As a kid growing up in Scotland in the 1950s, Dennis O’Donnell was aware of ‘loonies’, and the men in white coats who were supposed to take them away. Then, as a student, he became one of the men in white coats. At first, he thought he’d find himself in a world of Beckettian absurdity and insight. But it was grim. One man believed he was the King of Egypt. Another man smoked rolled-up bits of lavatory paper. One poor soul spent his time waiting for a visit from his daughter, who never came. When a patient died, O’Donnell was on hand to carry out official procedure: ‘Orifices have to be plugged — need I say more?’ He went back to university, where he was studying English literature.
Thirty years later, O’Donnell became a psychiatric orderly again. This time, the job lasted seven years. Again, he found himself in a grim world of people whose thought processes had become disordered. They mumbled, they soiled their underwear, they attacked themselves and others, they were delusional, they screamed, they spat. Each mental illness, he says, is individual. The range is enormous. O’Donnell guides us through this world; he is slightly catty, but you can tell he’s a man of immense patience. His tone is just right — perfect for the subject matter. He’s like a very good documentary maker; he knows exactly where to point the camera.
He shows us lots of types of mental illness. There is dementia, where you lose your memory — particularly bad, he says, because you lose it ‘from the wrong direction’. In other words, you can’t remember what’s just happened, even if you can recall stuff that happened half a century ago. He tells us about the nitty-gritty of taking an old man to the lavatory: the old man will find himself in an enclosed space, with someone behind him having pulled his trousers down. But he’ll have forgotten why he’s there. He’ll panic. Sometimes, he’ll hit out.
There’s a lot of hitting out. People who can’t think straight are often frightened and angry. They find themselves apparently incarcerated, surrounded by orderlies. Soon, they are being held down, while an injection is prepared. Occasionally, the violence spreads, as it might in a prison; patients move towards the site of the shouting, and join in. More horrifying, though, is the violence people mete out on themselves. One poor woman, dumped by her boyfriend, tries to strangle herself with her tights. A man goes to the lavatory; moments later, he has slashed his neck open with a shard of plastic, fashioned from a compact disc. ‘The little room was like a butcher’s counter,’ writes O’Donnell.
Sometimes the problem is religious mania. O’Donnell tells us about Donnie, a man obsessed with the Devil. One day, Donnie is combing his hair in the bathroom mirror. And then he snaps. He bashes his head on the washbasin taps — and, for a few seconds, nobody can stop him. But a few seconds is a long time when you’re trying to smash your own face in: ‘The noise was appalling: dull fleshy thuds against the metal of the taps.’ And: ‘He was croaking incoherently, a deep resonant rasp of terror and affliction.’ He thought he’d seen the Devil in the mirror.
The Locked Ward describes a woman who is sexually incontinent, another woman who became convinced that her GP was in love with her, and was signalling his affection in very subtle ways, a man who wore his watch on his bicep, who had to put his arm behind his head to tell the time, and a woman who urinated ‘like a Blackpool donkey’ on the doorstep of another woman, whom she fancied. And many more.
As the book goes on, you begin to realise something. These people have psychiatric problems. They lash out, they have delusions, they scream and shout. But really, they are just exaggerated versions of the people we see in the world outside the psychiatric hospital. I closed this book with one abiding thought. Normal people are nuts, too.
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