By Yohanna Abdullah
We just had tea – aromatic milk tea with three pieces of biscuits – two cream crackers and the coveted lemon puff, just one this time. We are now perched on our individual chairs reading the day’s newspapers, talking to bosom friends, communing with the nurses, watching television and some would be talking to themselves or their unseen friends. We are in a hospital but not just any hospital, we are in the much feared or maligned one – the Institute of Mental Health (IMH).
There is very little to fear about being in this beautiful, bright and breezy hospital, yes it is breezy even though the large windows are large louvers with three types of defence strategies – square aluminium grilles, wire nettings and the glass louvers themselves are strengthened with wire metal, criss-crossed on the glass. Our ward which is an acute C class ward is painted a cheerful orange, yellow, pink and purple combination to soothe jangled nerves and warm hearts.
The windows which grab so much attention to those new to the ward is presumably designed such to keep some of us from flinging ourselves out of them into the garden below. They are however not scary nor intimidating as many of our feathered friends, notably the mynahs love to perch on the louvers and sing their merry songs at all times of the day. The windows open up to an interesting garden with a nursery and bricked up boxes which reminds me of graveyards. Some of the windows look onto the beautiful sprawling complex which at its fullest can fit 3,000 patients.
I am one of them. I have been in and out since November last year, a total of six whole months at my IMH Hotel. This is the worst relapses I have had in my history of bipolar disorder (Type 1) since I was diagnosed almost 14 years ago.
It seems I have gotten worse with the years, or is it the change of medicines that had led to a fury of highs one after another? My doctor said it was likely to be family issues that are a trigger to my illness and got my family into therapy which will hopefully iron out some difficult matters, unspoken but felt like an awakening monster within. For the record, my family love me much and has stood by me all these years, but perhaps caregiver fatigue is setting in on the cruelly embarrassing manifestations of the illness.
As the patient, I was not as embarrassed as my acutely modest family are when in the highs I do not subscribe to any ideals of modesty or other religious tenets and ideals I normally adhere to. Caution is thrown to the wind and impulse and passion reign supreme. I was aghast in the beginning, mortified even, but year after year of highs had built a wall around me that said, “I was not me, when I was high.” And yes the highs was interesting and fun in their own way as never would I do one tenth of the things I did when I am in mania. My life had two tiers, the me who is normal and the me who is high. Yes the two meet and compromise and rationalise and accept one another – but not so for my family, especially my ageing mother and my teenage daughter.
My nurse asked me “Do you know what you were like when you first came in, the second last round? You were wearing only your top holding your bulging canary yellow bag and a guitar. We had to wrap a blanket around you. I sent your mum to the taxi stand with all the things she had to carry, and she was weeping and said she never knew that this illness could last so long and get worse with the years even.”
In that case of mania I had sung and strummed my acoustic guitar (I don’t know how to play a guitar) from West to East and North to South of the MRT lines and ended up at Marina Bay Sands outside a Polar Cake shop and played and sang what felt like two hours before the SMRT staff brought me to see the Aetos auxilliary police and they sent me to Cantonment Police Station where I continued to entertain the police, even in my cell, I played ball with my food and stripped teased down to my bra and panties.
My nurse said, “You were singing loudly and moaning in sexual ecstasy so loudly that we had to push you out of the ward and the next day sent you to High Dependency Ward. Really Yohanna I was surprised to find you a nice decent, praying Muslim when you were back in a normal mood.”
There are peace-breakers like me usually when they are new patients and have yet to receive enough treatment, by taking medications, injections or having Electro Convulsive Treatments (ECTs) which usually is the fastest way to bring my mood down to normal at the hospital.
I broke peace once when upset at not being allowed to fraternise with a patient’s guests, I threatened to kill anyone who get near me with my pen. Suddenly so many staff surrounded me including the Aetos folks and I was disarmed and thrown onto my bed and tied five –points (wrists, legs and waist) and sedated. Many of the patients who are new and unruly get this kind of star treatment for disturbing peace in the wards.
By the way, I like ECTs because the anaesthesia puts you out like what I imagine death does – after the anaesthesia injection, you kind of float for a few seconds and then – nothingness. You wake up some time later and your memory is affected. Mine has been much compromised over the years of ECTs. But really ECTs work for me.
