“Can be three to six months,” Canty said.
The psychologist said he usually found it counterproductive spending month after month psychoanalyzing parental conflicts and flaws in childhood development.
“What’s important is what we’re doing in the here and now,” Canty said. “And, we’re going to stay in the here and now.”
White explained his recent financial disaster, his hospitalization, and his membership in AA.
“I recommend you stay with AA, Ted,” he said. “It’s a good program, though I tend to think there’s too much reliance on God. I like to put my faith in my own reasoning.”
And rational thinking was what cognitive therapy was all about, Canty said. He added that he’d studied under Dr. Burns. But he preferred the works of Albert Ellis, another former teacher.
He assigned a lengthy reading list for White: Feeling Good, How to Be Your Own Best Friend, The Psychology of Self-Esteem, The Neurotic Personality of Our Time, Our Inner Conflicts, When I Say No, I Feel Guilty, and A New Guide to Rational Living.
White bought all of them except for a copy of the Ellis and Harper rational-living book, which Canty handed him.
“I read it at least once a year,” he said. “And you should too, for the rest of your life. It really has kept my thinking straight.”
White found A New Guide to Rational Living compelling reading. He underlined pertinent paragraphs and sentences with pencil. One chapter quoted a self-help group called the Associated Rational Thinkers on the benefits of rational-emotive thinking:
Rational thinking has the following four characteristics: (1) It [bases itself] primarily on objective fact as opposed to subjective opinion. (2) If acted upon, it most likely will result in the preservation of your life and limb rather than premature death or injury. (3) If acted upon, it produces your personally defined life’s goals more quickly. (4) If acted upon, it prevents undesirable personal and/or environmental conflict.
White and Canty had begun to discuss RET in their sessions before the psychologist became ill. At first White suspected Canty was a psychologist accustomed to getting results. Early on, the therapist offered him a fast cure for cigarettes. He had a couple dozen cartons of nicotine-free cigarettes in his office. He handed White a carton. White tried a couple but couldn’t stand the smell. His wife smoked the rest and quit. But eventually she was smoking again.
Before his psychologist’s hospitalization, White was growing discouraged by Canty’s therapy as well. He had read that in the cognitive approach the therapist took an active role in sessions. But he hadn’t seen Canty get that involved. If he wasn’t pouring one cup of coffee after another, he was answering the telephone. Without a secretary, he took a lot of calls.
Often Canty was late for the three-thirty appointment. He’d come down the hall apologizing, offering various excuses. He was tied up in court evaluations. He had work at the county prosecutor’s office. He was helping a Cass Corridor prostitute in the hospital.
Ted White could see how Canty had worked himself into physical collapse. Listening to him make those appointments, White had determined that the therapist was taking patients during every waking hour. He couldn’t understand why anyone would need to work that much, especially at rates approaching one hundred dollars an hour.
Well, White thought, maybe the sessions will improve now that his psychologist was rested up.
When he arrived for the May 15 session, Ted White would find the psychologist on time, exuding confidence, and more at ease. Canty would tell him that he had lightened his work load, switched to decaffeinated coffee, and was “learning to relax” a little more.
“I guess, more or less,” Canty would say, “I’ve got to start practicing what I preach.”
42
There are also those persons who optimistically think that emotional problems are just temporary, or situational, in nature. Unfortunately, this is seldom the case.
—W. ALAN CANTY,
Principles of Counseling and Psychotherapy.
John Fry and Dawn Spens had accepted the inevitable. Dr. Al Miller wasn’t coming back. When Dawn tried to telephone him, she got a female voice. “Dr. Canty’s office.” That was his colleague, Al once told her. She wasn’t to leave messages. She should hang up if he didn’t answer. Before, Al himself often answered with a simple “hello.”
They had expected the five thousand dollars on Friday the thirteenth. Fry said it was the wrong move on the wrong day. “It’s over—too much pressure too quick. It was good while it lasted. But we pushed him too far.”
