by Tom Sullivan
“Sometimes half is good enough,” Brenden said. “I felt like you do when I went blind, you know. I was climbing a mountain in Colorado and felt like I was at the top of the world. The last thing I saw was a beautiful bald eagle flying free, and then my feet slipped on some loose stuff they call scree. It’s really just rock. I fell, hit my head, destroyed the optic nerve, and, well, here I am, Blinky McCarthy.”
“There wasn’t anything the doctors could do?” Carver asked. “To fix your eyes, I mean?”
“Nope,” Brenden said. “I’m as blind as a bat, and it’s gonna stay that way.”
“How did you handle it?” Carver asked.
“Not very well,” Brenden told him. “Everything went dark in my life. The girl I thought loved me dumped me. I hated being around blind people in the rehab center, and I had no idea what I was going to do with my life. I was studying to be an orthopedic surgeon, but now . . .”
“But you’re a psychiatrist,” Carver said. “That’s still a doctor, right?”
“Yes, it is, Antwone. There’ve only been a couple of us blind guys who have become psychiatrists. It’s not easy, but you can do it. I’ve figured out over the last few years that you can do almost anything if you want it enough. The thing is, you have to make a decision to want it. Take a look back at your own life. Haven’t there been things you wanted and couldn’t get, and then been surprised because you did?”
Brenden sensed the man look down at the floor in concentration and then raise his eyes back to the doctor’s face.
“I used to believe that,” he said, “but all the things I wanted I didn’t get, or I lost.”
“What do you mean?” Brenden asked.
“Listen, man, I was everything in basketball,” Carver said. “During high school, all-city, I averaged twenty and ten, you know? Twenty points and ten assists a game. Probably was the best point guard, at least in California. Would have had college offers if I hadn’t gotten in trouble. Stupidest thing I ever did—stealing a car. So I spent time in juvie, and then, well, the Corps came along, and I figured that was a better team to belong to.”
“Antwone, I sense that you think the Marines have abandoned you. Is that what you believe?”
“No, man,” Carver said, agitated. “The Corps didn’t abandon me. They just don’t need me anymore. Not like this.”
“But you’re one of them,” Brenden pointed out. “They admire you. I know that a bunch of the guys have visited while you’ve been here. They even brought a cake, I heard.”
“Yeah,” Carver said. “It’s called an Alive Day cake. You get one to honor the fact that you’re alive. I mean, when everybody’s sure you’re gonna stay that way.”
“Well,” Brenden said carefully, “that means they care about you, doesn’t it?”
“But I’m no use to anybody,” Carver said, returning to his original theme. “Not like this.”
“Wait a minute,” Brenden said, “these guys are your pals. They came all the way from San Diego to see you.”
“That’s nothing but sympathy, man,” Carver went on bitterly. “They’re just visiting a brother because they feel sorry for him.”
Brenden continued to argue gently. “I don’t think that’s true, Antwone. I think it’s because they admire your sacrifice and believe that once a Marine, always a Marine. I suppose that’s what the cake is all about—being alive and being a Marine.
“Listen,” Brenden went on earnestly, “I’ve had the chance to talk to World War II vets who have gone on to have great lives, and they still believe that first, foremost, and always they’re Marines. I think Marines are maybe the most special brotherhood in the world—at least to a civilian—and I think you’re lucky to be one of them.”
Carver was quiet, so Brenden tried to lead him a little more.
“You know, Antwone, everybody wants to belong. All of us have a basic need to be part of something outside ourselves. Nobody can make it living in isolation. We need to know that people love us and care about us and that we’re part of the human community.”
“It’s a tough world out there,” Carver said finally, “and if you’re half a man, you don’t have a place in it. Back in my neighborhood, if people knew you were in a chair, it’d just make it easier for them to rip you off.”
“You really think so?” Brenden asked.
“Mm-hm,” Carver said. “That’s the way it works, man. That’s the way it always has.”
