Between the Devil and the Angels
Photographs of asylum patients: an analysis
A week in the life of a nursing assistant by Paul Tobia
It was 1981 and I had become a nursing assistant at Glenside Psychiatric Hospital. I applied for the job because I was skint and — as the job centre pointed out — my history degree did not qualify me for most forms of employment. Much to my surprise I enjoyed working at Glenside, perhaps because I’d always felt myself an ‘outsider’ and here I was among the ultimate ‘outsiders’.
I was on Ward 18. A ward for elderly men, who had been in the hospital for many years, but times were changing. As part of the plan to gradually introduce them to the outside world, a trip was secured to Butlins, Minehead. We were to learn this bit of the outside world was a lot stranger than Glenside; with a massive bar which held two thousand people and a volcano that erupted every 30 minutes. Welcome to normality.
I never fancied going to Butlins; the false and obligatory jollity enforced by the Butlins Redcoats was anathema to my quasi-hippy sense of enjoyment, yet I was chosen to go. With me went six men and two staff from our ward and similar numbers from an adjacent female ward. On arrival at Butlins we decided to give the men as much freedom as possible. There was a fence all around the camp so — unless they started tunnelling— they could not escape. Each patient was given £10 and told to do whatever they wanted. Not a wise move. Butlins is a big place. Thirty minutes later we could only locate one out of the six men. None came to any harm but it took hours to find them all. They could eat ice cream, candy floss and hamburgers and the pretty Redcoats were on hand to help them. They were, with one exception, having a great time.
The patients seemed to find Butlins a lot less bizarre than the staff. Our days were very long. The patients were often up by six. Some needed help dressing. Then we all would partake in some of the many activities Butlins provided, with the exception of the expensive helicopter rides. Although one of the female patients did try: she was found inside the helicopter imploring the pilot to ‘take me away from this; we could be happy together’. In the evenings we would go to the massive bars, our favourite being the south sea island one where the exploding volcano was accompanied by the soundtrack of a tropical thunderstorm. One evening one of our men refused to leave the bar explaining, ‘I’m not going out in weather like this’. Finally, at around 11 p.m. the patients would be taken back to their chalets and helped to bed. One member of staff would stay with them while the others went back to the bar till about 3 a.m. — we did need a drink.
The patients adapted well to this routine, even the usually melancholic Charlie produced a rather beatific smile and asserted, ‘Yes, I’d like to live here’. Another patient too was in his element. At Glenside he would spend all his time picking up cigarette dog-ends, which he then made into roll-ups. These he sold to the other patients for money or, it was rumoured, sexual favours. At Butlins everyone smoked – it was the 1980s – and he soon collected a massive bag of dog-ends, ten times what he would normally find. Despite us telling him he had money and he did not need to do that, he was not dissuaded and by the end of the week he had several hundred cigarettes prepared to take back to Glenside.
The exception was Mike, a small and slight man whose bitterness and bile knew no bounds. He hated the world and wanted everyone to know it. Why he was chosen to come to Butlins I will never understand. Someone must have thought it would cheer him up, but it didn’t. On the second day a Redcoat approached us and asked, ‘Do you have a very unpleasant old man called Mike with you? Because his trousers have fallen down and he is blaming passers-by. He is trying to hit them and is swearing continuously.’
I rushed to the scene. His trousers were round his ankles and he was swinging his fist at anyone who approached. Exhortations to calm down failed so I grabbed him round the waist, but he pulled away and fell into a rose bush. He emerged from the bush with several small cuts to his face and arms screaming to the now dozens of onlookers, ‘He’s trying to kill me; call the police’.
We had to drag him away; it was not a good advert for Glenside.
As the week came to a close, the patients (apart from Mike) had clearly adapted well and would have liked to have stayed longer but the staff were struggling. We had all taken to wearing headdresses with attached flashing lights, drinking too much and were suffering from sleep deprivation. When I got home I slept solidly for eighteen hours.
In retrospect this tale might say more about me than the hospital but I think it does capture a particular era. The psychiatric hospitals had been severely criticised for institutionalising the patients. The concept of de-institutionalising and introducing the patients to ‘normal life’ was in vogue. This story shows the vagary of that concept but in many ways it was a good time to start a psychiatric career. Things were changing for the better and ‘we’ve always done it like this’ was no longer a valid excuse for avoiding changes to nursing practice.
On Ward 18 the redoubtable Sister instituted a period of change which at least mitigated the worst effects of institutional life. One of my proudest achievements was that I got 30 out of the 32 patients to shave themselves after being told they were incapable of this. While the Butlins experience may not have achieved the questionable aim of making the patients more ‘normal’, it did give them a very different experience in a life that was lacking in variety.
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