Dave never did get back to me about the letters—at least not in any way I could anticipate. But he did join the group, and attended the first several meetings faithfully. In fact, I was astounded at his enthusiasm: by the fourth meeting, he told us that the group was the high point of his week, and he found himself counting the days till the next session. The reason behind the enthusiasm was, alas, not the lure of self-discovery but the quartet of attractive women members. He focused solely upon them and, we learned later, tried to arrange to meet socially with two of them outside the group.
As I had anticipated, Dave kept himself well concealed in the group and, in fact, received reinforcement for his behavior from another secretive member, a beautiful and proud woman who, like him, looked decades younger than her years. At one meeting, she and Dave were asked to state their ages. Both refused, offering the ingenious dodge that they didn’t want to be age-typed. Long ago (when genitals were referred to as “privates”), therapy groups were reluctant to talk about sex. In the last two decades, however, groups talk about sex with some ease, and money has become the private subject. In thousands of group meetings, whose members supposedly bare all, I have yet to hear group members disclose their incomes.
But in Dave’s group, the burning secret was age. Dave teased and joked about it, but adamantly refused to state his age: he would not jeopardize his chances of scoring with one of the women in the group. In one meeting, when one of the women members pressed him to tell his age, Dave offered an exchange: his secret, his age, for her home telephone number.
I grew concerned with the amount of resistance in the group. Not only was Dave not seriously working in therapy, but his bantering and flirtatiousness had shifted the entire discourse of the therapy group to a superficial level.
At one meeting, however, the tone turned deeply serious. One woman announced that her boyfriend had just learned he had cancer. She was convinced he was going to die soon, though the doctors claimed that his prognosis was not hopeless despite his debilitated physical condition and his advanced age (he was sixty-three).
I flinched for Dave: that man at the “advanced” age of sixty-three was still six years younger than he. But he didn’t bat an eye and, in fact, began to speak in a far more honest fashion.
“Maybe that’s something I ought to be talking about in the group. I am very phobic about illness and death. I refuse to see a doctor, a real doctor”—gesturing mischievously at me. “My last physical exam was over fifteen years ago.”
Another group member: “You look like you’re in great shape, Dave, whatever your age.”
“Thank you. I work at it. Between swimming, tennis, and walking, I exercise a minimum of two hours a day. Theresa, I feel for you and your boyfriend, but I don’t know how to help. I do a lot of thinking about aging and death, but my thoughts are too morbid to talk about. To be honest, I don’t even like to visit sick people or listen to talk about illness. The Doc”—again, gesturing at me—“always says I keep things light in the group; maybe that’s why!”
“What’s why?” I asked.
“Well, if I start being serious here, I’ll start talking about how much I hate about growing older, how much I fear death. Some day I’ll tell you about my nightmares—maybe.”
“You’re not the only one who has these fears, Dave. Maybe it would be helpful to find out that everyone’s in the same boat.”
“No, you’re alone in your own boat. That’s the most terrible part about dying—you have to do it alone.”
Another member: “Even so, even though you’re alone in your boat, it’s always comforting to see the lights of the other boats bobbing nearby.”
As we ended this meeting, I was exceedingly hopeful. It felt like a breakthrough session. Dave was talking about something important, he was moved, he had become real, and the other members responded in kind.
At the next meeting, Dave related a powerful dream he had had the night after the previous session. The dream (recorded verbatim by a student observer):
Death is all around me. I can smell death. I have a packet with an envelope stuffed inside of it, and the envelope contains something that is immune to death or decay or deterioration. I’m keeping it secret. I go to pick it up and feel it, and suddenly I see that the envelope is empty. I feel very distressed about that and notice that it’s been split open. Later I find what I assume was in the envelope on the street, and it is a dirty old shoe with the sole coming off.
The dream floored me. I had often thought about his love letters, and had wondered if I would ever get a chance again to explore their meaning with Dave.
Much as I love to do group therapy, the format has one important drawback for me: it often does not permit the exploration of deeper existential issues. Time and again in a group, I gaze longingly at a beautiful trail that would lead me deep into the interior of a person, but must content myself with the practical (and more helpful) task of clearing away the interpersonal underbrush. Yet I couldn’t deny myself this dream; it was the via regia into the heart of the forest. Rarely have I ever heard of a dream that so transparently laid out the answer to an unconscious mystery.
Neither Dave nor the group knew what to make of the dream. They floundered for a few minutes, and then I supplied some direction by casually asking Dave whether he had any associations to the dream image of an envelope which he was keeping secret.
I knew I was taking a risk. It would be an error, probably a fatal error, either to force Dave into untimely revealing, or for me to reveal, information he had entrusted to me in our individual work before he started the group. I thought my question was within the margins of safety: I stayed concretely with the dream material, and Dave could easily demur by failing to have pertinent associations.
He gamely proceeded, but not without his usual coyness. He stated that perhaps the dream referred to some letters he had been keeping secret—letters of a “certain relationship.” The other members, their curiosity aroused, questioned him until Dave related a few things about his old love affair with Soraya and the problem of finding a suitable resting place for the letters. He did not say that the affair was thirty years over. Nor did he mention his negotiations with me, and my offer to keep the letters for him if he agreed to share all with the group.
