A man came for an appointment on Christmas Eve. Ali was a Kurdish man aged about forty, although he looked sixty. He smelled strongly of alcohol and was tearful throughout much of the session, sometimes inconsolably so. He was accompanied by his wife, who smiled and apologised for him, held a bottle of water for him to drink from and tried to answer some questions.
He was really unable to do anything for himself in the session, or at home. His story was that he had been tortured in his country of origin. The torture had taken place over several weeks whilst he had been imprisoned. He and others had been made to stand in water for days on end without sleep. When sleep finally overcame him, the cold water would instantly revive him and he would be taken to be tortured. He received a serious head injury from repeated beatings.
Now he has nightmares. He used to see a Psychologist for Post-Traumatic Stress Disorder. In the session he cried and said he missed his mother, who had died some years ago.
This encounter was new for me in that it was the first time I think I thought it would have been better for a person to be dead. He was a completely broken man and it felt impossible to find any trace of optimism for his improvement. The pessimism was two-layered. First, with the best possible services available, what could possibly help this broken person? Years of psychology? Being placed in a protective environment? Finding fellow Kurds for him to share his misery with?
Second, my country (UK) is governed and financed by people who do not care about Ali. The services that may help him are being dissolved and dismantled by men who attended British public schools, who probably had names for brown people like Ali, (and still use them in private) who cannot and will not imagine lives unlike their own and blame the abused, the disadvantaged and unwell for their misfortune.
My sense of hopelessness was not misplaced: it took seven attempts to refer Ali to a crisis service. Even if they see him, I imagine they will not take him on because they will have no more idea of what to do with him than I did.
I am not writing with solutions, because I do not have any. This is just an attempt to describe a situation that arises every day, thousands and thousands of times in the health service of this country. Perhaps we should bill the governments of countries that torture their citizens, then send them here, broken, to be fixed. Our country has or had a reputation for humanity, civilization, in caring for desperate people from here and elsewhere. I believe it must continue to do so.
Of course that costs money. The reality is that it costs just a tiny fraction of the money that could be available if our government did not pander to tax-avoiding corporations, nor prioritize lining the pockets of their entrepreneur friends by selling off public services to them, driving down funding to maximise profits for shareholders. The reality is that we do not live in a humane or civilized country any more; we live in one governed by a regressive, greedy, selfish minority. It is a situation I am ashamed of.