PART 1 - INSIDE OUTSIDE - INTRODUCTION

Trick cyclists gong for a spin
Used to cycle round the bin
Now they take the tricky ride
With the rest of us outside

It’s meeting with the likes
Of us, makes ‘em fall
Off their bikes ….






The day my results came through confirming my registration as an SRMN (State Registered Mental Nurse) I should have been over the moon. Instead I arrived for work at the gates of Long Grove Hospital and stood for what seemed a long time outside the Head Porter’s lodge and the fading blue and white hospital sign and looked at the brooding buildings. Through the trees I could see the tower, the grey façade of the administration block, the wards curving away to the right and left. One or two staff passed me and I remember them giving me a quizzical look. Before me the road ran through the gates into what had been my world for several years, behind me the road stretched into the winding, leafy Surrey lanes. Something changed within me and my pent up anger at the system of which I had been part suddenly came brimming up into my consciousness. I felt helpless and alone yet at the same time very determined and thought that if it took the rest of my life to close down places like this then that’s what I would do.

It wasn’t that hospitals like Long Grove – and there were many of them – were intrinsically bad or that the staff were brutal and heartless or that the conditions were terrible. Of course there was all of that to a greater or lesser extent but overall I think the staff did the best they could according to the time and the knowledge they had. If anything that which affected me most was the callous disinterest in the patients and the way in which we often behaved as if they weren’t there. Mostly I think this was a defence mechanism to make our staff reality more bearable; if we identified too much with the patients and the environment of which we were part so we somehow became responsible. And that was a burden none of us wanted to carry. To some extent this is still extant today even in the most up to date psychiatric facilities. You only have to see how the system fails utterly to cope with one of their own when they have a mental illness. It is just too close for comfort and in spite of our enlightenment mental illness is still something that happens to other people.

We often hear people talking about a return to institutional care and in fairness there are a few, a very few people with mental illness who would be better off if there was a long term facility for them. But these are very much the minority and most, in spite of their struggle with living in society, are much better off than being in those long term wards. People who are quick to seek a return to the asylum invariably speak from a position of ignorance. One of my objectives in this book will be to balance that world against what we have today. We are still far from perfect and often make mistakes. But let us never even begin to consider returning to those locked wards, and endless days staring at the wall.

So my ambition to see these large, old hospitals closed was perhaps precocious, after all I was only mid-twenties, naïve, inexperienced and without a clue as to what I would do next. But every journey begins with the first step and knowing I couldn’t go back I turned around and taking a leaf from Robert Frost chose another road.

* * *

I guess the worst thing about depression (and I speak from experience) isn’t the misery or the sense of hopelessness or the dark, black days. It is the terrible damage it does to relationships and the way in which it makes people who are already isolated in themselves become isolated in the physical world as well. It is hard to maintain relationships when one’s behaviour drives away the very people you need close. And in many ways that has been the story of my life to date and no doubt the lives of the many people on whom the black dog sits. The statistics are bland – one in five people will suffer from depression at some time in their lives. One in five. But for those who quote this terrible statistic I wonder if they have any real idea of what it means to the one in five, or their families or their hopes and dreams. In some ways this book is a journey through an ordinary person’s life who has struggled and sometimes succeeded in the management and control of depression. And sometimes failed. But it is also a journey of hope and a dream to make life different for not just the one in five, but for all those who suffer the terrible ravages of what is really the least understood of all maladies – mental illness in its myriad variety of forms.

Not that I ever imagined how I would end up, or what twists and turns life would take. A serendipitous journey indeed with one thing linking to another to make a long and convoluted chain. Usually what passes for a biography begins at the beginning and ends at some point of transition – a career ended, a task done, a journey completed. Most have an order to them; you know that chapter one will be childhood and the last chapter will be wistful musings on what has been learned. This story will probably be different and I will unashamedly duck back and forth following my life like a flight of ideas, one subject leading to another and back again. In the end the journey will be obvious, sometimes funny, sometimes unexciting or uneventful, sometimes with an undercurrent of melancholy.