The group focused upon the issue of secrecy—not the issue that now most fascinated me, though nonetheless a relevant therapeutic issue. Members wondered about Dave’s hiddenness; some could understand his wish to keep the letters secret from his wife, but none could understand his excess of secrecy. For example, why did Dave refuse to tell his wife that he was in therapy? No one bought his lame excuse that, if she knew he was in therapy, she’d be very threatened because she’d think he was there to complain about her, and also she’d make his life miserable by grilling him each week about what he had said in the group.
If he were, indeed, concerned about his wife’s peace of mind, they pointed out, look how much more irritating it must be for her not to know where he went each week. Look at all the limp excuses he gave her for leaving the house each week to attend the group (he was retired and had no ongoing business outside the house). And look at the machinations he went through to conceal his therapy-bill payment each month. All this cloak-and-dagger! What for? Even insurance forms had to be sent to his secret post office box number. The members complained, too, of Dave’s secretiveness in the group. They felt distanced by his reluctance to trust them. Why did he have to say “letters of a certain relationship” earlier in the meeting?
They confronted him directly: “C’mon, Dave, how much extra would it cost to come out and say ‘love letters’?”
The group members, bless their hearts, were doing just what they should have been doing. They chose that part of the dream—the theme of secrecy—that was most relevant to the way Dave related to them, and they whacked away at it beautifully. Though Dave seemed a little anxious, he was refreshingly engaged—no game playing today.
But I got greedy.
That dream was pure gold, and I wanted to mine it. “Does anyone have hunches about the rest of the dream?” I asked. “About, for example, the smell of death, and the fact that the envelope contains ‘something that is immune to death, decay, or deterioration’?”
The group was silent for a few moments, and then Dave turned to me and said, “What do you think, Doc? I’d be really interested in hearing.”
I felt caught. I really couldn’t answer without revealing some of the material Dave had shared with me in our individual session. He hadn’t, for example, told the group that Soraya had been dead for thirty years, that he was sixty-nine and felt near death, that he had asked me to be the keeper of the letters. Yet, if I revealed these things, Dave would feel betrayed, and would probably leave therapy. Was I walking into a trap? The only possible way out was to be entirely honest.
I said, “Dave, it’s really hard for me to respond to your question. I can’t tell you my thoughts about the dream without revealing information you shared with me before you entered the group. I know you’re very concerned about your privacy, and I don’t want to betray your trust. So what do I do?”
I leaned back, pleased with myself. Excellent technique! Just what I tell my students. If you’re caught in a dilemma, or have two strong conflicting feelings, then the best thing you can do is share the dilemma or share both feelings with the patient.
Dave said, “Shoot! Go ahead. I’m paying for your opinion. I have nothing to hide. Anything I’ve said to you is an open book. I didn’t mention our discussion about the letters because I didn’t want to compromise you. My request to you and your counteroffer were both a bit wacky.”
Now that I had Dave’s permission, I proceeded to give the group members, who were by now mystified by our exchange, the relevant background: the great importance of the letters to Dave, Soraya’s death thirty years ago, Dave’s dilemma about where to store the letters, his request that I store them, and my offer, which he had so far declined, to keep them only if he agreed to inform the group about the entire transaction. I was careful to respect Dave’s privacy by not revealing his age or any extraneous material.
Then I turned to the dream. I thought the dream answered the question why the letters were loaded for Dave. And, of course, why my letters were loaded for me. But of my letters I did not speak: there are limits to my courage. Of course, I have my rationalizations. The patients are here for their therapy, not mine. Time is valuable in a group—eight patients and only ninety minutes—and is not well spent by the patients listening to the therapist’s problems. Patients need to have faith that their therapists face and resolve their personal problems.
But these are indeed rationalizations. The real issue was want of courage. I have erred consistently on the side of too little, rather than too much, self-disclosure; but whenever I have shared a great deal of myself, patients have invariably profited from knowing that I, like them, must struggle with the problem of being human.
The dream, I continued, was a dream about death. It began with “Death is all around me. I can smell death.” And the central image was the envelope, an envelope that contained something immune to death and deterioration. What could be clearer? The love letters were an amulet, an instrument of death denial. They warded off aging and kept Dave’s passion frozen in time. To be truly loved, to be remembered, to be fused with another forever, is to be imperishable and to be sheltered from the aloneness at the heart of existence.
As the dream continued, Dave saw that the envelope had been slit open and was empty. Why slit open and empty? Perhaps he felt that the letters would lose their power if he shared them with others? There was something patently and privately irrational about the letters’ ability to ward off aging and death—a dark magic that evaporates when examined under the cold light of rationality.
A group member asked, “What about the dirty old shoe with the sole coming off?”
I didn’t know, but before I could make any response at all, another member said, “That stands for death. The shoe is losing its soul, spelled S-O-U-L.”
