“He is gone”.
“I’m sorry. What do you mean, He is gone?” My mouth opened. I just about remembered to shut it.
“He managed to leave, while we were serving Tea. Please talk to Security, on the right hand side, just inside the entrance” Then, she was gone.
I was standing at the entrance of the not so secure facility in the Psychiatric Ward of the Hospital. I held a shopping bag containing his new pyjamas, slippers, robe, some juice and toiletries.
Somehow, my heart restarted. Whooshing and thumping resounded in my ears. My knees jangled.
It was 8pm on a January night. The day had been spent bringing my distressed, schizophrenic friend to the Doctor, and then onward by car – not the wisest, safest move – to the nearest Regional hospital, 25 km away.
There, we sat all afternoon in A&E, my friend becoming increasingly agitated. He eyed every man who came near, wary, alert, tetchy, assessing. He prepared to lash out at anyone who would breach his need for safety. My friend, well over six feet tall, and now heavy, as a side effect of the medication he had been obliged to take, had always been a lamb. He reminded me of a quiet dog who snarled and snapped when badly injured, full of fear and pain.
We had a farcical, Monty Pythonesque interview with a Doctor. Between the fog my friend was lost in, the lack of English the Doctor possessed, and the obvious time pressure, a coach and four horses clobbered over my friend’s rights and wishes. In the end, my friend was not packed off to his local Hospital, 100 km further away. Evidently, Geography overrides sense and safety in our Mental Health Service. As I refused to take both our lives in my hands again in an attempt to drive to this other Hospital, the staff accepted my friend as a patient. There was no mention of an ambulance service.
Three intimidating security Men in Black enveloped us and like a dark cloud, we made our way slowly to the Psychiatric Unit. It was all a bit dramatic. My friend was cowed, surrounded by these silent, strong men. People stared. I was glad we were never the kind to worry about what others might think.
Our leaden Security detail dispersed when my friend was allocated a room alone. He was given a hospital gown by a nurse. I helped him to change, then he got into bed. Finally, I was able to breathe normally again. Morning was a long time ago. We had eaten nothing all day. At least he was promised some Tea at 7 o’clock.
I decided to go buy my friend some pyjamas and explained this to him. He was pleased at the prospect of chocolate. At least something of him was still intact. Off I went, and was so happy to locate everything he needed within the tight budget. Thrilled, I raced back through the dark, thanking the myriad tiny stars above that he would at least be physically comfortable while dealing with severe mental distress. I thought of Van Gogh and those gentle people who see beauty and who try to share it with the rest of us in the gutter.
But now, my friend was gone. He had “escaped” from the Psychiatric Unit. He had walked through the Hospital in very few clothes and no shoes. He was filmed by CCTV as he left the Hospital grounds. I was shown this footage by Hospital Security staff. This was not to demonstrate their efforts in relocating my friend. A female Security Guard explained that, as my friend had left their Campus, they had no obligation to search for him.
Shock pervaded my body. My mind reeled with their legalese, their lack of any sense of responsibility or compassion. I explained that my friend was dressed only in a hospital gown and that it was a frosty night. I tried to impart that he was in the midst of a psychosis, almost completely unaware of who he was and where he was. By now it was getting late. The Security woman explained that they had called the Guards to let them know. Of course, I was entitled to go look for my friend myself, as the Guards did not have much capacity for that sort of thing. Involuntarily, one word came to me, Abbeylara, the poor young man who lay dead there and his family who had asked for help for him.
Meanwhile my friend was lost in a city he did not know well. There was a very big river flowing by a long quay. I realised I’d better get going myself or he could die of exposure, be hit by a car or truck, be attacked by someone or worst of all he could drown… that is, if something terrible had not already happened. Time to move…
I ran from the Hospital entrance dumbfounded. We had arrived in the reasonable expectation of finding some solace there. I paid the parking fee and drove out the gate, but where to go? Fatigue, after such rushes of adrenaline during the long day, had started to cloud my mind. Gravity tugged at my tired muscles. These sensations clashed with a strengthening sense of alarm. How do you find one person in this vast strange, dark and unfamiliar place. He could easily have an hour head start.
Frantic, I scoured streets as I drove. Nothing. He knew no one here. “Think”, I ordered myself. “Feel”. “Think like him”, assuming he could make any sense of his surroundings. He has an excellent sense of direction. Has. Not had. “Come on now. Keep going.”
