The Mind Laundry
It gradually enlarged in Dr Gold’s windscreen – the cracked and faded front portico of the Mayfields Psychiatric Hospital electroconvulsive therapy and laundry spur. He pulled up twice weekly on alternate weeks. It was more peaceful than the ward work on E block. This morning Gold had failed to dodge a face full of orange cordial, artfully lofted by one of his many grateful patients.
The E.C.T. ‘suite’ – just a couple of rooms – usually had a parking space available outside. The suite/laundry block was on the far fringes of Mayfields’ sprawling site. Dr Will Gold, Staff Grade Psychiatrist, could manage emergency on-call for the whole hospital from here. Gold, a 39-year-old of obscure ethnicity was someone people hardly noticed in general. He did appear to be wedded to his job at the hospital. He checked his black brick of a radio was fastened properly to his belt. A patient on Block C could kick over the meds trolley at 1433 hrs, and with a quick hop in his cherry red VW Polo he could be on the scene by 1443. “Block C” … Where were, thought Gold, the new trendy bucolic names for wards like ‘Woodlands’ and ‘The Mews’? The former asylum seemed stuck in time.
The afternoon in the suite promised to be straightforward. It looked like four on the list. The staff were busying around inside as Gold paused at the entrance looking back onto the central green. He was preoccupied. His Polo had just cut out on Streatham High Street that morning, no electrical activity at all, the engine apparently immobilised before it came back to life again. He thought this might be the Millennium Bug. Perhaps his car’s antediluvian computer chip was two weeks ahead of itself. The New Year ahead offered the possibility the suite would be downsized – exchanged for a mobile operation in any one of the nearby St. George’s Hospital operating theatres. The talk was that the Mayfields hospital management was looking to sell-off 70% of the red brick real estate for premium apartments ‘in a quiet garden setting’. The doctor reflected that he would find it hard to sleep in a flat where so much ‘shock therapy’ had taken place, often without the slightest assent of the poor patients. After the 1960s and 1970s hey days there was a belated introduction of general anaesthesia and muscle relaxants to the protocols. It became less terrifying, and stopped the fractures of spine and limb which could happen during the convulsions. Tough. As if the patent wasn’t already ill enough, thought Gold. It all might have been more justified if the ‘therapy’ was a sure-fire success, but, like every treatment in psychiatry, even at the dawn of the 21st century, effectiveness rates had always struggled to beat that of placebo, i.e. doing nothing. A famous study came to mind of ‘sham E.C.T.’ where patients were given no electricity at all, just the anaesthesia – they fared no worse than the normal control group.
Dr Gold pushed open the imposing outer blue doors, pitted by countless laundry trolleys. The block entrance was crowned with sandstone sculptured foliage, like vine leaves. This unnecessary Victorian pomp and the enamelled blood red façade reminded Gold of an old public baths in Ripon, North Yorkshire. Back inside, the team were now readying. A swimming pool smell of chlorine emanated from the floors. The corridors towards Laundry were unworldly. The clanking sound of the machines in the distance echoed around the empty space. Sickly yellow linoleum and flickering fluorescent strip lights emitting a cool medicated glow. His fat walkie talkie squawked for no reason. It was a noisy silence. There was no hollering, no shrill nurse-calls for medications, no flying furniture, nor flying orange juice. Gold secretly loved his little sanctuary.
Back inside the suite his eyes glanced once more at the list pinned to the wall – just names of patients and their ward location – Gold recognised a couple of the usual suspects instantly. Just in behind him and fashionably late as usual was the ultra-laid-back anaesthetist from St. George’s. The two doctors nodded to each other. The show was about to start. Dr Jack was quickly poised, the sleeves of his pink shirt rolled-up – gas, monitors and drugs ready. Three nurses gathered, the electrical equipment was switched on and tweaked by Dr Gold. The patient was wheeled in on a black padded table, almost as an after-thought. The E.C.T. machine itself, with its wooden casing, dials and, small indicator window looked something like the Volksradio, a Nazi wireless set popular in Germany in the 1930s. Candidly simple in operation, there was just a button to send out a pulse of electric current, and a dial to set the percentage energy to be delivered. There was a simple protocol that factored-in the patient’s age and weight determining the ‘dose’ to be calculated. It wasn’t brain surgery, but then, that Gold knew to be remarkably crude. He raised the two electrodes — corded nodes on black plastic handles with a hilt. The little pink heads were dipped in an electrolyte solution for maximum conduction through the patient’s skull.
