Dr Laura Marshall-Andrews - What Seems To Be The Problem?

Some names and events have been changed to protect the privacy of the individuals involved.

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First published in Great Britain by HQ in 2022

Copyright Dr Laura Marshall-Andrews 2022

Dr Laura Marshall-Andrews asserts the moral right to be identified as the author of this work.

A catalogue record for this book is available from the British Library.

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Ebook Edition July 2022 ISBN: 9780008445034

Version 2022-05-05

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For Will, Josh, Danny, and Tassia,

who make everything worthwhile.

If you have the choice between being kind or being clever, choose kind.

R.J. PALACIO, Wonder

Society today is being fragmented by a way of thinking that is inherently short-sighted because it disregards the full horizon of truth It ignores the very principles that enable us to live and flourish in unity, order and harmony.

POPE BENEDICT XVI

M y surgery finished late on the day I was strangled.

My patient, Sarah, had about her the air of a recent escapee. I had treated her before and knew her mental health could be very up and down. But that day she looked particularly disconcerting. Her dark black hair was untamed, and her skin sallow with large dark circles around her wild eyes. She rushed into my consulting room followed by a man I recognised as another mental health patient of ours.

I feel wild, I feel crazy. Sarah was writhing as she spoke, pulling at her neck and the top of her shirt.

She does, the man behind her said to me over her shoulder, nodding vigorously.

They had met at a mental health day event at the surgery, he explained. He looked to be in a state of panic. This was not uncommon for him as he lived his life in a fairly constant state of panic, but there was a different urgency about him that day.

Shes been trying to attack people on the way here, he said. She even tried to attack an old lady.

Sarah nodded in agreement, widening her eyes and throwing her head back.

Okay, well, just take a seat. I gestured to the chair by my desk.

My consulting room was in the shape of a small reversed L, with the desk tucked into the short arm of the L to maximise space for the patient and the couch. It was an arrangement I was starting to regret as I suddenly felt very cornered.

I cant sit down! Im wild. I feel dangerous. I need to be admitted! Her voice increased in energy and volume as she spoke.

Okay, Sarah, I will just call Millview, I said, moving my hand slowly to the phone and picking up the receiver. Millview is our local psychiatric hospital. It is not a pleasant place. Most of its patients spend their time trying to escape, and so wanting to be admitted there was in itself pretty indicative of a delusional state of mind.

I kept my eyes on Sarah as I dialled the number.

The ward clerk answered and put Graham, the team leader, on the line.

I explained the situation.

Oh yes I know Sarah, he said, too quickly. I absolutely dont think admission is the right thing for her. I think she is best off in the community.

She says she is going to attack someone.

Well, yes she does attack people. Shes attacked me. He paused as if this was somehow reassuring. I supposed that the fact that he was still alive was positive. That said, one couldnt tell down the phone whether or not he had suffered some sort of disfiguring disablement.

Okay, so what should I do?

Call her community team. They might be able to help her.

Right, I said. I certainly didnt feel right, but then I wasnt really in the sort of situation where I was expecting to.

Calling the community team is never straightforward. It is hopelessly understaffed, and its almost impossible to get through to anyone. I ended up leaving three or four messages on different voicemails.

I turned back to Sarah. Im trying to get you seen at home, I explained.

I cant go home Im going to kill someone! she shouted. I need to be admitted! I feel dangerous! And with that, she launched herself at me and grabbed my neck.

Time seemed to slow down as we pivoted backwards and forwards in a strange dance. Sarah was trying to strangle me, and I was trying to push her off. I had the palm of my right hand placed against her forehead, pushing it back. Her mouth was wide open and her chin extended towards me. Behind her, her friend was flapping his arms up and down shouting, Dont kill the doctor! I could feel Sarahs thumb on my larynx and the blood backing up into my head. Fortunately I have long Neanderthal-type arms and I was able to stretch her forehead back so much that her grip on my neck loosened.

Spotting an opportunity, I managed to wrestle her to the ground and place a knee on her chest, which kept her still for long enough for me to grab the phone and dial 999.

We stayed on the ground for what seemed like an eternity. Every so often, Sarah would thrash around under my knee, but my full weight was on her and I had her arms pinned to the ground on either side. The police arrived quickly two officers with walkie-talkies buzzing at their shoulders and with them came a sense of safety. As soon as they walked into the room, I burst into tears.

I was trying to explain what had happened when Sarah launched herself at me again, and the police jumped into action. They held her arms behind her and turned her round so she was bent over and pressed into the examination couch with her head turned to one side.

Okay, doc, well take it from here. Does she take any calming medication or anything?

Give me some diazepam! Sarah shouted from her compromised position. The couch roll (a long strip of thin, changeable paper that covers the couch) was getting caught in her mouth. She tried to move it with her tongue. Saliva dribbled onto the tissue, which clung to her bottom lip. I put out my hand to help clean it off, but thought better of it as she growled at me.

Diazepam is an addictive sedative medication. I am usually very careful about using it, but this did seem like the perfect opportunity. Hold on, I said, and rushed next door to my practice nurse.

I started shaking as the adrenalin hit me. Fi, I need some diazepam, I said. Sarah has just tried to strangle me. My voice rose in pitch at the end.

Fiona got up quickly and went to the locked drugs cabinet.