Envoi

The patient was still vomiting on the floor. The doctors had excluded the room from the cleaning rota, so Henry smelt him from the other end of the ward. When he entered the disaster of a room, Doctor Marshall was standing over the patient, who lay awkwardly on the floor. He appeared to be talking to him about his care.

“Alastair. This is a natural reaction to your condition, the body trying to expel it.” He pinched his brow. “It’s unpleasant, so much of life often is, but so is what you have allowed to take root in you. You can be something else. Someone better than this.”

Alastair knew better than to meet the Doctor’s gaze. He wiped his mouth and looked past him to the stocky nurse with a slack face, whose name he didn’t know and was half-hiding behind the doorframe.

Henry wouldn’t meet his eyes. He looked at the walls, the bed, the vomit, but not at the young man. Doctor Marshall continued, holding up a series of pornographic photographs.

“You must expel these unnatural desires.”

Alastair breathed deeply, trying to quell his stomach, and dragged his body upright. “My name is Al. I didn’t catch yours?” He looked at the doctor with all the upper-middle class guile he could muster. “I need a glass of water, a shower, and someone to clean this room please.” He spoke with the offhand grace of someone being introduced to another at a party.

The doctor stared back, unmoved. His hands fell to his side and he gestured at the floor. “This is where you need to be, Alastair.”

He pulled down his glasses and consulted his chart.

Henry knew the insane, the sick, and Al wasn’t that.

Finally, Doctor Marshall acknowledged Henry. “Nurse, this is your patient. See that he stays put.”

And this kind of punishment was something new. “In here?”

Doctor Marshall turned, scowling. He blinked two or three times to check that it was in fact a nurse talking back to him.

“Is this your first invert, Nurse?”

A just about audible, “Yes, Doctor.”

Henry had seen him be kind to patients, sweet even – usually towards hysterics, or disturbed children – but it was common knowledge that weak men disgusted him.

“Apomorphine administered every two hours, along audio reinforcement. ECT every morning. You’ll be administering both.”

He’d never done this before. He stared at the vomit. “Yes, Doctor.”

Doctor Marshall picked up a primed syringe from a portable metal tray beside him and handed it to Henry. “His first dose,” and turning to Al, he continued, “I’ve told your father that you’ll return in two weeks, fully cured. A much better option than prison, don’t you agree? And your father will be able to hold his head up high once more and people will quickly forget all about this fuss.”

Al’s smile faded at the sight of the needle and an anger he tried to quickly mask became apparent as the Doctor spoke. The doctor laughed gently and then turned to Henry, “And you. Just because he’s lucid doesn’t mean he’s not sick. Don’t engage, do your job, and everything will be fine.”

Henry took the syringe, knowing there was nothing he could object to. The Doctor watched until Henry administered the drug before leaving. Shortly after, Al started to retch. Henry mumbled an apology that was lost over the sounds of vomiting.

***

Everything will be fine.

What was that supposed to mean, Henry thought. It felt dangerous. Clearly, he had looked worried but had he seemed that inept? Useless? Susceptible? It rattled him and although many wouldn’t notice, Henry rushed through his rounds, checking mood, progress, administering anti-psychotics and the occasional sedative as quickly as possible, which he accomplished in record time as the patients were largely subdued by the heavy November rain lashing against the roof. Patient after patient had retreated to their bed, covers pulled up over them, trying to sleep through it, rather than listen to the deafening noise.

He wanted to talk to the other nurses, although he was currently at a loss for what to say. Despite working on different wards, they tried their best to eat together. When he arrived in the canteen, Barbara and James were mid-way through their lunch, and James was engrossed in today’s Mirror.

“Heard you got an ‘omo.” Barbara said without malice but with a clear delight for some scurrilous conversation that was, as usual, somewhat mangled in her thick London accent.

“Yeah, it’s, I’m a bit… worried.” Henry’s chin rested against his chest, considering the squashed sandwiches he’d brought for lunch.

“The doctors know wot they’re doin’,” Barbara offered.

“Do they?” James closed his newspaper.

