Two things saved me from my private Chernobyl. The first was the support from my long-suffering physio, friends and loved ones, and the second was the gift of a book from a lovely lady who I used to take for personal fitness in the gym. I’ve already spoken at length about Mary my physiotherapist and the effort she put into maintaining what at times was a difficult and testing therapeutic relationship, so let’s talk about my friends.

Based on the outskirts of a small Dorset market town the military camp generally enjoyed a good rapport with the locals. Many of us had bought houses in the town and I was fortunate enough to count many of the bikers and their friends as good friends.  Three weeks into my stay at the Twilight Home for Broken Soldiers and feeling particularly demotivated Johnny turned up. With his large, broad shouldered frame and thick muscular neck Johnny looked more like a bear than a bloke. Dressed in his customary dirty jeans, oil-stained cowboy boots, well worn black leather jacket and sporting a huge gingery beard and a mop of colour coordinated unruly hair forced into a reluctant ponytail by a couple of red post office rubber bands, Johnny looked every inch the biker he was. ‘Hello mate, how you doing’ he said in a deep baritone voice with pleasant cockney overtones. Pleased to see him I braced myself for my now well practiced move using what I called the monkey bars above my head and shuffled my sorry ass back up the bed so I was sat up. ‘Been better dude’ came my less than enthusiastic, slightly out of breath reply. Not known for his subtlety he glanced down at the metal frame at the base of my bed and came straight to the point ‘Mind if I have look?’ ‘Be my guest’ I replied and pulled back the bedsheets to reveal Joseph’s technicolour ankles.

Johnny was an enigmatic, charismatic guy who lived and breathed bikes and all that came with them. He worked hard and partied even harder. An ex hells angel he’d done time in a few prisons but had moved his life on and now had his own business building and repairing custom bikes. We first met when I took my Harley in to his garage for a minor niggling fault and we’d quickly become unlikely friends through our mutual love of custom bikes. A man of few obvious emotions he took a long, hard look at my swollen, freshly scarred and angry looking ankles and sucked his breath in. ‘What’s the score?’ he said quietly. I looked up at him internally debating which bullshit answer I should give him when I noticed the thoughtful, concerned look on his face. ‘This is one of your good friends’ my inner voice chirped ‘at least have the balls to be honest with him’. ‘It’s not good news at the moment’ I tentatively said in a hatefully small voice with my eyes reluctantly close to bitter tears. The depression I was sinking into must have been etched on my face for everyone to see bar me as he came and sat his big frame on the rickety, sun bleached blue plastic vinyl chair by my bed. Without a word he rolled up the left leg of his torn and faded Levi’s to reveal a network of twisted, pale red scars running down from his knee to below the rim of his dusty boots. ‘I don’t normally show anyone these Willie but I think you needed to see them’. Rolling his jeans leg back down he went on to tell me about a bike accident where a car had pulled out from a side road and hit him from the left. Initially told he would lose his leg as it was badly damaged he refused to let them amputate it.  As good with words as he was with bikes, he spoke with passion of the long pain filled hours that slowly drifted into weeks and interminable months on a ward similar to mine. His story, how he felt and the fear he experienced mimicked my own to the point of symmetry and left me asking him how he’d coped with it all. After a long pause he replied ‘Good mates – they might have been hells angels, but they were and still are good mates’. He paused again ‘I also believed in myself, believed I could get through this and come out the other side a stronger person for it – and here I am, Johnny two legs’. His big grin was infectious and I felt my spirits rise as he and I chatted and swopped stories that will never reach my blog!

Other friends came and went over the next few days as the word went around the town and camp. Some of them brought thoughtful gifts like a skateboard, big fluffy pink slippers and two pairs of incontinence pants for those caught short moments on the bed, whilst others brought words of support and laughter. It must have looked an odd mix at times. Big hairy outlaw bikers and army physical training instructors sat around and on the bed occasionally bursting into peals of raucous laughter at some dirty joke or story. I got a lot from those visits. They were both cathartic and catalytic and gave me hope I would get through this experience in a meaningful way.

That sense of hope was an ethereal thing at times. Like early morning mist on a lake it had a tendency to melt silently away in moments of great pain or in the wee small hours when sleep had escaped me once again. A visit from another friend came to my rescue and provided me with a more tangible reminder that a life still waited for me outside like a lover patiently stood in anticipation of my arrival.

Maria was a regular at the gym I worked in. A slim, lithe forty something lady with raven dark shoulder length hair and grey-green eyes who I first met as I took a class of ladies keep fit. Well known for working people hard in my fitness sessions I had around twenty five or so regulars who came from the camp and town for both the workout and the social aspect of the classes. Reluctantly (not) agreeing to go for a drink with some of them after one evening’s fairly robust ‘beasting’ as it’s fondly called in the military I got talking to Maria who’d only started a week earlier. Intrigued by her we spent most of the evening chatting about a wide-range of topics. She was knowledgeable, funny and, despite being twice my age, I found myself attracted to her. We quickly became good friends and worked out, ran and cycled together as often as she could fit it into her busy life. Less than two months later I was lying on my hospital bed once again staring out of the window at the distant view of the local park. The hiatus between lunch and the arrival of the mid-afternoon brown soup known as tea was always the most difficult period of time for me – that’s if you don’t include three in the morning and having to listen to the stentorian snoring of the bloke next to me. Medication wasn’t due for another three hours and my fragile mood seemed to take a definite circadian dip just after one o’clock. I saw Maria from a distance as she walked through the main ward doors and up through the ward. I say walk, it was more of a graceful, sensual salsa or rumba as she effortlessly moved towards me with a smile on her face. ‘Hello you’ she beamed as she leant forwards to give me a big hug. The smell of Dior’s Poison wafted over me in a wave of rich, evocative competing scents that enveloped me in a cocoon of sybaritic fragrance. After what seemed like minutes of much needed tactile contact I reluctantly let her go as she sat on the edge of the bed and asked me how I was doing. ‘Do you want the abridged or full version?’ I asked her as my ankles began their afternoon whine for morphine. ‘I’ve got all afternoon so tell me everything’ she replied with her Mona Lisa smile hovering on her lips. Half an hour and a few mugs of tears later I’d told her everything; how I felt stuck in here, my fears for the future and the possibility of life in a wheelchair. I left nothing out as I tentatively began to let go of an ego more swollen than my ankles. It wasn’t until I’d finished I realised her hand had been gripping mine the whole time as I emptied out my cup of woe to reveal the dregs of my despair. For a long moment she just sat there as she thought about all I’d just dumped on her. ‘Less than a year’ came her obscure reply. ‘What do mean?’ I asked in a puzzled, pain ridden and weary voice. ‘I’ll bet you a fiver you are climbing again in less than a year’ came her confident, calm reply. ‘Might as well give you the money now then’ I replied in a petulant voice. She smiled a knowing smile ‘You just need to find your self-belief again. Whatever’s driven you in the past to do some of the things you’ve done hasn’t gone anywhere. You’re just disconnected from it which, given the circumstances, isn’t too difficult to understand is it?’ Maria glanced at her watch and I realised she’d been here for over an hour and must have other things to do. She stood up with her enigmatic smile appearing again on her face and said ‘I’m going to have to go but here’s something for you to read when you are feeling up to it. It’s worked for me, and now it’s time someone else had it’ and with that she handed over a slightly worn paperback. Putting the book to one side I gave her another lingering perfumed embrace and whispered ‘Thanks Maria, I’m really glad you came over’.  Still smiling she nodded and pointed at the book ‘Read it, there’ll be a test on it next week when I visit you again’. Watching her leave with a mixture of relief that she was coming back and regret that she had to leave I turned to the book lying by my side half covered by the pale green NHS blanket I held partly responsible for many of my night sweats. Picking it up I could smell the faint lingering scent Maria had been wearing on it’s lightly thumbed pages. Somewhat guiltily I looked around the ward before sticking it under my nose and inhaling the heady waft of perfume deeply as if to burn a memory of it into my psyche. In a similar way to when I smell a bar of Fairy kitchen soap and I’m transported back to my gran’s dimly lit, spartan kitchen in Kendal, to this day I can’t smell that particular perfume without being whisked away to the ward and my times with Maria.

My guilty pleasure over I looked at the book and read the title ‘The Road Less Travelled’ by M. Scott Peck MD. Intrigued I read the preface and how the book blended the psychology of self-discipline, personal responsibility, honesty and a balanced life with a search for one’s spirituality. For the first time in three weeks my ankles seemed to throb less as I disappeared into the book like a bear lumbering back to it’s cave ready for hibernation. I had found a book with which I resonated. It suggested personal salvation was possible but was in my hands alone. It spoke to me and me only as it described a cycle of self-deception and ego-driven self gratification at the expense of others in our lives. He described me as if he’d visited the ward instead of Maria and concluded the first chapter by asserting that life was a difficult battlefield of problems which we either got on and dealt with or we forever capitulated to and remained in stasis bemoaning our fate. Almost startled by the clarity of his thinking I put the book down to realise two hours had passed by and it was nearly time for dinner. My head buzzing I barely remember eating with one hand as I tried to read with the other. I read that book from cover to cover in three days and then went back to re-read it on countless occasions during my stay. It became my bible, my Quran and provided me with the beginnings of a stable platform which I felt able to relaunch my life from.

