Moonman

Goldenhill Clinic used to be a bit of waste ground, which was used as a temporary car park, just off Dumbarton Road. Sometime I think it would have been better if it stayed that way. At least it would have had some kind of use value.

Goldenhill Clinic has all the modern paraphernalia of 21st century medicine, a wide screen TV and a vending machine, and two receptionists covered in a bubble of glass, so that you can see them working and, that alone, should speak of calmness, normality and reassurance.

I had a newspaper with me, but I couldn’t focus on it. A salesman came in. He was very good. I could hear every word, but I wasn’t sure what he was selling. He made it seem as if he had just nipped in, as he was passing, and wanted to speak to Phil, one of the care team, ‘just for a minute;’ ‘it was nothing really;’ and then he went onto explain what he wanted to the two receptions, ‘perhaps they could?’ He leant into the bubble, as the two receptionists discussed the best thing to do. ‘I could come back,’ he said, with all kinds of sincerity. But, of course, the receptionists wouldn’t hear of such a thing. Phil would be available for him soon.

I was hoping, of course, that Phil would be available for me. There were two other men sitting in the waiting room. They were both middle aged. One was perhaps older than the other. They were obviously related, perhaps even father and son. I wasn’t sure, not very good at that kind of categorization. I also couldn’t work out which one of them was, in the medical jargon, ‘suffering from a mental health problem’. They were probably looking at me and thinking: ‘that’s definitely the nutter’. It was an old game played out in hospitals, clinics and annexes.

Bob shuffled by us and the electronic doors opened and shut behind him I quickly folded my newspaper and jumped up out of my seat. I called his name. Bob stood, hooded, the rain falling on him, outside the electronic door, looking in. I was already signalling to him, even before the electronic doors opened, that I wanted him to come back into the clinic.

‘I want a word with that guy,’ I said. Bob knew who I meant. There was urgency in my tone that held Bob, standing, in the same space. I walked quickly up to the reception booth and asked to speak with Phil Brown.

Phil Brown had an appointment with Bob. He didn’t have an appointment with me. But I’d followed, just behind Bob, when he’d first shuffled up to meet Phil, who was coming out of one of the fire doors, leading into the consulting rooms.

I’d met Phil before. He was one of those type of folk that you'd need to imagine saying to their primary teacher, in all sincerity, they wanted to be a social worker, or a nurse, when they grew up, and to look like Val Doonican, without the guitar, but with rimless tinted specs.

Phil recognized that when I initially followed Bob I’d every intention of continuing on with him and being with him during their meeting.

‘I’d like to see Bob on his own,’ Phil said to me.

‘No,’ I said, ‘you can’t see Bob on his own, because I’m not happy, not happy, and I’d like to see the care plan. Have you got a care plan?’
That had stuck in my head. Don’t get personal- attack where you have a chance of success- the care plan. I also thought about asking Phil if they, Goldenhill Clinic, had a mission statement. Again I wasn’t sure what the clinic did, but I had a whole lot of personal experience of what they didn’t do. I knew I was beginning to ramble.

‘No you can’t see Bob on his own. I’m his carer and I’ve got a legal right to be there.’ I wasn’t sure if that was true, but it sounded true and it showed Phil that I wasn’t giving up on going in with Bob to their meeting.

Phil, Bob and me stood, just outside the reception area, in a little triangle, undecided about what was going to happen next.

‘What do you want to do Bob?’ said Phil.

‘I don’t care,’ mumbled Bob.

‘I’m coming in with him, there are things that I want to say to you,’ I said to Phil.

‘Ok,’ said Phil, leading Bob ‘I’ll just speak to Bob for a minute on my own and then we’ll speak. Just a minute’. And they were gone through the fire doors. I went back down to the reception area and unfolded my newspaper.

I sat impatiently, watching in High Definition, an extended advert about brushing your teeth. I was in the right place to think paranoid thoughts, one thought jostling with another. I thought I’d been conned. I thought Phil had spent more time with Bob than he usually did. I thought, Phil was using time, covering himself and his colleagues, I reasoned, to show that they had done something, although I wasn’t sure what. I also thought he’s sent Bob away after the meeting and by doing so he was outflanking me, because he didn’t need to see me. He was, in effect, dismissing both of us, at the same time.

Bob had come back into the reception area because he saw that I wasn’t leaving. He waited for me inside. What made it seem even worse was a youngish, prettyish woman, whom I didn’t know, but clearly Bob did, was standing beside him, touching him possessively on the arm. I was over at the reception desk. She was mouthing sweet-coated platitudes designed for and delivered in a tone used to ingratiate and capture preschool kids attention:

‘How are you? she said to Bob, in those high vocal notes,that kids can't get enough of, ‘we’ve been trying to get in touch with you!’

