I shoved the bald man. He was perched awkwardly and toppled easily. “Get off!” I shouted. “I said he can’t breathe!”
“Hey!” His companion complained.
The bald man glared at me, but didn’t make a move.
I told them to call an ambulance to take him to Columbia Presbyterian. I checked Al and was sure that he had a concussion. He slipped in and out of consciousness, losing it at one point for over a minute, his respiration so feeble that I began mouth-to-mouth and was prepared to do a tracheotomy. He roused enough from the CPR. I made sure his air passages were unblocked, that he was warm, and I quizzed the attendants about his medications. They claimed to know nothing. I didn’t believe them. I suspected they had raised his dose of Ritalin. I went along in the ambulance to the hospital. I called ahead to a friend in residence there who met us at the emergency room.
What followed was hours of bureaucratic hassles. X-rays confirmed Al had a concussion. The shelter insisted Al should be transferred to Metropolitan State. I wanted him kept overnight at Columbia until I could get the results of blood tests.
Until then, I had had good relations with the head of the Yonkers shelter, Becky Thornton. Not this time. She was outraged by my interference and stonewalled my questions about Albert’s assault on the boy as well as what drugs he had been given. She threatened to get a warrant and have Albert transferred by the police.
“You don’t want to do that,” I told her. “You don’t want me to go to court to vacate the warrant and demand an investigation. You don’t want people to ask how Albert got ahold of a weapon—”
“It was a spoon!”
“—or how well the children were being supervised or to have me testify to the brutal treatment I witnessed by your employee.”
“Tom and Bill were trying to protect you. That’s all.”
“Tom and Bill could have accidentally killed Albert.”
“That’s an outrageous charge.”
“No it isn’t. Something was affecting Al’s respiratory system and once he concussed he was in real danger of total failure. That would have been a disaster for your shelter and for my clinic. I don’t plan to expose their negligence. But if you interfere with Albert’s care, I will. At this point, I have no confidence in your people.”
“Look, I admit we can’t handle him. That’s why we want to transfer him to the Met State. We took him to your clinic as scheduled only because I knew you’d throw a fit—”
“Throw a fit? When have I ever thrown a fit?”
“Excuse me. I knew you would complain if we transferred him without your seeing him. It was out of respect.”
“It wasn’t out of respect. The court ordered those visits. You had to bring him. Do yourself and me and Al a favor. Leave him at Columbia overnight.”
“And what if he attacks somebody there?”
“He has a concussion.”
“That’s not a guarantee.”
“I’ll take full responsibility for him. If something happens, it’s on my head.”
“I need that in writing.”
Her two attendants, Tom and Bill, were still at Columbia. I wrote a note to satisfy her and gave it to them.
To be safe I would spend the night at his bedside. Albert was certainly capable, psychologically, of attacking someone, or escaping, or committing suicide. I could order them to put him in restraints or heavily sedate him, but that was exactly how people like Al, who have no one to sacrifice themselves for their benefit, are treated by our system. Drugs are used in place of contact; indifferent or hostile attendants instead of care. He had been bounced from psychiatric jail to shelters to foster care since he was rescued from his mother—Al’s rape of his niece was what called the police’s attention to his own abuse. I believed this new attack was another call for rescue. Something had happened; maybe it was the medication. Didn’t matter. I had to show him that someone was willing to deal with him as a person. Otherwise, certainly he would be lost. Lost as a human being; not as a menace. Eventually, the system would let him out and he could well become the world’s notion of an unfathomable monster—a vicious serial killer.
I called Diane and explained. She listened to the full account, not commenting until I was finished. “I fucked up, honey,” she said. “I was a wimp and I dumped it on you. I’m sorry. I’ll come right over.”
I insisted she rest and perhaps join me in the morning. I told her not to blame herself for her antipathy to Albert. And we discussed the beginnings of a plan.
