Сэмуэль Шэм - Mount Misery

Disarmed, I thanked him and asked, "Where do you hold your rounds?"

"In my office, right here on the ward," he said good-naturedly.

"You want me to bring the patients in there?"

"Only if there's a problem with insurance, Roy. I spend most of my time on the phone to the bastards in managed care, trying to give these borderlines as much time as they need as inpatients here. It's dirty work, but someone's got to do it. Later. Got some empty beds to take care of."

I was confused. This guy didn't match the guy Malik had described.

Later that morning Blair held his weekly Case Conference for the staff and residents of all three floors of Emerson. I volunteered to present Zoe, my rich young college student, to him. The conference room was packed. I took a seat in front of the crowd, to present the case, suddenly nervous. Hannah and Solini sat in the front row. Hannah smiled and Henry raised a clenched fist for support.

Heiler entered and sat facing me. Sound evaporated from the hot room, leaving that distilled, tight stillness you feel before a show begins. I presented Zoe's story, telling about her privileged Brahmin family, her sense of failure, her seeking out inappropriate men as lovers, her history of bulimia, her struggle at college and recent rejection, depression, and suicidal thoughts.

"She's done well in therapy," I said. "She's gained weight, plays sports, and she's just about ready for discharge. The treatment plan-"

"First comes diagnosis," Heiler said, "then comes treatment. Diagnosis?"

"Depression," I said, "reactive, to the loss of the man in her life."

"Great. Bring her in."

Stunned by the size of the crowd, Zoe flinched, and stumbled on the Oriental rug, murmuring, "I'm sorry-I'm so clumsy." She bent and turned down the up-flapped edge. Clearly, her self-esteem was rock-bottom. While she'd made an effort to dress up-crisp white sleeveless blouse and pressed jeans, lipstick and eye shadow-it was obvious from her scared look, tightly pressed lips, and clenched hands pressed thumb edge to thumb edge as if in a kind of petrified prayer, that she was feeling depressed and vulnerable.

Heiler rose, introduced himself, and then, smiling, flashing those gorgeous eyes, took her hand gently, as if he were about to raise it to his lips and kiss it. Seductive. Then he sat down and leaned back in his chair with hand to cheek and legs elegantly crossed. His loafers were dainty, pointy-toed, buffed a buttery dark. He flicked a blond lock and gestured to Zoe to start.

She blushed. "I didn't expect so many people here."

"You feel angry about that?" Heiler asked, his voice low, even husky.

"No, just a little surprised."

"Dr. Basch didn't tell your

"He probably didn't know."

"You look angry," Heiler said, his tone sharper.

"No, really, I'm not," Zoe replied.

"If it were me, I would be angry," Blair said indignantly, "damn angry, being put on the spot in front of all these people." Zoe glanced at me, puzzled. I smiled, to encourage her. Heiler gestured toward me. "You angry at your therapist?"

"No, I like my therapist. He's nice."

"Nice?" Blair said incredulously, as if she'd said that I was in fact not nice but a homicidal maniac. Sitting up in his chair, screwing up his face in distaste, he mocked her, "Nice?"

Zoe stared down at her lap, her face flushed. Tears eased out from her lowered lids, onto her cheeks. I couldn't believe this was happening.

"Anything that makes you uncomfortable," Blair said, again in his seductive, reassuring tone, "you don't have to answer, 'kay?" Zoe nodded. "Good. So tell me, Zoe," he went on, as if they were once again best friends, "what would you like to do with your life?"

Zoe hesitated, and then, with embarrassment, through her tears said, "After college, I'd like to become a… a social worker."

"A social worker?" Blair said, as if this were incredible.

"I don't want to talk about it."

"Why not?"

"It seems pretty pretentious, right now, being in a mental institution, saying I want to become a social worker."

'Tell us about wanting to become a-" He paused, and then, with obvious loathing, went on."-a social worker."

"You said I didn't have to answer anything that makes me uncomfortable."

