The Choice

by Edith Eva Eger

  How did the experience of calamitous events contribute to my subjects’ everyday functioning? I met survivors who had gone back to school, who had opened businesses (as Béla and I had planned to do), who had built tremendous close friendships, who faced daily life with a sense of discovery. Israel wasn’t an easy place for survivors; it’s not easy to live amid prejudice and not become an aggressor yourself. I met people who faced the political and cultural conflicts with courage and peacefulness, who took turns standing guard at a school all night so bombs wouldn’t greet their children in the morning. I admired them for whatever it was that allowed them not to give up or give in, I admired their strength for living through another war and for not allowing horrific experiences in the past to destroy what came after. Having endured imprisonment, dehumanization, torture, starvation, and devastating loss did not dictate the kind of life that was possible for them.

  Of course, not everyone I interviewed was thriving. I saw a lot of silent parents, a lot of children who didn’t know how to feel about their parents’ silence and numbness, who blamed themselves. And I met a lot of survivors who remained in the past. “Never, ever will I forgive,” many told me. To them forgiveness meant forgetting or condoning. Many of the people I interviewed harbored revenge fantasies. I had never fantasized about revenge, but especially during those first challenging years in Baltimore, I had fantasized about confronting my oppressors—I wanted to find Mengele in Paraguay, where he had fled to escape prosecution under the Nuremberg Trials. I imagined posing as an American journalist to gain entry to his house. Then I would reveal my identity. “I’m the girl who danced for you,” I would say. “You murdered my parents. You murdered so many children’s parents. How could you be so cruel? You were a medical doctor. You took the Hippocratic Oath to do no harm. You’re a cold-blooded killer. Do you have no conscience?” I would rage and rage at his withered, retreating body, I would make him face his shame. It’s important to assign blame to the perpetrators. Nothing is gained if we close our eyes to wrong, if we give someone a pass, if we dismiss accountability. But as my fellow survivors taught me, you can live to avenge the past, or you can live to enrich the present. You can live in the prison of the past, or you can let the past be the springboard that helps you reach the life you want now.

  All of the survivors I met had one thing in common with me and with one another: We had no control over the most consuming facts of our lives, but we had the power to determine how we experienced life after trauma. Survivors could continue to be victims long after the oppression had ended, or they could learn to thrive. In my dissertation research, I discovered and articulated my personal conviction and my clinical touchstone: We can choose to be our own jailors, or we can choose to be free.

  * * *

  Before we leave Israel, Béla and I visit Bandi and Marta Vadasz, the friends Béla had left waiting at the train station in Vienna. They live in Ramat Gan, near Tel Aviv. It is a poignant encounter, a meeting with our unlived life, the life we almost had. Bandi is still very political, still a Zionist, eager to discuss the anticipated peaceful agreement between Israel and Egypt over Israel’s occupation of the Sinai Peninsula. He can recite with precision details of Arab bombings in Jerusalem and Tel Aviv. He and Béla keep us at the table long after we’ve finished eating, enthusiastically debating Israel’s military strategy. The men talk about war. Marta turns to me, she takes my hand. Her face is plumper than it was in her youth, her red hair duller now, going gray.

  “Editke, the years have been kinder to you,” she says with a sigh.

  “It’s my mother’s good genes,” I say. And then the selection line flashes through my mind, the smoothness of my mother’s face. This moment is a ghost that trails me through the years.

  Marta must notice that my mind has traveled someplace else, that a darkness holds me. “I’m sorry,” she says. “I didn’t mean to say you’ve had it easy.”

  “You gave me a compliment,” I reassure her. “You’re how I have always remembered you. So kind.” When her baby was born dead, she didn’t let my healthy baby sour our friendship, she was never jealous or bitter. I took Marianne with me every afternoon to visit her, every afternoon of her year of mourning.

  She seems to read my mind. “You know,” she says, “nothing in my life was harder than losing my baby after the war. That grief was so terrible.” She pauses. We sit together in silence, in our shared and separate pain. “I don’t think I ever thanked you,” she finally says. “When we buried my child, you told me two things that I’ve never forgotten. You said, ‘Life will be good again.’ And you said, ‘If you can survive this, you can survive anything.’ I’ve said those phrases to myself over and over.” She reaches into her purse for photographs of her children, two daughters born in Israel in the early 1950s. “I was too afraid to try again right away. But life has a way of working out, I guess. I grieved and grieved. And then I took all the love I had for my baby, and I decided I wasn’t going to plant that love in my loss. I was going to plant it in my marriage, and then in the children who lived.”

  I hold her fingers in my hand. I hold the beautiful image of the seed. The seed of my life and love has been forced into difficult soil, but it has taken root and grown. I look at Béla across the table, I think of our children, of the news Marianne has recently told me, that she and her husband, Rob, are going to try to start a family. The next generation. This is where my love for my parents will live.

  “Next year in El Paso,” we promise as we part.