Brenden paused a moment, reflecting. “So tell me a bit about your childhood.”
“Childhood?” Carver said. “I didn’t have a childhood, man. I had a survival-hood. Christmas didn’t mean nothing. Birthdays, nothing. We didn’t have anything. Eight kids. I don’t know how many daddies. Project housing. Rats and gangs. Drugs and pimps. You survive by staying out of the way when you can and fighting when you have to.”
“So do you still keep in touch with your family?” Brenden asked.
“I was fourth in age,” Carver said, “right in the middle. I’ve got a couple of brothers doin’ time; one dead in a gangland drive-by; two sisters with two kids each, no daddies; and two that are doing okay. Not very good odds, but that’s the way it is in the hood.”
Brenden observed that most of the physical signs he had noted earlier relating to PTSD were evident in the man’s behavior—the agitation, the nervousness, the jumpy expression, the fast speech, the out-of-control finger tapping. And most of the emotional signs were there, too, including depression and anxiety. Brenden decided this was not the time to bring up the sudden departure of Corporal Carver’s wife. Better to leave that for another session. He hoped the Marine wasn’t even thinking of their time together as therapy, but maybe just two guys having a conversation. Sometimes that’s the best way, he thought, when you don’t make it technically a session. Sometimes you get far better results.
“Listen,” he said. “Check out the video. There are DVD players in the TV room. I’ll come back tomorrow afternoon, and we’ll talk about it. Maybe we can watch it together. As an old point guard, I’m sure you can tell me some of the inside ways Magic plays the game that other people miss.”
“I’ll watch it,” Carver said.
“Wonderful,” Brenden said. “By the way,” he went on casually, “now that you’re a patient of mine, I’d like to recommend a course of medication that might be help—”
Carver interrupted him and snapped, “I’m not taking any of that garbage. No drugs for me.”
“Antwone,” Brenden said easily, “like a lot of guys who come home from the war, I think you’re struggling with a condition called post-traumatic stress disorder. Have you ever heard of it?”
“Yeah, I’ve heard of it,” Carver said. “They talked about it a lot during training and when we were in country.”
“Do you know anyone who suffers with it?” Brenden asked.
“A few,” Carver said. “We had a few guys in my unit, but that ain’t me, man. That ain’t me.”
“I think you are one of those guys,” Brenden told him gently, “and I really believe the medication can be very helpful. Look, Antwone, it’s totally up to you, but I think you’ll find that it really makes a big difference to your overall sense of well-being. I hope you’ll consider going on the medicine, let’s say for a month. By that time you’ll be out of here and under someone else’s care, and you can discuss it with your new doctor. But I want you to know we’ve had tremendous success getting men back on track, and I think you could definitely be one of them.”
Now Carver’s eyes were directly on the blind man’s face. Brenden could sense that the look was challenging.
“Will I start to sleep better, Doc? Will it take away the nightmares? Will I be able to play hoops, dance with my wife, have sex, and feel like a man again? Will your drugs do all that, Doc?” Antwone’s voice seethed with pain and loathing.
Brenden waited a few seconds before responding. “There’s no guarantee, Antwone,” he said. “I can only tell you that, profession
ally, I’ve seen some wonderful results.”
“How many pills a day will I have to take?” Antwone asked. “I hate taking pills.”
“Well, let’s see,” Brenden said, “I’d like to start you off with two medicines. One of them is a mood stabilizer.”
The man laughed. “There’s nothing you can do about my moods, Doc. No drug is going to make a difference in the way I feel.”
“We’ll see,” Brenden said, going on. “And the second drug is for the anxiety I believe you’re feeling.”
Again the man in the wheelchair laughed. “No anxiety here, man. Nothing to be anxious about. When you don’t have a reason to live anymore, there’s no reason to be anxious. Nobody’s shooting at me, and nobody’s loving me.”
Right on cue, Nelson’s tail thumped the floor, as if he had been listening to the whole conversation.
