Mount Misery

by Samuel Shem

  Insurance started hassling Heiler and others about payment, decapitated right and left, and refused to authorize more nice green money. Patients and their families got caught in the cross fire. We encouraged said patients to walk their concerns directly over to the office of Nash Michaels, chief Counsel of Misery, or to Dr Lloyal von Nott, Chief of Misery. Of course patients and their families could not even get past the secretary guarding the outer office to get to the secretary guarding the inner office, let alone to the men themselves. Luckily, somehow the unlisted home numbers of the men themselves – von Nott, Michaels, Heiler, Cabot, Dove, and Lowell – all became readily available to the patients. These unlisted numbers were dialed.

  Somehow, Lloyal von Nott’s memo to us inviting us to the Misery Capital Campaign Luncheons, where we were asked to reveal the names of our rich patients so that Lloyal and Nash Michaels could hit them up for donations to Misery, turned up on the desk of the Boston Globe Spotlight Team. Failing to get through the barricades of secretaries to Lloyal and Nash at Misery, the Spotlight Team dialed their home numbers. The newspaper asked whether this memo, flying in the face of medical ethics, let alone common decency, was perhaps a joke, or a hoax? The media assumed that it, and their signatures on the bottom of it, could not be real.

  Nash Michaels and Lloyal von Nott responded with silence.

  Silence provoked the Globe further. It and TV began trailing them around with videocams, in much the same way they had done with drug dealers, mafiosi, and no-show judges. Lloyal and Nash became no-show shrinks. They flitted to and fro wearing sunglasses and hats and riding in big cars with darkened windows. They unlisted their unlisted numbers. It was amazing how fast this happened. All in a matter of weeks.

  We also went after the other side of the ongoing war at Misery, insurance companies. Gilda and Hannah prepared a legal form letter for clients and their families who were having trouble with coverage – either being denied admission to Misery or being kicked out – to send to their insurance companies. Said letter carried documentation of the severity of said client’s mental illness, and stated that any injuries to said client or family including suicide were events said insurance would be held strictly liable for. Misery depended on its relationship with insurance, especially with the big mothers like Blue Cross and Liberty Mutual and John Hancock. Since insurance was now calling the shots and could cancel Misery’s provider status in a second, in a few days limousines with darkened windows could be seen driving up the hill to the Farben. The limos carried insurance executives, all pink and beer-bellied and encased in the same kind of pin-striped armor as von Nott and his boys. Meetings were held to find out – as one secretary told us:

  ‘What the fuck are you doing, Lloyal, having our subscribers talk to us?’

  It was astonishing how easily such a solid-seeming system could be shaken to its core. Seemingly as solid as a bank, it was every bit as flimsy.

  We went after Schlomo too. We began to name his name. Wherever we went, whatever forum we found ourselves in – staff meetings or AA encounters or on night call on all the various wards of Misery, in talks with friends – we mentioned that we had heard on good evidence that Dr Schlomo Dove had sexually abused at least two women patients. The women were about to bring charges. Naming his name made us realize how we doctors never did this, never revealed the secrets we knew about another doctor if it might harm his or her reputation. Now, to break the code of silence was scary, but thrilling.

  ‘Screwing patients is legal,’ Gilda was saying, sitting with me and Hannah and Solini in my office in Toshiba.

  ‘You gotta be joking,’ I said.

  ‘I don’t joke. It’s not against the law.’

  ‘Of course it’s against the law,’ I said. ‘Has to be.’

  ‘Sexual abuse of a patient by a doctor in this state is not against the law. It’s not a crime. Same as in most states, in fact.’

  ‘You shittin’ us, man?’

  ‘I am not a man.’

  ‘You shittin’ us?’

  ‘Unless it’s done under the influence of drugs. If you fuck them, it’s not a crime. If you drug them up and then fuck them, then it’s a crime. And Schlomo didn’t drug them up.’

  No-one said anything for a long time.

  ‘So what do we do now?’ Hannah asked.

  Gilda went on to explain that Lily and Zoe could file a civil suit, for malpractice. They could also make a complaint to the State Medical Board to take away Schlomo’s license to practice, and try to get him thrown out of the Freudian Institute, Misery, and the BMS. And, of course, longer term, the victims could try to influence the state legislature to pass a law to make sex with patients illegal. Minnesota had such a law. We asked Lily and Zoe what they wanted to do.

