When I started as a senior house officer on the unit she was practically mute: the effort of speaking was immense, she could give none of the usual conversational cues, and it was difficult to maintain such a one sided encounter for long. She sat on the ward throughout the day, eschewing the group activities, her face conveying silent despair. “I just can't do anything,” she would manage. Later she recalled how she had felt the predicament of others trying to draw her out, but when I asked what she felt her attendants should do in that situation, she replied, “You can't, there's nothing anyone can do. When someone's like that you just have to leave them.” None the less, I went every day to see her, asking her how she was and taking blood to check the levels of her various antidepressants.
She disliked taking the tablets, and we kept increasing them. She acquiesced to this with that self contained sense of having to suffer fools gladly that only the Scots can truly master. Of course, she was right, and later we tipped her into mania, embarrassing her greatly at the things she then said. To begin with, as the drugs slowly took effect, she began to fret about her hair, which by then needed washing, and the time she needed to get ready in the morning. But then, majestic in intricate cardigans, she took up her knitting, and as she emerged so did part of her story, or that part of an era when she had been in control.
The notes gave the long history of her manic depressive illness and described her as an “ex-nanny.” Feeling at the time that I was having more than my fair share of nanny troubles, I was interested in her as a relic from a time when nannies seemed to me to have been real nannies. This encouraged her. She spoke of coming down from Scotland to the south coast of England with her employers to look after their four children. She described the large house, trimmed hedges, her uniform, and the mother who dressed elegantly to receive and visit friends for lunch. She recounted her day off each week, the long hours, and the evenings spent starching and pressing the children's clothes. Of course, she had an under-nanny to help her with this, but, she intimated, young girls these days didn't know their luck.
From my experience, I tended to agree, but this domestic scene was later shattered. One day in this household she had been unwell with a fever heralding pneumonia. The mother, pregnant with her fifth child, had visited the nursery, and the children had reported that Nanny was unwell. “No she isn't. She's just pretending,” the mother had replied.
Nanny had bit her lip, finished her day's work, and later confronted the mother with the news that she was leaving. “You should not have talked to me like that in front of the children,” she said.
The children cried all that night, and in the morning the mother was contrite. She had not really meant it. “How am I to cope with this next baby?” she wailed.
“You should have thought of that in the first place,” came Nanny's retort. Off she sailed without references to land another job in no time.
Back on the ward, she smiled a sad resigned smile. The stamina that kept her through the ups and downs of her current illness was part of the same strength of character that earlier meant she had not been able to know her place.
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