When our talk was over, I walked down the hall to Al’s room. He was tied to the bed. I wouldn’t have the test results until morning. He was awake. His right foot was shaking, the leg’s quadricep bulging and releasing rapidly. He stared at me. I untied the straps and massaged his leg. The spasms were ferocious and completely local. The rest of his body was enervated and motionless.
“Is it hurting you? The spasms?”
He shook his head. “I don’t feel pain, you know,” he said.
I couldn’t help the muscle—its demonic animation seemed to mock me. I covered him with another blanket and asked if he wanted to eat.
He shook his head.
I rang for the nurse and told her to bring soup.
When it arrived, he said, “Don’t want it.”
I spooned up some and held it near, but not at, his lips. He stared at me. “What?” he asked.
“I think you should reconsider.”
He turned his head away, then quickly back to swallow the soup, as if tricking me. I measured another spoonful and waited. He looked at me this time without any hostility. “I ain’t gonna change,” he said.
“That’s what everybody else thinks,” I said.
“Except you?”
“Me? I don’t know. I don’t have an opinion. Whether you change or not I’m still here to help.”
He took the spoonful, swallowed and then said mildly, “I tried to fuck him.”
“The boy whose arm you broke?”
“Yeah.”
“You tried to rape him?”
“No. He wanted me to fuck him. He’s gay.”
“He’s gay? They told me he was ten years old.”
“So what?”
“At ten I don’t believe people are gay or straight.”
“That’s bullshit. Everybody knows people are born gay.”
I offered another spoonful of soup. Al said, “I can feed myself.”
I gave him the bowl. He ignored the spoon and took a long drink.
“Are you gay?” I asked.
“I’m nothing. I can’t fuck.”
“That’s why you broke his arm?”
“That gets me hard.”
“And then you can fuck?”
“Yeah.” He smiled at me. “Fuck them over. Then I can fuck.”
“I see.”
“Now your Johnson is happy.”
“I don’t know what you mean.”
“That makes you hard. You got a jones for knowing shitty stuff.”
“I’ll listen if that’s what you mean.”
“I can tell you lots of nightmares. None of that Freddy the Thirteenth shit. Real nightmares. That what you want?”
“Yes,” I agreed. “You tell me all the shitty stuff.”
CHAPTER EIGHT
The Wishing Well
TWO DAYS LATER, WITH LESS THAN TWO HOURS OF SLEEP UNDER MY BELT, I was startled by Gene’s appearance at lunchtime for his session. I had forgotten our appointment. Diane, Ben, and our recently added therapist, Rand Carlton, were on their way out of my office after a staff meeting. Diane and I had told the others of our idea that we add a ten-room dormitory to the clinic, hire a few non-professionals we knew who had experience with abused children, and house those, like Albert, who were truly at risk in the welfare system. They were enthusiastic. Diane, still feeling guilty, told Rand and Ben that she had lost her nerve on Saturday and deserted me. I said her reaction was understandable, that Albert’s mental condition was fright
ening and now we knew why. The tests showed he had toxic levels of Ritalin in his system, prescribed by the Metropolitan State’s casual psychopharmacologist, who had spent less than ten minutes talking to Albert. I consulted Joseph as soon as I had the results. To his credit, he admitted that probably a rebound effect was in play; the medicine, instead of curing Albert’s alleged hyperactivity, was now its cause.
“Shrinks,” Joseph said. “They love to prescribe. Didn’t he know raising the dose—?”
“—He doesn’t see a human being when he looks at Albert,” I said. “He sees a repulsive frightening black boy.”
Joseph advised me on weaning Albert off Ritalin to minimize what was sure to be a severe withdrawal. When Joseph suggested I try another drug to ease his suffering, I said quickly and loudly, “No!”
“Okay,” Joseph said. “But you won’t dismiss Prozac because of this?”
“They’re not using it on kids, are they?” I asked.
“Well … I don’t know. Maybe.” He sighed. “Probably.”
“Listen to me, Joseph. I’ll keep an open mind and study your miracle. But do yourself a favor, try to issue some guidelines.”
“We do. Rafe, nothing can be done about sloppy doctors.”
