Strait-Jacket and Padded Cell

From WTP Vol. VII #6

Late one night I was stitching up a young schizophrenic man in a locked ward. It was a long but superficial wound: he had got hold of a broken bottle and had slashed his left forearm. It was the commonest injury in the hospital, at least, the commonest to which I was summoned. Self-harm was very common.

A thin sickle of a moon shone in through the window above the pines.

“Don’t try to communicate with him—it’ll lead him on into some interior he can’t explain: just stitch the wound,” said the charge-nurse as we approached. Jim Stolford was a kindly family man with unelaborate naval tattoos on his arms. Many of the older charge-nurses had been military or naval men; Jim had served in the Royal Navy on the North Atlantic convoys. “You don’t want to worry. Just do what you need to do.” He sighed. Jim rarely talked about his wartime experiences except to tell me once that he had been an able seaman on an escort destroyer. He didn’t say much, but I guess every day of each convoy had been filled with trepidation. And he had been a young man at the time. What he did now was perhaps light in comparison.

He unwrapped the suture-set, drew up the syringe of 1% lignocaine, handed it to me, and I began my work under his obedient but judgmental eye. The hierarchical system he had learned in his youth was rigorously maintained in his late middle age. To him I was an officer in embryo.

I had learned suturing in the Infirmary’s accident department and had found myself reasonable at it. I was a clinical medical student. In return for being on-call for suturing I was given free accommodation by Dr Straatverkoper, the medical director. I was handed a chatelaine of keys which was attached to my waist with a steel cord.

“A neat job,” said the nurse, admiringly rather, as I finished dressing the wound. “We’ll get him in a modified jacket when it’s done,” he said. “Or he’ll immediately pick at your stitches as the sedative fades. It’s for the best. A splint won’t be enough: he’s inventive. We’ll see how it turns out. He may be calmer in the morning.”

I never saw how it turned out that night: it was late and I had been up since six and up the night before and I wished to get to bed.

Four days later I saw Jim in the staff canteen.

“A good stitching-up,” he said, smilingly. ‘’Verkoper can certainly find ’em. When you have a moment come and see me in the ‘D’ Block locked ward and I’ll show you.”

I did this.

Surprisingly one of the keys on my chatelaine fitted the ward door.

“Christ, you can get everywhere,” said Jim, not alluding to my chatelaine of keys. He must have known that Straatverkoper gave the suturer the run of the place. “Come and look at your patient.” He led the way into the ward. “Good suturing,” he said.

I looked at the young man. The wound was healing fast. The patient himself was a good deal calmer.

“Don’t speak to him,” said Jim, warningly, as we approached him, “it’ll do no good. You won’t get a response. Let him talk, if he wants to, which he won’t. Save compassion for those who can use it. Honestly. I have compassion. But I don’t give it from the cuff of my sleeve. I’d get messed up in the head myself if I did.”

We took coffee together in his room in the heart of his secure ward. It was vile coffee, with essence of chicory and made with evaporated milk. This coffee had been his favourite on the destroyer. Then he rose and showed me to the door. On the way out, which lay at the end of a narrow corridor, we passed a row of narrow doors with viewing-holes in them.

“What are they?”’ I asked.

“Padded cells,” said Jim.

I turned to him.

“Padded cells? People are put into them wearing strait-jackets?”

“Well, of course. They might tear the padding or bite themselves if they weren’t restrained.”

I made a sudden resolution.

“Have you time?”

“Of course. It’s quiet on the ward at the moment.”

“Put me in a strait-jacket, and then immure me in a padded cell.”

He looked at me without much in the way of expression. “You are a born investigator, aren’t you? No-one has ever asked for that before. But I’ll do it. You’ll have to trust me, though. And if I get caught up in a difficult case you’ll likely be here all night. I have to warn you. Take off your white coat and remove your shoes.”

We stood before a wooden cupboard. He opened it; inside there were piles of canvas jackets. The neat arrangement had an air of service domesticity. He took one out. He held it in front of me as though he were a tailor. I put my hands in the sleeves. It fitted well; the sealed ends of the arms of the garment fitted my fingers like a pair of mittens which trailed bands of webbing. Jim tied the tapes at the back, asked me to fold my arms around my body and drew the webbing behind my back then round my body again and tied them. “We’ll forgo the crotch-strap,” he said.

He unlocked one of the cells and invited me in.

“Sit down.”

I sat down on the floor.

A band of wide webbing was buckled around my lower legs.

“I’ll leave you for a while,” he said. He left the cell and closed and locked the door.

It takes quite a lot of doing to put yourself voluntarily under someone else’s—an unknown’s—complete control. Paradoxically you have to be reasonably mentally stable to do it. The capacity to be a good subject in hypnosis has a similar requirement.

