“I read some.”
“Some. I bet you read plenty. So you know the technique?”
I nodded.
“You know why I think you did that?”
I shut my eyes.
“So you could win, so you could defeat Halston, even if winning meant beating yourself.”
I opened my eyes. She was right. I hadn’t liked being surprised about the Brown Bonnet. I smiled.
“But you’re not so smart. You know why? Because nobody is. Not even Freud. You aren’t smart enough to figure out why you testified against your father.”
I felt odd. For the first time, a little scared. What was there to be scared of? I was dead, really. I was furious and unhappy to be alive, but what could scare me?
“Think about it. What changed from when you arrived in Spain to when you decided to leave? What was new? It’s right here.” She tapped the folder, still on the floor, with her foot. “It’s not in your letter, it’s in Halston’s family history. Under the heading of siblings. It’s important to know, as I’m sure you found out from your reading, it’s important to know if a patient is an only child, and also what order.”
I stopped thinking. I shut my eyes and saw nothing, no past, present or future. I prayed for her to leave.
“Do you have a half-brother or a half-sister?”
I opened my eyes. The room was glazed pink for a moment before clearing to its hospital fluorescence.
“You don’t know and neither does Halston. Okay,” she bent over, got the folder, and stood up, straightening her white smock. “I’m going. But ask yourself, who did you send into exile? Your father or that sibling?”
The horror for me, at this revelation, was that I had forgotten completely about Carmelita’s pregnancy. Until Susan mentioned it, I would have said I was an only child. And, more shocking than that, I wanted to argue about it. I wanted to say: How do we know that child was ever born?
Susan moved toward the door and then, apparently irritated beyond all reason, turned back. “You blame yourself for all the world’s problems. You make yourself into the greatest villain in the history of the world, full of terrible feelings and fantasies. But the one, perfectly natural, unpleasant feeling, your sibling rivalry, that, oh no, not that, that you don’t remember, that you don’t even notice.” If someone had come in they might have assumed, from her passion and my passivity, that she was the patient and I the doctor. “You’re not a terrible person, Rafe. You’re not so great either. Here’s the awful secret, the thing you’ve been keeping even from yourself: you’re just like everybody else and there’s no escape from that. Not even suicide.” She waited for this to sink in and then she laughed. “I should be defrocked,” she said and walked out.
I was ready for her when she appeared next, late the following morning, bringing my lunch.
“You’re lying,” I said, while she maneuvered the tray’s legs so the boiled chicken, peas and mashed potatoes would levitate above my chest.
She untied my right hand and offered the spoon. I took it. “No kidding. What about?”
“You do think you can treat me. That’s just a lame trick.”
“No, you’re wrong.” She pushed the left side of her messy hair out and it stayed there again, signaling for something. A cab? A hairdresser? She was big and odd, like a clown. “I told them today to assign somebody else. You’ll be seeing Dr. Blaustein this afternoon. He’s very good.”
“You’re lying,” I said, my mouth full of peas. One of them fell onto my neck.
“That’s why I’m here. To tell you I’m out. Didn’t want you to think it had anything to do with our talk yesterday. It’s not your fault. You’ve read about countertransference, haven’t you?”
I shook my head no. She explained it. That the doctor’s personality and history could interact harmfully with the patient flabbergasted me. I ate less and less while she expounded on this theme.
“Well,” she said, standing up. “I’ll call the nurse and she’ll clear your meal. You know,” she moved to the other side of the bed and untied my other hand, “I don’t think we need these restraints.” She looked at me with an encouraging smile, her head hanging low between her broad shoulders. Her hunched posture was another habit born out of self-consciousness about her height.
“Do you think Halston did a bad job with me?”
“Horrendous,” she said with utter conviction. I had no idea at the time how outrageous this statement was, a complete violation of ethics and sensible procedure. It was also, I believe, a brilliant stroke, the very quality that makes Susan a gifted therapist. “And, on top of that, since he had treated your mother, he should never have treated you. There’s no excuse for it.”
