by Samuel Shem
He ‘clicked’ back. ‘Sleep tight, sweetheart, and lie like hell tomorrow.’
‘Can I?’
‘Can’t not. Once y’sense the truth, kid, the false loses its grip on ya.’
He picked a piece of litter off the asphalt and put it in his pocket, climbed up into the bus and rolled down the window. Leaning an arm on the sill like a friendly trucker, he offered me a Stim-U-Dent and stared down at me for a second. Nodding, he asked, ‘Authentic?’
‘You mean my authentic self?’
‘No, the opposite.’
‘What opposite? There is no opposite to self.’
‘There you go! “Self” is made up of all the non-“self” stuff.’
‘Like what?’
‘Like, for instance, all this!’ He swept his arms around the landscape, from the dark west toward the glint of sunrise in the east. ‘The whole damn world! Haha!’
‘I’ll try.’
‘You do better if you don’t,’ he said, grinning, ‘like in sports!
‘Pray for me in Israel, Malik, will you?’ I said sarcastically.
The only sound was the hum of the argon lights, high over our heads.
‘I will, Roy. None of us are here for long.’
He turned the key. The old bus cleared its throat and rolled off down the hill out of Misery, and for the first time I noticed his license plate:
BREATHE
What the hell does that mean? I wondered as I stood there working the beveled edge against my gum. The stretching sensation and crisp mint taste fit the still-clear realness of my friend, freeing up from metaphor the actual autumn night, the actual strength of the sun.
Six
‘LYING TO SUPERVISORS?’ Henry Solini shouted.
‘Learning psychiatry!’ I shouted back over the loud music.
‘Learning psychiatry?’ he cried out.
‘Lying to supervisors!’
It was the next day, after work. Solini, Hannah, and I were sitting in The Misery, a funky bar down the hill from the hospital. Henry and I were sharing a pepperoni pizza. Hannah was picking at a Greek salad without feta. Shouting over Marley’s ‘Natty Dread,’ I told them what Malik had said.
Ever since Heiler had accused Henry publicly of being ‘gay-latent,’ he had gradually imploded. Like a time-lapse film of a flower packing back up into its bud, Henry had gotten compacted in on himself: shoulders more hunched, head tucked between, nose and lips and eyebrows somehow squinched down and tucked into the face, as if for protection from a rain of blows. Now he sat blinking his eyes, moving his hands slowly, like a cat its paws at the end of a long run of purring, and asked, ‘Telling the truth to patients?’
‘Exactly.’
He blinked again, and his eyebrows seemed to unfurl from the creases of his brow, his chin lifted, lifting his nose, and his eyes seemed to blossom, bright and mischievous, as if suddenly he had the idea of planting a bomb under Ideal Cleaners in Mandan, North Dakota. ‘Enough of this shit,’ he said. ‘We got no choice. We’re getting killed, and the patients are worse.’
‘Which, of course,’ Hannah said, ‘may be better.’ She tucked a stray lock of raven’s hair back over an ear, an ear graced with a diamond earring that turned the sorry bar’s light into rainbows darting here and there. Of all of us, Hannah had been treated worst by Heiler. Her patients down in Depression were doing astonishingly badly, her marriage to Billy ben Lube was borderline violent, but Hannah was doing astonishingly well. Day after day she almost glowed. ‘Psychiatry,’ she said now, ‘is built on truth. There’s no way I could lie to him. Those eyes. They see right through you. Like radar. Could you look him in those eyes and lie, Roy?’
I realized it would be difficult. ‘Maybe, maybe not.’
Her own eyes rolled up to a fake Tiffany with a Clydesdale marching around it. ‘Even if I could lie to Blair, I couldn’t lie to Ed Slapadek – and they’re tennis partners, so he’d tell him. You should see his eyes. He not only knows what I’m thinking now, he knows what I’ll be thinking next!’ Her eyes stayed up. I winked at Henry.
‘It’s a good thing Malik was just joking,’ I lied to her.
‘Joking?’ Hannah asked.
‘Lying to supervisors? Who wouldn’t think that was a joke?’
‘No-one,’ Solini said, getting my message. ‘No-one at all.’
‘Truth is, Hannah,’ I went on, ‘Malik must have been using the concept of lying unconsciously, as a kind of reaction formation to show how we have to be absolutely scrupulous about telling the truth.’
