Picking up the pieces

February 2002

It’s impressive how much damage you can do to a sixteen year old in a bare three months. Enough to sabotage the next sixteen years, at least. The Florence Nightingale Unit had torpedoed Bink’s schooling, her relationships and worst of all by a very long way, her precious and so unusually sparkling mind.

We faced a daunting battle to get back to where she had been, without even considering treatment for the OCD which had landed her there in the first place. (And she would never be able to resume the same A-level course: some things were lost for ever.)

If I’d had any idea how many long and painful years it would take... well, thank the kind Lord He doesn’t show us the future.

The obvious place to start was with the beastly little pills. The sudden withdrawal of which had made her so distressingly and disastrously demented on Boxing Night.

She was taking one a day. I’ve no idea what that is in shrink-speak: Bink would probably remember the dosage. A pill was about half the size of your average-sized squashed pea or Ecstasy tablet. No, of courses I don’t! Excuse me: I’m a vicar’s wife. (Actually, I’m not a vicar’s wife any more, strictly speaking. Perhaps I should start to live a little... Afternoon tea dances and membership of nudist colony, maybe?)

Bink’s trust in me must have been sufficiently restored, now she was home again, to have given me charge of her medication. It was in one of those blister pack do-dahs. So I took this into the scullery (we lived in a Victorian Vicarage, with all the proper rooms a proper house should have) and climbed up a step ladder brandishing a nail file.

Curious; but I distinctly remember balancing precariously up there. I deduce it was so that if anyone came in unexpectedly, I could hide what I was doing without looking the slightest suspicious...

I then took pill Number One out of the blister thingy and filed the edges carefully, so it was very slightly smaller but still much the same shape. Then I returned it to the blister pack and smoothed the foil meticulously over it. Number Two pill I filed a bit more, and returned in the same way.

By the time I got to pill Number Ten, it was so tiny it was barely visible. She was bound to notice, but so what? By the time she asked how her pills had shrunk so mysteriously in the wash I’d be able to point out that she was nearly off them anyway.

Then I hid the pack on top of a very high cupboard, so no one could come across these Russian dolls of Sertraline lined up in their little blister beds, each one a bit more roomy than the one before, and wonder whether I should be committed to the nuthouse instead of Bink.

Extraordinarily, this Cunning Plan worked. In ten days she was off the stuff, and said yes of course she’d noticed but hadn’t wanted to be on them in the first place.

Except that, sadly, it didn’t really. It only achieved the immediate goal.

Before she was on medication, Bink’s mind had been sharp, witty, extremely incisive and with an absolutely infallible memory; capable of recalling conversations verbatim, even years later. After she’d been on Sertraline for a month or two she’d become irrational, confused and apparently capable of unrecognisable fantasies and imaginings. Her mind seemed to have deteriorated from the clearest focus to an incomprehensible fog. (We went to see A Beautiful Mind around this time, and all my fears were vindicated by the numbing and stupefying effect of medication on the brilliant John Nash.)

Though the real damage was far deeper even than this.

Sometime after I weaned her off Sertraline so her battered mind could recover, she went to see our GP about something else altogether.

I liked him very much, that GP. He was a proper, old-fashioned family doctor who used to come to barbecues in our garden with his glamorous French wife, and had a very un-NICE-recommended tummy, presumably due to her lovely French food and wine. I once happened to mention, in his surgery, that any booze – other than champagne, obviously – seemed to have a detrimental effect on my sleep. Could he advise?

“Stick to champagne,” he said.

But alas, despite this jolly attitude to the good things of life, he was pill-happy. A great many doctors are. He gave Shaun Prozac for his ME, and permanently undid all the good a whacky alternative diet had done him six months earlier. (And didn’t think to tell him, far less me – what does the wife matter? This is the data-protection-obsessed NHS – that Prozac can affect your libido. We’re back to common sense again: how can less sex possibly make you more happy? Given that he thought Shaun was depressed – he wasn’t: he had post viral fatigue, commonly known as ME – wouldn’t it make more sense to prescribe Viagra??)

And he handed Bink, when she visited him, a prescription for more SSRIs.

Before she went into the Unit she would have given him a firm, “No thanks.” But she had lost her drug-virginity... and her power to resist. Sixteen and a half years later, prescription medication is still her most obvious presenting problem.

And the first thing the Priory will tackle with her... at last.

Miracle medicine

November 2001.

We were not allowed to veto Bink's medication. But since we were invited into the psychiatrist’s consulting room on a regular basis, it seemed sensible to find out more.

Sertraline was the first (of many) she was put on. It was the elixir of life, that drug. Lily the Pink’s Medicinal Compound. The first genuine miracle invented by the human race.

1. It had no side effects. That’s right. Absolutely none whatsoever. At all at all at all.

2. It was also astonishingly easy to come off. The moment you wanted to. Though you wouldn’t ever want to, because it solves world poverty. But if you did. You could stop just like that. No negative repercussions or withdrawal symptoms. At all at all at all.

3. If you don’t trust us we can’t work with you.

Hello? Where did that come from? Have no parents ever asked any questions before?

Well no, I don't suppose they would. All the other adolescents in that ward came from families who wouldn't know how, even if they had the energy left over from surviving their own lives.

I happened to mention all this in passing, a couple of months ago, to a reputable psychiatrist – still mystified as to why anyone would lie so blatantly to a patient and her family – and she very kindly took the time to reply: “Ah, there is a good explanation. In the early years of SSRIs, we really thought they had no ‘discontinuation’ symptoms and were very safe to start and stop. It was only much later that they were discovered, so the doctor probably really was not trying to deceive but we would all have been unaware.”

It was good to get this explanation at last. Genuinely.

However... um... forgive my being awkward, but it still leaves two very obvious questions unanswered.

First, if the drug was so new and unknown that the body of medical knowledge didn’t yet include such basic stuff as the way it completely screws your head when you come off it, and that you can find yourself addicted to it for years and years and years, why experiment on our daughter? Have we learnt nothing from thalidomide?

And secondly, how then was it possible for my brother (well-educated but nonetheless a layman) to allay our terror a few months later – when we thought Bink must be schizophrenic, so dire were the effects – simply by looking up this drug and what it could do, on something we'd barely heard of called the 'internet'?

Be that as it may, what the psychiatrist didn’t bother to mention, to us and even more crucially to Bink herself, was that you weren’t supposed to imbibe alcohol while on it.

A couple from our church, with the hospital’s permission of course, took Bink out to Pizza Express. When they delivered her back, they were asked what she’d consumed.

A pizza. A salad. A glass of red wine.

Shit. Fan. Convergence of.

I must still have considerable residual anger over Bink’s time in the Unit: just thinking about the way our kind friends were treated roils my guts.

How about giving them information before they took her out, rather than demanding it of them when they brought her back? How about an apology for not advising them properly? How about the hospital's taking responsibility for the omission, rather than rebuking those solicitous enough to give her a generous treat, as if they were recalcitrant schoolchildren smoking behind the bike sheds?

And of course the reprimand dished out to the adults was nothing to the scolding given to Bink herself.

It’s exhausting: remembering. Anger is.

Let’s end on a positive note. A reader has just asked whether Bink get to her therapy session last Thursday?

Yes, kind friends, she did. “She’ll never make it,” Shaun had said with his customary encouraging Eeyore jollity.

But I knew she would, somehow.

As I wrote yesterday, mothers can be annoying like that. Knowing stuff without knowing how.

So give me grace to be right on this one too: that the Priory offers Bink the turning point we've all been praying for – for so many, many long years – to a glorious future of freedom.