Dear Barry

I’m glad that Brenda’s brief admission to Isis was beneficial. I think we all recognise the destabilising effect of recent events on Brenda and it is good to know that we have a safety net of admission to Isis in case of similar problems in the future. I’ll talk to Brenda about art therapy again when I see her on Friday, but when we discussed it on the ward she did not seem to be as keen on it as you are. Maybe this is a temporary viewpoint. Also, it is news to me that Erville Millar has endowed me with the power to make referrals direct to Fordwych Rd! Maybe a similar letter to me is in the post, but if not I’ll make enquiries as I wasn’t aware of any change of position, i.e. my referral could only be for generic art therapy and C & l had offered a place at Felix Brown but not Fordwych, due to issues arising from Brenda’s previous time there.

I’ll talk it over with Brenda on Friday, but I would not want another big row with C & l to add to the stress which she has been under recently. I suspect that she would benefit more from a period of quiet convalescence for the next couple of weeks.

Dr P

17 November 2005

Dear Dr P

I attach EM’S letter which seems to me unequivocal. I’m baffled about any uncertainty re Brenda and art therapy. There is no subject on earth about which in terms of her own treatment she is so passionate. She is most certainly not convalescing at home. Her opening words and thoughts today were ‘how can I get through today?’ She aims at the bench but recognises it’s probably beyond her. I see no problem at all with Camden & Islington.

Barry Tebb

21 November 2005

Dear Mr Millar

I was very relieved to receive your letter on Thursday. When Brenda and I saw Dr P on Friday afternoon he said that my request had not been forwarded on to him or perhaps not received by him as your letter intimated would have happened.

Brenda’s admission to Isis ward was undoubtedly beneficial but her depression is very severe and I would be most grateful of you would expedite matters – bearing in mind how ill she is I don’t feel I can really cope alone.

Barry Tebb
 

22 November 2005

Dear Dr P

As it is now a week since Brenda’s discharge and there has been no reply to a fax I sent Mr Millar yesterday I am beginning to wonder if my reading, however reasonable, if his original letter was not the correct one and that your hesitation was justified. Brenda remains very unsettled but her anxiety seems only too well justified as Lacan said ‘Anxiety does not deceive.’

If you were right then you deserve an apology for my rather pre-emptive pressure on Friday but as Brenda’s primary carer I cannot just wait and hope. This is what happened last year and a broken promise (now the subject of a formal Ombudsman investigation) led to an overdose.

I have shown Mr Millar’s letter to several people and all agree that my reading in the context of very differently worded previous correspondence was one they would have made and that if there was never any intention of making a place at Fordwych Road Day Hospital available then why send the letter in the first place?

Barry Tebb

24 November 2005

Dear Mr Millar

I am enclosing recent correspondence with Dr P.

Brett Vallence says only George Platts can resolve the matter but ‘he hasn’t been around for the last few days’ and hasn’t got back to either of us, although messages have been left on his mobile.

I am sure that you are as anxious as I am to have the matter resolved. All I want is Brenda in Fordwych Road asap and then we can all get on with our lives. Brenda is very ill indeed and this state of uncertainty is impacting very badly on her, as I’m sure you would know.

Barry Tebb

25 November 2005

Dear Mr Millar

I have just had a call from Mr Platts. His ‘take’ on your letter borders on the bizarre: he is now suggesting that Fordwych Road staff are so inept that Brenda would not be safe in their hands…

While it is true that Brenda did complain about some of the staff there, the most culpable was a student art therapist who seriously mishandled groups and never finished her training.

B D (who I have known for almost a decade) may have made errors but no one is perfect and in a letter to me (which Dr P has seen) he emphatically states that he would be happy to again become her key worker.

Mr. Platts made it clear to me that, although he does not rule out Fordwych Road, he is as against it as Brenda, Dr L and myself are for it. He spoke of ‘other services the trust might offer’ but I think we are aware of them and that their facilities for art therapy – the only therapy that works for Brenda – in no way match those of Fordwych Road.

I am baffled (and deeply worried) that Mr Platts is now apportionating all blame to staff who know nothing of his comments and cannot defend themselves. I can think of no situation in which ‘patient choice’ is so central – indeed (I must be blunt) Brenda’s very life I believe hangs on the thread of your words.

I cannot single-handed keep her alive. I cannot face the devastation of her death that a wrong decision, engineered by Mr. Platts’ incomprehensible manipulations and motivations, might only too easily bring about. Should your kindness and offer of safe harbour be somehow pushed aside by Mr Platts I have an absolute visual terror that she will die. Should this occur it is he alone I shall blame.

