The Cure of Folly: A Psychiatrist's Cautionary Tale

A PSYCHIATRIST'S CAUTIONAR TALE

GORDOn WARfflE, fflD

ECW PRESS

Copyright © ECW PRESS, 2003 Published by ECW PRESS 2120 Queen Street East, Suite 200, Toronto, Ontario, Canada M4E IE2 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any process — electronic, mechanical, photocopying, recording, or otherwise — without the prior written permission of the copyright owners and ECW PRESS. NATIONAL LIBRARY OF CANADA CATALOGUING IN PUBLICATION DATA

Warme, Gordon The cure of folly: a psychiatrist's cautionary tale / Gordon Warme. ISBN I-55O22-57I-5

I. Psychiatry—Popular works. 1. Psychiatrists. I. Title RC4fJo.W37 2003

6r6.89'i7

02002-905417-6

Cover and Text Design: Tania Craan Production & Typesetting: Mary Bowness Printing: Transcontinental

This book is set in AGaramond and Mason

The publication of The Cure of Folly has been generously supported by the Canada Council, the Ontario Arts Council, and the Government of Canada through the Book Publishing Industry Development Program. CanadS

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COnTERTS

1. MINDS THAT CREATE GODS i 2. THE BIRTH OF WEIRDNESS 21 3. HANDLED WITH A CHAIN

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4. THE CRITIQUE OF PURE REASON 63 5. DUMPING SYNDROME 79 6. MY VERY OWN HYSTERIA 99 7. THE CURE BY TOUGH LOVE 131 8. SECRETS /# 9. SEVEN LETTERS FROM CATHY JONES 185 10. PERFECT! 205 ii. THERE'S NOTHING LIKE A GOOD ARGUMENT 225 12. BACH'S MUSICAL OFFERING 247 13. A TRIP TO TORONTO 269 14. THE WARRIOR 27515. IN THE SHAMAN'S CAVE 293 16. LIFE TURNS ITS OWN PAGES 303 17. TROUBLE ON THE SUBWAY $29 18. MUSES 34$ 19. FINIS OPERIS 36$ AFTERWORD 377

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Sometimes I wonder whether the world is being run by smart people who are putting us on or by imbeciles who really mean it. MARK TWAIN

Much madness is divinest sense To a discerning eye; Much sense the starkest madness. 'Tis the majority In this, as all, prevails. Assent, and you are sane; Demur,—you're straightway dangerous, And handled with a chain. EMILY DICKINSON

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CHAPTER^OHE

Minos THAT CREATE GODS

Man is quite insane. He wouldn't know how to create a maggot, and be creates gods by the dozen. MONTAIGNE

When my medical school classmates and I graduated in 1957, we didn't have to take the Hippocratic oath, but I'd read it and knew I had obligations: don't give deadly medicines, even if asked; don't give a pessary to a woman to cause her to have an abortion; don't seduce patients. I also knew I was sworn to "impart a knowledge of the Art to ... disciples". I did what Hippocrates said a doctor must do and became a teacher. For 20 years, part of my teaching was to run an interviewing seminar at the Clarke Institute of Psychiatry in Toronto. In 1997, the residents (psychiatric students) and I met every Wednesday at 2 p.m. in a meeting room that had to be booked in advance and, as is usual when rooms are tightly scheduled, a colleague regularly inconvenienced me by overrunning her time. "We knocked and started to go in the way you told us, Dr. Warme,"

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Dr. Singh, a new student, said one day. "She says she isn't finished with the room." I knocked and walked in. My colleague — I called her the Iron Lady — ignored me and. continued teaching her students. She was talking about psychic trauma, trying to brainwash her students into thinking that all psychiatric patients were victims of traumatic events, bad parents and God knows what else. The severe crease in her forehead announced that in her view, she, too, was a victim, a victim of my intrusion on her class,, I didn't bother to apologize. Her poor students weren't paying attention anyway; in fact they were squirming with embarrassment because they knew they were trespassing. "The room is booked by our group. You are scheduled to finish at two. If you don't mind, please vacate the room. Would you like me to show you the schedule?" She salvaged her pride by saying a few more sentences, then stopped, assigned reading for her next lecture, and left the room silently.

Each week, my students and I hear a case report from one of the psychiatric residents, after which I interview the patient myself. All residents at the Clarke Institute of Psychiatry are free to attend the seminar and usually 10-15 of them show up. The patients who come to the clinic aren't just cases; they are people, tremblingly alive and, along with me, displaying themselves on the stage of life. In the interview, the patients and I demonstrate to the students human life in action, a drama in the process of which I also hope to demonstrate the principles of the psychiatric interview. I do my psychiatric duty and entice the patients to reveal their secrets, secrets they don't know they have until I woo them into revealing them. The students see how patients unconsciously arrange to have lives

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of folly, madness, and suffering, and since they are experts at self-ruin, the patients teach us that they are blood brothers of that great stylist of self-immolation, Mike Tyson. As a bonus, the students witness my odd tactics for angling into a human life. Students aren't stupid. Despite their attitudes — nervous, skeptical, admiring — they understand human life even in the unexpected ways I reveal it, and although they'd never admit it, they all know they might find similar folly in themselves. The interactions between me and the patient can get overheated, at times pushing the outer limits of psychiatric propriety I sometimes worry the depth and intensity of these interviews will scare off patients, but the opposite seems to be true; most become more eager than ever to examine their lives. Our impudeur [lack of inhibition] is partly an audience effect; the patient and I, whether we intend it or not, are performers and our actions are intensified and concentrated by being observed. Since I'm trying to teach something to the students, I do my best to demonstrate hidden and unexpected psychological issues. There is no rule that says a psychiatrist has to demonstrate the unconscious — as I try to do — in a first appointment but, apart from reading great literature, how else can students learn about human life so quickly? All psychiatric students should read The Brothers Karamazov, but the amazing insights contained in that book are not enough; they need to see in person a psychiatric teacher lay such things bare. The room itself is not designed for interviews, but it's the best we've got; the oversized conference table is usually littered with Styrofoam cups and untidy piles of handouts and reading lists. On a typical day, I weave through the maze of chairs to tidy up the place, perhaps switch off one of the ceiling lights which, just to annoy me, usually flickers unpleasantly I move aside an overhead projector or some other piece of technological gear, push the papers and cups off

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to one side — the patient will arrive momentarily, and the place has to look respectable. Most weeks, someone will have swiped my box of tissues. I move a few chairs so the patient and I will have some breathing room and can look at each other. By this point, the students know what to do and position themselves on the far side of the table, so the patient won't have to face their curious gazes unless he or she wants to.

Hanna Slendzinski was a psychologist with special training in bibliotherapy, a method of psychotherapy that uses books as a way of getting patients to think about themselves. Although she was not a psychiatric resident, I had given her permission to attend the seminar because there was nowhere else in the Institute for her to meet people with an interest in psychoanalysis and psychotherapy. Hanna came to Toronto from Poland, and I often worried about her because she had no official professional status in Canada and getting registered might involve years of extra training. I wondered how she and her husband managed financially because they had two children and he didn't have a job either. I'd heard they were moving in a few months to Detroit, where she hoped to get a position that paid real money. I was sorry she was leaving. I liked her and she had a good effect on the other students. When she spoke up in the seminar, I noticed a trait of hers that was psychologically important. Curtly, she would say, "I know," and "Why does he say that?" then alert the rest of us to something that hadn't been noticed. Simple phrases like "I can't believe it," were said so casually and with such perfect timing that I could never be sure whether she consciously saw the little paradoxes to which she drew our attention. Hanna often said she knew nothing about dynamic psychiatry because, in Poland, the psychiatry department where she had worked

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had been solely biological and psychopharmacological in its orientation. But I was skeptical; clearly, she grasped the inner life of the patients she interviewed — she had to take her turn examining patients like everyone else — and her case reports were excellent, including fine psychological profiles which were both well written and attuned to the hidden, secret sides of her patients. Hanna wasn't a kid anymore, and it was humiliating for her to be a student again. I'm no youngster myself, so she was not just another student; she and I shared a quiet sense of comradeship. She was also very naughty — out of earshot of the younger students, she firstnamed me. "Hi, Gordon," she'd say when we passed in the corridor. I liked Hanna Slendzinski's light blonde hair and pink skin, a reminder to me that Poles and Ukrainians are full-blooded Aryans who don't match my stubborn stereotype of eastern Europeans as dark and hollow-cheeked. I had a little crush on her, even though her womanliness and her beauty were subtle. When she joined the group, Hanna usually wore a wan, pensive smile, but on this day she was animated, perhaps because she was actively being a clinician. She had spent an hour with that day's patient and was about to present her observations to the group. "The patient's name is Salman Banda," she told us. "He is a 30year-old, Canadian-born East Indian and was referred by his family doctor. The doctor is puzzled because Mr. Banda is on welfare even though he seems competent and is not unwell. Mr. Banda is blase about the referral and doesn't know what the fuss is about. He isn't troubled that he's on welfare and claims his life is okay. Before going on welfare, he worked as a school janitor. 'I don't see anything wrong with being a janitor,' he said, although I hadn't said anything about it. He quit his job because he and his girlfriend decided to move to Guelph, but when they broke up he stayed in Toronto. "He was seen last year by a psychoanalyst, Dr. Hamilton, over in the

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THE CURE OF FOLLY

Assessment Clinic who told him to come back for another assessment in six months. Mr. Banda didn't understand that recommendation either. In her note, Dr. Hamilton says the patient was uninterested in psychotherapy, but she felt that during their interview, she had been able to stir up some important issues. She suggested to Mr. Banda he should think about these things for a few months and then come back. It was something about his disappointment in his father. "The patient's mother is one of seven children. There were many artistic people in her family, some very successful. She was an oddball and was known in the family as someone interested in nothing except tidying the house. When he discussed his mother, Mr. Banda used the phrase 'tidying up' many times, as though it was an obsession of hers. In fact, it eventually became her career: she is a cleaning lady. "Mr. Banda's father is an only child and has done little with his life. He does odd jobs and drinks too much. The father comes from a lower-class family and it seems no one expected much from him. "The parents came to Canada to start a new life. They were married just before they immigrated and Mr. Banda was conceived in India immediately after the marriage — 'Conceived on the wedding night,' he said. He was born in Canada and his birth was seen as a big event that was part of the new start the family wanted to make here. "It was also a big event when he finished high school because neither of his parents had achieved that. Because he was a good student, the family thought and hoped he would become a doctor or lawyer, but Mr. Banda sort of sneered when he said that. Something about his parents' phony values. Right after high school he spent a week sleeping in a field, 'thinking things over.' His parents freaked out, which he thinks was stupid. "He's had a few girlfriends but things never last long. He loses interest in them because they are too bourgeois. 'They're just like my parents. They think I ought to go to university or college, get a career.'

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"Mr. Banda sneers a lot. At first, I didn't see it because he has a friendly smile, but what he says always has a scornful side to it. He has an exaggerated 'laid-back' style, always leaning back and smiling when he speaks, and sort of being pompous, making pronouncements about everything. He also seems skeptical of everything I say, almost as though my words might make him puke. "He is pretty content with his life. He's going to do some thinking and reading, and when he gets his head straight, he will try to get his janitorial job back. He agreed to come here because it fits with his idea that this is a good time to rethink his life. "That's about it."

Hanna stepped out to get the patient. I smiled to myself as I anticipated the students' delighted dismay when they saw what was going to happen. One of the students, Osman Awad, noticed my grin. "Dr. Warme, why are you smiling?" Osman looked young and spoke carefully and courteously. Despite his politeness, there was a note of complaint in his voice. He didn't like my showiness. Just the same, he was intrigued by what went on in the seminar and was teasing me that day because he knew that, in my mind, I was preparing that day's "show." "Well, Osman, it's like this. We shrinks are mythoiogizers, aren't we? And I've invented a sexy myth for Mr. Banda." I let my eyes wander around the room and surveyed the other students. "Can anyone guess what it is? It's not about his genes, his pills, boring reallife events or anything like that. It's about him and how he can rethink the myths he's imposed on himself. My idea is a bit audacious and I'm chuckling in anticipation of how jittery it will make you youngsters, you nervous Nellies. So grown up — doctors and all that — but not yet ready to be illusionists. Oh, here comes our patient."

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Students have complex reactions to teachers, especially teachers who, like me, think silence is important: silence begets mystery and fantasies. Some students are awed by me, others think I'm a jokester, and still others, secretly or overtly, want to compete with me. The young doctors also have strong reactions to one another — behind the educational formalities, there is plenty of rivalry, victimhood, love and sex. It's exaggerated in our seminar room — really an overheated laboratory — because we identify with our patients, and their stories stir us up.

Mr. Banda was an attractive, brown man with black hair, better dressed dian I had expected. He smiled and sat down, turning his chair toward the students as if all of us in the room would now have a nice chat. But the scene was set up so that he and I would have our own designated area in the room, separated from the students by the conference table and my body language, a language that insisted that something dramatic was about to happen. I was polite and said the usual: "Hi, Mr. Banda." My greeting is always unenthusiastic; it's a conventional necessity and my tone is intentionally dismissive — if not scornful — of the fact that the patient and I must waste time on trivialities when we both know matters of great importance must now be discussed. I was briefly silent, a silence during which Mr. Banda could size me up and, more important, let his imagination get going. In that fraction of a second, I mused to myself about how he was always "rethinking his life," as though he was expecting or hoping for a transformation. A question with a will of its own ran through my mind: "Is it really you?" Where in the world had that come from? The words had almost jumped out of my mouth before I could catch them. I didn't care that

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Mr. Banda might have thought I was weird to say that; I would have rather liked it if he did. But shouldn't I have known what I was doing? Where, I wondered, did the line come from . . . ? Suddenly, I remembered. Yes, I had The Brothers Kammazov on my mind, and the line was from a story told by Ivan, one of the brothers. In the sixteenth century, the story goes, Christ appears at an auto da fe in the Grand Plaza of Seville and performs a miracle. Although everyone recognizes he is Christ, including the priests, the Grand Inquisitor also realizes that, now that the church has been fully established, Christ can no longer be what he was before. His presence on earth now can have only a subversive effect. The Grand Inquisitor has Christ thrown into a dungeon and later comes to his cell. "Is it really you?" he asks Christ. Ah, yes, I thought, this story resonates with some of my thoughts about Mr. Banda, so I'd best wait and see what happens. I remembered then that, in the story, Christ didn't answer; he was completely silent throughout the interrogation by the Inquisitor. It reminded me of a psychiatrist silently listening to a patient. In my daydream, I was the talkative patient and Mr. Banda was the silent Christ/psychiatrist; I was attributing to him the power to influence me.

"Well, Mr. Banda, what is it you need our help with?" "Nothing, really" "You are in the process of rethinking your life, I hear. Is that why you need our help?" "Nobody can help anyone else. It's a matter of will. I'm going to figure things out and then implement the appropriate solution. It's not something anyone else can do for me. There are things that can be done and I plan to do them." "You're never in need of help?"

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"People nowadays are not intellectually rigorous enough. Improvement of oneself, psychological progress and growth, are neglected in favour of thinking that they just need to lean on someone. A little more effort and thinldng things through is all that is needed." "Surely people have always turned to others for comfort and solace? You have no need for this? You're never lonely, and never need someone to lean on?" As Hanna Slendzinski had warned us, Mr. Banda was aloof and pompous. He acted as though I had cornered him and, as we proceeded, his pronouncements became more and more like proclamations. I'd said very little, yet my line of questioning had turned him off. I sat silently and looked past him, over his shoulder at the distant wall. "I used to believe in progress and stuff like that, too," I said. "I used to give lectures — preach sermons, in other words — and write papers for psychiatric journals." I noticed that I had his attention now, perhaps because of my mocking reference to myself "preaching sermons." "All that logical junk was sort of the academic game, where we all say the same thing over and over again and applaud one another when we're done. I decided I ought to write a novel, maybe something about a weird shrink and his weird conversations with his weird patients. Actually, what I had in mind was that the important things about people are poetic and imaginative . . . poetic truth rather than boring rational truth. I guess I'll have to write about you: 'The Man Who Believes in Rational Truth and Progress.' And as I write my novel about you — about you and me? — it will have something to do with intimate human events — passion, longing, hopes and fears. "And then, when you read the book, you'll be mightily pissed off because you'll see that human affairs are juicier and sexier than logic and planning allow for." To my amazement, Mr. Banda answered in kind. Perhaps he

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thought I'd unburdened myself to him, a turn of events that made me into the patient, appropriate given he was a man who had the answers to how a person can transform himself— by thinking things over — into a better man. "I wrote a script for a play, once." I stayed silent for a moment, wondering whether the students knew what the next question should be. Most students have a memorized list of questions, a list that lets them avoid the heat. The questions themselves are fine, it's just that the list leads them to believe that no question need be gone into exhaustively. When faced by their patients' disturbing secrets, they can gratefully proceed to the safety of the next question on their list. I paused for another fraction of a second and looked at Mr. Banda intently. "What was the play about?" Now it was his turn to be silent for a moment. He looked back at me, just as intently, He hesitated, not sure whether he now wished to take on the role of the one who "unburdens." "I was young when I wrote it, so it's kind of corny, but it's about a guy who's been in Nepal, doing the young rebel routine, thinking he's pretty cool and in touch with important Eastern stuff, smoking too much and so on. He's sort of like Joseph in the Bible because he's the youngest of several brothers. He gets involved in a project, trying to get into a community in the Himalayas, sort of a religious community. If he's like Joseph, then this would be like being sold into slavery in Egypt. The leader of the Nepalese community has died and the guy has to get in there so that they can re-establish contact with the outside world. But what he thinks will be an interesting adventure becomes a terrible journey, sort of like Ronald Coleman in Lost Horizon, because it's treacherous terrain. He is almost kidnapped by Chinese bandits. When he gets there, he sets up the shortwave radio and shows them how to use it so that they can make contact with the

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outside world. He's also prepared to take messages back and to help them in other ways if he can. "What the people really need is a new leader, so he hangs around for a while getting to know them and figuring out a little more about what exactly they need. Although they live very close to the land, they are philosophical and artistic and so the hero of my story knows it won't be easy to find the kind of leader such a community will accept. They aren't going to be interested in a cheap guru who tells them what to do. He also knows that since this community is already set in its ways, no one will want to come here. It will be hard to fill the shoes of the leader who has died and who has been so revered. "The story ends when the people tell him that, not only do they want him as the new leader, it turns out they have been waiting for him for years. They believe he is the son of a previous leader, spirited away when he was a young child (I can't remember how I explained this, maybe it was the Chinese bandits) and that they had always thought that he'd return some day. "He becomes the leader and the people . . . live happily ever after." "Perfect," I said. I made a fist, and pumped it ever so slighdy — symbolically — for effect. "That's the story I was waiting to hear. I know this story. I've heard it before." "What do you mean, you've heard this story before?" I collected my thoughts for a moment, because I wasn't sure what story it had reminded me of. I wasn't even sure it had reminded me of any particular story. I was scanning my mind for something about a lost soul who had come back to life. Promptly, the Muses sent the story I needed.

"A young patient — let me call him Jack — once told a similar story. He was an aloof youngster who had been in really bad shape for sev-

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era! years. Some psychiatrist thought he was autistic, or had childhood schizophrenia or something, and he was hospitalized for six months. Jack didn't speak to me for several weeks after we first started meeting. Instead, he drew cartoon strips about superheroes and brought them for me to look at. Eventually Jack started talking, although he was always detached and cautious. Come to think of it, you can be a bit aloof at times just like this kid. "One day he told me he was having a writing problem and needed me to help him out by giving him some psychiatric information. 'In my story, a man noticed his neighbours often had a light on in their attic. In fact, he'd been noticing this for 16 years but hadn't really paid attention. He was puzzled when he discovered the neighbours, a couple without children, had the whole house to themselves and had no need to use their attic. One day, fleetingly, the man caught a glimpse of a face in the attic window.' "And, Mr. Banda, as I listened to Jack, it came to me that Jack was the same age — 16 — as the boy in the attic. "Jack was stumped. His question was this: 'If there is a child in that attic, and if that child has been there for 16 years, can anything be done for him? If treated, could he become normal?' "I said the same thing to Jack as I said to you. 'Perfect,' I said to him. I made a fist, and pumped it ever so slightly — symbolically, so to speak — for effect. 'That's the story I was waiting to hear. I know this story and I've heard it before.' '"And yes,' I said in answer to Jack's question, 'I think such a boy could be helped.'" Mr. Banda stared at me silently. I stayed pensive, too. Then, I played my ace. "So, you are the Messiah?" Mr. Banda screwed up his eyes again . . . and played dumb. But I knew better. He and I had started to tell stories to one another, and

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this had changed everything, although he was still not sure he was ready to plunge into the depths with me. What was the change? The change was that he had decided to enter into my version of psychiatric theatre. That day we were performing Faust.

In Leipzig, in front of the historic Auerbach's Keller, the restaurant where, in Goethe's story, Faust and Mephistopheles met, is a statue of Mephistopheles with a group of students. He is portrayed as having begeistert the students, in other words, captured their spirits. In English we would say, "enchanted, enthralled, influenced." "Beguile" has a similar sound, but guile means trickery, and Geist means spirit. But the idea is the same: to highjack (by guile) someone's spirit (Geist). To come under enchantment is a well-known interpersonal event. In a psychiatric situation, we call it an idealizing transference (transference just means that everything has a history and that every experience is echoed in other experiences, is "transferred," so to speak). When an enchantment is enthusiastic and obvious, it can be called hysteria, common in all people, but which we take particular note of when it occurs in patients, worshipful students and adoring groupies. In patients, idealizing transferences are usually polite and respectful, but liable to evolve into submission or dependency. Such qualities, although we are always tempted to judge them, are neither good nor bad and, in other circumstances, are called loyalty, mass hysteria and hero worship. It's worth remembering that, while it's humiliating to be enchanted by a rascal, it can be wonderful to be taken in by a conjurer. It's surprisingly easy to ignite submissive and obedient reactions. Walking in Leipzig, not far from Auerbach's Keller, I was surprised by signs in store windows no different (apart from being in German) from signs in Toronto store windows:

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"Under new management." "Closing Sale." "Anniversary Special." "Fire Sale." "We've got to reduce our inventory." We all recognize these as come-ons, but market researchers also know that, despite the amused skepticism of shoppers, they improve business. It's a magical effect, a variant on being begeistert — having our spirits high-jacked. It's also the bit of human psychology that makes us benefit from placebos. A case from industrial psychology is often cited as an illustration. A company was told improved lighting would increase the productivity of its employees. New light bulbs were installed and, as sure as day follows night, productivity rose. The problem was that, shortly thereafter, it was discovered that an error had been made and weaker light bulbs had been installed instead of stronger ones. In other words, worse lighting had resulted in increased productivity. A follow-up study showed the essential factor here was change — any change. As long as there is an expectation of improvement, improvement generally occurs. As a result, psychiatric hospitals — innocently, it seems — are constantly renaming programs, announcing new projects and moving units from one floor to another, even when it's obvious these manoeuvres are just a recycling of changes that have been made many times before. It's the placebo effect. That's what had happened to Mr. Banda. When I changed my spots and became a storyteller (why a "storyteller" would have this effect, I don't know), he almost instantaneously granted me the role of the powerful, kind shaman — developed an idealizing transference — and from then on, hung on my every word. This is not unusual — many patients attribute great wisdom and power to their doctors. The unique twist in Mr. Banda's case was his initial skepticism and the

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sudden change when I became the storyteller.

"What do you mean?" Mr. Banda said in response to my "Messiah" comment. "I knew that you were the Messiah as soon as Dr. Slendzinski began to tell us your story. Widiin a sentence or two." "How did you know?" "You were the hope of the future when your parents came to Canada, you were immaculately conceived, sort of, and you've had a series of rebirths. You spent 40 days in die wilderness — okay, it was only a week — to think. To be reborn, in other words. You've come here to be reborn again, to rise from the dead on die third day, and you were the Messiah when you climbed over the Himalayas to get to Mongolia, or wherever it was." My speech was a classic example of overkill. I wanted to make sure Mr. Banda saw my point, so I gave him all my evidence in one chunk. I also wanted the students to recognize his private myth before we ran out of time. By ramming home my point and making it blindingly clear, I forfeited my most precious instrument, the air of mystery that keeps patients thinking. Had I kept ambiguous, there would have been space for more ideas to appear. "My middle name means 'Lord of Man.' How did you know this? How come you called me the Messiah? I never tell people diat's my name. I was supposed to be a doctor or a lawyer, or something very successful, like my mother's family." "You have been a janitor, I believe. Does that mean you are your mother or that you are your father?" He stared at me again. But the stare had become different from when he and I had begun 20 minutes earlier. Now he was curious.

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"I'm not sure what you mean?" "Well, when you are a janitor, are you wasting your life like your father, or are you tidying up the house like your mother?" "I never thought of that. My mother's family always made jokes about how, as a kid, she wanted to fix up the house. She liked to 'tidy the house,' they said." "Was it 'tidying' or was it 'fixing?' Now I'm confused," I said. "No, no. She was a fixer. She was always moving furniture and persuading her parents to change things in the house." "So she wasn't a neat freak, it was more making things nice?" "That's right. And that's what she does now, decorating people's houses." "Do you mean she's not a cleaning lady?" Mr. Banda smiled. "No, no. That's just the family joke; she tidies up and she's a cleaning lady. She's an interior decorator." "Is she any good? Does she have a talent?" "Yes, I think she's very good." "So she's an artist, like a number of other people in her family. But you became a janitor, really someone who is a cleaning lady and who tidies up. You are the real McCoy." "That's true, but I'm an artist, too. I paint and I'm sometimes successful and sell stuff." "This is brand new information for me, so I guess this must be a secret, just as artistry is a secret with your mother. Both you and she must be described as cleaning ladies so no one will know that you are artists. It turns out you became the Messiah that was hoped for after all. But there is a problem. If you are one of the winners, like all the winners in your mother's family, where does that leave your father? Maybe that's why your artistry has to be a secret, so your father isn't too blatantly put in the shadows. Unless he has a secret, too, one you haven't told me about yet?"

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"No, there's no secret about father. He just drifts from job to job and sometimes drinks too much. But I'd like to get back to the idea of me as the Lord of Man for a minute. I'm not really anyone's hero. In fact I'm sort of a disciple. I've got a Pandit that I talk to." "The only Pandit that: people here in Canada know is Pandit Nehru. He was very Western and he was a lawyer. Trained as a lawyer in England. I don't really know what the word Pandit means." Except: I knew what a "pundit" was. "Pandit is a title of distinction given to certain people like Pandit Satyajit Ray and Pandit Deepak Chopra. But when my art really takes off, I will be a Pandit, too. But I'm in the process of rethinking things. Do I want to be a doctor or an artist?" "I guess it's a mystery." Mr. Banda was eager to talk further — his own secrets had caught his attention. But there was no rush; psychotherapy is rarely an emergency. I stopped the interview while I still had him thinking. There was ambiguity in the air and that would be good for him. Yes, I thought, that's what Mr. Banda needs: darkness and ambiguity. "We'll find a therapist for you. Twice a week." "Twice a week? How come?" "Can't learn to play the piano if you only practice once a week. Or tennis. This is the game of life we're talking about. It's time to stop." The students were dying to ask how I had guessed Mr. Banda was the Lord of Man. God bless students: they think I know how the magical part of my mind works. They like my flashy tricks but are also puzzled about what I am up to. They don't know yet that I intend to create misgivings in them about their own profession, especially about psychiatry's built-in authoritarianism, hierarchy, patriarchy and hero worship. The bitterest pill for them to swallow will be my denial that they and I differ fundamentally from our patients.

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Because patients suffer, I have to be careful not to be a ham in my sessions. Just the same, I needn't be utterly sober and sincere. I can be comical, magical and whimsical if I do it right. Sober psychiatrists could do with a bit more impudence.

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CHAPTERjfWO

THE BIRTH OF WEIRDHESS

On Quebec Avenue, behind a garage, my friend and I, both of us five years old, had a good look at each other's rear ends. Rear ends were, of course, hard to see, as were the front ends of girls. Bums weren't as mysterious as the front ends of girls, but we had settled what we could. That day, my friend and I realized sex is a great mystery, and I figured out that, if I wanted to become a psychiatrist, I had to learn to investigate mysteries diligently. Of course, my mother wanted such curiosity to stop, but instead I transformed it into a career, a career for which unending curiosity is mandatory. I had on a hated pair of short pants, hated because they buttoned at the side. By age five, I had already decided that manliness was an issue, and these shorts were for sissies. It was hell. As if to bring extra trouble into my life, the damn shorts wouldn't let me button them up. "Why are your shorts unbuttoned?" my mother asked. I made an excuse. "Just tell the truth and you won't get into trouble." I had heard that one before, and also the one that promised, "I can tell by your eyes if you are lying." But I told the truth just the same, and got a licking. The betrayal was bad enough, but worse was to come. When Dona, my mother's

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sister, came over, with me right there in the room, the story of my sexiness was told. They laughed uproariously and I was humiliated. At age five, I made a resolution then and there I would never tell my mother my secrets again, and over the years, I've mostly stuck to that vow. I had been betrayed by my mother and was therefore justified in having perpetual revenge on her. It's a pretty hard fate for a mother. Most of die time, I am a responsible son, and on the surface, she has nothing to complain about. But somewhere in her being, she knows I have imposed a life sentence on her. This is one of my great personal myths, and, like all myths, it shapes and justifies my life. No one ever has to worry about me being a mommy's boy. If I have trouble with a woman, I'm always in the right. I'm especially good at always being in the right — I told the truth didn't I? You can see that my myth cannot include the idea that I am a bad guy; I do my duty. In our myths we carry the truths we like best, myths we can apply to the world when necessary. My myth includes the idea there is a bad mother on the loose in the world, and I am such a good fellow I haven't fallen into the trap of slaying the monster by turning into a monster myself. At this very moment, you can see I don't condemn my mother outright; I concede that this is a myth of mine. We all have analogous personal stories, usually with die same self-absolving intent. Narratives are the material of psychiatric work. You can see my first descent into hell takes me straight to my mother and straight to my eventual career. But hell has many levels, and the well of the past, many entry points. For some, it's past lives; for others it's in the stars. For me, it's in history.

I'm a conventional man — at least on the surface — so where do my magic thoughts come from? The ability to diink in odd ways has, I

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suspect, always been in me. In medical school, I had two groups of friends. My real friends, I thought, were athletes and beer-drinkers — regular, good guys. But my other group of friends was made up of oddballs, people liable to say to a patient, "So, you are the Messiah." My best friend was Graham Copeland. He had intended to be a concert pianist but at his mother's insistence had gone to medical school instead. Graham was effeminate and nowadays it would be obvious to me he was gay. In the late 19505 homosexuality was treated differently than it is now, and gay men tended to hide their homosexuality. Although I suspected Graham was gay, in those days, the tradition was to overlook suspicions and to think of someone as homosexual only if they were known to engage in actual homosexual activities. I'd had passes made at rne by a few male friends, and for them, the word homosexual applied. Since none of us knew of actual homosexual behaviour, neither I nor any of our medical school classmates labeled Graham as gay. Despite our modern self-righteousness on such issues, we were no more judgmental about homosexuality back then than we are now. But in the '508, the common courtesy was silence, so we held our tongues. Sure, my straight pals and I made vulgar and what we thought were hilarious remarks about "fairies" and "faggots" in general — much like the modern locker-room crowd — but we said nothing about particular guys we may have privately suspected were gay. I was drawn to Graham because his mind was different and odd. He was tall and raw-boned and, in an era when hair was to be parted on one side, his was combed straight back. The signs of effeminacy were in his soft puckered mouth and his fluttery, expressive hands. Graham didn't give a damn about fancy clothes or style because he preferred the world of classy, magical minds. Memory interrupts me with a thought that I don't like: My father pursed his lips; he had a mobile puckered mouth. And I, too, purse and pucker my lips.

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Graham's friends were musical aesthetes, but what I noticed was that their talk and their banter was ironic, mocking and playful. The world of heartiness, of good marks, and of being sexual was well known to them but, without rancor, they believed that world was the stuff of mediocrity. The standard society merited only plaintive amazement and wistfulness — a wistfulness that these things mattered so much to the rest of us. Graham and his friends Erkki, John and Gwen got together regularly to play the recorder. When invited, I was stunned to see these four, youthful adults passionately playing recorder duets, trios and quartets. There they sat, uninterested in prowling the city in search of girls (as I thought all young males were), fluttering their fingers over the stops of instruments I hadn't even known existed. On New Year's Eve, they roasted a boar's head (it was mostly gristle and fat), paraded it out the back door and back through the front, a procession accompanied by spirited Finnish songs and sayings. All were Canadian born, yet all had a distinctive way of speaking that, to my ears, was almost discrete enough to be a dialect: a mixture of effeminacy, prissiness and arrogance, with a bit of haughty, English pomposity thrown in. All were diseased in that they suffered from degenerate artistry and extreme and wicked outsiderdom. They scorned the ordinary and the coded messages they exuded caught me unawares, aroused me and tempted me. In my head and when I spoke to Graham and his friends, I sometimes practiced speaking as they did. But I never did it in the ordinary world. I still don't speak that way — except when I interview patients in front of the students, a clear giveaway that I've always been a secret blood brother of Graham, Erkki, John and Gwen. Graham was busy living life rather than living out his medical student duties. One night, before an important exam, he appeared at my door drunk and asked to borrow my notes. He'd taken no notes

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THE BIRTH OF WEIRDNESS

during the year, and had no textbook. I tutored him for a few hours and, smart as a cat, he passed. But the experience didn't seem to scare him; he kept playing his ukulele out on the grass while the rest of us were attending lectures.

I spent a happy year as an intern at the Vancouver General Hospital. A few months before the internship began, Graham called to say he, too, would be interning at the Vancouver General Hospital. I knew right away the arrangement had been made so he could be with me. In keeping with the semi-secret attitudes of the times, I didn't let myself clearly know the strength of Graham's attachment to me, and to the extent I did, I attributed it to his tendency to be "dependent." I didn't dare think he loved me or had a crush on me. My belief in Graham's dependency was supported by a phone call I got from his mother. "How many pairs of underwear are you taking with you to Vancouver, Gordon?" "How many pairs of underwear? . . . underwear?' I mumbled an answer but also had the standard reaction to the mothers of homosexual men: she was "overprotective," "overinvolved." No wonder Graham was . . . whatever he was. When our internship ended, on the afternoon Graham left Vancouver to return to Toronto, I found a note on the floor of my room. June 29, .rpj^ Dear Gordon I'm sorry. I didn't have a chance to pack. Could you pack up my room and ship my stuff to Toronto? Thanks. Graham

Graham had been my ticket to the most interesting people who

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worked at the hospital. He quickly attracted a group of friends just like die recorder-playing, boar's-head-eating gang back in Toronto. There was lots of ukulele playing, singing of folk songs, and the same high-spirited self-mockery, combined with a sensitive, confident elitism. They all spoke in the literary style usually reserved for the written word. How, I wondered, did they manage this? Had they memorized The New Yorker magazine? Was Bob Hartt practicing this special language when, on die chairlift going up Grouse Mountain to ski, he sat reading Emily Dickinson? But unlike the disdain for luxury exhibited by the Toronto-boar's-head gang, the Vancouverites were suave, beautiful people with aristocratic plans and pretensions. Secretly, under my breath, I again experimented with speaking their attractive, forbidden form of speech. During that year in Vancouver, Gwen, the girl from the Graham's Toronto gang, came to visit. I realized during her visit that she loved Graham, but also knew her love was futile. I wondered why she loved him, since she and another fellow in Toronto had seemed destined for one another. I also wondered why she didn't take a shine to me. 1, after all, was solidly male, available and interested. But no, Gwen only had eyes for Graham, who obviously couldn't reciprocate. He had eyes for me. Graham even pimped for me at the student nurses' residence across the road from the hospital. He and I frequently went to the foyer of the residence, where there was a grand piano. Graham played sonatas, polkas, and gigues — anything at all, as long as it had a penetrating bony sound. As though responding to the Pied Piper, the student nurses left their rooms and. gathered around the piano. Although the nurse's residence wasn't Hamelin, it was . . . heaven. But in retrospect, because Graham was soliciting for me, it wasn't heaven for him; it was hell. Toward the end of the year, the hospital had a big, end-of-year

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THE BIRTH OF WEIRDNESS

dance. I was with my nurse-sweetheart, and Graham, although he was faking, also had a date. Graham was busy "passing" but he no longer fooled me. That night, he got very drunk and, late in the evening, approached me tearfully. He embraced me drunkenly, kissed my cheek, and cried out in despair, "What am I going to do? I'm crazy, I'm schizophrenic." Consumed with jealousy and rage, he almost violated our unspoken vow of silence. In the language of the boar's-head gang, the correct thing for me to have said would have been, "Why, my dear Graham, this is rubbish. You are certainly not schizophrenic. You are merely confused about your sexual orientation." But for Graham that night, it was no laughing matter. Now, 40 years later, I know the story of Graham and me is an archetypal story; we were Sebastian and Charles of Brideshead Revisited. The realization came upon me like a bombshell when, by chance, I met Jeremy Irons, who played Charles — my role — in the television version of Brideshead. When I first watched that series, Charles was a heterosexual man who, through his homosexual friend Sebastian, discovers art and spirited life. No longer as nervous about my inner life, I now agree with the verdict of two floozies in the story who declared that Sebastian and Charles were "a couple of fairies."

Any psychiatrist worth his salt knows what I'm talking about. It's not possible to be a psychiatrist without having access to womanliness in oneself — manliness, too — not to mention an understanding of other, marginally acceptable things. Weird, magical thinking is what let me sneak into Mr. Banda's mind and ferret out his secrets, but I can't do that job unless I have a brace of unorthodox inclinations, "gay," perhaps, and maybe my dark, German side. But to really delve deeply into this, I must think strangely and turn rationality upside down:

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THE CURE OF FOLLY

We Germans wallow in music to excess — with us, music is a sickness — and every concert hall and opera house in Germany reeks of that vague, non-verbal sickness. I therefore search out the twisted obscurities of German music and, in keeping with my rational tastes, the twisted obscurities of Hegel, Marx and Heidegger, the tricky philosophers who fool us into thinking they are rational — until we try to read their books. Like them, I am rational on the surface, even in my approach to music. But if I'm not critically afflicted by the music sickness, I'm not a real German and therefore I must, methodically, rationally, and in mathematical order, learn the right symphonies and sonatas. No more pretending I'm simply a goy. I must face the delicious truth that I'm rooted in Jewishness. It's the horrible Jewish stereotype that comes to mind, the JAP of outwardness, the one who is mocked for his materialism, but that is the wrong image. The German identifies with a different Jew, the essential, dark-minded Jew who davens, thereby showing his kinship with the inward, ambiguous and skeptical German. It unsettles the standard world to know that Jews and Germans are blood brothers. German, Jew, weird-thinking, the sick sweetness ofSchonberg and Wagner: it's a filthy brew and the conformists — the ox-brains— don't like it. It is mandatory for me to be as Jewish as possible— my profession is largely populated by Jews— and I have to succeed at this before I can face up to being German. Jews and Germans relish their tendency to contemplate their innards, but we've achieved no sublime transcendence; it's just what we Germans and Jews like to do, marching to the tune of our cultural destinies — our reputed cultural destinies. We don't play the game of conformity as well as we should, which means we tend to be rulebreakers. Since World Wai' n, Germans have been furtive about this and, in order to stay invisible, break rules in the secret nooks and crannies of their own minds — we Germans who live in the diaspora behave ourselves. We also concentrate on semi-invisible things like music. Music is non-verbal so it's hard to catch us up in our depravity.

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THE BIRTH OF WEIRDNESS

Jews are more public-spirited rule-breakers — they let their presence be known. In 1939, when I was six, my family and I were at Lake Wilcox near Toronto. There was a sign posted on the beach: "Gentiles Only." I asked my father what it meant and he matter-of-factly said that we were Gentiles and Jews were not allowed on that beach. I had no idea what a Jew was, but I knew it was a category of person. Later that day, I spoke with a boy on the beach and told him (I was bragging) that my uncle Charlie taught swimming at the YMCA. He responded by saying he swims at the YMHA. I trotted back to my father and asked another question: "What's the YMHA?" "It's like the YMCA except it's for Jews," my father told me. I was indignant. Not because I had bad thoughts about Jews, but because there was a sign that said "Gentiles Only," which meant my Jewish friend was breaking a rule. German children are good, I thought, and always obey rules. Canadian children break rules — they are ruffians and are dirty — and this boy was a clear example. A sign was there for everyone to see and he had disobeyed. Ergo, this bad Canadian was transformed into a bad Jew. I can prove that I'm a German; somewhere in the family there is a piece of paper that, by way of baptismal certificates and church records, proved to the Nazis my family was Aryan. And then my mind turns to other truths, truths that are peculiar and delicious: My Jewish credentials are as impeccable as my German credentials. To this day, the bulk of my patients are Jewish. Jews and I attract one another; they sniff me out and I sniff them out. I have a story to explain this, but it's a made-up story with which I ward off the Nosey Parkers who aren't equipped to know the uncanny facts. When I was young, I wanted to fit in. I spoke English well, was a good, studious boy, became a doctor and chose as a wife a woman who had good Anglo-Canadian qualifications. I'd always known I would be

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a psychiatrist, but the odd and the unusual didn't show in me at first. Now, it shows with a vengeance and I expect diat by the time this book is done, I'll have degenerated enough so that I can sign off: "Auf Wiedersehen, Jerusalem, 2003." Don't forget my homosexuality, that mind-awakening trait disclosed by my seven-year friendship with Graham Copeland. Everyone knows about the Jewish-homosexual conspiracy, but most don't know that Germans, too, are implicated. We cleverly keep our creepy, homosexual side secret. Since a friendship is not conclusive evidence that I belong to that secret society, I need to provide additional proof that I am a sissy. In the spring of 1939, I got scarlet fever. I woke up in the middle of the night delirious, with a high-pitched humming in my ears, trying to make a dream go away. In those days, scarlet fever was a worrisome infectious disease, and I was hospitalized for six weeks at the Toronto Isolation Hospital. I had never been away from my parents before. Other children in the hospital had scarlet fever, but some had polio. There was no treatment for scarlet fever, so we just waited it out. I was homesick, but never let it show because, even at age six, my everything-would-work-out-for-the-best attitude was already well developed. The hospital was strange, mostly because I'd never slept on smooth, cool sheets before — our sheets at home were flannel — nor had I eaten the strange WASP food. Lunch was sandwiches made with white bread, and the evening meal was three discrete portions — meat, potato, and vegetable. I was accustomed to mixtures and sauces. My most vivid memory is of rice pudding and tapioca pudding, foreign and strange, both of which I loved. One night, the boy in the next bed dumped a shaker of pepper on my tapioca. I was shocked at his misbehaviour, and it only confirmed that Canadian children were, as my mother said, wild and bad. I, of course, was very good but 1 liked the mischief of the other kids, and

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THE BIRTH OF WEIRDNESS

would've been better off had I been more mischievous myself. I had a blister on my thumb, which the nurse punctured with a needle. I sat on the floor between her knees, gave her my blistered hand, and woke up in her arms as she carried me to my bed. It was the first time I'd ever fainted, but I don't remember being humiliated. It didn't happen again for three years, but when I was ten, I fainted again while we were lined up for our diphtheria toxoid shots at school. When I came to, I was sure that my reputation as a boy had been destroyed. Immediately after it happened, the boys in our class went to another elementary school for "manual training." We ran most of the way, and I ran hardest of all, trying to blot out everyone's sissy memories of me. That same year, in health class, the teacher spoke of veins carrying blood from the arms and legs back to the heart. "My God," I thought, "I'm sitting on my bum, there are veins there, and they're being squashed." It was time to go out for recess, and as I walked to the cloakroom the darkness was swirling in my eyes. I staggered, and fell into the wall. That time, I was able to pretend that I had tripped and knocked myself out by hitting my head. The teacher checked my head, seemed to realize what had really happened, but didn't say a word. It was Mr. Russell, a teacher who earlier that year I had challenged in class — it was 1942 — when he had made an anti-German remark. For 40 years, the threat of humiliation that came with fainting hung over my head. The need to be sure I was a man, a real man, was never far from my mind. No visitors were allowed at the Toronto Isolation Hospital, so parents gathered in the lane behind the hospital, waving and gesturing to us through a window. Some parents pried open the windows and passed in toys. A few children, knowing they would be leaving the hospital soon, handed toys out to their parents to be taken home. This was not allowed; toys in the hospital were contaminated, and had to be left behind.

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"Probably Jews," I thought. To me, clean and German, the window prying and the smuggling were outrageous. I was prissy and pleased that my parents did not try to break the rules. Or was I as pleased as I think?

In 1961, I began my psychiatric training at the Menninger Clinic in Topeka, Kansas. Graham Copeland followed me. He had worked briefly as an anatomy demonstrator in Toronto, and while I saw little of him, he knew my plans and applied to the same residency program. By then I was worried his attachment to me was harming his independence, so I made sure Graham traveled to Kansas on his own, hoping he would find his own life. After one year in the psychiatric training program, Graham abruptly quit and went to study music at McGill University, determined to become a concert pianist. He never practiced medicine again. During that year in Topeka, he stopped hiding his sexuality and moved in with Peter, a black psychiatric aide at Topeka State Hospital. Peter had the same mannered way of speaking as the Toronto boar's head gang and the Vancouver intellectual aristocrats. Had he learned it from Graham?

Karl Menninger s books convinced me I should train in his program. He wasn't Jewish, but as a German, he was close enough. Dr. Karl (that's what we called him) was a show-business character and a genius. His passion for social causes immunized me against those who feel psychiatry should be scientific and technological. I didn't know it at the time, but Menninger's humanistic approach to psychiatry tapped into my secret world of sissy interests — a traitor to manliness, logic and progress.

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I first met him over coffee at a meet-and-greet for new psychiatric residents. He was a tall, enthusiastic man with a broad smile. "I'm Karl Menninger," he said, with a definite Kansas twang (to a Canadian, his dialect sounded exotic, like he was from the Deep South). He wore a conservative suit, with a checked flannel shirt and string tie. For a psychiatrist, the "cowboy shirt" seemed daring. He led me to a group of people with whom he had been chatting, and introduced me to each one. I soon realized that these were new residents whose names Karl Menninger had just learned. He never forgot my name either. Dr. Karl's passion for social causes would have a strong effect on all of us. For example, he said that "To call someone a schizophrenic is no different from calling someone a nigger." For many years, I struggled with that phrase — it seemed too harsh and I feared that if I used it, I would be seen as a fool. Now I know I hesitated only because I didn't yet have the courage of my convictions. Karl Menninger could say it, but I couldn't. I eventually grew up and figured out that, even though it alienates me from many colleagues, I can say firmly that calling someone a schizophrenic is no different from calling him a nigger. I know that words like schizophrenia will always be with us, but when used earnestly and concretely, they corrupt our clinical thinking. Karl Menninger's favourite campaign was against psychiatric diagnosis, which, to him, was just psychiatric name-calling. Were he alive today, he would be appalled at the new epidemic of insulting talk about patients, about suffering people who are given the nasty titles "personality disorder" and "borderline." ("Borderline what?" I might ask.) He also raged against the killing of fur-bearing animals, bad prison conditions, and the mistreatment of North American aboriginals. These passions made passion legitimate to me, and inspired me to adopt passions of my own.

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I tried to identify with Karl Menninger, but identifying means changing your soul and such things can't be done by trying. A rocksolid identification with someone means becoming him, being him, a fundamental reorientation that, despite its profundity, is done unwittingly. Instead of admiring and loving Dr. Karl, basking for a while in my hero worship, I used to complain about his showiness, his carelessness about detail, and his tolerance for the sycophants who fluttered around him. I grabbed onto his virtues and claimed them as my own, rarely acknowledging that he had inspired me. I decided early on that I would be a psychiatric idealist: I'd never waver from my duty, never make jokes about patients, and never, ever, think of patients as having a status less worthy than mine. Karl Menninger didn't say most of these things explicitly, but he exuded those attitudes, and though I didn't see it at the time, his attitudes fell on fertile ground. Since I was a German, I was in need of a model for how to behave without prejudice. I knew how to rein in prejudice when I talked politics with my friends, but under Karl Menninger's influence, I learned how to do it as a psychiatrist. He came from Pennsylvania Dutch stock, but I knew "Dutch" was a euphemism for "German," though he never made mention of his German ancestry. I had modeled myself on plenty of other father figures before Dr. Karl. I was certainly a version of my music- and history-loving father, but he was wretchedly deficient for the world of idealism I craved. Instead of putting a stop to the stupid cruelties toward children of my mother and her sisters, he stayed passive. His love of my mother was expressed through unwavering tolerance of her ways and by indulging her. I was an angry, perfectionistic idealist, as was Dr. Karl, and my soul imbibed, feasted, and sated itself on him. His image stood on the shoulders of the other, earlier models I had tried out: my high school principal Norman McLeod, for example,

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who I admired and who, using a clever form of split thinking, I thought I scorned. He taught me never to say, "She is a Christian while you are a Muslim," but instead to say, "whereas you are a Muslim." There was also my Uncle Charlie, the swimming teacher with the muscles and Dr. Broad, our family doctor who, knowing that, as enemy aliens we had no money, had charged us no fee during World War n. The safest fathers were fictional characters like the enigmatic Tarzan of the Apes. Like all children of my era, I grew up with Greek myths, so I knew and loved Achilles, Jason and Perseus. I was also enthralled by Joseph, the biblical dream interpreter, who I learned about in Sunday School. I'd picked up the scent of idealism before I met Dr. Karl, but, without getting credit for it at the time, he gave me a language and a cause. No psychiatric name-calling, never abandon hope for anyone — anyone— and offer help to all who ask, no matter how stupid or hopeless they appear to be. The idolatry is not over yet. Tomorrow it will be Thomas Mann or Marco Polo. But the one who I loved — even though I didn't know I loved him when I was his student — is Karl Menninger. It was all about figuring out how to turn myself into a psychiatrist — a real psychiatrist, not one who chased symptoms away as quickly as possible — and watching the role take ever deeper possession of me.

Karl Menninger knew he was a public figure. Some saw his behaviour as a product of too much ego, but I knew better. This was no cheap vanity, but the sign that he was a creature of life, a warrior, a psychiatric Muhammad AIL He was never a thin-blooded obsessive and his flamboyance woke us up and made us think. Karl Menninger was enacting his destiny. It was a social role that owned him, body and soul. Drama attracts attention and Dr. Karl caught attention wherever he went. I took him to lunch in Toronto many years later and,

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although he didn't speak in a loud voice, others in the restaurant noticed him and whispered to one another, "Who is that?" Each Sunday, Dr. Karl taught a Bible study class at the hospital. The patients in the C. F. Menninger Hospital couldn't figure this out. Some thought he must be nuts; others suspected he was a Christian missionary. They must have been surprised when his subversive mind — not sacrilegious, subversive — stirred them up. What in the world could be going on when the most famous psychiatrist in the world teaches Bible studies, they wondered. The psychiatric community shared their ambivalence: "He's nuts," "Its show-biz," "Dr. Karl is just doing his number again."

We had the privilege of inviting Dr. Karl to consult with our hospital units, so I arranged for him to come to our little team meeting. He came, but we had to wait six months. On the big day, Dr. Karl arrived with a photographer, a dog, and a dog handler. I don't know whether this was a special day, but our reactions were mixed. Was he a fool? A hero? A god? Don't underestimate the importance of drama. After such an entrance, who could forget what happened later? I presented a case of chronic depression, a woman who lived several hundred miles away in western Kansas. When she arrived to be interviewed, there was more show business. When the woman sat down, Dr. Karl looked at her with a puzzled expression on his face. Suddenly he stood up. "Sarah," he said. "What are you doing here?" Sarah (patients are never to be addressed informally, by their first names) also stood up, they embraced, and both burst into tears. It turns out they had attended high school together 50 years earlier. And what did Dr. Karl recommend? It all seems impossibly silly to me today, but he recommended that she fly to Topeka three times a

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week for analysis. Her husband was wealthy and this posed no financial problems. To make such a recommendation with the sparse information he had was an outrage, but don't forget Dr. Karl was a dramatist and a teacher. He was telling "Sarah" there was hope for her, and he taught us youngsters the same lesson.

Saturday mornings, Dr. Karl held a colloquium. Most of the psychiatrists and students attended, perhaps 200 in all. On picnic tables around the perimeter of the room were duplicated copies of articles and book chapters the great man had read during the preceding week, and which he thought would be of interest. Many of the articles had been sent to him by colleagues (eventually, I also sent him an article or two). The colloquium consisted of Karl Menninger's commentary on the ideas that had stirred his thinking. In the front row sat senior colleagues, who acted as intellectual consultants. Most were psychiatrists and psychologists, but often there was an English or Philosophy professor as well. If he got stuck in his thinking — he often forgot words or phrases, a tic that kept the audience on edge — he would turn to his front row and say, "Harold, what is it that Shakespeare [Erasmus, Freud] said about this? What was that quote?" The colloquium was always spiced with complaints about social problems such as crime and jail conditions. "Uh, how many of you have visited the Shawnee County jail?" he asked. "It's just up the street here. It's a good jail, mostly because of the work of one woman, a wise woman who lives here in our town. As responsible citizens, have you visited it?" The audience was silent and a few people raised their hands. "Well, if y'all haven't visited our local jail, are you any different from the Germans, who, after World War n, claimed no knowledge of concentration camps?"

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What else could one hope for in a teacher? He made us think. Having chastised us, Dr. Karl proceeded to rub it in. "I tried to get some prisoners to come over here to the colloquium today, but nobody seemed able to authorize it. But I phoned the state penitentiary and they agreed to let the Leavenworth State Prison choir come to meet with y'all." Sure enough, at that very moment, the choir entered through the rear doors. They were in chains and, within minutes, the audience was in tears. Naturally enough, melodrama was compounded by more melodrama: they sang "Nobody Knows the Trouble I've Seen." As "flair" had come to own Dr. Karl's soul, he had no choice but to poll the prisoners. We all knew the questions and what the answers would be. A black prisoner. "What was your offense, sir?" "Break and enter." "What is your sentence?" tCT" »3 rive years. A white prisoner. "What was your offense, sir?" "Break and enter." "What is your sentence?" 1 nree years. Murderers? Black: 20 years. White: 12 years. As I watched Dr. Karl's performance, I realized his theatricality wasn't a quirk. He was an icon, madly doing his duty and performing his role. The power of roles became clearer as I watched him. I saw how I enacted the complementary role of student. I, too, had a destiny as a storyteller, as an admiring student, as a propagandist for a certain vision of psychiatry, and embodied a role, sturdy and irresistible. In my own way, I was as ardent as he was, and as skilled as a disciple of Socrates or of Christ. I knew how to do it now, and indulged it as passionately as I could. It was a once-in-a-lifetime «^T-ll

??

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opportunity. Karl Menninger was my one and only chance to be stamped into a psychiatrist, a role I'd always been moving toward. What else did Karl Menninger do? Well, he rode a horse, and made sure that we saw him, dressed as a Kansas cowboy, riding the grounds of the Menninger Foundation. He was 70 years old. He also read a book and wrote a review of it for publication, every day. I saw him at concerts, busily reading. Where he found the time, I don't know, but he also carried on an enormous correspondence. He once said that he wrote 40 letters a day. He also lectured to the psychiatric residents every week, something unheard of for the director of such a large institution. Usually, the lecturing duties of directors and heads of departments consist of ritual introductory remarks made at the beginning of the academic year. In September 1961, we had our first psychiatric lecture, in the auditorium of the Winter VA hospital. Sure enough, Menninger appeared at the front of the room, wearing a professional white coat. In his hand was a list of the psychiatric residents. "Instead of starting at the beginning of the alphabet, lets start at the end today. Let's see. Dr. Warme? Is Dr. Warme here? Ah, there you are. Would you please corne up to the front?" There were two chairs. "I have a patient for you. Please interview him for 15 or 20 minutes, then let him go back to the ward. His name is Mr. Donaldson." He gave me no advice, no support, no encouragement. The patient, a young man of 30, came in. I introduced myself, and we shook hands. His handshake was feeble, and he sat there silently during the whole so-called interview. I asked why he was in the hospital, what he needed help with, whether I could be of help or answer any questions. I offered him a cigarette, guessed out loud that he must be feeling uncomfortable, and reassured him about the 40 people watching. In the end, I probably needed reassurance more than he did. I was humiliated and on the verge of a

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nervous breakdown. After 15 minutes, I told Mr. Donaldson he could go back to his ward. "That was fine, Dr. Warme." Dr. Karl turned to the class, and asked for their opinions. There were a number of suggestions about how I might have proceeded and had a better result. Most of the remarks had to do with how I might have made Mr. Donaldson more comfortable. Dr. Karl was amused. "Well, Dr. Warme, let me now tell you something. Mr. Donaldson is actually not a patient. He is one of your colleagues, a fellow resident, who I asked to be the patient for today. I told him not to speak." I, for my part, was not amused. In fact, I hated him for humiliating me. Dr. Karl wanted to make die point that, when interviewing patients, we must use the social skills we already possess. We already have the interpersonal skills that make for a worthwhile interview, he insisted, and there is less to learn about interviewing than we sometimes think. To cling to an artificial "professional" style or to a predetermined series of questions is futile. What he wanted to illustrate was that, faced with an impasse, I had no recourse but to fall back on my personal methods. It was part of his personal propaganda, a message of humanism, dramatized at my expense. As I write these words, I wonder whether the interviewing seminar I have conducted for zo years was born out of that first humiliation Dr. Karl inflicted on me. Isn't it true that my own interviews are always a dramatic illustration of my social ingenuity, and never demonstrations of a silly technique? At the end of our first year of training, we were required to write a dissertation; only then could we move on to the second year of program. I was a conscientious student, and die first of the residents to complete and turn in my dissertation. Two days later, it was sent back. Dr. Karl had written on it: "I've only read one sentence. It's a dreadful

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sentence and I refuse to read any further." I was both humiliated and frightened. Would I have to produce a new dissertation? Was I in trouble with the great man? Hopefully, I thought, he doesn't know who I am, and I won't be in jeopardy. I couldn't believe that Karl Menninger himself took the trouble to read the dissertations. There were hundreds of teachers around, and he read dissertations? In despair, I went to my supervisor. He smiled. "Dr. Karl does this every year. Change the first sentence, change the title, and wait a few weeks before resubmitting it." A few years after I left Kansas, I had an article published in a journal. Within a few days, a letter arrived, three sentences long. Dear Warme I appreciated the nice article of yours in the current issue of the American Journal of Psychiatry. I didn't understand what you said about ethology. I trust things are going well for you and your family. Sincerely Karl Menninger, MD

I was flattered the great man had written to me, since I had been only one of hundreds of students. In a few weeks I wrote back, explaining what I had meant about ethology. Within days I had an answer. This pattern continued. Karl Menninger answered my letters immediately, I answered after a few weeks. I didn't want to burden him, you see — he had to be very busy — but it turned out that he was never too busy. The correspondence petered out because of me. For Dr. Karl, it was his duty to write to me. It was his duty to be who he was, the American psychiatric culture hero. These days, such heroes don't exist. On another occasion, Dr. Karl was in Toronto and I gave him a tour of the city. As we drove by the Clarke Institute of Psychiatry

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where I work, I shyly said to him, "Dr. Karl, now /am a teacher." He harrumphed, "This isn't the time to be a teacher, Warme. Now you have to do research." I thought to myself, Bastard. Wasn't he the one who'd taught me research has little to do with our work? But then he spoke up again. "I don't mean that silly research that measures statistics and surveys populations. I mean there ought to be research done on problems like epidemic greed and vengeance, problems that cause far more trouble than the so-called diseases everyone is so busy treating."

