Mount Misery

by Samuel Shem

  Oly Joe’s ledger was still in the false ceiling above my chandelier. We took it down, turned the light up, lay back together against the headboard of the bed, and started reading.

  There were hundreds of pages divided by that vertical line. The right-hand side was lurid and crude. ‘I suck your sweet boy’s cock till you come,’ was pretty regular. ‘When I feel your little boy’s cock rip at my asshole my clit gets big as a dick,’ was not atypical.

  ‘Do you believe this?’ I asked Berry.

  ‘It’s sickening.’

  ‘Uh-ohhh. Here it is. Listen.’ I read, ‘“Sucking your cock isn’t like sucking Poppa Schlomo’s ’cause his is shorter and thicker and he can be sucked a lot longer before he gets off.’”

  I looked up at Berry. Her eyes showed her revulsion.

  ‘But would you actually make that public?’ Berry asked.

  ‘Her thinking I would might be enough.’

  ‘To make her go public? And ruin her reputation?’

  ‘Ruining Schlomo’s might save hers. And she and Ike were best friends. There’s a limit, isn’t there, even if someone’s been psychoanalyzed? Maybe if she smelled blood in the water, if she knew there were two other victims filing suit, she just might take the chance. It might never have to be made public at all, if Schlomo sees the light. It would never come to trial. Gilda says these things never do. If it gets close, they settle out of court. It all comes down to money.’

  ‘You’re forgetting one thing.’

  ‘Which is?’

  ‘She’s an analyst. She can claim it was all fantasy, all in her mind. Her countertransference to him.’

  ‘Yeah, except for what Oly Joe wrote, in blood.’

  Reading the entire volume, I found many other passages where A.K., using the powerful tools of psychoanalysis, free-associated from Oly Joe’s penis to Schlomo Dove’s penis. The descriptions of what went on between A.K. and Schlomo – his ‘you buy the condoms,’ the Ziploc bag – matched what Lily and Zoe reported. There was a passage that at first seemed to defy physical possibility, which had Schlomo masturbating her with an unripe banana while she performed fellatio on him. And there were several detailed descriptions of the geography of the Schlomo Dove penis.

  First thing the next morning, I drove to my neighborhood L’il Peach convenience store and photocopied several of these pages. Then I drove to the nearest Rank Bank and opened a safe-deposit box and left the ledger there. At ten minutes before the hour I called A.K.’s secretary Nancy. I said I had an urgent matter to take up with A.K. and needed an appointment that day.

  ‘She’s just breaking from her nine o’clock. I’ll ask her.’ She put me on hold. She brought me back. ‘She will not see you.’

  ‘When can she see me?’

  ‘I’ll put you on hold.’ She put me on hold, then came back. ‘Roy?’

  ‘Yeah?’

  ‘She says “never.”’

  ‘Fine,’ I said. ‘Tell her I’ll be right over.’

  I went down the hill from the Farben to Thoreau and sat outside her office. At ten-fifty the door opened. Out came some poor bastard, rail-thin and pale as a pustule, all dressed up in a three-piece suit like A.K.’s, looking as if he’d just spent fifty minutes with a demon. I walked in and stood in front of her desk. She was doing her crossword on the rail-thin pale guy, but she stopped and stared up at me.

  ‘It is in your interest to talk to me.’ Silence. ‘Two women who have had Schlomo Dove as their therapist are about to sue him for sexual abuse. He was fucking them during their analyses.’ Silence. ‘I know that you too were a victim of his abuse.’ I thought I caught the slightest hint of movement, a clench of her jaw, but it might have been a play of sun across the skylight, or a bird. ‘I know from your ledger on Oly Joe. I have the ledger in my possession, locked up tight.’ I held out one photocopied page. She did not take it. I placed it carefully on her desk.

  Seeing her sitting there so alone, so trapped in her mutilated mind, seeing her muscular body and surgically remodeled nose, I felt for her. How sad it all was. But sad as I might have been for her, I was more sad for Cherokee and the gunshot that in a single moment had put a curse on his two young children, and had started a chain of suffering that would echo down through not only their whole lives, but the lives of their children, and their children’s children. Outrage swept away my sadness for her.

  ‘I would hate to have to make these notes public,’ I went on. ‘If you decide to come forward, as a Schlomo victim, I wouldn’t have to, would I?’

