by Samuel Shem
‘Nothing I do is ever enough!’
‘Forget it!’ she cried out, grabbing for her coat and hat. As she got up, she knocked over the lamp, and the bulb smashed, so that the only light was a hellish shaft from the bedroom. ‘Shit,’ she said. She started to bend to pick it up, but then straightened back up and kicked it as hard as she could across the living room, where it brought down a small table and a bottle of George Dickel sippin’ whiskey. She walked out, slamming the door. Her footsteps fell away down the stairs, one flight, two, diminished, diminished, died.
Devastated, I sank to the floor, numb, desolate, hoping against hope that she’d come back, listening for her footsteps rising toward my door instead of falling away.
Then I heard them. A knock on the door. I opened it.
Jill. Her face was tense.
‘I saw her leave, and I couldn’t stand it. I need to see you.’
‘Come on in.’
‘No. It’s not safe. Let’s go for a ride in my car.’
We went out. It had suddenly turned cold, freezing everything. We drove in the full moonlight along the mountain valley roads, the reflection off the ice on the fields making the night brighter than the day, which had been overcast with low clouds. The rare cloud was now like a child’s fuzzy animal, say a polar bear, or a white whale, filmed with silver from above. I felt cold and numb.
‘I have a real fondness for power lines,’ Jill said as they dipped and rose alongside us, in one long straight clear stretch beside the White River. ‘They’re beautifully designed – almost like Chinese characters. I’m having trouble right now, with you and her. She’s so intelligent, so educated – it makes me feel really inferior. I’m at a turning point in my life, I know that, but I’ve never had a real turning point before. I mean if you’ve never gone to college, or got married, or been in the armed forces, you never had turning points. I don’t do them all that well.’
‘Yeah, well, if it’s any comfort, I’ve had a lot of ’em, and I don’t do all that well either.’ We meandered along, not talking much, really.
‘One thing I’ve learned,’ she said. ‘A guy’s truth in bed doesn’t translate to truth in talking, but mine does. But I liked what you said before about grief. It was like from your heart.’
‘Thanks,’ I said numbly.
We got back to where she was staying up the street. I got out. Jill sat there. I went around to the driver’s side. She rolled down the window. It was freezing cold and it was hard to keep my footing on all the ice.
‘You really love her, don’t you?’
‘I have, and in a deep way I still do. She’s like family. But it’s pretty much over, I think.’
‘I know what I’m up against now. Something about actually meeting her, seeing her really real, woke me up. So goodbye.’
‘Please, don’t—’
‘Let’s not drag it out. It’s gonna be a disaster for me if I keep on with you, I just feel it. Just leave.’
I tried to talk to her, but she rolled up her window. I tapped on it, to no avail, and tried to mouth words to her – ‘I love you’ – but my breath crystallized to ice, obscuring her face and, to her, my lips. Finally I gave up and turned around, but my feet slid out from under me and I had to grab her side rearview mirror.
She rolled down the window. She was sobbing, and she clutched my hand clutching the freezing mirror and said, ‘I don’t care if it’s bad for me. I can’t give you up. I love you.’
Violence, death, and mutilation were the Father, Son, and Holy Ghost of Misery after Christmas. In my five weeks on Toshiba, I had gotten used to people being crazy. I was having a hellish time with people being violent.
Insurance, under pressure to pay out more money, was paying out less. The only ticket into Misery was violence, violence toward yourself or to someone else. People tried, tried damn hard. Ever since Christmas the weather too had turned violent, first an infernal mix of snow and drizzle, and then a relentless arctic wind that seemed to knock the breath out of your lungs and fling your testicles up toward your spleen. An ice pack had slid down off Canada, quick-freezing everything. The world turned to ice. Ice coated car windows and locks, front steps and front walks, sidewalks, roads, runways. Men ventured out to chip and chop and sand and salt it away. Chippers snapped, choppers split, sand got into everything – the ice was like iron. Giving up, returning to the house and being asked by the wife why the walk was still icy, the car stuck, the boots shedding sand on the rug, the man might snap, or start chipping or chopping at the wife or house-bound kids. Someone would call Misery. Misery would call Insurance. Insurance would turn them away.