Mary was not going to be any trouble. Old Mrs Mundy had been chronically depressed, in surging and receding tides, for as long as anyone could remember. So much for Community Care, as just as soon as a place was arranged for her in a home, or an apartment, she would be found collapsed on her floor calling out in panic about the end of the world, and her role in it, confessing complicity in a looming apocalypse – not appearing to have had food for days. She would repeatedly be returned to Mayfields to be kept alive.
“You OK Mary?” The nurse gently touched her sparrow-like shoulder on the table.
Mary just stared up at the yellow-stained polystyrene tiles on the ceiling, motionless.
“Don’t worry pet, you’ll get a nice cuppa after Recovery, maybe even a biscuit!” Gina radiated that typical balance of compassion and cheery condescension that nurses are made of. Many patients looked forward to a drink, having fasted for hours because of the anaesthetic.
Dr Gold had turned the dial down for Mary, her being well into her seventies, light as a feather. As he could recall she never failed to fit.
“OK she’s all yours Will” said Jack, removing his hands from Mary’s airway, lifting her mask, happy the muscle relaxant was in her system. She would not be breathing on her own for a short interval. Jack would be anxious to have the patient back in his care in under a minute, to keep the little sparrow-for-a-body alive.
Dr Gold moved close to Mary’s face beside the table, placed one pink sponge on a stick on her left temple, the other opposite, and squeezed hard, pushing the electrodes towards each other onto the skull as hard as possible. Experience told him this was much of the trick, twisting a little, keeping that contact firm.
“Treat please Nurse”
Having waited for the signal, Gina pressed the red button on the Nazi radio and a pulse of current travelled the wires, across Mary’s brain, instantly causing a seizure. Despite the relaxant drug, Mary’s little body rose under the bed blankets in a modest extension of her spine. Her face at the movement of treatment, as with all patients Gold observed, contorted into much the same grimace as his as he struggled to get the best electrode contact.
‘Gas Man’ Jack wheeled himself on his chair back next to Mary, replacing the oxygen mask, checking various parameters, whistling “My Love is True”. The tanned Australian, with mop of blond hair saw himself as the only “real” doctor around on his excursions from St George’s. He looked pleased though with Gold’s work, there was nothing worse than having to go a second or third time, when no fit happened – there were the risks to the patient, and the whole list could be knocked out of kilter. He might not get time to complete his crossword puzzle.
In between patients, Gold reflected on E.C.T. and its odd place in the armoury of modern treatments. At least the patients were better selected he thought than in the days when it was given to virtually anybody. Doctors used the word ‘radical’ a lot about treatments then. There was even a small surgical theatre at Mayfields to do partial lobotomies, or ‘leucotomies’, where morsels of brain were extracted – he’d gathered from now elderly eye-witness doctors – via the back of the nose. Just the severely depressed and some manic ones came through the big blue doors now, and few really protesting, although often still under Section, technical compulsion. Perhaps, thought Gold, E.C.T. could shake off its old reputation as sanitized torture and a throwback to blood-letting and the application of leaches. It was a non-toxic physiotherapy. True, no one could give a clear scientific explanation in how it worked on occasions to lift the most severely depressed back to life again in no time at all. But there was also the memory problem. There were certain debatable precautions aimed at alleviating the side-effect spoken about in hushed tones with patients and family. Placing the connectors in different spots and limiting the dose given had not in his experience made the slightest bit of difference. Patients were losing their memories. They didn’t lose all of it, but large chunks, usually of the period of treatment, the days of weeks of it, but also older memories were at risk. It seemed like a raw deal: to trade one’s memory for happiness.
Mary Mundy was wheeled out of the room, to Recovery next door, tended to by a nurse. She was expected to wake soon, for her tea. The little train of the department kept chugging along.
