None of this is remarkable. Elva had been traumatized and now-suffered from commonplace post-traumatic stress. After an accident or an assault, most people tend to feel unsafe, to have a reduced startle threshold, and to be hypervigilant. Eventually time erodes the memory of the event, and victims gradually return to their prior, trusting state.
But for Elva it was more than a simple assault. Her world view was fractured. She had often claimed, “As long as a person has eyes, ears, and a mouth, I can cultivate their friendship.” But no longer. She had lost her belief in benevolence, in her personal invulnerability. She felt stripped, ordinary, unprotected. The true impact of that robbery was to shatter illusion and to confirm, in brutal fashion, her husband’s death.
Of course, she knew that Albert was dead. Dead and in his grave for over a year and a half. She had taken the ritualized widow walk—through the cancer diagnosis; the awful, toxic, gut-wrenching chemotherapy; their last visit together to Carmel; their last drive down El Camino Real; the hospital bed at home; the funeral; the paperwork; the ever-dwindling dinner invitations; the widow and widower’s clubs; the long, lonely nights. The whole dreadful catastrophe.
Yet, despite all this, Elva had retained her feeling of Albert’s continued existence and thereby of her persisting safety and specialness. She had continued to live “as if”—as if the world were safe, as if Albert were there, back in the workshop next to the garage.
Mind you, I do not speak of delusion. Rationally, Elva knew Albert was gone, but still she lived her routine, everyday life behind a veil of illusion which numbed the pain and softened the glare of the knowing. Over forty years ago, she had made a contract with life whose explicit genesis and terms had been eroded by time but whose basic nature was clear: Albert would take care of Elva forever. Upon this unconscious premise, Elva had built her entire assumptive world—a world featuring safety and benevolent paternalism.
Albert was a fixer. He had been a roofer, an auto mechanic, a general handyman, a contractor; he could fix anything. Attracted by a newspaper or magazine photograph of a piece of furniture or some gadget, he would proceed to replicate it in his workshop. I, who have always been hopelessly inept in a workshop, listened in fascination. Forty-one years of living with a fixer is powerfully comforting. It was not hard to understand why Elva clung to the feeling that Albert was still there, out back in the workshop looking out for her, fixing things. How could she give it up? Why should she? That memory, reinforced by forty-one years of experience, had spun a cocoon around Elva that shielded her from reality—that is, until her purse was snatched.
Upon first meeting Elva eight months before, I could find little to love in her. She was a stubby, unattractive woman, part gnome, part sprite, and each of those parts ill tempered. I was transfixed by her facial plasticity: she winked, grimaced, and popped her eyes either singly or in duet. Her brow seemed alive with great washboard furrows. Her tongue, always visible, changed radically in size as it darted in and out or circled her moist, rubbery lips. I remember amusing myself by imagining introducing her to patients on long-term tranquilizer medication who had developed tardive dyskinesia (a drug-induced abnormality of facial musculature). The patients would, within seconds, become deeply offended because they would believe Elva to be mocking them.
But what I really disliked about Elva was her anger. She dripped with rage and, in our first few hours together, had something vicious to say about everyone she knew—save, of course, Albert. She hated the friends who no longer invited her. She hated those who did not put her at ease. Inclusion or exclusion, it was all the same to her: she found something to hate in everyone. She hated the doctors who had told her that Albert was doomed. She hated even more those who offered false hope.
Those hours were hard for me. I had spent too many hours in my youth silently hating my mother’s vicious tongue. I remember the games of imagination I played as a child trying to invent the existence of someone she did not hate: A kindly aunt? A grandfather who told her stories? An older playmate who defended her? But I never found anyone. Save, of course, my father, and he was really part of her, her mouthpiece, her animus, her creation who (according to Asimov’s first law of robotics) could not turn against his maker—despite my prayers that he would once—just once, please, Dad—pop her.
