THE M.D. A Horror Story

by Thomas M. Disch

  “How so?”

  “You haven’t tasted it yet.”

  Ben regarded the slice of cake on his plate, the morsel on his fork. “You’re right. I haven’t.” He ate the morsel with conspicuous deliberation. “And I’m right, too. It’s really delicious.”

  “Can I ask you a question?”

  “If it’s about my work, no. I’m feeling mellow.”

  “I wasn’t intending to attack you. I was just curious. Are you supposed to never discuss it outside the office? Is it like working for the government, where everything’s a secret?”

  “There’s that side of it, of course. Mostly it’s habit. Judith declared herself an enemy of the tobacco industry something over five years ago. That’s a year before she got to abortion, and two years before she became a vegetarian.”

  “Since when is she a vegetarian?”

  “She isn’t, anymore. The anorexia probably made it unnecessary.”

  “You think it’s just obstinacy then? You think she just refuses to eat?”

  “No, not at all. Anorexia is a medical disorder; I don’t doubt that at all. It’s also almost certainly psychogenic. But that is not to deny that it’s a real disease. I tend to believe all diseases are psychogenic. You know what I mean by ‘psychogenic’?”

  “It’s the same as ‘psychosomatic’?”

  “Not exactly. Psychosomatic refers simply to the interdependence of the mind and the body. Psychogenic is more specific: a psychogenic illness has its origin in some kind of emotional or mental conflict. The mind is the trigger of a psychogenic illness, but the final result can be as physiological as a bleeding ulcer.”

  William considered this for two more forkfuls of the cake. Then he asked: “So you think it’s all in the mind? And cigarettes don’t have anything to do with lung cancer?”

  “That’s not what I said. Cigarettes certainly have an effect, but just as certainly it’s not a one-to-one cause-and-effect relationship. If that were the case, nicotine would be a poison pure and simple, like strychnine. But it’s not. Some people, like Turnage, can go on smoking for years with relatively little ill effect. Others…” He shrugged. “It’s a lottery. Or that’s what smokers like to tell themselves, anyhow.”

  “What is it if it’s not a lottery? A very slow kind of Russian roulette? That’s what our gym teacher called it.”

  “It’s a good analogy, but it begs the question of why people play Russian roulette, why they climb mountains or race cars, why they risk their lives in a hundred foolish and unnecessary ways and call it entertainment.”

  “Flirting with death,” William said, savoring the words as though they were a morsel of the cake. “Why do they?”

  “Every school of psychology, every religion has its own theory, and each theory probably has its own grain of truth. Freud calls it a death instinct and claims that it’s a basic component of the subconscious. The trouble with that as a theory is that, almost by definition, it can’t be proven. The subconscious is the part of the mind we can’t be conscious of. We have glimpses in our dreams, that’s probably the nearest approach. But dreams may be just the froth on the surface of the subconscious. And its depths? Who can say?”

  “But it sounds like you have a theory.”

  “Mm.” Ben picked up his wineglass and lifted it to eye level so that the amber hemisphere of Almaden within condensed the light into a single bright node. The boy had never sought to draw him on this way before, and while it made him feel uncustomarily paternal and full of elder wisdom, he also felt uneasy. Circumspection had become a deeply ingrained habit. Sondra had no patience with any talk that smacked of philosophizing, and Judith had her own fully formed worldview in which he figured, monolithically, as the oppressor of her virtue. She was certain she knew his every patriarchal thought without his having to say a word. He had supposed that the boy, in his own quieter and less dogmatic way, had shared Judith’s estimation of him. But maybe he had been wrong. The boy was bright, and Ben appreciated that, but he was a boy nevertheless, who still watched the Saturday morning cartoons on TV. A birthday did not possess such fairy-tale magic that a child of twelve can be transformed overnight into a young man of thirteen. And yet… William did seem different tonight. Perhaps it was not the magic of his birthday, but of his new name. Or perhaps (the likeliest hypothesis) the difference resided in the Almaden, and all the bourbon that had preceded it. “I’m sorry,” he said, putting down the wineglass. “I’ve been woolgathering. And I’ve lost the thread.”

