Mount Misery

by Samuel Shem

  We laughed, but the laughter was shaded by our failure, two years before, to conceive. We’d even gone to a doctor – me, to a doctor! – but nothing abnormal was ever found. We’d stopped trying. We were living with the shadow.

  ‘Sounds wonderful,’ I said, ‘being with normal little kids.’

  ‘The two things they learn in school are how to eat “snack,” and how not to share. But they’re so sweet!’ She sang, ‘Will and Eva go wash your hands, Will and Eva go wash your hands, Will and Eva go wash your hands, ride, Sugar, ride!’

  ‘Sweet, yeah,’ I said, trying to hide my cynicism, after having had my hands in slit wrists and my face in borderline rage for the past thirty-six hours.

  ‘OK, OK,’ she said, picking up on it – she could read me better than anyone in the world; she had that same sixth sense about me that Malik had about everyone. ‘Let’s have it. Your day?’

  I told her about Malik, about how he seemed to respond to what you said by putting a spin on things the reverse of what you’d expect, and how, as I kept telling him I didn’t know what I was doing as a shrink, he kept telling me that my not knowing was terrific and to keep on not knowing for as long as I possibly could.

  ‘At least,’ Berry said, ‘this Malik isn’t accepting the Misery version of what’s “normal.” He sounds like he’s been hurt pretty badly too.’

  ‘You’re right.’ I told her about his being an alcoholic. My fingers were on the nape of her neck, caressing from the nuchal line of the occiput, along the trapezius, onto the deltoid insertion.

  Berry sighed, and asked, ‘Where are you about Ike White’s suicide?’

  I stiffened. ‘Please, not now. I didn’t really know him.’

  Outside, a siren wailed. We listened it down into silence. Crickets filled the vacuum, edging the silence with cellolike chirps.

  ‘But you respected him a lot. Just tell me what you feel.’

  I froze. ‘I don’t know.’

  ‘I know you know, hon. You can talk to me about it, it’s OK.’ But it wasn’t and I couldn’t and said nothing. ‘Oh boy,’ she went on, shaking her head, ‘you’ve got that “I work in mental illness” look. That’s the way I used to look, trying so hard to make it in psychology, remember? It’s so different now, so much easier, being on the opposing team.’

  ‘Opposing?’

  ‘Mental health.’

  ‘Oh. Yeah.’

  ‘Can you talk at all?’

  ‘I’m wiped out, fresh out of feeling, for today.’ I stroked her breast.

  ‘But we need to get in touch, to make love.’

  ‘You know making love is how I get in touch.’

  ‘Can’t you just talk to me a little first?’ she asked.

  Right then, this seemed like asking me to climb Mount Everest a little first. I had that same ‘I’m a cold fish’ feeling I’d had with my outpatient Christine, and, tensely, I said, ‘Please, please don’t spoil it.’

  ‘I’m spoiling it? All I’m asking is—’

  ‘Damnit, lay off!’ I shouted. She flinched, and her hands protected her breasts. Then, slowly, she sat back and stared at me, fear in her eyes. A rush of shame. Why the hell was I yelling at her? I felt horrible. ‘I’m sorry. I’m really tight.’

  ‘I’ll say.’

  ‘This stuff is so weird. During my medical internship I’d blow up ten times a day, but when I got home I was OK. Now, no matter what happens, I have to bottle it up, not show any feelings – and I get home and explode.’

  ‘But I want your intensity, Roy.’

  ‘I know, but right now I want to get away from it. It’s too much.’

  ‘You think that as a therapist you shouldn’t let on what you feel?’

  ‘If I do, people like Schlomo Dove tell me I’m sick and that I should be in therapy.’

  ‘You’re not sick. But maybe it would be a good idea.’

  ‘Right. I’ll go see Schlomo, he’ll make me a match, with that oh-so-special analyst, just for me. “Tell Schlomo,’” I said gooily. ‘“Tell Schlomo about sad and lonely.’”

  She laughed, I laughed with her, and the glass wall between us broke. We embraced, and like horny angels together we made that downstream journey where at best the notion of ‘Me, Roy, you, Berry’ goes under, tumbling along under the death-defying notion of ‘us.’

