A Child of Our Time

 

My first day as a consultant psychiatrist presented me with a shock that changed me for good. Ten of the twelve men waiting to see me on the inpatient ward that morning were from Manchester’s African-Caribbean community. Nothing I had been taught in my training had prepared me for this. That afternoon I went through their case notes. Most of these young black men had a diagnosis of schizophrenia. In the days that followed I interviewed them and questioned them carefully. By the end of my first week I had attempted to interview them all. Two had cooperated and answered my questions, but not the rest. One or two mocked me and laughed defiantly; another threw my questions back at me angrily, making it plain there was no way he would cooperate with me. Most remained silent, avoiding eye contact, staring at the floor. I had insufficient information on which to base any psychiatric diagnosis

Despite this these young men either had been, or still were, very distressed. They were disorganised and unable to care for themselves, and something else struck me. Most had been homeless before admission. They had been sleeping rough or squatting in derelict buildings, of which there were many in Manchester in 1983. Most had lost contact with their families. They were admitted via the police, the courts or the casualty department. Very few were referred for help by a family doctor, or attended the outpatient department with family members.

Something was wrong, and it troubled me deeply. Not only was my curiosity pricked, but my conscience too. What I was witnessing was not right. I had to try to understand it, but where to begin?

My new post covered inner-city Manchester, the districts of Hulme, Moss Side and Whalley Range where the City’s black community was concentrated. My work included ‘continuing care clinics’ in the community, which had been set up ten years earlier to ensure that people discharged from hospital kept taking their medication. Most of the patients I saw there were black, people of the Windrush generation who left the Caribbean in the late 1940s and early 50s in their best suits and frocks. If their small cases were heavy with possessions, their hearts were equally burdened with that curious blend of trepidation and hope common to all Diasporas. The balance between these two emotions soon shifted when they arrived in England. Unemployment, poor housing and racial discrimination on the streets shattered their dreams. Some were driven mad by this, and if hope had not evaporated on the dole, it was driven out by the powerful drugs used to treat their madness. The tragic circumstances of the older black people I saw in these clinics was compounded by the presence of growing numbers of young black men and women, the sons and daughters of the Windrush generation, sitting alongside their elders in silence.

Six months or so after starting my new job, I became involved in the care of Chris, a twenty year old man, whose life symbolised many of the problems that beset black people in psychiatric services.

*

At first I thought the room was empty. The curtains were drawn and what little light there was struggled through a heavy blue pall. My nose and eyes stung.

‘Chris. Wake up! You’ve been told not to smoke in your room.’ The nurse tugged the edge of the duvet.

As my eyes accustomed to the gloom I made out a shape beneath the duvet. The bed was chaotic; a sheet abandoned on the floor, a confetti of orange peel, torn up Rizzla papers, cigarette ash and sinuous strands of cigarette tobacco littered the mattress.

‘Chris, the doctor’s here. Wake up!’

As my sense of smell adjusted to the tobacco smoke, I sensed a deeper, heavier smell, one that clung to the walls of damp cellars whose floors were littered with rubbish, of a life lived in boarded-up houses, and spent scavenging wheelie bins for cast-off food; the smell of homelessness. I approached the bed and gently lifted the duvet. I glimpsed tight curls, tousled and matted ringlets, partly obscuring a black face with skin that glowed in the faint light, a blackness whose satin sheen defied the dark, refusing to be engulfed by it. I lifted the duvet a little higher to reveal an arm. then a grey t-shirt.

‘Chris, my name’s Doctor Thomas. I’m your consultant. Can we speak, please?’ Nothing broke the silence. Without warning a slim hand appeared from beneath the duvet, and drew the edge firmly back over the head, before withdrawing silently under cover. This balletic movement was calm and precise, unhurried and graceful.

‘I’m sorry to disturb you, Chris, but it’s important we talk. I need to understand how you ended up in here. Can you tell me?’ Beneath the duvet I sensed the body tense, and then a muffled response, which I couldn’t make out. ‘I’m sorry; I didn’t catch that.’

‘Leave me alone.’

‘Just five minutes?’

‘Leave me alone.’

