Mount Misery

by Samuel Shem

  And then he did. He hit every DSM diagnosis, ten for ten. Every damn one.

  ‘But doesn’t that just mean,’ I asked, ‘that the diagnosis is right?’

  ‘Nope, it just means that it’s bullshit. If you ask the “normal” status quo questions, you get the “normal” status quo answers. Like cancer. In the last fifteen years overall cancer rates are up twenty percent! Everybody’s gettin’ cancer! Kids, for Chrissakes! Don’t you have friends who have cancer? Think.’ Reluctantly I thought, and realized that I had gotten a number of phone calls since I’d been back, from friends, and friends of friends, sudden terrified calls announcing melanoma, pancreas, breast, asking me for help in finding them good medical care. I nodded. ‘We all know somebody. I got two cancer calls already since I got back – one’s my nephew, who’s only three – leukemia! People our age – lymphoma, ovarian – this didn’t happen to our parents! When they look back, this is gonna be known as the Age of Cancer.’

  ‘Yeah, man,’ Henry said, ‘but what’s that got to do like with this?’

  ‘That’s what I’m telling you. Getting cancer is “normal” now.’

  ‘So what do we do?’ I asked. ‘Give up?’

  ‘The hell! We open our eyes, we take it all in. We fight the “normal” bastards putting all the shit in our water, earth, air – the air we breathe, do you believe it? And we take care of business in here.’ He tapped his chest, in the zone of his heart.

  I’d forgotten how intense Malik was, volcanic, a force of nature wrapped in tinty glasses and sports mania and dumb-jock talk.

  Malik wiped his brow, and finished his carrot. ‘Jeez, you get me going, Basch – how do you do it anyways? I was so peaceful in Yisroel.’ He bounced the ball and pivoted smoothly away. Then he stopped and turned back. ‘Look,’ he said. ‘These people coming in here are sick of a sick world. They’re the canaries in the mine shaft, kid. Just like us.’

  ‘Us?’

  ‘Who else? Right, Solini?’

  Solini juked and jived, and sang some Marley.

  ‘Just remember, Roy,’ Malik said, ‘when you’re all computer-literate ’n’ cold? Like they say in Hollywood: “You meet the same people on the way back down.’”

  ‘But I don’t have the time it takes to connect with these people.’

  ‘Schmucko, schmucko! You still think connecting is a matter of time?’

  ‘OK, then – I don’t have the energy.’

  ‘The energy ain’t in you, like a little battery; the energy comes from the connecting! Like in tennis, taking a ball on a short hop, using its own momentum to fire it back harder over the net, or—’ He threw a no-look pass at Solini, hitting him in the nose. ‘—making a touch pass in hoop!’

  The siren’s wail rose in pitch. It was almost five o’clock, and I saw Nash heading out the front door, with Jennifer following close behind. With so much unfinished work, I felt I needed to talk to him. I ran out and caught him just as he was getting into his black Lincoln Continental Town Car with tinted windows.

  ‘I need to talk to you,’ I said. The siren came closer.

  ‘You can’t. It’s five o’clock.’ Jennifer was getting into her car, a black Lexus.

  ‘But if they stay for only seven days, what the hell are we doing to help them?’

  ‘Toshiba keeps them safe, gives them meds, I’m out of here.’ He got in. I stopped the door from closing with my foot.

  ‘Seven days of safety and meds doesn’t do fuck-all for most of them.’

  ‘So after seven days they go back out, and then come back in, sooner, sicker. They get sicker and sicker sooner and sooner till finally their insurance company can’t legally not send them further into Misery, for longer stays on Inpatient Unit. Now get your damn foot outta my door.’

  ‘But what about—’

  Suddenly the siren was close, and then closer, and it was heading right for Toshiba, and, seeing it, Nash shouted – ‘Get away!’ – and I thought it was so he could get out to tend to this emergency but in fact it was so he could slam the door and get out before the emergency emerged.

  I watched him peel the Continental off and down the hill and watched the Lexus tail him down and then I was caught up in the emergency. The EMTs rushed the body of a young woman into the lobby. Reflexively I slipped into real doctor mode, asking the medics what they knew – ‘OD, barely breathing when we found her, maybe barbiturates, maybe heroin, she was scheduled to be admitted here tomorrow’ – and started doing all the brutal, desperate medical things to get a heartbeat and a breath.

