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Miller H Caldwell, click here
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Chapters 6 & 7
6
The Open Door
The following week Tony filtered his mail, making a stack of some of the pre-paid reply letters he was anticipating. The other letter which took priority was a hospital referral. Actually it stemmed from a hospital assessment. Priority was always given to such referrals. They had potential to be serious and/or demanding quick intervention for effectiveness.
Yet he could not prevent his inquisitiveness.
The first letter was from Farook.
‘Salaam Alaikum.
‘Yes, I like the idea. It would be good to meet other clerics. It is what I really want, you know, getting the Moslem community more integrated. A good way to start. Put me down for the group.’
Tony spread the letter on his desk and weighed it down with a polished stone. The paperweight came from the beach at Nolton in St Bride’s bay in south Wales where a short break last year re-fuelled his mind and body. His family air loom ivory knife sliced open the second letter. It was less formal.
‘Hi Tony.
What a super idea. Yes, that would be a real ecumenical scream. Can’t wait to put in my oar. The group meeting sounds a real treat.’
Signed Lizzie.
Tony smiled, shaking his head. Such a letter could only come from Lizzie. He though it would not be out of place for her to have signed off, Love Lizzie.
The third letter was from Ivan.
‘Dear Dr Scriven.
I am grateful to you for your advice and support and feel I am in a much more stable frame of mind. I feel a group meeting with other clerics would be a negative experience for me bringing me back to face my daemons amid my growing atheist outlook. I wish you well with the group’s activities.
Signed Ivan.
This letter was a disappointment. Ivan was perhaps his most worrying patient. A man at an anxious crossroad. He decided to continue with his individual sessions and hope he could persuade him to join the others.
Tony placed his clerical class aside, under the stone. The hospital referral was opened as a cup of coffee announced 11am. He looked at his watch.
‘You need not look at your watch Dr Scriven. As long as you are not consulting, your coffee will appear at this very moment every morning.’
‘You don’t strike me as the fastidious perfectionist.’
‘I’m not. I have radio 2 on quietly. When they announce the 11 o’clock news will follow the record playing, I boil the kettle. I make your coffee as the headlines begin. If you notice, I actually arrive at 11.02am,’ said his secretary turning, waving her skirt in an arc as she did so.
Tony consulted his watch again. She was right it was 11.02 as he crunched his custard cream.
The referral he opened was about Miss Kane.
Karen Kane was not a cleric. She was however a church organist. Her world had caved in over two days. One Sunday and the following day at school on Monday morning she lost control of reality. When the hard-backed book flew across the classroom causing a dent in the plaster, it shocked the pupils. None could have foretold the event having seen no irritation to cause Miss Kane to have such an outburst. However one pupil put one and one together and at break knocked on the headmaster’s door.
‘Come in,’ shouted Colin Martin, the school head teacher.
Peter Anderson took a gulp. Reporting a teacher was a brave move. He was in unchartered territory. Would the teachers close rank on him?
‘Well, what have you to say,’ urged the Head, sorting his papers.
‘Miss Kane, sir. She threw a book.’
Colin Martin put down his papers. After a brief silence he enquired further.
‘Was anyone injured?’
‘No sir. It hit the wall.’
‘I’m a busy man Peter. You must realise teaching is not an easy profession. There are stresses. Children have more energy than us. From what you are saying, I think this is a mountain made out of an anthill.’
‘But sir, I was at church yesterday when she went loopy.’
‘Loopy?’
‘Yes, it was the final hymn of the service.’
‘The recessional, you mean Peter.’
‘Er..yes. She was playing Jesu, Joy of Man’s desiring....’
‘The Bach favourite.’
‘Yes, but half way through the classical piece she changed her tune and played the Entertainer followed by that racy piece, the Stripper tune.’
The Head pondered what he was now hearing. Two unconnected incidents over twenty four hours.
‘Thank you Peter, you did the right thing to tell me. That is all. Now, run along.’
Colin Martin thought about confronting Karen. A denial would prove awkward. No, instead he called in Mrs Grace Brown, the head of guidance, and of course female. He urged her to keep a close eye on Karen after the incidents were shared.
Then as the pupils left the school at 4:10 am Karen opened her class window and yelled as loud as her lungs would permit, the most vile and uncensored language ever heard from a teaching staff member. The words could not be misinterpreted and were heard by teachers and pupils alike. Colin Martin telephoned the police, who arrived promptly. They took a statement from Colin Martin and made their way in his company to Miss Kane’s room.
They did not knock. They had a view of her through the frosted glass. They entered and found Karen with her head in her hands and tears flowing down her cheeks on to the splashed desk.
‘I’m very sorry, really sorry. I don’t know why this is happening to me. I didn’t mean to swear. I don’t know...I didn’t...’ But her tears were now accompanied with cries of sorrow drowning her explanation.