The next patient was a 37-year-old City stock manager, his identity as an ex-banker drew discussion among the team. Michael Reid’s file revealed he’d endured some serious losses. There was a divorce, and the loss of his business having been caught red-handed rogue-trading with millions of pounds of government money. Illness levelled his elevated status to that of all the other patients. Mary, daughter of a navvy, was plagued by trauma too, and losses. She thought the world was going to end because everything she could recall of value to her had ended. Her weight of genuine memory included the murder of her husband, pounding on her consciousness every day if not every hour. Mary and her husband had been taken hostage with her husband by Arab terrorists twenty years previously; an Egyptian package holiday gone awfully wrong. This woman had to carry these memories around like a millstone. Gold thought it would be encouraging to see some signs of progress with Mary, with Mr Reid, with anybody for that matter.
There was a hiatus in the routine at the laundry block over New Year 2000, but the electricity was flowing freely by mid-January. The bit of snow that graced Dr Gold’s path to the suite was the first he could remember seeing for years. The magical sensation of snowflakes falling on the tip of his nose helped lift his mood, which had seemed to lag since December, quite uncharacteristically. Perhaps a millennial anti-climax.
Dear old Mary appeared in pole position once more on the list, having just made the icy journey across the central field with her care assistant for the day, Aurelija. She was taking to the young Lithuanian outside the big blue doors, gazing wide-eyed at the falling snow. Gold stopped in his tracks. She was speaking to Aurelija.
“God bless you darling. I’m not bothered about that… no don’t worry dear… Yes, we’ll see, hope so… Now how old are you actually little girl?”
This was not the Mary Mundy he knew. His psychiatric instinct of disbelief of appearances kicked-in. The phenomenon of fleeting false recovery had a lot of currency in the medical mess. Legendary research had shown that some of the most suicidally depressed appeared to rally a little just before they finished themselves off. Maybe buoyed-up by the prospect of a plan coming to fruition, or in a cunning show of concordance, to dampen suspicion.
“We’ll just see how much better she is”, he murmured a little later, to no one in particular, bowing over the Bakelite dial of the Volksradio, leaning in, as if straining to hear the disembodied voice of Goebbels.
Mary was a dream on this occasion. A good 30 second seizure by his watch. He thought with disquiet on her clinical change. Would he lose her from his list? How would he explain to Dr Wallace – even more cynical than he was – that Mary was genuinely better, after her thirty-year career of treatment for psychotic depression?
The doctor’s episodes started, that day, 10th January 2000.
It was hard to put a finger on it, but Gold had a flash, a waking dream, only half a minute long, while he was tightening the screwed head of an electrode. It would return in various guises week after week for the winter and beyond. The temporal association with the E.C.T. sessions was not too clear at first. It happened at work, in the car, in startling dreams in his bed that woke him in pools of sweat. It was a memory, or sets of memories, that he did not rightly own.
This first time was straight after leaving Mayfields for an early lunch. He had stopped to pick up a sandwich in a service station on the high street. He was transported elsewhere in his mind. Pyramids bound, on a tourist bus, he could see three young men board, clutching Kalashnikov rifles. They were angrily separating out the Muslim women from the ‘kaffirs’, the undesirables, the male Europeans singled out for rifle butt blows to their heads. He saw with the eyes of a matriarch of an Irish family. He was Mary. An emotion of deep motherly concern engulfed him. He sat upright holding his sandwich, leaning on a low wall as London streamed indifferently by. A man shot, thoughts of regret for fatherless children… then there was just blood, and shouting, and then darkness…
Then it was gone. The rest of the day passed by normally. Another day, and morning again found Dr Gold in the suite, rushing through another list. He plopped the electrodes back into the pink solution and turned towards the doorway, flicking his finger to Gina for the next patient.
“Come on! Time is money people”.
‘Second that’ grunted Dr Jack, barely looking up from his beloved Telegraph.