  A.K. picked up a pencil and held it, eraser down, on the desk. I had never seen this before from her, her holding a pencil vertically, point up, and was encouraged.

  ‘Why, it might never need to be made public at all. Your contacting Schlomo might be enough to scare him off.’

  The eraser tapped on the desk, once, twice, silently. I could have sworn I saw the sharp point tremble, a breath caught in all this desiccation.

  ‘It’s Monday. I’ll give you till five o’clock Friday to make up your mind.’

  Often in the past I had walked out of that vile office feeling like so much deadweight. Now I walked out feeling light.

  Twenty-one

  A.K. REMAINED SILENT, day after day, all that week. I told Hannah and Henry about the ledger, and swore them to secrecy. As the week went on, I was preoccupied with what was going on with A.K. She faced an impossible choice. I felt some sympathy for her. I recalled Viv and Primo telling me that as a first-year resident in Misery, before she’d gone under analysis with Schlomo, as Aliyah K. Lowenschteiner, she’d been a bright, young, fun-loving, and funny woman. Her nickname, Viv had told me, was ‘Sunny.’ Descended from a long line of eminent kosher butchers, not only had she been the first in her family to go to college and med school, but through sheer gutsiness she’d risen to the top of every class, and had gotten admitted into Freudian heaven, the institute. Then one day, she’d gone to the head of the institute, a man analyzed by Freud himself, and, expecting to be matched with a lesser analyst, walked out instead matched with Dr Schlomo Dove himself. Imagine her joy. She had it made.

  I saw how that moment of what she must have seen as her greatest success was in fact the moment of her downfall. She was doomed. Could she have done otherwise? Could she at any moment have stopped? Before the nose job? Before the first touch? Before the first fuck? Before the first banana? I too had felt Schlomo’s mesmerizing power. When I’d gone to him to confront him about his abusing Zoe, he’d overpowered me, shamed me, made me doubt my own eyes and ears. To be with that monster five times a week? Who could resist doing what he told you to do, especially when he said it was necessary for the success of the analysis? I saw, then, that Schlomo wasn’t even primarily into sex. This was about power. This was rape. Schlomo was a classic rapist.

  Friday at five was A.K.’s deadline to come forward. At noon on Friday Solini and Hannah and I sat together in the front row of the newly renamed Mutual of Life Theater, in the Farben. We were attending Misery grand rounds, where the topic was ‘How to Manage Your Risk as a Psychiatrist.’ Despite our having heard nothing from A.K., we were flying high: Henry and Hannah were just about done with Misery forever. I, despite the specter of two more years of training, now felt that I had finally come closer to understanding what I’d come to psychiatry from medicine to understand: how to be with people, including patients. The past few weeks working with my patients, I’d felt able to use all that I’d learned during the year.

  While our speaking out and taking small actions over the past few weeks may have had some effect, it turned out that Mount Misery was also being rocked by larger explosions in the culture. Things at the hospital were getting more and more chaotic. The algorithms, the decision trees, the boxes adangle from other boxes were banging into each other, coming to rest at weird angles. Just as doctors were no match for businessmen, the hospital was no match for the insurance industry. The industry now more or less owned the hospital, and thus owned the patient
s too. Talk was no match for drugs. The industry would not be paying for talking any longer. You could almost see the class split in America widening: those who could pay, could talk to a therapist; everybody else would be handed a drug. Most psychiatrists would be pill-pushers. It would be great for the drug industry and the insurance industry. They would be making a lot of money. In some ways, they were becoming indistinguishable, drugs from insurance, insurance from hospitals. Soon, as in publishing and entertainment, it would all be owned by the mammoth multinationals. Risk, once taken by insurance – in fact, risk had been the very reason for insurance, starting with the Medicis – would now be taken only by patients and doctors.

  Psychiatry had succumbed to the medical model: diseases, diagnosis, and drugs. Errol was in, Malik out. The shrinks had fallen prey to the very thing they were supposed to heal in their patients: the isolation of one human being from another, and the violence of one human being toward another. What made people sick in the first place was being replicated in the institutions set up to heal them, all these Miserys of the world. In this, allegedly one of the most human specialties in all of medicine, human beings often seemed to matter least. Perhaps it was inevitable, I thought, sitting there in the almost two-hundred-year-old auditorium, given the original concept of the Yankee founders, that diseases of the mind are a kind of flip side of diseases of the body. I now saw how a lot of the world experts in Misery acted as if they truly believed there was a medical treatment for the suffering of the soul.

