Dr. Neruda's Cure for Evil

by Rafael Yglesias

  I said I could believe it and congratulated him. I noticed he was wearing a wedding ring. “You’re married?” I asked.

  “Oh yeah. Junior year at MIT. And I got a son!” He was on the edge of his chair, talking energetically, though slurring his words. His eyes retained his boyish timidity, a tendency to avoid mine, rarely glancing at me, and those were darting movements, as if to catch me unawares. “He’s six.” He squirmed in the Ritz’s huge leather wing chair and pulled a wallet from his back pocket. It was falling apart, stuffed with bills and slips of paper. I looked at several photos of his boy, Peter, and his wife, Cathy. Peter’s hair was curly blond, the curls from Gene, the color from the mother. He had an appealing face, also a mixture of his parents: Gene’s big wondering eyes and expressive eyebrows; his mother’s strong chin and tight mouth. Cathy’s looks weren’t a surprise. Other than the sandy blonde hair and pinched mouth, she had Carol Kenny’s shape and attitude—wiry, head pushed forward, eager for approval, smiling too hard. Stop being a shrink, I told myself, and said, “What a beautiful family, Gene.”

  “They’re great!” he said. “Thank God for my wife. She made me who I am.” He glanced at me—the darting look of confirmation—and then away, reaching for his drink. “And you. I’d have no life at all if it weren’t for you.” He drained his glass, bouncing ice cubes against his teeth.

  “You did it, Gene. You’ve made a success of your life. You know, that’s the scam of psychiatry. The patient does all the work and we take all the credit.”

  Gene put his glass down. He cleared his throat and frowned. “I don’t believe that,” he said quickly and rushed on. “Cathy once asked me about you and I realized something terrible, really embarrassing.” He checked on me fast and then focused on a hunting print behind my chair. “I never asked you anything about yourself. I just poured my heart out for three years and never found out anything about you.”

  “You were right. You instinctively understood that I was merely a symbol. You knew everything about me you had to know.”

  That earned me the longest look of our relationship: head cocked, his wide mouth twisted into a blend of curiosity and amusement. “What do you mean?”

  “I was a stand-in for whomever you were working things out with. Sometimes I was your mother, sometimes I was your father, sometimes I was you, or parts of you anyway.” I realized I had fallen into pomposity, used to lecturing from all the testifying and interviews. I waved my hand. “Don’t worry about it. If you hadn’t gone off to college we probably would have continued the therapy for a while—”

  “Really?” Gene interrupted pointedly.

  “Not for long. Not really to discover things, just a more gradual end to the therapy. If you had had separation problems in general, we certainly would have taken our time, but you were eager to get on with your life and that’s healthy. Anyway, as part of that weaning, I guess you could have asked some things and realized I was just a person, someone quite different from the incarnations of the therapy. But I don’t approve of therapists and patients becoming friends afterwards. I trained under my psychiatrist—you remember Susan Bracken?”

  “Sure. She was your doctor? No kidding.”

  I nodded. “First she was my shrink, then she was my training analyst, finally my boss. We became good friends. But she’ll always be something other than merely a person to me. In fact, I no longer work for her partly because I couldn’t resist the urge to run to her for help with every patient. And, although I like to think I’m her friend, she’ll always be more than just a friend to me.” I looked at my watch. “I really have to get some sleep …”

  “Sure.” Gene waved to the one sleepy waiter left on duty. He asked for the check, which was instantly produced. Gene stopped me from reaching for it. “It’s mine. This is the first time in my life I’ve got an expense account.” He sent the waiter off with a hundred-dollar bill.

  “How are your parents?”

  “Dad’s great. I mean, he’s moody. You know, up and down about his career, but really he’s having a good time. And Mom.” He sighed. “Mom never really got over the divorce and then she got sick.”

  “Something serious?”

  “Yeah. Ovarian cancer. She died just before Peter was born.” Gene spoke with no affect, as the jargon goes. No sadness, no anger. Just the fact. I considered the timing. His mother had died three years after our last session, while his new wife was pregnant and he was graduating from college. The death of a parent is always stressful, naturally, and those circumstances would have made it much more so. To borrow a phrase from Gene’s work, my professional systems came on line, a bit wearily, but instinctively.

