Her shaking hand gropes for his under the sheet. Finding a finger, she strokes from scarred knuckle to curling yellowed nail. “Good morning, darling,” she whispers. “I’m here now.”

His eyes remain closed, hiding tortured regrets. “Sorry, I’m so sorry: sorry for the thousandth time.”

“Don’t be sorry, think how successful you’ve been in the brutal unending battle no one else can see or hear.” She grips his hand. “You’re alive. I’m here. They’ll discharge you if the psychiatrist thinks you’ll be safe for a while. Don’t be sorry, be triumphant. It’s bigger than you, always has been – ever since I found you under the tree. I counted. That was seventy-one years ago. Seventy-one times 365 days it has lost and you’re still here.”

He opens his eyes, “I’m still so sorry.”

“So am I, but not blaming you. That negative stuff just makes things worse, responsibility, guilt, pressure…”

“So you don’t want the story?”

“Not at all, dear. I wanted to know you’re still alive. Now I want damage assessment. How are you and how’s your body?”

“My body’s fine. Tiny bit of burning and I’ll have a couple of small scars. My mind is the same. They’ll change my tablets, say everything’s going to get better – so I’ll have enough hope to keep going for a while … until I notice the medication’s not working like all the rest. But … but let’s look at it your way. I’m alive, you’re alive, and they’ll probably give me a bit of hope today. They gave me an injection to take the anxiety and agitation away. It’s good. You know the one – that stuff they won’t let me take home in case I swallow it all at once.”
She’s about to answer when the cubicle door reverberates to a firm knock. She turns to her husband. “Who can that be?”

“Probably tea or something.” He calls, “Come in. We’re not doing anything that would shock you.”

The door opens and a woman walks in, smiling and carrying a clipboard over a packed folder. “Hi, I’m Emily. Mr. and Mrs. Walker?”

“This is James and I’m Nancy. Hello, Emily.” Nancy studies the woman and wonders just how young hospital staff can be.

Emily asks, “Would it be alright if I asked you both a few questions? I’m … I’m a research student.”

Nancy nods. “Research student? Well done, you! What are you doing?”

“Mind if I pull up a chair? I won’t be long though, honest. Oh, I’m researching coping strategies and, right now, those which fend off suicide attempts.”

James laughs. “I’m the wrong person to ask. I can’t remember how many times…” he lapses into silence.

Emily dumps her folder and board on the bedside table. A flimsy plastic chair squeaks as she pulls it across the floor. “But … James … you are sill alive.”

He squeezes Nancy’s hand and says to Emily, “It’s taken both of us a lifetime, a whole lifetime to keep me alive.” Nancy watches the young woman, whose head seems to be tipped slightly one way or the other as if permanently questioning something.

Emily lifts her clipboard, and sits down. “I know this is hard to talk about but, please, in your own words, what works? You said ‘both of you’ so you’re not alone in this. Teamwork seems to play a big part in survival. I suspect it’s the lonely people who die.” She looks directly at Nancy. “So what is your role?”

“Watching James’ mood, his socialising, concentration span, irritability and many other tiny signs. Well, the doctors call them signs, things the patient doesn’t notice. They only notice symptoms.”

Emily taps a tooth with the end of her pen. “James, are you ever aware you’re hiding signs of depression?”
“Yes and no. There comes a point where you’re not thinking clearly. If I’m trying to hide anything from Nancy, my head is already way out of control.” He falls silent, staring at the hospital blanket over his legs.

Nancy goes on, “Sometimes it’s me who calls the crisis people or the ambulance but mostly I can get James to do it before he loses control. We call it the cusp.”

Emily takes notes, chews her pen for a moment and looks up. “Cusp? Can you describe that to me?”
“James would be best to do that.”
He says, “That’s where logic and reason stop making sense – you’ve lost the ability to judge between truth and nonsense. You see everything so negatively, especially yourself, and can’t believe even close family would be bothered by your death; in fact you are doing them a favour by dying and not causing them more months or years of your company.”

