10. Waiting Room
"Do you want me to come and see the doctor with you?" Lara asked.
"No, it'll be difficult for you to take the time off" replied Neil.
"I don't mind. It's important. I can do it if it will help" she said.
Neil was now in his third week off work and he was starting to get anxious about returning to his job.
"I just wish I felt better, but I think I feel worse than I did a few weeks ago" he complained.
"Try not to stress about things. Go and see the doctor again and see what they say" she said in a comforting tone.
He'd left it almost to the last minute - Thursday - but Lara was now coming home expecting to find out what had happened at the doctor's. Neil was sat on the sofa as she came in the front door and hung up her coat. There was no new prescription on the coffee table in front of him.
"So, how'd it go?" she asked.
"They're referring me to a psychiatrist."
"Well that's good. You'll get a specialist's opinion" she said.
"Yes, but it could take weeks, months even before I get an appointment to see a consultant."
"What's the plan for the interim?" she asked.
"The doctor's signed me off for another two weeks. I said I was getting very stressed and anxious about going back to work. He said I should contact my HR department who can involve occupational health."
"Yes. I saw a different doctor this time."
"Doctor Hughes?" she asked.
"I can't remember. It'll be written on the sick note, I guess."
"How do you feel about things?" asked Lara.
"I'm anxious about what it's going to be like, going back to work after five weeks off. It's a long time, you know?" he replied.
"People get sick. It happens all the time" Lara said as reassuringly as she could.
"Yes. But not me. And hardly ever anybody else at work" said Neil.
"Everybody will be happy that you're feeling better again when you go back to work. It'll be fine" she soothed.
"We agreed I would keep taking the same antidepressants. It's too early to tell if it's going to have a positive effect yet. It could be weeks before it helps my mood improve" he said. "I've got enough to last me a couple of months now" he continued.
"You refilled your prescription?"
"Yeah. I felt embarrassed in the chemist. All those pills. All those sick people and then there's me" he replied.
"Lots of people have to take medication for all kinds of reasons. There's no shame in it"
"Yes, but I still felt ashamed. I didn't want anybody we know to see me, walking home with that paper bag full of pills from the chemist" he said.
"Awww. You'll feel better soon" she said, pulling his head into the crook of her neck and cradling him slightly. His eyes were downcast and sad.
"The doctor said to keep an eye on things. Go back if there's any problems. There's not going to be any follow-up appointments or anything. I've just got to wait for a letter with an appointment date to see the psychiatrist" Neil said with a resigned tone.
Psychiatry. Lara's only real first-hand experience with psychiatry was helping patients with their prescriptions when they were on the ward. The patients were often quite difficult to deal with, but not because of behaviour that she understood as classical mental illness. She would be pestered all the time by the patients - "Nurse, it's time for my medication" - who would get extremely upset about the disruption to their normal routine. There were endless arguments about their prescriptions.
On the ward, the nurses would do three medication rounds per shift, plus respond to patients who were allowed a certain amount of pain medication on request. Unless otherwise indicated in the patient's notes, Lara could only dispense small doses of paracetamol, taken orally. The patient's own medications were usually locked away in a bedside cabinet that only the nurses had the key to. Any medication that the hospital's doctors had prescribed would be dispensed by the nurses at set times and that was when they usually unlocked the cabinet if there was something else that the patient was taking.
Psychiatric inpatients had their usual medications meticulously recorded in separate notes. Although the patients often knew which pills they had to take and how often, Lara had to follow the notes to the letter. The routine of the general hospital was different from the psychiatric wards the patients were used to and they could get very agitated if they felt they were overdue getting their pills.
It was surprising just how many medications some patients had to take each day. There were mood stabilisers and antipsychotics. There were antidepressants and anxiety drugs. There were sleeping pills and tranquillisers. The night shift would start with two hours of hell, as patients begged for their sleeping pills. The first dispensing round of the night shift wasn't until 9pm, so the nurses would get no peace until then. Mercifully, the psychiatric patients were often knocked out cold until the next morning though, which meant they were less trouble through the night than the others.
