Tuesday, 15 August 2017

The problem with Nigel

The phone rang in the therapist’s office. The mother on the other end outlined the problem – Nigel, her son, now aged 44 had been in care for nearly 8 years in a state of catatonic schizophrenia. Various drugs and electroconvulsive therapy had been tried with only moderate and always a temporary success. Neurological assessments revealed nothing of significance. Nigel spent his days in a seemingly twilight world where there was minimal, if any, apparent interest in his surroundings. In short, Nigel appeared fully conscious yet totally unresponsive.

I think they have given up on him,” his mother told the therapist, and knowing his reputation asked, “Is there anything you can do?

Oh yes!” Replied the Good Looking Therapist.

The trickiest part was getting the psychiatric care home to allow the therapist in. There are all sorts of rules about these things and territorial considerations, but with persistence and some wiley charms, the therapist was able to get the relevant forms signed.

With minimal observation, Nigel’s care routine became obvious. In the morning, the care staff would wash him, drain off the catheter bag, dress him, place him on his chair, feed him and then park him in front of the window or television for the morning. Periodically, they’d lift him and move him to prevent pressure sores. On Wednesdays, the weekly enema was given to prevent constipation. At lunchtime, the catheter bag was emptied and Nigel was fed and watered and after lunch was parked either in front of the television or back in front of the window. The evening routine was similar and then he was put to bed.

This was pretty much Nigel’s life had been for the past 8 years. Now the care was mostly professional and was indeed very caring. He’d never developed a pressure sore, suffered unreasonable constipation or any other unreasonable physical health problem. Often, the staff would talk to him and read to him, but rarely was there even so much as a flicker of interest from Nigel.

I think he is lost to us,” one member of staff voiced to the Therapist, “what are you going to do?” she asked. “I’ll show you tomorrow,” the Therapist replied, “I’ll show you tomorrow.”

The following morning the Therapist was in early before the more dependent residents had been gotten out of bed. He brought freshly made doughnuts from the 24-hour supermarket and made all the staff tea and coffee and waited to be called. “Just let me know when you have Nigel out of bed,” he told them.

Forty minutes later, Nigel was out of bed and the Therapist waited patiently as the staff spoon fed Nigel who ate disinterestedly. When he had finished eating, the Therapist indicated to the nurses, “He’s mine, give him to me!” He demanded and as he took over control of the wheelchair leaned down and whispered into Nigel’s ear, “Just play along with me, I’m getting paid a fortune for this,” and wheeled him up along the corridor.

Reaching the small cleaners cupboard, the Therapist took out all the mops, brooms, dust pans – took out everything – and found to his delight that the cupboard was just about big enough to fit one man and a wheelchair into it. “Shhh! Just play along with me!” he said quietly as he shut the door, locking it after he did so.

It was at this juncture that the staff went nuts! What did this therapist think he was doing? Did he not know how unprofessional this was? What if something happened to him in there?

Look!” the Therapist explained. “That man is catatonic, he hasn’t moved in nearly 8 years and he is locked safely in a small empty cupboard. What on earth is going to happen to him? And besides, he’s safer in there than out here – haven’t you noticed, this place is full of crazy people?!

The staff were clearly uncomfortable with the whole situation and put up quite a protest. All this was occurring outside the cupboard where Nigel resided. This was part of the Therapist’s plan. Nigel might be unresponsive, but there certainly was nothing wrong with his ears.

He stays in the cupboard!” The therapist ordered, showing the staff the written authority that had been granted to him for the unconventional intervention. The staff went away unhappy. The Therapist did notice later that day that the doughnuts brought earlier remained uneaten.

At lunchtime, the therapist unlocked the cupboard and wheeled Nigel back to the care staff that ministered to him in the usual fashion.

After lunch, Nigel was wheeled back into the cupboard with the passing whisper, “Look, let’s see if we can string out this all week, it’s a really cushy number!” and the Therapist once again locked the door.

That evening Nigel was handed back to the care staff and the therapist went home. He was back in early again the next morning and when he took command of Nigel in his wheelchair, Nigel did something – he looked at the Therapist, and it was a look that communicated something. Precisely what that something was no one was sure, but the care staff saw it too. “He seems angry,” said one of the nurses.

At around 8am, with Nigel fed and watered, the Therapist wheeled him along the corridor to the cupboard. As he did so, he said in a jovial manner into one of Nigel’s ears, “Thanks ever so much for this – I really do appreciate it,” and placed him back into the cupboard and locked it.

By 1030am that very same morning, that cupboard door was off its hinges and a very angry looking Nigel was found standing in the corridor screaming, "cocksuckingmotherfuckingcuntingshitcuntbastard!” And as if to complete the image, he actually had spittle flying from his mouth and drool on his chin.

It certainly as if Nigel was awake and he was looking more responsive than yesterday. Yet, this behaviour appeared to unsettle the staff more than when he was locked in the cupboard.

So, the first thing that they did?

They sedated him.

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