Rafael Yglesias - Dr. Neruda's Cure for Evil

“Nothing to be sorry for,” I said.

“Did you sleep well?” she asked.

I told her, probably with a little manic excitement, that I had been up most of the night reading and I felt exhilarated.

“You don’t mean you agree with him?” she asked.

I tried to explain that I didn’t think agreement or disagreement with Joseph was the point. I know I concluded with pomposity. “What’s important is the truth,” I said.

Diane grunted. “Well, I certainly wouldn’t want to stand in the way of the truth.”

I was irritated. Diane is an excellent practical therapist: no one could be more dedicated and few of greater help to their patients than she. On the theoretical level, however, she lacks curiosity or broad-mindedness. Her bias is for what has evolved out of Freudian-based talking therapy, what I practiced in my first go-round with Gene, namely the therapist replacing bad parenting with good parenting, providing some insight and a lot of warmth and encouragement. In graduate school, once Diane had her “faith”—as is all too often the case with psychologists — she read opposing philosophies or techniques only to refute them.

“Somewhere out there is an answer, you know,” I said grumpily. “And if it can be found a lot of people’s lives will be better.”

She didn’t reply at first. I heard her bed sheets rustle. I could imagine her shifting to sit up, raising her navy blue blanket to cover her breasts. “She’s lovely,” Aunt Sadie commented to me after I introduced Diane. “She looks like your grandmother when she was young.” Sadie meant my mother’s mother. I was amused — and sufficiently appalled — to check an old black and white photo of Nana to reassure myself that the similarities were superficial. That Diane was a product of a long line of strong Jewish women was undeniable, however, and in that sense my feelings for her were incestuous. “I love that you’re tall,” she whispered one morning, legs drawn up, curled into a ball, cuddling against me as I stretched out to the limits of her bed. Had my mother once said the same words to Francisco? I pictured Diane: warm and trusting in my arms. Be careful, I thought, you don’t want to become a stranger to her intimacies. She sighed. “Look, Rafe, who are you kidding? You’ll be the last shrink on earth to say to your patients, ‘Take two Prozac and call me in the morning.’”

“Of course.”

There was another silence. She sipped something, probably coffee from the big white cup she had bought in Paris on our trip, to remind her of our room service breakfasts, especially their delicious, strong coffee.

“Can I say something?” she asked.

“Sure.”

“Your friend Joseph is jealous of you.”

I laughed — couldn’t stop myself in time.

“I’m serious,” she complained. “He’s not only jealous of you. He’s in love with you.”

I glanced at the clock. Although it was Saturday, we had a series of sessions scheduled, beginning in an hour and a half, with three children housed in temporary shelters. The family and juvenile courts had appointed us to evaluate them. The weekend, unfortunately, was the only time Diane and I could fit them in. One was severely battered by a stepfather; another, a seven-year-old girl who had been raped and sodomized by her thirteen-year-old uncle; and the last was the abusive adolescent uncle, Albert, himself a victim in early childhood of his mother’s sadistic and incestuous behavior. (She would force Albert to perform cunnilingus and, after orgasm, burn him with cigarettes or whip him with an electric cord. Being subjected as a child to a combination of sex and violence, by the way, seems to be the background profile of serial killers. With Albert, especially, the implications of the kindling studies might be particularly meaningful.) Surely Diane understood that too much was at stake for me to care if Joseph’s motives were impure. Albert, the nascent serial killer, had been put on Ritalin for attention deficit disorder by the state hospital. The psychiatrist who ordered the medication had decided that a thirteen-year-old African-American, living in the South Bronx, who had never known a father, whose mother was a crack addict, who, from the age of five, had been used for sex and physically tortured by his mother, was suffering from a chemical imbalance rather than from his life. Ritalin is a much less specific drug than Prozac or other drugs Joseph was then developing. He had conceded publicly (as have most scientists) that, whatever Ritalin’s benefits to caretakers as a sedative for disruptive children, it is dangerous, both addictive and likely to cause brain damage if prescribed for long. Sure, it quiets upset children — it would quiet any child. Ritalin’s widespread use for the so-called illness of attention deficit disorder, or the even more specious “illness,” learning disorder, was my main concern in writing The Soft-Headed Animal, the book Joseph had never finished. My duty with this thirteen-year-old rapist — besides the legal question of his state of mind when he sodomized his niece — was to evaluate his care. Joseph’s arguments were not academic — to us or to our patients. He conceded that Ritalin was a poor choice; his point was that the severe trauma experienced by children altered their brain chemistry irrevocably and, no matter how skeptical I was, I couldn’t prove him wrong simply because no drug exists that truly helps.

“Diane, we have to address these ideas. I can’t go before the judge and say, well, I don’t approve of drugs, and leave it at that. I don’t really care what Joseph feels about me — or to be more precise, why he bothers to proselytize. If you’re suggesting he feels a thwarted desire for me and that he expresses it through competition—”

“Well, as usual, you’ve put it much better than I could. That’s exactly what I think he’s about.”

“I understand. But so what? None of us can bear too close an examination of our motives. If I rejected this data out of homophobia or professional pride, I would hardly have improved matters.”

“How about rejecting it because it’s wrong?”

“I don’t know if it’s wrong. That’s why I have to study it.”

“What’s new about any of it? They’ve been making these claims—”

“What’s new to me is some proof that perceptible chemical changes occur after trauma. It still means the change is caused by emotion and conflict.”

“Then it can be changed by talking through the conflict.”

“Maybe. But maybe not if the trauma is severe enough. It doesn’t prove drugs are the answer. But—” I hesitated to say we, since I didn’t want to imply disapproval of Diane, “I really should know about it. Frankly, I’m ashamed to admit, out of my own prejudices, I ignored some of this research. In fact, some of these studies that suggest trauma can cause ongoing neurological damage were published while I was still in medical school. I’m guilty of being too close-minded.” I felt I now had to include Diane or I might seem condescending. I added, “You and I have a duty to investigate anything that might help. We’re doctors. We’re not supposed to toe a party line.”

“Look — You’re not understanding me — I don’t — This is a mistake—” Diane blurted each of these phrases rapidly, cutting them off and then resuming with an exasperated tone. The sheets and blankets whooshed. It sounded as if she had gotten out of bed. She had a wireless phone and liked to roam while talking. I was reminded of the day a year ago when she called to ask if I would entertain her while she mopped the kitchen floor. I was charmed. That was when I knew we were more than friendly colleagues. Just as, although I was irritated by her defensiveness about how Joseph treated me, I knew her protectiveness was love. Its recipe, after all, has a few ingredients that are best stirred beyond recognition.