And so I was immobilized in a strait-jacket within a locked padded cell. It’s true. It’s not much of a deal. I don’t expect it would be an easy experience to undergo these days. Increasingly effective chemical immobilizers have been devised—and so the purpose of the padded cell is fixed largely in the past.

To be honest I felt something of a fake; I had entered the cell of my own free will, and it was difficult for me to put myself in the mindset of someone stinking of paraldehyde who was waking up confused, trussed and confined. I was just as helpless as they, but at least I could look around myself and take in the austere aesthetic of the place.

Total, absolute silence, apart from the sounds of the body’s continuing physiology: that I noticed first. The padding, maybe, absorbing all the institutional sounds. No footsteps. No sound from the outside world. Certainly no birdsong. Insulation in a world reduced. Total silence.

Dim, dun dinge, downfalling from a diffuser set high in a mesh-cage let into the ceiling. It was very dim indeed. You couldn’t read by it. A dark, oppressive ceiling with a ventilator grille.

And then the texture of the padding. It was a dark-brown colour, like a tan leather, but it wasn’t leather; I think it might have been treated canvas, but I am not sure. The padding was secured to the wall by buttons at regular intervals, like some kind of upholstering. It was very well done: a craftsman had been at work. I pressed my face to the padding. It was curiously yielding. The buttons were set too deeply for my face to touch: too deeply for my teeth to attempt to pull out. The door was padded also; its outline was difficult to make out as the pattern of the buttoning was contiguous with that of the walls. A troubled man or woman might easily come to the conclusion that there was no door. For the first time I felt perturbed.

The only connection with the outside world was the judas in the door, and, of course, I had no control over that. I never knew when someone was looking in. Standing up I saw the deeply-set lens had a dull mirror-finish. For all I knew I might just as well have been inside a panopticon.

The floor was smooth-surfaced and waterproofed but was soft, pliable and resilient, and it sloped to a small drain in the middle. Everything human had been thought of.

I began to see quite soon that sensory deprivation would set in quickly. It does, even in the sanest person. I am familiar with sensory deprivation. As a caver I have experienced it on a couple of occasions. Once, while caving in Cantabria, Spain, I was one of a party investigating a river-cave (Cueva del Agua) in the Matienzo valley. Some way inside the cave, my light, powered by a belt-held Nicad Oldham battery—a miner’s lamp in fact—failed. I elected to sit alone at the edge of the underground river and await the return of the exploring party. I watched them go; the last vestige of light reflected from the wet rock walls faded, and all was stygian night. Completely lightless. And all the time the pervasive—and psychologically paradoxical—white noise of the fast-flowing, unseen river was reflected and re-reflected from the hard limestone walls. An ambient sound, altering with changes of head-position, and very disorientating.

In conditions like this it doesn’t take long before the imagination—or maybe some interior system less controlled and more primitive—begins to take the place of the exterior world. About half an hour in my own case within that river-cave. Voices form in the white noise of the flowing water. You are hallucinating. Very quickly you understand the precariousness of consciousness, if that word has any sense beneath the commonalty of supposed meaning. Many people would find this very worrying. I didn’t, for some reason. I don’t have much faith in the external integrity of reality. That’s a fluid construct of the (partially) exteriorly informed brain. So, in this mysterious cave, I began to enjoy my hallucinations. I allowed them free rein. To be truthful these hallucinations would have had their free rein despite any desideratum of my choice. They had free rein. The voices were mysterious indeed; they uttered profound and explicit metaphysical and existential truths which filled me with awe. (Yet I couldn’t remember any of them once I was outside the cave. Their arcane sense evaporated, like that of dreams.) My voices were numinous. Had I been of a paranoid disposition maybe these voices would have been slyly and then openly accusatory and hostile, though in this I speculate.

And then I found that various automatically-accepted conventions began to be stripped away. I started to lose track of time. I lost an understanding of my chronological age. How might I put it? My evanescence had become eternal. I’m not being clever. I’m not trying to express a paradox for the sake of it.

I lost my sense of gender. I was not male and not female. My sovereign identity began to flake away. Such was my experience on the banks of that river-cave, my dissolving self warm and comfortable in my neoprene wet-suit which fitted very closely round my body and limbs. What an experience, and not without pleasure! It was, in fact, liberating.

After an hour I awaited the return of the others. I saw a light in the distance; it was a down-stream reflection in the wet rock. The party was returning. Soon I would see the direct light of their lamps. Reality reasserted itself. Identity immediately returned. The internal voices muttered and then faded as though their speakers were overtaken by sleep.

Well, how the mind can deceive and re-deceive itself! The light faded and the perennial night reasserted itself. It had been another hallucination. (I might call it a visual metahallucination in that, while it lasted, it controlled and suppressed the primary auditory hallucinations.) The sleepers awoke once more and began their metaphysical disquisitions. Then, after another quarter of an hour the reflected light reappeared; this time from a totally unexpected quarter: in fact, from a face of solid rock. Another hallucination!