“Why? Because she killed herself?”
“No. Because he wasn’t listening to you, only to you. He had heard another side. He had years of impressions and judgments about key events in your life that hadn’t come from you. There was no way for him to give what you told him proper weight. He was prejudiced before you walked into his office. And there was the relationship to your uncle, to someone who had given him so much money. He couldn’t be open to receive your signals without a lot of interference.”
I must have fallen into a trance thinking hard back to every session, every exchange with Halston. I was startled when Susan said, “What are you thinking?”
She had sat down again, elbows on her knees, hair still askew, peering at me with her small, shy and yet intent eyes.
“I’m thinking something you won’t like,” I said.
“Big deal.”
“Big deal?”
“Lookit. You gotta do me a favor.” She straightened, locking her fingers together, and stretching her long skinny arms. “You gotta stop paying attention to what everybody else thinks.” Done with her body-yawn, she sat up, head back, allowing herself to be tall. “You’re carrying too big a load. To hell with what the rest of us think. So—what were you thinking?”
“I was thinking, if Halston was a bad doctor, why didn’t I see it?”
Susan smiled. “Beautiful. He does a bad job and it’s your fault. You know what that is? That’s pride. Yeah, I know, you think it’s modesty, you think it’s being tough-minded, hard on yourself. It’s grandiose. You were upset and confused. You were vulnerable. You didn’t have a chance in hell with Halston. No one would.” Susan shook her fist at me. “Don’t you get it? You’re a kid. You’ve been nothing but a kid your whole life. You haven’t had a chance with any of these people, from your mother to your uncle. Yeah, yeah, I know. You’re smart.” She gestured to the dismal room, the barred window, my untied restraints. From the hall I heard the almost perpetual moan of a seventeen-year-old schizophrenic. “Look where it’s got you.”
I felt like crying. My head was still broken by the drugs and everything hurt, keenly, unrelentingly. “Please,” I said. Susan leaned forward and said softly, “What?”
“Please. I need you to be my …” I was about to sob so I stopped, shut my eyes, forced the emotion down, and sighed. When I opened them, Susan was rubbing her forehead. The violence of her motion left streaks on her flat brow. She was uneasy. “Please help me,” I finished the thought.
Susan stared at me solemnly. I pleaded for rescue with my eyes. I was no longer sure what I had turned my back on. What had I wanted to die to avoid? There were double images for everything: my mother the lunatic, my mother the prophet; my uncle the barbaric king, my uncle the lonely patriarch; my father the revolutionary, my father the coward; my nation, the richest and most free, my nation, greedy and murderous. Was there really a different truth, a life I had lived and never known?
Susan looked down at the backs of her hands. Like the rest of her, they were long and bony. She turned them over, as if studying her palms. She had parted the index and middle fingers from the ring and pinky, making V’s, the silly and mysterious Cohen sign. She closed and opened them like scissors and glanced at me.
She looked surprised. “Why are you
smiling?” she asked.
“Do you know what my name means?” I said.
She looked confused.
“My name,” I said. “It’s a promise from God.”
Postscript
DR. BRACKEN’S WORK WITH ME AS A PATIENT TOOK TWO YEARS. THE reader does not need to go through the laborious, frustrating and often confusing process of the reconstruction of the facts, feelings, fantasies and truth of my past that was Susan’s difficult job, a job she did, I think it’s fair to say, brilliantly. The narrative account you have read was what we discovered in our work. Susan used many unconventional techniques, including having me do research to confirm certain memories.
