Ruth

Rebecca Smith

6th May 2020

Hey love, how are you?

Things are worse. He is slowly dying.

I have never seen someone completely vanish before. I sit opposite Ruth on the bench, a plastic tub of strawberries in my hand. She takes one at a time and feeds them to her 9-month-old son. I watch her, trying to find something of the person I knew.

11th May 2020

Hey love, I miss you! Hope you’re ok.

I miss me too.

A few months previously, Ruth is in Spain, where she lives with her husband and her son Koa. As the pandemic crept into each country and closed down the things that held us all together, Ruth is falling apart from the inside. She phones me to tell me that she walked out of the flat one morning and onto the motorway into the path of a truck. Her leg was battered and bloody and her arm bruised but apart from that, fine. She isn’t fine. She tells me again and again that her son isn’t normal and that she has broken him by stopping breastfeeding and giving him bottle milk. She says, I know it sounds crazy. But I’m not crazy. I do the only thing I can think of to do and post her a book on motherhood. I keep messaging her.

26th May 2020

It’s horrendous Becka

Koa is not normal

She is admitted into an acute psychiatric ward unit in the city in which she lives. Her husband wants her out of it. This place isn’t going to make her better. The noise of it is the stuff of nightmares. He has a pretty good hold on Spanish but it’s Ruth who is the fluent speaker. The medical language of the doctors in the unit is unnavigable to him. She is discharged into her husband’s care at home, and a mental health team visits several times a week. He does the only thing he can think of to do and arranges an appointment with his family doctor back in Scotland.

31st May 2020

Koa will stay the same. He’s not eating well at all.

He drives all the way from Spain with her and the baby, Ruth protesting all the way that she doesn’t want to go. The doctor requests an immediate psychiatric assessment and Ruth is transferred immediately to a Mother and Baby Unit in Glasgow. A few days later, on a hot morning, her husband arrives via my back gate and we sit outside in the shade of a newly bought parasol. It’s like he’s dragged the sun here with him too. I give him a San Pellegrino with ice as if he is the first guest to arrive for a garden party. Ruth has been diagnosed with Postpartum Psychosis. She is delusional. He repeats the things they have told him: sometimes, Postpartum Psychosis comes on gradually, sometimes quickly. Usually, it happens in the first few weeks after giving birth – the lack of sleep doesn’t help. But with Ruth, Koa was over five months old when she started saying odd things. I ask how long will she be in there for. He shrugs. As long as it takes.

17th June 2020

Do you really think he’ll be ok?

I really do. I think he’s just beautiful

And if he stays like he is?

The Ruth that sits opposite me outside the unit in the summer is a hollowed-out version of the one I knew from university twenty years ago. She is nothing like the girl who was always there. She knew how to show up, whether it was to the bar, the class, the meeting or the party. She was always present, flitting from one group of friends to the other, her blonde curly hair bouncing. She knew everyone.

The first time I am allowed to see her at the unit, we go for walk and a nurse follows a little behind us, listening and watching. We walk along the concrete path next to the river, into a car park beneath a blocks of flats and then across a busy road. We arrive back at the unit and walk the same route again, Ruth pushing the buggy. River, flats, road, unit. I smile and say, We can do it again if you want? She is diminished, smaller than she ought to be. She walks slowly, like it is all such an effort. Koa sits in the buggy and smiles at me and watches the trees. She looks at him and shakes her head.

24th June 2020

I’m not allowed out today but you can come inside and play in the garden.

I try to bring them something every time I go. Bubbles for her and the baby, a sunflower to put in her room to watch it grow. She messages me to say she thinks she’s killed the sunflower. Her husband and I start to arrange other friends to visit, friends that I don’t know very well but who knew other sides to Ruth. We start texting each other afterwards. How was she today? A bit better today. The same today. Its infuriating, isn’t it? Our friend from the other side of the world, a whole twelve hours into our future, asks me to buy her some coconut hand lotion. She always had some in her bag at university. In our own way, we are trying to pierce her psychosis, bring her back somehow. I take my own daughter with us on our walks, at first to show her that children do grow, (look, she’s running and laughing!) but later as a distraction for me. I can’t keep saying the same thing, He’s fine Ruth. Koa’s teeth will come in. He will walk.

 30th June 2020

Can you make it 1145? We’ll prob be in the garden.

Becka he isn’t going to be ok.