“Joe, that’s not really an answer. The truth is, you don’t know exactly what you’re doing.”
“We know enough.”
“Do you know what serotinin does?”
“Well, the monkey studies—”
“Do you know exactly what it does?”
“No. Not exactly, Rafe. We don’t really understand the brain.”
“So why fuck with it, Joe?”
“But Rafe. Be realistic. If we don’t try the drugs on people how do we know if they work? There’s no progress without risk.”
“I’ll keep an open mind, if you do a good job of monitoring how Prozac is being used.”
Joseph laughed. “Deal,” he said. He laughed again. “As if I really can.”
Our lawyer, Brian Stoppard, obtained an order from a friendly judge on Sunday to keep Al at Columbia Presbyterian under our supervision. I stayed by his bedside until Monday morning. By then, though still on a low dose of Ritalin, the flu-like symptoms of withdrawal had begun. He moaned while asleep and his sleep was more akin to a delirium: sweat soaking the sheets, legs twitching or bicycling in the air. A nurse’s reaction to his condition illustrates the difficulty with patients like Albert. She saw him, asleep, legs rotating in the air, and said, “He’s a real psycho, huh?”
I hired Tania Gold, a sixty-year-old woman with many years of foster care experience, to relieve Diane and me on Monday and went to the clinic.
If I had remembered my appointment with Gene I would have canceled. I was exhausted, anxious, enraged and confused. I knew the drugs in use were no good. But the kindling studies rattled me. What if emotional trauma caused unseen brain damage that no amount of talk could cure? Then my cause was hopeless and there were no medicines to help. I could believe Joseph on a theoretical level; not in practice. The only solution I could see was to care for these children more thoroughly, minute by minute. Seeing them two or three times a week was a farce. They needed more than insight; they needed consistent care and attention, consistent limits and consistent rewards; they needed, more than anything, patience and, if not love, then commitment. Yet there were obstacles and risks in that plan. Brian had listened to my legal requests patiently. He said, because of the criminal charges against Albert, his release to us would be tough; the other children were easy, especially with the plan for a new wing. He commented, “That’s going to cost a fortune. Is it covered by Medicaid?”
“No. Locking them up and drugging them is, because supposedly that’s real medicine.”
“I see. How about foster care? You would get government money—”
“—Don’t want to muddy the waters. We’re their doctors, not hired caretakers. I’m sure we can get some foundation grants, but it won’t cover half the expense.”
Brian lowered his voice. “Rafe. I have a question. Can you afford all this?” he asked.
Indeed. Good question. I would be spending the balance of my inheritance, a sum I had promised Bernie’s money manager I would preserve at all costs so it could provide an income for the rest of my life. Once that capital was gone, to earn a living I would need my work to become profitable. Treating these kids didn’t look like a gold mine.
Those were my thoughts when Gene entered; he apologized for being early (only by two minutes, in fact) and shifted in the chair opposite. I stared at him, surprised by his existence. Monday at noon, our regular time for three months—and yet I had forgotten.
Gene looked at me. I hadn’t shaved or showered. He furrowed his thick eyebrows at my seediness, then glanced away shyly. “I had the dream again,” he said. “Only this time you were in it.”
Gene went through the familiar dream: he is alone in the gym of One Room as a bare-breasted woman approaches with threatening nipples; he thinks she will say something nice; instead, she spits at him; he shouts for her to go away and his wish is granted; only she doesn’t go; Gene does, into his computer lab to sit at a terminal that has the answer to his whole problem. But it won’t yield the truth. Gene is forced to risk losing everything by hitting Escape, and yet that doesn’t work. He must destroy it all by turning off the truth teller. However, it doesn’t turn off. Instead, at last, comes the terrible message: “You are a son of a bitch.” Here, as a new twist, I entered the dream. Gene admitted the dream Neruda was also his father, a shifting image hardly bothering to maintain what he considered to be its obvious symbolism. The Neruda/Don figure said, “You’re a good woman.”
