by Tom Sullivan
The first article that caught his attention was written by Irma Fiedler, PhD, associate clinical professor of physical medicine and rehabilitation at the Medical College of Wisconsin.
In a five-year study, she sought to clarify some of the issues surrounding sexuality after spinal cord injury. She indicated that sexual health was not only about function but needed to include an understanding of all the physical and mental sensations of the partners before, during, and after sex. Also, though childbearing could be compromised, McCarthy was delighted to learn that over 80 percent of men suffering spinal cord injury could produce offspring with the support of appropriate medical participation.
On another site he read a significant article written by Dr. Marca L. Sipski. Here the question of the completeness or incompleteness of the patient’s injury was raised. Brenden concluded that it all seemed to come down to whether a person’s upper or lower neuropaths were affected.
Carver’s MRI showed that the young Marine seemed to have maintained some lower motor neuron feeling. This was encouraging, because over 90 percent of the men who had been tested had some kind of erectile function and were able to produce appropriate sperm. From his own academic study, Brenden knew that sexual impulses needed to register in three distinct areas: the sympathetic, parasympathetic, and somatic nervous systems. In the case of Antwone Carver, that information was not yet available, but early indications suggested that the lumbar area of his spine was completely intact; so Carver and his wife should be able to return to a mutually satisfying process of sexual engagement. After all, Carver’s libido should be unimpaired. The couple would need a great deal of patience initially, but they would be able to redevelop a close physical relationship.
Brenden sat back in his chair, drumming his fingers on the desk, thankful for the possibilities he would be able to offer Antwone Carver.
DARLA CARVER DIDN’T KNOW how long she had been sitting by the phone. Her mind was in turmoil, trying to decide what to do. On the one hand, she was a very private person, believing that what went on between a husband and wife was not to be shared with anyone. Also, she was a person of deep faith, believing that the power of prayer would lead her to the answers. She was sure that God would point the way if she believed and was open to his Word. But was it possible that this Dr. McCarthy was the instrument God intended? With the blending of his profession as a psychiatrist and the fact that he was blind and had a unique understanding of life with disability, had he been sent to her and Antwone by God? She found herself getting excited at the possibility, and so she reached for the phone.
THE PHONE RANG, JARRING Brenden out of his reverie.
“Hello,” he said.
“Dr. McCarthy? This is Darla Carver. Is now a good time to talk?”
Wow, Brenden thought, my lucky day. “Sure, Mrs. Carver. Go ahead.”
“Please call me Darla,” she said.
“Thank you, Darla,” he said. “How can I help you?”
“Oh, Doctor,” she cried, the dam breaking, allowing her emotions to flow freely. “I just don’t know what to do or how to act. Antwone has pushed me away; pushed me out of his life. I just don’t know how to handle it. I don’t know what to do, what to say. Everything I try to do seems to be wrong.”
She was crying now, her voice breaking.
“I mean, I love Antwone, Doctor. I love him so much, but I just don’t know how to help him.”
“Well,” Brenden said, trying to soothe her, “we’ll figure that out together, Darla. We’re on the same team, you know. We both want Antwone to get healthy, right?”
“Oh yes,” she said. “Yes. I just want my husband back.”
“Remember I told you I had some questions to ask? Well, here’s the most important one. Was there any kind of incident that happened while you were here that may have set him off and precipitated the change in your husband’s behavior?”
“I don’t know, Doctor. When I arrived and first saw Antwone, I could tell how much it meant to him. I could feel how much he loved me, how much he missed me, how much he needed me. Then after we saw the surgeon, Dr.—what was his name?—Dr. Craig. Yes, that’s right, Dr. Craig. After we saw him, everything changed.”
“Was there something that this Dr. Craig did?” Brenden asked. “Did he say anything that upset Antwone?”
“I don’t know if I should say this,” she said quietly, “but he was a horrible doctor. I mean, the way he talked to both of us.”
“What do you mean?” Brenden queried, alarmed.
