Rafael Yglesias - Dr. Neruda's Cure for Evil

“Shrinks,” Joseph said. “They love to prescribe. Didn’t he know raising the dose—?”

“—He doesn’t see a human being when he looks at Albert,” I said. “He sees a repulsive frightening black boy.”

Joseph advised me on weaning Albert off Ritalin to minimize what was sure to be a severe withdrawal. When Joseph suggested I try another drug to ease his suffering, I said quickly and loudly, “No!”

“Okay,” Joseph said. “But you won’t dismiss Prozac because of this?”

“They’re not using it on kids, are they?” I asked.

“Well … I don’t know. Maybe.” He sighed. “Probably.”

“Listen to me, Joseph. I’ll keep an open mind and study your miracle. But do yourself a favor, try to issue some guidelines.”

“We do. Rafe, nothing can be done about sloppy doctors.”

“Joe, that’s not really an answer. The truth is, you don’t know exactly what you’re doing.”

“We know enough.”

“Do you know what serotinin does?”

“Well, the monkey studies—”

“Do you know exactly what it does?”

“No. Not exactly, Rafe. We don’t really understand the brain.”

“So why fuck with it, Joe?”

“But Rafe. Be realistic. If we don’t try the drugs on people how do we know if they work? There’s no progress without risk.”

“I’ll keep an open mind, if you do a good job of monitoring how Prozac is being used.”

Joseph laughed. “Deal,” he said. He laughed again. “As if I really can.”

Our lawyer, Brian Stoppard, obtained an order from a friendly judge on Sunday to keep Al at Columbia Presbyterian under our supervision. I stayed by his bedside until Monday morning. By then, though still on a low dose of Ritalin, the flu-like symptoms of withdrawal had begun. He moaned while asleep and his sleep was more akin to a delirium: sweat soaking the sheets, legs twitching or bicycling in the air. A nurse’s reaction to his condition illustrates the difficulty with patients like Albert. She saw him, asleep, legs rotating in the air, and said, “He’s a real psycho, huh?”

I hired Tania Gold, a sixty-year-old woman with many years of foster care experience, to relieve Diane and me on Monday and went to the clinic.

If I had remembered my appointment with Gene I would have canceled. I was exhausted, anxious, enraged and confused. I knew the drugs in use were no good. But the kindling studies rattled me. What if emotional trauma caused unseen brain damage that no amount of talk could cure? Then my cause was hopeless and there were no medicines to help. I could believe Joseph on a theoretical level; not in practice. The only solution I could see was to care for these children more thoroughly, minute by minute. Seeing them two or three times a week was a farce. They needed more than insight; they needed consistent care and attention, consistent limits and consistent rewards; they needed, more than anything, patience and, if not love, then commitment. Yet there were obstacles and risks in that plan. Brian had listened to my legal requests patiently. He said, because of the criminal charges against Albert, his release to us would be tough; the other children were easy, especially with the plan for a new wing. He commented, “That’s going to cost a fortune. Is it covered by Medicaid?”

“No. Locking them up and drugging them is, because supposedly that’s real medicine.”

“I see. How about foster care? You would get government money—”

“—Don’t want to muddy the waters. We’re their doctors, not hired caretakers. I’m sure we can get some foundation grants, but it won’t cover half the expense.”

Brian lowered his voice. “Rafe. I have a question. Can you afford all this?” he asked.

Indeed. Good question. I would be spending the balance of my inheritance, a sum I had promised Bernie’s money manager I would preserve at all costs so it could provide an income for the rest of my life. Once that capital was gone, to earn a living I would need my work to become profitable. Treating these kids didn’t look like a gold mine.

Those were my thoughts when Gene entered; he apologized for being early (only by two minutes, in fact) and shifted in the chair opposite. I stared at him, surprised by his existence. Monday at noon, our regular time for three months — and yet I had forgotten.

