The screen burst alive with what could have been a direct shot of the sun, or a close-up of a lightbulb. No sense of space: it could have been a racquetball court or a decompression chamber or the inside of a septic tank, a place blank and depthless. The shifting contours, rolling across the gigantic screen, made it seem as though the room itself was moving, inverting itself, the corners moving away as the center drew close, a swelling belly of emptiness pressing against him and mashing his bowels, Jonah getting seasick. He should turn it off, he could not turn it off. Unsteadily he sat, falling back on his elbows. Now he discerned a horizontal. The camera pulled back and there appeared a person—a woman—lying facedown on a table. She was naked. She did not look real; she was liquid. The image was grainy and scarred, a copy of a copy of a copy. The camera repeatedly softened and sharpened, his head hurt. The woman was Eve. He could tell. Not exactly naked: a jungle of loose ropes, hung from above, effleuraged her back. Ropes?, ropes. They began to go taut.
The ropes were attached to her back with hooks, glinting like mouthless teeth, two dozen stingers left by bees the size of babies. Her back spiked; grew stalagmites of skin. She extended her arms and began to fly. Legs aligned and stiff; head up; beatific. Rising from the table, attached to the ropes attached to her skin. She bled. It coursed down her ribs. The camera tracked upward until she stopped rising, and hung in space, sculptural, swinging in and out of shadow, like a cast-off angel plummeting through the clouds. Repulsive, beautiful; and his whole head was wet but before he could get up blackout
And at once the screen again flashed bright: Eve, naked from the waist up, handcuffed to a post, being flogged with what appeared to be a belt, although the whipper stood off-screen, and all Jonah could make out was a flicker of motion and a popcorn crack. Red stripes appeared across her back. crack As her skin showed no marks, he intuited that what he was watching had occurred much earlier or much later. crack Her back bled; she cried out. Shifting in one direction earned her lashes from the opposite side. When one well-placed hit sliced open her shoulder, she fell to her knees, screaming in a way he found familiar, almost lovingly known, an idiosyncrasy like that’s all folks or finger-lickin good. The disembodied hand dropped the belt and began to beat her viciously about the neck and head; she slumped like cloth; and as the hand stopped clubbing her he heard an electronic buzz, whimpering
blackout
JONAH STEM, I REGRET THE POOR QUALITY OF THESE IMAGES.
fade
AT THE TIME, YOU SEE, I COULDN’T
AFFORD A DECENT CAMERA.
fade
I AM THEREFORE INCLUDING ONLY TWO
OF THE EARLIEST CLIPS
fade
SHORTLY THEREAFTER, MY LUCK IMPROVED,
I CHANCED INTO SOME DECENT EQUIPMENT.
fade
HENCE THE GREATER VARIETY AND SUPERIOR
QUALITY OF THE FOLLOWING:
fade
PART THE SECOND: LATER WORKS
(THEORY/PRAXIS)
The remote control. He could turn this off. He did nothing. He was sewn to the ground.
Eve, again: older, a clear, close shot of her bare back. He had never seen her fully naked in real life and now he understood why. Between the previous movie and this one, she had changed, horribly: her upper body not that of a young woman but a twisted mass of scar tissue, pink and white swellings like melted Styrofoam; injuries healed and reopened so many times that her torso was gone, smothered, a slum atop the ruins of a palace.
Gloved hands, holding a screwdriver and a barbeque lighter, appeared on-screen and then retreated. Click. The screwdriver reappeared, its tip smoking. Eve raised her arms above her head and the screwdriver moved to her left flank.
He covered his face until the sizzling, the screaming, stopped. He would get up and leave. He would do that. Open his eyes and get up. He heard nothing. There was no screaming, probably the tape was over. He would get up without looking at the screen. He put his hands flat against the unwashed floor and started to push himself to his knees. But drunk and sightless he lost his balance, slipped, and as his eyes opened reflexively he caught a glimpse of the screen, a fifth of a second but it was long enough, more than long enough, a pair of scissors clipped off the tip of a nipple.