“I think you said, ‘woman,’” Gene added. “Maybe it was ‘daughter.’ I can’t decide.”
“Decide?”
“Remember. Actually, I’m pretty sure it was ‘daughter.’ ‘You are a good daughter.’” Gene was silent for a moment. When he spoke it was in a loud voice, a touch too loud for my tired ears: “So? You think I’m homosexual? Or, I mean, I think you think I’m homosexual?”
I laughed. Rather, a snort of amusement escaped, derisive and arrogant. Gene was ashamed; he lowered his eyes. “I’m sorry,” I apologized without an explanation. “You keep asking me to interpret this dream. Is that what I should do? Tell you flat out what I think it’s about?”
“You can? I mean—it means something?”
“I don’t consider myself a brilliant dream interpreter. I’m getting a message from it. But I think you’re trying to send a message to yourself, not to me.”
Gene’s eyes were fixed on my chest. He glanced up at me to say eagerly, “What is it?” and immediately lowered his eyes to my torso.
“You were secretly glad your mother died. She wasn’t providing mother’s milk with her swollen nipples, only frightening anger, so you wished her away, you made her into a terminal and escaped to the answer of your computer. At first I thought the message on the screen—You are a son of a bitch—was your judgment of yourself for this wish. But actually I think it’s a judgment of your mother—buried anger at her surfacing. Take the message literally: you are a son of a bitch. The computer, of course, is your machine and it always tells you the truth. My guess is that this new comment from me or your father—we are probably strong images of yourself—is a longing to be recognized as a good child in spite of your anger at your mother and your wish that she die.”
Gene had forgotten his fear of looking into my eyes. He stared. His prominent Adam’s apple moved up and down.
“Of course there are other messages and emotions in the dream,” I continued. “The woman who seems to be both your mother and your wife—the woman in the gym?” Gene, still dumbstruck, nodded. “With her swollen maternal nipples, who you think is going to say something nice, but instead spits? That’s a complicated one. She’s a phallic woman—her nipples, her spit, which is an ejaculation of rage. My guess is that she is also your father—or you trying to be manly. I
know it sounds odd but compression is common in dreams. The woman figure is rage. Your mother’s rage, your father’s rage and your rage at Gene the needy son. But I’m convinced when you shout, Go away, and she disappears into a terminal—the first of your puns—or rather, when you disappear from One Room to making computers—which represents your rejection of both your mother and father—I’m convinced that’s you sending her off to death. Gratefully.” I yawned. I was tired, true, yet I knew the yawn was also tension at what I was doing, abandoning the technique of my youth, risking an open confrontation with Gene’s psyche. “And you’ve continued the androgyny theme with a father figure—me or your father—telling you that you’re a good woman or a good daughter. Of course, this is all part of a theme in your life—so maybe I’m imposing it on your dream symbols. You aren’t very phallic and you’re afraid of women. You’re especially afraid of expressing anger at them or being phallic with them. One thing is perfectly clear. The punning message is precise: ‘As a son of a bitch, you are a good daughter.’”
“My God,” Gene said in a husky whisper.
I waited.
“My God,” he said again, still whispering. “My God, you’re smart.”
“Not me, Gene. You. You’re the gifted punster. You’re the one with the insight. Years ago, I missed all this. Your deep sexual frustration and fear, the emotional confusion about gender, I dismissed all that because I didn’t want to seem to be criticizing who was earning money in your parents’ household. I was so politically correct that I overlooked the emotional confusion of your relationship to your parents. I had no insight, Gene. It’s all you. ‘As a son of a bitch, you are a good daughter.’ Your castrating mother wants you to be a weak man. The dream is your creation, your judgment, your desires, and your joke. It’s quite witty.”
“I can’t hear what you’re saying.” Gene bent forward, hands rubbing his thighs. He shook his head in despair. I peered over the desk. His knees bounced up and down. “I hear the words. But I don’t—I can’t understand them.”
“You’re scared.”
Dr. Neruda's Cure for Evil Page 42