‘OK. I’ll come back later to see how you.’

Later that morning in the ward round, the junior doctor outlined his psychiatric history.

Chris was a twenty-year-old single unemployed African-Caribbean man who had been sleeping rough before admission. As far as we could establish he was born and brought up in England; he had a local accent. He was admitted under Section of the Mental Health Act after he had been arrested for shoplifting and assault. The duty psychiatrist thought he was suffering from mental disorder. This was his first admission, although he had been in and out of Youth Offender Institutions and jail since the age of fifteen for theft, shoplifting, criminal damage, assault, and possession of drugs (cannabis). On the ward he refused to cooperate, so it was not possible to obtain background information. He also refused to cooperate with mental state assessment and physical examination. It was difficult to make out what he was saying, but it was probable he was whispering in response to the voices he was hearing. The content of these experiences appeared to be persecutory. He whispered ‘They’re going to kill me, Scooby’, but wouldn’t elaborate. He also had strange mannerisms. He wrung and then shook his hands as though draining water off them. His mood fluctuated rapidly and unpredictably, and often appeared to be at odds with what he was saying. For example, when he said, ‘They are going to kill me’, he smiled and laughed. Then he suddenly became angry, hitting the wall with his fist.

The junior doctor ended by summarising the possible diagnoses but in truth we had no idea what was going on. Our hands were tied because Chris wouldn’t say what had been happening to him, how he saw the world, or what sense he made of it.

On the ward he stayed in his room with the curtains drawn, smoking continuously. He refused to answer questions and the food he was offered. He only drank water that he ran for himself from the tap. On several occasions nurses heard him shouting, but when asked why he refused to talk about it. On this basis they too believed he was hearing voices. ‘It sounds like he’s saying where are you Scooby, or something like that’ said the charge nurse. ‘He’s also terrified of a Skull that speaks to him, probably a visual hallucination, but he won’t say anything about it.’

‘Medication?’

‘He was written up for it if required, but so far he hasn’t caused any problems so he’s not had any.’

‘Any visitors?’

‘None’, replied the charge nurse, checking through the nurses’ notes.

‘Phone calls?’

‘Nothing.’

‘Do you know him?’ I asked Duwayne, the social worker who was attending the meeting that morning.

‘Not personally, but I checked before I came up. He’s known to probation.  They’ve requested social background reports in the past. Until a few weeks ago he was living in Martin Luther King House.’

‘Never heard of it’ I replied, shaking my head.

‘It’s a hostel for homeless black kids.’

‘Yeah, we’ve had quite a few admissions from there recently’ added the charge nurse.

‘I see. Who runs it?’ I asked.

‘Oh, various folk from the community, youth workers, elders from the churches, people like that’ replied Duwayne. ‘It’s managed by Mrs. Black.’

‘Maybe we can discuss it when we meet up at social services next week’ I replied. ‘In the mean time what are we going to do with this young man?’

‘Well I think he has a schizophrenic illness’, said the junior doctor chewing a paper clip while he scribbled in the notes.

The charge nurse agreed. ‘The sooner we start treatment the sooner he’ll get better and out of hospital.

‘The difficulty is we have so little information to go on. I agree that he appears to be psychotic, but we aren’t in a position to make a diagnosis’ I replied.

The charge nurse shook his head. ‘That may be so, but I’m worried he’s on a short fuse. Things could get out of hand very quickly if we don’t act promptly. He’s a big lad, and we’ve a responsibility to the other patients and staff.’

I listened carefully to what they said, aware of things lurking unsaid in the spaces between the words. ‘But we are talking about treating him in ignorance of his background,’ I insisted. ‘And of the events that led to him being here, and with no clear diagnosis. We need more information. We need to talk with his family, or at the very least with the hostel staff.’

The charge nurse looked doubtful. There was no clear consensus. They wanted him on medication. Duwayne and I were less sure. Everyone agreed that we needed more information. Despite the pressures to start treatment I managed to hold off until we found out more about him.

