The Unreal and the Real - Vol 1 - Where On Earth

by Ursula K. Le Guin

  He said after a while, “Maybe you aren’t a fool, Doctor. Maybe you’re just very absorbed in your work. That can be dangerous, you know, to be so absorbed in your work.”

  “I love my work, and I hope that it is of positive service,” I said. I was alert for symptoms of disaffection.

  He smiled a little and said, “Prig,” in a sad voice.

  Ana is coming along. Still some trouble eating. Entered her in George’s mutual-therapy group. What she needs, at least one thing she needs, is companionship. After all why should she eat? Who needs her to be alive? What we call psychosis is sometimes simply realism. But human beings can’t live on realism alone.

  F.S.’s patterns do not fit any of the classical paranoid psychoscopic patterns in Rheingeld.

  The De Cams book is hard for me to understand. The terminology of politics is so different from that of psychology. Everything seems backwards. I must be genuinely attentive at P.T. sessions Sunday nights from now on. I have been lazy-minded. Or, no, but as F.S. said, too absorbed in my work—and so inattentive to its context, he meant. Not thinking about what one is working for.

  10 September

  Have been so tired the last two nights I skipped writing this journal. All the data are on tape and in my analysis notes, of course. Have been working really hard on the F.S. analysis. It is very exciting. It is a truly unusual mind. Not brilliant, his intelligence tests are good average, he is not original or an artist, there are no schizophrenic insights, I can’t say what it is, I feel honored to have shared in the childhood he remembered for me. I can’t say what it is. There was pain and fear of course, his father’s death from cancer, months and months of misery while F.S. was twelve, that was terrible, but it does not come out pain in the end, he has not forgotten or repressed it but it is all changed, by his love for his parents and his sister and for music and for the shape and weight and fit of things and his memory of the lights and weathers of days long past and his mind always working quietly, reaching out, reaching out to be whole.

  There is no question yet of formal co-analysis, it is far too early, but he cooperates so intelligently that today I asked him if he was aware consciously of the Dark Brother figure that accompanied several Con memories in the Uncon dimension. When I described it as having a matted shock of hair he looked startled and said, “Dokkay, you mean?”

  That word had been on the subverbal audio, though I hadn’t connected it with the figure.

  He explained that when he was five or six Dokkay had been his name for a “bear” he often dreamed or daydreamed about. He said, “I rode him. He was big, I was small. He smashed down walls, and destroyed things, bad things, you know, bullies, spies, people who scared my mother, prisons, dark alleys I was afraid to cross, policemen with guns, the pawnbroker. Just knocked them over. And then he walked over all the rubble on up to the hilltop. With me riding on his back. It was quiet up there. It was always evening, just before the stars come out. It’s strange to remember it. Thirty years ago! Later on he turned into a kind of friend, a boy or man, with hair like a bear. He still smashed things, and I went with him. It was good fun.”

  I write this down from memory as it was not taped; session was interrupted by power outage. It is exasperating that the hospital comes so low on the list of Government priorities.

  Attended the Pos. Thinking session tonight and took notes. Dr. K. spoke on the dangers and falsehoods of liberalism.

  11 September

  F.S. tried to show me Dokkay this morning but failed. He laughed and said aloud, “I can’t see him any more. I think at some point I turned into him.”

  “Show me when that happened,” I said, and he said, “All right,” and began at once to recall an episode from his early adolescence. It had nothing to do with Dokkay. He saw an arrest. He was told that the man had been passing out illegal printed matter. Later on he saw one of these pamphlets, the title was in his visual bank, “Is There Equal Justice?” He read it, but did not recall the text or managed to censor it from me. The arrest was terribly vivid. Details like the young man’s blue shirt and the coughing noise he made and the sound of the hitting, the TRTU agents’ uniforms, and the car driving away, a big grey car with blood on the door. It came back over and over, the car driving away down the street, driving away down the street. It was a traumatic incident for F.S. and may explain the exaggerated fear of the violence of national justice justified by national security which may have led him to behave irrationally when investigated and so appeared as a tendency to disaffection, falsely I believe.

