‘Oh God. Please tell me they’re not all like her.’
‘Not all of them.’ Kerry sighed. ‘Some are even halfway decent. Trouble is, though, that you’ll barely see the same person twice – apart from Enema. They employ mostly agency staff – and the minimum number they can get away with. They’re chronically understaffed; that’s at the root of everything that’s wrong here. Humanity costs time and money, and they like to spend as little of that as possible. Their chief aim is making a profit. No one gives a shit about fruitcakes. We’re scary and we’re smelly. And so Enema gets to rule the roost exactly as she sees fit.’
‘What, you mean this isn’t even an NHS hospital?’
‘No, it’s run by a private company. A particularly crap one. The NHS just outsources mental health services to them.’
Louisa felt her chest tighten with a growing sense of panic. If this was a non-NHS hospital that made things even worse. The overseeing of such places was notoriously lax. Every week the newspapers seemed to carry a new story about negligence, or even abuse, in privately run care facilities like this.
‘Ten minutes till therapy!’ A nurse on the other side of the room clapped her hands.
Kerry rolled her eyes.
‘What about everyone else?’ Louisa asked urgently. ‘What are their diagnoses?’
Kerry shrugged. ‘Schizophrenia, depression, OCD, drug addiction, dementia, alcoholism, eating disorders, self-harm, blah, blah – you name it, we’ve got it. Most people are dual diagnosis with some kind of drug or alcohol problem. Some are just terminally off with the fairies, but I don’t think there’s a medical term for that.’
‘So they just lump everyone in together?’ asked Louisa, feeling more and more panicked. ‘The anorexics and the addicts and the psychopaths? Aren’t some of the patients violent?’
‘Sure. But trouble doesn’t happen that often. They keep the real nutters on a special locked ward – the aggressive ones, I mean. You just have to be sensible, look out for yourself.’
Oh God, Louisa thought. ‘What about Marisa?’
‘Marisa’s back?’
‘They put her in my room last night.’
‘She’s a regular here. Paranoid schizophrenic – thinks she’s in league with Satan and pregnant with his devil-spawn baby; pretty standard stuff really. He speaks to her from small kitchen appliances: toasters, kettles, sandwich makers, that sort of thing. She’s OK when she’s medicated. Doesn’t say much, though. You see the doctor yet?’
Louisa shook her head. ‘I just got here last night.’
‘Look, if you want to get out, just tell the docs what they want to hear, OK? The psychiatrists don’t do anything much worthwhile, but they’re the gatekeepers to everything else – and the ones who sign your release papers. First rule of Crackpot Club: you’re sick. They’ve decided that, OK? The last thing they want to do is admit they’re wrong. So, you just say what they like to hear. Keep your head down and go through the motions. Just keep repeating: “Yes, you’re right. Yes, I’m mentally ill. Yes, I want to recover. Yes, the meds and therapy are helping.” And don’t let them see that you’re bloody livid about it all, or they’ll just decide you’ve got some kind of persecution mania. Do the group therapy shit. Don’t make any trouble. And if you don’t smoke, take it up.’
‘Why on earth would I do that? I hate smoking.’
‘Ciggie breaks outside. You get more fresh air that way. We don’t get any other outdoor recreation these days cos they’re too short-staffed. Oh, and another thing: get your family and friends to hassle your GP, OK? The shrinks need to know there are people on the outside keeping tabs on them – it keeps them on their toes.’
‘I haven’t got any family.’ Nor even any real friends any more, Louisa thought sadly. Dropping out of medical school to look after Granny had put paid to that.
‘Ah,’ said Kerry. ‘That’s too bad. But chin up; it’ll be OK. Oh, and make sure to hide your stuff or it’ll get nicked – and don’t give anyone else your personal details or they’ll be phoning you up suicidal at three in the morning once you’re back out on Civvy Street.’ She patted her stomach. ‘And have the pancakes next time. That’s the best advice of all.’ She smiled reassuringly. ‘Try not to freak out, all right? Most of us are OK. Just remember, the people in here are more likely to hurt themselves than hurt you.’
Louisa wasn’t convinced. ‘OK,’ she said. ‘I’ll try. But to be honest, I am freaking out – completely and utterly. About a million years ago I was a medical student. I always thought I might eventually go into psychiatry. It’s bloody ironic that I’m locked up in a mental hospital now myself.’
‘Wow, really? You were studying to be a doctor?’
‘I didn’t get that far. Just two and a half years. Mostly, it was anatomy, disease progression, pharmacology, dissecting cadavers, that sort of thing.’
‘Seriously?’ Kerry leaned forward, her eyes wide. ‘You cut up dead people? That’s bloody insane! You miss it?’
‘Very much. Well, not dissecting cadavers specifically – medicine in general. But it almost seems like someone else’s life these days.’ She smiled. ‘Thanks, Kerry. For talking to me, I mean.’
Kerry got up. ‘You’ll be all right, you’ll see. And anyway, Doc, I’ll look out for you. It’s nice to have someone halfway sane to speak to. Catch you later, OK?’
Kerry headed off towards the queue of people outside a hatch in the wall at the end of the canteen. A nurse was standing at the hatch handing out drugs and watching apathetically as each patient swallowed their pills, then asking mechanically whether they were hearing or seeing things, and how they would rate their anxiety or depression on a scale of one to ten. One man shuffled forward too far and was barked at to keep behind the line on the floor.
With Kerry gone, fear clutched at Louisa’s insides once again. Some of the patients looked very disturbed indeed, grimacing and making sudden movements. How was it possible to know who was harmless and who a violent psychopath?
‘Excuse me?’ Louisa called to a passing nurse. ‘I don’t know where I’m meant to go. I’m supposed to see the doctor.’
‘You have to go to therapy,’ she said without looking around. ‘In the day room.’
Where was the day room? There were no signs anywhere. Louisa went back to the nurses’ Perspex fortress, located near the main door in a sort of atrium. Several long corridors led off it. She set off down one – only to find it soon ended in locked double doors. She backtracked and tried another corridor.