*

In the days that followed Chris refused to speak to anyone, and his behaviour became more bizarre. The frequency of his verbal outbursts increased, directed at staff and other patients. The pressure from the nursing staff to do something mounted, and I felt I was being forced into practicing what was little more than a form of veterinary medicine. In fact the situation was worse than that. A good vet sees a sick animal and obtains a full account of the problem from a worried owner. Not only does the vet treat the animal, but the owner too. We had had no contact with Chris’s family. We didn’t even know who his next of kin was.

I held regular meetings with the mental health social workers in the local office, and the following week Duwayne and I continued our discussion about Chris.

‘We’re stuck’ I said. ‘I don’t know how best to help him other than through drugs, which he flatly refuses.’

‘Tough’ said Duwayne. ‘Tough for him, and tough for you.’

‘That’s a strange thing to say’ I replied. At times I found Duwayne’s attitude difficult to fathom. I felt he had a chip on his shoulder.

‘Well it’s true. Chris is trapped in a system he doesn’t understand and has no control over. And so, for that matter, are you.’

‘I don’t follow you’ I replied, frowning. “I’m here to help people like Chris, but that’s impossible without a trusting relationship. If he won’t talk with me than there’s no chance of trust.’

‘So the problem’s his’ replied Duwayne.

‘No, that’s not what I’m saying.’

‘Look Phil, with all due respect, I think you’re very naive. I know you mean well, but you’ve no idea what life is like for youngsters like Chris. You flit in and out of his life like a moth around a candle, but that means nothing to him. All he sees is another white guy who’s going to stick the boot in.’

I shook my head. Duwayne’s attitude angered me, but there was little to be gained by expressing it, so I tried to push it to the back of my mind.

‘OK. You may be right about my naivety, fools rushing in and all that, but I need to understand Chris if I’m to help him. If he won’t talk to me then I need to speak to those around him who do know him and are concerned about him. I’ve spoken with Mrs. Black at Martin Luther King House, and we’re meeting up next week.

Duwayne stretched back in his chair and rested his head on his arms which were folded behind his neck. His eyes narrowed as he looked at me. ‘Why are you doing all this? I just don’t get it. You’re the doctor. All you’ve got to do is make your diagnosis and treat him.’

‘That’s not how I see it. If he were white we’d have a much clearer picture about what was going on, how he saw his problems, his life, his experiences, about everything that had happened to bring him into hospital. We’d likely as not be in touch with his family and friends, and found out how they saw what had happened to him. But not with Chris and others like him. I hate drugging someone up because that’s all we can do. It’s not right.’

‘Look, I’m not trying to be awkward, Phil, but I really don’t see what you’re going to get out of visiting Mrs. Black.’

‘You may be right; I just don’t know, but I have to do something and this is the best lead I have.’ I replied. ‘Sometimes I just don’t get your attitude Duwayne. It feels like you want me to keep my nose out.’

He sighed and shook his head. ‘You’re just another well-meaning white guy who doesn’t understand. You haven’t thought through what you’re getting yourself into. OK, go see Mrs. Black, but don’t say I didn’t warn you.’

*

The house was at the end of an imposing terrace close to a large Victorian park. Its once elegant facade was defaced by an ugly fire escape which sprouted from the warm bricks like a metal parasite. I approached the main entrance and rang the bell. After a few moments the door was opened by a young black woman who introduced herself as Millie, a support worker. She led me through to the main office at the front of the building, and made me comfortable in an armchair next to a large desk set beneath a window that looked out over the park.

‘Mrs. Black sends her apologies, but she had to pop out. She’ll be back in 5 minutes. She said to make yourself comfy. Can I get you a drink?’

‘Yes please, tea, milk no sugar. Thank you.’

She left the office and could be heard pottering about in the kitchen next door. The office would originally have been the drawing room, and it still retained some original features, notably a large white marble mantlepiece and an ornate cornice. Now, it was a busy space crammed with filing cabinets, two smaller desks, and a large table that carried a jumble of files. Shortly after my tea arrived the door opened.

‘Dr. Thomas, so pleased to meet you. I’m Mrs. Black. I do apologise for keeping you waiting but something cropped up which needed my attention.’

