Wednesday, 5 October 2011

Ramblings: Cup-a-Soup



In 2006, I succumbed to an episode of severe depression. It wasn’t just the usual run of the mill sadness and inability to enjoy life which had plagued me on and off previously. I’d experienced churning dread and anxiety before and a three month intermittent loss of function back in 2001, but this one was like running headlong into a brick wall. It persisted for six months, most of which were tortuous, compounded by a rare reaction to an anti-depressant which tipped me into a state of perpetual motion and agitation.
It was at this point that they referred me to the Crisis Team, a team of doctors, mental health nurses, nursing auxiliaries and social workers. This was when I met the Amazing Cup-a-soup woman.
I’d hit total rock bottom. Three months of depression and anxiety with three different anti-depressants all tried and failed had left me frazzled and depleted. I wasn’t washing, eating or sleeping and was suffering badly from a rare reaction to a drug which had made my levels of noradrenalin soar to a massive high. I was exhausted and incapable and living in a constant state of sweaty shaky fear. I got referred to be seen by the Crisis Team and they sent a lovely cheery nurse round to see me to do an assessment. She assessed that I was indeed properly quite mental and sent round an equally lovely psychiatrist. He validated the diagnosis of searing painful madness and felt that rather than admit me to a psychiatric ward they’d try and keep me at home with daily visits from nurses or social workers and bucket loads more pills, new anti-depressants and handfuls of sedatives.
I got into a routine of seeing a nurse every day and there was someone available 24 hours a day at the end of a phone should things get too bad. It was pretty grim but within a few weeks the combination of pills and support helped a little and my good days were getting better and the bad days were more bearable. The nurses were generally soothing and encouraging. The doctors made a couple more calls too and adjusted doses. I was showering and getting dressed before it got dark and managing to eat the odd morsel too. I got downgraded from daily visits to alternate daily ones and they started sending me the odd care assistant too instead of the trained nurses reserved for the dangerously mad. I was more able to concentrate, reading a little fiction again and studying things about depression too to try to take control and understand what had happened to me. My sanity was returning slowly. I was forcing myself to take punishing long walks each day and be structured in the hope that the rigorous exercise of a two hour walk would do my mood good. It didn’t. It was December. The walks were grim and grey.
The nurse was due to visit and I answered the doorbell to be greeted by a plump middle aged lady with a home perm who introduced herself as the care assistant come to see how I was. As I walked her through to the lounge she took a good long look round and declared:
“Nice and clean! Can’t be too depressed now, can you ducky?”
I eyed her sensibly clothed figure up and down and felt myself shudder a little. I hate being called “ducky” and I hate fatuous comments even more.
“Now you’re the lad who’s been reading about depression a lot and thinks too much.” She pronounced, popping me into a little mental box she’d created. “We talked all about you in handover this morning.”
“Hang on a minute.” I said “I think you’ve got yourself off on the wrong foot. I don’t appreciate you walking into my house and within one minute of meeting me, telling me I think too much. It’s not helpful unless you have a solution to stop that? Informing me of your little group chats about me isn’t so great for me either. If you’d like to sit down then perhaps we can start again.”
She looked at me sullenly and made a small “tsk” noise which I chose to ignore.
“So, where do you want to start?” I asked after offering her a coffee and thanking her as she admired a bunch of blowsy tulips on the mantel piece.
“Let’s start with nutrition. What are you eating, love? I did a course on nutrition. It’s my thing.”
“Well, on a good day like today, I’m managing a slice of toast and perhaps a sandwich for lunch, maybe a small meal in the evening. On a bad day it’s really hard to eat. I just can’t seem to get food past my throat. I feel sick a lot. I struggle but try to force down the odd cake or yogurt. I’m regaining some weight though.”
“A yogurt! Cake! That won’t do at all.” She bellowed, stirring with excitement that she was getting to impart her superior knowledge of nutrition. “What you need is a cup-a-soup.”
“Yogurt!” She chuckled to herself, shaking her head, as if I’d told her I was eating the legs off of small dogs. “I’ve done a course about this and I think a cup-a-soup would be great. Much better than a yogurt.” My dander was up, again.
“So what would be the calorific content of a cup a soup versus a full fat yogurt? Is it higher in protein and fat than a yogurt? In fact, do you really think it’s got any nutritional value?” I hated to do this to her but whatever course she’d done didn’t really compete with my knowledge of nutrition. They might have been discussing me in the handover but they’d neglected to tell her one fact, I was a charge nurse on a gastroenterology ward. I think I had the edge on the soup versus yogurt debate.
She extolled the virtue of cup-a-soup at length. I decided to play a trick my mother taught me well growing up. I call it playing the snob card. I learnt it from a master at it.
“I hate to be belittling but I think your knowledge of nutrition is sadly lacking. Are there maybe any other refresher courses you could do? Also, I don’t want to be rude, but I actually wouldn’t buy a cup-a-soup. They’re cheap and rather tacky. I much prefer a nice Covent Garden fresh soup. Have you tried them?” I did want to be belittling and rude and indeed I was.
“All I know love, is that eating is the key out of depression; if you don’t want to listen it’s your look out.”
“Wow! If only I’d had your wisdom six months ago, maybe I wouldn’t have got myself in this mess. I could have nipped to Iceland or Asda and eaten my way out of this with bad food. Thanks for your help. I’ll clearly be cured now. Anyway, let’s move on. Anything else you want to ask about?”
She glared at me from under her bad perm. “Are you exercising?”
I decided to let her have a last chance. “Yes. I’m trying really hard. I’m taking myself for long walks every day which is hard to motivate myself to do but I’m trying.”
“Walking? Ha! That’s no good. You need to swim.”
I decided it was time to up the ante with a quick mind game. Pretending to look stricken and shaken, I mentioned the time I almost drowned in Greece in 2001 and why that had left me with a horror of swimming and watched gleefully as she looked a little embarrassed to have mentioned it. I told her that although a lovely idea, the swimming was a no go. This was, of course, a lie. I still swim from time to time but not often as you can’t smoke at the same time.
“Well, take it or leave it, swimming is my advice.” She said undeterred by my hand-at-throat traumatised act.
“Can I ask you something?” I said. She nodded.
“If I said potato would you say “pot-aa-to”, if I said tomato would you say “tom-aa-to”?”
She looked a little cross. “One more question.”
She raised a quizzical eyebrow. “Can you get the fuck out of my house? You’re irritating the tits off me.”
She left quite quickly. As I walked back in to make myself a coffee, something suddenly dawned on me. I was getting back to my old self. The recovery had begun in earnest. My inability to suffer fools was back. Oddly, they didn’t send her again and within weeks I was discharged and back to seeing my usual nurse and psychiatrist.

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