Rick the duck

Gavin lives in a new development near the station.
‘It’s tucked away,’ he’d said to the call taker. ‘Ours is the one with the triangular balconies.’

Except – they’re actually rectangular.

‘Maybe he got his shapes mixed up,’ says Alexi, pressing the buzzer. ‘Maybe it’s more of a geometrical crisis.’

It’s a smart, designery place, with a wide, plate-glass main door and giant chrome handle, the name etched into the glass in bold lettering – the kind of details you might expect to see on a hotel. There are lots of nice touches, in fact. A rack of multicoloured letterboxes, a series of inset lights. And then out front, a garden area that incorporates some old industrial features, with a slatted wooden walkway snaking gently up to road level alongside a wall with climbing hand grips. A kid on his way to school is demonstrating their use, doing some last-minute bouldering on his way to school, his mum creeping up the slope beside him, his superheroes backpack in one hand whilst she checks her phone in the other.

We’ve come out early because Gavin has rung the service to say he was going to kill himself. The person who took the call tried to give him the crisis number for Mental Health, but he rang off, so our only options are to call the ambulance service or go ourselves. We know the ambulance is appallingly stretched, and we’ve got space this morning, so we’ve come along to triage the call in person.

Gavin comes down to meet us at the front door, although he could just as easily have buzzed us in and let us come up. If you didn’t know he’d made such a distressing call you would never have guessed. He’s a trim, easy-looking guy in his early fifties, stubbly white hair, tanned complexion, dressed in a white cotton shirt and trousers, and comfy sports sandals. He could have stepped out of a catalogue for the stylish retiree.
‘Have you been here before?’ he says, pleasantly. ‘Follow me.’
He shows us up to his flat, a smart, bijou studio overlooking the communal gardens. There are art prints and photos around the place, a bookshelf crammed with art books – Van Gogh, Goya and the like – an expensive SLR camera on the coffee table, and then a smaller bookcase with Penguin classics and a few self-help titles, and on the wall a collection of DVDs that reads like a list of the Fifty Films You Must See Before You Kill Yourself.

‘Take a seat,’ says Gavin, smiling pleasantly, and then running his hand backwards and forwards across the silvery stubble on the top of his head.
‘How can we help?’ I say, as Alexi and I sit on the sofa.
‘You can’t,’ says Gavin. ‘No-one can.’
I nod as neutrally but encouragingly as I can. Alexi’s leg begins to jiggle up and down. He has his obs kit on his lap. I know he’s keen to get stuck in medically.
‘So – you rang the office saying you wanted to kill yourself?’
Gavin takes a long breath and closes his eyes.
‘I’m sorry things are so difficult for you at the moment,’ I say. ‘But just to be clear – have you done anything to hurt yourself this morning, Gavin? Or made specific plans to do that?’
‘I’ve been planning to kill myself since I was nine,’ he sighs, carefully pulling out a chair and sitting down. It’s an odd and not entirely comfortable configuration – me and Alexi side-by-side on a low sofa, looking up to Gavin on our right.
‘I have monsters in my head,’ he goes on, rubbing his stubble again, as if that’s all he can do these days to contain them.
‘Do you have a support worker? Or a number to call when things get difficult?’
He shakes his head.
‘No-one can do anything,’ he says. ‘I’m dangerously ill. I have severe heart problems. Lung problems. I almost died when I was rushed into hospital. They didn’t know what was wrong. I collapsed several times. It’s been going on for years. I’m on every medication you can think of.’

We’d looked over his past medical history before setting out. There’d been nothing about heart problems or any other medical issues other than some minor orthopaedic work in the past. He’s not on any medication for anything other than Mental Health.

‘I’m constantly dizzy,’ he goes on. ‘I have pins and needles. I can’t breathe. My legs aren’t working properly. This morning I went outside and collapsed….’
‘I’m sorry to hear that, Gavin. What happened?’
‘My legs buckled.’
‘Did an ambulance turn up?’
‘No,’ he says. ‘I managed to get up again and crawl back inside.’
He looks at me and sighs.
‘I’m fighting for breath,’ he says. ‘I can’t speak. I’m dangerously ill, but no-one can do anything. I know more about my condition than the most senior doctors in the country. I have to tell them what’s wrong with me, and that can’t be right, can it?’
‘It does sound difficult for you.’
‘I’ve tried every approach under the sun. You name it, I’ve done it. Deep meditation, CBT, group therapy. I’ve been exorcised. I’ve done cleansing rituals. I’ve swallowed every antidepressant and antipsychotic that was ever made. I’ve even written a book about my experiences…’
He reaches over to the table behind him and produces a red plastic document pouch bulging with paper.
‘It’s not quite ready to be published but when it is it’ll change the way they do medicine in this country.’
‘What’s it called?’
Don’t Think I Won’t Because I Will’ he says.
‘Amazing.’
He puts it back on the table.
‘The thing is, Gavin – we’re a little limited how we can help you this morning. As you know, we’re a community health team. We either support people coming out of hospital or try to stop them going in to begin with.’
‘I see,’ he says.
‘So – I think this morning we’ve got two options. One is to help you contact the Mental Health crisis line, or the other is to call an ambulance to take you to hospital. I really don’t think hospital is the right thing to do, though. It’s horribly busy there at the moment – definitely not the place to go if you’re feeling anxious or – you know – delicate. So why don’t we ring the crisis line? See what they have to say? They’re the experts. How does that sound?’
He nods, then crossing one leg over the other and hooking his hands around the knee, waits for me to make the call.

The line is answered almost immediately by Rick, a mental health liaison nurse I know well. Rick is the most affable guy you could wish for, addressing the most extreme behaviours with such a soft Irish accent it immediately makes you feel better.
‘Jim!’ he says. ‘How funny! What’re ya doing there today? How can I help…?’
I explain the situation as evenly as I can, then pass the phone over to Gavin. It’s strange to hear Gavin describe his situation: struggling to breathe… collapse…. monsters…. all in the most conversational tones. I can hear Rick responding, gently but firmly getting to the nub of it all. After five minutes, Gavin hands me the phone back.
‘That’s fine, Jim. Leave it with me. I’ve got his notes here. There’s a few bits and pieces we can do. I’m going to ring him back in five minutes and talk some more, but it’s fine if you want to toddle off. Thanks for coming out – and it’s so lovely to talk to you again…!’
‘You, too! See you soon.’
I put the phone back in my pocket.
‘So – is that okay, Gavin? Rick’s going to ring you back in five minutes, and we’re going to head off. But in the meantime, if anything happens, you’ve got some numbers you can call, including 999 in a desperate emergency.’
‘My whole life is a desperate emergency,’ says Gavin, rising and smiling pleasantly. ‘I’ve had fifty years of it.’
‘Good luck with the book,’ says Alexi.

Back outside, we tear off our plastic aprons, our masks and gloves, and breathe in the sharp morning air.
‘I couldn’t work in mental health,’ says Alexi.
‘Me neither,’ I say. ‘I thought about retraining as a counsellor at one time, but I’m not sure I’ve got the patience.’
‘Rick is amazing, though,’ says Alexi. ‘Did you see the way he coped with it? It was like water off a duck’s back. Is that the expression? Water off a duck’s back?’
‘It is!’ I say.
And I think of Rick as one of those lush Mandarin ducks, button eyes and punky hair, splashing about in a big old pond somewhere, bobbing under the water, up again. Under. Up. Shaking off the water. Basically loving it.

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