Mount Misery

by Samuel Shem

  Zoe collapsed on her belly, hiding her face in her hands.

  Schlomo, penis encased in a condom and hanging below his belly like a surgical afterthought, jumped up and slammed the door in my face.

  A dead bolt was thrown. The door was locked.

  I stood there, head spinning, even in the first few seconds asking myself, Did I really see what I saw? – already doubting it. I knew full well what I had seen, but I didn’t know if I could bear seeing it, or knowing it, really.

  That night I spent with Gloria the head nurse. Glo fit my mood perfectly, as she was not particularly interested in it. Our lovemaking took place in pitch-black, soundlessly, on drugs. I got up to go to the bathroom in the middle of the night and found that her medicine cabinet was as chock full of drugs as a suburban freezer is with food.

  After she left for work, I got out of bed and went to the medicine cabinet. Many of the drugs were easily lethal. I pocketed a bottle of barbiturates – phenobarb 30 mg. – and left. When I got home I took one pill.

  Twenty-four hours later I awoke from a dreamless sleep, my best damn sleep in the eleven months since I’d come to Misery. It was like that blissful sleep of childhood when one moment your head is hitting the pillow in the scary dark and next thing you know there’s your mom pulling up the shade and it’s light.

  Is this like death? I wondered, searching through the fuzz for coffee.

  It took a whole pot of coffee and three Ritalins to burn off the fuzz.

  In my mailbox from the day before was a postcard featuring a turtle – one of those bow-legged turtles that look like cartoon cowboys – being ridden by a girl in a bikini. The caption read: ‘Galápagos Giant Turtle of Pre-history.’

  In Jill’s schoolgirlish handwriting, all loops and circles, was:

  Weather here, wish you were beautiful.

  Seen nothing yet but trying to see.

  Love and XXX Jill.

  Who cared.

  My father is dead who cared.

  Seventeen

  ‘THEY GO OUT seamless.’ Ike White and A.K. and Poppa Doc had told me that.

  ‘What makes one person kill themselves and another not?’ This was the question that Mo Ali, A. K. Lowell’s little boy, had asked.

  Now I knew the answer: It’s this, this big disconnect.

  I was not in good shape. I was taking a phenobarb before I went to work and taking two at night. Already my liver enzymes had revved up to metabolize the barbiturate so that I needed a stronger dose for the same effect, the essential feature of an addiction. I needed the higher dose now to sleep. To forget my failures, to try to deny what I’d seen. I was still in shock at having seen – or thinking I’d seen – Schlomo and Zoe. It was too heavy, and I was too depressed to try to do anything about it. I thought of confronting Schlomo, or calling Zoe, or telling someone else, but it was just too heavy. It lay there in my mind next to Cherokee, with all the surprising weight you feel when for the first time in your life you try to lift up a dead body. Deadweight.

  There were some successes on the West. If a patient was lucky enough to have bad insurance and got out quick, discharged to a local psychiatrist or a family doctor who had some common sense, things might go well. Patients who stayed any length of time were doomed. The further into the topiary maze of six-drug Marienbad they traveled, the harder it was to find their way back out. Errol and Win killed a lot of patients, in a number of different ways, and they didn’t seem to care.

  One of the worst drug runs, for me, was Thorny.

  Errol quickly ran him through the drug protocol, thirteen drugs one after another, with no luck – what Thorny, in a rare lucid moment, called ‘Thirteen-drug Mardi Gras.’ Then, because he had failed drugs, Thorny was deemed ‘a good candidate for shock.’ He and I were both against it. His legal guardian, the Burn King of the Bayous, was all for it. So one day, after adding a Valium to my war chest, I went with Thorny down to Errol’s ECT concession in the Farben basement.

  I expected ghoulish, but got garish. The shock room was like a spare bedroom of a split-level ranch, with silk flowers and prints of red-coated men riding to hounds. The shockbox itself was disguised to look like a stereo receiver.

  ‘They gonna kill me?’ Thorny said, lying down, clutching my hand.

  ‘Nope. This is safer than street drugs.’

  ‘Gonna turn me into psychobroccoli?’ I said not. ‘If I die, tell Zoe I love her. And tell the Burn King that too?’

  ‘Deal.’