Yet some of them, the Walking Worried, would just show up. They would sit in the lobby of Toshiba, hoping to talk to a doctor. Each day by midday they were spilling out onto the front walk and frozen lawn, trying to get a foot-hold on the ice. When I or Nash or Tunaba would walk by, they would clutch at us. We would try to escape, slipping and sliding away. Some camped out in cars and vans. Some held up pill bottles like petitions. It was heart-wrenching.
My last day on Toshiba, the last day of the year, was hell: a run of horrific admissions, the sequelae of violent, mutilating acts. By admission Number 21, I was fresh out of compassion, for the day, the year, and maybe even, I realized with alarm, for the rest of my life. Number 21 was a 31 y.o. heroin addict with a CC: ‘I’m in withdrawal, I need detox, and this is the only place in the state that will take me.’ Unfortunately, while he’d been waiting in the lobby, the last bed on Heidelberg East, Alcohol and Drug, had been filled. I had to refuse him admission.
‘What the fuck am I supposed to do!’ he screamed. ‘I’m in withdrawal, I feel like shit, I gotta get a fix.’
‘Do whatever you’ve been doing. Maybe a bed will open up tomorrow.’
‘What I been doin’, Doc, is knockin’ over little ol’ ladies in the street and snatchin’ their purses. Is that what you, in your professional opinion, are tellin’ me to do? Go out right now and knock over another little old lady?’
‘Christmas is history. We’re all in full-catastrophe mode now.’
That morning the Boston Globe had published a list, in chronological order, of every woman and child killed by a man during the past year. It averaged out to one woman or child killed every five days. A woman had been killed every nine days. A child had been killed every fifteen days. Many men, after killing the women and children, killed themselves. A week before, the upper half of the torso of a Swedish au pair had been found in a Dumpster. Terror turned to horror.
The latest murders had been just the day before in a ‘safe’ suburb; a family named Quist. Norman Quist first slit the throats of his two small children and dumped their bodies in a river, then came back home and bludgeoned his wife Colleen to death. He then shot himself dead.
I had just admitted Colleen’s sister, with a Chief Complaint: ‘I was the one who found my sister’s body. Her head was split open by an ax and her brains were all spilled out and blood was soaking everything. Everywhere I go, I see her lying there, the ragged white of her skull, the dark blood, the pink brains. And he slit the throats of his children? They were angels, little angels. How can I live with this?’
When I came to giving her a DSM diagnosis, my mind got stuck. She wasn’t crazy, she was what anyone would be: crushed. But she needed time to heal, to be safe. The hospital wasn’t a bad place to stay for a while, for her. But her insurance wanted her treated as an outpatient. I gave her the most innocuous DSM for which they would pay, ‘296.20, Major Depression, Single Episode,’ and she made it in.
I felt sick. Sick not only at the carnage, but at being a man. For most people, who learn about a killing by watching TV, the killing fades as quickly as anything on TV, basically gone by the next commercial and helped along to oblivion by the commercial itself and the fake TV killing that soon follows, leaving no residue. But in Misery I had to live with the aftermath of the carnage, the enduring reality. What most people looked at from a couch as
a flat run of pixels, I saw. Saw what it did to real live human beings, how it lasted not the six minutes to the next commercial, not six hours six months six years, but a lifetime. More – how it echoed down the generations. For weeks I had been having nightmares. I walked around enraged, sick at heart.
I wasn’t totally alone. One potential admission that day was a 32 y.o. assistant district attorney with a CC of ‘I’m supposed to get married next week but after seeing all the killing and things done to the kids I keep thinking over and over that if I do go ahead and get married and have kids I might wind up doing the same. Four out of ten American households have a gun. I have a gun. I’ve lost my faith, I guess. Is that crazy or what?’
‘I’ve lost my faith too. You’d be crazy not to. Insurance won’t accept it. Go home to your fiancée.’