Dawn hustled to finance two drug habits ballooned by four months of prosperity. She went from collecting Comerica envelopes filled with crisp cash to squeezing johns for tips of worn ten-and twenty-dollar bills. Her workday was no longer limited to the lunch hour. There was no talk between her and John about the house in West Bloomfield.
On May 6 Dawn Spens was arrested again by the vice squad. After she was released, they got into an argument over drugs and money. It seemed as though John always got a bear’s share of both. The argument ended when John swung a broomstick across her thighs.
Later Dawn complained she was coming down with the flu. She had a fever, chills, and sweats. She kept working nonetheless.
Lucky Fry was sprawled on the sofa when Dawn returned from the streets May 10 just after the lunch hour. She sashayed into the apartment and left the door wide open behind her.
“What the fuck are you so happy about?” John said.
“Look who’s here!”
John looked up to see someone’s head poking around the edge of the doorway. He focused on a familiar grin, wide as ever.
“Hi, John,” said Dr. Al Miller.
Al walked over to the couch in his Chaplin toddle and shook John’s hand. He eyed the small apartment like a man returning to his boyhood home.
Al was eager to explain his absence. He said he’d gone to a medical conference in Ann Arbor with a colleague and crashed in an automobile accident on the way back. He spent four weeks in University Hospital, two of them in a coma. He just was released yesterday. Al went on a good five minutes with the story. Fry forgot most of the details, but he wouldn’t forget his first impression.
“I didn’t think the punk was in no hospital,” he later said. “I figured he had tried to get away. He had tried to deal Dawn out of his life, but realized he couldn’t do it. For some reason, he couldn’t live without her. The next move was up to him.”
The trick already had made it. He already had asked Dawn Spens if the five-thousand-dollar deal still stood.
43
The psychopath should never be trusted.
—W. ALAN CANTY,
Henry Ford Community College lectures
Dr. Al Miller brought a stethoscope on his next visit to the Homewood Manor. He also brought five thousand dollars in cash, most of it in hundred-dollar bills.
Dawn Spens was suffering shortness of breath. Al listened to her chest and back with the instrument. She asked him if she should go to the hospital. He pulled off the earpieces and told her to get plenty of bed rest. She really didn’t have much choice. She was so weak she could hardly walk. She threw up anything she ate.
As for the five thousand dollars, the cash prompted John Fry to move his clothes to a friend’s apartment down the hall. John said he was still making arrangements to leave town—but he had moved out. Before that could be pursued, however, the two men had a more pressing concern. Dawn was gasping for air and had a temperature of 104 degrees. She wanted Al to take her to the hospital.
“Are you sure you want to go?” he said.
“Yes, I’m sure,” she said.
Al drove Dawn and John to the emergency room at Detroit Receiving Hospital. He didn’t accompany them into the facility. He said he had a full schedule that day. But again, she didn’t have to wait for admission. It was May 11.
Physicians diagnosed Dawn as suffering from bacterial endocarditis—a blood infection in the h
eart, common among IV drug addicts. Doctors had no difficulty determining she was one. Her groin abscess still was open from her hospital stay in January. She had it packed with a fine-mesh gauze. She confessed to doctors she’d been using the area for injections.
The bacterial endocarditis was a bigger concern. It was potentially fatal. With the disease, bacteria build up on the valves of the heart, forming clots that could break loose and flow to the brain and other organs. Her physicians ordered heart tests. She would have to stay in the hospital at least twenty-eight days while they gave her an intravenous antibiotic.
John Fry, meanwhile, would have no problem keeping himself occupied. In the Cass Corridor, five thousand dollars made him a wealthy man. He could stay high for weeks. He planned on keeping a low profile, but Dr. Al Miller and Dawn Spens had other plans for him.
