When I started my degree, I had every intention of going back to nursing, once I’d absorbed this stuff called psychology that would make it possible to handle problems sparked by inexplicable aversions to red underwear. I applied for the Diploma in Advanced Nursing which pre-dated the degree and for which a Sister’s post was required. Kings offered me that post, should I get on the course. I also applied for PhD places, encouraged by a seismic shift in the third year when I suddenly ‘got it’ and a post graduate life seemed possible. Chelsea college offered me one of its first Doctoral places for nursing studies; then a raft of other institutions piled in with offers – largely, I think, because they all knew each other and when one was ‘in’, the whole Will.i.am followed suit. I chose UCL and I like to think Elvis Costello’s ‘I don’t Want to Go To Chelsea‘ played no part.
Going down that route was the fork in the road, the one that leads irrevocably towards a life hitherto unanticipated. The smell of ancient journals, the reverence in the air of a library that had fed the kinds of scholars I had only seen in films and who had all been men, the intensely dynamic quiet of ‘the zone’ that meant my head had processed everything I needed in order to write the next chapter. There wasn’t really any going back to a less cerebral way of conducting business. But I am essentially a do-er, a maker. I draw, write, talk, hop about to music, build shelves and flat-pack furniture, and clean up after cats. Cerebral couldn’t just mean intellectual, it had to be applied and clinical psychology had all the boxes; all I needed to do was get in there and tick. Easy.
Easy? The competition – unlike that for the PhD – was visible. Interviewees appeared in herds, each of us armed with sheafs of papers from a who’s who of centres of excellence, and all affecting a facial chimera of intellectual aptitude and warm human cosiness. Those of us who couldn’t manage the mix and got stuck on steely insularity because the wind changed suddenly, found ourselves at the Institute of Psychiatry which wasn’t much fussed about feelings. I had my interview there in one of those chairs with a cushion supported by rubber straps and, due to a certain disdain for practicalities, the straps had perished so that I was slowly folding up – knees to chin and bum to floor – while being interrogated on the relevance of rats to psychosis.
That essential detachment pretty much illustrated the IoP‘s approach to trainees: they had let us through the door, what more did we want? Surely not nurturing? I discovered some things early on in addition to the IoP not really having that much interest in whether we survived or not. The first was that, even with a strong wind behind me, I could just about count myself in the bottom 25% for intellect, my visualisation method for statistics would fall apart when required to account for α, and whatever research I did for my dissertation would have to be accomplished without the benefit of the tape spitting, punch card chewing piece of steampunkery that passed for a computer. A chi square must suffice. The second was that, along with a number of other slightly older, professionally qualified, not-so-glitzy-in-the-centre-of-excellence department co-students, I knew better than those brilliant minds how to relate to actual people.
Naturally, it wasn’t all plain sailing. A man whose intellectual functioning I had been sent to assess threatened to hang himself by the light flex when he got home. My child placement was a lock-up for young offenders who executed a break out while I was in the loo, banging on the door with broken furniture as they charged by. I learned there how important peripheral vision is when only the staff have a key to the unit door and everybody knows you’re the trainee. I discovered that the beep of my new digital watch sounded like an alarm and so feigned surprise when it went off and everyone jumped up, and that another gadget could be triggered by crying – not an asset when watching a video about grief counselling. I never did get the hang of α but my numpty chi square did the job nicely.
Somehow or other, I also ended up on stage with Jo Brand, dressed as a parrot. Jo was Sister in charge of the Emergency clinic at the Maudsley next to which outpatient appointments were held, and in the waiting room in amongst the jittering sufferers of anxieties and phobias, the imploded depressives, and taut as a drum anorexics, were lurkers from Ward 1. From the top of a set of stairs, not entirely unlike the ones on Strictly Come Dancing, we would call out the name of the person whose distresses we had been charged with alleviating and wait for a figure to detach itself from the throng. Mostly, we got the one we expected, although that might not have been reciprocal – they, after all, were expecting to see someone who knew their arse from their elbow. Occasionally though, as a punter made his way across the room, Jo’s voice would thunder an injunction, ‘NOT you, Bill!‘, and ‘Bill’ would shamble back to shove someone out of their seat, trying to bum a fag while they edged away to hover by Jo’s desk.
Jo played Peter Pan in the 1984 Bethlem-Maudsley pantomime which parodied what was then described as the ‘Sainsbury’s’ model of health care – one which counted costs and had us all pricing up everything from medications to bedpan emptyings. We were scathing. We objected. But we lost and, arguably, we’re better for it. Back then, it gave us licence to regress very cleverly, give a few consultants cause to worry about being hauled up on stage, and, for some reason, introduce disparate elements of the show via a dancing troupe of Hot Parrots – all of us psychologists more accustomed to professional reserve than public hoofing but taking to the idea suspiciously quickly.
I had placements on wards where people tore at their stomachs to release the demons or beetles or satanic foetuses they thought were in there. I met a man who showed me intricate and plausible schematics of his invention and told me it was powered by angels’ breath, and another whose psychosis was rooted in a belief that his veterinary research on aerosol vaccination was being stolen by spies from Iraq. I wondered, a couple of years later, whether he still had that diagnosis when the consultants heard that Iraq was developing biological weapons for remote delivery. In a large mental handicap hospital where the entrance was red-carpeted all the way up the sweeping stairs but stank of wee and cabbage beyond, I tried to use a psychometric test with a man who had done more of them than I had. He showed me that having a learning disability did not preclude wit or the capacity to spot a sucker. By the time I was asked by the nursing staff to identify the ward ‘shit flicker’, I was not that sucker – there were four of them so surely one could stand in the middle and the others could track the trajectory of the flying crap. The referral went away.
Fortunately, the institutions were going away too and people who had been incarcerated all their lives were beginning to find new futures in ordinary houses next door to ordinary people in ordinary towns. One of these was Bromley, in Kent. It was close to where I lived so when a post came up there, I applied. I didn’t have the most noble of reasons – for me, this community job meant no more sessions in rooms full of chain smokers, or ward rounds where it was ok for the doctor to get the nurse’s name wrong every week but not for the patient to be unable to recall the anonymous ‘Mr Brown‘ she had been told about earlier as part of a rule of thumb dementia test. I took the post, bought a house, and got a dog.
Ach, wouldn’t you know it? We only got to 1984 today so can you come back later? We should look at what Wolfensberger’s ‘normalisation’ did for people, how services had to leave behind preconceptions of learning disability and accommodate a new landscape of issues. Being a patient is demeaning and the abuse often hidden. Take a look at ‘Skallagrigg‘ by William Horwood, a novel that evokes the smells of deprivation and the spark of hope. I had this in mind stylistically when I wrote ‘Lovely girls‘ but I had the milling desolate people of Darenth Park hospital, the Royal Earlswood, and St Lawrence’s at heart as I tried to shine a light into one dark, not entirely fictional corner. But being emancipated, we discovered, is not always liberating. For many people, private covert institutional oppression was exchanged for debt, exploitation, isolation, loneliness, alcoholism, pregnancy, the family and criminal justice system, and the stress of work in a world that moved too fast. But don’t cover your eyes and ears because there are real joys. Some big and public – like the man whose group won funding from the National Lottery and who made an impromptu speech live on TV – some small and private, such as the woman whose dad told her how proud he was of her when her article was published in Community Care. We’ll do this in a little while so, see you soon?