‘We’re here mate’ the driver called startling me out of my reverie. I looked out of the window to see my very first house nestled up against the other brown brick one and two bedders that formed a tight three quarters circle abutting a small green. Hope and fear at returning home and leaving the ward environment surged in my mind like two greyhounds trying to out race each other. The back door of the ambulance opened and I felt the warmth of the sun spread through the thin fabric back of my wheelchair and into my suddenly cold bones. A quick ride on the ramp later and I was slowly wheeled to my front door where my shaking hand did it’s best to foil my attempt at getting the key into the lock. Cursing to myself I berated my insolent digits and forced my hand to work properly. The resulting clunk of the lock allowed me to push the door open and I was pushed over the doorstop into my home. Thankfully I’d given a spare key to a friend from the gym and the mountain of accrued mail had been neatly stacked in one corner balefully waiting for me.

The driver came back with what few possessions I’d ended up with in hospital and with a wry grin produced the Zimmer. ‘Any chance you could ”forget” that and leave it in the ambulance mate?’ I halfheartedly asked. His grin widened by a metre. ‘Mary would make my life a living hell. She expressly mentioned you needed it. A community physio will be out tomorrow but you can use the zimmer to do some minor weight-bearing until she arrives’. With that he said his goodbyes and closed the door behind him leaving me on my own. I was home…

“You only live twice:
Once when you’re born
And once when you look death in the face.”

Ian Fleming – You Only Live Twice

Prior to leaving the ward I’d successfully argued to just about anyone who wouldn’t listen I should be given a chance to trial out a new technique involving fibreglass casts. The word ‘Argued’ probably doesn’t quite cover my daily diatribe that I didn’t want to be sat a moment longer than was necessary in a ward full of mainly elderly civilians, none of whom understood why I was either permanently pumping weights in bed, or trying to do situps without my ankles falling out of their stirrups. My by now exasperated physiotherapist finally capitulated, shaking her head in a knowing way she’d never had before I arrived and told me it was far too early but she would ‘see what I can do’. An hour later a consultant I’d never seen before arrived, lifted up the bottom of my sheet without even a ‘May I?’ and took a long studious look lasting all of two seconds at my still rainbow-coloured ankles sat in their backslabs. An eyebrow raise and two purses of his lips later he thrust a form at me absolving him, and anyone else you cared to mention of any repercussions should my impatience lead to tears before bedtime. Before I knew it I was being wheeled into the plastering room to meet Bob the plasterer. Bob was one of life’s characters you instantly warmed to – if you were a fan of Zombie movies that is. At around six feet and some spare inches, and not weighing much more than a couple of bags of crisps Bob already looked like he was halfway to being one of the undead. My dad would have taken one look and conspiratorially whispered he’d seen more meat on a butcher’s pen to me under his breath. Pale, sweaty skin with feverish, bruised looking dark circles under staring, slightly bloodshot eyes and gaunt, hollow cheekbones completed his transition from the living to a Michael Jackson extra in Thriller. Don’t get me wrong. I’m not being unkind about some guy with a horrible wasting illness. There was nothing physically wrong with Bob according to everyone I asked afterwards. He’d looked exactly the same when he arrived eleven years ago and hadn’t changed a jot. Putting his occasionally disconcerting looks to one side he was actually a top bloke. Quietly spoken, very adept at his craft and extremely knowledgeable about all things orthopaedic he spent a lot of time talking to me about the risks and benefits of casts made from a material similar to fibreglass. Finding myself idly thinking it was probably time for him to start moonwalking with his arms outstretched towards me I forced myself to refocus and concentrate on the simple, but irrevocable fact getting the casts reduced my stay at the palace of screams that was the orthopaedic ward by over a month. Grotesquely tired from weeks of broken nights, moaning patients, ongoing pain and coming off some of the happy pills I was convinced both my mental and physical health were retreating not recuperating. Half an hour later I was the proud recipient of two incredibly strong resin casts designed to let me partly weight bear and stand for short periods of time. Knowing I was finally leaving the ward the next day I spent my last night drifting in and out of fragmented sleep that now consisted of the often shown repeats of my fall from grace. Occasionally jolted awake by the groans of people in pain, or noisy nurses laughing at some shared dirty joke, dawn’s early light filtering through the blinds found me wearily upbeat and keen to get back to my home. With barely disguised relief on both sides I said goodbye to the nursing team as the porter arrived with the world’s oldest partly working wheelchair and I was squeakily trundled down the long grey corridor that led to the creaking escalators. Next floor freedom please.

Left waiting for transport at the exit in my bath chair by a porter who had an urgent call from his mate to ‘pick up a patient’ ready for the 1345 hrs flat race at Chepstow, I found myself looking down with a mixture of pride and trepidation at my newly acquired, rock solid fibreglass casts Bob had expertly constructed. Built into the base of them was a purpose made heel and score marks to replicate some kind of grip ready for the one small step I was uber determined to take for mankind. Tearing my admiring gaze away from my two tickets out of here I began to notice the stares from the people now towering above me. Glaring back in my best ‘What the f*ck are you looking at’ stare it dawned on me I was entering new, personally painful territory with my now very public disability.  Welcome to Wheelchair World went through my head as yet another individual gave me an undisguised look of morbid curiosity not dissimilar to rubberneckers looking for their gore-fix as they passed a car accident. They were looks I would come to loathe over the coming months. Still struggling with how bright, busy and frenetic life was on the outside I suddenly felt the first faint fingers of anxiety caress the back of my neck. Colours seemed to intensify and merge into a blurred kaleidoscope of garish tones whilst sounds became distorted and strangely amplified. The sudden thumping of my heart in my ears and the feeling of rushing blood to my temples created a wave of nausea along which my stomach began to reluctantly surf. Although I didn’t know it I was having my first panic attack. Overcome by the transition from the insular, predictable and now familiar confines of the ward to this wide open space with its maelstrom of movement and noise, and struggling to control my racing pulse, I closed my eyes to the overwhelming visual onslaught whilst tremulously reaching for my Walkman headphones and quickly putting them on – I’ll explain what a Walkman is to anyone younger than thirty another day, or you can Wiki it. As the stimulus from the outside world receded so did my feelings of panic and I began to calm down to the point where my hammering pulse returned to something closer to normal. Shaken by what I’d just experienced I started to question my decision to leave the safety of the ward for the madness I’d briefly, but keenly felt.

With the Pet Shop Boys warbling away in my ears and my eyes closed I was oblivious to my physio as she stood in front of me for however long. Gradually I became aware of her presence and took the headphones off. ‘You okay?’ she said trying not to look concerned. ‘Yeah’ I blagged, still pale faced and sweaty but desperately trying to maintain the hard man image I’d cultivated on the ward, ‘just need to get home that’s all’. Her thin, all knowing smile told me I lied like a cheap watch from the local market. ‘Okay, transport is just coming for you, and you’ll need this’ she said with a subtle hint of satisfaction in her broad dorset accent. Looking past her slim frame I noticed a shiny steel and chrome semi-circle shaped frame with four legs and two rubber grips at the top where I suspected your hands went. ‘What the fu…’ I started to say but stopped in time as I gawped at this odd metre high contraption. ‘This is a Zimmer frame Paul, you are going to need it for at least the next two months to help you get your balance again, strengthen your ankles and to help you get around the house’. ‘I know what it is, but that’s for old people not blokes like me’ I retorted in a voice two octaves from whining. Her now firm voice said ‘You don’t have a choice. If you want to walk again, this is your best chance. Forget how it looks to all of your hard mates, if you don’t want to be in that wheelchair for the rest of your life then start to use it’. As if on cue the transport arrived and any further discussion around telling her what to do with it was neatly negated as I was pushed into the back followed by the frame. ‘Bye Paul, take care and look after the Zimmer won’t you’ came her final words to me through the windows of the ambulance. Quickly glancing up with my now default sarcastic reply primed on the tip of my tongue I saw the faint shadow of a kind smile on her face and realised that once again, much as she’d had for the last three torrid months of my tantrums, self-indulgence and impatience, she still had my best interests at heart. I realised with a sick feeling of internal loathing I had, without knowing it until now, been given a twelve week masterclass in tolerance, restraint and professional commitment I would never know the like of again. ’You ungrateful, selfish b*stard’ my inner voice thoughtfully shouted out to me as I experienced what I can only describe as an epiphany of self-realisation which laid my soul bare and shone it’s honest light into the dark shadows of my egocentric, self-absorbed self. Unpleasant as it was to acknowledge just how damaged I was it was still a watershed moment of transformation I’ve not forgotten to this day.  ’Thanks for everything’ came my choked reply as I turned away before she could see the raw emotion in my face. We slowly pulled away as the bitter tears started to overflow from my brimming eyes and I began the next stage of my arduous journey to physical, spiritual and personal recovery…

