woman.’ Actually, that is not ramping things up. That is the truth.

‘Would you say that she is a danger to herself or others?’

‘No, but—’

So much for the truth. It doesn’t get you anywhere.

‘I can only advise that you go back to the GP.’

Dead end. Back to the beginning. Square one.

I am going to have to exaggerate if I am ever going to get us out of this labyrinth.

When the next call is answered, I take a deep breath and blurt out the most shocking thing I can think about Mum’s current state of mind.

‘I am worried that my mother is going to do something stupid. She has already burnt her hands with caustic soda.’

A gasp. At last – a reaction. ‘That’s awful. I’m sorry. Let me take your details and I’ll get someone to call you back as soon as possible.’

Call me back? I can feel a scream building. I can feel the urge to punch, to kick, to shout and swear. I can see now why Dad howled down the phone at me. It’s tempting to hurl my mobile at the path. But then ‘someone’ would have no way of calling me back as soon as possible.

Why do I do as I’m told?

Why do I answer questions truthfully and wait and listen and hold and nod and do as I’m told?

Why don’t I bundle Mum into the car and drive her to A&E and shout, ‘Somebody do something! My mother’s a lunatic!’?

Because that’s not what we do in this family. We listen to the professionals. If the doctors are busy, you don’t disturb them. If they tell you to wait, you do. I’ve been brought up not to bother doctors with trivial things and certainly not to go to A&E unless I have broken something or it is a life-or-death situation. Even in the turmoil of the past thirty-six hours, even as Mum jibbers beside me, I cannot, in all honesty, say that this is a life-or-death situation. Rules are rules. A place for everything.

I clutch my phone like a talisman. Now I am the one pacing. I’m not whooping, but I’m not breathing properly either. I’m holding my breath while I wait for calls from the mental health services, from the geriatric mental health team, from Mum’s GP. It can take a while. Don’t hold your breath!

It is afternoon before Mum’s GP calls back. Dad and I have spent the hours following Mum around to make sure she doesn’t do anything dangerous. We are exhausted, so when the call comes I almost sob with relief, thinking, ‘Now. At last. The cavalry.’

But no.

‘I’m afraid there’s nothing I can do right now,’ the GP says.

I can hear the weariness in her voice as she explains how hard it is to get an older patient assessed for psychiatric care.

‘It’s particularly difficult in your mother’s case as the psychiatrist she has been seeing appears to have officially signed her off since yesterday,’ she explains. ‘He says there is nothing more he can do for her.’

Anger roars through my chest. That man! I have to grit my teeth and swallow to stop myself from shouting, Signed her off? How can he do that? Does Dad know?

Mum’s words in February come back to me. He says I will probably always be miserable.

The bastard. He’s given up.

The only consolation is that the GP now sounds as angry as I feel.

‘I’m sorry,’ she says. ‘If all else fails, you’ll have to take your mum to A&E. That’s the only way to get her assessed quickly. Otherwise it could take months.’

Months!

‘She needs a full medical screening to rule out the possibility of her having an infection, which might have precipitated this episode—’ I make an incredulous noise but the doctor raises her voice to finish what she has to say. ‘I know it’s probably not the case with your mother, but some elderly people become delusional as a side-effect of a urinary tract infection.’

A fucking what? Nonononono. Mum does not have an infection. She is insane. This has been building for months and months, possibly years!

The thing is, even in the state I’m in, I know there’s no point in saying this. This GP knows Mum. She knows what’s wrong. She is the one who has counselled alternative therapies, relaxation techniques, CBT. None of this current situation has come as a surprise. It was a nightmare waiting to happen.

So I don’t shout. I don’t protest. I thank the GP and put the phone down. I tell Dad what to do and he tells Mum.

Any scrap of resistance that Dad had left has vanished. He has accepted it now: Mum needs urgent help. Damn it, he needs urgent help.

‘Come on, Gilly,’ he says. His face is drawn, determined, grim.

He bundles Mum into the car. ‘No,’ she says, her voice dangerously high, as though she might scream. ‘No, I don’t want to go.’

