Monday, September 3, 2012

Families: Hamlet & Forgiveness!

Some family!

The Cockroach Catcher
Chapter 26  Forgiveness

….My fault is past. But, O, what form of prayer
Can serve my turn? 'Forgive me my foul murder'?...

Now might I do it pat, now he is praying;
And now I'll do't. And so he goes to heaven;

Hamlet Act 3, Scene 3.
William Shakespeare

ometimes we are reminded of our patients in the most unusual way.  One summer we had the opportunity to go on a Baltic Cruise which started and finished in Copenhagen. It is unavoidable on such tours to come across tragic stories in history.  The different Baltic countries had their fair share of wars, sieges, slaughters and some of the most macabre murders in the history of mankind.

© Am Ang Zhang 2006

         Our last stop was outside Elsinore and those of us who were interested were tendered to visit Kronborg Castle, the setting for Shakespeare’s Hamlet.

            Hamlet reminded me of Anita.    

She refused to attend school because of Hamlet.  In my work I have come across many unusual patients but it has never occurred to me that someone would refuse school because of Hamlet.
         I can still remember being called to see her on a Domiciliary Visit as she had refused to come to the clinic.  The parents were not very forthcoming and felt that at seventeen, she should be able to talk to me herself.
         She reluctantly agreed. We then had a most interesting discussion about Hamlet. She was upset because her English teacher did not like what she wrote about Hamlet. The essay was about Hamlet and forgiveness. She felt that Hamlet indeed should have been more “forgiving” and killed his uncle when he was praying.
         “So what if the uncle goes to Heaven?  Big deal!”
         “Instead,” she added, “he got himself killed as well.”
         Our sweet prince was no hero to her and that upset her teacher. He really wanted the class to write about Hamlet and Laertes exchanging forgiveness.

           Exchange forgiveness with me, noble Hamlet:
           Mine and my father's death come not upon thee,
           Nor thine on me.
        Hamlet, Act 5, Scene 2
         She then refused to return to school. At least that was what appeared to be the problem.
         I eventually got her back to school and persuaded her to see me at the clinic regularly for the next eight months or so. She wrote a good deal and told me that she kept a diary that was kept under lock and key. She said whatever happened she would never let anyone see it, not even her psychiatrist, as she would probably have to kill that person afterwards. I did not ask to see it and told her that I had no intention of asking to see it in future.
         Teenagers have their secrets and I certainly want to respect that, I thought. She did show me some other writings and she had some very interesting and unusual things to say.
         Looking back, I often wondered about the challenges we faced, having to base our diagnosis and treatment on some of the most subjective things related to us by our often very disturbed patients.  We could hardly expect to get any “truth” from them, and yet various psychiatric professional bodies seem to accept psychiatric diagnosis made in this way as infallible.  She probably did give me a clue but unfortunately I missed it.
         One day she was very distressed, saying she thought she might have caught something from a Spanish Waiter that she slept with. I was a bit puzzled as she did not appear to be the promiscuous type and certainly not the type who would sleep with someone she hardly knew.
         We had some discussion and I advised her to go to the Special STD Clinic to have it seen to.
         She never turned up again despite several reminders.
         Then she came to the notice of the adult psychiatric department following a serious overdose. This was on the day of her father’s death. She saw a lady psychiatrist and disclosed to her that her father had been abusing her since she was eleven. She never kept any follow-up appointments though and there had not been any further episodes of self harm.
         Nearly a quarter of a century later we had four boys referred because of serious sleep disturbance.  One of my colleagues at the clinic made an initial home visit and afterwards asked to see me in a distressed state.
         She said it was one of the worst cases she had ever come across and asked me to see the mother, who happened to be my patient twenty some years prior.
         It was Anita.
         She, who should be in her early 40s then, appeared worn and exhausted, and looked much older than her age.
         When her father died it was all too much for her. She said she was very confused by what happened to her. She admitted that there never was a Spanish Waiter but she was hoping that I would inquire further.  She was desperate to understand what was going on then.
         “The overdose woke me up,” she recalled, “I felt I had to forgive what my father did to me.”
         She decided to go into journalism. One of her assignments was to do an article on a notorious murderer.  For that, she had to interview that murderer in prison.
         “That was the start of all my troubles.”
         Fascinated by her first case experience, she became a voluntary prison visitor for those prisoners who did not have any visitor of their own.
         “We live in a very forgiving society.”
         Then she met this man that was to become her husband. He was serving time for murder.
         “He killed his father who abused him for as long as he knew,” Anita recalled, “I could identify with him and I felt so sorry for him.”
         Was it the process of reparation?  I too struggled to understand her.
         She found herself falling in love with him.
         Prisons allowed conjugal visits and before long she had two boys by him. Because of her and the children the parole board soon granted him day release passes.
         A murderer granted day release!  Not long after he was out on license.
         We indeed do have a rather forgiving penal system.
         “But he never even knew his father, let alone killed him!”
         By age nineteen he was doing time in a borstal and soon after his release he killed the landlord who took pity on him and gave him board and lodging. The landlord was unfortunate enough to catch him trying to steal from him.
         “I did not know until the trial.”
         It is amazing how protective we are of convicted criminals. I could never understand why the probation service did not warn her.
         No wonder the public has little faith in our rather liberal judicial and parole system.  People sitting on parole boards seem to continue to fail to see into the darker side of the human psyche. Often those trained to understand the human mind also appear not to understand, or are they so driven by performance targets and results that they just want another successful treatment to add to their credit?
         This man had “anger management” therapy when he was doing time. The truth is a psychopathic personality is capable of adapting to suit his ulterior motive. We do have too many psychiatric casualties from such unfortunate releases from maximum security mental hospitals and I am not even referring to psychotic patients.
         He could not hold his job as a security guard and started to do break-ins. He was open to his wife and she said she did not understand why she never informed his probation officer.
         “Perhaps I was afraid of him but he convinced me that these people would get their money back from insurance and he was never going to hurt anyone as he loved her and the children and did not want to be locked up again.”
         One cannot help wondering how much the wives of “famous” serial killers actually knew and to what extent they were convinced by the arguments put forward by their spouses.
         She had two more boys.
         One day he decided that they could make more money if he set her up as a prostitute. He would stop the house break-ins as it was getting more dangerous with the alarms set up by people.
         Surprisingly she went along.
         “I had to do something to stop his burglary activities.  I did not want to lose him.”
         “I was sick over the first client.  As it reminded me so much of what my father did, I told him I could not do it.”
         The next day he said he was resuming his break-in business.
         “The rest is in the papers.”
         He came home when the children were having tea. He was covered in blood.
         “The idiots tried to stop me!” he told her.
         The children were screaming.  Suddenly she felt a strong repulsion and called the police.
         Even the most forgiving philanthropist had her limits.
         “I was thinking more of my children. I was not going to be like my mother. I was sure she knew all along.”
         I had to agree.
         How could this ever have been allowed to happen? What did her forgiveness do to her? Could I have done anything?
         He was tried for murder and sentenced to life imprisonment without parole. What he did was much worse than what he told her on the day he came home covered in blood, but that was by and by. Hopefully no one will think it unkind to lock him away forever. You never know.
         Anita had to pick up the pieces of her life again, having had her long held belief in good human nature and forgiveness totally demolished.
         It was probably destroyed a long time ago by someone she should have been able to trust.

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