“There is a saying in Tibetan, ‘Tragedy should be utilized as a source of strength.’ No matter what sort of difficulties or how painful the experience is, if we lose our hope that’s the real disaster”

HH The Fourteenth Dalai Lama

I became a mental health nurse after leaving the army for lots of reasons, although to this day I’m still not privy to all of them. Some of it was my stuff – stories for another day – and some of it was wanting to help solve the problems many of my comrades experienced, but seemed to get little help with. After much deliberation, at the tender age of thirty four and with only four distinctly average O levels to my name I began an A level in Sociology at night school. A year later I was accepted on to a Bachelor of Science in Mental Health Nursing at Bournemouth university. Having undertaken my own version of the Twelve Step program for my triple addictions to chaos, mayhem and adrenaline I maintained my focus on academia and stayed in recovery for the three years of the degree – other than a brief spectacular fall from one of the children’s skateboards as I tried to be a cool fourteen year old. After completing what I can only describe as the most poorly organised and laissez faire course I’d ever done I went on to work in mental health rehab but, like all addicts, relapse was never far away. Thoroughly bored and experiencing all the old cravings for excitement, danger and risk I applied for a newly created post in an Assertive Outreach Team, or AOT. AOT’s were an American concept designed to work with the most unwell, chaotic, and poorly engaged clients standard mental health teams were unable to cope with. Flexible, discrete multidisciplinary teams with low caseload to practitioner ratio’s and working in a very different way, AOT’s were proclaimed as the cutting edge treatment for a small, but extremely troubled group of people – usually with a history of accompanying drug and/or alcohol misuse, and a high risk of hurting themselves or other people. Looking through the job spec most of the pages of text magically disappeared to leave just the words ‘High risk’. My relapse was complete when I got a phone call saying I’d landed the job and several weeks later I handed in my resignation with undisguised relief on my face and joined the AOT.

I first met Alan six months into my new role. To be honest it was less of a meeting and more of a glimpse; a brief view of a forty something shaggy haired, shambling giant through a dirty, flyblown and torn net curtain that only partially stopped me looking through a grimy, rain streaked window into his small, chaotic flat. This was as far as I got on my first two visits as I tried to make contact with him following a referral from the Community Mental Health Team (CMHT) who, try as they might, had not seen him since he’d been discharged from psychiatric hospital two months earlier. Having been hired for my tenacity I visited his flat again later in the week, and as luck would have it caught him returning from the local shop with a pint of milk and a packet of value digestives in his hand. ‘Hi Alan’ I quickly called out before he could get the key into the scratched and weathered bronze keyhole of his faded black, battered and paint blistered front door. Startled he looked up at me his pale blue eyes, framed by black, slightly awry glasses, lit up with suspicion and fear before he turned away without a word. Fearing I was going to miss the opportunity to speak with him I walked quickly in his direction and said ‘I’m a nurse Alan, I’ve come to see how you are and if there’s anything you need’. I couldn’t honestly blame him for the look on his face that said ‘Bollocks, who are you kidding’ as I realised my sentence had just come from a guy with a permanent thousand yard stare, shaved head, four days of stubble and wearing scruffy jeans, desert boots and a ten year old checked shirt – we tended to dress casually in the AOT. At least I’d caught his attention I thought and seamlessly showed him my ID which curiously enough had a picture of me with a shaved head, four days of… You’ve got it. The faintest flicker of amusement crossed his lined face as he looked at my badge then back at me and said in his surprisingly low toned voice ‘You look like you’ve just come out of prison’. I frantically searched my mind for a witty one-liner to keep our infant conversation going, to buy me some time so I could begin to form the all important therapeutic relationship engagement was based on. ‘They let me out early for good behaviour’ I blurted out, painfully aware how cliched that sounded. Alan looked up, the ghost of a smile back again on his haunted face. He sighed. ‘You’d better come in seeing as you aren’t going to go away are you?’ he said in his quiet, cultured voice. Together we entered his shambolic, dark and cramped bedsit and began what was to become an eight month friendship that taught me more than any book I would ever read.

My approach to working with people like Alan was to go at their pace and wherever possible work to their agenda. One of the key strategies to effective outreach work is to establish and maintain strong, personalised relationships based on mutual trust and continuity. There was an expectation you’d be creative in your approach to engaging people who, for whatever reason, didn’t feel ‘normal’ psychiatric services were for them. For example: If a client only wanted someone to talk to down at the pub then you’d meet up there and share a pint. It wasn’t unusual for members of the team to take people to the cinema, bowling or just about anywhere else that would allow you to form some kind of alliance strong enough for them to accept you could be called on if there were problems.

Alan and I met up several times during the next month or so. A softly spoken law graduate from a prestigious college at Oxford he was reluctant to pass anything other than the time of the day with me. Our conversations, if you could call them that, were short, desultory and invariably revolved around the weather. Try as I might to find some common ground Alan would cut the conversation short like unexpected summer rain bringing a picnic to a rude halt. Sat one day in what had become our default positions in his cramped, slightly claustrophobic, full of of dusty books flat as he rolled and smoked endless roll ups by the window I decided to take a different approach.  ’Alan’ I said looking directly at him, ‘could you give me some advice?’ Quizzically he looked up and over his bent glasses, took the cigarette out of his bearded mouth and said in measured tones ‘Depends what you need to know’. ‘Well’, I started hesitatingly, ‘I know you studied law and wondered if you had any idea about how to take someone who infringes your copyright to the courts?’ For the first time in our meetings I saw him looking intrigued. ‘Tell me more’ he said, and with that I went on to speak to him about my passion for photography and how I’d discovered another photographer had copied an image of mine and was using it as his own work. Hesitatingly at first, as if his voice had grown rusty from lack of use, Alan spent the next fifteen minutes talking about the various laws involved, and how he’d been a keen bird photographer during his Oxford days. Seeing his eyes light up behind those oddly misshapen glasses as he fondly recounted the various species he’d got photographs of lightened my heart, and gave me new hope I would be able to somehow help him with his ongoing fight against the demons his Schizophrenia had left him with.

Around one person in a hundred will develop and go on to endure the symptoms of Schizophrenia. The positive symptoms include hallucinations of all five senses, and delusions strong and real enough to the sufferer for their suicide rate to be twenty to fifty times greater than the general population. Negative symptoms of low self worth, depression and feelings of hopelessness significantly contributed to the nearly fifty percent of people diagnosed attempting to take their own lives at some point in time during the course of their illness. Ten to fifteen percent of those who attempted suicide went on to succeed in killing themselves. It’s a horrendous, insidious and destructive mental illness that destroys not only the lives of those diagnosed with it but also their circle of family and friends.

I have a strong belief in appropriately disclosing aspects of my life to clients I worked with. How can you expect to form an alliance with someone based on a one-way flow of personal information? Gauging what is okay to talk about and what is off limits is a uniquely personal process with few formal guidelines. A degree in common sense and a masters in life experiences should be the minimum prerequisites for this kind of work as much of what you do is unscripted and on the hoof. Over the next four months Alan and I learnt much about each other. I heard about his chaotic, fragmented childhood and how his father, who suffered from bipolar illness, had killed himself when Alan was only seven, and I told him how devastated I was to lose my dad a week after his sixtieth birthday in the year I left the army. With a dreamy, wistful look in his eyes he spoke longingly about time as a child with his mother who came to represent an oasis of calm in the desert that was his fathers erratic, unpredictable and frequently abusive behaviour. We discussed death and dying, theology, psychology and any other ology that came to mind. He had an almost encyclopedic ability to recall information and effortlessly thrashed me at Scrabble and chess – occasionally and not so subtly letting me win to help my self-esteem. We compared our various degrees and the merits, or not of our respective seats of learning, and he finally began to talk about his illness and how it had robbed him of a potentially stellar career in the legal profession only months after he’d graduated. More than once I found myself deeply upset by his erudite description of the twists and turns of fate his illness had imposed on him only to eventually lead him here to this bedsit and the lonely, tortured life he now lived. Like someone helplessly adrift on a raft being carried along a raging river through the canyons and gorges of his mind, Alan often found himself helplessly at the mercy of the pitiless eddies and currents of his illness.