Now that’s a good word. It doesn’t fit easily into today’s lexicon or taxonomy of psychiatric disorders. It is a word coined many centuries ago when the early writers tried to find words to describe the indescribable. The philosophers and physicians of Hippocrates and Plato’s time had little other than observation to support their science and so they classified mental illness simply by what they saw using the observable signs and symptoms as an anchor. Melancholy of course meant just that. It was a word used to describe feelings of abject misery and hopelessness. Melancholics were people who withdrew from the natural world and caved in on themselves. Sometimes they killed themselves and in more recent ‘enlightened’ times they often became the long term residents of the large, rambling county asylums that marked the eighteenth and nineteenth century’s great confinement. Indeed the Victorians were great reformers and the mental hospitals that sprang up in England and later the US and Europe were often the pinnacle of institutional building. But I get ahead of, or maybe behind myself.

So why write about one life? I haven’t thought of my life as particularly different and if it has been hard from time to time, then no-one ever said life should be easy. I have been persuaded though that it is a story worth telling, especially my journey in and around the mental health services of half the world. It is a journey that began in the crumbling, grey, Victorian asylums that still existed in the 1960s and ended with a complete change of direction into the world of technology and telecommunications. Along the way I have travelled the less trodden road, suffered the anguish of mental illness, successfully developed a number of business interests (and had my failures too), but most of all applied some of the lessons learned to ensuring that community services for people with mental illness can be provided successfully.

Along the way I have met some wonderful people, some of them sane; had some great times, had some times when I carried the despair of the world on my shoulders. At all times trying to see the funny side of life, seeking to lose myself in the poetry and written word of the English language when things were really bleak. But always coming up for air, waving, not drowning.

So who will find this interesting? I think I did for as I wrote it so I found to my surprise that one thing led to another, memories long forgotten surfaced on the screen in front of me, so in many ways for me the writing has been cathartic. Self aside I hope this book will interest any who have lived with mental illness either as sufferers or as carers. It will give hope to many and along the way explore what the current buzz-word ‘recovery’ really means. It is also a book about business, why do some things work and others not; why is one business successful and another a failure? The importance of following one’s instincts and also of, to a certain extent, sticking to one’s knitting.

I referred above to Robert Frost’s evocative poem “The Less Travelled Road” as a constant theme as it applies to all of us – life is full of ‘what ifs’. What if we did this or didn’t do that? Why did we choose this way and not that way? Life is full of choices and we cannot go back and undo any we make. So what we have we have and what we choose we choose. In the end we shuffle off this mortal coil at whatever destination our chosen path has taken us. Some cultures talk of kismet or fate but to me this removes some of our self determination and in the end we must be fully responsible for where we tread. I can think back (as I am sure we all can) to a number of sentinel events in my life that have led me to choose a particular path and some of those will become apparent throughout the course of this book.

Many years ago I read that wonderful book “Diary of a Nobody” by Weedon Grossmith that took as its theme the daily ramblings of Mr Pooter living his ordinary life with his wife Carrie and his numerous relations and friends. I always read that book thinking that the Pooter’s life was in fact far from ordinary because he reminds us that we are all so unique in our way. The most ‘ordinary’ of us have a part to play; there are kings and princes enough but their empires are built on the support of ordinary people who succeed by simply being ordinary and in so doing become extra-ordinary.

I have kept places and dates reasonably accurate but invariably have disguised the identities of staff and patients, families and others to protect their privacy. After all their distress and triumphs are theirs to own and not for me to exploit. If I dwell on their situations it is to present them in such a way as we can learn from their dilemmas, not see them as entertainment. All in all though this is as much their story as it is mine. As well I have unashamedly made some situations and characters as composites to illustrate a point or connect a series of disconnected elements that may have happened over a long time.

Where does that lead us with my life then? Ordinary, yes; extra-ordinary, maybe. Overall though I hope my journey may also provide a beacon for people who like me have given up time and time again but have never given in. On the wall of my study I have a wee aphorism that says “Don’t wait for the light to appear at the end of the tunnel – stride down there and light the bloody thing yourself”

Let’s go and light lights.