My uncle was patient and faithful to his guardianship of me. He paid for all that help. To be sure, he was often angry with me and for a time seemed to be permanently disappointed about my prospects. Susan got me back in school by the following term and, although I was not the compulsive student I had been, I did concentrate on the sciences. My uncle wasn’t thrilled that I chose psychiatry as my discipline, but he understood, as I assume anyone would, why I felt obliged to devote myself to the imperfect science that, finally, in the hands of a talented practitioner, had saved me. Susan helped me understand the danger of my illusions. I chose psychology knowing I was not a genius and that I could not rescue the world, but I confess I embarked on my career with the hope that I might return, in a small way, the gift of peace and forgiveness granted to me by all the men and women who had dared to attempt an answer to these child-like questions: Who are we? Why do we do what we do? And—most naive and beautiful of all—can we change?
PART TWO
Gene Kenny:
A Case History
CHAPTER ONE
Countertransference
WITHIN MINUTES OF MY FIRST INTERVIEW WITH GENE KENNY, I KNEW I didn’t like him. I was twenty-five. I had received my medical degree from Johns Hopkins, done my residency at Bellevue, and was completing my training under the supervision of Dr. Susan Bracken at her clinic in Greenwich Village. I had no hint that treating Gene would profoundly alter the course of my life, I had no inkling of the tragedy that would engulf him, but I knew I didn’t want him for a patient.
Gene wasn’t my first patient, not by a long shot. He was, however, among the very first I worked with under Susan’s guidance. She had opened a community mental health clinic in a brownstone on Tenth Street, off Sixth Avenue. Uncle and Susan both considered me to be overqualified for this low-rent venue, but I wanted to learn from her and I liked the fact that the free or moderately priced therapy offered would attract a different class of patient. The well-heeled, articulate, attractive, mild neurotic that is typified in the public mind by Woody Allen movies, it seemed to me, had plenty of talent at their disposal.
In 1977, the year Gene Kenny began treatment, the clinic saw a wide variety of distress. Alcohol and drug addiction, wife and child abuse (and one case of husband abuse), a constellation of sexual disorders, crippling anxiety and chronic depression—all were plentiful, displayed by the diverse population of New York City, ranging from artists to Lower East Side gang members. What our patients had in common, with one exception, was lack of money. (The exception, an elderly woman, featured miserliness among her many anal-retentive attributes.) Of course schizophrenics also showed up, and a few people with problems I discovered were purely physical, but whose symptoms were first apparent in behavior—brain tumors, thyroid problems, certain kinds of migraines and one man with a collapsed lung. (He assumed his agonizing pain was psychosomatic. Not surprisingly, later on he did become my patient.) We referred those cases to Bellevue Emergency, as well as the schizophrenics, although we did see a few of the latter as outpatients.
Gene was fifteen. He had a full head of thick black hair, pale unhealthy skin, pouting lips, a strong chin, dark eyes, and a long skinny nose set slightly off center, like one of those Picasso Cubist faces. He looked European, although I must confess I don’t know what that means when, as a technical matter, everyone who isn’t black or Asian looks European. I guess what I mean is that his features were clearly not mixed. He seemed to be the child of generations of breeding from a specific region—Eastern Europe to my eyes. I was surprised when he opened his mouth and spoke in a thoroughly American way.
“They told me I was supposed to sit here,” he said from his slouched position in a chair. It was placed by the right wing of the desk. We were in one of two basement rooms for private sessions.
I had come from a group therapy session upstairs. It was eight o’clock, my last appointment of a twelve-hour day. I sat in the desk chair. “Hello, I’m Dr. Neruda.”
“Yeah,” he said. He averted his eyes with child-like shyness, a boy of eight, rather than the sullenness of an adolescent. “You’re Gene?”
He nodded. He rolled his full lips inward, between his teeth, and pushed them out, over and over, eyes intent on the surface of my desk. He appeared to be very nervous.
