by Samuel Shem
‘Tell me about it?’
He opened up about his sense of failure in feeling things, especially when his wife asked him what he was feeling. ‘The other day we were sitting on the beach after a marvelous picnic lunch. The girls were off with the nanny. We’re both feeling good, OK? And Lily turns to me and asks, “What are you feeling, hon?” Her asking seemed to paralyze me. I felt a sense of – I don’t know – you’d have to call it a sense of dread, as if I were saying to myself, “Nothing good can come of my going into this with her, it’s just a matter of how bad it will be before it’s over. And it will never be over.”’
I laughed at this, and he smiled. ‘I know,’ I said, ‘I’ve felt that too.’
‘Really?’
‘Oh yeah. What happened then?’
They’d gotten into a terrific fight, ending up with his going off sailing alone, and her going home. Now, suddenly, he and I were working together, on the same team, trying to puzzle out his pain. It felt like we were friends. In my month as a shrink I’d never felt this before. At the end of the session he said he had forgotten to tell me they would be off on vacation for the month of August. ‘We always go to Via Cigno, our house on the Vineyard. Ever since I can recall, every August, Via Cigno. And I mean every. The rituals in WASPdom are carved in stone. August the first, go to Vineyard. Labor Day, come back. Hell could freeze over on August first, and the WASPs would still get to Vineyard Haven.’ We laughed. ‘But this year … I don’t know.’ I asked about this year. ‘He—’ He bit his lip, his brow and eyes twisting in jealousy. I realized that he couldn’t bring himself even to say the name. ‘He does August at Wellfleet. She won’t be seeing him, but it’s just a short ferry ride—’
‘Why not do something different?’
‘Different?’ he asked, as if I’d suggested he do something lethal.
‘Sure. Go someplace else, someplace you and Lily love?’
‘Genius! Basch, you are un gènio!’ He laughed, clapped his hands, and let fly with a stream of Italian, voice ringing in that half-dopey, half-tragic lilt, hands pointing and waving like crazy. ‘Toscana! Our favorite place in the world. We’ll rent a villa, with a pool for Hope and Kissy, and cavalli! Horses! Ha! I grew up there, honeymooned there. Magnifico! Magnifico psichiatra, magnifico paziente! As Hope says, “Like awesome!” Ciao ciao!’
He did the Italian hand wave and trotted out. I felt great. His dread, his feeling a failure in relationship – I’d sometimes felt it too, with Berry. Maybe underneath we were similar? I remembered, then, a day riding the tube in London, as six English schoolboys entered and stood, each in a blazer and jacket and cap and umbrella, and you could see each as his life went on getting more tightly wound up in darker blazers and then dark suits with that dark vest for added tightliness and black hats and black brollies, the years accreting with terrifying certainty, darkening that boyish glitter. Decades on, you couldn’t poke a pin underneath that suit, that black. Here, now, with Cherokee, we were starting to undo it. He’d gone out of my office boyish, yes.
Now, as Malik and I walked along toward the Farben, a stream of sensible cars flowed past us: mostly Volvos, Saabs, and those big American babies shaped like coffins. These safe, solid cars moved along in an orderly flow, most containing a man in a suit. One curly-haired little man in a big black Caddy turned out to be a honking, waving Schlomo Dove heading for vacation on the Cape, his bumper sticker reading: I’D RATHER BE IN THERAPY. Here were the ‘talk therapists’ of Misery, each having finished their six o’clock at six-fifty, heading home in their safe cars to their thought-to-be-safe first wives and even-less-safe second wives and safe-but-perplexed children suffering from what Malik said was a disease called the ‘analyst’s child syndrome.’
With the exodus of the doctors came the liberation of the patients. Barred from the cafeteria during lunchtime, the patients were heading for chow in groups of about a dozen, each hall of Misery herded along across the broad perfect lawns by a mental health worker, the frozen trudge or shuffle signifying the dose and overdose of drugs, as well as diagnosis, which came last. Malik pointed out to me the hopping, skipping manics, the herds of trudging depressives, the paranoids darting and peering, tree to tree, the schizophrenics seeing in each bush a bear, in each dusky cloud a closet, the psychopaths trying to hustle the eager-to-be-hustled hysterics – even a rare agoraphobe, squinching down like a soldier running crazily to make the next foxhole. The group from the Child Unit was particularly heart-wrenching, the kids in bright colors in one long linked chain, a many-colored crocodile, the last segments limping along spastically, trying to keep up. When the doctors went safely home to supper, Misery changed for the brighter and the wilder.
