Dr. Neruda's Cure for Evil (19 page)

C
HAPTER
S
IX
Misdiagnosis

A
UNT
S
ADIE WAS NERVOUS.
S
HE SWUNG MY HAND BACK AND FORTH TO
soothe me, but her palm was gooey with perspiration. I was nervous also. I tapped my brown loafer on the marble floor, unable to stand still. We were in a large reception hall of the Hillside Psychiatric Hospital, a private facility set on four acres in Great Neck, waiting for Uncle Bernie to return from his conference with my mother’s psychiatrist. We hoped Uncle would come back with permission for me to see her.

The central hall was part of Hillside’s grand main structure, a stone and marble mansion built by one of the Roaring Twenties stock manipulators. His ruin in the crash and the forced sale of his possessions at depressed prices led to Hillside’s creation by Dr. Frederick Gulden. Gulden was an early refugee from Nazism, trained by Freud himself, who had earned the good will of a wealthy widow for the “cure,” or improvement anyway, of her manic-depressive son. In the late forties, Dr. Gulden added a three-story concrete dormitory for patients and the mansion itself was converted into offices and consulting rooms. The reception hall’s high domed ceiling and sweeping marble staircase was an oddly imposing entrance for a sanitarium. Nor did the mahogany reception desk and its sour-looking occupant, Bill Reedy, make the place more inviting. Reedy drank heavily every night, nursing his hangover while on duty, staring at prospective patients and their nervous families through bloodshot eyes. He looked enraged that anyone had dared to enter his domain.

I was intimidated by Reedy’s face: it started my foot going again. That disturbed Aunt Sadie. “Don’t tap your foot, honey,” she whispered and its echo scurried across the marble floor up to Reedy’s florid cheeks and squinting eyes. His frown intensified, as if focusing to identify me as a miscreant. That set off another fusillade of foot tapping, completing the vicious circle.

Uncle Bernie was conferring with Dr. Halston, who ran Hillside in the 1960s for the semi-retired Dr. Gulden and, given Uncle’s stature, had personal charge of my mother’s case. When Bernie returned with him, they led us into a reception room in the dormitory wing. Its walls were painted green down to the level of the mopboard, then white down to the linoleum floor. The room where I saw my mother was furnished like a doctor’s reception area; a couch, a love seat, a coffee table, a lamp, a magazine stand, and museum posters of masterpieces on the wall.

Ruth sat on the couch, shoulders slumped, eyes fixed on a copy of
Time
that someone had left open on the coffee table. Her hands were limp at her sides, palms up. She was very thin and her face seemed devoid of blood. I almost screamed—I thought she was dead.

Aunt Sadie sensed my panic. Her grip tightened and she pulled me close. My mother didn’t look up.

“Your son is here,” Dr. Halston said. He had thinning blond hair combed straight back and, as long as I knew him, wore glasses whose thick black frames looked more like goggles for a World War II pilot than aids for weak vision. He was a compact muscled man with a military posture, but his voice was thin and rather high-pitched. There was little natural warmth in it to begin with and Freudian training washed out any other coloration. “Ruth. Look.” Halston waved Aunt Sadie to bring me forward. “Your boy is here to see you.”

As soon as I realized she wasn’t dead, I recovered my nerve. I broke off from Sadie, rushed to the couch and tried to hug my mother. I hadn’t been given any instructions or advice by Halston about how to behave or what to expect. (I cannot fathom why not; I am amazed that no one discussed her condition with me in advance. Perhaps my memory is faulty.) Ruth didn’t move. I pressed against her awkwardly, trying to fit into her limp body. Once I had wished she would never touch me again; now I longed for the energy and passion of her abuse. I felt her love for me had died.

“Mom,” I said into her ear, leaning my cheek against hers, my arms attempting an embrace. “I’m here, Mom.” I held a rag doll. I smelled her. Someone had perfumed her with an unfamiliar scent. She was dressed in a demure white blouse and a long blue skirt. The clothes were unlike her usual style, which was both more dramatic and always sexy. Hillside was really an institution for the wealthy, or more often, the mentally ill relatives of the rich. Except on the rare occasion that a patient became violent and required restraint (before the widespread use of antipsychotic drugs), Hillsiders were encouraged to dress neatly in their regular clothes; even catatonic patients were carefully groomed. Obviously someone had made up Ruth for the occasion. I was put out by her rouge, her eyeliner and lipstick. All were applied by a stranger. The incorrectly drawn lines made this Ruth seem more like an lifeless imitation, an approximate mannequin of my mother.