Of course—soul, not sole! That’s beautiful! Why hadn’t I thought of that? I had grasped the first half: I knew that the dirty old shoe represented Dave. On a couple of occasions (for example, that time he asked a woman member forty years younger for her phone number), the group had come close, I thought, to calling Dave a “dirty old man.” I winced for him, and was glad that the epithet had not been uttered aloud. But in the group discussion, Dave took it upon himself.
“My God! A dirty old man whose soul is about to leave him. That’s me, all right!” He chuckled at his own creation. A lover of words (he spoke several languages), he marveled at the transposition of soul and sole.
Despite Dave’s jocularity, it was apparent he was dealing with very painful material. One of the members asked him to share some more about feeling like a dirty old man. Another asked about what it felt like to reveal the existence of the letters to the group. Would that change his attitude about them? Another one reminded him that everyone faced the prospect of aging and decline, and urged him to share more about this cluster of feelings.
But Dave had closed down. He had done all the work he was to do that day. “I’ve gotten my money’s worth today. I need some time to digest all this. I’ve taken up seventy-five percent of the meeting already, and I know that others want some time today.”
Reluctantly, we left Dave and turned to other matters in the group. We did not know, then, that it was to be a permanent farewell. Dave never returned to another group meeting. (Nor, it turned out, was he willing to resume individual therapy with me or anyone else.)
Everyone, no one more than I, did a great deal of self-questioning. What had we done to drive Dave away? Had we stripped away too much? Had we tried too quickly to make a foolish old man wise? Had I betrayed him? Had I stepped into a trap? Would it have been better not to have spoken of the letters and to have let the dream go? (The dream-interpretative work was successful, but the patient died.)
Perhaps we might have forestalled his departure, but I doubt it. By this time, I was certain that Dave’s caginess, his avoidance and denial, would have ultimately led to the same result. I had strongly suspected from the beginning that he would likely drop out of the group. (The fact that I was a better prophet than therapist, however, gave me little solace.)
More than anything, I felt sorrow. Sorrow for Dave, for his isolation, for his clinging to illusion, for his want of courage, for his unwillingness to face the naked, harsh facts of life.
And then I slipped into a reverie about my own letters. What would happen if (I smiled at my “if”) I died and they were found? Maybe I should give them to Mort or Jay or Pete to store for me? Why do I keep troubling myself about those letters? Why not relieve myself of all this aggravation and burn them? Why not now? Right now! But it hurts to think about it. A stab right through my sternum. But why? Why so much pain about old yellowing letters? I’m going to have to work on this—someday.
The Lost Mariner
OLIVER SACKS
You have to begin to lose your memory, if only in bits and pieces, to realize that memory is what makes our lives. Life without memory is no life at all.… Our memory is our coherence, our reason, our feeling, even our action. Without it, we are nothing. (I can only wait for the final amnesia, the one that can erase an entire life, as it did my mother’s.…)
Luis Buñuel
This moving and frightening segment in Buñuel’s recently translated memoirs raises fundamental questions—clinical, practical, existential, philosophical: what sort of a life (if any), what sort of a world, what sort of a self can be preserved in a man who has lost the greater part of his memory, and, with this, his past, and his moorings in time?
It immediately made me think of a patient of mine in whom these questions are precisely exemplified: charming, intelligent, memoryless Jimmie R., who was admitted to our Home for the Aged near New York City early in 1975, with a cryptic transfer note s
aying, “Helpless, demented, confused, and disoriented.”
Jimmie was a fine-looking man, with a curly bush of gray hair, a healthy and handsome forty-nine-year-old. He was cheerful, friendly, and warm.
“Hiya, Doc!” he said. “Nice morning! Do I take this chair here?” He was a genial soul, very ready to talk and to answer any questions I asked him. He told me his name and birth date, and the name of the little town in Pennsylvania where he was born. He described it in affectionate detail, even drew me a map. He spoke of the houses where his family had lived—he remembered their phone numbers still. He spoke of school and school days, the friends he’d had, and his special fondness for mathematics and science. He talked with enthusiasm of his days in the navy—he was seventeen, had just graduated from high school when he was drafted in 1943. With his good engineering mind, he was a “natural” for radio and electronics, and after a crash course in Texas found himself assistant radio operator on a submarine. He remembered the names of various submarines on which he had served, their missions, where they were stationed, the names of his shipmates. He remembered Morse code, and was still fluent in Morse tapping and touch-typing.
A full and interesting early life, remembered vividly, in detail, with affection. But there, for some reason, his reminiscences stopped. He recalled, and almost relived, his war days and service, the end of the war, and his thoughts for the future. He had come to love the navy, thought he might stay in it. But with the GI Bill, and support, he felt he might do best to go to college. His older brother was in dental school and engaged to a girl, a “real beauty,” from California.
With recalling, reliving, Jimmie was full of animation; he did not seem to be speaking of the past but of the present, and I was very struck by the change of tense in his recollections as he passed from his school days to his days in the navy. He had been using the past tense, but now used the present—and (it seemed to me) not just the formal or fictitious present tense of recall, but the actual present tense of immediate experience.
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