In my office, I have a collection of miniature horses. Horses are quiet, like Tarzan of the Apes and North American aboriginals, and I have a life-long admiration for all three because they are of the strong, silent persuasion. Silent, like a psychiatrist who won't give his students a chance to ask questions and leaves them to flounder in puzzlement and mystery — to think for themselves. As a kid, it seemed to me that Indians and horses weren't into overt displays of affection or of any other emotion. They understood things quietly and were therefore deeper and more sincere. The silly, superficial Canadian kids were glitzy and false. They liked things that waste time — parties, for example. Better to identify with a horse or an Indian, because to openly identify with Germans was risky business during World War u. Germans in Canada were, of course, reserved. Besides, what else could they have been if, as my mother believed, exuberance was a phony Canadianism. Early in Dostoevsky s Crime and Punishment, Raskolnikov dreams that a carriage driver beats a horse to death with an iron bar. Freud, too, in the case study of Little Hans, tells of a horse that is beaten to the ground. Bodi of these dignified animals sank to the ground, one to his death, without giving up their quiet integrity.

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When I was a child, milkmen and bread men still drove through the neighbourhoods in horse-drawn wagons. I was attracted to the horses, mostly because they were serene; to a child in the late 19305, a horse was a quiet animal that stood by the curb waiting for its master to finish deliveries. When horses walked, they clippity-clopped 15 or 20 metres to the next house, then stopped and stood once again. They had plenty of time to brood and think. But horses were also vividly alive, as confirmed by various bodily functions that were both strange and obvious. Periodically, their contemplativeness was interrupted by neighing, coughing, and sneezing. Enormous patches of skin reacted crankily to flies and twitched them off. Their bum-holes opened up wide and, in slow motion, big steaming turds plopped out, and when they peed, it was a noisy, splashing, smelly waterfall. But even as their bodies performed so splendidly, the horses themselves were composed and thoughtful. "Nobody'd better cross them," I thought. One day, I fiddled with a horse's iron shoe. It stepped on my finger, and I lost a nail. My memory is that losing that nail taught me right from left — it was my left middle fingernail that I lost. Later, I drew horses constantly, hundreds of horses, herds of them, wild, armored, or with cowboys and medieval knights aboard. The interest in horses had started when I was even younger. At four, I put elastic bands around my head, between my teeth (a bit) and over my neck (a halter), to the chagrin of my parents, who warned that I would choke myself. I knew different and continued to play this game when they weren't around. With tables and pillows from the couch, I built enclosed spaces that, to me, were stables. In my private stable I stood silently, and without ostentation my horse body functioned as it should: I rested one hoof, horse-fashion, on its toe, purred and bubbled with my lips (the nearest I could come to reproducing a horse's sneeze). I also tried twitching my skin. I didn't play at having

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bowel movements and peeing, but puzzled over them, too. I think of my horse collection as having been accumulated by accident, but it didn't happen accidentally. As I tell of my interest in horses, I sense that these are not idle recollections because I'm getting stirred up. And a pun: my parents said I would choke myself; the memory chokes me up. I'm the same with goodbyes. They don't bother me, I say, but there's lots of contrary evidence. My grandfather in Germany had told war stories of the neglected, injured horses at Flanders. My brother, Ernie, whose middle name is "Horst," became a jockey, I was spatially oriented to the world by the horse who injured my finger, I drew horses and now collect toy horses. The past keeps erupting into my mind when people react to my horse collection. I hear their comments and think to myself that, while they don't know it, they are with my grandfather in Flanders fields, with the dying horses. And they are on the racetrack, at Hialeah and Suffolk Downs and Woodbine with Ernie.

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CHAPTERjhKRjpE

HAIIDLED WITH A CHAIII

If you talk to God, you are praying; if God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; if God talks to you, you are a schizophrenic THOMAS SZASZ

Janet Hunter was still interviewing the day's patient, Margaret Jones, so I had time to watch the students. They were all doctors, but to me they all looked very young. I was 64 at that time, but still bemused that the students were awed and impressed by me and that some, probably because they were awed and impressed, were irritable and looking for a fight. I didn't feel like a charismatic leader, but to my amazement, that's the role that I occupied. I needed only the title of teacher, to narrow my eyes enigmatically, and that's what I turned into. In the back of my mind, I'd always had the feeling that, because I fainted, I was an unimportant sissy. But people refuse to cooperate; my opinions are listened to. That day, across the seminar room, sat Leila Singh. She was sweet

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and pretty, like a child, but smarter than she let on. I suspected she kept a low profile so I wouldn't call on her to offer an opinion. She wore a sari and, as I walked into the room, she had casually — or should I say cunningly — wrapped her long silk scarf about her head. Leila was not Muslim, of course, but I thought to myself that, like many Indian women, she was copying the Muslim tradition, using her scarf to turn her sari into a modest chador. She knew hiding her charms would alert the world to them. I have to be careful about noticing womanly charms because, since my divorce fifteen years ago, my reputation is stained. Those who guard my morals — my paranoia suspects that it's everybody in the psychiatric community — are acutely aware that I notice womanliness more than when I was married, an observation that is surely pure imagination. A first year resident in psychiatry, Leila was still prone to rely on traditional medical thinking. She wanted me to make clear-cut diagnoses, and was always quick to suggest drug treatments. Her ambition was to be one of the orthodox, desperate to establish that psychiatry was about real, biological diseases and real treatments. She noted my eccentricities, but hadn't yet realized I was demanding that she radically change her way of thinking about patients. Beside her sat Osman Awad. Osman was my oriental prince, a very handsome devil. He was a Lebanese Christian, lean and tall with nice white skin, fine bushy mustache and a bass voice. Osman was flirtatiously trying to start a conversation with Leila but he was too obvious, too overtly friendly, too masculine. This seemed to make her nervous, so she avoided his attentions by turning toward a suitably Canadian student across the table from her, a student whose name I didn't know. Osman was an intellectual. He had read a lot of Freud, and like Leila, he was keen on discovering final answers about patients. But the final answers he was looking for were not the strictly medical answers

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Leila wanted. He wanted theories that would nail down truths like "he is a criminal because he has superego defects" or, "his primitive impulses broke through." Osman was a lot like me when I was a resident, very focused on rationalism, and I was impatient with him because I thought he ought to get over his reliance on reason — he ought to make it snappy and start thinking like me. He had seized on Freud's metapsychology: people do what they do because of an ego, an id and a superego — structures that govern their behaviour. The ego is the steering mechanism, the id is the fuel, and the superego a set of rules that guide the ego. Osman propped up his thinking by quoting Freud who, I have to admit, did like to play around with fuzzy metaphysical ideas. What Osman didn't realize was that this was a side interest of Freud's, and his real aim was to describe the striving, lively people who came to his office and notice things about them that hadn't been noticed before. This was Osman's second year in my seminar but his misreading of Freud — very common, of course — made him prone to being thrown off balance when I didn't use psychiatric jargon. He thought words like ego, self, cathexis and narcissism were terms that referred to real, solid things. His pursuit of Leila hinted that he was interested in a real, vivacious life, but when he described patients, he became wordy and intellectual. He was a typical psychiatrist, if not a typical member of the human race — we all theorize: "She does it because of her genes, her chemicals, her upbringing, the bad company she keeps, her Oedipus complex." Nobody wants to take notice of Wittgenstein and Shakespeare, luminaries who teach us to attend to the fumes and sparkle of what people actually do. To hell with metaphysical certainty, they teach us, and to hell with its opposite, skepticism — that refuge for those who glom onto a reverse dogma when they realize the truth can't be pinned down. Osman was neither bad nor stupid; he sought solace in theories

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like the rest of us. Not everyone can be like me (when I'm not a sissy) and know the final truth. It's just that everyone thinks he's got the final truth. One day, when I spoke of how a patient laughed so he wouldn't cry, Osman translated my words with just a hint of impatience: "Her laughter is a reaction formation against grief." Another time, when "envy" was mentioned, he turned it into a quasi-theoretical term: "His pathological envy causes him to repress any awareness of aggressive impulses toward those who surpass him." I hadn't yet fully whipped her into shape, but Christine Brydon, a new member of the seminar group, was catching on fast. She had an appointment to meet with me later that day because she was applying to be my full-time resident for the next academic year, beginning July I. I had heard that she was a good resident, and while we waited for Janet Hunter, she commented on Mr. Banda, the patient we'd seen the week before. "Why do psychoanalysts make patients sound so boring by reducing them to uninformative theories?" she said. "Why, for example, do they say people like Mr. Banda have an Oedipus complex? Why don't they just describe his actual fear: that he has made everyone love and admire him — including his mother — and that he'd pushed his father into the shadows?" It was an excellent question, and not one I expect to hear from students. Obviously she had smelled my way of thinking and was letting me know she and I were on the same page. I noticed I was looking forward to my interview with Christine which, perhaps, was precisely what she had intended. I never had to answer Christine's question because at that moment Janet Hunter, breathless, entered the room. "The patient came a half hour late. When I took her into my office, she said she needed some water and went to get some. Then, when she got back, she said she needed a cup of coffee. She didn't

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come back for 15 minutes, so we didn't have time for an interview. When I told her that she would be meeting with you at two o'clock, she said she couldn't stay because she had an appointment." Janet had been in the psychiatric training program for two years, but I didn't know her very well. I looked at the information sheet and saw that her patient, Margaret Jones, was 18, an age at which psychotherapy is an unattractive prospect. To an old hand like me, her flight behaviour was no surprise. The students, baffled by Janet's news, were waiting expectantly. It was time for me to be a model psychiatrist for the students, calm and inscrutable. I had done my inscrutable routine so often that it had become automatic, and there was no sign, even to myself, that I had any doubts about my actions. Let them find out for themselves, I thought, why teenagers aren't keen on the introspection game. "It's common for adolescents to be uninterested in the world of introspection," I told them. The students knew, because I was scheduled to interview Margaret Jones, the coming hour was free for me and, despite past experience, wondered if I would give them a little lecture about adolescents and psychotherapy, or whether they could raise other work problems with me. I said only that we would meet again next week, and left them sitting in the room. The students always stayed in the room after our meetings and as I left I smiled to myself as I imagined what they would be saying in my absence.

In my office, I was surprised to notice I felt teary. I was imagining that Janet Hunter was a raw beginner, that this was the first psychiatric patient she had ever seen, and that she had lost her case. In my daydream, she was frightened and hurt by today's non-standard assessment. I was identifying with her, thinking of my own first case

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when I was a resident — not today's Miss Jones, but Cathy Jones, a Jones girl of my very own. I'd been thinking about my sick granddaughter, Mariah, and that led me to think of my students as children, too. Despite his fine mustache, Osman Awad was little more than a keen youngster, as was Christine Brydon, who had impressed me, her teacher, with an eager question. Christine wore expensive, dark blouses that didn't reveal her secrets, but her hearty laugh suggested she was robust and erotic, so I tried to cheer myself by thinking that, since Christine showed no breasts, she was also a child. I decided that in the interview I was to have with her later that day, I would have time to check on whether it was really true that she had no bosom. Oh, yes, and pretty little Leila Singh, as well. In 1962, I had been an eager student taking on my first psychotherapy case, Cathy Jones. Cathy was also a child, referred to me by my friend, Graham Copeland, who was her hospital doctor and had told me enthusiastically that her IQ was 140. We were both greenhorn doctors, impressed by intelligence, so we figured this was a good thing. Cathy was only 16, and had been hospitalized a few weeks earlier. She had reported she had been baby-sitting for a neighbour, and when the child's father walked her home, he had assaulted her in a clump of bushes. Cathy became wildly psychotic — hallucinating and delusional — and was sent to Topeka State hospital, a traditional large asylum or mental hospital. She stayed five years. It wasn't usual for a student to take on a schizophrenic patient, especially as a first case. This didn't faze me; I was sure of the powers of psychotherapy, and just as sure my dedication would guarantee a positive outcome. High optimism is a characteristic common to most psychiatrists, especially eager beginners; I've still got a built-in certainty I can help anyone. My teacher, Karl Menninger, had an office down the street, and I was eager to prove the correctness of his words:

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"Calling someone schizophrenic is no different from calling him a nigger." "Wow," I thought, "racism is finished: niggers, kikes, and schizophrenics get psychotherapy and get cured like everyone else. Cathy Jones will benefit from my heroism, and when my colleagues go astray, I'll show them the error of their ways." My teachers didn't question my optimism about Cathy, partly because it fit with some of the then-popular theories of schizophrenia. Put coarsely, the theory was that such patients had been badly patented — mothered — and were psychologically damaged. They were, according to this theory, developmentally stunted, in other words, vulnerable to being described in discourteous language: "She is infantile, primitive, immature." The theory used a lot of euphemisms, such as "inadequately internalized maternal introject" and similar balderdash, but there was no escaping the bad-parenting charge that lay behind it. I happily assumed I would successfully re-parent Cathy, with a few fancy psychotherapeutic flourishes thrown in. I did my best, but in those years, my best included a bland belief that Cathy was damaged goods, and I was in mint condition. I adopted two common prejudices: first, that schizophrenics must be made to face reality and, second, that diere should be no risky attempts made to awaken her unconscious. Whose reality, I might ask, had to be faced? Mine? Yours? The patient's? Once it had been decided whose reality was at stake, we would have to decide whether it was the internal or the external reality that was to be faced. In hindsight, I wish I'd focused on her life with relentless curiosity rather than always walking on eggshells.

Cathy was labeled a paranoid schizophrenic. When she was mute and immobile for weeks on end, the label was changed to catatonic schiz-

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ophrenia. The day I met her, Cathy was tied to a chair, both wrists bandaged. The previous day she had attacked a nurse, and when attempts were made to restrain her, had punched both fists through a window and made sawing motions with her wrists against the jagged glass. She was convinced she was under attack and that she had no choice but to defend herself. The rows of dirty windows were usually covered with heavy, escape-proof screens, so someone must have left the screen in her room open. Cathy's door was heavy and reinforced, in case she needed to be locked in. The room was on a big, open ward, 45 metres long and 15 wide, with rows of doors along each side and a nursing station perched like an island in the middle — a fortress boxed with shatterproof glass. There, doctors and nurses huddled together, safe from contamination by the madness that surrounded us. Those who we had baptized as officially mad spent most of their days watching television. The patients made the wooden floors gleam using heavy, weighted polishers. And there was an ineradicable, filthy smell that had infested the old buildings for a hundred years: stale urine, mouse droppings and carcasses, sweat and dirt, disgusting and improper. On that ward a new, antidepressive treatment was in use, a treatment that required patients to do menial work. Despite their scrubbing, polishing and dusting, the smell remained. It was eternal. What was a i6-year-old girl doing in this hellhole?

"Hi," Cathy said warily, as I approached. This was a big day for her. She had been picked to have a psychotherapist, an exciting event in the Menninger Clinic's hospital culture, in which psychotherapists were akin to gods and in equally short supply. As I walked past the other patients on die ward, I realized I was a celebrity:

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"Are you Cathy's new therapist?" "How come that bitch gets a therapist?" "Do you know any therapists for me?" Despite a lot of medication, Cathy was suspicious. She was also pretty, but in those days I thought it was unprofessional of me to notice. Her beauty, her sexuality and her soul didn't interest me because I was searching out disease. I knew her for 30 years and never had the courtesy (would certain moralists not realize that this is a courtesy?) of noticing her figure and the sparkle in her eyes. I only know in retrospect that she was womanly and back then, I unsexed her. She might as well have been a wooden plank, or at least a wooden plank with schizophrenia. There was a deep worry line between her eyebrows, but the eyebrows themselves were prettily arched and mobile. Her cheeks and her figure were pleasantly plump. She wore shabby hospital clothes, and didn't try to hide her bewildered and disheveled state. The day I met her, and for several weeks, she argued with voices: "Shut up. None of your business. Go to hell." Cathy didn't hide these conversations, but when asked, denied talking to anyone. I'd worked with schizophrenic people before Cathy — as a hospital doctor, not as a psychotherapist — so strange talk didn't unsettle me. Usually, I could get Cathy's attention, even when she was in the midst of an elaborate conversation with one of her voices. But some days, she mumbled to herself and completely ignored me. "It's not true. I never did. The last time I saw him was at school. He wanted me to drive him. Everybody wants to dance some more. It was a great party but my father won't let me go again. I'm going to stop. They won't let me anyway. Just tell them to shut up. Shut up! You shut up yourself." She licked her lips, and asked me to bring candy. I looked closely, and recognized the sensuality in her posture, her pouty lips, her eyes

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— and then, as fast as possible, censored what I'd noticed. "I love Almond Joy candy bars." I knew what they were only from the radio-commercial: Oh, boy, Almond Joy. Peter-Paul Almond Joy.

I brought Cathy an Almond Joy every time we met but if she ate them at all, she didn't until after I'd left. Tuesdays and Thursdays, at 10 a.m., I sat beside her bed for an hour as she lay in a catatonic stupor. I didn't know what to do. I was supposed to be doing something important for her called psychotherapy, and, like the U.S. Mail, therapy must be delivered rain or shine, whether she slept or ranted or smeared her feces. I tried thinking and speaking out loud, because my supervisor — whose life goal seemed to be to confirm the stereotype of the drinking Irishman, whose name I don't remember and who eventually drank himself to death — didn't seem to know what I should do either. "Be with her," he said. Even then, I knew this was a banality, but avoided acknowledging the obvious: Irish Eyes understood little about psychiatry. Occasionally, I'd get a chance to bootleg some supervision from Bob (Saturnino) Ortega, a Cuban staff psychiatrist who never babbled about theories but rather asked me to provide more and more detail. "What else did she say?" he asked me, then smiled when I used psychoanalytic jargon and made me nervous with his implication that Freud's theories weren't sacrosanct. There was a whole contingent of inspiring Cubans at the Menninger Clinic and when I discussed Cathy with Tony (Antonio) Fueyo, also not my official supervisor, he asked me why she didn't move. Tony's authoritarianism drove me mad, but he was insatiably

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curious: rather than dismissing her immobility as catatonia, he thought of Cathy as a person with a will. At a team meeting, someone mentioned our Coke machine was broken. Fueyo, our clinical chief, treated the observation as something with symbolic meaning, as though the complaint was on behalf of the whole psychiatric team: "We feel unfulfilled and say so, Dr. Fueyo, in the language of Coke machines." I thought Tony was nuts not to take the Coke machine problem at face value, but his response also taught me that psychiatrists shouldn't take things literally. Tony may have been haughty and infuriating, but he inspired me. "If you don't move, Cathy, nothing bad can happen," I said to her at our next meeting. "I guess you're scared of what you might do, so you're keeping as still as you can. In your mind, maybe there's a danger that if you move, you'll harm me, or maybe harm the whole world. I even thought for a minute you might be afraid that the world would explode if you moved." "You lie so still it reminds me of a corpse. Maybe you are a corpse today. I heard about a guy who used to daydream that he was Marilyn Monroe, dead, lying on a bier. Did someone in your family die and, if so, have you turned into that dead person?" For weeks Cathy didn't move, nor did she eat or speak. Once I came to the ward just as the hospital doctor was pushing a feeding tube into her. She was wrapped in sheets so she couldn't move, and the thick tube was forced into her nose and down her throat. I remember her terrified shrieks. "Take it off my nose!" she cried. "Stop doing bad things to my nose!" It was grim doctoring, saving lives, and I was part of it. I shuddered that she suffered, but my uneasiness was something that needed to be squelched. I had to be cool and collected; had I been a softie, my patient would have been even worse off.

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Another day, I saw one of the hospital doctors (hospital doctors confine themselves to prescribing medication and to the administrative management of the ward) walk down the corridor carrying a tray filled with hypodermic needles and syringes. He was taking blood samples from patients for various tests, in those days, most commonly tests for syphilis. Cathy suddenly jumped from her seat, grabbed his crotch shouting, "You promised me, you promised me, a feel of your cock!" The old-fashioned glass syringes went flying. The doctor's awkward dance of avoidance was funny, and didn't leave me worried about Cathy's forwardness; I had the cocky thought that I could easily handle it. Of course I could handle it; I'd turned her into a plank, hadn't I? Like most schizophrenic patients, Cathy wasn't interested in thinking about herself. When we began, she was sure she knew what was going on — she spoke with proud confidence, and quietly dared me to contradict her. At other times she was suspicious, and when I spoke about what she'd told me, took my comments as criticisms. I'd often heard that schizophrenic patients weren't reflective — something considered to be a prerequisite for psychotherapeutic success — but I figured I had time to find out for myself. I was indefatigable because I worked in a high-powered academic setting in which there was an implicit assumption that schizophrenia could be treated with psychotherapy, but also because my intuition was that sense could be made of deviant thinking. How, I wondered, was I to undo her blaming, and get her to recognize that she attributed to others what she didn't dare to know about in herself? How could I get at the cauldron of rage inside Cathy? I wanted to enter her deepest, most hidden parts, to open her soul, and stir it up. I didn't think of Cathy as an ordinary person who had a disease. To me, her madness was not something that had been added to her, but was rather her whole-hearted and unique way of being in the world. Her mad ways reflected her hopes, fears and intentions; they had a

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purpose. Although painful, this was the life Cathy had chosen. Every intellectual, bank robber, and religious fanatic also has a wholehearted and unique way of being in the world and, like the mad, members of each group have qualities in common. The paradox is that all of us are both distinctive and resemble those widi whom we share a label. I'm different from every other psychiatrist in the world and yet resemble most psychiatrists just the same, just as Cathy resembled other schizophrenics, but was also one-of-a-kind.

We doctors had decided that our patients suffered from an affliction, something that was in them or had possessed diem, and it was our job to administer treatments that would cure, ameliorate or repair the things that afflicted them. What we called their illness was not them or their souls, we believed, it was an alien thing that had come upon them. Our treatments were twofold: we dosed the person with psychological talk (I wish this still went on in hospitals) and dosed the illness with antipsychotic and antidepressive drugs. The patients sat, bored to the point of madness, and waited for our ministrations and our decisions. These days, hospital doctors pharmacologically attack the same mythological illnesses we believed in three decades ago and, as a secondary issue, as we did, dispense morality, haircuts and entertainment. We residents tried our best to practice the philosophy of the Menninger Clinic, paying close attention to the ward culture. "Why," we asked ourselves, "are there more incidents of violence this week? Why are doctors prescribing more medications this week? Why are there more escapes?" When we could manage it, we assigned all patients to recreational activities. But this hospital was poor, and only at the private hospital — the C. F. Menninger Hospital — could patients live in a true asylum culture, where a patient can both lick his

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wounds, and wholeheartedly re-engage with the world of tests and life-adventures. On the wards were patients diagnosed as schizophrenic years earlier, and who had, at that time, been sterilized. They had been victims of the old earnest belief that the demon within really exists, the demon who must be slain lest he return in another incarnation. By the time I worked in Kansas, sterilization of schizophrenics was no longer allowed, but the attitudes that approved of it endured. To some extent they still do. Other patients had had their names changed during World War n. They were of German descent, and the new names were intended to spare them persecution during the war years. This change reduced persecution, all right; it also rendered the patients less than human, just as neuroleptic drugs protect certain patients from psychotic terror by turning them into walking zombies. To arbitrarily change a person's name and to administer dehumanizing drugs is an incivility based on the belief schizophrenics are less than human, less human than those who treat them, and less human than you and me. The belief in harmful chemicals in their brains is also part of the designation of schizophrenics as less than human. This is a strong charge, but magnetic fluids, non-existent genes, and bad chemicals, with great fanfare, have had their day. It's time that we, the questioners, had ours. Fifty years ago, the family members of schizophrenic patients who came to that hospital were told not to visit their relatives, to just tell themselves that they had died, and forget about them. We do better now, but to say that a person has a permanent biological abnormality, a "schizophrenic" abnormality, smacks of a similar denigration.

My mind had drifted far away from the students. That day, they had looked to me like children, and that day's patient had also been young, a teenager. Cathy, my tragic i6-year-old patient, had come to mind. In

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my early years of practice, I was a child psychiatrist, so it's no surprise that concern for youngsters is a big part of my psychology, and similar concerns get transposed onto my work with adults. The urgency with which I work and teach gives me away; in my mind there are children to be helped everywhere. Like the psychiatrists who find biological inferiority in their patients, I find child-like inferiority everywhere. It's no surprise that the interview I was to have with Christine Brydon later that day — she's the student who asked why psychiatrists talk so much about theories instead of just describing what patients do — would turn out to be a time for me to debate with myself about whether she was a youngster or an adult. All students at the Clarke Institute could attend my interviewing seminar, but Christine was applying to work full-time at the Psychotherapy Centre in the next academic year. Although modestly dressed — dark silk blouse and straight skirt — I realized immediately that she wasn't going to be child-like and submissive. Instead, I saw a potential Muse. A potential Muse means I'd noticed her sexuality and that was precisely what I hadn't wanted; I would have preferred her to be a child. Had she been child-like, I would have been safe — not from her — from myself. That's probably why I became a child psychiatrist in the first place. No worries about being faced by adult life and adult women. All of us, men and women alike, are liable to do a sexual inventory on the opposite sex and many of us — I certainly am — are uneasy when we notice ourselves doing it. My usual thought is, "What's the matter with me? Am I turning into an old lecher? I definitely didn't notice the sexuality of women so obviously when I was younger." But it's a lie. I'd already noticed the attractions of my female classmates in the last grades of elementary school, but I sniffed indignantly when I noticed this, and made sure I emphasized my interest in higher things like intellect. Freud was smart when he said

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that sex is everywhere, smart because he wrote about it in a way that got people to pay attention. But it was nothing new; everybody knows that sex is ubiquitous. Just as I perform not-to-be-acknowledged sexual inventories on women, they do the same to me. When I was younger, women were interested in me because I was healthy and youthful. Now, I observe that there are women, some of them decades younger than I, who are attracted to my well-honed posture of brain power and seniority. Despite wrinkles, baldness and shrunken muscles, talk of Nietzsche and opera awakens their interest. Through the ages, countless PhD supervisors, managers, priests and presidents have routinely made this observation — although nowadays we aren't supposed to notice or talk about it. I worry like everyone else that unscrupulous supervisors will sexually exploit their students. I also worry that students with equally exploitative agendas will seduce their supervisors. But I also know that, when heroes and young goddesses are put in the same room, they fall in love. To a lesser extent, this also happens when mature goddesses and coltish stallions are put in the same room. So, old lecher that I was, I noticed Christines rump, which she skillfully flicked and twitched in my direction. It reminded me of the belly dancers I'd once seen in Sharm-el-Sheik. This joking appraisal of her behaviour and mine was, and still is, my favourite defensive trick — except it wasn't just a joke. Clearly, she was putting her sexiness on display. I tried nervously to avoid noticing the rumpish part of her anatomy but, when I looked downward for safety, I noticed that she had long legs, clad in attractive gray stockings. When I sensibly raised my eyes to look her in the eye, her bosom passed across my field of vision, the bosom that I'd been joking about to myself when I'd thought earlier in the day about this interview. Oh, God, I thought, doing my best to neuter her, I don't need a hysteric like this on the service for the next year. I saw no evidence, of course, that /was the hysteric.

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"I didn't really want to be a doctor," she said, "I only went to medical school and took up psychiatry because I want to train as a psychoanalyst. Before medical school, I was an English student." "You'd thought of being an English teacher?" "Actually, no. I wanted to be a writer. After I got my degree I sat down and wrote two novels — embarrassing — and some short stories. I got one or two of the short stories published." "What were they about?" I asked. "They were mostly about the struggles of adolescents with their families and with the world. Mostly how they survived having pathetic families." I see. I noted that her face had fallen. Despite her initial confidence, it was easy to see that Christine was depressed. "Are you okay? You're looking a bit depressed." She tried to hide her tears and answered, "Just some marital problems." CCT

»

Once upon a time, every candidate applying for a psychiatric position was interviewed with great respect: he or she was invited to be a mini version of a psychiatric patient, to look inward a bit. How else could we teachers know that the applicant has the anomalous interests, mostly introspective interests, indispensable for the aspiring psychiatrist? While those interviews in many ways resembled those conducted with patients, they were modified both for the task at hand and the sensitivities of applicants. A discussion of sex, for example, wasn't obligatory, as it is with patients. But when I applied for training, I was asked detailed questions about my sexuality. I was 28 at the time, and two of the interviewers wondered why I hadn't yet married — in those days we married younger than they do now. The questions made me

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uneasy, but I was impressed that my interviewers took me so seriously. These Americans, I thought, are honest, determined and fervent. Not like cautious Canadians. By the time I interviewed Christine, the world had become politically correct, and asking her respectful and concerned questions about her depression was verboten. Taking an ordinary, humane interest in the fate and destiny of the person in my office, an interest made safe by years of psychiatric educational tradition, was no longer allowed. Dr. Brydon did not object to my question; she knew my eccentricities before she applied and had seen my style of working in the interviewing seminar. I expect she was grateful that I took her seriously. She was my choice for the position, a charge of talent waiting to be ignited, I thought. She wouldn't be easy, but better someone with spice and intelligence than a tiresome conformist who doesn't really recognize the oddness in the world.

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George Inge did unorthodox interviews and this qualified him to be one of the outsiders. The Menninger Clinic was high-powered but mainstream, so we psychiatric residents thought Inge exotic, if not outright mad. His eccentric, non-rational interviews were a challenge to reason itself. When he interviewed a patient, we could never catch exactly what was going on. He made allusions, and shared insights that awed his patient and which we knew were important but couldn't quite decipher. We were fascinated, frustrated and bewildered. Some wrote Inge off ("He's flipped") and others thought he was a genius. Now, I prefer to think of him as an inspiring madman. Inge had a knack for teaching, never bothered to expound theories, and never generalized. He just spoke enigmatically to his patients and eviscerated them — liberated their inner marvels for us to see. He and the rest of us had a common mentor: Karl Menninger. Dr. Karl didn't bother much with teaching psychiatry, but he hardly seemed to be an outsider, or, more accurately, few realized that he was. I once asked him which of the books he had written he was most proud of. The Vital Balance, he said. That book was theoretical, so perhaps Dr. Karl suffered from the same rationality madness as Osman Awad and consciously thought he ought to be both a theorist

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and a scientist. But he couldn't make himself be what he thought he was, and he didn't fool his students, either. He was life and passion and show business; it owned him heart and soul and we, his students, got the message. I, too, thought I ought to be a theorist and, like Dr. Karl, never suspected I had eccentric passions that mattered more to me than dry reason. From time to time, psychiatrists like George Inge make an appearance on the psychiatric stage. Colleagues are liable to say of them that they are in touch with the unconscious. What's meant by this is that they are quickly intuitive, refer obliquely to unexpected sides of the people they interview, and leave their victim, their amazed beneficiary, confused and grateful. The problem is that the patients are never exactly sure what it is for which they should be grateful. We're uneasy about our real belief about people like Inge — that to us they are magic. Which is not to say that talented interviewers are universally benign: one or two I've known were even disturbingly paranoid. Rather than being showy, as I am, there are many good psychiatrists who are gentle and soft-spoken. But what all good psychiatrists have in common is that they surprise, delight and unsettle the people to whom they speak. I couldn't get enough oi: teachers like George Inge but, at the time, had no idea that they were teaching important lessons. I thought they were just entertainers. Now, they are my heroes. But I don't try to be like them. That would violate their message, which has nothing to do with "trying." I now take pleasure only in whatever seeds of weirdness I notice in myself.

The best teachers were unorthodox, the opposite of me when I was young. I was ultra-orthodox at the time and acknowledged no legitimate critique of pure reason. I came from an immigrant family so I

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had to be sensible and conventional; I became a doctor. My brother Ernie, the jockey, was the eccentric. Not only that, but he became a racetrack celebrity, a Damon Runyan character. A strange reversal had occurred. I had been the important child; special, diligent and proper. But Ernie became successful, no longer Gordon Warme's brother; in fact it was the other way around. People I met said, "Oh, are you Warmie's brother? I bet on his horses all the time." "Warmie." That was Ernie's track moniker. Everyone on the track had a moniker, but my brother's was simple, a twist on his name. Others had handles like "Weak Eyes Grogan" (who wore spectacles), "Hook" (for his nose) and "Horseshoes" (for the big shoes on his big feet). I was not without a sense of humour, but I thought this kind of life was a luxury and not something to be indulged. Ernie's unusual profession embarrassed me. It had to do with class. Although I was born in Canada, being a German during World War n had exaggerated my sense of myself as an immigrant, and I was determined to wipe out that stigma. A life of adventure — riding horses — and of humour, was never to take centre stage. But humour was the centre of Ernie's world. One day, one of the jockeys, known for his glitzy self-importance, arrived in the locker room wearing a pair of new Italian shoes, which at that time were quite exotic. The shoes had long pointy toes; the jocks thought them hilarious and there was lots of teasing. Ernie suddenly took centre-stage. He had a large pair of snippers in his hand, the kind used to clip extra flesh from horse's hooves, and he lopped off the toes of the new shoes. Within two or three years, pointy Italian shoes were commonplace among the jocks. They also wore sharply tailored gangster suits (they had lots of money) and snap-brimmed fedoras. Ernie wore a big diamond and drove a white Thunderbird. Pretty low-brow, I thought enviously. Part of me knew that judgments about Ernie's class or my

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class were hogwash, but for a while I was tempted by the prejudices of the conventional world. Fortunately, I've become unorthodox, just like Ernie.

At the hospital, it was inspiring to have a reference group, especially given that, in Topeka, they shared my folly: "The Menninger Clinic is an intellectual Mecca for theorists. We are the true Freudians and the perfecters of advanced Freudian theory." Secretly, I held the sentimental belief that I cured my patients with love. Still, I continued to define myself as reasonable, industrious and theoretical. It had never occurred to me to be an overt purveyor of the love panacea because I didn't (and don't) believe such attitudes can be taught; I just assumed that I possessed an advanced form of human compassion and that no one else could practice it as well as I. It was a comfort to join the rationalists. Our joyous groupthink, our mass hysteria, was that we were rationalists with a vengeance, devoted to our lofty interest in the logos and the tbymos. By comparison, Osman Awad, my latter-day theoretical pasha, was a rank amateur at the rationalist metaphysics diat drove me when I was his age. He had a lot of work ahead of him if he wanted to catch up with me and my theories. I was a single-source theorist. I saw the world exclusively through my own inventions, and was convinced that Freud's mechanical model of the mind was the secret pathway to the soul. I was as reductionistic in that belief as are the psychiatric biologists of today. A reductionist picks his poison and from then on, he can use it to explain everything, whether it involves the functioning of a mental apparatus which needs to be tinkered with (me), a chemical abnormality which can be corrected with the right drugs (the biologists), or being a good replacement for bad parents who caused their children's illnesses (the empathy propagandists).

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The stakes race to explain human life draws a big crowd. The politically safe people's choice is a group of blithe eclectics. Does chemistry make us mad, they ask? Yes. Is it all about conflict? Yes. Astrological influence? Yes. Pollutants, parents, past lives, trauma, archetypes? Yes, yes, yes. They cheerfully endorse self-evident contradictions — tough love and empathy, free will and determinism. I didn't stay a rationalist forever; no deduction led me to spot Mr. Banda as the Messiah. I almost wish that Dostoevsky had given me a good scolding, maybe even a good hiding, many years ago. He, of course, discovered long ago that the most destructive and dangerous of religions is a faith in reason, science, revolution and the perfectibility of man. Dostoevsky figured this out with his guts; when I finally decided to grow up, I had to use my reason —- my puffed-up reason — to escape from my infatuation with intellect and theory. Some god or madness forced me in the direction of poets and artists, people who knew intuitively what I struggled to find with my intellect. Like my mentor, Dr. Karl, I thought I ought to be a theorist, but I was wrong. There were good intuitions in me, all right, but they were so walled off I had to dig them out with my mind and, later, bring them to life via the inspirational models of Thomas Mann, T. S. Eliot and Vladimir Nabokov. Has a psychiatrist ever unraveled the mind of a brilliant pedophile as Nabokov did with Humbert Humbert? To escape from rationality was to escape from all popular positions, to plant my feet firmly in mid-air and pay the price of estrangement from colleagues. Slowly but surely, I became an outsider, and while I earned brownie points widi cheerful camaraderie, it hurt to see how few of my colleagues understood my ideas, let alone agreed with me. Everyone wants a foundation on which to ground their ideas; my postmodern antl-foundationalism might have found soulmates in quantum physicists, but not among psychiatrists. Little do my colleagues know that we have no choice but to be postmodern. An

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obvious example is that we all believe in causality and in free will, a dramatic illustration of the world's lack of system. The easiest escape route for me was skepticism, the perfect foil for the belief systems everyone else seemed to prefer. But skepticism is a belief, too. As Nietzsche observed, you shouldn't make an idol out of smashing idols. What hurt most was that many students I thought I had inspired, after they stopped working with me, committed diemselves to one of the naive dogmas — a fact which was a terrible assault on my vanity. During this time, the feedback from students changed and, instead of being another pretty good teacher, their evaluations of me changed: Brilliant-4 For more senior students—9 Incomprehensible—4 No comment-8

I had an older brodier, also named Gordon, born 14 months before me, who died at about the time I was conceived. He lived his life backwards. Instead of living his life and then dying, he died first and let me live his life for him — after his death. In loyalty to him, I have also lived my life backwards. I began as a good cooperative boy, living my life in harmony with the world, declining to be a young rebel. I was not a rebellious adolescent until I was 50, and saw the truth about the Emperor's New Clothes at the wrong end of life. It has been a marvelous, gay ride; it's much more fun condemning stupidity now than it would have been 50 years ago. Since I have a lifetime cargo of information available to me, I'm good at looking like a dangerous opponent, much more dangerous than a youthful adolescent could ever be. It feels to me as though all of this has been of my choosing, but if I allow myself to see that the world is as real upside down as it is right side up, doesn't that make me just another puppet? 68

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It's useless to complain about bad literature. Best just to try and write something good. The same goes for psychiatry; better that I practice my trade well and try to write something worthwhile. But I can't resist being a stinging gadfly.

What did it take to get me to think for myself? My best answer is that I sought out independent thinkers and historical figures with whom I could join forces. That's probably why, during the years I was freeing myself from traditional dogmas, I read so frantically. The best fun is to explain the development of independence by playing psychoanalyst: to carry out a thought experiment that concerns sex. But don't forget that thought experiments prove nothing —they can only make us reflect. Sex, if you think about it, is a template for independence, something private. When we are young, masturbatory sex is a solo activity, the first important activity kept private from parents. It starts even before adolescence because, when toddlers fondle themselves in the supermarket, they are told, "Don't play with yourself." The parents' ban on public sexuality coerces children into becoming sexually private, and privacy is the training ground for independence and self-reliance. In adult life, sex becomes a privacy shared by two people — a celebration of their oneness. As some wag put it, "Always remember that you are unique. Just like everyone else."

Hanna Slendzinski was more serious about psychotherapy than I realized. The American Psychiatric Association met that spring in Toronto and, although I had stopped going to boring meetings, I dropped in to the Royal York hotel to meet an old friend. There sat Hanna on a sofa in the lobby talking to Don Kinsley, a one-time

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child psychiatry colleague of mine at the Menninger Clinic. Kinsley was an over-intellectualized fool but, since fools can fool people, he was well known in the American psychiatric world. Hanna, who worked with youngsters in Poland, had tracked him down. I was early for my meeting, so I sat with them. Hanna asked Don about his work with severely disturbed adolescents and he spoke enthusiastically about setting limits, and the importance of maintaining the structure of the psychotherapeutic situation. I remember particularly that he insisted it was important to repeatedly review with the patient the rules of therapy that had been set up. Hanna was well aware that I often said the opposite, that there are no rules for the patient except that he pay his bill. What struck me then was Hanna's calm disagreement with Don. My own style would have been to wage intellectual war, to find logical reasons why my liberal attitudes were better than his and, without outright saying it, dismissing his approach as dictatorial and punitive. But Hanna put into practice with Don the manner and style she used in her psychotherapeutic practice. "I just like to listen and talk to people," she said. "If they misbehave, there's no use scolding them and laying down the law. If they come to my office, that's all that I need. If they come, I can talk to them." Don asked Hanna if she insisted her patients read the books she assigned them. Her answer was that while she was a bibliotherapist, she didn't really care whether she and her patient talked about books, the weather or any other topic. So long as she and her patient talked, she could do her job. Hanna liked talking about everything. To her, dreams, symptoms and character traits were all just pieces of the same person, and the pieces were relevant to the patient's way of being in the world. If a patient misbehaved, it was her job to find the hidden meaning of their misbehaviour. She told Don she wasn't sure why he'd

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want to prevent behaviour — since what youngsters do is about the only clue to what they are struggling with. Hanna used the word "unconscious" once or twice — mostly to hint that Don, in controlling his patients so tightly, perhaps didn't want to hear the secret issues that stirred them up. When she described her work her manner was often more persuasive than what she actually said. Her comments seemed ordinary, but Hanna had a quiet awareness of what mattered when talking to patients. She never doubted herself for a minute, even when talking to an expert in the field. At her age, I would have laboured and struggled intellectually — and probably missed the point. Kinsley left before I did. I complimented Hanna on her calmness in the face of Don's theoretical storms. She shrugged. When I complained about how, for years, I'd struggled and argued with him, she said, "Yes, I know."

When I was a young, rationalist doctor, I went into analysis. My analyst, Phil Holzman, fit the bill. He was an intellectual, but when he taught seminars, he showed us how to use stories, for example from James Joyce's Dubliners, as psychological models. For me, literary teaching brought psychoanalysis and my patients to life. In my analysis, Holzman spoke allusively of Joyce's Ulysses, and of the point of the novel: the story of a father's search for a son and a son's search for a father. Holzman brought this up the right way. When I discussed Ulysses, he pointed out how I spoke of the theme of fathers and sons innocently, without knowing I was doing it. As a result of his comment, he and I enacted — of course — the roles of father and son. In my analysis, I was surprised to notice I was quoting Shakespeare, even though I'd never had a great interest in him. I knew it was Shakespeare, but didn't know from which play. Holzman cryptically

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pointed out that all the quotes were from Hamlet, again the story of a man who had lost his father. Was the invisible analyst who sat behind me, who listened and watched, my father's ghost — Hamlet Senior's ghost? "Winning" and becoming the father, the primary male, was the central issue of the analysis. Repeatedly, Holzman pointed out how I avoided winning, or at least, avoided overtly winning. This often came up as a play on the German word Gluck, which can be translated as either "joy" or "luck." It would spring up when I thought about the German translation of a famous operatic aria, Che faro senza Euridice, from Orfeo ed Euridice, written by (more wordplay) Christoph Willibald Gluck. The idea was that any joy I had in winning was only a matter of luck — I hadn't actually done it myself. The words of the German version of the aria added even more interest: "O, Ich habe Sie verlorenlAll' mem Gluck istjetzt vorbei." (Oh, I have lost her/All my joy is gone forever.) I'd identified with those lines and, like Orpheus, wanted to announce that I hadn't won and had "lost her forever." At first, I didn't accept Holzman's ideas about my fear of winning. He, I thought, was the one who was focused on banal achievement. It also wouldn't register for me that irony could be a form of winning — a triumph and, at the same time, an evasion of triumph. I wasn't smart enough at this point to realize that everyone likes to win, or that winning could take many forms — blatant, vulgar, quietly persistent, or winning disguised as losing. How better to defeat a doting father than to become a derelict? The issue with me was the deviousness of my successes: deferred, roundabout, disclaimed and joked about with clever self-mockery. Some of these nuances became clear during my analysis; to my amusement, I discover others every year, every day, and that's how it should be. The best outcome of any analysis is an understanding of the idea of analysis. Analysis can't prod us into doing this unless we're

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already willing to thump ourselves off balance and endure some bewilderment about who we are. Although Holzman was good for me, he didn't understand my interest in weirdness, or my fascination with my homosexual friend Graham and his prissy friends — especially their recognition of life as play. Life as a series of solid items, as tables, chairs, cats and dogs, is the end of life, and injecting a bit of theatricality is the beginning of life. Perhaps the artistic side of me was so undeveloped in those years no one could have recognized what I was up to. But that weird stance was the beginning of creativity, and my hidden ambition, still hidden at the time, was to be artistic in my work as a psychiatrist.

Holzman was politically adroit; it was said he was Karl Menninger's best friend. I teased him unmercifully on this point, and called him a "kiss-ass." I teased him because I guessed he was strong, proved by his intellect. I could indulge the delicious pleasure of attacking him, sure that he would survive. My real father could never have handled such attacks, but I'd always made sure I didn't know this. When my father told weak and vulgar jokes to his business associates on the phone — such jokes weren't his style — I recall that I cringed, disturbed by the servility and false comradeship. Holzman eventually moved to Chicago. Not long after his move, I was asked to introduce Roy Grinker — a professor of psychiatry, and a prominent public figure in Chicago — to a university audience in Toronto. At dinner before the meeting, Grinker and I chatted. When he heard I had trained at the Menninger Clinic, he asked me who my analyst was when I had been in Topeka. "Phil Holzman." "Really? He's in Chicago now, you know. He's my best friend." The last time he and I spoke, Holzman was at Harvard doing

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research on schizophrenia. His approach to the subject is the perfect opposite of mine. He's interested in genetics and scientific causality; I'm interested in schizophrenia as self-invention.

Karl Menninger was pushed out of his position as Chief of Staff of the Menninger Clinic in 1968. His brother William (the brothers seemed to be jointly in charge of The Menninger Foundation) had developed cancer, and had decided to secure the family succession before he died. Both Dr. Karl and Dr. Will had psychiatrist sons, and the outcome of the coup was that Will's son, Roy, ended up in the chieftain's chair. This was not a change of management at a cozy family clinic; the organization had enormous financial and physical plant resources. The Menninger Foundation was made up of a private hospital, a large state hospital, perhaps the finest in the U.S., and a large, prosperous Veterans' Hospital. It had acquired a complex of former insurance company buildings, used by the Foundation for research, education, and administration. Will Menninger feared Karl's capriciousness, and built up a dependable structure that ensured this huge psychiatric complex wouldn't get into administrative trouble. I wasn't smart enough then to know I was witnessing a familiar historical drama. Imaginative leaders are never tolerated for long, and Dr. Karl's demise anticipated what, years later, I would see in the Toronto psychiatric establishment. Serious scholarly thought and imaginative creativity, those stinging gadflies, must always be squelched. Smoothness and mediocrity must always triumph. Because he was Karl Menninger's "best friend," Holzman's career at the clinic became shaky. The turmoil and the suspiciousness were bad enough that even my career seemed precarious for a while. I was the analysand of Holzman, best friend of Karl Menninger. Holzman made

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a quick decision to move to Chicago. My analysis ended suddenly; I had about four weeks warning. It's natural I would be upset to lose my analyst. But my reaction proved too extreme, too much like the symptoms of mental illness, and lasted too long. I had a serious anxiety attack at work. While chairing the weekly staff meeting, I was overcome by the textbook symptoms — I feared I would faint, that I would be unable to speak, that I would bolt from the room. On one occasion I had the same symptoms while interviewing a patient and had to step out of the appointment. While teaching a group of medical students, the panic carne again. This time there was an added issue, about a student, a young man, good-looking, blonde, and articulate. I can't remember the exact thought, but it was clearly a case of homosexual fear. Was he after me? Did he see I was a sissy just like him? I made an excuse and went to the washroom. A few deep breaths, splashes of cold water, and a quick return to the seminar room to gut-out the horror of it. My worst fears had come true. I was weak, effeminate, and fleeing from life. My mother had been prone to fainting, and her ghost had turned up in me. I'd done everything in my power to be a man, a doctor, a father — and I had failed. The anxiety, the dread in my gut, had become permanent. It was an illness of the soul, a terrible mixture of anxiety, guilt, and depression, the "sickness-unto-death." I began running — a frantic regime — two miles several times a week in the Kansas heat. The summer temperature in Kansas regularly hits 100 degrees Fahrenheit but nothing stopped me. I was determined to kill the panic. Every day, I went home for lunch. Instead of eating, I went to the bedroom, knelt beside the bed, and sobbed desperately into the mattress. No helpful thoughts accompanied that daily ritual crisis. I thought about it, of course, trying desperately to analyze my disabling,

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terrifying madness. My poor wife knew what was happening, but also knew me well enough to offer her help in careful doses. I didn't want help, and assured her everything would be okay. My children saw nothing. I was, and still am, a good actor. After all, I had to be a real man, didn't I? The symptoms were at their peak when I was centre stage, as the teacher, the leader, or the father. My son and I were involved in Indian Guides, a father-son club. We were "Little Bear" and "Big Bear." What a burden. At the meetings, I was Big Bear, and in a panic. The group included just three or four fathers, friends of mine and their sons, but it was terrifyingly difficult. One evening, my wife and I went out to a movie — Closely Watched Trains — with our friends Ian and Sue Graham. The film includes a suicide scene in a bathtub with plenty of blood and horror. For the first time since childhood I fainted, and had to be carried out of the cinema. I was terrified, afraid I would stay sick for the rest of my life. Perhaps I wouldn't be able to support my family — like my father during the three long years he was in the internment camp. I feared I wouldn't do my duty, the duty assigned to me by God. It was easy to put two and two together and understand what was happening. Obviously, my anxiety was just a repetition of my childhood trauma, when the RCMP had taken away my father in the middle of the night, right? Twenty-seven years later, my analyst-father had also been yanked away. Both had been caught up in a political mess. Although I recognized all of this intellectually, I didn't feel it in my heart. I also didn't recall being intensely upset when I was a child, 16 years earlier. The political demise of Karl Menninger didn't consciously upset me either. I was sure everything would turn out okay for Dr. Karl and, as for Will Menninger, he was dying, and therefore, in the style of my family, I had to believe that when Dr. Will died he wouldn't die after

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all. I didn't go to his funeral, and when Karl Menninger died 20 years later, I skipped his memorial service as well.

While in analysis, I had a dream that puzzled me. "Last night I had a dream about Phyllis Leavy," I told Holzman. "Why the hell would I dream about Phyllis Leavy? I hardly know her. And that's the whole dream." There was a brief pause. A voice behind me spoke cryptically. "Phil is leaving." Holzman's stingy output of talk had been getting on my nerves that week. "What do you mean? Can't you quit playing smoke and mirrors?" I said. Suddenly I understood. I'd completely forgotten Holzman was going on vacation and realized the dream was a pun on his first name. Phyllis Leavy. Phil is leaving. Phil is loving. Phil is living. Phil is dying. To make things worse, it was a prophetic dream, one that anticipated the trouble I'd have when my analysis ended. My usual trick is not to notice endings, or even to acknowledge that endings affect me. So such events can only show themselves in a dream, carrying with them extra baggage about love and death: "Phil is living, Phil is dying." To top it off, I developed symptoms later that day. I was in the library going over some papers for that night's seminar. I'd successfully put the unpleasantness about dreams, leaving, loving and dying out of my mind, or so I thought. There in the library, my librarian friend only a few feet away, I suddenly had an aching urge to masturbate. It bewildered me, but now it's clear what the urge meant.

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If I masturbated, I was independent, self-reliant and safe — whether or not Holzman lived or died. But understanding my dream wasn't enough for me. I needed to protect myself a second time, longing for the reassurance of sexual self-sufficiency. Becoming an independent, subversive thinker involves the same psychological manoeuvre as masturbation. It demonstrates that I belong to no tribe, so there will never be anyone for me to grieve.

My separation madness in 1968 was a transparent repetition of my wartime crisis of 1939, when I was seven years old. At first, the idea seemed foreign and intellectualized, but as the months and years passed, the analogy felt more and more real. A few years later, I ran into Holzman at the Waldorf Astoria hotel. We chatted, and he told me of a recent mountain-climbing trip. Not until we'd been talking five minutes or more, did I notice that his arm was in a cast. He had broken it while mountain climbing, but during the course of our conversation, I hadn't noticed the cast. My eyes just didn't want to recognize vulnerability and injury in a father.

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CHAPTER^FIVE

Dumpinc SYHDRpfflE

People in this city are brown, white, black and yellow and, as we waited for Dr. Erez Mizrahi to arrive, I wondered to myself what that day's colour would be. My students are multicoloured, too, and so accustomed to other races and tribes that they no longer notice. The patient, Mateen Kori, was Iranian and Mizrahi, his interviewer, was an Israeli, trained at Ben Gurion University in Beersheva. He was a smart student, very sinewy and intense, but still psychologically precocious. Good psychologists, like novelists and literary critics, are disinterested — they have no personal stake in what they observe — although when I use this word, the students usually think ! mean ^interested. Despite his intensity, Dr. Mizrahi also had this trait. I knew Erez was interested in Jacques Lacan, a linguistically oriented psychoanalyst, but I couldn't figure out how he might have developed such an interest. Perhaps there had been Lacanian psychoanalysts in Jerusalem. He started right in on his presentation. "Mr. Kori has been seeing doctors for many years. He has a medical condition no one can figure out and from which he never gets relief. He has come here because he has been so advised, but he's pretty skeptical that we will be of help. Actually, he's been complaining to his endocrinologist for some time that his problems are psychological, but

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now that he's here, he does nothing but complain that his problems are biological. When I mentioned this to him, he understood my words but he didn't seem to understand the contradiction. He maintains his symptoms are so obviously physical that seeing a psychiatrist doesn't make a lot of sense. Still, he is very polite and cooperative and tries to reveal as much of himself as he can. "The way it works is that when Dr. Kori eats, he begins to feel unwell almost immediately. He starts to sweat, feels faint and sometimes has to throw up. Every time he eats he is totally devastated and incapacitated. The problem has become so bad in recent years that he has been left without energy and his life has been totally wrecked. He's seen many doctors, but they haven't found anything. I asked him whether any of the doctors thought he suffered from dumping syndrome, because the symptoms sounded like dumping syndrome, but he said he'd never heard that term. "Dr. Kori's life has been ruined by his disorder. He works, but getting through the day is torture. His relationship with his wife is non-existent. But he hasn't: lost any weight; he eats despite the debilitating effect food has on him."

My goodness, I thought to myself, dumping syndrome. I haven't heard that term for decades. If I remember correctly, it's a disorder that comes on after stomach surgery, so Dr. Kori can't really have it, but Mizrahi is right to mention it because his complaint seems so similar. I remembered my teachers in medical school talking about this strange malady. The belief was that after eating, patients with dumping syndrome had an extreme outpouring of insulin that had the effect of radically lowering their blood sugar, and producing their symptoms. We used to advise such patients to eat many tiny meals a day to prevent the insulin "dumping" from happening. I also remembered

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dumping syndrome was poorly understood and some physicians didn't believe there was anything physically wrong with such patients. It was another mystery disorder, like chronic fatigue syndrome and fibromyalgia, which stirs up unexpected passion in some medical circles: "It's a real disorder, real, real, real!" Since I'm a shaman, and my mind wanders like a spirit, I'm suddenly aware that I have "dumping syndrome" myself: I feel unwell, tired, and bloated if I put sugar in my coffee or on my cereal. Magically, I can eat a tub of ice cream without trouble. A Mars bar after lunch wrecks my day, but chocolate syrup on my ice cream in the evening is fine. Unfortunately for me, I don't get that opposite placebo reaction to sugar: the sugar buzz. We magicians are liable to forget the marvels of everyday madness when it applies to us; even when we do remember, it afflicts us just the same. We become collaborators in this nail-things-down folly when we fail to remember that our patients confront us with a cornucopia of mysterious wonders: multiple personality disorder, false memory syndrome and attention deficit disorder. And then there are the calmer claims of the orthodox who insist that depression, schizophrenia, and generalized social phobic disorder are "real, real, real."

