Rafael Yglesias - Dr. Neruda's Cure for Evil

The bald paratherapist looked me up and down. There was something funny about being evaluated in this way. I was more than a foot taller and eighty pounds heavier than Al.

“Okay, I guess it’ll be safe. But don’t turn your back on him. All right? Technically we shouldn’t’ve brought him here, but they said you would insist and we can’t take him to Met State until three for some crazy reason.”

Al shuffled in, ignoring the chairs, and sat on the floor, his back against the wall. There was a welt above and around his right eye. His skin was a deep dusky black. Al’s face was elegant, a high forehead and strong chin, eyes dark and brilliant. He was a handsome boy with no adolescent awkwardness. I asked if he wanted something to drink. He said he’d like a Coke. I offered ice water. With Ritalin in his system he could do without adding caffeine. I noticed his mouth was slightly swollen. After I gave him the water I asked about his bruises and he said, sullenly, nodding at the door to the waiting room. “They did it.”

“Not the boy whose arm you broke?”

“He didn’t lay a fucking finger on me. They punched me. They enjoyed it too. You know, the bald guy’s a fag. He wants my sweet ass.”

For the next half hour Al told me how he would have enjoyed scooping out his victim’s eyes, or better still, cutting off the bald man’s balls. He told me he was sorry Diane wasn’t there. He liked looking at her tits; he wished he could bite off her nipples. He wondered if cutting off a nipple would cause a lot of blood to flow. Those were some of his milder remarks. In my previous interview with him he had been sluggish and quiet, the docile manner of a drugged kid, not this, the “monster” that was supposedly caused by a poor brain recipe. Was he off the Ritalin? Not according to his chart. Had he been dumping it? Supposedly his caretakers were too smart for that: the boys were watched while they drank their medication.

I listened patiently to his horrible threats for ten minutes and then commented, “I’m disappointed in these fantasies.”

“Yeah? I’m sorry. I’m real sorry.”

“What about me? Don’t you want to do something terrible to me?”

“Yeah? You want me to? You want me to fuck your ass?”

My fatigue caught up with me, amplified by despair at Albert’s situation. I had been up most of the night reading. If the kindling studies on rats (and Albert seemed very much like a rat at the moment) were applicable to people, then when his mother used him sexually and tortured him physically his brain chemistry was altered (presumably to compensate for the extraordinary stress) and that change was ongoing, serotonin or dopamine or lord knows what flooding him in excessive or insufficient quantities, fighting off rage, despair, and loss from a past that no matter how distant or well understood, continued to hurt him without a break or diminishment. But if true, why couldn’t it be measured against a so-called normal brain? And yet it might be true anyway. Could I fight its control with mere words?

“No, you probably want to fill my hole,” Albert was saying. “You want to suck my cock?” Albert stood up quickly. I didn’t move: I wasn’t frightened of him. He wasn’t threatening me, anyway. He pulled off his shirt. His chest was a boy’s — flat, ribs showing. A line of four scars began above his right nipple and to the right of his navel: circular puffs of twisted bleached skin where his mother had pressed out her cigarettes. He tried to cup the dark nipple beneath the first scar, but it was too flat for the gesture to work. “You want to suck my tit?”

Of course my colleagues love to prescribe drugs for patients like Albert, I thought. Perhaps it was the right road, maybe Prozac was the leading edge of some bright future where psychiatrists can heal with the ease of GPs curing ear infections, but that wasn’t why my colleagues were so eager to abandon psychotherapy for pharmacology. It was despair at the hopelessness of human relations, of our ability to heal each other with love and understanding.

“Albert,” I said, “I want to take you off Ritalin.”

Albert let go of his breast. “Maybe you want to suck my cock.” He jerked the belt of his jeans and quickly unzipped, pulling both dungarees and underpants down to his thighs.

The reality of the damage his mother had done to his penis — it had been described in his medical file and by Albert verbally — was much more horrible to see than I had imagined. I pressed the edge of my fingernails into my palms to help control my features. It was crucial not to react with either horror or pity. I asked, “When did he see you?”

“You want to suck it?”

“When did the boy you attacked see you naked? Today? Or did it happen a while ago?”

Albert rotated his hips, gyrating like a stripper. He grabbed his wounded penis. “I could make it into a pussy. They can do that. They make a hole in you and push it in. They make a clit outta this”—he squeezed the scarred head to almost nothing—“so you still get off.”

“Did he see you in the shower? The bathroom? Where?”

“What the fuck you talking about?”

“You’ve taken off your clothes to show me what your mother did. I understand. But I need to know exactly what happened with the other boy, Albert—”

He let go of his penis and stopped gyrating. He frowned and interrupted. “Don’t call me Albert. Okay, fuck face? That’s not my fucking name.”

“What should I call you?”

“Zebra. You like that? Call me Zebra.”

“Is that what he called you?”

“He didn’t call me nothing. You ain’t so smart. You think you know everything, but you don’t know shit. You think you making us better? You think Shawna’s better?” That was the niece he had sodomized. “She’s sucking off all the boys. She’s seven and she gives better head than your wife.”

“Did she suck off the boy whose arm you broke?”

Albert smiled. He turned around and showed off his buttocks. The burn on his right cheek had the shape of its cause, an iron’s triangle. “Kiss my ass.” He was facing the wall. He lowered his head and rushed at it. His skull whacked hard against the plasterboard. The impact pushed him back a step or two. He paused and then repeated the action. His legs wobbled this time. He staggered. I was up from my chair now. He gathered himself, slammed into the wall again, and collapsed.

I hurried over and rolled him on his back. Blood flowed from his left eyebrow. His eyes were unfocused. He probably had at least a mild concussion. I was worried about what was in his system. One possibility was a rebound effect, that his brain was accustomed to the doses of Ritalin and now demanded more and more. His physical movements were jerky, foreshadowing the damage neuroleptics and Ritalin can create, namely tardive disorder. [Neuroleptics cause tardive dyskinesia — loss of muscular control resulting in painful disfiguring spasms — in at least twenty percent of patients who take them for longer than a year. I had seen research that showed Ritalin, not a neuroleptic, can have the same effect and much quicker on children. Hence my alarm.]

While I tried to take Albert’s pulse, the attendants pushed me aside. I hadn’t heard them enter. The bald one put his knee on Albert’s chest. The other grabbed his feet, staring at his genitals, mouth open with disgust.

“Did he hurt you?” the bald one shouted.

“He never touched me,” I said. “Get off him. You’re making it hard for him to breathe.”

Albert reached — ineffectually, like a drunk grabbing for support — for the bald man’s shoulder. In response, the paratherapist put his other knee on Albert’s stomach and slapped his face.

I shoved the bald man. He was perched awkwardly and toppled easily. “Get off!” I shouted. “I said he can’t breathe!”