“He was so matter-of-fact, so cold when he talked about Antwone’s injury. It was as if he thought being a paraplegic didn’t matter. He was just so . . . unemotional.”
“I’m sorry, Darla,” Brenden said, meaning it. “During my time in practice, I’ve observed that surgeons tend to function this way. In many cases I think it arises out of their own fears of inadequacy. I believe that many of them think that if they can’t automatically fix the problem, they don’t want to deal with anything related to adjustment or rehabilitation.”
Darla Carver’s tone changed abruptly, and Brenden could hear the anger rise in her voice.
“That’s not all of it,” she said. “When he talked about sex, it was so awful.”
“You mean your husband’s ability to participate in sex?” Brenden suggested. “You understand, Darla, that there are many ways to deal with this issue, and I’ll be happy to point you in the direction of things to read and also talk with both you and Antwone when you come back again.”
“Do you think I will?” she asked hopefully. “Do you think Antwone will want me to see him again?”
“I’m sure of it,” Brenden said. “Please go on. Tell me more about what this Dr. Craig said.”
“Well, he kept looking at me while he was telling Antwone about where his spine was broken and how his ability to have sex would be affected. He just kept looking at me while he . . .” Now she was crying again. “While he took away my husband’s manhood!” She paused, and her tears turned to anger. “You know, Dr. McCarthy, I actually think he was hitting on me.”
“You what?” Brenden said, shocked.
Darla was even more emphatic. “His eyes never left my body. A woman understands these things. When he shook my hand, his fingers slid up my wrist. And when we sat down, his hand kept brushing my thigh. Then there was the way he gave me a business card with his private number while he was telling my husband that he would be sexually impotent. It was awful! I’m telling you, Dr. McCarthy, he was a pig. A pig! And something should be done about him.”
Brenden gripped the phone hard in his right hand, squeezing the receiver, outraged and disgusted.
Working to control himself and remain professional, he said, “I’ll look into all this, Darla, but right now I want you to stay positive and remain hopeful. I think Antwone and I are making good progress, and I don’t believe it will be long until you’ll be able to come back up here and talk with Antwone yourself.”
“You really think so?” she said through her tears. “Do you really think Antwone will want to see me?”
“Remember what I told you,” Brenden said. “We’ll work on this as a team, Darla. I think Antwone is a great guy, and I can feel how much you love him and how much he loves you. I really appreciate you calling me back, and I’m here to help.”
“I know that,” she said. “I could hear it in your voice when you talked to me about your own disability. I’m glad you’re Antwone’s doctor. Please send me any materials I should read and tell me when I can come back to Seattle.”
“I promise,” Brenden said. “And I promise to have a long talk with Dr. Craig. Oh, one more thing,” Brenden said, remembering. “If for any reason you talk to your husband, please don’t tell him about our conversation. It could upset him.”
“Oh, I understand,” Darla said. “I won’t say a word. Thank you, Dr. McCarthy.”
When they hung up, Brenden went right back to his computer, and this time he was Googling “Dr
. Jonathan Craig.” Brenden remembered that under full disclosure, all physicians were required to post pertinent information on any malpractice cases in which they were a principal. Upon examination of Craig’s file, he knew he had hit the mother lode. Three women had filed separate sexual harassment lawsuits: a nurse and two patients.
What a jerk, Brenden thought. What a manipulative, miserable person.
DR. JONATHAN CRAIG RARELY went into the doctors’ lounge at the VA hospital. The only time he interacted with his physician colleagues was when consults were necessary or when he needed his morning fix of coffee. It was an addiction, he knew, but he had compensated for it by the treatments he got to whiten his teeth and the Altoids that were always in his pocket just to freshen his breath in case an attractive patient or nurse could not resist his charms.
Women just can’t resist, he thought arrogantly. Except for that black beauty, Darla Carver. He could have made her so happy, especially considering her husband’s impotence. A couple of nights with him would have done her good. Ah, well, c’est la vie, que sera sera, and all that. Someone else will come around. They always do.
