The Baying

A mind recoils

Back in my previous life, I long ago learned that when wading through a period of depression, the worst thing I could do in the mornings was stay in bed. Sure, my life might feel utterly pointless, with there apparently being no good reason to try and get on with the day. But giving in to these sentiments – opting to lie there half-awake, endlessly contemplating the futility of existence – was guaranteed to make me feel worse. By contrast, if I could find the motivation to get out of bed, then I would soon start to feel at least a little bit better.

Unfortunately, knowing this truth did not always reliably translate into acting on it. That’s one of the nasty ways that depression can work its tricks: that even though you might know that staying in bed is only going to make your mental state worse, the depression itself can make you feel like you will do best if you just stay in bed – and the feeling has a habit of winning out over the knowledge. Which in turn makes you feel worse...and the cycle spirals downwards.

Still, at least in those days I knew that I just had to try and make myself get up, even if I didn’t always succeed in doing so. Compare that to now. Every morning I wake up confronted by the blackest depression I can imagine living through, something not helped by the fact that every day begins with strangers coming in to stick suppositories up my backside. My life feels objectively pointless, the future holding nothing whatsoever to look forward to. However, I do know that these feelings will be mitigated if I can get up and into my wheelchair, attempting to try and do some reading or writing for the day (that much hasn’t changed). But here is the rub: I physically can’t get up. I have no choice but to lie there, waiting for the staff to come and attend to me, whilst my mind ruminates endlessly about how ruined everything is, about how much better it would be just to die. The best way to deal with this vicious rumination, I know, would be to get out of bed. But I literally can't.

In fact, it’s worse than this. A non-negotiable part of my routine in the mornings continues to be manual evacuation. Translation: two people enter the room in order to squeeze and stimulate me until I shit myself in bed. Once that is done, somebody cleans my arse. The way is then cleared for things like having a shower, or somebody putting my trousers on, before I can eventually make it into a wheelchair. However, as there is only one member of staff qualified per shift to lead the evacuation, until they are free, I have no choice but to wait. And sometimes that can mean waiting well over an hour. So I just lie there, ruminating away, whilst waiting for the worst part of the day to be enacted.

And it really is the worst part of the day. Back last September, a friend asked me if I wasn’t perhaps starting to get used to manual evacuation, having by then been doing it every day for about three months. I chortled and replied: not even close. The humiliation, the shame, the visceral sense of self-disgust and uselessness; these remained as powerful as in the very beginning. But hell, even I thought that in another six months’ time I would surely have made my peace with this indignity.

Well, no such luck. I still hate it with the same intense passion that I did at the very beginning.

So this is how every day starts for me. I lie around, trapped in bed, ruminating about the need to die, waiting for my ritual humiliation. Hence, indeed, why it is usually the case that by the time that I do actually manage to get out of bed, into a wheelchair, and thus regaining a modicum of independence, my mood often improves. I mean, how could it not? Unfortunately, manual evacuation is the gift that keeps on giving. Because it seems that it just doesn’t work properly for me. Although I’ve had several weeks at a time, since moving to the care home, where my bowels have settled, and become somewhat reliable, it never lasts. Shitting myself in the middle of the day remains a very real threat, even though I am long ago supposed to have trained my bowels into only “opening” in the mornings, when commanded. The last two weeks, in fact, have been particularly bad. I once again feel as at-risk as during the low points of rehab.

The result is rampant paranoia, and an even greater shrinking of my already vastly reduced world. I am terrified of the prospect of going back to work. It seems only a matter of time until I have to abandon a lecture because of the stench I have unleashed upon students – my mind duly reeling at the prospect of this future incarnation of shame. In the more immediate term, I am scared to leave the building where I spend 99% of my life already. At least here if I have an “accident” the staff are kind enough to clean me up quickly, and it sort of helps that they’ve seen it plenty of times before. But the other day I went to a café round the corner with a friend. After a pleasant hour of conversation, I duly shat myself. I think they guessed, but were kind enough to escort me home without saying a word about it. But imagine we had tried to go further afield? What then? To which my brain concludes: well just don’t risk it. Stay here, where at least it is safe. Do not leave.