‘No problem’ I replied, shaking her hand. ‘Lovely to meet you.’ She was a tall, stately woman in a navy blue dress and immaculate white cardigan. Her movements and posture were majestic. Her eyes, which were set in a warm, expressive face, sparkled behind her gold-rimmed spectacles. Her voice was confident and musical, with a gentle Jamaican lilt. It conveyed the impression of a woman who was equally at home munching a pattie at a share cropping festival, or nibbling a cucumber sandwich at a garden party.

‘I love this time of year. Jamaica doesn’t have spring like we have here, but we read all about the seasons at school. Are you familiar with Wordsworth’s To the Daisy?’

‘Er,no, I’m afraid not.’

‘Then Daffodils. You must know it.’

‘I’m not sure I do.’

‘The poem!’ She said, her eyes wide with mock surprise.

‘Ah, yes, of course. You were taught English poetry at school?’

‘Wordsworth, Keats, Shelley. I was very fortunate for a black girl. My parents weren’t well off, but I won a scholarship to a church school. It didn’t matter that the church was Anglican and we were Baptists. My parents valued education for their children. Our teachers were from England and everything we were taught revolved around the mother country. We were taught English history and geography, and all about the Kings and Queens.’

‘I’m amazed’ I replied. ‘I really had no idea.’

‘Why should you? People over here are generally ignorant of what goes on in the colonies. Of course it’s all changed now, but I was educated at the end of the old colonial days. We were told that we were all members of one family under the King, and that England was the best place to live because the King and Queen lived there. All this made we Jamaicans on our little emerald island in the blue sea special.’ She smiled and chuckled to herself for a moment before continuing. ‘Why, our school closed on Empire Day so we could salute the union flag and sing God Save the King. And then we had speeches and stories about great events from English history.

‘My goodness’ I exclaimed. ‘You must know more about English history than I do.’

‘I probably do, Dr. Thomas’ she replied, beaming at me. ‘I probably do.’

‘No, please call me Phil.’

‘Alright then, Phil it is.’

‘So when did you come to England, Mrs. Black?’

‘1954. It’s funny, you know. My head was filled with this sweet image of a green land full of happy little villages, each with pretty cottages splashed with colourful flowers, an old church, a pub and village green where they played cricket at weekends. A land of happiness where strangers smiled at each other and said hello, a place where the sun was always bright in the sky, shining down on fair people with beautiful children. Then I arrived at Tilbury docks in November and travelled up to Manchester by train. I could not believe my eyes. The place was filthy. The air was foul with smoke from ugly chimneys, and factories that were decaying into bricks and rubble. The real England was falling apart at the seams. Where was the grass, the villages and the trees? Worst of all were the people, shuffling through the smoke like duppy.’

‘Duppy?’ I interrupted.

‘Ghosts, Phil. Their faces were so thin and pinched, their clothes little more than patched up rags. They looked so downtrodden, as though they couldn’t bring themselves to lift their heads high and pull their shoulders back. That’s what we were taught back home; we were special because we had had an English education. We were told always to take pride in our appearance, in how we spoke and presented ourselves, because that was the English way. And then I saw them, the English, sad miserable people with their heads bowed, and I wondered.’

Her gaze shifted from me to the window, through which she stared for a moment abstractedly, as though trying to grasp something lost or forgotten. Then she sighed and smiled wistfully, and I nodded and sipped my tea as we fell into a companionable silence.

‘Anyway, you didn’t come to hear me reminisce.’

‘Well no, but it is fascinating.’

‘You came to discuss a mutual acquaintance.’

‘That’s right, Chris. It would be really helpful if you could let me know how you see him, and how we might find a way to help him.’ I set out the problems as I saw them.

She sat motionless at her desk listening closely, her expression serious, eyes closed, deep in thought. Occasionally she nodded, or sighed, or shook her head.

