He crouched behind the table, hit a short-angle return to Miki’s backhand, followed by a deep top spin, when the public address page announced:
“Dr. Robbins. Dr. Hal Robbins. Please call extension 516 immediately.”
“Damn,” he muttered, hitting wildly off the table, and went to the phone.
“Hello. Robbins here.…” His mood was crisp. “What?… Can’t the intern handle it?… Okay.… Okay.” He sounded deflated. “I’ll be right down.”
“Sorry, Hal,” Miki smiled. “Better luck next time.”
“Luck, hah?” Hal answered. “It’s just your luck that someone overdosed. But don’t you disappear, you son of a bitch. As MacArthur said, ‘I shall return.’ And then you’d better watch your ass.”
He grabbed at his stethoscope, which lay on the couch, and stuffed it in his rear pocket. Then he slipped into the white laundered jacket with its imprinted St. Vincent’s Hospital insignia, looked in the mirror, smoothed his hair, walked into the hallway, and waited, irritably, for an elevator to carry him down to the first floor.
The Emergency Room was relatively quiet, considering it was Friday night. Fridays were paydays. Paydays meant more drinking, more assaults and more muggings. Yet there hadn’t been a single shooting or stabbing. Just the usual head colds, sprained ankles, heart attacks, mothers in labor, miscarriages, venereal diseases, dehydrated infants, a few psychos, and now this girl in a coma.
Janice D’Amico, the portly head nurse, met him at the entranceway.
“Glad you finally got here, Doctor,” she said. “Where were you, vacationing in Miami?”
“Taking a shit, my dear,” answered Hal. “But before we lose any more time, why don’t you take me to the patient?”
“Third door on your right,” she snapped behind clenched teeth. “Dr. Carmichael and Nurse Moffit are with her. And you might, by the way, watch your language. This is a hospital, not an outhouse.”
“Get wed!” Robbins snapped as he walked past her. He’d never liked these ball-busting know-it-all old-maid virgin head nurse types, and he’d be damned if he’d take any crap from D’Amico or any of the others. But Moffit. Ah, there’s a nurse for you. Sweet, competent, and knows how to give good head.
“Hello, darling,” Hal crooned as he entered the small room and put his hand on Sally Moffit’s ass. “Been thinking about you and thought I’d pay a visit.”
“Oh.” She turned around. “Hi. Glad you’re here. Dr. Carmichael’s got it under control, I think.” She nodded at the freckle-faced, sandy-haired intern.
“What’s up, Jack?” Hal asked.
“Lady OD’d on Seconals and booze.”
“You’re sure?”
“Well, the booze you can smell and her boyfriend gave us an empty prescription bottle.”
“What’ve you done?”
Jack finished taping the I.V. needle to the back of the woman’s hand. “Put a splint under that arm, would you?” he asked Sally as he walked around the examining table and stood alongside his chief.
“I’ve drawn blood for electrolyte levels, have started an infusion, and pumped her stomach.”
“Find anything?”
“No. Just some bile. She must have taken those pills some time ago.”
“What’s her blood pressure?”
“One hundred over sixty.”
“Do you think she’s in shock?” Hal couldn’t resist using this case as a teaching example.
“No. Many people register a low pressure normally. Also, her pulse seems strong.”
Damn, Robbins thought. Can’t catch him on that.
“Have you catheterized her?” Hal asked.
“No. Why?”
“Why?” his voice mimicked Jack Carmichael’s, and like an old army sergeant looking for an opening to display his superiority over the enlisted man, he proceeded to lay Jack low.
“Because, Doctor, it’s important in cases of barbiturate poisoning that the kidneys keep functioning. The only way we can tell that is by measuring urinary output. And since she is unconscious, she is not likely to pee in a bottle. Surely they taught you that much at Harvard.”
“Yes, sir,” Carmichael replied, looking crestfallen.
“Now let’s take a look at her.”
Robbins pulled the sheet back.
“God,” he exclaimed, looking at her soiled clothing as the stench of stale sweat and excreta invaded his nostrils. “Who is she? A local hooker?”