He saw the tall man and the dog enter the room as he was pouring a second cup. Surgery would be in an hour, and this would be just enough buzz to put him on top of his game.
The blind man had stopped and was speaking to another doctor, who then walked in his direction, with the big dog and the man following easily through the chairs.
“Thank you, Doctor,” the blind man said to his friend, who nodded and walked away. “Dr. Craig,” Brenden said, “I’m Dr. Brenden McCarthy, the psychiatrist who is treating Antwone Carver, and you’re a piece of garbage.”
Dr. Craig blinked, nearly dropping his cup as McCarthy stopped directly in front of him. There was an audience now as the heads of all the physicians in the room turned.
“What . . . What are you talking about?” Craig said, trying to gain control of the situation.
“I’m talking about your patient, Antwone Carver. I’m talking about you—not only did you demonstrate incredible insensitivity to his condition, but he could probably bring you up on malpractice charges for hitting on his wife as you were telling him he was going to live the rest of his life sexually shattered. That’s what I’m talking about, you low-life scumbag.”
Dr. Craig recoiled from the blind man’s assault.
“And I’ll tell you what else I’m talking about,” Brenden went on. “I’m talking about bringing you up on charges to this hospital’s medical ethics committee. I’m talking about supporting the Carvers in any lawsuit they might mount and recommending an investigation by the state medical ethics board into your overall patient performance. That’s what I’m talking about.”
For the first time, Dr. Jonathan Craig felt the veneer that protected his gigantic ego begin to fray.
“Now, Doctor,” he said, “I don’t think that will be necessary. I’m sure that whatever has gone on with Mr. and Mrs. Carver is nothing more than a simple misunderstanding. I’ll call them right away and settle things down.”
“You won’t call them at all,” McCarthy said, moving forward with Nelson, getting right into the guy’s face. “You won’t disturb them in any way. Let’s be clear about that, Dr. Craig.
You won’t have any contact with them. You’re off this case. I’m sure I’m going to gain support for that idea from your chief of staff. I have an appointment with him in an hour.”
Now Craig was a little desperate. “Listen,” he said, trying to talk to Brenden colleague-to-colleague, “don’t you think you’re overreacting to the situation a little bit, because of your own . . .” He searched for the words. “Your own circumstance?”
“You mean my disability,” Brenden said, his voice resounding in the room with a cutting edge everyone could hear. “My handicap?”
“Well, yes,” Craig said, stammering. “Yes. That’s what I mean.”
“And I suppose you think that Darla Carver was just being overdramatic when she described how you nearly raped her with your eyes. She said it felt like you were taking her clothes off right in front of her husband. Do you think he missed all that, Dr. Craig? Do you think it didn’t add to his pain?”
Dr. Craig saw the big dog stiffen and begin to quiver as the blind doctor held the harness in his left hand. Then he heard a low growl coming from deep in the animal’s chest.
“You see,” Brenden said to the doctor, “my friend Nelson, here, feels exactly the same way I do about your moral conduct. Don’t you, boy?”
The growl got loud enough for the whole room to hear, and the dog moved forward a step, causing the doctor to back even farther away.
“Please control your animal,” he said.
Brenden smiled. “I wouldn’t want him to hurt you the way you’ve hurt the Carvers. Okay, Nelson,” he said, patting the big dog, “I think we have an appointment down the hall with the chief.”
Turning, and without another word, the psychiatrist and his guide dog walked out of the lounge, leaving Craig standing alone and embarrassed in front of his colleagues.
chapter fourteen
The rhythm of the session was wrong—very wrong—and Brenden knew it. In therapy, a good psychiatrist may lead in order to draw the patient out, but in general it is hoped that the patient will come to his or her own conclusions. In that way there is a great possibility that the outcome can be lasting.
Wonderful in theory, Brenden thought, but the practical side of his mind said, He’s sending me the wrong messages. There’s something not authentic in what he’s telling me. Why?