All I could do with Elva was to hold on, hear her out, somehow endure the hour, and use all my ingenuity to find something supportive to say—usually some vapid comment about how hard it must be for her to carry around that much anger. At times I, almost mischievously, inquired about others of her family circle. Surely there must be someone who warranted respect. But no one was spared. Her son? She said his elevator “didn’t go to the top floor.” He was “absent”: even when he was there, he was “absent.” And her daughter-in-law? In Elva’s words, a “GAP”—gentile American princess. When driving home, her son would call his wife on his automobile telephone to say he wanted dinner right away. No problem. She could do it. Nine minutes, Elva reminded me, was all the time required for the GAP to cook dinner—to “nuke” a slim gourmet TV dinner in the microwave.
Everyone had a nickname. Her granddaughter, “Sleeping Beauty” (she whispered with an enormous wink and a nod), had two bathrooms—two, mind you. Her housekeeper, whom she had hired to attenuate her loneliness, was “Looney Tunes,” and so dumb that she tried to hide her smoking by exhaling the smoke down the flushing toilet. Her pretentious bridge partner was “Dame May Whitey” (and Dame May Whitey was spry-minded compared with the rest, with all the Alzheimer zombies and burned-out drunks who, according to Elva, constituted the bridge-playing population of San Francisco).
But somehow, despite her rancor and my dislike of her and the evocation of my mother, we got through these sessions. I endured my irritation, got a little closer, resolved my countertransference by disentangling my mother from Elva, and slowly, very slowly, began to warm to her.
I think the turning point came one day when she plopped herself in my chair with a “Whew! I’m tired.” In response to my raised eyebrows, she explained she had just played eighteen holes of golf with her twenty-year-old nephew. (Elva was sixty, four foot eleven, and at least one hundred sixty pounds.)
“How’d you do?” I inquired cheerily, keeping up my side of the conversation.
Elva bent forward, holding her hand to her mouth as though to exclude someone in the room, showed me a remarkable number of enormous teeth, and said, “I whomped the shit out of him!”
It struck me as wonderfully funny and I started to laugh, and laughed until my eyes filled with tears. Elva liked my laughing. She told me later it was the first spontaneous act from Herr Doctor Professor (so that was my nickname!), and she laughed with me. After that we got along famously. I began to appreciate Elva—her marvelous sense of humor, her intelligence, her drollness. She had led a rich, eventful life. We were similar in many ways. Like me, she had made the big generational jump. My parents arrived in the United States in their twenties, penniless immigrants from Russia. Her parents had been poor Irish immigrants, and she had straddled the gap between the Irish tenements of South Boston and the duplicate bridge tournaments of Nob Hill in San Francisco.
At the beginning of therapy, an hour with Elva meant hard work. I trudged when I went to fetch her from the waiting room. But after a couple of months, all that changed. I looked forward to our time together. None of our hours passed without a good laugh. My secretary said she always could tell by my smile that I had seen Elva that day.
We met weekly for several months, and therapy proceeded well, as it usually does when therapist and patient enjoy each other. We talked about her widowhood, her changed social role, her fear of being alone, her sadness at never being physically touched. But, above all, we talked about her anger—about how it had driven away her family and her friends. Gradually she let it go; she grew softer and more gentle. Her tales of Looney Tunes, Sleeping Beauty, Dame May Whitey, and the Alzheimer bridge brigade grew less bitter. Rapprochemen
ts occurred; as her anger receded, family and friends reappeared in her life. She had been doing so well that, just before the time of the purse snatching, I had been considering raising the question of termination.
But when she was robbed, she felt as though she were starting all over again. Most of all, the robbery illuminated her ordinariness, her “I never thought it would happen to me” reflecting the loss of belief in her personal specialness. Of course, she was still special in that she had special qualities and gifts, that she had a unique life history, that no one who had ever lived was just like her. That’s the rational side of specialness. But we (some more than others) also have an irrational sense of specialness. It is one of our chief methods of denying death, and the part of our mind whose task it is to mollify death terror generates the irrational belief that we are invulnerable—that unpleasant things like aging and death may be the lot of others but not our lot, that we exist beyond law, beyond human and biological destiny.
