During his first week as a psychiatrist, Benji Waterhouse visited a patient with paranoid schizophrenia named Billy.
Billy's concerning delusions about sacrificing his mother were juxtaposed with his seemingly normal behavior and a fridge full of milk.
Transcript:
Benji Waterhouse
I remember when I started at medical school, I was sitting in a great old lecture theatre, wearing a stiff white coat. And our plummy dean was saying to us, your main job as future doctors is to keep your patients alive. Into my fresh notebook, I wrote, keep patients alive. And then I underlined it. By the end of the six years, though, I realized that I was less interested in the body and more into the mind. And so I hung up my now-stained lab coat and specialized in psychiatry. I now know that people are quite confused about the difference between a psychiatrist, a psychologist, and a psychic. So just to quickly explain, psychiatrists are medical doctors who usually specialize in more serious mental illnesses, things like schizophrenia, and can prescribe medications. And boy, do we. We also have the power to kind of detain or section people, which is like a strange superpower that allows us to lock a person up in a psychiatric hospital against their will and even force Them to take medication without breaking the terms of the Geneva Convention. A kind of sad but what's considered necessary evil to keep patients and society safe. There are a lot of unfair, I think, misconceptions about psychiatrists that like the male ones all have mad families themselves and like wear cashmere jumpers and have beards and which Just isn't true. This is a machine washable wool polyester mix. The most, it is true though, that one of my motivations for becoming a psychiatrist was hoping to get my hands on the secret codes to fix my own slightly dysfunctional family. So I remember turning up optimistically on my first day as a psychiatrist, enthusiastic to get my hands on these secret codes. Instead, I was given a strangle-proof lanyard, a panic alarm, and self-defense training. Our judo instructor was this, like, martial arts guy. And he told us before we taught us the throws and the slams and stuff. He said, the most, the biggest bit of advice he would tell us if we wanted to last long on the medical register was that we avoid any of our patients committing homicide. I couldn't believe what I was hearing. Like, this was nothing like Frasier. Or how psychiatry was depicted in Woody Allen movies. But he said, don't worry, he reassured us, the chances of a psychiatric patient killing a random member of the public are very low. Thank God for that. Far more likely, he said, they'd kill someone they knew, like their family member or a mental health worker. And so he said, I said, he said, though, but don't worry, like, the most important thing, he said, was if going to see a patient in their home, the most important thing was that if you're Going, it was that you have to go for safety, always go in pairs, if staffing levels allow. So it was my first week, and I was working in this like inpatient ward which also we also under a consultant we also had a clinic and a patient one day didn't come to his clinic appointment Which my my boss told me it could be a red flag that people are deteriorating so he wanted me to go and check he was all right so i was going on this home visit in this first week. I was alone, obviously. And I knocked on the front door, like, trying to not look like I was absolutely shitting myself. And the person I was going to see was called Billy, and he was a young man with something called paranoid schizophrenia, which, contrary to what Hollywood depicts, isn't actually about Split minds and multiple personalities, but more usually delusional ideas and hearing voices. And after knocking on the door, I was pleasantly surprised when Billy opened it and he gave me a warm smile and I told him why I was there and he said, oh, sorry, I completely forgot. He said, do you want to come in? Fancy a cup of tea? Slice a cake? I thought these were early signs that Billy was doing okay. So yeah, I got great for it. I went in and the daytime TV was burbling away in the living room and like we went through to the kitchen. And as he was fixing the teas, Billy told me a bit about himself. He said he lived there with his mum and he said they supported each other and they like watched TV together. And he said, although they weren't churchgoers, apparently they watched Countdown religiously. But she was just out, he said. I took the opportunity to ask my generic psychiatric questions that my boss had taught me to