He scrambled across the room, slamming the door behind him, which failed to drown out another bout of digital-quality screaming dressed atop reports of (no; but yes) snapping bone. Like a dog he flopped in front of the toilet, losing undigested hunks of dough and tropical liqueurs and then nothing, nothing but retching still, drooling crystal and viscous. He cleared his burning sinuses into the toilet; took off his shirt and wrapped himself in a towel. He instructed himself to think clinically, recast her as a series of component layers: skin and fat and muscle and bone and vessels and nerves. Not a person but a model. You trained to see the human body as an object. Like a car, like a coloring book. You kept your distance. And in his mind’s eye he saw scissors and a ragged bloody hole where there should have been supple pink and, to his amazement, he vomited again.
Lance rolled over in the bathtub, murmuring about Nam.
The bathroom tiles smelled of Gold Bond; the grout was black. Jonah shook. Invisible bugs crawled all over him, down his pants and across the soles of his feet and into his armpits. Furiously he sawed the towel against his skin. Something was wrong with him. He was seeing things. There was no letter, no DVD. He was asleep or blacked out in his bedroom. Pot always put him over the top, especially in quantity and quality and after a long hiatus. The sight of the toilet made him want to throw up again. His stomach cried out for something to sop up the sloshing acid. He grabbed the towel rack to hoist himself up but the screws pulled out of the wall, sending plaster raining down on him. Cursing, he got to hands and knees, got up, gargled sinkwater, washed his forehead. He put down the toilet seat and sat, scraped out and sweating.
A few minutes later he felt well enough to stand.
Inside the editing studio, the DVD was still going. He waited outside, listening to what sounded like a normal conversation; a girlish laugh he recognized as Eve’s. He entered expecting to make a dash for the screen, but stopped instead in the middle of the room to watch something new.
The man on-screen had an uneven moustache. Soft-shouldered but muscular, his shapelessness seemed the result of poor maintenance rather than genetic disadvantage. He wore a Yankees cap and looked at the camera with longing.
Are you ready? Eve’s voice, behind the camera, swallowing the microphone.
The man said Yeah.
Excited?
Yeah.
As am I. As am I. Her laugh. You want me to touch you now?
Yeah.
I will shortly. Would you care to say anything first?
No the man said. He was sitting on the floor, his back against a squat cherrywood nightstand. Behind him, a window whited out with mid-morning glare.
Who are you? Show me who you are.
He held up an old photo of a black man—not him.
And who am I?
He held up another old photo, this one of a white woman—not Eve.
Do you love me? How much do you love me. How much.
The man smiled.
Say good-bye.
The man continued to smile.
Say good-bye.
Good-bye.
The image jerked, then jumpcut to a dark exterior. Close rustling, as though someone was swaddling the camera in rags.
Twenty feet away, across a street, the same man stood in front of a Dumpster. He swam inside a threadbare coat whose sleeves dangled past his wrists. With pendular regularity he glanced up the block, down it. Once he paused to wave at the camera.
The rustling stopped and Eve walked into the frame, crossing the street to join him. They talked inaudibly. She demonstrated a downward motion which he copied until, satisified, she pecked him on the cheek and pointed off-screen.
They turned toward the sound of an oncoming car.
A taxi
passed through the frame.
They watched it go. Eve said something. The man went in the direction of the taxi, returning thirty seconds later, shaking his head. She shrugged, kissed him again, this time on the lips, and jogged back toward the camera, disappearing behind it. The focus went in, out; fixed. Okay.
She crossed the street and stood with her back to the man. He took something out of his pocket and positioned himself ten or fifteen feet behind her.
Eve called Go and began to walk away from him.
He ran up behind her and stabbed her three quick times in the back. She turned to fend him off and a fourth stab caught her across the palm. Screaming, she fell to her knees. He hung back as she began to crawl away from him. He followed her at a distance of several feet.
oh my God he stabbed me
The man took a step forward, and then—seeing something off-screen—retracted his hands into his sleeves. Eve was screaming, screaming, screaming like a song.
please help me
Then came a new voice.
hey
Jonah watched himself step into the frame.
