‘All of you ought to know by now what the goals of in-patient treatment are, the criteria for Discharge, what we look for.’ Severance sat up straight, very much surprised, realizing that he for one didn’t. Two months altogether he’d been here: why didn’t they tell you? He had sat in fifty discussions of this all-consuming topic without ever hearing a clue. He did know, better than most of his friends on the Ward seemed to, that Discharge was hardly one damned thing: then the trouble began. He felt none of the anxiety to be released that he had in the Spring or last Fall at Howarden, none, he was prepared to celebrate Labor Day in W if they wanted him to. Still, he was interested all right. He even half-guessed what was coming, prepared by the transformations—some sudden, most gradual, and fifty percent alas not enduring—observed in others and even in himself as recovery at any rate began. ‘You come in all clammed up, defences in depth, alibi-systems long established, delusions full-blown. In order to have a chance of staying sober, or rather of staying dry and becoming sober, you’ve got to change. Nobody likes to change. What you really want, when you come into hospital, even for the second or third or ninth time, is to stay just who you are and not drink. That’s not possible, of course. Jack-Who-Drinks has got to alter into Jack-Who-Does- Not-Drink-And-Likes-It. The alcoholic is conservative. He hates where he is, certainly, but he can’t even imagine being anywhere else. He doesn’t want to be anywhere else. His chemical is home. That’s where he’s safe, with a bottle of whiskey or a six-pack or pills. The idea of Elsewhere fills him with panic. How many of you have waited, shaking, for the bars or liquor stores to open?’ He looked around. ‘Everybody?’ Eager or pained nods. 4003 times, Alan estimated. ‘But you know they will open. Right? What about the morning when you know they won’t open, for you? For everybody else, but not for you. Freezes your blood, right? It’s exactly there that you’ve got to become comfortable. How can it be done?—for those of you, that is, for whom it can be done. You’ve got to take risks. You can’t stay where you are; if you do, you’ll drink. We don’t expect miracles here. What we hope for is enough openness to establish a continuing chance in out-patient treatment over the two years. One estimate is fifteen percent open. Almost every patient improves some, over the self-imposed solitary-confinement he came in. The question is how much, and that’s what the whole staff has to determine in each case, and often we’re wrong. But we can’t keep you here forever. Right now there are seven alcoholics, some drinking, waiting for your beds. Now one of the judges of your progress—this will surprise some of you—is you. You are all deluded, but some of you have begun to recover, and know it, and have begun to feel real fear, and have begun to recover even from that. You think you have come far enough to have a chance. If anybody thinks he has it made, there’s no hope for him. But some progress, towards self-confidence. You see this scale. I want you to rate yourself on it, Wilbur, and then we’ll go around the Group, saying where we see you. Take your time, and be absolutely honest. Don’t put yourself down, but try not to con yourself either. How open have you been in Group, on the Ward, with your doctor, with your parents on the screwy telephone. Give yourself a mark.’
They all waited. Wilbur’s face worked, elongated, lonely.
‘Six.’
‘Okay.’ Keg marked it. ‘Hutch, where do you see Wilbur?’
‘Two,’ Hutch said reluctantly.
‘Mary-Jane?’
Her voice was low: ‘Zero.’
‘Okay. Letty?’
The big eyes stared at the board, Wilbur, Keg. ‘Three.’
‘Stack.’
‘One, I guess.’
‘Jeree?’
‘ … Two.’
‘Alan?’
Severance was unhappy. ‘One.’
Keg looked at Harley. ‘One.’
‘Luriel?’
‘I don’t know,’ she spat. ‘It’s none of my business.’
‘You have no impression of where Wilbur stands.’
‘He’s a mean shit, just like the rest of you.’
Christ, thought Severance. Whatever Wilbur was, he was not a mean shit and sister you are even worse than I gave you credit for.
‘You won’t rate him?’
