My wife and I are yet to be convicted people watchers; the daylight equivalent of Peeping Toms. We observe our fellow human beings in all their florid glory as they struggle to cope with the world and themselves. Before I retired from practice as a psychiatrist I even got paid for this pleasure.
Earlier last month we had to visit Southport. Me to do some paid work, Hazel to consider spending it, before we had earned it, in the lovely shops on Lord Street. As ever, the sea was a very long way out, apparently almost as far as the oil and gas rigs that do their stuff in Morecambe Bay. Seeing them reminded me of Geoff, who behaved in a very bizarre way on one of the North Sea platforms.
I first met Geoff when he was an inpatient on the intensive care ward at our local general hospital. The carpenters who had reassembled him, (sorry, the highly skilled orthopaedic surgeons, of which my brother is one, but not for this case) were very bothered by Geoff's indifference to his major injuries. Particularly as it seemed as if Geoff had slashed both his wrists, both his groins and both sides of his neck, using a sharp kitchen knife, in an amazingly unsuccessful suicide attempt.
My first visit to talk with Geoff was meant to be deliberately brief, low key and informal. He was swathed in multiple bandages that made him a more than passing resemblance to an Egyptian Mummy. He was well aware of this and seemed amused. So, I broke my habit, and declared myself, on the first visit, to be a psychiatrist. Geoff welcomed me to his side-room, apologised for the trouble he had created and then opened his own can of mental worms for me.
"Doc. I know what I have done, but I don't know why I have done it. Can you help me?"
Over the next three weeks I met up with Geoff for at least 15-20 minutes each day, sometimes longer, as we plotted his life history. The damage to his throat limited his conversation but relatively short chats were tolerable. He even allowed me to talk to his parents, when they visited, to corroborate his account and fill in any gaps. What emerged was a frightening tale of an apparently quite balanced and sane man driven to the edge of fatal insanity by agoraphobia.
Geoff was the middle of three children of a "bog standard" average working class family from one of the old mill towns of Lancashire. His parents were pleasant, hard working, kind and with no obvious vices that I could elucidate.
Geoff passed the usual tests of growing up, potty training, viral maladies, going to primary school, with flying colours. He went through a phase of not liking snakes, when in his late single figures, which the Freudian analysts will interpret as indicating much, but I concluded was irrelevant, beyond healthy common sense in a townie.
Despite failing the dreaded Eleven plus exam, Geoff enjoyed his time at what his parents described as an above average secondary modern school. He survived puberty with minimal skin damage, and a growing interest in girls, when he discovered his first love, golf. The school was situated near to a course and some of the less team minded pupils were offered free golf lessons by the professional, in exchange for dredging the course ponds for missing balls. Geoff demonstrated a natural ability for the game and was soon the star player of the school. He kept up his book work and was quite satisfied to gain a clutch of "O" level equivalent CSE examinations in proper subjects, maths, English and so on.
Then came the first hint of something to interest a psychiatrist, Geoff didn't know what to do with himself. He would have liked to continue playing golf every hour that God sent, but would need money to pay for the relevant costs. Retrieving golf balls would never provide enough, and his parents needed him in a job to supplement the family income. Further study at Technical College was of no interest to Geoff, so he had to find employment. But at doing what?
Over the two years from age 16 onwards, Geoff had half a dozen temporary positions mostly menial sweeping, labouring, production line stuff. But, back in the mid 1980's, decent and well paid jobs were hard to come by. So, like many other young people, he joined the military to get a trade and travel the world. Geoff was recruited by the Royal Air Force and made into a storeman.
He soon adjusted to the peculiar demands of service life, really enjoyed his job, and found that he could still frequently play golf. His handicap dropped ever lower as his collection of clubs and trophies went up. He would have stayed doing this, but was let go by the RAF at the end of his 9 year engagement as they no longer needed his skills.
Geoff was still single, despite numerous pleasant sexual liaisons around the world and had not contracted any of the nasty diseases. Going back to his parents meant a major change, and backward step, in the lifestyle he had become used to. As employment prospects in his home town were even worse than before, Geoff looked further afield and was interviewed for a job as storeman on one of the North Sea oil rig support platforms.
The requirements were less demanding than his uniformed career, and the salary considerably better. This would allow Geoff to earn enough each two months afloat to fund his needs for the next eight weeks ashore. So, having been recruited, and trained in the helicopter crash techniques that all oil and gas rig workers learn, Geoff went off for his first spell of work. And disaster happened.
The part of the gigantic metal trifid in which Geoff was to work each twelve hour shift was a windowless, air-conditioned series of rooms. Within ten minutes of being left there alone, after a guided tour from his colleague who covered the other half of the day, Geoff was sweating and panting with his heart banging away and his mind in a whirl. He assumed that he was reacting to the fluorescent strip lights, or perhaps the bone dry atmosphere and concentrated on finding some required items. His symptoms sort of settled down over the next couple of hours, then returned with a vengeance when he sat down for a break and a brew. Geoff started to read the crew manual and the stores handbook, and the horrible feeling again abated.