  * * *

  At home, I wrote my dissertation and completed my final clinical internship at the William Beaumont Army Medical Center at Fort Bliss, Texas. I had been fortunate to secure both master’s- and doctoral-level internships at William Beaumont. It was a competitive and desirable placement, a prestigious post, where the best of the best speakers and teachers cycled through. I didn’t realize that the true benefit of the position would be that it would require me to look more deeply within.

  One day I arrive at work and slip on my white coat and my name tag, DR. EGER, DEPARTMENT OF PSYCHIATRY. During my time at William Beaumont, I have developed a reputation as a person willing to go above and beyond the technical requirements of my position—to stay up all night on suicide watch, to take the most discouraging cases, the ones that others have given up on.

  Today I have been assigned two new patients, both Vietnam veterans, both paraplegics. They have the same diagnosis (lower T-injury of the spinal cord), the same prognosis (compromised fertility and sexual function, unlikely to walk again, good control of hands and trunk). On my way to see them, I am unaware that one of them will have a life-changing effect on me. I meet Tom first. He is lying on his bed, curled up in a fetal position, cursing God and country. He seems imprisoned—by his injured body, by his misery, by his rage.

  When I go to the other vet’s room, I find Chuck out of bed and sitting in his wheelchair. “It’s interesting,” he says. “I’ve been given a second chance in life. Isn’t it amazing?” He is brimming over with a sense of discovery and possibility. “I sit in this wheelchair, and I go out on the lawn, out on the grounds, and the flowers are much closer. I can see my children’s eyes.”

  The way I tell this story now, when I’m talking to my current patients, or addressing an audience from the stage, is that every person is part Tom and part Chuck. We are overwhelmed by loss and think we will never recover a sense of self and purpose, that we will never mend. But despite—and, really, because of—the struggles and the tragedies in our lives, each of us has the capacity to gain the perspective that transforms us from victim to thriver. We can choose to take responsibility for our hardships and our healing. We can choose to be free. What I still have trouble admitting, however, is that when I first met Tom, his rage thrilled me.

  “Fuck America!” Tom screams as I enter his room that day. “Fuck God!” I think to myself: He is letting all that anger out. And witnessing his fury calls out the huge rage in me, the need to express
it, release it. Fuck Hitler! Fuck Mengele! It would be such a relief. But I am the doctor here. I have to assume a role, present myself as in control and having solutions, even though inside I want to punch a wall, kick down a door, scream and cry and fall apart on the floor. I look at my badge, Dr. Eger, Department of Psychiatry, and for a moment it seems to read, Dr. Eger, Impostor. Who is the real me? Do I know who I am? I’m so scared of the feeling, of the mask falling apart, of seeing how broken I am, of all the rage that pushes at me: Why me? How could this happen? My life has been changed irrevocably, and I’m furious.

  It was thrilling to watch Tom because he was so overt about expressing what I’d been hiding. I’d been too afraid of others’ disapproval or anger, afraid of anger itself as a destructive force. I hadn’t let myself feel the feelings, afraid that if I started to let them out, I might never stop, I’d become a monster. In a way, Tom was freer than I was, because he was giving himself permission to feel the rage, to say the words, the ones that I could barely allow myself to think, much less speak. I wanted to get down on the floor and rage with him.

  * * *

  In therapy I timidly say I want to try it, I want to express that rage, but with a professional there to help pull me out if I get stuck in it. I get on the floor. I try to yell, but I can’t, I’m too scared, I curl into a smaller and smaller ball. I need to feel a limit around me, a boundary, I need to feel something to push against. I tell my therapist to sit on me. He is heavy, his weight almost suffocates me. I think I’m going to pass out. I am about to tap the floor, to beg him to let me up, to give up this silly experiment. But then a scream comes out of me, so long and full and anguished that it frightens me, what awful wounded thing would make a noise like that? But I can’t stop making the sound. It feels good. More than thirty years of silenced ghosts come roaring out of me now, the full-throated outpouring of my sorrow. It feels good. I scream, I scream, I push against the weight bearing down on me. My therapist doesn’t make it easy, and the effort makes me cry and sweat.

  What happens? What happens when the long-denied part of me is let out?

  Nothing happens.

  I feel the force of the rage, and it doesn’t kill me after all.

  I’m okay. I’m okay. I’m alive.

  It still isn’t easy for me to talk about the past. It is deeply painful to confront the fear and the loss all over again each time I remember or recount it. But from this moment on, I understood that feelings, no matter how powerful, aren’t fatal. And they are temporary. Suppressing the feelings only makes it harder to let them go. Expression is the opposite of depression.

  * * *

  In 1978, my son, John, graduated from the University of Texas, one of the top ten students, and I earned my PhD in clinical psychology. It was a triumphant year for our family. I decided to pursue my licensure in California because it was the toughest state (there I was, putting on the red shoes again!), and beyond the ego needs of proving my worth (as though a piece of paper could accomplish that), California licensure had the practical advantage of allowing me to practice anywhere in the country. I remembered Béla’s struggle to earn his CPA license, and I girded myself for a difficult journey.