  Solini arrived and joined in – he was the DOC. We tried everything, nothing worked. Finally, exhausted and scared – for she was young, younger than Henry and me – we pulled the sheet up over her face and retreated to the boardroom, where we slumped down into our chairs.

  ‘Sorry, Cowboy, it’s rough. Shall I send in the next of kin?’

  Henry looked at me sadly. I said, ‘We do it together?’

  ‘Cool,’ he said.

  Her husband came in, a solid-looking young man with a blond crew cut and a colorful work shirt. He sat down and turned to me. ‘How bad is it, Doc?’

  ‘Bad,’ I said, trying to keep my voice steady. ‘She’s dead.’

  He stared at me for a second, then at Solini, then turned away. And then he screamed, ‘Bitch! Fucking bitch!’ threw his chair down and stormed out.

  ‘Not what I expected,’ I said to Henry.

  ‘No joke. In psychiatry you’ve gotta have no expectations about patients and no interest in them.’

  ‘What?’ I said, startled. ‘Who told you that?’

  ‘Dr A. K. Lowell, the chief on Thoreau, the Family Unit. She’s classic Freud. I started my rotation with her today. She was totally silent the whole day, and then at the end she said that. She’s weird, but maybe about that she’s cool?’

  As if weights were attached to my feet, I trudged out of Toshiba sometime after nine at night.

  A neat thin man in a tweedy sport jacket and Woody Allen glasses stopped me, asking, ‘Are you a doctor?’

  My guard went up, like an off-duty pediatrician is on guard around kids.

  ‘Yes.’

  ‘My name’s Sedders. I think I need admission to the hospital.’

  I clicked on what I’d learned to be the first question of any psychiatric interview, and as empathically as possible asked, ‘Do you have insurance?’

  ‘Yes, that’s the problem.’

  ‘How’s that the problem?’ I asked, framing a Chief Complaint of I have insurance.

  ‘It’s managed care, an HMO. “Healthycare Incorporated.” Admission has to be approved by two doctors from the HMO, and none will return my calls. I’ve been trying all day. Most of the time all I get is a busy signal. The office is in Washington. State.’

  ‘Keep hitting “redial.”’

  ‘I do. When I do get through I get a secretary, never a doctor.’

  ‘Is it an emergency?’

  ‘That’s what the secretaries all ask. I’m not sure. It’s certainly urgent. I’m thinking seriously of killing myself.’

  ‘How seriously?’

  ‘I’m not sure. I have no standard of comparison.’

  ‘Tell them it’s urgent. Be a little more self-assertive.’

  ‘You think if I say that, they’ll get the doctors to call me back?’

  ‘It’s worth a try. Keep redialing.’

  ‘Thanks muchly, Doctor—’ He read my name tag. ‘—Basch. You’re the first doctor who’s taken the time to talk to me. I feel a little better already.’

  ‘Good.’

  When I got home there were three messages on my machine:

  ‘What a boffo session, Doc. Nothing Mickey Mouse about you. I feel better. Good luck with that sweet family of yours on Thanksgiving. I’ll try to keep in touch. Putnam.’

  ‘Don’t worry, buddy, I love you.’

  ‘Me. Call me. Now.’

  Eight

  FLORIDA IS WHERE my parents are dying
and living.

  ‘Roy?’

  Florida is where a lot of great Americans die.

  ‘Quick or you’ll miss them!’

  I opened my eyes and it was still dark. Florida. In a hotel with Jill. I followed the tropical breeze toward her. ‘What time is it?’

  ‘Just before dawn. Look.’

  She was standing on the balcony, wearing nothing. Her back was to me. My eyes went from her punk thatch over her muscular shoulders down the line of her spine and then to the incurling of her rump, one leg straight, the other hiked up on the railing of our balcony, like an explorer sighting a shangrila. I walked over, leaned against her, and clasped my hands over her slightly rounded belly. ‘What?’

  ‘E.T.s – Extraterrestrials.’

  ‘Again?’

  ‘This time for real. See that? What do you think that is?’

  I followed her finger and there, across the long flat surface of the Gulf of Mexico, were four ovals of light, hovering in the breaking sky. ‘Airplanes,’ I said. ‘We’re not that far from Tampa, and the flight paths to Central America and the Islands.’

