by John Updike
"Absolutely, sir." This is another lie, Nelson can tell from a certain retraction in the young voice, a telltale flattening, but Michael wants to believe it, he wants to be cured, of an illness that seems to be nothing less than himself, a rot of his most intimate ego, that voice within, where it was nestled supposedly safe in his skull.
"Any side effects from the Trilafon you want to take up with Dr. Wu?" Howard Wu is the Center's M.D., here three half-days a week. Golden in color, stocky in form, he is much beloved, for his hearty Chinese pragmatism and large convex teeth. He is their jolly Buddha.
The boy readjusts his position, perching on the chair's edge and jerking forward. "I feel plugged up. At both ends. It's like a cold in my nose all the time. I feel sleepy all day, and then I can't sleep at night. I feel shitty," he says, and titters, as if to disown his feeling. A fission, a scatter, in his young face makes him hard for Nelson to look at.
"Do you want me to write down, 'No voices'? If I do that, Dr. Wu will see no reason to adjust the medication."
Nelson's deliberate gaze elicits from Michael a flutter of avoidance, a batting of lashes under the shapely black brows, which have that touch of a built-in frown Italian men have, a thickening toward the bridge of the nose. He must have cut a tidy swath at Brewer High, not to mention summers cruising among his peers in the convertible his parents had bought him, proud they could afford it. He peaked too early, like Dad in a way. There is still a little bravado, mannerly but dangerous, in the boy's smile, and in the slick way his bouncy black hair was tamed by the comb. The grooming is a positive sign. Or did his mother comb his hair for him today, for this appointment, and see to it that he shaved? "There were some voices," he admits, huskily, then smirks as if to dare the world to make much of it.
"What did they say, do you remember?"
No answer.
"What did the voices say?"
"Nasty stuff."
Nelson waits.
"They tell me what a miserable fuck-up I am. They tell me to kill myself. Or maybe I think of that myself, to shut them up. It might be worth it."
"Michael," Nelson said, loud and urgent enough to make the boy, whose eyes sidle and flutter, look at him. "If you ever, for a moment, think you might follow through on these impulses, you must do what?"
A long pause. "I don't know."
"You must get in touch with the Center. At any hour."
"Yeah, well, shit, I'm not apt to be calling any center at four in the morning."
"The recording gives the number for Emergency Services. Call it. Here's the number in case." He writes it out on a Fresh Start memo pad and rips the sheet off. A renewed surge of rain slashes against the window at Nelson's back. He pictures the leaks venturing, trembling, lengthening, out onto the windowsills of this old school, the paint flaky from previous soakings. "Do the voices say anything else?" Nelson can hardly hear the answer against the noise of the rain.
"They tell me to kill my parents."
This is delivered with a mumbled huskiness and yet with some defiance, a twitch of teen-age swagger and a smirk that hangs on his face forgotten. "How does that make you feel?" Nelson asks.
Michael surprises him with a surge of affect: "Horrible. I love my parents. They've been great to me, giving me everything I've ever wanted and not putting any pressure on about entering the, you know, fucking dry-cleaning business." His voice is hurrying, to keep up with his brain. "They sent me to college when a lot of parents would have had me go straight into the business. My dad's getting older and hasn't been strong for a while. They sent me to Penn, the finest university in the state. So what did I do? Hey, I fucked it up."
"You didn't, Michael, you got sick. We're trying to make you better. You're better now. You dress yourself, you're no longer violent-"
"I can be violent at home." He begins to brag, to someone imaginary sitting where Nelson sits. "My mother, what a naggy bitch, honest to God. She says to stop watching the old movies on TV, get up, get out, do this, do that. I don't see the use."
"The use is what we call normal psychosocial functioning. It doesn't come without effort. Let's look at your graph. You have not been in to the Center for a week, and then only twice the week before. That's why I've asked your parents to come in with you. They, and Dr. Birkits, and all of us want your attendance to improve." Birkits was the Brewer psychiatrist the DiLorenzos had taken him to on the advice of the Penn psych service after his break. Birkits, one of these demoralized post-talking-cure shrinks, referred this hot potato to Fresh Start. They don't get many clients with an intact home, and who can afford a private psychiatrist.