There are peace-breakers of all sorts at the ward. Some like A who talks non-stop and inanely over so many different topics, tears magazines and wake you up from your sleep, some like S who sermonises their speeches and end with a super duper loud Amen which wake you up from sleep too. They irritate and they are sweet in their own way. S said that I was the secretary of King Fadh (King who?) and could make my way up as his wife one day. She talks or sermonises to herself all day long and it is interesting to listen to her if you had the time.
It is interesting to listen to any body’s case history if they care to open up to you and share. Some will not even share their name with you, let alone a smile or toilet paper. One lady shared with me rolls of toilet paper when she found me crying early one morning in my prayer. She was soothing in her assurance that my time there was only temporary and I will be cured and go home soon.
I was shocked to find that N, 27 had been in and out of IMH since she was primary 5 and had been locked in for 9 whole years of her young life, hardly having a home visit. F, 45, has been in IMH for 11 years, she has Schizophrenia and her family cannot take care of her at home. N does not really have a mental health issue but she has low IQ and tend to vent her anger with shoutings and scoldings and turning over tables and chairs with her petite frame and her beautiful innocent face. Her family could not take care of her as her mother too was in the same situation as her and one of her brothers was retarded. A nurse told me that she once had an abortion. I asked her if she did and she said yes then denied her story, later telling me she only had anal sex and her virginity is intact, pulling her blue shorts down and showing me her vagina.
Then there is K who has been in and out of hospital for 4 years, just being promoted to the adult ward after terrorising the children’s ward and police from her district police station who are always on standby for her harassing her family or threatening suicide.
I talked to the Sister H about the sad situations of my two friends and she said that if I do not take care of myself and show an improvement in my behaviour and how I handle my illness, I could also end up a long term stayer of IMH if my family can no longer take care of me. I cried two nights in a row contemplating my plight and the plight of my friends, living a life effectively behind bars, in a mental ward.
Some of my friends are luckier, they are expecting a place in a home such as the Simei Care Centre where they can work and go out in the day and return for shelter at night. If N was better behaved, she could elevate her status to this stage and she can take on a job, but Sister H said she cannot even behave herself to earn the $4 Sister H promises to her if she behaves in one whole month. My doctor assured me that it was really the state of the mental patient that determines that they become a long stayer or not and it is not the hospital that is out to cause suffering in these cases.
B counts herself lucky as she is staying at a one roomed rented HDB apartment with a fellow IMH patient and live on their government grant of $400 and $300 each and are happy to be free though they make frequent visits to IMH. Her helpful mate will nonetheless drag out all her clothes and pee on them every month or two.
In fact, far from causing suffering, I can see that IMH goes all out to treat the patients well, with love and respect. We have four square meals a day, breakfast, lunch, tea and dinner, plus a drink of Milo or Horlicks before bedtime and the nurses, harried as they are with paper work, make their time to learn the patients’ cares and sorrows. My nurses even let me use their phones for me to get on Facebook with my friends some times. One of my favourite nurses gave me her favourite hairclip that I liked just before I left and even promised to visit my home when she is free.
Indeed all the staff that I met were nice, obliging people who gave their best in what they do, be it washing the toilets or managing our cases. Indeed, we feel at all times that IMHians both staff and patients live up to the IMH motto of Loving Hearts, Beautiful Minds.
My friend and fellow patient SK has a beautiful mind, she struggles with the possibility that her future, dreamed of marriage with her ex-boyfriend, F, who left her to marry another, who is actually Jesus is an illusion or delusion yet she holds dear her fancy dreams of worldwide celebrated weddings and tour around the world to do the Lord’s work. In reality, she is always sleepy, drugged from her medications and her cute tweety bird mouth is always open as if expecting a kiss from her Prince Charming, though she said that that too was the side-effect of her medicine. I cry at the beauty of her dreams and at the knowledge that it is just that – dreams. So for some of us dreams are our only reality, the only kind of real fantasy.
I know that my mind was broken too at a broken heart and it is a common story in the mental institution that broken hearts lead to broken minds. Mine leads me to doomsday scenarios and expectations that the world is about to end just as mine in actuality ended. This last episode, I expected the world to end on 25th March after World War 3 on 13th March. When 13th March passed by without much incident only then did I let go of my delusions which I had caught from some internet postings or docudrama about Doomsday in 2012.