She holds on to the car, so that we have to prise her fingers away. We all but push her in. It’s like putting one of my cats into the travel basket before going to the vet. I half expect her to snarl and spit and lash out. I hope to God no one passes by and sees this. It must look like kidnap. Or abuse. Thank goodness the workmen have gone.

She collapses into the seat and I reach across and strap her in while Dad starts up the engine. I rush around and get in the other side and Dad starts driving before Mum can try to get out.

Dad pulls out of the drive onto the road. Mum whoops, holds her breath, gasps, says over and over that she doesn’t want to go. Dad ignores her. I ignore her. I stare out of the window at the park opposite our house where only a year ago Mum came for a walk with me and the children. I used to have tennis lessons in the corner of that park. Every Saturday with three of my friends. Mum used to play there too with her friends. I have a sudden image of her in pristine tennis whites, her long legs smooth and brown in an impossibly short skirt. She was very beautiful as a young woman. I wanted to look like her. Glamorous. Slim. Stunning.

I can’t look at her now. I’ll cry if I do. I reach out and hold her arm as she puffs and gasps and writhes in the seat. I meant the gesture to be calming, but it feels more as though I am restraining her.

Restraints.

Straitjackets.

Electric shock therapy.

What are we taking Mum to? Are we doing the right thing? What else can we do?

I can’t think. I can only act. I must focus on Mum. On getting her out of the car and into the waiting room at the hospital.

Dad pulls in to the car park. He drops me and Mum at the entrance to A&E before going to find a space.

‘I’ll join you inside,’ he says.

We both know Mum would never make it across the car park into the building without causing a huge scene. Better – for her or for us? – to bundle her in, just as we bundled her out of the house.

I hold on to Mum as we go inside. In case she slips from my grasp and skitters off. Like a cat. We wait in the lobby. I can’t go up to the desk without Dad. I can’t do this without Dad.

Mum is trotting on the spot again. ‘I don’t want to be here. I want to go home. I don’t want to be in hospital. Let me go home.’ She is very distressed now.

My stomach and chest are squeezed tight. A small part of my brain is saying, ‘What am I doing to her? Poor Mum, poor Mum, poor Mum.’ The rest of me is desperate to hand her over to someone who knows what to do with her.

Dad walks in. I can tell by his face that he has shut down. He’s not looking at me and he’s not speaking. I am coaxing, keeping my voice low, crooning almost.

‘It’s all right, Mum.’

Empty words. But I have to say something to reassure her, even if in truth I am as frightened as she is. Dad goes to the desk to explain why we are here while I take Mum to sit down. She sits for a second, then shoots up as though scalded, sits down again, whoops, stands up, lurches towards the door. I’m aware of people around us, convinced they are staring at her. At me. What do they see? A grim, badly dressed woman, her hair scraped severely from her face, holding on to an older woman and forcing her to sit. It looks bad, I know it does. Oh, let them think what the hell they like; I have to fix my attention on Mum. Her face is pale and sweaty. Her forehead is crumpled with anxiety, her eyes wide, her mouth pulled down.

I want to hold her – not to restrain her, to hug her. I want to cuddle her, to smooth her hair.

I want her to shut up too.

Once, when my daughter Lucy was small, she had an asthma attack that drained her face of colour and squeezed the air from her lungs. It was just before Christmas. It was a dark, dank evening. The moisture in the air made it harder for Lucy to breathe. She was too weak to protest when I scooped her up and put her in the car. I drove fifteen miles to our nearest A&E, strapped her in to the buggy and told her even smaller brother to hold tight to the buggy board behind her. I ran with them from the car park through air white with fog. A Salvation Army brass band was playing Christmas carols. The warmth of brass tones from trombones, trumpets and tubas washed over me, soothed me; carried me and my children through the doors and on to the ward. A&E was welcoming and the nurses were kind. We were seen quickly. I felt cared for and reassured.

This time there is no comforting music; there is no calming movie soundtrack to this drama.