"I bet you all do," Michael sneers.
"We do, Michael. We want to improve your functioning, and we offer here at Fresh Start a safe environment for you to practice in, with the groups, the activities, the counselling. But you must attend."
"Hey. Sir. O.K. Can I be frank?"
"Of course."
"I can't stand these people. They're fat. They're queer. They're ugly. They're not my type."
"What is your type?" Nelson asks, and instantly regrets the hostility he hears in the question, which popped out reflexively.
"Loser," Michael responds, and laughs, a barking abrupt noise that doesn't belong to his frightened face. "Loser is my type."
"Not so. You or anyone here. We're human, which isn't always easy. The other clients are kind people, here to help each other. They care about you, if you let them."
"They wouldn't if they knew what's inside my head." He jerks forward in the straight chair. His complexion looks a little clammy, moist at the hairline. The poisoned eyes swarm with shame and yet with an excitement that something transformingly strange is happening to him. "The voices whisper to me about girls I see on the street. This one and that one. They tell me to picture her shitting."
"Shitting?" Nelson has been betrayed into confessing surprise. Perhaps Michael intended this. He wonders how much of an enemy the boy sees him as. Does he sense, within his mental-health counsellor, some ethnic enmity, with envy of his easy slender build and dago good looks? When Nelson tries to picture what a schizophrenic sees he remembers Howie Wu telling him, Their sense of distance has broken down. Things up close look far away, is how Nelson has framed this-there is no clear depth in which to locate yourself. The gears that notch us one into another fail to mesh, maddeningly, meltingly. Trying to think his way into Michael's head plants a sliding knife inside Nelson, a flat cold queasy sensation below his ribs.
"They show me her squatting down. I want to rub her face in it. I want her to eat it. Does that shock you?"
"No," Nelson lies.
"Well, it does me." Michael slumps back as far as the chair allows him. His affect is flattening; his eyes narrow as he recalls, "Thirty thousand bucks a year, think of it, plus extras and my own car. Pussy everywhere. Hot-shit professors. A bunch of frats rushing me. And I fucked up. I couldn't hack it. I didn't even know what courses I was supposed to be taking. I hid in my room with the shades down until my roommate complained to the dean and they got the psych service on me. They tell me I told the dean or somebody he was the Whore of Babylon. I never heard of her." He snickers a little, testing the face opposite his.
"Michael," Nelson says in firm conclusion. The boy was bragging now, bullying. When you feel uncomfortable, Howie has told him, trust your gut. Get off the horse. "I can't emphasize enough how important it is that you are faithful with your medications. I've made a note here to Dr. Wu to reconsider the Trilafon dosage."
"I drank beer and tequila at Penn," Michael tells him, uncertainly standing, sensing he is dismissed and being relieved yet not, unsatisfied, uncured. "My parents didn't know it, but I would get fucking blasted. I think that's what screwed up my brain."
"I don't think so. The human brain can take a lot of beer. Michael, this is not your fault" Nelson says, coming around his desk so that in the tiny office the boy-tall when he stands up, his girlish mouth sagging, his face glimmering in the rainy light, be
gging to be understood-has nowhere to go but out, to the waiting room, where his parents are eager to come in.
"Such a gorgeous child," says Mr. DiLorenzo, when a second chair has been pulled up for his wife in front of Nelson's desk. "Bright, good, A miracle boy. To have this boy after his three sisters and Maria over forty, it seemed to us a miracle." He speaks carefully, with dignity, as one who remembers when he spoke English less well, the child of immigrants who spoke it hardly at all. His hair, brushed straight back, is going white but his bushy eyebrows are still black.
The wife speaks up: "Even as a little boy, though, he stood apart a little. He would play with others, but then wander away and come inside. I'd say, 'What's wrong?' He'd say, 'Nothing.' As if he didn't see the point of people. He was quiet. He never had a tantrum."