  I will show why I believe this. When the episode was done I said, “Flores, think about democracy for me, will you?”

  He said, “Little doctor, you don’t catch old dogs quite that easily.”

  “I am not catching you. Can you think about democracy or can’t you?”

  “I think about it a good deal,” he said. And he shifted to right-brain activity, music. It was a chorus of the last part of the Ninth Symphony by Beethoven, I recognised it from the Arts term in high school. We sang it to some patriotic words. I yelled, “Don’t censor!” and he said, “Don’t shout, I can hear you.” Of course the room was perfectly silent, but the pickup on the audio was tremendous, like thousands of people singing together. He went on aloud, “I’m not censoring. I’m thinking about democracy. That is democracy. Hope, brotherhood, no walls. All the walls unbuilt. You, we, I make the universe! Can’t you hear it?” And it was the hilltop again, the short grass and the sense of being up high, and the wind, and the whole sky. The music was the sky.

  When it was done and I released him from the crown I said, “Thank you.”

  I do not see why the doctor cannot thank the patient for a revelation of beauty and meaning. Of course the doctor’s authority is important but it need not be domineering. I realise that in politics the authorities must lead and be followed but in psychological medicine it is a little different, a doctor cannot “cure” the patient, the patient “cures” himself with our help, this is not contradictory to Positive Thinking.

  14 September

  I am upset after the long conversation with F.S. today and will try to clarify my thinking.

  Because the rib injury prevents him from attending work therapy, he is restless. The Violent ward disturbed him deeply so I used my authority to have the V removed from his chart and have him moved into Men’s Ward B, three days ago. His bed is next to old Arca’s, and when I came to get him for session they were talking, sitting on Arca’s bed. F.S. said, “Dr. Sobel, do you know my neighbor, Professor Arca of the Faculty of Arts and Letters of the University?” Of course I know the old man, he has been here for years, far longer than I, but F.S. spoke so courteously and gravely that I said, “Yes, how do you do, Professor Arca?” and shook the old man’s hand. He greeted me politely as a stranger—he often does not know people from one day to the next.

  As we went to the scope room F.S. said, “Do you know how many electroshock treatments he had?” and when I said no he said, “Sixty. He tells me that every day. With pride.” Then he said, “Did you know that he was an internationally famous scholar? He wrote a book, The Idea of Liberty, about twentieth-century ideas of freedom in politics and the arts and sciences. I read it when I was in engineering school. It existed then. On bookshelves. It doesn’t exist any more. Anywhere. Ask Dr. Arca. He never heard of it.”

  “There is almost always some memory loss after electroconvulsive therapy,” I said, “but the material lost can be relearned, and is often spontaneously regained.”

  “After sixty sessions?” he said.

  F.S. is a tall man, rather stooped, even in the hospital pajamas he is an impressive figure. But I am also tall, and it is not because I am shorter than he that he calls me “little doctor.” He did it first when he was angry at me and so now he says it when he is bitter but does not want what he says to hurt me, the me he knows. He said, “Little doctor, quit faking. You know the man’s mind was deliberately destroyed.”

  N
ow I will try to write down exactly what I said, because it is important.

  “I do not approve of the use of electroconvulsive therapy as a general instrument. I would not recommend its use on my patients except perhaps in certain specific cases of senile melancholia. I went into psychoscopy because it is an integrative rather than a destructive instrument.”

  That is all true, and yet I never said or consciously thought it before.

  “What will you recommend for me?” he said.

  I explained that once my diagnosis is complete my recommendation will be subject to the approval of the Head and Assistant Head of the Section. I said that so far nothing in his history or personality structure warranted the use of ECT but that after all we had not got very far yet.

  “Let’s take a long time about it,” he said, shuffling along beside me with his shoulders hunched.

  “Why? Do you like it?”

  “No. Though I like you. But I’d like to delay the inevitable end.”