All of patients at IMH I suspect has some favourite delusion or fantasy, scary or nice, which they eventually share with their doctors and nurses.KH when asked by the nurses if she still hears voices, she says “No” but she will talk at all the windows to imaginary people out there, reporting of her doings and engaging in conversations. Frequently I heard her talking to a Mr Lee and I wonder if it is the great Mr Lee Kuan Yew himself as she is overly polite and officious with him.
Many of the patients in IMH do in fact treat it like a hotel, they come in and out as and when they have an episode or relapse, which like mine follow closely one after another. This is very worrying to everyone as the doctors said that after many relapses, the mental condition gets increasingly difficult to treat.
Now it has been almost a week since I am out and I am considering myself lucky every day that I stay out. I take it not as my right to be out in the fresh air and having freedom of movement, in fact I had preferred to stay home and only once went out with my daughter to celebrate her coming of age, receiving a place in a college of her choice. I hadn’t been there for her all these five months and I want to make up to her, yet I know I have already failed in some of her books, yet she is sweet to me. Tomorrow I will go out for religious classes with my friends and on Friday I have a work stint in the morning. I hope to bring my son home on that day and cook for him and fuss over him this weekend which I was unable to do so last week as he was busy helping his dad move house. He stays mostly with his paternal grandmother and comes home on weekends.
I am taking work in my stride, knowing that stress at work can be a trigger for me. One day at a time and yet there can be many things happening in one day that I wish did not happen. I have yet to have a good grasp of my life and where it is heading. I am praying hard that I hold it together for the sake of my children. Yet I don’t know whether I am doing them a favour or really having my own agenda at the forefront which may collide with what is best for them.
Nothing is easy as it seems these days, losing one night’s sleep can be detrimental to my health so I am so careful with myself, I am losing my carefree self. I was if not the happy-go-lucky type, yet now I feel like luck is not on my side. I need to gain mental strength which I draw from the motto of IMH – I need always to have a loving heart and a beautiful mind, and my case manager upon listening to my nine page long poem about waiting for my children to visit me at my gilded cage, IMH Hotel, said, “Yohanna, indeed you have a beautiful mind and you let me experience that my job is so very important, knowing it is important and experiencing how important it is two different things and really you have touched my heart with your raw poem. Keep it raw, for it kills. Here is the poem, Waiting for Bloomsday. Just remember that a visit to your loved one is so important when they can’t visit you – especially when they are in IMH Hotel.
WAITING FOR BLOOMSDAY
The wait started since a month ago
to see my precious children
born of love and lust
two people who trusted one another
never to wreck the matrimonial bed
with seeds of infidelity
Yet one fine day one such seed was sown
for the eyes innocent and blind
blinded, struck dumb in shock
a third party in the holy bed
the bed holy no more
slept no more
except to rest tired, separate minds
Hearts once united now in discord
they play to different songs
one of trysts and wanderlust
one of madness and despair
In the hearts of hearts
lies a tiny seed
which wish to grow into a tree
to shelter injured souls
with a past, a history
Herstory was one of struggle and mists
misty tears to tear the heart, mind, soul apart
the tree must grow to great heights
to tell the tales untold
For the children must not be hurt
for the sins were not their own
what did they ever do but to exist
between the loins of Eve
ejected painfully into this world
to breathe a life their own
for dad is not at home
mum goes in and out of
a hospital for beautiful minds
a mind which sees angels
in the sacred sky
scattered are petals on the street
songs of old delight
a soul injured beyond repair
transformed to lotus pink
to ride the river of life
And thus she waits
armed with a pencil and a paper
to record her fruits of mind
shells and mosaics she drew
with a pen she threatens to kill mere mortals
who stop from her sojourn
many nurses and auxillary police circled her
and pinned her down to bed
tied five points, sedated
her wilderness abated
A week and two passed
another two flew by
she waits a mother in waiting
to see the seeds she sowed
A visit from two precious seedlings
now 15 and 17
why did they forget her
in her prison of love
wasn’t it love that brought here there
or was it hate and despair
It was love and wanderlust
it was impulse and desire
to be with a love gone by
answered like a prayer
in the gust of the azan sky
A love censored and not
terminated in despair
not wanting to hurt
her little children and elderly parents
no, not no more
Yet love comes unbidden
love is not dictated as such
petals of frangipani flowers
seeds of laughter, love and lust
Her two seedlings of love crushed
their hearts only the heavens knew
their mum a betrayer of sanity
insanity she drew
around her crown of thorns
clothes of roses she grew
Here week of wanderlust
will pay a price, but at what price?