“Name’s Arlene Lewis,” Sally Moffit answered. “An editor at some big publishing house.”
“Get these clothes off and clean her up while I talk to the guy who brought her in.” Hal walked out of the room to the waiting area.
“Someone here with Arlene Lewis?” he asked.
A short man in his mid-fifties, slightly jowled and somewhat paunchy, stood up. He was precisely dressed in a short-sleeved white cotton shirt, knitted tie open at the neck, pinstriped gray slacks, black socks and loafers. Walking over to Hal, he extended his hand with solemnity and solicitousness.
“I’m Doctor Robbins.”
“Al Newfield.”
“You must be a lawyer,” Hal dryly noted.
“As a matter of fact, I am. You know me?”
“No. I can just tell.”
“How is she?” Newfield asked.
“Too soon to tell, but …” he could see Al worry, “I think she’ll be okay. Are you a relative?”
“No.”
“Does she have any?”
“None that I know of.”
“You a boyfriend?” He threw Al a knowing glance.
“No. I’ve dated her once or twice but I’m just a friend. I live next door.”
“You were the one who found her?”
“Yes. I was supposed to take her to dinner tonight. When I phoned her office this afternoon they said she hadn’t been in since Wednesday. Peculiar, I thought. She never mentioned going away to me.
“At about eight this evening, I decided to knock on her door. It was unlocked. I went in and found her on the floor of her bathroom. Totally out. So I ran into the street, flagged a cab, and got the driver to help me carry her out and bring her here.”
“Why didn’t you just call the police?”
“I was afraid they wouldn’t come quickly enough. I didn’t know how serious it was. And I didn’t want them carting her off to Bellevue.”
“Uh-huh,” Hal murmured, sounding like Lionel Barrymore about to make a definitive diagnosis. “Any idea what happened?”
“Yes,” Newfield answered, his jaw tightening. “I think she was disappointed by her boyfriend. Also a doctor.”
“Were there … any notes?” Robbins asked, a defensive note in his voice.
“None from her.”
“As a suicide attempt, you know, we’ll have to send her over to Bellevue once she regains consciousness.”
“Have a heart,” Al pleaded. “Can’t someone take a couple of pills, get drunk, forget, take some more? Particularly when they’re unhappy?”
“Sure,” Hal advised. “But that’s just a less responsible form of suicide.”
“You’ve got options, though,” Newfield protested. “You needn’t report it that way. At least wait ’til she regains consciousness and talk to her. I’ve seen clients at Bellevue. It’s really a loony bin. Grungy, crowded, chaotic, scary. The worst possible place for this woman.”
“Come on, counselor. That might be your assessment or mine. But when you’re sufficiently scrambled, the surroundings aren’t all that important. Having competent medical staff about—which they have—is more important than the color of the wallpaper. Anyway, thanks for your help. I’ve got to get back to my patient.”
“Will you let me know what happens?”
“Leave your number with Nurse D’Amico. Someone will call you.”
An orderly, Carmichael and Moffit were lifting Arlene from the table to a rolling stretcher when Robbins reappeared. He walked over to her side, pulled the sheet ab
ove her ankles, and ran the edge of a tongue depressor over her sole. Arlene’s toes fanned outward. Then he lifted her eyelid and touched her pupil. No blink. Taking his stethoscope from his pocket, he asked the others to raise her. They took Arlene’s arms, pulled, and like some limp rag doll, she bent at the waist. Hal, supporting her head, listened to the back of her chest.
“Rales.” His lips curled downward. “I don’t like the sound of her lungs. She may have aspirated some vomitus. Add a million units of penicillin to the I.V. and let’s get her on oxygen.”
Sally Moffit began to carry out the orders.
“And while you’re at it,” he added, “put in a page for Dr. Tatara. Tell him I want a tracheotomy.” That, Hal thought, would wipe the smile off the Jap’s face.
“Anything else?” Nurse Moffit asked.
“Yes. When you’ve finished, send her up to intensive care. And put a note on the chart to transfer her to Bellevue once she stabilizes.”