I had already read the preliminary interview, done by a New York University psychology graduate student interning for Susan. These were the facts: Gene was fifteen, an only child, in the ninth grade at the One Room School, a progressive private school in the Village, living with his parents on Lower Broadway. His father’s occupation was listed as photographer, and his mother’s as a copy editor working for a school textbook publisher. Since they qualified for free treatment, their income, at least on tax returns from the previous two years, was modest. (The private school was paid by his father’s mother. This could mean their income didn’t reflect their actual wealth; but Susan’s policy was first to decide if the patient deserved treatment and worry about payment later. If we took on Gene and discovered his grandmother was a millionaire, we would hope to be paid eventually. Anyway, this was less of an issue for me than for the other two staff therapists. I didn’t need a supplement to what Susan paid me.) At the bottom of the interview a paragraph stated he complained of sleeplessness, palpitations, loss of appetite, difficulty concentrating in school and that his mother had brought him in. She reported that Gene’s school had suggested they seek help; the school’s psychologist, a friend of Susan’s, had recommended us as a low-cost option. To relax him, I began with questions we both knew the answers to.
“Did your mother bring you?”
He nodded. “She’s waiting.”
“How old are you?”
“Fifteen.”
I went through a few more. Then, “So, what’s going on, Gene? Why are you here?”
“Mommy brought me,” he said.
I noted that he used a child’s term for her. “You don’t want to be here?”
He shrugged. His eyes roved the desk.
“Many people prefer to talk while lying on the couch. Would you like to lie on the couch?”
He frowned. His eyebrows were thick and jet black against the pallor of his skin. They were expressive and let me know he certainly did not want to. They crossed together in a frown, reared up in surprise, and then scanned the couch with an unmistakable look of fear and disgust.
I was about to tell him he could stay in the chair, when he said in a mumble, “Okay.” He hurried to the couch, never looking in my direction. He sat on the edge, head hanging, and waited, as if ready to be punished.
This was the moment when I experienced a strong feeling of dislike for Gene. It shocked me. I had never felt anything like it as a doctor. Both at the hospital and at the clinic, I had hostile, repulsive, sometimes physically deformed patients; patients who were trying and upsetting because of both their behavior and their appearance; patients who were virtually autistic or psychotic. I treated one schizophrenic who moved his bowels while I took his blood pressure. Certainly I hadn’t enjoyed many of those encounters but I never felt dislike, a complete lack of sympathy.
“You can take off your shoes,” I said, following a routine.
He pushed off each of his Keds sneakers without untying them and flopped back. Only his torso, however. His legs dra
ped over the side, feet skimming the parquet floor—another indication that he wasn’t happy about lying down.
“Do you want to be on the couch?”
He shrugged. I saw, but pretended not to. “What did you say?”
“It’s okay,” he said, almost inaudibly.
“I’m glad we’re doing what you want,” I said and immediately regretted it. What in God’s name did I mean by this taunting comment?
“What?” he mumbled.
“Nothing,” I said, compounding my mistake. A therapist should be the last person on earth to maintain that something said casually has no meaning. Besides, he had probably heard me. His “What?” was a reaction to the oddness of my remark. My cover-up just made things worse. For a moment I considered ending the session and fetching someone else to see him. Unfortunately, Susan was the only other staff present at that hour and she was busy.
“You can put your feet up,” I said.
He winced. His reaction was unmistakable: my suggestion caused him pain. Yet he promptly raised his feet to the couch. He submitted, but did not relax: keeping his knees bent, arms rigid, palms pressed onto the cushions, as if prepared to leap up.
I left my seat to move to the wing chair placed a little behind and to the side of the patient’s head on the couch. That would keep me out of sight unless he twisted his head and gave me an angle to view his expressions. Although it may strike the reader as silly, this seating arrangement was a deliberate reform of the tradition, which is a chair placed directly behind the couch, to prevent both therapist and patient from any chance of seeing each other’s face.
Gene heard my movement. Our floor had buckled from water damage over the winter and groaned at the slightest pressure. His head snapped to the side, his feet arched, and his right arm reached out as if to ward off an attack, like a newborn’s startle reflex.
“I’m going to sit in this chair,” I explained. Gene twisted to watch me. “If I stay behind my desk you’ll have to shout.”
Dr. Neruda's Cure for Evil Page 29