  Four

  Dear Basch,

  We started out well enough in Tuscany but it soon turned into the vacation from hell. Lily left last week to go back home, saying she needed some ‘space.’ I accused her of needing to see you know who! She said I was pazzo – crazy – and that everything was bravo – fine. Tuscany felt tainted so the girls and I are doing Amalfi. It’s beautiful but not when the woman you love can’t share the beauty. Hope and little Kissy and I are having good fun, but there are moments – times when we’re in the most breathtaking spots, like this ‘Terrace of the Infinite’ in Villa Cimbrone, Ravello – when I sense them missing their mom so much my heart breaks. At times like that I try to joke. Città Fiasco. Failure City. We’ll keep on doing the tourist thing. I’ll call you after Labor Day.

  Ciao,

  Putnam

  HE HAD MAILED a postcard in an express letter. The postcard showed a curved railing edging a sheer drop to the Mediterranean. The view south toward the boot was infinite: mountains, clouds, sea easing into sky. I had been in that exact same spot, with Berry. One step off, you’re dead.

  I was relieved that he was in touch with me, but worried about him. If there was one thing he could be sure of, it was that Schlomo Dove would not be seeing his wife while he was vacationing on Cape Cod. In much the same way that the august Pope was sacred to Catholics, the August Cape was sacred to Freudians. Having spent eleven months of the year in vicious gossip about each other and their patients, Schlomo and the other Freudian yentas had been spending the month in vicious gossip about each other and their patients while lying next to each other in floppy hats and baggy swimsuits on the bluntly narcissistic beaches of what Viv called ‘Misery East.’ Schlomo was said to be into nude sunbathing, airing those pits, those girlish tits, that pendulous belly, to the trade winds. Reading poor Cherokee’s card, I worried again about his sanity, and hoped he’d call soon.

  It was the day after Labor Day, and I was sitting in Malik’s rounds chair on Emerson 1, awaiting the arrival of Dr Blair Heiler. The day before, Malik had left to do Advanced Child Pathology in the Public Sector, the first of several third-year resident rotations that would take him away from Misery. His first rotation would be on the Children’s Unit at Candlewood State Hospital, down the hill and across the swamp. His wife Bronia, the tough Israeli whose name was accompanied by an eye-roll, would be his boss.

  The Emersons were in good shape. In my month with Malik, my work with patients had gone pretty much as he had predicted: to the extent that I had been able to stop acting like a psychiatrist and be a person to them – starting by discarding my suit and tie for shirt, slacks, and running shoes – they had responded not as patients but as people. For a month the ward secretary had presented Malik with piles of pink message slips from insurance companies. He always said he would get to them after a carrot or a run or tennis, and most of them went into the garbage. ‘Mental hospitals are hazardous to your mental health,’ he’d say. As their insurance ran out, those Emersonians who were ready were discharged, often in buddy pairs to the growing outpatient LAMBS system, which Malik called ‘my retirement.’ For us first-year residents, empty beds meant an easier time.

  If a patient needed to stay, Malik would dazzle or threaten the insurance company into paying. Thorny and Zoe were on the runway, revving for takeoff. Mary Megan, recovering slowly from the single blast of Placedon, still twitched and shouted, but was talking to Hannah. Malik had always stressed just how sick sick people are, and it had taken all of our efforts to help the Emersonians deal with Ike White’s suicide and get them back to a sense of basic safety, trusting that we their doctors would not kill ourselves too.


  On his last day, offering us fresh packets of Stim-U-Dents, Malik had proclaimed, ‘The rip in the fabric, from Ike White’s suicide, has been healed. Beware of Blair Heiler, and do more sports!’

  That morning, as I was waiting to begin rounds, Heiler returned from his vacation in Stockholm. Given his reputation for terror, I was on guard.

  Six feet five, with light blond hair, eyes the silvery blue of mica, a Roman nose and a movie-star chin, walking onto the ward in an airy summer suit and Liberty of London tie, Blair was a stunning sight, an image so clear and sharp that, set against the bizarre background of Emerson 2, for a second it seemed to fool the eye, and I found myself thinking: This guy can’t be real. It was as if you’d been sitting in your living room expecting Jack the Ripper, and in walked the Boy Next Door. An alluring male cologne completed the package. Blair’s manner was relaxed, modest and friendly. He had a charming habit of tossing his head to flick a blond forelock back out of his eyes, and then patting it down with long slender fingers. His eye contact was unwavering, and while his looking down at me was disconcerting, his easy laughter was disarming.