  Dr Miles Wucov and Nurse Wic slipped in an IV and placed electrodes sweetly on his temples. Then they ran in Pentothal, a barbiturate.

  ‘Holy shit,’ Thorny said, ‘what a fantastic high and—’ and he was out.

  When he was out everything changed. Wucov and Wic, Argentinians, clattered on in Spanish. Cheerily, they paralyzed him with succinylcholine, pumped oxygen into his mouth, and whipped big leather horse straps down across his body. They shoveled a tongue blade between his teeth. Wucov hit the button once, twice. Thorny, drugged up, didn’t convulse as much physically as, it appeared to me, he convulsed in his aura. It was as if he too had been made suddenly translucent and one hand of death had passed through him quickly, taking stock for the future, weighing what was now lost and how much would be left, throwing a shadow. Quicker than I’d expected, it was over and he was coming to.

  I sat with him in recovery while other ‘good candidates for shock’ got theirs. He was so dazed he didn’t remember what day it was or what month. The thing he did remember was the Pentothal. Thorny’s first words to me were:

  ‘What a high! Gotta get me some mo’a that shit! Catch ya later—’

  ‘Hold it.’ It wasn’t hard to keep him from leaving, as his body seemed to have lost substance, some vital stuff stolen by that hand passing through.

  But from that morning on, all Thorny could talk about was his craving for drugs. Downers had been his drug of choice. He’d been clean for nine months, but now the barbiturates had revved up his addiction. His insane craving, coupled with his loss of memory, put him at tremendous risk, if he were to escape. Well, I thought, at least they’ll end it here, with Thorny a failure at both thirteen-drug lotto and electroshock therapy. Now he fits in the little box for turf to social worker, for Placebotalk. They won’t try anything else to harm him, like changing his diagnosis and shipping him upstairs.

  They changed his diagnosis and shipped him upstairs. Thorny’s obsession with the drugs he’d been given for shock treatment soon got him diagnosed as Obsessive Compulsive Disorder, the newly fashionable OCD. He was turfed upstairs to West Ward 2 with the handwashers and the famous financier who scratched his rump incessantly. They started him on a new OCD six-drug roulette, at which he soon failed. Now, I thought, surely he’d be turfed to social worker, to talk. Even they would not shock him some more.

  They shocked him some more. Now it was against his will, and not allowing me to come with him. Thorny resisted with maniacal strength, but six steroidal mental health workers wrassled him onto a stretcher and tranquilized him and wheeled him along to the Farben, where Wucov and Wic did their fandango on his brain. Thorny was on a once-a-day schedule for these blue jolts, and so rather than have to cart him back and forth, they converted part of the dog lab into a Quiet Room, and he lay there between toastings, tied down in four-point restraints, the horror of his isolation made monstrous by the reverberations off tile of the whining, barking, caged sacrificial dogs. They blasted him with enough watts to light up Mandan, North Dakota, Solini’s hometown. I took it on myself to be his medical doctor, making sure he was physically all right. Sometimes, after a particularly vitriolic shock session, I stayed with him most of the night. The only tangible result of all this wattage was an increase in his barbiturate craving. When he spoke, all he said was, ‘I gotta get out, and get high.’

  All this was orchestrated by Errol, who never once talked to Thorny in person. Errol billed Thorny’s father for these daily nontalks at $150 per thirty-minute session. It wa
s a perfect scam: Thorny’s memory was shot. He never remembered who came to see him, or when. Errol pulled the scam with psychotics as well. He could always claim that since they hallucinated him when he wasn’t there, they could hallucinate him not there when he was. As Malik had said, ‘They cheat on everything: billing, taxes, research data, and wives.’ I focused my attention on doing the minimum, keeping Thorny safe, waiting until he was a clear treatment failure and they turfed him to talk. My only worry was that Thorny would escape. I bugged Errol about this incessantly. Mindful of being sued by a rich Burn King, Errol wrote orders for incredible surveillance of Thorny. Errol said, ‘One thing you can be sure of, Frank: Thorny will not escape.’

  Thorny escaped. There was no sawing through bars with a sharpened Misery knife, no bedsheets out a window, no slow crawl through a heating duct, no tunneling under, no Hollywood horseshit, no. Rather, one of Solini’s Jamaicans whom Thorny had jammed with, when asked by Thorny to let him out to get some cigarettes, obliged. Without a memory, without money, and with a revved-up addiction to barbiturates, Thorny was sure to use street drugs, and meet disaster.

