Open City (31 page)

Following Cabrini a few hundred yards farther, to its farthest extent, would have brought me to Fort Tryon Park, in which was nestled, like a jewel in velvet, the Cloisters museum. I remembered my last visit to the museum, when I had come with my friend. We’d stood in the walled garden, which overlooks the Hudson. There was a large espaliered pear tree, shaped into a kind of green candelabrum against the stone wall, its branches, ramified like those on the Tree of Jesse, had been forced through the years by the attentions of gardeners into right angles and a single, two-dimensional plane. At my feet were the various herbs typical to a monastery plot—marjoram, parsley, marshmallow, garden sorrel, leek, red valerian, sage. They grew
freely, thriving so well that we talked about how wonderful it would be to have a kitchen garden identical to this one.

I remember how, on that day, I knelt down close to the herb plot and inhaled its thin fragrance. The plot contained soapwort and liverwort, herbs that had been given their names by the old wisdom of simpling, or sympathetic herbal medicine, a quasi-mystical art by which the medicinal properties of plants were related to their physical appearance. Liverwort was thought to be good for liver ailments because its leaves evoked the shapes of the lobes of the liver; lungwort, likewise, was good for breathing complaints because its leaf was shaped like a lung; and soapwort was valued for its dermatological uses. This is where the search for meaning had led our medieval ancestors: to the certainty that God, who made all of creation, had scattered clues to the useful functions of created things in those things, and that only a little vigilance was necessary to decode those clues. Simpling was but the most basic of this kind of learning; the search for Signs, as undertaken by the sixteenth-century German humanist Paracelsus, was a further extension of the same idea.

For Paracelsus, the light of nature functioned intuitively, but it was also sharpened by experience. Properly read, it informed us what the inner reality of a thing was by means of its form, so that the appearance of a man gave some valid reflection of the person he really was. The inner reality is, indeed, so profound that, for Paracelsus, it cannot help but be expressed in the external form. On the other hand, as in the case of artists, unless the work of art addressed the question of an inner life, its external Signs would be empty. And so, Paracelsus developed a fourfold theory around how the light of nature is manifest in individual men: through the limbs, through the head and face, through the form of the body as a whole, and through bearing, or the way a man carries himself.

We are familiar with this theory of Signs in the debased forms of phrenology, eugenics, and racism. However, this sensitivity to the
play between inner spirit and outer substance also underpinned the success of many of the artists of Paracelsus’s time, not least the wood sculptors of southern Germany. By showing an extreme attentiveness to the properties of wood, and to how those properties might be translated into sculptural character, they created enduring works of art, precisely of the kind that lined the rooms and halls of the Cloisters. Riemenschneider, Stoss, Leinberger, and Erhat brought a complicated material knowledge of lindenwood to bear on their carving of it, and their attempts to marry the spirit of the material with its visible form, craftlike though it is, is after all not so different from the diagnostic struggle that doctors are engaged in. This is particularly true in the case of those of us who are psychiatrists, who attempt to use external Signs as clues to internal realities, even when the relationship between the two is not at all clear. So modest is our success at this task that it is easy to believe our branch of medicine is as primitive now as was surgery in Paracelsus’s time.

On that day, with these thoughts of Signs and simpling in mind, I had tried to give my friend an account of my evolving view of psychiatric practice. I told him that I viewed each patient as a dark room, and that, going into that room, in a session with the patient, I considered it essential to be slow and deliberate. Doing no harm, the most ancient of medical tenets, was on my mind all the time. There is more light to work with in externally visible illnesses; the Signs are more forcefully expressed, and therefore harder to miss. For the troubles of the mind, diagnosis is a trickier art, because even the strongest symptoms are sometimes not visible. It is especially elusive because the source of our information about the mind is itself the mind, and the mind is able to deceive itself. As physicians, I said to my friend, we depend, to a much greater degree than is the case with nonmental conditions, on what the patient tells us. But what are we to do when the lens through which the symptoms are viewed is often, itself, symptomatic: the mind is opaque to itself, and it’s hard to tell where, precisely, these areas of opacity are. Ophthalmic science
describes an area at the back of the bulb of the eye, the optic disk, where the million or so ganglia of the optic nerve exit the eye. It is precisely there, where too many of the neurons associated with vision are clustered, that the vision goes dead. For so long, I recall explaining to my friend that day, I have felt that most of the work of psychiatrists in particular, and mental health professionals in general, was a blind spot so broad that it had taken over most of the eye. What we knew, I said to him, was so much less than what remained in darkness, and in this great limitation lay the appeal and frustration of the profession.

