Сэмуэль Шэм - Mount Misery

cover more. Any questions?" It looked like George had a lot of questions, but before he could start, Nash was saying, "Thank you very much Dr. Basch will do your physical and have a pleasant stay in Misery," and was gone. Jennifer and I followed.

"Four minutes," he said, back in the boardroom. "Have a nice day." He left.

Jennifer remained. I sensed in her face a kind of contempt for what we had just seen, and I asked, "It seemed incredibly cold, didn't it?"

A pained look came across her face. I felt that I might just have an ally here. She walked silkily around the rosewood table to the thermostat.

"It's sixty-nine, precisely." She rushed out after Nash.

I was appalled. This technique was the classic "medical model" I'd learned in the House of God. Starting with a live human being, you asked a lot of quick questions to funnel the human down into a diagnosis and a treatment. You cut off conversation, for talk meant less time for sleep. Malik had shown me that being a shrink was doing the opposite: turning the funnel upside down, opening things up in order to connect. It was delicate, meticulous, intuitive work, and I finally had a sense that I was learning how to do it, and now- Viv's voice burst out of my beeper:

"Number One's ready for a physical, Cowboy, and Numbers Two, Three, Four, and Five are waiting, and Number Six is the Lady Who Eats Metal Objects and she ate her hairdresser 's wedding ring and is on the way in too so don't think, honeypot, decide."

I did the physical on George the bumblefuck driver. When I asked him if the scars across his chest where he'd cut himself with glass were attempts at killing himself, he refused to open up to me again and said only:

"Y'know, I really liked that guy, Doc Michaels. A real pro. Got straight to the point. Guy like you could learn a lot from him, y'know?"

When I went to do George's write-up I found it already done, laser-printed and in the chart. Nash had given the computer the Yeses and Noes, and the computer had given back a terrific Admission Note, in the medical model that made poor George's catastrophe look as bloodless and manageable as any

medical illness-though he'd missed the glass-mutilation question suicide gesture, which I wrote in by hand.

"I'M BRAIN-DAMAGED BUT I don't think so," was the Chief Complaint of Number 2, a twenty-two-year-old woman whose heart-wrenching story included being hit over the head with a pipe after being raped in the parking lot of Misery Mall. I did what I thought was a terrific interview, but it took until noon and Nash was on my back to hurry up. As I escorted Number 2 through the lobby waiting room, I was accosted by Numbers 4 and 5 and their families-the "angle of the dangle" man was Number 4-as well as Number 6, The Lady Who Ate Metal Objects, who, when she recognized me, started screaming, "Your watch! Hey big boy, gimme your watch!" Primo Jones was standing next to a man dressed as a woman holding two grapefruits for boobs. This was Number 5.

"Thanksgiving's comin', Doc, and the turkeys are gath-erin', y'get me?"

I typed poor Hit Over the Head with a Pipe Number 2 into the Toshiba and it climbed Decision Tree out to the limb called "Organic Mental Disorders Arising in the Senium and Prese-nium 290.13." This seemed too cold, given what I'd felt with her, and too damning, labeling her forever as "brain-damaged" when in fact her organic sequelae were minimal and she was reacting normally to a terrible trauma. I tapped in, for diagnosis, "Depression, appropriate." I listed no DSM code.

By the time I got to Number 3 it was way past lunchtime and I'd had no time for lunch. I was so overwhelmed with work that I decided I would try to do the Number 3 interview the Toshiba way-strictly multiple-choice medical model- but Number 3 was just about the saddest story in the world, an imploded fourteen-year-old boy who'd tried to hang himself in his mother's walk-in closet.

Interviewing him and his parents-parents who seemed decent, concerned, caring, and mystified, and who'd done everything right as far as I could tell-I was drawn in, thinking of my own parents and of my too being a mystery to them. But at a particularly delicate point in the interview Viv paged me stat to the waiting room where Number 5, the Grapefruits Man, and Number 6, the Metal Lady, were rolling

on the floor fighting. I told Primo to bring the Grapefruits Man into the other interview room and I'd be there in a minute.

When I went back to the boy who'd tried to hang himself, it was strange: he and his parents were still where I'd left them-opened up, ready to try to understand-but I was not. Frazzled and pressured, my mind elsewhere and my heart closed down, try as I might I could not get back to where I was, and things were going badly. Viv paged me that my patient Zoe was wondering why I hadn't shown up for her appointment. I realized I'd completely forgotten it. I cut to the physical with the poor suicidal kid and locked him up in Toshiba and went to see the Man with the Grapefruits.

The Lady Who Ate Metal Objects, Number 6, took me until late afternoon. I was exhausted. There were at least four more patients to go. How was I going to make it through the day?

I shifted my mind-set, away from the hard, subtle work of being human with patients, to distance, diagnosis, and treatment. Don't think, decide.

Sweet relief. Admitting Number 7, a gay man, hearing his plaintive question to me-"Do you know what it's like when you're a kid and every other boy is out playing baseball and you're in the basement playing Cleopatra?" — I smiled, ran the symptom checklist for depression, and hit 296.20, Major Depressive Disorder, Single Episode. With Number 8, a woman who kept saying, "This life is a test. It is only a test. If it were a real life you would have been given instructions on where to go and what to do"-I cut things short, sealing her up in 295.40, Schizophreniform Disorder. And when Number 9, a Heiler Anorgasmic Dissociative, started screaming at me, "You fucking doctors don't know what this fucking Prozac you give us does!" — I hardly flinched as the future of psychiatry in my lap popped out "300.15 Dissociative Disorder."

With the burden of trying to help lifted, I cruised, filling in the blanks of the medical model, doing the physicals, tapping into the toy Toshiba, hitting "print," snapping the Admission Note into the three-ring binder.

Number 10 was a 44 y.o. rural rabbi of the Reform movement with a Chief Complaint of "I'm gayogenic and I'm abusing suckinols." "Gayogenic?"

"I turn women gay. A year ago my wife left me for a woman, a few months ago my female cantor left the temple for a woman, and just after Succoth the head of my temple's Haddassah made aliyah to Israel with my cousin's wife. My faith in God is shaken. How could God do this to me?"

"Good question and shalom," I said, locking him up. I sat with my cute little Toshiba Satellite Pro, with 90MHz modular Quad-Speed CD-ROM and 810-million-byte hard drive, watching admiringly as it did 305.41, Barbiturate Abuse (Sec-onal) in living color, and thinking, Hey this is almost fun.

"Fun, eh kid?" said a familiar voice.

"Malik?" He was in a blue and white sweatshirt emblazoned with a line of Hebrew, translated as "It's Better in Israel," and twirling a basketball in his hands. With him was Henry Solini, in baggy gym shorts, red, green, and black Marley T-shirt, and rainbow-colored wool Rasta cap.

"Let's play some hoop\" Malik shouted. He was eating a carrot.

"When'd you get back?"

"Yesterday. We do Thanksgiving in Chicago. My family. I need Chicago, after a month in the Promised Land with Bronia. I got the gym for an hour."

"Don't have time."

"C'mon c'mon-you can't make any real contact with these patients, there's no time, right? Don't get involved. C'mon out 'n' play with Henry V me."