Poppet

The Maude

LEGEND HAS IT that Maude is the ghost of a matron from when Beechway High Secure Unit was a workhouse, back in the 1860s. Born a dwarf, she’d risen to a position of authority in the workhouse through sheer determination and single-mindedness. It was a position she abused. It is said that children who misbehaved would be subjected to Sister Maude straddling their chests, spooning ‘medicine’ into their mouths until they choked. That she would make the children write out biblical texts – line after line until their fingers bled. Some versions of the myth say Sister Maude had something under her robes she kept private: that she wasn’t really a ‘sister’ at all but actually a male dwarf dressed as a female.

Four and a half years ago, just before AJ first came to work on the unit, an anorexic patient named Pauline Scott had convinced herself something was coming into her room at night. She claimed it would sit on her chest, would try to suffocate her. She’d showed the doctor where her thighs had been slashed. The words Be thou not one of them that committeth foul acts had been gouged into her leg. Two unfolded and bloodied paper clips had been found in Pauline’s bin – which she denied all knowledge of. No one much liked Pauline, they thought the engraving on her legs was apt. She’d been returned to Acute Assessment, where they’d monitored her for three weeks.

When AJ arrived, shortly after the incident, it was all the staff could talk about. At night in the nurses’ station there’d be whispers and jokes, people trying to spook each other hiding in dark doorways. A few took it seriously – an agency nurse on a midnight shift swore she heard the scratches of fingernails on a windowpane and refused ever to set foot inside the unit again. One of the more highly strung social workers claimed she’d once looked out of a window and seen a dwarf sitting on the lawn, wearing a white Victorian gown. The dwarf was doing nothing. Just watching the unit. Its face was smooth and shining in the moonlight.

AJ was one of those who found it little more than entertaining – a bit of a diversion. Then The Maude paid another visit. And this time it wiped the smile off everyone’s face.

Moses Jackson was a long-stay patient – a grizzled grey guy with thin limbs and a nasty attitude. A downright, whole-enchilada, nasty little shit. He was vicious and deceitful and rude. He would call the female staff ‘Splits’ and was always pulling down his pants to show them his penis. Female staff couldn’t be alone with him, which complicated his care and made him even more time-consuming. Of course if any of this was pointed out to Moses he’d scream racism and demand that the Trust’s top brass came and met him to explain what they were going to do about it.

AJ was still a nurse in those days. He’d arrived for the early shift that morning to find the place in chaos: nurses were rushing around from ward to ward, grabbing notes, grabbing phones, council workers traipsed in and out carrying toolkits, and an unearthly screaming was coming from Buttercup Ward. The allocated ‘Control and Restraint’ nurses were in another ward – so eventually, when AJ couldn’t stand the noise any more, he decided to go and attend to it himself. Moses was standing in the middle of his room. He was stripped naked from the waist down, and was hugging himself and crying – staring at the walls. Every inch had been scribbled on in red felt-tip. Hundreds and hundreds of words – on the walls, the skirting boards, even the ceiling.

AJ had seen the worst and the weirdest in various institutions before Beechway, but this was a different level of bizarre. He was silent for a moment, gawping at the sheer extent of the damage.

‘Moses.’ He shook his head, half wanting to laugh, half to cry. ‘Moses, mate, what did you do this for?’

‘I didn’t.’

‘Have the doctors changed your meds?’ AJ studied Moses carefully. He couldn’t recall seeing a note in the care file – usually the nursing staff were given clear instructions if anything changed. Especially with medication. ‘Did you have something different last night? Yesterday?’

‘I didn’t do it!’

‘OK,’ AJ said patiently. The room smelled, the vaguest undertone of something like burning fish, so he cracked one of the window vents. He glanced down at the old guy’s genitalia, which dangled in front of his scrawny, grey-haired legs. ‘How about putting your drawers back on, mate? The doctors will need to check you over – you don’t want them seeing all your man stuff hanging out.’

‘I never took them off.’

‘Well, how about you just put them on anyway?’ He handed over the pyjama bottoms. ‘There you go.’

While Moses was putting them on, AJ wandered around the room, his head canted on one side, reading the words:

Anyone who looks at a woman lustfully has already committed adultery in his heart.

On other sections: If your right eye causes you to sin, gouge it out and throw it away.

The lines were repeated dozens and dozens of times. They’d have to be scrubbed out, or painted over.

‘Moses,’ AJ said calmly, not drawing attention to the writing, ‘shall we go to breakfast?’ There was nothing in AJ’s long experience of psychiatric nursing more effective at changing the subject or distracting a patient than the mention of food. ‘They’re doing waffles and syrup for dessert.’

Moses went along willingly to the dining room, though he had the appearance of someone moving further and further away from reality. The drugs, which he usually tolerated with few side effects, seemed to have started to work against him. There was a wet patch on his trousers and lines of drool hung like pendulous beads of pearls from his mouth. The other patients gave him a wide berth. He was withdrawn, standing quietly in the queue, one fist jammed into his right eye socket, which he kept rubbing at like crazy.

Isaac Handel, a runty long-stay patient with a pudding-basin haircut, was the first to notice when things crossed over into the serious.

‘Hey,’ he said to one of the nurses. ‘Look, look.’

The nurses looked. Moses had separated from the queue and turned his back on the room. He was bending slightly at the waist, head down, and seemed to be struggling with his face. AJ was slow off the mark. Instead of responding instantly, he meandered across the dining room, a half-smile on his face – more curious about what Moses was doing than anxious.

‘Moses, mate? You all right there?’

‘A spoon,’ Handel said. ‘He’s got a spoon.’

The patients were allowed spoons on the pre-discharge wards. It had never been seen as a danger or a threat. AJ approached Moses from behind. He was about to put a reassuring hand on his back when he noticed something dangling from the guy’s jaw. Or rather, not dangling but dripping. It was blood and it was coming in such a steady stream he’d mistaken it for a cord hanging there.

‘C and R!’ he yelled, automatically tugging out the ring on his panic alarm. ‘C and R, dining area. Paramedics.’ Three other nurses came running, trying to grab Moses and get him on to the ground to the supine position. But he had the strength of ten men. He wrenched away from AJ and continued struggling with whatever it was he was doing to his face.

‘I’m on the head,’ one of the nurses yelled. ‘Left arm, left leg,’ yelled another. ‘GET EVERYONE OUT OF HERE,’ yelled AJ.

More staff came running and the panic alarms shrieked through the building. From Moses’ face came a strange, crisp popping sound – quite compact and clear, considering the mayhem around. Later, when AJ was writing his report, he had to think about the best way to describe that sound, and reflected that it sounded like the snap of tendon and movement of greased white-bone socket when a barbecued chicken leg is pulled apart (he won’t eat chicken again from this day hence). Of course it was no chicken joint responsible for that noise. Instead a stringy globe, like an egg with bloodied albumen, fell out on to Moses’ cheek. The spoon clattered to the ground and he dropped to his knees, then keeled on to his left hand, half fainting.

‘Paramedic,’ AJ bellowed. ‘Get a fucking paramedic. Paramedic. Paramedic, Paramedic …’