  Blair was forty-two, happily married to an heiress of one of the major convenience store chains, and the father of a three-year-old boy. He had been born on an army base in Alaska, where his father was on the rise toward major general, and his education had been typical of military children – many different schools in many different cities and countries. As a young man he had gotten used to transience, to seemingly impulsive swings in and out of school systems and playgrounds. He had grown familiar with a life of unstable personal relationships and fear of abandonment, and had learned to handle the powerful mood swings and emptiness associated with repeated hellos and abrupt goodbyes. In a sense, he had lived with the Krotkey Factors a long time. Now, Blair too was a guy on the rise, a happy, healthy member of the Misery family. Already an Associate Assistant Professor of Psychiatry, his high-powered research on borderlines was rumored to be about to lift him a rung higher on the academic ladder, to Assistant Associate Professor of Psychiatry. I stopped him on his way into his office and introduced myself.

  His face lit up and he shook my hand warmly. ‘I’ve heard a lot about you, Roy – Rhodes scholar and all. The chief says you’re a star.’

  Disarmed, I thanked him and asked, ‘Where do you hold your rounds?’

  ‘In my office, right here on the ward,’ he said good-naturedly.

  ‘You want me to bring the patients in there?’

  ‘Only if there’s a problem with insurance, Roy. I spend most of my time on the phone to the bastards in managed care, trying to give these borderlines as much time as they need as inpatients here. It’s dirty work, but someone’s got to do it. Later. Got some empty beds to take care of.’

  I was confused. This guy didn’t match the guy Malik had described.

  Later that morning Blair held his weekly Case Conference for the staff and residents of all three floors of Emerson. I volunteered to present Zoe, my rich young college student, to him. The conference room was packed. I took a seat in front of the crowd, to present the case, suddenly nervous. Hannah and Solini sat in the front row. Hannah smiled and Henry raised a clenched fist for support.

  Heiler entered and sat facing me. Sound evaporated from the hot room, leaving that distilled, tight stillness you feel before a show begins. I presented Zoe’s story, telling about her privileged Brahmin family, her sense of failure, her seeking out inappropriate men as lovers, her history of bulimia, her struggle at college and recent rejection, depression, and suicidal thoughts.

  ‘She’s done well in therapy,’ I said. ‘She’s gained weight, plays sports, and she’s just about ready for discharge. The treatment plan—’

  ‘First comes diagnosis,’ Heiler said, ‘then comes treatment. Diagnosis?’

  ‘Depression,’ I said, ‘reactive, to the loss of the man in her life.’

  ‘Great. Bring her in.’

  Stunned by the size of the crowd, Zoe flinched, and stumbled on the Oriental rug, murmuring, ‘I’m sorry – I’m so clumsy.’ She bent and turned down the up-flapped edge. Clearly, her self-esteem was rock-bottom. While she’d made an effort to dress up – crisp white sleeveless blouse and pressed jeans, lipstick and eye shadow – it was obvious from her scared look, tightly pressed lips, and clenched hands pressed thumb edge to thumb edge as if in a kind of petrified prayer, that she was feeling depressed and vulnerable.

  Heiler rose, introduced himself, and then, smiling, flashing those gorgeous eyes, took her hand gently, as if he were about to raise it to his lips and kiss it. Seductive. Then he sat down and leaned back in his chair with hand to cheek and legs elegantly crossed. His loafers were dainty, pointy-toed, buffed a buttery dark. He flicked a blond lock and gestured to Zoe to start.

  She blushed. ‘I didn’t expect so many people here.’

  ‘You feel angry about that?’ Heiler asked, his voice low, even husky.

  ‘No, just a little surprised.’

  ‘Dr Basch didn’t tell you?’

  ‘He probably didn’t know.’

  ‘You look angry,’ Heiler said, his tone sharper.

  ‘No, really, I’m not,’ Zoe replied.

  ‘If it were me, I would be angry,’ Blair said indignantly, ‘damn angry, being put on the spot in front of all these people.’ Zoe glanced at me, puzzled. I smiled, to encourage her. Heiler gestured toward me. ‘You angry at your therapist?’

  ‘No, I like my therapist. He’s nice.’