Try as I might I was unable to convince Alan that medication might have made a difference to his symptoms. Modern treatments had come a long way from the sometimes barbaric quackery of the early 20th century and the latest antipsychotic medications were showing some remarkable results for a percentage of people with schizophrenia. One particular morning Alan and I were sat sipping his achingly strong coffee from the only two chipped and stained mugs he possessed. The now customary packet of biscuits I’d insisted on bringing each visit sat unopened and precariously perched on the edge of his battered and careworn sofa. He seemed to have become more distracted than he usually was. There had been many times when you could sit with him and he would tail off the conversation, cock his head and turn slightly as if he’d heard his name being called from a distance, or he’d stop talking and look intensely at something only he could see in the corner of his flat only to return back to our conversation as if nothing had happened. Sometimes a precursor of relapse I mentally made a note to discuss it with the rest of the team. Alan rarely discussed his current symptoms but I knew from experience he suffered from visual and auditory hallucinations. He’d once briefly started to touch on his ‘voices’ but quickly pulled up short as if he’d been ordered not to tell anyone. Auditory command hallucinations were perhaps the most problematic and distressing of symptoms. Usually intense and belittling in nature, people were often bombarded by an almost incessant cacophony of denigrating voices insisting they were, for example; worthless, not fit to be alive or that they should harm someone or themselves. I had to ask Alan several times if he was okay before he slowly raised his head and looked back at me with a blank face. I could see he wanted to speak but held back and silently shook his head as if to say ‘I can’t talk to you right now’. He murmured indistinguishably to himself before he nodded towards the door indicating I should leave. Concerned, I tried to convince him to let me stay but he became agitated and began to stand up. More than fluent in the silent language of non verbal communication and recognising the subtle, almost imperceptible warning signs of somebody becoming emotionally over aroused I left saying I’d be back later in the week. I revisited for the next three days with no answer despite knocking hard enough to dislodge more flakes of faded paint that fell like autumn leaves down on to the existing carpet of black fragments.  Unable to see into the flat as a large piece of scrap cardboard had now been put up against the window I passed on my concerns to the other team members. Together we decided Alan needed an assessment to see if he was deteriorating to the point he had to be forcibly hospitalised, or sectioned as it was sometimes known. He was seen a day later by an approved social worker who knew Alan well, and although he wasn’t ill enough to be taken in under the Mental Health Act, he was convinced to voluntarily go to a hospital unit he’d previously felt safe on for a week’s respite.

I went to visit Alan on the ward the next day. He looked pale and tired,  the mental pain he was going through etched on his face like lines of text that made up his life story. With a lackluster, almost slow motion movement of his head he tore himself away from the whispering, sibilant voices I knew he must be experiencing. Peering owlishly in my direction over the rims of his glasses he gave me the briefest of waves and the barest of wan smiles. ‘Hi Alan’ I said trying to force the shock at his appearance from my voice. ‘Seeing as it’s nearly the weekend I’ve splashed out and bought custard creams, shall I make us a brew to have with them?’ It was like I’d not said a thing to him as he returned back to staring vacantly at his wall with only the occasional distressed response under his breath breaking our uncomfortable silence. Recognising he wanted space I left him saying ‘I’ll see you on Tuesday mate, hope the weekend goes okay’. After a brief update from the ward team who felt he still wasn’t poorly enough to be forcibly given medication I drove back home subdued and at a loss what to do next to help Alan cope with his illness.

I returned back to work on Tuesday to discover Alan had taken his own discharge from the ward on Monday. He was after all a voluntary patient on a unit staffed by a highly experienced nursing team who had sought a number of opinions on his mental state – all of which had supported the view he was unwell but not to the point he could be detained. One of the other AOT team members had seen him at his flat on Monday as I’d been off. She felt he’d looked tired but was less distracted and more positive about things. He’d also been keen to accompany her down to the local shop for some basic provisions. Slightly more reassured I went to visit him later that afternoon only to find he wasn’t answering his door again. Unable to gain entry I tried to rationalize my rising concerns. ‘He’s gone to the shop’ I told myself only to realise I’d passed the shop on my way and it had been empty. ‘Okay, then he’s fallen asleep with his headphones on’ came my next thought. There was a considerable amount of research supporting the idea that factoring in another source of noise like music could subdue the voices and help reduce the distress they caused. ‘Nope, you know they’ve been broken for weeks’ came my by now irritating inner voice. ‘F*ck it’ I whispered under my breath and, decision made, rang the landlord of the block of flats Alan lived in. Five long minutes of what started as negotiation but quickly turned into veiled threats later and a less than helpful portly, red faced man in his late fifties arrived sweating profusely. Dangling a huge bunch of assorted keys in his chubby hands he opened his mouth as if to once again whine what a waste of time this was and how – somewhat illogically all things considered – we should really get the tenants agreement before we entered. As quickly as it opened his mouth snapped shut as he looked at my face and realised I wasn’t a guy who got anxious about much when all was said and done, and that at this moment in time he would be wise to just open the door and keep his mouth shut. For what seemed like an age his sausage-like fingers fiddled with the collection of keys held together by what looked like old gardening twine. Occasionally finding one and then discarding it again with a theatrical sigh he eventually located a key and tried it in the beaten up lock. With a dull click the worn tumblers fell back and the door eased open. I asked him to wait outside as I slowly entered the dim confines of the narrow, dank smelling corridor with its cracked plaster, and worn threadbare carpet that led past the small bathroom and on towards the dirty brown MDF door you opened to reveal Alan’s bedsit. My voice faintly echoed back at me as I called out ‘Alan, it’s me Paul. Are you in mate?’ The silence that met me was heavy with meaning as I carefully stepped over piles of old magazines and walked towards the door. Eyes slowly adjusting to the near darkness I was able to make out where Alan had once kicked it in a frenzy of frustration and fear. The pale splintered shards of wood, accentuated by the deep chocolaty stain of haphazardly applied paint almost glowing in the gloom. My heart pounding I called out halfheartedly once more just as I reached the damaged door ‘Alan, are you in?’ With my senses exquisitely alert and adrenaline flooding my body I slowly pushed the creaking, complaining door open until I could see partly into the shadowy room. Years of military training for room entries like this kicked in as I quickly scoured the immediate area for any potential risks before I fully committed to stepping through the door. Realising I’d been holding my breath for the last twenty seconds I let out an exhalation of pent up air and entered the gloomy bedsit. With most of the window blacked out by the cardboard the only other light source was a fly covered forty watt bare bulb that hung forlornly from the centre of the nicotine-stained ceiling. Struggling to see anything beyond the first few yards I reached for the well-worn, once white plastic switch and clicked the light on to reveal Alan half lying on his sofa with his face turned away from me. My palpable sense of relief I’d overreacted and Alan was simply in a deep sleep only lasted until I got closer and saw his face. No stranger to death, I was already well acquainted with the ghostly pallor only the deceased had. From habit I quickly checked for a pulse with one hand whilst reaching for my mobile with the other. With surprisingly steady fingers I punched in triple nine and asked for an ambulance and police to urgently attend the flat. That done I rang the team to let them know I’d discovered Alan dead in his bedsit and asked them to contact his mother and sister who also had schizophrenia. Phone calls made I took time out to sit and talk with Alan who finally looked like he’d found some peace in his troubled life. As a Buddhist it was my belief that Alan’s life force;  soul, karmic energy – call it what you will – was still in the room and would be for some time as it made sense of it’s now intermediate state. On the floor nearby was a rainbow of spilt tablets, opened containers and a note written in his distinctive, scrawling handwriting.

Without moving anything I bent down to look at the torn scrap of paper which simply quoted the eminent german philosopher Friedrich Nietzsche:

The thought of suicide is a great consolation: by means of it one gets successfully through many a bad night…

Why have I blogged this? Is it not somehow disrespectful to highlight the life and death of someone like Alan and what they have to endure? I don’t believe so. I spoke with his mum at length after the funeral. A lovely, bright eyed, intelligent and positive soul who had nothing but praise for the efforts of everyone who’d tried to improve the quality of his life. She said this: ‘Knowing all I know today, and what he would go through I still wouldn’t change a thing. He and I were very close when he was a child and he’d bombard me with questions about how did frogs work or do stars go to sleep in the daytime. We’d spend hours reading his favourite books, or walking through the nearby fields where he’d ask even more questions. He wasn’t always ill and sure we’ve had tears, rivers of them, but we’ve had far more laughs and love and he’s given me moments of great pride and shown me what true courage is in the face of adversity’.

