Monday. Something has happened in Gorazde. I have the feeling I am on the receiving end of an exponential increase in violence and distress, as if my being a psychiatrist here has suddenly given people permission to go mad. This morning, instead of preparing my seminar, I had to see a young woman who had stopped me in the hospital courtyard two days ago saying she was having a nervous breakdown. The story is a simple one: Elvira is 18 and she and her husband are refugees from a village near Visegrad (now in Republika Srpska). They share two rooms – a bedroom and living-room/kitchen – with his sister and her husband. The latter couple sleep in the kitchen, but the two women were fighting all the time, so Elvira decided to set up separate cooking facilities in the bedroom. This led to an almighty family row, with her husband threatening to leave, and Elvira running out and jumping into the Drina. As she sits there with dark shadows under her eyes, wringing her hands, saying she hadn’t wanted to die but did not know what to do, I suddenly recognise her. Back in Britain, I had been seeing her counterpart on the emergency wards at least once a week for two years: there’d been a row with parents or boyfriend the night before and she’d reached for a bottle of paracetamol as one clear way of communicating intolerable distress. Here the river is more accessible, and while I can reassure the girl that she is not going mad, and that getting the family together to talk about the conflict might provide a more lasting solution than the injections of diazepam she has been getting from the emergency room, I cannot provide new accommodation or any possibility of a return home.
In the afternoon two social workers interrupted a crucial seminar on the use and abuse of minor tranquillisers, to ask if I could come and see another 18-year-old who had been holding her family at bay with a shotgun, and threatening to kill herself. When, after some hours, the police had disarmed her, she had bitten them and become highly disturbed. At the police station, I find a dishevelled and exhausted young woman sitting quite quietly with a woman police officer. We talk and she tells me of her best friend’s suicide in front of her a year ago, also with a shotgun, which she replays and replays in her mind, of her guilt at not stopping it and her feelings of hopelessness. She is certain that she will try to kill herself again if given a chance. My immediate choice is between admission to the intensive care ward in Sarajevo or to a police cell. The police tell me the cells are full and the hospital social worker tells me it is too late for a car to take the ‘blue route’ through Republika Srpska, which means using the ‘Corridor’ over Grebac mountain, but as yet the hospital ambulance is not back from a journey to Sarajevo. Dr A. in the emergency room says it’s not her problem. If the girl shoots her family and herself, it certainly will be, I shout. The trouble with shouting through my translator, Dzibrila, is that she gets the flak from me, and Dr A. just gets Dzibrila’s careful moderate tones. Never mind: I got my ambulance and a nurse escort. Luckily, the girl actually wanted admission and accepted an injection of chlorpromazine. She’s quite small so if she gets agitated in the car two adults can contain her. I cannot raise anyone at the Kosevo hospital in Sarajevo on the phone, so I write a long letter and pray they will accept her.
Before I came out here, I thought the ‘Corridor’ promised by the Dayton Peace Plan was a decent highway, like the road to West Berlin, linking the former enclave of Gorazde safely to the Bosnian Croat Federation without going through RS. The reality is four parallel lines on a map and a single track road that is benignly named ‘Canary’ on the IFOR maps and on little white placards beside the road. The name doesn’t seem particularly appropriate for a route that is in large part a dirt track and that switchbacks across mountains taking four hours to drive in the winter. There is a bus twice a day that goes through RS and takes only two hours, but when Dzibrila was on it a few weeks ago, it was stoned by four youths outside Rogatica, glass shattering by her head. Cars with Gorazde number plates are often stopped by Serb police who offer the driver the choice between an instant fine and a court appearance. UNHCR has argued that there should be a uniform number plate for the whole country so that it is impossible to identify a driver’s origin, but there is no sign of this being implemented.