ask. Like, was Billy sleeping okay? Was his mood all right? Was he thinking of killing himself? No, no, no. Everything was fine, he said, except for the voices. My ears pricked up. And that probably, I thought, explained the unopened packets of medication that I'd noticed on the side table. I tentatively asked him what the voices said. They're telling me to get milk, which is so annoying because we've already got milk, he said. I relaxed a lot because even I knew back then that schizophrenic voices are often more sinister than that, and psychiatrists don't tend to get struck off or make front pages for having Patients well-stucked in the lactose department. But for completeness, like I asked, do they like, do they say anything else? And Billy said, well, yeah, they're not going to like me telling you, but yeah, they do also say that I'm the Antichrist and that the only way to wash away my sin is to sacrifice my mum. I was like, ah, yeah, that's more like it. But I just ignore them. He said, I just ignore them. They're stupid. I don't do what the voices say. I let out another huge sigh of relief. It's when patients don't feel able to ignore these so-called command hallucinations that psychiatrists don't sleep so easily. And so this wasn't the case with Billy, you know, reassuringly. And as he was like making me this nice cup of tea and, you know, that I could hear the intro music of cash in the attic just starting up from the living room and the sunshine was pouring in Through the windows, I was thinking, I think I'm going to quite enjoy psychiatry. And Billy asked if I took milk and (Time 0:03:21)
The Cost of Treatment
Waterhouse reflects on the complexities of psychiatric treatment, noting that medication can control symptoms but also have debilitating side effects.
He questions whether he, as a psychiatrist, causes more harm than good.
Transcript:
Benji Waterhouse
In a loving kind of what-are kind of way, she said, yes, angel, I got you your milk. And I managed to avoid sectioning Billy on the condition that he restart taking his medication, which with much persuasion from me and his mum, we managed to make him agree to. And back at my workplace in the hospital, I was telling my boss about how shit-scared I had been, and he told me that actually people with schizophrenia are more likely to be victims of Violence than perpetrators of it. He also told me that alcohol and drugs are far bigger risk factors for homicide than schizophrenia is, so actually, technically, I was safer being in a psychiatric patient's house Than at a psychiatrist's house party. And it's a weird one because I am now the consultant psychiatrist with 10 years experience now. And I've seen thousands of people not dissimilar to Billy. And I've had a few close shaves, but I'm yet to judo slam any patients, which is a strange thing for a doctor to boast about. And the dean of my medical school, I think, would be proud of me too. Like, all of my patients, luckily, are still alive, as are, you know, the people that they've kind of crossed paths with. But I sometimes wonder at what cost. Yes, with medication, Billy's voice is quietenedened and we got the milk situation under control. But they took away other things. On this powerful anti-psychotic medication, side effects meant that he'd sleep for like 16 hours a day. And when he was awake, the lethargy meant that he felt like a zombie. The meds also gave him obesity and later diabetes and heart disease. And during a painfully lucid moment when I was reviewing him later in the year in clinic, he said to me through groggy eyes, I know you're going to write in the notes that I'm doing well, Aren't you? Just because I'm taking my meds, but on them, I'd rather be dead. So, I'm still very much looking for the secret codes for my family and for, at the more extreme end, people like Billy. It seems that often, you know, the solutions to people's lives aren't straightforward. And even psychiatry's modern best cures, you know, best treatments can be as disabling as the conditions that they aim to cure. And it's been weird for me, like, remembering that back then, you know, 10 years ago, the thing that really scared me was the patients. But now, with the benefit of experience and being more informed, by far the biggest thing that I'm fearful of is that as a psychiatrist, I am maybe causing more harm than good. (Time 0:14:37)
Twitter Storm
Jamie McDonald, a blind comedian, appeared on "Have I Got News for You?" and guessed pictures humorously.
His performance sparked a Twitter storm with users criticizing the show for not adapting the format for his blindness.