Dedicated to all the Alan’s and their loved ones out there…

If this blog has affected you in some way, or you need further support either with your own mental health or that of a loved one the following resources may be of help:

http://www.mind.org.uk/?gclid=CPbVnOW6q6sCFW8JtAod4xJ43w

http://www.turning-point.co.uk/Pages/home.aspx

http://www.rethink.org/talk/?gclid=CPOGyoW7q6sCFagntAodwmkv4g

http://www.sane.org.uk/

http://www.mentalhealth.org.uk/

http://www.samaritans.org/?gclid=CILUwK27q6sCFbEntAodNEk75A

The first visitor I can definitely remember was my boss from the army gym I worked in. Tall, lean and swarthy with a huge black mexican bandido moustache that made his teeth a dazzling white when he smiled – I shall call him Pete to protect the innocent. Lying on my bed with it’s nearly sea views I was impatiently counting down the minutes until my next fix of the hospital equivalent of a ten bag. Distracted with the pain from my ankles I was staring out of the window on to the blank wall that formed seventy percent of my view of the outside world. ‘What the f*ck have you been doing Willie?’ came a gruff voice close enough to startle me from my reverie. Perhaps this is the point where I explain the armies fondness for bastardizing your given name to either make it easier to shout or to give amusement to the select group of people in the know on the joke. I’ll give you an example:

Bear in mind we’re slap bang in the 1980′s. An amazing decade I look back on with fondness and regret that it ever slid into the insipid 90′s. Political correctness, particularly in the military, was unheard of. The armed forces, and to an extent nurses, police officers and the fire brigade share a love of the black, gallows humour that would turn some people’s hair grey with it’s sometimes morbid and on the surface disrespectful approach to the bad things that happen in life. Done with the right audience in mind it’s a sanity-saving safety valve that negates some of the shock you experience when you are in the thick of it, and helps lighten the mood in the direst of circumstances. I digress. One of my good friends in the gym was an army rugby player. Wider than he was higher he was a beast on the field and a gentle, lovely bloke with a permanent, infectious grin the second he shook whatever was left of your hand at the end of the match. Originally born in Trinidad he’d moved as a baby to Ealing and joined the army around the same time as I had. Everyone knew him as Chalky – partly because that’s how he introduced himself but mainly because his last name was White. The fact he was black had no bearing on it as far as he or anyone else was concerned. It wasn’t ever about racism or bullying that I can remember – although I’m sure someone somewhere in this odd decade we now live in would do their very best to make it so. Scots invariably became Jocks, or if there were a lot of them, Jock Smith, Jock McSmith etc. whilst the Welsh and Irish were accorded Taff and Paddy respectively. As for me? Well Williams as a surname just cried out for me to be anointed Willie at the baptism of fire that was army basic training. Faintly amusing to anyone under the age of twelve, but that was my nickname and it stuck with me throughout my career. Indeed, I liked my moniker enough to get it tattooed under the obligatory needle-crafted figure of the Grim Reaper on my arm.

I looked up at Pete as he loomed over me looking more like he belonged in a spaghetti western than in an orthopaedic ward. ‘Hi Pete. I won’t be in today’ came my surprisingly witty reply. He grinned that big white shark grin of his and sat his rangy, Ron Hill clad body next to my bed. ‘We’d heard all sorts back at the camp mate’ he ruefully said. ‘One minute you’d been badly hurt and the next you’d died on the operating table’. Shocked I turned and looked into his eyes expecting him to be taking the piss.

Known for his practical jokes Pete was that excellent mix of professional soldier, natural leader and genuinely nice guy that made coming into work more of a pleasure than it already was. Our loyalty to him in the gym was legendary, as was our dedication to getting him back for every joke he’d played on us. One fine Friday afternoon Pete, away on an external course, rang the gym and spoke with me. ‘Willie, I’m coming back for the weekend as I’m seeing a girl on the camp, but no one is to know as it’s tricky’. ‘No problem Pete, have a great weekend’ was my short but confidently conspiratorial reply. Pete was, shall we say, a ladies man. He enjoyed the company of women and the combination of looks and his ability to charm inevitably meant he was often in demand. ‘Tricky’ for Pete would be he was double-booked, wanted to avoid a scene with someone aware of the double-booking or there was an irate boyfriend/husband/partner wanting to explore some ongoing relationship difficulties with him – or all three. The main thing was that Pete wanted no one to know he intended coming back. With that basic premise in mind I met up with the other guys and proposed we should print a stack of A4 signs saying ‘Pete’s Back’ and put them up in as many prominent places as possible. Our joint conspiracy agreed, and with around fifty copies made, I grabbed twenty and a stapler and ran out of the camp gates down the steep hill that was the only route he, and everyone else in the regiment would take to get back up to the camp. Nearly prostrate with laughter as I stapled the first of the bright white sheets of paper with fluorescent pink writing to a large tree by the road, I headed up the hill adding more to farmers gates and telegraph poles as I tried my best to run with tears of mirth blurring my vision. As I got to the guardroom and the entry barrier at the top I realised I had one message left so pinned it to the sentry box next to the smirking guard who was now in on the joke. Mission accomplished I met up with the others who’d placed the rest of the flyers around the camp. I’ll never forget how eight supposedly grown men just sat and howled with laughter as we recounted the positions we’d left Pete’s communique in. Sure enough, about an hour later the phone rang. ‘You little b*stards’ came the snarling voice down the line. ‘You f*cking little b*stards. You can tell them all from me to expect a beasting session Monday morning’. Trying not to howl with laughter I called the others into the office and put the phone on speaker as the tirade of expletives and threats continued. Suddenly there was silence followed by roars of laughter from Pete. ‘Nice one’ he said still trying to sound a bit angry, ‘not sure I’ll ever top that Willie, but prepare to suffer on Monday’. Still chuckling and swearing under his breath Pete put the phone down. By now we were all reduced to a limp heap of humanity clutching our sides and wiping away rivers of tears. For hours afterwards my sides ached and I looked like I’d been in the cookhouse peeling a week’s worth of onions.

Pete glanced back, genuine concern in his dark brown eyes. ‘No mate, we thought you’d bought it for a short while, then I rang the hospital direct and they said you were out of theatre and doing okay all things considered’. We shared a moments silence only comrades in arms can truly share before he said ‘I was gutted when I heard Willie’ as he paused and looked at me ‘I was all ready to break into your locker and get first dibs on your boots and climbing kit too’. With that the moment melted away and we laughed and chatted away like the good friends we were until I could no longer stay awake. ‘See you soon mate’ Pete said and turned away only to turn back again. ‘Oh, nearly forgot. I got you a little something to help you through your stay’. Genuinely touched I felt the bitter sting of early tears as Pete reached into his jacket and brought out a small, neatly wrapped parcel. Silently he passed it over to me and turned to look at my blank wall outside as I thanked him for the kind thought. ‘Go on then, open it up’ he said as he gazed out of the window. The package, no longer than eight or nine inches was soft, pliable and very light. I eagerly tore the corner of the wrapper off to reveal a silvery pink material underneath. Intrigued I removed the rest of the paper to find a pair of size five pink ballet shoes. The sudden realization I’d just been had big time dawned on me and I looked across at Pete who’s shoulders were now shaking as he tried to stifle waves of laughter. ‘B*stard’ I shouted loud enough for half the ward to turn their heads in unison towards me as if they were on the centre court at Wimbledon. Pete turned back towards me his eyes damp and shiny with mirth, ‘Gotcha’ he said giving me a cheery wave before he chortled his way off the ward…

Don’t walk behind me; I may not lead. Don’t walk in front of me; I may not follow. Just walk beside me and be my friend                                              - Albert Camus

For the last six years I’d been one of a small, tight knit team of physical training instructors responsible for the fitness of over five hundred men and women. I’d quickly become an adventure training specialist teaching a number of pursuits including windsurfing, kayaking, climbing and abseiling. If you added aikido instructor, sports injury therapist and personal fitness trainer to name but a few more strings to my particular bow, you’d get some idea of how much I enjoyed working in the field of fitness training. On the day of my fall I was twenty eight years old and at the very top of my game. Lying in my bed, thoughtfully labelled WILLIAMS. PS in streaky black marker pen, I was suddenly struck by the synchronicity of my rapid 80 foot descent back to earth and my equally accelerated fall from the pinnacle of my career.

Day two of my newly acquired status as ‘The squaddie with the knackered legs in bed 7′ – as the junior doctor from Greece so eloquently and loudly enunciated in thick, syrupy broken english – began with my introduction to the ward physiotherapist. A slim, slightly built lady in her late forties with an inner strength of purpose her frame belied, and with a broad Dorset accent I understood less than the junior doctor’s; she was to become pivotal in my recovery as I took my first painful steps along the long, slow road back to some semblance of mobility. Still groggy from the morphine I glanced blearily up at her as she came into view. ‘Marning’ she said, clutching what I could only assume were my notes to her crisp white uniformed chest. ‘What?’ I replied, not quite sure if she meant ‘morning’ or something else. ‘Marning, oi’m Mary, your physiotherrrapist’. Ah. ‘Would it be possible to have someone translate?’ cruelly popped into my head. Somehow this was synaptically converted into ‘Hi, I’m Paul’ and with our introductions complete she went on to outline my options for physio – at least I think she did. Halfway through our somewhat one way discussion on just how crippled I would be my morning morphine kicked in and my mind gratefully rose on the opiate thermals to join the seabirds outside raucously chiding each other over the pecking rights to upended takeaways. Later that day Mary returned, sadly minus the half expected translator, but bringing with her what I can only describe as a modern day version of some kind of medieval torture machine. ‘As discussed’, she far too cheerfully said as she proceeded to assemble the orthopaedic equivalent of a Transformer. Blankly I just stared at the collection of surgical stainless steel components she was putting together with the ease of a robot in an Audi factory. ‘Funny’, my internal voice piped up, ‘why don’t I remember this discussion?’. ‘Maybe you were too busy squabbling with a seagull over half-eaten crispy noodles?’ I mentally retorted. Sensing my bewilderment she brought the assembly line to a halt and preemptively dealt with the heuristics dancing on the tip of my tongue.