The weather too was changing. Ever since my arrival the Misery air had been that heavy, damp, polluted gunk that makes your lungs act like dehumidifiers and your head like the collecting tank. Now the sky was uneasy, with small bruises far off to the northwest where a first edge of the cold front sliding down from Canada was encountering the fat, couched heat from the Gulf of Mexico, billowing up over the south face of the mountains, clouding the shimmer on the oblong lake. The day, darkening as it went, seemed filled with portent.
We entered the Farben. Malik tapped on the bulletproof glass protecting the operator, Viv. She buzzed us in. Viv was a short plump woman of fifty with gray-blond hair in a beehive perched on her head, and blue eyes under plucked brows. Her voice – all clackety and tough – suggested a tenacious, working-class background. I liked her at once. She was just back from her vacation.
‘Roy? Like Roy Rogers? Mind if I call you “Cowboy”? It’s not every day a woman like me is given French pastries by a handsome young doctor. Is he like you, Lucky?’
‘Not yet,’ said ‘Lucky’ Leonard Malik, ‘but he has potential.’
‘The human potential movement is one of my absolute favorites,’ Viv said. The switchboard squawked, a frantic voice asking to speak to the Doctor on Call, me. Viv put the caller on loudspeaker. With one eye on us she asked a few questions, found out that the caller already had a therapist but was hesitant to call him at home. ‘Doll, you’re paying good money for his time – you call him right now, ’kay? Tell ’im Viv at Misery toldja to do it.’ A few more interchanges and the caller, calmed, hung up.
‘Genius, Basch,’ Malik said, ‘genius. Did you catch it? I mean the first question you ask in the psychiatric interview?’
‘The first question is, “Tell me, how are things?”’
‘Nope. The first question is, “What is your insurance coverage?”’
‘Didja tell this cowboy to be nice to me?’ Viv asked coyly.
‘Viv is the night operator. She screens all calls. This magnificent woman is all that stands between you and the mass of Great Americans seeing TV ads saying “Unhappy? If so, if you want to feel better, dial 1-800-2MI-SERY.” Viv is your guardian angel. You promise to treat her accordingly?’
‘I do.’
‘I hereby pronounce you man and operator.’
We sat chatting in the bulletproof back room. Viv and I ate pastries, Malik broccoli.
‘Broccoli?’ I asked.
‘Antioxidants. Best protection against prostate cancer.’
‘Uh-huh. And just where is it you put the broccoli?’
‘Ooo-wee!’ Viv cried out. ‘That can hurt!’
‘You laugh,’ Malik said, ‘but you don’t know shit. Let’s talk organic, let’s talk leafy greens.’
Like many athletes, Malik was meticulous about what he put into his body. Now he waxed poetic about wax beans and soy nuts, kohlrabi and kale, and cabbage, red and white. He claimed to be able to actually taste the pesticides in nonorganically grown fruits and vegetables, and challenged us to test him. Vegetables were mostly revolting to me, and I soon tuned out.
Other night workers dropped by to talk. Viv handled incoming calls easily, as if talking to friends: a woman wanting to terminate with her therapist because he kept a live snake and a live owl in his
office, a man wondering if it was possible to strangle yourself with your own two hands, and others. If there was no insurance, the caller was turfed to Candlewood State, down below the swamp.
A tap on the bulletproof glass announced the arrival of a well-worn, shabbily dressed older man who, from his battered nose spotted with red spider telangiectasia, I knew was a chronic alcoholic. My guard went up. I’d been abused by enough drunks and addicts in my internship to last a lifetime.
Viv buzzed him in. George had been Malik’s patient two years before on Heidelberg East, Alcohol and Drug. Viv and Malik greeted him warmly. We all talked for a while. In two days with Malik I’d yet to see him leave for home. Half joking, I said, ‘What are you, Malik, a workaholic, or something? Go home.’
Silence. George and Malik and Viv exchanged glances.
‘Not bad!’ Malik said proudly. ‘Shall we, George?’ They got up to go.
‘Wait,’ I said. ‘What’s “not bad”?’