Transcript:
Jamie McDonald
That high enough? Is that as high as it goes? Thank you very much. Good evening. So, October 2022 I was invited to be a guest on the long-running satirical panel show have I got news for you and if you're not familiar with the format right the show it features two teams, Each with a guest, captained by comedy legends Paul Merton and Ian Hislop. And together we answer questions humorously on that week's news. The show is an institution. It's been running for over 30 years and its panels are a kind of who's who of comedy greats. So to be invited on, it was a massive highlight in my stand-up career. Only slight concern. The show is riddled with loads of video and picture rights. Which is a kind of unique challenge for a blind comedian. But I wasn't worried, right? Because in this game, you know, my concerns are more about, you know, how do I get to stage without killing myself or somebody else? So a few pictures, I wasn't bothered. I was just excited. And the day of the recording arrived, and I was collected from St Pancras Station in this air-conditioned Mercedes Benz, like a superstar. It was driven through London, up to the studio where I was greeted by a runner, and I was whisked down to hair and makeup. Then it was up to this audience-packed studio where amidst this light flashing din, I met the captains, you know, Paul and Ian, who are two comedy heroes of mine. And we were applauded into our seats, and from nowhere I was given a bottle of water and a layer of anti-shine powder. There was some shouting, the cameras started rolling, the theme tune blasted out, and with this kind of bowel-melting surge of adrenaline, we were off. Now, prior to the show, the producers and I, we had had a chat about the video and picture rounds, and we all just thought it would be funny. That whenever a picture or a clip come up for comment, I just have a guess. At what it might be. So a Ford Fiesta popped up. I guessed it was Vladimir Putin. More unseen images popped up. I kept guessing it was Vladimir Putin. It turns out it was a very effective answer. It went down well with the audience. The recording was good fun. The producers were happy. You know, I thought, I've done a good job. The morning after the show aired, my wife and I, we were driving to Bristol and I opened Twitter just to see if there'd been any buzz around the show. And boom, I was hit with this force 10 Twitter storm. If you don't know what a Twitter storm is, it's where a ton of Twitter trolls decide to suddenly get incandescent with rage at a person or an issue that has absolutely nothing to do with Them. They lampoon, they attack, they go nuts, in this case, on my behalf, until something else as equally as nothing to do with them happens and they bugger off to shout at that for a while. (Time 0:23:52)
Owning Disability
McDonald reflects on his journey of accepting his blindness and finding humor in it.
He asserts his ownership over his disability and comedic style, rejecting others' attempts to define his experience.
Transcript:
Jamie McDonald
And the first sight situation I remember finding funny, I was in a supermarket and I reached out for an apple. And just as I was about to grasp the Granny Smith way, I glimpsed another hand going for the same piece of fruit. So I whipped my hand back and I said, sorry. Just to realise that the apples were next to a mirror. I just apologised to my own hand. I chuckled away. No, my brass neck was allowing me to own my disability, and that was incredibly liberating. And, you know, constantly finding my life funny kind of naturally led me into stand-up comedy and now my comedy and my blindness are inextricably linked so to be invited onto a show like Have I got news for you wonderful you know chatting over ideas with producers brilliant but. But now, I had all these faux, outraged trolls deciding I hadn't been in on the joke. I'd been exploited. Not only were these people hijacking my disability, but they were using it to go after a show I'd loved being on. And no joke, right, the Twitter storm, it made the papers. The Sun, the Metro, the Times all attacked the BBC and have I got news for you on my behalf, right? Not one of them asked me for comment. And tweeting my enjoyment of the show hadn't worked, and I was very reluctant to, you know, engage any further in case this was taken as some kind of vindication or recognition. God knows how much the storm would rage if they felt they had agency. I was absolutely powerless in the face of it. So I did what you do in any storm. I battened down the hatches. Hope it blew itself out before it wrecked my career. Producers don't love it when you turn up to their show completely your very own angry Twitter mob. And part of me started thinking, you know, have I got this wrong here? Do I have the right to full ownership of