Swan Lake

It was the summer of 1989. Following post graduation, I got my first job as a senior resident at the Swan Lake Institute for Mental Health and Neuro Sciences. I always found buildings intriguing. They seem so calm and quiet, almost lifeless, even though so much happens inside them. Birth and death. Love and hatred. Peace and violence. Truth and lies. Normalcy and madness. Even as it all unfolds, you rarely get a peek behind the glass panes and curtains. You seldom hear a sound. Swan Lake was no different. It stood gracefully like a royal palace, but also, more like a lulling stone shroud to contain the storm inside.

“Dr. Mitchell Hawk,” Dr. John Dunst, the head of my unit, entered the meeting hall with his entourage and greeted me. “Gold medallist with 4 publications. Hmm, You come highly recommended by your professors. Welcome to Swan Lake.”

“Thank you sir,” I said with an awkward posture, my respect suppressed by the wave of his hand that signalled for me to stay in my chair.

“Meet our team. That’s Dr. Rose Mann, Dr. Timothy Engelberg, Dr. Alex Brown, and Dr. Kate Parker.” They nodded their heads with half a smile when Dr. Dunst’s shaky finger pointed at them. “Kate will be your guide. You will be working under her in Ward C. That will be all.”

Dr. Dunst rose up and smiled. Even his smile operated with a bunch of subordinates. Accompanying his mouth-tearing grin, his nostrils dilated, eyes expanded and ears rotated a little towards the front like fans over a medieval king’s seat. There are smiles that spread joy and there are smiles that wipe out the rest of their species. Dr. Dunst possessed the latter.

***

My first impression of ward C was that it was rather calm. No, it was more than calm. In my eight years of medical school, three of which I spent exclusively with psychiatry patients, I had never seen a ward where no inmate was causing trouble. Someone would always be shouting, wailing or trying to hit themselves or others. After a while, you get used to working with that kind of noise. So when I entered the open unit, the absence of that sound was instantly palpable. I might as well have entered a library or monastery.

“Good morning Sam, how are you this morning?” I picked up the writing board from the bed of the first patient, one Sam Norton. He was facing the roof with rapidly blinking eyes and tightened lips and was also tapping his chin.

“Sam is counting the stars,” he said after a minute of scanning me from top to bottom.

“But there aren’t any stars. It’s day time.”

“Yes, it’s day time. It’s safer now.”

I smiled an ‘Oh, I see’ smile. Wondering what he meant and deliberating my next question, I scanned through the 40-bed unit. Most inmates seemed to be stable. Two were engrossed in a game of chess, a few were reading books, and some were just walking near their bed, stretching and talking to their neighbours. And then there was the majority of those staring out of the windows at the world that was too far. I proceeded with my job of taking readings of the patients’ vital signs and getting acquainted with their history.

***

The inmates of Ward C took a liking to Mitchell Hawk as the weeks passed. He was kind and patient and treated everyone with more respect than they deserved, never minding their inability to reciprocate his behaviour. They almost saw him as one of their own. Straight out of college, nurse Leslie Simmons made observations, not that she could make herself too useful with them. It was the only interesting part about her job which otherwise revolved around restraining agitated patients and administering them their pills and injections. It also involved tolerating taunts of ‘Lusty Leslie’. That she had to do for free. All men are mentally ill, that’s why they think with their dicks. She needed that tenet to survive at Swan Lake.

***

This happened on a Sunday. I was the only doctor in the unit in the afternoon. I was almost done with my work and waiting for my shift to end, when Thomas Heavensbee, a dysthymia patient expressed a desire to talk to me.

“Dr. Hawk, please come here,” Tom hissed at me. I moved towards him.

“You have been here a while Dr. Hawk, haven’t you?”

I nodded in agreement.

“Don’t you think Bob, Roger, and Sam are all right? What’s your diagnosis of Roger?”

“He is suffering from schizoaffective disorder,” I said.

“Dr. Hawk, I am not asking you for the lies on that writing board written by your seniors. I am asking for your diagnosis. Do you ever see him doing or saying anything that would help you make such a conclusion?”

“Hey, calm down. All right Tom, I’ll finish my round and be back for this.”

“No, please don’t go away. It’s not every day that we get the chance to speak to you alone.”

All the patients he had named were already looking at us. At his glance, they — Sam and Roger — came closer to us along with the wheelchair-confined Robert Painslaugh.

“Bob, tell Dr. Hawk, what’s going on here.”

Bob, a 57-year-old, with the appearance of someone at least 15 years older, took his time to collect his thoughts.

“Dr. Hawk, sir, I do not think you will believe us. We are at a mental hospital. So you could just call us crazy with sophisticated terms. Terms, which for your information, Tom, Sam, Roger, and I are all well versed with.”

Bob paused and drank the water on Tom’s bedside table.

“You are a good man Dr. Hawk and we are placing our trust in you. Listen to me carefully. All four of us are qualified psychiatrists. We have been tortured and confined to this ward for four years by some inmates. There was a fire in Ward A in 1985. You know who stays in Ward A, don’t you? That hasn’t changed, I know.”