“Antwone, in one of our early conversations, you were clearly upset when you were talking about sex and Darla. Now you’re telling me it doesn’t matter?”
“It don’t matter, man,” Carver said. “I mean, when you ain’t got it, you ain’t got it. Isn’t that right, Doc? Like you, man. You can’t see, right? I mean, you’re blind, so that’s the way it is. And what it is, it is, right?”
“It’s not always that black-and-white.” Brenden tried to smile. “You know, there is a thing in life called gray, and most of us live in that state most of the time.”
“What’s that old saying my mother used to tell me? The proof is in the pudding?” Antwone laughed darkly. “Well, there ain’t no pop in this pudding.”
“Antwone, I’m trying to tell you that’s not necessarily true. There have been amazing breakthroughs in spinal cord injury. People can go back to having a very satisfying sex life, even having children.”
“Well, that’s good for them, Doc, you know. But Darla, she’s all woman and needs to be satisfied—the right way, if you know what I mean.”
“Antwone, I think you’re taking a really limited view on this subject. Look, there are some terrific interviews I’d like you to watch, with couples talking about their sexual relationship after spinal cord injury. I think they’re very informative. I’ve watched them, and they’re extremely positive.”
“I ain’t gonna watch losers have sex, Doc. If I want to see skin flicks, there are better ones on cable. You know what I mean?”
Brenden’s mind was spinning, and the question kept pulling on his brain. Why is this guy being so cavalier about the thing that before meant so much to him? Why is he taking such a different attitude?
“Have you talked to Darla in the last few days?”
“She’s called a couple of times, but I haven’t picked it up.”
“Why, Antwone? Why haven’t you talked to your wife?”
“Because there ain’t nothing to talk about, Doc. We’re done. I’m done. You know, it’s just that simple; it’s all over, and it don’t matter anymore. It just don’t matter.”
“Why doesn’t it matter?” Brenden pressed. “Why has your attitude about Darla changed?”
“Marvin is right, you know,” Carver said. “Sexual healing.”
“Marvin?” Brenden asked. “Sexual healing?”
“Marvin Gaye, man. Eighties soul. Weren’t you hip
back then?”
“I guess not,” Brenden said.
“Well, when there’s no healing, there’s no healing,” Carver said, his hands drumming the sides of his chair. “There’s no sense trying anymore.”
“Antwone, I’d like to suggest that before you give up on your marriage, you have Darla come back up here so that we can all share in this conversation. What do you think?”
“Get out of my face about this,” Carver answered angrily. “That just ain’t gonna happen. Aren’t you listening to me? We’re done! I’m done. Can’t you just let it go?”
“Antwone, I believe that sometimes when a person is hurt—really deeply hurt—they can become paralyzed by the pain.”
Immediately Brenden knew he had used the wrong word.
“That’s right,” the man screamed. “Finally you got it, man. Paralyzed. Paralyzed. Paralyzed. Nothing works. That’s the way it is. That’s the way it’s gonna be. Nothing working. Period. End of story. We’re done.”
Abruptly the man’s mood shifted, and he began crying. The doctor waited.
In these moments with a patient, it was hard to know what would happen on the other side. Sometimes when the tears stopped, patients would be willing to step back and take another look, but Brenden was sensing that in this case, at the end of the tears, Carver would be even more resigned to the idea that his relationship with his wife—and, Brenden feared, with his life—was finished.
The doctor didn’t expect to hear Nelson’s chain rattle as the big dog stood, and before he had a chance to command him to lie down again, the animal moved forward toward Carver. Brenden heard the sound of Nelson’s nuzzling as he placed his nose in Carver’s hand as if to say, Is something wrong? Can I help?
Then Brenden heard the rustle of the man’s shirt as he pulled his hand away. But the big dog was persistent, and the doctor listened to his paws click on the hospital tile as he moved in even closer, resting his head on the man’s knee.