‘If you need me,’ he replied, ‘I’ll be at the meetin’ down the hall.’
‘What meetin’?’
‘Alcoholics Anonymous. A meetin’ George here founded.’
‘The “Misery Loves Company” meetin’,’ George said, smiling.
‘George’s my sponsor. We’ll be just down the hall.’
Malik an alcoholic? Dependent on an old drunk like George? I watched them walk off, the bulky, battered classic drunk and the thin trim doctor – also a drunk? Weird.
I began to be called out to attend to various problems around the hospital. The place was so big – 350 beds – and so spread out, often I’d walk ten minutes between visits, my black bag pulling heavily at my arm socket by the time I arrived. Like a hired gunslinger riding into town, I’d walk in, feel the curious stares of the patients, be directed by a lone mental health worker or nurse to the problem, do my thing, write it up, and leave, beeped along to another gathering of humans quarantined by some shared diagnosis, which Malik said didn’t exist.
Outside again on the freshly mown grass, looking up at the darkening sky, I had to struggle to see the normalness of this grass, this sky, as if there were a torque on my sight, a spin on the natural world, this grouping together of crazy people pulling the iron in my blood, my brain, into an afterimage that was warped, and weird. Them, not me. Not like me, no way José. These people are sick. They are the patients, I am the psychiatrist. Prego.
‘Forget you’re a psychiatrist. Wake up!’
Malik. Pulling me away from the erotica of dreamland: Berry in a sari, four naked Thai dancers, an elephant, two happy macaques, and a—
‘We got a hot one! This is your big chance, come on!’
Two a.m. I’d fallen asleep only eleven minutes before, trying to write up my fourth patient, a paranoid MIT student who’d seen a bug in his pizza and was sure it had been planted by the FBI.
‘Big chance for what?’ I asked, feeling grubby, my shirt all dried sweat, my underwear stale, my socks damp on my feet. All I wanted was a big chance for a shower.
‘To learn. Zoe Bicker. Rich college kid. Dartmouth. Looks like she stepped out of Town and Country. Drove herself here. Won’t say why. A mystery. And you and me and Primo are gonna solve it! Wake up!’
‘Primo?’
‘Live and off-color, Doc, y’get me?’
This ‘Primo’ was a tall, bulky, uniformed member of Misery Security. My eye caught the glint of his badge, a bas relief of the Misery logo: a pine tree, a half-moon, and a duck rampant. Primo’s face seemed to spread too far in all directions, and his thin dark hair was slicked, like Elvis’s. Long black lashes shadowed dark eyes, a long large nose fell quickly to a smile where a Stim-U-Dent wedged itself between two scary teeth and one pink gum.
‘We got some real doozies here tonight, Doc,’ Primo said. ‘Y’get me?’
‘Forget you’re a shrink,’ Malik said again. ‘You’re sitting on a train. This Zoe sits down across from you. She’s upset. You ask her about it. She tells you her story. An amazing story. You’re totally absorbed.’
‘But I’ve got to get a psychiatric history.’
‘History comes from effect. Find the feeling, the red thread running through, you find out everything. What’s the first question you ask?’
‘What’s your insurance coverage?’
‘Bad news.’
‘Bad insurance?’
‘Good insurance – she’s rich. If we let her in, and she stays till Heiler comes back, he’ll never let her out. And what are you gonna be with her?’
‘Human,’ I said sleepily, ‘gonna be human.’
Primo and he rolled their eyes. ‘Kid,’ Malik said, ‘you are on a roll.’
Zoe Bicker sat forlornly in a corner, knees primly together, head lowered. She looked young, barely twenty. My ‘corner of the eye’ take? Shame, and – from a man’s red bandanna around her neck – love lost. She was slender; and her fine straight nose, hollowed cheeks, and thin lips gave her an aristocratic look. Her light brown hair had recently been styled in that windswept look of fashion models, but now it looked mussed. She was girlishly dressed in a crisp white summer dress with tiny pink flowers encircling her slender neck. In one hand she clutched a red teddy bear, and I flashed on Heiler’s famous diagnosis of BPO with SA, Stuffed Animal. In the other hand was a letter. Her face was ashen. I thought, Sitting on a train, and asked, ‘What’s going on?’
‘I don’t feel all that bad anymore. I don’t want to be dramatic. Maybe I should just leave. I’m sorry to bother you at this hour of the morning.’