In spite of our many differences over the years your letter – as far as I am concerned – more than makes up for any anger between us.

I beg you before you leave to make sure that the meeting next week grants Brenda a safe passage.

Barry Tebb

25 November 2005

Dear Mr Millar

I have been in my flat another four days here since my discharge. I face another four days here until Mr Platts becomes available again. I had to leave the ward early as I was unable to sleep because of the noise around me. While I was there my chief priority was the welfare of my seven cats. I had to remain very calm in order to be allowed to accompany Barry to feed them. I would not have been allowed to do this had I betrayed any anxiety at all.

After seven days Barry was too exhausted to go on and I was allowed to take over. I thought I could safely return to the protest in St Pancras Gardens last Monday and put everything behind me. Each day since then has got worse. I cannot settle to anything I am left in a place I cannot be in and I haven’t the mental or physical energy to get to the only place of refuge that I know.

I described to Dr L on Wednesday that it was like being on Death Row. Your letter came as a reprieve but I couldn’t let in as a reality because I know Dr S and Mr Platts and I am afraid, Dr P only too well. I knew it would end like this but I know for your part you have done your best as has Maria Sophia (who Dr P was too busy to speak to) Brett Vallance who has helped Barry to keep going and Dr L.

On Monday I have no choice, prepared or not, I must return to St Pancras Gardens but I want you to know that you gave us both hopes where there had never been any hope before.

Brenda Williams

25 November 2005

Dear Dr P

George Platts assertion re Felix Brown comes as a shock to me as does his lack of availability. Neither I nor Brett Vallance can contact him by mobile and Brett Vallance says ‘he has been around for a few days’ calls from George Platts to Brett Vallance and you seem opposed diamemetrially in content. I’ve faxed these details to Erville Millar. Perhaps there is some illicit alliance to preempt Erville Millar’s departure. I still cannot see why you can’t simply admit Brenda to Fordwych Road - sign and be damned to coin a phrase. I absolutely believe you have this mandate directly from the CE Continuation of this uncertainty can only make Brenda more ill.

Barry Tebb

29 November 2005

Dear Mr Tebb

Thank you for sending your faxes of 23rd, 24th, 25th and 29th November 2005 to me and Mr Brett Vallance, Complaints Manager and Ms Ros Lettman. Mr Vallance has informed me that he has forwarded your fax to Mr George Platts, Assistant Director, North Camden and to Dr P.

I would like to clarify the contents of my letter to you of 14th November 2005.1 did not mean that the Care Trust has changed its earlier decision about this issue and is now making Fordwych Road available to Ms Williams. There continues to be concerns about the appropriateness of this service to meet her needs. I stated that your fax has been forwarded to Dr P who would consider your request in conjunction with local managers. I am sorry for any misunderstanding.

I would like to advise you to contact Mr Platts for any management issues or issues about referrals and to contact Dr P for any clinical issues. Mr Platts can be contacted on 020 7941 1656.

Yours sincerely

Erville Millar

Chief Executive

Change at the Top

Erville Millar, the Chief Executive of Camden and Islington Mental Health and Social Care Trust is leaving. Service users and carers are being invited to St Pancras Hospital on Tuesday, 6th December 2005, to take part in the appointment of his successor. The process lasts all day and includes lunch a reception at 5.30pm and afternoon presentations from potential candidates.  Numbers are limited and are restricted to service users and carers who already have a relationship with and knowledge of the Care Trust anyone interested in taking part is encouraged to write in by the 1st December 2005 stating reasons for wanting to participate and or relevant skills that you may have.                                       

For more details contact Ros Lettman, at St Pancras Hospital, London NW1

Camden Bugle

Barry Tebb, a Camden carer who fits all the criteria above barred from the meeting by the present Chief Executive Officer, on the grounds that his presence would be ‘inappropriate’. He is the author of over 20 books including 3 on mental health and together with Brenda Williams has campaigned many years for better care in Camden.

THE OVERDOSE

05 01 06

    “During the afternoon and the evening of the overdose I was trapped between an overwhelming need to get to A & E and the terror of going there only to be turned away. I was unable to speak about how I felt, however many times I went over the details in my mind, the words would not come. If I was turned away I felt it would be fatal because it would give me the excuse and the trigger that I needed. I spent the evening   unable to talk to Barry or to anyone and my thoughts began to be no longer if but where, this was very important to me because of the absolute need to keep everything calm around me. There must be no drama. There was a foolish notion that it all had to be done quietly and with dignity because that is how I am. The cats were a major concern, not what would happen to them afterwards but that their last sight of me would be with an ambulance crew tramping into the flat and this had to be avoided at all costs. I had to leave the flat behind me in order to go through with what I had to do. I made sure that they had enough food to last for the next day and opened up six packets of paracetamol and put them in a bag.