my eyes or do others have a stake in them if I'm using them for entertainment? It wasn't so much an existential crisis, it was more a question of, do I, as a blind person, on a high-profile show, have a duty to entertain or to uphold best accessible practices at all Costs? At the recording, if a voiceover had come on saying, Jamie, you're looking at a picture of a Ford Fiesta. Brilliant. Yeah, that's accessible. But as a comedian, what am I going to do with that? I'd probably say something like, just another car I can't drive. The trolls would go nuts. Insensitive monsters. How do you tell a blind person he's looking at a picture of a car? You can't win. And I think one of the problems is that some people, they see disability as one thing. It's not. You know, blindness is like infinite combinations of psychological and physical impacts on people. You know, you can have a relatively good sight, be miserable, vice versa, everything in between. You know, blind people, we're all different. You know, we're like snowflakes. You know, not two of us the same. And if a lot of us fall, people panic. And I was reflected in all this when I opened Twitter to see how the storm was doing. And it was finally fading, but one tweet did catch my attention. At, finally somebody with some skin in the game, wrote, I watched this as a newly acquired sight loss woman. And I found Jamie the cup of tea with no sympathy I'd been needing. Being Glaswegian, I got both his personality and his patter. And that decided it for me. You know, these trolls, they may have given themselves the right to attack anything and everything they please. But I have been given the privilege to use my eyes to make myself and other people laugh. (Time 0:33:31)
Breakdown and New Beginnings
Salima Saxton recounts her husband Carl's breakdown on Valentine's Day, prompting a life change.
She describes their different upbringings and their early, somewhat unconventional wedding.
Transcript:
Salima Saxton
You. Thank you. So it was Valentine's Day. My husband Carl came into the sitting room and he closed the door. He was wearing a big thick winter coat even though it was quite mild outside and he was shivering. He was trembling. I didn't recognise him. Something terrible has happened, he said. My husband Carl is a coper, he is a man with a plan. If you want someone on your team, pick Carl. He's an oak tree. Then he said, I just can't do this anymore. Whatever I do, it is never enough. He had a business. He has a business. He'd been navigating it through COVID, through Brexit, through all of it. And I'm embarrassed to admit right now that I just kind of got used to him being stressed all the time. I barely saw it anymore. And then he added, do you love me? Can you still love me? Because sometimes I just think it would be better if I wasn't here anymore. I met Carl when I was 22 in the waiting room of an audition room for a Bollywood film. Neither of us got the part. I asked him for the time as a really spurious reason to talk to him, because he was simply the most handsome man I'd ever seen in my life. On our first date, I asked him if he wanted children over the starter. I cried over the main course. I am a crier. And over dessert, I very optimistically asked him for a second date. Miraculously, he agreed. And six weeks later, he asked me to marry him. The following summer, we were married in a London registry office. Me in a red vintage dress, him in an ill-fitting suit. But he still looked really handsome. We cobbled together a reception at a pub down the road a chef friend of ours made a big chocolate cake we bought tons of box wine from a cash and carry so on my side my family there was my dad Very angry because i'd walked myself down the aisle there were my extended family the the budists, the Amnesty International members, the liberals, the very earnest guests. On the other side was Carl's family. They were different. There was a man called Mickey Four Fingers whose name really explains the man. There was a group of ex-cons whose gold jewellery competed for attention with their gold teeth. And then there was his dear dementia-ridden mum, Pat. She'd actually been a getaway driver for her naughty brothers in the 80s. She was an amazing woman, but now she was. She just called everybody darling, very, very charmingly, but mainly because she didn't really know where she was or who any of us were. So it was a joyous, it was a sad, it was an awkward, it was a stressful occasion, and it made both of us yearn for elders that could be there to hold our hands in such big life events. (Time 0:42:01)
Redefining Success
Saxton reflects on their pursuit of a "perfect" life, driven by a desire for safety and success, but lacking joy.
She realized that external markers of success didn't equate to happiness, leading to a shift in priorities.