With a sardonic smile, Blair said, "Wanting to become a social worker?"

It went on like that, Heiler assaulting, Zoe withdrawing, like a turtle withdrawing into a shell, and the shell being ripped off, polygon by polygon, exposing the pink flesh. I felt terrible for her, and furious at him, and thought several times I should jump up and stop him. In other situations, seeing this kind of public cruelty, I would have. And yet now I-and the others-seemed paralyzed. Starting to weep, Zoe talked about her depressions and her trying to kill herself. Heiler, who didn't seem too interested in these depressions and these try-ings, interrupted her:

"What's wrong with you? Why haven't you gotten better?"

"Dr. Basch says I am better."

"Isn't it possible that your idealization of Dr. Basch is a denial of your primitive rage at your bad-object mother and your hatred of men?"

What the hell does that mean? I wondered.

"What does that mean?" Zoe asked.

"You've been here several weeks! Why are you still so sick?"

"I don't know."

"C'mon, c'mon-you must've thought about it. Why?" Zoe said nothing. "Why?" Blair shouted, so harshly that I jumped "Why?"

"Don't know! Leave me alone." Like a child, she pleaded, "Please?"

Heiler paused. With frank contempt he said, "A social worker, eh?"

"Asshole!" Zoe screamed, and jumped up and ran out, slamming the door so hard my teeth seemed to rattle. Stunned, I watched as Heiler turned to us, smiled, spread his arms wide, palms open in that kind of grand gesture that the star of the show uses at the last curtain call, and said, once again back into that charming, friendly, boy-next-doorish voice, "So, guys, what do you think? A seven?"

A few nervous chuckles. Not to chuckle seemed a definite risk-if you didn't side with this madman, you too might get attacked.

"I'm toying with the idea of another Krotkey Factor, Number Fourteen: TDS, The Door Slam. Independent observers could rate it on a scale of one to ten. I bet it would predict the diagnosis, and correlate with severity and prognosis."

The hairs on the back of my neck tingled: Surely he didn't think that this obviously depressed woman was a borderline?

"What diagnosis, Dr. Heiler?" a BMS student asked innocently. He was a frail, sickly looking boy, and seemed to be wheezing.

"Borderline. DSM 301.83. Textbook case. I was working on Krotkey Factor Number One: LNT-Latent Negative Transference. Let me explain."

Solini squeezed my knee in horror. In a cheerful, good-natured tone, Heiler explained that his technique, "confrontation," had evoked the anger that was "latent," or hidden, in each and every borderline. "She wasn't angry at me" he said, "it was her transference to me. She was distorting her real relationship with me based on early infantile experiences, with her bad mom, in the first year of hie."

"But she was angry at you," I said. "Anyone would be."

"Not that angry," he said, "not borderline angry."

"How do you know she's a borderline?"

"Because of that incredible anger."

"But she didn't start out angry-you provoked it."

"Who says?"

"/ do. It was obvi-"

"You? You, who've been a psychiatrist two whole months? You don't know diddly-squat about treating borderlines. Your so-called 'concern' is going to be a real problem-you're

already overinvolved, imagining that you can rescue her. To you, what I did seemed cruel, right?"

"It was cruel, it was vicious, and I won't-" "My friend, you'll get used to it. We all start out oversensitive. These darn borderlines make us oversensitive, make us feel sorry for 'em. Beginners like you always get drawn in- overconcerned, trying to rescue them-these gals are seductive. The things they get us to do for 'em-give 'em meds, find 'em places to live, even loan 'em money! This one-Zoe- she's the kind who'll even show up at your home] You unlisted?" I shook my head no. He shook his head too, as in You poor bastard. "Seduce the pants off us, given half a chance. Incredible talent they have, to somehow pick up your weakness and go for it-like they have a special radar or something." He shook his head in a kind of humble admiration and dismay, a dismay over male helplessness in the face of a female sexual expertise that would make Cleopatra look like Mother Teresa. "But hey-armed with the theory, it gets a lot easier."