I went on, on autopilot, my heart as hidden and numb as the tiny silicon one hidden somewhere inside my laptop – except for a jolt when I remembered Lily Putnam’s black eye. Could Cherokee, out there somewhere on the loose, turn even more violent and turn up in tomorrow’s headline, something like WILD WASP WASTES WIFE, KIDS, PROMINENT SHRINK S. DOVE, SELF. In an icy sweat I called Aspen information. No luck. I left a message on his home machine to call at once, knowing I wouldn’t sleep easily until I heard they were all safe.
‘You stobbed caring about me and I don’ wanna live!’
This was the CC of my next to last admission that day, Number 23, none other than my patient Zoe, who had come in totally drunk.
Since her discharge from Emerson, she had done well in therapy with me, helped along by her LAMBS partner, Thorny. They had continued to live together in Misery Garden Apartments. Thorny was going to NA – Narcotics Anonymous – and volunteering at a local recycling and alternative energy company.
Zoe and Thorny had decided, since they were doing well, to show their near and dear ones just how well they were doing. Wouldn’t it be cool, these good buddies thought, to spend the holidays visiting each other’s families? Big mistake. The trip to Louisiana to meet ‘the Burn King of the Bayous’ had gone badly, given Thorny’s new focus on cleaning up his father’s mess. They left early for Palm Springs, California, where Zoe’s family wintered in Rancho Mirage, an armored enclave of the rich set between Bob Hope Drive and Frank Sinatra Way.
I hadn’t seen Zoe in a few weeks. Now I was stunned by how she had changed: her tall, slender, college-girl frame was no longer in jeans and blouse and Reeboks, but in flowery dress and gold lamé shoes and fake red fingernails, her light brown hair now in a garish fading perm. She was heavily made up, the makeup so messed up that her aquiline nose seemed stuck in her sun-reddened, feverish face. The Rancho Mirage look. Having used booze to come down off a long run on cocaine, she was totally exhausted, drunk, sniffing and blowing her nose, and slurring her words.
‘She’s been fighting with her mother and father,’ Thorny said, ‘and scorin’ coke since Christmas. She’s up to almost a fifth of scotch a day. Her parents wanted her to go to Betty Ford, but I got her back here to you.’
‘I’m glad you did.’
‘Better the dickhead you know than the one you don’t. Even though she can’t talk to you right now, Doc, when we talked about you last night she told me she thought you were smart. Smart, but cold.’ He considered this. ‘Me, I think you’re warm. Warm, but stupid. But hey – you’re miles ahead of Solini.’
‘Are you still seeing Solini in therapy?’
‘You gotta be jokin’. Seeing Solini, now, is useless as stirrin’ shit.’
I tried to make contact with Zoe. Crashing from the coke, out of it from the booze, she said, ‘Youbeen disdracted ’n’ distant,’ and slumped into sleep.
‘Shit,’ I said, feeling bad about her relapse, and my part in it.
‘Sono tutti catzi, Doc,’ Thorny said.
‘Which means?’
‘“Everybody’s a Dickhead.” But we’re all doin’ our absolute best. Even me. Later.’
I started Zoe on a detox program, and called Heidelberg East, the Alcohol and Drug Unit, to see if I could transfer her over there. They still had no beds. I admitted her to Toshiba for the time being.
My last admission of the day – which would fill all the beds in Misery for the year – was a 16 y.o. Hispanic-American woman brought in by her parents. Her father was the CEO of a supermarket chain, her mother a pediatrician. Her CC was: ‘My boyfriend dumped me life sucks I want to die.’ Such was the family wealth that Nash himself did the admission interview, Jennifer and I watching. The parents were not allowed to participate.
It was a masterpiece of efficiency lasting a mere five minutes, but as Nash finished her off and got up to go, out from her boot came a carving knife. She lunged at Nash. I froze. Jennifer crouched in a tae kwon do stance. Nash screamed ‘Help!’ grabbed me between one arm and one hook and threw me out of his way and toward her. He opened the door and ran out.
I tripped over Jennifer, rolled toward the young woman’s feet, and as I saw Jennifer run out the door I thought, My life is over but I’ve given it to a worthless cause trying to deliver quality mental health care to this unfortunate rich young woman, and then I saw the glint of the blade and raised my hands to protect myself and had another thought, which was, Oh shit!, but suddenly someone barreled in and tackled her and pinned her and the knife dropped soundlessly to the thick carpet and I was saved.