"Dr. Kori is a dentist, 45 years old, and he and his family left Iran when he was 17. His two younger brothers, a younger sister, his parents and himself came together. They didn't leave for political reasons: they had relatives here and thought life might be better. "Dr. Kori knew this was a university hospital so, right off the bat, he told me a story about his education. He had had a professor in the faculty of dentistry in Teheran, who taught things besides dentistry to the students, things like humanities and literature. Some of the students came from very poor, outlying regions of Iran and this

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professor even had to bring a knife and fork to school to show these kids how to use them. "Kori's family was Europeanized and wealthy. They were very social, and he recalls that in Iran they associated with what he thought was a fast crowd. At parties, people wore Western clothes and he also thinks they took drugs and drank alcohol, even though this was against the law. Actually, it was Dr. Kori's mother who liked moving with the fast crowd; his father went along with her but always complained. He was the serious type and had to be browbeaten into going to all the parties. "Dr. Kori also describes something odd about the family — his father and grandfather are dentists, as are his two brothers and his wife. He himself sees nothing unusual in this. It is just a family tradition, which to him — and here he protests too much — is neither a good nor a bad thing, and he can't see why I would be interested in the subject. Dr. Kori has been in practice for many years but still works for someone else. He can't explain this either, and doesn't think the topic is relevant. He doesn't seem to see anything as psychologically interesting. "He can't tell me he finds pleasure in anything he does and says his illness has ruined his marriage. Except for one thing: he enjoys playing the flute. It's his only pleasure."

The students asked a few questions, pointing out that Mizrahi hadn't given us any sexual information — not even, for example, the fact that Dr. Kori had declined to discuss sexual matters. Just the same, Erez Mizrahi had brought his patient to life, despite the briefness of his presentation. Was his lively manner responsible or was it my uncanny knack for smelling a rat and catching Wagnerian themes? Perhaps I'm good at attaching universal themes to people, a skill that

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tricks students and patients into believing I'm a wizard. The young man in the group whose name I didn't know had a morose look on his face. He was chubby and wore a suit and tie, a style of which I approve, even though his clothes were more formal than is usual in the casual atmosphere of a hospital. These suits distinguished him from the other psychiatric residents, most of whom wore informal clothes, even jeans, to work. He was an earnest fellow and I suspected he didn't appreciate it when his fellow students were joking around — too much hilarity in the room for him. "Any other comments?" I said, looking toward the morose young man. Taking my cue, he addressed a question to Erez. "Did you ask him how he felt about his mother going out all the time back in Iran?" It was a good question, because asking about feelings elaborates on what has happened; the devil, of course, is in the details. But emphasizing feelings also slows the psychological chase; I'm liable to rush in faster than many colleagues. The logical progression of possible questions, each deeper and bolder than the last, goes like this: "How did you feel about your mother going out all the time back in Iran?" "Did you worry that your mother was going out too often back in Iran?" "So your mother ran around when you were young?" "When your mother went out so much, did you think she was a slut?" When the students have perfected their impudeur, they will go beyond the factual world and ask questions in the language of archetypes. Then, they will be getting at Platonic truths, not merely the patient's thoughts. "When did you realize your mother was a slut?" Dr. No-name didn't like that I was pushy with patients, that I poked

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my snout into their secrets. He seemed disconcerted when I made jokes — even though my running gag is innocent and predictable: the students are hopelessly timid; I am tough and can't be fooled. When the other young doctors gave their verbal reports of their interviews with patients — before my interview — Dr. No-name regularly made little pronouncements about the case, always relying on the cliche of empathy: "I think she suffered an empathic failure when her brother was ill and her parents spent so much time at the hospital."

Dr. Kori, hair parted on the left, had a thick cluster of curls flowing in front of his right ear, and his upper lip featured a carefully trimmed pencil-thin mustache. He looked vaguely familiar, but I couldn't place him. He leaned back in the stiff chair and eyed me skeptically. I liked him immediately and sensed electricity in the air. I was vaguely aware my back and shoulders had straightened and my eyes had narrowed. "I hear you enjoy playing the flute." "Yes, it's one of the few things I like doing." "When did you start?" "Oh, that started when I was a kid. My mother is sort of lively, sings a lot and likes music, and got me to play. For a while I was a promising music student. But, like a lot of teenagers, I sort of lost interest in it. Now, 1 just play for myself." "What is it like when you play? Does it delight you, get you worked up?" "I guess so. I'm not sure exactly what you mean." I noticed Dr. Kori was very cautious, so I told him a little story, hoping to warm him up. "Actually, what I have in mind is something that an artist, a patient of mine, once told me. Like you, he was pretty much a loner and led a pleasureless life. He also had no friends. He was gay, but had never

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had an intimate relationship with anyone. One day, he mentioned a piece he was working on. I asked him what it was like and he described it for me, an elaborate, detailed portrayal. I couldn't imagine the thing because it was too abstract, but he described wood, painted red, underpinned by textile materials and held together with chain and rope. There were steel elements and . . . well, you get the idea. '"What amazed me was that, for the first time, this young man became animated. He was enthralled by his artistic creation — full of passion, eyes sparkling, animated gestures. I was amazed. I guess I was wondering if there is any of that in you when you play the flute? But I also want to add another story about the same young man." I was overdoing my storytelling by illustrating the idea of "joy" so extravagantly. I certainly wouldn't have done this had I been alone with the patient, where I would have had the luxury of time and Dr. Kori could have unfolded in front of his own eyes at his own pace. But because there was an audience, he and I were also entertainers, and pumped up by our dramatic performances. Had I lost control of myself, I wondered? Had our audience compelled us to be extravagant and theatrical? I also have a reputation to live up to: I'm known to do unusual interviews and the students are not to be disappointed. If they interviewed like me they are likely to fail their specialty examination, but I was not preparing them for an exam; this was their one and only chance to see mystery and awakened thinking on display. I was sure I was on the right track, that I could awaken Dr. Kori's interest. I was also determined to show my students a side of Dr. Kori that was not serious, rational or in despair, trying to get his Dionysian side up and running. I was also getting ready to tempt him further — give him more bait — convinced that a joyful, erotic side of Dr. Kori was accessible. As I was telling my next story, I realized there was something odd

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about Dr. Kori's appearance. Or did he look like he might have been gay? My gay radar only works intermittently, so I wasn't sure. "As I told you," I told Kori, "this patient was gay. One day, lying on my couch, he said there was something he wanted to do, something he had wanted to do his whole life, but had never had the nerve. Suddenly he began to make loud, high-pitched sounds, a mixture of squealing and singing and howling, sort of 'mincing' with his voice. He'd turned into a hysterical drag queen, said no words, only shrieking, pealing sounds, very high pitched and amusing. It was hilarious, but also sad because it underlined the impoverished life this young man had designed for himself. He continued for at least five minutes and, finally, fell silent. 'I've wanted to do that all my life,' he said. It was only the second time I had seen him animated, the first being when he described his art construction to me. "Dr. Kori, I've told you these stories because I'm wondering if you know what I'm talking about?" "Yes, I know what you mean." "About your flute." "Yes, I know. Yes, I get that feeling when I'm playing my flute." "So there is an artist hidden inside the dentist? But before you answer that question, let me tell you something else I've noticed. "You are a dentist, so I expected you might be a bit on the formal side, and you are. But your appearance is, to me, even more than that. There is something dignified about your appearance and about your language — sort of proper. Your mustache is carefully trimmed and your hair, well, it sort of goes off to one side — a lovelock, I think it's called. It reminds me of something I was reading about Rembrandt the other day. He had a lovelock, of which he drew many versions in preparation for a self-portrait. He was concerned that he should invent himself properly, establish correctly who he was. He was a bit of a dandy, you know, dressed himself up in fancy costumes.

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Maybe you are a new version of Rembrandt?" Dr. Kori smiled as though he wanted to speak, but I carried right on, perhaps enthralled with my own version of drag-queen-speak. "When you raise your eyebrows, you only furrow the right side of forehead, a nice complement to your right-sided lovelock. All in all, your appearance is just slightly old-fashioned, sort of like a 19405 movie. In fact you remind me of someone, but I can't quite get who it is." A voice from across the room pierced the cozy world that Dr. Kori and I had created. "It's Errol Flynn," the voice said. It was one of the young whippersnappers, Christine Brydon, breaking my iron rule that only the patient and I are allowed to speak. Christine knew perfectly well a dose of sadism spills out of my eyes if anyone dares make a peep during my interview. How can I mesmerize my patient when there is chatter coming from the audience? I looked over and unleashed a charge of invisible hatred in her direction, to which she returned an impish, invisible smile. Dr. Kori smiled. "Yes, people often tell me I resemble Errol Flynn." And sure enough, that's who he was. It was uncanny how much he resembled him, the actor whose Australian dialect had been re-honed into an English accent, the "formality" that I had noticed in Dr. Kori. "That is a very interesting description of me," he said, and smiled at me warmly. "Yes, I know what you mean about getting excited about playing the flute. I certainly get that a bit, once in a while." There it was! Right before our eyes, in one short speech, he'd switched from genuine enthusiasm to muted enthusiasm. First, he said he knew about artistic excitement, then switched (including a switch in his tone of voice) to knowing it "a bit" and "once in a while." "Did you see what you just did, Dr. Kori?" "Huh?" "How you switched from being my artist patient singing out passionately, to being a dull dentist who knows about enthusiasm 'a

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bit' and 'once in a while.'" Dr. Kori's face fell and he looked glum and depressed. He didn't like it that his madness was so clearly identified, the madness that I paraphrased ("formulated," in psychiatric jargon) to myself as follows: /, Mateen Kori, am the man who has moments of joy and eroticism that are never sustained. You, Dr. Warme, and the world— and I myself — may see my fine appearance and my pleasure in music and fine eating, but look again. Can you (and the world, and I) see that my joys are spurious and transitory? My good looks are merely aping those of someone else — ErrolFlynn — or, as you suggest, Rembrandt. But it is aping, not genuine. It is not me who is joyful. Observe my eating; it looks as though I love food but it is more misery than pleasure. I am an eating disaster. That is why my face fell: you mustn't think that my interest in what you say is anything but momentary. It is my glum face that is the final reality, not the momentary interest that I showed you. And my flute? That only shows that, in the world of joy, I'm a failure in yet another way: I didn't capitalize on a talent that I had, and I only mentioned it because you caught me off-guard. Dr. Kori's pallid statement that he was depressed was only a rough approximation of his real symptoms. His madness was a figure, an etched-in-stone sequence of joy followed by despair. He happily succeeded in pushing his rock to the top of the mountain, only to have it roll to the bottom again. He was Sisyphus.

But at least Dr. Kori had become enthralled with me, and his current glumness was not the full-blown wretchedness he got when he ate. "You are an interesting man, Dr. Warme, and you are quite right about my artistic side. Most of the time, I am a very serious person. I work hard at dentistry and am a perfectionist. My wife is a careless person while I tend to be very sensible and this often causes trouble

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between us. I don't like it that you follow so many hunches. And I don't understand the point you are making by telling me about that other patient. You'll say that I'm just doubting everything or being obsessively uncertain. That's true of me all right, I do worry a lot. It pays to be careful about things and I wouldn't want to go off halfcocked. I understand what you said about good things changing into disappointment, but you don't really seem to have much evidence for this, do you?" Dr. Kori had dried up. In my psychiatric way I was judging him for this, as though I knew a way of life better than his: "He ought to be more enthusiastic, ought to be peppier and more radiant." At that moment, I seemed to believe being rational and sensible was somehow less worthy. I suppose what was happening was a countertransference, that is to say, I was acting out with Dr. Kori one of his typical scenarios, a scenario in which he possessed all the seriousness and other people in his world got to play out frivolity and enthusiasm. What else could I have expected? Surely, Dr. Kori had to appear in everything he did, whether I liked it or not? What obligation, I might have asked myself, did he have to become lively? My guess was that Dr. Kori's doubting guaranteed that he would never burst into artistry, drag-queen-ness, or whatever it was he feared. If other impulses should assert themselves, doubting would nicely cancel them out. Difference and uniqueness — that is to say, assured self-confidence — was anathema to Dr. Kori and he had done his best to avoid them by becoming a cookie-cutter copy of the family tradition. If he became a dentist, he wouldn't have to take on new or exciting ways of thinking. He joined forces with the men in his family, all industrious, conscientious, and boring. His mother and sister (and Dr. Kori hinted that this may have been true of his wife, too) were exactly the opposite — artistic, musical, gay (in the old sense), and lived their lives singing and laughing.

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Meanwhile, all boldness and confidence was masked by Dr. Kori's malignant tendency to doubt and undo everything he thought. Indeed, he second-guessed and doubted what others said as well. He told his doctor he needed psychological help; he told us he needed biological help. Psychologically, it was the perfect guarantee that he would never be definite, self-confident or potent. Dr. Kori's self-canceling life was painful and made him a cousin not only to Sisyphus, but to Hamlet.

"Dr. Kori, I wonder if your artistry means that you resemble the women in your family, your mother and your wife?" His face fell. He looked for a moment as though he might have a nervous breakdown. I had touched a sore spot. "Not at all," he insisted. "How did you come up with that?" Underneath Dr. Kori's fa9ade lurked a strong identification with his mother's gaiety, a dangerous possibility relegated to unconscious status by unrelenting, sober industriousness. Like many of us, he feared being disloyal to his father and my speculation was that, had he not followed the tradition of men becoming dentists, he would have felt he was letting the family down. But perhaps that's too mild: he would have been a traitor to his father's traditions. "Your mother and sister are Dionysian and you and your male relatives are Apollonian," I told him. Dr. Kori's ears perked up. Fancy language and references to mythology made him feel safer. "Yes, my mother and sisters are full of life and energy, and the men in my family are too sensible and thoughtful," he agreed. "I remember a sensuous Brazilian woman who nearly drove me wild. She helped me to understand life, passion and energy. But I developed extreme ejaculatio praecox with her and when I really tried hard to restrain my

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orgasms, I became utterly impotent." Well, of course Dr. Kori would have ejaculated prematurely. The sensuous Brazilian woman was a reincarnation of his sexy mother who ran around to parties. Or, further along in the progression of possible questions, his mother who was a slut. But I didn't say this to Dr. Kori, probably because 1 didn't want to give Dr. No-name the satisfaction of knowing that he'd been on the right track. ! was a bit pissed off with him for being such a do-gooder, full of empathy and earnestness, but he had been the one who asked Dr. Mizrahi how the patient felt about his mother going out all the time, so I knew he had a dirty mind like me. "When you were a young man," I asked, "were you more energetic? What were you like? Certainly, it seems that when you risked choosing a sensuous Brazilian woman, you were tempted to be energetic and more, to be adventuresome and erotic." "Oh, yes. I had much more energy. I had a nice life like other people." "Did you have girlfriends?" "Yes, I had quite a few girlfriends." "Can you tell me more about that?" "Well, I'd often really like a girl, but when she started to like me, I'd want to get away. With my wife, I knew the same thing would happen. But I wanted to get married, so I married her on logical grounds, not because I longed for her. She was a sensible woman with a good career — she's also a dentist, you know — so we got married. But I can't say we've been happy, mostly because I have been unwell. I wish I could get the proper treatment for this eating problem before the rest of my life gets wasted." "So girls liked you?" "Yes, they did." He paused, thinking. "They liked me a lot. I was very sexually active with a lot of different women. I just seemed to fall

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into sexual relationships with women." "Well," I said, "I guess being Errol Flynn made that inevitable?" "Yes, I know. They seemed to like my looks." Did Dr. Kori know, I wondered, that Errol Flynn swung both ways? He often answered with the phrase, "I know," and I believed he meant it. Dr. Kori was aware of much more than he let on at first. But his illness and its attendant wretchedness were untouchable. In the world of his illness, which had become the centrepiece of who he was, no knowledge of what he knew was permitted. He clung desperately to his wretchedness, needed it, diereby assuring that he could not be the scoundrel Errol Flynn. "You were the eldest son in your family. Were you special because of that?" "Not really." "Your mother and your sister weren't like the women you met later in your life, then. They weren't vulnerable to your charms?" "Why would a first son be special?" I was definitely turning into an incorrigible storyteller, perhaps because Dr. Kori had begun his interview with Dr. Mizrahi by telling the story about the Iranian teacher who showed students how to eat with a knife and fork. And Dr. Kori had already shown me he would melt when I entertained him widi a telling story, a story that turned me into another admired dental professor. I decided on a story that might lead him to see more of his hidden, exciting side, the part of his personality that dangerously linked him with his mother. "I knew a guy from the Levant [ 'Levant"? Why the fancy term?} once," I said. " When he was born — or when he was about a year old — his mother sat him on a stool naked, with his legs spread. She then took a full frontal-view photograph and proudly sent prints to everyone in the family in Lebanon, U.S., London — everyone. The reason why your mother did that was because you were her first-born

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son . . . oops, excuse me . .. my friend's mother, I mean, did that was because he was her first-born son." Dr. Kori laughed. He and I were satisfied with the interview. We sat and looked at one another briefly. "It's time to stop. You probably realize by now that this is so much a part of your character that you'll have to take a really serious crack at it. I think you probably need to get into analysis three or four times a week, you know. We will find someone who has the time available and call you in a few weeks." "Thanks a lot."

On this day, the group deserved a little pep talk, not just because Christine had broken my rule, but also because I'd made an unexpected recommendation. "He's an interesting man, but difficult," I told them. "You know I rarely recommend analysis, but this guy's troubles are so deeply ingrained I doubt anything else will touch him. He's also the type who might go for analysis three or four times a week. Usually, I reserve analysis for people in the mental-health business, because it makes us so much better at our work." In response to my recommendation, Leila Singh batted her eyelashes and did her "I'm just a naive beginner" number. "Aren't psychosomatic disorders depressive equivalents? Should the patient also be put on an antidepressant?" I was convinced Leila knew what I thought about such drugs. The Iron Lady had once left a reading list on the seminar table and I had directed my group to an article that made it clear that, because the placebo effect is so powerful, we couldn't know whether antidepressants did anything at all. I'd found it amusing at the time that such an enthusiastic drug peddler had left behind an article on placebos. Leila Singh

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was a keener, and almost certainly would have read the article immediately. Had she to ally herself with the Iron Lady and make my life miserable? Or was she flirting? I just smiled enigmatically. My usual self-satisfaction — or smugness — was not humming like a Ferrari, as it usually does. Although she was feigning seriousness, Christine Brydon was secretly giggling because she'd put one over on me, despite violating my students-stay-silent rule. Leila wasn't finished with me, either. She had another question: "Shouldn't it be explained to him that these psychosomatic disorders are depressive equivalents so that he begins to understand himself better?" What a waste of time that would have been. Dr. Kori wouldn't have been convinced for a second. People with psychosomatic complaints are always intractable in their conviction that they have a physical disorder. Explaining that it was otherwise would not only be a waste of time, it would have alienated him. Explanation may provide a comfortable, cordial pastime for some people, but it's also a sure sign of thin-bloodedness, measuring out one's life in coffee spoons. "Don't forget to live," Goethe said, echoing a popular expression I've been hearing lately: "Get on with it!" As a psychiatric method, explaining is futile and Leila had seen enough of me to know that I don't explain, even to excuse myself — perhaps especially when I suspect that I'm trying to excuse myself. While I was meditating, Leila waited for an answer. By Jove, I thought, the little rascal has even rolled her eyes at me. "Hmm," I said. The women had beaten up on me that day, but I'm a pro and they never realized they'd gotten under my skin. Erez had news he'd delayed telling us while I interviewed Dr. Kori. It seems that when he'd gone to bring him in for his interview, Dr. Kori had not been in the waiting room as expected. Erez found him

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in the cafeteria, about to tuck into a generous plate of food. A few days later, Dr. Kori left a message on my voice mail, not the voice mail of his primary physician, Dr. Mizrahi. He said he had decided not to enter psychotherapy because he needed to get his eating problem straightened out first. If he decided to proceed later, he would phone again. He'd made an appointment with another endocrinologist who he'd heard was good. I was surprised at this sudden change of heart; in the interview he seemed so anxious to talk to someone. But he was repeating his usual pattern: an initial flurry of interest, followed by withdrawal and disappointment. A few weeks later, Dr. Kori phoned Dr. Mizrahi — not me, this time — and asked for another appointment.

I used to invite other teachers to do my seminar from time to time so the students could be exposed to a variety of interviewing styles. The last visiting professor was Jack Edelstein, who, like Dr. No-name, went on and on about "empathy" — some tripe about non-empathic parents causing the patient to have a fragmented self, "failures in intersubjectivity," and some pretty naive talk about the supposed cure. To his mind, a psychiatrist should be empathically responsive — as though an insensitive, natural-born boor could be empathic on command. I guess the idea was that psychiatrists can, and should be, better, more empathic parents than the patient's real parents had been. In his demonstration interview, Jack repeatedly asked our patient how he felt about this or that event, apparently unaware that my seminar allows only highbrow theatre, and is not a suitable venue for the feelies. My student without a name spoke the same weak language, earnestly and with a hint of rebuke in his voice. In recent years, a cohort of nervous teachers like Jack Edelstein have been trying to teach students to avoid some of Freud's unsettling

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ideas. Freud saw, and wrote down, that evil, usually unconscious, is in all of us. He also wrote about how we ignore this, especially in ourselves. I want to say the avoidance of this unattractive fact is new, but it's not; Freud's ideas have always been found repellant. This shows up in clinical work when evil, cowardice and falseness in our patients is denied. We trick ourselves by using words for their actions that emphasize innate goodness and the need for fulfillment. The constant temptation is to let them off the hook by blaming someone or something else. It's parents, we say, or the bad chemicals in which their brains are bathed. In die past, we blamed demonic possession, the gods, or fate. When we get nervous about the unattractive things we see in our patients, we're ready to blame anyone about whom we hear a complaint and stop listening for die hidden messages. None of us wants to keep Goethe's words in mind: "We are most offended by our faults when we discover them in others." I'm amazed at this — although I shouldn't be. I keep hoping good literature will immunize psychiatrists against error, but it won't. Turning people into "things" is another tactic for escaping the passions of real life. We all avoid Buckminster Fuller's recognition that "I seem to be a verb." "It's my need (impulse, drive, instinct)," we are always tempted to say, "that made me do it." The truth is that it's me, and not my need. The use of nouns for what we do can be crudely silly. Dr. No-name, for example, propped up his damaged patient theories by hanging onto a metaphysics of mental "things" such as cohesive or fragmented selves, true or false selves, and other such twaddle, a tangled grammar in which the mind became a minefield of silly, newly invented nouns. When used well, nouns can be lyrical and poetic. I was recently browsing through a biography of Emily Dickinson written by my

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friend John Cody and came upon a passage in which her poetic mind is treated as a noun: "Emily's mind was like an opal, rent by fissures and fractures, brittle, never coalescing into a unity, reflecting first this, then that fracture-surface." It's a fine simile and captures the magic of every creative mind.

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CHAPTEFLSIX

ttly VERY Own HYSTERIA

I was sitting across from Dr. No-name one day — he's the resident to whom Leila had turned a couple of weeks earlier when Osman tried to chat her up — and an unbidden thought popped into my mind: "I hate him." This struck me as peculiar, because I'm fond of my students, even Dr. No-name who, in his proper suit and tie, looked cuddly and vulnerable. I guess that's why I kept forgetting his name — his mushy fervor for empathy, his conviction that he was kinder, more understanding and responsive than the rest of us, had gotten on my nerves more than I realized That what I felt was "hate" gave me away. I've got mushiness in my system, too, and it takes a special effort, something extreme, to fight off what I fear and loathe in myself. A fragment of my mother had also been awakened; she was someone who confidently hated anyone whose actions didn't suit her taste. My distaste for Dr. No-name's style was becoming a tangible revulsion, a dead giveaway that it was a reaction with deep roots in my psychology. I'm good at covering up my arbitrariness but deep down, I'm still a despot. It's not that I am unkind to patients, or that I never share some of Dr. No-name's arrogance, his belief in himself as the universe's big breast. I had thought the same thing of myself when I was his age. But in those days, such

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fantasies were safer — the "cure by love" hadn't yet become a cult. We don't call it love, nowadays; the grand fantasy of being the best, most nourishing breast on the planet has become institutionalized and has a doctrine, a rationale and a lexicon of ceremonial terms: empathy, "fragmented selves" that need empathic nutriment, "cohesive selves" that miraculously flourish in the wake of empathic responsiveness. It's a pretty insulting thesis that we humans have no will of our own, and are merely straightforward creations of the world's treatment of us. Were this true, the shit that rains down on every life might convince us we are all victims. These unfortunate, fragmented patients (although said to be broken, they look like people to me, no different from you or me), these psychiatrists tell us, all had bad parents who failed to dose them adequately with empathy. If the world is divided into nurses and patients, it becomes easy to see patients as weak and vulnerable. But my kind of psychiatrist is different. We don't see patients as vulnerable; we treat weakness as a psychological posture with a purpose. When we stand back and observe our patients, it isn't that we don't care, it's because we've learned to tolerate the terrible tension between moral concern and objective observation. Although we may appear hard-boiled, we are also supple, not so single-minded. When I suffered from Dr. No-name's affliction, I was more secretive about it; I didn't publicly crusade on behalf of empathy. In a way, I was worse because, all by myself, without being indoctrinated by a cult and without a theoretical rationale, I had decided I knew the secret of how to love my patients. I was the one and only person who cared with unqualified determination. The belief in the cure by kindness is a universal affliction, and so I curbed my impatience with Dr. No-name. How could I be impatient with him when I had held the same beliefs myself? No matter how much I mocked my belief that I cured people with love, no matter how much I scorned what hints of

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it snuck into the open, I was as convinced as anyone else that my dedication could effect miracles. In the days when I worked with Cathy Jones, I wasn't bashful about believing in the cure by love. I was like Ralph Greenson, the man who thought he could cure Marilyn Monroe by love. In the last months of her life, Marilyn's work habits were getting worse. She repeatedly phoned in sick and the film she was working on, Somethings Got to Give, fell hopelessly behind schedule. Eventually, she was fired and the film was never completed. In 1962, Ralph Greenson was arguably the best-known psychoanalyst in the US. He had written the standard textbook on technique used in American Psychoanalytic Institutes and had a high profile in psychoanalytic and psychiatric politics. He was also Marilyn Monroe's psychoanalyst. During the filming of Something's Got to Give, Ralph Greenson succumbed to the belief he could cure Marilyn with love. He intervened with the film's producers, asking for patience and reassuring them he would ultimately be able to make Marilyn comply with any reasonable request. In the end, he couldn't. In his final and most bizarre move, he had the star move into his home so that, in his words, "she could learn what it was like to live in a normal family." Greenson's arrogance is remarkable in itself but how in the world could he justify talking about her to other people? Marilyn was his patient and medical ethics dictates, especially for a psychiatrist, he shouldn't even have acknowledged she was a patient. An unprofessional madness had taken hold of Greenson. Somewhere along way, he'd forgotten the technical guidelines that help us evade error — and he wrote the textbook. He acted like the student who told me that, when a patient brought beer to his appointment, they shared a six-pack. Amazingly, the student s supervisor agreed with this approach, seeing it as the administration of worthy love, a sort of pub-love therapeutics.

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Occasionally, such nonsense is even advocated in the psychiatric literature, as on this occasion, unabashedly: Dr. Earl Bond, in a lecture to the Fellows of the Menninger School of Psychiatry, March 1957, described a patient afflicted with severe mental illness of lengthy duration in the course of which she expressed overtly many sexual wishes. One day her physician, in an experimental mood, picked her up and held her in his arms, thrusting the nipple of a nursing bottle between her lips. She drank the milk avidly, expressing great satisfaction. "This," she said, "is what I have always wanted, this non-sexual love." This episode marked the beginning of a rapid return to recovery.

There are also accounts of cures produced by spankings, sexual intimacy or symbolically smearing feces. I wouldn't be surprised if, one day, I hear that mutual poop-smearing, this time with real poop, has been found to cure something, a brand new ritual that perhaps could be toasted with a swig of golden urine. I'm pretty smart at avoiding hokum these days, but as you will see, my work with Cathy Jones became a monkey-see, monkey-do imitation of the Ralph Greenson strategy.

All competent psychiatrists know the pitfalls of excessive belief in their own powers. Without realizing it, most take steps to immunize themselves against collapses into love — the belief they love better and more thoroughly than anyone else. They are aware their patients idealize them, thinking of them as ultimately wise and powerful. A few fools fall into the trap of believing what they hear, a trap that's easy to fall into, if only because most patients tend to feel better no matter what their psychiatrists do. But wiser psychiatrists see to it that they don't believe everything they hear.

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On the surface, it looks as though psychiatrists never grow up, because so many of them pursue more and more training. After qualifying as psychiatrists, many doctors train as psychoanalysts or as specialists in psychotherapy, while still others receive ongoing supervision of their work from senior colleagues. Study groups are popular and in these groups, psychiatrists present their work to one another. Most psychiatrists don't think about why they do these things, but it's clear to me it's because they have a secret wisdom; they see things like Ralph Greenson's conduct with Marilyn Monroe as a warning, and that the fantasy of being the primal father or the earth mother is liable to corrupt us all.

By now, I've got my cure-by-love fantasies well disguised; they usually show themselves in my work habits: an excess of dedication, industriousness, conscientiousness and reflectiveness. I'm always determined to be the most studious kid on the block. It takes a shrewd observer to see this as anything other than good doctoring. I'm a fabulous liberal, too, so liberal I never have to give advice. If it's asked for, I tell my patient that, by asking for advice, he is assuming I know how he should live his life better than he does. I believe I'm right on that point, but my response has become so automatic it spills the beans: it's life or death for me that I remain an unconditional liberal. I have many colleagues who also avoid answering questions, but lapses are common and I'm probably the champion at sitting silently (like a horse), just listening and analyzing. I'd hate to get a clear look at the arbitrariness that hides behind this style of mine. Why else would my liberalism be so extreme? It was a patient of mine, Susan Wever, who first startled me by drawing attention to this character trait of mine. One day, as she chattered away, I was pondering a tone in her voice that had caught my attention on other occasions. She wasn't exactly whining, although

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there was something akin to whining in the way she was speaking. I knew it wasn't whining, because that's a specialty of mine — making everything the patient does into "a specialty" is part of the ideal psychiatrist I've invented for myself. I have a trick I use when my resolve weakens and a patient gets on my nerves: I turn the obnoxious trait into a pet project. Nothing can threaten my professional balance. If the real world won't live up to my ideal standards, then fuck it, I just set up in my mind an ideal psychiatrist who can flog me into doing my job properly. My ideal phantom psychiatrist isn't a do-gooder. He puts his faith in serious thinking and has consulted with the Muses and the gods. That doesn't guarantee that he can always make me do good work, but it does keep me on my toes. If whining gets on my nerves, I theorize about it. "Why the hell would someone whine when they know it turns people off?" One day, the answer came to me. They do it precisely because it turns people off. Upon reflection, this counterintuitive conclusion is obvious. Everyone knows whining is unattractive, and those who don't want to put people off don't do it. Whiners, I realized, were no different from drinkers, gamblers, and braggarts; they know they will reap a bitter harvest, but persist nonetheless. All are disciples of the goddess Ruin, Zeus's first daughter. Self-ruin is the root of madness and is what makes our profession necessary. It's easier to see in children: they whine and whine and whine, until the parent blows up. Some explosive yelling, or a clap on the bum and, presto, the whining stops. The child whines to turn people off, earns the clap on the bum it (unconsciously) wants, and the guilt problem, whatever it was, is solved. It's one of those things that, as a psychiatrist, I should have figured out much sooner. But as I listened to Mrs. Wever, I realized again it was not whining I heard. The best clue was it didn't annoy me. Ah, here was the word

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I needed, come to me from God-knows-where. It was protest. It wasn't "complaining," nor was it unattractive. The word protest, legitimate protest, fit the bill. Once I had a good word, I could talk to her about it. "Mrs. Wever, I've been puzzling about a certain tone in your voice. For a while, I thought it might be whining, but you're not really a whiner. Just now, I realized what it is. You are making a protest. Can you tell me about that, about what you are protesting against?" Mrs. Wever was quietly thoughtful for a while, but there was a hint of impatience in her eyes. It was as though she was thinking, "Why the hell didn't you notice before?" "This is hard to tell you, but you're right," she said. "Once you said 'protest,' I realized there is something on my mind that I haven't been telling you. Part of it is that you are so fucking conscientious. It drives me crazy. You never chat, you're always on time, you think so hard about everything I say — it's maddening. If, once in a while, you would let up, relax, it would be easier. I can't even complain that you're uptight or fussy — you're actually quite relaxed and friendly. But it's the damn, endless, conscientiousness." What does she expect? I thought to myself. I'm a German. Mrs. Wever paused. I remembered that, a couple of months earlier, I had pointed out in her something similar to what she had just identified in me. She was fussy and tidy, and had been worrying about touching my wall, and getting nail polish on it. She never wept, because she feared getting my pillow dirty, and brought me bigger tissues — king size. Now, Mrs. Wever was complaining about something I had devoted my life to perfecting: being the good father who never lets anyone down. How could she disapprove? Like a psychiatrist, she was describing a pattern, and got me to think about myself. "When your father died," she continued, "I read the notice in the

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obituary column. It's bizarre — you saw me that very afternoon, the day he died — but I never saw any reaction in you at all. It's that infuriating conscientiousness of yours. I also heard that you separated from your wife a couple of months after your father died, but I didn't see any sign that you were going through a crisis. It drives me crazy, especially when I haven't got anything to complain about. That's the protest you hear in my voice." Mrs. Wever's comments made me rethink who I was. At first I wondered what the devil she could be complaining about; wouldn't anyone want a conscientious psychiatrist? But slowly it sank in that I was hoarding all the virtue, and leaving her as the only sinner in the room. Like the empathy floggers I'd scorned, I was a virtue-flogger, busy making my patients feel guilty. Knowing what I now knew about a trait I thought I already understood, made my head spin. That elusive thing called change, the something sought so eagerly by psychiatrists, arrives in unexpected ways. I knew I couldn't just will myself to become negligent or lazy once in a while, but something began to ferment. New forms of love became a possibility.

I had started worrying about Hanna Slendzinski again. I'd become very fond of her and once in a while we even gently flirted with one another, but something had gone awry. I sometimes saw Hanna in the nursing station of the emergency department as I walked to my office. Then, when I arrived in the corridor outside my office, she would "coincidently" happen to be there. Obviously, having seen me walk past Emerg, she'd deliberately taken the inside route to my corridor so that we would meet. It happened so often I could no longer write it off as an accident. I had suspected she had a little crush on me, but Hanna was a restrained and dignified woman, so chasing me down meant there was love trouble in the air — romantic rather than merely

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flirtatious or curative love. I told myself I would have to talk to her about this when I got a chance. It was nearing Christmas, and the psychiatric partners were holding their seasonal party. I knew Hanna would be there, so to quell my anxiety I took a swig of vodka from the bottle I'd planted in my bottom desk drawer two or three years back. The bottle was intact, though once the cleaning staff make their periodic discovery of my emergency bottle, the level of booze has a habit of rapidly diminishing — along with telltale lipstick marks. As expected, Hanna was there and, after snatching a glass of wine to give my hands something to do, I cornered her. "Ah, Hanna," I told her. "You are my good friend. But you and I have to be careful, you know. We are bumping into one another too often." I can't remember what she said, but whatever it was, I suddenly lost my resolve to settle our little turmoil. Most of all I was suddenly very aware of Hanna's face, and saw things in it I'd never before noticed. I'd always thought she wore no makeup, but I now noticed she was wearing lipstick, subtly but beautifully applied. She had used the little trick whereby her lips were outlined in a darker colour than die rest, both so faint I had to look carefully to see it. I was also aware that I was suffering. Hanna was emitting sparks of womanliness, and they were going straight into my heart. I didn't know what had gone wrong with my body, but it had hurts and thrills running through it. Hanna and I were still talking, but I couldn't keep track. I knew the real conversation was in our heads. She had on just a smidgeon of eyeliner, just enough for her eyes to turn into goddess eyes. "Oh, my," I said. "Let's take our wine and go downstairs." I realized that sex, even where there is no sex, is a private thing. Downstairs we went, wineglasses in hand. In my office, I regained

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my poise. There was no point in beating around the bush. "Don't jump Hanna. I'm going to touch your lips." With my right forefinger, I gently stroked my finger along the length of her lips. She looked off dreamily into the distance. "What did it feel like?" she said. "I'm not sure," I answered. "When I was a child, I used to crawl into my parents' bed on Saturday and Sunday morning. They wanted to sleep in, but I used to touch my parents' lips just like that. I don't know why I suddenly remembered that and had to touch your lips, Hanna, but I do know that it isn't our turn in this life. In another life it will be our turn. Right?" "Don't be upset, Gordon," she said. Oh, God, 1 thought. I knew that, like all things in life, our moment would be brief but, just the same, I murmured under my breath, "Let us put our heads and feet together, mouth on mouth, heart on heart." That's all I remember. Someone had seen us go into my office with our wineglasses, so there were a few rumours — harmless gossip, I guess.

My infatuation with Hanna showed me that, for me, love has to be in the romantic mode; it's my very own hysteria. And, to my good fortune, my hysteria matched hers. In 1960,1 practiced for six months as a family doctor in Toronto and witnessed another kind of hysteria, as classical and well known as mine. I was working in Geoff Cranston's practice in Scarborough, a suburb of Toronto, and was surprised to discover he was not a good doctor. He listened avidly to pharmaceutical company representatives who pestered us and enthusiastically peddled their wares to patients until a new salesman arrived with a different product. When I told

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Cranston tkat in Germany the doctors used herring salad as a laxative, he was impressed and eager to try that on his patients as well. Even when I argued I'd been poking fun at the German doctors over what was only a superstition, he still wanted to know how herring salads were prepared. When cornered, Geoff abandoned all direct treatments and relied instead on prayer. I was looking forward to running the practice on my own when Geoff went on vacation. I already thought I had the inside track on how medicine should be practiced but, to my surprise, few patients came while Geoff was away: most just waited for his return. My feelings were hurt and I was puzzled. If I was a better doctor than him, why would the patients wait for his return? It was an early lesson in magic. I was too young to be cast in the role of sage — my medical skills were easily trumped by Geoff's age. Geoff belonged to an evangelical Baptist church and every morning, before our office began, he gathered the staff to pray. Marion Robertson, a social worker who'd developed malaria while working as a missionary in Africa, was one of our patients. She did her best to make herself plain — wore no makeup, sombre clothes — but in a movie, she'd have ripped off her glasses, let down her hair and been transformed into a ravishing beauty. She had worked in our office for a while and at our morning prayer meeting I'd expertly scanned her fine figure — not with love or lust, but perplexed by the conjugation of beauty and primness. We had two offices, one fully equipped, the other suitable only for routine matters. One morning, I was in the smaller office, and needed a piece of equipment from the larger office, but Geoff was in there with a patient. Office visits were usually brief, so I waited. I didn't like to interrupt, but I, too, had a patient so, eventually, I knocked apologetically and walked in. Marion Robertson stood naked in the centre of the room. Geoff

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Cranston was on his knees behind her, studying her back, and palpating it. How long does it take to examine a back? I wondered. What the hell is he doing? I noticed Geoff had beads of sweat standing on his forehead. "Gordon," he said, "I'm glad you've come in. Marion is having back pain. I've examined her up and down, and just can't figure out what's going on." Naive and young I may have been, but I had no trouble figuring out what was going on. I could sense Marion's sexual arousal while Geoff, in an equally intense state, convinced himself he was doing his medical job. Neither he nor Marion had any idea they were performers in an obvious hysterical episode. The sexual crisis ended when I arrived, and routine measures and investigations were recommended. At midnight a few weeks later, in Fran's restaurant at Yonge and College streets, I checked my phone messages. There was a call from Geoff. "Gordon, I'm not well. I know it's late, but would you mind coming to the house? I need some help." Geoff hadn't said what was wrong, still I dropped off my girlfriend, and headed for Scarborough. The house was dark when I arrived. I knocked, but there was no answer. I opened the front door, and peered into the dark house. "Geoff?" I could see a light on upstairs, but no one answered. I'd been in the house before, so I cautiously entered and went upstairs. The light came from the master bedroom, where I heard Geoff calling. "Gordon, I'm in here." In the middle of the bedroom stood Geoff, naked. There was no sign of his wife. His figure, I'm afraid, did not rival Marion Robertson's. "It's bad, Gordon," he told me. "My back is in bad shape."

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Such hysterical adventures are more common than we like to think, and while Geoff's plight makes for an amusing scene, I have to be careful not to be frivolous or mocking.

What in the name of God is this love thing, more mysterious than time and death? Despite the blathering pundits, it's not our hormones. I'll earn enemies if I call it a cultural ritual, because cultural rituals feel optional — even when they're not. In our depths we all believe that a destiny like Romeo's or Juliet's is one of the great achievements in life. But why does love tear us to pieces, and why have countless poems and stories been written about love? And why do we all worry about people who've never experienced love? I guess it's necessary for each culture to devise a reproduction story that works — our species would disappear without one — and being male and female plays a central role in that story. So when I met Hanna at the Christmas party, the essence of the tumult was that suddenly two archetypes switched themselves on — she turned into the primal woman and I turned into the primal man. Our 3O-minute love affair had all the poignancy of a performance of Tristan und Isolde, Wagner's mad, intoxicating opera. That 3O-minute affair may have been shorter than we deserved, but duration has little to do with it. Maybe fevered talk was less than we deserved, too. The cure by love that I spend so much time damning is in the story of Hanna and me, too. We don't always acknowledge it, but part of love is the idea of healing, helping, awakening. I thought Hanna was in a bad marriage and that I'd be the cure for that unhappiness. I expect that she aimed to cure me with love — that she'd heal a lonely bachelor.

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My sickness over Hanna is mixed up with my feelings about my German grandmother. Both liked the way I was and it bewildered me, because I expected them both to tell me I ought to be a good boy, a good, German boy. I admired Hanna's quiet intelligence, which, because my grandmother was similarly brainy, made it easy for me to blur the two. In my grandmother's case, she didn't bother being quiet about it. My trip to Germany in 1958 was to be an adventure and a sentimental visit with the grandparents I'd never met. It was also the fulfillment of my father's duty to visit his parents, a duty which, for money reasons, he was never able to do himself. I had a scholarship, and had arranged to work as a Gastarzt (visiting physician) at the Ludolf Krehl Klinik in Heidelberg. Many historically important psychiatrists had worked in Heidelberg, including Emil Kraepelin, Kurt Schneider, Karl Jaspers, and Wilhelm (Willy) Mayer-Gross. MayerGross moved on to London, and for many years was the predominant influence in British psychiatry. His textbook of psychiatry was still in use in Toronto when I was a medical student. I also had in mind plenty of skiing, and relearning the language that, many years before, had been my mother tongue. I had booked passage on the S. S. Maasdam of the HollandAmerica line, sailing out of New York. A few weeks before I left Toronto for New York, I got a phone call from Graham Copeland. "I'm going to Europe too, Gordon. I hope you don't mind but I've arranged to go on the same ship as you." I knew this could be trouble, but my liberalism disorder was already at work, so I made no complaint. There were many young people on the ship and 1 teamed up with Maria, a German girl who had been an au pair in Los Angeles for the past year. Graham made sure his homosexuality stayed a secret by pairing off with a woman — she's still my friend — named Lois Hummel.

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In Rotterdam, we all went our separate ways — except for Graham, who stuck with me. I was on my way to Winterberg to visit the parents of a friend, where I intended to brush up on my German before meeting my grandparents. I also had in mind a quick trip to Hamburg to visit Maria. Graham had the problem solved "I'll see you in Heidelberg," he announced. I suspected the worst: Graham would go to my grandparent's home and wait for me there. I had my first good look at Germans in the Koln (Cologne) railway station. I was 2,5, and when I saw the crowds I heaved a sigh of relief. Without realizing it, I'd expected signs of wickedness in German people. The people I saw were ordinary. Clearly, I had imagined a race of monsters populating Germany, a fear of which I was never conscious until that moment in the station. It's not even that the people were particularly well behaved. Two men, for example, argued noisily at a stand-up food counter. "Don't you dare say 'du'to me, you jerk," was the gist of what was being said. Although the arguing was boorish and loud, they didn't look like monsters; just jerks. Although I hadn't done it at the age of five, over the years I'd learned to discriminate between trivial conflicts like a public squabble, and real evil, which needs earnest attention. Earlier, I had assumed my mothers shenanigans were evil when, in fact, they were just an ordinary form of silliness. The Koln railway station awakened my interest in monsters, an interest shared by all psychiatrists. The thing to keep in mind is that monsters both exist and don't exist, and are highly mobile. I, for example, rarely find myself a monster, but am skilled at projecting evil into other people.

I arrived in Heidelberg in November. As expected, by the time I got

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to my grandparents Graham was already ensconced, but in the grand gala that surrounded my arrival, he was ignored. My grandmother knew when my train would arrive, and stood on her doorstep. Over the door was a big banner: "Herzlich Willkommen!" [Welcome from the heart]. I was taken aback. My family had no rituals; we never celebrated, in my mind because we were sensible Germans, unlike the windy, false Canadians. I had never allowed myself to complain about our lack of birthdays, or even to act with joy or enthusiasm. But there was that gaudy sign, contradicting all my protective thoughts about my parents. Germans, it seemed, celebrated after all. "Mein Kind, mein Kind," [My child, my child] shouted my grandmother, as she embraced and kissed me. I had no living memory of my parents kissing me. Inside, sitting in his chair by the window, was my grandfather, acting dignified and sensible like a military officer, but with tears in his eyes. There I was, in Heidelberg, the first tangible sign of my father, their only child, in thirty years. Wine was siphoned out of a barrel. Within minutes, neighbours arrived, and joined in on the cake, wine, coffee, curiosity and wonder. I was full of wonder, too. My family were being sociable, they belonged to a neighbourhood, to a group. Here was my very own Oma and Opa. Oma was snaggle-toothed and stout, the spitting image of the witch from "Hansel and Gretel." Opa was a small, trim martinet — a martinet lest his sentimental side should show. He was erect and proper, and had a smartly waxed mustache and a small goatee. Oma wouldn't let a hint of dialect come out of her mouth, and spoke only High German, but my grandfather spoke with a Berlin dialect. Many years later, when my children were born, my father became O'pa, and now, I am Opa. Meeting my grandparents tore me to pieces, as did meeting other relatives in Europe. I was in a trance, and despite the firestorm of emotion, I moved methodically from situation to situation, as if I'd burst myself open. For 26 years I had believed separations and reunions

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meant nothing to me. In Germany, I searched out everyone, seared my soul, and shed nary a tear. At first I lived at the clinic where I worked, but my bed was on the top floor, in the lab where, every night, a researcher spent hours playing with test tubes. I quickly gave up and moved into my grandparents' house. It wasn't much better. In the winter of 1958-59,1 nearly froze for lack of heat. I didn't like it, but the place and time made it feel normal. Once a week, I stripped to the waist, and washed myself with soap and cold water. Then I dressed my upper body, undressed the bottom half, and did the same down below. I could have had a bath, but that would have involved borrowing a galvanized steel tub from a neighbour. The tub was reputed to have once been used by Adolph Hitler, so I might have snuggled my arse into the same spot his arse had once been snuggled. The only warm place in the house was the kitchen, with its wood-burning stove. Since all the doors in the house were closed and locked with heavy keys, little heat escaped from the kitchen to ease the chill in the rest of the house. I was callous about Graham, who I avoided by keeping busy on my own. He acted as though he didn't notice. Oma instantly understood Graham: "Bin warmer Eruder" [A warm brother]. A few months later, I went to Switzerland to ski with Lois Hummel (by then Graham had given up the pretense he was involved with her) and Marc Hamel, a friend from Montreal. When I got back to Heidelberg, Graham was gone — Oma had lacked him out. I spied packages of food in the cupboards, packages I had helped to wrap when I was a teenager, in the years immediately following World War n. Food had been in short supply, and we shipped coffee, tea, SPAM, sugar, and whatever else could be sent by mail. Years later, my grandmother was still hoarding some of this food, "just in case." We ate according to the German tradition. In the morning, I was given a wooden board and a sharp knife, while the table was spread

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with bread, various cold meats and cheeses. The evening meal was exactly the same. But at exactly noon, we ate the main meal of the day, my grandmother having been up at six to start the soup. When the clock struck 12, my grandfather stood up from his chair by the window, and took his seat at the table. His plate of soup arrived just as he sat down. If it didn't, he'd want to know what was going on. Opa dropped his dialect, and spoke precisely in High German. "Can a man not expect the ordinary civilities of everyday life? Damn it all, this is an outrage." As he spoke, he twirled his waxed mustache. Oma, though far more robust than he, was frightened, and hustled to get the food on the table. After lunch, my grandfather returned to his window, to watch a daily spectacle: Emil was due to come by. Emil was a derelict, perhaps a madman, and very obsessional. He would walk, hesitate, retreat, and then try again. He tapped and checked the sidewalk [the Trottoir] with his cane, obviously in distress, unable to decide whether it was safe to step here or to step there. Meanwhile, my grandfather gave a running commentary that cracked us up. "Da geht er noch mal. Ach, nein, jetzt zuriick. Vorwarts, march'!" ["There he goes. Oops, no, now back again. Forward, march!"] In recent years I've discovered another Emil, also a derelict, who haunts the street outside the Clarke Institute. He is a drinker, and arrives outside my office window each morning, summer or winter, wearing a parka with his bottle in the inside pocket. He also begs for handouts on the street. Like the Emil in Germany, he is a fretful worrier, taking out his bottle, returning it to his pocket, checking his surroundings, and then trying again. "Da geht er, noch mal." My grandfather had been a career soldier, and when he spoke of World War i, his most worrisome memory was of the horses and their terrible suffering. Again and again, he returned to the mud of Flanders, to the wounds and helpless distress of the animals. But his

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concern about horses stirred my interests: my model horses, my brother Ernie (Horst), the jockey and racehorse trainer. When my grandfather was decommissioned in 1918, in accord with German custom he was given a civil service job at the Universitat Heidelberg as an assistant to various professors. He had mischief in him, and spent a lot of time with the students. I have many photos of him with my father and his classmates, drinking and partying. There are also pictures of dueling sessions and of the gatherings of the legendary dueling fraternities. When I was a boy, I liked to look at pictures of the bloody aftermath, the opponents formally posing for their portraits, covered with blood. German dueling is not fencing, and is done with sabres. The idea is to cut your opponent on the head or cheek, to give him one of the sought-after dueling scars. As a child, I was amazed at the bleeding combatants, bloodied despite that fact they were allowed a variety of protective gear. Some wore protective collars so that the heavy swords wouldn't cut a carotid artery or vein. Others had on steel-rimmed goggles. I guess it all depended on where they wanted to have their scar. Lest Oma overwhelm him, my grandfather kept tight control over money. Oma had to beg for every cent and complained bitterly to rne; not just because of the money, but because she was determined I should recognize my grandfather's faults, and prefer her. I realized my father had been similarly stingy with my mother and feared I would repeat the pattern when I married. One day in our basement when I was 16, I had said to my father (out of earshot of my mother), "Why don't you ever give Mutti some money? She has to beg for every cent and in the end you have to give her housekeeping money anyway." My father's face turned red with rage. For him — for me too — this was an archetypal moment. I was standing with my mother against my father — like so many Greek heroes, Telegonus, Oedipus,

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even Zeus. For a moment I thought he would hit me, and if he had, I might have hit back. We were both filled with fury. The moment passed, but my stomach was knotted for days, and I couldn't look at my father or speak to him. I hadn't stood up for my mother on her account; I had always found her cruel and selfish. I didn't duplicate my father's stinginess, but I reprised my fathers money habits in other ways. My father had been a tightwad, but gave my mother gifts. Her clothes came from the expensive shops in Toronto, she had jewellery, and my father worked long hours to ensure she lived in a home she could be proud of. More precisely, my father wanted to be sure her dearest dream would come true: that she would be a "lady." My mother was from a peasant village in Austria, and he, the student prince from Heidelberg, rescued her. I am the same romantic as my father. All of us have our conditions for being in love, mine have often been contingent on being able to enact my version of prince charming rescuing the maiden in distress. Hanna knew this about me and, while he disguises it as a technical intervention, empathic responsiveness, so does Dr. No-name.

My grandmother was a wonderful but difficult woman. She was an intellectual, and we spent hours drinking coffee (German coffee was far better than anything I'd ever tasted), drinking beer (also very good) and smoking Marlboro cigarettes (I had easy access to the American military stores). I was accustomed to the Waspish formality of Canada, and it was awkward for me when she hugged and kissed me, especially as her hygiene was always a bit precarious. But as my father's reincarnation, it was my duty to let her embrace me. She, it turned out, cured me with love. It was strange to watch her. I sat at the kitchen table while she happily insisted on serving me. Oma awakened in me a mother hunger that

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I never knew existed, and which I've understood better as the years went by. I watched my grandmother's hands as she ground the coffee and poured water through the filter (at that time, filtered coffee was uncommon in North America). They were old hands, but they moved elegantly and lovingly as she prepared the wonderful, God-given coffee. My grandmother's hands were also full of love when she served food — wine or beer as well. When she served herself, her hands were ordinary; when she served me, they were alive, erotic and glowing. It didn't matter that her hands were dirty or her nails broken because they pulsed with love and tenderness. She looked like an old battleaxe, she was an old battleaxe, but her lips moved sensuously when she ate and when she spoke to me, her reborn child and hero. She touched the tip of her tongue to her lips as Aphrodite would have done, pouted and curled them with her own, private genius. She didn't flick her hair to die side like Hanna, or twitch her bottom at me like Christine, nor did she hide cunningly behind a chador/scarf like Leila, still my grandmothers eroticism shone through. As part of her self-assigned mother function, Oma taught me proper German manners. "After eating," she said, "you must not say, 'Ich bin voll'[l am full]. The proper thing to say is, 'Ich bin zufrieden [I am content]." Her coaching was different from what I had grown up with. Rather than criticizing bad practices, she was passionately aiming to enrich my character. She also had humourous advice: Nach dem Essen, soil mann rauchen, Oder eine Frau gebrauchen. After eating, one should smoke Or make use of a woman.