  They wanted to do it all: sue for malpractice, file complaints with the state, the Freudians, Misery, and the BMS. They were excited about the idea of forming a nonprofit organization – which Zoe named TALL: ‘Therapist Abuse Link Line’ – to find other victims. They wanted to talk to the Globe, as well.

  Gilda informed the state board that she would be filing a complaint with its Ethics Committee against Schlomo Dove. The board informed Gilda that Schlomo Dove was a member of its Ethics Committee.

  ‘Like unreal!’ Solini said.

  ‘Hardly,’ she said. ‘I’ve researched it. These pricks are often members of these so-called ethics committees. They get their kicks from it.’

  Gilda demanded Schlomo recuse himself from the deliberations. Schlomo, in a bravura performance at a semiprivate emergency hearing before the board, a hearing to decide about the issues of the public hearing, convinced a majority of the board members that he was being slurred maliciously and that to remove him from Ethics without due process would set a dangerous precedent for ‘the hundreds of upstanding physicians threatened by mentally disturbed patients,’ and might lead to his filing a suit of his own against the board for its proceeding without due process. The board, in secret deliberation, recommended another, strictly private hearing of all parties separately, which would lead to a fairly-strictly-private rehearing of the original semiprivate emergency hearing, to see if there were grounds for a public hearing to deal with the matter. Then the board lost the records.

  ‘Even if we get rid of that little putz,’ Gilda said, ‘his cronies are on the Ethics Committee. The whole thing sucks.’

  She immediately prepared to file, on behalf of Lily Putnam, a suit for malpractice against Schlomo Dove.

  The backlash from Schlomo was swift and vicious. He sent identical letters to Lily and Zoe:

  You two women are not the victims, I am the victim. Your complaints are totally false and pretty pathetic. You are severely disturbed women diagnosed as severe borderlines (BPOs, 301.83, with HF – Hysterical Features). Your hospital records will embarrass you and your families in a court of law.

  I am assured by my lawyer, Nash Michaels, that your testimonies are further contaminated by the fact that you obviously have had extensive talks together to collaborate in fabricating your stories. Dr Roy G. Basch’s record is filled with complaints by nearly every division of Misery, from Chief von Nott all the way down to Buildings and Grounds and Nursing.

  If you persist in this ‘Misery Conspiracy,’ Dr Dove will file suit for defamation of character. The monies figure suggested by Schlomo Dove’s counsel is $2.75 million. Each.

  Grow up, get a life. Any further correspondence should be addressed to N. Michaels, Chief Counsel, Mount Misery.

  More in anger than sadness,

  Schlomo Dove, M.D., F.R.A.P.S.

  ‘Let me give it to you straight,’ Gilda said to Lily. ‘Juries respond to authority. He has all the authority of Mount Misery, the medical school, and Freud. It’s your word against his. In court he will bring up every lurid detail anyone has ever written down about you, and his own lies about you, from his files. He will paint you as crazy, march out expert witnesses to testify that you are crazy and that part of your craziness is you
r being vindictive, and more experts to testify to his own integrity. This will give the jury the impression that you are at best an ax murderer and that he is at worst a hybrid of Simon Wiesenthal the Nazi hunter and Saint Francis of Assisi. The odds are stacked way against you. The humiliation you will experience, in front of your friends, family – children! – as you are sucked up and spit back out by the press and TV and film industries hungry for your life – the pressure of public degradation, will be unreal. And there is a risk of countersuit.’

  ‘So you’re saying,’ Lily said, ‘that we don’t have much of a case.’

  ‘Oh, you have a great case. You just don’t have much of a chance.’

  ‘But the truth,’ Lily said, ‘is that he did abuse us both.’

  ‘Sweetheart, sweetheart,’ Gilda said, smiling and shaking her head. ‘The law is not about truth, but proof. That’s what I was taught by the world-expert lawyers at Yale. That’s why I bought my spread in Wyoming. Land and livestock are about truth.’

  A sense of gloom settled over us. We felt the weight of the status quo press up against us, as a mountain might against a climber who is tiring, caught a little too high up in the unexpected cold of a spring afternoon.

  ‘Is there anything that would strengthen our case?’ I asked.

