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The young woman knocked on Melanie’s door, waited for a few seconds then opened it and looked in.
‘Hello, I’m Sarah,’ she said, smiling at the patient.
‘Oh, hello,’ replied Melanie, sleepily. She was sitting in the chair next to the bed, dressed in a pair of pyjamas which Izzy had brought in for her. A magazine was on the floor next to the chair, presumably having slid off her lap as she dozed off. Melanie stretched, yawned and then picked up the magazine. She remembered she had flicked through it periodically but none of the articles held much interest for her, and if pressed, she would struggle to remember a single thing about them.
‘I’m from the Liaison Psychiatry Service here at the hospital, is it OK if we have a chat?’
Melanie frowned slightly, ‘I’ve not heard of that service before.’
Sarah dragged over a plastic chair from the corner of the room and sat down near Melanie. She was dressed in plain black trousers, flat shoes and wore a loose long-sleeved blouse, with a geometric brown and black design. Her slightly wavy fair hair was pulled back and fastened in a messy bun at the back of her head.
‘We work alongside the other doctors who are caring for you to make sure that we look after your mental health as well.’
‘Oh, I see, OK.’ Melanie gazed at Sarah and thought how pretty she looked, noting the small mole on her left cheek which was perfectly positioned, like a beauty spot. Sarah’s professional image made Melanie feel even more untidy and dishevelled.
‘I can come back another time if you don’t feel up to speaking today?’
‘No, it’s OK, really. I think I must have fallen asleep.’
‘How’s your arm?’
‘Not too bad, I can’t really feel anything much, it’s a bit itchy sometimes.’
‘That’s good,’ she smiled. ‘How about your head?’
‘It’s painful to touch, I’m still taking painkillers as I get headaches.’
‘That’s understandable.’
‘My hair feels gross, I wish I could wash it, I must look awful.’
‘You’ve had an accident, don’t worry about how you look.’
‘Thanks,’ replied Melanie, managing a weak smile. Self-consciously she swept her hair back and tried to secure it behind her ears.
‘I’d like to talk a bit about what happened on Monday evening if you feel able. You can stop at any time if you feel you are getting too upset, OK?’
‘OK, I’ll try.’
‘Now, what do you remember about Monday evening?’
‘My recollection of the evening is very confused. I’d not been feeling well over the weekend.’
‘In what way did you not feel well?’
‘I became very depressed. I sort of spiralled down into a hole and I felt at rock bottom.’
‘Have you felt like that before?’
‘I have, but not for a long time. I used to cut myself when I was a teenager.’
‘OK, when did you start self-harming again?’
‘At the weekend, I cut my arm. It was the only way to get rid of the pain. I think I cut my leg as well.’
Sarah listened to Melanie allowing her to relay the details at her own speed.
‘I can’t remember how many times I cut myself but I remember leaving my flat, and I must have met Izzy.’ Melanie closed her eyes to help her remember the recent events. ‘I remember being at the pub, although I’m not sure which one we went to. After that, I’m not sure, I remember walking across town, but I didn’t feel very well.’
Melanie began to cry. Sarah got up and picked up a box of tissues by her bed and handed them to her.
‘Thanks,’ said Melanie, wiping her eyes and blowing her nose.
‘I think we should finish now. You’ve done really well, as I said, there’s no rush to talk about things. Would it be alright if I come and see you again tomorrow?’
‘Yes, sorry, it’s just remembering what happened. I can still feel the car as it hit me.’
Melanie closed her eyes as she remembered the accident.
‘I can hear the screech of the tyres. After that, well, I don’t remember much apart from some fuzzy images of being in hospital.’
‘OK, let’s leave it there. You’ve done really well.’
‘I’m feeling tired now, I need to lie down.’
‘That’s a good idea. Can you get into bed alright?’
‘Yes, thank you.’
Melanie climbed on the bed and lay back against the pillows.
‘Here’s the call button, if you need the nurse.’
‘Thanks.’
‘I’ll come and see you again tomorrow.’
‘Thank you. What did you say your name is?’
‘Sarah.’
‘Thanks, Sarah. See you tomorrow.’
Sarah left and headed along the corridor to see her next patient. She felt genuinely sad for Melanie, who was having such a difficult time at the moment. Their brief conversation was a start, but she would need to talk to her for longer to decide what was best in terms of her care and to set her on the road to recovery.
**
Trish Webster had been seen straightaway at Urgent Care and as a precaution, she had been taken for a CT scan on her brain, just to check physically there was no damage. Trish and Tom were now back in a cubicle, waiting for a doctor to discuss the results with her.
‘Hello, Trish,’ said Dr Welling, who was short and stocky and appeared to be in his forties. He entered the cubicle and drew the curtains behind him. ‘How are you feeling now?’
