“I never want to come back here,” she said bluntly. “I’m absolutely determined this time not to become ill again.”
She had said it before, many times before. If being well was simply a matter of want and willpower, she would be fine forever. Free choice had about as much chance of curing manic depression as a sheet of rice paper had at stopping a runaway train.
“I know,” I said calmly. “I don’t want you to have to come back here either.”
It was a major step forward in her recovery that she even recognized that she had been ill in the first place. For me, one of the most distressing things about her condition was that when she was manically high or depressively deep, she couldn’t appreciate that her bizarre, occasionally outlandish behavior was in any way unusual.
“Come on,” I said, breaking the morbidity of the moment, “let’s go and have some lunch.”
We walked hand in hand back up the expansive lawn towards the house.
“I love you,” Sophie said.
“Good,” I said, slightly embarrassed.
“No, I mean it,” she said. “Most husbands would have run away by now.”
Wow, I thought, she really is nearly better. For the time being anyway.
“I haven’t been much of a wife, have I?” she said.
“Nonsense,” I said. “You’ve been the best wife I’ve ever had.”
She laughed. We laughed together.
“I will really try this time,” she said.
I knew she would. She really tried every time. But chemical imbalance in the brain couldn’t be cured by trying alone.
“They have some new drugs now,” I said. “We’ll just have to see how they do.”
“I hate them,” she said. “They make me feel sick.”
“I know, my love. But feeling sick for a bit is surely better than having to come back here.”
We walked in silence up across the terrace, the sound of our shoes on the gravel unnaturally loud in the still air.
“And they make me fat,” she said.
We made our way back into the building through the French doors of the patients’ dayroom. What must have once been a spectacular salon, with great works of art and crystal chandeliers, was now a rather dull blue-vinyl- floored utilitarian open space. It was filled with functional but uninspiring National Heath Service furniture and lit by rows of fluorescent tubes hanging down on dusty chains from a superb ornamental-plastered ceiling far above. Such sacrilege.
Sophie and I sat down at one of the small square tables, on chairs that were so uncomfortable they must have been designed by a retired torturer.
Overall, the staff were very good with the patients’ families, encouraging us to spend as much time as possible at the hospital. There was even a guest suite for relatives to stay overnight, and Sophie and I were not the only family group sitting down to a Sunday lunch of roast beef and Yorkshire pudding in the dayroom. More comfortable chairs, I thought, would have helped.
“Please, can I come home for next weekend?” she asked me.
“Darling, you know it’s up to the doctors,” I said. “I promise you I’ll ask them later.”
We ate our meal mostly in silence.
The only topic Sophie wanted to talk about was going home, and I had just put the stoppers on that. But it was up to the doctors and not up to me. Patients in secure mental health accommodation could be released back into the community only on the say-so of a consultant psychiatrist and by agreement of a relevant “Care Programme Approach Review,” involving someone called the “Responsible Medical Officer,” as well as the appropriate “Mental Health Care Coordinator.” If they thought she needed two more weeks in the secure unit, then two more weeks it would be, however much I might want her home right now.
It was the drugs that were the problem.
Over the years, the doctors had tried electroshock treatment, but, if anything, that had made things worse, so Sophie’s only option was to take a daily cocktail of brightly colored pills. Some of them were antipsychotic and others antidepressant, but they were all referred to as “mood stabilizers.” Whereas together they could usually prevent and treat Sophie’s symptoms, they all had side effects of one sort or another. Not only did they make her feel nauseous, they also tended to reduce the activity of her thyroid gland while increasing her craving for carbohydrates. Hence, Sophie was right, they were inclined to make her fat, and that, in turn, was bad for her state of mind, especially for her depression.
But the most problematic thing about her condition was that when the drugs made her feel free of any form of psychosis, she started to believe, wrongly, that she didn’t need them anymore. The pills, and their side effects, were then thought of as the problem rather than the solution, and hence she stopped taking them, I think more by neglect than design, and then the whole wretched cycle started once more.
For some sufferers, they miss the manic “highs,” and so they purposely stop taking their medication. The high time for some can be very creative. There is a prevalent theory that Vincent van Gogh was a manic-depressive and that during his manias he produced some of the greatest art that man has ever seen while during his depressions he first cut off his own ear and then ultimately shot himself to death.
Many great writers and artists of the past have been referred to as “troubled souls” long before their condition was seen as being mental illness. Manic depression may have given the world more than it realizes. Nowadays, it has been relabeled as “bipolar disorder,” and appears to be almost fashionable amongst the young literati.
“Would you like some fruit salad and ice cream?” said one of the staff, taking our main-course plates.
“Yes, please,” I said. “How about you, my love?”
“Yes,” she replied rather quietly. “Lovely.”
“Are you all right?” I asked.
“Fine,” she said, but her eyes were distant.
The doctors were right, I thought. She might need at least another two weeks of their care to get the drug doses sorted out properly.
We finished our lunch and went up to her room. She regularly took a nap in the afternoons, and I was hopeful that it had just been tiredness that had caused her to be somewhat vacant downstairs and not the start of another inward-looking depressive episode.
The two of us sat down in armchairs in front of an old black-and-white war film on the television. Sophie drifted off to sleep while I read her newspaper, mostly the racing pages. Regular domesticity.
The inquest into the death of my father was opened and then adjourned on Monday morning at the Coroner’s Court in Maidenhead.
The proceedings took precisely fourteen minutes.
Detective Chief Inspector Llewellyn was called first, and he informed the coroner that a violent assault had occurred in the parking lot at Ascot racetrack on the sixteenth of June, the previous Tuesday, during the evening at approximately eighteen-twenty hours, which had resulted in the subsequent death of a man at Wexham Park Hospital, Slough. The time of death had been recorded as nineteen-thirty hours on the same day.
A written report from the post-mortem pathologist was read out, stating that the primary cause of death was hypoxemic hypoxia, a lack of adequate oxygen supply to the organs of the body. The hypoxia had been brought on by pooling of blood in the lungs as a result of punctures to each side of the deceased’s abdomen caused by a sharply pointed, bladed instrument approximately twelve centimeters, or five inches, in length and a little more than two centimeters in width. The blade had been angled upwards during each strike and had, on both occasions, penetrated the diaphragm and ruptured a lung. The hypoxia had further resulted in acidosis of the blood plasma, which in turn had led to cardiac arrest, cerebral ischemia and, ultimately, death.
Or, in laymen’s terms, my father had died from being stabbed twice in his stomach with a knife. The wounds had caused his lungs to be full of blood rather than air, so he had suffocated to death.
My father had, in fact, died due to a lack of oxygenated blood to his brain.
Just as my mother had. But for different reasons.
I was called by the coroner to give evidence of identification. The letter of summons had indeed been in the pile