After six hours he was allowed a 45 minute meal break in the mess room that had windows overlooking the sea. This passed very pleasantly and he returned to his workplace, where he again felt bad within 10 to 15 minutes. Further parts had been ordered, so he was occupied for another 3 hours locating and bagging them up. Then the panic attack, for that is what it was, really took hold of Geoff and his imagination.
He could recall to me seeing the walls and floor moving and hearing unconnected musical noises. Each time he moved his head the visions became more distorted and alarming, assuming the shapes of deformed human heads. Geoff was fairly sure that he blacked out at some point and was found asleep in his chair by somebody calling to collect the items. This person obviously failed to notice anything unusual and went about their mission as normal.
Geoff handed over to his opposite number and retired to bed after a light supper and a shower. He took some time to drop off to sleep, ruminating about what he had been experiencing during the day, and concluded that it must be a kind of DT's. The rig was dry of booze, so most of the workers tended to have a bit of a binge before coming aboard. Geoff had joined in at the transit hotel the night before, and couldn't really remember how many he drank. He could vaguely recall feeling similarly off after an RAF golf bash in Cyprus, when he definitely had far too much.
Unfortunately for Geoff, his unpleasant symptoms in the store room persisted, indeed got worse over the next two days. Being a man of the world, he knew that it was not sobering up, or the lights or the air supply. During the third shift on duty he realised what was happening; simple really, he was going mad.
Geoff had seen one fellow serviceman who suddenly snapped and ran amok. He disappeared, "to the funny farm" as Geoff called it, and there was no way that he, Geoff, was following him. After due consideration for about 10 minutes, Geoff decided to kill himself. Immediately, before he lost control of himself, and his mind, and went berserk.
He handed over the stores at the end of his shift, went to the mess to fetch a knife, stripped off in his cabin, climbed into the shower and slashed himself. Down the right side, then the left and a final deep cut across his throat which ripped into his larynx. Geoff collapsed to the floor, bathed in blood, washed by the jets, unable to cry out and in excruciating pain. He slipped in and out of consciousness until the shower door was suddenly opened by his stores mate.
Looking back, this man had been a bit bothered by the look on Geoff's face when they handed over. He went to the cabin about 15 minutes later, heard the shower running and wandered away. For whatever reason, and he could never explain why, this chap went back again about 30 minutes later, again heard the shower but went in to check on Geoff, and found the butchered mess.
Understandably, pandemonium erupted around Geoff as the first aider' s arrived to do their stuff. They stemmed the bleeding using field dressings and set up a fluid re-hydration by drip into the rectum, something Geoff, fortunately, wasn't aware of. A paramedic was helicoptered to the rig to assist and prepare Geoff for the return flight to the nearest hospital, which was ours.
Whilst I was piecing together all this information, Geoff's employer and the police had been doing their own investigation into the possibility that Geoff was assaulted by someone else on the rig. After a couple of weeks they, the boys in blue; well one boy and one well endowed girl in a nearly see through white blouse that raised more than Geoff's spirits, asked permission to see Geoff and then speak with me.
I have always found that cooperating with the police yields far more useful information for psychiatrists than they ever glean from us. These two came straight to the point.
"Doctor, we can find absolutely no evidence to suggest that anyone else was involved in this matter. Was it really a suicide attempt? We've never seen or heard of anything like it!"
"Most likely, yes." The look of bewildered gratitude on their faces as they were relieved of having to find any other explanation gave my opening. "Perhaps you can tell me what you've managed to clarify?"
Taking turns, the officers briefly presented their evidence, which neatly confirmed my history taken, from Geoff and his family. They could find no suggestion of any stress or strain in Geoff' life, no blackmail, illicit drugs, debts, illegitimate kids. Most importantly, they had interviewed everyone on the rig who had met Geoff and there were no hints of unusual behaviour in the few days he was there, apart from the final act.
I ended the interview by explaining the concept of panic attacks and agoraphobia, but I am sure that the pair left somewhat unconvinced.
Towards the end of my time with Geoff, I spoke to him and his parents about my, our, conclusion that his outburst had been caused by this type of transient, very unpleasant but quite common psychological phenomena. When I say "our", I have to be honest and admit to taking advice from a few psychiatrist colleagues. Geoff's failed suicide was so serious that I wanted to be sure that I wasn't missing anything else.
Geoff, himself, understood and accepted the diagnostic formulation, especially after I made him hyperventilate, rapid deep breaths, for two or three minutes and he induced all the early symptoms like being back in the oil rig store room.
Geoff moved on to another hospital near his parents, where he could continue the long road of physiotherapy to recover as much function as possible in his hands. We never mentioned his golf, after the first few sessions. I think he knew that the damage he had inflicted on himself would make it very, very difficult to resume that sport with anything like his old ability.
WHAT I LEARNED FROM GEOFF
Bizarre and extreme behaviour is not always caused by similarly unusual mental states; common things happen commonly.
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