Ward A, situated right next to the crisis stabilisation unit, housed the most suicidal, violent, and dangerous patients with severe mental illnesses.

“Seeing the fire as an opportunity, some of the inmates tried to escape in the confusion. Five of them succeeded. Two days later, we got kidnapped. After a week of getting beaten up by three masked men and two women with maniacal laughs and getting injected with whatever random drugs they could get, we ended up here as patients of post traumatic stress disorder. We were not in a stable state when they admitted us. And later of course, our condition worsened to what you see in their diagnosis.

“The worst part is that we don’t even know know who they are. Their names don’t matter as you wouldn’t find them anywhere. They never let us go near Ward A for obvious reasons. No one listens to us, again for obvious reasons. But we know that they are working here as doctors and in clerical jobs. We won’t still be getting the drugs we are otherwise.

“What they have been administering to boost the symptoms of our so-called respective illnesses are less effective than they think. On occasion, we pretend to show some symptoms so they give us less injections. Please help us get out of here. Please help the other genuine patients whose lives they are destroying.”

If a friend had told me that story when I was off-duty, my first reaction would have been to laugh. It sounded like a far-fetched story to me. Perhaps just an elaborate prank to mess around with the doctor. You get a lot of that. But I looked from one face to the other. They all had hope in their eyes. I couldn’t deny that had I passed them by on a street and not met them at the hospital, I would think of them as being completely normal. But mental illnesses can be very powerful and yet entirely imperceptible for years. Sometimes, even after months of treatment, you can’t diagnose what’s wrong.

Nonetheless they had my attention and I probed with questions about the medical history of the patients they had dealt with in Ward A and the events that followed their involuntary admission in Ward C.

I was in the middle of questioning them when a compounder came to the ward and informed me that Dr. Dunst had asked for my presence in the meeting hall. I had to leave what I was doing midway but assured Bob and the others that I would be back.

***

Dr. Dunst had summoned the team to examine details of a rare case. Once the discussion was over, I followed him to his office and recounted what I had learnt in Ward C.

“Mitch, that Mr. Painslaugh has succeeded in transferring his delusion to other patients is though, a situation that requires utmost attention and immediate action, it is a matter of greater concern that you are equally convinced of what is merely his hallucination. Perhaps his condition is infectious,” he sniggered. “I may by inclined to think that you, as a lay man would say, seem to be, losing your mind.”

“Sir, all I am saying is Bob wouldn’t know all that he does about psychiatric treatment if he weren’t–”

“Dr. Hawk!” he did not shout but his voice acquired an unprecedented ferocity, “Mr. Painslaugh has been at this facility for four years now. He is very intelligent, sure. But if you didn’t see a classic case like his during your MD, I am beginning to have doubts over your merit. The fact that you are impressed with his knowledge of psychiatry leaves much to be desired.”

“Sir, just–”

“Are you questioning my medical opinion or my authority? Because frankly, you have the qualifications for neither.”

“Sir–”

“Dr. Hawk, that will be all.”

Dr. Dunst smiled his scary all-senses smile as the door of his chamber closed on me.

***

“I went home that day, feeling humiliated, but more so scared, confused and panicked. Dr. Dunst disinterest in the details of Bob’s account surprised me. I didn’t know what to believe. My sleep was restless but I did eventually fall asleep. The next thing I knew was that I woke up in this ward, feeling extremely drowsy and weak, perhaps injected with an overdosage of thiopental.”

“Mitchell, was Bob here when you were admitted to this ward?”

“No, like I told you. They took him away. Him and all the other inmates in the ward. That fat clown Dunst did it. Or one of the so called doctors on his team. It is the five of them. Three men. Two women. Believe me Dr. Helton, they are all severe cases of schizophrenia. We should be examining them.”

Dr. Helton took a long breath.

“Mitchell, we have been through this, haven’t we? Remember, I brought a copy of the hospital’s records last time. There was no Robert Painslaugh here, not in 1989, not any time before or after. Nor were any of the other names you mentioned.”

“What? Dunst must be behind this! Get him!”

“All right Mitchell. I’ll see what needs to be done. Take some rest.”

Dr. Helton signalled for the nurse to take over.

A middle aged nurse moved towards Mitch with an injection, ignoring the laughter-ridden hoots of ‘Lusty Long Lumps Leslie’.

“No Leslie, please,” cried Mitch.

“It’s ok darling. C’mon, c’mon just lie down.”

“No Leslie… No…”

His voice trailed off.

Dr. Helton looked up. Dr. Dunst was on on his round. He pointed at Mitchell Hawk and raised his eyebrows. Dr. Helton replied with a horizontal nod of his head.

Dr. Dunst carried on. Later, his Audi joined the thousands of other vehicles speeding past the Swan Lake Institute for Mental Health and Neuro Sciences. He sat with Dr. Kate Parker in the back. Both had an extraordinarily big smile on their face.

— — —

Written in response to the following prompt:

“You are a recently hired psychiatrist at a mental hospital. Some of your patients insist that they were once staff, but are being held prisoner by the actual patients that now run the hospital.”