While my grandmother and I smoked and drank, we argued — mostly about politics. I had never had close contact with an intel-

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lectual before, and had to be in top form to keep up with her arguments. We definitely settled on a preference for North American men, who were cheerful and helped to do the dishes, versus German men who were intellectual and serious. Despite his anal obstinacy, we decided that Martin Luther was preferable to the papists. My German was weak:, so Oma insisted on using Latin based German words. "Since I use Latin-based words, you must understand what I am saying; English also has many Latin based words." What she really meant was that English was nothing more than a clumsy, working version of the language of Ovid and Caesar, so on command, I should be able to understand her. It was all bullshit, of course, though she expected me to believe it. My grandmother was one of those wonderful outrageous characters who are lovable in their demandingness, and reminded me of my demanding teachers, Sammy Sergeant and J. C. Boileau Grant. One day, while we argued and smoked, there was a knock on the door. She answered, and I heard some banter. "Ach, du, noch mal, Affen-G'sicht?" [Oh, you again, ape-face?] In came the visitor; it was the Lutheran clergyman. My grandmother had formally left the church 20 years earlier, but the clergyman still loved her, and when he came in, I was displaced. Now, they smoked, drank and argued — and adored one another. My grandmother still loved men, even with only one fang left in her mouth. She rented rooms, mostly to visiting professors at the university. These professors had the same reaction as the pastor and me: they loved her. One of them, an American from Oregon, even paid to have central heating installed in the house in the 19305, although my grandparents couldn't afford to use it while I was there. In 1945, it had created a problem: since the house had central heating, it was to be commandeered by the American military. When two officers came to the house to inform my grandparents, my grand-

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mother reacted with quick shrewdness. Communicating in sign language, she adopted a look of horror, led the officers to an outside window, and indicated that they should look inside. She ran indoors, threw open the blind, and pointed to the bed. She uncovered her old mother, exposing the huge, liquid-filled pemphigus blisters that covered her body. The officers needed no further persuasion. They left, probably believing my great-grandmother had leprosy or the plague. My mother told me Oma had had an affair with one of the professors in the late 19205 while my father was still in Germany, and that he had caught them in bed. It was important to my mother to pass on this information; to her, all women were Ludern [whores] — except her. But I suspect the story was true, and think that's what precipitated my father's flight to Canada. I doubt it was her only affair, although the photographs show she was never pretty, and never adorned or beautified herself. She had erotic Aphrodite powers independent of flashing smiles and body display. We argued about one more thing: her belief— her stated belief— that the Holocaust never happened. Western propaganda. She also believed genetic engineering was important, as had been demonstrated by Emil Kraepelin, the central figure during Germany's one-time dominance of world psychiatry. Jews, Africans and Asians, of course, were minderwertigen Rassen [less valuable races]. She seemed to think I didn't know she read Heine, and listened to Mendelssohn. In the middle of our shouting matches, while she went downstairs to get more beer, my old, quiet grandfather spoke up. "She knows. The Nazis took her friends." But he said nothing in her presence because he was afraid of the power of her mind. I didn't hear much other Holocaust denial while I was in Germany, but one incident stands out. One night I went to a movie, and before the feature, they screened a documentary about the liberation of the camps, showing heaps of starved, dead bodies. I'd seen such films before,

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and watched with a mixture of fascination and horror. Suddenly, there were shouts. "Bullshit. Propaganda! Turn this garbage off." "Shut up, you Nazi!" "Who are you calling a Nazi?" "You, asshole, so lick me on the ass." And it was not just an isolated argument. A cluster of people at the front of the cinema had begun to quarrel in loud voices. Then, to my astonishment, it got worse — punches were thrown, bodies were flung to the ground, the cursing increased. That's all I remember. I was horrified that some Germans still denied what had happened, and proud that others had stood up to them. Germans typically have their own Stammhaus [literally, a "stemhouse"] , a favourite cafe to which they go regularly. Every Tuesday, we went to my grandmother's, "Das Eisernes Kreuz" [The Iron Cross], always sitting at the same table, and joined by a group of my grandmother's friends, the "free thinkers." The evening was spent drinking wine and beer and enthusiastically denouncing religion. On Saturday nights, we went to my grandfather's Stammhaus, "Zum Seppel," a university watering hole, famous because it was a hangout in Sigmund Romberg's operetta, The Student Prince. The place was filled with students, smoke, and noise, but my old grandfather was noticed right away and a cigar and his personal stein of beer always arrived immediately. I made my last visit to my grandmother in 1975, after my grandfather's death. She was 92 by then, and wouldn't live much longer, so I had taken my children to meet her. Oma made a little speech to each of them, confident that she was the grand matriarch who had important last words to deliver to them. They didn't understand German, of course, but her style and her message were obvious. "Continue your education. Your parents are educated people and

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you must emulate them. Germany is your country as well as Canada, and you should learn the language. Lebe Wohl [live well]." My children stared in silent amazement that this ugly, ancient, but queenly woman was really their great-grandmother. Ten days later, she was gone. She had waited to meet my children, and having fulfilled her last matriarchal duty, died. I had spent my life struggling to explain the problem of Germany, and I still do: it was a historical inevitability; one of countless holocausts that will afflict mankind forever; a Jewish victim stance called it down on their own heads. My struggle for an explanation was no different from the struggles for understanding I faced when I listened to my patients. Freud's solution, reduced to a banal formula, was that all can be reduced to history and myth. His primary example was that, in our personal lives, all of us face the heat and the passion of sexual sin and sexual triumph within our own families — the story of Oedipus, obligatory and inevitable. As the years passed I, too, saw the inevitability of myth and history in my patient s lives, but there was always a problem: how to acknowledge myth and history without inviting my patients to evade the heat, the hurt and guilt over what they actually do. When my patient hates me or loves me passionately, it's always easier to shift to history. "You're just repeating with me what happened with your mother, your father, or whoever." The value of myths, I realized, was that they can — and must — be told over and over again. Like the movies, they are tolerable, though brute facts can't always be swallowed. Telling Germany's Holocaust story as plain fact, over and over, is liable to wear thin, lose force, and invite rejection of the story. I have a myth for the Holocaust. It is the story of Daedalus's labyrinth, originally as beautiful as any German beer garden. Pasiphae, King Minos's wife, fell in love with a beautiful bull and, from that union, was born a racially different child, Astetius. All was well until

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Asterius reached puberty, when filthy sexuality tipped the balance against his inter-species, his racially mixed origins. The labyrinth became a concentration camp in which he was segregated and where he was given a new name, the Minotaur. 1 felt sorry for the Germans. Times were tough and people were poor. I read in the newspapers of the German economic miracle, and in a fundamental sense, the country was doing well. But in comparison to Canadians, the people in the streets wore shabby clothes, the automobiles in the streets were small — some only had three wheels. On the other hand, there was good food in the stores, the police drove BMWS, and the taxicabs were Mercedes-Benz. One didn't see much of the police. If they made themselves too obvious in the streets, people made sarcastic remarks: "Bloody nerve, standing out in public like that." Police discretely stayed on side streets near the main thoroughfares, but rarely appeared on the main street itself. The public was sick of uniforms. There was even an article in the Frankfurter'Allgemein, complaining of too much public police presence. I eventually ran out of money, and for a few months worked for the American army in Kafertahlwald, with the status of a German civilian physician. We were hard on the soldiers. If we thought one was on sick leave improperly, we gave him two ounces of castor oil. Once they paid that penalty, we could check off on their record that their sick call had been "in the line of duty." My most difficult job came while working in the military prison on Christmas day, 1958. All soldiers in solitary confinement had to be seen by a doctor every day and, while I was on duty, I had to visit those sad youngsters. Bewildered and shocked by the furious blow fate had dealt them, they were depressed, and I became depressed as well. They were boys, many of whom had never been away from home before. I'm always telling myself I'm immune to the sting of loss and loneliness, but the world keeps bloodying my nose.

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I was roughly the same age as the American soldiers, but was Canadian, and a civilian. I didn't wear a necktie and a jacket — obligatory for off-duty Americans — and MPS repeatedly assumed I was non-compliant American military. My English was indistinguishable from American English, so they didn't believe me when I told them I wasn't American. I must confess it was fun spooking the MPS. I, too, was youthful and a bit rebellious. My industrious work habits were well established, and I didn't bother with lunch, coffee breaks, or any of that nonsense. One day, one of our volunteers, the wife of a senior American officer, made a medical appointment to see me. When she arrived in my office, she produced a basket which contained lunch for me — and for her. "You work too much," she said. She was attractive: plump, charmingly light-hearted, and 15 years older than I. Her breasts were noticeable, even in a volunteer's uniform. I liked her because she was feisty and energetic, but she was married, had children, and her husband was a high-ranking officer. I managed to convince myself that, despite her flirting, she was simply a kind-hearted volunteer. We ate our lunch, flirted and laughed, and after half an hour, I maneuvered her out of my office. That night after work, as I headed for the intercity Strassenbahn [streetcar], my lunchpartner intercepted me in her big American car. As we pulled away, she passed me a bottle of whiskey. She drove me to Heidelberg, but I saw she was too drunk to drive back, so I took the wheel and drove her home to Kafertahlwald, parked the car in front of her house, and fled. I ended up at a tram station waiting for the streetcar I had intended to take two hours earlier. Also waiting was an American doctor, a captain, who worked in our clinic. He knew both my lady friend and her husband. Kafertahlwald seemed to have turned into an open plain. To the right were the neat, clapboard houses of Patrick Henry Village, to the

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left were open fields. We could see the streetcar approaching tar away on the left. Suddenly, we saw my lady friend's car, weaving across the lawns of the houses. She had spotted me, and her goal was to get to where I was waiting for my streetcar. It all happened in slow motion. I was transfixed: would she get to me first, or would the streetcar? The moral is that, in our dangerous world, an industrious, virtuous doctor is liable to be persecuted by a seductive, frivolous adulteress. When I think how judgmental and hysterical — yes, hysterical — any of us are liable to become, I summarize my story differently: a stuffy doctor is invited by an adventurous, cheerful woman to join in an escapade known to mankind since the dawn of history.

November nth in Germany isn't like Canada's Remembrance Day or America's Veteran's Day. At n minutes after the nth hour, of the nth day, of the nth month, Patching begins. Patching is Mardi Gras, or Karnival. That night, my friends and I gathered to listen to the new songs for that year's pre-Lenten celebrations. Not much happened during December and January, but as Lent approached, the celebrations began. The various Kneipen [inns, drinking spots] hired entertainers, piano players, and singers, and more elaborate entertainment appeared everywhere. We began going out regularly to drink and eat, and one night in a neighbourhood Kneipe, a young woman approached our table and asked me to dance. Not only that, but she addressed me as "du. "At that time, the intimate form of address was never used casually, but during Fasching, everything was reversed. 1 learned how to use the intimate form "<^"when I lived with my cousin, Jacky Gomez — he was the son of my Tante Alice [ah LEE seh], who had married an impoverished, Spanish ne'er-do-well, and later became Madame la Baroness de Trobriand by marrying an equally impoverished member

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of that famous French family. Only after Jacky and I had lived together for a month did he propose a toast so that we could address one another as "du." In the Kneipe, the young woman and I danced gaily between the tables, but after a few whirls, she disappointed me by taking me back to my friends. Intimate language during Fasching meant nothing. Soon, die Fasching parties began, often balls in the city hall. Everyone was costumed and masked, and it was rumoured people sold their furniture to pay for expensive gowns and celebratory paraphernalia. At one event I spied Hanna, 35 years before I'd ever met her, disguised as a magnificent green cat, much in demand, and dancing superbly with many eager young men. I knew immediately she was the girl of my dreams, especially since, instead of the usual ambiguous mischief in her eyes she displayed her exciting wickedness by being green from head to toe. I marshaled my courage, marched across the dance floor, and cut in. I whirled her around for a minute or two and then, without warning, she merrily fled. That was 43 years ago, and except for her brief reincarnation at die Christmas party, I've known her only in my dreams. I'd made myself an expert at Fasching, and my fellow students joyfully cheered me and joined in when I — to their amazement — sang beer-hall songs that even they didn't know. Before coming to Germany, I'd studied up on die German language and learned many German songs. "In Munchen steht ein Hofbrduhaus,! Bins, zwei, . . . " "Mein Vetter war ein Wandersmann I Undmir liert's , . ." o "Geh'n wir mal 'riiber, /getin wir mal 'riiber..." "Ich hob' mein Herz in Heidelberg verloren . . . "

But in 2002, when I sang the same songs with Frau Madlon and her family in Bayreuth (she runs a bed and breakfast), her university-age children looked at me as though I was a relic from the Stone Age. They 127

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all knew about Wagner and the annual Wagner Festspiel— they lived on Stolzingstrasse, named after Walter von Stolzing in Die Meistersinger von Niirnberg— but scorned the Hofbrauhaus drinking songs. It was mad, wild, fabulous Fasching. The world had turned upside down, an indispensable experience for a psychiatrist-in-the-making who needed exposure to unconventional thinking. Propriety was shed; impropriety reigned. The balls became more frequent as Lent approached. The week before Shrove Tuesday, there were splendid parties every night. The bands played till 2 a.m., we dragged ourselves home, and the next day, dragged ourselves to work. Finally, Shrove Tuesday. The band is playing madly, the world is singing and dancing madly, midnight approaches, then strikes. In mid-flight, the orchestra goes silent. A pause, and to my utter amazement, everyone goes home. I never see my green cat again.

In 1985, 25 years later, I attended a convention in Hamburg. The 1985 meeting of the International Psychoanalytic Association was its first in Germany since World War n. On my way there, I visited Walter Brautigam, who had been my host when I lectured in Heidelberg in 1983. He told me an amazing story about psychoanalytic training. Walter had not only trained in psychoanalysis in Berlin during World War n, his training had been sponsored and paid for by the German military. I knew that under the Nazis, psychoanalysis had officially been banned, so I asked him how this was possible. It was done quietly, he told me, although it was no great secret. Brautigam didn't think of it as a big deal, but it amazed me. In Hamburg, I walked down a fashionable street, and was stunned by the prosperity. The streets were filled with slim, fashionably dressed women and big expensive cars. There were no more shabby clothes,

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and none of those ridiculous three-wheeled cars. At that moment, I felt a rage toward Germans I had never before allowed myself to know.

When I first arrived in Germany in 1958,1 wasn't aware I still believed in the monster, and was taken aback at my expectation of discovering it in the Koln railway station. By 1988, I should have known that such fears blithely live on forever. Sometimes the monster takes the form of German, Jew, or Gypsy. This time it took the form of my father. My friend David Berger had sent me an article he had come across in a political science journal about the Canadian government's internment of Germans during World War n. Apparently there had been a wave of hysteria in Canada about the alleged spying activities of German immigrants, and under the powers of the War Measures Act, those who the government could track down were taken into custody. This was hardly news to me, but just the same, I was taken aback. Suddenly the truth I had always known really became the trudi. While this was what I had been told as a child, and what I had consciously believed, it suddenly struck me that I had simultaneously doubted the story. Somewhere I had believed diat, when my father had been taken into custody, he must have done something wrong. I'd figured out — constructed — the thought I must have had in September, 1939, the feeling my father must have been a Nazi. I was never aware of that disturbing possibility until a scholarly article brought it to light 50 years later. Angels and monsters must be acknowledged, remembered, and pondered. If not, they will think us and live us. As I'm a psychiatrist, it's my job to deliver this message. It's the only service that I have for sale. I don't sell cigars, apples, or hugs, nor small talk, advice or behavioural opinion. I aim to beard the lion in its den, even when my patient might desire otherwise. It's my ridiculous, but inevitable destiny.

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CHAPTER^SEVEII

THE CURE BY TOUGH LOVE

Years later — by then I was practising psychiatry in Toronto — I had a letter from Cathy Jones in which she mentioned Jake Sutherland, a psychiatrist at the Menninger Clinic who had been a fellow student of mine when I was a junior psychiatric resident. I'd long forgotten him until Cathy said that he was the doctor she saw when her regular psychiatrist was away. In her letters, she complained that Sutherland didn't really talk to her. He just renewed her prescriptions and occasionally adjusted the dosages. I'd thought Jake was a jerk when I knew him 30 years back because he was pompous and self-important. I eventually discovered that I was no better than him — I enthusiastically embraced a psychiatric method so silly even a junior resident should have seen through it. Blind, despite the fact that I was inspired by Karl Menninger, the only genius I ever knew. I was impressed by other teachers at the Menninger Clinic, but couldn't always figure out which ones were able and which were mediocrities; gods and false gods are often hard to distinguish. If a teacher had a national reputation, I was liable to be taken in and copy his habits, good or bad. Real scholars are in short supply.

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At the Menninger Clinic I had been assigned to treat Juanita Ortiz, a 3O-year-old depressed woman who, after I had been working with her psychotherapeutically for six months, I switched over to an experimental program called "the antidepressive regime." I was amazed that, when I began to write out the case for this book, I couldn't remember her and had to consult my notes from 38 years ago. After working with someone for six months, it is usual to remember much of what went on. Psychotherapeutic treatments are like love affairs — personal, intense, passionate — and patients, like past loves, are rarely forgotten. But I had actively shed those memories because I still feel so horrible about those three preposterous weeks Mrs. Ortiz and I participated in the experimental antidepressive program. The notes bowled me over. In 1963, I hadn't seen her complex, intriguing mysteries. Christ Almighty, I thought as I reread her case, I didn't even seem to know she had any mysteries. Like my current Toronto students, I had been required to do an initial assessment interview. To my surprise, Mrs. Ortiz, a Cuban, had blonde, straight hair. Instead of dramatic, Latin eyes, she was blueeyed and pale. She was wary of me, almost evasive. She thought carefully before answering my questions and I noticed something I didn't like: she was melodramatic. Everyone who comes to a psychiatric clinic is in a state of suffering, but to my mind Mrs. Ortiz emphasized her suffering too much, interspersing her words with sighs and half-closed eyelids, as though to signal an impending swoon. At the same time, she was sexy. Her slacks were tailored to show off her trim figure and she gave off the message: "I'm a maiden in distress. Save me." But it was overdone. Mrs. Ortiz had grown up in Cuba during the pre-Castro era. Her father was a member of an underground revolutionary movement, but his involvement was, according to her, silly and adolescent. Her father did not associate with the serious revolutionaries, she said, but hung

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around with youngsters — schoolboys. They did mischievous things like handing out leaflets, defacing signs and spraying graffiti on buildings. According to Mrs. Ortiz, youngsters like this were shooed away by the police and weren't dealt with using the full severity of the law. The stupid thing about her father was that, although his offenses were juvenile, had he been caught, he would have been punished as an adult. She said her father was a cheerful, carefree man who carried a musical instrument — "like a small flute," she said — which he pulled from his special nylon bag whenever there were people around. This humiliated Mrs. Ortiz: "So childish." He was also a drinker and, although Mrs. Ortiz had only seen him tipsy, her mother often told more ominous tales of her father, who, when drunk, passed out, bullied her and violently broke household furnishings. In contrast to her father, Mrs. Ortiz's mother was portrayed as a sober and harmless woman. Although devastated by her husband's behaviour, she bravely (melodramatically?) put up with him and kept a good home. Although I couldn't get her to be explicit on this, Mrs. Ortiz felt her shiftless father had ruined her mother's life. Her mother's message to the world was, "Woe is me." When Mrs. Ortiz finished her political studies at university, the family moved to the U.S., afraid that the father's political indiscretions would eventually lead to a knock at the door — and a trip to jail. Mrs. Ortiz stayed on in Havana, but not for long. As soon as she'd finished her degree, she moved out into the hinterland of Cuba and joined the revolutionaries. For her, this was nothing like her father's trifling links to the movement in Havana. Mrs. Ortiz had joined the authentic movement, the heroes and the martyrs of the future free Cuba. But she never felt she was fully accepted as a comrade. Her role was always as a helper and hanger-on and she resented the exclusivity of a male warrior culture, which she felt was after nothing but sex and glory. Women, though always marginalized, were the backbone of the move-

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ment, she said — they held things together. All the same, Mrs. Ortiz befriended and became sexually intimate with many senior revolutionaries, and each encounter briefly sparked into love. A few years later, Mrs. Ortiz married an American lawyer who had joined Castro's movement. Shortly after the marriage, the revolution accomplished, they moved back to his home in Kansas. Her husband obsessed brilliandy about legal matters, Mrs. Ortiz said, but was ineffectual. She, in contrast, was a hard worker who got things done, although she seemed always to position herself to get things done for men, implacably defined as inept. A few months after her arrival in Kansas, she and her husband separated and, since then, she'd been raising their son on her own. In the U.S., she'd also had an affair with at least one member of the pre-Castro regime, someone who may have been — she was always circumspect about the names of her famous lovers — the playboy son of one-time dictator, Fulgencio Batista.

It was time for me to present the case to George Inge (Dr. Inge, in those days), the service chief. Even though we were in a dilapidated mental hospital, the conference room had a long, gleaming mahogany table at which sat 15-20 people — psychiatric residents, social workers and psychologists. Everyone was sweating in the Kansas heat: there would be no air-conditioning for the psychiatric idealists who had come to train at the Menninger Clinic. George Inge was short and African-American — there was a rumour going around that, in 1965, he was the only African-American psychoanalyst in the U.S. Later, I discovered he had never trained as an analyst. I presented my findings and George listened silently, alternately pursing his lips and then sucking them inward. I hadn't been in Kansas long and, having come from lily-white Toronto, Inge looked exotic.

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"Bring Mrs. Ortiz in please, Dr. Warme." She looked glamorous, a woman who may have had affairs with Fidel Castro, Che Guevara and other world famous revolutionaries. Why hadn't I had affairs with glamorous women like her? Given half a chance, I felt, I'd be able to wow her with my charms, whatever those might be. Inge looked at Mrs. Ortiz sternly. "Your father was a bad man, I hear." "He was a drinker, yes. My mother could never depend on him. He was always having fun and didn't take things seriously. It made my mother very unhappy." "Your mother's happiness depends on what your father does?" Mrs. Ortiz stared at Inge intently. There was a long silence. Inge repeated himself, except this time it was not a question, but a more fully elaborated assertion. "It is conclusively true that your mother's happiness depends on what your father does?" "What do you mean?" "I mean, an unhappy woman is only a response to what her husband does. Women do not have a say in how their lives go." There was another long silence, again broken by George Inge. "There is no need for us to talk further. If you wish to pursue this, please call Dr. Warme who, if he has time, will see you himself. If he has no time, he will find someone for you."

I began working with Mrs. Ortiz a few weeks later. As Inge predicted, her pattern with me was immediately clear: she was her unhappy mother and I was her hapless father, she was weak and helpless and could not change, while I kept spinning my wheels and didn't help her to get better. This was no surprise, she said, because all men were like me: we enjoy life and leave the grunt work for the women. Her father's

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work on behalf of the revolution had been a joke because he was just having fun: only she had taken real risks. Not only had she sacrificed her Cuban citizenship, she'd risked her life. Men knew nothing about love, she contended, they just want sex with as few encumbrances as possible. It was Mrs. Ortiz's mother who'd held the family together, enduring a life of misery because of her fathers drunkenness and flashiness. Even diough George Inge's words had implied Mrs. Ortiz and I might want to rethink her initial version of her family story, there wasn't a word in my notes about her father's boyish enthusiasm, his political idealism or its inspirational effect on her, or of his tolerance of an eternally glum, pessimistic wife. I couldn't see what was obvious in the notes: Mrs. Ortiz was more than just inspired by her father — he was her hero. Instead of pursuing this, my notes hinted that I simply grew tired of Mrs. Ortiz's complaining and wrote her off as a hopeless case. After six months I volunteered her as a suitable candidate for the antidepressive regime. She was depressed, her treatment was not going well (or so I thought) arid she was willing to participate. Those who switch their patient's treatment in mid-stream generally aren't thinking clearly — they have lost their way.

To understand my new approach and how I implemented it, it's important to address an unpopular truth: a clap on a baby's bum often settles a child and helps it to sleep or to behave well in a public place. That doesn't mean claps on the bum are to be prescribed; some parents will choose to administer them and some won't, and in the long run, I'm not sure whether they help or harm. But we do know that a clap on the bum can quiet a child, and this observation is worth keeping in mind. At that time, however, I didn't reflect, and allowed

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myself to participate in a nasty psychiatric method, blind to an unattractive streak of cruelty emerging in me. These events happened early in my psychiatric training and at that time my psychiatric team was experimenting with the "antidepressive regime," a new-fangled approach to depression. Psychiatry, in fact, has a long history of new-fangled approaches, but I didn't know this back then. Austin DesLauriers, our consultant from Chicago, had devised the method by way of a thought experiment. He had noted two things, neither of which were new, but which we were now to use in the service of a faster, better way to treat depression. DesLauriers was also an expatriate Canadian, so I had a special attraction to him. It is typical of depressed patients that they speak insultingly of themselves, often accusing themselves of preposterous misbehaviours. Hamlet, who some say is the most intelligent character in English literature, is a typical depressive: "O, what a rogue and peasant slave am I." Like Hamlet, depressed people call themselves names, insisting they are lazy, selfish, or stupid. Obviously, some voice or person inside the depressive thinks and makes these insulting accusations — "I, the accuser, say that you, Hamlet, are a rogue and peasant slave." We are all many people, although most of us are circumspect about making our multifaceted selves public — unlike those who arrange to have themselves labeled as multiple personalities. Hamlet, like a typical depressive, pushes into the foreground his two preferred incarnations — the accuser and the accused. It's common enough to see self-accusation as one of the signs of depression, but I make a stronger claim: self-accusation is the same thing as depression. When I experiment, and ask a depressive how he knows he is depressed, it's precisely what he says — "Well, I feel horrible cuz I'm such a jerk. It's obvious. Who wouldn't be depressed? I've wrecked nay life, my marriage and my family." Alternatively, depressives insult their bodily status — "My guts are a mess, my bowels are like

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cement, my skin is a wreck." Their explanations for their ailments turn out to be simple repetitions of the self-accusations. DesLaurier's second observation, key to the antidepressive regime, was that kindness and affection often make depressed people more depressed. I am a good example of this trait — on birthdays or at Christmas, especially if I receive a fine gift, I'm liable to get into a funk. For the depressive, good things are forbidden, and when treated well, he will redouble his poor treatment of himself. There is a paradoxical response to kindness among depressives, and long before the introduction of the antidepressive regime, hospital staff had been cautioned to be matter-of-fact rather than friendly toward depressed patients. Paradoxical responses to good news are common: career promotions, successful childbirth, and the completion of a PhD are all well known precipitants of guilt and unhappiness. The phenomena of "those wrecked by success" (a sequence of events named after a paper written by Freud) and "the negative therapeutic reaction" (again, named after a phrase of Freud's) — people who falter when the treatment goes well — are well known to psychiatrists. DesLauriers had concluded that depressives prefer to be criticized, and faithfully criticize themselves whenever possible. If they disliked kindness, and made sure that they never had kind attitudes toward themselves, would it be possible, he wondered, to capitalize on this? Our psychiatric team decided to test the theory. Depressed patients were no longer to be treated kindly, or even matter-of-factly. Instead, we would treat them with a form of unkindness. We would make demands and speak brusquely — if kindness increases depression, perhaps rough treatment would decrease it.

The protocol of the antidepressive regime demanded that I be exacting, and that I demand of Mrs. Ortiz that she be superconscientious. That

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was it — I was to make Mrs. Ortiz very diligent. The treatment was planned, theoretically reasonable, and designed to help. If I insisted on conscientiousness, I had good reason. If my demands looked preposterous, I had a rationale. I was "outcome-passionate." I instructed Mrs. Ortiz coolly: "Every day, clean your house from top to bottom. Keep a diary and record the details of what you have cleaned. Record your activities for the whole day, including the times at which you do the various housekeeping jobs. When you come in on Monday, bring the diary with you." Three days later Mrs. Ortiz returned with her diary. She had washed many floors, vacuumed rugs, dusted, mopped and polished. Everything was recorded, including the schedule she had followed. I, too, had a schedule and a series of tasks. I was to be demanding. "Good work," I said, "but what you've done isn't enough. Have you cleaned the garage? The attic? The toilets? Please do better, and return in three days." "Good work," said my supervisor, "but you must demand more." Mrs. Ortiz returned. She had cleaned the garage, the attic and the toilets. "Did you wash the garage floor?" I demanded. "And did you wash the attic floor, disinfect the toilets, air the bedding, and clean the basement? Why not? Please come back in three days and try to do better." "You have done better," said my supervisor, "but try to do more. You must be very demanding." I'd heard from the day-hospital staff that Mrs. Ortiz was definitely improved. Three days later, she had done what I asked. "This diary," I said, "is inadequate. It gives me no detail. What did you wash the floors with? Don't you know we are trying to make you better? I expect conscientious work from you. Could you, perhaps, have used a toothbrush in the corners of the garage floor? And in the

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attic? Did you not vacuum on Wednesday? Why not? This is not good enough." "You're doing better," said my supervisor. "Keep it up." When Mrs. Ortiz returned, she did not look friendly. When she handed me the diary, I scowled. "This diary is inadequate." I tossed the loose-leaf pages across the desk to where she sat. A clap on the bum. Mrs. Ortiz stood up and said, "Go to hell." She walked out of the office and slammed the door. She was no longer depressed. Like the depressed Achilles, awakened by the loss of his friend, Patroclus, Mrs. Ortiz had emerged from her depression in an outburst of rage.

Achilles emerged from his depression by way of the most impressive outburst of rage in literature. With a shout, he turned back the Trojan forces, killed dozens of them, and even fought the river Scamander when the river-god turned against him. There is, it seems, a grain of truth in the still-current psychiatric chestnut that asserts that depression is "self-directed aggression" cured by redirected rage. My supervisor (Irish Eyes, the inept teacher who had told me that the proper psychotherapeutic tactic with Cathy was to "be with her") and I were giddy with mutual congratulation. As that scene from 36 years ago returns to me, a memory fragment appears: Irish Eyes and I chuckling at our cleverness, and at the discomfiture of Mrs. Ortiz. He and I were doing what my parents and I did when, after my father's release from the internment camp, we took in foster children to make extra money. These were children who had lived in many foster homes and had had a lot of trouble with ordinary living. They misbehaved, fought and hit. We had a cruel and amused reaction — if the children didn't behave, we told them goblins and bogeymen would get them. We even made secret noises in the dark. In my eyes, the children were

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all bad — badly behaved Canadian children — and we chuckled as we "cured" them.

The story Mrs. Ortiz had told us during her initial assessment was clear. After her treatment with me began, even she recognized her story was stereotyped, judging men to be evil, and eternally whitewashing the deeds of women, especially her mother. One day, well before I railroaded her into joining the antidepressive regime, she'd spoken with insight of how ugly her attitudes were. "It's so horrible," Mrs. Ortiz said. "I feel as though I'm vomiting out a lot of stale images." At that moment I remembered the story of how Zeus created the world of the Olympians. Although my mind got going, I hadn't yet figured out that the story had universal importance, or that it was relevant to Mrs. Ortiz. Instead, the image of vomiting switched to some rot about oral fixations and introjection and projection. Why couldn't I see the magic in living terms? Why didn't I tell her the story of Zeus and how he created the world of the Olympians? Why didn't 1 speak to her with energy and wit: "Yes, you want to vomit out all the filth within. You didn't just adopt a few traits from your mother, you know, subtle traits like her taste in clothes and the voice you use to yell at your son. What you did was swallow your mother's whole story, unaltered. Sometimes I feel as though it's your mother lying here on the couch. Actually, I misspoke: it's not as though your mother is lying here, some days it is your mother who lies here on the couch. Like Zeus, you knew the power to transform the world was within you, that you could swallow her whole, but then you mismanaged your own magic. Let me tell you how Zeus, the master magician, did it: "Before Zeus became king of the universe, there were two other

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kings, Uranus and Cronus. They were bad guys, and while they ruled, heaven and earth were disasters. The gods fought and killed one another, often in horrible ways. These nasty gods cut one another up and chomped up and ate their own children. The world was confused, dark and stormy. People were so bad that a father — who you and I know well — even went out and put up graffiti and signs, handed out leaflets, while his wife did a lot of whining and complaining about him. "Cronus killed the first king of the universe, his father, Uranus, by slicing off his testicles with a sickle. He then took over as the new king. Cronus's son Zeus did the same. He warred against Cronus, and killed him. It looked as though the darkness, the killing, and the eating of children would go on forever but, when Zeus became ruler, he changed everything. "Zeus brought light and beauty into the world. For the first time, there was love, and the people and gods had fun, made jokes and began to play. Zeus's methods were peculiar. He started by swallowing the whole world: the people, the gods, the mountains, trees, and animals. He even swallowed the planet earth, the other planets, the moon, the sun, and the stars. It's like you and your mother; when your madness gets going we can see you've swallowed her whole, she's here in this office, with her melodrama reproduced in you. "Once Zeus finished all his swallowing nonsense, he vomited everything up again. Probably he was listening in when you were talking, Mrs. Ortiz, and got from you the idea of vomiting everything out. Everything came back — people, gods, planets, and stars — the whole kit and caboodle. The other gods worried this was all nonsense and that Zeus, the chief of all gods, was a fool. They had good reason to worry, because, in many ways, Zeus was a. fool. He ran around, usually chasing pretty young women much like the Spice Girls. What the other gods didn't know was that his swallowing and vomiting trick was very shrewd.

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"To everyone's amazement, when the world reappeared, everything was different. When the gods and the people looked closely, they saw that a delicate golden net was holding everything together. During the time of chaos, the world had been flying apart, but after Zeus's swallowing and vomiting trick, everything was connected. "The net is made of glittering gold and to see it, you have to notice the places in the world where the glitter is visible. When the sun sparkles on the waves of lakes and oceans, that's Zeus's golden net glittering, the net that holds the whole world together. Just as early in the morning cobwebs have strings of dew that sparkle as beautifully as the twinkling of the stars, or frozen snow gleams, shimmers, and reflects the light. "Anybody who lives in a northern country will have seen the northern lights, dancing wildly in the sky. In Canada, where I come from, there are fireflies, and at night they are like flickering lights in the darkness. Here in Kansas they're called lightning bugs, and children catch them, squash them on their fingernails and run around laughing, trying to scare one another with their glowing nails. The story of Zeus helps explain why there are fireflies in the world. Finally, if you look into a friend's eyes, there's a twinkle and, if you look more closely, you'll see your own reflection sparkling in your friend's eyes. "Everything has been changed forever by that golden net Zeus created. But it's not only brightness and glitter that have been added. In the new world Zeus made, everything is connected to everything else, and there is no more danger that the world will fall apart. Doesn't a net hold everything together? Like this story, the net is made of words, and when we hear it, we are connected to Zeus, a god who hasn't been around for thousands of years. The net of words also connects you to me, the person who is telling the story. Just as you have to look closely at the snow and the stars to see them glittering, so you have to look closely at words, to see that they connect me to you, and you to Zeus.

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"That fabulous net has also changed things so that we keep our friends and family forever. If someone dies, through memory, Zeus's net holds us to the people we love. In a funny way, we never lose anything, and never lose anyone we love — and it's all because of memory." Had I told Zeus's story to Mrs. Ortiz in the 2003, I would have added an example: "The internet also connects us to other people, and to everything else in the world. If I'm right, the internet is also part of Zeus's golden net." "Life has lots of troubles in it," I would have concluded, "and without Zeus's net, there might be nothing else. We're lucky there are sparkling lakes, twinkling stars, and flashing jewels. They are Zeus's great gift to the world."

The story of Zeus is fresh in my mind these days because I told it to a patient just recently. But in 1965,1 was too young and frightened to understand that truth lies in history and in myth. Had I been wise enough back then to tell Mrs. Ortiz this story, she would have been taken aback. There would have been a long, thoughtful pause, she would have sighed, then said — as my patient did a few days ago — "That's amazing!" And I, wise and calm, would have said, "I sparkled for you today." "You were great, Dr. Warme; I should have applauded." And then I would have been able to administer the coup de grace: "When I sparkled for you by telling a great story, you and I became a perfect reproduction of what went on between you and your father. He sparkled for you and you adored him. And now, Mrs. Ortiz, j accuse. I accuse you of'pretending.' It's not exactly pretending, but there is something in that melodrama of yours that persuades me that, in a remote corner of your mind, you know you're performing. By applying the exact science of psychiatry, I also gathered proof that I

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am right. When I've mentioned your melodrama from time to time, you failed my test. A purebred whiner would have acted hurt and called me heartless. But you listened calmly. I call that absolute proof. Anyhow, the truth about yourself that you are avoiding is the opposite of what's on the surface. You are actually a fine version of your father — not, as you've been trying to tell me, your mother." Despite the presence of romantics like me, it isn't love that holds the world together — it's definitely Zeus's golden net. It's wonderful that we humans are moved to keep putting the world together. But it's not accurate to say we do this because of love, out of wisdom, or by exercising free will or our instincts. Nor do we do it because of some preposterous "synthetic function" postulated by a psychologist once upon a time. It's just what we humans do. So let's give credit where it is due and explain how the world holds itself together with a captivating myth, a story that's truer than the baloney romantics and scientists have tried.

But back then, the ward staff and I were often irritated by depressed patients, especially when they didn't get better quickly. We shared an unspoken suspicion that depressives were cowards, whiners, or fakers. Yes, we were impatient, but plenty of good doctors, nurses, and mental health workers, eager for patients to get better, are also impatient. The real problem was we didn't recognize that our impatience was a countertransference — an instructive and complementary reaction to the depressive style — and that we might have learned about our patients by examining our own reactions. Guilt over our ungenerous reactions made us easy prey for the antidepressive drug propagandists who appeared on the psychiatric scene in the mid-1960s, and who insisted depression was a chemical disorder. It's only in the last year or so that the psychiatric literature has started to confess doubts about these

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drugs — that they are less effective than once thought or that their benefits are a. placebo effect. Although many studies and academic papers suggest antidepressives are no more useful than sugar pills, psychiatrists put forward a million excuses and explanations. I expect antidepressive drugs will be promoted as a specific treatment for depression for quite a while. "Oh, that's it!" we thought back then, "They've got a disease. Thank God for these new drugs. And if the treatments don't work, the patient's biology is to blame. Nothing can be done, and we're off the hook." Maybe we thought we'd caught hold of a piece of Zeus s golden net — but we were mistaken. The psychology of depression is transparent, but it's risky to generalize, because generalizations slot people into the misleading formulas psychiatrists are liable to embrace ahead of intelligent psychiatry. But, despite my skepticism about formulas, I believe there is a pattern after all. Depressives, each in his or her unique way, are successful, intelligent, and ambitious. If you pay attention, you see they have more talent than their parents and siblings — or so they think. Sometimes, they report a talent in a parent or sibling that has never been developed. The depressive often goes on to develop the talent the parent reined in — by choice or because it was so destined. In the depressive's mind, it's the sin of pride, the first of the seven deadly sins. The talented patient, now depressed, fears he is the smartest of all, and has harmed those in his wake. Not only has he done harm, he has humiliated the less talented in his family. "Who said I should be more attractive than my father, my pathetic father, who kept failing in business?" they will ask. "To be the light of my mother's life, and a reminder to my father that he's fumbled the game of life?" But such patterns are not rules. I, too, was the living reminder of

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my father's failures and the light of my mother's life. Still, I'm not the depressive type, rather I'm energetic, critical and scornful of others — the manic cure for depression in me and anyone who comes my way.

Nietzsche lays out the problem marvelously, but in 19651 took him literally, and thought I could cure my patient using the tactics he used to cure himself: I want to make things as hard for myself as they have ever been for anybody: only under this pressure do I have a clear enough conscience to possess something few men have or have ever had — wings, so to speak.

It's true that an internal tyrant flagellates the depressive, but he is a tyrant more demanding than any flesh-and-blood person, or any antidepressive regime, could ever be. In my silly demands, I was not outstripping Mrs. Ortiz's superego, or inciting her to turn against me, a superego worse than her own. I was simply caught up in one of the psychiatric fads that have, and always will, bedevil the profession. Once upon a time there were sanitarium "cures" for tuberculosis; insulin coma treatments for schizophrenia; lobotomies, bloodletting and mustard plasters. Outside of the profession there are Chinese herbs, Benny Hinn and Yogic Flying. When she told me to go to hell, Mrs. Ortiz may have felt better for a moment, but it was hardly a cure. She simply saw me for what I was and told me off. She'd used the cure by hatred in a way that was helpful to her, but these spurious cures don't last. I suffered from a disorder common in psychiatrists: furor therapeuticus. I needed to believe my actions had done her good, and was reassured on that point by others who shared my enthusiasm. My furor therapeuticus may have been a sadistic madness, but it fit

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into the customs of the system, and the world was therefore blind to it. When custom reigns, nothing can change. Change is only possible in the presence of a higher madness, the precious folly of questioning all belief, of melting hard positions and worrying about, and laughing at, the earnestness of the world. I learned early on that my job was to tear down the idols, and having learned a diing or two about philosophy, I'm also careful not to make an idol out of tearing down idols.

With Mrs. Ortiz I could not act other than with the greatest earnestness. I was a believer — when I threw her diary notes across the desk, I believed I was at war with a real conscience-monster, and it was a fight to the death. Was that what those two demanding teachers of mine did — the surgeon Sammy Sergeant and the anatomist J. C. Boileau Grant? Both of them had struck me across the knuckles with the back of their scalpels, sharply and unexpectedly, for not knowing my anatomy, one as I tied a surgical knot in a patient's abdomen, the other in the anatomy lab. The easy answer would be yes, but it may not be the right one. Let me, then, talk about a real sergeant, a drill sergeant. Drill sergeants, it's said, are sadistic bastards. Pious commentators deplore their existence and call for a ban on such improper military and cultural practices. But should we, perhaps, rethink this question? I'm no longer so sure about monsters. And could my teachers, Sammy Sergeant and J. C. Boileau Grant, really have shared qualities with drill sergeants? I think they did. Here is what a real sergeant might say: "Get on the floor, you goddam wop and do a hundred pushups. You fuckin' shithead, you've been loafing around the track. Get going or you'll do another hundred. You'll learn one of these days, you lazy, good-for-nothing motherfucker."

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Sure, he has a pretty nasty mouth, and he's noisier and cruder than I was when I spoke to Mrs. Ortiz. A point for me, then? Well, no. If you look at it closely, he is the wiser one, because I was in earnest when I said, "Have you tried using a toothbrush in the corners?" without a twinkle in my eye. I believed there was a monster in Mrs. Ortiz that I had to slay, just like my colleagues who believe in bad parents and chemical cures. But what about the drill sergeant? He believes what he says, doesn't he? That his recruit is a slacker? Wrong. The drill sergeant believes no such thing. But in the world of psychiatry, I'm liable to get in trouble by saying this, because nowadays everyone's words are supposed to be taken literally. The stories of patients who portray themselves as victims are taken at face value, and psychiatrists are encouraged to forget about the unconscious. This is certainly not what I was taught when I was a psychiatric student. Following this new logic, we should believe those who claim to be victims of a Jewish conspiracy, and enjoin them to act against their oppressors. We should also believe those who say they are the Christ, reborn. Psychiatrists, when they're thinking like psychiatrists, never take words at face value. This new attitude assures that rough people like drill sergeants are not thought about deeply, adequately, courteously or psychiatrically. Pay attention, and you'll see that the drill sergeant no more believes his recruits to be lazy than Sammy Sergeant or J. C. Boileau Grant believed we medical students were lazy. On the contrary: they loved us. This is what I hear in the drill sergeant's tirade: "Listen, recruit. You and I are brothers. We are going to fight side by side. You're willing to die for me and I'm willing to die for you." "Ich hatt 'einen Kameraden. Bin besser'n find'st du nicht." [I had a comrade. None better will ever be found.] "I love you, you deaf jerk." " That's why I hit your knuckles with the back of the scalpel." It's sadism, all right, but it's sadism with a loving purpose. The

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pious will remind us that the drill sergeant called his soldier a "wop," a racist slur for which he should be reprimanded and disciplined. Here is a man not fit to train recruits. Where do such blockheads come from? Are they so tone-deaf they can't hear nuances? Can they really not hear the drill sergeant say "wop" with love and good humour? When I see my friend Andy Coppolino, I still enthusiastically call him by his medical school monicker, "Big Wop." He, in turn, fakes a punch to my arm and calls me "Kraut." The politically correct autocrats are not, after all, merely autocratic. As it turns out, in addition to being dumbbells, they are monsters, always ready to discover evil in the other. We've gone back to before the Trojan War all over again, an era of black-and-white heroes and monsters, before nuanced characters like Odysseus and Oedipus came along. I'm no advocate of coarseness, but very much want to distinguish between the evil of a nasty treatment and the innocence of personal styles that, even though I find them vulgar, are ultimately harmless. I fear "zero tolerance," an attitude thoughtlessly celebrated in some circles. I'm convinced the antidepressive regime is a far more worrisome practice than are things like cursing and throwing around jocular, pseudo-racist insults. I'm also convinced diat many mild-sounding psychiatric treatments are just as worrying as the antidepressive regime — the mindless use of drugs, banal advice and revivalist invitations to share, feel and blame. People who overdo good attitudes and behaviour worry me. I fear them because, in a culture tempted to believe in concrete truth, we have no protection from their intolerance. When concrete, the blamer won't understand that, if called an ass, he is being called neither a braying animal nor an anatomical part. Let me remind zealous censors that sergeants, surgeons, anatomists, and friends love us when they say, "You goddam kike."

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"You goddam kraut." "You goddam chink." "You goddam honky, whitey, Paki, frog, WASP, nigger, twat-face, horse's ass." Many who speak like this are practicing a brand of humor that aims to de-fang racism, and to celebrate a warrior culture. Eggheads like me are important members of our culture, but so are warriors. Have we reason to judge if their intent is to inspire young men to become soldiers and the young recruits enjoy the fun?

The antidepressive regime was born of a commonplace human desire to make misery and suffering go away as quickly as possible. If this doesn't work fast, try Chinese herbs, consult the planets or design a new drug. We're normal, so, without thinking it over, we rush to demolish something normal like human misery. God help us if we literally believe there is a monster (chemical, traumatic, structural, or neurotic) in the patient that we can slay (the euphemism is that we can "cure it") with a drug. Most of these socalled cures are just solace for the soul — like poultices, aspirin, draughts of rum or, in some cultures, ground-up tiger bones. Forget this and we have lost our bearings. I'm tempted to invoke the traditional medical jargon that holds that these refreshing remedies have a "non-specific" effect. The real truth is that the effects of sorcery are highly specific, because they act on the deepest elements in the mind — they inspire and redirect the soul. Aspirin has no pharmacological, sleep-inducing powers but, for many people, it works. That effect is magical and it does no harm. Human sacrifice also produces no actual benefits, even when those who make sacrifices feel better. It's the same magic as using aspirin for sleep. But killing babies does harm, so we'd better not choose our

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treatments on the grounds that they "work." Our magic minds make it hard to nail down what works and what doesn't, but we can usually tell what does harm.

When I recognize that soul-study is my main job, I play a legitimate psychiatric role in our culture. But when I believe that I'm curing diseases — slaying monsters — I legitimize a tyrannical demand for conformity. That's why the "outcome" of treatment is a tricky criterion for how psychiatrists should proceed. It's a wonderful enigma why patients so often feel better after they meet with us. Because I'm an old hand I've developed a certain flair and my patients tend to get better quickly, sometimes shedding symptoms after just one appointment. But anything that's dramatic has similar beneficial effects. Surgery is dramatic, and has powerful placebo effects that drive researchers crazy. For example, patients subjected to surgical ligation of the internal mammary arteries, a procedure intended to improve heart function that was eventually shown to produce no cardiac benefits, often experienced dramatic relief from their heart symptoms. Washing out sore knee-joints through an arthroscope — a "rinse and trim" — also produces bogus good effects. The serious medical question is whether we want to use human sacrifice, flagellation, drugs, joining a church, or inspecting the soul as our method of creating such placebo effects. Psychiatrists tend to ignore the similar degrees of effectiveness in all kinds of treatments for fear they will despair of what they are doing. I say to them: "Cheer up. This is of great interest. There are, in these truths, the greatest of wonders and the greatest of intellectual fuel." In contrast to my colleagues, the kinky side of me likes it when I read the statistics, and find that two-thirds improvement rates pop up with nearly every method of treatment of every psychiatric disorder.

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Treatments don't produce cures — cures don't exist — but they do lead to improvement.

My concern over authoritarianism was and is so central to my story that I sought answers to my psychiatric concerns in mythology, my favourite source of wisdom. After all, monsters are the ultimate authoritarians, so a digression into the history of monsters and demons is in order. Greek mythology is heavily populated with monsters and, as is their duty, Greek heroes must slay them. As usual, my colleagues will think I'm a freak for using Greek mythology as a psychiatric reference and as a casebook, but the story of Perseus is a good illustration of how this monster business works. Perseus slew the Gorgon, Medusa of the snaky locks. He couldn't look at her while he did so because, if he had, he would have been turned to stone. He was clever, and polished his shield into a reflecting mirror. When he approached Medusa, he looked only at her image reflected in the polished shield, cut off her head and put it into his sack. Later, when he needed a place to spend the night, he asked Atlas (who was busy holding the heavens on his shoulders) if he would give him shelter, but Adas refused. Perseus took Medusa's head from the sac, shook it in front of Atlas's face, and turned him into stone. The Atlas mountains are still there to be seen. In the process, Perseus had taken onto himself the powers of Medusa, and used them. As Nietzsche said, when you slay the monster, beware that you don't turn into the monster yourself. All the old-time heroes performed this kind of nasty self-transformation. They tore a talisman from the body of the monster, and wore it as a sign they had taken on the monster's powers. It is a cautionary tale I should have heeded when I was a young psychiatrist. I, too, had torn a talisman from Mrs. Ortiz. In her cruel depressive madness, she

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had insulted herself, and I, another Perseus, had not only taken her cruelty into myself, I'd joined in on it. For too many years I'd thought of myself as one of the old, one-dimensional Greek heroes, obligated to discover and slay the demons in my patients: "It's the trauma. Go confront that husband, that parent, that rapist." "It's that chemical. Let's blast it out of existence with this or that potent drug." "It's this corrupt culture, full of capitalist (socialist?) pigs who exploit our economy, our workers, our system. Change the system." "It's that unconscious Oedipal dilemma, that identity diffusion, that abandonment anxiety. You must 'work this through.'" I'd done what I now deplore, many times over. When subversive thoughts — like the feeling I was conducting a hoax with my patients — entered my mind, I pushed them aside so quickly that I barely knew I had them. I considered such thoughts unseemly, so I censored them. They only became tolerable to me after I woke up and invented a new language for them. Instead of hoax, I began to use kinder words. What if the psychiatrist's work was a ritual or a ceremony — as life enhancing as a birthday party or a symphony concert? The real problem was my earnestness. When I was a therapeutic enthusiast, I was always in a state of earnest belief — Oscar Wilde's sure sign of a slow metabolism. Rather than recognizing the limits of thinking, I had indulged in the same tyrannical enthusiasm as Zeus's early heroes. The question I now struggled with was whether I could be rehabilitated. Did I have to do it alone, or was there another Zeusfather who could help me? Zeus had rehabilitated the ancient heroes, but where could I find him in the modern world? I found that help in great writers and in my patients who, one by one, over a period of many years, taught me change has little to do with cure, that it is ambiguous and slippery, and that glimmers of wisdom are all we can hope for. Some — a lucky few — will also experience

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major relief of symptoms, and almost all will find some relief. But talk of symptoms misses the point. Patients shed symptoms fast, but the change they eventually come to care about is more modest, and more discerning. How did Zeus give up on fast cures? The early Greek heroes all fought and were killed in the Trojan War. That was the purpose of the Trojan War: Zeus was killing off the old breed of heroes, but he didn't do it in the old stereotypical way. Instead, the heroes had time to become complex before they died. Like all soldiers, the Greek and Trojan heroes had time on their hands. They thought about honour, courage, and the ambiguous cause for which they were fighting. They even thought about the honour and bravery of their enemies. Once their enemies and their cause came to be seen as ambiguous, they no longer thought of themselves as fighting against clear-cut monsters, and instead of simply glorying in their cause, war became something to think about. When the war ended, those who remained were a new breed — thinking heroes like Oedipus and Odysseus. Remember, Oedipus bested the Sphinx with words — he did not touch her. And Odysseus chose not to slay the Sirens at all; he imposed restraints on himself and listened to them. In so doing, he was the forerunner of the modern, listening psychiatrist, besieged by a new swarm of old-style hero psychiatrists looking for monsters to slay.

Like every psychiatrist, I have plenty of opinions about the results of our treatments, which also means I have an opinion about the methods used by psychiatrists when they slay their monsters. Since I'm a "talking doctor," I'm skeptical about drugs and behavioural models; I prefer the style of Odysseus, who was wily, thoughtful, and slow to action.

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For years, I succumbed to the temptation to discover villainy in parents. It's one thing to note that people complain about their parents, but it's quite another to decide those parents are actually bad, that they're the "cause" of a patient's unhappiness. This is the cure by hatred. The stories patients tell us can be very convincing, sometimes so convincing that it's hard not to agree with them. But it is a grotesque error to naively encourage patients to believe venting their anger at their parents represents some final truth, that if they challenge or confront the parents, they will be cured. A better alternative is self-knowledge. Obviously, drug treatments, behavioural management, retraining, and social support have a place in helping patients, but I don't look at them as my central task, mostly because a good psychiatrist's duties are somewhat different. To me, it is an error to think of myself as an extension of the culture's comforting support system, because I am called into action precisely at the point the social support system has failed. It would be arrogance to think I provide better support than anyone else — that I am a better parent, friend, spouse or lover. (Sure, psychiatrists often have stupid thoughts like, "She'd be better off with a man like me." I know, because I've often had them.) The pills and advice dispensed by family doctors are common rituals. Doctors look for real disease, and treat it when it is found, but much of the time nothing of biological importance is found. This treatment often boils down to doctorly reassurance — comforts for the soul like rest, fluids, and aspirin. Placebos — worthy treatments — are routine and automatic. I want to draw a distinction between family doctors who are usually aware that care is more valuable than the drug, and hospitals, who've all too often lost track of the value of placebos. In hospitals, where organic disease is usual, placebos like cough medicine are rarely prescribed. The psychiatrist, usually without knowing it, is only the most single-minded of soul doctors. Despite the revulsion such language stirs up in my colleagues, during

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our therapy sessions, my patients and I are enacting an important and valuable cultural ritual. Ritual, usually unconscious, is the lifeblood of any culture. Meeting with a psychiatrist is just one of many rituals that make life worth living. There are, of course, less mysterious cures — cures that are also rituals, but which risk becoming exercises in covert tyranny. I'm talking about drugging patients into zombie-like submission, removing patients from care because they have a "personality disorder" (to my horror, students have started referring to such patients as "PDS"), and glib recommendations for "tough love" or "more empathy" — gross opposites that live in dizzy coexistence in the psychiatric arsenal. In their flight from real life, psychiatrists frantically pursue "scientist" status, collecting "data" and, worst of all, forgetting that their duty is to listen. If they listened, they would notice the weeping, wailing and gnashing of teeth coming from the souls who have been entrusted to their care. Focusing on symptoms, and the elimination of symptoms, justifies almost anything in the medical world. It took time before thoughtfulness was awakened in me, and I learned to give tender attention to the bruised souls of my patients. This didn't mean that patients had to lie on my couch for 10, 100, or 1000 hours, according to textbook formulas. Sometimes a single meeting was enough to refresh and reorder the soul.

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CHAPTE FREIGHT

SECRETS

It was Dr. Hunter's turn to present a case again. As she came into the seminar room, I was lost in a daydream or, better, a reminiscence. It had to do with children again, just as it did when she had presented a case to me a few weeks earlier. That day, our teenage patient had fled from Dr. Hunter's interview and, hiding in my office, I tearfully remembered Cathy Jones and her miserable fate as a i6-year-old, hospitalized on a mental ward for adults. Now, I was remembering a scene from the previous evening in which I was looking at a reproduction of a painting. It was The Calmady Children, painted in the iSios by Sir Thomas Lawrence. Laura Anne is about four years old, and her sister Emily two or three years older. Like so many daughters, granddaughters and nieces, these are glorious little nymphs. Laura Anne has brilliantly red cheeks and lips, and her translucent dress, askew and revealing, is perfectly suited for wayward arms and legs. A ringlet curls across her right eye. There is no doubt that she is a ravishingiy beautiful sprite. Inadvertently, I've pulled from the shelf of my library a book of paintings of children from the Metropolitan Museum in New York. As I look at the portrait, I do my psychiatric duty and pay attention to my own mind, which today I'm inclined to call errant. Since

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Laura is a ravishing four-year-old, it is clear to me that I must seize her, kiss her throat and eyes, blow bubbles on her tummy, tickle and pinch her. In my mind's eye I speak to her: "Giggle-belly McSqueezePinch," I say. It is a moment of high eroticism, and I'm enchanted by her smell, her taste, her texture — but I'm not supposed to say so. Her response to me appears to be equally erotic; it possesses her whole body, wriggling, kicking and squealing. Her red cheeks become redder and she is glowing and moist. Are these shrieks and squeals orgasmic? Am I a pervert for wondering? My eroticism (I'd best not say "sexuality") is not the common eroticism. I feel it in my face and mouth and skin — it's also in my fingers and my soul — but there is no hint of stirring in the loins, so you can see that, in addition to being a pervert, I am normal. But if I'm normal, why do I feel duty-bound to live out a passionate loveadventure with little Laura Anne, especially if she represents my child, my granddaughter, my niece? Mothers, aunts and grandmothers are also inclined to such love-play with four-year-old imps; we do it with boys of the same age. But for me, love-play with boys is lighter, careful, less consciously erotic: it seems that even with a four-year-old, gender makes a difference. I notice in the painting that Laura Anne's legs, flung apart, barely hide her secrets. Is such immodesty, such gay abandon, a child's sexuality? And if this is a full-blown version of four-year-old sexuality, is it perfectly analogous to sexuality at 20, 40, 60? And if I call this "an infantile, undeveloped sexuality" do I become another kind of pervert, one who misrepresents and demeans something real and splendid and unique — as appropriate for a four-year-old as eroticism at any other age? Why is it that we are anxious to dismiss young love as "just a crush" or "puppy love" even when we know from experience these supposedly inconsequential events can be strangely potent and heartbreaking.

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Weirdly, I now imagine an equally erotic event involving a sixmonth-old. With the younger child, its (not his or her) gender seems of no consequence, but the kisses, the excitement and the shrieks of joy are identical. How marvelously we introduce our children into that vital social world of eroticism, how eagerly and lovingly, perversely and without perversion, we do our cultural duty. Emily, Laura Anne's sister in the painting, is a few years older. I have a cultural responsibility to her, too, but my behaviour will be different. As I look at the painting, I see she is as beautiful as her sister, her cheeks and lips as red, her bodice as enticingly revealing. But there will be no uninhibited kisses for her, my soul instructs me: she is already too old. Were I to kiss her throat and tummy it would be a violation. In the painting, I see Emily has already learned caution; her posture is restrained, her demeanor careful. Like Leila Singh, the student who hides behind her silk scarf, Emily is pleased with her beauty, but cautious. I can still tickle and pinch her, not to speak of tender teasing, chasing, horseplay. She will giggle and squeal, knowing all the while that she must not abandon herself too thoroughly to this love game. She and I will enact our roles perfectly because both of us know precisely the degree of sexuality permitted between an eight-year-old and a man. With Laura Anne, all responsibility is delegated to me, but as she must, Emily has already invented her own world of moderation. As she and I know, abandonment is no longer the order of the day. What happens between Laura's state and Emily's? That is, what happens to make Emily more guarded, aware of what's right and proper? How does she learn she needs to keep her knees together and her tummy covered? It's a big gap — Warme, you truly are a pervert— maybe a chasm that I'm liable to neglect out of prudishness. Like many elisions, my neglect slides right past a very interesting whirlpool. How does eroticism connect with assertiveness or feeling comfortable in one's skin? Or should I say, become disconnected from it? No bad

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parents here, no demons, just a nastiness some of us never get over. There is something about teaching in all this, teaching and introducing Laura Anne and Emily to the world of sexuality, heterosexuality and artistic lovemaking. If these goddesses-in-training and I are so naturally artful in our learning, how can adult love ever go awry? Why, instead of love-making, do some of us prefer to "fuck," "screw" and "get laid?" Worse, how could someone rape a child, copulate with a corpse, or fall in love with a shoe? There are a thousand fools who claim to have the answers but, despite those who would blame biology, "bad parents" or our so-called corrupt culture, the honest answer is that we don't know. It is a mystery why so many, and perhaps all of us live lives of folly. Despite the virtuous perversions of people like me, I guess there are real perverts after all.