For your sanity and mine I’ll use my literary prerogative and convert her Clotted Cream font back to something closer to Comic Sans or Times New Roman. ‘This’, she said, ‘is probably your best chance of ever walking again’. One simple sentence but it lifted the painkilling fog of morphine like a spring breeze blowing through early morning mist; she now had my complete and undivided attention. She went on. ‘Basically your feet are placed into a large padded shoe at the end of a platform with flexible paddles. These gently move your ankle forwards and backward, mimicking normal movement and speeding up the healing process to help stop your ankles and ligaments from seizing up. You control the rate and degree of movement using the controls.’ I looked at her, a thousand prevarications running around my head like so many wayward protons in a particle accelerator. I could see she had my best interests at heart. Ignoring the usually suspicious, logical part of me that occasionally interceded in a vain attempt to stop me from making irrational decisions like scoring my next adrenaline fix, I made the decision to put my trust in the diminutive, at times almost incomprehensible stranger I’d just met.

With the ankle autobot set up and my now badly swollen ankles resting in the deep, soft and comforting lambswool that buffered my injuries from the cold surgical steel Mary gave me a brief guided session on the controls and how much time I should use the contraption for before taking a rest. With her encouragement ringing in my ears I summoned up my best thousand yard stare and took a baleful, considered look at puffy, flaccid ankles gradually becoming iridescent with colour as the bruising progressed. Okay. Here we go. With the controls in my slightly sweaty hand I tentatively turned the dial to it’s lowest setting. The resulting hum from the motor preceded the paddles starting to alternately flex and I was instantly reminded of powering the brightly coloured pedalos around Stanley park lake close to Blackpool beach. I’d been forewarned by Mary, somewhat euphemistically as it turned out, my ankles would be ‘Unhappy’ at being asked to move this early on in the process of healing. I quickly substituted her word for a more robust anglo-saxon adjective as stereo blasts of agony shot up my legs leaving me with an ashy taste in my mouth and bitter tears in my eyes. The sharp shards of pain were both catalytic and, in an odd way, affirming. They brought me out of the self-pitying place I’d retreated to since the accident and galvanised me into taking control of the direction I could go at what became a watershed moment on Dante’s ward. I was alive. I wasn’t paralysed or lying on life-support with a catastrophic head injury, nor was I the kind of guy who gave up. I’d never jacked a thing in my life and I wasn’t about to start now. Two minutes and a big, deep breath later I took the first hydraulically assisted steps of my thousand mile journey to recovery.

Buoyed up by my newly rediscovered set of cahones I asked for the machine every chance I got. I became addicted to it. I was able to tolerate the pain better as my ankles gradually became stronger and more flexible despite the rainbow of bruises and swollen, still angry looking tissue below both knees. If it wasn’t grinding away at the foot of my bed I felt cheated – like my rehabilitation had been put on hold. Mary patiently tried explaining to me I somehow wasn’t the only star in the firmament of the physiotherapist’s universe, and the machine was needed elsewhere at times. ‘Fine’, I replied with a pout you could land a Chinook on, ‘but could you give me a heads up when it becomes free? With a theatrical roll of her eyes and a mixture of mock mild exasperation and professional pride on her face she slowly smiled and nodded before leaving me to reflect on my journey to date…

Life shrinks or expands in proportion to one’s courage                           Anaïs Nin

]]> http://paulwilliamsimaging.wordpress.com/2011/09/14/welcome-to-the-ward-transformers/feed/ 4 paulwilliamsimaging The Swan and the Lake http://paulwilliamsimaging.wordpress.com/2011/09/13/welcome-to-the-ward-commode-wars/ http://paulwilliamsimaging.wordpress.com/2011/09/13/welcome-to-the-ward-commode-wars/#comments Tue, 13 Sep 2011 10:50:00 +0000 Paul Williams Imaging http://paulwilliamsimaging.wordpress.com/?p=99 Continue reading →]]> When just about everything you rather selfishly took for granted is whisked away in the blink of an eye and you are sent to a hell of your own making as a result, it’s probably time you paid some attention to the wake up call. In little more than 80 feet I’d gone from a guy who could run a mile and a half in less than ten minutes carrying a forty pound bergen – try it before you go ‘So what’ – to a bedridden automaton who could barely keep his balance on the commode. Ah, the commode, I conveniently forgot to mention it earlier didn’t I?

The bed commode. Sounds fairly nondescript. Not a big deal asking for one when all you can do is ride the dull grey metal chariot of dreams that is the hospital bed. A nine bed ward full of grown men in similar positions to one’s own should make going for number one’s and two’s a relatively straightforward process. If it was just the other eight grown men for company I would readily agree with you. Sadly you have to factor in the variables first: visitors, attractive nurses and the WI book lady to name but a few. The commode on it’s own though isn’t quite enough to completely destroy your already fragile self-esteem. No. For that you have to add the bed curtain. Sounding like a pub you’d do well to avoid, the Commode and Curtain is a personification of a perversely symbiotic relationship designed to suck the very last drop of self-worth you may have had before you entered Dante’s ward. I’ve yet to find anyone who can explain why drawing a flimsy piece of opaque plastic made out of recycled shower curtains around your bed is somehow tantamount to any semblance of privacy. We all know the curtain. Fully extended it’s nearly always two feet short of joining up which leaves a nice gap for you to gaze out from atop your steel throne at the now pale faced, slightly queasy looking visitors a whole four feet away by the next bed. As if this wasn’t bad enough the curtain somehow amplifies any noise within it’s confines from a subtle pianissimo to a glorious crescendo with an acoustic efficiency beloved of most opera halls. I think the vast majority of us stuck in our beds held on for as long as humanly possible – a feat made slightly easier by the lack of calories resulting from the daily chess game you had with the bland, fibreless baby food to avoid eating it.

Just when you think you’ve reached your own personal ground zero of embarrassing moments along comes the ward stomach bug. Less than a week into my stay at the Hotel of the Damned and one fateful tick on the menu later I joined the other founding members of the Food Poisoning club. Joining was no problem. No secret handshakes or threats to cut out your heart if you dobbed on the other members, no waiting list and entry was free if you’d paid National Insurance. The ward was laid out in two rows of five and four beds respectively. I had been placed by the window where I got the faintest of sea glimpses and the nurses got me as far away from the nursing station as was humanly possible. Opposite my bed was a nice enough guy of around fifty who’d been badly injured in a car crash but was now on the mend. We had very little in common other than we both relied on Nurse Wilkes to bring us the commode when it fitted into her schedule, and between us we probably had enough metalwork to warrant we should never visit a magnet factory together. After a brief doze in the morning I woke up feeling decidedly out of sorts. My stomach gurgled, making noises like the last inch of bath water as it frantically exited via the plug hole. I felt clammy and sensed the first waves of nausea begin to roll over me as I lay unhappily in bed. The man opposite me suddenly sat bolt upright and without any warning began to vomit for Britain  The ensuing mexican wave of emesis that circled the ward in less than half an hour was something I’d never forget. One by one my fellow detainees on the orthopaedic ward coughed up their cookies and chundered their way through the rest of the day. My unwavering belief I was on the Styx ferry with Charon meandering towards Hades was given added weight forty minutes later when I too reluctantly took part in the initiation ceremony for our newly formed gentleman’s club. My already weak constitution took a further kick in the balls when I fainted for the first time in my life after losing too much fluid in too short a space of time. My commode, it’s contents and I quickly parted company as I fell back in a faint like some lollygagging fop with the vapours. Later I was unreliably told by a gleeful club member known for confabulating he’d seen Nurse Wilkes running for her life as my steel frisby flipped towards her in a less than graceful arc.  The ensuing ward-wide commode fest was a mind-boggling cacophony of wide-ranging sounds and groans interspersed by expletives and retching. The more robust visitors were treated to our gastrointestinal version of Tubular Bells boosted by the curtain subwoofer and commode amplifier. Our club membership, which lasted for a little over three days and long nights was, we were assured by a very unconvincing nurse, not linked in any way to the fact we’d all eaten the egg mayo sandwiches the night before…