When on night shift, trying to sleep during the day was hard. Slamming car doors, traffic noises, people yelling in the street below, children screaming in the back gardens. The world was set up for the 9 to 5, Monday to Friday worker. Nearby builders and roadworks could mean a week with barely any sleep at all. Lara often longed for some sleeping pills herself and she knew that some of her colleagues did use medications to help them get some quality sleep during the day.
The few psychiatric patients Lara came into contact with were the most extreme. She saw the aftermath of self harm, suicide attempts and psychotic episodes. However, on the general ward the patients were heavily medicated. They were dazed and confused, with cloudy minds. They shuffled around. Some of them had uncontrollably dribbling mouths and involuntary tics.
She knew that Neil was going to see a psychiatrist - as an outpatient - but Lara made no association between him and the kind of extreme cases of mental illness she occasionally encountered at work. Neil seemed perfectly healthy and normal to all outward appearances, although she could tell that he was lethargic and more anxious and negative than she'd ever known before.
Later that Thursday evening, Lara attended an engagement party for a couple they distantly knew through other friends. Lara had started to socialise again, but on her own. She could see an expression of exhaustion and stress spread over Neil's face when the topic of going out was ever discussed. It was clear that he really wasn't up to socialising yet.
"How's Neil?" asked Katie.
Katie was Russ' new girlfriend. She was still slowly ingratiating herself with everybody and Lara felt sorry for her, as she struggled to become included in the group. Katie was young and pretty and the other girls treated her as if she wasn't worth getting to know. "She'll just be another casual fling" the girls said behind Katie's back.
None of the other girls had really asked about Neil. They had decided to just ignore the issue. If anybody else had asked, Lara would have dismissed the question with a cheery "he's fine". However, Katie was somehow disarming and approachable. Lara drew her to one side. The rest of the group were engrossed in their usual comfortable conversational routines.
"He's ever so depressed. It's sad to see him like that. I don't know what to do" Lara confided.
"There's not much you can do. Don't beat yourself up. Is he taking anything?" Katie asked.
Lara was taken aback by Katie's directness, but it was good to talk to somebody who seemed to immediately understand what the couple were going through.
"He started antidepressants a couple of weeks ago" said Lara.
"Well, it can take time to find the right one. Don't lose hope if you don't see any quick improvements" said Katie.
"Do you?..." Lara tailed off, worried her question was too personal.
Katie gave a little chuckle.
"It's fine. You can ask. Yes, I've been on antidepressants for a few years now. They do help, when you find the one that works for you" said Katie.
"But you seem. You seem so..." Lara stumbled, not knowing how to finish her question.
"Normal? Happy?" Katie said, grinning.
"Yeah" said Lara, nervously.
"Well, I have my bad days like everybody, but life is mostly OK now. A few years ago I just closed the curtains and didn't get out of bed for what felt like forever. I couldn't face the world"
"That sounds like the stage Neil's at" said Lara.
"Well, it does get better; easier. Recovery can be slow and nonlinear. Or it was in my case, anyway" said Katie, with as much reassurance as she could muster.
"He's just so desperate to get back to work, but at the same time I can see he's anxious. I know he can't face it at the moment. He's barely left the house in weeks" said Lara.
"There's no rushing these things. Tell him there's no rush. It can be a long road"
There was something harsh and brutal about this, even though it was spoken kindly. Katie spoke directly, truthfully, sympathetically. Lara had read things like this on websites, but it hadn't sunk in until now. There had been a sense of denial; there had been false hope.
"Look. Phone me. We'll meet up, just the two of us. You need support. You need to think about yourself too" said Katie.
Lara felt strong emotions welling up inside. She had been holding it all down, holding things together, acting like everything was going to get back to normal overnight. She was worried she was going to cry but she didn't. She was stronger than that.
Katie reached down and squeezed Lara's hand and made a sympathetic face. Lara was grateful to have made a friend who talked so openly, so freely, so directly.
The party was starting to disband and Russ was making his way over to the girls. Katie's face immediately switched to the bright happy expression she usually wore. It didn't seem fake to Lara. It made sense, to present a front and avoid discussing things that most people wouldn't understand.