"My wife imagines things in hindsight," Mr. DiLorenzo says, sitting back erect, his eyes enlarged by thick spectacles, eyes frayed to death from closely inspecting fabric. "He was a perfectly normal boy. Got top marks, too, all the way up through senior year. Gave the salutatorian speech about how we should help Russia keep democracy and capitalism. Never any trouble to anybody- teachers, me, nobody."
"A little trouble would have been more normal," his wife says. "At the time I wondered if having all those older sisters hadn't taken something out of him. My daughters and me, we had too good a time, always laughing, always busy at the house, always telling each other things. Michael was like a little prince, detached."
"Don't listen to her, Mr.-"
"Angstrom. Nelson if you'd rather."
"Don't listen to her, Nelson. He was fine. He played sports, got the good marks, ran for student council. Said no to drugs, booze. An altar boy, too, until he was fifteen, and we didn't push that. In America religion becomes your own business. Likewise I told him, 'Michael, listen, you want to forget the dry-cleaning business, be some kind of professional-a doctor, lawyer, whatever, sit behind a desk using your smarts-that's O.K. with me, and Mamma too. Whatever makes you happy. This is America.' But no, he wanted to learn dry-cleaning, summers, after school, it was what he loved. From me there was absolutely no pressure."
"There was pressure," Mrs. DiLorenzo tells Nelson. "Joe needed him to carry on and he knew it. That he didn't come out and say it made it worse. The girls, they married and got out of here. They'd had enough of it, the chemicals, the presses, the hours until seven, eight. Only one of them even stayed in the state, and she's way out near Pittsburgh, a nice suburb up along the Allegheny. Their husbands, what do they care about dry-cleaning? It was all on Michael, and he knew it. He snapped. Men don't want their whole lives mapped out for them. They want adventure. Isn't that right, Mr. Nelson?"
"She's crazy," Mr. DiLorenzo confides. "He didn't want adventure. He wasn't like these young hoodlums these days, their heads full of, what do they call it, hip-hop, grabbing guns and going off to shoot their classmates to make the evening news. Shooting their parents, no respect for anything under the sun. He wanted to carry on the family business. There was no pressure. At Penn he was taking chemistry to be on top of the best, the newest solvents, the most environmentally sensitive as we say now. Disposal of used cleaners is the number-one headache in this business; a single cancer lawsuit can wipe you out-defending against it, even if you win. I love America, but not its justice system."
"Joe, there was pressure." To Nelson Mrs. DiLorenzo explains, "My husband, he slaved to build up Perfect. He began by doing dirty work for this old Jew in South Brewer, just a basement in a row of houses, a little dark slot, his equipment crowded into the back, a shed built illegally, fifty cents an hour if he got that, Joe was always being chiselled. When the Jew died Joe borrowed to buy the business from the widow and named it Perfect Cleaners himself."
"It's prettier in Italian, perfetto" Mr. DiLorenzo said, drawing out the word, "but this is America. Things want to be perfect here. Don't mind Maria-Jake was good to me, he taught me the trade. Had me out on the vats first, breathing in carbon tetrachloride before the switch to petroleum solvents, then had me as a finisher, on the steam presses, and then a spotter, that takes skill-you can ruin a silk blouse, a fine wool suit. After a while it was going so good I opened a branch in West Brewer, and then one up in Hamburg, and two years ago this industrial acreage came up for sale in Hemmigtown. For a long time I'd been wanting to build a bigger plant, with summer fur storage and equipment to take anything, to take even old lace tablecloths, they get yellow with age, very fragile, and big velvet curtains where you could choke on their dust, some of these mansions in Perm Park and up along Youngquist, the owners never-"
Nelson has heard enough about dry-cleaning. "And you were counting on Michael to take all this over someday."
"Someday, not now. Maybe ten years, maybe less. We have a little place in Florida, the winters here aren't so good for Maria-"
"Don't blame me if you want to go to Florida and stick the poor boy with all these plants, all these employees and their benefits-"
DiLorenzo takes this up enthusiastically, telling Nelson, "It's socialism without being called that. It's putting everybody smaller than Perfect out of business-the benefits, the insurance. There used to be a cleaner every other block. I shouldn't complain, it's good for the bigger outfits that can absorb it, but still you hate to see it. Setting out the way I did back then, with no assets to speak of, I couldn't do it now."