“Look, I know it’s barbaric but it’s been in the papers. The treatment works. They cured one down south last year.”

“Did they? I had one last year and after a few days, all that had changed was he knew to play along so they’d let him go home.”

Henry was thankful that James had said it but was unable to concur, having broken into a sweat. James had a wife, children; he was secure. Henry lived alone, had no family, and was a nurse. One wrong word – 

“Yeah but yours came voluntarily. This one’s here on court order. They’ll do wot they like to him.” Barbara turned to Henry.

“Don’t be worried, love.” She lowered her voice so only those at the table could hear her. “They’re not normal but they ain’t bad people.”

***

Later that afternoon, James caught Henry on the back stairs, staring at another primed injection. “It’s bullshit, Henry.” And quieter, “We all know that.”

Henry looked at him and weighed up the responses he could give. Every single one would’ve given far too much away, so he said nothing.

James moved closer and spoke even softer. “Look. If a wife and child can’t fix me, nothing will.” Henry inhaled sharply. “And that’s okay.” James smiled and laid a hand on Henry’s shoulder. “There’s ways and means around everything.”
Henry recoiled and, backing away, tripped over a step. Careful of the injection, he quickly steadied himself and growled, “Get the hell away from me.”

James sighed. “Son, go look after your patient.” His incredulous head shaking in disappointment as he left.

Henry tried and failed to catch his breath and bolted upstairs to the roof. When he hit fresh air, it made him a little lightheaded. Despite his large size, he’d always been relatively fit: he’d learned how to run, to weave, at camp back in the States before he came here. He doesn’t know anything. He doesn’t. He doesn’t know. He-

The rain battered him. He stared at the injection and his mind settled, his breath evening out. He found himself emptying the syringe, whose contents the rain washed away almost instantly. He changed into dry scrubs and filled a fresh injection with saline.

But that wouldn’t be enough. He’d have to talk to him.

***

Henry brought in a chair and carefully placed it in the cleanest part of the room. “Al, right?”

Al got up, and sat on the bed, facing him. “Yes. And you are?”

“Henry.”

Al’s eyelids were dark and heavy. He wanted the day done with and to sleep an unbroken night. “What’s going to happen to me?”

“First, I have to give you another injection of Apomorphine. It’s an emetic.”

“A what?”

“It will make you sick. Like before.” Henry paused. Al was surrounded by stinking vomit. They both knew what this was.

“Punishment.”

Al smiled briefly at his honesty before the reality of his situation wiped it away. “I should have picked prison.”

Henry earnestly asked, “Do you want to get better, Al?” only to remember echoes of it, addressed at him.

Al stood, steadying himself against the frame of the bed. “I’m not sick.”

Henry had said that too. I’m not sick. Over and over to his parents, the priest, the camp counsellors. I’m not sick. His parents told everyone they’d sent him to a summer camp. And they had. The first of its kind. A place, neatly tucked out of sight, for sick boys to realise the error of their ways. I’m not sick. They didn’t have drugs or electro-shock but they had God and belts and The Bible. They even believed they could really change him if they just prayed hard enough. Henry didn’t want to change. I’m not sick, he said. But as the days wore on, he realised that I’m not sick was keeping him there. He needed to get out. Home wasn’t an option anymore, but he was just about old enough to find somewhere else.

“If you say that, you’ll be here a long time.”

Al stared at Henry, testing. “Can I have a glass of water?”

“Yes, but you can’t tell anyone.”

When Henry returned, Al’s mood had lifted considerably. He guzzled down the water and eyed Henry curiously. “Do you like being a nurse?”

He knew not to engage anyone on personal matters, especially patients. “I like it when I can help those who need it. I like seeing people get better.”

“Those who need it?”

Henry was calm. He knew what he would do and how he would get away with it. Doctor Marshall would be pleased at his success, Al would be free, and he would’ve made that happen.