Although Elva responded to the purse snatching in ways that seemed irrational (for example, proclaiming that she wasn’t fit to live on earth, being afraid to leave her house), it was clear that she was really suffering from the stripping away of irrationality. That sense of specialness, of being charmed, of being the exception, of being eternally protected—all those self-deceptions that had served her so well suddenly lost their persuasiveness. She saw through her own illusions, and what illusion had shielded now lay before her, bare and terrible.
Her grief wound was now fully exposed. This was the time, I thought, to open it wide, to debride it, and to allow it to heal straight and true.
“When you say you never thought it would happen to you, I know just what you mean,” I said. “It’s so hard for me, too, to accept that all these afflictions—aging, loss, death—are going to happen to me, too.”
Elva nodded, her tightened brow showing that she was surprised at my saying anything personal about myself.
“You must feel that if Albert were alive, this would never have happened to you.” I ignored her flip response that if Albert were alive she wouldn’t have been taking three old hens to lunch. “So the robbery brings home the fact that he’s really gone.”
Her eyes filled with tears, but I felt I had the right, the mandate, to continue. “You knew that before, I know. But part of you didn’t. Now you really know that he’s dead. He’s not in the yard. He’s not out back in the workshop. He’s not anywhere. Except in your memories.”
Elva was really crying now, and her stubby frame heaved with sobs for several minutes. She had never done that before with me. I sat there and wondered, “Now what do I do?” But my instincts luckily led me to what proved to be an inspired gambit. My eyes lit upon her purse—that same ripped-off, much-abused purse; and I said, “Bad luck is one thing, but aren’t you asking for it carrying around something that large?” Elva, plucky as ever, did not fail to call attention to my overstuffed pockets and the clutter on the table next to my chair. She pronounced the purse “medium-sized.”
“Any larger,” I responded, “and you’d need a luggage carrier to move it around.”
“Besides,” she said, ignoring my jibe, “I need everything in it.”
“You’ve got to be joking! Let’s see!”
Getting into the spirit of it, Elva hoisted her purse onto my table, opened its jaws wide, and began to empty it. The first items fetched forth were three empty doggie bags.
“Need two extra ones in case of an emergency?” I asked.
Elva chuckled and continued to disembowel the purse. Together we inspected and discussed each item. Elva conceded that three packets of Kleenex and twelve pens (plus three pencil stubs) were indeed superfluous, but held firm about two bottles of cologne and three hairbrushes, and dismissed, with an imperious flick of her hand, my challenge to her large flashlight, bulky notepads, and huge sheaf of photographs.
We quarreled over everything. The roll of fifty dimes. Three bags of candies (low-calorie, of course). She giggled at my question: “Do you believe, Elva, that the more of these you eat, the thinner you will become?” A plastic sack of old orange peels (“You never know, Elva, when these will come in handy”). A bunch of knitting needles (“Six needles in search of a sweater,” I thought). A bag of sourdough starter. Half of a paperback Stephen King novel (Elva threw away sections of pages as she read them: “They weren’t worth keeping,” she explained). A small stapler (“Elva, this is crazy!”). Three pairs of sunglasses. And, tucked away into the innermost corners, assorted coins, paper clips, nail clippers, pieces of emery board, and some substance that looked suspiciously like lint.
When the great bag had finally yielded all, Elva and I stared in wonderment at the contents set out in rows on my table. We were sorry the bag was empty and that the emptying was over. She turned and smiled, and we looked tenderly at each other. It was an extraordinarily intimate moment. In a way no patient had ever done before, she showed me everything. And I had accepted everything and asked for even more. I followed her into her every nook and crevice, awed that one old woman’s purse could serve as a vehicle for both isolation and intimacy: the absolute isolation that is integral to existence and the intimacy that dispels the dread, if not the fact, of isolation.
That was a transforming hour. Our time of intimacy—call it love, call it love making—was redemptive. In that one hour, Elva moved from a position of forsakenness to one of trust. She came alive and was persuaded, once more, of her capacity for intimacy.
I think it was the best hour of therapy I ever gave.