Her husband has to go back to the rigs and between both their families and her friends, she has a busy schedule of visits. I send him photos of Ruth holding Koa. She is always smiling in the pictures. After I take them, she puts him back in the buggy and says, See, he’s not normal. The medication is upped and changed, mixed and boosted. It is not working. She is still a long way away from us. One visit, we are playing in the enclosed garden, Koa on a mat on the floor. She repeats over and over that she needs to start again, she needs to have a baby from the beginning and do it properly. I sit in the car outside the unit and look at my phone. Our friend from the other side of the world pleads with me to speak to the nurses. She has woken up to messages from Ruth that scare her. I tell her the nurses know. After that, Koa goes to stay with his grandmother for a few days.

1st July 2020

Hey! I’ve been allowed back out for walks again!

That’s great! How you doing?

Not great. I just know he isn’t right Becka.

I’ll be saying this ‘til my dying day

The decision is made to start ECT: Electroconvulsive Therapy. I picture huge wires attached to her head, black and white footage of people strapped to beds and whiter than white rooms. When I google it, I am shocked to find that modern ECT isn’t too far from what I’d imagined. It takes a few sessions to make a chink in her delusions, but something is shifting. Sometimes, she starts to doubt them.

10th July 2020

Everyone keeps telling me he’s ok.

She is allowed to go in the car with me and we drive to the big shopping centre nearby for pizza. It is a tense hour and a half. She swings from focused to absent minute to minute. It must be exhausting for her. Koa chews on a pizza crust and smiles at me.

22nd July 2020

Any good hairdressers near you?

I meet Ruth and her husband at our old university. We park in the car park for the halls of residence and hug. Ruth and I walk around the loch that sits in the centre of campus while her husband takes Koa for an hour. I ask questions but she doesn’t know how to answer them. The disappearance of her short-term memory makes her cry.

22nd August 2020

Anything you want to do tomorrow?

Ruth and her husband come to our house. I open the door but I’m not ready for who is on the doorstep. She looks like Ruth. She walks into the living room and says hello to my kids, smiling. She hugs me. You’re back I say. I look at Jamie and he nods. She has brought little presents for the children, a roll of colouring-in for my youngest. I watch her the whole time, playing on the floor with Koa and my three-year-old. I want to say all the things in my head, but I say nothing.

6th September 2020

Hey! How are you guys?

Ruth is left piecing the year together. Her memory is peppered with black holes, zapped by electrical currents, broken and remade, then sealed up with the mind’s own version of duct tape. Or at least, that’s how I imagine it. She takes hefty anti-psychotic drugs and all three of them fly back to Spain to pick up the fragments of life they left behind in May.  

5th Nov 2023

Hey!! We’ll be outside for my party so just make sure you have layers and maybe a big scarf.

Three years later, just before her fortieth birthday, she’s taken off the anti-psychotic drugs. We meet in a grand house with gardens and a swimming pool. It’s out of season and freezing cold so they have borrowed it for a couple of cents and filled its fourteen bedrooms with friends from around the world. It is a birthday and celebration party.

There is a surprise saxophone player, plates and plates of local Spanish food, a whole pig to roast by an Argentinian chef (a friend, of course). Tables of red wine and prosecco and a mini bar for Aperol Spritz. There are thirty or so children who come and go throughout the day with their parents, they play in the boules pit with plastic diggers and knock down giant Jenga. Koa runs around the legs of his parents and with his friends, his blonde curly hair ruffled. He laughs and cries when it gets a bit too much and they pick him up and hug him.

Towards the end of the night, I am in the kitchen with one of Ruth’s friends. I have met her before, four years ago, when I came to Spain to see Ruth after giving birth. Around ten of us had gone for lunch on a farm in the hills above the city. Most of them had young kids and babies in buggies and we drank wine, ate chorizo, jambon and Manchego. It was just like my group of friends at home, juggling new babies, work and relationships (albeit with more sunshine and additional languages.) In the kitchen at the party I say, clumsily and drunkenly to the girl I recognised from that day, Thank you for being there for Ruth. She bursts into tears. I didn’t mean to make her cry. She says, I should have noticed, I should have known. I shake my head again and again. How could you have noticed? How could anyone know? You lose yourself in motherhood a bit anyway – we both nod and smile – especially the first six months, Ruth just lost more of herself than some. I have drunk too much wine to make sense, or maybe we have drunk just enough to have the conversation. Ruth is dancing in the garden, bordered by the fairy lights we strung up earlier. They light up only some of the dark corners of the garden but it is enough to dance by. Beyond that, the houses in the fawn-coloured village have their shutters down. We are in the first few weeks of winter and there is a chill in the air. I wonder if they can hear the music in their warm bedrooms.

Postpartum Psychosis affects 1 in 1000 women after giving birth. Its symptoms can range from hallucinations, delusions and mania and is treated as a medical emergency. For more information, please go to app-network.org

First published in Issue #31

Rebecca Smith is a writer and journalist. Her book Rural: The Lives of the Working Class Countryside is published by William Collins.