At that moment, Janet Hunter and the students sitting around me no longer existed, and my memory took me on another excursion, this time back to 1935 — I was three years old — when my mother and I visited my paternal grandparents in Heidelberg. I spoke no German and, when my mother and grandparents tried to teach me words, I stayed silent. Suddenly, after four weeks, I spoke out, but to everyone's amazement, it was in the local Heidelberg dialect. How could this be? Like Laura Anne and Emily I had learned far beyond what was expected. My mother was Austrian and my grandfather spoke with a Berlin dialect. My intellectual grandmother spoke only High German, so how in the world did I learn Heidelberger Dialekt? This was long before television and radio talk was High German. I had somehow learned something impossible to learn. I had figured out that the fragments of dialect I'd heard in stores and from the neighbours was the real language, the real German, and that's what I spoke. Within a few days, a visitor came to the house. "Heil Hitler," I

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piped up. This was not the fashion in my grandparents' home, but I had figured it out. I can just imagine them rushing to clap their hands over my mouth. I did a repeat performance of this blunder on a streetcar in Toronto after our return to Canada. Having been reprimanded the first time, I'd come to the conclusion that "Heil Hitler" was not a greeting after all, but referred to a man with a square mustache. So, when a man with a square mustache boarded the streetcar on which we were riding, I piped up again, "Heil Hitler!" How could I, at age three, have gathered enough information to calculate that a square mustache denoted a man who I thought had the name "Heil Hitler"? I assume that, like the Calmady charmers, I also knew plenty about eroticism and its attendant mysteries. Freud and Jung were so amazed at the sexual knowledge of children they assumed it was an innate, genetic given that children are born with sexual knowledge. "Archetypal knowledge," they called it. Could my speedy grasp of a local German dialect be the same phenomenon: was I born knowing it? Or did it mean that, even more amazing than innate knowledge, children are geniuses at learning? It's no surprise, I say; how could the species survive without its gift for learning about language and sex? A child's hunger for knowledge, for conformity, is great beyond comprehension. It is a wonder, a leitmotif that runs through human behaviour. It's a mystery that, inexplicably, we all too often deny by inventing theories, explanations and slogans for matters that warrant only more careful thought.

I was still lost in my reverie, oblivious to my students and Janet Hunter, who was waiting for my okay to begin telling us about today's case. Is it really possible that such reminiscences could have raced through my mind in 10-15 seconds? And the memories weren't done with me yet.

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My son Paul, age four, often practiced a game of his own invention with a foam-rubber Nerf ball, repeatedly bouncing it off the wall and catching it. In two hours, he'd become very good at this game. A few days later, I threw the ball to him, but a bit too high and off to the side. Like the football players he'd seen on TV, he turned and caught the ball over his shoulder. This was not simple learning; it was avid cultural hunger and absorption. He became the football players he had seen on TV. A year later, Paul entered kindergarten and learned to read. Diana, one year younger, was intensely interested in her brother's new skill. She learned how to read from him — in three weeks. Jack and Jill WEnT up The hill to Fesh a Pel uv woter Jack fel dab. and brock his kron and Jill cam . . .

Could there be a better illustration of the hunger for cultural nutriment, that appetite so characteristic of our species? Such desires can't be satisfied, exhausted, or spent, any more than lovers can stop telling each other of their love, or moralists refrain from preaching. Desire goes on forever. It is a deeply subjective intangible, an obligatory, human given. But, since it's a hunger for culture, it can't be seized, studied or dealt with objectively. My desire is a stance on life so deeply personal that my array of desires becomes what defines me. Bill Clinton is a serial philanderer, but he merely has a sex drive.

I finally emerged from my reverie and paid attention to Dr. Hunter. Janet was tall and English, and a bit bony and stiff as, in my stereo-

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type, an Englishwoman should be. A few weeks earlier, after she had prepared an abysmal report of her case, and in response to my critical comments, she produced a stellar revised version of the report, far better than I expected from a second year psychiatric resident. As she handed me her revised case report, I was surprised to see she didn't look stiff and awkward any more. Her covering note to me was brief and a bit flirtatious. Dr. Hunter was well aware, I thought, of how a woman and a man negotiate and celebrate their womanliness and maleness together, even in the subtleties of everyday life. She also knew that young chicks flirt with older guys and young dudes flirt with older dames — and vice versa. But I wondered if she knew that a young woman and an older man had best be careful? Because Hanna Slendzinski and I had both been grown-ups, my crush on her had been safer than flirting with Janet Hunter. I wondered what Janet had in store for me as, for the second time, she would present her findings to me and the group of students. Janet spoke quietly, frequently shaking her brunette hair out of her eyes and offering us a crooked smile. But she puzzled me by describing her patient, Lydia Paris, using a naive tabula rasa model, as though she were merely a product of external life events. Osman Awad, my theoryloving student — despite his splendid mustache, he still looked veiy young to me — had observed the initial interview and, inexplicably, repeatedly interrupted and corrected Janet's version of what had gone on. This seemed to be partly a product of the style of presentation: Janet's voice was becoming fainter and she meekly acquiesced when her descriptions were discounted and corrected. To my amazement, other students were soon interrupting and asking questions and, before I knew it, had turned toward Osman and started to address their questions to him. Everyone, including Janet herself, seemed to be conspiring to deny Janet her due as today's star performer. It was time for me to interrupt:

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"What is going on?" I said. "I've heard a few brief sentences about the patient, descriptions which suggest she is merely a victim of an unhappy past who contributes nothing to who she is. And now, right in front of my eyes, Janet has turned into the patient. She is passive, without will and without input into her own presentation. Apparently all of us agree this is okay." I hoped the students hadn't heard the annoyance in my voice; after all, I was the inscrutable, undemonstrative, mystery man and they didn't need to be disillusioned while they were busy learning. They looked uneasy, trying to anticipate what I was driving at, hoping to figure out an unexpected, paradoxical angle on Mrs. Paris before I sprung one of my traps on them. All were chastened. "Janet," I said firmly, "please tell us Mrs. Paris's story." She did as she was told. "I noticed right away Mrs. Paris relates everything in the passive voice; she tells of a long series of disappointments and nothing I could say changed this. It's very hard for her to tell her story, and she said there were some things she definitely will not be able talk about. When I tried to question her further about this she just went silent. She never described herself as doing anything, as being the agent of her own life." "Agent of her own life." Very good. Despite her earlier submissiveness, Janet had been paying attention and knew patients often disclaim agency in their own lives. Janet seemed to be following the same pattern as when I critiqued her first case report. She wanted to be corrected, so she could consider me to be the agent of her subsequent good performance. No wonder she identified with Mrs. Paris's passivity. I wondered if she understood that, as well as disclaiming agency, people also often claim agency: "My parents broke up because I was a bad boy ?" "Mrs. Paris's father was a nervous man," Janet continued. "He once told her he was afraid of everything, even though he was a lawyer and a

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very successful businessman. Her mother was a big baby, always crying and fainting, but just the same spent most of her time fussing over her frightened husband. The way the story came out, both parents were frightened most of the time, and the mothers job was to comfort and soothe the father. When she was young, Mrs. Paris was not really frightened like her parents, although she was quiet and submissive. Her sister, one year younger, was the only self-confident person in the family. She was actually cranky and told off the parents for their stupidity. "Mrs. Paris has two children and they are doing well. Her marriage has no serious problems except that her husband is very quiet. "She also said that her time at school had been difficult because her teachers 'didn't understand her.' She was an average student, had casual friendships and took part in some school activities. She didn't go out with boys because the family was Roman Catholic and strict. She studied nursing and worked for a family doctor until her children were born. "Right at the end of the interview, Mrs. Paris told me she had had two affairs in the last few years. She also said that, in high school, she'd had an affair with an older man. But I didn't have time to get any details about this."

The group was quiet and, having been chastised, looked chastised. They didn't ask Janet the usual boring questions obsessional medical record-keepers insist on — the drugs that had been given to the patient, the medical history of Mrs. Paris and her family, the exhaustive catalogue of symptoms she may or may not have had. Normally when faced with a troubled person, students are prone to seize immediately on "medical" thinking and thus sabotage their fledgling psychological thinking. The group members didn't seem to have noticed (or had they

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noticed all too fearfully) that there were huge gaps in Janet's report, gaps that reminded me of our culture's blindness to the sexuality of children like Emily and Laura Anne and, all too often, of people like Mrs. Paris. That blindness is an earnest, perhaps even a necessary, cultural practice — except when psychiatrists do it. Janet's omissions reminded me again of the thoughts stirred up in me when I looked at Sir Thomas Lawrence's painting. Janet hadn't said a word about love, sex, eroticism or joy — let alone chasms and whirlpools. As we psychiatric teachers often say, "Why has she not told us the psychosexual history?" Even the story about Mrs. Paris' parents — the only hint of anything going on between a man and a woman — was a depressing record of worry, fear, concern. In fact, Mrs. Paris' description of her parents' interaction guaranteed that eroticism between mother and father was unimaginable. Shouting and beatings would have been more erotically evocative. I half expected the group to chastise Janet for not taking extra time with Mrs. Paris to get more detail about the affairs, the stories of which she blurted out only at the end of the interview. Or had I underestimated my students? Perhaps they realized perfectly well that if the patient waited until the last minute to discuss her love affairs, she did so precisely because she couldn't bear to go into them at length, and extending the appointment would have been a demand she reveal what she wished to keep secret. It would also have been a violation of her contractual arrangement with Dr. Hunter who would have told her, "We will meet until two o'clock, and then I will be meeting with Dr. Warme . . . " Mrs. Paris had, of course, mentioned that she had another secret that could not be told at all. Perhaps this last-minute report of her past affairs was a hint that the secret was of a sexual nature. But it also sounded as though Janet was half-hearted in her attempt to learn about this. Didn't she intuitively know that blunt questions don't

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tempt patients to tell their secrets? That what was called for was the exercise of her own, life-developed social skills: "Ah, yes, secrets," she might say. "Aren't secrets wonderful? Wonderful and terrifying?" Later, when the moment was ripe, she might practice her own social wizardry just a bit more (if she was not too terrified). "Remembering and telling secrets is trouble and, amazingly, not remembering and telling is also trouble." Of course Janet "knew" how to do this. She had demonstrated her social skills a few weeks before in the flirtatious note she included with her re-submitted case report. Good god, I thought. Hadn't she said in her note that I had "nudged" her into producing a better report? And wasn't she now, inviting me to "nudge" her to tell her patient's story on her own? Even her coyness in revealing her high intelligence gave away her knowledge of how to deal with a male supervisor. Blunt questions about secrets are useless, a version of dumb romance — "Do you want to fuck?" — when it's obvious that what's called for is flowers, sighs and poetry. Or a nudge? When it comes to secrets, allusions, metaphor, humour and aphorisms work much better than straight interrogation.

"Okay, why don't you bring Mrs. Paris in?" I said. I was thinking the first order of business would be to see whether she was as incorrigibly passive as Janet believed. Next, I would try to demonstrate to the students that taking a psychosexual history -— the story of a patient's erotic life — could be very revealing. Mrs. Paris appeared younger than her reported 42 years, modestly attractive in a simple, white summer dress. Her hair was long and hung to her shoulders. I noticed she had a lock of hair that strayed across her face and that, like a teenager, she tossed it aside with a shake of her

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head. Hadn't Janet offered the same hair-tossing gesture when she was telling the group Mrs. Paris's story? I was struck that I had taken to noticing hair styles which angle to the right: a few weeks before, Dr. Kori had affected a flow of hair to the right and I remembered little Laura Anne in the painting, who also had an errant curl across her forehead. As she took her seat, Mrs. Paris cast her eyes downward. "Hi," I said. "Perhaps you could start by telling me a bit about how you do harm to your own life?" That should corner her nicely, I thought. My question demanded that she declare her agency, that her life was a matter of doing and not just a series of "happenings." Those who are resolutely passive neatly sidestep such questions and carry right on with a litany of their powerless way of being in the world. To my surprise, Mrs. Paris answered my question. "I always dwell on the bad side of things," she said. "I can't seem to get any fun out of life." "I've heard that in the first interview you talked about bad things a lot. Is focusing on bad memories a way of spoiling your own life?" "You're absolutely right," she agreed. "I'm aware of it as I'm doing it. It's sort of automatic to switch away from what's going on and think about my unhappy childhood."

What were Janet and the others thinking as they listened to this? All, especially Janet and Osman Awad, were already convinced Mrs. Paris was hopelessly passive, one of those "bad cases" with whom it is so difficult to work. And already, in her opening words, Mrs. Paris was self-reflective and observant of her own pessimistic style. But this was not merely self-reflectiveness and cooperation; her submission to my psychological agenda had been too quick. I was the variable in the equation, so perhaps she'd worn a hangdog mask with her student

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interviewer, and perked up with me — the older man and unit commander. Hadn't Mrs. Paris said that she'd had a love affair with an older man while in high school? And wasn't I thinking about a love affair involving an older man when I imagined what was going on between Dr. Hunter and me? In other words, Mrs. Paris seemed to be yielding to me. Depending on the circumstances, "yielding" can be a splendid thing, yielding wisely, that is, like Lear did at the end of his life. For others, however, yielding is bitterly opposed — to them, yielding is a humiliation. There is also a joyful yielding, the joyful terror of the woman who yields to the first lovemaking, the feminine parallel to the man who, when he goes to war, yields to honour and duty and puts his life at risk. Mrs. Paris's quick yielding to my agenda was too good to be true. She was setting me straight, telling me I was to think of her as a fine and worthy patient — or so her words and actions indicated. What went on between us, she was insisting, would be pleasurable and satisfying to both of us. My mind drifted to autistic children, children who can never engage in joyful yielding. They prefer doorknobs, light switches and mechanical toys: predictable items that present no surprises. That's why autistic children avoid human contact: humans are unpredictable and have incomprehensible expectations. In the 19605, we treated such children enthusiastically in mental hospitals. To us, they had been psychologically deprived, and we held the self-important belief we could cure them by being better parents to them than their own families could be. When these children watched television, they liked the commercials because they were absolutely predictable. But in the mid 19605 television commercials changed. Some innovator realized that, after showing a commercial for a period of time, one could get the same marketing benefit with an abbreviated version of the same commercial. I recall my

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autistic patients being unnerved by this: the predictable haven of television advertising had suddenly become erratic and dangerous.

"Have you always been negative like that?" I asked Mrs. Paris. "Were you like that as a child?" "I never had fun as a child," she said. "The first time I had fun was when I was in high school and met an older man. He sort of rescued me from my boring family. After a couple of years I broke up with him, but in college we started up again for a few more years." "Were you in love?" "Yes, I loved him." Her statement of love was unconvincing. There was caution in Mrs. Paris s way of answering, so I tried again. "Were you really in love? Like, absolutely mad about him? Head over heels in love with him?" "I've never been in love like that." "Not with your husband?" cc-yT No.» "So you don't know the joy of magnificent love and magnificent love-making. You've never had the experience of making love like the gods?" "Oh, yes, I really loved the older man in high school. The trouble was he was a selfish lover. But I was lonely and I loved him so I didn't really know any better. He's the only man I ever loved. My husband is nice to me but he's weak and stupid. I told him to not pester the dog but he did it anyway and he ended up getting bitten on the nose and upper lip. The dog is old and getting blind and is afraid when she isn't sure what is going on. Because my husband had been so stupid, I didn't even want to take him to the hospital for stitches. In the car, I couldn't help laughing." Mrs. Paris laughed again as she told this story.

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"So you don't know what I'm talking about when I mention the glory of great love, the love that includes making love like the gods? You change the subject to men as fools and to your scorn for them." "Oh, yes, I do know about love."

Mrs. Paris's story was getting confusing. I wasn't sure whom she had loved, nor did I know whether the fine lovemaking had happened with men she loved or with those she didn't love. My habit is never to take anything at face value, so I assumed her story was confused for a reason; I didn't settle for the idea that she was just befuddled or inaccurate. The story was supposed to confuse me. Was the secret Mrs. Paris had not yet told us hidden somewhere in this confusion? But I was also falling into the trap of demanding rational coherence, something I complain about when I see it in others. Could anyone other than naive Platonists ever think the world could or should be rationally coherent? There were two coexisting truths about Mrs. Paris's confusing story. She was confusing and rationally incoherent because she was a prattling mortal like anyone else. Simultaneously, she was rationally incoherent as a strategy to confuse herself and me. I was increasingly aware that Mrs. Paris was very feminine, that her manner and posture were womanly and appealing. Was that little touch of hysterical irrationality part of her charm, her childlike naivete? Like a lover, I was starting to notice her every tremor, her every breath, her every flicker and shadow. Was I responding, I wondered, to a womanly response to me, a man? Or was I falling into vanity, some seductive, wishful self-indulgence I was using to titillate myself? Alternatively, was I just being dramatic for the benefit of my students? Stop this nonsense, I told myself, it's a stupid line of thought, so hold your tongue before you make a fool of yourself. Wasn't this the same damn thing I was doing with Janet? Imagining that her note to me was flirtatious?

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And then another of the innumerable people who live within me spoke up and cautioned me in another direction. Wait, wait, said this bolder, equally wise side of me. Where is your courage? Aren't you always saying all of us are uncanny at reading what is going on in others? Haven't you read Tolstoy's descriptions of psychological uncanniness, his flickering, twitching world of awareness? Isn't it obvious that her eyes are flashing with pleasure when you gaze at her intently, and ask daring questions? Mrs. Paris was, I realized, prettier than I'd first thought. I particularly noticed that she wore no eye makeup; there was no ocular artifice, nothing alerting me to her flashing eyes. "I notice that you wear no makeup?" "I just don't like it." "Eyes can sparkle and make you noticeable," I said. "They can catch the attention of men. Do you know how to sparkle your eyes?" "Perhaps." "Do men like you?" "I guess so." "I notice that you answer very cautiously. I mean the question very seriously. Do men seem to be attracted to you? Do you have that spark men find interesting?" "Yes, they do," she said, lifting her chin and looking at me boldly. "So you know how to be wonderful and womanly, how to flash your eyes at men. Perhaps you know how to flash your eyes at me? Perhaps you've already flashed your eyes at me?" "Yes, I know what you're talking about. My husband loves me, too, but I don't love him." Bold and evasive, both at once. But I was not evasive. I was bold and charged with psychological determination. "I understand you've had some affairs, that other men like you and love you."

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She looked boldly at me again, a hot, eye-to-eye look. She was, I now saw, quite splendid. "Yes, I've had two affairs. That's why I wear no makeup. It's easy for me to get men interested. I didn't really love either of these men, but I liked them. I am lonely in my marriage and have a pleasureless life." "You describe yourself as a woman who knows how to make men love you. All the men in your life seem to have loved you, but you are never fully in love. Or perhaps with your first young love you were, but he did not know how to 'make love,' how to evoke your womanliness. Something is always missing for you. Despite that, you say that you know about the madness of love and the magic of glorious lovemaking. You know everything but cannot know the joy of what you know. "When we began 20 minutes ago, you were a bit sombre, but you now seem cheerful. Could we call this 'joy'? Could it be that you know joy, but don't know that you know it? Your parents were unhappy people, too. Must you be like them and be unhappy? I know that you have a secret. Could your secret have something to do with joy, happiness, womanliness?" Mrs. Paris and I were both silent. "These are the things you need to talk about, I guess. We'll find a therapist for you. Twice a week. Dr. Hunter will give you a call." "Twice a week?" Yes. Mrs. Paris knew our time was up and began to pick up her bag. She hesitated. "There's something else." She took a big breath. "I wish I had a cigarette. This is very hard. When I was a child, my father sexually abused me. My sister, too. It went on from when I was seven until I was 10." CCy J) 1 see. "And he blamed me." Jesus Christ, I thought to myself. Here is the world of agency «T7-

M

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again. Who was it that caused the sexual events between father and daughter? He says she has caused the incest to happen — and she agrees! That's why her earlier stories had been confusing — it was never clear who she loved or even whether she loved. She knew about love without ever having known love. Or it's her eyes; her eyes have this effect on men, or so she claims. Father disclaims agency and she claims agency. Can none of us get it straight? It's like those sages who can't decide who has written a poem: The poet's unconscious writes the poem. The historical moment writes the poem. The gods write the poem. Language writes the poem. All the poetry ever written before writes the poem. The poet writes the poem.

All want simple causes, as though poetry or anything else can be explained by causality any more than they can by mystery, magic or sin. Mrs. Paris spoke into my reverie. "I passed him on the stairs one night and he slapped me. 'When I come to your room it's because you walk around wearing pajamas like that. It's your own fault.' That's what he was like. He used to hit me all the time." She paused. "It was rape. He wasn't even nice to me. But he said that he loved me and I loved him — and that what we were doing was normal."

I'm full of knowledge, experience, weirdness and boldness, or so I think. And yet, as I mused about Laura Anne and Emily Calmady, I couldn't daydream beyond wholesomeness and the "possibility" of breaching propriety. I've heard plenty of stories about filthy fathers,

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uncles and neighbours, but when faced with Mrs. Paris I wanted to focus on "glory," "joy" and "splendour," nice safe words that emphasize purity. Shouldn't I have considered the possibility of dirt — incest — before she told me? And didn't she warn me that she, too, was full of rage and sadism when she described her reaction to the dog biting her husband — rage and sadism, her identification with her sadistic father? Did she know she had identified with her father and, if she didn't, how would she react when, someday, her psychotherapist raised this subject? As she did with her interviewer, Janet Hunter, Mrs. Paris had waited until the last minute before revealing her secrets. Best that I obey my own rules and let her escape rather than pressing for more or, worse, sinking into pathetic empathy and support. "Its time to stop for today." Mrs. Paris perked up. Her eyes flashed hotly again. "Can you be my therapist?" No, i said, it cant be me. "Why not?" she demanded. "I'm not taking on any patients right now," I said. This was the wrong answer to give — I should have stayed silent so she could have noticed her own thoughts. I don't know why I made the excuse about not taking on any patients, except I vaguely knew I wanted to silence her, rather than endure her pressure. She stood up to go, eyes flashing, and shook my hand, and I managed to stay silent. But not the students. Once Mrs. Paris had left, Leila Singh spoke up about my interview. She, too, was retreating from being effective and potent in her own work: "I could never do that," she said. It was a last gasp of passivity. Like Janet Hunter and the rest of the group, Leila had identified with Mrs. Paris's first version of who she was: passive wax shaped by events. Keep Mrs. Paris in mind, we will hear from her again. CC-p, T

?J j

" 1

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I'd smoked out her secrets. This time it was sexuality that, with heterosexual genius, I'd zeroed in on. Calling it "genius" is rubbish, of course, we all know everything that matters. Discretion or nerves can make us believe there are things we don't know or can't let ourselves think about. I'm pretty slick at recognizing the game of love and sex between a man and a woman, and my recognition of gay love is pretty good, too. For the latter, I'd had years of secret training at the hands of Graham Copeland. Graham had been an unlikely friend, because he was a scholar and I just wanted to be popular. He scorned medicine and studied Latin and German fervently — I'd studied those subjects furtively, so that my classmates wouldn't know. I hadn't seen Graham for decades, but he'd phoned the previous week. "Hello Gordon. This is Graham Copeland speaking. Do you remember me?" It was a peculiar question since he'd been my best friend for years and I'd suffered from Copeland-envy since 1962 when Graham had left psychiatry and become an artist and scholar, an envy periodically inflamed by information I'd picked up about him along the way. I knew he had been an Ordinarius at a German university, the LudwigMaxmillians-Universitat in Munich, and that he'd held another scholarly position in Berlin, where he kept a second home. I'd never thought to contact Graham myself, probably because I knew, despite his joyfulness, he was a fervent scholar and I, a furtive dabbler. I guess I still wanted to be popular: make money, play tennis, get my picture in the paper. "Graham!" I said. "Are you in Toronto? How are you? It's amazing, I recognized your voice as soon as you spoke." As I talked, I realized 1 was talking 1997-talk, the casual, slangy, vernacular, the closest Canadian equivalent of Heidelberger Dialekt.

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Did I speak that way because, at 68,1 still wanted to be popular? Like my intellectual grandmother, Graham would never speak in vernacular/'Di&lekt. He still had the prissy, slightly effeminate manner of speech with which I'd secretly experimented, experiments that proved that a sissy was alive and well in me. "I was hoping we could meet," he said. "In medical school, you were one of the few intelligent people to whom I could talk. There was really no one else. I'm visiting my mother but I have some tickets to a concert tonight and wondered whether you'd like to come along." My God, I thought. He's barking mad. Graham was so formal it was as though we'd been distant acquaintances and the whole drama of his love for me had never happened. And he'd committed a blunder. Not against me; I loved his claim I was one of the few intelligent people at university. But his unabashed reverence for intelligence was badly out of fashion. We can love and admire intelligence, all right, but we're not to be explicit. It's okay to admit it out loud only if it's done ironically. I sensed Graham had become very serious, not someone prone to indulge in allusion or humour any more. It felt as though he was not himself, that he was temporarily playing the part of another character. He was as caught in his new sobriety as he had previously been in his life of gaiety. Graham was not playing the modern game, not getting the point. I loved him for it, and it made me remember why we were friends. What a relief it would be to see him. I wouldn't have to talk about the Blue Jays or the tennis club. I knew what we would talk about: a current version, a spanking new 1997 version of how stupid David Paster (physiology teacher) was and of the intelligence of Jeremy Browne (white haired at 45, who taught histology — microscopic anatomy — to medical students without a university degree, with the full approval of the departmental professor, though he held only the

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title of lab assistant). We would talk about music and universities, snobbishly, approvingly and self-righteously. But would Graham know we were being snobbish elitists when we thought of ourselves as the philosopher kings? The wonderful game of elitism is a game I've enjoyed all my life, but another involves irony, skepticism, relativism. Graham seemed uninterested in playing that game, so I thought I'd best watch my tongue. What had happened to his vivacity, his celebration of life? He had become like me when I was younger, disdainful of Canadian celebrations that, to me, had seemed false and superficial. Only foreign rituals — Greek Orthodox Easter, Bar Mitzvahs, Pesach — seemed genuine. Graham's route had been the opposite of mine: where his celebrations dried up, I'd had a late awakening to amazing truths about Hallowe'en and Valentine's Day. Had Graham's brain shriveled in the last 35 years, or had his juvenile, rebellious joy been a cover for an internal, over-intellectualized fusspot who took over as the years passed? Did I dare to test him out a bit? Surely, the tender self-mockery game was too delicious for him to have abandoned it completely. Should I try to crack open his earnestness and bring him back to the world of fun? We could only be philosopher kings by ironically observing that philosopher kings, intelligence and scholarship were just games that some of us like to play, one of our preferred "forms of life." Graham and I arranged to meet at the George Weston Recital Hall. When he spotted me, he waved. After so many decades, I instantly recognized the angle at which he held his wrist as he stretched out his arm — like an oar, I thought. His hair and beard were snow white. More envy: my damn beard insists on being salt and pepper grizzled. Above his forehead was his white sweep of hair, combed straight back; in medical school it had been blonde. But to me, the world scholar still looked like a rangy, pouty-mouthed boy. In this era of hugs, Graham and I soberly shook hands.

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Graham was no longer secretive about his homosexuality. He had brought with him two men who were clearly gay. Heinz was a tall, burly German, mustached like a British army officer and apparently Graham's special friend. He gushed cheerfully and excitedly about Ewa Podles, the Polish contralto whom we had come to hear. Heinz was infectiously gay and charming and I chuckled at his endless, knowledgeable chatter. It seemed as though Graham's happy-go-lucky side had died and been reincarnated in Heinz. Only Graham's musical intelligence had been kept alive. His second friend, Dan, was a doctor, so I knew that if my nerves got the better of me, I could at least retreat into medical shoptalk. In the lobby, I recognized more gay men — it seemed to be a gay convention — including several psychiatrists. I remembered how, when we were interns, Graham had been the Pied Piper for my benefit, playing the piano in the nurse's residence to entice the young nurses out of their rooms. At the George Weston Recital Hall, things were reversed: I was a homosexual virgin on offer to the gay world. Heinz fluttered his hands happily and carried on with his enthusiastic commentary on the vocal treat that was in store for us. Graham fluttered his hands, too, but without enthusiasm. Nor did he smile much; his mouth was puckered, as it had been three decades before and, I noticed, I was holding my mouth tightly puckered as well. When we'd reached our seats, Heinz leaned over and told me about the Canadian Opera Company orchestra as it warmed up on stage. His breath stank, and I wondered how the breath of such a sweet, cheery man could be so rank. Perhaps it was nervousness. I leaned in the other direction toward Dan, hoping for a chance to talk shop and get out of range of Heinz's nasty fumes. Graham sat two seats further along. He had produced the tickets for all of us, and after decades of not seeing each other, he had opted not to sit beside me. Ewa Podles made her entrance. She was short and stocky and had

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on a black suit, military and boxy. The outfit was simple except for soldierly, rhinestone buttons. She smiled at the audience politely, narrowed her eyes and exuded courtesy and confidence. Her message was like the message I try to give to the patients I interview: "What is about to happen is serious, I know what I'm doing, we are going to enter into things deeply." I adored her before she'd even begun. She had a strange voice, or more accurately, a strange set of voices, all of them magnificent. "Bizarre," said Peter Voore, a psychiatrist friend. What he meant was that he adored her, too. I loved her deep contralto voice: it didn't seem to be entering me by way of the ears but through my entrails. From my bowels, it marched up through my body and poured out of my mouth, eyes and ears. Despite having adopted few of the trappings of femininity, as she sang Ewa Podles was transformed into glorious womanhood. I listened, as spellbound as the gay aficionados surrounding me. I realized that, as the singer achieved supreme womanhood in song, her gender didn't matter any more. She had become pure mankind, alive and Dionysian. She was the Obermensch, an icon above mere womanliness or manliness. Like a woman in the act of love, the act of love as it ought to be, she was filled with orgasmic magnificence, life itself. It wasn't just a matter of sex or music anymore. How fortunate we are when we meet people like Hanna and Cathy and Ewa Podles and, yes, Mrs. Lydia Paris. And more important: how fortunate when we know what we are seeing. After the intermission, a miracle: Ewa Podles came onstage wearing a scarlet, sleeveless chiton — ancient Greek style — dramatically held in place by a diamond rhinestone brooch pinned in the centre of her sternum. She'd put on women's clothes and her repertoire was lighter and cheerier. Her voice no longer entered via my stomach or ears, but through my eyes — her voice knifed itself into my eyes. She was letting

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me see she was the same archetypal woman as Lydia Paris, someone who also hid her secrets at first. The audience was still cheering, but we left after two encores because serious Graham was hungry. Where was the young Bacchus with whom I'd gone to medical school?

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CHAPTERJrtiriE

SEVEH LETTERS FROM CATHY feriES

In Topeka, home of the Menninger Clinic, Cathy Jones and I met twice weekly for seven years. When I moved to Toronto in 1969 our formal meetings stopped, but she knew my address and often wrote long letters; I wrote short letters back less often. During the next 30 years, she wrote hundreds of letters, and I wrote less than a hundred. I no longer had a window on Cathy's flamboyant periods of madness — at those times she did not write letters. I heard from her only when she was more or less well. I could have ended the correspondence by writing less often, and being politely cool, but I didn't. I kept the correspondence alive because I thought she needed it, and that I had a mission to help her. The truth is she was Marilyn Monroe to my Ralph Greenson. I was dedicated to showing her what it was like to live in a normal world. Stupidly, I seemed to think the normal world was me. Empathy, as someone once said, is "all about me" — about how wonderful I am for being such a nice empathic fellow. In 1969,1 was still infected by the idea that schizophrenics were weak, and that psychiatrists were actually powerful — not just the objects of attributed power. Since I'd left Kansas, Cathy had lived with her parents, in group homes, and recently to a halfway house that in Exeter, the Kansas

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town were she lived, was called a partial hospital. She earned spending money by babysitting and sewing, but Cathy never had a real job. From time to time, she had a boyfriend and, while she didn't tell me about it until years later, she also had two illegitimate children.

It's time for a little theory. To help the medicine go down, I'll try to tell the theoretical story with a bit of dash, and a bit of fun. Except that, for Cathy, it was a serious business. I'll say it whimsically, but with Cathy, I was never whimsical enough. When she told me about her disastrous boyfriends, I should have said: "Cathy, it's time for a little theory. To help the medicine go down, I'll try to tell the theoretical story with a bit of dash, and a bit of fun. Except that, for you, it's a serious business." Once upon a time, before psychiatry was born, those who were mad dictated how we would theorize about them. They said they had voices in their heads, evil persons and spirits who oppressed them and gave them no choice but to act as they did. In our theoretical naivete, we thought it best to agree they were possessed by demons. "Before you and I smartened up, Cathy, we decided to agree with you. When you said you picked hurtful boyfriends because you were crazy, or just couldn't help it, we thought it best to agree that madness caused you to make mistakes." Psychiatrists decided 200 years ago that schizophrenics were possessed by demons; we used the theories of the mad to explain their madness. But we haven't moved far beyond such false explanations. When I suggested this to my friend, Robin Roger, she felt I was making a weak argument. What she meant was that it's obvious that demon theory is preposterous. Robin is one of the smartest and most imaginative people I've ever met, but like everyone else, she is caught up in the modern scorn for the theory of demons. No one will risk noticing

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that demon theory is perfectly analogous to the brains-bathed-inabnormal-chemicals theory. The biologists make the same argument as the demonologists: "We have suggestive evidence that . . . ." Despite this claim, neither the existence of demons or chemicals is supported by evidence. I know that researchers point to suggestive chemical abnormalities, but those who proposed demon theories also found suggestive evidence. They examined the so-called possessed and found head bumps that suggested to them the presence of rudimentary devil's horns, and tiny protrusions they noted at the base of patient's spines that suggested rudimentary devil's tails. Calling a demon a "chemical" doesn't change anything, and robs the patient of the dignity we afford to anyone else — the basic acknowledgement that they have a hand in their own destiny. "In our conversations, Cathy, we sometimes say that you do crazy things because voices told you to. In other words, we use your own theories to explain your craziness, except that we call your voices "chemicals." We're still ready to believe you, except we use a word that's fashionable in the modern world — schizophrenia. But calling your voices schizophrenia, doesn't change anything, and robs you of the dignity of knowing that you have a hand in how you live your life." "A role is selected," I should have said to Cathy, "for many reasons. I wouldn't hesitate to try to figure out why someone is a bitch, a wimp or a hero, so why wouldn't 1 try to figure out why you pick badly when it comes to boyfriends — or why it is that you hear voices? Surely we'd be better off if we thought about you more respectfully?" The argument I should have made to Cathy can be made about all the other intriguing characters in the world: lovers and confidence men, whose lives can certainly be analyzed, and psychiatrists, whose strange choice of profession also warrants scrutiny. Why was it always so hard for me to analyze that radical form of madness called schizophrenia? The answer is embarrassing: I was prejudiced and afraid. I never granted

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Cathy the courtesy of seeing her as a full human being. I succumbed to the passion to normalize — always present in all of us, of course — but in the case of schizophrenia, grotesquely exaggerated. Jan. 30,1981 Dear Dr. Warme, I moved to my new apartment on Jan. i/th. Some friends with a pickup and car helped nne. I like my place and take pride in keeping it nice. Once in a while I get lonely and bored, but most of the time I enjoy the peace and quiet. At home Mother had the radio or TV on almost constantly. She likes it; I don't. I do watch TV some in the evenings, but quite a while ago I decided daytime soap operas are garbage. I have some friends here in Exeter and have made new friends. I'm already baby-sitting for the apartment manager who lives in my building. Her boy has Down's Syndrome. I love him so much. He makes me feel protective and motherly. I would've been a good mother. I'm on the ground floor. There are six apartments in my building. It is government low-income housing. I have a kitchen-dining area, living room, bedroom, and laundry room-bathroom. Plenty of cabinets and closet space — I like that. I may be able to buy a used piano. I know someone who has a piano and wants $200 for it. I'm offering to make time payments on it but it'll be a little while before I can find out if that's acceptable to the owner. A week ago, the social worker came to see me. She brought a bunch of free gifts, plus coupons for 25 different free things, everything from a chicken dinner to a haircut to a month's subscription to the local newspaper. I've redeemed seven coupons already. My heart hardly acts up at all anymore. I'm supposed to lose weight because I had high triglycerides. I've lost about 15 pounds. I do a lot of walking and bike riding. I'd sure like to hear from you more often. It doesn't have to be long. Love, Cathy

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I'm hard-boiled. When I got letters like this from Cathy, my heart broke for her — but only for a split second. Once in a while I'd get teary-eyed, but would force myself to think: "What's the best thing to do? Rotten though it is, this is her destiny and I mustn't get too sentimental. Write back, help her to see more clearly what she has on her mind, and smarten up. You can't change the horrors of the world just because you want to." Besides, Cathy was lucky enough to be in the partial hospital, a real asylum, which left her a bit protected, but required her to negotiate with friends and neighbours on her own. No more sitting like a zombie in front of a television waiting for her paper cup of pills three times a day. It didn't require the wisdom of Solomon to see that Cathy was putting on a brave front. I was so horrified by her unhappiness that I didn't say the obvious. I wrote back in a controlled panic, filling my letters with talk of the weather, banalities about the meaning and the misfortunes of life, and administrative information about where I worked. "They're paving part of the roof of the Clarke so the children in the hospital have a place to play." I was filling up the page so I wouldn't have to feel guilty about abandoning Cathy in Kansas. "Cathy," I should have told her, "I'm glad that you're getting your life in order. But I can sense your cheerfulness is a bit forced. I think there's still a lot of disappointment about how life has been going. When you write again, could you tell me a bit about this?" Such a simple and humane thing to do, and liable to have started us on the road to knowing about her rage and scorn for so many people in her life, including the drug fanatics, the pale criminals who had turned her into a fat, seborrheic zombie with tardive dyskinesia — disfiguring thrusting movements of her tongue — an irreversible side effect of her medication. It doesn't matter whether Cathy's silent

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blaming of her doctors was true; it was the way she saw it. But I didn't want to hear about her perception of the world. If she'd complained more forcefully, I might even have corrected her "misperception" of doctors, that is, tried to shut her up, which I did anyway by not reacting to her complaints. " . . . Mother has the radio or TV on almost constantly. She likes it; I don't..." Cathy had said in her letter. Was she simply saying that she had a good mind, not easily satisfied by superficialities like television? She used a very formal phrase when she referred to the piano: " . . . if that's acceptable to the owner." In her next letter, Cathy uses the same proper style. "If it made him happy to give it to me, indeed he has made me happy, too." Rural Kansans don't talk that way, and she may have been copying my more formal, Anglo-Canadian style. Was she saying, "I'm the woman with an IQ of 140, and want to ally myself with you?" It was a touchy subject. Not only was Cathy the prettiest woman in her family, she was also the smartest. Her guilt needed to be discussed, and with anyone else, I wouldn't have hesitated. But Cathy was schizophrenic — a nigger — so I just kept patting her on the head. She likes her landlady's child with Down's syndrome, and would have been a good mother. Here was a chance to talk about her disappointment in not being a mother, and her grief about having to give up her two illegitimate children. But I let it pass. March 30,1981 Dear Dr. Warme, . . . Do you know I haven't had a date for four years? No boyfriend, nothing. I don't know how, but I'm coping very well. But I'm grateful I have you for a friend. I'm not the same wild person I used to be. Actually now my only vice is smoking. I'm not an alcoholic like I thought when I went to AA. I really can take it or leave it, so I just leave it....

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The owner of the piano has decided to give it to me for nothing because he knows that I need to practice before playing at church. He said that it made him happy to do so. If it made him happy to give it to me, indeed he has made me happy, too. My mother is critical of everybody, and it's a relief when my father is around. He quiets her down . . . . Please write again soon. I'm grateful that you take the time. Let me know how you are. Do you have a Teddy Bear? Mine's in Salina. Love, Cathy

I let her not-very-hidden messages sail by. She is grateful, she says, which is a chance for me to discuss her love for me in the comfortable language of "gratitude." She says she hasn't had a boyfriend for four years, another hint that love is in the air. And what did I say in my reply? I suspect that I was "supportive" and told her how pleased I was that she was "coping" and that she is not wild anymore. I was again filling up my pages with bland commentary on the information in her letters. April 17,1981 Dear Dr. Warme, It's a dark rainy Saturday, a perfect time for letter-writing. A week ago we still had snow on the ground in Saiina (1 was visiting the folks). Also in April there were snow flurries. No more snow in Exeter though. April 19 I'm supposed to get my piano! Two more days! I have been trying to get it for four months. The Partial Hospital group I'm in is going to move the piano. I'll try to get a picture of me and the piano and send it to you Now I realize, much as I love solitude, I wasn't meant to live alone. Don't get me wrong — I will stay here. But I wish I had someone who loves me to stay here with me. My father is getting more childish and forgetful all the time.

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Sometimes in a conversation he says something totally off the subject. But he's happy because he doesn't know enough to worry about problems or money. He doesn't have Alzheimer's, just hardening of the arteries. Aside from that, he's quite healthy, physically, for an 83-yearold. Mother's mind is as good as ever at 66, but her physical healdi is not good. She has not had any more cancer, though. My health is sort of falling apart. It began about four years ago. I'm supposed to get a physical the zgth and lab tests. I'm getting deaf, particularly in one ear; my eyes bother me; I have arthritis in one ankle that keeps me from walking as much as I'd like, having no car; my heart still acts up sometimes; I have all the symptoms of diabetes again; my hair is getting very thin on top; my back hurts all the time; I have lumps in my arms; I have high triglycerides and cholesterol and I can't make myself diet anymore. Please forgive me for laying all this heavy stuff on you. I needed to get it out but I know you have problems, too. Thanks for listening. I just have a feeling I won't live too many more years. I'm not deluded that I'm dying, though. I mean, I'm in touch with reality. But all the things wrong with me are real. Wednesday was quite a good day. I saw Dr. Mandrake for a prescription and when we were through talking he took my hand between his and said, "Take care, my friend." I always feel good when someone likes me. I am truly wealthy to have friends such as they and you. I must eat supper and get ready to baby-sit now. Love, Cathy

Cathy was losing her elderly father, but at least she had me. Even though I was an obvious (psychiatric) father, I didn't say a word. She is not cut out to live alone, she says, and wishes that she "had someone who loves me to stay here with me." She writes to me on a dark rainy afternoon and mentions that she likes Dr. Mandrake, a transitional doctor figure whom I could easily have used to talk about her love for me. Was I dense, as well as not having the courage of my convictions?

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Perhaps. Most of all, I felt guilty that I had had intensified Cathy's attachment to me by encouraging this correspondence. I therefore continued filling my letters with words — any words. They were duty letters like those written by adolescent boys to their parents, reporting the weather and other banalities. April 20,1981 Dear Dr. Warme, I got the piano yesterday! The pictures were taken here in my apartment. I must say getting the piano made yesterday the highlight of my year! It took six of us to move it — four men and two women. It weighs 900 pounds. It's a good brand, Packard — the same brand as the one at my folks' home I learned to play on. Every note plays and it seems to be in fairly good tune. The old upright pianos like this were well made and have a good sound because of the height of the sounding board. I am tickled to death! I'm now going to church and they want me to play piano for church sometimes, so now I can practice! I baked a double batch of brownies this morning to share with the patients and staff of the Partial Hospital. I have a great time there. I guess I'll close for now. Please write and send me a picture! Lots of love, Cathy

It was an old story that Cathy played the piano at church and baked cookies for the people at the partial hospital; I'd known her for 2,0 years and she'd always been generous. If I needed to change an appointment, hers would be the easiest one to change, because she would always agree. In other words, Cathy was easy to take advantage of, so easy that I didn't notice I was doing it. She said the opposite. She was plagued by guilt, and constantly spoke of herself as selfish. It was a mantra; over and over she denounced her alleged selfishness. It wasn't my selfishness, for example, when I

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chose her appointment as the one I had to change. She never hesitated when her family wanted her to play the piano at church. The other patients ate her cookies, but never made cookies themselves. It was a fabulous mystery: a generous woman who thinks herself selfish. I should have pointed this out imaginatively, wistfully, glamorously. Why didn't I say: "Wow! What a mystery! The most generous woman in the world claims she is the most selfish woman. Good says it's bad, and white says it's black. It's like the two poles of a magnet, positive and negative, that repel one another and can't be brought together. Hey, all of a sudden, Cathy, a whole bunch of images are coming together in my mind. I just thought of a nuclear bornb. When two lumps of nuclear material are brought together there is a big explosion. When selfishness and generosity are brought together, would there be a big explosion? Actually, I wasn't thinking of a bad explosion. I was thinking of you exploding into a woman, instead of remaining only the obedient piano player, and the good cookie-giver. I even thought of you as a woman with regard to me. You've hinted in some of your recent letters that love was in the air, that you were alone and had no boyfriend, and that Dr. Mandrake, briefly, was a substitute. "But the world of your womanliness is dangerous. It's that fear of yours that you are a sexual bombshell, and this had caused trouble in your family because your mother and sisters were plainer than you. It was your brain, too. You always read, and were interested in literary stuff. I think you believed you were like a nuclear bomb in that house, too sexy and too brainy. That's why you're the nice, boring, good person you are these days. "It probably looks to you as though you tried being womanly when you were younger, and it caused trouble. Best to stay restrained in your life lest you mess up again the way you did as a teenager. But you're wrong. The error you're making is that, when you were running around

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with a lot of guys, it was awful sexuality, a sexuality aimed at messing you up, not a sexuality aimed at you winning the romantic sweepstakes. In a way, you were sexy so that you wouldn't be sexy. You always picked guys that were trouble, made sure everyone, especially your parents, found out, and got stopped. That's it: by getting caught, your family — the whole community, including Topeka State Hospital — put a stop to your sexual activities. In other words, your actions weren't womanly or feminine except in a self-restraining way. You were like die kids I've run into who masturbate to make their sexual thoughts go away. They sort of masturbate so they won't masturbate." Had I been less nervous about Cathy's fragility — as demonstrated by my dutiful approach to writing letters — I would have gone further, and talked about her way of being sexual with me: "There's something else about the nuclear weapon, and bringing together two dangerous things like generosity and selfishness, or two pieces of radioactive material — you and me. If we did a dance of words, a romantic or a sexual dance, it would be dangerous. It wouldn't be pure and sweet like generosity. Nor would it be bad like selfishness, it would be more like exciting and complicated. It would be trouble and grabbing on to excitement in life simultaneously. "You wouldn't be able to turn me into the wonderful Dr. Warme any more, and I wouldn't be able to turn you into the poor, unhappy Cathy. I'd smell your bad breath and you'd see my wrinkles and pot-belly. It would be real life, warts and pimples, joy and glory, both at once. "You once mentioned Milan Kundera's The Incredible Lightness of Being," I should have said. "What I remember about Kundera is that when he writes love scenes, he always tarnishes it a bit. The girl smells the guy's bum or something stupid like that. I used to get mad because it spoiled the romance, but I now know he was right. Kundera was talking about real life — about your bad breath, my wrinkles, and my pot-belly. He was also talking about vitality and energy."

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Some months later, a letter arrived which, despite my uneasiness, was a vital sign of life. Cathy was braver than I. Dec. 29,1983 Dear Dr. Warme, Another year is ending. Christmas is over, but not in my heart. I had a lovely, loving Christmas. I hope you had the same. This is a very hard letter for me to write. I'm going to bare my feelings to you at the risk of being rejected. It takes all the courage I can muster to tell you how I really feel toward you, but I can't hold it in any longer. And please know that whatever your reply is, I can bear it and I'll go on living. But please write soon and don't keep me on tenterhooks. Plain and simply, I love you. I cherish you. I have for a long time, but only recently have I admitted it to myself and even dared to hope. You sign your letter "Lots of Love," and "Much Love," so I know you love me but I don't ilcnow in what way. Maybe you love me with a fatherly love and still think of me as 16 years old. Or maybe you just love me as a friend, which of course is wonderful in itself. But do you — could you love me as a man loves a woman? It tears me up wondering, so you see why I finally had to write this letter. I ache widi longing just to see you again. Is it possible? I could save up to come see you. Even if you don't feel the same as I do, I hope we can continue to write to each other and be friends. We have too much behind us to throw our years of friendship away. I'll be 37 on January 4, so you know I'm a grown woman and I know my mind and heart. I'm also growing into a stronger person. I have done a lot of maturing in the last several years. We only live once, so I had to let you know my feelings and I had to find out if there's even a small chance for my dreams to come true. I can't let life and love get away from me by default. On a more mundane level, I told you I'd let you know the results of my physical exam. The doctor says the lumps in my arm are fatty tumors — not serious. He took a blood sugar, liver function and thyroid test. I don't have the results back yet. He says my ankle is

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arthralgia. I say it's worse than that. He hardly looked at it. According to him I should feel fine, but I don't. I feel like an old lady physically. My heart is acting up again, but the tests showed nothing wrong with it, so I'm not worried about it. I'm going to get new glasses in January. It's been four years since I had my eyes tested. Also going to get my piano tuned. So you see I have a lot to look forward to. But most of all I'll be looking for a letter from you. All my love, Cathy

What had I done? Had I led Cathy on? I was shaken by the letter. I had thought of myself as the kind, fatherly doctor, and something had gone awry. I knew that life is bedeviled by love and passion, but had convinced myself I'd kept things cool with Cathy: parental, and free of such complexities. I'd probably ruined Cathy's life, I thought. I'd been too charming and possessive, had tempted her to love me, and left her lonely forever. So cocky. She had other doctors, but I never doubted she liked me best. Oh, dear, how vain I'd been, trying to be the special saviour of the i6-year-old Cathy in the five years I'd been her psychotherapist, and still doing it 14 years later. Although I'd never had the thought that some people were inferior to me, my actions showed I believed otherwise. My reassurances, my fear of speaking frankly showed that, to me, handicapped people like niggers, Jews and schizophrenics all needed to have external strength given to them — they needed a saviour, in other words. But the truth is that Cathy needed a saviour no more than anyone else. We may all want saviours — but we don't need them. My worst nightmare had come true. I'd failed in my campaign to prove I didn't make judgments about the inferiority of others. Cathy had fallen for my ruse, the belief I was the hero with whom she should fall in love.

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Jan. 17,1984 Dear Dr. Warme, I hope you are well and happy. I realize my last letter may have made you feel uncomfortable or at a loss as to how to answer me tactfully. Please answer anyway. If you have to let me down I know you will do it easily. Yes, I still love you, but if you don't love me the same way, please don't let it affect our long-standing wonderful friendship. I'm strong and will be all right no matter what you say in response to my last letter. I didn't mean to be insensitive in telling you how I felt. I'm sorry. I never did tell you, but right after I moved here I had a psychotic episode. I had been up in the air about moving and hadn't been sleeping much. I was totally out of touch with reality for about three hours and about to explode. I thought the police were watching for something I didn't do. Totally delusional. I was going to move right back to Salina, even though I knew it would be admitting failure. I took extra medicine then and got a fair night's sleep. I am lucky I know when to take extra medicine. A lot of the other patients don't realize it if they need extra medicine. Anyway, the next day I went to the mental health centre but my therapist and the social worker weren't there so I didn't get to talk to anybody. But the next day I was better. When I moved here, I decided to take it one day at a time. God is helping me. I have never lived in an apartment this long before and I aim to stay until I'm financially able to move to a better place, or get married. Then I saw a TV show about schizophrenia on the educational channel that said professionals believe schizophrenia causes brain damage after you have it a few years. I already have brain damage from the angel dust. It has profoundly affected my short-term memory, which means I can't ever be a nurse or have certain jobs I might have wanted. I can still learn though. I just have no presence of mind to speak of. But my faith in God tells me that someday things will even out — if not in this life, then in the next. May God bless and keep you. Love always, Cathy PS. Please send me an answer to my last letter!

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When I finally answered, I took the bull by the horns and said, "No, Cathy, I don't love you in the way you are hoping." Then I said the banal: "Love shows up everywhere, and is inevitable in any longterm relationship." I didn't have the courage to ask her to tell me more about her love, and Cathy's next letter made it clear that over the years I'd figured out how to kill love, but killing love was an error. One of her great issues was her style of being in love — her determination to be an executioner of love. Cathy made sure that, even had I loved her back, my love would wither. Blabbing about her unattractive hypochondriasis and her psychotic episode guaranteed a sullied image of her; she aimed to repel the advances she thought she was inviting. Not the best tactics. It was a fresh example of her teenage promiscuity, a form of love that kills love. Cathy had provided me with a great opportunity to help her see her own self-defeating tactics, but I didn't want to know more about the love volcano that I'd stirred up. Some psychiatrists would have said something theoretical: "This love of yours, Cathy, is a reenactment of a love from somewhere else. It's called the transference." Had I said this to Cathy, it would have silenced her, and deflected her emotions away from me. It's a favourite trick of psychiatrists who don't want to be hated. Who could be annoyed if the psychiatrist has a perfect rationale for what he does? Had I done it, I would have stifled a living, suffering young woman; it would have been a weak admission that Cathy's love existed, quickly demeaned by identifying it as misplaced and fraudulent. I'm as frightened and intrigued by love as anyone else, and should have asked to hear more. It's the strange, once-removed answer that neither squelches nor promotes love. Ambiguity is always a good tactic because it leads to puzzlement or disquiet, well-known fuel for the engines of love and powerful thought:

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"Tell me more about your love." "What a glorious possibility." "You and I are sensible and act like doctor and patient as we should. But both of us know there's plenty of love between us, even if we never say so." "How sad. The blessing called love has come along and yet we know you won't permit it; you have to find a way of killing it. In the past, you've picked dorky guys who you know in advance will screw up. But you do it with nice guys, too. Remember Jessie? He was a nice guy and you stood him up and went out with some other guy. Now that I think of it, you did it twice, and he broke up with you. "You did the same thing with me in your letter telling me about your love. You said you'd been psychotic, about what a bad physical specimen you are — I wont call it your hypochondriasis, because you always have fits when I use that word. You started in right away doing what you've always done. You weren't able to live our love." Part of me still thinks that, had I spoken that way, I'd have been playing with fire, tempting and inciting her. In a way, it's true. Had I challenged Cathy to live our love, she would have been puzzled and disquieted, not sure whether or not I was suggesting that she and I should be together. Such love talk, like all love talk, would have been risky, exciting, and liable to misunderstanding. Don't we all remember how shrewd and suspicious we get — like detectives — when we are jealous? Explaining my motives clearly, as I actually did, killed the love and killed the thinking, and that should have been the last thing I wanted. I could have given Cathy the same courtesy I would give to anyone else, to acquaint her with her way of being in love, and her way of expressing it. I could have — but I didn't — allow her love, her honourable, worthy, and glorious love, to live, if only just a little. Conservative colleagues, and others, will object to my proposal that a psychiatrist should speak to patients this way — and I often

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have — and nervous professional bodies are always at risk of caving in to their objections. This baffles me because it is the psychiatrist's obvious job to acquaint the patient with every emotion — tasteful or distasteful, loving or hateful, discreet or indiscreet. In moments of self-doubt, I thought my critics might be right: that I owed my patients the truth — to tell them what might happen, and to always explain my actions and words. But this was plain, familiar, human cowardice. I'm filled with desire — to explain, to relieve the tensions of love and to be spared the pain of being hated, but that doesn't mean I should give in to my discomfort. Love includes hatred, hurt and resentment, and Cathy needed to understand her ways of being in love, especially her bad ways of being in love. I'd signed my letters "love." This had been careless. A statement of love doesn't prompt the ambiguity that leads to thinking. Thank God I was never stupid enough to give out hugs, or share my personal sorrows. Cathy could never have unburdened herself if I'd given her responsibility for my suffering. This is self-rebuke, but it also points to something else: a pressing question about how resolute I can be in hanging on to my professionalism. If surgeons don't back away from dangerous surgery, why should I flinch when I'm required to do dangerous psychiatric work? Kindness is important, but so is respect for the task at hand. Could my colleagues ever understand that "kindness" isn't always kind? Feb. n, 1984 Dear Dr. Warme, I was happy to finally hear from you today. Get braced for another long letter from me! I hope you like them. I must say I'm disappointed but the pain is not too bad. I didn't pin my whole life on your reply. That wouldn't be wise. I guessed your hesitating to reply was my answer, so I was prepared. I must say I admire

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your professional integrity very much. I also knew if you had to let me down you would do it gently and graciously and you did. I am grateful. My overall feeling, strangely enough, is one of happiness. Happy that you wrote; happy we are still good friends. Of course, there is a tinge of loneliness, but diat: will always be there. I am proud and privileged to know you and be your friend. I can't think that anyone who knows you as well as I do wouldn't love you. You are a rare human being. Next time you write, it's okay with me if you sign it "Lots of Love" again. Don't let me make you self-conscious. I will understand your love is friendship love and won't hope for more. I got an elastic ankle brace for my ankle and now I have virtually no trouble or pain from walking. I don't have to take pain pills for my ankle anymore. I'm hanging in there. I hate growing old and decrepit. My mind will always stay young though. I'm still happy to be living on my own. If I should die tomorrow, my life would be worthwhile (to me and I hope to a few friends and loved ones). I may not have accomplished much (in some people's eyes) but I have lived and loved much. I have suffered too, but hopefully I have gained from it. I have family and friends I love very much. God is good to me. Trouble only draws one closer to God. I have regrets, but not too many. I've not always chosen right but life is a learning process. I feel so full of life and so thankful for it. I think I'll close for now so diis will fit in the envelope. Love, Cathy

I'm pretty wonderful, it seems. The letter could be used as evidence that, yes, it had been good that I hadn't stirred things up. Cathy was cheerful, and said clearly how well she was doing. But I didn't like the letter. Cheerfulness was always Cathy's brave front, and since I was still her psychiatrist, I should have talked to her about it. A brave front is still only a front. Many patients put their psychiatrist on a pedestal, and it's often a problem. The problem is us: no matter how wise, experienced or well-

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trained we are, we react to idealization paradoxically. Intellectually, we don't believe our patients' statements about our grandness, but deep in our hearts, we're liable to believe what they tell us. Since almost all patients get better, at some level we feel they are right about us. It would have been easy to write to Cathy about this, but I didn't. I still can hear my own condescending rationale: She's too fragile; she needs the presence of the idealized object, the selfobject [horrible jargon].

