My life in a lunatic asylum

I can see why rock stars and other impetuous celebrity types accidentally top themselves with drug cocktails. When you are spaced out on medicaments it’s easy to forget what you have or haven’t taken. A month ago I was prescribed a dose of corticosteroids to see off a chest infection: 60mg a day for four days. Apparently, it’s a big dose. Nurse Catriona says it’s the largest she’s seen. (She was a practice nurse for donkey’s years.) For some folk corticosteroids have a similar effect on the mind as coke. Which means, in my case, I become chatty, overconfident and overassertive, occasionally tipping over into aggressiveness and paranoia. In his palmy student days, the oncologist told me, rubbing his hands together inside his groin and giggling like a girl, he and his classmates definitely noticed this effect.

From the village pharmacy I received a handsome box of the corticosteroid prednisolone in a hessian carrier bag. Forgetting that the prescription was a one-off, I started swallowing 60mg on the flimsiest pretext: to fortify myself on chemotherapy days, to write a column, or simply to cheer myself up. It wasn’t until Catriona saw me throw a handful into my gob that my mistake came to light – ‘How long have you been taking 60mg of those?’ she said. After that, things started to make sense, including my unwonted touchiness and what can be described as paranoia, as evidenced in black and white, thought Catriona, by last week’s column about David Goodhart.

In my mid-twenties, I trained to be a psychiatric nurse at the old West Ham Lunatic Asylum in Essex, whose patients hailed from the poorest part of the East End of London. And because mental illness is not unconnected with poverty, the admission wards were a dazzling showcase of the A-Z of psychiatry.