  ‘No way,’ she said, and, as if in answer to my skepticism, the ovals dipped down toward the surface of the water, not in the unison of some kind of reflection, but each a little differently, and then seemed to bounce, two, three, four times on the mirror of the sea, before, hovering again for an instant, they waggled once and were gone. “You never saw airplanes do that!’

  As we stood there I could feel the tension in her body, her tight tummy, her sporadic breathing.

  ‘I’d give anything to go up,’ Jill said quietly.

  ‘Up?’

  ‘With them. People have, you know. People do.’

  ‘You believe those stories?’

  ‘I’ve met people who have. Lots of people. In Montana last summer.’ I stroked her tummy. ‘Mmm, nice. I’ve thought, a few times this year, that they followed me back. I’d wake up and feel them there, by my bed.’

  ‘You saw them?’

  ‘Sensed them. I have something to tell you, Roy.’ She turned to face me, pivoting like a ballerina on one leg, hiking the other leg, which had been on the railing, over my hip. ‘I think they were here.’

  ‘Here?’

  ‘In our room. Around the bed. Last night when we were making love.’

  ‘The little perverts.’

  ‘They were just curious, that’s all.’ She put her palm to my cheek, looking into my eyes. She was taller than Berry, almost my height. ‘Do you think I’m crazy? Are you clicking away with your little DSM diagnoses?’

  ‘Nope. That was no airplane. Do you think they’re dangerous?’

  She shook her head no, put her chin down, and leaned into me, forehead-to-forehead. I felt wetness on my eyes, and realized she was crying. I asked what was wrong. ‘My mom saw UFOs, and when I was in high school they had her picture in the paper – it was a small town – and when I got to school the next day the other kids really got on me – called her a loony and all. So it means a lot that you accept this in me.’

  ‘And it means a lot to me that—’ I was cut short by her gesture of appreciation, which was, by stepping up on a low cast-iron balcony table, hiking herself up to straddle me.

  ‘Think you can handle it?’ she asked coolly, as if she were asking whether the guy wires to the main pole of a tent would hold.

  ‘I’ll die trying.’

  ‘Hmmm,’ she said, encircling my neck with her arms. ‘Know the difference between fucking and making love?’ I said I did not. ‘In making love, you kiss.’ Putting one finger under my chin, she looked into my eyes and smiled, and I smiled, and then slowly, maybe a millimeter at a time, she moved toward me, her mouth opening, her tongue lying in it like a pink cushion on a purple couch, and kissed me.

  Later that Thanksgiving morning we drove to my parents’ condo. I had switched coverage with Arnie Bozer, he taking my Thanksgiving Day, I his Christmas. He was still dating my former outpatient, Christine, who, after my Heilerizing her, had never come back to see me again.

  ‘This is a very special Christmas for me, Roy,’ he’d said. ‘I’m taking Chrissy home to Indiana to meet the folks. Thanks so very much.’

  I usually spent Thanksgiving with Berry at my family’s house in Columbia, New York, but in the past year my father the dentist had retired to Naples, Florida, and had invited us down here, to celebrate with my brother and his family, who were flying in from Phoenix. Berry was going to her parents’ in Maine, saying that she didn’t feel comfortable being with my family with me right now. Although I hadn’t told her explicitly about Jill, I had a sense that she knew. Jill had no family nearby. She had no money either, and I had paid her airfare. Misery had paid my airfare, for me to be its representative at a conference entitled ‘Is Psychotherapy Dead – or Just Mismanaged?’

  ‘What did you tell your parents about me?’ Jill asked as we parked the rented cobalt Saturn carefully in the lined box marked Vistor Car in the condo lot.

  ‘That we worked together, and we both were down here for a conference.’

  ‘Uh-huh. And they’ve met Berry?’ I nodded. ‘They like her?’

  ‘They love her.’

  ‘Okay. Just like to know what I’m walking into.’

  ‘It won’t help. No preparation helps.’ An hour before, I had found an index card in my wallet, written by Berry and me after our last visit here:

  How to Survive a Trip to Your Parents’

  1) Live Through It; 2) Breathe and Smile; 3) Primum Non Nocere: First, Do No Harm; 4) Get Out of the Condo – Change the Setting; 5) Pray; 6) Try to Surprise Them, Without Hostility; 7) Get Set to See Yourself at Your Very Worst.