  “I’m sorry, Gene,” I said with all the feeling I thought he should have. I didn’t have to fake it; I felt true sympathy. His relationship with his mother had been difficult and, as far as I knew, unresolved. The timing of her death was cruel; not that death can be well-timed, but, given her emotionally incestuous relationship to Gene, somewhere it must have felt to him that she died because he had replaced her with another woman, another family. Had Gene really managed this without the need for help? If so, that was impressive and meant our work together had been much more successful than I had any right to expect.

  [Cure is used too casually, to say the least, in my profession. Psychopharmacologists use it when an objective observer might say the patient has had his most severe symptoms overwhelmed by chemicals. Talking therapists use it when others might say that a particular issue has been resolved. In theory, a cure should mean that a patient has achieved a feeling of harmony—homeostasis—and has the strength to regain that balance on his own each time life deals one of its inevitable blows. In my experience the latter is the rarest of accomplishments. An event such as Carol Kenny’s early death just as Gene was pouring the foundation for his own family, often sends a patient back to therapy, usually to repeat what was done before, but sometimes—this was Jung’s main preoccupation—for the sake of consolidation and further growth. Some believe, in particular psychopharmacologists, that this apparent recidivism proves talking therapy doesn’t work. That seems to me to underestimate life’s difficult terrain. To scale one mountain doesn’t mean a higher one won’t require a guide or that previously acquired skills were useless.]

  The waiter had returned. Gene occupied himself with taking his change and leaving a tip. He hadn’t acknowledged my sympathy. He stood up, feet wavering from the alcohol.

  “It must have been hard on you.”

  Gene pressed his lips in and nodded. “I thought about calling you.”

  “You could have. I hope I made it clear—”

  “Oh yeah. I knew that.” He was so unsteady on his legs that he reached for the wing chair with his left hand. “But what could you say? She didn’t last long. They caught it late. Cathy got me through it. And then Pete was born. I was just sorry Mom never got to see him.” He looked down and was a sad sight, in his prep school clothes, seemingly on the verge of tears. The frantic energy of the computer triumph was gone. “Well,” he said with a sigh. “Time to go home.”

  I walked him downstairs to the lobby, pausing near the doors. I asked him if he wanted me to recommend therapists near his home.

  “You got a network, huh?” Gene said with a laugh.

  “I can ask around and—”

  “Thanks,” he lightly touched my shoulder and immediately let go. “Everything’s okay now. Really. I gave you the wrong impression. If Flash II had been a bust, I would need help, but now I’ll be fine.” I got one of his sideways glances: his eyes were bloodshot and, to my mind, scared. The doorman asked if Gene wanted a cab. He said yes and offered me his hand. “Thank you for everything. That’s what I wanted to say.”

  I shook his hand and said, “Wait.” I removed a card from my wallet. “Here’s where you can reach me. Call if you want me to recommend someone to see in your area. Or just to talk, of course.”

  Gene declined with a shake of his head, eyes down. “I’m ok
ay.” Then he accepted the card. “Okay. Thanks.” He hurried out the revolving door, stumbling when he reached the curb. The doorman took his elbow for a moment. Gene looked back before entering the cab and waved, still, to my eyes, a little boy bravely going to school.

  I knew it was only a matter of time before I would hear from him again. He called a few months later, in the spring. He said he was having trouble sleeping. “We worked like madmen on Flash II,” he told me. “Eighteen, twenty hours a day. Sometimes I didn’t sleep for two nights running. I guess I can’t get back to norm, I can’t unwind. Is there someone I can see who will give me some sleeping pills?”

  Obtaining sleeping pills, unfortunately, is easy in America, the land of instant gratification, so I assumed this was a smoke screen. I wondered why Gene was embarrassed to admit he needed help. Did he feel he was letting me down? “Let me make some calls and get a few names for you. I want to make sure I can tell you something about them so you have a basis for making a choice.”

  “Well … it might only be for a session or two, you know. Don’t go to too much trouble.”