Emily sits immobile, not making notes. “Mm, I’m familiar with all that. Before it happens – when you feel it’s coming, what strategies are best for you?”

“There are so many. It’s more a case of using them in time rather than which one you choose. Grounding is OK if you’re in the country, but if all you can sense are the sight of crowded people rushing, the smell of exhaust fumes, hear the roaring sound of traffic and jets taking off, and all you can feel are people as they push past you – well, none of that works for me.”

Emily writes as fast as she can, her pen almost blurring. “What about the lucky stars technique?”

“Doesn’t work for me either. I quickly decide I’m not worthy of them. Moments work. If nothing else it’s a fun exercise.”

Emily looks up and tosses aside a curl falling over her left eye. “Moments? I don’t know that.”

Nancy speaks while James takes a sip of water, “It’s remembering moments of significance, little events that stand out as special.”

James puts down the plastic beaker. “It doesn’t have to be nice things. It can be rain on a watercolour painting you were nearly finishing, a lorry going through a puddle and soaking you, holding a young girl after a road accident as she died. And good things, like standing on a cliff at the age of five and watching the sun’s dazzle reflected by waves – sparkling.” He coughs and reaches for the beaker again.

Nancy continues, “I use it when I can’t sleep. You know, that first book you read as a child when a whole new world opened up for you, when a ballet dancer signed his photo for me after a performance. How I fought to save that picture when my parents told me it was too old and yellowed to stay on the wall. Yes, moments can keep me distracted and entertained for hours.”

James nods. “It’s about distraction more often than not – getting through that minute, hour, day. Helping someone with something is a good one, for instance. After having someone like Nancy around – and listening to her – the best, the very best things are practical. Having the number of the crisis team pinned by the phone and listed in your contacts, having a bag packed that will get you through a few days of admission to a safe unit. Then there’s making sure you have all the tablets you need to last through a bank holiday when the pharmacy is closed. Always taking your tablets – even when you think you don’t need them. Recording when you’ve taken them – because your memory can be affected.”

Nancy presses his hand between hers. “When I say ‘I’m taking over’ James hands all decisions over to me and does what I say – even if he thinks he’s fine. We’ve learned over the years. The time to call for help is when he’s trying to do something and looking confused or I’m calling him and he’s staring into space or shaking his head.”

“It’s circular thinking. My head thinks the same thoughts round and round and round … then it’s time to pick up the phone quick. Sometimes I only have minutes after realising what’s going on. Pretending I’m in control and it will pass is a fatal mistake.”

Emily presses her lips together and frowns as if struggling to find a way to ask the next question.

Nancy takes the lead, “You want to ask about what went wrong last night?”

Emily’s brow clears. She nods.

Nancy turns to James. “What was it, love? It must have happened after I went to bed. I know we had a glass of wine. Did you have more?”

“No – that’s asking for hell as we both know. I don’t know what happened really. Sometimes it comes out of the blue or in a way you’ve never planned against. Last night was just emptiness, exhaustion – not wanting to fight any more. That release of giving up.”

There’s another knock on the door. Emily stands, grabbing the folder but fumbling and dropping her pen. “I’d better get going. That could be the doctor.”

The swing door opens as a small trolley is pushed through, bumping and clattering. A nurse in casual clothes enters with the consultant, similarly dressed. “Good morning, Mr. and Mrs…” The nurse sees their visitor. “Emily! Is this you socialising? That’s really good. Well done.”

Emily hunches over, shrinking down and backing against the wall. Nancy stands and lays a hand on her shoulder. “Don’t worry, dear. If you want to know what works, you don’t have to pretend to be a student. I did very similar things once. These days it’s not needed so much, not in here anyway. People are more open. It’s not like outside where few understand and the rest are terrified. We share, that way we all cope better. You can ask us anything you want. These two will be finished in a moment. You can stay and listen if you like – we have no secrets. Then we’ll have all the time in the world to talk things over. If our experiences are of any use to you we’d be delighted to help. If you have permission to leave the ward, you can come with us and we’ll chat at our home, or in a cafe: anywhere. I’ll give you my number.”

©Gary Bonn 2019