  Family and Berry. They seemed to go together. Recently she’d said to me, ‘It’s as if we grew each other up. You and I were each other’s ticket out.’

  ‘Out?’

  ‘Of our families.’

  Now, her image rising up in my mind’s eye like a dental X ray rising up out of a developer in that eerie red light of the darkroom in my father’s office, I felt torn. Why was I doing this? Being with Jill could be a big mistake. I stared up at the four-story concrete-block building, identical to another beside it. Each condo had a railed balcony protected by green screening, giving each a lime tint. The lot was full of huge American luxury cars. I spotted my father’s Chrysler New Yorker. ‘The biggest car Chrysler makes and it has the most trunk space.’ He would say this with pride. I would feel irritated, and then guilty. Why should a man’s love of his big car irritate his son?

  How flat the whole scene seemed. Even the sunshine felt two-dimensional, flat slabs of light slapped up against white walls, and against the flat chlorine kidney of the Cyclone-fenced pool. We got out, staring at a sign:

  POOL RULES

  Swim at your own risk. Shower before entering pool. No radios without earphones. Bathing load 15 persons. No food, glass, or alcoholic drinks. No floats. No pets. Toilet-trained infants only. You must shower before entering pool. After using chairs and lounges, please replace in proper position. See other rules on bulletin board in Pool Hut.

  ‘Control is big in Florida,’ I said. A well-tanned woman and man, dressed in shorts and banded T-shirts like members of Team Senior, rolled up on tricycles. Only as they passed was their age apparent. ‘It’s a utopia for second childhood.’

  ‘It doesn’t say you can’t go topless.’

  I laughed, remembering my father telling me about his recent reaction to the French Riviera: ‘They go topless and it doesn’t bother you that much.’

  We turned and walked toward the building. Through the gap between the two buildings we could see the flat green of the golf course, a lone geriatric palm, and, on the horizon, the Gulf of Mexico. A fishing boat was heading across the flat blue, a cloud of gulls pluming up in its wake, an ever more chaotic white wedge against the flat blue sky. The sea was so still that the plume of gulls was reflected in the darker blue. I saw this as a hint of entropy, a break in the
square flat concrete of the condo world where the fifties generation had gone for golf and tennis and concerts and restaurants, with clear rules, clear sightlines, and protective netting, like around a playpen. The unruly plume of gulls was like a rip in a Norman Rockwell. I wanted to be on that boat, heaving fish over, feeding the chaos of those gulls.

  Hold it. My parents were basically good people. Dad had stayed in the same office on Washington Street for thirty years before retiring the previous year, filling cavities, hauling out molars, going home to my mother’s hot lunch, meeting with the Jolly Jews, his investment club, and golfing, always golfing. In his golfing prime he had an admirable tail hook, and got a lot of roll. Once he and I had contested the Hendrik Hudson Club Championship. It escaped me who had won. Mom too had slogged it out – slogged, hell, lived her dream: a ranch house a big car two kids one a doctor even if a psychiatrist one a wealthy banker. I stared up at the green balconies. This was their dream come true. A little generosity was required. I felt a rush of sadness, then tenderness. This would be my only day with them all winter. Make it good. As Malik said, ‘None of us are here for long.’

  ‘Maybe,’ I said to Jill, ‘this time will be different. One thing: under no circumstances go into a room alone with my mother.’

  ‘Why not?’

  ‘In a room alone with you, she’ll destroy anything between us.’

  ‘Hey, if there’s one thing I know about, it’s “the boyfriend’s mother.’”

  ‘Yeah, but not mine.’

  We were buzzed in through the heavily locked door and up to the third floor and then down the hall to where my parents stood in the spotlight of their open condo door. As I approached, seeing the hope light up in their eyes, the memory of how I had been as a college student, a teenager, a boy, a baby, hope lit up in me too, the hope for the return of the imagined remembered, and tears came to my eyes. When I was almost to them, seeing them so much smaller than recalled, I felt ashamed of my suspicion, and felt a rush of joy, like a young boy’s.

  ‘Hi, bud, and welcome,’ my father said. His voice trembled as he took my hand, as if he would cry. He wore a pink sport coat and polka dot tie clasped high on his belly, the belly itself straining hard against a big brass cowboy buckle on pants pulled up almost to his chest.