Nurse in a Mental Hospital

Thirty years ago, in August 1987, I began working as a volunteer nurse in a mental hospital in central London.

A couple of years before that, the thought of going abroad, leave alone working in London, would have sounded as fantastic as going to the moon. To my knowledge, nobody in the DNA lineage between Manu (the Indian Adam) and me had ever left Indian soil. My parents’ professions brought in just enough to make ends meet - my father played the sitar, and mother taught Sanskrit. By the time I qualified as a Chartered Accountant, I hated accountancy enough to resolve never to practise it. The CA firm paid me Rs 450 (37 dollars) as a monthly stipend. [It was one of the top firms; the mandatory stipend was only Rs 60 (5 dollars)/month]. My savings over three years had amounted to Rs 2400 (200 dollars), not enough to buy an international air ticket. Like most lower-middle class Indians, my birth-to-pyre journey was supposed to happen exclusively in Indian geography.

Fyodor Dostoevsky, the legendary Russian novelist, was the first to amend my destiny. During my bearded teens, his novels had inspired my study of the Russian language. Dr Nikolay Maevsky, head of the Bombay consulate’s Russian language dept, had recommended my name for a fully paid scholarship for higher studies in Moscow. After Dostoevsky, Dr Maevsky was the second person responsible for my going abroad.

In those days, the Indian passport was handwritten. The opening description page included the colour of your eyes and hair, your height, profession, visible distinguishing marks, and name of father or husband (but never mother or wife). Below that, the name of the person who should be contacted in the event of your death or accident. The passport was valid for all countries except South Africa. It had no expiry date. It was given for five years, and could be extended every five years. I was told one needed a passport and dollars to go abroad. Only fools (or corporate employees) converted rupees at the bank. Black market rates were far more attractive. One of my neighbours was working on a ship. I bought 200 dollars from him at a mutually beneficial rate.

At the airport, for some enigmatic reason, you were required to buy 20 dollars officially, and that entry was made on the passport. On 6 September 1986, visiting an airport for the first time, I proudly held in my hand the free Aeroflot ticket, part of my scholarship package. I carried no credit cards, no travellers’ cheques, no gadgets of any kind – my wristwatch was the only thing with moving mechanical components. My wallet contained 220 dollars in cash that I planned never to spend.

*****

In Moscow, I should have completed my Russian language education, and returned to India on the free ticket. There was no question of ever going to the expensive West.

Seth Godfrey was a close friend at my Moscow Institute. He was an American communist, but with a healthy sense of cynicism about communism. One day, during a walk in the woods next to the institute, he said: “Ravi, now that you are in Moscow, why don’t you travel to Europe? It’s a wonderful opportunity to go to places like France, Germany, England.”

“Seth”, I said, “I need visas to go to all these places. I am unmarried, with no money and no job. Which country will give me a visa?”

“You can go to work there.” Seth said.

I laughed. Americans can be so naive at times. “If tourist visas are so difficult, how will I get work visas?”

“Listen, you can do voluntary work. I am on the board of Volunteers for Peace.”

That was the first time I had heard of voluntary work. Volunteers for Peace (VfP) organised camps around the year. A booklet gave detailed information about each camp. You needed to submit your preferences. For each camp, 15-20 volunteers, up to 27 years of age, were chosen. The organisers made sure the group would be diverse; you usually had more than ten nationalities at a camp. You were expected to land at the camp at your own cost. After arriving, until the end of the camp, you had no expenses. Your accommodation and meals were taken care of in exchange for your labour. Volunteers for Peace sent a confirmation letter for each camp. That letter would serve as the basis for getting visas. I had applied for camps in countries where I had friends. VfP changed only one of my requests. Instead of the Ireland camp I had asked for, I was booked as a volunteer nurse in the St Mary Abbott’s hospital in London. You would work with psychiatric patients, thanks and best wishes, the letter said.

*****

My Indian training on virtue and economy had benefited me. I had saved 400 roubles from my Russian stipend (with the 220 dollars still intact for a black day). That money bought me a railway ticket that would take me to each of my camps. I have previously written stories from my Poland camp where volunteers restored coffins in a beautiful Warsaw cemetery. [E.g. Ashes to Ashes Dust to Dust(week 32: 2004) and The Gentleman with a Dog (week 33: 2004)]. From Warsaw, in August 1987, with a train-ferry-train combination, I landed in London. Straightaway, I made my way to Kensington, to reach St Mary Abbot’s hospital.

