Сэмуэль Шэм - Mount Misery

We hadn't seen all that much healing yet, but Malik had yet to steer us wrong, and besides we'd be damned if we'd follow Heller's orders, ever again. Not that it was easy. We were still having a bitch of a lime moving out Zoe and Thorny, who were reconstituting from cruelty slowly, in fits and starts, and Mary Megan Scorato, still acutely suicidal, and of course Mr. K., who, thanks to the buoyant surgeons, was always sinking just that one little frontal lobe shy of discharge.

MARY MEGAN SCORATO was being presented by Hannah to Heiler at the final Case Conference of our Emerson rotation. It was mid-November, and in a week the three of us would be

leaving Emerson, for various other rotations in Misery: I would be going to Toshiba, the Admissions Unit; Henry to Thoreau, the Freudian Family Unit; and Hannah to Heidelberg West, Psychopharmacology. Now, sitting beside each other in the conference room, Henry and I were reading a memo each of us had gotten that morning from Lloyal von Nott:

Misery Capital Campaign Luncheons

Mount Misery is embarking on a capital campaign. Each of you will have a luncheon with Dr. Lloyal von Nott to identify any of your patients who are potential donors. You will not be asked to solicit your own patients for monies. Rest assured the contacts will be made by us.

"Give them the names of our rich patients?" I said. "Isn't that unethical?"

"So what else is new?" Henry answered.

Into the garbage.

I had been on call the night before, and at some ungodly hour I'd been called to see Mary Megan Scorato. In a panic about Heiler conferencing her the next morning, she was having fantasies about hanging herself. Staring at her, at the bags under her eyes almost as black as her grandmotherly sweater, watching a vestigial Placedon twitch slither across her cheek like a dun recollection of her beloved therapist Lee White, I sensed how deep her depression was and how far she'd fallen since Heiler's reign of terror had begun. I liked her immensely, and felt immensely sad. I wanted to help her.

"What's your worst fear about tomorrow's conference?" I asked. She sat quietly, wringing her hands, and did not answer. "Are you worried that Dr. Heiler will be nasty to you again in public?"

"No, I know from Dr. Hannah Silver that he's just trying to do the best for me."

"What, then?"

'That Dr. Heiler will discharge me."

"If there's one thing you can count on," I had said, patting her hand, "it's that he won't discharge you. You've still got plenty of time left on your insurance." This had comforted her. She thanked me as I left.

Now, we sat in the jammed conference room as Hannah presented the case. Mary Megan was brought in- Heiler took a tack I'd never seen him use before:

"Why are you still here?"

"I… I don't know."

"You've been here over four months, for a simple depression. Why?"

"I'm not feeling better. I'm thinking of killing myself."

"I doubt that. How do I know you're not just manipulating me?"

"I've never manipulated anyone. I don't want to live. I want

to die."

"Sounds like manipulation to me." They went on like this, Heiler accusing Mary of manipulation, which made her try harder to convince him that she really did want to kill herself. Finally he said, "I'm discharging you tomorrow."

Silence, one of, What? Before Her Insurance Runs Out? "Please," Mary Megan said, "please don't. I'm not ready. Hannah, please don't let them do this. It is wrong, and I'm afraid. Hannah, please?"

Hannah, shaken, said, "Oh Mary, I'm really sor-" but then she glanced at Heiler, and, a good soldier, went on, "Dr. Heiler is in charge. I'll continue with you as an outpatient, when I get back from my vacation next week." "No!" Mary Megan shouted.

"Now, now," Heiler said. "Now, now. It'll do your SELF-confidence a world of good to get out of here. I'll write the order myself. Right now. Good-bye."

Crushed, Mary Megan was escorted from the room. Solini and I couldn't believe what had just happened. "But she still has insurance!" I said. "Nope. Yesterday her HMO changed the protocol. Payment

ran out today."

"And you're not gonna go to bat for her?" Henry asked.

"When she's actively suicidal?" I chimed in.

"Suicidal, hell. Manipulative. Think / don't know when a borderline is manipulating mel Read my article: "Thirteen Ways of Looking at a Borderline.' " Heiler kicked out over to the nursing station and wrote the order himself.

An hour later, with many hugs and kisses and best wishes and tears, all of us Emersonians said good-bye to Mary Megan

Scorato. In her eyes was terror. I unlocked the door and helped carry her suitcases downstairs. Her husband Joey and six-year-old Down syndrome son Tommy-in that shortened face, those epicanthal-fold eyes streaming tears of joy-helped her to the aging Isuzu whose defective roof rack had started her trip into Misery. Waving bravely, she left.

Heiler flew off for his week conferencing in the rain forest near Kuala Lumpur, where Krotkey's status had been upgraded from a "maybe not" to a "maybe." Hannah flew off for a week in Sun City, Florida, with her Holocaust survivor parents.

Solini and I, appalled and enraged, went into high gear, discharging as many of the healthier Emersonians as possible before Blair returned. Our mission was to leave as few patients as possible at Heiler's mercy after we were gone from Emerson.

By now we'd learned a great deal about how to discharge people, how to prepare them for the terrors of freedom- learned just how pragmatic an art psychiatry was-how getting someone back to the "real" world was not a matter of THEORY or TECHNIQUE or SELF or OBJECT but of the nuts and bolts of where will they live and how will they eat and what will they do all day long and who will they have for support to keep them from the killer isolation and thoughtless savagery that we have numbly come to call "civilization." Malik's LAMBS network was a blessing, and by the end of the week we had discharged almost half the Emersonians, each hooked up with a buddy.

Our greatest coup was Zoe and Thorny. Having been on Emerson so long, they were stuck tight to it. They were too opened up, too human for "normal" life: too kind to fight through traffic, too compassionate to pass a panhandler by, too believing around salesmen, not to mention religions. Their day passes into "normalcy" had made them realize how unprac-ticed they now were in the cruelties of daily life. Henry and I had tried everything to pry them loose. No luck. Finally I saw that to leave Mother Misery felt, for each of them, just too damn lonely.

"Henry, I've got it. Thorny and Zoe as buddies."

"Cool. Let's ask 'em."

We did. Sitting on the half-deserted ward, we watched as

they turned their radars on each other, sizing each other up as potential buddies. We saw them suddenly see each other as sex OBJECTS, what Heiler had labeled the TET (Total Erotic Transference) in each of them sizzling, like meat on adjoining barbecues. Having sizzled, it quickly fizzled. Zoe said:

"I'll room with you but I won't fuck you."

"Dickheads Off the Hook!"

"If you promise to protect me from other men," Zoe said, 'Til try it."

"And I'll try it," Thorny said, "if you promise to protect me from other men too. And help keep me away from dogs and cough syrup?"

"And you've both got to find work," I said, "either for pay or volunteer."

They agreed. The deal done, they got on the phone to find an apartment.

The two of them walked out triumphantly the next morning, to cheers from us all. Henry and I called them that night at Misery Garden Apartments. Behind their dead-bolted door and barred windows, they were eating pizza and watching Star Trek reruns. When I asked Thorny how it was going, he said:

"Dickheads Make Great Americans!"