‘We know Chris well here.’ She said, after I finished speaking. ‘We know his mother; we go to the same church. There are hundreds of young black people like Chris in our community. They are the reason we set this place. We could see that something terrible was happening to our children. They started to drop out of school; some were expelled. Then they couldn’t find work and were left on the dole. Many got in trouble with the police, and then they started disappearing off the streets. Gradually we pieced together what had happened to them. Many had found their way into prison, others were living rough, and more had found their way into the big mental hospital. But what was worst of all was that when parents found their children and tried to talk with them about what had happened, they wouldn’t discuss it. A huge gulf had opened up between our children and people of my generation.’

‘That’s terrible’ I replied.

‘It is’ she continued. ‘First it was whispered about in church, but we could barely speak to each other about it; then the whispers grew until we came together, different churches, different islands, because something had to be done. That’s how Martin Luther King House started.’

‘What you were saying about Chris and the youngsters like him certainly fits with how he comes over to me. Sometimes I get the feeling his silence hides something. I’m not sure what it is, anger, hurt, or despair, but maybe it serves a purpose.’

‘I would agree with that. Our children are different from people of my generation by virtue of being born here. Things happened to them that have made them angry, angry with their parents and the world into which they were brought up. Look, all of us have experienced racism here. I’ve been sworn at, spat at, called names, refused service in shops all because I’m black. But I’ve had to bite my tongue, because although I was brought up to feel English through and through, I’ve always been aware that this isn’t my land. In some ways I’m a stranger here. That puts me in an odd position. But for Chris it’s much worse. He was born here, and England is the only place he’s ever known. It’s his home as much as anyone else born here, but most white people don’t see it that way, and he has had to face the same abuse that my generation faced. No matter how much we talk with our children about Jamaica, and how it fills us with a sense of security, they just don’t get it. The children of our time are lost, cut off from their roots and unwelcome in the place of their birth. It is a tragedy, a real tragedy.’

Overcome with a growing sense of futility, I sighed. Duwayne’s warning flashed through my mind, and I sensed what he was getting at. I felt sad and powerless because the situation was so painfully complex. We fell silent again.

‘Look’ I said. ‘The problems you describe are just overwhelming. I’ve no idea how to improve the situation for people like Chris, but perhaps one way forward is for us to find ways of working together. I don’t know what you think about this, but what if we were to meet here regularly to discuss people we’re both involved with, then maybe something good would come of it.’

She paused for a moment and turned her gaze on me. She probed my eyes, her expression grave, as though trying to see right into me. Then her face lightened.

‘That would be helpful’ she replied. ‘There are times when we might be concerned about a resident, only we don’t know where to turn to for advice. If you don’t mind I’d also like to raise our discussion with colleagues and friends in the community. I think they’d be interested to meet up with you because they too want to make things better for our children.’

We arranged to meet up again two weeks later, and parted company.

*

At home that evening the phone rang. It was the duty doctor who told me that they had transfered Chris to the secure ward. He had hit another patient and they had to restrain and tranquillise him. I went to see him first thing next morning. I read the duty doctor’s account of events the previous evening. Chris had asked a nurse if he could go into the grounds for some fresh air. This wasn’t in his care plan so his request was refused. A few minutes later he was seen arguing with another patient who was using the public phone. Shortly afterwards he returned to find the phone still in use, so he tried to grab it off the other man. A scuffle followed, and the two were separated. Chris was escorted back to his room, but the other patient followed him down the corridor, shouting at him. Chris turned suddenly and hit him in the jaw, knocking him to the floor, and breaking a tooth. The nursing staff intervened and Chris was transferred to the secure unit. The situation was deeply frustrating, and getting out of control.

*

In the weeks that followed, Mrs. Black and I met regularly to discuss people we were involved with, and more generally the concerns of the local black community. I updated her on Chris’s progress, which involved venting my frustration at our inability to do anything other than force medication on him. At the end of our third meeting she told me she had discussed our meetings with colleagues from the community. They wanted to know more and she asked if I could meet up with them at the social services office the following week.

Duwayne met me at reception and took me to a meeting room at the back of the building. Three people, including Mrs. Black, were deep in conversation as we entered.

’So you’re the Doctor Thomas we’ve heard so much about.’ A tall slim figure stood up and shook my hand. ‘Welcome. I’m Leroy, the youth worker who manages the Uhuru Centre.’