I
FOUND THE RIGHT BUILDING, AND
J
OHN SPOKE TO ME ON THE
intercom, and let me in. I took the elevator up to the twenty-ninth floor. He was at the door, wearing an apron. Come on in, he said, it’s nice to meet you in person finally. There were quite a few people there already. John was a hedge fund trader, quite wealthy already, to judge from the house, which was spacious and rather richly decorated with mid-century modern furniture, an assortment of kilim rugs, and a Fazioli grand piano. I estimated he was about fifteen years older than Moji was. There was something forced in his gregariousness, and the ruddy pink cheeks and salt and pepper goatee did not appeal to me. Moji came up to me, and we embraced. What’s with the bandage? she said. You’ve taken up boxing or what? I mumbled something about slipping on a threshold, but she had already gone into the kitchen. From there she called out, asking what I wanted to drink. I shouted an answer, unsure of what it was even before the echo of my voice faded, as my mind was still on how beautiful she looked, how desirable and, of course, unavailable.

B
Y ABOUT 2:00 A.M., MANY PEOPLE HAD LEFT, AND THE PARTY
quieted down. Someone replaced the electronic dance music that
had been playing on the stereo with a recording of Sarah Vaughan with strings. The dozen or so guests that remained were all sprawled on the sofas. A few were smoking cigars; the smell was pleasant, seductive, a baritone fragrance that evoked feelings of equanimity in me. One couple slept in each other’s arms, and a girl with heavy black eye shadow was curled up on the carpet near them. Moji and John were deep in conversation with an Italian physicist. He was from Turin. His wife, a woman from Cleveland, whom I had met earlier, was also a physicist. There had been something about both her delayed reaction in conversation and the slightly odd way she spoke that had made me wonder if she was deaf. Naturally, it wasn’t possible to ask, and I let the matter slide. I had spoken to her and her husband for a while. She’d been happy to get into a discussion about Italo Calvino and Primo Levi with me; he’d seemed bored and, on the pretext of going to refill his drink, had drifted away.

I stepped out onto the terrace, which I had been wanting to do all evening: the view was a marvel, as Moji had promised. It wrapped around the apartment on two sides and, from up there on the twenty-ninth floor, I could take in, in a single glance, the dwellings of millions. The way the tiny lights winked across the miles of air made me think of all the computers in all those homes, most of them sleeping now, with their single lights silently toggling between on and off. I was on my third glass of champagne. The day felt far away, and my spirit was soothed. There was, too, the pleasant sensation of flirting with Moji, not with any expectation, but for the pleasure of it. And I noticed, this time, less tension, less conflict, in my interaction with her. I was glad I had come.

The glass door clicked open behind me, and John came out onto the balcony. He also had a full champagne glass in his hand. His cheeks were flushed with drink. I complimented him on his generosity, and on his beautiful apartment. There was a row of bonsai trees, maybe a dozen plants in all, along the plate-glass window in the living room. They could not have been more different from ordinary
houseplants. Each bonsai tree, stocky, ancient, and gnarled, had been growing since before we were born, and each had within its trunk and roots the genetic secrets that would ensure that it would outlive us all. I had been admiring them earlier, I told him. He asked me if I had noticed the one tagged
Acer palmatum
. That little baby is a hundred and forty-five years old, he said. Some call it the Japanese maple, and it can grow, I don’t know, seventy feet, eighty feet. But this game is not about size now, is it? Did you notice how its leaves are like those of the marijuana plant? He chuckled. I was put off, but even he couldn’t spoil my mood.

