Chapter one (complimentary)

  
 “Are you a witch?”
      Barbara, standing, arms crossed, back flush up against mirrored glass, grimaced at her interrogators.  She had experienced the elaborate ordeal of committal to a mental health facility twelve months previously.  She dreaded the thought of confinement and of compulsory treatment with drugs whose long Greek names were as puzzling to her as were their effects.  And she feared, knowingly, that the stigma of diagnosis of long-term mental illness and the trauma of intensive drug therapy could damn her to exclusion.  Exclusion from life.
     Glancing furtively at the doorway, which led from the clinic to the hallway, which in turn led to the main entrance and to the hospital grounds, estimating a twenty-five minute hike to the city highway, Barbara knew there was no escape.  Like  Alice in Wonderland, fallen down the rabbit hole, she was adrift.
Dr Douglas Milton, the junior of the two interviewing medics, reached over and slowly closed the door, and with steady persuasion he had Barbara seated.
     “Tell us, are you a witch?”
     The question was closed, and to Barbara it seemed to require little more than a nod, ‘yea’ or ‘nay’, in response; but Barbara is not a tractable sort.  Unfolding her arms, raising her gaze to the ceiling and taking a deep breath, the bemused young woman sought to answer:
     “It depends what you mean when you use the word,” she enunciated, eliciting attention as she exhaled, speaking in a high-pitched voice.
     “According to The Concise Oxford,” she initiated, “a ‘witch’, from the Old English, ‘wicca’, is a person, usually a woman, who practises magical arts, usually in service of the Devil.”
     Barbara paused.  She wished to savour a moment of serendipitous brilliance: at only nineteen-years-of-age she had studied a little of the occult and knew a definition of the word ‘witch’.  She also wished to allow the doctors occasion to esteem her as of sound mind: a concrete definition of the word might have indicated that she had some intellectual grounding in reality.  But a desire to entertain, if not to seduce, was too great for bedevilled Barbara:
     “According to this definition, young doctors, I probably am a witch, but nay, I’ve never ‘ridden over the moon on a broomstick!’”  She screeched a gleeful cackle and lowered her view to meet the eyes of Doug Milton.    
     Dr Douglas Milton, a house surgeon in his first year of psychiatric practice, smiled in defeat.  He slouched in his chair and looked over to his senior colleague, Dr Rajish Palakshaapa, a thirty-eight-year-old Asian Indian on transfer to New Zealand from Malaysia.  “Looks like this one’s for you, Rajish,” he said tongue in cheek. 
     “Out of your depth?” retorted Palakshaapa.  The senior psychiatrist put down the computer pad on which he had been taking notes and considered the situation: twenty-six-year-old Doug Milton was no longer a student; yet Doug lacked hands-on experience; Barbara Mason was a veritable nutcase and Milton, a medical intern, should not miss the opportunity for learning:
     “Well, I’m sorry Doug, you’ll just have to cope,” concluded Palakshaapa.
     So the interview proceeded:
     “Barbara,” ventured Dr Doug Milton, “have you ever felt able to influence people and events with your thinking?”  Milton was formulating a list, or more accurately, a matrix of symptoms for diagnosis.
     ‘Here they go!’ pondered desolate Barbara.  She had encountered psychiatric gobbledegook twelve months previously when she was committed to Blueberry Court Psychiatric Hospital for three weeks’ ‘assessment and treatment’.  Confined to the provincial institution, an enclave in the countryside, south of Auckland city, she had been shut up and shut away.  Now, she knew the value of freedom, ‘breathing space’ - the liberty to think and act as an individual – I  move to the beat of my own drum.  So what!’ she mused.
     Dr Rajish Palaksahaapa turned to his computer notebook and resumed his commentary.  Barbara was an attractive part-caste Maori girl, with distinguished Maori lineage, of the Ngati Kahungunu iwi, of southern Hawkes Bay, on the maternal line, who, Palakshaapa noted from her file, bore none of the marks of disadvantage one might associate with  her ethnic identity: she was a student of law with an above average academic record and significant social and cultural assets.  She had noteworthy Samoan heritage, her paternal grandfather having been a high-standing Scots missionary in the Islands who married a Samoan lass of prominent heritage, with whom he raised nine children.  Barbara’s other European forebears were English and Scots settlers.  Palakshaapa noted her peculiar cultural mix.
     And Barbara was an attractive girl with straight shoulder-length shiny black hair, a visage clear of blemish, dark brown eyes, so dark that they appeared permanently dilated, and light brown skin.
     Palakshaapa observed that student Barbara was dressed with  significant personal style.  She wore a navy blue satin blouse with puffed sleeves, thrown loosely over black satin harem pants.  Her footwear, dark suede moccasins, indicated for Palakshaapa social liquidity and practicality at a cost.  Peach-red lipstick and a touch of rouge on the cheeks identified Barbara as comfortable with her nineteen years of age.  Accessories, a gilt-edged watch and a white leather clutch purse, completed her ensemble.                            
     Palakshaapa himself was Hindu.  He wore a gold necklace and a gold signet ring.  His double-breasted navy suit was haute couture.  He enjoyed Barbara’s banter, her attempts at ‘reaching the high notes’, while he observed both Milton and Barbara in his role as supervisor. 
     On edge, Barbara opened her white leather clutch purse and pulled out a gilt-edged cigarette lighter and a packet of cigarettes.  She could afford a few luxuries currently as she had maintained work as a waitress and bartender, and the extra pin money that the job provided supplemented her student allowance. 
     But now the medication which she had stopped taking six months previously had almost completely worn off, and her employment had lapsed.  An astute observer could have predicted what was coming.
     “Strictly no smoking on hospital grounds, Barb,” Milton informed perfunctorily.  Barbara tucked the cigarettes in her clutch purse.   
