27 JUNE 1987, Page 50

Home life

Living in a madhouse

Alice Thomas Ellis

When I've got a minute I'm going to write a book called Osmosis and Institution or maybe Institution and Osmosis. Not merely because I greatly fancy this as a title, but because I am beginning to wonder about the precise nature of the membra- nous walls which separate those of us who are inside from those of us who are outside. Take universities, for instance. I know some idiots who reside in universities and some very smart people who help me out round the house. The criminal popula- tion is unfairly distributed, with many villains holding respectable positions and a number of innocents incarcerated. I know doctors who I would not have thought could have got a CSE in breathing, while I met a madman living in the streets of Alexandria who spoke four languages fluently and expressed himself in all of them with grace and what, in the sane, would have been described as intelligence; and what has given rise to this reflection is my recent visit to a lunatic asylum.

I don't suppose they're called this any more. I expect they're called Temporary Shelters for the Rather Upset or some- thing, but that's what they're supposed to be: asylums for the mad. Patrice, who has a friend in one of them, injudiciously used this term to one of the charge nurses and was reproved. 'We do not call people mad in here,' he said. 'Well, what do you call them?' asked Patrice. 'We say they have a little breakdown,' he said. Sometimes this description is far from adequate. There are people in there (and out here) who need to be kept under lock and key; some because they are a danger to themselves, and some because they are a danger to others. They are 'sectioned' for a while. (This is what we now say, rather than 'certified', and I don. I see why it should be considered euphemis- tic. It will soon, if it does not already, aril exactly the same connotations.) But there seem to be very few curbs on their move- ments, and it is also very difficult to Pia down a person in authority who will give a measured opinion or prognosis of any particular case. I sympathise to a certain extent. Madness is not only confusing to everyone involved, but infectious. None the less, professionals who choose to earn their money in this field do seem to be uniquely elusive when questions are, being asked. Patrice has been castigate' for not telephoning for information (uncar- ing) and for telephoning (hassling). She Is beginning to feel a little crazy herself. The top doctor wears a red carnation in his, buttonhole and she finds this odd. It could be construed as eccentric to consider 3 carnation-wearer potty. On the other hand, when you come to think of it, a person with a carnation who is not going to a wedding could well be seen as rather strange; especially in the NHS. It somehow does not relate to the real world. I went with Patrice to see her friend and' going up the stairs, was clapped on the back by a person in dark glasses who said, `Darling, wonderful to see you again- I had never seen him before in my life, but then thi., happens at parties all the time. 1i drunk turned up in our house the other evening and imagined himself to be in an Italian restaurant, and me the propriet?ri We had a really barmy conversation until ' tottered to bed wondering about the para- meters of sanity. Someone got him out 01 our house at five o'clock the next morning- I can't think how he got himself home, bat I would have done anything to get rid of him and I didn't care where he was going. This reminded me of the asylum, where the doors and gates are all unlocked, and wondered whether the authorities felt the same as me. Do they think to themselves on an 'unconscious level', as we analysts put it, that their charges might as well g,°, and take their 'chances in the community • Are they just utterly fed up with the whole thing? The mad, being obsessed, generate great energy and feeling. The ostensibly sane, being, on the face of it, concerned only with getting home the groceries, can find themselves overwhelmed.

Patrice's friend said to her as we left, `You'd better get me out of here, otherwise I'm going to go insane.' As we walked to the bus a bird flew past. Her friend is frightened of birds, thinking them to be aliens. 'They do look a bit dodgy,' said Patrice thoughtfully. 'Maybe . . Yes' well — maybe.