Hope Remains
A dispatch from a suicide respite centre
"I've popped them out of their packets”, Tommy tells me. “I’ve got them in a freezer bag.” It’s one o’clock on an April morning when Tommy rings up. I’m one of two volunteers on the sleepover shift. Tommy has recently been discharged from hospital following his most recent overdose, and he is on the verge of overdosing again. He tells me he’s counted out the pills in multiples of twelve. I ask why.
“Because twelve is the most important number.”
I find myself agreeing with him – apostles, times tables, months of the year. Tommy goes on to explain that after he dies he will be reincarnated as an American girl named Hope, but only if certain, mostly numerical, conditions have been met, including but not limited to number of pills, paces walked since taking them, and hours since his final meal. “Do you think I’m mad?” he asks.
“I don’t know”, I say. “Do you feel like you are?”
“I don’t know either”, Tommy says – he is from south-east London and speaks with urgency. “It’s not fucking usual though is it?”
***
The Maytree Suicide Respite Centre occupies an ordinary-looking terraced house near Finsbury Park. The interior is pastel shades and white. There is a small garden and a living room with books and jigsaw puzzles. It feels like a clean and well-stocked student houseshare, and it offers a one-off stay of four nights and five days to people at risk of killing themselves.
In the northern hemisphere, April and May are the worst months for suicide. This goes against what one might believe about depressing winter days, but the fact seems to be that in winter quite a lot of people feel miserable, and there is little expectation to be otherwise. In spring we sense ourselves coming into bud. And just as autumn’s drawing-in can be a comfort, I wonder if pulling back the curtains of night can leave us feeling exposed.
I offer Tommy a way to look at unusual beliefs. If one person thinks he’s going to be reincarnated as an American girl called Hope, that might indeed be labelled madness. If fifty people believe it then it’s a cult. If a billion people believe it, that’s just religion. “When I come back”, he says, “I’ll be free of it.”
Tommy has told me that “it” is emotionally unstable personality disorder and raging OCD. Either of these on its own can make life extremely difficult; together they are unimaginable. He has been sectioned five times in 2019 alone, and tried to take his own life more times than he can count. “What if you come back and Hope has it too?” I ask. “What if it’s something you need to work through in this life, so that she can be free of it in the next one?” Perhaps suicide’s most pernicious myth is that talking about it encourages it. Maytree preaches the opposite – that if something is expressed in words it is less likely to be expressed in action.
Tommy has gone quiet, and I’m starting to think we’re getting somewhere. Then he exhales. “Pfff. Don’t know until you try it, mate.”
***
Each person who contacts Maytree has a file created in their name. This contains a cover sheet showing their contact details, as well as a print-out of any emails and a written account of all phone calls. Each file lives in a plastic folder, and the folders are housed in ring binders, with one ring binder representing one half-month – about a hundred files on average. The binders are stored in clear plastic boxes and on shelves, in a small room at the top of the house. They reach from floor to ceiling. The sense of scale is dizzying. Each week a jovial woman called Louise sits here for several hours and enters the latest batch of files onto an immense Excel spreadsheet. I cannot ask her what it is like to do this work. Perhaps it is not “like” anything at all.
Plans are afoot to computerise Maytree’s records. The room at the top of the house will be repurposed. I am sure that there are good reasons for this, but not having something physical to represent each caller does feel like a loss. A sheaf of papers in a plastic folder can be inconvenient to search for, but when one finds it one can handle it gently, can open it up with care. I don’t feel I’m being careful in my opening up of Tommy, but instinct has taken over. “Why aren’t you dead yet?” I ask.
We’ve been on the phone for forty minutes and Tommy has told me he is “70 per cent” going to take the pills. His plan (and his habit) is to swallow them and then call 999 when the sickness kicks in. “If they promise they’ll give me pain relief and a bed then I’ll say where I am, but any talk of treatment and I’ll go die in pain on my own. I’m imposing a … a something. Jesus Christ what’s the word?”
I feel very sad at this, but Tommy does not need my sadness now. What he needs is a word. “Condition?” I offer him.
“No, no, something foreign,” he says, “What is it?” Tommy’s OCD manifests verbally, but his short-term memory is in tatters (“too much raving in the nineties”). What this means is it becomes extremely important for him to utter a particular word, but then he can’t remember what it is.
“Prerequisite?” I try. “Stricture?”
“No! No, I’m pacing now. Fuck. It’s gone up to 80 per cent for definite.”
I tell him as calmly as I can that I am going to open the thesaurus on my mobile, and then I read him all the synonyms it offers for “condition”: “Contingency? Proviso?” Fucking 'codicil'?” I feel like I’m conducting a hostage negotiation while cheating at a crossword, and none of the words is right. “Let’s talk about something else”, I say. “Sometimes things come when you don’t think about them.”
So we talk about raving, and the fact that Tommy’s nan, whose house he is staying in, has got a bit of cheesecake in the fridge. Ten minutes later he blurts out, “Caveat! Fucking caveat. Jesus …” His relief sounds almost carnal. I look down at my mobile and tell him that I am going to complain to the thesaurus people.
