Dr. Neruda's Cure for Evil (52 page)

“Did you sleep well?” she asked.

I told her, probably with a little manic excitement, that I had been up most of the night reading and I felt exhilarated.

“You don’t mean you agree with him?” she asked.

I tried to explain that I didn’t think agreement or disagreement with Joseph was the point. I know I concluded with pomposity. “What’s important is the truth,” I said.

Diane grunted. “Well, I certainly wouldn’t want to stand in the way of the truth.”

I was irritated. Diane is an excellent practical therapist: no one could be more dedicated and few of greater help to their patients than she. On the theoretical level, however, she lacks curiosity or broad-mindedness. Her bias is for what has evolved out of Freudian-based talking therapy, what I practiced in my first go-round with Gene, namely the therapist replacing bad parenting with good parenting, providing some insight and a lot of warmth and encouragement. In graduate school, once Diane had her “faith”—as is all too often the case with psychologists—she read opposing philosophies or techniques only to refute them.

“Somewhere out there is an answer, you know,” I said grumpily. “And if it can be found a lot of people’s lives will be better.”

She didn’t reply at first. I heard her bed sheets rustle. I could imagine her shifting to sit up, raising her navy blue blanket to cover her breasts. “She’s lovely,” Aunt Sadie commented to me after I introduced Diane. “She looks like your grandmother when she was young.” Sadie meant my mother’s mother. I was amused—and sufficiently appalled—to check an old black and white photo of Nana to reassure myself that the similarities were superficial. That Diane was a product of a long line of strong Jewish women was undeniable, however, and in that sense my feelings for her
were
incestuous. “I love that you’re tall,” she whispered one morning, legs drawn up, curled into a ball, cuddling against me as I stretched out to the limits of her bed. Had my mother once said the same words to Francisco? I pictured Diane: warm and trusting in my arms. Be careful, I thought, you don’t want to become a stranger to her intimacies. She sighed. “Look, Rafe, who are you kidding? You’ll be the last shrink on earth to say to your patients, ‘Take two Prozac and call me in the morning.’”

“Of course.”

There was another silence. She sipped something, probably coffee from the big white cup she had bought in Paris on our trip, to remind her of our room service breakfasts, especially their delicious, strong coffee.

“Can I say something?” she asked.

“Sure.”

“Your friend Joseph is jealous of you.”

I laughed—couldn’t stop myself in time.

“I’m serious,” she complained. “He’s not only jealous of you. He’s in love with you.”

I glanced at the clock. Although it was Saturday, we had a series of sessions scheduled, beginning in an hour and a half, with three children housed in temporary shelters. The family and juvenile courts had appointed us to evaluate them. The weekend, unfortunately, was the only time Diane and I could fit them in. One was severely battered by a stepfather; another, a seven-year-old girl who had been raped and sodomized by her thirteen-year-old uncle; and the last was the abusive adolescent uncle, Albert, himself a victim in early childhood of his mother’s sadistic and incestuous behavior. (She would force Albert to perform cunnilingus and, after orgasm, burn him with cigarettes or whip him with an electric cord. Being subjected as a child to a combination of sex and violence, by the way, seems to be the background profile of serial killers. With Albert, especially, the implications of the kindling studies might be particularly meaningful.) Surely Diane understood that too much was at stake for me to care if Joseph’s motives were impure. Albert, the nascent serial killer, had been put on Ritalin for attention deficit disorder by the state hospital. The psychiatrist who ordered the medication had decided that a thirteen-year-old African-American, living in the South Bronx, who had never known a father, whose mother was a crack addict, who, from the age of five, had been used for sex and physically tortured by his mother, was suffering from a chemical imbalance rather than from his life. Ritalin is a much less specific drug than Prozac or other drugs Joseph was then developing. He had conceded publicly (as have most scientists) that, whatever Ritalin’s benefits to caretakers as a sedative for disruptive children, it is dangerous, both addictive and likely to cause brain damage if prescribed for long. Sure, it quiets upset children—it would quiet any child. Ritalin’s widespread use for the so-called illness of attention deficit disorder, or the even more specious “illness,” learning disorder, was my main concern in writing
The Soft-Headed Animal,
the book Joseph had never finished. My duty with this thirteen-year-old rapist—besides the legal question of his state of mind when he sodomized his niece—was to evaluate his care. Joseph’s arguments were not academic—to us or to our patients. He conceded that Ritalin was a poor choice; his point was that the severe trauma experienced by children altered their brain chemistry irrevocably and, no matter how skeptical I was, I couldn’t prove him wrong simply because no drug exists that truly helps.