     Milton patted down his hair with his right hand, covering a premature bald spot and shading his grey-blue eyes momentarily.   His ash blonde locks gave him the air of a cherub. while his thick beard and hairy arms suggested more the appearance of a gnome.  There was certainly something unworldly about young Milton, a doctor, and, thereby, a near godly power in New Zealand society.  His black thick-rimmed spectacles affirmed his intellectual station.  And his white business shirt with blue and white tie, dark business trousers and black dress shoes stated his formal authority.
     “I don’t have any ‘special powers’”, Dr Milton.  “I have ‘special knowledge’.  You should be aware of that!”  Quarantined sophomore student Barbara Mason was intelligent.
     “And does this knowledge give you a feeling of power?  Are you someone special?  Are you the cat’s whiskers?”  The interrogation continued.
     Barbara, sensing a quickening of pace, clasped her golden cigarette lighter tightly between her hands in her lap.  Her white leather clutch purse dangled loosely from her left wrist containing the panacea cigarettes.  For a moment the beleaguered young woman focused on a mantra for visualization: ‘I am golden’.
     “Dr Milton, Dr Rahman,” began Barbara, addressing the two doctors in turn, “I seek The Alpha and the Omega.”  Putting her cigarette lighter in her purse and placing the purse in her lap, she opened her arms out with palms facing upwards like weights on a balancing scale: “The Alpha and the Omega,” she declared with some semblance of authority.
     “What about voices?” Milton continued.  “Do you hear voices?  Does God talk to you?”  Milton, a psychiatrist, in New Zealand society is deemed a demigod in his own right.  His suggestion that God might have something to do with Barbara’s ‘para-malaise’ seems to posit her as two steps removed from his own station.
     Barbara answered the double-barrelled questioning hesitantly:
     “Sometimes I can hear some sort of monologue going on.  But I can cope with that . . .  As for God, I imagine he’s not too busy to include me in his schedule!”  The young woman did not lack a sense of humour.  And a manic disposition might have had her positing herself at the top of God’s list of priorities.  A tendency towards facetiousness, however, might open a Pandora’s Box of other demons.
     “What do the voices say?”
     Barbara did not know how to answer the question.
     “Do you ever think someone is trying to put thoughts into your head?”  Milton continued.  It is crucial that a psychiatrist identify in a patient any likelihood of violence.  Barbara Mason patient number DHF1175 had never demonstrated a tendency towards violence.
     “No!” Barbara answered sharply.  “Well,” she hesitated, “the radio – euh, and the telly are a little strange.”                                                                              
     “And is the radio talking to you, personally?  Is the radio talking about you?  And the TV?  Are you being told what to do?”                                                         
      Barbara was confused.  “I’m not crazy!” she cried desperately.  “What is this!   The Spanish Inquisition?” Her shouts put her at risk of being deemed anti-sociable.
      “Do you ever think people are talking about you?” Milton pressed on.  He adjusted his black thick-rimmed spectacles so that they sat comfortably on the bridge of his nose.  He looked very much like the senior-school swot!
     “No!” Barbara answered sharply.  She covered her eyes with her right hand as a shade against the glare of the single uncovered light-bulb in the examination clinic.  The white painted walls of the clinic magnified the glare of the bulb.
     “Can you read people’s minds?  Do you know what people are thinking?” 
     A supposed sixth sense, in terms of psychiatry, is an indicator of potential instability.  In fact, many traditional psychiatrists discount altogether the validity of any assumptions that any sixth sense exists at all, favouring a diagnosis of ‘delusional thinking’, for example, where a ‘sixth sense’ is claimed by the patient.
“Can people read your mind?  Are your thoughts broadcast to other people?”  Dr Douglas Milton continued delineating a matrix of symptoms for diagnosis of psychoses.
     “Were you brought up in a religious family, Barbara?”  The question to many people would seem an unfair part of Barbara’s psychiatric assessment.  Most observers no doubt would like to believe that in a freedom-loving country like New Zealand people are able to worship how, where and what they may.
     “Well, we used to go to church, if that’s what you mean.”  A square response.
     “What religion are you?”
     Many of those of us who consider ourselves as sane as C23PO find this particular question unnerving.  But Barbara was not overly perturbed by the intrusion on privacy.  Besides, she had an eloquent ready-response from her repartee as a waitress and barmaid:
     “I’m a pantheistic Christian . . . with hedonistic tendencies.”  She enjoyed making the statement.  It amused her that she might baffle society’s bailiffs:  “Comprendez-vous, Messieurs?”
     Both Milton and Palakshaapa ignored Barbara’s ridicule.  Neither of the doctors understood what she had said, but each was certain that the young woman’s peculiar spiritual deviancy would mark her as a statistical anomaly.  Within the confines of psychiatric parlance, there would be a designation for her ailment: schizophrenic?; bi-polar?; schizo-affective?; psychotic?; dissociative? schizoid?. . .  There are more than three-hundred maladies identified in the psychiatrists’ bible, The Diagnostic and Statistical Manual of Mental Disorders.
     “Would you like to elaborate, Barbara?”  Milton laboured on.
     Barbara obliged with aplomb with a few words on her self-formulated theological ideology: “A ‘pantheist’ is someone who believes the UNIVERSE IS GOD . . . and   ALL GODS ARE MANIFESTATIONS OF THE ONE GOD, the universe.  A ‘Christian pantheist’ attributes the omnipresent, omniscient, and omnipotent to manifestation in God the Father, God the Son and God the Holy Spirit, who are the UNIVERSE . . I  just threw in the ‘hedonistic’ bit for a laugh.”
     The explanation of Barbara’s theological beliefs was not highbrow but  pithy.  It indicated that Barbara’s psychological framework entails a rudely active spiritual dimension.  The young woman is a neophyte with precocious dexterity, something potentially traumatic for any young person.  The doctors would have to excel themselves and tread lightly simultaneously.
 