‘—’
‘Okay. I give him zero.’ He marked it, and studied the board. ‘Wilbur, there seems to be a difference of opinion between you and the Group about your progress. Some of us don’t believe you’ve made any, and nobody believes you’ve made much—except you. How do you feel about that?’
Wilbur stared sullenly up at the marked line, heavy on the left, so empty on the right, except for his grade. ‘I can’t help it about the rest of you. I think I’ve got the Programme. I’ve levelled as much as anybody.’ His voice was stubborn but whining and his gaze dropped to his knees again.
‘Bullshit you have,’ Harley said with a rare edge on his tone. ‘Your old man sits in the kitchen all day drinking and sharpening the ax he keeps down there to sink in your skull one day, as he’s promised you sixty times. You sit upstairs in your room drinking, trembling with fear. You come in here and you ring him up morning noon and night out of anxiety for his and your mother’s health and fight like hell with him on the telephone. And you want to go home. You’ve got to go and look after them. You think you’ve “got the Programme.” Get the hell out of here, Wilbur, and drink yourself to death.’ Severance had never seen Harley angry before, it was bloodcurdling.
‘Well, we have accomplished exactly nothing today,’ Keg said, ‘and you are all one day nearer to the Promised Land, where booze is flowing just as usual and just as desirable as ever and with just as much blood-sludge and brain damage. Let’s say the Lord’s Prayer.’
They rose without the usual relief and joined hands in a close circle and some of them prayed the Lord’s Prayer and at least two of them wished they had never been born to this unusual fate, common to millions.
‘What are you still doing around?’ Severance asked. ‘Didn’t you take your Fifth Step?’
Jasper drew a paper cup from the bottom of the stack and turned the coffee spigot. It was after ten. Severance had been alone in the Snack Room for many dreary minutes.
‘Sure,’ said the poet, ‘four days ago. They’re whimsical. I still have kinks to straighten out, it seems. I’m in no hurry.’
‘Nor am I. Christmas is all right with me.’
Jasper sat down across, lighting a cigarette. ‘Tell me, how did you get into this bind?’
‘You mean, being a medical man?’
‘Yes. Or maybe you didn’t know it was a disease? Wasn’t it some time rather recently that the AMA recognized it?’
‘That’s only the good ole AMA, one generation behind the planet Jupiter. No, I knew it was a disease all right. The edition of the Merck Manual I entertained myself with at P and S, where I trained—this was thirty years ago—was in no doubt about its being a real disease, “not merely” (as they put it) “a bad habit.” I looked it up this summer in my attic. There’s one charming sentence: “It is characteristic for an alcoholic to be a veritable museum of pathology and yet to make but little complaint thereof as long as he can secure the relief given him by his accustomed narcotic.” ’
‘Droll. But what about it?’
‘What about anything? I did not have the faintest idea I was an alcoholic until my second week at Howarden. It takes shock, my boy. Tell you a story about one of the lecturers there. He liked flying. Somebody left him some money and he bought a plane and flew about in it. Heavy drinker, long long oldtime heavy drinker. Knew he ought to do something about it (so did I)—say two weeks after the Second Coming of Our Redeemer. What brought him to was this. One morning he woke up and he was in his own bed. Good—for he remembered nothing since nothing. Not feeling well, in fact he might die, but he got up and went across to the drapes over the picture-window of his bedroom, drew them apart, and looked out into the bright day. There was his plane in his front yard. “At that point,” he said, “I knew I had a problem.” For me, it
was the imposing and uniform and entirely unacceptable world presented to me by the life stories of eight or ten men during my first twenty-four hours after I was taken out of Intensive Care and assigned to a unit at Howarden. Three-quarters, at least, of every story was my story. Mirrors on every side. It was unavoidable. At least I’ve had no trouble in that direction, as so many patients do.’
‘What is the disease picture then?’ Jasper asked very seriously.