He moved closer, lifting his chair over a patch of vomit. In a whisper, that his mouth seemed reticent to let escape, he told Al,

“They want you gone but for that to happen you have to comply. If not, you’ll be here indefinitely, or until they break you.” He held up a syringe. “This isn’t Apomorphine; it’s saline – as harmful as water. So when they come looking, you need to have made yourself sick, to make it look as if you’ve spent the night vomiting.”

“Why would you do this?”

“Because you’re not sick.”

Al started to cry. Henry shushed him. “Don’t. We don’t want someone else checking up on you.”

A cold pragmatism settled over Al. “What do I have to do?”

“Only what I said.”

Al relaxed a little. “Can I have some more water?”

Henry went and fetched him another glass. He took a large gulp and smiled. “Thank you. And thank you for helping me. I know you’re putting yourself at risk here.”

Henry stiffened, flushing red. “Do you want my fucking help or not?”

Al quickly drank the rest of the water, for fear it would be taken from him. “Sorry.”

“It can’t all be faked. You’re going to have to go through ECT. Probably three or four times. And I’m going to have to administer it. The doctor will be watching.”

He was in his early twenties but he looked barely a teenager to Henry in that moment. “What will that do to me?”

“Scramble your brain in the short term. Beyond that, honestly, I don’t know. We haven’t been using it here that long.”

“Is there no other way?”

Henry stared at the ground. “No.” Al sighed but it sounded more like a shudder. “The doctor will be here around ten for rounds. Make yourself sick before then.”

“I don’t – I don’t want to be shocked.”

“I know.”

“I’m terrified.”

“You’re right to be but it’s the only thing standing between you and the rest of your life.”

Al’s breath and speak was fast and shallow. “There must be some other way. Prison. Something. Anything. Prison would be easier than this.”

“It’s too late Al. Either, it happens and you play along, or it happens until they make you believe you’re sick.”
His attempt at composure ruined. “I’m not sick. I’m not.”

“I know.”

***

The next morning, Doctor Marshall insisted that Al underwent the ECT in his vomit-stained gown, stinking of bile. Henry restrained him, affixed the chair’s helmet to his freshly-shaved scalp, and inserted a gag, which looked like a horse’s bit, for him to bite down on.

The Doctor was standing at the door cheerfully giving the case history to two eager but increasingly horrified interns.
“Alastair Cooper, son of a well-respected local businessman, was arrested along with his friend Simon for indecent exposure and buggery. They were sentenced to jail or rehabilitation. Both, naturally, chose the latter. Simon was sent to St. Bart’s but shortly into his therapy, due to the incompetent foreign nurses there, he managed to get his hands on a belt and committed suicide.”
Al, still gagged, started to scream. He thrashed so hard that he broke one, and then both, of his restraints and two other nurses had to be called. They held him down and affixed extra restraints, while Henry clasped his head, attempting to stop it from hitting the sides of the metal gurney. Henry tried to think of something else, anything else, but all he could see was the pain in Al’s eyes. He didn’t know. Al started to keen.

The doctor raised his voice. “Now, we are going to administer a short course of Electro-Convulsive Therapy which will, over time, reorient his mind and make him a productive citizen again.” One of the other nurses rolled his eyes, whilst the interns, who’d abandoned any concerns they had, were eager to see their first ECT. They, and the extra nurses, left, trailing the doctor into the other room to view the procedure.

Henry had been instructed on how to administer the shocks and their benefits. He knew it could help patients whose mind was completely addled, particularly the manics who became almost level-headed for a while after, but he also knew what it would do to a healthy mind. He remembered his counsellor beating him every time he was honest; fracturing his ribs once when Henry was caught caressing a boy called Brad behind their chalet. Every time Henry breathed deeply, as he was then, he was aware that his body had never completely healed.

He pretended to be double-checking the neck restraint and as he got in close, whispered “You are not sick” over and over until he was sure that he was attracting suspicion. It was only then that he turned away and pulled the lever, staring instead at the faces in the viewing room.