We sit on plastic chairs as the waiting area fills with more and more people. Dad goes to buy sandwiches. I realise we haven’t eaten since the porridge he made at breakfast. I didn’t eat that. I’m not hungry. I have a sharp pain in my stomach. I’m thirsty, though. So thirsty. But Mum is very agitated, so I can’t leave her. I hope Dad gets some water.

‘Martin? Where’s Martin? Where’s he gone?’ Mum shouts, looking around wildly.

‘He’s gone for sandwiches.’

‘Martin!’

Dad comes back. He looks so tired I could cry. He hands Mum a sandwich, murmuring softly. She rips the sandwich from the packet and bolts it so fast I’m afraid she’ll be sick. I feel too sick to take one bite.

We sit.

We say nothing.

We wait.

Mum whoops and gets up and down and up and down.

Where has my real mum gone? Where is the woman who cared for me when I was sick, who sat by me and sang ‘Golden slumbers kiss your eyes’ when I was feverish and tearful? Where is the strong, opinionated woman whose bright-green eyes flashed with passion when discussing politics and history? Where is the mother who mopped up grazed knees and sewed on loose buttons and cuddled me?

She has gone. And, right now, I feel as though she will never come back.

Eleven

‘A person with Asperger’s syndrome “starts to suffer if they encounter unexpected change”.’ 11

Eventually, two women come to find us.

‘We’re going to take your mother for a screening,’ the first woman says. I glance at her blue uniform. I think she’s a nurse. It’s hard to tell. There are so many different coloured uniforms coming and going through this place. Blue, white, purple, red. ‘We need to make sure she hasn’t got an infection,’ she’s saying. ‘Could you and your father follow my colleague, please?’ She gestures to the second woman, who’s wearing a white blouse and black trousers.

‘I’m a mental health nurse,’ the second woman says. ‘You’ll need to give me Mum’s medical history. Then we’ll go from there.’

Both women speak in a tone that is kind but brisk. Well rehearsed.

Dad and I ask no questions. We nod. We get up to follow. We do as we are told.

Mum is less compliant as she goes for her screening. She calls out, ‘Martin! Martin, don’t leave me! Martin! I need you, Martin!’

Dad and I turn away, heads bowed. We follow the mental health nurse as she leads us down a corridor and into a white room.

The nurse picks up a clipboard from the table next to her. ‘Please.’ She gestures to the chairs in front of her. ‘Take a seat.’ She doesn’t smile. She settles herself and pulls a blue Bic out of a slot in the side of the clipboard. ‘This will take some time,’ she says, ‘but don’t worry. Gillian will be fine. She will be seen by a psychiatrist after the tests have been done. I’ll take you to her when we’ve finished.’

I don’t ask what tests Mum will have. I’m numb, waiting to be told what to do. Other people are in charge now.

The mental health nurse starts a long list of questions, most of which seem perfunctory and have very little to do with Mum’s mental health. After asking a few things about how Mum is behaving, she goes on to ask when she last saw her GP, whether she has any allergies, whether she has had any problems passing urine, whether she smokes or drinks, what her living arrangements are, whether she has had any operations, whether there is any history of medical problems in her family …

I keep waiting for the important questions. I don’t know what they will be, but I know I’ll know them when I hear them. They will be the questions that will unlock the secret room: the one full of answers, full of diagnoses and relief and solutions. They will be the questions that will lead to fixing Mum. Because isn’t that why we’re here? To get my broken mum fixed?

Apparently not. The nurse continues to ask banal, pointless things. What does Mum eat? How does she sleep? Any recent physical ailments? The woman’s quiet voice and her calm manner seem to act on Dad like a sedative. His responses are low, slow and deliberate. He stares at a point on the floor in front of him as he speaks. He answers each question as though he’s taking an exam. As though it’s essential that he choose his words carefully in order to give the correct answer and score the highest possible marks. He goes into great detail about what Mum has eaten recently and about how she can’t take penicillin.

She doesn’t need bloody antibiotics! She needs … she needs … I don’t know what she needs! That’s why we’re here!