I was beside Bob in two long strides. She didn’t know who I was. I’d lots of things I wanted to say to her. But I said none of those things, because Phil appeared just then.

‘You want to come back inside?’ Phil said to Bob, guiding him once more through the fire doors.

I followed at both their backs.

Phil tried ‘if you just give us a minute’ speech again, but it was only half hearted. He knew there was little, to no chance, of that line working now.

I was actually in his consulting room before Bob and him. I was surprised there was actually another, younger guy, sitting comfortably in the room, beside the door. There were three other chairs in the room. The younger guy looked up at me as I took the chair facing him. Phil came into the room next and took the seat next to me. Bob shuffled in last and finally managed to sit down, in the remaining seat, across from Phil.

Phil introduced me to the young guy as Bob’s stepfather. That wasn’t actually true, but I said nothing. And Phil introduced the young guy to me. He was a doctor. I was told his second name, but that didn’t really matter. It was the first part that caught my attention.

The young doctor said ‘we’ve been conducting a few tests on Robert and…’

Bob pushed up out of his chair, taking a second to get his balance:

‘It’s that all yous do is talk,’ he said, ‘can you no help me?’

The young doctor was very affable and said to Robert,
‘Just a few more tests and that’ll be us. And then, maybe, we can do something for you’.

The young doctor also said to me, ‘if you want to just give us a few minutes and then we’ll be finished.’

‘No,’ I said, ‘I’ve got a few things I want to say to him.’ I nodded with my head in the direction of Phil.

‘Who gave Bob his Depo injection yesterday?

Phil told me another nurses name. The only thing that told me was that it wasn’t Phil and I couldn’t blame him personally.

‘Bob was in and out in about five minutes. Did the nurse not notice that he couldn’t pull up his joggy bottoms himself after the injection? Who did that for him?’ My tone was getting higher and I couldn’t stop myself speaking faster and somewhat disjointedly, ‘didn’t he notice that he could hardly walk, that his back was bent like an old mans, that there is a rigidity in his limbs, that has tremors and that he has not expression on his face, that it’s like a mask, that his speech patterns have changed and he can hardly speak. He can't eat. Did he ask about these things? Did he notice any of these things. Did he put them on the care plan. I want to see the care plan. Care plan. That’s a joke. What caring have you ever done for Robert?’

I was shaking my head looking at Phil. I started again. Usually taciturn, there was something of the preacher and showman about me now, vomiting up words.

‘What have you ever did for him? He’s been hospitalised three times and every time we have phoned Golden Hill for help and what help have we got. Nothing. You’ve got a Crisis Team. That’s a joke. What kind of Crisis do you deal with? I expect to phone the Crisis Team and be helped in a crisis, just the same as when I phone the fire brigade I expect them to come and put out a fire. I don’t expect them to turn around and say it’s the wrong type of fire, or it’s not really our kind of fire… Good luck and phone us if you need any help! Three times we have asked you for help and three times you’ve did nothing.’

Robert got up out the chair and walked out of the room. But I wasn’t finished.

‘Three times he’s been hospitalised and on each and every occasion it’s been a layperson, a police officer, that’s had him committed, that has decided what everyone else already knew, that he was stark raving bonkers. And the fourth time he wasn’t committed, he was taken to prison, because he was carrying a knife. I knife we told you about,months before, because he was hearing voices and was terrified. He fitted right in. That’s were all the other mentally ill people end up. Then you said you couldn’t visit him because he was dangerous. Why didn’t you visit him in prison and assess how dangerous he was? But no. He comes out and another policeman takes him right up to Gartnavel. How many times it that?’

‘Crisis team,’ I nodded my head.

‘And now,’ I said, ‘look at him. You let him walk away from here yesterday without doing a thing.’

‘That’s why Doctor…is here’ Phil said the Doctor’s name again, but I forgot it instantly again.

Doctor … leaned across and shook my hand. I was no longer talking to Phil I was talking to Doctor…or he was talking to me.

He told me he lectured to medical students and his speciality was Parkinsonian symptoms. He talked about Dopamine and Acetylcholine being a kind of see-saw and some psychotic drugs caused a syndrome called pseudo-Parkinsonism. I already knew that. Some part of me wanted to show off and say something about the basal ganglia or the substantia nigra regions of the brain. But I didn’t. I did fling in ‘the neurotransmitter dopamine,’ as a childish kind of search for affirmation that only the uneducated need. He looked at his watch.