  And if, already, some of the millions of schoolkids and adults labeled with ADD – Attention Deficit Disorder – and, put on drugs such as Ritalin, were starting to develop a Tourette-like syndrome, with facial tics and twitches that might be irreversible? Well, it’s the price we pay, isn’t it, for drugging ourselves to attention, for living better chemically? And if, with the two billion prescriptions for Prozac written during my year in Misery, some of the Prozacians had seen their sex drive wither? Well, wouldn’t a bit less sex drive be better for society, as a whole, in the end? And if, as is always the case when you throw something as gross as a drug into something as delicate as a brain, you lessen the human part? Well, maybe we’ve all had enough of this so-called human part, no?

  All year long, whenever my common sense had come up against the received wisdom of Misery, the phrase that had come to mind was: ‘They must be joking.’ Today’s grand rounds was no exception. Mount Misery had decided to address the hot issue of ‘Therapist Risk’ head-on. At the front of the refurbished old auditorium, on a small toy-like stage spread under that beautifully proportioned, long and gradual arc you see on doorways and windows and roofs of Shaker dwellings, sat Dr Arnold Bozer, Dr Schlomo Dove, Dr Blair Heiler, and another man I’d never seen before, all in power suits. Schlomo looked neat and clean, his curly hair full of snappy energy, as if it had been permed.

  Dr Bozer presented the case for discussion, in his words, ‘a DSM 300.14, Dissociative Disorder, Multiple Personality, a young woman who I had had in therapy on Emerson.’ With a haughty sarcasm that I knew he had copied from Blair Heiler, Arnie said, ‘Sometimes she would be Sharon Stone, other times Hillary Clinton, sometimes Bambi’s girlfriend Faline, up to a grand total of seventeen multiples. The Sharon Stone multiple claimed that her therapist, me, was abusing her sexually. I have a policy of never touching a patient. I swear I never touched her. Soon thereafter her inpatient insurance ran out and she was discharged to Candlewood, clutching a man’s shoe. She still tries to call me sometimes. Gosh, it’s embarrassing. She was discharged on Prozac, Ritalin, Placedon and Zephyrill, and nystatin, for her athlete’s foot.’ He sat down.

  A tall, handsome, thin man with straight blond hair styled like Bill Clinton’s stood up. He was wearing a fine suit and a tie with an insignia with no ducks rampant. This was Dr Bobby Lee Shpitzer, a Texan who was a world expert on Therapist Risk.

  ‘There’s a lot of schtupping going on out there,’ he said. A lot of people laughed. ‘Lights out, please?’

  He proceeded to give a slide show with a commentary that was so witty that soon much of the audience was laughing, as if we were watching Seinfeld. At one point he put up a slide of a famous James Thurber cartoon, of a male doctor leering over the headboard of a hospital bed at a female patient. Dr Shpitzer read the caption out loud: ‘“You’re not my patient, you’re my meat.”’

  Roars of laughter. Solini grasped my right knee, Hannah my left. I grasped theirs. We all squeezed, hard.

  The slide show ended. Dr Shpitzer then made a heart-felt statement that patient-psychiatrist physical contact was absolutely off limits. Touching the patient, but for a handshake, was off limits. A hug was totally out of bounds. Yet what was the psychiatrist to do when a female patient, maybe a borderline or dissociative or multiple, suddenly got up out of her chair and approached, intent on hugging him? Dr Shpitzer asked Dr Dove to demonstrate. Schlomo, ever the showman, popped to his feet.

  First Shpitzer said he would show us all what not to do, and told Schlomo to go ahead. Playing the woman patient, Schlomo started toward Shpitzer, arms forward. Shpitzer crouched in a martial-arts stance and with a scream – ‘Hyahh!’ – karate-chopped Schlomo’s hands down. Roars of laughter from the audience, horror in Henry’s and Hannah’s faces, squeezes of knees.

  Next the world expert showed us the correct response. Again Schlomo danced toward him for a hug. Shpitzer grabbed both wrists, crossed them over each other firmly, pushed them down toward the zone between breasts and genitalia, and said, ‘No, no. This is not therapy.’