I had driven past the centre many times, and often wondered what went on behind its vivid red, black, yellow and green walls. He gestured to me to sit next to him. ‘Mrs. Black you know, and Duwayne of course’ he continued, ‘and this is Mrs. King.’ He indicated a woman with close-cropped hair wearing a kente cloth dress and a batik blouse. The bracelets on her wrists jangled as we shook hands.

‘Good to meet you, Dr, Thomas.’ She said, smiling warmly. ‘I run the family centre around the corner. We’ve heard a lot about you from Mrs. Black.’

Leroy set out why they wanted to meet up. They were part of a group of community activists who worked with and spoke out on behalf of women, young people and families in the black community. They had long been concerned about the relationship between the community and the police, and were now worried about what was happening to black people in the mental health system. They had heard about the meetings that Mrs. Black and I had had, and wanted to hear more. I outlined my concerns and then listened carefully to what they had to say.

‘It starts at home,’ said Mrs. King. ‘Our families are demonised by social services. They take our children into care because they say black mothers can’t cope, and our families are unstable because they lack father figures. They judge us by their standards, and they blame us, because they have no understanding of our history, culture and family structures. And when I speak up over the way they treat our young mothers, they accuse me of being over-involved and not being objective. Objective! Have you ever heard such nonsense. I’m sick and tired of these people saying that we bring these problems on ourselves because of our culture, when it’s brought about by racism, poverty and all the evils that go along with that.’

‘It’s the same in the schools’ added Leroy. ‘Our youngsters have to take all sorts of abuse from white and Asian kids, but worst of all from teachers. If they stand up for themselves in class they are accused of having an attitude problem. People wonder why black kids underachieve at school while racist psychologists come up with crackpot theories about black people being less intelligent than white or Asian people. So black kids end up being pushed into special needs, or they’re excluded because they’re seen as difficult. And forgive me,’ he said chuckling noisily, ‘but I ain’t said nothing about the police, or prison. So you can see,’ said Leroy summing up the discussion, ‘the problems you’re dealing with are just the tip of the iceberg as far as we’re concerned. But don’t let me put you off.’ He leant over and patted me on the shoulder, laughing heartily as he did.

I smiled back at him, a fool’s blank stare. And so the meeting continued. They described discrimination in health, education, policing, housing and employment. As they did so my blank stare became one of concern, then anger. Their words moved me. I felt something had to be done, but what? In the end my anger got the better of my silence.

‘It’s clear that the reason I came here is just one part of many injustices you face. What you’ve said makes me angry that you can be treated this way, and while there’s little I can do to change that, I really want to do everything I can to help in the area I can do something about. I’ve seen and heard too much to go back.’

Leroy and Mrs. King exchanged glances. Mrs. Black smiled then turned to Duwayne. ‘What about you, Duwayne. You’ve said little enough; what do you think?’

He looked up at Mrs. Black, his eyes shadowed with doubt. He sighed and shook his head. ‘I don’t know, Mrs. Black. I just don’t know.’

‘But your views are really important here’ she continued. ‘After all, you see both sides of the fence.’

‘Perhaps. I just have to ask myself where’s all this leading? Where’s it going to take the community? Since the riots we’ve had too many white experts coming into Moss Side, politicians, reporters, academics, police and the rest. They’re all quick enough to come down when there’s trouble, make their soundbites on telly and radio, and clear off afterwards. Then they get their knighthoods, their papers and articles published, their documentaries broadcast, but it means sweet Fanny Adams for the people here.’ The others around the table nodded in agreement. ‘Don’t get me wrong, Phil, it’s nothing personal, but for us it’s a matter of trust. Where, I ask myself, will it all end up? How will it benefit the community?’

‘I understand’ I replied.

‘You have a point, Duwayne’ said Mrs. King, ‘but lighten up man! I know it’s early days but this feels different, if only because Phil’s here for himself. He’s not representing the mental health services or the university.’

‘I’m with Mrs. King on this’ said Leroy. ‘I think he’s here because he’s concerned as a human being who just happens to be a psychiatrist. For that reason I don’t think he’s playing the power games white people usually play when they come here.’ He turned to address me directly. ‘The problem is the fire in the kitchen’s going to get a hell of a lot hotter, and we need to know if you’re up to it, Dr. Phil.’ He winked at Mrs. King.

