We reproduce Nenagh GP Dr Pat Harrold’s short story ‘High Walls’, which won this year’s Irish Medical Writers’ Aindreas McEntee Prize for fiction.
Peter watched the chief psychiatrist from the door. ”I’ll kill him, I’ll bloody kill him.” The Chief stood squarely in the middle of the office, staring up at the admissions board, muttering. “He’s back on the drink. Wait till I get him.”
Nobody took much notice, maybe because he was smiling broadly. “Mick is in as well, I knew he wouldn’t take his tablets. I’ll kill him.”
The front office was crowded as doctors and nurses hustled about, getting the Monday morning sorted.
The chief psychiatrist spotted Peter. ”Year of the Biker!” he said, nodding at Peter’s rucksack and helmet.
”You’ll see the board is still here. You can take it down when I go next year.” Another minor victory over Peter, the new psychiatrist.
“I just think it’s old fashioned to have admissions’ names displayed in the front office,” said Peter.
“Well, it’ll do for another while. The committee voted to keep it.”
Pick your battles; thought Peter. I’ll have you out by Christmas. You don’t know the committee as well as you think you do.
“There’s another doctor in.”
“Another SHO?” asked Peter.
“No, another patient. That makes four doctors out of four-hundred patients,” said the Chief, rubbing his hands together and smiling. “She’s not on the board yet. Came from Dublin. She’s from here originally. Chronic schizophrenic I, transferred her to your long-stay ward. I’d hope that with your new neuroleptics you could make a difference. Get her life back.”
“Jesus, Tom, you can’t just put her in like that. It’s against all the rules.”
“And of course Jim and Joan are in drying out again.”
“You don’t put them up on the board,” said Peter spitefully.
“Can’t,” said the Chief cheerfully. “They are not officially here. You know the score with them.”
“The fact that they are well known GPs has nothing to do with it?”
“And last there is Professor McKenzie, poor soul. Still thinks she’s conducting ward rounds down in Geriatrics.”
‘You’ll be the bloody fifth if I can manage it,’ thought Peter, and he then jumped as the Chief laughed. “I suppose I’ll be the fifth — ha?”
He slapped Peter on the arm. ”What’s the matter Doctor? Don’t you know that when you’re a psychiatrist as long as I am you can read minds?”
It was a relief to get out of the office into the May morning sunshine. Peter unlocked his bike and took his helmet out of his rucksack. He took the path to the long-stay wards past the towering grey wall of the psychiatric hospital.
The patients were already being led out into the fresh air from the villas scattered through the grounds, most of them wearing straw hats to protect them from sunburn.
One man stood out from a shuffling line. He was tall and thin, with a high stepping gait and elfin features.
Definitely a syndrome, thought Peter, I’ll have to get genetics on him. I’ll transfer him over first though, no sense in treading on too many toes. I’ll swap him for that bloody schizophrenic doctor.
An untidy old lady, with wild straggling hair, stared at Peter as he flew past.
Dr Jim and Dr Joan were out for a walk. They must have been in a few days. She waved at Peter but he didn’t stop.
The nurse in the long-stay ward was in her forties, blonde and calm.
“Good morning doctor. Isn’t it glorious? I was going to ask you about letting some of them out for a while today, under supervision.”
“Maybe later. What’s this about the new woman? It’s most irregular, the way she ended up here.”
“She’s a thirty-three-year-old chronic schizophrenic with predominantly negative symptoms. Late onset, she actually qualified in medicine but never worked, as it became apparent that she was unwell. Good family support, but she just cannot cope on her own. Her family requested that she be transferred down here.”
She handed Peter a thick folder. He glanced at the front and then stopped. It had to be. He couldn’t speak for a moment.
“Let’s see her.”
The nurse led the way, down to the interview room. She had changed, but not much. Still slim, the huge black eyes staring at the corner. A thread of grey ran through her dark hair.
“Could you leave us a minute nurse?”
The nurse gave a small smile and vanished.
“Hallo, hallo… It’s Peter…”
She did not look at him..
Was she there? He felt, incredibly, a sob building in his chest. She is gone. A phrase entered his mind, “lost and gone forever”.
Then a small hand as trusting as a child’s slipped into his. ”Peter,” she said. ”It’s all right. Don’t cry.”
He jumped up. “I’ll call again. I have a few things to do.” The nurse was in the hall, waiting.
They returned to the office without a word. He sat and read the chart intently.
Then he stood up. ”Maisie,” he said, ”you let whoever you think fit out in the sun today. I’ll back you.”
“Call me Peter.”
He swung back on the bike. Left the helmet in the bag.
He now saw that the thin man had the stricken face of a Goya saint. The old lady was now sitting on the grass. He noticed that she was playing with an ancient teddy bear.
He stopped for a few words with Jim and Joan. When you got closer you saw that his handsome face was puffy and lined and that her beauty had faded, and that they were still as close as they ever were. They were going home tomorrow. He wished them good luck.
A car pulled up beside him. The Chief let down the window. ”You don’t look as big a bollix without the helmet.”
“The new girl. I can’t look after her.”
“Can’t or won’t?”
“You go back?
“We do. It was only a small thing. But it was a thing.”
“But I had a look at her chart. She would be suitable for a new neuroleptic.”
“Sure. We’ll look into it.”
“And you know the tall chap in Elm ward? I always thought he had a syndrome. Meant to get him checked out.”
“I’ll work with you on it. On both of them.”
The Chief put up the window, then put it down again. ”You’ll be reading minds next.”
The Aindreas McEntee Prize is supported by an educational grant from Boehringer Ingelheim.