PICTURES THAT PAINT A THOUSAND WORDS

( OR SO…)

VIOLET THE PIANIST

Original story by Dave Hambidge published 08/03/2007 on this blog

Republished 13/02/2009 in issuu format

My wife and I convicted people watchers; the daylight equivalent of Peeping Toms. We observe our fellow human beings in all their florid glory as they struggle to cope with the world and themselves. Before I retired from practice as a psychiatrist I even got paid for this pleasure.

Now that my father-in-law is resident in an old folks care home, I have regular reminders of “the little, grey haired old ladies” who have influenced me over the years. Fortunately, none of them have yet reminded me of Violet, whom I met while working at a famous psychiatric hospital in London.

Violet, which was not her name of course, was the tinniest person I had seen in years, barely 4 ½ feet tall and weighing less than 4 stone. Her weight loss was the direct consequence of a nasty, mostly untreatable blood marrow cancer that had been destroying her for months. So, why was she admitted to a psychiatric hospital you may well ask?

Violet had, apparently without reason, stopped eating, drinking and talking and started screaming, incessantly, all day long, and most of the night as well. The caring staff at the nursing home she was staying at were at their wits end about what to do with her. The boss had seen her there and decided to admit Violet to our hospital for observation. She arrived by ambulance just as I was going home, and could be heard long before she arrived at the ward, a piteous screeching. Violet was clerked in by one of the other doctors on the team, who was on call for the whole hospital that night.

The next day I was asked by the ward nurses to review Violet. She had continued screaming throughout the night, despite being given some pain relieving tablets. What upset me was the quite pathetic and grossly inadequate analgesic that had been prescribed by my younger, female colleague; aspirin. Violet was known to have bone cancer, and X-rays done the night before had clearly shown a number of fractures in the bones of her arms and legs. At the very least, a dose or two of morphine would have been compassionate, so I wrote a prescription for the same.

I was off the ward for most of that day and only returned to collect my coat and bag at “POETS time”. (Piss Off Early Tomorrow’s Saturday). Violet was not screaming and had slept most of the morning before eating a little of the lunch. Not enough to keep a sparrow alive, according to the nurses, but a start.

On the following Monday Violet was sitting up, well, lying back on a tower of pillows, smiling to the nurse feeding her and obviously not in pain. Rather embarrassingly the ward sister sang my praises to Dr. Bloggs during the team meeting, in front of the “offending” doctor, for sensible use of potent analgesia. Violet had only needed three injections of morphine and was otherwise pain free taking regular codeine tablets.

The boss was quietly supportive of me, at least in the meeting, but very grateful when we had a private chat the next day, my final day working with him. He commented on the therapeutic naivety of some young doctors starting in psychiatry, and I, in retrospect, thoroughly agree with him.

Dr. Bloggs mentioned that one of the nursing assistants had approached him, in confidence, to say that Violet was talking about being abused by the care staff in the home. All those years ago, in the mid 1980’s, such things were rarely discussed in public, or thenconsidered seriously when raised. So often they were attributed to the complainant’s mental state. Things have changed a great deal on that!

He, my about-to-be-ex-boss, seemed to be giving some credibility to the third hand allegations and promised to let me know what transpired. Which he did, nearly a year later, long after I had left St. Elsewhere’s, when we briefly met at one of those frequently tedious,large psychiatric conferences.

Violet had succumbed to the bone cancer after only a few weeks, but had enjoyed pain free lucidity to the end. As she emerged from her tortured state over that period, Violet had revealed an intriguing life story as a pianist of some quality who had lived professionally from her skill. She also disclosed a nauseating catalogue of verbal and physical abuse at the hands of some of the so called caring staff at the old folk’s home she was placed in when she could no longer cope on her own.

Dr. Bloggs had believed Violet and taken the matter to the relevant authorities and was told that other complaints had been made, but no action taken about them. He shared with me a one sided version of the row that erupted in that meeting when he called into doubt the professional morality of not investigating these very serious concerns. His view prevailed, and a police led unannounced visit discovered a number of dreadful things going on. The home was immediately closed down, the residents moved and three of the staff prosecuted and jailed for 2 years each.

Nobody, whatever their state of mental or physical health, deserves to be mis-treated by those paid to supposedly care for them. If a person is in severe physical pain then they need, want, potent analgesics, now. Oh, and never automatically disbelieve information that seems to you to be implausible.

The very evocative painting to accompany this story is by;

Ceri Andrews

And is available to view online at;

http://www.swanseaheritage.net/article/full.asp?ARTICLE_ID=1828