Constable Amy Stevenson stepped forward and placed her hand on Karen’s shoulder.
‘Not been a good day for you,’ she said.
Karen looked up and agreed in a head nodding movement.’
‘Let’s go, come along with us.’
‘Where to?’
‘Hospital. That’s the best place to go just now.’
Karen looked at the uniformed police and reflected on the decision to go to hospital. ‘So, no charge?’
‘No Karen. I suspect you are ill.’
The hospital detected a first episode of schizophrenia and released her two days later with an instruction to attend treatment with Dr. Tony Scriven. Prompt intervention with the patient was essential and Tony knew group sessions were crucial to aid Karen’s recovery. The treatment of schizophrenia often required a combination of antipsychotic, antidepressant, and anti anxiety medication. Dozes and ratios would have to be tried and monitored. But so too was a need for Karen to be integrated. It was a tenuous link but a church organist might add a certain interest to the clerical minds about to meet.
When Tony had his first consultation with Karen Kane, he realised she was a very special patient. A warm feeling drained through his veins. Karen appeared as a woman in her prime. A woman who took care about her appearance and a dimpled smile greeted him. But she was anxious to inform him that the events over the twenty four hours were not recognisable to her. Voices in her head made her throw that duster. And as for the music, she felt it was someone else who took over the keys of the organ. It could not have just been her playing inappropriate music. It was just not like her.
‘Yes, hearing voices ...’ Tony said nodding his head.
‘You are under 45 years aren’t you?’
‘Yes 37, three weeks ago. Why?’
‘First onset is significant and usually before 45.’
‘So I will have many episodes?’
‘No, not if we can agree a plan. One that gets you out and about, circulating in society. Doing things you enjoy doing. Will that be difficult?’
‘I’ve not got many interests. I don’t play bridge, don’t go to the gym. I spend time playing the piano of course,’ said Karen.
‘Dedicated to work, I am sure you are. Musicians are known for that. Not a bad thing but perhaps you should concentrate on people for a change. They can effect change. You should find a new outlet to meet non colleagues.’
‘And keep up the medication?’
‘I should keep an eye on that. Cures are not an exact science despite society knowing about schizophrenia form centuries. We fine –tune your medication, make it what suits you. It can take time. But with this ailment, you are in good company.’
‘Really?’ asked Karen with eyes lit up.
‘You are among many creative people. Vaslov Nijinsky, Jack Keronac, Pete Green of Fleetwood Mac, Syd Barrett of Pink Floyd so you see some pretty clever folk.’
‘Are you suggesting creative people have mental health problems?’
‘As I say, many do. Beethoven was bi-polar as is Russell Brand, Dusty Springfield was and so is Britney Spears. I’m sure there is a doctorate in that statistic for someone. But there are many more not listed because they are unknown. They are by far the majority.’
‘I don’t make much of my doctorate.’
Tony looked at her case notes. He flipped through them.
‘But you are known as Miss Karen Kane at school.’
‘Yes, I know. I find it’s a bit pretentious. That’s why I don’t bother with it.’
‘So what’s your doctorate in, may I ask?’
‘Doctor of medieval keyboard music.’
‘Wow, that’s a niche of its own. I mean there can’t be many of you with that.’
‘There are a few of us. Another girl did a similar thesis on medieval song music.’
‘I see. And which university was that?’
‘King’s College Cambridge. You see I really don’t want to be forward, with that background.’
‘That is an achievement not many can achieve certainly, but no reason to hide your accomplishment.’
‘You are right. Actually your advice has made me think. I should get out more.’
Tony smiled. She was prepared to take a step in the right direction towards her recovery.
‘Yes, I have heard about a local rambler’s group. Active Ramblers they call themselves. I think I’ll join that. Won’t that be good for me?’
Tony shuddered in his shoes with a bolt from his heart. Of course it was good for her but ......
‘That’s a group I have joined.’
Karen’s dimples deepened as her smile grew. A natural chemistry was at play. Each was aware of the stirrings. But Tony had to keep his interest in check. It would be unprofessional to take one step further with his patient.
‘So I should think of some other activity?’
‘Tony smiled. No, I think you will be in good company.’
7
Absent minds
Tony’s caseload fluctuated. Thirty five cases were as much as he could take on comfortably. Some cases required several sessions while others were over in a matter of half an hour, particularly if the GPs had proscribed appropriate medication and were returning under their care. Ages ranged from eighteen to eighty. The CAMHS service (Child and Adolescent Mental Health Services) attended to juveniles while the dementia clinics and geriatric counsellors attended to the over eighties. The demography was as distinct as the left from the right hand and it held professionals as well as unemployed individuals and those in every kind of occupation and relationship both established and transient. It was not surprising that Tony detected another case with a clerical perception when it came along.