She pondered this. I could almost see the words clicking into place, little keys fitting little locks in the labyrinth of the Borderline Theory in her mind.
‘Yes,’ she said weightily, ‘that does make sense. Besides, even a little white lie cripples me with guilt. Ed Slapadek is excellent on Jewish guilt.’
‘“Guiltiness,”’ Solini sang out, danced over to the juke-box, and put on the Marley song of that name. Out on the dance floor, shuffling his arms like the pistons of a steam train, his face squinching up in delight, he lip-synched the words.
Solini’s new girlfriend Nique Nique came in and joined him in dancing. She was a tall, powerfully built, ebony-black Jamaican he’d met through the Misery cafeteria workers he jammed with. I felt relieved that he and I had easily lied to Hannah, but I also felt sad that she’d declared so clearly against what I now saw as the inevitable ambiguity of the merely human, and declared herself for the Heiler machine. Holding my beer, I joined the two dancers as we, white, white, and black, transformed our chilly and insular bar into a warm, sun-filled one alive with revolution, decades back, in Trenchtown, Jamaica.
As the chill of October congealed into the cold of November, as Solini and I would walk sschlwoosh! sschlwoosh! through the fallen leaves of Misery, kicking them up in puffs of snapped bright colors into the crackling sunlight, while we might have felt some fear, we felt little doubt. We had no choice. While we might not yet know what to do with our patients, we knew what not to: we would not be cruel to them. Feeling choiceless, we felt free.
Heiler was away the rest of that week at meetings of the International Dissociation Association, first in Germany doing ‘Borderlines on the Autobahn’ and then on to Israel doing ‘Borderline Jews and Jewish Borderlines’ – the same lecture he’d given in Germany but with the word ‘German’ changed to ‘Jew’ throughout – so we had a whole week of telling the truth to our patients without worrying about lying to him. It started with Thorny’s untied shoelace.
Thorny had been threatening to kill me. Now, as I sat with him on Emerson, his scarred face looked particularly nasty. Even his teeth looked scary. I was on guard. He bent to tie his shoelace. Tying a shoelace is not something you think about – thinking about it makes it harder. Thorny tied his shoelace painstakingly, thinking about each loop and bow and pull. When he finished, the lace was loose and clearly wouldn’t hold. Looking up, he saw me staring and he flushed.
‘My parents never bothered to teach me. I learned by watchin’ other kids, in gym class ’n’ such. I tie ’em like I’m lookin’ in a mirror … dickhead.’
‘Want me to teach you?’
He stared at me suspiciously, wondering if this was a Heiler technique. Then he nodded. And so I taught him. Or tried to, for with him sitting across from me, mirroring me, I started trying to mirror him, which didn’t work. We had to sit beside each other. Trying not to think, I made the ties and he followed. We did it over and over, making those child’s rabbit ears of bows, then making them vanish, like magic. With each success we chuckled, sharing the child’s sense of wonder at this tight but slippable knot. He sat back, looking with satisfaction at our work. We were sitting side by side facing out the window at the lake, the woods, the mountains alive with dying leaves, chlorophyll receding, revealing the husks of fire. He started to talk. It was pure Malik: two passengers on a train.
‘Imagine what that was like, Doc, goin’ to Princeton without bein’ able to tie you
r damn shoes? Freshman year was hell.’
‘Yeah, I know. I felt that way too, my first year at Harvard.’
‘You too?’ he asked. ‘A red-hot like you?’
‘You bet.’
‘That ain’t too convincin’, Doc.’
‘Dickheads Ain’t Too Convincin’.’
He burst out laughing, but then his face fell. ‘Yeah, but that was the fork in the damn path. I went down. Guys like you went up.’
‘Why?’ I asked, realizing as I said it that it was a Heiler word, one I’d used with viciousness on Thorny before. But now I’d said it sincerely. He went on in the same friendly tone. So it’s not the word, I thought, it’s what the word travels on. Heiler, on guard, put his patients on guard. If I stayed authentic, I needn’t be so careful about what I was saying. A relief.