     But Dr Douglas Milton had aroused Barbara’s temper.  Anger mixed with despair thickened an already coagulated flow of natural energies.  Barbara descended from her natural high.  And in the weeks to come, confined to the institution, she would dwell in self-pity and respond to hospital staff with abrupt disdain.  At the same time she would pour out stories dramatizing what in fact had been a superlatively advantaged childhood and upbringing - one of the worst side effects of mental health care being ‘navel gazing’ which may serve little useful purpose. In fact, there are neuroscientists who define ‘stress’ as ‘rumination’ about events, as opposed to ‘events’ being ‘stressful’ in themselves.
     Barbara showed some minor psychological maladjustment through her anger and despair.  A disdain manifested to hospital routines and a lack of cooperation with staff, though, are common reactions among clients of mental health services. 
     Barbara’s discussion of her childhood and upbringing, also, was not an unusual reaction to hospitalization.   With ‘beautiful people’, male and female nurses, ‘at her beck and call’ throughout each day, Barbara was inclined to treat the clinic as a respite for the soothing of psychological ills.  Her tirades, though, verged on self-absorption.
   The clinic, however, was a ‘psychiatric’ unit: it was a clinic where specialist psychiatrists dealt in the treatment of psychotic illness with drugs. To say, however, that the clinic was a psychological ashram, would not be too generous an extension of a description: in the enlightened 2000s the clinic  offered holistic treatment in the form of aid from psychologists, for example, or New Age therapists, occupational therapists, ecumenical hospital chaplaincy services, Maori and Pacifika mental health services – even a Catholic priest. However, these supplementary services were not always utilised in practice.
     It is noteworthy that the terminologies ‘psychiatric’ and ‘psychological’ are not automatically interchangeable.  During her eighteen months’ acquaintance with mental health services, Barbara Mason DHF1175 had been interviewed by a clinical psychologist on only one occasion, and that interview was conducted by a student of clinical psychology seeking credits for a graduate course (budget constraints restrict availability of psychologists – and a fifteen-minute session with a psychiatrist prescribing drugs is sometimes considered a much more cost effective treatment than many hours of sessions with a psychologist).
 