Yet rather like staying in bed when depressed, staying forever in a nursing home full of the demented, the dying, and the bedridden, is not exactly good for the mental health of a man in his 30s. Indeed, it has in fact recently been getting a whole lot worse, due to what I have started referring to as The Baying.

As I have mentioned before, one of the patients here suffers from severe brain damage. He is unable to speak, and it is far from clear that he understands what is said to him, although he does react to other human beings in his vicinity. Being unable to speak, when he wants some kind of attention, he rocks himself violently from side to side, unleashing as much noise as he can muster. There is no English word that adequately describes this sound. It is somewhere between wailing, screaming, and shouting. But it is also animalistic – and so I settle on ‘baying’.

The thing is, The Baying has recently grown unbearable – hence its elevation to a proper noun. When I first arrived it was an occasional thing, often soothed by the tones of Michael Jackson, or the showing of a Marvel movie on the communal TV. But those palliatives seem to have worn off. Now it lasts for hours, regardless, and can start up at any time, early in the morning or late at night.

From what I can tell, there are three triggers:

1.        He is in pain, and reasonably enough wants it to be relieved. He is calling for help.

2.        Given that the staff treat his presumed pain with regular doses of morphine, he is now an opiate addict – and who has become tolerant to his previous doses. A lot of the time when he’s screaming, he is seeking a (bigger) fix.

3.        He doesn’t like to be alone, and is asking for someone to come and sit with him. This is evidenced by the fact that if anybody goes into his room whilst he’s Baying, he tends to stop and smile – only to resume if they leave.

Of course, when spelled out like this, it is hard to view his situation as anything other than heartbreaking. I have no idea what it is like ‘in there’; what it is like to be him. But it seems pretty awful. An involuntary drug addict, alone, in desperation for company he never really gets.

Yet be that as it may, his Baying is a hard thing to endure. The only way I can attempt to explain this is by recalling an incident I witnessed when playing Sunday league football many years ago. Following a routine aerial challenge, our centre forward landed awkwardly and dislocated his knee. Clearly being unable to continue, we covered him in coats to keep him warm, and waited for an ambulance. When the paramedics arrived they opted to relocate the injury on site before transferring him for the drive to hospital. They administered pain medication, and began. What happened next will stay with me forever. Despite attempting to make him as comfortable as possible, when the medical team began attempting to press our player’s knee back into position, there erupted from him sounds the likes of which I have never heard before or since. These were the noises of a creature in the depths of absolute agony. A fellow creature. A human being. And my immediate, unthinking, instinctive, response? I turned around and began to walk away, even before I consciously knew what I was doing. The noises he made triggered a hardwired, evolutionary instinct: that when you hear a human being scream like that, then you need to escape– because nothing good is happening here.

In the end our player made a full recovery. That short term pain was very much worth it for his long-term outcome. But I will never forget those screams. They were the kinds of noises that cannot be faked in movies, cannot be replicated by actors. The kind of sounds that you only hear when a real human is being forced to endure too much. And the natural, untrained, response is to get away.

OK, so The Baying is not at that level. But it is, I think, on the same spectrum. It is the noise of nearby suffering, which the human brain is hardwired to reject, to seek escape from. Of course, one of the amazing things about human beings is our ability to override this instinct. I can tell that the staff here find The Baying as psychologically grating as I do – yet they put up with it, trying their best to make this man as comfortable and happy as possible. By contrast, I cannot do anything help him. But I also cannot help myself, escaping somewhere else. Or rather, I stay here more than I should, because I am too scared to leave the confines of these walls, wary as I am  of being betrayed by a body I can no longer trust. Fearful of the fire, I embrace what I know to be a frying pan.

But hopefully not for too much longer. Without wishing to tempt fate, I will risk saying that the enormous efforts and generosity of my family may soon bear fruit. The end of being an institutionalised inpatient may, finally, at long last, be in sight.

I certainly hope so. I am genuinely unsure how much more a mind can take before I, too, begin to Bay.