As an ice-breaker the ward malady was unparalleled. It provided us with a humbling, collective experience; a shared commonality that crossed the divide of class, colour and creed allowing those of us who had endured and survived Commode Wars to form friendships that sustained and supported us throughout our stay – although none of us ever ticked the egg mayo box again…

There is something in sickness that breaks down the pride of manhood.  ~ Charles Dickens

]]> http://paulwilliamsimaging.wordpress.com/2011/09/13/welcome-to-the-ward-commode-wars/feed/ 7 paulwilliamsimaging The Playground http://paulwilliamsimaging.wordpress.com/2011/09/12/welcome-to-the-ward-home-is-where-the-chart-is/ http://paulwilliamsimaging.wordpress.com/2011/09/12/welcome-to-the-ward-home-is-where-the-chart-is/#comments Sun, 11 Sep 2011 23:49:14 +0000 Paul Williams Imaging http://paulwilliamsimaging.wordpress.com/?p=86 Continue reading →]]> If not publicly then at least in private she would forever be known to me as Nurse Wilkes – the psychopathic ‘number one fan’ in Stephen King’s novel ‘Misery’ who gets to keep her favourite author captive following a car crash near her home. The irony he suffered shattered legs in the accident hadn’t escaped my dulled mind. Day two of my self-inflicted stay on the orthopaedic ward began almost exactly as the first, the only significant difference being I reluctantly, but wisely kept my innermost thoughts to myself. ‘Did we sleep any better’ asked Nurse Wilkes in the sickly, sweet voice I knew she reserved for difficult patients who had the temerity to question why their face needed a wet flannel slapped around it at six in the morning. I chose to ignore my immediate response of ‘We’ve never slept together that I can remember’ and instead offered the one that would give her the least satisfaction. ‘Yep, slept a lot better thanks’. ‘That’s good then’ she replied in glorious monotone as she took off a layer of my skin and wrung out the brillo pad that was my NHS flannel, ‘you’ll be up in no time.’ Stifling the insane giggle that begged to be let out from my morphine parched lips took a while. I’d just shattered both of my ankles and lower legs falling 80 feet off a cliff and here was this orthopaedic oracle prophetically predicting I would rise Lazarus-like from my bed and walk out of the door. Too tired to explore this a moment further with her I sank back on to the bed and waited for breakfast.

For those of you who have not had the pleasure of a long stay in hospital it goes like this:

You quickly come to realise the only way you are going to emerge from this experience with a vestige of your sanity intact is to break down the day into it’s component parts. Looking forward and guesstimating how long you may be in the gulag is an abstract, somewhat arcane dark art beset by errors and a constant bombardment of low ballers from the medical team. In what was to become a central theme in my life I opted to live in the moment and focus on the tangible here and now’s.

We’ve already discussed the post-crimean throwback that is the bed bath and the dangers of questioning the validity of the practice. Like it or not though that rough flannel dropping into soapy, tepid water becomes the starting flag for the rest of your day.

Breakfast. I remember it well. You got a card with lots of choices on it the night before – not so great when you are off your head on morphine and you’ve got the motor skills of a chimp on LSD. On the few occasions a pen was provided to fill it in it rarely worked and so the card lay there, the faintest slug trail of waning ink petering out into indentations even Sherlock Holmes couldn’t find. Failing to fill the card in correctly damned you to a breakfast not even the March Hare could have dreamt up. Yes nurse, of course I ordered four bowls of solidified porridge, half a grapefruit with the faintest red circle in the centre where a cherry once lived and ten pieces of dried toast to go with my egg. However, breakfast, eclectic as it occasionally was, became the second chapter in the short story that was another day in hospital.

The Newspaper Man. Gawd bless him. According to a fellow patient he’d been coming to the hospital for close to thirty years. A slightly stooped, twinkly eyed septuagenarian with huge bushy eyebrows and tufts of short grey hair sprouting from his ears like sheaves of stacked straw. Seeing him arrive on the ward pushing his battered, slightly squeaky trolley with one insolent wheel that refused to join the others and laden with the daily news, glossy magazines and all manner of chocolate bars and sweets was to become one of my day’s highlights – I’d got to ten o’clock.

Morning tea. Try as I might I never got used to the dark brown liquid that looked more at home surging down the Ganges than swirling around the chipped and faded teacups that rattled together like tropical rain pounding down on to corrugated iron. The tea lady surely had to be related to the Newspaper Man was my first thought when I saw her. My second, slightly more surreal thought which I blamed on the morphine, was they were both the same person. He had merely dumped his paper trolley and quickly donned the shapeless, off-white coat missing two buttons that must have belonged to a doctor back in the 1960′s. He then threw on a huge wig of slightly gingery hair that neatly hid the harvested sheaves in his ears and topped it off with some kind of chefs cap. Other than that they were the spit of each other even down to the same walk. Had I ever seen the two of them together in the same place I asked myself. I hadn’t. Proof to my wayward mind that it was therefore possible, and something I still occasionally ruminate about to this day as I never once saw both the trollies crossing my path at the same time.

Lunch.  See Breakfast.

The Library Person. After the inevitable siesta-like snooze that followed the smorgasbord of lunch based on an unticked menu I’d usually be woken by the gentle tones of the WI lady asking if anyone wanted a book to read. Asking my eyes to focus for more than five minutes in the first few days was like asking a politician for a straight answer to the question about the large, fat roll up they’d been photographed with in their university years – neither of us were going to cooperate. As time went by and my pain levels subsided to the point I was able to concentrate on something other than my ankles I began to pay more attention to the selection of books on offer. One day I found myself peering at the faded, well-thumbed and scuffed books in the vain hope I would discover something in the middle of a continuum that began with Mills and Boon and ended in the extended works of the Brontes. With a big sigh as I was about to once again pass I suddenly spotted a slightly newer looking paperback hiding under a pile of Golfing Weekly magazines.  In a split second I can only describe as a moment of serendipity I greedily pulled out a Stephen King novel. Now if this is the moment where you say to yourself ‘How predictable, he found ‘Misery’ then you’d be wrong. Instead I found a tatty, dogeared and slightly greasy feeling copy of ‘The Stand’. Over the next few weeks I devoured every word. It transported me from the banality and humdrum of the ward to a place where nothing mattered but the story and the characters therein. I owe Mr King a big drink if I ever get the chance to meet the master.

Afternoon tea. Still the same luke warm brown brew from the morning poured from the once chrome, forever stained large tea pot, but with the added frisson of either a bourbon or a digestive biscuit admirably served up by the Newspaper Man. Oh yeah, made it to five o’clock.

Dinner. How I wish I could extol the virtues of the last meal of the day. I consider myself to have a reasonable lexicon upon which I can depend on to help me retrieve the right word for the right moment. Not so for this pastiche of food that arrived barely warm in plastic trays and more suited to the fare grudgingly provided on the cheapest of discounted flights abroad. Dinner became a desultory affair. Similar to a hated chore that had to be done, I began to resent every mouthful and frequently left it unfinished. For a guy used to eating well and training hard the end of my day, like the food, was often bitter sweet.

There you have it. More or less a life in a day in hospital. Of course there were visitors, people looking at your charts with slightly pursed lips, ward rounds, physio sessions and other distractions, but the essential structure around which my waking hours were built was much the same day in, day out. I remained unconvinced I wasn’t still in hell…

With my face now freshly scrubbed, but minus the thankful look beloved by Nightingale, and with nurse Wilkes striding up to the next unwashed, ungrateful soul, I glanced down at the sheet covered mound of throbbing pain at the foot of my bed. The first of what would be many conversations in my head started up. ‘You don’t want to see what’s under there Paul’ said my slightly whiny, tremulous morphine-fueled inner voice, ‘the only thing you’re going to find is your shattered career’. ‘Possibly’, I  mentally retorted, ‘but I’m still going to see’.

With a degree of trepidation I drew back the light cotton sheet that covered some kind of surgical cradle that both kept the bedclothes off the injuries and left my ankles supported in two suspended compartments. As they still had a considerable amount of swelling left to do both of them had been left in what were called backslabs. Essentially half a cast leaving the front of the limb free, full casts would only be created once the inflammation had been significantly reduced. Odd, I thought as the sheet fell fully back to reveal a pair of legs shaved from the knees down, I don’t remember them being this colour.