‘Well.’ Severance gulped coffee. ‘Progressive, fatal, incurable. Worse than cancer in items one and three—it attacks the moral sense, and spontaneous remission is unknown. There’s a symptomatology. But otherwise they’re no better off than they were in 1940—I mean my colleagues: it seems to be loss of control. Unpredictability. That’s all. A social drinker knows when he can stop. Also, in a general way, his life-style does not arrange itself around the chemical, as ours does. For instance, he does not go on the wagon—except for a joke like Richard Burton, who bet that homewrecker of his he could stay off it three months—the wager was a kiss, I believe—and when I last saw a gossip column he’d gone five months. Sound alcoholic to you?’
‘It does not sound alcoholic to me,’ and the poet sighed.
They smiled with deep contentment with each other. Comfortable on the ocean-floor. Plenty of special company.
After two hours Severance did an unusual thing. He quit work and got up and lay down on his bed, shoes on, plumped the pillow once twice and settled back not to try to nap but merely daydream. An image appeared in his mind of The Enemy: a transparent colourless mobile and volatile liquid, having a slight, characteristic odor and a burning taste, about 5’6”, 37+–23–36, with a specific gravity not above … something at 15.56’ C. Miscible with water. Decidedly. Inflammable. With amyl alcohol being approximately 6-8 times as toxic as ethyl alcohol. No pharmacologist of course but he could read and home from Howarden in the winter he had looked around a little. Also he read Time magazine every week with a vengeance and the skepticism with which he faced a lab report. They checked, though—not only his brother but friends had worked for them. What killed more young than any other cause? Cars, cars, with ‘measurable alcohol’ the critical factor 60% of the time. What was that: five whiskies in one hour. Quite a bit of stuff for kids. Only one-tenth of 1% alcoholic content in the blood, technology, and out. Could happen to the nicest people. Not entirely ignorance, either (an acid-head knew he was in trouble), but substantially. One of his ex-mistresses in New York was on marijuana and Librium, and she had the worry—what there was of it, for a girl whose black lover (elevator boy she’d just given a car to) wanted her to move in with him and his wife—upside down: it was the called ‘drug’ she wasn’t entirely comfortable about. The other she got on prescription (from one of his orbiting colleagues) so she felt safe, and the picture he’d given her one afternoon of pill-withdrawal she labelled ‘science-fiction’—just as he had done the contingency of convulsions, and had one, five days later.
His colleagues. (And the kids.) Or say, since he hadn’t gone on into practice, ex-colleagues. He took a dim view of them privately, on stern grounds. Severance enjoyed statistics, but he believed narrative, what you had seen happen. One of the medical fraternities asked him to talk to them about Medical Ethics and he agreed. A little reflection told him he knew nothing whatever, he asked two friends and they not only confessed they didn’t either, they denied that there was such a subject. At the medical library he drew a very considerable amount of uplift and blank and only as a last resort before withdrawing his acceptance he went across to the new main University library, scrounged around among the usual crud and pap and peptalk until, sticking to it—bonanza! an actual discussion. Not by a medical doctor of course. The old dean of Harvard Divinity, plagued for decades by friends at Mass General with problems, had finally set down his thoughts. Severance made a rapid digest, rearranged and cut it, threw in cases from his own experience, observation, reading, and gave the young men a goddamned serious talk. They listened respectfully and asked many questions afterward—about fee-splitting. In vain, with growing outrage and scorn, he waited for one question about either any difficulty that he had proposed or indeed anything except fee-splitting! which neither he nor the theologian considered material. Their single topic: kickbacks. Not so good. Besides the ignorance, of drugs especially, and in particular pills and alcohol, the legal killers. No, Severance was not happy with his original profession. He knew marvellous men in it, of his own age. The marvellous men not in it but of it were kids—the kids whom when he wasn’t putting them down he marvelled at. Even the Army—the most vicious organization in the country, he thought, not excepting the Air Force and the greediest-of-all so-long-by-him-admired Navy which he hadn’t been able to get into in 1942 in the wet-heat Washington summer—knew what the medics were like and had cut their tour in Nam from the usual year down to seven months, because after that long of shared suffering they went freaky. Cut down their water and food to hitch more medical supplies —stole plasma bottles and walked around on patrol with six pounds of glass in their rucksacks—wrote home for medical catalogues to buy their own endotracheal tubes. Wouldn’t leave their units when their tour was up. Kids, looking after kids. Somewhere down in his left jaw Severance hurt, behind his eyes bitterness accumulated, he didn’t feel good about the world they’d presented to the kids. The junkies proved the most dedicated of all—and got off the stuff, incidentally.