"He slaves" his wife says, "and he wants to lay it all on Michael. He wants to go to Florida and look at the girls on the beach and make himself dark as a black."
"The boy was eager, I mean it, with no pressure from me."
"Joe, the boy felt pressure. Even his senior year, he was drifting away, into his own world. He was bringing home B's."
Nelson intervenes, to stop their love feast. They love each other, and the child of their hearts is Perfect. "Michael is very angry with himself," he tells them, "for what he calls letting his family down. But, I keep trying to tell him, it's not his fault. It's not your fault either. It's no one's fault."
"What is it then?" Mr. DiLorenzo asks simply, of this invisible invader, his son's destroyer.
Good question. "It's a," Nelson says, "it's a disorder of the nervous system, having to do with dopamine flow, with the chemical control of the synapses' tiring."
"I often wondered about that," Michael's mother breaks in. "When he was so young, thirteen, fourteen, working with his father summers, inhaling all those poisons."
"Get sensible, Maria," her husband says, hoarse from his talking. "Look at me, inhaling all my life."
"It's not that kind of chemistry," Nelson says. "I'm no doctor, I don't really understand it, brain chemistry is very complex, very subtle. That's why we don't like to assign a diagnosis of schizophrenia without six months of following the client and observing his symptoms continuously. What we do know about the disease-the disorder-is that it quite commonly comes on in young men in their late teens and early twenties, who have been apparently healthy and functional up to then. Michael does fit this profile. A breakdown early in college is pretty typical." He looks down at the yellow pencil still in his hand. On the upper edge of his vision, the faces of the parents before him, it seems to Nelson in a little hallucination of his own, rise like balloons whose strings have been released, but without getting any higher.
"What can we do?" Mrs. asks, her voice fainter than he has heard it before.
"Is there no hope?" Mr. asks, heavier, the chair under him creaking with the accession of weight, hopelessness's weight.
"Of course there is," Nelson says firmly, as if reading from a card held in front of him. "These neuroleptic medications do work, and they're coming out with new ones all the time. Michael's hallucinations have diminished, and his behavior has regularized.
Now-where YOU can help-he must learn to take advantage of our resources here, and to assume responsibility for his own medications, the prescribed daily dosages."
"He says they make him feel not like himself," his mother says. "
He doesn't like who he is with the medicines."
"That's a frequent complaint," Nelson admits. "But, without nagging, without seeming to apply pressure, remind him of what he was like without them. Does he want to go back to that?"
"Mr. Angstrom, I know you don't like to make predictions," the father says, manly, ready to strike a deal, "but will these medications ever get his head so right he can go back to work- keep a schedule, pass his courses?"
Another good question. Too good. "Cases vary widely," Nelson says. "With strong family and environmental support, clients with quite severe psychotic episodes can return to nearly normal functioning."
"How near is nearly?" the father asks.
"Near enough," Nelson says carefully, "to resume independent living arrangements and perform work under supervision." To have a room in a group home and bag groceries at a supermarket that has an aggressive hire-the-handicapped policy. Maybe. "Keep in mind, though, that many tasks and daily operations that are obvious and easy for you and me are very difficult for Michael at this point. He not only hears things, he sees and smells and even touches things that get between him and reality. Yet it's not oblivious psychosis-he knows his thoughts aren't right, and knowing this torments him."
The two wearily try to take this in. Their appointment is winding down. They hear the rain lash at the loose-fitting elementary-school windows in a tantrum, in a world unhinged.
"It's a heartbreaker," says Mr. DiLorenzo. "All those years since the boy was born, I thought I was building it up for him. Building up Perfect."
"Don't look at it so selfishly," his wife says, not uncompanionably. "Think of Michael. Suddenly, where did his life go? Down the drain into craziness."
"No, no," Nelson urges, almost losing his therapeutic poise. "He's still the child you raised, the child you love. He's still Michael. He's just fallen ill, and needs you more than most young men need their parents."
"Need," Mrs. DiLorenzo says, the one word left hanging in air. She pushes herself up, holding on so her black-beaded purse doesn't slip from her lap.