I don’t feel we’re getting any closer to the point. I should say something, butt in. But Dad is talking. He is the husband, and I am the daughter and I mustn’t. Mustn’t interrupt.

This room is too small. There is not enough air in it. My breath comes in short bursts, my stomach hurts so much, I’m still very thirsty, I have a headache. I want to stop this woman. There should be a sense of urgency, surely? Doctors running, stethoscopes, beeping noises, syringes. Watch out, everyone! There’s a mad woman on the loose!

The dreary questions go on and on and on, as though we have all the time in the world. I grip the sides of my chair to stop myself from jumping up and shouting, ‘I don’t care about what she had for breakfast and nor should you! She is mad! SHE’S BONKERS!’

Dad continues to give long and involved answers. He has adopted his serious lawyer voice and is using complicated words to say simple things. This is what he does when he’s embarrassed or stressed. He once came to my school to give a talk about his job. He was nervous and hid his nerves behind a speech that was so complicated, friends told me afterwards that they hadn’t been able to understand a word. He’s doing the same now.

‘Gillian has been more than a little obdurate of late … she has not been very compliant with the medical advice we have sought …’

The nurse listens patiently, makes notes. Nods, murmurs to show she understands. Asks questions, questions, questions.

I am a coiled spring. I don’t know how much longer I can contain myself.

Then the nurse seems suddenly to change tack. She says, ‘So, it would seem that for years your wife has been showing patterns of behaviour that could be seen by some to be odd or even disturbing?’

No kidding! This is more like it.

‘Oh. Do you think?’ Dad seems astonished. As though he has never thought about Mum in this way before. In spite of everything John has said recently. In spite of everything Carrie and I have said in recent months. In spite of what has happened since I came down yesterday. In spite of him howling like a wounded dog.

He is silent. He looks paler. Frightened, even. He begins to speak, and the more he talks about what his life’s been like with Mum since his retirement, the more he gathers momentum. The scales have begun to fall. He talks about how she won’t go anywhere without him and how she didn’t like him to go out alone.

‘She just didn’t like me doing things without her,’ he says. ‘She needed me with her all the time. It was exhausting.’

I bite my lip. I swallow and blink as tears threaten to spill. Dad had told me this, more than once. He had tried, I realise, to tell me how hard it was for him, looking after Mum 24/7. And what had I done about that? What had I done to help him? Nothing.

Nothing.

I had been too wrapped up in how Mum’s increasingly controlling and anxious behaviour was affecting me. I had wanted Dad to step in and sort things out for me. I hadn’t allowed myself to think about how bad things were getting for him.

Two summers ago I had bought tickets for Dad and me to participate in a Big Sing at the Royal Albert Hall in London. A rare attempt at spending some time alone with Dad, without Mum at his elbow, haranguing me for not coming to see them more often. During a break in rehearsals we had gone to sit in the park opposite, near the memorial. We had been laughing and joking as we always did. Then, out of the blue – or that’s how it seemed to me – Dad’s face had crumpled; he had drawn his hand down over his eyes and said, ‘She does nag me, you know. I don’t know how much more of it I can take.’

How did I react? I know I was shocked. Embarrassed, probably. Struck dumb, at any rate. Dad never had anything negative to say about Mum. He would become defensive if anyone ever dared to point out that Mum’s behaviour had been difficult or inappropriate. So where had this blurted confession come from? I was inadequate, brushing the comment away, as I would later accuse him of doing to me. Only now, now that things have reached crisis point, am I beginning to see just how much has been swept under our living room carpet. The elephant in the room, contained, caged. Out of the way, hidden from view, neat and tidy, like the linen on the shelves in the airing cupboard.

The nurse nods and writes. Nods and writes. She moves on to questions about Mum’s levels of anxiety in childhood.

‘Was she an anxious child?’

Dad hesitates. This is my chance. I jump straight in before I can stop to think whether I should or not. I recount the family anecdotes that have been passed down from Grandma and John about Mum’s social anxiety, about her extreme stress over academic work, about huge crises of self-doubt, self-loathing.