***

Al could barely function afterwards, and Henry knew that since he was too weak to pretend that he had to inject him with the emetic, but he stayed with him overnight, making sure he was hydrated and safe. Al didn’t so much sleep as pass out, and when he did, Henry climbed the roof to smoke. He lit a Players and stared out over the city. He had travelled thousands of miles and had now become one of them. He wanted to run, to quit, to burn the hospital to the fucking ground but he was stuck in his silence, his obeisance. And as solitary, and horrifying, as it could be, he was free, in a country where no one knew him, and he knew if he was found out again, it would be the end of him. He smoked the cigarette down to the butt. At least here, he could help, couldn’t he?
James found him in the same stairwell as before at the end of Al’s second cycle of recovery, injections and ECT, and told him to stay strong and that it wouldn’t be long now. Henry said nothing but when James held him by the arm again, Henry grabbed his wrist and twisted it, causing James to double over in pain, looking like a servant extending an arm of introduction at a formal ball, head bowed as if in reverence, or he would’ve without the muted screaming. After a minute or so of struggle, Henry let go and James dashed off.

Al knew what he had to do and was trying. He flirted with the female nurses, telling Doctor Marshall that he felt disgusted (his face contorted with vitriol) at what led him here, peppering in references to his church and solace and God, all whilst making sure to get hard enough to satisfy the plethysmograph when they showed him their dirty movies.

On the night before what would likely be his final ECT treatment, Henry and Al talked: Henry softly and quickly told him about Brad, and consoled Al as he cried over Simon, the thought of their reunion having been all that had kept him going. All that motivated him now was getting out of here, away from the shock treatments, and being able to have an unfettered mind again. His future would become clearer then.

“My head is killing me.”

Henry slipped him a painkiller and schooled him on the responses the doctors would want, trying to ingrain them in him whilst his mind was clear and knowing that the ECT would erase much of it, but if some scrap remained, it should be enough. Al smiled vacantly with a seemingly aimless sadness.

When the final session arrived, the doctor instructed Henry to lengthen it. As he had constantly since Al’s arrival, Henry wondered if the doctors knew about him. James sure did, but he would say nothing – he wouldn’t even look at Henry now. And the doctors could prove nothing, he would make sure of that. He would stay here and help others. That’s what he was good at.

Henry started the machine and Al screamed until he was hoarse. Henry made himself look, knowing that the Doctor was watching.

***

It took two whole days for Al to simply sit upright, let along function, however it wasn’t until the following Monday that his post-treatment interview was scheduled, and the Doctor, well-rested from his weekend and eager to start the week afresh, gave him only a brief interrogation. Yes, Al said, he was disgusted at what he had been and did not recognise that man, nor his urges. He wanted to find a wife, and there was a girl he’d courted in his youth back home that he’d been thinking about. The Doctor rattled off questions listlessly and glanced through charts of new intakes. After ten minutes, he called Henry in and instructed him to arrange Al’s discharge.

***

“You’ll need to get some physical therapy. The more you remind your brain how your body works, the easier things will be.”

Henry had his arm around Al, supporting him, and was leading him through the exit.

Al was curled around himself, like a child mimicking a hug. “Everything either hurts or feels fuzzy.”

“You’ll be alright.”

Between his breaths, each of which were almost too much of an effort, he said, “I don’t think I will be.”

Henry smiled, “But you’ll be free.”

Al’s mouth wasn’t working correctly. It sagged like a stroke victim, something that Henry assured him would pass in a few days.

“I’ll never be okay though.”

“Al, there was nothing wrong with you in the first place.”

He laughed, his eyes furious. “No, but there sure as hell is now, isn’t there?”

“People recover from ECT. All of this will eventually become a distant memory”.  Like camp?, a voice in his head asked.

With a concerted effort, Al pushed Henry off him. “No, it won’t.” He hobbled to the kerb and stuck out his good hand for a cab. He sighed. “I want to thank you. For everything.” He paused, and turned away from Henry, towards the traffic, relishing the air currents whipping by from the passing cars. “You’re about as free as I am, Henry. I hope there’s someone like you to look after you when they decide it’s your turn.”

A taxi arrived and Al disappeared into it. Henry stared at its absence until eventually someone came out and asked if he was okay.