‘Bad?’ I asked, really nervous that Malik was watching. ‘About what?’
Silence. Earlier in the day Malik had mentioned ‘the Eskimo Effect.’ Just as Eskimos have names for different kinds of snow, shrinks have names for different kinds of silence. This was a silence of fear. It was hard to wait for her to respond when all I wanted to do was finish up and get some sleep. But then she looked me in the eye, a look of desperation, and said:
‘If Mother knew … I want to die. I want to kill myself.’
Oh shit, I thought, I don’t need this. My mind tugged at its tether, wanting to run. She was staring at me, staring really hard. Things got quiet and still, but the stillness was so intense it seemed loud. Her little-girl eyes searched mine, searched hard. Her pain was palpable, like a thing, floating right there between us, a new element created by this searching, a flash.
Suddenly I felt enormous pressure – from her, from Malik – to do something to help her, and I found myself asking, ‘What about your mother?’
Whatever had been there between us fizzled. She looked away, stood up and said, ‘I don’t need to be here. I’ll go now.’ She took a step toward the door. ‘OK?’
‘No, wait—’ I said, realizing I’d blown it.
‘Why? I’ll be better off at home. Why should I stay?’
I glanced at Malik and Primo. Stim-U-Dents hanging from their lips, their faces were pursed in concern, sad for this poor young woman, and suddenly I felt it too. Turning back to Zoe, I said, ‘God, you look sad.’
Her eyes widened in surprise, startled that she had been understood. ‘It’s awful!’ she cried out, with self-loathing and rage. ‘I’m so fucked up!’
It was like a dam had burst. Crumpling down into her chair, she began to sob so hard that the chair shook. I had to fight the urge, in the face of all this watery pain, to head for the high ground. Then she told us of being dumped a few weeks ago by her latest boyfriend, a Dartmouth student, and of how this rejection echoed with a string of others, one-night stands and brief flings fueled by pot and booze and degradation. I followed the red thread of sorrow through her life, a saga of purposeless wealth and empty privilege. With a few questions from me it led back to struggles with her older brother, past a cool, powerful father, a rich and famous Manhattan corporate lawyer, to an obese mother raised in high society.
‘Whenever any of us felt bad, Mother would say, “Now, now, children, back into your Happy Box
es!” I grew up thinking there really were these boxes! It was horrible! I never for one moment felt that anyone really loved me! I couldn’t bear to live anymore. I decided to kill myself, tonight.’
Her story felt complete. I said, ‘It’s time to stop.’
‘Wait a sec,’ Malik said. He asked her a few questions about wanting to kill herself: how she’d thought to do it, whether she’d gotten pills and written a note, etc. She did have a bottle of pills – Xanax – which she handed me with the letter she’d been clutching, a suicide note. I’d failed to ask the one obvious question: Is she really suicidal or not?
‘But maybe I’m not so bad?’ she said. ‘All this doom and gloom. Maybe I shouldn’t come into the hospital at all? Isn’t it a sign of weakness?’
‘Coming into a hospital on your own,’ I said, ‘is a pretty strong thing to do, don’t you think?’
Silence, one of Watch Basch Destroy All He’s Achieved.
Zoe turned to me. Her mouth was open, like a dazed sleepy child, her eyes puffy and red. Her red teddy, too, seemed dazed and sad, staring out at me from the fortress of her arms. ‘Are you just starting your residency?’
Thinking, Don’t be an asshole, I said, ‘Yes.’
‘My cousin is too, in Texas. Will you be my therapist?’
‘Sure.’
Back in the office, Malik distributed fresh Stim-U-Dents to Primo and me. I was shaking. ‘Is it safe,’ I asked, ‘to leave her alone in there?’
‘Now it is. So.’ He settled back. ‘You almost blew it.’
‘You mean when she started to leave?’
‘Uh-huh.’ He worked an incisor. ‘Think back. Why’d she wanna leave?’
I thought back. ‘When I – because I asked about her mother?’
‘Yop. She says she wants to kill herself, you ask her about her mother? Earth to Basch: “Where are you?” Dincha feel the “click,” when everything got still and you and her connected?’ I nodded. ‘But then you ran like hell?’
‘I didn’t know what to do for her.’
‘For her pain? You thought you had to do something?’