***
Maytree is a busy place: three shifts a day with three or four volunteers on each, plus two staying over each night. Guests will almost never speak to the same person twice. This seems to go against what my current psychotherapy training is teaching me: that “it’s the relationship that heals”, and that the only way to have a strong relationship is to be in long-term therapy. How can an hour or two with twelve different people do anything?
The best answer I can think of sounds flippant, and it’s that it works in a similar way to one-night stands. The most connected sex may indeed arise in a committed relationship, but the first and last time two people will see each other has an energy to it as well. There might also be something in play about sheer numbers. If your therapist suggests that you’re not such a terrible person, there is always the suspicion that they said it because you paid them to. When diverse unpaid people all say it, then it may feel more likely to be true. Something is working anyway. Shelves of bright cards in the office from former guests say “Thank you”; “I found my life again”; “You showed me that it’s OK to be me”.
***
My phone call with Tommy is drawing to a close. He is not going to take anything tonight. Instead, he is going to go down to his nan’s kitchen and eat that bit of cheesecake. “I don’t think she’ll mind”, he says.
I don’t know how we got here. It feels shore-like. I ask Tommy if he is quite certain that he is not going to take the pills later, after he has eaten the cake.
“No!” he exclaims. It sounds like he is calling me an idiot. “Got to do it on an empty stomach haven’t you. Cheesecake’d fuck it right up.”
***
In over a year of going to Maytree every week, I have never met a guest I didn’t like. Other volunteers, who have been there longer, say the same. I certainly do not like everybody that I meet elsewhere.
Emotion works similarly to the First Law of Thermodynamics. If you experience abuse (and many of Maytree’s guests have), then that hatred and violence has to go somewhere. People either direct it outwards and become abusers themselves, or inwards. An abused child knows that something is badly wrong, but the wrongness cannot be with the caregiver on whom his life depends, and so must be with the child himself. A guest who had been in and out of NHS psychiatric care for years told me, “This is the first place I’ve come to where nobody has told me that I’m ill. I am not ill. I just feel terrible because terrible things were done to me”.
Along with the victims, I expected to meet people at Maytree who felt guilty because of things that they themselves had done, but I have not encountered a single one. This is limited evidence, but it does suggest that the doers of harm can get along fairly easily; it is harm’s survivors who come to find life unbearable. And when one meets a person who hates themselves because they have been hurt, then Thermodynamics’ Second Law comes into play: energy flows downhill. What arises is care, and love.
***
Tommy does not call back. A couple of weeks later there are no guests when I’m on shift, and I get out his file and telephone him. We do not normally do this without being asked to, but there was something about Tommy: an iridescence. After a few rings he picks up.
“That is uncanny”, he says. “Today’s the day.”
Tommy had been feeling alright since we spoke, but he woke up this morning with the absolute certainty that he was going to end his life.
“I’ve made all the preparations”, he tells me. “Washed, shaved, put my best clothes on.”
I ask what that is about.
“When they find me I want them to feel it. I want them to think here was a proper bloke. So sad. Such a waste. You know?”
It is hard to answer him. I’ve heard a lot of sad things at Maytree, but Tommy shaving and putting on his best clothes to kill himself is the saddest. In volunteer training they told us not to say, “Don’t do it”, so I say the thing that I say, which is, “We’d hate to lose you”. I am plausibly speaking on Maytree’s behalf, but feel like I’ve been sent in to bat for the whole human race.
Because all of us feel worthless some of the time. We all despise ourselves and feel that we are not enough; we all want to own or do a certain thing to fill the nagging emptiness in our hearts. But where does this emptiness come from?
Picture a baby. It is not yours. Perhaps it has been born in another part of the world. And even though you do not know the baby, you do know that it has intrinsic value. What the baby is like does not matter; the baby is precious, valuable and deserving of love simply because the baby is. And when this baby grows into a child, and a teenager, and an adult, it does not lose that essential worth at any point. Whatever suffering that person experiences – whatever they come to believe about themselves – you, a person who has never met them, absolutely know this to be the case. And, of course, you are that baby, too.
I do not manage to say any of this to Tommy. I say something lame and too aware about Hope still being there for him if he doesn’t end his life today. I say that, at the moment, he cannot come and stay at Maytree because he can’t guarantee he won’t attempt suicide while he’s here. I say that I will email him some places that can offer support, and that we’d love to hear from him when he’s in a steadier place.
“If I chicken out and call the medics again”, he says, “maybe you and me could go for a pint.”
I explain that we are not allowed to do that.
“Thought so”, says Tommy. “Maybe in the next life, eh?”
“I’ll look forward to it”, I say, and he ends the call.
Postscript: Tommy did not kill himself that night. I later emailed him, requesting his consent to publish this article. I explained that I had changed his name and where he was from to protect his identity. He gave his consent, but added a caveat: “I am tired of hiding my ‘illness’ and a false name would only serve to reinforce the stereotype that mental health is something to be kept under wraps. My real name is Tommy, and I live in Sidcup”.