Wednesday, July 18, 2007

“Someting’s happenin!”

I don’t know what it is about me and mad people. Aside from having gone slightly mad myself (with PTSD after the bombings) I seem to attract the friendship of people with unsound minds. Or maybe it is that I am attracted to them, I just don’t know.

A friend had arranged to take me to Mustique for lunch on the anniversary of 7/7 this year. He had arranged for a boat to pick us up and whisk me across the high seas to the manicured millionaire’s island a mere 7 miles from here. It was to be a surprise, a treat to take my mind off things. I can see it now from my porch as I write, but we never made it there that day.

Wilf is a friend from Bequia. A ‘typical’ West Indian rasta man. He has dreads and smokes weed and is always immaculately dressed in complementing bright Caribbean colours. He doesn’t drink alcohol, which is a rarity around here, he says it makes him into ‘a bad man’. For a couple of weeks there was calm in the rum shack at the harbour’s edge. The crew of the boat bringing over the molasses had been arrested for carrying drugs and the extra strong rum had consequently run dry. The men here drink this potent paint stripper of a drink neat with a water chaser. It is 80% proof and fuels violence and fights. Now it is back on the grocery store shelves and island fever has returned.

Two weeks ago Wilf took the boat to St. Vincent, the capital of this tiny collection of Grenadine Islands. He was going to sort out a new passport so that he could visit his son in England. But whilst he was there he was held up by 5 armed police, guns held to every part of his body, and robbed of the $800 in his pocket. Corruption in paradise runs rife. Who can you report it to when you’re mugged by the police themselves?

This was the trigger for the ‘bad man’ to return. He hit the bottle to mask out his pain and anger. The money was to fix his boat, on which he relies for his living, and to pay for his new passport. He drank himself into despair. If he couldn’t fix his boat he would never be able to make the money back to get the passport and he would never be able to see his son. A thought which has made him weep before me many a time. Emotions here run high and are worn openly on people’s sleeves. A far cry from the British stiff upper lip, it is normal to see a grown man crying, hear raised voices in the street and to pass people dancing with joy as they walk.

A week of the ‘bad man’ then a mad man appeared. A desperate phone call on the morning of the 7th
“Something’s happening, come quick!”.
I found him, face gleaming with tears, standing in front of his house.
“Every time I lie down I hear voices talking to me” he cried.
He said he had heard his mobile ringing in the night, even though it had run out of power, and when he put it to his ear there were voices on the other end. All night these voices had raged in his head, he asked me to take him to the hospital.

There was a gathering of people at the hospital entrance, people waiting patiently on benches, in the shade, to be seen. As we approached his eyes filled with terror and he started edging away from them backwards, finally turning and running out of the gate. I caught up with him to find him sweating and shaking, terrified of all who approached.
“I’m frightened of everybody” he told me “what’s happening to me?”.
He wandered around the village eyes streaming and his body dripping with sweat. He picked out his friends one by one
“Something’s happening” he repeated “I’m hearing voices in my head”. They all looked concerned and tried to help. One contacted the private doctor, who can usually be seen straight away without the nerve wracking queues at the public hospital, but he is a 7th day Adventist and doesn’t work on Saturdays.
“I’m hearing voices in my head’” Wilf told a passing old lady.
She looked deep in thought for a while and finally declared
“You need somebody who believes in the Lord God Almighty to get rid of that!”. He looked at her in despair and walked away.

I sat him in the shade under the almond tree to try and calm him down
“Who are you?” he asked me “are you an alien?”.
Another friend approached with a portrait of Che Gue Vara on his T shirt.
“Who’s that?’ Wilf asked, clearly terrified again ”Who’s that on your T-shirt?’ as he cowered under the tree “Go away, you’re frightening me”.

With the help of an old friend of his who is also a policeman we finally got him to the hospital. We walked through a small wooden door with peeling paint to find a man dressed in white sitting at a rickety wooden desk.
“We are only seeing emergencies” he said, without looking up.
“Who defines an emergency? You?’ asked the policeman incredulously as he marched through the room and into the main ward behind looking for a doctor.
“You can’t go in there” said the man in white sternly “And this is not an emergency”.
“Well in my opinion it is” replied the policeman “I have known this man a long time and I don’t like what I am seeing here”. Eventually, more through stubbornly refusing to leave the room that tactful negotiation, the man in white, who revealed himself to be a nurse, started talking to Wilf and asked him what was wrong.