  ‘Nice?’ Blair said incredulously, as if she’d said that I was in fact not nice but a homicidal maniac. Sitting up in his chair, screwing up his face in distaste, he mocked her, ‘Nice?’

  Zoe stared down at her lap, her face flushed. Tears eased out from her lowered lids, onto her cheeks. I couldn’t believe this was happening.

  ‘Anything that makes you uncomfortable,’ Blair said, again in his seductive, reassuring tone, ‘you don’t have to answer, OK?’ Zoe nodded. ‘Good. So tell me, Zoe,’ he went on, as if they were once again best friends, ‘what would you like to do with your life?’

  Zoe hesitated, and then, with embarrassment, through her tears said, ‘After college, I’d like to become a … a social worker.’

  ‘A social worker?’ Blair said, as if this were incredible.

  ‘I don’t want to talk about it.’

  ‘Why not?’

  ‘It seems pretty pretentious, right now, being in a mental institution, saying I want to become a social worker.’

  ‘Tell us about wanting to become a—’ He paused, and then, with obvious loathing, went on. ‘— a social worker.’

  ‘You said I didn’t have to answer anything that makes me uncomfortable.’

  With a sardonic smile, Blair said, ‘Wanting to become a social worker?’

  It went on like that, Heiler assaulting, Zoe withdrawing, like a turtle withdrawing into a shell, and the shell being ripped off, polygon by polygon, exposing the pink flesh. I felt terrible for her, and furious at him, and thought several times I should jump up and stop him. In other situations, seeing this kind of public cruelty, I would have. And yet now I – and the others – seemed paralyzed. Starting to weep, Zoe talked about her depressions and her trying to kill herself. Heiler, who didn’t seem too interested in these depressions and these tryings, interrupted her:

  ‘What’s wrong with you? Why haven’t you gotten better?’

  ‘Dr Basch says I am better.’

  ‘Isn’t it possible that your idealization of Dr Basch is a denial of your primitive rage at your bad-object mother and your hatred of men?’

  What the hell does that mean? I wondered.

  ‘What does that mean?’ Zoe asked.

  ‘You’ve been here several weeks! Why are you still so sick?’

  ‘I don’t know.’

  ‘C’mon, c’mon – you must’ve thought about it. Why?’ Zoe said nothing. ‘Why?’ Blair shouted, so harshly that I jumped. ‘Why?’

&n
bsp; ‘Don’t know! Leave me alone.’ Like a child, she pleaded, ‘Please?’

  Heiler paused. With frank contempt he said, ‘A social worker, eh?’

  ‘Asshole!’ Zoe screamed, and jumped up and ran out, slamming the door so hard my teeth seemed to rattle. Stunned, I watched as Heiler turned to us, smiled, spread his arms wide, palms open in that kind of grand gesture that the star of the show uses at the last curtain call, and said, once again back into that charming, friendly, boy-next-doorish voice, ‘So, guys, what do you think? A seven?’

  A few nervous chuckles. Not to chuckle seemed a definite risk – if you didn’t side with this madman, you too might get attacked.

  ‘I’m toying with the idea of another Krotkey Factor, Number Fourteen: TDS, The Door Slam. Independent observers could rate it on a scale of one to ten. I bet it would predict the diagnosis, and correlate with severity and prognosis.’

  The hairs on the back of my neck tingled: Surely he didn’t think that this obviously depressed woman was a borderline?

  ‘What diagnosis, Dr Heiler?’ a BMS student asked innocently. He was a frail, sickly looking boy, and seemed to be wheezing.

  ‘Borderline. DSM 301.83. Textbook case. I was working on Krotkey Factor Number One: LNT – Latent Negative Transference. Let me explain.’

  Solini squeezed my knee in horror. In a cheerful, good-natured tone, Heiler explained that his technique, ‘confrontation,’ had evoked the anger that was ‘latent,’ or hidden, in each and every borderline. ‘She wasn’t angry at me,’ he said, ‘it was her transference to me. She was distorting her real relationship with me based on early infantile experiences, with her bad mom, in the first year of life.’

  ‘But she was angry at you,’ I said. ‘Anyone would be.’

  ‘Not that angry,’ he said, ‘not borderline angry.’

  ‘How do you know she’s a borderline?’

  ‘Because of that incredible anger.’

  ‘But she didn’t start out angry – you provoked it.’

  ‘Who says?’

  ‘I do. It was obvi—’