A
FTER
I
LEFT
J
OHN’S PLACE
, I
STOPPED BY A DINER AT 181ST AND
Cabrini for a coffee. I drank it quickly, then walked farther down Cabrini to 179th, and negotiated my way around to the George Washington Bridge. I wanted to see, closer at hand, the sun rising over the Hudson. The city was still asleep. In the diner, I had seen one man with a tattoo that covered most of his arm resting his head on his knuckles. When I came out, I saw another man, Dominican or Puerto Rican, in a parked car, who was either asleep or staring blankly at the GPS device in front of him. The reflection of the sun turned half of the windshield into a bright metallic field. When I got on the pedestrian walkway on the Fort Lee–bound side of the bridge, I saw, ahead of me and on the other side of the median, a stalled, maroon-colored car. It was one of the large American models from the late eighties, possibly a Lincoln Town Car, and it had plowed into a guardrail. The accident must have happened not more than fifteen or twenty minutes before I got there; the fire truck and police cars were just arriving. They pulled up in silence, clustering along the length of the bridge; there was almost no traffic, and they hadn’t needed their sirens. I could see that both of the car’s front doors were open, and that the windows had been smashed. The front end of the car was crumpled, and there was glass on the road,
and blood as well, pooled on the pavement like an oil leak. I walked a few yards more, and could now see the car from the east.

On the concrete ledge near the car, with the rising sun gliding up the sky behind them, sat a couple. They were silent, bewildered, taking in the bad dream of a Saturday morning. From the distance, they looked Filipino, or perhaps Central American. As I walked onto the overpass, the firemen had just reached them, all business. The bright red of the fire truck was like a gash across the empty road. Where could all the blood near the car have come from? The man and woman both had leg injuries but didn’t seem to be bleeding profusely. It was surreal, as surreal, in my memory of it now, as anything I had ever seen. This vision of needless suffering colored what else I saw of the sunrise, the river, and the quiet morning roads in the hour that followed, when, coming down from the bridge, I walked down Fort Washington until it met 168th Street, at the medical campus, and from there walked on Broadway, through the littered, sleeping barrio, all the way down, through Harlem, then on to Amsterdam and Columbia University’s quiet campus. I saw my neighbor Seth—it had been months, I don’t think I had seen him once since he’d told me of his wife’s death—and I stopped to greet him. He was, with the building superintendent’s assistance, dragging the second of two large mattresses out to the front of the building. Have to buy new ones, he said. He appeared to be reading something on the surface of the mattress, which had been propped up against the front of the building. Then he turned around and, by way of explanation, said, These ones have been invaded by bedbugs.

Seth asked if I had seen any sign of them in my own apartment, and I said I hadn’t. But then I remembered that, before he left about two weeks earlier, my friend had mentioned trying to rid his place of them. His tenure application at Columbia had been unsuccessful, and he had left New York, bedbugs and all, for a teaching position at the University of Chicago. Much to my surprise, the new girlfriend, Lise-Anne, had gone with him. And it was at that particular
moment, speaking with Seth in the front of the infected mattresses, that I had an inkling of how acutely I would feel the absence of my friend.

E
ACH PERSON MUST, ON SOME LEVEL, TAKE HIMSELF AS THE CALIBRATION
point for normalcy, must assume that the room of his own mind is not, cannot be, entirely opaque to him. Perhaps this is what we mean by sanity: that, whatever our self-admitted eccentricities might be, we are not the villains of our own stories. In fact, it is quite the contrary: we play, and only play, the hero, and in the swirl of other people’s stories, insofar as those stories concern us at all, we are never less than heroic. Who, in the age of television, hasn’t stood in front of a mirror and imagined his life as a show that is already perhaps being watched by multitudes? Who has not, with this consideration in mind, brought something performative into his everyday life? We have the ability to do both good and evil, and more often than not, we choose the good. When we don’t, neither we nor our imagined audience is troubled, because we are able to articulate ourselves to ourselves, and because we have, through our other decisions, merited their sympathy. They are ready to believe the best about us, and not without good reason. From my point of view, thinking about the story of my life, even without claiming any especially heightend sense of ethics, I am satisfied that I have hewed close to the good.