We kid ourselves even more easily when it's a student who tells us how wonderful we are. Many years later — at that time I hadn't heard from her for many months — I got an email from my former student, Hanna Slendzinski, telling me she was doing well in Detroit. As soon as I knew the letter was from Hanna, my affection for her came back to life. Even though I hadn't thought of her recently, my heart was still ready to respond to her flattery; bits of arousal, longing and memory pulsed through my body. After our excited meeting at the Christmas party and in my office, Hanna returned to the seminar for a couple of months but, throughout that time, she and I knew she would soon leave for Detroit with her family. I tried not to look at her too much during the seminars, just as — I could read her mind, you see — she tried not to look at rne. But I had glimpses of her worried looks as she did mine. In her letter, Hanna expressed her gratitude for letting her attend my seminar. She did not say: "Will you, or will you not admit that you are a wicked person? Do you think I didn't know that you lusted after me?" Nor did she mention her husband. It was still four months until Christmas and yet, in September, she was sending me Christmas greetings, something that reminded us both of a Christmas party at which she and I shared a glass of wine and talked. Her email had an attachment

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Dear Dr. Warme, Merry Christmas! Happy New Year! I wish you to be full of sparkling energy And brilliant ideas, as always. Admired by your patients, students and colleagues. I wish the prosperity in your department and of the people under your control. Good luck in the New Year! Hanna Slendzinski

My beautiful, admiring student was, at that moment, a sparkling piece of my soul. She was not a trigger, a sample or a screen, she was it. I saw and tasted her in rny mind's eye: pink, pale and blonde. How unworthy it would have been of me to analyze and dissect her little poem. Of course she had to send me such a note — I was the teacher who'd introduced her to new ideas and to magic, a magic for which she had a talent. She was well behaved in her poem and addressed me by my professional title. A year before, she'd been naughty and firstnamed me when we were out of earshot of the younger students. Did she guess she still made my heart ache? Perhaps, I thought, I should write her a little note to remind her of our delirious moment: Dear Hanna, I'm very touched by your little poem. Many people come to my seminars, but only a handful understand the strange and important things that go on in that room. I hope your life is going well and that Xmas and the New Year will be happy for you and your family. I talked with Roman Borsch the other day and he says you come to Toronto once in a while, so if you are in town, you are always welcome to show up at the seminar. But you'd best check with me first because we meet in a different room. GW

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I'm the gold standard. Despite my claims of innocence and polite protestations, I'm like everyone else, sure that I know the right way to think about everything. There are a lot of ways to be a psychiatrist, but I maintain my way is the honourable and true way, and I heartily scorn the psychiatrists who think they can correct years of suffering by jiggling a few molecules or via six sessions of cognitive-behaviour therapy. My eager student, Dr. Leila Singh, was similarly sure her way was best when, on a cold January afternoon, she proudly told the group about that day's case. Not only did she report her observations and findings, she felt she had made an important psychiatric intervention. Leila's confidence surprised me, she had been working with our group for only a few months and was still trying to understand my idiosyncrasies. I also wasn't sure how, in just one hour with her patient, she could be so sure of what had been accomplished. "The patient, Albert Evans, is a 33-year-old white male, suffering from post-traumatic stress disorder," she began. Although nervous about being so direct, Dr. Singh had done her duty as she saw it, extracting from her depressed patient a promise that he would address the issue of his parents. From the ages of nine until 13, a schoolteacher had sexually abused Mr. Evans, a wrenching experience

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to which his parents had been oblivious. With the excited, earnest and vengeful encouragement of a support group, Mr. Evans had launched a lawsuit against die teacher, but to their chagrin, the group hadn't succeeded in persuading him his cure-by-vengeance required that he also confront his parents. And now, his conscientious young psychiatrist had persuaded him to do it. "He's still somewhat depressed," she said. Having paid attention to my comments about other depressed patients, Dr. Singh promptly identified the patients self-insulting talk about himself and assured me that Mr. Evans had progressed and improved: "He still thinks he is an inferior person and that he has wrecked his life, but he's much better." What could Dr. Singh mean? Better than he had been at the beginning of the one-hour interview with her? Had merely the prospect of telling off his parents, scolding them, been enough to transform him? And did she think she instinctively knew a correct way for Mr. Evans to react to parents who have committed as yet unspecified crimes? Who said noisy confrontations are the answer? The world is full of busybodies, do-gooders and tamperers, but how the hell did this get institutionalized into psychiatry? I was having trouble with my Sikh student. Dr. Singh was very earnest, as my colleague Anne Wigglesworth had warned me. Sikhs tend to be earnest, she'd said. One day I'd met Dr. Singh in the corridor with her very serious husband — hair done up religiously in a cloth with a baseball cap perched on it — and a rather too-fat and tooquerulous little boy, dressed like his father. The boy had enormous round eyes and turned away from all my attentions. My face was impassive as I listened to Dr. Singh tell her story. My student was a modern psychiatrist, and spoke with a hint of pride: "They tried to get him to challenge his parents, but he couldn't get up the nerve. I got him to agree to do it."

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Oh yes, honey, good for you. But do you mean you aren't aware — like I, your reptilian, would-be mentor — of every nuance of how you got him to agree to do it? What is it Mr. Evans's parents are to be challenged about? Can he — or his revenge group — seriously believe his parents should have read his fucking mind?

To tease Leila, someone in the group said laughingly, "No psychosexual history!" Two weeks before, I had poked fun at Janet Hunter for not obtaining a psychosexual history from Mrs. Paris, and after I'd demonstrated how to approach stories of love, romance and sex, Mrs. Paris's incest secret emerged. Admittedly, it's hard to extract a sexual history from a stranger, but shouldn't my students try their best to be frank about private things like sex and money? Mr. Evans had beguiled Leila into thinking the story of the teacher who had abused him was the only sexual story she needed. Before the patient arrived to be interviewed, my psychiatric team hoped that I would say a few words about diagnosis and therapeutics. But they knew me by then and were also half-hoping to hear something unexpected, something dinosaurian, perhaps concocted in my primitive hindbrain. And I wouldn't disappoint them. I certainly didn't plan to talk about dull facts or boring reality. Would Dr. Singh ever understand the stories patients tell represent their personal version of reality, and not an actual portrait of what happened? Robert Musil's Der Mann Ohne Eigenschaften [The Man Without Qualities], is a direct commentary on the shaky ground we stand on when we size up reality. When we think we've got it straight, someone else has an alternate view. The only way to stay sure of our ground — our reality — is to write off those who view things differently. That's why we all fall so easily into the external devil trap — the cure by hatred. Like many of us, Ulrich, the protagonist of Musil's novel,

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awoke to the vagueness of truth as a child. Might this passage from The Man Without Qualities wake Dr. Singh up? Would it shake her belief in clarity and, despite the risk, tempt her with the wooziness of the genuine reality: . . . in his essay on "Love of Country," Ulrich wrote that anyone who really loved his country should never think his own country the best. And then, in a flash that struck him as particularly beautiful, although he was more dazzled by its brilliance than able to see what was going on in the light of it, be had added to this suspect sentence a second, to the effect that even God probably preferred to speak of His world in the subjunctive of potentiality (hie dixerit quespiam — here it might be objected), for God makes the world and while doing so thinks that it could just as easily be some other way. He had been very proud of this sentence, but perhaps he had not expressed himself quite intelligibly, for it created a great stir, and he was almost expelled from the school.

"Justice will be done, it seems," I said. That, I thought, ought to be cryptic enough to get the little darlings thinking, suitably sweeping and sententious. A few nervous students wanted to distract from the drama of Mr. Evans's life by discussing the details of his symptoms, what drugs he was on. Why are these youngsters like squirrels, preoccupied by nut gathering? I guess they can't deal with bigger concepts, or anything fuzzy or provocative. I noticed a look on Christine Brydon's face, as though she wanted to vomit and, barely perceptibly, she was shaking her head. "Christine?" I said. "Nothing," she answered, but then paused. She'd once had the audacity to speak during one of my interviews, so maybe this time she was holding her tongue. But Christine couldn't help herself. "I just don't get why everyone thinks there is a quick cure for things," she said impatiently. "Like 'expressing your feelings' and 'owning your feelings'

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and stuff like that. I don't get why this is going on here in psychiatry. Mr. Evans wasn't given a chance to look inward." Christine was my ally, but didn't yet know that if people aren't interested in looking inward, there's no use arguing with them. I thought to myself that once she'd had a couple of divorces, or watched politicians on television for 20 years, she'd understand that the inward look isn't popular. I was looking forward to working full-time with Christine when she came to the Psychotherapy Centre in July, but I also saw what I'd be up against: the same youthful impatience I hadn't fully overcome in myself, and her systematic doubt about everything. Christine was the opposite of Leila Singh, who believed in verifiable diseases, and of Osman Awad and Dr. No-name, each of whom had dependable psychological theories in which he believed. Christine may not want to believe in anything at all, I thought to myself. She'd be tricky to deal with, because skepticism is a commitment that's just as silly and just as easy to defend as realism. Samuel Johnson's famous argument against Bishop Berkeley on behalf of reality was that reality is obvious: "I refute it thus," he said, and kicked a stone, hard. Arguing that something is "obvious" is convincing until we consider that Hitler thought he knew something that was obvious: there was a Jewish conspiracy. Kicking a stone refutes skepticism, and the obviousness of reality is refuted by our species' endless disagreements. The belief in finger-thumb reality — raw feel — is just as silly as skepticism. With their chatter and their questions, the students were trying to distract me from the true way, a tactic I neutralized with a barely discernible smile, and a twinkle in my eye, tenderly ironic and, simultaneously, a barbed rebuke. How could I know they'd picked up my signals? Because, despite my impassivity, my attitudes ooze from every pore in my body, and, like all humans, my students are geniuses at picking up the odors I give off.

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I'd long given up logical explanations and challenges. By the winter of 1997, I had become a performer; I taught my students using the theatre of real, blood-and-guts life. This showmanship can't be easily emulated, but a small handful of students will be inspired. I'd delivered my cryptic overture, the comment about justice, and now the opera itself could begin. Mr. Evans was ushered in.

Mr. Evans was about 30; a factory worker, handsome and well spoken. His face was drawn and his shoulders drooped. He looked depressed, but it was immediately apparent he was more than merely well spoken; in fact his grammar and vocabulary were almost classy. I had the snobbish thought that a factory worker shouldn't speak this way, that I would have to tease this apart. A slightly pompous tone would serve — perhaps touched with irony. "The problem," I said, "is whether justice will prevail." Actually, justice didn't have much to do with it. It was more like righteous bio-anger, with Mr. Evans inflating himself to make a display against the neglectful parents and the transgressing teacher. I wasn't just saying words, because my manner and tone were evocative and provoked thinking. Hunched in my chair, slit-eyes trained on him, my intensity suggested it was now time for soul-searching. There was also a trace of humour in my manner. I am, after all, a new incarnation of the fool, like Lear's fool, or one of the other great fools of literature who see the truths to which others are blind. I don't wear the modern costume of the psychiatric fool — the psychoanalyst's suit and beard — because I'm an old hand and can create the right atmosphere with my eyes. Nor do I wear a wizard's hat, a white coat, or the traditional cap and bells. But secretly, hidden among my grandchildren's toys, I have a traditional fool's bauble, a hook-nosed jester toy.

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Mr. Evans's head was turned to one side and he looked at me out of the corner of his eye: sly, puzzled, suspicious, and fascinated. The interview was just 30 seconds old, but he was ready to play the psychiatric game. He, too, had no need for a special costume. Not for him, the "headgear of a madman" fancied by Odysseus when he feigned madness. Mr. Evans knew the modern cultural imperative: he presented himself as "sick." I felt the queer delight of knowing he and I were immersed in a cultural ritual, during which he would grant me the power to influence him, and ultimately reveal secret, uncanny aspects of himself. Mr. Evans looked at me, puzzled, in response to my remark about justice. "You've become a blue collar worker so no one will get hurt because you're an intellectual. It wouldn't be 'justice' if you were the only one." I didn't intend to speak for Mr. Evans, but I knew because I'd done the reverse in my own life; I made myself intellectual to hide that I'm German, an industrious worker, well-armed to battle those who want to give me a hard time because I'm German. I'd moved close to Mr. Evans's soul and as expected, he hesitated. He wasn't fully ready yet to take off his mask. "What do you mean?" "You don't hide your intelligence as much as you think: your grammar and vocabulary give you away. I've heard from Dr. Singh that your parents are uneducated people, which means that you've tried out being sophisticated outside of your family." Privately, I wondered whether the abusive teacher had loved Mr. Evans because of his mind, and perhaps even had inspired him. Already I could sense my own, developing affection — my love — for Mr. Evans, and how I was feeling determined to be his teacher and his inspiration. "I'm a reader," Mr. Evans said. "But what's this got to do with my depression? I've been depressed for years and I need help. My doctor has

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tried all kinds of drugs, but I hate taking drugs so he sent me here." "Being a reader might be connected to your depression and something I read the other day may help us out. The book woke me up to something about Zeus's attitude toward justice." Having said this, I knew that the watching students were excitedly anticipating what would happen next: "Warme's about to go nuts again." Mr. Evans probably shared their thoughts, and in a way so did I. I relished watching myself watch others watching me. Being in a heroic role is fun, of course, but more important, it's a way of seeing how the patient and students react when faced with the image of a powerful doctor. Despite his curiosity about my talking approach, Mr. Evans wasn't yet sure he wanted to play this game. "I don't know what Zeus has to do with it. I've done everything the doctors told me, and nothing helped. I took drugs and was in a support group. I did what the group told me, too. Dr. Singh convinced me I ought to confront my parents, but I'm still depressed. I can't waste time talking about Zeus." Mr. Evans looked as though he wanted to talk about his difficulties, but his words were self-protective. Was this just a token reluctance to talk, or was he warning me that he wouldn't tolerate certain subjects? I suspected he wanted an inspiring doctor and not just symptom treatment. I expect most secret readers like Mr. Evans want to hear about the life-shaping myths of ancient Greece. My students needed an inspiring teacher, too, so I had to be careful not to talk too much about my doubts. But I was also tempted to get into unnecessary intellectual talk, to seduce him with parallels between him and two other self-insulting depressives, Hamlet and Achilles. Best to stick with my original plan. Besides, Zeus's attitude toward justice seemed, for the moment, more pertinent.

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"The ancient Greek heroes had a great interest in justice," I said. "That's why they were so busy slaying monsters, deposing tyrants, and saving maidens in distress. Your support group and Dr. Singh have helped you to become more of a heroic person, to stand up for what is just. Once the legal proceedings against your teacher are done, and you've told your parents what you think of them, your ordeal will be over and you can start living your life." Does life begin tomorrow? At some hoped-for time when wickedness has been corrected, goals have been achieved, and love has been found? Or does life happen this very minute, between the ticks of a clock? Did Mr. Evans see that I was nudging him into thinking about whether his life would change after he'd achieved his vengeance? Maybe I should nudge him again, see whether he wanted to think some more, or whether he was determined to hang on to his idea he has to have justice. "Zeus wasn't so sure about his monster-slaying heroes, you know. He got rid of that early breed of heroes in the Trojan War. That's why there was a Trojan war; Zeus had decided the ancient heroes were out of date, and had most of them die in the war. Ancient heroes like Perseus and Jason ended up being just as bad as the monsters they killed. Perseus, for example, turned everyone to stone by showing them Medusa's head, just as Medusa had turned to stone everyone who looked at her. He became the same monster as the monster he had killed. The only heroes who survived the Trojan War were of a new breed. Like Odysseus, the man of twists and turns, who was a thinking hero and didn't himself become a monster." Mr. Evans looked at me slyly. Because Dr. Singh had been so fixated on the subject in her report to the class, I'd expected the patient to be blindly fixated on revenge. Instead, he seemed interested in thinking. And he'd said nothing to me about the abuse he'd suffered. "My father is so stupid," he said. "He walked into the door of his

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car yesterday and I had to take him to the hospital. On the way, I got a ticket for speeding." "You aren't as vengeful as you let on, Mr. Evans," I told him. "You're careful to hide your intellectual superiority to your parents; I guess you don't want to show them up. ['Nay, my lord, I am too much i' the sun.'] Like Odysseus — the wily trickster' they called him — you adapt and figure things out. You read and learn, and don't show off the way I do with my talk of Homer and The Iliad. And when your father acts foolish, you make sure you suffer, too. He damages his head and, to make sure there's justice, you damage your pocketbook by getting a speeding ticket. You're an honourable man and want fair play. If father loses, you have to lose." "My mother is no fool," said Mr. Evans. "Her brother was an actor and she almost became an actor herself. She's the one who encouraged me to read. She wanted rne to be an actor. After high school, before I started working, I wrote a play." Mr. Evans had only contradicted my "fool" comment with regard to his mother. He and his mother, it seemed, were intellectual soulmates, while his father was excluded. Did this secretly intellectual twosome scorn the father? Was Mr. Evan's identification with his mother troubling him and did their world of art and intellect suggest to him that he was a sissy — a sissy who messed around with a male teacher? Was that why having vengeance on the teacher was so necessary? After all, misanthropes like me aren't as horrified by such things as Mr. Evans was; we're liable to recognize the existence of the neighbourhood dirty old man as a familiar character in the life of many boys. "What's this got to do with my depression?" he asked. "Your depression looks as though it's cured, isn't it? You aren't acting depressed right this minute. Perhaps, now that your abuser is about to get his legal comeuppance, there is no reason to be depressed. Just as the slaying of Medusa by Perseus and the Minotaur

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by Jason, were occasions of joy." I didn't say this to him, but it was also clear by now that the depressive demeanor Mr. Evans had displayed when he entered the room had vanished, just as it had when he talked to Dr. Singh. On the contrary, the patient had become animated and alert, caught up in our vivacious talk. I may also have become a brand new father in his life, someone who momentarily solved the problem of weak fathers. At that instant, there was no need for Mr. Evans to present himself as depressed and inferior — impotent, self-insulting, pathetic — because I seemed to be intact and competent. "Why are you telling me this?" he asked. "Isn't this what's been burning inside you? Haven't we zeroed in on what matters?" Mr. Evans smiled and sighed, then slowly put his face in his hands. "Will we have a chance to talk about this again?" "Yes, of course. You've met a heroic seer and you have to talk to me again. I think your world is full of heroes and monsters, so God help us if I or the therapist we'll find for you should stumble; you'll have to stumble, too." The poor devil didn't know yet that the monster and the hero always turn out to be the same person. My students might have been appalled to see me make a "transference interpretation" so quickly, that is, the interpretation that in Mr. Evans's mind I had already become his vulnerable father. The books will have taught them that it's tricky to make transference interpretations early on in the therapy, that such conclusions shouldn't be reached until after several weeks or months of treatment. I never explicitly suggested that, as an ardent avenger, Mr. Evans was also turning himself into a monster, although I hinted at it in my use of mythology. I'm not saying Mr. Evans shouldn't have pursued legal redress; it's just that self-cure by hatred is a worrisome proposition. Like

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most people, Mr. Evans felt better when he had monsters to hate — bad parents and sexual abusers. He also caught on quickly when I used allusive language. If he entered treatment, I thought, Mr. Evans would tire of allusions and ask to be taken literally. "Why don't you take what I say at face value? Why do you treat everything as a metaphor? Don't you ever give a straight answer?" he will say to his therapist. Mr. Evans knew only too well I was opening his wounds, exposing the unsavoury and the glorious, and he wanted no part of it. Strangely, it's often the glory that gives most people trouble. That shouldn't be a surprise since most people devote a lot of energy to thwarting their own potential: pain and self-defeating behaviour provide perfect antidotes to success.

The interview was over, but I remembered Mr. Evans told me he'd written a play, and I hadn't asked what it had been about. What had I not wanted to know? My students hadn't noticed, even though two weeks earlier I had warned them to pursue all references to plays, art and creative adventures. I didn't want to give the students a chance to ask questions, and I'd started to leave, when I remembered I first had to speak briefly to Osman Awad about an unrelated matter. A patient he'd assessed with the group had left me a voice-mail message asking why a therapist hadn't yet been assigned to her, but her name hadn't registered with me. "Which patient was Mrs. Howard?" I asked Osman. "She phoned and I need to respond to her questions intelligently." Out of the corner of my eye, I noticed Dr. Singh, flirting and giggling with Dr. No-name, straightening his tie, then peeking over to see if I had seen what was going on. When she'd come in that day, I had been joking with Hanna Slendzinski, and Leila had noticed. I had the

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improper thought that Leila was getting too westernized and her husband had best send her back to India quickly.

Another scene involving doctors, students and a patient: St. Joseph's Hospital in Toronto, 8:10 a.m., July 28, 1932,. It's my past sticking its nose into my life again, and it seems that, even then, I was onstage. My psychiatric colleagues and I have to pay closer attention than most to such unannounced recollections: if we don't, we won't do our work properly. My mother is in labour, about to give birth to me. Above the delivery room is a gallery for medical students to sit and watch, a gang of students whose ghosts are liable to creep out into the audience who are watching me interview Mr. Evans. They're nervous and, like my students, eagerly anticipate the start of the show. What in the name of God is going to happen now? Mutti, my mother, has her legs spread wide, in stirrups. The doctor has his left knee braced against her hip. "Push, push," he says. He is flooded by the fumes of life, a hot smell: shit, sweat, amniotic fluid. Every madman struts the psychiatric stage following the same stage directions as did his forebears. The well of the past holds countless medical fathers who anticipated my psychiatric drama with Mr. Evans. Life is a pattern, a cultural celebration of sameness, a cliche. But it's also, always, brand-new.

On his deathbed, Augustus Caesar asked if he had acted the play of life properly. Like Shakespeare, the great Greek poet Palladas of Alexandria saw that all the world's a stage, and that man must learn to put aside his seriousness and play lest he get stuck experiencing only the pains of existence. If we ever fully understood that everything is a

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performance, there'd be a fabulous payoff: there'd never be any reason to be enraged, or to hate and judge. But we'd lose something, too. If everything is play and role-playing — which it is — there'd be no passion and love, nor any reason to stand resolutely against tyranny and evil. Still, we shouldn't give up our smiling awareness of life as performance art too quickly. Earnestness is a problem, and has a nasty grip on my soul. Whenever I hear the word earnest, my brother Ernest's name and his tragic story sounds for me — like the "ping!" of the sonar in an old submarine movie. Dr. Singh sets off my sonar when she speaks of Mr. Evans in the currently fashionable psychiatric language: he is just the place where a post-traumatic stress disorder happens to strike — he has nothing to do with it. Whenever I take myself too seriously, I cure myself by recognizing that, like everyone else, I'm my own piece of madness and performance. If I'm as narcissistic as the next person, I'm saved by knowing that life is a farce, a performance, a mad party. My self-centredness is no surprise. I'm an eldest child, a quick replacement for an older brother also named Gordon, who died at about the time I was conceived. His memory was so obliterated that my parents don't remember where he was buried, but having the same name made me his thoroughgoing reincarnation. My adventuresome life has been a double life: one for him and one for me. When I was four, my mother and I went to Germany and stayed with my father's family. It was 1935 and times were bad in Canada compared to Germany, where the economy was supposedly booming. When my father had earned enough money, he was to join us. At the time, my parents thought the Nazi government was temporary — things would change. I was the centre of the universe: I had my mother to myself while my grandparents, who hadn't seen my father, their only child, for seven years, doted on me. But these glory days didn't last. The madness of 1935 Germany couldn't be treated as temporary theatre

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forever, and we soon moved back to Canada. "They've all gone crazy," my mother said at the time. When I was five, I was shocked by the birth of my brother Ernie. In my personal version of the world, I was the blonde-haired king of the Aryan universe, the primary male. So why did Ernie have dark hair like my father? My brother Rudi and sister Gretel came later, when I was 13 and 14, events that seemed to make sense. Both were blonde like me, and though I was a scornful young teenager, I had the magic thought that I was their father. That dangerous way of staging my life eventually coloured the dynamics of my whole family. To this day, my younger siblings treat me as a father.

September 14, 1939, Lindsay, Ontario. Canada had declared war on Germany a few days earlier and that morning, at 4 a.m., the RCMP knocked at our door and arrested my father. My father had been fired the day Canada declared war and many of our possessions were already packed, ready for a move to Toronto, where jobs might be available. Then came the roundup of German men living in Canada. My father was interned for three years in secretly located camps — which later proved to have been in Fredericton, Kananaskis, Fort Henry and Petawawa. I was seven years old at the time, and confused because the Mo unties were in plain clothes. My mother told me not to worry, these men were the police, but it quickly became clear that these police were not our friends. With crowbars, they tore apart the floor and our wooden boxes of packed possessions. By 6 a.m., it had turned into a beautiful summer day; die sun shone, and the kids in the neighbourhood could see what was going on. But we were bad Germans and to prove it, my father sat in a police car in

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front of the house. The pretty girl who lived across the street, and with whom I had just yesterday shared body secrets, now saw new, more shameful, secrets. It was shame, shame, shame — except I didn't know what I was supposed to be ashamed of. I knew a war had started, that Canadians and Germans were now enemies, b u t . . . so what? Germans didn't seem bad to me and Canadians didn't seem to be bad either. Still, I knew I ought to be ashamed and that from now on, being German was a secret. It was time to become an actor. I became German with my family and Canadian with Canadians. I remember, a few months later, explicitly thinking to myself, "My English is perfect." Without knowing what it was, I decided my grammar was better than that of most classmates, confirmed by my good marks in school. My performance was flawless. Perfect. Perfect is a word used by Ernie, who, 25 years ago, had a major, disabling stroke. His speech is grossly impaired and in his search for words he uses perfect to mean anything good, complete or superior. As a child at home, I also tried to live up to these words. I was a good German child: clean, tidy, obedient and industrious. To this day, my table napkin, like the napkin of every true German, is unsoiled at the end of a meal. Perfect. The young dissimulator — actor, performer, artist, was not a shrewd manipulator. I became, from the bottom of my heart and to the depths of my soul, both a German and a Canadian. The secret, internal sentimentalist who lives inside me, weeps for Germany as easily as he weeps for Canada. And my double life helps me be a good psychiatrist. I'm strangely liberal about how my patients live their lives. No matter how unexpected, provocative or unconventional they are, I see this only as their uniqueness, something blindingly obvious

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once it's been noticed. I won't pathologize my patients, a boon when trying to understand another person's world, but awkward when the world of psychiatry asks me for diagnoses, wants me to "normalize" patients or to eagerly try to change people. Change in what direction? Do they really believe I know the right way to live someone else's life? This puts my high liberalism to the test. With my colleagues — the fathers — I'm no longer liberal. Of them, I demand wisdom, intellectual rigour, freedom from cliche. Do they expect me to be an engineer of human souls? The Canadian authorities, the German authorities and the psychiatric authorities had better not misbehave around me. No wonder I'm enthralled by my work, even if my profession is currently uneasy about my way of doing things. For the time being, and despite my unpopular methods, I'm happy to be who I am, in much the same way that being who he is enthralls the madman. Whether it's depressive misery, the bizarre craziness of the schizophrenic, or the terrified anxiety of the phobic, in each case a role has been passionately claimed, along with its attendant suffering. If our judgments about abnormality are weakened, everyone ends up in the same boat: tyrants, derelicts, psychiatrists and solid citizens are all strongly invested in the self they have designed for themselves. Tennis champions, criminals, geniuses and fools ardently pursue their roles, as do madmen or King Lear. In the modern world, the custom is not to say our destiny is in the hands of the gods — we say it's in our own characters. When we occasionally believe in planetary influences, in past lives or faulty genes, we are only doing what people have always done — temporarily disclaiming agency over our own lives. Except in psychiatry. Nowadays, my wrongheaded colleagues are sure that people's lives are caused, and that very soon those causes will be identified. What I demand of my students and my peers is that they be philosophically sophisticated. If they aren't, how can they presume to attend to another person's soul? I expect them to read

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Wittgenstein and Hume — or somebody else whose ideas matter. In his Tmctatus Philosophicus Wittgenstein speaks bluntly about causality as a scaffold, useful for certain purposes, but never to be mistaken for substantial truth: Belief in the causal nexus is superstition. (1.1361)

But surely, you might reply, no one "chooses" to suffer? It often seems the whole world thinks painful ways of life are afflictions; that suicide, gambling, drug abuse and business failures can be caused by faulty genes, bad parents or unfair social conditions. For 50 years, psychiatry was psychological: people were thought to be engineers of their own lives. Today things are different. I am the anomaly, even to the psychoanalysts who once spearheaded the idea that our lives are self-designed. Despite changing times, I insist the most profitable and elegant way of understanding people is by understanding they have a strong hand in how their lives go. Free will doesn't tell the truth about human beings. It's only a practical method for understanding some aspects of the world — people — but valueless for understanding chemistry. Causality is also a practical method, useful in technology and Newtonian physics. Fairies and praying to God have uses, too — spiritual uses. In other words, we should think of ourselves as having a will — as designing our own lives — not because it is verifiably true, but because there is a payoff. One of the payoffs for me is that my enemies' attempts to see people as sick and inferior are weakened. If I say our patients choose their way of life, it's easy to slip into unfair moral judgments, but I sidestep such judgments by sticking to an existential "doing": it's what our patients do. I underplay the word "choosing," thereby avoiding implications of behaviour being good or bad. Analytic philosophers disown me because I won't grab onto

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underlying structures, while the existentialists disown me because I don't celebrate choice and freedom. My attitude makes me an outsider. Just the same, I relish it. "Not fit for human company," I say. This doesn't mean I've failed or succeeded at the demands of my job; it only means I've chosen an odd role that suits me, consciously and unconsciously. It no doubt has to do with my history of being an outsider, a German, but it involves plenty of other things, too. As a child, I was the ultimate insider and now, out of a sense of justice (would it have been fair had I been the specially loved insider forever?), I must be the outsider. To put it another way, I have a libidinal investment in the self that I've designed for myself — which only means that I'm like everyone else, a reassuring thought for me and for everyone who experiments with identifying with the whole world. While soothing, the notion of universal narcissism, that everyone loves his own way of life, gets me into trouble with my colleagues who, almost universally, think of narcissism as sick or pathological. At best, they are being silly; at worst, they are judgmental and moralistic. My weird ways are shocking to the colleagues who want the safe, calming language of disease, treatment and diagnosis. Cowardice drives them to invent a biological mythology propped up by fake research that always yields the same conclusions: most patients get better whatever the treatment. I tell my friends they should keep their fingers crossed for their patients; any officially approved action will work just fine. Their preoccupation with imaginary diseases helps them evade the psychological insights of people like Homer, Shakespeare or Thomas Mann. Like bloodletting, phrenology and the antidepressive regime, their methods will fade; Shakespeare will still be studied 500 years from now.

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CHAPTER^ELEVEII

THERE'S Horninc LIKE A GOOD ARGVIXIEIIT

I'm not easy on my students. Jim Forster — he had been Dr. No-name until Janet filled me in on his name just before his first assessment — did his interview having just heard some special news about that day's case: like Jim Forster himself, the patient was a psychiatric resident. When he phoned the clinic, Dr. Long probably thought he was making an appointment with me, but when the secretary scheduled him to be seen by a student, he didn't object. I'd guessed Jim would be a nervous wreck about interviewing a colleague, but I'd quietly told him to go ahead with it. Wasn't Jim a doctor? Shouldn't he be ready to take on any patient that comes his way? As soon as I came into the conference room, Jim breathlessly began. "He's a resident over at St. Mike's. I've never met him, but he's in my year." "A/ res. " The other students weren't sure they'd heard correctly. "Do you mean he's one of the psychiatric residents? How come he's being seen here in the clinic?" Propriety dictated I should explain. "I expect there has been a mixup," I should have said, or, just as bland and inoffensive, "I didn't know who was coming today until the secretary told me." I ought also

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to have offered words of comfort: "I presume Dr. Long has his reasons for coming through the clinic. Perhaps he doesn't want special privileges and has decided that he shouldn't get to have an appointment with me any other way." But in the treacherous waters of teaching psychiatry to young doctors, I couldn't fall back on propriety. I was dieir role model and wanted it clear they didn't need to be calmed, nor did I need to calm them. Out of respect, I should leave them alone with their objections and bewilderment. The enigmatic psychiatrist is honour-bound to be politely inscrutable. Someday a few of the students, all by themselves, would figure out the meaning of Wotan's words in Siegfried. Wen ich Hebe, lass ich fur sich gewahren; Er steh' oder fall', sein Herr ist er, . . Whomever I love, I leave to find his own way; Stand or fall, he is his own master . . .

"This doctor's name is David Long," I said. "If any of you know him, you should excuse yourselves." No one spoke up. "No one? Okay, Jim, why don't you tell us about him?" "David is a 4O-year-old student of psychiatry. He states there is nothing wrong with him, and that he just wants to get into psychoanalysis to make himself into a better psychiatrist. When I questioned him more closely, he was a bit puzzled. He seemed to think it was very ordinary for him to be without symptoms. I tried to explain to him that everyone has troubles, but David was insistent that he was looking for a 'learning experience.'" "David?" I thought to myself. How come the first name? Haven't I taken pains to address patients by their tides, to honour them with the proper honourific? Occasionally, when in a bad mood, I'd even lectured

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the students about this. Todays patient is Dr. Long, isn't it? But now that I'd thought of it, when I'd asked anyone in the group who knew him to excuse themselves, I used his first and last names, but not his title. "He says he's met you, Dr. Warme. When he was a medical student in the 19805 he spent a summer at the Menninger Clinic and you were both at some meeting and he talked to you. Before coming here to be a resident, he worked as a family doctor for 12 years. Actually, he worked at the Lakehead Psychiatric Hospital in Thunder Bay. They have hardly any psychiatrists, so although he was technically just a family doctor, he did the work of a psychiatrist. So he's had a lot more experience than most residents. He came to Toronto because he wants training, and he's also thinking of getting into psychoanalytic training. He's here because he wants to get into analysis with you. "David was born in Hungary, but came to Canada when he was four years old. His mother tongue was German and one of the reasons his family emigrated was that they couldn't pursue a German-language life in Budapest. The family believed Germans were culturally and intellectually refined people, and that Hungarians were less sophisticated, I've always seen Hungarians as pretty sophisticated people, so I asked him about this. It seems that Dr. Long's mother was from a 'low-class' Hungarian-speaking family and his father had influenced her to learn German and to live a more urbane life. He'd even persuaded her to go to university after they married. "This strikes me as peculiar — I don't think many people in Hungary speak German anymore — but Dr. Long insists it's true. He also said that by marrying a literature student he made sure he wouldn't end up in the same boat as his father. Dr. Long's wife is a teaching assistant at the university and her big interest is Roman history and artifacts. Dr. Long is interested in English literature, especially Shakespeare. He likes psychoanalysis because of its literary and mythological elements.

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"As he was growing up, he realized his father's project of training his mother to be sophisticated had been a failure. He saw that, in many little ways, his mother had not escaped her lower-class background. This was especially obvious in her cooking: too much Bauernteller (farmer's plate) and Wurst. She also often left the bathroom door ajar while using the toilet, and walked around the house wearing only her underwear. He admired his father for not complaining, but he sometimes noticed the barely disguised disgust on his fathers face. Dr. Long's wife is not at all like his mother. She had some rough edges when he married her, he says, but he has shown her how to act. She learned quickly. "He and his wife get along very well. As far as he can tell, their marriage is pretty well perfect. The only problem they have is his inlaws, who are noisy and intrude on their life more than he'd like. "Dr. Long's father saw to it that he went to Upper Canada College, and when it was time to go to university, chose Trinity College. That's where he met his wife, and knew right away that she was the girl for him. She had a peaches-and-cream complexion and didn't wear sloppy jeans and sneakers. Getting married was a relief, he was feeling increasingly impatient living in the same house as his mother. He knew it was silly, but he had the feeling she had a smell. "I thought he had given me the opening I was waiting for, so I asked him whether it troubled him that he reacted this way to his mother. He flatly denied any cause for concern. "He tries to read a bit of Shakespeare every night, and often reads Greek mythology as well. He's a bit puzzled that his wife would have an interest in Roman artifacts and Roman emperors, complaining the Romans were boors while the ancient Greeks were more refined. He compared it to German Jews and the Jews of Eastern Europe. He thinks the German ones were classier. Dr. Long knows he's a snob but, just the same, he's definite about enjoying being an Anglican and a doctor who

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doesn't often have to deal with bad smells and low-class people. "I asked him whether his patients didn't come from many different social strata, and he agreed that they did. But he aims to be a psychoanalyst and expects his future patients will be more sophisticated than they would be in a general psychiatric practice." "I asked him whether he thought it strange to come to a public clinic, especially since he likes refinement and might prefer to see Dr. Warme privately? "To my amazement," said Jim, "he was well aware of this. He says he kind of thought it would be a great adventure to come through the clinic. It didn't seem to matter to him who he saw, because an assessment is just an administrative procedure so he can get into analysis. There's nothing wrong with him anyway, he said. At this point, Dr. Long suddenly changed the subject and started talking about how he likes Jewish delis, especially if they are 'joints.' He can be quite reflective, even if he is so unwilling to think about troubles in himself. For example, he quickly connected going to delis to coming to the public clinic. He says he would never go to a classy Middle-Eastern restaurant, and when he goes to Shopsy's or Bagel World, he often eats sausage even though he doesn't like it if his mother cooks it. To him, Jewish sausage is great, but a German sausage doesn't make sense. "He didn't want to accept that there was anything interesting in his food complaints, yet he kept coming back to them. When I asked about him coming to the clinic, he'd changed the subject, sort of midsentence, back to food. For the life of me, I couldn't get him to admit to any 'problem' he needed help with. "Oh, yes. Another thing. He's very athletic. He plays hockey and works out all the time."

Now it was my turn. But first the students had their obligatory ritual

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commentary to make. Osman Awad spoke first. "If his mother was so dependent on the father, was she able to respond to Dr. Long sympathetically when he was a child?" The question surprised me coming from Osman, a budding theoretician who didn't usually play the empathy card. It sounded as though he was teasing me by not saying it directly and, instead, using the euphemism "sympathy," perhaps not realizing it was actually the better word for what he was driving at. Other students also spoke up; I listened without comment. "Was he separated from his parents at any time?" "Has anyone else in the family ever had a psychiatric illness?" "I wonder if he felt sorry for his mother because his father patronized her?" There was nothing wrong with these comments, still they bothered me. The students hadn't yet developed the confidence to speak of their young patient/colleague's flashes of madness, madness not in the sense of sickness, but in the sense of uniqueness-as-a-human-being. Hadn't they recognized what a wonderful melange of ambivalence Dr. Long was? It seemed like they wanted to avoid his craziness by retreating into speculation and theory. When Dr. Long insisted he was perfectly okay and wanted only a learning experience from us, he clearly hadn't yet realized that madness is universal and that, in principle, all of us are in the same boat. But his words proved wiser than his soul. Like all the young doctors, Dr. Long thought he was okay, that it was just patients who suffered from pathological afflictions. But the behaviour of residents often contradicts what they think they believe. Psychiatric students, including Dr. Long, enthusiastically use psychiatric labels when they gossip about one another and their teachers, letting slip their recognition that madness can be found everywhere. Privately, they anxiously ask themselves, "Do I have an obsessional neurosis, a panic disorder, a depressive illness, a borderline personality?"

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I was struck by Dr. Long's feeling that his interview with Dr. Forster was simply an administrative matter. Surely, being interviewed by a psychiatrist is one of the most personal experiences imaginable? Or was he like those business-school graduates who have recently been showing up in hospitals and who think that everything can be neatly solved by ticking off boxes. When these people knock on my door, they are baffled when I tell them one must never knock on doors in a psychiatric hospital. "But I needed to talk to you," said one such befuddled administrator. Who is it that doesn't understand the sanctity of the psychiatrist's lair, or, better put, the privacy we owe our patients? When I was a psychiatric student at the Menninger Clinic, we all knew these things. Every year, Margaret Mead would visit Topeka for a few weeks and frequently mentioned her fascination with the psychological attitude that pervaded every nook and cranny of that institution. "Even the cafeteria staff talk to the patients with psychological awareness," she told our seminar group. I had another story to contribute to her collection. "Dr. Mead," I told her. "I've been given the assignment of meeting with the maintenance staff weekly to 'supervise' them. The idea is that a lot of the adolescent patients go to the boiler room to smoke and end up telling their troubles to the staff. My chief told me I should meet with the janitors and boiler-room people once a week and get them to tell me what goes on with these patients — to give them supervision so they can respond helpfully to the youngsters. It was the same supervision we residents get — meeting weekly to present clinical material to a teacher." These days, the business-school types wouldn't understand such a story, and Dr. Long had presented himself to us as though he was the same. To them, everything is a matter of facilitating, streamlining and

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efficiency. They've forgotten the most important medical nutriment around: the soul-sustaining value of personal talk.

It was time to get back to work. "Could you ask Dr. Long to come in please?" He was a fine-looking young man; not tall, but his large, pleasing head was covered with curls and he offered me a polite, red-lipped smile. He wore chinos, running shoes, white athletic socks and a light windbreaker, even though it was a cold spring day, and even though he was a doctor. Instead of a shirt, he had on a green operating-room top with a sleeve stamped, "Property of St. Michael's Hospital." Dr. Long's running shoes had orange bits on them; the Nike logo, one eyelet on each shoe, and a tab at the back of the heel all featured a bright version of that cheerful colour, lending the shoes a jaunty air. "Good morning, Dr. Warme," he said. I offered in return a tiny fragment of melodrama: I looked at him intently, and stayed silent a shade longer than expected. Had I read these words of concert pianist Sviatoslav Richter 30 years earlier, it wouldn't have helped me, nor would Richter, a few decades before he'd said them, have understood his own words. Paying attention to patients and to audiences instructs us in, he insisted: . . . a dangerous stratagem that would almost certainly not work for others but that has rendered me sterling service. I come out onto the stage. I sit down, and I don't move a muscle. I create the sense of emptiness within myself, arid in my head I count up to 30, very slowly. This causes panic in the audience: "What's happening? Is he ill?" Then, and only then, I play the G. In this way, the note sounds totally unexpected, but in an intentional way.

"I hear that you are a lover of Shakespeare," I told Dr. Long.

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"You're not Othello, I wouldn't think — black, mysterious, foreign. You must be one of the native Venetians, probably the honourable Cassio. Would Cassio be a better version of you if he were Greek?" This got him thinking, all right; he looked at me as though I was out of my mind. He probably expected me to ask about symptoms, about his personal history and complaints. Although I had momentarily captured him with my eyes, Dr. Long quickly shifted his attention to the watching students. Young doctors, as they progress through their training, are interviewed many times, so Dr. Long was already an expert. But on this day, as I'd intended, he was stumped. He didn't even smile knowingly at my oblique, literary reference to one of his character traits. Perhaps his reading of literature and of Shakespeare was less artistic than I had thought. Did he read just to collect facts and information, to arm himself against the world? Didn't he understand literature is about real life and about him? "What do you mean?" he asked. I paused again, but was careful not to leave it so long it would have made him nervous. Just long enough to keep him puzzled and thinking, and not just focusing on facts. I was more aware than usual of my interviewing strategies, unusual because I've interviewed in front of audiences for 35 years and have had many students as patients. Why, then, would I be so hyperalert? Was it because Dr. Long was a classmate of some of my students? But I suspected it was something about Dr. Long himself I was worrying about. I knew it was important for him that his belief in the sublime — sublime gentility, sublime "Greekness" — should not be questioned and that I'd have to be careful how far I pushed him. I also knew I'd have to avoid giving in to a habit of mine, badly timed teasing. He wasn't in the mood for humour. "This is silly. I don't understand what you're driving at." "I guess I'm talking about a whole world of things you'd rather skate around: Hungarian-ness, Wurst, and Romans. And I have a hunch that

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you don't like madness and weirdness, either, especially when they show up in you." Dr. Long didn't look as though he understood. He was annoyed and didn't speak right away. I'll give him a few minutes, I thought to myself. He was reflective when he talked about coming to the public clinic, and his mixed-up reactions to Hungarian and German sausage, about Eastern European and German Jews. "I was hoping we would talk about my psychology a bit. I'm not sure why you're mentioning things like sausage and Romans. Those are just habits of mine and you act as though it's some big deal." Here, I thought, was an opportunity to illustrate an important examinational principle. If a patient has a painful abdomen, I must palpate it — examine the abdomen with my hands — even though it's tender. Similarly, when a patient flees from self-awareness, I have to screw up my courage and talk about his actions, even if he is hesitant. What I forgot was that, for each slogan (and the injunction to palpate a tender abdomen is a slogan) there is an equal and opposite slogan. In this case, the opposite truth is Pogo's (Walt Kelly's comic possum) first rule of cooking: Don't let the meat get away. By trying to create drama, I could have scared Dr. Long away. For the sake of the show, I risked being cavalier about his annoyance with his mother, by too eagerly displaying the opposing attitudes that lurked under the surface. Surely, Dr. Long's antipathy toward his mother was a cover for its opposite: an enthrallment with his mother's ways, especially her hearty Hungarian-ness, and with sausages, Romans and joy. That prissy gentility of his made him feel safe and he hadn't adopted it without good reason. Vanity made me want to pull off an expose and wow the people who were watching. Would it have been easier on Dr. Long if I'd told him stories that touched on his kind of madness, in which people poke fun at their background without getting bent out of shape about it? I wanted to

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tell him about friends, Sephardic Jews from the Belgian Congo, who when I'd visited them in Belgium, took me to a resort town — it may have been Oostende — on the North Sea coast. "Wait till we get to this restaurant," said my host. "It's full of Jews, and you'll see them showing off their wealth just like the Jews in Canada. They're all noisy, demanding and flashing their expensive jewellery." Ha, ha, I thought to myself. He's pulling my leg and poking fun at Jews in an unexpected way. But when we got to the restaurant, he said, "Look at them. Aren't they a riot?" Sure enough, right before my eyes, was the Jewish stereotype in action. They wore ostentatious jewellery, expensive clothes and many of the women had on furs, even though it wasn't winter-cold. I was supposed to laugh, I suppose, or say something about how Jews are the same all over. I smiled and said, "Yeah, just like you said it would be." Then it was my friend's turn to laugh. "Ha, ha. They aren't Jews, they're Flemish. It's all the hard-working, Germanic-Flemish, nouveau riche showing off their wealth." My friend had fooled me. As he'd intended, I blurred the categories, confused "flashiness" with Jewishness, when it more properly applied to those who'd recently accumulated wealth. And why had I wanted to tell this story to Dr. Long? To reassure him that Hungarians weren't bad after all. That he was making an error because boorishness applies to Jews, intellectual phonies, Hungarians and Germans, and that gentility applies to them all, too. After all, Germans write philosophical treatises and&iit sausages, don't they? And then there was the Flemish farmer in whose home I rented a room for one night on the same trip. At breakfast, he and I found we could communicate if he spoke Flemish and I spoke German. "Since World War n, we Germans have to stick together," he'd said.

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What had he meant? That we Germans were liable to be discriminated against because of World War n? Or did he mean that we Germans, the master race, had to stick together? And since when was a Flemish farmer a German? Enthralled as we are by the madness of progress, it is easy to forget the power of historical memory. I understood the Flemish farmer better when I read Ian Kershaw's biography of Adolph Hitler; Hitler was greedily aware that Belgium has two ancient Germanic provinces, Flanders and Brabant.

"Maybe sausages and Romans are more important than you think. It does seem very important that you should be culturally and intellectually sophisticated, just as it was important for your father. Maybe this makes you a bit one-dimensional, you miss out on frivolity and fun. Juicy sausages and Roman warriors — like The Sopranos on television — can be fun." "I don't see that I'm one-dimensional," he protested. "I have a lot of interests. "Why don't you take a crack at this, Dr. Long? It's actually a very interesting part of you. Here's another nifty example: you say you've come for a 'learning experience,' which is a very cleaned-up reason to come to a clinic like this. Could such a cleaned-up idea be like your preference for the ancient Greeks — all squeaky clean and rational — over those lusty, rowdy Romans?" "I don't see anything wrong with being intellectual. It seems to me the only thing that will get us anywhere is our rational powers. That's why I went to medical school, to try to apply rational knowledge to people's troubles." It wasn't me doing the interview, it seems. Another character, a rather nasty and antagonistic one, was doing the interview with Dr. Long for me. It must have been some person who secretly lives inside

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me, who keeps his existence quiet. Now, unbidden and unexpected, my mouth was thinking and speaking his opinions — it couldn't have been me! What did he have in mind? Did he want to crush Dr. Long, force him to be insightful — a vain hope — or was it more complicated? Did this bully intend to get egg on his own face, to interview in such a way that he would embarrass himself in front of the students? "Just for fun, let me try again," were the words that emerged. "Sort of anodier trial balloon to see if we can get a little angle on who you are, a sort of intellectual perspective on the shape of your soul. I hear you read a lot of Greek mythology. Could we say that you are an admirer of Apollo and a foe of Dionysus?" This intellectualized tactic had worked a couple of weeks ago with Dr. Kori, perhaps it would also work with Dr. Long. The coolness of intellect — or, as some of the younger generation would say, a "mindfuck" — might provide a language in which he'd feel safe. "I haven't got a clue what you're talking about. 'Foe of Dionysus?'" "Yeah, Dionysus, the god of fun and frolic who likes wine and sausages and swearing in Hungarian." "You're weird," he said. "I don't know what this has to do with me getting into analysis. Do you think it would be a good thing for me to do? I'd heard some people have ego weaknesses and are best off not going into analysis, and I'm wondering what your opinion is about that?"

How should I react to such an interview? I could blame Dr. Long and call him a bad, resistive patient. He was fearful and defensive (a misleading word like resistive — both are a form of name-calling), and wouldn't cooperate with my attempts to look beneath the surface. But Dr. Long was only being who he was. Didn't Nietzsche teach us something about this? "Become who you are!" Did I think Dr. Long could

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be someone other than who he was? The purpose of the interview was to have the person called David Long appear on the psychiatric stage, and that's what had happened. Why complain about it? I could just as easily lay a complaint against myself. Such a bad psychiatrist, I could say. Why push so hard? Why not take note of Dr. Long's uneasiness and back off, slowly easing into his mind by talking obliquely about his history, his career, or his thoughts about psychiatry and psychoanalysis? Surely he'd have given me hints about his personal dilemmas, framed in terms not as emotionally charged as bare-naked sausages, lusty Romans or the wine-besotted Dionysus. Such reactions are easy and moralistic. Why not just note that when Dr. Long and I, two flesh-and-blood people, were placed together, this was the nature of our interaction? The payoff to looking at it this way is that it allows a new question to be asked: "Why are we having such a cranky conversation? What's in it for us, that we're sort of quibbling about everything? Both of us must have a stake in having the conversation this way, otherwise we'd be having a different one, wouldn't: we?" If he and I were making sure we stayed at dagger-points, there was no chance we'd like one another, and no chance the interview would be satisfying. As I'm determined to accept my German ancestry — and it's not always easy — I had grounds to be uneasy about Dr. Long's story. Unlike me, he'd been offended by his foreign background, at least when it came to his mother's loyalty to her Hungarian traditions. I'm at war with that style of heritage-management. I try to love my German background, despite its World War n baggage, so why couldn't Dr. Long come to grips with his Hungarian past? It is part of my professional style to be mistrustful of myself', to question all my precious pretensions — things that in everyday life I think of as sensible beliefs — so why shouldn't Dr. Long, also a psychiatrist, do the same? For me, it was obligatory and understandable that he'd get on my nerves.

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But what about Dr. Long? More important we figure him out. Should he have shared my ideas, he might have become curious about his internal psychological treasures, which would have led him to like, if not be fascinated by, me. But that was Dr. Long's hidden dread, the emotional, feeling side of himself. He wanted coolness and impersonality, our meeting should be formal and administrative, and whether he was seen by me or whether he'd just come through the public clinic, hadn't made a bit of difference to him. It's an old psychological game, and both of us wanted to play. It's the Who's Afraid of Virginia Woolftnck, by which people fight so they can't love, hate to prevent intimacy, goodness and wholesomeness. In the case of Dr. Long, the stance was linked to his mother, an idea to which a different patient might have been receptive — not because he was a better patient, but because he was mad in another way. We're off-track when we call Dr. Long "unmotivated," "not psychologically minded" or "not insightful," and equally off-track if we decide I was a bad psychiatrist who'd conducted a bad interview. Were we scientists, I'd say it is shockingly unscientific that we judge people this way, and yet psychiatrists who declare themselves to be scientists make such judgments all the time. And while we're not scientists, we'd better do what scientists do: observe and think. Besides, there's nothing like a good argument. Dr. Long and I were armed with a set of rules about how to behave, and both convinced important principles were at stake. But there are no universals when it comes to how we behave. We psychiatrists ought to listen patiently, attend to detail, and bring an odd or novel perspective to what we hear. But we must be quick and flexible as well. These psychiatric principles are not rules; they are only a guide to how humans might interact. Families, too, operate according to a perplexing array of principles and, like patients and psychiatrists, are at risk of getting stubborn and

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rule-bound. If we watch families in action, we find that the whole enterprise is quite contrary. Nietzsche, too, has something to say on this score. It is the price of fruitfulness to be rich in internal contradictions.

It was bedtime and a child had misbehaved. Although in her mother's arms, Sasha was sobbing and inconsolable. The mother — my daughter, Diana — was beside herself with frustration and annoyance. Both she and Sasha were lonely, stubborn and frantic. "There will not be a bedtime story tonight" said Diana. I, the grandfather, came upon the scene and said, "Let me put you to bed." I carried Sasha to her bed, and on the way, whispered in her ear. "Now you won't have to cry anymore because Opa is magic. You'll see, the crying will stop." In the bedroom, Sasha's sister Mariah was sitting bolt upright, shaken by the intensity of everyone's upset. She, too, had tears running down her face. "Ssshhh," I said, "It's okay. It's magic. Sasha is going to stop crying. Don't tell Mama. It's a secret." I twinkled my eyes, and both girls regarded me with amazement, their eyes wide open. They were spellbound by this nonsense. In a whispered voice, a conspiracy to break the rules, I told a bedtime story. Of course, this is an example of calming and soothing by suggestion. But it's a much more important communication than that, and although you may not want to call it magic, it's a good word for what happened. Most important of all, it was a vital example of culture acquisition: by scolding Sasha for misbehaving, Diana had delivered important information about the rules of the culture. Had I sabotaged a mothers teaching? In fact, I hadn't, because I had conveyed to Sasha

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and Mariah cultural information just as important as bare rules. I was the grandfather here and not the parent, so my job was to modulate, complicate, and add luster to the world by demonstrating that rules are not inviolate, an obligation I share with uncles, aunts, and family friends. Sasha's mother had decreed there'd be no bedtime story, but a story had been told nonetheless. The culture, embodied in Diana and in me, was passing on complex information to the children, and Diana, the children and I, instantly and intuitively understood the situation. We all heaved a sigh of relief; we had seen to it that the world unfolded as it should. So much for the banal call for consistency. Consistency, I suggest, is a virtue only when it refers to things like airplanes and trains being on time. Yes, this was complicated and contradictory information for young children to internalize, and the experts agree that, early in life, young children's minds develop better if they are exposed to complex concepts. This doesn't mean they should be reading Kant's Critique of Pure Reason or Wittgenstein's Tractatus Logico-Philosophicus. It does mean we should read weird tales to children like Where the Wild Things Are and Jack and Jill. Such stories contain the complexity and "contrariness" of real life, rilled with intricate logic and novel ideas. Literature instructs adults, too, in the complexities of our culture — the wonders of the whole restless mess in which lives unfold. I like novels and stories, first, because their cultural lessons are onceremoved. As readers, we don't have to suffer the catastrophe of missing our bedtime story. Instead, we can read about how another family negotiates catastrophes that have no clear solution. I also like stories because they introduce us to the voice of the storyteller or playwright, a magical voice which suspends judgment on the characters. Playwrights and novelists, if they ve done their jobs, work on a plane beyond judgment. That odd place is like a good psychiatrist's office: there are no moral imperatives, so there's no choice but to keep

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thinking. To me, rigid moral positions are the plague. My patients, poor souls, are forever goading themselves into self-injury because of their own grotesque moral baggage; they don't need more from me.

Dr. Long and I were both stubborn. Even when an experienced talker like myself speaks with tact and wit, the stubborn can always find a quibble: "Yes, but . . ." If I speak to such patients skillfully — don't forget I'm a pro and rarely get as pig-headed as I did that spring day in 1997 — about how they might find this pattern in themselves interesting, they don't see it. When I scrutinize their reasons and objections, I see them take lots of logical liberties: the literal gets abstracted and the abstract is taken literally; a noun takes priority when a verb should. This can go on forever. One day when I was sitting with a remorseless quibbler, uneasily becoming aware of his stubbornness, I reminded him of a joke he'd once told me, the punchline of which was, "The phantom piddler strikes again." What I said was, "The phantom quibbler strikes again." I'd intended to say "piddler," but a secret person in me said "quibbler" instead. And just as there was a secret person in me who "accidentally" chastised him — a piece of my unconscious — diere was a secret person in him I could address. "Mr. Sweet," I'd said. "We know there's a quibbler in you. Even today when he isn't making himself obvious, and when you hate it that he's a part of you, he'll show up. When I stop talking, even if we can't see him, his quibbling will be in your words one way or another, probably disguised in some way. If you and I are smart, we'll find your argumentative side, no matter how sweetly [his name is "Sweet"] it's disguised. The phantom quibbler has got hold and won't let go. He sticks his nose in everywhere."