I wanted to cry but I was worried the visit would end if I showed I was upset. Dr. Halston urged me off Ruth, saying, “She needs time to
get
used to you being here.” To hide my feelings, as I slid away to sit beside my mother, I pushed my forehead against the outside of her shoulder. She didn’t react, hands at her side, palms up, face immobile, eyes blank and fixed on
Time
magazine. It was awful, worse than any state I had yet seen her in, worse than her rages, worse than her brutalized body on the car, worse than her seductions. She wasn’t human.

Uncle came forward. His cello didn’t resonate with its usual confident sound. “Ruthie,” it quavered. “Rafe is fine, as you can see. We all want you to get better. Everything is taken care of. I don’t want you to worry. When you’re feeling better, you can come live with me, and raise Rafe, and …” I heard a tear in his powerful voice, a note of boyish awe and distress. He trailed off. “And … uh … everything will be okay. That’s all. Don’t worry.”

I peeked out at Ruth’s profile. I felt that Uncle’s unusual display of tenderness would move her. No. She looked right through him.

Sadie covered her mouth, quelling a sob. She turned away. Bernie backed off, appalled. “I thought with Rafe here …”

Halston took my uncle by the elbow and moved him toward the door. He mumbled as they retreated, “No, she’s totally schizo. Living in a fantasy world. I doubt she knows you’re here.”

Aunt Sadie choked out a phrase, “Don’t talk about it.”

I assume Sadie meant because of my presence, since Bernie’s reaction was to glance in my direction. He turned, and nudged Halston to turn away, giving us their backs while they talked in whispers. Aunt Sadie joined them, forming a huddle at the far end of the room.

It was a short time, perhaps ten seconds, while Sadie, Bernie, and Halston weren’t looking my way. I continued to kneel on the couch, angled toward my mother, my nose flattened against her shoulder. Ruth’s eyes suddenly flashed with intelligence and mockery; big and green, they moved in their sockets while her head remained still. She whispered rapidly, lips hardly moving: “Rafe. Don’t react. Just listen. Everything they say is a lie. I’m playing possum. I’ll come
get
you soon as I can. Keep my secret or they’ll put you in here. Be brave.”

“Mom …” I started to answer, but I was stopped when Ruth’s eyes glazed over and died. I glanced at the door to see Halston peer in our direction. Because of their thick black frames, his glasses were so obstructive that I couldn’t tell whom he was scrutinizing, me or my mother. After a brief survey, Halston returned to the huddle.

Immediately Ruth’s eyes came to life. Her lips moved into a smile. “Fool,” she whispered.

“Mom,” I said into her ear. “You’re not crazy?”

Her profile crinkled with delight. “No. Read
Hamlet.”

“What… ?” I leaned closer. Her eyes dulled. Presumably Halston or Bernie or Sadie were checking on us.

Ruth resumed her lifeless pose, but she did whisper with unmoving lips:
“Hamlet
by Shakespeare. ‘I am but mad north-north-west. When the wind is southerly, I know a hawk from a handsaw.’”

“Rafe, honey,” Aunt Sadie called. “Come on. Kiss your Mom goodbye. You’ll see her soon.”

“What!” I shouted, startled. Ruth instantly returned to her impression of catatonic depression. (A very good impression if my memory is accurate; good, but no mimicry should fool a careful—or, at least un-dogmatic—doctor’s examination.)

“We have to go, honey,” Sadie said. She came near and beckoned me off the couch with an offer of her worried hand. I made sure to kiss my mother goodbye since the real her was present, entombed in her imitation of a corpse.

After I got up, Sadie bent down and kissed her little sister on top of her head, pressing her lips into my mother’s thick mass of black hair. Sadie almost broke down again. Her plump torso heaved and she gasped out, “Get better, Ruthie. I miss you.”

I wish I could report that my mother’s eyes flickered, that she gave a signal she had heard her sister’s loving if stupid plea for a happy ending, something that wouldn’t have risked exposure of her performance and yet could have eased Sadie’s pain. [I learned later how rigid, how tyrannical paranoia can be, especially when it is fueled by traumatic and therefore confirming events. My mother could no more feel pity for Sadie or trust her love than she could decide to discard her delusional and grandiose fantasies because they were interfering with her ability to be a good mother. There is no prison guard more alert or more tireless than mental illness. If Ruth could have trusted Sadie, then she could have trusted anyone; if she could have broken the wall of her terrible secrets just once then it would have crumbled altogether. There is no such thing as being a part-time paranoid psychotic]

I glanced back as Sadie led me out. The mannequin of my mother was still propped up on the couch, dead. While we walked to my uncle’s limousine, I marveled—silently, of course—at how she could possibly keep it up; hour after hour, pretending not to hear what was said to her, pretending to have no needs or desires.