*****

The hospital was built in ‘Jacobethan style’ whatever that means. It was a four-storey lime-white and brick-brown structure, typically English. On a brochure, it was described as a long stay hospital for chronically sick, geriatric or psychiatric patients. Lush green lawns in the courtyard made the ambiance pleasant. The round-the-year rains make the English green greener, and lift the spirits even at a mental hospital. The top floor of the hospital was spacious, bright and empty. We, the volunteers, were allotted beds there. It was the most comfortable stay among all my camps. Breakfast and lunch provided in the hospital canteen were clean and in plenty. The camp gave each volunteer two and half pounds daily, in lieu of dinner. Alas, the following month showed that such hospitability is not enough to sustain the volunteers. Working with the psychiatric patients is not easy. Volunteers began leaving the camp one after the other (voluntarily), and by the end of the month, I was the only one left attending the famed morning meetings.

*****

Every day started with a formal meeting of the patients. Each group of nearly twenty patients was assigned a doctor (generally male), a nurse (generally female) and a volunteer nurse (such as me). The starting time was 08.00. In a giant room, we all sat in a circle. Each day, a new chairman was appointed. The chairman of the day was chosen from among the patients.

“You select a patient as a chairman. But aren’t they... aren’t they.... mad?” A German volunteer had asked on the first day during our briefing.

“Most of them are classified as psychiatric cases, yes. But the degree varies. Day-patients are here only during office hours. The residential patients, again, can vary widely. Our aim is to improve their condition. It’s important they chair the meetings, and not us.” The English doctor had explained.

Each patient was encouraged to speak. Topics were not prescribed. Everyone was free to talk on subject of his/her choice. Usually, a patient would try to unburden himself by talking about his condition, his fears, his experiences, his dreams (or nightmares). For the patients, this was their community. Some of them looked forward to this meeting, a few dreaded it.

Kevin, a recently retired man, was fairly shy. He was a day-patient. Many times, he turned up at the hospital after the meeting was over. He would apologise for the delay. His doctor then made the meeting mandatory for him. As a volunteer, I got the additional task of getting him to the hospital every morning. He lived within walking distance. I would call on him at 07.30. I had to ring the bell a few times before he opened the door. Kevin was polite and reserved. Yes, yes, I am coming; he would say and disappear inside the house. The following week, he came out with a colourful, big brush in his hand. He was painting the walls.

‘You see, I need to finish painting this wall. Please tell the doctor I can’t attend the meeting today’, he said to me.

‘Kevin, it’s the other way round. You’ve started painting the wall, because you don’t want to attend the meeting.’ I said. One didn’t need an education in psychiatry to see through Kevin’s mind. On my sharing the wall-painting news with the doctor, he smiled. ‘You are absolutely right’, he told me and assigned another man, a strongly built security guard from the hospital to bring Kevin in from the next day.

The morning meeting was scheduled for 90 minutes. The chairman of the day was expected to facilitate the meeting as well as take notes. The doctor and I were not allowed to say a word. It was like a school classroom. Because the twenty odd patients met daily, they knew much about one another. Their stories and experiences were assimilated by the fellow-patients.

People were generally well behaved. But a team of guards always stood outside, ready to be summoned. My most vivid memory is about Thalia, a sweet looking round-faced young girl. When she talked to you, nothing seemed wrong with her. At that hospital, for the first time, I realised that distinguishing between sane and insane people was not an easy task.

Many years later, as a mature student, (I was 41) I studied psychology at the University of Derby. At the beginning of the first lecture on abnormal psychology, the professor took a quick survey. Please, he said, those of you who consider yourself completely normal, raise your hands. I knew I couldn’t fall into that category. I had acquired a CA degree and refused to use it, I had left my career at forty to write books. No way could I be normal. But my classroom was shared by more than one hundred students aged 18-22. Surely, many of them should be normal. Well, not a single student dared to raise his hand.  

Anyway, back to Thalia. This sweet looking girl would suddenly become unrecognisable. Her language and actions became aggressive, with loud banging on tables and throwing of objects. One day she was telling us, in a very nice way, about her friend from school. In the middle of a sentence, she pursed her lips. Her eyes began burning. And then she started shouting, swearing and throwing everything in the room she could lay her hands on. Papers flew, plates broke, tea splashed in the face of another patient. She ran to a cupboard in the corner and knocked it down. It made a terrifying sound as it crashed along with all its contents. Initially, two female guards tried to control her. When they couldn’t, their male counterparts rushed in and took Thalia away. For several minutes, nobody spoke. Even the doctor sat in stunned silence. We wound up the meeting soon. For a week after that, we didn’t see Thalia. When she returned, she looked dull and aged. The spark in her eyes was gone. I guess she was heavily sedated after the incident.

(To be continued)

Ravi