  “Why do you insist that it’s inevitable, Flores? Can’t you see that your thinking on that one point is quite irrational?”

  “Rosa,” he said, he has never used my first name before. “Rosa, you can’t be reasonable about pure evil. There are faces reason cannot see. Of course I’m irrational, faced with the imminent destruction of my memory—my self. But I’m not inaccurate. You know they’re not going to let me out of here un…” He hesitated a long time and finally said, “unchanged.”

  “One psychotic episode—”

  “I had no psychotic episode. You must know that by now.”

  “Then why were you sent here?”

  “I have some colleagues who prefer to consider themselves rivals, competitors. I gather they informed the TRTU that I was a subversive liberal.”

  “What was their evidence?”

  “Evidence?” We were in the scope room by now. He put his hands over his face for a moment and laughed in a bewildered way. “Evidence? Well, once at a meeting of my section I talked a long time with a visiting foreigner, a fellow in my field, a designer. And I have friends, you know, unproductive people, bohemians. And this summer I showed our section head why a design he’d got approved by the Government wouldn’t work. That was stupid. Maybe I’m here for, for imbecility. And I read. I’ve read Professor Arca’s book.”

  “But none of that matters, you think positively, you love your country, you’re not disaffected!”

  He said, “I don’t know. I love the idea of democracy, the hope, yes, I love that. I couldn’t live without that. But the country? You mean the thing on the map, lines, everything inside the lines is good and nothing outside them matters? How can an adult love such a childish idea?”

  “But you wouldn’t betray the nation to an outside enemy.”

  He said, “Well, if it was a choice between the nation and humanity, or the nation and a friend, I might. If you call that betrayal. I call it morality.”

  He is a liberal. It is exactly what Dr. Katin was talking about on Sunday.

  It is classic psychopathy: the absence of normal affect. He said that quite unemotionally—“I might.”

  No. That is not true. He said it with difficulty, with pain. It was I who was so shocked that I felt nothing—blank, cold.

  How am I to treat this kind of psychosis, a political psychosis? I have read over De Cams’s book twice and I believe I do understand it now, but still there is this gap between the political and the psychological, so that the book shows me how to think but does not show me how to act positively. I see how F.S. should think and feel, and the difference between that and his present state of mind, but I do not know how to educate him so that he can think positively. De Cams says that disaffection is a negative condition which must be filled with positive ideas and emotions, but this does not fit F.S. The gap is not in him. In fact that gap in De Cams between the political and the psychological is exactly where his ideas apply. But if they are wrong ideas how can this be?

  I want advice badly, but I cannot get it from Dr. Nades. When she gave me the De Cams she said, “You’ll find what you need in this.” If I tell her that I haven’t it is like a confession of helplessness and she will take the case away from me. Indeed I think it is a kind of test case, testing me. But I need this experience, I am learning, and besides, the patient trusts me and talks freely to me. He does so because he knows that I keep what he tells me in perfect confidence. Therefore I cannot show this journal or discuss these problems with anyone until the cure is under way and confidence is no longer essential.

  But I cannot see when that could happen. It seems as if confidence will always be essential between us.

  I have got to teach him to adjust his behavior to reality, or he will be sent for ECT when the Section reviews cases in November. He has been right about that all along.

  9 October

  I stopped writing in this notebook when the material from F.S. began to seem “dangerous” to him (or to myself). I just reread it all over tonight. I see now that I can never show it to Dr. N. So I am going to go ahead and write what I please in it. Which is what she said to do, but I think she always expected me to show it to her, she thought I would want to, which I did, at first, or that if she asked to see it I’d give it to her. She asked about it yesterday. I said that I had abandoned it, because it just repeated things I had already put into the analysis files. She was plainly disapproving but said nothing. Our dominance-submission relationship has changed these past few weeks. I do not feel so much in need of guidance, and after the Ana Jest discharge, the autism paper, and my successful analysis of the T. R. Vinha tapes she cannot insist upon my dependence. But she may resent my independence. I took the covers off the notebook and am keeping the loose pages in the split in the back cover of my copy of Rheingeld, it would take a very close search to find them there. While I was doing that I felt rather sick at the stomach and got a headache.