6
“Do Not Go Gentle”
I didn’t know how to respond. Never before had a patient asked me to be the keeper of love letters. Dave presented his reasons straightforwardly. Sixty-nine-year-old men have been known to die suddenly. In that event, his wife would find the letters and be pained by reading them. There was no one else he could ask to keep them, no friend he had dared tell of this affair. His lover, Soraya? Thirty years dead. She had died while giving birth. Not his child, Dave was quick to add. God knows what had happened to his letters to her!”
“What do you want me to do with them?” I asked.
“Nothing. Do nothing at all. Just keep them.”
“When was the last time you read them?”
“I haven’t read them for at least twenty years.”
“They seem like such a hot potato,” I ventured. “Why keep them at all?”
Dave looked at me incredulously. I think a shiver of doubt went through him. Was I really that stupid? Had he made a mistake in thinking I was sensitive enough to help him? After a few seconds, he said, “I’ll never destroy those letters.”
These words had an edge to them, the first signs of strain in the relationship we had been forming over the past six months. My comment had been a blunder, and I retreated to a more conciliatory, open-ended line of questioning. “Dave, tell me some more about the letters and what they mean to you.”
Dave began to talk about Soraya, and in a few minutes the tension had gone and his self-assured easy jauntiness returned. He had met her while he was managing a branch of an American company in Beirut. She was the most beautiful woman he had ever conquered. Conquer was his word. Dave always surprised me with such statements, part ingenuousness, part cynicism. How could he say conquer? Was he even less self-aware than I had thought? Or, was it possible that he was far ahead of me and mocked himself—and me, too—with subtle irony?
He had loved Soraya—or, at least, she was the only lover (and they had been legion) to whom he had ever said, “I love you.” He and Soraya had a deliciously clandestine affair for four years. (Not delicious and clandestine but deliciously clandestine, for secrecy—and I shall say more about this shortly—was the axis of Dave’s personality around which all else rotated. He was aroused by, compelled by, secrecy, and often courted it at great personal expense. Many relationships, especially those with his three ex-wives and his current wife, had been twisted and torn by his unwil
lingness to be open or straight about anything.)
After four years Dave’s company transferred him to another part of the world, and for the next six years until her death, Dave and Soraya saw each other only four times. But they corresponded almost daily. He had kept Soraya’s letters (numbering in the hundreds) well hidden. Sometimes he put them in a file cabinet in quirky categories (under G for guilty, or D for depression—that is, to be read when deeply depressed).
Once, for three years, he had stored them in a safe deposit box. I wondered, but did not ask, about the relationship between his wife and the key to that safe deposit box. Knowing his penchant for secrecy and intrigue, I could imagine what would happen: he would accidentally let his wife see the key and then devise an obviously false cover story to churn her curiosity; then, as she grew anxious and inquisitive, he would proceed to despise her for snooping and for constricting him by her unseemly suspiciousness. Dave had frequently enacted that type of scenario.
“Now I’m getting more and more nervous about Soraya’s letters, and I wondered if you’d keep them. It’s just that simple.”
We both looked at his large briefcase bulging with words of love from Soraya—the long-dead, dear Soraya whose brain and mind had vanished, whose scattered DNA molecules had drained back into the basin of earth, and who, for thirty years, had not thought of Dave or anything else.
I wondered whether Dave could step back and become witness to himself. To see how ludicrous, how pathetic, how idolatrous he was—an old man, stumbling toward death, comforted only by a clutch of letters, a marching banner proclaiming that he had loved and been loved once, thirty years before. Would it help Dave to see that image? Could I help him assume the “witness to himself” posture without his feeling that I was demeaning both him and the letters?
To my mind, “good” therapy (which I equate with deep, or penetrating, therapy, not with efficient or even, I am pained to say, helpful therapy) conducted with a “good” patient is at bottom a truth-seeking venture. My quarry when I was a novitiate was the truth of the past, to trace all of a life’s coordinates and, thereby, to locate and to explain a person’s current life, pathology, motivation, and actions.
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