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Dr. Long and I were embattled warriors. He liked to fight and, having learned at my mother's knee, I liked to fight myself. Neither of us wanted to yield. Yielding is the great theme of King Lear. The play's embarrassing opening scene is a myth, weird like any piece of life looked at closely. It's really a variant on Where the Wild Things Are and The Cat in the Hat, and not meant to be taken literally. At the outset of the play, Goneril and Regan prudently flatter their father with extravagant descriptions of their love for him. They know his black-and-white thinking, so why make waves when the consequences of refusal were obvious? An occasion as ceremonious as this calls for cooperation, and the two wicked sisters, not yet wicked, do their duty and heed the sensible aphorism which holds that: "Children and fools speak the truth." Cordelia, on the other hand, is dead honest. Doesn't she know honesty should be balanced by wisdom? Lear's abdication is a moment of political importance, and Cordelia isn't following the script that is required by the occasion. By acting according to some private, silly principle, she is being a very poor sport, who not only humiliates her father, King Lear, but is self-righteous about it to boot. For her, Lear's request is arbitrary and she replies with equal arbitrariness when thoughtfulness is in order. The same dangerous strategy can be found in Coriolanus, when Menenius speaks of his leader's behaviour — behaviour that ultimately earns Coriolanus the same banishment as Cordelia: His nature is too noble for the world: He would not flatter Neptune for his trident, Or Jove for's power to thunder. His heart's his mouth: What his breast forges, that his tongue must vent, And, being angry, does forget that ever He heard the name of death. [111.1.257-2.62]

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The great stage of fools: rude, stupid and prideful. Pride — the stubbornness of Dr. Long and me — is the first of the seven deadly sins. Edgar speaks the last lines of King Lear. Both Cordelia and Lear are dead, and his words (note the ambivalence in the second line) seem — but only seem — to vindicate Cordelia's dead honesty. The weight of this sad time we must obey, Speak what we feel, not what we ought to say: The oldest hath borne most: we chat are young Shall never see so much, nor live so long, [v.iii.323-326]

But Edgar is speaking ceremonially, and his words aren't dangerous unless taken literally. As he realizes, forthrightness can be disastrous, and the injunction to "speak what we feel" is a tricky one. Were we dead honest, we'd tell an ugly woman her appearance repels us, and I would have bluntly told Dr. Long he had a sexual interest in his mother. But this is sadism, not honesty. Lear had a silly plan about his abdication, and Cordelia responded with a silly principle. Like me with Dr. Long, she is in no mood for yielding — which is an ingredient of wisdom and goodness. Before Lear and Cordelia die, diey're given another chance. This time, they get their lines right, in what Northrop Frye saw as one of the supreme moments in English literature. Lear now knows that Goneril and Regan have mistreated him. Lear: You have some cause, they have not. Cordelia:No cause, no cause.

This is the second time that the chips are down, and now Cordelia tells the noble truth instead of being horrible and literal. Of course she has cause. Her father, Lear, has been awful, a son-of-a-bitch, but she

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loves him and speaks to the ceremony of love. Cordelia has given up stubbornness and yields to gentleness. Some day, I might have occasion to tell this story to Dr. Long.

"Our time is up, Dr. Long. I will have time available for us to start in September. Give me a call after Labour Day." Dr. Long gave me a quick little smile, got up and left. As usual, the students were pissed off at me when I wouldn't stay in the conference room to discuss the case.

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CHAPTERJTWELVE

BACH'S ItixjsicAL OFFERIIXG

The previous year, at the Ewa Podles concert, Graham had suggested I visit him up at his mother's island on Georgian Bay. "You were there in 1957, if you remember." It had been the great discovery every Canadian makes — an island on a rocky lake, opaque yellow-black water that extends down seemingly beyond hell, and naked rocks covered with lichen, moss and pines. It was the island that inspires Wanderlust, back-to-nature crazes, and abandoned love of country. "Did you just ask if I remember it, Graham? I could never forget that amazing place. I've got a cabin of my own in Muskoka now — not an island, but it's got the same black water, rock, birds, bears, deer, mink and otter, the whole shebang." This year I made the return visit to Georgian Bay. When I arrived at the public dock, I spotted Graham across the water, half a mile away, coming to get me. He was in an old aluminium boat, motor at full throttle, while on his head was a Tilley hat, the only concession to modern fashion I was to see all weekend. We shook hands. "Hang on to the boat for a minute." Graham bustled onto the dock, deposited garbage in the bins, and marched back. Off we went. Ten minutes later we pulled up at the

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island, tied up the boat and surveyed the cottage and the island. "I remember an icehouse," I said. In the late '505 someone came to the island every winter to cut ice out of the frozen lake with a handsaw, depositing it in a log cabin, and covering it with sawdust. These days, there was electricity and a phone. The cottage was neat as a pin, with maple furniture, doilies and traditional china. The three bedrooms and bathroom had neatly closed doors. On a side table sat a Hummel figure of a boy playing a flute. Of course: as well as the piano, Graham had played the recorder in university. That had been his nickname: "Toot." Against the wall beside the fireplace sat Graham's piano. It had been there when he was a boy because Graham's folks, like the parents of Glenn Gould, had made sure their budding concert pianist, always had a piano available, even on an island in cottage country. Graham and Gould were exactly the same age and even went to high schools in adjacent Toronto neighbourhoods; Graham went to Riverdale and the Gould to Malvern. Graham's mother, 96 years old, was out sawing wood. She had been sawing wood, cooking and tending her little garden on that island for nearly 80 summers. She didn't remember me from 45 years ago, but smiled and sparkled. I saw instantly that she was, or had been, a Spice Girl — one of those beribboned maidens who played with the white bulls on the beaches of ancient Greece. Inevitably, these young girls were raped or carried off by Zeus, became pregnant, and helped found new continents and cities. Later, they referred to these events as their nuptials because the founding of a city is also the founding of a family. Mrs. Copeland wore a bright blue tracksuit, baggy, but not baggy enough to hide her hunched back and crooked spine. Still, she was spry and radiant. I wondered about Graham's deceased father, a working man. He had built the cottage himself and had loved work, fishing, and the lake. Was he earnest like Graham?

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"Dinner is at six," Graham said. We sat on chairs a few feet from the lake, removed our shoes and padded our feet into the carpet of pine needles. It was two in the afternoon, I was hot from driving, but Graham hadn't offered me a coffee or a cool drink. "Could I have some water?" "Of course. Would you like a soft drink?" "I think just water." Graham was as generous a host as anyone else, but he had no time for rituals; the truth was he wasn't even up to date on rituals. Dinner was at six, he'd said, so some rituals were established and observed. But, once the sun had sunk below the yardarm, would he offer me a real drink? The odds were he wouldn't. If he'd known that I'd like a beer or a whiskey he would have made sure to have it available, but on his own, he was oblivious. I'd brought a bottle of wine with me. When the time came to produce it, just before dinner, he would respond right away. But for the moment, Graham just wanted to tell his story.

"Do you remember when we went to Basel in 1959? That was where I discovered mountain climbing. You used to climb, too, I think. Since then I've climbed in many places: Italy, the Caucasus, California. I've worked very hard all my life. Every day for 30 years I've started working at 8:30 in the morning and stopped at n:oo. It's tremendously detailed work because it would be a tragedy to miss anything. To discover something takes a lot of effort. Most of the time I'm studying archives, examining old manuscripts. It's often material that isn't in libraries, nor is it indexed. Much of it hasn't been seen or read by anyone for, sometimes, hundreds of years. My only respite has been mountain-climbing." Yes, I remembered now. He and I had gone to Basel in 1959,

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Graham to attend master classes with Artur Rubenstein — Graham was still playing the piano at that time — and I to ski. Eager young intellectuals, we went out to see if we could find Tribschen, the house in which Wagner lived and where Nietzsche, then the professor of philology in Basel, had visited him. Graham was not a musician any more, nor did he teach music at the universities at which he worked; he was a musicologist and lived in that tiny, specialized world. He was very serious. I wanted to make little jokes about subterranean archival galleries, dripping with cold humidity and crumbling papyrus, and inhabited by cowled monies. But no, Graham told it straight. He'd climbed in the Caucasus Mountains, where the white race had originated, and he and I were in a very WASP cottage, with doilies, white dishes, a tablecloth. There were none of the trappings of rusticity, none of the pioneer log furniture so often preferred by wilderness cottagers. "After graduating from McGill, I studied in Berlin," he continued. "I thought I might stay there, but I got an offer from a good department at Columbia University in New York — I'm actually an American citizen now. I stayed quite a while and also worked in California for a few years." Graham talked eagerly; he couldn't stop. I heard the details of everything he had done over the years, including his salary, his pension, and the legal tangles about his citizenship. On and on he went, with few pauses for breath and little chance for me to respond, let alone discuss myself. "The most wonderful thing that happened was when I was appointed Ordinarius in Munich. The German university system is superior to ours, completely different from the system here. An Ordinarius is roughly the same as a full professor except that, in Germany, there is only one Ordinarius per university department. One of the sensible tilings about their system is that you cannot be promoted within your own department; the only way to get promoted

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is to be invited by another university to take a higher position. This cuts down tremendously on nepotism. "At Ludwig-Maxmillians-Universita't I was totally free. I didn't have to strike any committees, consult anyone or be democratic. I made all the decisions in the department and no one could argue with me. The Germans think that when they appoint someone to be Ordinarius in a department, they have acquired the best-qualified available academic in the world, so it seems obvious to them the Ordinarius should make all departmental decisions. I didn't even have to worry about money; When I asked for it, the university gave it without question, sometimes more than I'd asked for. "As professors, everyone in the department, including me, were civil servants, so I never had to negotiate salaries. Faculty members in law and medicine got the same salary as those in musicology, and every other department. This is very different from the States — Canada, too, I guess — where there's lots of resentment over the high salaries in the law and medical faculties. "From the time I went to Germany, I spent 80 per cent of my time doing research. I spent almost no time on administration because I had a very good secretary who ran everything. And I did some teaching. To tell you the truth, I didn't like teaching, but I fulfilled my responsibilities. Unfortunately, many students in Germany, like students in Canada, are not interested in scholarship. I have no patience with such people — I don't understand why they work in a university. "Over the years, I've collected a tremendous amount of data and have now published five books." Graham brought out two of them, and I spied the other three on the shelf. They were beautiful volumes, bound in gold-stamped leather. Inside, they were printed in Italian, German, and English, with many pages of indexes and appendices. A sixth book, a professionally published, %-inch thick hardcover, was an annotated record of

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Graham's personal library, now donated to the Humbolt-Universitat zu Berlin library. There were hundreds of items listed, in many languages, including Latin and Greek. "How did you accumulate so many books for your library?" I asked. "They must have cost you a fortune." "Nearly all of them," Graham said, "were given to me by the authors." "And the books you've written — how many copies do they sell? They must be expensive." "About 300 copies." I thought to myself that my first book sold three thousand copies, pretty good for a textbook, a how-to-do-it book, and certainly not full of real facts like those that Graham had written. "Three hundred. That's about how many copies of Freud's The Interpretation of Dreams were sold in the first five years after it came out. I think Nietzsche's books sold about the same. In fact, Nietzsche said it's more important that one person should read your book in 100 years than that 1000 people read it now." "Is that so? The discoveries recorded in my books are of interest to only a small audience." I couldn't tell from Graham's face whether he was pleased by my comforting words, or flattered I'd compared him to Freud and Nietzsche. And had he said "discoveries?" I guessed he found hidden or unknown facts in the archives — real discoveries. In psychiatry, there are no discoveries, although high-profile research claims are made every day. Nothing has ever been discovered by a psychiatrist except, perhaps, by me: I've discovered that two-thirds of my patients will idealize me, about the same ratio helped by any psychiatric treatment. Perhaps my discovery has been made by hundreds of thousands of shamans, priests and psychiatrists before me — though most won't have realized it.

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Two-and-a-half hours had passed and Graham gave no sign he was ready to slow down. He hadn't said a word about his personal life and hadn't paused for breath long enough for me to ask questions. I was curious about Heinz, who I'd met at the Ewa Podles concert and who I had assumed was Graham's special friend. It took a while before I realized that Graham was doing what patients do: he had appointed me his psychiatrist, without knowing it himself. He hadn't told any dreams, a surprising habit of most patients who, by and by, spontaneously indulge. "Oh," says the voice from the couch. "A dream I had last night just came to mind." Graham wasn't the type who'd tell a dream because dreams require a kind of light-heartedness, a trait he'd once had in abundance, now missing. A serious man would never admit to dreaming, let alone telling his dreams to someone else. "Would you like to swim around the island before dinner?" said Graham. "I do it every day. It's about two kilometres and takes an hour." He had talked my ear off and, while his domination of the conversation hadn't bored me, I was mentally tired. A swim would be just the ticket. I needed to get my bearings back because this conversation, monologue really, had puzzled me. Graham was so driven to talk, I was thrown off balance, and I couldn't immediately sense why he was doing this. It's not that I felt any urgency to speak about myself, but it was bizarre he never thought to ask about me. Once or twice, I squeezed in a comment, usually mild jokes to lighten the mood: "In my business it's the same thing. Only a few of us weirdos take scholarly thinking seriously." "Are the madmen the psychiatric and musicological publicityseekers, or are the madmen those of us who dabble in Socrates and Greek myth?" His response to such remarks was to be momentarily flustered, quickly regain his balance, then carry on. "A swim would be great," I told him.

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When we told Mrs. Copeland where we were going, she was still sawing the same piece of wood she'd been working on two-and-a-half hours before. Now she had an axe head, and was trying to force it into the slot she'd sawed into the wood. She pried at and splintered the log with no result. "We're going for a swim around the island, Mom." "Oh, good. I'll see you when you get back. Should I start supper?" "No, no. It's okay. I'll get supper when we get back." We clambered down a rocky face, Graham instructing me on every foot and handhold, then off we went. Blessed peace and a rest for my ears, I thought, except Graham didn't stop talking. For well over an hour we swam and he talked, continuing to access his repertoire of attention-grabbers. As we swam, I could see the heavy muscles at the back of his neck and between his shoulders. It's the same bulky lump that's at the back of a bull's neck, that muscle the picador must damage and weaken; and it seemed fitting that Graham had developed it because, against all expectations, he'd acquired the determination of a bull. These days, he could coach me through the night before an exam. In university, we had all been required to participate in Phys Ed whether we wanted to or not. Graham hated it, but I remember that when we did chin-ups, he could do it forever. Neither water nor waves slowed his talk, and slowly it dawned on me that he was playing the ancient Mariner, reincarnated and bound to tell his tale. As you may recall, the Mariner had been condemned to find people who had sinned, and who were required to listen to his cautionary tale. It is an ancient Mariner, And he stoppeth one of three. 'By thy long grey beard and glittering eye, Now wherefore stopp'st thou me?'

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Had Graham discovered my sins, pierced me with his glittering eye, and compelled me to listen? "Yes," he continued, "I've made a major musicological discovery. Do you know Bach's Musical Offering, BMV 1079? Bach visited Frederick the Great in Potsdam in 1747. The king gave him a musical theme on which to improvise, whereupon he sat down at the harpsichord and invented a variation on the spot. Frederick was impressed. When Bach returned to Leipzig, he wrote 10 canons based on the thema regium. Somehow, over the years, the order in which these variations should be played got lost. "I was fortunate enough to come upon the necessary facts and figured out that the order for the Musical Offering was the same as the conduct of a successful oration. The order Bach followed was noted by Marcus Fabius Quintilianus in 92-95 AD: exordium, narratio, egressus, exordium, andperoratorio." These five figures were only the barest outline of what Graham explained to me; there were more extensive rhetorical figures than the few I have listed. As Graham discovered, Bach's contemporary, Johann Abraham Birnbaum, confirmed the composer's knowledge of rhetoric: He has such a perfect knowledge of the parts and merits which the working out of a musical piece has in common with rhetoric, that one not only listens to him with satiating pleasure . . . but one also admires their clever application in his w o r k s . . . .

In ancient and Renaissance times, rhetoric was an indispensable course of study for aspiring politicians, lawyers and orators. Speeches, like music, followed established rules, the rules of rhetoric. There are many rhetorical canons and figures, which Graham had meticulously correlated with the canons and figures of the Musical Offering. On a hunch, for example, he counted up not the canons in Bach's Musical

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Offering, but the total number of movements. The 10 musical canons contained 16 movements. He then went to the movements themselves and, since music unfolds in time just like rhetoric does, scrutinized them for evidence that they followed the rules of rhetorical figures. Sure enough, they matched, and the lost order for the canons of Bach's Musical Offering was identified.

The route for swimmers to climb up the rocks and out of the lake was different from what we'd followed when we had entered. Again, Graham had familiar foot and handholds, probably remembered from when he was a child 55 years earlier. He gently guided my every move and then, once on dry land, we padded through the woods to the cottage. Mrs. Copeland was fetching water for her little garden, but came right in to help with dinner. Graham cooked quickly and efficiently, offering his mother advice about how she might help, usually by tidying up or putting things away. We neither barbecued, ate out-of-doors or drank beer, and in short order sat down to a city-style meal: breaded chicken, rice sprinkled with fried onions, and green beans — nothing so exotic as the boar's head I had shared with Graham and his friends 40 years before. With the meal we drank my wine, Graham and his mother having only a small glass each. For dessert, there was blueberry pie.

"I want to run by you a talk I have to give in the fall," Graham said afterwards. When the dishes were done he proceeded to deliver a formal lecture on mountain safety, complete with notes and slides. I peeked at the notes, which were written in a mixture of English and German. To instruct me properly he produced an array of ropes, buckles, crampons

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and an ice axe, followed by slides of his mountain conquests. The presentation lasted three hours. "I guess it's too long. I'll have to cut it down." Graham had told me that when he came to Georgian Bay from Paris he brought no luggage; he had all he needed at the cottage. He travelled from the Toronto airport to Georgian Bay by bus. How then, could he have had mountain gear on hand? I learned from the slides that Graham had had many climbing companions. But, reading between the lines, I suspected that he had also lost companions. When they were tired, Graham would not give up, determined to finish every climb. Bad weather didn't deter him either and this likely frightened off some climbing partners. Frequently, he admitted, he has had to complete climbs on his own, a practice his own safety lecture had condemned: "One should never climb alone. In fact, one shouldn't even climb with one partner, because one person cannot hold a colleague to whom he is roped. Climb only in a group of three or more." Not only did Graham climb alone, he'd spent nights alone on icy mountainsides, unable to get down before dark. Once, he'd broken his ankle, and when night fell, put his feet in his backpack and snuggled into his down jacket. The night was so dark he could see nothing and he dared not sleep for fear of freezing. So he waited 12, hours for daylight to break, then walked out alone, skis strapped to his back, on a broken ankle. Graham told this heroic tale with complete diffidence. He was merely giving me information, urgently telling me about his life. He was rational, methodical, intelligent and courageous — but I could hear his passionate resolve. It was already bedtime, and by then I had realized I could not listen to Graham's cautionary tale for an entire weekend. During the slide show, I'd managed to tell him I'd be leaving the next evening.

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Graham's face had fallen — imperceptibly. "Breakfast is at eight o'clock," he told me.

I got up at six, read my book, and scanned the bookshelves. At precisely 8 a.m., Graham's door opened. "Do you drink coffee in the morning?" The toaster was a museum piece, an open horizontal contraption unseen in a private home for 100 years. Toast, jam and Harvest Crunch, and then he started talking again. "Wait," I said. "Let's sit outside." Out we went to the lakeshore. Finally, he asked me about my life but, after I'd spoken a little, he'd interrupt and add more details about his own. I could see he was worried about being impolite; still, he couldn't stop himself. The desperation of the outpouring made me recognize he had a rationale. It seemed urgent that Graham convince me he'd led a worthy life. I'd never known Graham to be vain or selfcentred, so this new focus on himself had to have other motives. "I live in the Hotel Seehof in Berlin," he told me. "It's a beautiful little hotel located by a small lake in the Charlottenburg district — very nice. It's just two stops on the U-Bahn from the Deutsche Ofer, where the finest opera in the world is performed. The Staatsoper and the Komische Oper — the Philharmonie, too — are on the same subway line, so I can easily get to them if I need to. It seems to me that the greatest contributions to civilization have all come from Europe. That's why I live in Berlin: Berlin is, or soon will be, the world centre of serious music." In 1959, my friend Lois Hummel told me she would never live anywhere except New York or Moscow. To her, they were the centres of modern civilization. Others prefer the outback of Australia, the Riviera, or Florida. Graham's conviction — and he was adamant

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about this — was that the Deutsche Oper was the navel of the planet, and he must therefore live hard in its vicinity. "I've willed this island to the Deutsche Oper and had my American university pension diverted to it," he continued. "I'm convinced that with Christian Thielemann at the helm, they are going in the right direction, but I'm not so sure about Daniel Barenboim at the Staatsoper. He's terribly overextended, I think. I've had an awful time making my bequest legally solid so that my wishes will be honoured. The lawyers have been driving me crazy, so I finally spoke with Thielemann about it to make sure it will be administered in the way I want. I even mentioned it to Gerhard Schroeder when I met him at a cocktail party [Graham Copeland at a cocktail party? Did he wear his flannel shirt and his climbing boots?], though he probably forgot about it as soon as I was out of sight." To ordinary citizens, the mention of personal interventions with Thielemann and Schroeder would have sounded like name-dropping. For Graham, who was devoid of pretension, this information was simply a signal of the urgency with which he pursued his goals. I wasn't surprised Graham loved the German opera houses, especially the Deutsche Oper, though some might disagree with his claim that the finest opera in the world is performed there. When Graham had worked in German universities, he loved being an Ordinarius, so the special, unquestioned status of the Germans who run opera houses appealed to him. Full professors, opera intendants or fathers rarely need to consult with those who work for them. But why had he willed his pension and island to the Deutsche Oper? Was it because he hoped the Berlin opera wars — three houses competing for chunks of a shrinking Rheingold — would end with a patriotic and paternalistic Christian Thielemann at the helm of a national opera house? Would Thielemann then renounce love and forge a new Ring des Nibelungen? Graham didn't know I owed a debt to the Fates, those glorious

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women who control our destinies. They obviously love me, because they have parachuted me into my psychiatrist's chair, a front-row seat in the grandest of opera houses. My theatre is not like Graham's beloved Deutsche Oper in Berlin. It's more like Berlin's Komische Oper. "Komisch," in German, has a double meaning: it suggests comedy, all right, but it also means weird, strange, odd. In that opera house, tragedy, and romance too, have their place.

"Do you remember my friend Heinz who you met up at the George Weston Recital Hall when I was in Toronto?" Graham asked me. "He and I are having trouble because he's become a drug user. He does this in Paris, even in my hotel in Berlin. The triviality and immorality of it are unbearable. He smokes marijuana and sells it, too. Once, while we were eating Christmas dinner, he rushed outside to get a plastic bag of something from a friend's car. He also steals things from the suite we live in, probably to pawn them. He even stole my grandfather's gold pocket-watch. There is something frantic about the way Heinz takes drugs. A few years ago, he and a group of his friends took pills out of somebody's medicine cabinet — some neuroleptic — which left them all drugged and sleepy for a couple of days. Heinz had an idiosyncratic reaction to the drug and had back spasms so severe he developed opisthotnos: he bent backwards in the shape of an arc. In the end, I had to take him to the hospital and, although this experience scared him to death, he never for a minute stopped taking drugs. These days, he hangs around with people with a lot of money and fast cars, who go to expensive restaurants. I don't know how he affords this expensive lifestyle; although he is a musicologist, he managed his finances poorly when he worked at the university. "Heinz and I used to be very close. When I'd come home from work, his eyes would open wide with happiness. He was impressed by

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my scholarship. He may have even been a little envious. A friend of ours noticed Heinz's reaction to me one day and told me that, when I walked into the room, he'd never seen anyone open their eyes so wide with astonishment. Heinz bitterly resents my plan to give my American pension and the island to the Deutsche Oper. He shrieks at me and calls me an asshole and he's offended because I still work long hours. He no longer values my musical work; he calls my research a waste of time. We've been together for 30 years and I'm afraid he may be able to contest my will. That's why I have taken such extraordinary precautions to ensure that my bequest to the Deutsche Oper won't be challenged. I'm even afraid Heinz will try to get his hands on this island." Heinz was Graham's lost self, the person I thought had disappeared. Graham's youthful pep and risk-taking remained intact, except it lived in Heinz, there to be condemned. I wondered if Graham had noticed that Heinz was peppy like his own mother and like Graham himself back when he was young? He, too, had stupefied himself with a drug: booze. So, I thought to myself, he shrieks at you and calls you an asshole. Doing research has blinded you — it's just your blindness is what led you to do research in the first place. Like modern psychiatrists, you've lost your focus and have forsaken irony, beauty and dilemma. You've given up on the enigmatic beauty of music just as my psychiatric colleagues have given up on the enigmatic beauties of the mind. The whole bunch of you avoid the texture of life, and think that research will lead you to tangible discoveries that matter. Heinz is pointing out that you don't dream the way you did when you and he first got together — the way you did when we were medical students. If you do dream, you probably keep it a secret. If my seven-year-old granddaughter said to you, "Aren't dreams wonderful?" you wouldn't know what she meant. To change the malignant standoff between Graham and Heinz, I

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thought, would have required superhuman wisdom — Graham had only strength Good thoughts, but I'd also fallen into a trap: literalism. At work, I'm careful to avoid taking; peoples words at face value. But in daily life, I'm as gullible as everyone else. I'd seen Graham's kindness toward his mother and his awkward generosity of spirit toward me. But suddenly, in reference to Heinz, he was rewriting his self-image. He was no longer a nice man — or so he said. He was, he implied, a blamer — not one to reflect on his own role in Heinz's story. "Heinz hates me and rarely speaks to me anymore," he continued. "With some of our friends, he won't speak my name and refers to me only as your friend,' comparing me to a mole — because I work in archives [yes, Graham, I caught the analogy]." There was a question in Graham's voice, a question for a psychiatrist. Graham knew he and Heinz were caught in separate worlds, worlds as different as: A prostitute and a nun. A Palestinian and an Israeli. Blair Allen and his wife. Jim Forster and me. Graham's research and writing had made him happy, but they'd also become a blight when faced with Heinz's different and opposite beliefs. Graham raged against Heinz as if warding off the enemy: frivolity. Heinz's enemy was industry, so he waged an equal and opposite war against Graham, fighting in him what Heinz could not tolerate in himself. Goethe, like Freud after him, instructs us: "We are most offended by our faults when we discover them in others." I couldn't decide whether, in the back of his mind, Graham considered asking my advice. Was he hinting that he wanted my help? I wouldn't have minded sticking my nose into his life, but I wasn't sure yet that he'd given me a clear invitation.

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We talked for the rest of the day. Although born Anglican, Graham had become Roman Catholic. I told him I doubted that firm belief pays off, and offered my usual alternative: that mysteries are to be savoured, not necessarily solved. In the preceding 24 hours I had commented several times on what Graham had said by invoking that credo — that mystery is good. If religions don't keep their mysteries alive, they die; their adherents need mystery. When religions get too sensible, church members privately turn to things like food fads, medical quackery, and speaking in tongues. What hope was there for Graham and Heinz unless one or both could retreat from firm belief and settle for uncertainty? Over the years, I've toyed with other turns of phrase for this fluctuating state of mind: wistful intelligence, bewildered amusement. Once you've embraced such notions, what other sense of the world could one want? Given what Graham had told me, I knew neither he nor Heinz were inclined to step back. Graham had said Heinz was wicked but had also made sure he himself looked arbitrary in his opinions. Heinz did the opposite; he acted like a jerk and insisted Graham was at fault. Graham hadn't reacted visibly when I had joked with him as he was telling me his life story. Nor did he when I brought up mystery in the context of his tangible belief in God. I wasn't aiming my remarks at his religious beliefs; I was thinking instead of his precious belief in his life path, and of Heinz's similar faith in his own life path. Graham had held ardent convictions, challenged by Heinz (and now, more gently, by me) but like all of us, he wanted to shore up the beliefs to which he was committed and to draw strength from my moral support.

It was time for Graham to take me back to the public dock. There he repeated the routine that we'd followed when I'd first arrived.

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"Would you hold the boat for a minute?" Graham strode across the dock and disposed of the garbage and the recycables. "Could you give me a lift to the mailbox? It's a couple of hundred yards down the road." As we drove, he again raised the dissonant theme for which I had no resolving chord: "Do you think there is anything that can be done about Heinz?" Like every person upset about a family problem, Graham fell back on the banal — except that for those concerned it is never banal. "I gave in to him too much; I should have taken a stand sooner. Heinz is without morals." He was in the midst of a life catastrophe, a wrenching wound in his soul. Like Philoctetes and Tristan before him, Graham had arranged his life so that he would sustain an agonizing wound, thereby becoming part of history and mythology. His was a common human predicament, a sort of dysfunctional "marriage" which, in plain English, only meant he was in a marriage.

I didn't make another trip to Georgian Bay in 1997, but arranged to meet Graham at the airport before his flight to Berlin. I spotted him rushing across the bus depot carrying an enormous backpack. "I've got a year's supply of Harvest Crunch," he said, "and some Canadian honey — 'creamy honey.'" Although he looked like a sturdy mountaineer, Graham and I had bourgeois cappuccino and chocolate cheesecake. On Georgian Bay we had been barefoot, but ate from porcelain on a white tablecloth. "Thanks for coming out: to meet me," he said. "I've written a letter to Heinz and wondered if you would be willing to look it over and tell me what you think? I want him to know how I feel about our situation

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before I get back to Berlin. It's actually three letters, but they are really just different versions of the same letter. One is cautious, the second is more direct, and the last very strongly condemns his behaviour. I'm not sure which one I should send, but I know for sure he can't live in my hotel anymore." "Okay, let me have a look at them. Actually, I've also brought some stuff for you to read, stuff that I have written." There was a therapeutic intent in the material I'd chosen to give Graham. The idea was that he'd get a taste of my campaign against excessive moral judgment, but written in a novelistic way. Graham was scornful of novels, although he liked other literature. He'd recently read Dante's Divine Comedy in Italian and had reread Milton's Paradise Lost-that spring. In Dante and Milton I had formidable opponents in my campaign to repair Graham's soul. I thought that, if Graham read my psychological ideas, maybe he'd smarten up and rethink his allegiance to Dante and Milton, psychotherapists unsuited to the modern world. I also knew my proposed "read some fiction" therapy was as illusory in its benefits as anything else, but my friend was in trouble and, if he'd asked for my opinions, it was just possible he wanted me to nudge him in a new direction. Of course, his biggest hope was that I would pat him on the back and tell him he was right. I also knew that if I stuck my nose into his affairs, I'd have to sneak up on him metaphorically, rather than naming his idiocies directly. He would not have been inclined to accept nay contention that idiocy is universal — nor would he have been pliant enough to enjoy the paradox: idios means "unique." I read through the drafts of the three possible letters he could send to Heinz. They were all of the "Will you or will you not admit that you are an evil person?" variety. Even version number one, the mildest, was unequivocal in its condemnation. The idea of evil as something out there still had Graham by the throat. There was no sign in the letters

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that my vague pronouncements on Georgian Bay about mystery had had an effect on him. Without realizing it, Graham seemed intent on distracting me from Heinz's idiocies by being the most moralistic, conscientious, insufferable virtue-flogger in Europe. Graham had devoted his life to being a mole and still hadn't a clue that this wasn't everyone's cup of tea. He also didn't realize that invoking evil is the human default setting. Strangely, I seemed immune to his unattractive propaganda against himself, propaganda suggesting he was arbitrary, intolerant and unreflective. I had recovered my balance and was no longer offended by his virtuous stance: I liked him again. I also worried about him. When I told my grown-up children about rhetoric and Bach's Musical Offering, they found the story interesting, but didn't like Graham. When I told him about my children's reaction to Graham, another friend agreed: "No, I don't like him either. But I admire him." If there was something good in Graham, why could no one but me see it? Graham's dilemma would have been easier to deal with had he been a criminal, had relations with a sheep, or produced fake research. I doubted Graham was good at one of the requirements of joint living: could he participate in mischief and naughtiness, did he tease and pinch and giggle? Or did he leave it to Heinz to be the only person in the household who farted? Sadly, Graham misinterpreted his crimes of earnestness as virtues. The real crime was claiming all the virtue, and even that had a distracting purpose: if he shoved his moralistic errors into the foreground, Heinz's misbehaviours would become less noticeable. If he was always sincere, if he only took life seriously, if he never knew his way of life was crazy, then he'd never see that he was actually getting people to point the finger of blame at him. He was too scared to know that hoarding virtue alienates and messes up the world, or that he was orchestrating the rest of us into judging him.

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A lesson: being bad once in a while — committing small crimes — purifies us. I assumed Heinz had taken on his shoulders the dirty job of standing against everything Graham had assumed to be right and proper. I wonder if anyone else had ever told Graham what a stuffy old pecker he had become? Is Heinz the only person who'd told Graham to "Wake up! Wake up!" And was Graham the only person who had the guts to tell Heinz he was acting stupidly?

As I sat there thinking, I suddenly noticed Graham reading bits of my essay. "This is like a novel," he said with surprise. "It's amazing. I'll read it on the plane." "Send the first letter," I told him. "The others are too final and would guarantee that nothing could ever be salvaged. I hope the letter helps." Graham is my friend but I didn't do what I should have done. I couldn't tell him what I'd been thinking. I should have said, "Graham, for god's sake say something different to Heinz. Tell him you can't handle him in your hotel anymore, but also tell him you know the two of you have different passions and that your passion for smelly archives is the same thing as his passion for the drug world. That you are alike but different. That he will always be your friend, even though the two of you are like oil and water. And Graham, believe it when you tell him your passion is just as self-indulgent, erotic and hurtful as his. Or tell him a lie. Tell him that you are a druggie, too, a secret booze-hound, or confess that you lust after little boys — like Mephistopheles when he lusted after the boy cherubs that came to transport Faust to heaven." To turn his world upside down, I'd have had to add that Heinz had once idealized Graham; his eyes had popped out of his head with

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amazement whenever Graham returned from work. My conclusions about Graham's theft of the virtue in the home may have been exactly right. Heinz's rage may riot have been about Grahams stuffiness, but rather a way of fighting off his dependency on Graham. If Heinz — and now I'm just guessing — had felt oppressively attached to Graham early in their partnership, he might have been using argument (don't forget that "there's nothing like a good argument") as a tactic for freeing himself. My daydream of delivering a sermon to Graham was, ironically, a sermon that suggested he shouldn't be so preachy. I don't know the truth about Graham and Heinz — nor does anyone else. Nor would anyone know the "right" thing to say, despite my self-flagellation for not saying the right thing. When I work with patients in my office, I'm not so passionate. I'll pray to the gods of psychotherapy that Graham learns something.

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CHAPTERjTHiKjEEn

A TRIP TO ToRonro

Cathy Jones decided to visit Toronto in the fall of 1997. "I'll see a bit of the world," she said. "I've never even been to Kansas City." I picked her up at Pearson airport. She was readily recognizable as strange, if not crazy. The spirit of two Emils — a derelict in Germany who my grandfather watched from his window, and another Emil who drank his wine every day outside my office window in Toronto — stood in front of me. An outsider wouldn't have known that Cathy was also a spirit; anyone else would have thought she was simply a derelict. Her cheap print dress didn't fit, she was overweight, and repeatedly jerked her head anxiously. She was chewing gum, and as soon as she was sure she'd spotted me, lit a cigarette. But she didn't light it with elan; she bent her head, puffed clumsily, and ignored me. Why did she endlessly puff at that damn cigarette and inhale as fast as she breathed? When I got close to her — we kissed each other on the cheeks — I could see in Cathy's eyes something that inspired no one but me: her inner nobility. "Hi, Warmie," she said. She was 51 years old now, looked 60, and still had pimples. Her tongue darted in and out of her mouth like that of a demented lizard,

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a movement caused by the tardive dyskinesia she'd told me about in her letters. There were a hundred sobs strangling me, but outwardly I remained perfectly calm. Inside, I was confused. Why had I agreed to this? I hadn't wanted Cathy to challenge me with the disintegration and dissolving of memories. I wanted glorious women, muses who I could adore, or monsters I could write off or hate. Cathy wouldn't play either game. During her visit, Cathy locked herself in my mother s apartment while I was at work — she had assumed I'd find a place for her to stay — and only went out in the evenings when I took her somewhere. She asked me over and over whether there were really 350,000 Chinese living in the city; she couldn't get enough of Chinese restaurants. Like all Torontonians, I was proud of my city's diversity, but thought Chinatown was old news. I wanted her to be interested in the Greek and East-Indian areas, but she wasn't. Cathy and I took the ferry to Centre Island. She took no interest in the boat or in Lake Ontario, despite never having seen such a boat or a large body of water before. Nor was she interested in the Scarborough Bluffs, those sandy cliffs that tower over the lake. Cathy preferred to talk, but talking with her upset me. She was inclined to mind-numbing discussions of the weather, and how she ought to try harder — a regurgitation of the trite advice that had been dumped on her thousands of times by well-meaning people like me, people too terrified to take her seriously. Even her description of her parents bored me because she endlessly focused on their good and bad behaviours, exactly as she did with regard to herself. "Why is your focus always on whether you and your parents are good or bad, better or worse? Is judgment all there is?" To which Cathy would answer, "But I have to improve myself." She wanted to go to a movie, but I wouldn't agree to take her. I'm

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a snob, and wanted to broaden her impoverished, narrow world. Cathy had an IQ of 140, and used good grammar, didn't she? During the day, my family and friends took her to Casa Loma, the CN Tower and to Niagara Falls. She was politely grateful but showed no sign she found any of it interesting. The weather was good, and I was annoyed Cathy wouldn't go out on her own, take a walk, or go out and watch the children playing in the park. I hated that she smoked all day, and fiddled with her pills, opening and closing the bottles, counting how many capsules were left, and setting out those she needed to take that day. Then she'd check and recheck whether she had it right. I was repelled by her hands — not because they were repulsive, but because I had seen such hands so many times before. They were the hands of a drug-treated schizophrenic: smooth, half-open, and immobile. Strangely, I was reminded of my grandmothers hands, which had not repelled me. I looked again, and saw the gentle movements of Cathy's pale hands had a beauty of their own. The fingers were immobile, but her hands moved smoothly and gently. The drug poisons had tried to transform her hands into those of a freak, but a ghost, the ghost of my grandmother, had saved them. I tried not to judge, and not to think that because Cathy was different, she was crazy. Cathy was a master at coming up with disrespectful definitions of herself, and one day I asked her, "Why is it, Cathy, that you are so determined to only use unattractive language when you talk about yourself? You're always saying you're sick, diat your body is falling apart, and forever remind me of pills, doctors, paranoia, schizophrenia and so on. You know I hate goodie-goodies, so don't misunderstand — I'm not trying to pep you up, or pat you on the back. I just want you to notice that you never use kind words for the way you live your life. You might just as well define yourself as 'unconventional,' but I doubt it would cross your mind to say such a thing." It was hardly profound, but at least I'd spoken seriously. Cathy

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played down her psychological unkindness toward herself, and concluded that the most important thing about my comment was that it showed how wonderful I was. But I think she got my point. The idea that she might be "unconventional" eventually delighted Cathy. Here was a neutral word with which she could redescribe her life and her madness. She even threw the word "unconventional" back at me, because I tried to make a joke out of everything. The word also gave Cathy the courage to give me a new name, the name with which she'd greeted me at the airport: "Hi, Warmie." Dr. Warme, she'd decided, was too formal, and Gordon too intimate. Henceforth, I was to be called "Warmie." Dec 7,1997 Dear Warmie, I was very happy to receive your letter and the pictures. I'm so glad the pictures turned out all right. Thanks a lot! I'm enclosing the poem that starts, "Time Flies," but I don't think I know the other one you wanted. Was it something about "getting older and the world getting colder?" If it was, let me know, and I'll find it (hopefully) and copy it for you. I sure enjoyed seeing you too, and you weren't a stranger either. I feel I have a correct impression of your "ironic" view of life now, which is okay. Ironic means "bitterly humorous," so I guess I can say I have an "ironic" view of life, too. Sometimes more bitter than humorous. I've got to be careful right now or I may start crying. My depression hasn't left me yet, hospitalization notwithstanding. But I'm only having about one really bad day a week now instead of two or so. Today was so-so. Pretty good, I guess. Tonight I'm desperately lonely. I miss you and some other friends tonight. I was devastated and torn up after coming home, but I'm glad I went to see you. If there were any questions in my mind, at least now they're settled. I mean of course it was great to see you!! I have therapy tomorrow morning. I feel as if my therapy is now

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getting somewhere. We're really digging and I'm trying hard. Dr. Jackson, my endocrinologist, has me on a steroid now to try to even out my hormonal levels. I sure hope it works. I've lost a lot of hair lately and it's showing. This is the last medicine he can try, he says. I don't know what happens if it doesn't work. Maybe surgery? Time flies, And with each Fleeting moment Steals A portion of Your life And leaves nothing In return But what you gave To life. Time steals; You give. You die; Time lives. I will close for now. Hope you'll write soon or whenever. Love, Cathy

What evil fairy had decided Cathy needed more madness, more hospitals, more drugs and misery? What goblin had led her into more depression and abomination — the drugs which pushed her more deeply into zombie subjugation, an effect that, as it preserved her mind and spirit, destroyed them?" If the Fates believe it was hubris for me to let Cathy visit in Toronto, they're wrong. It was they who blundered when they bashed her to the ground again. Their excuse is that the harmony and decorum of

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psychiatry had been breeched, which just shows that the Fates and gods that guard us can be blockheads. I haven't seen any sign from the Fates about the story of Hanna and me, but they disapprove of that story, too. The content of Cathy's letters was no different from anyone else's — full of vanity, generosity, love and bitterness. Except hers were better: superior, fantastic letters. In them she described her friendships, family get-togethers, and her heartbreaks — which were like everyone else's. On judgment day, her hypochondriacal fretting won't matter a damn. It doesn't differ much from the health and appearance obsession with which our whole culture is afflicted. I wish that Cathy had been spared her pain, but I never wanted her to be a different person.

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THE WARRIOR

My struggles with orthodox opinion are pretty well over. It's 2001, and I'd hope that by now I'm thinking for myself and relying on my own imagination. As much as I can, I'm practicing psychiatry without asking my patients to submit to anything. It's just that a gang of saboteurs spoils my attempts to be the perfect psychiatrist. It's that rotten unconscious of mine: unknown and never-to-be-known intentions lead me off-track without me knowing it. Psychiatry has to be the impossible profession. Just the same, I'm getting pretty good at not expecting my patients' stories to have happy endings. I don't even expect them to make sense. They'll talk, and I'll try to stir up new ideas. It's good luck to listen to people reluctantly exposing their inner treasures — horrors, too — but how much better would it have been had I listened well years ago, especially to Cathy Jones, my schizophrenic patient? In the face of her madness — and that word, schizophrenia — I was cowed and stayed safely on the surface, denying her a respectful, inventive ear. On this day, with my father ears in place, I'm listening to David Long — actually "Dave" Long, as he insists — the psychiatric resident who I assessed with the group. I think it was Jimmy Forster, "Dr. Noname," who did the initial interview — in June of 1997. Dr. Long and

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I began meeting that September and it's been four times a week on my couch for the last three-and-a-half years. He's long given up his claim he's after a learning experience, but since he is himself a psychiatrist, his colleagues will think of his analysis as "learning" and as "training." Thankfully, Dr. Long has no more illusions that his analysis is an administrative matter. Soon after we began, he and his wife divorced, despite his brave assertion when first assessed that his marriage was "pretty well perfect." It's hard to see him as the same person. That June, he had talked a lot about his parents. Now he never mentions them, even though psychiatrists like me are interested in stories about parents. When I ask him why such a dramatic change might have taken place, he ignores me — except once, when he promised me, without elaborating, "Someday I'll tell you about them." Today, Dr. Long is whining and bitching as usual. That's not a problem since I'm an old hand at this, and well-versed in how to behave myself. I know the automatic and human thing would be to coax Dr. Long into "being sensible," or seeing the bright side. Maybe he should get some hobbies, meet new people, join a club? But I'm never tempted to normalize him — a good thing for my self-respect, since persuading someone to be normal usually involves passing on a bunch of cliches. Cliches are not benign. Like small talk, cliches and ordinary chatter have a powerful role in convincing us to behave within bounds, persuading us to act "normally." Cliches and chatter are also a refuge for busybodies and meddlers. Eavesdropping in a restaurant or other public places teaches us how demanding and moralistic the world can be: "Don't let him get away with that. Give him an inch and he'll take a mile. I'd ground him for a week." It's all about rules, applying them, passing judgment, usually without much thinking. We're all sure we know how others ought to behave. It's

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what we psychiatrists struggle with — not because we don't believe in social standards, but because our job is different. Arbitrary opinion, all too often, can be translated into bogus mental-health terms: "I told him years ago he needed to go to a shrink." "If you don't get some help, I just can't go on with our marriage." "No wonder the kid is such a mess. The family is completely dysfunctional." "God, he's a self-defeating guy!" "His relationships are all fucked up because of his mother complex." "Unconsciously, he's anally fixated and can never let go." "She's always out to undermine father figures." Such statements are just cleaned-up invitations to psychiatrists to become behavioural policemen. The speaker does not approve of what he sees, tries not to speak maliciously, and recommends psychiatric intervention — which usually means the speaker wants a psychiatrist to get someone to behave the way the speaker wants. The payoff for calling something a disease and then "treating it" is that the real aim is disguised: get the person to act in a way that I like. Don't misunderstand me. The world has always been moralistic, and always will be. A culture can't survive if some standards aren't agreed upon, but it's easy to shift from standards to oppression. As a psychiatrist, my job has little to do with standards anyway.

Although he didn't let us see it when he was assessed, Dr. Long is a son of Sparta. He's also now a qualified psychiatrist and recently moved from Mt. Sinai to Toronto General Hospital. "Well, I've made another move," he told me. "I've never worked in such a disorganized place in my life. It's shit. I suppose I'm fucked 'cuz there's no way I can go somewhere else right away." Well, here he is, fucked again. Dr. Long is always fucked, and it was

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no different in his previous job. Even as a junior psychiatric resident, Dr. Long insisted that working in the university was not an option for people with scholarly minds. Academia had become, he maintained, a place of chiefs, directors and even, nowadays, "presidents." He is right, of course. Transparently useless research is the entry ticket: researchers and their credulous flunkies dominate academic psychiatry. It brings to rnind a point made by Goethe: Nothing is more revolting than the majority; for it consists of few vigorous predecessors, of knaves who accommodate themselves, of weak people who assimilate themselves, and the mass that toddles after them without knowing in the least what it wants.

Dr. Long is obsessed with the problem Goethe identified here. In a corner of his mind he knows that working full-time in the university guarantees he can describe himself as "fucked." He won't have the easy time I had. I was lucky enough to get my career going during a brief era — enlightenment crops up every so often, and then withers away — of inspirational psychiatry. Dr. Long is highly intelligent, and lets his wide literary knowledge spill out as it did when he was originally assessed in 1997. When Dr. Forster first interviewed him, Dr. Long had said he tried to read a bit of Shakespeare every day. Sure enough, he quoted from Hamlet the day we began his analysis: So, oft it chances in particular men, That but for some vicious mole of nature in them, As in their birth, wherein they are not guilty (Since nature cannot choose his origin), By their o'ergrowth of some complexion Oft breaking down the pales and forts of reason, Or by some habit, that too much o'er-leavens

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The form of plausive manners — that these men, Carrying, I say, the stamp of one defect, Being nature's livery, or fortune's star, His virtues else, be they as pure as grace, As infinite as man may undergo, Shall in the general censure take corruption From that particular fault: the dram of [ev'l] Doth all the noble substance of a doubt To his own scandal.

Three years earlier I'd begun rny interview with Dr. Long by suggesting he was definitely not Othello and was probably an ethnically refined Venetian like Cassio. Maybe he'd started our analytic sessions with a quotation from Shakespeare as payback for my pugnacious Shakespeare jab back then. Still, he was not a false intellectual as I'd thought back when he was assessed. Literature was real for him — except when thrown off balance by his humanity. Because Dr. Long is a fine athlete, he has a healthy smell — I'm vaguely aware of the smells given off by all my patients. His athleticism is surprising because of his pie-shaped face and wide-hipped body. He plays a lot of pick-up hockey, and is known to be as hard as nails. He doesn't avoid fighting, and is always on the lookout for evidence of unfair play so he can go after the violator. Although he weighs only 150 pounds, he'll take on any opponent. One day, he and some friends were playing shinny when an acquaintance, Mortie, wanted to join in. Dr. Long refused him — Mortie was a difficult, selfish man who, in a flashy way, would have hogged the puck. Furthermore, said Dr. Long, Mortie was an outrageous charlatan in business. Later, in the dressing room, Mortie approached Dr. Long. "It was rude of you not to let me play." "Fuck off!" "It's just a pick-up game. You could have let me join in."

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"Fuck off!" Dr. Long told me he was hoping Mortie would take a swing at him. Even though Mortie is 30 pounds heavier, all gristle and sinew, Dr. Long said he wanted a chance to "level him." "The only trouble was that I would have had to take him to Emergency." I've written about this incident elsewhere, and a friend of mine decided Dr. Long was a "preverbal asshole." In psychiatric (language, she might have called him an "impulse-ridden" character, or a "preOedipally fixated borderline," except that her distaste would have been disguised. I have the opposite reaction; I'm inclined to think of Dr. Long as a new incarnation of Achilles, someone who was also "fucked" by the world. You may recall that Agamemnon stole Achilles' concubine/wife Brisei's, leaving him in the same state of despair as Dr. Long. I was also relieved he was a fighter, because that let me off the hook for the combative interview I'd had with him three years earlier, when I'd tried to "level" him. I liked Dr. Longs warrior style, probably because I have a fondness for Achilles, Muhammad Ali and Alexander the Great. Warrior heroes are cultural building blocks that give thymos to the world: pep, texture, and life. They are among the icons — or archetypes — from which social life is assembled. Each of us, as the linguists might say, is suspended in a web of signifiers. Just as we can't live without heroes and goddesses, neither can we get by without criminals and parsons. I'm therefore not tempted to try to make Dr. Long behave. On the contrary, the trouble-making demon in me wants to encourage Dr. Long's toughguy behaviour. He'd been an annoying quibbler when I first met him, then came to life. Warriors love, celebrate, and treasure an aggressive life: phallic, Dionysian, potent, intrusive, and the very enemy of soulful thinking. As one could guess, Dr. Long drives a fast, powerful car. Since I'm talking about warriors, one more observation might be in order. Because Dr. Long's actions are tough and bold, he is the

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opposite of the hysteric. She, of course, is frilly and subject to the vapors. Since the word hysteric is too contaminated for daily use, I suggest we call her a goddess instead. Isn't Dr. Long's super-masculinity a perfect parallel to the super-femininity of the hysteric? At times, Dr. Long is in despair, and doesn't know why. When he was younger, he'd go out with "broads" and "get laid," and after a few hours, he'd make an excuse and go home. But he can't do it anymore: "I'm not the man I used to be." I know the meaning of his explanation. Back when he was merely a warrior-in-training, Dr. Long could only achieve trivial victories like — as he put it — going out with broads and getting laid. Now that he was approaching full manhood, he's become nervous about the expectation that he should enter into real love and real love-making with a woman. Why did Dr. Long insist that his archetypal maleness was finished? As it turned out, I didn't have to guess why despair and inferiority had become that day's psychological preference. Dr. Long bragged of how, earlier that morning, he had outsmarted a lawyer. Like all the young heroes of Greek mythology, he had held himself responsible for the overthrow of a symbolic father. "You slew the father and now you must pay," I told him. "Of course you have to be fucked today." My quirky understanding of what precipitated Dr. Long feeling "fucked" today impressed him; perhaps he hadn't vanquished the powerful father after all. Like a potent god, hadn't I survived? But if I tried to nudge him about possible weaknesses in me, he claimed he knew my faults perfectly well. "You may vanquish a lawyer but it doesn't look like you'll ever vanquish me. Despite what you say, you never talk as though I have weaknesses." "You should take me seriously when I make jokes about your secret

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tippling from that bottle hidden in your drawer," he countered. "Do you think I don't hear you pulling the drawer open?" I had an answer for him: "It's a cute joke, Dr. Long, but my point is an important and serious one. I'll say it again: although you know me very well, you never really nail me about my failings. Never once, have I felt the sick humiliation of you drawing my faults to my attention." Had I not been intellectually potent, Dr. Long's reaction to the incident with the lawyer might have been worse. For the moment, I'd complied with his madness, and had another sturdy insight: Of course Dr. Long was thinking of himself as a weak male. That put him in the same boat as his father, who'd gone bankrupt two years back. But Dr. Long had propped up his father long before the bankruptcy. He'd already been building up his father when I'd first seen him with my students three-and-a-half years before.

When Dr. Long, once again, told me he was fucked, it was my job is to draw the pattern to his attention, so we could learn why the world always took on this negative appearance. Again, my words bounced off him. "What good is it telling me that this is a pattern, Dr. Warme? You know as well as I do it's true. We're all fucked. The world is shit, the hypocrites and the opportunists get ahead, they even enjoy their superficial lives." Emphasizing each trivial moment was not the real issue — the background problem was Dr. Long's mind. He saw through the world like the child in "The Emperor's New Clothes." He was Adam, who took a bite from the apple of knowledge. God placed the tempting apple in the Garden of Eden for this very reason, so that Adam and Eve would eat it — and sin. Only after committing this original sin

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were they fit to live in a community and capable of behaving themselves. Sin and guilt guarantee that the world won't fly apart. That's why the calf with the gilded horns is sacrificed, and why we drink its blood and eat its flesh. Eating the body and blood of the god keeps us frightened, makes us obedient citizens of the polls. As the Greeks advised, "to found a city, you must first kill your babies, eat the flesh, smear the blood . . . " When Dr. Long was so acutely focused on the stupidity of the world, he committed the archetypal crime: seeing through God, through the world, and through the shortcomings of his father. But he didn't see through me. Dr. Long didn't see through the world wisely. All the ingredients of the insightful man were in him, but his purpose wasn't to be amazed, only to be disappointed and suffer. He made sure he didn't enjoy what he saw — he was like a chef who chops celery instead of attending to the subtleties of spicing and the flourishes of presentation. Rather than knowing the wistful joys of seeing through conventional truths, he waged a painful war against them. When he saw that we are all "fucked" — in a certain sense he was right, of course — he didn't smile at the irony, but rather raged against it. Like a revolutionary, he was at risk of destroying life instead of recreating it. To be inspired — as opposed to being a revolutionary — was a state of mind he'd gotten rid of in himself. With his Ferrari thinking, he could see through the world, but couldn't apply his brainpower to his own self-sabotage. He flailed like a caveman, missed the fun, and did it that way willfully. Dr. Long was like those youthful, rock 'n' roll rebels who thought the world could be cured by a head-on assault, and copulated for the television cameras at Woodstock. Dr. Long's enlightened blindness required him to neglect his greatest gifts. He knew sincerity could be seen through, knew and loved intellect, parody and irony, but he was

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crippled by his horror of his father's weakness — Dr. Long's words always emphasized "financial errors." It was a tragedy and only a tragedy, a pure fact plain and simple. Dr. Long was also crippled by the world's errors — more pure facts he saw only as pure facts. He didn't want to get the joke. How many of us do — when it comes to us? How can I, as a psychiatrist, help bring my patients out of their earnestness and into the world of irony so they too can enjoy the joke? The Dave Long I've been describing is a real patient, but for the purposes of this book, I've used a pseudonym. Is it an accident and an irony that I picked the name "Long" for him? What if I had called him Dick Long? Would you think I was making jokes?