‘Compared to guys like you I felt so damn inferior – Princeton took me ’cuz Daddy was rich – so I tried to find somethin’ where I could stand out. I joined the Appalachian Mountain Club, rock-climbin’ – all so’s I could pound six pitons into the ceiling of my room and hang my bed from ’em. Things fell apart.’
‘Tell me about it.’
Easily, honestly, and in a way that soon had us both laughing at the absurdity of it all, he did. He’d gotten into booze, then narcotics. Opiate in cough medicine was his drug of choice. He’d learned to cough. When he’d run out of emergency room doctors to dupe, he bought a dog and trained it to cough, duping veterinarians for dog cough medicine. All along the way picking fights with bigger men, continually getting beaten up, thrown out of bars, finding himself at dawn lying in desolate parking lots, in ditches.
Listening, I asked myself: Why him and not me? Why, at the end of the day, do I take my keys and let myself out, locking him in? Our histories were not dissimilar – good genes, busy, battle-weary, obsessive fathers and bored, battlewise, depressed mothers, bright boyhoods of sports and girls and A’s on report cards – similar until we hit college and I dug in and he flipped out. Years later I’m locking him up for the night. Had I myself made myself ‘succeed’? Had he himself made himself ‘fail’? Was he defective, I not? Born and raised him, would I be him? The Borderline Theory would say that his sick SELF was his fault, my less sick SELF my triumph. What horseshit. All at once I saw Thorny not as basically sick, but as basically healthy.
My rotation on Emerson would end in six weeks, just before Thanksgiving. My final week, Heiler would be away in Kuala Lumpur doing ‘Borderlines of the Pacific Rim.’ Thorny and I agreed he would leave before I did. He’d have to find a buddy, a place to live, some work.
‘A job? Who’d hire a dickhead like me?’
‘Not necessarily a job. Work. You don’t need money. Volunteer.’
‘Like my mom?’ He blinked, ran his thumbs up and down his suspenders, and then, shyly, revealed his secret passion. ‘Toxic waste?’ I nodded, knowing he was thinking of his father, whom he referred to as ‘the Great Polluter.’ He licked his lips. ‘Ozone holes!’ He was grinning. His face looked open and powerful. But then fear drifted in. ‘Shit. Leavin’ here scares me.’
‘We’ll work on your fear, together. Like your shoelaces. Deal?’
‘Dickheads Make Deals!’ He opened the door. ‘But you gotta take me off the meds – they make me crazy – like all my goddamn narcotics or something.’
‘Talk to Mr K. He’s running a Department of Defense Drug Support Group.’
‘Him? You jokin’?’
I looked down at his shoelaces, as did he. I looked back up at him, meeting his eyes. I asked, ‘Still tied?’
‘Still tied.’ And then he got it, that now we were rebels together. ‘Mr K.?’
‘A great American. Send in the next victim.’
The next Emersonian came in, and the next, and while I still didn’t know what to say to them that might help, I focused on not using Borderline Technique, trying to not be cruel to them, to not do much of anything to them. It helped. Their radar picked up my trying hard to do nothing to them, and they tried hard to do nothing to me. We shared a sense of relief.
Last, I went to see Zoe in her room. She had been doing better recently and eating solid food, but she refused to see me. I felt ashamed at the way I had screamed at her in the Quiet Room that night with Malik. He’d suggested I apologize. In my many years of medical training, no-one had ever suggested that I, a doctor, apologize to a patient. Zoe lay on her bed in jeans and a sweatshirt with Nelson Mandela smiling against the colors of the African National Congress. Knees up like a teenager, she was reading Catcher in the Rye. She stared at me skeptically.
‘I’m sorry, Zoe. I lost it, and was cruel to you. I made a mistake.’
‘Get out.”
Feeling hurt, I did. Had I lost her? Lost Cherokee and Christine too? Berry? I drove home overwhelmed with a weird exhaustion, as if to be a shrink were an unnatural act, a movement decidedly against human nature. The lines on the road home wavered as I tried to keep my lids up until I crashed into bed before eight and fell through that membrane to the sleep of the dead.
Phone. I struggled up from the deep, not knowing which country I was in, France or Turkey or China, let alone in what bed.
‘Zoe wants to talk to you,’ the night nurse on Emerson said. It was eleven that same night. I said OK, to put her on. ‘She won’t talk to you on the phone. Afraid you’ll hang up. She wants to talk to you in person.’
