He’s looking out the side-window of the van, onto a grey landscape of such wetness, it reminds him of peering from a ship’s porthole at a churning sea. Endless stretches of functional housing that could only have been built behind the Iron Curtain, with an attractive looking train – Brief Encounter – keeping tag with the van’s progress. What day-dreams occupy its passengers? What homes are they heading towards, who do they love, what makes them smile? Surely not this landscape, he thinks, and turns his face to the van’s interior. His colleagues are sat in front, clearly tense, given the hunch of their shoulders. Wild techno-pop bounces off the carpeted walls, to which the age-proof driver nods his grizzled head, in time to the beat. Welcome to St Petersburg, Dr Archer, we hope you enjoy your stay with us.
*
Leaving home at 4am. All leave-takings are portents of the ultimate departure from the loved one. Feeling it more strongly this time than usual, his bog-standard anticipatory anxiety about flying combining with a suspicion that a week spent visiting secure mental health institutions in the Russian Federation won’t be one of those work trips to excite the interest and envy of friends. Refuses to catch the Mister’s eye, waving from the bedroom window. Be careful crossing the roads, Keith. At least the Company still does long-haul travel in style and there’s some comfort to be taken from the limo with driver, the leather seats to sink into, the suspiciously generous use of "sir": Are you interested in sport, sir? No. I’ve never picked anyone up from Hackney before, sir. Oh. I know where I am, but I don’t know where I am, if you know what I mean, sir. Turn right here, onto Hackney Road. It’s astonishing, he knows, the gap between his image of himself, open, warm, friendly, and the way he sometimes fails to interact with others: Just leave me alone.
*
Report, Day 1
Well. First impressions of cities are always wrong. It’s a beautiful place. Not that I’ve got any time to see it properly. Tatiana tells me that I will find Moscow much less European-looking, and it’s true that the Prospects which form St Petersburg centre are reminiscent of Paris of the belle époque, only much, much larger. Prospect comes from the Russian ‘perspectiva’, I’ve learned, hence ‘perspective’. Much more suitable than ‘avenue’.
I’m completely disconcerted by Russia. I rush to cities like I rush to people: I know if I’m going to love them within twenty-four hours. So despite the physical similarities, St Petersburg is the opposite of Paris. If I’d come here as a student, I wouldn’t have wanted to leave. Not what I expected. From the corner of my eye I can just catch sight of ~Graeme, collar up, stalking down a street to a coffee bar to discuss literature (because ~Graeme would never have been a sadsack scientist) with his mates.
Of course, the Big Thing is, I couldn’t have come here as a student (in the 1980s). We talked about this at dinner last night with our Russian hosts, well, I did, my colleagues being too well brought up to mention the past. I told them how excited I was to be in Russia, how when I was growing up, I was always aware of their existence, but that they were them, a sort of amorphous mass of pulsating malevolence. The map of the known world ended at Germany: beyond here there be monsters. Politics aside, that’s undergraduate sociology, innit. It must be hard, I thought, for Russians of our age to explain to their savvy children how things used to be. Natalia agreed, she laughed, telling me, my kids say to me, you had planes then, why didn’t you travel, you had planes, you get visa, you travel, what was the problem?
Today we visited the first of the psychiatric hospitals we hope to work with on our Project. I think words may fail me here too.
*
Would you like to tour our hospital? asked the Professor. He looked expectantly at his guests. The discussion about the protocol had been useful, but he was tired, and over-worked – his phone had rang four times during their conversation – and he didn’t understand clearly what was expected for the rest of the visit. But his suggestion seemed to be welcome: the British man who had done most of the talking in the last hour beamed in pleasure – Yes please.
They started in the outpatient clinic. We run this centre to try to help the families of our patients get more involved with their recovery. The church is very helpful too; we were originally an institution owned by the church. Then upstairs to the secure wards, where the inpatients stayed. We have 180 beds, with over 1000 admissions a year, from patients diagnosed with severe depression and psychotic disorders. This is our head nurse who looks after our female patients. The competent-looking woman smiled at the quiet visitors, who nodded their heads in the universal greeting of warm wishes. I wonder why they're here, she thought, as they passed through the locked door.
Graeme saw the patients in the wards and stifled a moan. Rooms no larger than a classroom, with eighteen beds arranged top-to-toe in three columns: room after room. A memory of a Peter Greenaway film stirred in his mind. But the patients were clearly cared for. The wards were warm, and clean, and safe. The patients sat, some together, some with the nursing staff, some alone, lost in their thoughts. Such thoughts! I ponder about love, thought Graeme. But what homes are they heading towards, who do they love, what makes them smile? Surely not this landscape? Sometimes, often, yes - this landscape.
One of the patients bounded up to the professor, hallo-ing him with a massive grin. Objective correlative, Graeme thought, your impression of a man who cares was correct. An old lady was carefully eating a bunch of grapes, while a fellow patient chatted away to her left. Graeme thought - I don’t know I’m born, this is amazing, this is love, look at the look on that nurse’s face, don’t you ever feel sorry for yourself again.
*
Report, continued
Afterwards in the car we talked about that which we’d witnessed today. No-one is pretending that the Russian healthcare system is a source of universal good: one thing that Natalia told us last night is that 80% of all federal expenditure on healthcare in the Russian Federation is spent in Moscow, which leaves psychiatric care, here in St Petersburg, as much of a Cinderella in the health service as its counterpart in the UK. But we’re all agreed: something very bad happened in Britain when we closed down all the secure psychiatric institutions in the 80s.
Think about it: St Petersburg is a city of five million people. The hospital we visited today has 1000 admissions a year. We’re visiting four more hospitals here, all larger than this one, before we move onto Moscow; say four thousand admissions a year, to be conservative. What happens to similar patients in London? One of my colleagues gave voice to our thoughts: we throw them onto the streets.
