Walker Percy - The Thanatos Syndrome

THE PLACE WHERE the strange events related in this book occur, Feliciana, is not imaginary. It was so named by the Spanish. It was and is part of Louisiana, a strip of pleasant pineland running from the Mississippi River to the Perdido, a curious region of a curious state. Never quite Creole or French or Anglo-Saxon or Catholic or Baptist like other parishes of Louisiana, it has served over the years as a refuge for all manner of malcontents. If America was settled by dissenters from various European propositions, Feliciana was settled by dissenters from the dissent, American Tories who had no use for the Revolution, disgruntled Huguenots and Cavaliers from the Carolinas, New Englanders fleeing from Puritanism, unionists who voted against secession, Confederate refugees from occupied New Orleans, deserters from the Confederate Army, smugglers from both sides, criminals holed up in the Honey Island Swamp.

Welcomed in the beginning by the hospitable and indolent Spanish of a decrepit empire, some of these assorted malcontents united long enough to throw out the Spanish and form an independent republic, complete with its own Declaration of Independence, flag, army, navy, constitution, and capital in St. Francisville. The new republic had no inclination to join French Louisiana to the south or the United States to the north and would as soon have been let alone. It lasted seventy-four days. Jefferson had bought Louisiana and that was that.

As pleasant a place as its name implies, it still harbors all manner of fractious folk, including Texans and recent refugees from unlikely places like Korea and Michigan, all of whom have learned to get along tolerably well, better than most in fact, who watch L.S.U. football and reruns of M*A*S*H, drink Dixie beer, and eat every sort of food imaginable, which is generally cooked in something called a roux.

The downside of Feliciana is that its pine forests have been mostly cut down, its bayous befouled, Lake Pontchartrain polluted, the Mississippi River turned into a sewer. It has too many malls, banks, hospitals, chiropractors, politicians, lawyers, realtors, and condos with names like Château Charmant.

Still and all, I wouldn’t live anywhere else.

It is strange, but these Louisianians, for all their differences and contrariness, have an affection for one another. It is expressed by small signs and courtesies, even between strangers, as if they shared a secret.

In what follows, the geography of the place has been somewhat scrambled. All of the people in Feliciana have been made up. The only real persons are the German and Austrian professors and physicians who were active in both the Weimar Republic and the Third Reich — Drs. de Crinis, Villinger, Schneider, Nitsche, Heyde — and the Swiss psychiatrist Dr. C. G. Jung. For this information about the Nazi doctors and their academic precursors in the Weimar Republic, I am indebted to Dr. Frederic Wertham’s remarkable book, A Sign for Cain.

WALKER PERCY

1. FOR SOME TIME NOW I have noticed that something strange is occurring in our region. I have noticed it both in the patients I have treated and in ordinary encounters with people. At first there were only suspicions. But yesterday my suspicions were confirmed. I was called to the hospital for a consultation and there was an opportunity to make an examination.

It began with little things, certain small clinical changes which I observed. Little things can be important. Even more important is the ability — call it knack, hunch, providence, good luck, whatever — to know what you are looking for and to put two and two together. A great scientist once said that genius consists not in making great discoveries but in seeing the connection between small discoveries.

For example, a physician I once knew — not a famous professor or even a very successful internist, but a natural diagnostician, one of those rare birds who sees things out of the corner of his eye, so to speak, and gets a hunch — was going about his practice in New Orleans. He noticed a couple of little things most of us would have missed. He had two patients in the same neighborhood with moderate fever, enlarged lymph nodes, especially in the inguinal region. One afternoon as he took his leave through the kitchen of a great house in the Garden District — in those days one still made house calls! — the black cook whom he knew muttered something like: “I sho wish he wouldn’t be putting out that poison where the chirren can get holt of it.” Now most physicians would not even listen or, if they did, would not be curious and would leave with a pleasantry to humor old what’s-her-name. But a good physician or a lucky physician might prick up his ears. There was something about that inguinal node—“Poison? Poison for what? Rats?” “I mean rats.” “You got rats?” “I mean. Look here.” There in the garbage can, sure enough, a very dead rat with a drop of blood hanging like a ruby from its nose. The physician went his way, musing. Something nagged at the back of his head. Halfway down St. Charles, click, a connection was made. He parked, went to a pay phone, called the patient’s father. “Did you put out rat poison in your house?” No, he had not. Is Anne okay? “She’ll be fine but get her to Touro for a test.” At the hospital he aspirated the suspicious inguinal node. Most doctors would have diagnosed mononucleosis, made jokes with the young lady about the kissing disease — So you’re just back from Ole Miss, what do you expect, ha ha. He took the specimen to the lab and told the technician to make a smear and stain with carbol-fuchsin. He took one look. There they were, sure enough, the little bipolar dumbbells of Pasteurella pestis. The plague does in fact turn up from time to time in New Orleans, the nation’s largest port. It’s no big deal nowadays, caught in time. A massive shot of antibiotic and Anne went home.

This is not to suggest that I have stumbled onto another black plague. But if I am right, I have stumbled onto something. It is both a good deal more mysterious and perhaps even more ominous. The trouble is, unfortunately for us psychiatrists, that diagnoses in psychiatry are often more difficult — and less treatable. There is seldom a single cause, a little dumbbell bacillus one can point to, or a single magic bullet one can aim at the tiny villain. Believe it or not, psychiatrists still do not know the cause of the commonest of all human diseases, schizophrenia. They still argue about whether the genes are bad, the chemistry is bad, the psychology is bad, whether it’s in the mind or the brain. In fact, they’re still arguing about whether there is such a thing as the mind.

It began with little things. The other day, for example, I was seeing a patient I hadn’t seen for two years. I’ve been away, but that’s another story. She had a certain mannerism, as do we all, which was as uniquely hers as her fingerprints. If she said something in her usual bantering way and I had the good luck to get behind it, make a stab in the same bantering tone and get it right, she had a way of ducking her head and touching the nape of her neck the way women used to do years ago to check hairpins in a bun and, as a slight color rose in her cheek, cut her eyes toward me under lowered lids almost flirtatiously, then nod ironically. “Uh huh,” she’d say with a smile. She monitored her eyes carefully. A look from her was never a casual thing.

An analyst who sees a patient several times a week for two years and who has his eyes and ears open — especially that third ear Reik talks about which hears what is not said — comes to know her, his patient, in some ways better than her husband, who probably hasn’t taken a good look at her for years.