I rarely have regrets. I tend to move on after an event and put it down to experience – with the caveat that to constantly repeat things that bring you pain and unhappiness is foolishness. I do however regret not taking some pictures of my ankles as they cycled through the myriad blues, purples, yellows and blacks that combined to create a rainbow of bruising like some mad artists palette. Day one after my operation and I was already looking down at a pair of Van Gogh masterpieces in not so subtle, slightly stomach churning pastels adorning swollen, stretched and angry looking ankles three times their normal size. On both sides of each ankle – thankfully now pointing the right way from their 60 degree post-fall deviation – were six or seven inch strips of adhesive tape covering what I surmised must be the insertion points for the metalwork. I’d seen enough for one day and quickly pulled the covers back over the frame and sank back exhausted by just this little effort. ‘Told you so’ my unwelcome inner voice pointedly whispered. ‘Piss off’ I whispered back as thoughts tumbled randomly around my head like a lone pair of socks in a madly spinning washing machine.

The rest of the day was spent in a vortex of pain, morphine, visits from medical staff and a poorly briefed liaison officer I’d never met from the army. The ward was busy, full of patients in varying degrees of incapacity and their visitors coming and going. All I longed for was a bit of peace and quiet – a Turner’s Bridge of Sighs, or a Constable’s Haywain of a day. Instead, influenced in no small degree by a combo of opiates, pain and post-operative reaction to anaesthesia I ended up enduring Dali, Munch and Picasso all competing to out do each other in the gallery of my mind. It had been a long day.

]]> http://paulwilliamsimaging.wordpress.com/2011/09/10/welcome-to-the-ward-day-i/feed/ 4 paulwilliamsimaging Buddhist Monk I http://paulwilliamsimaging.wordpress.com/2011/09/10/welcome-to-the-ward/ http://paulwilliamsimaging.wordpress.com/2011/09/10/welcome-to-the-ward/#comments Sat, 10 Sep 2011 14:47:50 +0000 Paul Williams Imaging http://paulwilliamsimaging.wordpress.com/?p=62 Continue reading →]]> Our greatest glory is not in never falling, but in rising every time we fall…

Confucius

‘Is this hell?’ was my first groggy, but not particularly surprised thought as I came around from the anaesthetic. After all, hell is where I’d convinced myself I’d end up sooner rather than later. I tried raising my uncooperative, lethargic eyelids for a better view of the other damned, suffering souls but they refused to open more than a crack before they slowly closed again like heavy curtains briefly blown open by a light breeze. Considering I was now in hell for the rest of eternity I drifted back into an oddly calm, deep and dreamless sleep.

The operation, according to the less than animated, weary looking junior doctor who thoughtfully woke me later that afternoon had ‘Gone as well as could have been expected’. Too tired to be troubled by this perfunctorily delivered hospital cliche I promptly fell asleep again. Following my earlier climbing faux pas I’d been helicoptered off the cliffs at Swanage and quickly transferred to a waiting ambulance at Sandbanks which whisked me in a frenzy of noise and blue lights to nearby Poole general. As luck would have it two orthopaedic consultants attending a presentation were already scrubbed up with surgical tools glinting in their skilled hands after an update from the helicopter crew. In less than an hour I’d gone from an 80 foot freefall and subsequent cliff rescue to operating theatre. Several hours later and with enough Meccano in my lower limbs to deny several children their christmas presents that year I was wheeled out into the frenetic ward that was to become my reluctant home for some time.

Later that evening I was awake enough to take in both my surroundings and my situation. One of the two consultants involved in my operation came and sat by my bed. A tall, well built, softly spoken man who looked like a rugby player but sounded like a priest taking confession. He introduced himself and gave me his carefully worded prognosis. My ankles hadn’t just been broken – they had shattered. Over nine breaks in my left lower leg and ankle and close to twelve in the right were now all held together by a network of screws and metal plates that would forever damn me as I went through airport security. The random thought ‘But will I ever dance swan lake again’ crazily entered my head and nearly made it out into the open until he tentatively told me ‘Walking may become difficult for you. These are life-changing injuries and you have some tough times ahead’. A thousand questions exploded in my head like fireworks seeing in the New year. What about running? Climbing? Taekwondo? My list of things I still wanted to do, like my sudden despair, seemed endless. Before I could let my torrent of heuristics out his bleep went off and with something akin to relief he made his excuses and strode off. There would be no time in the surgical confessional for me this evening. Overwhelmed by a spring tide of thoughts and the surge of morphine I’d recently had I turned my head to the wall and quietly cried myself to the pale imitation of sleep I’d come to know too well during my stay in hospital.

To be continued…

Four o’clock on a freezing cold and foggy 6th of December morning in 1996 and I’d just been startled out of what had become a fragmented and tortuous night’s sleep by my heavily pregnant partner.  ’The baby is coming’ she said – fairly matter of factly all things considered. Galvanised by her words, and with sleep an already distant memory I grabbed the packed overnight bag, threw on some clothes and helped her slowly to her feet. Together we made our unsteady way to my car outside the flat we were living in at the time. To the casual observer not in the know we would have probably looked like two people leaving a particularly late party after one sherry too many. By the time we’d reached the communal door it was becoming obvious we were never going to make the hospital. Almost bent double my partner was moaning in pain and clutching her stomach barely able to walk. We somehow staggered outside and I got her into the passenger seat of my car – a not so voluminous peugeot 205. Sporty, nice leather seats and with the inimitable styling of Roland Garros but possibly not designed with imminent childbirth in mind. As she sank on to what was to become our birthing chair she suddenly cried out ‘It’s coming out, I can feel the head’. I remember the moment exactly. Time stood still like a frozen waterall and my senses went into overdrive. I could feel the moisture from the light mist on my face like a thin sheen of sweat. The orangey glow from nearby street lamps bathed us both in an eerie glow making our features barely discernible. Flight or fight. I knew both of them intimately, like old friends who’d popped around on the off chance of catching up with the latest news. I looked at the flats thinking someone must have heard the noise we’d been making. There was nothing. No slightly moving curtain revealing a disheveled , slightly irritated neighbour. No single welcoming light bulb being flicked on like a beacon of hope in the stygian darkness. Nothing. Just a blank, black facade. We were on our own.

I felt myself physically snap back into the here and now. It’s happened before in combat situations. The huge dump of adrenaline you’ve just had delivered like a long expected, much anticipated parcel surged through my veins and I turned to see my partner pushing the seat back the whole seven inches extra it gave you for leg room. I entered the eye of the storm.

I’d left the army two year earlier and made a decision to become a mental health nurse for too many reasons to pick at in this particular story. The first 18 months of the degree were called the Common Foundation Path or CFP – the NHS loves it’s acronym’s more than the military. The purpose of the CFP was to give everyone a three month secondment to the other nursing disciplines out there in an attempt to support practitioners to become acquainted with the concept of holistic care – the buzz words of the degree. I’d been given a maternity placement early on in the semester which I’d oddly enjoyed. I was present at a number of births, enjoyed the company of the slightly politically incorrect midwives and felt immensely privileged to have been invited into what is still a huge, intensely personal event for most people. I listened, learnt and did as much as my remit as a student nurse allowed me as that’s the kind of guy I am.

Reaching down I felt the crown of the babies head. My partner was doing her best to breathe correctly, the cold air forming plumes of smoky vapour from her mouth as she panted. She looked pale and blue even under the faint sickly yellow of the street lamps that were my only source of light. Cradling the now partly emerged head I asked her to breathe and then bear down when it felt right to her. Several breaths later I was able to ease the head totally free. As she took a rest before what I hoped was the final big push I realised the umbilical cord was around the babies neck. Intensely searching for more detail in the gloom I became aware there was very little movement and no sound from this tiny scrap of humanity who’s life was now in my hands. I forced myself to recall what I’d learnt on the maternity ward and managed to free the cord after what seemed like minutes of fumbling with fingers that refused to work properly. With the release of the cord I was able to deliver our baby into the world. For the briefest of moments I thought I’d got it all wrong and had been too late. Still, pale and making no sound I reached for a pulse and gently tried to rouse my newly born third child whilst I ran through child resuscitation in my head ready for what looked like an inevitable next stage.

Suddenly there was a cry followed by more cries and movement. I looked with tears at a pair of tired, tiny eyes that briefly looked back at me as if to say ‘You took your time’ before they closed again. It was going to be okay. I quickly wrapped both of them in clothes from the bag, closed the car door and dashed back into the flats where an amazed neighbour called for an ambulance. Waves of tiredness, elation, fear and joy rolled towards me like surf on a beach and I gratefully let myself be carried away from the calm, measured place I’d been in for the last ten minutes.

The ambulance duly arrived and the paramedic, after a brief but thorough assessment of mother and baby, congratulated me on the arrival of my son. Confused I looked at him before realising I’d never registered what sex our baby was during the delivery. I smiled back at him as he grinned and shook my hand ‘Nice job mate, well done’.

There you have it. A son. Two more awesome sons have arrived since making it a nice round number of five children in total. I love them all equally as you should, but there is a connection between my firstborn son and I that’s hard to define, and harder still to quantify -but it’s there in my heart, and I look at him as he grows into an adult still with a sense of pride and wonderment at just how he and I came to meet in the eye of a storm…