Gene looked at me. I hadn’t shaved or showered. He furrowed his thick eyebrows at my seediness, then glanced away shyly. “I had the dream again,” he said. “Only this time you were in it.”

Gene went through the familiar dream: he is alone in the gym of One Room as a bare-breasted woman approaches with threatening nipples; he thinks she will say something nice; instead, she spits at him; he shouts for her to go away and his wish is granted; only she doesn’t go; Gene does, into his computer lab to sit at a terminal that has the answer to his whole problem. But it won’t yield the truth. Gene is forced to risk losing everything by hitting Escape, and yet that doesn’t work. He must destroy it all by turning off the truth teller. However, it doesn’t turn off. Instead, at last, comes the terrible message: “You are a son of a bitch.” Here, as a new twist, I entered the dream. Gene admitted the dream Neruda was also his father, a shifting image hardly bothering to maintain what he considered to be its obvious symbolism. The Neruda/Don figure said, “You’re a good woman.”

“I think you said, ‘woman,’” Gene added. “Maybe it was ‘daughter.’ I can’t decide.”

“Decide?”

“Remember. Actually, I’m pretty sure it was ‘daughter.’ ‘You are a good daughter.’” Gene was silent for a moment. When he spoke it was in a loud voice, a touch too loud for my tired ears: “So? You think I’m homosexual? Or, I mean, I think you think I’m homosexual?”

I laughed. Rather, a snort of amusement escaped, derisive and arrogant. Gene was ashamed; he lowered his eyes. “I’m sorry,” I apologized without an explanation. “You keep asking me to interpret this dream. Is that what I should do? Tell you flat out what I think it’s about?”

“You can? I mean — it means something?”

“I don’t consider myself a brilliant dream interpreter. I’m getting a message from it. But I think you’re trying to send a message to yourself, not to me.”

Gene’s eyes were fixed on my chest. He glanced up at me to say eagerly, “What is it?” and immediately lowered his eyes to my torso.

“You were secretly glad your mother died. She wasn’t providing mother’s milk with her swollen nipples, only frightening anger, so you wished her away, you made her into a terminal and escaped to the answer of your computer. At first I thought the message on the screen — You are a son of a bitch — was your judgment of yourself for this wish. But actually I think it’s a judgment of your mother — buried anger at her surfacing. Take the message literally: you are a son of a bitch. The computer, of course, is your machine and it always tells you the truth. My guess is that this new comment from me or your father — we are probably strong images of yourself — is a longing to be recognized as a good child in spite of your anger at your mother and your wish that she die.”

Gene had forgotten his fear of looking into my eyes. He stared. His prominent Adam’s apple moved up and down.

“Of course there are other messages and emotions in the dream,” I continued. “The woman who seems to be both your mother and your wife — the woman in the gym?” Gene, still dumbstruck, nodded. “With her swollen maternal nipples, who you think is going to say something nice, but instead spits? That’s a complicated one. She’s a phallic woman — her nipples, her spit, which is an ejaculation of rage. My guess is that she is also your father — or you trying to be manly. I know it sounds odd but compression is common in dreams. The woman figure is rage. Your mother’s rage, your father’s rage and your rage at Gene the needy son. But I’m convinced when you shout, Go away, and she disappears into a terminal — the first of your puns — or rather, when you disappear from One Room to making computers — which represents your rejection of both your mother and father — I’m convinced that’s you sending her off to death. Gratefully.” I yawned. I was tired, true, yet I knew the yawn was also tension at what I was doing, abandoning the technique of my youth, risking an open confrontation with Gene’s psyche. “And you’ve continued the androgyny theme with a father figure — me or your father — telling you that you’re a good woman or a good daughter. Of course, this is all part of a theme in your life — so maybe I’m imposing it on your dream symbols. You aren’t very phallic and you’re afraid of women. You’re especially afraid of expressing anger at them or being phallic with them. One thing is perfectly clear. The punning message is precise: ‘As a son of a bitch, you are a good daughter.’”