Fred Tomkins, resident of C Block, wasn’t easy like Mary. Twice absolutely nothing happened after the beep and the facial contraction. Puzzled, Gold cranked up the energy level to 75% and, with Jack’s consent, went straight back in right away. Still no seizure. Jack’s patience was under strain as he bent over to ventilate Tomkins a little more with the bag & mask. Gina, taking typical nurse relish of the chance to show up her superiors, took an alcohol swab and rubbed Tomkins’ temples then looked up at the two doctors. Tomkins was a retired prison officer dismissed amidst corruption allegations. The third attempt saw him take off from the table, like a large eagle straining to fly against his restraints. All hands rushed to hold down his large body and delinquent limbs for almost a minute before he sagged back down, a strangely blissful appearance on his face. Gold noted down on Tomkins file that next time 50% energy might suffice; ‘with adequate skin preparation’…
Former Officer Tomkins had described finding himself to his horror to be the star of a candid Channel 4 documentary last year. His unmistakably large form, with a pixilated face, was featured lumbering around H.M.P. Pentonville dispensing cannabis, heroin, and so-called ‘legal highs’ like an ice cream seller at intermission. Obviously, the performance did not go down well with his superiors. Tomkins had suffered from serious drug dependence issues of his own over the years. Brought down by his notoriety, he’d become suicidal. He’d refused to eat or even drink fluids, making him ideal E.C.T. material.
Gold gazed out the window, thinking about getting to the hospital canteen in time for lunch – before the fish baked dry on the hotplate, contorted much like Tomkins.
His heart sank a little more to see it was young Basela next. Ms Al-Masri was often difficult to tempt onto the table. This 23-year-old Palestinian, daughter of a shopkeeper in Penge, was a real handful. She, like Mary, was plagued with psychotic depression. She was convinced that she was the cause of the whole Middle Eastern conflict, from well before she was born. Her brother had died in a tunnel in Gaza in 1994, at the hands of Israeli settlers, and she had suffered a prolonged grief reaction. Basela had gotten it into her head that the E.C.T. Suite was a kind of execution department, and one that she deserved. Bizarrely, she berated the staff for only “teasing” her, as she would of course wake up after each procedure, feeling her same miserable guilt-filled self. The staff had learned to not entirely deny her delusion about the sinister purpose of the suite.
“You actually gonna do it this time or are you just jerking me around?!”
“Just settle down babe” Gina cooed.
“Come on why do I bother?”
“Let Jack do his work babe”
“Doctor”, She looked at Gold, “You 100 per cent you finish it this time?”
“Maybe Basela, we’ll see.”
She settled down. The room gave a collective sigh of relief. Jack could move in and do his magic. Overcome with sedatives, Basela sank into the table.
“Treat please Gina”
Her back arched. Gold’s stomach grumbled. The canteen fish returned to mind.
Over two months into the brave new millennium and no computer-controlled aeroplanes had fallen out of the sky. The Volkswagen chugged on dutifully, magnolias were in bloom outside the old chapel, but no sign of spring could be found in Dr Gold’s heart. The prospect of annual leave offered him nothing but a dark abyss of meaningless existence with no one to share his ‘quality time’. His love life was an embarrassment. He recalled his last two ‘ex’s – Isabella and Kate. Isabella had found her way from his bed into Kate’s… well into his bed actually but it didn’t bear thinking about. Lately though, he was remembering everything. Like a sickness.
He could give a detailed account of every single dull day January to March, every pathetic moment. He’d started mistrusting positive signs, seeing them rather as preludes to catastrophe. The work on the wards wasn’t all that bad, though he had grown a little bored recently, bored of its predictability. The E.C.T. department though was on a kind of high. There had been a statistically improbable run of successes, and consultants were referring more and more cases, the list swelling to a dozen twice a week.
Even ‘The End is Nigh’ Mary Mundy had made an unequivocal recovery. On the ward, she had started turning out nicely each day, and doing improbable things like collecting flowers to put into plastic vases about the place. “Old ward sure needs cheering up to be sure” she twittered proudly.
There was that memory thing with her though that hid behind her improvement. Strangely, Mary would bring in the flowers every day and then look perplexed as to who had seemingly beaten her to this act of charity. Tests were done, the consultant team had discussed it, and Mary’s deficit was put down to all the E.C.T. she’d had. Gone too were the repeated visualisations of her traumatic past, gone was the rumination over her losses, the phantoms that had born her psychotic features aloft. Social work were setting-up twice-daily home visits to commence on discharge.