Heiler would have slammed that one out of the park. ‘Be right there.’
Zoe sat in the living room, ashen and scared. ‘I … I just wanted to say … that … I accept your apology. And that we can start to work together again.’
‘Great. Glad to hear it.’
‘Your cruelty wasn’t your fault. I mean you’ve only been a psychiatrist a few months. You’re still learning, struggling with incompetence, right?’
‘Who isn’t?’
Startled, she stared at me quizzically. ‘Really.’ She yawned. ‘Anyway that’s all I wanted to say. Go home to your wife and kids.’
No-one knows what a shrink is doing behind closed doors. Solini and I found it easy to be not cruel to our patients without anyone knowing.
The week that Heiler was away, we worked hard to unHeiler. It was astonishing to see just how quickly we and our patients shifted from adversaries to allies. Soon our patients, no longer under attack, no longer attacked; no longer humiliated, they no longer humiliated; treated more humanely, they acted more humanely. It was all so obvious – but what Malik called ‘the elusive obvious.’ Henry and I soon had a sense that we were riding some pretty strong unseen forces, much like, as we walked toward Emerson those bright crisp fall mornings, we’d see the last fugitive leaves spinning in scarlet and gold whirlwinds, riding the unseen breeze.
That Friday afternoon Heiler was due back from Germany. I was scheduled to see him at six that night, to report on the three wards of Emerson. As the time approached, I realized that, face-to-face, under pressure from those blue jolts of eyes, I might not be able to lie. At six sharp I called him in his office. My heart was racing. I said, ‘I can’t make it to supervision.’
‘Why?’
‘I’m beat, and Berry and I are leaving early tomorrow morning to hike.’
‘To hike?’ he said derisively. ‘You realize that while you’re out hiking, other psychiatry residents will be in their labs, working? Getting ahead?’
‘I need to take care of myself, that’s—’
‘Have a “nice” hike,’ he said and hung up.
The next afternoon Berry and I were taking a break from our day-hike up nearby Mount Jackson, in the Presidential Range of the White Mountains. The view was exquisite, the long bright rainbow of autumnal color stretching west at the bottom of the clear cold sky, the stretch coalescing the spectrum into a smudged pastel and then into an imagined smudge over an imagined Lake Champlain and, even, an imagined curve of the planet itself. Having been stuck behind the long caravan of Winnebagos and Airstreams fighting their way u
p the Kancamagus Highway to ‘see the leaves,’ having found a break in the caravan of hikers clomping up the mountain, we were finally getting a small hit of nature. The air was that chill mountain variety. Our sweat soon cooled.
As had our relationship. Each of us was more edgy and guarded, neither mentioning what we were doing in the increasing number of nights when we were no longer seeing each other. I had seen Jill a few times more, at home and, with Viv’s vigilance, in the on-call room, and it had been the same hard run of martinis or champagne lubricating frank, wild, mutually self-centered sex. The gap between Berry’s days singing nursery rhymes and mine shouting down borderlines had widened. But this weekend was a chance to heal. So far, so good.
I had told her about Heiler, and now, sitting side by side in the nostalgic lift of the vista, I said, ‘But I don’t think I can lie to him, face-to-face. When I’m with him, I get so damn flustered, I feel totally unsure of myself. I can’t lie to him, but I can’t tell the truth, either. I’m screwed.’
‘Who is?’ Berry asked.
‘I am.’
‘Who?’
‘Me. What do you mean who? Me. Myself. I.’
She smiled. ‘So that’s what you’ve got to do.’
‘What?’
‘Get him to talk about himself, and you won’t have to lie. If he’s into himself, he’ll never even get around to you.’
‘HimSELF! Of course.’
‘“Male station-identification.” Once he settles into using the word “I,” you’ve got him. Like I was just doing with you.’
‘With me?’
‘Asking you about yourself, about how you’re going to deal with Heiler – your hopes, your fears. Taking care of this relationship. Being curious about your experience, drawing you out. How often do you do that with me?’
‘But you always seem so interested in hearing about me.’
‘See?’ She smiled and got up, brushing off her jeans. ‘Let’s go. We’ve got another hour or so to the top.’
‘Wait. You’re not interested in me? It’s a lie?’
‘Who’s asking?’