  It was only after he had escaped that I understood how lucky it was that he had. The next day, next to the cappuccino machine, I found a thick, well-worn book: How to Do Brain Surgery. Volume II: Humans. On a pink Post-it note tab stuck into the chapter on ‘Thalamic Lesions and OCD’ was:

  Errol: It says here cingulectomy is the treatment of choice for irresponsive [sic] OCD. It worked on Van Dusky, why not with ole Thorny? Let me know. Win.

  I had no idea what I could do about any of this. I buried my care in silence. You’d have to have a heart of stone, to see all this and not feel it. I was not feeling it much. My heart may well have been stone. I had told no-one about my seeing Schlomo fucking Zoe. Since then I’d begun to doubt myself even more. Did I really see what I saw? Could there be some other explanation? Fatigue? Side effect of one of the drugs I was on? Could it have been not Zoe but a Zoe look-alike whom Schlomo had been dating without the Barracuda’s knowledge?

  But of course seeing Zoe being fucked by Schlomo in therapy made me realize that in all likelihood Lily Putnam was being fucked by Schlomo in therapy too. Cherokee had even imagined the same position I’d seen: doggie style. I knew that I should do something about it, but what? I had to talk to Lily, but she was still too wigged out to talk. So far it was my word against his, and I was enervated totally from being on barbiturates. Everything was an effort. My fuzz made it harder to think and to act.

  Then one day I forced myself to go to my Outpatient Team Meeting, in the clinic at the swampy, sulfur-scented end of the sausage-shaped lake. I watched from behind a one-way mirror as Schlomo did his ‘down and dirty’ shtick as the leader of an outpatient group therapy. After the group was over I filed in with the rest of the Outpatient Team for discussion, and watched Schlomo do his up-on-his-tippy-toes dance of celebration of himself as the mensch of psychotherapy.

  I said nothing, sizing up my enemy. His piggy slits of eyes seemed to be avoiding mine. By the end of the session my heart was racing. The pulse in my temporal arteries cut through my barbiturate fog like the bell on a buoy. To wake up I ate a Ritalin. I followed him out and waited as his disciples peeled off gradually to their own offices. I found myself standing behind him as he unlocked his office door in the Farben, the door I had opened to my glimpse of hell. He turned and saw me standing facing him.

  ‘Royala!’ he cried out happily, as if we were old friends. ‘Nu?’

  ‘I’ve got to talk to you.’

  ‘Schlomo is delighted.’

  I followed him in. Bananas were everywhere, in various stages of decay. I faced him, again dazzled by the actuality of his ugliness. Doubt rolled in, crashed over.

  ‘I – I—’ I stammered. ‘What I saw you doing, when I came in here that morning, with my patient Zoe …’

  ‘You came in here with your patient Zoe?’

  ‘No, no, I opened the door, and you were with Zoe.’

  ‘You came in here?’

  ‘You know I did. You were … having intercourse with Zoe.’

  ‘What?’ he said.

  ‘Fucking her. I saw you having sexual intercourse with my patient Zoe.’

  His eyes widened from their porcine slits and his jaw dropped as if the jowls had gotten just too heavy for the fat-ridden masseters and buccinators. His teeth looked fierce, and I spotted a clumsily capped incisor and a badly rotated bicuspid. ‘What?’ he cried out again. ‘Schlomo Dove having – look, Schlomo can hardly mouth the words – sex with a patient?’

  ‘Yes. I saw it. I’m going to do something about it. It’ll be easier if you admit it.’

  His eyes narrowed again. The masseters not only pulled that jaw back up but clenched, wobbling those cheeks, those jowls. His mouth closed hard, to a line. ‘You never came in here. You never saw Schlomo with a patient in here.’

  ‘I know what I saw.’

  ‘No you don’t. Schlomo’s door is always closed and locked. The consulting chamber is a sacred place. A safe place for one and all.’

  ‘I saw it. And I believe, now, that you’ve been fucking Lily Putnam too.’

  ‘You are confused, Roy Basch. Confused and deeply deeply depressed.’