“Is she like that all the time?” I asked Uncle Bernie, breaking the heavy silence of our ride home.

Aunt Sadie covered her face, overwhelmed by my pathetic question. Her reaction surprised me. We had no common ground: I was awed by my mother’s strength of will; Sadie thought I was in agony about Ruth’s condition, suffering from that vision of her as a zombie.

Bernie squinted at the view out his window. “No, not all the time.”

A long silence.

“It’s like she’s dreaming,” Aunt Sadie said, uncovering. She showed me a tired, but brave smile. “She’s awake but she’s dreaming. She wakes up sometimes, asks for things she likes. And she asks about you. She’s not in pain. That’s what the doctor said, right Bernie?”

“Yes,” Uncle hissed. The farther we got from the sanitarium, the angrier he seemed.

He hated my mother, I knew that. They hated each other. I had to remind myself over and over: my uncle was bad. No, not bad. My mother herself had made the distinction to me: he was a good man who believed in a bad system.

There was another long silence. I shut my eyes somewhere in the middle of it and pretended to sleep. My aunt brushed the top of my head after a while and mumbled, “Poor baby.”

“Sleeping?” Uncle asked. Sadie indicated yes. “What a mother,” he mumbled with surprising bitterness, as if he were the son who had suffered.

“When will they start the treatments?” Sadie said.

“Tomorrow.” Bernie’s music was a single note, low and angry. “They’ll do a series often and see if there’s improvement.”

“They put her out, right?”

“Of course! This is one of the most expensive and advanced psychiatric hospitals in the country.”

“I know. It’s wonderful of you, Bernie—”

“I’m not looking for thanks, that’s not what I mean. I mean they know what they’re doing. They use anesthesia and the voltage is set lower … Anyway, she won’t know a thing about it. He said it lifts them out of the severe depression so they can begin treatment. You can’t deal with her the way she is now. How can Dr. Halston talk to her? She’s unreachable.”

“I pray it works, that’s all.”

“Look. Anything is better than how she is now. It’s a living death. It’s worse than death.”

“Shh!” Sadie was in pain. “Don’t say that.”

“It’s the truth, God damn it.”

“No, it’s not. There’s always hope.”

I did not understand the implications of their conversation. Since I intend this to be read by a lay audience I should state what is obvious to any professional: although electroshock therapy is advocated today as an effective symptomatic treatment to major depression and is in use on roughly twenty percent of its sufferers, nevertheless, no one, including its admirers, considers it to be appropriate in a case of paranoid psychosis or posttraumatic stress, the two indicated diagnoses of my mother’s condition. [Readers of my book
The Soft-Headed Animal
know that I do not believe in the use of the electroshock under any circumstances, including major depression. Evidence that prolonged use of electroshock therapy causes permanent brain damage is plentiful and there is no scientific proof that it cures depression itself. However, as stated above, even ECT’s advocates would not recommend its use on a patient with my mother’s problems.]

My mother received the wrong treatment. Nine-year-old Rafe did not know that. He did not know that keeping his mother’s secret was doing her harm. Nor is the mature Rafe confident that had I been less skillful at deception, had I been found out and forced to confess that my mother wasn’t really withdrawn—that she spoke to me and said she was deliberately fooling her doctors—I am not confident that I would have been believed. I hope I am not overstating Dr. Halston’s error. All doctors make honest mistakes, especially when a clever patient is deliberately deceptive. But I am sure that, having made his diagnosis, Dr. Halston would not have been quick to overrule himself because of the account of a child, a child who could easily have made it up out of his own fantasies. Moreover, I understood my mother’s motive and I respected it. What is madness to a normal adult made sense to me as a traumatized child: my mother, acting out of her paranoia, meant to be loving by her injunction that I should keep silent and not identify myself with her and her “cause.” That would only have landed me in the care of the same monsters who tormented her. It is hard to understand, but Ruth’s actions, which seem heartless and unconscionable to a normal person, were, by her lights, the actions of a loving mother.