They brought her to the ward in a spring morning. I don’t remember which month it was. But it was one of those days with warm sunshine and a wind that doesn’t get under your skin. There was a scent of renewal in the air. One of the emergency admissions in the Psychiatry Department. She was a young doctor, one of the few I saw being admitted there. One day like any other, plenty of notes and the ward round to finish. Most of the patients wandered around very quietly. Someone looked out the window waiting for a kind of redemption, someone else smoked in the courtyard “because smoking helps to pass the time”, as they used to say.
Recently registered, I had seen just a few psychiatric outpatients and I didn’t have any idea how to manage a case like that. Luckily, I was there just for a training experience and people more skilled than me would have the honour and the burden to make such an important decision. I didn’t clerk her, but I heard immediately her cries. Awful and hopeless, you could hear them even from outside the clinic. Apparently it all started from her fiance’ having an affair, but obtaining a confirmation from her was impossible. Surely, she wasn’t the first person to expiate her love pain among those walls.
In a few months I had heard stories of all kinds: derealized mums, depressed teachers, young people trapped in obsessive rituals or speaking with the devil. There was also who had never been in the world, the real world, if not for short periods of time. They just observed it through clinic like that one. Year after year, season after season. The world outside, far as it was, seemed like a hope. In contrast with the popular opinion, however, that was a quiet place most of the time. It was a house of broken dreams, where everyone put in their cabinet their special sorrow. Lonely souls, at the mercy of themselves and the world, hurt by an awareness that sometimes they would prefer not to have. One day, interviewing a patient who was about to be discharged, I heard a colleague asking her about her future and family plans: “Who would ever date me? I am a lunatic”. I felt miserable.
Then there was the death, but even that was different from what I used to know. It didn’t hide behind cancer or infectious diseases waiting the right moment to appear out of the blue. In some cases it felt like death was always there, maybe only in a vague idea, playing with people until they couldn’t fight it back. But we could just imagine these thoughts, contemplate them sometimes, just like the epilogue of a story with unlimited pages. Some other times, standing aside, we faced the illogic paradigm of an already dampen life. As Seneca said, “in proximo mors est” (death is near at hand). Every person with a suicide history knew it very well, and I was actually often surprised by their creativity.
Nevertheless, that patient was different; she didn’t have any psychiatric records and her collapse had been as sudden as aggressive. One day it had happened, that was it. Her world had fallen with her. I don’t remember how long the cries lasted, days, maybe more than a week. It didn’t matter what I was doing, if sneaking off for a non-decaffeinated coffee in the near clinic of Paediatrics, or being in front of the pc to work on some research studies. Sometimes the cries would restart, like a strident and monotonous lament, a river in flood from which all of us were overwhelmed.
Despite the best treatments possible, the anger or the sorrow that was inside her didn’t want to leave. Neither to be quiet. Whatever it was that upset her mind was gradually fraying her beauty, preventing her from eating or drinking properly. That broken life, that inescapable draining of the absurd in the solitude of a hospital bed, was a demoralizing and unfair entertainment.
Everyone who was, despite himself, in front of her room, promptly fell victim to all kinds of cries and insults. You could see them from a distance, shaking their head upon leaving, whispering words of disapproval.
I still haven’t understood the reason, but another junior doctor and I were spared from that pillory. Our presence must have been so inoffensive that results disarming even for the most furious person in the world-I use to tell myself.
So we started to approach her. To say hello or sometimes to help her nourish the body that she did not consider relevant anymore. Her pain had surfaced in a burst, with all violence possible. Then nothing could be done, apart from trying to figure out if she would pull through. Beyond the formal psychiatric diagnosis, we were wondering if her problem was a long time repressed disquiet, or just an unlucky fate.
In the end, without any notice, the light came back. The patient restarted to eat and to confront other people in a quiet way. Even to speak about her problem. I bumped into her outside, in a clear morning, some weeks after her discharge. She was sitting with her mother on a bench out of the clinic, having come for a routine check. She was fine. Her face looked different. They told me that she had returned to a normal life and in a short time would be back to work.
“Thanks”, she said to me suddenly.
I didn’t know if she had a clear memory of me or of those bad times. I could have asked, but I preferred to keep the doubt.
I thought about her again, from time to time, wondering if the mental illness could be with some of us only for a limited time or if, no way out, it represented a shadow over our future. I eventually stopped. Suffering from a mental illness is like silently plummeting through the darkness. It is impossible to know when or if it will get to an end. The only thing we can do is to teach the world to fight the silence. Because speaking helps to keep the darkness away. And the dark, sometimes, scares.
- Walking back home