Dr Wallace, Mary’s consultant, patted Gold on the back, suggesting there was a great case history to publish there. The prospect of medical fame did nothing for him in his condition. In his jaundiced imagination, the old bird Mundy had been faking her illness from day one – yes, garnering sympathy first, and then glory.
Annual leave in April for Gold ended up in not relaxation, but alarming self-destruction. He didn’t know where it came from, but he struggled with an urge to consume drugs. His head was increasingly soaked with psychopathologies sponged up it seemed from the sickly Mayfields milieu. He spent three fevered weeks experimenting with cannabis, amphetamine and methamphetamines he’d picked up in on Brixton High Street, disguised by an increasingly disheveled appearance. He was self-medicating against waking nightmares that would not leave him. One was of noisy sounds of slamming steel – auditory hallucinations – echoes and cursing and exaggerated laughter that were unmistakably from one of Her Majesty’s Prisons. But he’d never been in a prison in his life. There were countless other experiences he seemed to be re-living that he’d never had. There was an humiliating appearance before a Westminster parliamentary committee, a morning confessing to a wife he’d never had of a double life, of debts and misadventure. Gold was far from his ‘living for the moment’. He was in grief for the past and in fear for the future. He was barely managing to eat, sleep, wash. It felt like he was dragging an unbearable weight of the past. He put in for more leave from work. Just paying his bills were an unbearable effort, let alone doctoring. It was hopeless. Weeks became months. Dr Gold rarely opened the curtains of his South London apartment to let in the spring sunshine. He sat alone hatching a plan. He was a psychiatrist. He was not going to let the pathology he was a master of over overcome him. It was not too late. He had inside knowledge. He was working out an escape route. Either do this thing, or wait until all I can do is throw myself under a tube train. His last chance beckoned like flickering red digits in an electronic display.
The height of summer found a new excitement and anticipation in Dr Gold – a long-awaited homecoming. It had been a while. The craggy red megaliths of Mayfields had remained, permanent as Arizona rock formations, staring him down as he crossed the central green. The grass was now scuffed and browned, having endured day after day of high summer heat. A slim young woman with dark hair and an olive complexion came galloping up to him like a gazelle, beaming happiness.
“You’ve come back doctor… uh… Dr Thingy!”
Basela, who he barely recognised, had never he thought had a problem with his name before. Sometimes it was ‘Gold’, or ‘Dr Death’ – in a kind of affectionate way. It had been almost a minute and so far, there was nothing about her complicity in the Arab-Israeli wars either.
“Where have you been?”
“And what happened to your arm?”
Gold re-adjusted his arm sling a fraction. The slight pain confirmed he was not dreaming. His memory eluded him of late in social settings. He could still recollect Basela’s previous appearance – emaciated and tortured – nothing like the bundle of exuberance now before him. He was almost lost for words.
“It was a nice long holiday Basela. You look great by the way… how are you getting on?”
“Good, doctor, good. My father’s ready to have me back in… where? There I go… I forget. Yes, Penge, back in Penge… it’s funny, he sees me, and just cries!” Her former resentment for him not ‘snuffing her out’ now seemed just an absurd notion.
“What is it with your arm doc?”
The arm fracture was under a cast and sling. Gold suddenly realised he was going to need a story. He had not taken a moment to think up a good one. Luckily it was just Basela.
“Skiing accident… stupid really.”
This seemed enough for her. She frowned in happy exaggerated fashion, like a clown. Thankfully it hadn’t occurred to her that July was a little implausible a time of year for winter sports. He might say it was a dry ski slope next time, somewhere in England. Basela ran off gleefully to spread the word of the doctor’s reappearance.
By the afternoon, news of the enigmatic Gold in his sling was all over the hospital. In the time that had lapsed since his long absence, Dr Gold had taken on something of a legendary status, as the hero of the E.C.T. department. The man who had led the team that brought a veritable number of poor souls away from Death’s door to become reverse images of their former selves. Many had already been discharged from Mayfields. But conversely at the time that Gold had left, the laundry block seemed to lose its magic. Some poor souls were pulled off treatment to go back to their ward day-rooms to face the walls, to slowly rot on the inside.