  “That’s okay. We can talk about it another time, if you’d rather.”

  He would rather, and he appreciated being let off the hook. But he felt a sting in the kindness. A drunk does not like to be thought to be too drunk to carry on a conversation.

  “In a nutshell, William, what I think is that there are more things under heaven and earth, and in the subconscious too, for that matter, than are dreamt of in anyone’s philosophy. Once we’ve mapped every neural path of the brain, and charted every twist and coil of DNA, even then…”

  “Even then?” William prompted.

  “Even then we won’t know everything.”

  It seemed—indeed, it was—a cop-out. Ben felt, absurdly, like a small rodent that has been chased into its hidey-hole by a larger predator.

  “You’re probably right,” William said, and then, with the indifference of a cat that does not really need to eat the mouse it has pursued, he got up from the table and said, “I’ll take a slice of cake to Judith now, before she turns in. See you in the morning.”

  Ben nodded. He knew he’d funked out. But why did he feel such inexplicable relief? What had he been afraid to say? To even think about? He glanced at the bottle of wine. There was nearly one glassful left. He waited till he’d heard William’s knock on Judith’s bedroom door and then poured the last of the wine, with gratifying precision, into his glass, filling it till only the surface tension kept the liquid from overflowing the crystal brim.

  38

  As soon as she was in her own half-bathroom, Judith stood in front of the toilet and waited for her stomach to revolt against the meal she’d eaten. Invariably after a dinner-table quarrel, her stomach would empty at the sight of the pink porcelain toilet bowl. It was as automatic as a windup toy, as reflexive as the bouncing of a rubber ball. But tonight it wasn’t happening. Her stomach, like some dog jealously protecting its dish of Alpo, refused to surrender its contents to the toilet; it was actually processing the stuff. Judith would not, as a matter of principle (she’d made a promise to her therapist), induce vomiting artificially, and so, after dousing her face and neck with cold water at the sink, she returned to her bedroom, feeling a strange, diffused queasiness all through her body. Not the familiar queasiness that might precede the release and relief of a good puke. It felt like a bad sunburn that had soaked through her skin deep into her muscles. And stranger than this queasiness, she still felt hungry. Though she’d eaten twice what she usually did at dinner, she could have returned to the table and eaten twice as much again.

  Hunger, however, was something she knew how to deal with. Indeed, it is the glory of an anorexic to combat hunger, as it is the glory of a saint to resist temptation. One simply turned one’s mind to other matters. And there, on her worktable, was the perfect refuge—her poor wounded diary, and lying on top of it, like a suicide weapon still clutched in the corpse’s hand, were the scissors she’d used to cut out its eight meager pages of entries.

  She sat down and wrote:

  Dear Diary,

  What a foolish, self-defeating thing to do—& anger is no excuse. What I did was cut out all the Diary pages from January 1 to now—& served them at dinner! It wasn’t easy to get the paper into a cookable state, but after I’d soaked it a long time in milk and then put it through the Cuisinart for a few spins it served quite well as the basis for a white sauce. It didn’t taste exactly like milk anymore but I put a lot of spice in the sauce & I don’t think anyone noticed. Maybe I should enter the r
ecipe in the Pillsbury Bakeoff! Spam Casserole in Diary Sauce!