‘Fine, thank you. A bit tired.’
‘Well, the good news is that you’ve not had a stroke.’
‘Oh, what a relief,’ said Tom, ‘thank you, doctor.’
‘Your blood tests were all normal, blood glucose is fine, cholesterol is also good. No sign of inflammation or infection. Full blood count normal and white cell count is OK. In fact, they are all excellent,’ he informed them, looking at his folder.
Trish nodded.
‘Can you tell me what happened to you this afternoon?’ he continued.
‘I felt dizzy and then when I stood up I must have fallen over, I don’t remember anything much after that but you’re saying I’m perfectly alright.’
‘Can I ask you some questions?’
‘Yes, if you want to.’
‘Do you know who is the Prime Minister?’
‘Yes, Teresa May.’
‘What day is it today?’
‘Er, Tuesday, I think. Isn’t it?’
‘Where do you live?’
‘Bishop’s Avenue.’
‘OK, that’s great,’ replied the doctor, noting that her answers were now completely correct, in contrast to his earlier examination when she had struggled to answer them. Although you’ve not had a stroke we’d like to keep you in tonight just to check you didn’t hurt yourself. There’s nothing to worry about.’
‘Oh, is that really necessary?’ she sighed.
‘Do you have any idea what it was?’ asked Tom.
‘My theory at the moment is that it is some sort of amnesia, most likely what we call transient global amnesia.’
Trish raised her eyebrows at this information.
‘It’s normally quite short lasting, up to twenty-four hours from when it manifests itself. There isn’t usually any long-term damage.’
‘Will it happen again?’ asked Tom.
‘I can’t say. Have you ever had any epileptic episodes in the past?’
‘No, never,’ replied Trish.
‘What about your history of mental health? Any problems with depression and anxiety?’
Trish seemed reticent, so Tom looked at her, ‘Do you want to answer or shall I?’
‘I did have a major depressive illness when I was much younger. Since then there have been other milder incidents.’
‘Is there anything worrying you at the moment?’ Have you had any really stressful events happening?’
‘Not particularly,’ replied Trish.
Tom looked at his wife, raising his eyebrows. ‘My wife has been supporting her friend at the SEKare Inquiry which started this week. It seems they were shown some upsetting footage and it was at that point that my wife fainted. Because of her medical history, I’m worried that it’s all become a bit too much for her,’ he paused. ‘I’m sorry, Trish but we need to be open about things.’
‘OK, that’s very useful to know. Trish, I’ll speak to some of my colleagues, and I think it would be useful for someone from our mental health team to speak to you.’
‘But I’m a counsellor myself,’ said Trish. ‘I don’t think I need to speak to anyone at the hospital. My husband worries about me too much.’
‘Let’s see how you are in the morning, OK?’ suggested Dr Welling and he smiled comfortingly at Tom. ‘Right, Trish, the nurse will be in to let you know when a bed is free, and I’ll see you in the morning.’
‘Bye,’ said Trish.
‘Thank you, doctor,’ said Tom and shook the doctor’s hand.
They were left alone once more.
‘Don’t worry, Trish, we’ll soon have you back home and feeling better.’
‘I can speak for myself, you know.’
‘I’m sorry, I was just trying to help.’
‘I’m feeling a bit better now, actually. I remember the inquiry. I heard you talking about it. I think some of it’s coming back to me although I have no memory of how I got home.’
‘Beth brought you home in a taxi.’
‘Did she?’ Trish closed her eyes. ‘I remember this morning but then after lunch, I just can’t seem to remember.....’ her voice trailed off.
‘What is it?’
‘Nothing, no, it’s nothing,’ she replied.
‘You can’t help Beth if the images you see there are upsetting you so much,’ said Tom. ‘She will have to find someone else to go with her.’
Tom held his wife’s hand. At least she had stopped talking complete rubbish, even if she was still a bit confused about the events of the day. Somehow her brain had blanked out a few hours, and those memories may have been lost forever. He looked at her and saw that tears were beginning to fall from her closed eyes. Soon her silent agony turned into sobs, and she leaned forward, putting her head in her hands.
Tom felt so alone, and it was at times like this when he wished they had a family to share the burden. Perhaps that was a selfish thought, but just then he couldn’t help thinking like that. However, Trish had never wanted to have children as she was so anxious about the whole concept of motherhood and had convinced herself that she would be a poor mother because of her mental frailty. He had respected her choice, and it wasn’t something that had hugely bothered him, and he had thrown himself into his job and career. Now it was too late, and Trish’s care was his responsibility and his alone. Feeling thoroughly exhausted and unable to formulate any comforting words from his overtaxed brain, he stroked his wife’s back and willed the nightmare to end.