“Diane, we have to address these ideas. I can’t go before the judge and say, well, I don’t approve of drugs, and leave it at that. I don’t really care what Joseph feels about me—or to be more precise, why he bothers to proselytize. If you’re suggesting he feels a thwarted desire for me and that he expresses it through competition—”

“Well, as usual, you’ve put it much better than I could. That’s exactly what I think he’s about.”

“I understand. But so what? None of us can bear too close an examination of our motives. If I rejected this data out of homophobia or professional pride, I would hardly have improved matters.”

“How about rejecting it because it’s wrong?”

“I don’t know if it’s wrong. That’s why I have to study it.”

“What’s new about any of it? They’ve been making these claims—”

“What’s new to me is some proof that perceptible chemical changes occur after trauma. It still means the change is caused by emotion and conflict.”

“Then it can be changed by talking through the conflict.”

“Maybe. But maybe not if the trauma is severe enough. It doesn’t prove drugs are the answer. But—” I hesitated to say we, since I didn’t want to imply disapproval of Diane, “I really should know about it. Frankly, I’m ashamed to admit, out of my own prejudices, I ignored some of this research. In fact, some of these studies that suggest trauma can cause ongoing neurological damage were published while I was still in medical school.
I’m
guilty of being too close-minded.” I felt I now had to include Diane or I might seem condescending. I added, “You and I have a duty to investigate anything that might help. We’re doctors. We’re not supposed to toe a party line.”

“Look—You’re not understanding me—I don’t—This is a mistake—” Diane blurted each of these phrases rapidly, cutting them off and then resuming with an exasperated tone. The sheets and blankets whooshed. It sounded as if she had gotten out of bed. She had a wireless phone and liked to roam while talking. I was reminded of the day a year ago when she called to ask if I would entertain her while she mopped the kitchen floor. I was charmed. That was when I knew we were more than friendly colleagues. Just as, although I was irritated by her defensiveness about how Joseph treated me, I knew her protectiveness was love. Its recipe, after all, has a few ingredients that are best stirred beyond recognition.

“What’s a mistake?” I asked. We were late and needed to cut this conversation short, but I didn’t want to seem to be running from it.

“You’re too conscientious,” she said in a decisive tone. “That’s all.”

“Can a doctor really be
too
conscientious?”

“The world’s gonna break your heart, Rafe, if you care that much about everybody and everything. Joseph’s not a friend to you. He wants to brag to the world that he’s taught Rafael Neruda how to treat his patients.”

“Now you’re being neurotic,” I said. And immediately regretted it.

There was a heavy silence. I heard her breathing and that was heavy also, labored and dangerous.

“Sorry,” I said quickly. “I mean, Joseph isn’t like that and anyway he can’t take credit for my work. We’re not really in the same field. No one would believe him, for one thing.”

“Okay. Let’s drop it.” Her tone was irritated and irritating. “We have to get going.”

“Look, maybe Joseph’s research can help improve my treatment. Why is that something to be afraid of?”

“You’re not understanding what I’m saying. Is that deliberate? Do you really not understand?”

“I really don’t.”

“Okay.” She sighed. “Let me try to say it again. You’ve cured dozens and dozens of kids—there are plenty of people out there, like Felicia, like ‘Timmy,’ who owe their lives to you, and Joseph talks to you like you’re incompetent. And he treats me like I’m a waitress. I can’t take it. And I don’t think you should take it. I think it’s neurotic!”

“Diane, I discovered a long time ago that no blessing is unmixed. Joseph has a brilliant mind and for him to use it well he needs the illusion that his is the most brilliant mind in the world. That need is nothing to envy, because it’s doomed to be unsatisfied. I value his friendship. I know, and I know it for sure, that if I really needed Joseph, he would do everything to help me. But when we play games—and that’s what an argument is to Joseph, a game—he has to win, or at least seem to win. That’s what he needs from me.”