‘How do you mean?’ I asked, puzzled.

‘Well what you’ve heard today is just a drop in the ocean,’ he continued. ’And man, that ocean’s deep and wide and a lot of people have travelled across it over the centuries. You need a history lesson.’ He chuckled away quietly to himself.

‘I know what he’s talking about’ said Mrs. King, sensing my bewilderment. ‘Leroy, stop being so oblique. You want him to watch the film.’

‘I sure do, mama.’

‘Phil, my guess is I speak for all of us when I say that I think we can trust you, but there’s something we need you to accept about the way we feel today about living in this country. And we need you to accept it no matter how uncomfortable it makes you feel as a white person.’

‘OK, I’m up for it’ I replied. ‘But what do you want me to do?’

‘That’s easy enough’ replied Leroy. ‘We just want you to sit down and watch a documentary with us.’

Outside in the car park Leroy approached me and asked if he could visit Chris on the secure unit. It turned out that until he was arrested Chris had attended the centre regularly. I jumped at the offer and the next day told the ward staff to expect Leroy.

*

It’s difficult to put into words the feelings I had a few weeks later when I arrived at social services to see the documentary. Mrs. King and Leroy arrived, followed by Duwayne and finally Mrs. Black. Leroy started the video, and we settled down to watch it. It was part of a documentary series on the history of slavery, which dealt with the role of Britain in the slave trade, and the implications of this for the lives of black people living in Britain today.

We watched in silence, five people four black one white. For the first time in my life I began to grasp the magnitude of the emotional consequences of the history of slavery for the relationship between black and white in Britain from a black perspective. When the film ended we sat in silence for five minutes, maybe more. It wasn’t an uncomfortable silence, just one that held five people together in compassion and respect. It was also tinged with deep sadness as far as I was concerned. I thought about Chris, about what had really happened to him in prison, in police cells, and before that at school. My sadness and anger magnified. I was overwhelmed, too moved to say anything. In the end, still without words, we stood and in turn embraced each other.

*

Later that week Leroy, who had been to see Chris regularly, took him to the Uhuru Centre. This went well, and as a result he began to attend regularly. There were no further incidents on the unit, and, as his condition seemed to be improving, he was transferred back to the admission ward. The ward staff believed his improvement was due to medication. This I doubted, but there was little to be gained by arguing the point. Although he was calmer, he remained suspicious and unwilling to talk to the staff who believed this was because he had residual psychotic experiences. After four months in hospital he successfully appealed against his section and he returned to Martin Luther King House.

In the months that followed Chris saw me regularly in the clinic with Duwayne. He said little but from Duwayne’s account he was making good progress both at the hostel and the Uhuru Centre. I started to reduce his medication. Then, about a year after his discharge, Leroy phoned and asked could I pop over to the Uhuru Centre. I dropped by on my way home that evening and was greeted by Leroy who led the way up to a quiet room on the second floor. Chris was waiting for us. It was some time since we’d last met and at first I didn’t recognise him. He was slimmer, and I could tell from his reaction when I entered that he had regained the fluidity of movement that I detected when we first met on the inpatient unit. He looked at me, not just at me, but looked me up and down.

‘What are you doing here?’ he asked, the emphasis on the ‘you’.

‘He’s here at my invite’, said Leroy. ‘Remember?’

‘Yeah’, Chris nodded and smiled.

‘Well? You said you wanted him to know …’

‘What, now?’

‘As good as any time. I’d be drawing my pension if it was up to you.’

We fell into a strained silence.

‘You’re looking well, Chris’ I said, awkwardly. ‘How are you keeping?’

He smiled, this time anxiously.

‘Well tell him!’ said Leroy.

‘No, you. It was your idea.’

‘My idea? Bullshit. You said.’ They smiled.

‘Would someone please tell me what’s going on?’ I pleaded.

They looked at each other. ‘Let me start then’, said Leroy. ‘There are things both Chris and I think it’s important you know. We’ve spent a lot of time discussing this, and the time’s right.’