  ‘Your chances?’ I nodded. ‘Let me think.’ She reached into a pocket of her cowgirl vest and took out a Swiss army knife, one of the thick ones with blades enough to open a reluctant can or scale and fillet a tough trout. She flicked out a white plastic toothpick and picked away for a while, Malik-like. ‘OK. Here’s what will give you a chance. Find another victim. With impeccable credentials. Who has contemporaneous evidence – that is, notes which she, the victim, actually wrote down at the time of the abuse. She has to be totally willing to come forward.’

  ‘Cool,’ Solini said. ‘Anybody know another Schlomo victim?’ No-one did. ‘There’s got to be like somebody.’

  ‘Perhaps if TALL gets the word out,’ Lily said, ‘one will come forward.’

  ‘If so,’ Gilda said, ‘don’t talk to her. Send her to another lawyer.’ She paused. ‘And if you don’t find anyone else, we drop the case?’

  ‘Yes, there would be some relief in that,’ Lily said. ‘We could all get on with just trying to heal.’

  We tried to find another victim, and could not. Days passed, then weeks, and we were stuck. Henry, Hannah, Gilda, and Malik would all be leaving in a few weeks. Momentum would slow, then stop. Time was running out.

  Despite my feeling so awake, so alive, so in tune with the onrush of summer, despite seeing so much new life in Berry, my patients, and my friends, there was a hum underneath, as if of heavy machinery, a hum of death. Deaths echo deaths. The hole left by all the deaths of the year was getting bigger, deeper and wider. I was beginning to feel more and more gloomy about our chances of bringing Schlomo down, about Malik’s disease, and about how the hell I was going to survive another two years of my training to become a dear and glorious physician-shrink in Misery.

  One night on call I was walking with Solini to pick up my beeper in the Farben when we ran into Win Winthrop and Arnie Bozer, standing in the foyer outside the Conference Room, which now had a shiny brass plaque nailed to its door:

  DR ISAAC WHITE CONFERENCE ROOM

  COURTESY OF GLÜCKSSPIEL APOTHEKE LTD.

  ‘Well, hi there, Doctors,’ Arnie said cheerily. ‘How’s business? Will you be attending today’s Resident Support Group with us?’

  Henry and I had not gone to A. K. Lowell’s group for months.

  ‘Fuck no, Arnie,’ Solini said.

  ‘Locked out by that bitch,’ Win cried, enraged, smashing at the door with his fists. He seemed more bulked up than ever. The steroids would explain his rages too. ‘She meant it.’

  ‘Meant what?’ I asked.

  ‘Thanks for asking, Roy,’ Arnie said. ‘Dr Lowell said she was tired of us showing up late. She locked the door on the hour. She’s in there free-associating.’

  ‘Ah, the hell with it,’ Win said, with one final kick. ‘Let’s go.’

  ‘But how would that look?’ Arnie asked. ‘If she should open the door early, and we’re not here?’

  ‘Yeah, you’re right.’

  ‘So how’s the family, Win?’ Henry asked. He’d always liked Win’s older son.

  ‘Who knows? The bitch won’t let me see ’em.’

  ‘You moved out?’ I asked.

  ‘She found out about me and Gloria.’

  ‘Gloria?’ I said.

  ‘Fire in the belly. And lower.’

  ‘But, man, like what about the kids?’

  ‘I’m using the Glücksspiel company lawyer. No way she’ll get my money.’

  ‘You’re not trying to work it out with her?’ I asked.

  ‘Cheaper to change. Like Errol. Long as you got a prenup. Warrior cash. “Victories of the Heart!’”

  ‘And what will you young doctors be doing come July the first?’ Arnie asked.

  ‘Quitting,’ Henry said. ‘Getting out of this shithole for good.’

  ‘I’ll be here for year two,’ I said. ‘And you?’

  ‘National Institute of Mental Health Prize Fellow,’ Win said. ‘And on salary for Glücksspiel. Bly says no more sibling shit, and we all better just grow up! But hey listen: Errol referred me a cousin of the Kennedys!’

  ‘Psychopharm is truly fascinating,’ Arnie said. ‘I’m rotating on the West myself and it’s really interesting. Boy what we can do with drugs now. On July the first Dr von Nott is sending me to the Harvard Business School, to specialize in the business of psychiatry. My subspecialty training will be in gerontology. The seniors are the fastest-growing segment of the American health-care system and America itself. My expertise is in death and dying.’