    I bought some water at Swiss Cottage and went to Keats’ House, where I had often taken my children when they were young. It was also the place where I had begun a 600 sonnet sequence, written over the course of almost twenty years. I had lost both my children. I felt I had nothing left to say and that I would never write again. It was the evening of the anniversary of a large overdose the year before when I had taken 85 diclofenac, believing they would work. I was angry that nothing had moved with the managers and never would. I did try to go to A & E and got as far as the waiting room but left and walked up to Keats’ House instead about six minutes away. I took twelve tablets outside Keats’ House and then walked down to the phone box at South End Green and there I took another twelve, my chief concern was only that no one should see what I was doing.

    There was no intervention possible at this stage, I was taken over by an absolute compulsion to punish myself for what I had failed to do and to destroy everything that I stood for. Anything that had been of value to me before was now completely forgotten. The only thing I could remember was walking with my mother as we’d always done but she was no longer there and I was alone. I walked back up to Keats’ House to look at it for the last time and tried again to go into the Royal Free. I was aware that I’d been admitted from A & E exactly two months before and I thought there was no way they would believe me a second time.

    I walked up to the benches where I had sat in protest for so many years and even they were gone. I continued up to the main road where I knew there were two phone boxes outside the garage and I took the last eleven tablets there because I felt that it was too late. I had drunk 750 ml of water and I had to find more in order to take the forty, the goal I had set myself. I walked back down Pond Street hoping that something would just takeover and get me to A & E. because at this stage I could not make the attempt.

    I remember being gripped by an absolute need to see St. Pancras Gardens, which I could get to by the 46 bus from Pond Street, I thought that if I could see through the gates to where the protest bench was, that it would make me see that I needed to go to A & E, I also knew there was a hospital there. The only 46 I could see was going up Pond Street, away from that direction and I had to get more water. The feeling that everything was now irreversible gave me an insight into what my mother’s last years had been like. The terror I went through was the worst experience of my whole life. I knew I had only a limited capacity to withstand this and yet I was aware at the same time that my mother had lived with the same terror for five years. The journey to the first stop seemed endless and the bus had almost reached the post office when I realized that I was no longer afraid of going into A & E. If I could face the end of my life I could face anything and that maybe there was a chance that they could save me. I was in full possession of my faculties throughout the whole process, my actions were both deliberate and thought through but if anyone had offered me a way out I would have taken it. I did not want to die but there seemed to be nothing left to live for and nothing left to fall back on.

    All I was aware of was numbers, because the words had gone, that it was 9.40 pm when I started to take the tablets, that I’d only managed to take x, that even this number was becoming a blur. I could no longer remember the sequence of when I took what and the rest of them had to be counted and where would I get the chance? It was 10.10 pm when I walked into A & E and the tablets were starting to affect me. I would no longer need to explain, the strain of speaking was taken from me. While they prepared the charcoal drink I had the remaining tablets with me, there was an urgent need to make sure I’d not made any mistakes and not taken more than I’d said, or less, I counted x tablets twice over and was aware that there were taps in the room but there was no desire to take any more.

    Somehow the compulsion had exhausted itself, it had taken half an hour. I remember thinking there were only numbers left now not words. The kindness of the staff in A & E became an absolute barrier to the world outside that had driven me to this place. When it was pointed out to me by the duty psychiatrist in A & E how dangerous the dose was I went into some kind of shock, it was as though I was shivering in an icy wind without any clothes and this went on for half an hour, an aftermath to what I had done. When he said “Did you intend to kill yourself?” I answered as emphatically “No”. I realized at that point that the words had come back and I could speak again. It was a cry for help in every sense and one that was finally heard.

KEATS HOUSE

after a failed suicide attempt

for Jeremy Reed

When I was last at Wentworth Place, the end

Of my life had then already begun,

Ill met there yet lingering it happened

To be, with all that I was, left undone,

Trapped between two poets, lasting silence

Summoned me to a place I was not meant

To see, unlit and planetary, where once

My mother took her leave of me, intent

That I should follow as I’d always done

To the end as once and with her again

When there was nothing left to call my own

But Keats alone and unknown and now in vain.

Jeremy I wanted to say goodbye

Imaginary there as I passed by.

                                                            8th – 9th January 2006

Brenda Williams