Brenden smiled. “Well, Antwone, I think you’re wrong. Nelson doesn’t agree with you. I’ll bet he can love you. He taught me about love after the accident that left me blind.”
Brenden sensed the man’s acknowledgment, even if it was grudging, so he moved on to describe the drug protocol.
“So for anxiety, I think we’ll begin with Ativan. It’s a proven medicine, and people have had astounding success with it. For the depression you’re probably feeling, I’ve seen great results with Zoloft. Now, with the Zoloft we’ll begin with a low dosage for a week, and then if you’re not having any reaction—and I don’t expect you will—we’ll increase it. Okay?”
“Okay, Doc,” the man relented, surprising Brenden. “That’ll be fine. Let’s try the drugs.”
“Fine,” Brenden said. “I’ll check in with you in the next couple of days. Hope you enjoy the video.”
“The Magic Man,” Carver said.
“Earvin ‘Magic’ Johnson.”
“Yeah, Doc, he was the man. Thanks.”
“Say good-bye to Antwone, Nelson,” Brenden said. This time when the dog came forward, Brenden heard the Marine rubbing the dog’s ears without any prompting.
WHEN BRENDEN RETURNED TO his office, he sat at the old desk, pondering his feelings on the session. Because their first visit had been a confrontation, Brenden had not taken a full history or mental status exam, but he felt that this second exchange had given him what he needed to reflect on the patient’s chart. Antwone Carver was clearly mentally stable under the mental status criteria. His memory was excellent, and Brenden did not feel that the man would have any trouble dealing with abstract concepts. His concentration was excellent, and his focus, though affected by PTSD, was reasonably consistent as they moved from subject to subject. The question was whether Brenden would be able to create a therapeutic connection with Antwone Carver. The jury was still out on that, he decided.
He spoke into his cassette machine: “I believe it is possible for me to forge an appropriate therapeutic alliance with the patient, Antwone Carver. Trust will be the important question, but I believe it is possible because the patient is so vulnerable at this time in his history. I may be able to become a surrogate support system for him, and I intend to try to use a number of concepts to obtain his trust.”
Turning off the machine, McCarthy reached down and patted the big dog. “I could use a little therapy myself, Nelson,” he said. “Let’s surprise the family and call it a day early. What do you think?”
The dog stood, stretched, and shook, as if he completely understood what his master was saying, and Brenden mused that he probably did.
chapter ten
The heavy morning fog was back, compressing the sound of their breathing, making the exertion take on a surreal effect. Brenden and Kat rode the tandem bike up the long hill at the east end of the island, working together to engage every erg of energy, propelling the machine over the top of the hill and then, like a runaway train, picking up speed as the bike rolled down the other side. The wind roared through the ear holes of their helmets as they hunkered down over the handlebars, getting the most from the descent.
Kat was a superb captain on the front of the tandem, controlling their speed with the delicacy of a surgeon as she used her hand brakes and drum brake just enough to maintain the line between control and reckless abandon.
Brenden also understood his job, keeping his body centered and always being alert to any signal Kat might give him through their pedaling. It was important for the biker at the rear of the tandem to be aggressive in his effort, but also to make sure that in working for the best performance he did not move the bike offline by trying to pull too hard with his upper body. Because Brenden was probably eighty pounds heavier than Kat, this issue was even more important. But as in everything else they did together, the couple loved their particular sense of team and common goal.
They were training for the Chilly Hilly bike race that would be held on the island next winter. They had won the tandem couples division three times, and they had no intention of giving up their crown. Along with their daily individual exercise, they tried to share their bike riding twice a week—once when Brenden took a short day at the office, and always on Saturday mornings.
They were able to find a responsible teenage girl to babysit the children, which allowed them to go out after their ride for a long, lingering breakfast. More than any other time during the week, this Saturday morning biking and breakfast was the real nurturing of their relationship. No kids, just time to remember why they were in love.