No: this time it really was the returning party. Disorientation, followed by quick reorientation. What an experience. Cueva del Agua, and what I learned there. It’s a fascinating cave, by the way, and relatively simple, though it does involve a long swim through a natural underground canal (best done in backstroke so that you can appreciate the formation of the high roof.) I later considered the story of a man who had been marooned in another cave nearby—Uzueka—for a period of many hours: overnight, I think. When rescued he described visual hallucinations of immense complexity and religious significance—altars—unknown muttered masses in a phonetically correct but undecipherable language taking place against a background of geometrical constructions not dissimilar to Louis Wain’s late cat paintings. This story was detailed to me second-hand, so I cannot vouch for it. One of my lasting impressions is that the sleeping speakers are forever present in the mind, waiting to rise and wake from their slumber and to begin their arcane and world-replacing polylogue once more when conditions are right for them to do so.

These experiences made me wonder whether some types of psychotic illness might not be due to an internally imposed mental isolation—an inner sensory deprivation—of areas of the brain crucial to the understanding of the outer world. The hippocampi, which apportion memory, come to mind. Abnormalities of the left temporal cortex have been associated with auditory hallucinations. But even now we understand so little about the brain.

If there is anything in this idea of internal sensory deprivation, then surely the last thing you need, if you have a hallucinatory psychotic illness—self-harming or not—is to be immured in the dim silence of a padded cell.

I sat there in the totally silent twilight of the padded cell slowly and passively losing my identity. I didn’t mind. Identity isn’t that important to me, and becomes less so as I grow older. I can write—record—stories to occupy myself, while listening to, say, Vaughan-Williams’ sixth symphony with its mysterious tenor saxophone solos.

How long was I kept confined?

I honestly don’t know. Several hours. Long enough to need to take a piss, which was difficult to arrange. First I waited for release until my bladder was near to bursting. Then, when release from the cell was not forthcoming, I managed eventually to work my trousers down—fortunately I didn’t have a belt—and then my underpants, and then position myself on my stomach over the drain. It was neatly done, though I say it myself, and quite satisfying. It was something practical to do. There can be something very practical about working hard and inventively in order to relieve yourself. The sensation is sheer bliss. Piss-bliss.

So I sat there in the unending twilit silence. Time passed without much reference. I have never liked to wear a watch. Whenever I have tried I have always paid too much attention to it. Having a watch wastes time as far as I’m concerned. Anyway, had I a watch, and been attuned to its examination, it would have been half-way behind my back inside the sleeve of the jacket.

Then rescue came.

There was the muffled rattle of a key in the door’s lock.

The light was increased: the cell was suddenly unbearably bright: I might have expected a theophany. The door opened. My rescuer, Jane du Lac, the duty registrar, stood there, unsmiling, one hand in the pocket of her white coat, the other holding the recessed knob of the door. I lay on the floor, embarrassed, my pants and trousers round my calves.

Jane du Lac came into the cell, pulled me into a sitting position and unfastened the tapes behind my back. She ignored my semi-nudity.

“Your own mother wouldn’t love you now,” she murmured in my ear, the tone of her voice nothing if not affectionate.

“How did you discover me?” I asked.

“I had to see patients on the ward, and they told me you were here. They had two new admissions under section and they’d temporally forgotten you.” She paused. “Trust you,” she said, endearingly, rather. She snorted slightly. Somewhat unexpectedly she leaned forward and ruffled my hair with her right hand. For a moment she left her hand resting on my head. Contact with another person—especially a woman—was wonderful. This incalculable person always mysteriously knew the right thing to do. I looked up at her face, which was in shadow, the bright light being above her head. I often seemed to see her in silhouette. She slowly lifted her hand from my head.

“Stand up,”she said.

I stood up, took off the strait-jacket and hitched up my clothes.

Jane du Lac looked at me with a mixture of, oh, I don’t know what emotions: mostly positive. Well, all positive.

“Jeez, ’Verkoper may be dumb, but he can choose ’em, can’t he?” Jane broke into a rare smile. “You know, I could keep you as a pet. I really could. Perhaps I should. You’d never bore me. That’s rare.” She consulted her watch. “Cider in the mess in a quarter of an hour,” she said, her voice authoritative. “Be there.” Then she walked off down the corridor, her hands in the pockets of her white coat.

David Wheldon is the author of four novels. The Viaduct was published by The Bodley Head in 1983; it won The Triple First Award, from final judges Graham Greene and William Trevor. This novel was shortlisted for the Whitbread Award, and was published in the United States by George Braziller. The Course of Instruction, A Vocation, and At the Quay followed. Most recently he’s been published by Confingo, Nightjar Press, and The Woven Tale Press.