‘Close call, Doc, y’get me?’
Shaking all over, I couldn’t speak, but nodded.
‘I wasn’t fuckin’ after you,’ the young woman said, ‘I was after him.’
‘Who, sweetheart?’ Primo asked.
‘That motherfucker who only gave me five minutes of his time. It took a lot for me to come in here, and that cock-sucker gives me five fuckin’ minutes?’
In another five minutes she was escorted back out and released to the icy windy night, too dangerous for a mental hospital. I was bleeding from a scratch from Nash Michaels’s hook. I put a Band-Aid on. My problem now was that there was one free bed. Two were on the waiting list. I read their charts.
The first was a Vietnamese refugee named Ngo, who, on finding his four-year-old daughter raped and strangled in an abandoned apartment, had flipped out and gone stalking the streets, searching for Henry Kissinger. He was totally psychotic and dangerous.
The second was one Grasci and his lawyer. Grasci was the creator of a hot new NASDAQ hit called Softi Serv, which was some software that linked with some other software and that in fact would turn out to do little or nothing except hook a few more million computer nerds and suburban male obsessives and make him rich. He was paying out of pocket and desperately wanted to be admitted. It turned out that he’d just beaten his wife silly with a pool cue. His Chief Complaint? ‘Why the hell was she putting on sexy underwear when we were getting dressed to go to court for our divorce, when she’d never wear sexy underwear when we were married?’ He was here to create a legally binding defense.
It was musical beds. Nash Michaels was at the keyboard. It was no contest.
‘They tell us America is best country!’ screamed Ngo the Vietnamese man as Primo led him out the front door and pointed him toward Candlewood. ‘They say here you have chance. What chance my little girl have? I kill them all you wait and see!’
I sought out the sanctuary of the bulletproof.
‘Terrific,’ I said to Viv, taking her Christmas bottle of Chivas out of the drawer and sipping. ‘We admit someone who is sane, and we send someone who is insane and dangerous back out into the world. What’s wrong with this picture?’
‘Yeah, Cowboy,’ she said, ‘it makes you wanna puke.’
‘Makes you want a law banning men from women and children.’
Hannah came in, to take over as Doctor on Call. She’d just gotten back from a trip to Philadelphia to give a dissociative lecture at a hospital, and was distraught.
‘On my way down there this morning, at the Philly airport, when the cab dispatcher asked the cabbie if h
e knew how to get to the hospital, the cabbie said no, so the dispatcher motioned me to the next cab in line. But then the first cabbie and the dispatcher started arguing, and the cabbie pulled a gun and shot at the dispatcher and drove off! So the dispatcher says to me, as if nothing unusual happened, “Take the next cab, young lady.” So I jumped into the next cab, who said he knew the address, but after we were going he said, “I don’t know the address either but I wasn’t going to lose the fare.” He was stoned, going eighty miles an hour, and we ended up in some deserted park. I thought he was going to kill me! But we finally got there and it was forty-five dollars! And then I got out and went to the psychiatry department, and I’m white as a sheet and I told all of them what happened and no-one said anything to me, no words of comfort, nothing!’
‘No-one said anything, dear?’
‘None of the psychiatrists. The secretary did. She was very nice. She said to me, “Oh you poor girl,” and got me a cup of coffee. She was very nice. None of the psychiatrists said anything. I mean I’ve taken cabs all my life in New York. There used to be some morality; now there’s none.’
‘People out there are seethin’ with rage, dear,’ Viv said, ‘seethin’ with rage. Everybody feels they’re not gettin’ what they deserve outta life.’
‘But this is America,’ she cried, her eyes rolling up to the fluorescents. ‘I mean it’s not like this isn’t it – this is it! This is normal life! This is where we live! What are we supposed to do? Stay away? Away where? How?’
‘You need some support, dear. Where’s your family?’
‘New Guinea.’
‘Funny, dear, you don’t have a New Guinea accent.’
‘No, no, they’re visiting my sister and her husband in New Guinea for Chanukah. The successful sister.’
‘There are some good people in life too, dear.’
‘Sure there are,’ I said. ‘Where’s Blair Heiler?’