Sitting on a central bench on the green that was missing one horizontal slat, enjoying a cigarette and the deadening three O’clock calm, Gold spotted a man homing in on him. Sloping across the grass he came – portly and balding and sweating a in tweed waistcoat, shirt & tie. Gold was acutely aware his memory was still on holiday – who was this man? It was only after an awkward handshake with his only functioning left hand, and a glance at his name badge that he remembered, of course it was ‘Toad’ – “DR TOD WATERMAN – MEDICAL DIRECTOR”. His boss’s boss. The man almost leaped up and down, breathlessly begging him to start back on the E.C.T. programme as soon as possible. Much of it went straight through Gold, his attention floating away with the dreamy afternoon heat. Toad droned on about research grants, new equipment, government initiatives, Trust hospital status…
“If it’s remuneration you’re after old boy, I can see what we can do…”
Gold was blissfully elsewhere. Unusually elated. He needed to go and lie down in a dark cool place.
“…. And there’s the post of Assistant MD coming up Will too…”
Playing on his mind was an image of Toad springing up to him in a reptilian embrace, trying to force him into a slimy tongue kiss. The mental cartoon had Gold quietly laughing out loud… His private bliss was so far away from March’s waking nightmares – Israeli gunmen dispatching Arab boys in tunnels and the blood, the darkness…
“You may well laugh Will.” Toad grinned ear to ear. “Give it a thought eh?”
Clambering up the outside wall Gold’s heart thrilled to the scent of cotton and washing detergent wafting from the open upper window at the outside of the back of the laundry block. It was two AM, again, security guard napping. The department lacked ventilation and a film of water droplets clung to the inside of the windows as he climbed inside. Along the internal corridor, with the help of the general pass key, he slipped into the chlorinated void of the E.C.T. suite. He opened his kit bag – a now well-practiced routine – two static battery lamps, a pile of stretchy bungee cords, duct tape, and finally a mouth bit a little like he’d worn on the rugby field many years ago.
A new preoccupation was his arms. It was easy enough to lash his legs and torso, Houdini style, but he needed an arm to press the button which would also need restraint if it was going to avoid another break. A second ‘skiing’ accident in weeks wasn’t going to wash. Lacking the luxury of anaesthetic and muscle relaxants had turned out to be only a relative loss. A carefully practiced sequence culminated in the taping of the electrode heads to his temples making him look an alien extra in a Dr Who episode. He’d got used to being well-prepared. That lame gift of exfoliant gel from Isabella last Christmas had finally come in handy in preparing his skin. The old E.C.T. box was warmed-up, the bit in place. It was no worse, he consoled himself, than being hit in the head by a gloved fist, he imagined.
Gold’s left arm extended, he pressed the button.
A loud eerie beep rang out, rattling around the half-lit empty room. Within milliseconds Gold was knocked unconscious and then his body jerked, the table shuddered, his whole skeleton straining at the elastic cords in a mad dance for a little over half a minute.
Silence descended. Time elapsed.
It was thirty minutes past three when he came to, according to his illuminated watch. He was woken from a vivid dream of stained bed sheets whirling around in the suds of a large hospital washing machine. A manifestation of a psychic laundering process where week after week of deep-stained trauma, obscenity, blackness, stuff no one wanted to see – was all washed clean. Human souls dancing as clean sheets in a steel drum rejoicing with resurrected lives. He saw collective human experience – grief, mental injury, the whole history of human suffering as stains lifted away and forgotten. He dreamt of a foaming-white utopia where the weight of all the melancholy in the world was sublimated. His gift was to be able to absorb all the horror and existential angst, to carry the ballast of regrets, and then to have learned to dump them all into this electric mind laundry.
He came fully awake recharged with a sense of calling. If he could return each week it was going to work. His own grubby past and the pasts tarnishing his patient’s minds systematically dissolved and drained away. His dementia was a happy kind. He had become a mystical conduit for the misery of humanity. Goodbye past. Long live the present.