Transcript:
Salima Saxton
We both wanted to rocket away from our upbringings. Carl partly for physical safety, both of us for emotional safety and together we did that. I also had ideas of success from 90s rom-coms and TV series. Do you remember The Party of Five, the OC? I had an idea that if I had a kitchen island, freshly cut flowers, linen napkins and a gardener, like just a weekend one, then somehow the perfect TV family would just walk in so together Carl and i did actually do some of that we lived in the she-she neighborhood i had a tiny dog that i carried under my arm raymond because he couldn't really walk very far um and our three Kids they went to a progressive private school where they called the teachers by their first name, didn't wear uniform and didn't learn so much. But they were happy in their early years at least. I hadn't had this kind of education, by the way. I'd been to a state school. I'd ended up at Cambridge. I'd really been like a happy geek at school. And sometimes Carl and I wondered what we were doing, kind of pushing ourselves to such an extent to make sure that our kids went to that kind of school. I think it was another idea of ours to be safe, to be successful. But there wasn't much joy in all of this you know we were just like busy frantically scrabbling up this hill all the time yet we had the kitchen island we did have linen napkins but they Were grubby and they were mainly kept in the in the back of the kitchen cupboard so that valentine's evening when carl said to me he couldn't live like this anymore, it cut through all Of it. He kept saying to me, do you love me? Can you still love me? Do you love me? And I kept saying, you are loved. Oh my God, you're so loved. I felt angry. I felt angry at him. I felt angry at me. How could we have got this so wrong that the boy in the ill-fitting suit was asking me whether I still loved him? I phoned our family doctor, who said that she thought Carl was having a breakdown and that he needed medication and respite immediately. I phoned a friend whose husband had had a breakdown a few years earlier. And I remember standing on the front lawn in my pyjamas. It was dark. I was freezing cold and I was kind of whispering into the phone so my kids wouldn't hear so the neighbors wouldn't hear I mean who cares so I realized that things had to change really quickly This life of ours that we had created was a weight around us and Carl in particular was gasping at the surface for air I had to change things immediately I knew it so I told Carl that. I said that we were going to move to my childhood home, that we were going to take the kids out of the school and we were going to do things very differently and look after him. He'd always looked after us. So I did that. It was a bit like triage, I suppose. I gave notice to the school. I started to pack up the house. And then I would drive out of London with my car filled to the brim to set up my kids' bedrooms in advance of us moving. I would do that at that end. I would go to the tip, visit schools, and then drive home to London sobbing. I felt like I'd taken a shrinking pill. I felt like everyone in London with their game faces were saying, who did you think you were trying to live this big life? I felt ashamed. I felt ashamed for feeling ashamed. I remember saying to people, oh, please don't tell them because I think it'll make really good gossip but then then there are the people and there are the moments that stand out for me There was the friend that flew across the ocean with squish mellows for my children and words for me saying we have got this we have got this there were the class mums who organized my son's Birthday party there was the woman in the playground who squeezed my hand because she could see I was feeling really wobbly all those signs of kindness had actually always been there But I've been too busy looking for other things So for about 13 weeks, I lived on coffee, sausage rolls and adrenaline. And by that April, my kids were in their new school. Coal was beginning to resurface and I could kind of exhale again. That February the 14th, it took the sheen off everything. I couldn't give a fuck. Can I swear? I don't know. Couldn't care less about... I couldn't give a fuck, actually, about... About appearances, suddenly. I just couldn't. I felt like I'd woken up. We lost delivery. We lost complicated cupcake flavours. We lost hotel people bar watching, which I love. We lost the perfect butter chicken tally. Oh, and we lost 24-hour access to buttons, chocolate buttons and Pringles. We lost the people for whom a postcode matters. Surprisingly of all, we lost the fear. Because, you know, when your life explodes and it morphs into something far better, the fear evaporates, disappears, distills, just goes into the atmosphere. I'm not scared anymore. There's just like a little firefly of fear, and that's to do with the health of the people that I love There was an afternoon last summer. I was sitting in the garden in the farmhouse that we now live in, and it was sunny. And I was watching my husband and my son tear up the lawn on the ride on Moa. There were my two girls, and they were leading their (Time 0:45:36)