“So you’re enabling him?”

“Diane.” I couldn’t fight my irritation. “I’d really prefer it if we didn’t use jargon.”

“What you mean is, if
I
didn’t use jargon.”

“No. Jargon is jargon no matter who’s using it.”

“Look, Rafe, honey, all I’m saying is if a patient talked like you are—”

“Diane, we’ve got to get going. I’ll pick you up and we’ll finish this on the way. Okay?”

“I’m done. I’ve said what I have to say.” Her tone was clipped.

“You sound furious.”

“I’m not. I’ll be waiting downstairs.”

At first I didn’t feel my reaction. I left calmly, happy to be in my car driving on the empty Saturday morning streets. A few blocks from Diane’s apartment, however, my heart raced as I rehearsed replies, some angry, some earnest. But when I turned onto her street, I laughed. It was funny. We were having a fight, a married fight.

I stopped laughing.

We were having a fight over our identities, testing the limits of each other’s private selves. Just how deep did I want Diane to plant her flags in my life’s terrain? She didn’t know about Joseph’s rescuing me from the streets of Washington Heights. She didn’t know that he had spent his childhood in isolation, that he had no clue how to conduct a friendship. She didn’t know that Joseph himself belied his conviction that all of human character is merely a matter of how the chemistry was mixed at the instant of insemination. Joseph’s ideas were driven by the emotional need to prove his parents had no damaging effect on him. How could he blame them for anything after what they had suffered in Germany?

Diane knew none of this and, to be fair to her, how could she comprehend my behavior without the information? (I also wondered why I hadn’t told her. Did I resent that I owed Joseph anything? Did I want to maintain an illusion for Diane’s benefit that all the giving was on my side?) The most tangled knot for me was the self-consciousness of any exchange with her. I was sure Diane wouldn’t agree that, in spite of Joseph’s emotional need to believe environment had no impact on people, his ideas might still have a great deal of objective truth. Once I told Diane his history, she would probably feel affection for him and she would forever dismiss him intellectually. This weakness, a reductive view of human beings reinforced by her training, a need to feel in secret command of why people behaved as they do as a prerequisite for tolerance, was the dark side of her initial interest in psychology.

In the same vein, I believed she dismissed my fear of falling victim to what Joseph suffered from—seeing only those facts that confirm a comforting theory of life—as nothing more than a by-product of the traumas of my childhood. She knew of the passionate ideologies of my childhood and its results: my mother’s suicide, my estrangement from my father, Uncle’s alienation from everyone he loved, my nervous breakdown, my own attempt at self-murder. But those bald facts weren’t really all of it. Not even my mother’s incest (a secret from all but Susan Bracken and Diane), not even that would fully explain my attitude. The lurid events are too overpowering in themselves; in their glare, the effects on the real person cannot be seen. She would have to hear as complete an account as this to understand. And would she hear it? Or would she hear it as a psychologist? I didn’t want to be Diane’s patient.

Or did I? Did I need
her
as a woman or as a therapist? Did I want to be loved or understood? Were both possible? With Julie that was never a question. She was a part of my life despite her ignorance of all its facts. She understood without telling. She loved without questions and answers.

Of course I could push our relationship through this impasse. A single anecdote about Joseph’s mother would melt Diane’s objections to him; a recounting of how he saved me from my mother’s abandonment would silence and embarrass her. She would tolerate my investigation into his research as some sort of repayment and leave me alone. But that was a trick really, a manipulation. Did I want a relationship that I was managing?

These questions played in the background while Diane got in the car, kissed me with an open lingering mouth, settled in the seat and energetically reviewed aloud her notes from our first interview with the children we were about to see. Apparently the subject of Joseph was closed. Just as well, I thought. The mid-November day was cool, but a pale sun struggled to make us comfortable and implied that day might be our last chance to enjoy being outdoors before winter settled in. Entering the clinic, I longed to escape the office. Diane did too. She whispered, “I wish we were in Paris.”