Wilf told the story of voices and fear again. The nurse calmly asked him if he used marijuana or cocaine.
“I’m a ratsa man!” Wilf replied indignantly, “I don’t use cocaine”. He told of his mugging and the drinking and said he was afraid of people in the street.
“Are you afraid of me?” the young nurse asked calmly.
“No” my friend meekly replied.
“What do you think they are going to do to you?”
“Hurt me” he said.
“Do you think I am going to hurt you?”
I was impressed with how this young man was handling the situation. He asked if he had ever had a breakdown before, if there was any history of it in his family.
“My Nana went senile” replied Wilf “a lot of my family gone that way”.
The nurse nodded and continued to make notes.
“Do you think you have any special powers?’” he asked and I knew where he was going. I have sat in enough small rooms with men in white and mad friends at my side. I know that a common symptom of mania is belief in holding extraordinary powers. The voices, the delusions and paranoia together with this belief would set the perfect scene for a manic episode. In my experience, your every day GP at home does not even know this, so this young nurse was winning my respect.
“Yes I have special powers” Wilf told him, and my heart shrank inside,
“Oh no, not again” I thought to myself.
“What sort of special powers?’ the nurse persevered.
“I can see inside people”.
“Oh God no!” I inwardly cried.
The nurse looked unmoved and asked if he could see inside him.
“Yes” said Wilf
“What can you see?”
“I can see you are a good man”. Relief flowed through me but the nurse was not yet convinced. He picked up his stethoscope and waved it at Wilf
“You can’t see solid things like this inside me?’”
“No” Wilf solemnly replied, not even flinching at the absurdity of the question. “I can just see that you are a good man”.

The nurse seemed satisfied and picked up the phone, apparently speaking to the doctor. His mumbling and his accent made him hard to understand but I gathered he was giving the doctor a brief synopsis. More mumbling, more notes, the phone went down and he walked over to the counter and picked up a syringe.
“Your blood pressure is very high, I am going to give you something for it”. There was muttering of Valium and other drugs incomprehensible to me. The doctor hadn’t even seen him yet the nurse was ready to give him a cocktail! Wilf started to quiver again
“No! I am allergic to lots of things, I’m not taking no mad person’s medicine, I’m feeling much better, I don’t need no drugs”.
“Well” the nurse replied sternly “I have no idea why you came to see me then”.
“You have made me feel better” Wilf told him and hurriedly we left. He was right, though, the nurse had helped, just by listening and talking and diagnosing a tangible physical problem of high blood pressure.

I took him back home, fed and watered him and put him to bed. He slept fitfully for a few hours and awoke looking drained and exhausted. Over the last few days he has complained of a racing heart a couple of times but there have been no further episodes. He has been eating like a horse and is slowly regaining his strength.

His insight is remarkable. Not just in the aftermath, but even at the time he was acutely aware of what was happening to him. I have seen people talking to themselves, to their voices, unaware that they are doing so, unaware that there was anything wrong with them. I have spoken to so many men, particularly black men, in hospitals in London who stringently deny their illnesses. It is, I think, a matter of stigma and pride. To admit that you are mentally ill makes you less of a man, to admit it is losing, better to deny it and keep a glimmer of hope that it can yet be beaten. But this was different and fascinating because of it. No hushed whispers, no hiding away, no denials or refusals to seek medical help. He was out there in the street wailing, desperate, telling all that were passing “Something’s happenin, something’s wrong”.

Perhaps it is the security of a small island community that made him feel able to do this. His friends are still concerned, looking out for him, but there seems to be no stigma attached to the fact that he went a little doollaley for a while and he shows no sign of embarrassment or shame. It’s just something that happened, and everyone is glad that he’s better. Perhaps it happens here all the time which is why no one batted an eyelid, I suspect not, though. I suspect that this is just the way of dealing with things here. People are open with their emotions, their troubles and their joys and are not, it seems, judged for it.

We, at home, would do well to learn from this lack of inhibition and openness, particularly where matters of the mind are concerned.

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