  I felt an enormous weight, as if he were a block of strange metal emitting particulate metal from those eyes, that mouth, coating me, confusing me with weight, pressing out of me anything I might know for sure. The full weight of accusing him, the top analyst in town, one of the guys who matched tens of thousands of poor souls to other analysts, came down on me. I tried to speak. My tongue had gone metallic, it was too heavy to move.

  ‘Roy,’ he said in a kindly tone, ‘to have a father die, and a patient die, all in the same month? Who wouldn’t be depressed and confused? Why, no-one wouldn’t, no-one wouldn’t at all. You’d be crazy if you weren’t, right? Schlomo understands. Now, Schlomo has another patient waiting. Goodbye, Roy, and be well.’

  My body felt as heavy as a dead man’s. I got out.

  I needed help. Who could I ask?

  That’s the hooker, I thought, over and over when I roused myself from my despair and lethargy to think at all – who could I ask? It was astonishing to me that in almost a year in Mount Misery, surrounded by people who were allegedly the ones you would most want to go to to ask for help with your despair, I could think of only two people I could turn to: Berry and Malik. Berry seemed too risky. ‘Ask!’ Malik had made us say. It had to be Malik. But he’d told me to burn his phone number. Could I call him?

  One rainy evening a couple of days later, after finishing up with my patient Christine, who was responding to Prozac and Ritalin by not obsessing as much about Cherokee’s suicide, I phoned Malik at home.

  No answer. No tape. Strange.

  Maybe because of my depressed haziness I had the thought that this meant he must be with his wife over on Ironwood, the Child Unit at Candlewood State Hospital. I climbed down from my office in Toshiba and walked toward my old Mustang, but I’d been eating more phenobarbs and my feet weren’t making great contact with the ground and the cool wet drizzle felt so good on my feverish dull face that I decided to hike through the swamp to Candlewood.

  It was one of those damp cool dusks where you can’t tell if it feels ominous because winter is coming or liberating because it’s about to be summer. The damp cool felt good. Leaving Misery was always easier than entering, and I moved quickly downhill and then farther downhill to the long straightaway through the marshland. The road was two-lane only, a rarity, and soon on either side as far as the eye could see there was nothing of civilization, for the land was too wet to build on, and by some miracle in these rapacious times, still too protected to drain. The lowland, set in a natural bowl of hills with thinning forests, was misty and hazy like the inside of my head. In the marsh there were no real trees, but bushes and cattails and swamp grass, last year’s brown mixed with this year’s green. The smell of skunk cabbage hit me, sharpl
y as smelling salts, and opened my eyes wide.

  The dim sunset was reflected in jagged pieces of pooled water, broken by hummocks. The only sounds were my feet on the blacktop – the reassuring thunk thunk reminding me of my many other solitary walks over the years, from Aranmore off the west Irish coast to Buyukada south of Istanbul in the Sea of Marmara, from the thin ancient paths boxing the rice paddies at Mao’s birthplace near Changsha to the Cotswolds, where I’d spent years alone learning not to be lonely – I’d thought, at the time, for good.

  Deeper into the swamp I heard birds, and saw, like a ghost or a goddess, a lone white heron, beak poised like a sword, still as my father’s face in death. I could have sworn I heard a flute, and stopped, still. Lonely lilting notes tore up from the far edge of the marsh, seemingly from one direction, then another, sad, desolate notes, held long, moving not in major steps but in chromatic elisions, making me feel cold and sorrowful. I hurried on.

  In the wasteland of the state facility I skirted the main building, feeling guilty remembering my trip to Women’s Chronic 9, for I had never been back. Ironwood, the Children’s Unit, was a lone brick building on a small hill in the back. I used my keys and entered. A pounding came at me, rhythmic, through a wall: Whrrr-thwak! Whrrr-thwak! I searched out the door to this room and went in.

  It was a large white box, with a ceiling twenty feet high. From the center of the ceiling was suspended a swing. In the swing, swinging hard, was a child, a boy. He would pump – whrrr – and pound his two feet into the wall – thwak! and pump back – whrrr – and kick the other wall – thwak! Where he kicked, the wall was black, and eroded, as if he were a prisoner who would kick through and then fly through and out and up and up. His body was rail-thin, and his face was demonic, focused only on the spot he was kicking ahead of him. I watched for what seemed a long time. He took no notice.