  Yeah, why go to any trouble? It’s only your mental health. I was annoyed. Passivity and the self-defeating fear of satisfying his needs—his symptoms were back, full-blown. Maybe Gene had been right to be afraid to ask me for help; my vanity didn’t seem to be taking it well. “No trouble,” I said. “You know, Gene, I don’t really think merely taking some sleeping pills will help. You might need only a few sessions, but if this has been going on for months, there’s more to it than getting a night’s sleep.”

  “Oh,” he said and was quiet.

  “I’ll get you some names and call you back.”

  Once again, I felt there was an odd connection between Gene and myself, and I was relieved I could pass him on to another therapist. The timing of his reappearance felt provocative. That very day Uncle Bernie was in the Tower at New York Hospital, about to undergo a gruesome radical treatment for advanced pancreatic cancer. His doctors planned to flood his body with a massive dose of chemotherapy, dangling him over the edge of death. His appendix and spleen were to be removed. His kidneys would be continuously filtered, a respirator would breathe for him, his blood would be changed many times over. For three days he would run a fever of one hundred and four. He would probably need to be packed in ice to keep it that low; any higher and there would be brain damage. And throughout this there would be excruciating pain, none of it able to be relieved with morphine; Uncle would have to endure unaided. Basically the idea was to kill all the stem cells, followed by a bone-marrow transplant from his daughter. If he survived, presumably the cancer would be permanently gone. The treatment was a roll of the dice. To me it sounded like the old joke: if the medicine didn’t kill him, he would be cured. This procedure had been tried only six times. Four were a success—in the immediate sense, since the survivors had been in remission for merely a year. The two failures died within twenty-four hours. Of course the numbers were too small to be meaningful. The rationale for its horrific risk was that Bernie was doomed anyway.

  Before leaving for the city, I had a free half hour to call a friend from Hopkins, Bill Roth, now at Cambridge Hospital. I assumed he could recommend psychiatrists near Gene in Massachusetts. I was in my office in White Plains, used as a base for our work with abused children. We were minutes from a state-run child welfare center where Diane, Ben and I were on the staff, our prime responsibility. The Grayson Case continued to keep at least two of us traveling to Boston, now for the sake of treating the children rather than satisfying the law. Thus, things were backed up at the welfare center and I was going to lose at least three more days because of Bernie.

  “Is your ex-patient a serious fruitcake?” irreverent Bill asked. “Or just a whiner?”

  “I think he could use some grief work, but I don’t know for sure. I’ve been out of touch.”

  “Oh, you want a hugger. How about Toni? Remember her?” She was an excellent psychologist we knew at Hopkins. “She’s somewhere in the Massachusetts burbs now. She could make anyone feel glad to be alive. Press against her melons and you could watch your house go down in flames without a peep.”

  “She only hugged you, not her patients. Also, my patient wants a psychiatrist to write prescriptions. He thinks he needs sleeping pills.”

  “And you approve?”

  “I’m hoping the genius you recommend will see through my patient.”

  “I’m looking at the map. Toni can’t be more than half an hour from this guy. Why don’t you tell your patient that if Toni thinks he needs downers, you’ll write the prescription?”

  “I thought of that. But I assumed you’d call me a control freak.”

  “What’s wrong with being a control freak?”

  Toni was a good choice, in many ways a better choice for Gene than I was, certainly now that Gene was an adult. I tried her, but she was out. Getting to her and then to Gene would have to wait. It was time to drive into the city to gather with what was left of the Rabinowitzes at New York Hospital. More to the point for me, I needed to make what might be my farewell to Bernie.

  When I got off the elevator on Bernie’s floor, Aunt Sadie was there, leaning on a cane. She had broken her hip two years ago in Palm Beach, chasing after Daniel’s firstborn near the pool. She walked without a limp, using the cane when she felt tired. She feared another fall; it offered security more than support. “Oh, Rafe,” she said. “I was just going for coffee. They won’t allow any food in there.”

  I hugged her. Her cane tapped against my side. She was clear-eyed when I first saw her. While we embraced, I felt her head tremble against my chest. Sure enough, as we broke the clinch, there were tears.

