21. The Cell
"If you don't mind, please empty everything out of your pockets into this plastic tray."
Neil put his wallet, mobile phone, house keys, loose change, used tissue and a folded piece of paper into the grey plastic tray, which had a sticky label on it with "Neil - Room 8" written on it in red marker pen.
"Do you have anything sharp in any of your pockets that could hurt me? I'm afraid we have to check we've got everything."
The nurse patted Neil's clothes down and checked the waistband of his trousers and underpants.
"OK, would you mind taking off your belt and your shoes, please. Just pop your shoes down on the table here next to the tray."
"We have to keep your belt, sorry. I saw you brought a dressing gown and we have to keep the cord from that too. We're also going to have to take the laces from your shoes. We'll go through your bag from home in a minute but you can't have necklaces, cables - such as mobile phone chargers - razors, scissors, keys or anything else sharp."
"If it's alright with you, we'll hang on to your mobile phone and keep your wallet safe here at the nurse's station. If you need something for any reason, you can ask one of the staff to get it for you, but we'd really like you to try and relax and get used to the ward for the first few days, so we'll be keeping your phone right here."
The nurse was now coiling the dressing gown cord and putting it in the tray, as he went through rest of Neil's belongings.
"We have to keep aerosols here. If you need your razor you can have it while somebody supervises you shaving."
"I'm not feeling suicidal" Neil said.
"OK, that's great, but there are other patients here who might be. The bedroom doors aren't locked so we have to keep all these high risk items here for everybody's safety."
The nurse showed Neil to his room. The door had a window with a blind which could be opened and closed from the outside. There was a single bed with a foam mattress, a writing desk, a plastic chair, an open wardrobe with drawers at the bottom, a sink and a plastic mirror screwed to the wall. A big window was secured with a wire tether so it could only be opened a few inches. There were no curtains. Across the hallway there was a wet-room with a shower. There was no shower curtain. There were no locks on any of the doors.
"Get yourself settled and then come and sit in the lounge. We try to encourage patients to not spend time in their rooms during the day."
Neil sat on his bed with his bag next to him for a few minutes. He thought about unpacking but he really didn't want to give the impression that he was OK about being detained in hospital against his will. He'd been told to bring a few essential clothes and toiletries. Visitors could bring him anything else he needed once he'd settled in.
In the main part of the ward, there was a lounge at one end with several sofas arranged around a big TV which was hung on the wall. At the other end of the room were a number of tables and chairs. There was a nurses' office and two rooms with sofas in, which had big windows so you could see in and out. There was a doctors' office and an examination room which were private. There was a door leading to the male bedrooms and another one leading to the female bedrooms. A recreation room had a pool table, table tennis table and books in it, as well as a number of patients' artworks displayed on the walls. There was also a small kitchen for the patients to be able to make their own drinks and snacks.
A noticeboard displayed a timetable of the week's events, which had many of the same things that Neil was familiar with from day hospital: art therapy, music therapy, drama therapy and community meetings. A whiteboard had the first names of the 18 patients who were staying on the ward, with their allocated nurse's name written next to it in green marker pen. The ward was at its maximum capacity, with 9 men and 9 women.
There was a dispensary hatch where patients would queue up to get their medication several times a day. There was a door that led out to a small courtyard surrounded by high walls on all sides. That was both the smoking area and the only place that patients were allowed outside without staff supervision.
CCTV cameras were everywhere, except in the bedrooms and bathrooms. The ward was secure but the patients were considered low risk. There was only one locked door between the ward and the main corridor of the hospital that led to the other wards and facilities. For a few days, Neil had to stay on the ward, but then staff members were allowed to escort him to and from the drama studio, art studio and music room.
Some of the patients had obvious scarring on their arms where they had cut themselves. A girl's neck was bandaged. Other patients had problems that were more subtle. A man with a big beard smelt of pooh and always wore pyjamas. Many were quiet and withdrawn and a few would shout randomly, talk or sing to themselves.
"BBC one, BBC two, ITV" a man started. "Channel four" he said, raising his voice an octave higher. He repeated this same phrase over and over in a lyrical and rhythmic way, like he was chanting a mantra. It was quite catchy and Neil found it stuck in his head too.
"I just want to be dead."
This is what Michael said loudly every single morning before breakfast. Neil was a late riser, but he could hear his fellow patient shouting all the way down the corridor.
"OK, Michael. Time for your morning medication" a staff member would coo, coaxing him towards the dispensary hatch. Michael would shuffle along in his slippers. By the time Neil got up for breakfast, Michael would be sat quietly at a table with a vacant stare and a half-eaten bowl of cereal in front of him.
"NEIL! What are you having for breakfast?" Nicole shrieked with excitement.
Nicole was young but some developmental disorder meant that she was even more childlike. Her eyes were always half-closed with her bottom lip protruding. Saliva dripped liberally from her mouth. However, despite her tenuous grasp on almost all aspects of reality, she had latched onto Neil, much to his annoyance.
"I don't know. I might have toast."
"I was going to have toast."
"Actually, I might have corn flakes." he toyed with her.
Nicole hesitated for a moment, looking crestfallen. Then her face lit up.
"I'm going to have corn flakes."
Neil swiftly poured himself some rice crispies and dashed out of the kitchen to find a table with only one spare seat.
"Those aren't corn flakes, Neil." said Nicole, coming out of the kitchen and looking with dismay at her own bowl. "Sit here with me" she gestured, standing by an unoccupied table.
"How's it going?" Neil asked a patient who he didn't know, sat at the table next to him, ignoring Nicole's entreaties.
"Not great" the man replied.
Nicole huffed and sat down to eat her breakfast. A staff member rushed over to join her, fearing there would be an upset outburst if the poor girl felt too overlooked.
In his first three weeks in hospital, Neil saw the psychiatrist three times. He had a few meetings with mental health nurses and a physical health check-up, but his life was one of ordered institutional hospital routine: medication, mealtimes, planned activities and lots of time spent watching TV.
Suddenly losing his liberty had been terrifying and his natural instinct was to yell for lawyers, demand his human rights and to complain about the arbitration that had led to him now being held under lock and key. However, he also feared the power of the state institutions. The police, the National Health Service, the government, the law: he was no match for these massive entities and he knew that he would only make things worse for himself if he made a fuss.
He now deeply mistrusted the system and regretted seeking medical help at all. He felt betrayed by his doctors, he felt that the medications had made him sick, he felt that the crisis team and Lara had conspired to lock him up. He was angry that the police were used for his "welfare" when he really felt they simply provided the muscle to drag him away from his home if he tried to fight for his freedom.
Neil's faith in medicine had been completely shattered, but now, as he lay contemplating his wrecked body he knew he urgently needed medical help. He was dying.
The can of cola that he had found in the shopping bag he'd left outside the caravan had worked its way quickly through to his bladder and he needed the toilet. Grabbing a half-full glass from a nearby shelf, he urinated into it. His urine had been getting more and more cloudy and smelled terrible, but now there was a copious amount of blood present.
His organs were failing. His lungs were flooding with fluid that he couldn't cough up. His chest was tight and his breathing was laboured. His ankles were swelling up as his heart struggled to pump blood around his body. His dehydration and malnutrition had reached the point where his body had start to eat itself and his muscles were wasting away. He was so fatigued that he struggled to move and he blacked out from low blood pressure if he raised his head too quickly.
Death in the filth and darkness of the caravan was nearly upon him.