Marty Mayvor fell into the Baha’i religion by chance. It was in her final year of university that she encountered this peace loving, understanding and all-embracing religion. She came from a sheltered Irish family drenched in Catholicism but found the harmonious and multi-ethnic tenets of the new faith rewarding. It welcomed her and she thought she had found her new home. Two months after her mathematics degree graduation, she began to work at a secondary school. Life was bringing its rewards and her mind began to focus on finding a husband and being a mother. That was now, no longer a priority.
The school Christmas Pantomime gave its last performance and Marty walked home to prepare a Christmas atmosphere in time for her parents to arrive from Brazil. But an unmarked police car sat outside her home. As she turned into her path, the doors opened and two police officers followed her to the front door.
‘Miss Mayvor?’ said Sergeant Karen Scott.
‘Yes, officer,’ said Marty observing two nervous police officers.
‘May we come in? We have some sad news for you.’
Marty fumbled with her front door Yale key. It was reluctant to be inserted. Her heart was racing. She could not accept what bad news could be coming. She entered her home and put the light on in the lounge and closed the curtains.
‘Please have a seat,’ she said as she herself sat down on a hard backed chair hardly placing any weight on it as it began to tip forward.
‘Your parents, Owen and Hilary Mayvor were in Brazil?’ asked Inspector Brian Fox.
‘That’s right. They work for the White Fathers in Brazil. They are responsible for all the financial side of their work,’ said Marty in staccato words as a veil seemed to lift and reality hit her.
‘It’s my parents. They have been killed haven’t they? Haven’t they, well?’
Both officers nodded simultaneously.
‘I am sorry. It seems that they were flying in a two-seater Albatross L60 monoplane,’ said the Inspector as Constable Karen Scott approached Marty and placed her hands on her shoulders.
‘Yes, I know that’s how they travel between stations, but....what else...’
‘Last Friday there was a storm. Lightening too, apparently. It seems they came down on the Mato Grosso between Guiratinga and Diamantino. That was where they left from and were heading for.’
‘But it’s just that the plane is missing perhaps?’ Marty said with hope in her voice.
‘I’m afraid not. Wreckage was sighted and there was no sign of life. I am truly sorry Miss Mayvor, your parents died.’
That was two years ago. Since then she had travelled to Brazil and met many of her parent’s former colleagues. They flew her to where the plane came down and Marty saw the remains of the wreckage. She walked though the fuselage and turned over some of the wreckage which had never been removed. She bent down and found a sandal she recognised as her mother’s. She placed it in her bag.
That Christmas no decorations were on display in her house. Marty descended into a deep depression for the last five days of the Christmas term until the first few days of the New Year. The very same thing happened the following year and found her in a far deeper place from which she had no energy to escape. Her deputy head called to see her and met her in slurred daze. He wasted no time. His assessment was of meeting a very ill colleague. He called for an ambulance.
And so in due time, Marty appeared at Tony’s surgery. When they met, there was no sign of depression.
‘The two episodes, they are seasonal, not so?’ he asked.
‘Yes that’s right,’ she agreed.
‘No illness throughout the year?’
‘No, just at Christmas.’
‘It was a terrible time to lose your parents.’
‘I know. I had been so much looking forward to seeing them that year. I had not seen them for three years.’
‘What will you do next Christmas?’
‘It seems so far away. I cannot say if this will be a recurring depression.’
‘I think I can. Unless we break this cycle, the pattern will be established. Tell me your notes show you are a Baha’i follower. Is that right?’
‘Yes, that’s true.’
‘They don’t celebrate Christmas do they?’
‘No, nor the New Year. We have a different calendar.’
‘I see,’ said Tony. ‘Perhaps if you spent some time with them over the Christmas week it might help.’
‘Yes, that’s true.’
‘I think you might also benefit from a group session I am organising. It is yet to get off the ground but I think you would be a good candidate.’
‘Oh, you think so?’
‘Yes, they are all known to me and all have a clerical background,’ said Tony looking for a flicker of reaction to his proposal.
‘I’m a busy teacher. I might not make all the meetings.’
‘I think a Monday night for an hour and a half each week should be adequate. Would you care to join the group?
‘A self help group?’
‘Yes, I think that is it. You see clerics are all figures in their communities. They have a persona to show but an interior which is under strain. It’s good to know that others feel the same and if they don’t do anything about it, it leads to a referral after what I might call a breakdown or an incident.’
‘So it’s a crash course?’
Tony smiled. ‘I hope it’s a course for winners.’
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Web Site:
Fault Lines
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I did, run across a few minor glitches that I took note of while reading:
"heirloom ivory knife" Since when is being an atheist an "anxious crossroad?" "On to the splashed desk?"
Ron