  Allergy: A person can be exposed to pollen or bitten by fleas a thousand times without reaction. Then he gets a viral infection or a psychic trauma or a bee sting, and next time he meets up with ragweed or a flea he begins to sneeze, cough, itch, weep, etc. It is the same with certain other irritants. One has to be sensitized.

  “Why is there so much fear?” I wrote. Well now I know. Why is there no privacy? It is unfair and sordid. I cannot read the “classified” files kept in her office, though I work with the patients and she does not. But I am not to have any “classified” material of my own. Only persons in authority can have secrets. Their secrets are all good, even when they are lies.

  Listen. Listen Rosa Sobel. Doctor of Medicine, Deg. Psychotherapy, Deg. Psychoscopy. Have you gone native?

  Whose thoughts are you thinking?

  You have been working 2 to 5 hours a day for 6 weeks inside one person’s mind. A generous, integrated, sane mind. You never worked with anything like that before. You have only worked with the crippled and the terrified. You never met an equal before.

  Who is the therapist, you or he?

  But if there is nothing wrong with him what am I supposed to cure? How can I help him? How can I save him?

  By teaching him to lie?

  (Undated)

  I spent the last two nights till midnight reviewing the diagnostic scopes of Professor Arca, recorded when he was admitted, eleven years ago, before electroconvulsive treatment.

  This morning Dr. N inquired why I had been “so far back in the files.” (That means that Selena reports to her on what files are used. I know every square centimeter of the scope room but all the same I check it over daily now.) I replied that I was interested in studying the development of ideological disaffection in intellectuals. We agreed that intellectualism tends to foster negative thinking and may lead to psychosis, and those suffering from it should ideally be treated, as Prof. Arca was treated, and released if still competent. It was a very interesting and harmonious discussion.

  I lied. I lied. I lied. I lied deliberately, knowingly, well. She lied. Sh
e is a liar. She is an intellectual too! She is a lie. And a coward, afraid.

  I wanted to watch the Arca tapes to get perspective. To prove to myself that Flores is by no means unique or original. This is true. The differences are fascinating. Dr. Arca’s Con dimension was splendid, architectural, but the Uncon material was less well integrated and less interesting. Dr. Arca knew very much more, and the power and beauty of the motions of his thought was far superior to Flores’s. Flores is often extremely muddled. That is an element of his vitality. Dr. Arca is an, was an Abstract thinker, as I am, and so I enjoyed his tapes less. I missed the solidity, spatiotemporal realism, and intense sensory clarity of Flores’s mind.

  In the scope room this morning I told him what I had been doing. His reaction was (as usual) not what I expected. He is fond of the old man and I thought he would be pleased. He said, “You mean they saved the tapes, and destroyed the mind?” I told him that all tapes are kept for use in teaching, and asked him if that didn’t cheer him, to know that a record of Arca’s thoughts in his prime existed: wasn’t it like his book, after all, the lasting part of a mind which sooner or later would, have to grow senile and die anyhow? He said, “No! Not so long as the book is banned and the tape is classified! Neither freedom nor privacy even in death? That is the worst of all!”

  After session he asked if I would be able or willing to destroy his diagnostic tapes, if he is sent to ECT. I said such things could get misfiled and lost easily enough, but that it seemed a cruel waste. I had learned from him and others might, later, too. He said, “Don’t you see that I will not serve the people with security passes? I will not be used, that’s the whole point. You have never used me. We have worked together. Served our term together.”

  Prison has been much in his mind lately. Fantasies, daydreams of jails, labor camps. He dreams of prison as a man in prison dreams of freedom.

  Indeed as I see the way narrowing in I would get him sent to prison if I could, but since he is here there is no chance. If I reported that he is, in fact, politically dangerous, they will simply put him back in the Violent ward and give him ECT. There is no judge here to give him a life sentence. Only doctors to give death sentences.