  ‘Death and dying, you?’ I said.

  ‘Working with the dying is the only truly time-limited psychotherapy.’

  Solini and I were speechless.

  Finally Henry said, ‘Never seen you so happy, Arnie.’

  ‘Yes, yes,’ Arnie said, ‘I am one happy camper, yes.’

  ‘Great drug,’ Win said, ‘that Zoloft.’

  ‘You’re on Zoloft?’ Henry said.

  ‘Yes, I am. I like myself on it, but my girlfriend loves me on it. We’ll be sorry to lose you, Dr Solini.’

  ‘Go fuck yourself, Arnie.’

  ‘Thanks, guys,’ Arnie said, ‘for sharing.’

  That on-call night was different. In tune with Viv, I found myself being curious about the people I was doctoring. Whether it was the voice floating on the other end of the line or the people locked up on the wards, even brief contacts were fun. It had nothing to do with how much time I had to spend with the person, and everything to do with how much I was really there with the person. I was finding out that connection can be made in a second or never made in fifty years of marriage, can be present from a thousand miles away and can be absent in the same room. That night, sometimes, I was really there.

  ‘You’ve been awesome tonight,’ Viv said as I handed in my beeper at the end of the shift.

  ‘How?’

  ‘You have engaged in no bullshit. It’s not something I see very often around here. What the hell happened to you anyways?’

  ‘You tell me. Malik says that whatever happened I’d be the last to know.’

  ‘Yeah, well, be careful, Cowboy.’

  ‘Why be careful?’

  ‘The good ones get it in the neck.’

  Leaving, I saw Errol Cabot in his Ferrari growl past, up toward the lead boxes and radioactive isotopes of the West. He had a new bumper sticker:

  SO MANY PEDESTRIANS

  SO LITTLE TIME

  ‘Have you gone up?’ Jill asked a few days later, getting out of her rusty old Buick in front of Heidelberg East. It was raining, a first summer rain, big sprouting drops that hit the hot asphalt like notes from a jazz pianist on a wild riff, raising the scent of boyhood summer in Columbia. We faced each other as the
raindrops popped upon our heads.

  ‘You think?’ I said. I was stunned by her fullness, her live-ness, her beauty, her sensual energy. Her blond hair was again long, as when I’d first met her. She had a sleek dark tan, as if bronzed.

  ‘Lemme see.’ She put her palms to my temples, and stared into my eyes. I stared back into hers. It was intense. Rain dripped down onto my lips. She said, ‘You are on the beam! What a treat!’

  I went to kiss her. She pulled back. I asked, ‘What’s wrong?’

  ‘You’re back with Berry, right?’

  ‘Well …’

  She kicked me in the shin. ‘You lying sack of shit!’

  ‘Oww-wow!’ I screamed, bending to rub my leg. ‘OK, OK, yes I am.’

  ‘Good. Someone like you should be back with someone like her.’

  ‘And you? You’ve got someone?’ She nodded. My heart fell. ‘Who?’

  ‘A guy. It’s fabulous.’

  ‘Fabulous?’

  ‘Mostly. But what can you do? I mean he is a guy. Can we walk?’

  ‘In the rain?’

  ‘Sure. I love rain! Everything is so green! Like the tropical sea.’

  We walked through the woods, down the ravine, along the asphalt path through the oaks around the lake, then down into a marshy hollow – where, last New Year’s Eve, they’d found the frozen body of Sedders, the Man Who Couldn’t Get Admitted to Misery in Time and Had Died Trying – and then onto the mossy carpet up into the high pines, where the scent vaporized up into the dampness of the day.

  When we started walking, there were light circles of dry road under the trees that overhung the dark, wet road. We walked for so long that, after the rain had ended, by the time we retraced our steps the road was dry, and what had been light circles of dryness under the trees had now become dark circles of wet. The rain had soaked through the leaves, and the trees had shaded the hot sun, preventing it from drying the damp circles under them. And maybe it was the day itself, or the woman, so bright and alive and fulfilled that I found myself worrying that being with me might jinx her; whatever it was, this cojoint arising of wettening and drying circles was like a metaphor for our lives, no longer lovers but friends. What a challenge to me, a man, to have a woman friend. I who had been taught from my first awareness of boyhood that either you ignored girls completely or you tried to get into their pants.