He sat bolt upright. He and his fellow-Repeaters were the smashed kids in the paddies; and they were each other’s medics too. His own hope was to forget about himself and think about the others. And the Enemy was not alcohol after all, just delusion—the VC dropping the point on the soldier, shooting not to kill but wound, get him screaming, so they can get the medic too. He’ll come.
Delusion was contagious, nothing more powerful. He had been taken in by Luriel’s. It took last night listening to the stolid nurse’s not being taken in by her hallucinating about her overeating to make him look down at her stomach on his left below the tabletop and for Christ’s sake it was as flat as a board (if not concave) and always had been and always would be (‘400 pounds!’) and she did not have an eating problem, it was a cop-out (sincere though, real real sincere) from her drinking problem and her psychiatrist and the others had been right to laugh at her, it was not real, she was unreal and he Severance was unreal with her and things were very bad all over. But not as bad as he thought last night. He had cleared up on that, he had one more ground of self-suspicion, and his motive in trying to help her had been okay, only he hadn’t been well enough yet to see through her, as the non-alcoholics (and some of the patients too) did like a flashlight. Okay. Doctors were not so bad, either. The only enemy was Delusion, and her daughters whiskey gin brandy and rum.
15
ALAN AND HUTCH made common cause. Each had been accused of being unable to level. ‘Okay,’ Severance said to the big man on the way down to lunch after Group, ‘maybe we can help each other. Let’s talk after lecture this afternoon.’ They agreed on Hutch’s room, and picking up a cup of coffee at two-fifteen he went carefully down the hall and knocked on the half-open door, heard a voice, and walked in.
Hutch was standing on the near side of the bed, with a book in his hand, looking as if he had been about to go somewhere. The bed-table had a book and a magazine on it. The bed was neat and empty. The long windowsill, where patients kept things, was empty. No clothes were visible. The top of the bureau was empty. Severance felt odd before he realized why he felt odd: the room was all right. That is to say, all wrong. It looked as if nobody lived there.
‘Hutch,’ he said involuntarily, ‘why is your room so damned neat?’
‘What’s neat about it?’ very defensively.
‘Well, look at it.’
Hutch looked around uneasily. ‘What’s wrong with that? I’m just neat, that’s all.’
‘You are? You told me the other night your workshop was a shambles.’
&nb
sp; ‘My office is open to inspection at any moment.’ He sounded angry.
‘I’m not talking about your office. I’m talking about your workshop at home. You said you could never find anything.’
‘That’s a lie!’
‘No kidding, you actually said that,’ Alan said sturdily, sorry to be in this, with a pal, but God almighty—
‘I may be a little untidy now and then, but what about you? You live in a pigpen, I’ve looked in through your open door.’
‘I’m not too neat. My point is that no other patient’s room I’ve seen in any degree resembles this room. You haven’t moved in.’
‘Damn you, Alan, I come back and I’m here. You’re making something out of absolutely nothing. Now listen, we’ll have to talk later, I haven’t read the Big Book yet today, okay?’
Severance was helpless. ‘We’re supposed to level with each other, you know. In Group and out of Group. You and I have the same trouble, and here it exactly is. You’re not levelling with me.’
‘I am levelling with you, damn it! What about, anyway?’
‘Your room! It’s too neat. It’s not real.’
‘I told you, you’re out of your mind. Just because I happen to be a neat man, instead of a slob like you, you accuse me of not levelling. Just how have I not levelled? Tell me that!’ He was as angry as a bull, fists clenched, head lowered.
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