II. The Lines Are Drawn
16
The rest of August hadn’t been the best of times. As was his custom, though, Jonas tried to overlook his disappointments. It was a response he’d learned from Paul Cook, a therapist who’d strongly influenced Jonas during his own years of study at the Analytic Institute. Shortly before Paul dropped out and traded in his analyst’s couch for a farm in upstate New York, he’d cautioned Jonas to “Never succumb to Drek’s Disease.”
“Drek’s Disease? What’s that?”
“A focus on shit,” Paul answered in his solemn, Teutonic way. “And do you know what causes it?” Dr. Cook loved Socratic dialogue.
“No. What?”
“The asshole notion, in this culture, that life is supposed to be free of angst; of pain. And the doubly asinine attitude of most psychoanalysts who encourage their patients to examine every detail of every lousy experience in the hope of getting to the root of all their disappointments. But will they ever reach nirvana? No. All they do is constantly wallow in crap.”
It was not that Jonas denied his tribulations. That would be equally unreasonable. But if life, each day, offered both ripe and bitter fruits, what purpose was served by resavoring only bad tastes? So, when he’d think of Arlene—miss the warm and loving moments they’d shared—he’d tell himself it was all for the best. Difficult as it was to give her up, he was freeing her from a questionable relationship; allowing her to invest energy and attention in someone else who might have less divided loyalties. Wasn’t that, ultimately, a loving act?
And if the reunion with Phoebe was not providing much nourishment, it was nonetheless a plus that they were at least attempting it. Not to mention the enjoyment he had in being around Liza, watching her bloom into adolescence.
The same attitude was evident on Labor Day, when he returned to the city. Contrary to popular mythology, a break in schedule did not revive Jonas’ capacities as a therapist. Rather, it increased his zest for play. Instead of belaboring the deprivation of leisure, though, he considered himself fortunate to be in demand, able to command high fees, and capable of helping people overcome neurotic doubt.
So far, so good. By refusing to let morbid aspects clutter up his mind, he managed to avoid depression.
He was sitting in his office the second day back, hearing Cynthia Adler bring him up to date on her summer. She had recently taken an apartment with her girlfriend Not only that, but she’d informed her mother that she was a lesbian.
“How’s that for accepting responsibility?” she asked, smilingly.
“A pretty far cry from the shame you used to feel,” Jonas beamed.
“And,” she looked down, blushingly, “I’ve even begun to fantasize about men.”
“Anyone I know?” he asked, doubly pleased to see her growing sexual curiosity.
“I don’t know that I’m ready to say, just yet,” Cynthia squirmed, crossing her legs.
Jonas cast an appreciative glance at her calf, waited, and then interrupted the silence.
“Was it me?”
She stiffened and glared up angrily.
“No! Why do you ask that?” she demanded.
“Why not? It’s not untypical for patients to fantasize about their therapists. And I thought that if you.…”
The explanation was interrupted by the ring of his telephone. He reached for the receiver and put it to his ear.
“Dr. Lippman here.”
It was Art Matthews, a young analyst in training whom he was supervising at the Institute. Art must want to schedule some fall supervisory hours. Not so. He’d called to tell Jonas that a patient of his had just been admitted to Bellevue.
“Who?” Jonas asked, and as Art answered he felt a ball of energy rise from his chest to his throat and then plummet down into his bowels.
“I’m sorry to have to interrupt you,” Art went on, “but she’s in a catatonic state and can’t give us any history. Do you know anything that might help us?”
“No.” Jonas was greatly shaken. Cynthia, sitting and facing him, was forgotten as he pressed Art for details. None were forthcoming.
“Maybe you can stop by and try talking with her?”
“But I terminated treatment with her this summer,” he protested. Not illogically, Jonas rationalized that he didn’t know the reasons for this calamity. Who could tell what had happened to Arlene during the weeks of their separation; what people, events or biological forces had combined to bring about this frightful state? Yet, of course, he’d have to see her. As a doctor and a friend, could he do otherwise? “Okay. I’ll drop by after work tonight. Will you be there? Around seven? Fine.”