Though Dawn was getting fifty milligrams of hospital Demerol three times a day, she wanted more drugs. A couple of times Al drove to the Homewood to see John, who gave heroin to Al for Dawn. Then Dawn had Fry introduce Al to one of his drug connections, a small-time Corridor dealer who lived in the Homewood named Gene Johnson. Some days Al brought Johnson to her room with the drugs. On others he visited Johnson and brought the heroin himself, smuggling in one to four packs and syringes she could use with the IV.
She spent a lot of time just watching TV and staying stoned.
“Basically it was my own fault that I kept doing it,” she later told another addict. “But I seriously think the man wanted to watch me kill myself.”
Al also said he knew all the doctors who were treating her. He had discussed her case with them, he said. One day, Dawn watched him step into the hall with a third-year medical student who was assigned to her case. When Al returned, he said he knew her from a class he once taught. Dawn would forget the student’s name but remembered that she had a large diamond engagement ring.
Al also had some ongoing stories about himself. He said that while he was in the hospital, the home he owned in Grosse Pointe had been burglarized. Thieves had trashed every room. He had a crew of workers repairing the damages. Then one day, after a visit, Al complained that his new Buick Regal had been stolen from the hospital parking lot.
Back at the Homewood Manor, John Fry was shooting a hundred dollars’ worth of mixed jive and Dilaudid at a sitting, while trying to dodge his own series of bad breaks. Street creditors were after him for a three-hundred-dollar outstanding debt. He’d borrowed the money to get Dawn out of jail earlier in the month. Fry planned to pay them off with part of the eighteen hundred he had left from Dr. Miller’s payoff money. One night his creditors threatened to send over a wrecking crew. It was the same group that one time clubbed a friend senseless with a baseball bat. He told them they’d get their money that evening.
That night Fry made a drug purchase at one of the Homewood’s dope pads. He had the eighteen hundred in his wallet. He pulled off his pants so another addict could hit him in the leg. Later he found that his wallet was missing. He suspected another junkie stole it when his pants were down. He returned to the apartment and a fight ensued. Another addict shot him in the hand with a pistol, he later told friends. The bullet cut away the flesh of the middle finger. He wrapped the hand with gauze but didn’t seek medical treatment.
The third week in May John called Frank McMasters in Alanson. He told him he had to get out of Detroit. Then he went to Detroit Receiving and visited Dawn to tell her his plans.
He made Dawn promise she would taper her habit and ultimately quit using in the hospital. John said he would get medical care in the north and kick his habit. When she was released, he would send for her from Alanson. Maybe he could get a job there.
They had lived in the Homewood Manor for nearly eight months. Eight months was too long, John Fry said.
“I’ve got to get out of here and get clean,” he told her. “I’m going to Frank and Cheryl’s. It’s got to change. If you keep using you’re going to end up dead from the dope. And I’m going to end up dead because these motherfuckers in the street are going to kill me.”
Then he headed north, leaving Dawn in the care of Receiving Hospital and Dr. Al Miller.
44
As she looked at the records of Dawn Marie Spens, third-year medical student Barbara Tacoma found the prospect of treating yet another addict depressing.
Her twelve-week rotation in internal medicine at Receiving Hospital had offered a lot of medical knowledge, but not a lot of hope. So many of the hospital’s ample caseload of addicts had thick hospital files that told the same story. They received medical attention for drug complications only to return to the streets and end up admitted again from further abuse.
The twenty-four-yearold aspiring doctor just wanted to finish her studies and return home to western Michigan. She had a fiancé and internship waiting for her in Grand Rapids—her kind of town, where family values were practiced as though they were on the endangered species list.
Tacoma could see Dawn Spens was in serious trouble, and it wasn’t only her endocarditis. She had an open abscess on her leg. Her admission chart said it all: a “deep, foul-smelling sinus track draining purulent exudate.”
Tacoma was moved that someone five years her junior was so physically spent. She expected Dawn, with her medical file of a hard-core addict, to be indifferent to her bedside manner. That impression changed when they began to talk.
“Oh … let me see your ring,” Dawn said.
The young addict complimented her on her three-quarter-karat solitaire. Barbara held out her hand and told her about her fiancé and their wedding later that year.