she calls her precious ones
at last she appeals their presence
a visit to her prison-haven
for loving hearts, beautiful minds
They said Yes, Ma will come a-visiting
and she waits, trusting
cards, precious she made for all her loved ones
son, daughter, mother, father
to say how sorry she is
how proud she is of her brave ones
Can love be terminated by a week of abscondment?
can love be betrayed by neurotransmitters gone haywire?
a bipolar brain which seeks greater and greater heights
of delusions and insights
And so she waits, counting the minutes and seconds
a mother loves her brood no doubt
but this was a brooding brood
in the throes of teenagehood
Could they be angry?
her daughter if not her son?
Her shadow who has a role model
all of the wrong kind?
Her own mother, her fatigued caregiver comes
her beloved dad more often
their child, their precious
they knew needs them in the most trying of times
Age means wisdom that life has taught countless of times
death of a cherished son at 17
sickness of a brilliant daughter 14 years and counting
When will she heal at last
is there a cure for her disease?
like any other diseases it doesn’t just disappear into thin air
no amount of wishing and praying could?
She has tea and cream crackers
and writes for she is a writer
her hurts she heals by writing
her secrets she share with the world
her sins told she feels unsure but a little better
For doesn’t everyone sin?
and in mania does it count as sin?
for her sensible mind is cast to the winds
impulse and passion reign supreme
The digital clock ticks
It is now 2.20pm
today she has been incarcerated for a month
yet five whole months she has been in and out of her prison
Institute of Mental Hospital
Institute of Mental Happiness
Happiness comes with a price
tears abundant is one of them
free flowing at the oddest times
sobs to tear the heart out
A Buddhist lady hugs her as she prays her morn prayer
“Child, here is only temporary
you were sick when you came
but when you go you will be well
take your medicines for they will surely cure you
don’t cry my child for this earth is not forever
and surely your stay here will not be forever”
I finished my prayer and returned her hugs
and accepted her gift of rolls of toilet paper
to dry repentant souls and aggrieved hearts
“Auntie, I am not new in this place and game
14 years I have suffered and not
I have rode the highs and lows
I repent to my dear Lord
He never forsakes me and surely never will
He loves me more than I love Him
I cry my heart to Him
it relieves the pain dear Auntie
yes I know my sojourn here is temporal
I count the ticking ticks and tocks
in my mind I wonder
will my two little loved ones
come to mummy in hospital
are they tired of this routine?
at least once a year
they make this pilgrimage to this inn
This Inn of Happiness leaves trails of tears
it is happiness to me but not to them probably
their tender hearts bleed each time I call them
to meet in my sanctuary
a sanatorium for those with aberrant brain chemistry
Surely they have got used to it?
it has been 14 years after all
but no this attack was too great
it took five months of their lives
away from mummy
never before had an episode lasted so long
why mum? why mummy?
Who is taking care of me while you are gone mama?
thank god for grandma and grandpa
but they are old already
soon they will be ailing and passing
then who will take care of us?
who will take care of you?
We will be adults soon
and have our young lives blooming
what about you?
how often will you fall sick again?
Mama, again and again?
I know my babies
I somehow have to hold it together
I cannot afford to be sick again
grandpa is getting more ill
diabetes and heart problems and now his kidneys are only 1/3 functioning
By God’s grace and only by His grace
I will find my cure and way
to check this errant monster
to cast it to Hell from whence it came
I promise my dear ones
I will live my life chaste and pure anew
may Allah not wreak his wrath on me
for all my weaknesses and sins
I can be strong
I will be strong
I will summon my every breath
to tame this beast in me
help me my children
be there for me
And so the clock which watches me
says it’s 3.30pm
I wait my children
I wait for your love and gift of yourselves
please do come
don’t ever abandon the one who brought you into this world
in pain, love and laughter
please be here for me dearies
now and forever
Epilogue – like clockwork Ayesha and Hykel came when I finished this longest poem of my life.