Brenden understood why he loved Kat, but he figured he was the luckiest man in the world that, for reasons he could not understand, she felt the same way. He was thinking of that at the end of their ride as they sat at a table in Jack’s, a restaurant with the best omelets on the island, fresh, buttery croissants that melted in your mouth, and some of Seattle’s best coffee.
Life on a Saturday morning just couldn’t get any better. As Kat poured Brenden his second cup of coffee from a pot the waiter had left on the table, the grateful husband found himself thinking about Antwone Carver and his wife. Could they find the same kind of lasting happiness that he shared with Kat, or would the emotional challenges and physical limitations, including the added complication of sexual dysfunction, destroy the critical balance of love and passion necessary for a marriage to be sustained and grow? He decided to broach the subject with Kat, but first he needed to make her understand the ethical implications of their conversations about Antwone.
“Do you remember the Marine I told you about whose spine was shattered by an IED?”
“Sure,” Kat said. “I’ve thought about it a lot since you brought it up—the devastation, I mean, for him personally and for them as a couple.”
“I need your advice,” Brenden went on, “but this conversation has to remain completely confidential. You understand, right? Because of the client-patient relationship. Technically, I’m not supposed to talk to anyone—even my spouse—about my clients, but I trust you to keep this information just between us.”
“Yes,” she said. “Certainly I understand.”
“Okay,” Brenden said. “Well, his wife went back to San Diego. She was very upset when she left, or at least that’s what the nurses who were on duty have told me. I haven’t brought it up yet with Carver, because I wanted to talk to you first.”
“Me?” Kat queried. “How come? Why me?”
“Because you married me.” Brenden smiled. “Because you had the courage to marry a guy who felt that there wasn’t much to live for, who felt that his disability had made him worthless to anybody, most importantly himself.”
“Listen, baby,” Kat said, taking on a tone more serious than Brenden expected, “I waited all my life for you, and I knew the first day I met you, when you came skiing and I saw you in Hal O’Leary’s office, that you were the person I wanted to grow old with, sleep with, have children with, and share mornings like this with. I love you. Now, do you need any more strokes for a Saturday morning, or is that quite enough?”
“Okay, Kat,” Brenden said, laughing. “You know
how much I love you, but what I want you to talk to me about are the adjustments you had to make around my disability. I mean, are there times when my blindness is a burden for you?”
Kat considered. “Well,” she said, “there are times when I have to take it into consideration—like when we’re out in public, and I have to remember to guide you when Nelson’s not around, or when I need to set your closet up just right so you can find what you need, or make sure that you know where everything is in a strange place. But that’s just learning how to make a system work, and none of that has anything to do with who you are as a person or how I feel about you. Our relationship doesn’t have anything to do with your disability. It just has to do with our uniqueness, our chemistry, our love.”
“Sure, Kat, but there have to be things that bother you,” Brenden pressed. “Things that create—how should I put this?— things that cause a difference in the way we love and the way other couples share.”
“That’s exactly right,” Kat said. “To put it in a simple way you could share with your client, I’d say that our specialness is made up of the elements that make us different from anyone else. We talk more than other couples do. I mean, we have to. I can’t give you one of those looks that kill because you’ll miss it, so I have to be more open about telling you exactly how I feel. The way we ride our bike so intimately together, you know how special that is. And your faith in God and his purpose for your life shows in everything you do. I love the way you teach our children about the senses and the way you’ve come to appreciate the world—like the other day, taking Nelson to Brian’s school. How many dads get to do that?”
Kat moved her fork around on her plate. “Look, let me add this. Okay, sure, there are times when we’re going somewhere, and I dress just so. Certainly I’d like it—no, I’d love it—if you could see me and understand that I’ve dressed just for you. But it’s okay.”
“I know, Kat. I think about that sometimes—”
She interrupted. “But I always know you appreciate me, and I know that you see me as beautiful inside out, rather than outside in.”
