Psychology and Other Stories (24 page)

But Dr. Ngi had stopped listening. He wrote in his careful hand, visualizing the correct spelling of each word before putting it down, and avoiding all those troublesome pronouns:
Greatly agitated. Flights of fancy. Loose associations. Logorrhea.

Two weeks earlier, in the weekly team meeting which Dr. Ngi himself had initiated, Dr. Alban and Dr. Niederwaldt had criticized him, in front of everyone, for mistaking an “obvious case” of manic depression for schizophrenia. Well, they would find no fault with his diagnosis this time; here was a textbook case. With defiant pride he wrote out the words:
Schizophrenia, with paranoiac features.
Then,
while the patient talked on, he filled out a chit for thirty days of insulin shock therapy, to be repeated in forty-five days if necessary.

The sheep-dip baroness allowed herself to be talked into selling to Singular Soda Crackers a token ten thousand barrels of sheep dip— which Douglas Singleton, who did not know what to do with them, did not insist be delivered.

Germaine Singleton, on visiting day several weeks later, was delighted to see how calm and quiet Jerome had become. Though she was somewhat discomfited by the bars on the windows and confused by the youth of some of the guests, she liked that the doctors here were mostly foreigners and that the nurses were mostly fat, ugly, ill-bred, and discourteous. The thought of dying badly in a place like this gave her an anticipatory thrill of spite.

Years later, when her father finally passed away, Katherine Osbret, née Singleton, surprised herself by weeping at the funeral.

Everyone was surprised by the will—by just how much he had left behind.

Very few of us go through life, or even through one day, on an even emotional keel. No one of artistic temperament ever does; and the closer the individual of artistic temperament approximates genius, the surer he is to display waves of exaltation and depression which can scarcely be distinguished from manic depressive insanity.

Joseph Collins, M.D.

A HUNDRED YEARS AGO
,
in May, 1884, Freud received his first shipment of cocaine from the Danish pharmaceutical company Merck. He was then twenty-eight, and hoping to make a name for himself—or at least enough money to permit him to marry his fiancée.
The Interpretation of Dreams
was still fifteen years away. The coke was frightfully expensive.

He started by taking a twentieth of a gram, presumably by mouth. It made him feel good—or rather, it made him feel normal:

The psychic effect of
cocainum muriaticum
in doses of 0.05 - 0.10g consists of exhilaration and lasting euphoria, which does not differ in any way from the normal euphoria of a healthy person. One feels more vigorous and more capable of work; on the other hand, if one works, one misses that heightening of the mental powers which alcohol, tea, or coffee induce. One is simply normal, and soon finds it difficult to believe that one is under the influence of any drug at all. This gives the impression that the mood induced by coca is due not so much to direct stimulation as to the disappearance of elements which cause depression. One may perhaps assume that the euphoria resulting from good health is also nothing more than the normal condition of a well-nourished cerebral cortex which is “not conscious” of the organs of the body to which it belongs.

Freud had high hopes for cocaine. It relieved hunger, so he thought it might work as an anti-nauseant. His sister, in fact, had
found it useful in dispelling seasickness. One researcher had found it effective in forestalling asthma attacks. It might have some application in the treatment of diabetes. In America there were numerous reported cases of using it to ease the withdrawal pains of morphine addiction. And, of course, it made people feel good. As Freud pointed out, there was no shortage of tranquilizers capable of calming frazzled nerves, but as yet nothing one could prescribe to “increase the reduced functioning of the nerve centers.” Perhaps here was a potential cure for melancholia—that is, for depression.

But Freud's hopes were never quite fulfilled. The fame that should have been his was snatched away by a colleague, Carl Köller, who discovered the potential of using cocaine as a local anesthetic in eye operations. This application, in fact, soon came to be recognized as nearly the only legitimate use of an unpredictable and often dangerous drug. Within a year, reports of addiction and toxic side effects had begun to appear in the medical literature. Freud, whose name was associated with the drug thanks to his popularizing articles, was denounced for having unleashed “the third scourge of humanity,” after alcohol and morphine. (In fact, one of his own good friends, Ernst Fleischl, who had, in the course of treating a phantom pain in his amputated thumb, become addicted to morphine, subsequently became, in the course of being treated for morphine addiction by Freud, addicted to cocaine.)

Freud defended himself, somewhat belatedly, in 1887 by saying that no one without an innate weakness was susceptible to “cocainism”; that is, no normal, healthy person could possibly succumb to addiction. He also blamed the needle: by mouth cocaine was harmless, under the skin sometimes dangerous.

This last argument, however, was a bald contradiction of what he'd written in an earlier paper. In 1885 he'd gone out of his way to reassure those harboring “unjustified fears” that “even
subcutaneous injections—such as I have used with success in cases of long-standing sciatica—are quite harmless. I have no hesitation in recommending the administration of cocaine for withdrawal cures in subcutaneous injections of 0.03 - 0.05g per dose, without any fear of increasing the dose.” But two years later, he considered it “advisable to abandon so far as possible subcutaneous injection of cocaine in the treatment of internal and nervous disorders.” He further covered his tracks by removing from his list of published works the incriminating 1885 article. And even
fifteen
years later, in
The Interpretation of Dreams
, he was still absolving himself: “These injections in the dream reminded me once more of my unfortunate friend who had poisoned himself with cocaine. I had advised him to use the drug internally only, while morphia was being withdrawn; but he had at once given himself cocaine
injections
.” Apparently Freud's conscience wasn't quite clear; no wonder he was having troubling dreams.