‘I’m sorry to keep you’ I said.

‘I’ll just go and write a note to Robert’s GP. He’ll need to prescribe, procyclidine. That should help Robert. He couldn’t do that at the time because he was unsure...' His words trailed off. 'This is just to let him know to go right ahead.’

That was a lie, but I said nothing. Robert’s GP, Dr Fintry, had seen Robert the night before. He'd said to Robert’s mum, sitting in his practice, ‘that there was something very wrong with him’. But Dr Fintry had to look up Robert’s antipsychotic medication in the pharmaceutical yearbook. Even then he didn’t know what that something was. His suggestion was that Robert should see someone from Goldenhill. Which brought us full circle, because Goldenhill had referred us to Robert’s GP because, according to them his problems were physical, not mental. They,of course, dealt with mental health.

The young consultant shook my hand for the second time that day. ‘Have you any questions?’ He asked.

‘Yes, how long will it take for this other medication to kick in? What kind of timeframe?’

‘A couple of days, said the Doctor.

‘What happens if Bob takes a drink?’ I asked.

He considered it and said ‘it shouldn’t really have much effect. Go down to any local pub and there will be guys sitting there that say things “I’ve been drinking for twenty years and it hasn’t done me any harm”.

I laughed, ‘aye that one down there, the one I drink in The Drop Inn'.

‘But of course,’ he continued smoothly, ‘ it does, the mineral deficiency shows up in the brain eventually, but in the shorter term it shouldn’t really do any great harm’

‘Thanks,’ I said and I meant it and he was away.

Phil nodded. ‘We’ll leave it on that positive note.’

‘Aye,’ I said, ‘the thing is Phil what happens to all the guys that don’t have anyone to speak for them? We shouldn’t have to rely on luck, that that guy is here to see another patient and you persuade him to see Bob. The thing about you is you never take the lead. You always follow. When are you going to take the lead in caring for Bob?’

‘We’ll leave it on the positive note,’ said Phil again, mimicking my movements as I got up to leave.

The promise of procyclidine had gave us something to hang onto.

‘I still want to complain,’ I said to Phil, ‘and I still want to see the care-plan,’ but there was no longer the same fervour in those same words.

I kidded on Bob’s mum that I provided a tuck in service. But in a way it was true. Bob went up the stairs to the bedroom and I had to help him into bed. His legs wouldn’t bend and his fingers wouldn’t work. So I had to pull the blankets up for him and tuck him into bed. It looked very uncomfortable, but there was nothing else to do, and nowhere else to go.

I walked up to the window at Bob’s GP practice ten minutes later. It was a very busy practice, but nobody was at the window. The receptionist looked over at me and then looked away and carried on with some task. The phone rang. She answered it.

‘Yes?’ she said to me, finally.

‘Hi,’ I said, ‘I’m not really sure what to do here. I’ve got a letter for Dr Fintry asking him to prescribe medication. So what do I do? Do you give me a call or something and I’ll come and pick it up?’

The receptionist was a woman in her fifties. And she was well practiced in these matters. Every word was dripping with scorn.

‘No. You phone us and we tell you when to come and pick up the prescription.’

‘Ok,’ I said, ‘that’s fine. So when should I phone?’

‘Today’s a half day,’ the receptionist said, ‘phone back tomorrow afternoon.’

‘Tomorrow afternoon?’ I said. I wasn’t sure Bob could wait that long, but she was sure enough for both of us.

‘Tomorrow afternoon,’ she said and she went back to some clerical task.

I walked a few step outside Clydebank Health Centre and stopped. I walked back to the reception desk.

‘Hi,’ I said.

It was obvious the receptionist wasn’t pleased to see me back.

‘We close in five minutes,’ she said determinedly.

‘What happens I said if you need a prescription filled that day?’

The receptionist walked away from me, but she couldn’t walk away from her post.

‘Have you not got some kind of protocol that allows you to deal with such matters?’

It had been a long time since I’d actually heard a person tutting. But the receptionist came out from behind her desk with the brown envelope I’d given her and said, ‘follow me’.

I sat with some older folk who looked as if they were waiting for a lift or a life, in the main corridor, outside all the practices. I wished I’d brought a book, because I was sure I would be made to wait a few hours. But the receptionist surprised me. After about three minutes she walked out of the practice and handed me the prescription. All I needed to do was to take it to the chemists. If only life was that simple.