  I needed three thousand clinical hours to sit for the exam, but I doubled the requirement. I didn’t even sign up to take the exam until I had six thousand hours—almost all at William Beaumont, where I had developed such a good reputation that I was asked to conduct sessions behind one-way glass, so that my fellow clinicians could observe my way of building rapport, establishing trust, and guiding patients toward new choices. Then it was time to face the written test. I was terrible at multiple-choice tests—I had to study for months even to pass the driving test. Somehow, through gritty persistence or sheer luck, I passed the written exam. But not on my first try.

  Finally, I sat for the oral exam, which I thought would be the easiest part of the process. Two men conducted the interview, one who wore blue jeans and had long hair pulled back in a ponytail, and another who wore a suit and had a crew cut. They grilled me for hours. The man with long hair spoke sharply, tersely, asking me all the questions about statistics, ethics, and legal matters. The man with the crew cut asked all the philosophical questions, the ones that got my mind working more creatively, my heart more engaged. Overall, though, it was an unpleasant experience. I felt stiff and numb and vulnerable. The examiners didn’t make it easy—their expressionless faces, cold voices, and emotional distance were alienating. It was hard to put my energy into the next question when each previous one left me churning with self-criticism, with the desire to go back and revise what I had said, to say something, anything, that would elicit a nod of recognition or encouragement. When the exam finally ended, I felt dazed, my hands shook, I was both starving and nauseated, my head hurt. I was sure I had blown it.

  Just as I reached the front door, I heard footsteps behind me, someone running to catch up. Had I left my purse behind in my disorientation? Were they telling me already that I had failed? “Dr. Eger,” the man with the crew cut called. I braced myself, as though awaiting a punishment. He reached me, paused to catch his breath. My jaw and shoulders clenched. At last the man extended his hand. “Dr. Eger, it was an honor. You have a wealth of knowledge. Your future patients are very lucky indeed.”

  When I got back to my hotel, I jumped on the bed like a little girl.

  CHAPTER 16

  The Choice

  My joyous optimism, my sense of professional accomplishment, my feeling that I was reaching a full embodiment and expression of myself all withered when I established my private practice and met my first patient. I visited him in the hospital where he had been living for a month, awaiting diagnosis and undergoing treatment for what turned out to be stomach cancer. He was terrified. He felt betrayed by his body, threatened by his mortality, overwhelmed by the uncertainty and loneliness of illness. And I couldn’t reach him where he was. All of my skill in establishing a climate of warmth and trust, in building a bridge between me and my patient, had disappeared. I felt like a child dressed up in a doctor’s white coat. A fake. My expectations of myself were so high, my fear of failure so toppling, that I couldn’t see past my own self-absorption to reach the man who was asking for my help and my love. “Will I ever be healthy again?” he asked, and my mind flipped like a Rolodex, spinning through theories and techniques, my eyes pointed at the wall, trying to mask how nervous and scared I was. I was of no help to him. He didn’t invite me back. I realized, as I had when I met Tom, the paraplegic veteran, that my professional success had to come from a deeper place within me—not from the little girl trying to please others and win approval but from my whole and authentic self, the one who was vulnerable and curious, who was accepting of herself and ready to grow.

  In other words, I began to formulate a new relationship with my own trauma. It wasn’t something to silence, suppress, avoid, negate. It was a well I could draw on, a deep source of understanding and intuition about my patients, their pain, and the path to healing. My first years of private practice helped me to reframe my wound as something necessary and useful, and to shape and develop my most enduring therapeutic principles. Often the patients I worked with mirrored my own discoveries about the journey to freedom. Equally often they taught me that my search for freedom wasn’t complete—and they pointed me in the direction of further healing.

  * * *

  Although Emma was the identified patient, I met her parents first. They had never spoken to anyone, least of all a stranger, about the secret in their family: Emma, their oldest child, was starving herself to death. They were private, reserved people, a conservative German American family, their faces creased with worry, eyes filled with fear.

  “We’re looking for practical solutions,” Emma’s father told me that first visit. “We have to get her to start eating again.”

  “We heard that you’re a survivor,” Emma’s mother added. “We thought Emma could learn something from you, that you might inspire her.”
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  It was heartbreaking to see their panic for Emma’s life, to see their shock. Nothing in life had prepared them for a child with an eating disorder; they had never considered that something like this could happen to their daughter and their family, and none of their existing parenting tools was having a positive effect on Emma’s health. I wanted to reassure them. I wanted to ease their distress. But I also wanted them to begin to see a truth that might be even more painful for them to acknowledge than Emma’s illness—that they had a part in it. When a child is grappling with anorexia, the identified patient is the child, but the real patient is the family.

  They wanted to tell me every detail of Emma’s behaviors that concerned them: the food she refused to eat, the food she pretended to eat, the food they would find tucked inside napkins after family meals, the food they discovered stuffed into her dresser drawers, the ways she pulled away from them and retreated behind closed doors, the terrifying changes in her body. But I asked them instead to talk about themselves, which they did with obvious discomfort.