The man glanced at the camera. He looked lost.
please look at me
The man looked at him.
nobody’s going to hurt you
I’m dying
you’re going to be okay can you do something for me mister please take a step back
The man tried to come forward but Jonah blocked him. okay hang on I don’t want to
Eve scampered away from them, across the street. The man made to follow her but Jonah grabbed his arm.
listen I don’t
Eve slipped from the frame.
nobody wants
On film it looked awkward, anticlimactic, incongruent with his memories. The Raymond he remembered had pressed forward, but the Raymond on the screen was pulling away, losing ground to a Jonah that the real Jonah did not recognize. Yet this was how it had happened. He watched and relearned, his preconceptions shriveling and blowing away. At that moment—as if to emphasize the new truth—something incredible happened, something that allowed Jonah to see firsthand the confusion and terror and dumb trust in Raymond Iniguez’s face.
The camera zoomed in.
The fall that he remembered as direct was in fact staggered: Raymond reared back, lifting him off the ground. He convulsed, causing Raymond to tilt and fall to the side. As they went down, Jonah’s head banged against the lip of the Dumpster. His legs folded and he pulled Raymond down on top of him, landing hard and hitting his head a second time against the sidewalk. Raymond fell chinfirst atop the knife. He turned over, grabbing at the ground and at his throat. Then he seized up and was still.
That was how it happened.
On-screen, Jonah fumbled out his cell phone and dropped it. He felt around, found it, dialed, dropped it again, reached
blackout
TWO
PSYCHIATRY
• 18 •
“THEY’RE GROWING people for food.”
“Who is?”
“The Polish government. They have them in pods. They incubate them for a hunnert twenty-eight days, number of days you need to become fertile, and then the flesh has properties, the hunnert and twenty-eight languages of the world match, language is fire, they use the bodies for fuel, they have a chamber, the walls are nine thousand cubic meters deep, and a hunnert, a hun—they, all, they they pump the electricity running through the brains, the juice, they feed them juice from Florida, where they built the American Polish consulate.”
So many places to begin. “You have electricity running through your brain?”
“No. The Polish. Yes. I have electricity in my brain, they put it there.”
“Who did?”
“You’re not telling me the truth.”
“Who put the electricity in your brain?”
“Eastern European Jews of Ashkenazi descent. You’re a liar.”
“Mr. Hooley—”
“They’ll grow them and eat them, burn the bodies for fuel, to heat the secret chambers of the Polish information. They breed embryos. You can eat them if you’re hungry but then they get angry because they want them for fuel to make orange juice.”
“I see.”
FROM PAGE TWENTY of the Guide to the Third-Year Clerkships:
The clerkship in psychiatry will be an opportunity for you to learn about many of the most important issues facing medicine today. Treatment of psychiatric disorders constitutes one of the nation’s single largest health expenditures. In the course of her or his career every physician will encounter patients requiring mental health care in addition to the primary care being sought.
The clerkship is often less physically demanding than others due to its regular hours and relatively relaxed pace. However, it can be equally—if not more—emotionally demanding. Mild depression is common, as are conflicting feelings about the appropriateness of treatment. These emotions should not be considered unusual or a sign of weakness. Nor should they be ignored; students are encouraged to speak with their supervisors or call Student Health (× 5–3109) to discuss and resolve issues as they arise.
From page fourteen of the Book:
I AM LOSING MY MIND
or
PSYCHIATRY FOR NONPSYCHIATRISTS
All those of you who aspire to be headshrinkers may flip past this section and go find something useful to read, like a comic book.
Psychiatry is best summed up in one simple phrase: SPARE TIME. Now would be a good time to catch up on your sleep or your studying. One of us completed an entire research project while doing psych. It got published, too (Missour. Jour. of Med. Vol. 13 N. 2, check it out!), so you could say that we got something out of the experience.