  Why did I do such a dumb thing? Because I found out this morning that my father had read the letter I wrote & left under William’s door. I was so furious at first I almost went into Sondra’s room to smash one of her silly Steuben figurines. But I controlled myself & came here & saw you on the table, dear Diary—& I thought: I’ll see to it that they don’t read any of this at least. And right away I knew what I would do. I would make them eat my words. So I made my Diary Stew, but at the last moment I couldn’t bring myself to spring my big surprise & tell them what they were eating. Partly because my father had brought home that awful Mr. Turnip from the Tobacco Alliance, who is so thick he would never have understood why I’d done what I’d done—imagine having him for a father!—and partly because it was William’s birthday—& he was being so nice I couldn’t spoil things more than they were spoiled already by having the Turnip for dinner. William actually insisted on being the one to serve the Diary Stew—& at that moment I realized that what I’d done was mean and spiteful and nothing else. But did that make me behave with any more consideration? No, I deliberately provoked the Turnip till he did something impossible—for which of course I was sent to my room. Sondra came to see me right afterward & was as nice as could be & apologized for Winky, saying he surely realized that the fault was the Turnip’s much more than it was mine but that he had to avoid giving offense to the Turnip for “business reasons.” As tho that were any excuse! On the other hand, it’s not a surprise either. Everything he does is for “business reasons.” I really do hate him. I know it’s wrong of me, but there it is, I can’t help it—& if he ever does read this Diary—which I won’t lock up or hide away but leave right here where he can violate my privacy any time he likes—then he’ll just have to swallow that fact. I’ve hated him absolutely as long as I can remember having any feelings about him at all.

  She stopped there, with a feeling somewhere between shock and satisfaction at the awfulness of what she’d written. It was always like that with the diary. She’d be writing a blue streak until such a thought would come wriggling out of her pen, like an inky little snake, something perfectly impossible, and probably untrue. Just like her mother when she got angry: “I hate you!” or “You’re ugly!” or just some low obscenity. It had to be hereditary, since she’d actually lived with Rhoda so little time and most of that time while she was an infant.

  There was a knock on her door. Not a knock, really, but a subdued kick. “Come in,” she said, and William answered, “I can’t. My hands are full.” She opened the door, and there he was with two slices of the hazelnut upside-down apple cake on the hand-painted china plates from the sideboard.

  “I don’t know if you still have any appetite left after the row at the table, but I’d have had a guilty conscience if I didn’t share some of this with the person responsible. I can tell you already that it’s delicious. The apples make a kind of crust.”

  She laughed aloud, as though at a joke, and then felt obliged to explain: “It’s weird, but you know… I really am hungry! I could eat both slices. Come in, sit down. Did you get your wish?”

  “I think it’s only very old people who don’t get their wishes on their birthdays. It’s really not hard to blow out fourteen candles. Anyhow, he’s gone.” William set the plates down on her worktable.

  “The Turnip? I know, I heard them drive off.” Self-consciously she cleared away the diary and the scissors. Then she fetched the second bentwood chair from its place by the window.

  “Ben didn’t go with him, actually. Turnage had to drive himself. That’s why I couldn’t bring you your slice of cake earlier. Ben and I were talking, just the two of us.”

  “Amazing. He actually gave you five minutes of his time. It must be because of your birthday.” She could hear the spitefulness as soon as the words were out of her mouth. “I’m sorry, I shouldn’t be so sarcastic. I know Father is not a total ogre. What did you talk about? No, that’s not a proper question. It was your conversation. Asking you about it is almost as bad as eavesdropping, or reading a person’s private correspondence. Let’s have that cake. I really am famished.”

  To her surprise the cake was delicious, and her joke that she could have eaten two slices was not an exaggeration. As they ate, William kept looking up at her, as though expecting her to say something. But her mind was a blank. Sometimes he smiled as though she had said something and he were offering his silent concurrence. His lips seemed redder than lips would be unless they’d been painted with lipstick. She could not keep from thinking of the two false teeth in his mouth and the wires that held them in place—his flipper, he called it—and wondering how he kept food from tangling in the wires. She thought: What if he asks me what I’m thinking about at this moment? If she were honest she would have to say, I’m thinking about the inside of your mouth.

  “Actually,” he said, as though continuing from where they’d left off a moment and not a minute ago, “Ben and I talked about the same thing you tried to get Turnage to talk about. But on a more abstract level. He thinks when people get sick it’s all psychological. Not all, he didn’t say that. But it begins that way. Psychogenic, that was his word. But we didn’t really get into the subject. Just sort of skirted around it. I think he felt a little shy.”