But in 1887, three years after he had first experimented with cocaine, three years after he had written his first “song of praise to this magical substance,” maybe Freud hoped no one would catch the change of heart; maybe he wasn't aware of it himself. His enthusiasm, in any case, had suffered a blow; his interest began to flag. With this last, limp attempt at saving face, Freud put the whole mess behind him. “The Cocaine Episode,” as his biographer Ernest Jones disparagingly called it, was at an end.

The problem with this story, thought Devon, as he stood up and rubbed his hands together in the cold garage, was that Freud was again—or still—using cocaine as late as 1895. He admitted as much quite guilelessly in
The Interpretation of Dreams
, where he submitted one of his own dreams to analysis:

What I saw in her throat: a white patch and turbinal bones with scabs on them.
The scabs on the turbinal bones recalled a worry about my own state of health. I was making frequent use of cocaine at that time to reduce some troublesome nasal swellings, and I had heard a few days earlier that one of my women patients who had followed my example had developed an extensive necrosis of the nasal mucous membrane. I had been the first to recommend the use of cocaine, in 1885, [
sic
] and this recommendation had brought serious reproaches down on me. The misuse of that drug had hastened the death of a dear friend of mine. This had been before 1895, i.e., the date of the dream.

Or was this guileless? To what exactly was Freud admitting? The “at that time” seemed to imply that the “frequent use” was, at the time of writing, a thing of the past; in other words, sometime between 1895 and 1898 or 1899, when he wrote the book and analyzed the old dream, he had given up the habit. And the phrase “to reduce some troublesome nasal swellings” suggested that his use of the drug had had, at least in his opinion, a clinical justification. But did this particular method of application preclude all others? Was he, through this limited confession, implicitly denying that he had used it in any other way, or for any other reason?

And he was worried about his state of health. It could not have been the nasal swellings themselves that worried him so much as the possible side effects of their
treatment.
He must have been afraid that he, too, like the patient who had “followed his example,” was going to end up with an “extensive necrosis of the nasal mucous membrane”—in other words, a dead, blown-out nose.

But this didn't prove much more than that in 1895 he had begun to worry that putting the stuff up his nose might not be good for him in the long run. This bad dream might only have persuaded him to
go back to taking the drug by mouth. Or it might not have changed anything at all. The only word that Devon had on the matter was, of course, Freud's. And Freud did not always tell the strict truth—as he'd first demonstrated in 1887, then again in another passage from
The Interpretation of Dreams
:

Injections of that sort ought not to be made so thoughtlessly.
This sentence in the dream reminded me once more of my dead friend who had so hastily resorted to cocaine injections. As I have said, I had never contemplated the drug being given by injection.

Devon went into the house, moving almost on tiptoe. He looked at his digital watch: it was 10:56. For a moment he could not make these numbers mean anything; he wasn't even sure if it was morning or night. Then, gradually, the bricks of his life fell back into place around him. Barb was on the phones tonight, and Devon was home alone with Clyde. He crept on stiff legs past Clyde's open bedroom door but did not look into the darkened room, the only dark room allowed in the house. He closed the bathroom door softly behind him. He held his breath, thinking he had heard Clyde's voice. When no sound came, he went to the medicine cabinet and looked in the mirror.

Which was it:
still
or
again
? Did Freud use cocaine regularly for ten years, or did he at some point quit, then resume the habit? But even this by no means exhausted the possibilities. What was really meant by “regularly,” after all, or “habit,” or, for that matter, “quit”? How often had Freud taken cocaine? Once a week? Once a month? Three times a day? How much did his use vary over the years? How many times did he “quit”? Once? Once a week?

His mind was off again, racing pleasurably.

There was, unfortunately, very little concrete evidence to go on. During his engagement, which lasted four years, Freud wrote to his fiancée, Martha, almost daily. Aside from the published articles, these letters seemed to be the main source of information about Freud's cocaine use—indeed, about much of his private or inner life at all; but even today, a hundred years after they had been written, most of them remained unpublished. Jones, in researching his sycophantic
The Life and Work of Sigmund Freud
, had been given complete access to the letters; a few years later Freud's own son had edited a sparse, one-volume selection of them, which, not surprisingly (they spanned something like fifty years, and Freud had been a prolific letter-writer) featured some sizeable gaps: like the maddening
three-year
gap between letters 107 and 108, dated July 13, 1891 and June 7, 1894. Between what Jones had chosen to reveal and what Ernst Freud had permitted to see the light of day, Devon could glean very little that was definite. It was like connecting the dots, but the spaces between the dots were astronomical.

The first mention of cocaine appeared in a letter to Martha dated April 21, 1884, when Freud was still awaiting his first shipment:

I am toying now with a project and a hope which I will tell you about; perhaps nothing will come of this, either. It is a therapeutic experiment. I have been reading about cocaine, the effective ingredient of coca leaves, which some Indian tribes chew in order to make themselves resistant to privation and fatigue. A German has tested this stuff on soldiers and reported that it has really rendered them strong and capable of endurance. I have now ordered some of it and for obvious reasons am going to try it out on cases of heart disease, then on nervous exhaustion, particularly in the awful condition following withdrawal of morphine (as in the case of Dr. Fleischl). There may be any number of other people experimenting on it already; perhaps it won't work. But
I am certainly going to try it and, as you know, if one tries something often enough and goes on wanting it, one day it may succeed. We need no more than one stroke of luck of this kind to consider setting up house.

Unfortunately, the very next letter in the
Letters of Sigmund Freud
was dated more than a month later—May 29—and contained no mention of his cocaine studies. The entire month of May, when he had actually begun to experiment with the drug, was missing.

The next reference to cocaine appeared only in June, when Freud assured Martha, whom he was about to visit, that he wouldn't be tired, “because I shall be travelling under the influence of coca, in order to curb my terrible impatience.”