My friend has been sectioned again. The fire alarm has gone off, again: he tells us it goes off every time a patient smokes. At least this ward has a courtyard, so he can go outside- where I worked briefly those detained could not except with a nurse supervising them, and not at all in their first weeks in.
He seems less angry and manic than he did when he was taken in, but his delusions and preoccupations remain the same. On first encountering him, he can seem spiritual. When I met him twenty years ago his image of insect larvae in the rainforest dying, and uncountable souls ascending to Heaven, struck me. He quotes a lot from Buddhist scriptures. The longer I know him, though, the less profound he seems. He has a small range of subjects: Bodhisattvas, other Universes, reincarnation, suicide, prisoners on American death rows, rape and sexual assault of sex workers, how blessed it would have been to be among the 9/11 hijackers, and the wonderful smell of a woman’s genitals when she is ovulating. He repeats that Bodhisattvas can connect to their equivalents in all other universes, and has taken to loose internet metaphors, such as that the connection to other universes is a “Stone-age internet”.
In hospital, he is full of the skills he has learned to benefit the World: he has finally worked out the principles of the natural neutron internet, the one mountaineers use to navigate treacherous first ascents in atrocious weather.
He can be detained in hospital, or compulsorily medicated, if he is a danger to himself or others because of mental illness. He told me he was first sectioned in 1982 after he proposed that he could prove reincarnation if he ritually vivisected a particular woman. He was compulsorily medicated for decades, then won a tribunal, saying the authorities could not prove that there was a risk to anyone if he was off medication. He believed that the medication inhibited him from being in touch with spiritual reality. Off medication, he went hypomanic, was sectioned again, and put back on depot injections.
He won a second tribunal, came off the medication, again went hypomanic and was sectioned yet again.
He tells me he has a medical degree. He spent time as a child in Africa with his eminent anthropologist father, a Commander of the British Empire and Fellow of the Royal Society of Edinburgh. He has shown me his father’s book, and I believe him about his degree. I do not think he would deliberately tell an untruth, though it is not always possible to tell when he is deluded. He joins Quaker spiritual discussions, but always shares on his small range of preoccupations, and does not seem to listen to anything others say except “I agree with you”.
Probably the depot injections will manage the hypomania eventually, and he will be released. He might even win another tribunal, and come off the meds again. He seems terribly angry about the medication, and I think with his father as well.
He has had a wasted, miserable life.
What alternative could there be to medication? Decades ago, he would have been institutionalised permanently, if not medicated then restrained by strait-jacket or padded cell. I imagine that would be more horrible for him, but the current medication only manages his symptoms, rather than curing him.
To cure him, you would need to convince him of the worthlessness of his delusions, and they are what gives his life meaning. I doubt he will ever surrender them.