‘About what happened to you before you were admitted?’ I asked.

‘Yeah, and in hospital’ replied Chris.

‘Go on.’

‘OK. You remember the time you locked me up?’

‘Yes?’

‘I hit that white guy, right.’

‘Uh huh.’

‘But you’ve no idea why, right?’

‘No.’

‘OK, we’d had a row. He was hogging the phone and I wanted to talk with Mrs. Black. They wouldn’t let me into the grounds, and I thought maybe if she spoke to them, or if she came down, she could take me there. All I wanted was some fresh air, see the sky, feel the rain on my face. I hated being cooped up. Anyhow, this guy just kept hogging the phone so I couldn’t use it. In the end I tried to grab it off him and we scuffled. The nurses broke it up but he followed me as they marched me back to my room, shouting at me. Right? Shouting abuse. “You fucking stinking nigger! You black bastard.” I just saw red and went for him. And you know what happened? He gets away with it. Me? I get jumped on, stuck full of drugs, and carted off to the locked ward. All because I’m the black guy who stands up for himself, who ain’t gonna take no shit from no one. ‘

‘I understand’, I replied.

‘Do you, doc? Do you really? I don’t think so. It’s the same all the way through life if you’re black. At school as a kid, I mean the teachers, man, they’re not racist!’ He smiled broadly. ‘But believe me, if you’ve got colour, people believe you’re more into fighting than reading. And if you’ve got some muscle then they think, OK, we’ll stick a book in front of him and then we’ll pull him up. Like my English teacher, right? I was nine and he said, “Don’t end up like those other black boys”. So I says, “What do you mean, man, I am black.” And he said again, “Just don’t turn out like those other black kids.” What the fuck did he take me for? I saw red and hit him. I kept complaining to the teachers about all the shit they used to hand out, and all they could say what that I had a chip on my shoulder.’

Leroy was stretched back in his chair, listening carefully. ‘Tell him about prison.’

‘When I was eighteen?’

‘Yeah.’

‘Last time I was in I met up with this guy I used to hang around with. Everybody called him Scooby because he was a musician; he sang scat and rap so he was called Scooby Doo. We used to play, listen to music, but I hadn’t seen him for years. Anyway there was this screw, we called him the Screaming Skull cos he was thin and grey like a corpse, with black rings around his eyes. He hated us black kids. He used to call us all sorts. “You fucking niggers,” he’d say, “why don’t you all crawl back to the jungle?” So one day he tells Scooby to fuck off back home! “OK,” says Scoob, “gimme 50p.” “Why”, asks the Skull? “Cos that’s what a single to Moss Side costs,” replies Scooby. We’re all pissing ourselves, but the Skull loses his cool and jumps Scooby, pushes him to the floor, sticks the boot in, and screams at him. This other screw just stands there laughing.’ Chris closed his eyes for a moment. ‘This is serious shit, man. Blood all over the place and the bastard goes on laying into him, while I’m watching; I’m frozen. By now Scoob’s almost unconscious and whimpering like a whipped puppy, so the Skull drags him over to the stairs, presses the alarm, and when the others arrive he tells them Scoob slipped at the top and fell all the way down. They cart him off, and the Skull comes up to me and says, “You, nigger, are next if you don’t behave”. I heard later on that Scoob was in a coma for several days, and that he was paralysed, lost the use of his right side, and worst of all, he can’t speak or sing.’

The Centre was silent when I left. I paused and turned to Leroy. ‘What can I say?’

‘Why do you have to say anything when you know the truth?’

‘Nowhere in his notes was there any mention of what happened to his friend, or the racial abuse he experienced from the other patient.’

‘They didn’t think it was important. They probably didn’t even notice it.’

‘It’s shocking, terrible. Jesus Christ! There are times I hate this job.’

‘Well don’t give up on us yet’ replied Leroy, smiling. ‘The struggle’s just about to begin.’

‘I suppose you’re right’ I said. ‘When are we next meeting up?’

‘Friday, to discuss funding.’ We shook hands, and went our separate ways.

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