As he returned the receiver to the cradle, the second shock wave hit. What would happen if their extraordinary relationship became common knowledge?
Cynthia eyed him warily, her own resentfulness blunted by the peculiar disorientation Jonas seemed to be undergoing, staring at the wall as his hand gripped, released, and regripped the telephone. Trying to get her own bearings and be helpful at the same time, she asked her analyst the analyst’s traditional question.
“What are you thinking about?”
In the dazed state he was in, Jonas gave an unusually direct and potentially dangerous answer.
“I was wondering what the effect would be if a therapist went to bed with his patient.”
Again she stiffened, troubled by the faraway look in his eye and the unexpectedness of his answer. Sensing her distress, Jonas returned to the reality of the room, a dreamer suddenly awakened from his trance.
“I’ve got nothing more to say,” she fidgeted. “Can we end this session now?”
Arising from her chair, she walked past Jonas, who put his hand out to stop her. Everything was happening at once. Utterly distracted, he couldn’t figure any of it out.
“Can’t we discuss it?” With his thoughts still on the phone call, he was nevertheless puzzled by Cynthia’s sudden and unexplainable shift in mood.
“Please let go,” she insisted. Naturally, he obliged.
“We’ll talk about it tomorrow,” he said automatically, as she left the room, neither affirming nor denying his remark. Little matter. There would certainly be time to clear up this misunderstanding. But how, by God, would he get through the next few hours?
Later, at the hospital, he was again frozen in time, prolonged all the more by constant rumination. Worrying, in the lobby, that someone would see him. Concerned, as the elevator carried him upstairs, about Arlene’s welfare. Fearful, as he was escorted down the dingy corridors to an examining room where he would meet her, that she might incoherently begin talking about their affair. Grieved, deeply, by the sight of her—remote, wooden, in hiding.
When the orderly left, he took her hand. “It’s me … Jonas.… What’s happened?”
The urgency and concern were real, but he might as well have been talking to a statue.
“Did I do this?” he asked, to no avail. He put his arm around her, trying to break through the deadness that enveloped her, as the door to th
e room creaked open. Pulling back instinctively, he worried that the embrace might have been noticed. How would it seem? Psychiatrists didn’t do that. To his relief it was just a patient, looking for some private corner. He would not have minded one himself.
“Sorry, Doctor,” the woman said, in better contact than most of those on the ward. “I didn’t know that this room was being used.”
Talking afterward with Art Matthews was another ordeal. What to say? What to omit? Eventually he gave him a summary rich in generalities and deficient in particulars.
City hospitals do not allow outside physicians privileges. So it was out of the question for him to treat her. Nor did he want to appear overly concerned. Whatever occurred, he must avoid any indication of personal involvement. One fortunate aspect, at least, was that Matthews was the treating resident. Certainly Art could keep him informed. As soon as Arlene began to communicate, he’d visit her again, talk things over, get through this impasse, find out what went wrong and why. Perhaps he’d be her therapist once more. Or should he renew their social contact? It could pass over. Why not? Don’t overexaggerate the problem. It might not even be of his making.
Might he, though, have misjudged her? Could his withdrawal from the scene have triggered this crisis? Wouldn’t Arlene, though, have contacted him if that were the case?
Jonas suffered, for the next two weeks, through Arlene’s long silence, realizing the possibility that his present-day worries might only be a foretaste of a larger catastrophe. What made it most unbearable was the waiting; standing interminably in the arena of his preoccupations, guessing, second guessing, and third guessing himself, wondering whether the door he’d opened would bring forth a lady or a tiger.
Drek’s Disease had finally caught up with him.
17
“I disagree,” Art Matthews had said, challenging Dr. Whittenburg’s treatment plan. “In my opinion Miss Lewis deserves a trial of daily psychotherapy sessions.”
Errol Whittenburg’s slight but constant smile was replaced by raised eyebrows. The tall, silver-haired attending psychiatrist was not used to having residents challenge his judgment. His impulse had been to smite young Dr. Matthews. But his ego, modifying this instinctual id reaction, settled upon a subtler punishment.
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