ALONG WITH ITS ATTENDANT TEACHING COLLEGE, THE HOSPITAL of Upper Manhattan occupied a demilitarized zone between the Upper East Side and Spanish Harlem. As such, it served two radically different patient populations; helmet-haired Park Avenue matrons attended by harems of sweaterset-clad daughters roamed the hallways alongside abuelitas leaning on Medicare-issued walkers. The neighborhood wasn’t truly upper Manhattan, unless you ignored everything north of 96th Street, which plenty of people did: taxicab mapmakers, for instance, who sold tourists on the quaint notion that the Apollo Theater was the farthest tip of the known universe.
The central building of the hospital was similarly split: a decrepit old tower that faced north, overlooking the projects, and a shiny new wing, designed by a Pritzker Prize–winning architect, who had sought and achieved a strict obedience to feng shui. The skylit central atrium that allowed natural light into every patient room also turned the lobby into a massive greenhouse. Shirts adhered to backs; terrazzo planters in full thriving bloom.
The department of psychiatry occupied two non–feng shui’d, nonnaturally lit, nonplantered floors of the old wing. Big Green, as the ward was known, had cheery yellow walls. Its nickname had nothing to do with Dartmouth or Fenway Park or jolly canned vegetables, deriving instead from the ostentatious plaque that announced that this portion of the hospital had been funded by a generous grant from the James B. Green Foundation. Other plaques dedicated the nurses’ station, the dayroom, the Quiet Room, and the Larson Center for Electroconvulsive Therapy. The looped central hallway was a gift of Frederick and Betty Hall. Nobody called it the Hall Hall.
Compared to surgery, the hours were a joke. He came at eight and left at five; earlier, if there wasn’t much to do. Morning conference—table-talks held without the patient present—bled into hour-and-a-half lunches. In the afternoons they paid visits, tweaked meds, offered solace, and called it a day. During stretches of downtime, residents would slip out to jog around the north end of Central Park, returning damp and flush-cheeked.
Along with two other HUMmers, a social worker, and two residents, Jonah belonged to Dr. Hugo Rolstein, a spacey, longhaired Freudian relic. Flouting current fashion, Dr. Hugo didn’t care much for dosing. Nor did he bother to meet with patients, relying on sec
ondhand reports to craft baroque etiological analyses that made reference to his own specially designed psychometric, the Rolstein Curve of Ano-Oral Growth. Chess problems absorbed much of his day, as did a plodding quest to complete the novels of Anthony Trollope.
The real work fell to the senior resident. Four-foot-ten, freshly pressed, flawlessly complected, Bonita Kwan boasted an M.D.-Ph.D. from Johns Hopkins. In childhood she had toured the world as a violin prodigy; one of the HUMmers brought in a CD for her to sign. At the team’s introductory meeting, she announced that her interests included the translation of Appalachian folk ballads into Mandarin, Gustav Klimt, and computational neuronal modeling of anxiety across Class Mammalia.
Bonita took everything extremely seriously, providing a necessary foil to Dr. Hugo’s unstructured disquisitions. Rolly Rounds—conducted from the refuge of his office—could linger on one case for an hour or more, moving on only when Bonita insinuated that perhaps they’d exhausted the implications of whether the man who believed he was de Gaulle had ever witnessed the glory of springtime in the Loire Valley.
There were enough beds to accommodate fifty-five people, mostly in-house referrals or rollovers from the psych ER. The bulk of the patients were either psychotic or depressed, although this was a distinction far from sharp. One woman had tried to hang herself because her husband and all four of her children had died in a housefire. She had no high-school degree, no living relatives in the United States; she hovered over a financial abyss, and her HMO had recently begun to deny her claims, asserting (falsely, she swore) the presence of another provider to cover the cost of her diabetes medication. If her misery didn’t justify suicide, Jonah didn’t know what did.
Nothing did. Recurrent suicidal ideation was a symptom of mental illness, Diagnostic and Statistical Manual of the American Psychiatric Association, Fourth Edition, p. 327.
Trouble Page 16