  Schlomo got up on his tippy-toes and danced coyly. ‘Please, Doctor, just one little hug?’

  Roars of laughter.

  ‘No, no. This is not therapy.’

  ‘But you’re so cute, Shpitzy! Pretty please? One eentsy-weentsy?’

  ‘No, no. This is not therapy. If you persist, I will terminate.’

  They stopped. The audience applauded. Schlomo took a grand low bow.

  The discussion then centered on variants of this technique. Dr Shpitzer passed out his brochure, describing his video course – ‘Six Quick Steps to Avoid the Pitfalls of Risk’ – which we could all buy for $399.95. This would allow us to pass our risk-management requirements for state relicensure as shrinks in the comfort and privacy of our very own homes.

  Next, Dr Blair Heiler rose from his chair onstage and went to the podium to offer his comments. ‘Dr Bozer did not pay enough attention to the LNT, the Latent Negative Transference. If he had, he would have been able to hate the patient and—’

  ‘Hate?’ cried a voice from the back. Heads turned.

  It was A. K. Lowell, standing up against the back wall, a yellow pencil in her raised hand. ‘Hate?’ she said again, triumphantly, having caught her rival red-handed. ‘What a slip!’

  ‘No, no. Love!’ Heiler said defiantly, but his face reddened. For many of us this classic Freudian slip was a poignant reminder that he had failed his analysis because of problems with premature termination, anger, and sadism, or Latent Negative Transference, untreated. ‘Let me decenter myself,’ Blair said, sitting down, blinking his eyes. Then, with a tremor in his voice, he said, ‘Dr Bozer would have been able to love his patient.’

  ‘You meant hate,’ A.K. said.

  ‘Did not!’

  ‘Did so!’

  ‘Oy!’ Schlomo said, standing. Up above us on the toy stage, with the other men onstage sitting down, Schlomo seemed tall and solid. He seemed to grow even more solid and powerful as he put a hand on Blair’s shoulder and fixed A.K. with his eyes, which, as he tightened his face in anger, became slits, ominous and terrible. It was incredible, just how much power seemed to be beaming out from this chunky little man onstage. ‘Lowell?’ Schlomo said. ‘Sit!’ A.K.’s face went ashen. ‘Sit!’ Schlomo hissed. ‘Down!’

  Humiliated, A.K. sat down.

  I turned to Solini. His forehead was beaded with sweat. I too was sweating. Hannah’s eyes were wide with horror. It was the same horror we’d
felt that day when, in this same room, we’d seen Lloyal von Nott deny Ike’s suicide. Now, our horror had returned. Where had it been?

  Schlomo went on as if what had happened had not happened. He gave a classic Freudian explanation of ‘how this multiple gets men to schtup her.’ As he went on – amusing, intelligent, and sincere – the audience was in the palm of his hand. The three of us looked at each other. In this room almost a year before, Geneva Hooevens had gotten up, spoken out, asked for the truth. I wanted desperately to get up and speak out, but I felt as if a weight were holding me down, making my tongue too heavy to lift. I felt the weight of the others in the room who thought Schlomo was a great man, a brave man for confronting this delicate issue in therapy, and even braver because he could say that while of course the therapist was responsible for abusing the patient sexually and must be held accountable, the patient had a hand in provoking the abuse. I felt the weight not only of those present, but of all those who had sat in this room through its past, the weight of so many years of denying what was being seen in the moment, to preserve what was thought to be known.

  ‘Within the consulting chamber,’ Schlomo said, ‘careful Freudian analysis will uncover exactly what leads these women to get themselves sexually abused.’

  ‘Right,’ Hannah whispered, loudly enough to be heard by a few people around us. ‘They all had light brown hair and looked like boys.’

  ‘And like goys,’ Henry added.

  Schlomo glanced at us, but went on, ‘I applaud Dr Shpitzer’s brilliant program of risk management. Folks, it’s just not worth the risk. To hold a patient’s hand, to acquiesce to what is, deep down, as much an aggressive act as an erotic one, a hug? Not worth the risk.’

  ‘But screwing a patient,’ I said to Solini, again loud enough for those around us to hear, ‘now that’s worth the risk.’