  “What a convenient theory for him to have,” Judith scoffed.

  “But he was ready to admit that smoking has a connection to the whole thing. In fact, he got kind of nasty with Turnage on the subject. I could hear them from out in the kitchen while I was lighting the candles on the cake.”

  “You shouldn’t eavesdrop,” she said primly.

  “Listen, if the person who designed this ‘ranch’ had put doors between one room and the other, it would be possible to avoid eavesdropping. Anyhow, my point is your father is not the complete hypocrite you seem to think.”

  “What kind is he then?” she demanded sharply. “A half a hypocrite? A third? The fact remains that he is employed by an industry that earns money by getting people to poison themselves. I don’t see that his working for the Mafia would be any better.”

  “I don’t know, maybe he’d dress better if he were in the Mafia.”

  “Be serious, William.”

  “I’m being serious. Do you actually know what the research is that he does? Have you ever read any of the studies that MIMA publishes? The one on tattoos, for instance, have you read that?”

  “I’ve heard him talk about it often enough, and call it his favorite statistical freak. But I can’t say that I remember much about it, except that it had nothing to do with smoking one way or the other.”

  This was a lie, for she did in fact remember all too clearly the actual physical nausea she’d felt four years ago when the report had come out and she (then age twelve) had looked at the leather-bound copy of it that had been given a place of honor in the middle of the coffee table. It had been full of pictures of dreadful tattoos, all of them tattooed on prisoners awaiting execution or serving life sentences. What the study had shown was that prisoners who’d been tattooed with the nastier kinds of designs—skulls and devils and such—were likely to develop malignant cancers or have fatal heart attacks at a younger age than prisoners who’d been tattooed with pictures of animals or women. But both groups proved to be significantly healthier than those who had not been tattooed at all. Judith simply could not see the point of such “research.” It seemed as immoral, in its way, as laboratory experiments on dogs and monkeys, except that in this case it had been human beings who were in the cages, not animals.

  “The point,” William lectured at her, “is that the differences from one group to the other had to be psychological differences. Unless you believe in magic. I don’t suppose the research has any practical use. I mean, it probably wouldn’t keep other people from getting cancer if they were tattooed with lions and eagles.”

  “What a thought!” Judith said, wrinkling her face into a mask of revulsion.


  “But that’s because the decision wouldn’t have come from deep down inside them. From the subconscious. From inside the cells.”

  “They were inside their cells, all right,” Judith said.

  “You know what I mean.”

  “And I know how easy it is to make statistics lie. There could be a hundred other factors that could have accounted for the same results. And in any case, what does it prove? And why is ATA so eager to have Winky digging up these statistical freaks?”

  “Okay, forget it. I didn’t want to start an argument.”

  She realized that if there had been an argument it had all been of her making and looked down abashed at the crumbs left on her dessert plate. Somehow, as they’d been talking, she’d eaten the entire slice of cake without being aware of it. “I’m sorry. It’s my fault. I do see your point. I’d have to be very dense not to. It just all seems so… ugly. It’s the same with the research they do on animals. Forcing hamsters and rabbits to smoke until their little bodies are riddled with cancer.”

  “A lot of medical research has to be ugly. Because disease is ugly.”

  “Then why not do research on health instead of disease?”

  “Sure, why not?”

  Was he making fun of her? She could imagine her father making the same snap response, but there was no sarcasm in William’s voice as there would have been in Winky’s.

  “I’m serious,” he insisted, as though he’d heard her speak the question in her mind. “There should be research into lots of things that medical science usually ignores. Acupuncture, for instance. Or faith healing. Or wounds that heal overnight. The medical establishment ignores that whole area, because it doesn’t fit in with their scheme of things.”

  Judith was amazed to be hearing her stepbrother say such things. She knew that he meant to be a doctor someday, but she hadn’t really credited it as a serious intention. She’d thought he wanted to be a doctor the way a younger child might say he wanted to be a deep-sea diver or a fireman or a cowboy.