      Dr Milton’s questioning continued for forty-five minutes; gruelling treatment.  Barbara put up an arduous fight.  She did not speak of having regular hallucinations while ‘scrying’, crystal gazing, in an amethyst crystal her grandmother had bequeathed to her.  She refused to let on that she believed she had predicted, while drunk at a spring party, the recent California earthquake, three weeks before its occurrence.  And she did not tell the two doctors about her phobia – snakes and scorpions, albeit imaginary vermin – there are no snakes or scorpions in the ‘GODZONE’ (‘God’s Own’ – New Zealand).  Especially, she did not speak of the tactile hallucination of a snake in the belly!
     It was this execrable experience which had led Barbara to present at the Accident and Emergency Clinic of Blueberry Court Psychiatric Hospital.  But the hustle and bustle outside the triage station had distracted her, alleviating the temporary hallucination of a snake moving slowly in the belly.  It was a terrifying but transitory hallucination.  By the time she was attended to by the presiding doctors, her initial ailment had subsided.  Barbara then realised that she did not at all wish to be admitted to the institution.
 
     Barbara had caught a forty-five-minute taxi to Blueberry Court Psychiatric Hospital in the provincial  south of Auckland.  She was officially resident at the Monroe Student Village, university halls of residence, south of Auckland city, and attended the Monroe Faculty of Business, where she was completing a diploma in legal studies.  Her admission to Blueberry Court Psychiatric Hospital would interrupt her academic responsibilities.
     The Monroe Faculty of Business provides significant leadership, particularly in the provinces south of Auckland, where New Zealand agricultural production thrives.  Dairy farming, sheep farming for wool and meat and cattle farming in the provinces are the backbone of the national economy.  Orchards, including kiwifruit, and vineyards also merit international repute.
     The farmer, fostering hard manual labour with an attendant conservative political outlook, may not be tolerant of complicated mental illness.   Dissection of the mind may be considered an academic indulgence by the reserved farmer.  The farmer may demand conformity of ideas – politics, religion, philosophy.  An understanding of mental illness, may, generally speaking, be lacking in some quarters.  Was our protagonist, Barbara Mason, in the provincial south an intolerable curiosity?
     Barbara, ‘a city girl’, had been brought up in Auckland.  But she was nonetheless not at all what could be described as ‘streetwise’.  She came from a conservative church background and had no acquaintance with the vice of young adulthood: alcohol, sex, drugs.  But she did enjoy the cosmopolitan ideas of the ‘New Age’, and she read, enthralled by astrology, numerology, tarot card readings, and the like; in a big city the ideas of a ‘New Age’ thrive.  Barbara was a neophyte.  Her academic studies might allow a pursuit of mystical enlightenment.  Her urbane interests would foster an exploration of ideas beyond the mundane.
 
      Poor Barbara had called upon two specialist psychiatrists at the dawn end of night-watch.
     Dr Douglas Milton had been awoken by his pager tone at 5.30am.  Despite his station, he was required to answer calls for service even at the haunting hours of early dawn.  Juggling night-shift and day-shift, he was granted no special dispensation with regard to a choice of favourable work hours.
     “Barbara Mason?  Oh yes, the Mason girl.  I recall meeting her last year.  A relapse?  God damn it! – Another statistic!  Well, I’ll wash up, and I’ll be there shortly.”  Milton answered the call.
     Dr Rajish Palakshaapa, senior consultant, had been hovering around the coffee machine in the Emergency Clinic.  When paged to attend to Barbara, he took his coffee in one hand and his computer notepad in the other.  His world view as a Hindu did not fit well with the majority of his Kiwi clients, so he welcomed any call for his input.
     Drs Douglas Milton and Rajish Palakshaapa were not able to easily depart from textbook formulae that morning.  Given the ungodly hour of 6.00am, it is not surprising that the two doctors dealt with Barbara summarily.  Her tendency toward manic mannerisms in speech and presentation, and her peculiar spirituality were enough for these two medics to preclude the young woman from further participation in the community. That she may be a danger to herself or others is a moot point; but Milton and Palakshaapa overlooked ‘the niceties of the law’:  Barbara Mason DHF1175 was committed formally to Blueberry Court Psychiatric Hospital under the New Zealand Mental Health (Assessment and Treatment) Act 1992.
 
The strong-willed Barbara Mason is a young woman of significant value as a daughter, a sister and a friend; of practical utility as a student and a worker; and of individual merit as a citizen and a tax-payer; a non-violent and ordinary if not special individual.  She now faced the most challenging role in her life: diagnosis as ‘schizophrenic’ and a sojourn toward an elusive recovery.
 
 
  

SURVIVING SCHIZPHRENIA BY STEPHEN C. SOUTHON AMAZON.COM