'Where's your panic button then?" He's about 10ft tall, but kind enough to lean over and put his huge ugly mouth right in front of my nose. "I'm sorry?" I smile, while he stares intently at me with funny red eyes. To be fair, there's something a bit put on about this aggression, but I start shitting myself just to be on the safe side and take a casual look around the room. Nobody's told me about any panic buttons. I probably should have asked before I started clinic.
"I don't think there is one," I say casually, my relaxed manner implying that nothing could be less needed at this moment, what with how unthinkable it would be for any patient to try to attack a nice, cuddly, chilled-out psychiatrist like me.
"Don't fuck about, I know you've got them. And where's your personal attack alarm?" He bends his enormous frame around to scan my belt from all angles while asking his second, extremely good, question. "I think I left it on the kitchen table. I don't like them," I smile, as he starts doing something funny with his eyes to imply that he's so mad he thinks he could get away with killing me in return for a few relatively tolerable years in a nice forensic secure unit.
"I don't think I need one." I smile hugely. I am so chilled. I repeat it to myself. I am so chilled. He wrinkles his nose and stares incredulously at me. Maybe he's thinking I'm too stupid to be worth crippling.
"I'm a nice guy," I shrug. "I smile a lot. No one wants to hit me." I smile some more. This is a mind control trick I learned watching Star Wars. He shrugs and sits down. "Can I smoke?" he asks. Clearly the answer is no. I open the window. "Of course," I smile. Not bad, I think: it's my first clinic, and I may be failing to maintain barriers, but I still have my looks, and the use of two good legs.
But I don't have a lighter: and so my potential mass murderer, who only sat down five seconds ago, sighs and gets up to go and find one. "Wait ..." I say, trying to think of a way to re-engage him, so I can work out if it's just me he wants to scare or if I have a protective duty to society that needs discharging.
"Wait ...?" He gazes out of the window and turns his head to stare back at me wearily, like he can barely stomach my ham-fisted attempts to negotiate a good rapport. "Good one," he snorts, quietly contemptuous, and shuts the door behind him.
I pick up my pen professionally and prepare to frame the events of the preceding two minutes in the notes. "SHO outpatients, 23/2/02. Patient seen alone. Threatened to attack me and left immediately. Disappointed with self. Don't know what to do. No one to ask. What am I doing here? Shit. Foxton."
And then the gravity of the situation starts to trickle in. My consultant's away, I'm the only psychiatrist in a clinic in some middle-of-nowhere provincial town and a known schizophrenic patient has just come in, threatened to attack me, and then walked out on to the streets. I feel dizzy under the evil fluorescent lights. He has gone now, and there's no way I can get him back. He's out there somewhere. I stare at the wall in front of me. It's getting closer. I swear they all are.
Why didn't I section him? I wouldn't even know how to. I'm so alone I feel short of breath. I stare at the blank page in front of me. I couldn't even get him to answer my questions. I didn't even ask them. What if he kills someone? I didn't even ask him if he was going to. I want to puke. He's probably doing it right now. He's probably got a knife in his pocket. He's probably sticking it in some little old lady. Oh shit. It'll be on the telly. Should I call the police? Oh shit. And they'll say I saw him on the day he did it and I did nothing. It's over. Oh shit.