I had done some training, had some experience and heard stories of hypothermia. How long could a psychotic man in a hospital gown last in minus 2 degrees Centigrade? Traffic was light this night, this quiet week after the New Year. Silver linings.
“You know him so long, you should be able to figure out where he would go”. I chided myself for leaving him at all, but that was nonsense. Surely, it is OK to trust that someone would be safe and secure in a secure facility? Was that really a lapse in logic?
I could not work up a sense of guilt, just disbelief and distrust in this Hospital. It was as if these people did not really want to admit my friend and were then quite happy for him to amble slowly, psychotically off their Campus. A pang of anger. My fingers gripped the steering wheel of the car. Where were those Men in Black when we needed them?
We’d been through enough for several years now, dealing with this alien world of schizophrenia. It was an entirely new experience. There was little help, beyond pamphlets, pills, internet searches.
There had been short stays in hospital, returns to work amidst strange looks, loss of pay and increasing discrimination, isolation and degradation and shunning by family. The phone did not ring much anymore.
We did not think a psychosis was that big a deal. Other people pay good money to get high, to get mad drunk, every weekend. But when someone gets a bit disorientated quite naturally, everyone gets so weird about it. Delusion is an everyday experience. The real insanity was that my friend was missing.
Everything in this city slopes down towards the river. I worked my way slowly along the quay. The river was a big, black, absence of light. There was only dark movement and lapping. I got out of the car to work along the metal rail. It stopped in places where seaweedy stone stairs slithered down into black water.
My hair blew around my face. Water filled my eyes with cold. “Please don’t let him fall into the river” I begged. My friend did not like to swim as much as I did. Still, a voice in his head could tell him to do something. The cold alone would take him. The tide was strong here. Small white caps of waves were picked out by the street lights as the wind whistled over the water. “He must be so cold already” I reasoned. Surely this would keep him from wanting to get wet.
I got back in the car and thought hard. The train station was a possibility. He might just try to go home. It is a natural, basic thing to do if you are fearful or upset. He would not think about being in a hospital gown. He would not be worried that he has no money. Whoever he meets might have a hostile reaction though. I drove, scanning all the way, and parked by the station.
Just as I went to open the car door, I spotted a figure in the dim light from a lamp post. I knew him by the beating of my heart and let’s face it, not too many walk around in hospital gowns. Relief fell on me like a soft blanket, silent, warm. I breathed out so loudly that I startled myself. “Wow, he is alive. He is here. What should I do now?” Bring him back to that stupid Hospital that lost him? Would he be willing to go? I nearly could not believe that he was there, about to go into the station.
Quietly, gently I approached him. He was pale and shaking, his gown flaring slightly in the breeze. He had not seen me. “Hey”, I said quietly, “I was looking for you. Will you come and get in the car?” “Yes”, he said simply. I helped him in. I was shaking too. It was partly from the chill but mostly it was due to such sudden decompression. Is it possible to get the bends on land?
“Will you come back with me to the Hospital?” I asked. “It is warmer there. I’ll stay with you as long as you need”. “Yes” he said, then nothing. He sat, staring forward. I drove us back in minutes. It was all so simple when the alternatives could have been so messy, so tragic, permanent. Images flashed through my mind and I shuddered. So easy. Others have not been so lucky. I praised all the powers of the universe for the gift of another day with him. He nodded off beside me as the car heater churned out warm air.
We were dazzled in the lights of the hospital foyer. We walked down long quiet corridors to the right door. I knocked. We washed him. His feet were filthy and cut, as he had been barefoot. He had an unexplained graze on his knee. That was all.
The psychiatric staff said they were sorry but did not explain how they could lose a person who was so unwell.
My friend slept a lot for several days, heavily medicated.
During the years of caring for him, I had grown to realise how people can lose so much – employment, home, family, friends, security – due to mental illness and other people’s reactions to it here. Even though we had both received fantastic educations and had such promising futures, a lot of that lay in ribbons. “At least he is alive”, I thought. He could have disappeared in the river and then nothing, not even answers. “We have to rely on ourselves” I decided.
Ten days later, my friend left the Hospital, like a timid fledgling, he was so vulnerable. No tests had been carried out to address his general health. No investigations had been made into potential causes of his symptoms. The Psychiatric staff helped my friend to come back to himself and for that we are eternally grateful. We drove away together to begin to re-join the world. We faced the additional wreckage of the past couple of weeks to the general pile. He was alive and improving in himself. That was the important thing.
“He is gone”.