  “I was afraid you wouldn’t be here,” she said.

  “Of course I was coming.”

  “I thought you’d get stuck somewhere with your work.”

  “Sadie, what’s wrong?”

  Her old face was soft and benign: padded cheeks, eyes uncertain, mouth slack. Uncle Leo had died suddenly five years ago, a massive coronary. Her sons and grandchildren lived in Houston and Chicago. She saw them only a few times a year. And the hip, too, of course. She was sarcastic: “You’re asking what’s wrong?”

  “I mean, is there something new?”

  “She’s here.” Sadie said the pronoun with scorn. “She” was my uncle’s second wife, Patricia, about twenty years his junior, a sharp-tongued real estate broker who sold Uncle his home in Palm Beach and then sold herself to him. The family, meaning Sadie and Bernie’s daughter, believed Pat was more interested in Uncle’s money than in him. They had been married for a decade, and happily so far as I knew.

  “Well, she is his wife.”

  “Can’t stand her. Not now,” Sadie added, pulling away from me, brushing lint off her blue blouse.

  “Don’t you see her all the time in Florida?”

  “Not if I can help it.” Sadie narrowed her eyes. The look reminded me of my mother. “She’s counting his money right now.” But here was a difference between my mother and her sister. The stern, suspicious look evaporated and Sadie laughed at herself. “Don’t listen to me. I’m crazy. Old and crazy. She deserves his money. She’s been good to him.” She moved to the elevator, focused on her cane, which she wielded more like a toy than an aid, jabbing the floor, using its handle to press the button. “He’s my baby brother,” she said, her throat clutching on the word baby.

  I studied her face. It was placid. “He’s a strong man,” I said. “He could make it through this.”

  “Doctors are crazy. They like to torture you before you die. What do they care? It’s all about money.”

  “You sound like a communist, Aunt.”

  “I didn’t mean you, dear. You’re a saint,” she said with absolute seriousness.

  I laughed and then sang softly, “El veinticuatro de octubre, el dia de San Rafael.”

  Sadie smiled. “What’s that?”

  “The twenty-fourth of October is the
day of Saint Rafael,” I translated. “My saint’s day. My grandmother Jacinta used to call me on the twenty-fourth and sing it.”

  “Was she religious?”

  “No.”

  Sadie frowned. The elevator arrived. She entered. Behind her was a tired orderly in a dirty smock, a mop and bucket beside him. He leaned against the back, eyes closed, ignoring us. Sadie pressed a button, still frowning, preoccupied. “Your mother used to say she was a sweet lady.” The doors closed on her.

  I found Uncle in a huge corner room, commanding a sweeping view of the East River and Manhattan. His wife, Pat, was with him. She was tanned and fashionably skinny, dyed black hair brushed back flush to the scalp, and dressed with understated elegance: white blouse, black skirt, and a rope of simple but expensive pearls around her neck. She said, “Here he is,” as I entered. She kissed the air near my cheek, a hand squeezing my forearm. “He’s been driving me crazy waiting to see you.” She went to the door. “I’ll keep everybody out until you’re done with Rafe.” She left, shutting it behind her.

  Although his face was still full, Uncle had already lost fifty pounds. His hair had receded halfway back and was all gray, but the skin had amazing youthfulness—few lines and the translucent glow of a newborn. He sat in a chair by the windows, wearing a long navy blue robe, a glass of water beside him. There were piles of legal documents on a table. He stood up and that’s when the frailty of his torso became obvious. His head was too big for his skinny neck and wasted chest. I hugged him. He patted my back tentatively. “You look great,” he said and pushed away. He seemed unsteady. I took his left hand and held it while he carefully settled back into the chair. My eyes fell on his knuckles. The tufts of hair were white now, still seemingly brushed into an elegant knot, but looking sparser because of their color. There were several liver spots, a big one under his thumb, another beneath his pinky. There was a persistent tremor in the wrist that vibrated to his fingers and kept them perpetually animated. He gestured for me to pull up a chair opposite him.