Run With Your Client, Not After
This article has been published in the British Medical Journal (BMJ 2004;329:1176 [13 November], doi:10.1136/bmj.329.7475.1176). So if you are citing it, please do so accordingly. Well... They seem to have had a GCSE student re-write it, so if you want to quote this superior version instead, that would be your prerogative...
Chris was always climbing the fence. It was tall, a mosaic of chain-link and climbing weeds, about eight feet, and surrounded the euphemistic “garden” on three sides – the fourth being a three-storey red-brick ward. The ward was a home of sorts to a dozen people with learning disabilities and challenging behaviour and, similarly, a half-dozen nurses. Chris’s most prominent behaviour was “absconding from the ward”, a curiously circular reason for his admission and an activity he engaged in quite successfully on a daily basis.
Absconding was more often than not preceded by a few minutes of artfully presented nonchalance, entirely cloaking him from the watchful eyes of the nurses posted strategically about the place looking for, and only seeing, those behaviours listed in the various reports and management guidelines currently in action. The abscond itself was never witnessed. By sheer well polished sleight, Chris would fade imperceptibly from the consciousness of the assembled staff and then appear, as if conjured from ether, running full-tilt away from the fence.
The staff would snap into action. Blood, previously thickening in our veins, would course effervescently around our bodies. A unified flock-consciousness would drive us towards our joint and single purpose: to catch Chris and bring him back to within the confines of the fence.
To catch Chris.
Our prey stood in excess of six feet and, with daily practice, had developed both the athleticism and gait of an ostrich. He could turn in an instant and be suddenly careering in a completely different direction with no evident change in speed. He could slow down and speed up with no suggestion of inertia or momentum. His flight, essentially, was Brownian.
We would fly from the ward like light streaming from an opening door. We had a purpose. We had a plan. Roles were never discussed but somehow we knew to break into smaller units and try to bisect Chris’s unknowable path. We would run at break-neck speed towards him as if locked onto him like missiles. We would run orthogonally to limit the available directions he might take. We would unspokenly gather volunteers to the chase as if in a stampede. We would hide behind trees.
Catching Chris, despite the iniquity of numbers, invariably took upwards of an hour. Pursuers would retire from the chase exhausted, or perplexed. Sometimes entire shifts would change over the duration of the hunt. Ultimately, however, Chris would be apprehended in a frenzy of arms, legs and divots, attracting staff and onlookers like flies around a kill. Only partially subdued he would be guided, in a ruck, back to the ward where more often than not he would be carefully watched for the rest of the day while he returned our gaze repackaged as a scowl.
I don’t know how it happened. Nobody remembers, if they ever knew.
Chris had breached the fence again and was high-tailing it across the grounds. Somebody went to fetch him back. The mood was completely different, completely at odds with the usual galvanizing sense of mutual excitement. Perhaps we no longer cared. Perhaps, somehow, we were inspired. Our solitary staff member didn’t pursue Chris. He didn’t barrel after him like a Pamplona bull. He just ran. Within a few minutes he was shoulder-to-shoulder with Chris and running alongside. And they kept running. They ran for a further ten or so minutes and then returned to the ward. Nobody laid a finger on Chris. Nobody said a word. There was a ten-minute run and then home.
There were no absconds after that. Just runs.