“What are you going to do?” Dawn asked. “Tell me about your wedding.”
She was surprised to find Dawn so pleasant. Dawn had the vocabulary of a college freshman, rather than the street vernacular Tacoma had grown accustomed to hearing. Dawn asked intelligent questions. She gave articulate answers.
Over the next three weeks Tacoma found herself spending more time with the young addict than with any of her other patients. She sensed Dawn liked her, and she liked Dawn. She found their visits uplifting. Her heart went out to her. Here, she thought, is someone who would respond to help.
One day she asked Dawn if there was anyone special in her life. She said she had her boyfriend John, but she didn’t seem all that enthused.
On another day, they talked about her drug addiction.
“You know there is help available,” she told her.
“I know, I know,” Dawn said. “I should get help. I should. It’s all the people I’ve been around.”
At first, Barbara Tacoma had the feeling Dawn was just appeasing her. She made it a point to do a little digging. Where was her family?
“My parents don’t care what I do,” she said. “My parents don’t care where I am.”
Then an ultrasound examination was made of Dawn Spens’s heart. It showed an abnormal mass of echoes in the right atrium. There was the possibility of a clot. Tacoma was there when a resident delivered the news.
“You’re not just fooling around with anything here,” he said. “This is for real. With a thrombus sitting on your heart, it could be any moment and you’re gone.”
For the first time Dawn seemed to take seriously what Tacoma had been telling her about her habit. She wanted to know all the possible medical scenarios. She said she was going to seek treatment. A number of options were available through hospital social services.
“You’re right,” Dawn told her in one heart-to-heart talk. “I need help. I can’t do it alone.”
One day, early in her stay, Tacoma saw Dawn entertaining a visit by a casual-looking but professionally dressed man. Dawn was excited, even proud, when she introduced him.
“This is Dr. Al Miller, from Harper-Grace Hospitals. He’s a psychiatrist—an M.D.”
Dr. Miller extended his hand and grinned, downplaying his credentials with a self-disparaging remark. Later Dawn explained he was a friend of the family. Her family had desert
ed her, but Dr. Miller hadn’t. He was trying to help her out, she said.
That day, Barbara and Dr. Miller went into the hall outside Dawn’s room and chatted. The psychiatrist wanted to know all the details of her condition. He wanted to know her progress. He had a good grasp of medical terminology. Tacoma didn’t have to clarify any of her statements, at least.
Tacoma asked him a couple of questions about his work, but he was evasive. She had done a six-week tour in psychiatry at Harper-Grace but couldn’t recall seeing his name. But that wasn’t unusual. Psychiatrists often spent a lot of time in their offices.
Dr. Miller also had a strange demeanor, she thought. Maybe it was his all-knowing smile, as though he knew something she didn’t. She hated to stereotype his specialty, but he wasn’t the first shrink she’d met with that kind of look. A lot of them were secretive. It seemed to go with the field. After he left, it struck her that she’d learned little about him, though they talked a good five minutes or more.
In time she noticed Dr. Miller visited every day at lunch. Tacoma was impressed that an M.D. was taking that kind of time from his practice. She knew few who would make that kind of sacrifice, even for a nice girl like Dawn who really needed the help.
Two other things struck her as odd. When Dr. Miller was around, Dawn seemed quite carefree about her body. Hospital gowns could be quite revealing, and Dawn made no effort at modesty. She would casually walk around the room, her bare buttocks showing in the back. Also, Dr. Miller always arrived with a reddish brown overnight bag made of parachute material. It was not the kind of valise she’d expect to see with a physician. It looked very unprofessional.
One day during a break a thought struck her. She remembered other addicts caught using street drugs in the hospital. Dawn had never been screened because nothing led anyone to believe she was using; she was making progress. Plus, her room was close to the nurses’ station. But that bag of Dr. Miller’s got Tacoma wondering.
“You know,” she told a resident, “I wonder if that guy has a bag of goodies with him.”
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