Dr. Long was neither a true victim, nor one of the false, "I'm-amartyr" victims; he sought out suffering, not in order to make himself pathetic, but so he could do battle: stupidity, corruption and hypocrisy were his targets. In contrast to his vision of a corrupt world, he was passionately moral and I expect that, when he dies, he'll die bravely and heroically. He said nothing about how his father coped with financial ruin, but hinted at abject unhappiness, and blaming of others. This imposed a terrible burden on Dr. Long: he had to be heroic vicariously — on his father's behalf, so to speak. Long before the bankruptcy, Dr. Long had been an excellent student, compensating even then for his father's pathetic behaviour. Dr. Long was performing two tricks: his disappointment with his father was highly inflated — he was similarly disappointed with the whole world during his analysis — so that he, Dr. Long, was unhappy just like his father. Secondly, by being unhappy, he didn't surpass his father: both were pathetic. But Dr. Long rarely talked about disappointment in his father and,

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instead, talked about disappointment in people other than his father. He raged against them flamboyantly, a desperate smoke-and-mirrors distraction from his father. There were also issues about his mother — he'd had silly complaints about her when he was assessed — but during his psychotherapy he never spoke of her. The pattern wasn't hard to see. He was caught in — had seized upon — an oppressive world picture, and clung to it for dear life. Dr. Long was a model of how to battle stupidity; his father was immune to being caught out in his stupidity. But there was a difficulty. How was I to avoid joining up with those who condemned Dr. Long's crabbiness with the whole world, thereby becoming just another character for him to complain about? I could, I suppose, have said something like: "Don't you see that your persistence in only seeing the world's evils is precisely what makes you suffer?" "Every time I point out your pattern, you fight me off. It's as though I'm also going to 'fuck' you. You fight me just like you fight everybody else." "If you could see this behaviour as futile, you could start examining your motives for hanging on to it." Such statements would have made sense, but would they have helped? Or would Dr. Long have seen them as more evidence the world just wants him to "smarten up?" He speaks first: "I know what's going to happen. Now you're going to shaft me. Whatever you say, it'll fuck me good. I know what you're going to say, and I understand. But even if you're right, what am I going to do? The world still screws me up, I can't do anything about it, so what is there to do?" It was time for me to say something, and I couldn't really disagree. The world is (among other things) a piece of shit, so I knew I'd have to agree with him that far. I decided on a personal anecdote (always a

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risky move for a psychiatrist), but not with the intent he ought to try it my way. "I was in emergency at Sunnybrook Hospital the other night," I told him. "My brother Ernie, who's had a stroke and is severely handicapped, had a bad fall and was waiting to be admitted. We'd been waiting three hours. Although I'd asked, no one had brought a bedpan, and Ernie had peed on the stretcher. Nor had he been given anything to eat. He was fucked. I walked up and down the corridors and counted 18 staff members, but not one of them was with a patient. When I did another walkabout half an hour later, the story was the same. Ernie was in the same inefficient situation you describe in your new hospital. "But that night in the emergency department, I wasn't you. I neither blew my stack — I didn't complain or make a fuss — nor did I sink into despair, as you might have done. I was above it all, transformed into a god or something. "I guess I had a superrnortal reaction to what I saw: I was bemused. I knew this was only the world at work, a world as complicated and full of interest as any other. The emergency staff was busy, although not with patients. Some sat at computer terminals writing notes, and others were seriously discussing the patients. All of them were caught up in a creaky, bureaucratic structure. Everyone worries they might be sued, so — as a medical friend once put it — everybody gets an X-ray, a blood test, and a prescription. "Surely, Dr. Long, this is exactly what happens at Toronto General? You're not a god, though, so you can't see how amazing the world is as it writhes before your eyes."

It was a longwinded speech, and I wasn't yet done. Ordinarily, I'm circumspect and quiet, arid while it's not typical, I'm occasionally

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silent for a full appointment. But from time to time a long speech is in order. I was trying not to challenge Dr. Long head-on, so I was teasing and flirting with him. I wanted to give him a strong message, but to say it in a way he couldn't dismiss as an example of the world dumping on him. When I called myself a god, I was also poking fun at myself. When up against a man like Dr. Long, full of urgency, the immediate, and lots of calamities, I stay cool by shifting into abstract thought, mythology, and archetypes, attitudes that help us understand tragedy and comedy. With intellectualizers like Graham, always living in the world of abstraction, analogy, literature, and grand pronouncements, I do the opposite: I speak of soup and dumplings, of tables, chairs, cats and poop, and, yes, arguments, loneliness, and sex. Dr. Long was a man prone to absolute statements: "That's it. I'm fucked." There was no tentativeness, no curiosity or bewilderment. I fell into the trap of quarreling with him once in a while, although my challenges were disguised. "Shit happens," they say, even though, as a god, I should have been above such things.

I had paused for a moment. Dr. Long was quiet too. Although I don't usually take notes during an appointment, that day I had my note pad in hand and felt the urge to write something down. Instead, I told Dr. Long another story. "When you young psychiatrists think about going into psychoanalytic training, you worry whether four more years of boring seminars are worth it. The way to make the seminars interesting is to study the people there, both teachers and students. As the topic is psychoanalysis, the idea will be to discuss the unconscious, how we humans forever deceive ourselves, and how sexually lively we all are, even when we don't always know it. Instead of doing what they aim to do, the teachers and

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students avoid discussions of the unconscious, self-deception, or sex. In the end, it is they who are the best examples of self-deception! "Nearly all of the seminar time will be devoted to exceptions, to development, and, yes, to 'normalizing.' Patients will be talked about as though they've developed abnormally, and described by words like infantile, primitive or fixated. If the patients are abnormal, what else could they do but discuss ways of getting the patient out of pathology and into normality? No matter how subtle, tolerant, and patient they want to be, ultimately they'll fall into the hands of the normalizing demon." "That, Dr. Long, is how I persuade you guys to go through with psychoanalytic training, and, at the same time, immunize you just a little bit against falling into the traps." "Well," Dr. Long replied, "I knew you would shaft me."

I still had my pad in my hand. There was a line wanting to come into my mind, but I couldn't quite catch hold of it, a line that described the way I was speaking to Dr. Long. It had something to do with patience, persistence, quiet resolve, and calmly bringing forward a succession of arguments. It felt like it might have been a line from Shakespeare, perhaps Thomas Mann. Suddenly, I remembered. It was from a dirty poem we recited as adolescents called "Rangy Lil." Lucky for you, I don't remember all of it, but I'll repeat the lines as I remembered them, including the one that arrived after 50 years. The poem was about a copulating contest between two legendary specialists in the art from the far northern reaches of Canada, Rangy Lil and Pete. Here are a few fragments from mid-contest: Lil tried shunts, and double shunts,

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And tricks unknown to common cunts, But Pete kept reeling out more hose. 'Till through the portals of Lil's ass, Nine feet of slimy penis passed. They hung Lil's pants on the shithouse door, In honour of that gallant whore.

I guess it wasn't Shakespeare, after all. I love it when I can play wise old fellow and quote Shakespeare, perhaps that's why the line disguised itself as the Bard before showing its face as the Boor. The line that had made me get out my writing pad, was, "Pete kept reeling out more hose." It was none too subtle, but the connection didn't click at first. Then, suddenly, I understood. So I recited to Dr. Long the poem, pointing out the key line, in which I played Pete, calmly and methodically reeling out more hose. "Dr. Long, it's a homosexual fantasy. You are the passive partner, and I keep inserting things into you. And, come to think of it, we should have thought of it long ago. You regularly say you are 'fucked' and that I 'shaft' you. Since there is a certain obviousness to this language, I suspect both of us are uneasy about it, otherwise we would have talked about it sooner. "That's why, no matter what, you experience yourself as 'fucked.' It's a wonderful set-up in which you can always experience yourself as the passive person, messed up by the world. It's the safest spot for you, because if the world messes you up, you can never be a winner, an achiever, or triumphant. You never fuck anybody — they fuck you." It was silent for a few minutes, after which I said, "Our time is up for today." Dr. Long sat up and announced he couldn't make his appointment on Tuesday. Typically, when I offered him a substitute time, he turned it down. Nevertheless, I stuck to my ritualistic practice: "I could see you on Wednesday a t . . . "

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He interrupted and told me his week was really tight. But when I finished the sentence, " . . . at 1:30," he told me that, actually, he could make that time. Dr. Long left. Why, on the day we discussed homosexuality (albeit briefly), did Dr. Long agree for the first time to have an alternate appointment?

When my analysis ended in 1968, I had panic attacks, one of which was clearly a homosexual panic. Signs of weakness make many men uneasy, and the year my analysis ended was the worst year of my life. It was especially hard because I didn't have enough machismo in my character to fall back on: no swearing, spitting or bragging. I defined my manhood by intellect, a dangerous tactic since being smart could also signal I was a sissy. When I talked with him about his homosexual fantasy, Mr. Long yielded to my words — for him, a big risk. Despite his brassy claims that being tough was all that mattered, he came, listened and changed. Dr. Long and I played out our precious cultural ritual — psychoanalysis, psychotherapy, soul-talk or whatever you want to call it. The conversation between troubled citizen and wizard is common to every culture, and each has its cherished rules and customs, always tinged with mystery. Except that it isn't just "tinged" by mystery; the whole shaman enterprise — including western psychiatry — is underpinned by magic and mystery. Dr. Long and I were skilled performers: our stage was life, and being "performers" didn't make what we did ephemeral or unimportant. A Midsummer Night's Dream and Death in Venice move us because they are about the real world. Dr. Long and I knew our parts and performed them well. We could have talked about planetary influences or energy fields — but we didn't. Our game was different. We were the people who read The New Yorker, a snobbish

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subculture that draws pleasure and wisdom from the theatrics of Broadway and The West End. When I have such conversations with labourers, derelicts or school dropouts, their eyes narrow with surprise. They don't expect my highfalutin' talk, full of philosophy and literature. As well as being flattered, they are fascinated by biblical and mythological stories, understanding perfectly well that they themselves live out such archetypal stories. They can't put it into words as I can, but they know that in my office they have dropped out of clock-time and entered the timeless world of myth. I've played out the same script with philosophers and factory hands, with the utterly mad, and with CEOS. We all know how to do it.

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CHAPTEB^FIFTEEn

In THE SHAinAn's CAVE

I'm annoyed about the room in which we hold our seminar. The latest indignity is the air-conditioning, which is out of whack and hisses at one end of the room, so the students sitting there can't hear what the patient is saying. They won't see a real psychiatric office unless they get into treatment themselves, and my private office would fit the bill perfectly. My office is a cave with no horizon; still, its walls limit me. Psychiatrists hate being hemmed in and limited, long to be free to view the world sublimely, without being hemmed in by any belief in the sublime. We'd be fools to believe the sublime could be achieved, so we lurk in our caves to remind ourselves that we're as limited and fettered as everyone else. Which leads to an important truism: he who thinks his psychiatrist is wiser than he, is an ordinary mortal, but he whose psychiatrist has not helped him to see the folly of that belief has been neglected. It is necessary to regularly remind ourselves of the words of Frederick the Great, a man of humility, who, when the crowds cheered him, remarked: "Put a monkey on a horse and they will cheer him just the same." My office is dimly lit, carpeted and furnished with a relaxing chair and a couch. Above my couch is a painting by Monique Harvey

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entitled Marie Fleuve, depicting a pale young woman with a blank face, sitting on a wicker bench beside a river. She is impassive, and when secrets stream toward her from the couch below, she does not react. In her lap she holds a bouquet that sprouts gaily from her crotch — or so it appears — which suggests she is blossoming into womanhood. On another wall is a rubbing from a Stella at Bonampak, close to Palerique. The young man in the rubbing is a Mayan priest, and on his head and back he wears decorations and insignia that can be admired by the public as he climbs the steps of the pyramid. He, too, is proudly blossoming into adulthood. Beside me is a table holding miniature figurines. An Inuit shaman carved from walrus ivory stands there placidly and, aldiough his round mouth is shaped like an "O," he never speaks. Beside him sits a Netsuke figure of a Japanese musician playing an unidentifiable instrument. Nearby, there's a proud ceramic Ram from Crete, perfectly intact, despite being 2500 years old. Like a cave, my office is narrow and deep. The walls are mirrored and, next to the figurines are 42 miniature horses. My office, the students will notice, is modeled on a stable where, as when I pretended to be a horse many years ago, I continue to be silent and inward. Sure, I twitch my skin, sneeze, flick my tail, but none of those actions distract me from my relentless, silent listening. A colleague who is a poet says that, in another life, I was a shaman. A Houyhnhnm shaman, I would guess. My colleague's worksheet could give my students a sense of the psychiatrist's world. Shaman Sits with his horses in the cave and stares into the mirror of my mind

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silent the shaman sits with his horses in the cave stares into the mirror of mv mind silent shaman sits with his horses in the cave searches the mirror of our mind silent the shaman sits with his horses in the cave searches the mirror of our mind silent in the cave the shaman sits with his horses stares into the mirror of our mind

Leila Singh has been doing better work lately. She no longer pesters me to force concrete diagnoses on patients, and seems genuinely interested in what gets seen when we look at them from odd angles. Nor is her furor therapeuticus as disabling as it once was, the therapeutic fury that tempted her to tell all patients, "Take this pill." A few weeks ago she'd done a fine interview with a difficult man, during which I sensed she had truly lost herself in his inner world. It is her turn to interview again today. She's nervous as she enters the seminar room. When she starts, I see

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that she is more than simply anxious; she's a nervous wreck. Atypically, she speaks quickly; her grammar is so bad I can barely decipher what she is saying. Dr. Singh repeatedly assures us that today's patient, Blair Allen, has told her little. "He keeps saying he is 'bipolar." He insists his parents were mean to him as a child and this is what's caused his distress. But I have no sense of what form that distress takes." The other students seem embarrassed for Leila; they stare glumly at the table and at their own hands. I see Osman Awad wants to rescue her by asking questions, but he knows I always want the student's version of the case, so he bites his tongue and resigns himself to watching and thinking, the state my quietness is intended to promote. I watch Leila intently. It's not my job to treat her like she's a psychological invalid so I let her struggle to tell the story. I'm trying to figure out what has happened — nothing she's said about Mr. Allen suggests she should be frightened. Finally, having told the best story she could under the circumstances, her ordeal ends. The group members make a few tired observations, including a remark out of the blue by Christine that can only come from her uneasiness about what she's seen — she wonders if Mr. Allen might have an organic brain disorder. Eager to turn the patient over to me, Leila escapes by quickly going to fetch him. Once she is out of the room, Osman speaks up. "Leila is very embarrassed about her English, and when she's nervous, her English deteriorates." What a peculiar idea this seems to me, although I recall hearing Leila say that her English was bad. But she speaks English perfectly well, as far as I can see, and her written reports are always clear and acceptable. After all, her medical education in India had been in English. Leila returns without Mr. Allen. "He isn't out in the hall where I asked him to meet me," she says.

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I watch silently. Christine speaks up. "Has he gone to the cafeteria?" Leila stands helplessly in the doorway and mumbles that she doesn't know. "Why don't you go to the cafeteria and see?" says Christine. Leila is as pretty as ever. Even in her nervous helplessness, her smile is pert and her eyes sparkle. Has she gotten herself in trouble with her Western-style flirtatiousness, I wonder? I'd always thought she was old-school traditional Indian, but recently I've been worrying about her perpetual gaiety. I'd also heard a rumor she was having a good time at student parties. Is she in the doghouse (am I just wondering, or should I call this is a fantasy I'm having?) with her religious husband? Is he sending her back to India so she'll behave? After a few minutes she returns, again without her patient. The students are worried about her and are not annoyed. Christine wonders if he's gone downstairs to the waiting room beside Leila's office. That hadn't occurred to Leila, so she submissively trots off to check. She returns with Mr. Allen in tow. He sits down with a smile. I note that he is very tall and powerfully built. Because his skin is a handsome, chocolate brown and his small ears snuggle tightly against his skull, I instantly stereotype him as some kind of athlete: a basketball player for the Raptors or an Argo football player. He smiles and his white teeth show me that he has a fine, solid skeleton. He is gorgeous. tcj y » T rli, I say. "Hi," he says back. There is a touch of an accent. "Where are you from?" "My family is from England." Why have I started with a banal question? I am probably concerned that he is on edge and therefore I'm easing him into the conversation. But if I don't interview him in the same style I use with other patients, how will I be able to see how he stacks up?

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"Something is going wrong in your life, I believe?" "My parents have messed me up good," he says. "Are you sure?" I say. "It's easy to blame your parents." Mr. Allen is mildly incredulous that I haven't immediately taken him at his word. To him, it's obvious his parents are the cause of his unhappiness, whatever that might turn out to be. But he is also goodnatured and is willing to explore a new point of view. I also notice something else. Despite his smile, his emotional reactions to me have an unsettling deadness — "blunted affect," we psychiatrists call it. Though he has barely spoken, his answers have been very concrete. In other words, Mr. Allen takes things literally and probably has a simplified understanding of cause and effect. To him, A causes B, and that's tliat. He would be well-suited to be one of those modern psychiatrists who think behaviour can be explained by recourse to simple causes. Could Mr. Allen's demeanor explain Leila's anxiety? Had she looked at him and seen a version of herself? True, Leila tends to be literal in her understanding of patients, but she isn't, like many modern psychiatrists, an extreme example of literals terminalis. I look closely at him, but my nose gives me the answer I'm looking for — Mr. Allen is schizophrenic. Like all psychiatrists who have been around a while, I can smell schizophrenia right away. There is an odd vacancy in Mr. Allen's look, and his smile is giggly rather than warm. Hebephrenic schizophrenia is out of style these days, but when he giggles, Mr. Allen looks very like the bewildered hebephrenic patients I saw 30 years ago. Perhaps that's why he got lost after Leila's interview. Hebephrenia is the psychotic equivalent of a well-known neurotic condition, also banished from current systems of classification: hysteria. In both types of patient, rationality and logic are avoided while emotionality and intuition rule. I'm surprised Leila has missed this: she works on an in-patient ward and sees many schizophrenic patients. Mr. Allen bombards me with pathetic cliches. He senses his own

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madness and has been told many times to "be realistic." So with me he is realistic with a vengeance. "I try to be a good person." "I want to have a good life." "I want to get a job." "I want to be a good husband."

"What do you like to do, Mr. Allen?" I ask him. "I like science fiction. Tonight I'm watching Star Trek. "He smiles and then giggles. "Hey, you look just like Captain Picard!" I've been told before that my bony skull makes me look like Captain Picard. But Mr. Allen goes a step further: for the remainder of the interview, I am Captain Picard for him. Does he really believe this, or is he pretending? Making fun? "What other important things do you have to tell me?" "You're the Captain." "Tell me some of your ideas about what might be important about •y> you. "Whatever you say, Captain." Most of the time Mr. Allen is chuckling, and he never once mentions the bipolar illness he belaboured when interviewed by Leila Singh. He is so agreeable I decide to move ahead quickly. "Tell me some of your crazy thoughts, Mr. Allen." This question gives him pause. It's the first remark of mine that has pushed him off balance. I notice a frothy spittle at the corners of his mouth. "What do you mean, 'my crazy thoughts'?" "You know. Tell me about some of the crazy thoughts you have sometimes." He relaxes and smiles. "Oh, my crazy thoughts."

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He giggles. "They're crazy! I think the TV is talking to me and sometimes I think I can get people to communicate with me when they are not around. People think I'm nuts when I tell them. When I went into the hospital last month, I was running around the neighbourhood yelling, and people were afraid I'd hurt them. They were probably scared because they think I'm gay, and have seen me at the bar where I'm a bouncer. But I want to be a truck driver. I love driving and traveling. But it would be terrible if I drove the truck into a ditch." "What happened the other time you had to be in the hospital?" His face falls. "I don't: really feel like talking about it now." Mr. Allen probably needs to be on some antipsychotic drug, so I tell him I'd like to refer him to someone who might prescribe a helpful medication for him. "I'm already on plenty of meds. They make me groggy, so I stopped them last night." When I ask what drugs he is on, he names an antidepressant and an antipsychotic. Someone, it seems, has already made the diagnosis of schizophrenia. We talk briefly about drugs. "It's time for us to stop. I want to sleep on our conversation. I'll think about it and give you a phone call in a few days." "Great," he says cheerfully, then packs up his belongings and leaves. He pauses in the doorway. "I hope I haven't embarrassed you." This last comment is strange and intriguing because there's embarrassment in the room, all right, but it can't decide where it belongs. Mr. Allen thinks that / may be embarrassed, but I'm not. The students, however, are embarrassed — for Dr. Singh. Mr. Allen, however, the one whose actions are odd, is not embarrassed. I've already decided what I'm going to do; I will see Mr. Allen in psychodierapy myself. Partly, I'd like to work with a schizophrenic patient — most won't come for psychotherapy and I think he will — and partly I want to show the students they don't always have to take

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patients who are university graduates, writers and artists. I'm showing off, too. Students won't often see their teachers take on such a case. But the anxiety Mr. Allen stirred up in Leila Singh tells me I have to be an example for the students. An act of bravery — schizophrenic patients are notoriously hard on the nerves — is in order. For now, Mr. Allen is functioning pretty well, so I'd best start his treatment right away. I'm actually going to psychoanalyze Mr. Allen, even though the received wisdom in the profession is that schizophrenics can't really be analyzed, at least not in a traditional way. My experience is different; I welcome psychotic patients on my couch and generally find their analyses to be both as ordinary and as unique as anyone else's. But why had Dr. Singh been so disconcerted? I hadn't taken seriously the gossip I'd heard about her, so I assumed she was overwhelmed by either Mr. Allen's maleness or his madness. Still, his madness hadn't been very obvious.

I've never heard of anyone but me trying traditional psychoanalysis with a schizophrenic patient. Everyone in the business is incredulous that I do it and many think I'm either lying, or the schizophrenics I say I'm analyzing aren't really schizophrenic. If I take their views too seriously — and for many years I did — I get lonely. Psychiatry is my profession after all, and these people are my friends. Their doubts lead me into doubt, and when things are tough, into despair. While it's true there's nothing like a good argument, this is an argument that drives my colleagues and I apart. Because I'm liable to relapse into conventionality at any time, I fend them off, denounce their ideas, ridicule and call them names. And so, I'm compelled to say that those who retreat from schizophrenic patients are cowards and, like all cowards, find solace in dilapidated cliches and slogans: "Schizophrenic patients are fragile and their ego

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weakness dictates that psychoanalysis is contraindicated." Sounds a lot like me when I treated Cathy Jones as damaged goods. Let's call a spade a spade. The voice of post-modernism demands that I speak against many iforms of cattle-diinking: academic, religious and scientific, and, most of all, the moralistic and politically correct. Mine is a voice of protest and not a philosophy. My job is to show my patient — the only person who counts — his suffering is something he does to himself, that it stems from his own set of hurtful rules and that, most of all, he is harmed, hampered, and enslaved by his own cowness. Just like me. The antidote? Wit, individualism, drama, challenge, logos and spirit/thymos/will/life. The modern world has produced plenty of heroes who have imagined themselves in this mold, so there are people around upon whom I can lean when I start to feel faint. I keep some of their pictures on the wall of my office, just in case. Oh, yes, die price. It's pretty high, as W. H. Auden warns us in his poem "The Witnesses." The Fates are the divine beings who pass out the thread of life. For committing the sin of pride and speaking out against convention, the Fates cut our thread. You are the town and We are the clock. We are the guardians of the gate in the rock, The Two. On your left and on your right, In the day and in the night, We are watching you. Wiser not to ask just what has occurred To them who disobeyed our word; To those We were the whirlpool, we were the reef, We were the formal nightmare, grief And the unlucky rose.

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CHAPTER^SixfEEII

LIFE TURIIS ITS Own PAGES

'Tis with our judgments as our watches, none Go just alike, yet each believes his own. ALEXANDER POPE

For two months, Mr. Allen and I met four times a week but he then reduced his visits to twice weekly. At the time we changed the schedule, he gave voice to something he'd been puzzling about: "What kind of a doctor are you? How come you don't give pills?" Against the advice of so many psychiatric worriers, I invited him to recline on the couch and to express his thoughts to me as freely as he could. "Tell all your thoughts, even if they seem irrelevant, unimportant or impolite. As far as possible, say everything. Some people call this the basic rule although it's not really a rule. But it sort of gives you the idea of how this works. So why don't you start, and we'll see how it goes?" When I told them, my students were nonplussed that I would do an analysis with Mr. Allen, because they had heard so often that schizophrenics do badly in psychoanalysis — some rot about them being unable to bear the regressive pull of the couch, the analyst's silence, or 303

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the frustration of the analyst's analytic distance. Obviously, the students hadn't paid close attention when I'd interviewed Mr. Allen three years before, or they would have seen his white teeth, as I did, as a sure indicator of a good skeleton. In other words, they'd have seen he has backbone. Mr. Allen had been hospitalized three times in the two years before he came for the assessment but since he and I had been working together, he hadn't been in hospital once. I can't say this happy state of affairs was because of the analysis; it was just the way things were going for him at that point in his life.

Until recently, Mr. Allen had talked mostly about his difficult marriage. Although he bitched about his wife, he actually cast himself as the marital villain: silly jokes, forever giggling, never taking things seriously. Mr. Allen and I had established early on that one of his preferred tactics was to be a "big baby," complaining and claiming to be upset. This infuriated his wife, who was always telling him to grow up and act like a man. When wounded by his wife's words, Mr. Allen went to massage parlors where he solicited masturbation and oral sex. He was so uninterested in intercourse that the masseuses didn't seem to him to be prostitutes — like their massage treatments, blow-jobs were merely something soothing. My prompts led to the confession that this was also his preferred form of sex with his wife, and that she was tiring of these demands. When I asked whether he'd ever experienced terrific, heterosexual lovemaking, he claimed not to understand. When I pressed him, he admitted he had no interest in that kind of sex. Dr. Singh had had a panic attack when she assessed Mr. Allen three years earlier and I wondered at that time whether she'd been frightened by his extravagant maleness. After all, as I'd noted when she joined my

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seminar, she was a modest Sikh lady. But as I thought about Mr. Allen, my thoughts were different. Had she been frightened, perhaps, by Mr. Allen's weakness and silliness? Frightened, among other things, that she had the power to attract him? When Dr. Singh assessed him, I'd had a fleeting memory of my daydream some months before, that her husband ought to make her behave. Six months back, Mr. Allen's brother, Elaine, an identical twin, had been diagnosed as having the sickle-cell anemia trait, which meant he inherited the gene from only one parent. Only when the gene is contributed by both parents, does the full disease appear. Elaine, the brother, was hospitalized twice for investigations, even though he was neither clinically unwell, nor was it anticipated he could become unwell. Nevertheless, he'd been spending a lot of time sitting silently in his living room, worrying. Elaine's wife had been worried, too, but not about the anemia — it was his overreaction to his diagnosis. Though he'd never been ill, he'd missed a lot of work and in the evenings and weekends did little but watch television. Blair Allen, my patient, worried more about his brother's illness than Elaine's wife; he also had the trait, so found his brother's worries understandable. When he returned from work, Mr. Allen complained bitterly and endlessly about his upset over his brother, and felt sure that his own son, too, must carry the trait. Although Mr. Allen's wife had always found his "baby" behaviour annoying, she'd now reached her limit. "You're nothing but a wimp," she'd told him. Mr. Allen was baffled, not by the idea that he was a wimp; that, he freely acknowledged. What puzzled him was why his worrying and fussing — tellingly, he preferred to call it "acting like a baby" — bothered his wife. Why couldn't he just be allowed his overreaction? Mr. Allen had been similarly baffled when I had noted his childish attitudes. As his bewilderment increased, I realized this wasn't just puzzlement or an annoyance; he was taken aback that we weren't at peace

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when he whimpered and wept. Everything he hoped for was under fire: maybe we wouldn't passively worry along with him any more. "Why would you even notice this?" he complained. "Who wouldn't be upset by my wife's crankiness? And anyway, even if I do complain a lot, I really don't understand why that would upset someone else. The stuff that's going on with my son and my brother is a sure sign that I have passed on this dreadful illness to my son, an illness that, now that I think of it, my father must have had, too. My son had a headache last night, which upset me. It's terrifying because I know it's from the disease. The headache's got to be from his blood cells breaking down. I remember my father had headaches, so that proves my son has it, too." Mr. Allen was trying to nail down "the truth," but going overboard with his protest. He was on the verge of seeing that the oneness and bliss for which he'd hoped for so long, didn't exist. "Mr. Allen, I have to say something to you that is full of risks for me," I told him, "risks of treating you like a baby or a child, risks of deciding that I am the alpha male in this room and that you are just a little boy. But here goes: "First, my son, don't you know it's time to grow up and be a man? Don't you know that your wife, in order to fully be a woman, needs you to fully be a man? You have to make fine and extraordinary love with your wife — or maybe I should say, to your wife. With love, strength and tenderness, you have to awaken her body, her womanliness and her soul. Then she'll know what it's like to really be a woman. As you do your duty — this is one of the duties of warriors — your wife will also do hers. The idea is that she will become so responsive and womanly that you'll be really stirred up by her. There'll also be stuff about her being potent and you passive, but diat isn't the important part; the important stuff will be when your maleness rises up in you and you find yourself transformed into a great pillar of love and

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heroism. Afterward, in dumb gratitude, you and your woman will give thanks to the god that instructed you so well: me. "Second, there is no right way to live a life. The path you and your wife have chosen is okay, and since life is a bloody mystery — a pile of shit among other things — your complaints aren't surprising. This is the balancing act you and your wife figured out together, which means there's no obligation for you to pay attention to moralistic fucks like me who tell you you're supposed to be a big-time romantic lover. Romeo and Juliet is a story about something wonderful about humans, but it isn't a model for everyone and, among other things, it's also a romantic scam. God bless you and me for not falling into any of these moralizing traps. "Third, the way you and I interact is a fabulous example of your life in action. There's a tension in this room and, although both of us are responsible for making this tension happen, we're best off if we blame you. That way we exaggerate who you are and get a dazzling look at you in action. Here's what I'm talking about. You, you rascal, have cajoled me into thinking I'm supposed to take on a paternal role with you, to show you how to be a real man, a hero. Fortunately for you, you are in the hands of the premier analyst in the city, so there isn't the slightest risk of me falling into this trap. "Four, now that I've got the jokes out of my system, I'll remind you that this pattern is intensely you, and it's no secret that it wrecks your life. But we're not out to teach you how to live. What we're after is the Delphic oracle thing, 'Know thyself.' So, what else can we know about this childishness of yours? For example, what is it that's impossible to know about yourself when you wipe out every possible thought except, 'I'm a baby!' 'I'm a wimp!' 'I'm suffering!' and 'I can't take it!' I used to think it had something to do with your handsomeness and your powerful build. Baby, baby, baby is a perfect distraction from your obvious maleness. I'm not as sure as I used to be that I'm right

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about that, but nothing else comes to mind as something you have to ward off or hide from yourself. I used to wonder whether you were unusually smart or had a mind like a steel trap, but you haven't given me anything that suggests that." "Dr. Warme," Mr. Allen responded. "The reason I'm so upset about my brother is that he's exactly like my father — sitting at home sulking, blaming my mother, and ending up with everybody disliking him and thinking he was a jerk. And it's starting in my son, too. He doesn't make people reject him by joking around, the way I do, he does it like my brother and my father, by acting like a weakling. I'm better off because at least some people like me because they think I'm funny. But most of the time, people think my jokes are silly and I end up with everybody thinking I'm a jerk. The four of us are alike, but the one that always upset me was my father. When I looked at my brother, I thought he was like a marionette, following the same script as my father. And now it's showing up in my son. "When I was a boy, I was very good at mathematics and science. My mother was very involved in my schoolwork because she herself hadn't had much of an education. She used to watch me doing homework — she actually beamed as she saw me solving problems and drawing graphs. I remember one day I saw my father out of the corner of my eye, watching the scene of me doing homework and my mother sitting beside me, sort of admiring what I was doing. I thought he had a look of pain on his face, but actually, it was humiliation. My father was humiliated because I was a good student and he wasn't — although I don't really know whether he was a good student or not. But the thought I had was that he had had a terrible twinge of pain and it was my fault." Mr. Allen fell silent, and I stayed silent as well so I could see where his mind would go. But I was also struck with amazement at the idea that the course of a life could be altered by a perception. His father

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had a look of pain on his face so, Mr. Allen concluded, was humiliated. A life, a destiny and a world determined by a fleeting perception. Would the fear of humiliating the world, or humiliating me, stop Mr. Allen from being reflective and — any minute now — make him turn helpless again? "Would he change the subject or make one of his silly jokes? But Mr. Allen remained silent and I could see his eyelashes flickering, so I knew he was thinking. "Go for it, Mr. Allen," I said. "Can you be the one who figures it out this time? Or will you humiliate me if you figure it out before me? Is that why I have to do all the analyzing around here, so that you won't humiliate me? Like you did your father? These days, only you are supposed to suffer, is that it?" Mr. Allen heaved a big sigh. "There is something else, Dr. Warme. My marriage is suddenly in big trouble. My wife and I have always had this problem, but it has suddenly come to a head and she doesn't want to put up with me anymore. I think she is going to leave me." There was something grown-up about the way Mr. Allen had told me this, a touch of pensiveness in his voice and an acceptance of the trials of life. "Mr. Allen, you just told me this without portraying yourself as a baby and without making any silly jokes," I remarked. "What's going on? You're not turning into a man right in front of our eyes, are you? The next thing I know, you'll be telling me that you are the father figure in the household." There was a long pause. He chuckled. "¥' 1 A J) >J 1 m the maitre d . I paused, too, and thought this over. "I guess you mean that you're turning into the actual father, but you feel safer if you say so 'once removed,' by saying you are only a maitre d', a sort of artificial father."

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There was yet another pause. "Thanks for being sensitive," Mr. Allen said with a twinkle. He was playing the humour game properly for a change, so I knew I'd better respond in kind. "I think it's time for a. hug." We both roared with laughter.

Jim Forster — the former Dr. No-name — had the same problem with me as Mr. Allen had with his wife. Just as Mr. Allen couldn't believe his wife and I were troubled by his passivity and complaining, three years earlier in my seminar, Jim couldn't believe I'd been troubled by his habit of seeing our patients as victims. It baffled him. He'd been intrigued by my interviews, and so he couldn't figure out why he and I thought so differently about things. He was also disconcerted that I didn't explain much, and always left him wondering what the devil I had in mind. But Dr. Forster was a smart resident and very determined — so determined, in fact, that he asked to have me as his psychotherapy supervisor. I was surprised at his request. In the seminar, he was clearly uncomfortable with my interviewing tactics, and was always pestering me to talk about theories. In his comments to the group, Dr. Forster tried hard to get me to acknowledge instincts, ego weaknesses and developmental fixations or, failing that, reverted to the theoretical stance he liked best: the speculation that patients have suffered parental or "empathic" failures, as he liked to put it. In this respect, Dr. Forster's ideas were very modern. Everybody is talking about empathy these days, tangled with die assumption that patients are victims or survivors. But he was also old-fashioned because, unlike the other residents, he always wore a suit and tie. Dr. Forster was determined that he and I should understand one

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another, and that the nasty truth about life should never arrive for us — the fact that, between any two people, irreconcilable realities eventually come into play. Martin Buber and Jiirgen Habermas had the same naive hope as Jim, arguing that if two people go about it the right way, a harmonious interpersonal deliverance will emerge. It's a wonderfully optimistic warm-bath reverie but, with all deference to Jim, Buber and Habermas, the water soon gets cold. I suspect Jim imagined I would somehow see the error of my ways and come around to believing in a final, correct theory, especially the one that insists a hurtful and neglectful world is what causes people to suffer. In this, he and I were alike. Despite myself, I'd secretly had the same thought: that one day I could convert Jim to my ways. A few weeks earlier, my mother had lodged her own protest when the world wouldn't conform to her preferences. Ernie and I had been visiting her in the nursing home and she began by criticizing Ernie's trousers. "They're awful," she said. "They don't fit. Why do you wear them?" It seemed she hasn't yet learned that, after the age of 30, all men's trousers are baggy because they no longer have buttocks — unless they're squash players or speed skaters. But my mother's main target that day was me. "You have two pairs of socks on! Why do you wear two pairs?" I didn't respond, perhaps assuming that, as with one of my students, my silence would inspire her to think. "Why are you wearing two pairs of socks?" she repeated. "You are crazy. Do you hear me? You are crazy." She turned toward Ernie. "T T ' ries crazy." All my life I have been filled with loathing for my mother when she pulls such stunts. I still loathe it, but am now more like a wise old horse. This "loathing" is nothing more than me doing the same thing, wanting her to come around to my vision of how a mother should

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behave. In these moods, my mother is like Dr. Forster, insistent that my world should match hers. In other words, like the rest of us, my mother madly wants the world to come round to her way of thinking. She is in a panic lest we, her children, should be distinct and unique. I fear that this madness —Jim, my mother, and I are only this moment's examples of it — condemns us to never-ending wars, divorces and estrangements.

The woman whose psychotherapy Dr. Forster chose to follow with me was Mrs. Paris, assessed when he was in my group, and who, at the very end of the interview, had revealed she'd been sexually abused by her father. Janet Hunter had done the first interview and I remember watching Janet's English boniness melt away when she'd coyly let me see she was a woman. Mrs. Paris was Jim's first psychotherapy case, and I suspect he asked Janet Hunter to refer her to him. Mrs. Paris was an incest victim, and victims turned Jim's crank. When our supervision began, he'd been seeing her for three years. "The therapy has gone very well and Mrs. Paris hasn't been depressed for ages," Jim told me. "The story of the incest was a lot worse than she told us; it went on for a lot longer than she first said. She's been badly traumatized because she and her father were sexually involved until she was in her 205. She didn't tell anyone about it and what she said about her sister also being abused wasn't true. Even after she was married, Mrs. Paris s father would come to her apartment to help out with something and she would be angrily aware of the sexual power she had over him. Sometimes she would lead her father on as a sort of revenge. She could see that he felt bad about it. She even worries sometimes that her daughter might be her father's child and not her husband's. Though she is much better, she wants to keep coming, and I suspect there is still some secret that she hasn't told me about. If

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you remember, Dr. Warme, she had several secrets back when we first interviewed her. "But she doesn't really speak ill of her father. In fact it's quite the opposite — she talks a lot about what a good person he is, how successful he is, and how helpful he has been to her and her husband. Oh, yes, the 'older man' she mentioned during the assessment, the one she had the affair with in high school — that was actually her father she was talking about." I remembered the story very well. Mrs. Paris had been confused and inconsistent as she told the story of her "psychosexual development." And I remembered how she tried with her flashing eyes to get me to be her therapist. Surely she had also tried to seduce Jim, although he may not have been aware of it. He was alert only to feelings of a certain sort: sadness, loneliness and the other signs of hurt. The rest he avoided, trying to make both of us believe he doesn't know about that other category of feelings: lust, hatred, envy, vengeance. Whether Jim wanted to notice Mrs. Paris's seductiveness or not, I expected he'd let me see it when it came up. Then, when I'd pointed it out, he'd be able to say I was the one with the dirty mind. Poor Dr. Forster was increasingly aware that conflict never ends. His work with Mrs. Paris had robbed him of an exclusive villian -— the abusive father — who he could blame for her depression because Mrs. Paris had now implicated herself. I prayed it was sinking in that his preferred cure was treacherous: the cure by racism and judgment of others. Hating parents, Israelis or Palestinians has fine but spurious therapeutic effects. "She really does speak a lot about what a good person her father is," Jirn said, puzzled. "It comes up all the time. Considering her history, it seems strange." "Have you made any comment about this?" "Not really."

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"Any ideas about why she might do this?" Jim shook his head. "No rush, Jim. Keep thinking about it." "I'm getting kind of frustrated with her about this. I try to empathize." "What do you say?" "Well, I kind of underline it, that she really speaks well of her father and how it's important to her to let me know about it. I say things like, 'He is a very smart and effective man and you admire him for this.'" "You know me pretty well by now, Jim. Can you imagine what I'd •oj sayr "You'd come up with some odd angle, I guess." "You might think so from the interviewing seminar, but this isn't a diagnostic interview — this is treatment. You have the leisure to go into everything in detail rather than momentarily identifying a few dramatic themes. What I would say to her would be very similar to what you say, but it would also be different." Jim liked to nitpick with me in the seminar, but now that I was his supervisor, he seemed to be intimidated. It was hard to get him talking because he was still stuck with his "decisive moment" with me, the moment at which he realized we are in different worlds. He hated it that philosophical differences were so hard to bridge. "What I'd do is caricature her praise of her father," I said. "I'd help her to see that the praise is overdone — too emphatic, too one-sided. I'd hint, and eventually say direcdy, that all the talk about how wonderful her father is suggests she's trying to convince you — and herself, too — that he is good. 'Methinks the lady doth protest too much,' I'd say. Were nothing bugging her, she'd only have had to say it once. I'd keep mentioning the frequency and the broken-record nature of what she's saying. This is what: you are doing, except you are doing it by

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feeding back to her exactly what she says. You don't add that she must have a self-deceiving purpose in mind. The way you do it is a standard approach, but I'm impatient and I'd push her into thinking about her motives for going on and on the way she does." Jim's face twisted, he squinched his eyes and pursed his lips. He could not disagree or argue with me, but he clearly didn't like what I said. My tactic, to him, was aggressive and pushy — which is in some ways true but could just as easily have been thought of as determined. Jim preferred interventions that emphasized sadness, regret and love — words that were encompassed by his favourite code-word: empathy. Jim was dying to have me see patients as so full of suffering that he and I could do the external devil trick. Mrs. Paris was a poor soul and had been harmed by that nasty devil, her father, who Jim and I could denounce together. Instead of making Jim happy and becoming his ally, I'd put Mrs. Paris in the drivers seat, nailed down the idea that she was actively engaged in praising her father, and was up to something. To Jim, Mrs. Paris had to be a victim. Mrs. Paris is as disappointing to Jim as I was to my mother. She was proud I was a doctor, but she would have liked me better had I been more helpless. My constant self-reliance robbed her of what she wanted — a child she could take care of. Nearly all of us (maybe with the exception of manipulative opportunists) like taking care of others, but Jim likes his charges to stay dependent — I insist to him they're going to become self-reliant. Incompatible worlds.

Hanna Slendzinski had moved back to Toronto earlier in the year and was again attending my interviewing seminar. We had our personal reunion in the corridor outside the meeting room, the same corridor where she had once wickedly called me by my first name. This time we

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kissed politely, but instead of cheek touching cheek, our lips contrived to have a half-hearted meeting. That kiss, our first and last, meant that for the next few weeks at least, we didn't tiptoe around what was going on between us. We often had lunch or dinner together and, on one of those evenings, she even told me she "needed a hug." Had Hanna said that I should hold or embrace her, kiss her or make love to her, I would have reacted, as I'd often done, with waves of love and longing. She and I might have become lovers there and then or, had I been in my prudish mode, I might have responded with a coward's version of moral wisdom. Still, for that terrible moment, the request for a "hug" sounded ominously needy and absurd to me, absurd enough that I was overwhelmed with sadness. The day had arrived, I thought, when Hanna and I would discover we lived in different universes. "I need a hug" had called up my knee-jerk repugnance for modern fads. The pressure of my personal madness blocked out wisdom and, like every human act, my sudden alienation from Hanna had a secret, mad purpose, to give a message to the world and to myself: "I'm a crotchety crank and not a young panther as the world and I may have been deceived into believing." I couldn't have immunized myself against this by living in a compartment or by avoiding people like Hanna. The nasty truth is that everybody is different from me. I might as well have decided that, since cobras, elephants and roses were different from me, I should have blocked my ears and eyes to them as well. I wasn't just troubled by cultural differences and fads; anyone outside of my skin would have eventually alienated me. No matter how much I wanted affinity between us, I couldn't get curious about Hanna's dissimilarity from me, and compulsively judged her for a fault that was not a fault. This suggests racism and prejudice will endure and all bliss will be temporary. Hanna had worked for a short time in Kosovo. She still had flashbacks and bad dreams, she told me, and wished the organization she'd

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worked for had done a better job of debriefing her. My craziness about the word "hug" reappeared, this time not momentarily. For me, Hanna's story about Kosovo was a claim that she was a victim. Hanna was suffering, and someone else was to blame. Our romance, I realized, was being sabotaged by my usual nuttiness, my absurd, malignant nuttiness. I told her my reaction, with a pretend twinkle in my eye, but Hanna quickly understood the driven pessimism that lurked behind my weak humour. There would be no mutual tolerance of difference for me. I made jokes and poked fun at myself, but Hanna recoiled when I told her what I, in contrast to her, would have done about flashbacks and bad dreams. "I would have waged war," I told her. "Debriefing would have been a chance for me to raise hell about what I had seen and, had I still not gotten over it, I would have designed new ways of raising hell within the organization, probably by writing a stinging brief." It would be easy to claim that I reacted so weirdly simply because I couldn't tolerate the external obstacles to our romance: she was my student; she had a husband. But the truth lives inside me, not in exterior events. Like half the human race, Hanna invited her devils to transform themselves; they had been wicked and must repent, soothe and comfort her. Meanwhile I, in alliance with the rest of the human race, was equally unforgiving, and would contemplate only a delicious battle against devils. Her way of dealing with devils repelled me, and my ways — I know for sure — would equally repel her.

There was another poor soul harmed by a nasty devil. Graham Copeland's devil was me, oblivious to the perils of the heart he'd risked by loving me many years ago. Despite my experimental attempt at treating him with bibliotherapy, I'd had no word about him. But later

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that year, Roman Borsch phoned to tell me that Graham had died. Roman had been in Topeka at a reunion of Menninger alumni when he'd heard the news. No one Roman had talked to knew where Graham was, or even that he'd lived in Berlin. Nor did anyone know what caused his death. By the time I called, Graham's phone in Berlin had been disconnected. It was my turn to search out words of sadness, regret and love. Unlike my reaction to earlier experiences of death and loss, when I heard about Graham's death, I had very ordinary reactions; I wished I'd spoken to him about certain things, not about the tremendous change in him between 1962 and 1997, nor about his feud with Heinz. Instead, I wanted to talk about how, in the face of his youthful love for me, which lasted many years, I had feigned being coyly oblivious. I wanted to make it up to Graham. I also wanted to tell him something that I probably would never have said out loud — that I'd loved him, too, and of course, to lighten things by saying it was the fault of the gods that our ways of loving didn't match. For me, things like that must be lightened up. I say it's just part of Zeus's golden net when humour eases the pain of the world, but it's more than that; it's also fear and flight. I grieved Graham in repeated flashes of hurt and loneliness — and by developing a chronic conviction that, because I never had the chance to talk to Graham, I'd feel frustrated the rest of rny life. Strangely, I also pitied myself, as though I'd spent 35 years intending to clear things up with Graham, and now I'd left it too long. Life turns its own pages. Death, too, turns its own pages. Six months after I heard about Graham's death, my brother and sister-in-law, both in their mid-5os, died within three weeks of one another. I felt little grief, but then wept when I told people and when I was with my family. As Ernie and I drove to my brother-in-law's funeral, both of us were crying, even though I was worrying about Ernie. There was a smell of urine in the

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car, and I wondered whether he'd peed his pants. But there was no stain on his trousers, nor could I smell booze on his breath, booze being the usual cause of his incontinence. We sat with the family in the front pew of the church. When the service was finished, Ernie and I walked up the aisle first, for Ernie a slow, cane-assisted task because his neurological handicap was much greater than that of most stroke victims. The clergyman stood at the back of the church, composed and reverential. When Ernie spotted him, his face lit up. "How ya doin'?" he said in a loud voice, doubly loud because the church was silent. He pointed at himself and said, "Ernie Warme, Ernie Warme . . . racetrack, racetrack." I looked down and saw that Ernie's trousers now had a large wet patch. Later, I spoke to the priest and said sheepishly, "I guess at every funeral worth its salt, someone gets drunk, someone picks a fight, or someone faints."

The weeks passed and Jim Forster tried my way with Mrs. Paris, although his heart wasn't really in it. He was also approaching her his way, emphasizing only what she said and not pushing the idea she had a motive for her behaviour. But he was also getting impatient, or more accurately, jealous. I read between the lines and realized what he might be thinking: "Mrs. Paris, how can you speak so well of that bad man who abused you, when you never speak well of me, a man who is only kind and sympathetic to your plight?" Just slightly, Jim had lost his temper with Mrs. Paris a couple of times. Once he used the word "ridiculous" for her praise of her father; another time he said directly that a bad man like her father deserved her anger, not her praise. To hear this was a great relief to me, because

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it meant that I wasn't beating up on Jim as much as I feared. Had I been really roughing him up, he would never have confessed to his little outbursts of temper. As it turned out, Mrs. Paris was acutely attuned to Jim's hurt. She knew about men, and read his reaction to her right away. In her typical fashion, she waited until an appointment was finished before, yet again, springing her surprise. "Dr. Forster, I have something important to tell you," she'd said. "That whole business of incest never happened. My father isn't really a bad man and that's why I've been telling you about his virtues. When I first told you about the incest, I really believed it had happened — I'd believed it for years. But in the last year or so, I realized that it never happened. I don't know why I ever thought it happened because, really, I always knew it wasn't true. But it seemed true when I told it to you." Reality cavorts and writhes, and makes us mad. I'm an old-timer, but I was still bowled over when, yet again, I was faced with the madness of the world. But for Jim it was worse: this turn of events was incomprehensible — he thought Mrs. Paris's new story had to be a lie. Poor soul. He wanted the final truth — louder music, stronger wine. Jim thought he had found a patient who was a true and exemplary victim, a doctor-patient set-up that satisfied his every instinct. Were Mrs. Paris lying about the incest not having happened, Jirn was faced with a new problem — a liar. It's hard to see a liar as a victim, and one way or another, Jim was faced with a world (the only world there is) that is always a story. Once he has the gut-knowledge that we trade in narratives, he'll have turned into a psychiatrist. "Well, Jim, it's not too late to change your mind about being a shrink," I teased him. "This is a crazy business we're in; anyone with an ounce of sense would get out while the getting is good." Jim gave me a weak, baffled smile. He looked pale.

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Six months later, there was a further turn of events. Mrs. Paris affirmed one day that her husband had sexually abused their teenage daughter just before she came to the Clarke for her initial assessment. She had suspected this and recently had discussed with her daughter what had happened on a particular evening. There'd been a party for her daughter's young friends, and her husband had gotten involved. After necking with one of the girls, he had seduced his own daughter. Deciding such stories were true, or denouncing Mrs. Paris as a liar, was easier than not knowing. One of the problems Jim and I had was that we'd never had a good argument. We should have considered this learning tactic, because Jim had assessed Dr. Long, and seen us battle one another when I did my interview. Through the grapevine Jim will also have known that, despite our war, Dr. Long had become my patient — a war followed by understanding. It's true that, in the crunch, Jim wanted everything to be nice. But I, too, had avoided arguing; perhaps I feared that if I challenged him too strongly, he would never become my disciple. It had occurred to neither of us that a good quarrel might have brought us together.

Frank Kellner, who was also in analysis with me, lived in a completely different world. He was angry that he'd lost the religious beliefs he had before he began taking antipsychotic medication. He'd scoured the literature on schizophrenia and insisted that a high percentage of those who recovered from madness maintained they were happier when they had their delusions. With Mr. Kellner I did better than with Cathy Jones. When I began seeing him, he had spent five years in his parents' home writing

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up his thoughts about his place in the world. In the process he had decided he had become a woman. Indeed, he had invented an alternate universe. Subsequently, Mr. Kellner became violent at home and in his neighbourhood, and was twice hospitalized. After a few months of testing me suspiciously, Mr. Kellner stated he had a gift for me; he knew of a new universe created by God which I could now share in. In that world there were different physical and natural laws, and it was populated by alternate species unknown in our world, some of whom could speak, albeit in a new language. These creatures had very different values from ours and were divided into genders we know nothing about. God, he told me, had created him as a part of that universe and he, Mr. Kellner, was the creator of yet another universe, just as different as the special one God had put him in. In the universe Mr. Kellner had created was someone who, in turn, would create yet another alternate universe. His gift to me was that, should he die, he had bequeathed to me the universe that he himself had created. If, as I did at first, I'd hinted that he might be tempted to participate in our current universe, Mr. Kellner would get annoyed. "I'm neglecting my universe enough already by coming to see you," he replied. "I'm responsible for my universe and for the living creatures who populate it. You forget, Dr. Warme, that ideas are real and have an existence independent of those who think them, and independent of their existence in books and libraries." I had a choice with Mr. Kellner. I could align myself against his personal universe or, alternatively, if I could figure it out, I could talk to him in his alternate world. Whether or not he joined me in my world (if he could figure zYout), would be up to him. By then, I was smart enough to do the latter. This neither cured him nor changed him. I say I "did better" because, instead of pushing him to adjust, I helped him think about his life. Bit by bit, he talked about why he

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lived in a different universe, and why he created his universe as he did. A few months after he stopped coming to my office, Mr. Kellner began smashing dishes, then struck his mother and was hospitalized. There are two glib explanations for this turn of events. First, he stopped seeing me because he was beginning to break down, or alternately, he broke down because he stopped seeing me.

Madness was in the air, and this time it decided to light on Leila Singh. I wonder if, in 30 years, she'll be at peace with this story. One afternoon, she gave me a phone call: "Hi, Dr. Warme. This is Leila Singh speaking." "Well, hello Dr. Singh. You're here at the Clarke again, I think. Isn't your office down near Emerg?" "Yes, I've been here since July," she said. Dr. Long, still in analysis with me, had occasionally given me an update. He focused on Leila because, like me, he'd noticed her manic enjoyment of Western ways — a reminder of Dr. Long's negative reactions to his own mothers sensuality. Leila had adopted Western dress, he told me, and at a recent party (her husband wasn't there) Leila had danced gaily, then enthusiastically smoked up. Later, he'd heard she passed out. Dr. Long was gently amused by Leila's antics. Did this mean I was curing him?

"Uh, Dr. Warme," Leila continued. "I'd like to make an appointment to meet with you. It's a personal matter and I'd like to see you in your private office if that's possible." We set a time for the following week. When she arrived, Leila was as charming as ever, but she was pale and her smile forced. I paid attention, but more than 1 liked, I still had an agenda — I was looking for opportunities to convert her to my way

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of thinking about psychiatry. Leila played her tongue over a bit of loose skin in the corner of her upper lip, a habit I'd noted when she was in my group a year or so before; I'm now sure my grandmother touched her tongue to her lip in the same delicate, sensual way. As I'd heard, she wore Western clothes, slacks and a sweater. Like all beautiful women, Leila knew instinctively how to select and wear clothes; her slacks fit perfectly and I, not adjusted to modern fashion, noted uneasily that her mons veneris was plainly outlined.

She has a mons veneris that's interesting, but I've reached an age when I'm short of anatomical virtues. My grandchildren are well aware of me and my body and at "Camp O'Cotteg," my summer cabin, little Stefani licked my bald head after I'd been chopping wood, a gustatory appraisal of my pate that earned me the title of "Salty Head" for the rest of the summer. Before I grew a beard, Jessica noticed my cleft chin (does a cleft chin resemble the pudendum?) and announced my new name was to be "Bum Chin." My grandchildren haven't noticed that the seat of my trousers is now always baggy. Once fi]led with ample buttocks, my trousers now give away my physical decline. It came to my attention when I consulted a weight guesser at a fair (I look thin and can often fool them). To my horror, the barker pulled on the seat of my trousers, and discovered the seat was empty. "Your rear end seems to have gone missing," he said. I'd obviously misplaced my gluteal parts somewhere on the fairground. My arthritic left knee had its cartilaginous meniscus removed 30 years ago and, after so many years, the cartilage on the articular surfaces of my thigh and leg bones has completely worn away. My knee is now bone on bone, and the loss of my buttocks means that, when I ride my bicycle, my skinny rump and the saddle are also bone on bone.

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Such absurd private musings were a sure sign that I was worrying about why Dr. Singh was here, that I'd anticipated she would tell me a disquieting story. "So why are you here, Dr. Singh?" I asked her. "I've gotten myself in trouble," she said. "I didn't know what to do and I was talking to Jim Forster about it. He said I ought to talk to you. What's happened is that I've been involved with a patient at the hospital where I worked last year, a man who is paraplegic. He is older than me and has many cultural interests. He knows about art and literature and a lot of things I've never had anything to do with. My husband isn't interested in such things, so it was all very new to me, even though my brother writes poetry. Because he was handicapped, my brother was encouraged to develop his writing, but right from the start, I was supposed to be a doctor." I waited for her to say more. "It's awful. My friend has a minivan and we used to go out in it, but after a while I started to feel really bad. I have three children, you know." I had seen Leila's son on the unit one day, but was unaware she had three children. And for a lover she had picked a paraplegic man, paralyzed from the waist down, which automatically meant their affair was sexually complicated. I'd heard of physiotherapists getting involved with their paralyzed patients, but I was surprised the childlike Dr. Singh would have done this. I would have expected her to pick a strong man, but perhaps this man's obvious intellectual strengths had filled the bill for her. Her choice of a handicapped man as her lover showed that, in addition to getting herself rescued, she also wanted to save someone. "I've told my husband about this and he's ready to forgive me. I'm

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not seeing this fellow right now, but I don't know what to do. I'm in love with him." Ten minutes had gone by, and I already knew enough to refer her to a psychotherapist. Nevertheless, I did my duty and began to collect historical information from Dr. Singh. She stopped me. "No, no, Dr. Warme. I'm not here to get help — I want to arrange for my husband to get some help. Can you see him? Or, if not, can you recommend someone for him to see?" Up to now, I hadn't noticed that being a helper was so important to Dr. Singh, even when she insisted in the seminar that patients should be diagnosed and quickly treated. She'd assessed Mr. Evans for me, and thought she'd cured him in one hour by persuading him to confront his parents with some imagined evil they'd done him. Leila had been upset the day she assessed Blaire Allen — his masculine physique had made her nervous, I thought. Later I realized it was his childishness that bothered her, and now she was rescuing someone — her husband. But surely she was worried about herself, too? A few seconds before, she'd said of her affair: "I don't know what to do. I'm in love with him." When Leila told me she wanted help for her husband, I guess I was supposed to get on board with some moralistic and preachy psychological slogans: "Psychological help is a very personal thing . . . " "Your husband really ought to decide for himself that this is what he wants . . . " "If you arrange for this treatment on his behalf it will mean that . . . " Even though such stuff is alive and well in me, and while I'm usually annoyed when people try to use psychiatry to get their spouses to think their way, the truth is it doesn't matter a damn how a patient comes to be in a psychiatric conversation, so long as it helps tliem.

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"I'm working on forensics," she said, as though signaling it was now time for social chit-chat. "I'm becoming very interested in genetic factors in people with antisocial personalities." Dr. Singh had heard me make jokes about those vague genetic factors we invoke when we don't know what else to say, so she wasn't passing on innocent information. Unlike Jim Forster, who truly wanted to find common ground, Dr. Singh seemed out to goad me. But why, then, would she have sought me out? I guessed then that my suspicions about her — when she'd been in my seminar, I'd thought they were just fantasies — were correct — she wanted someone to rein her in, make her behave like a proper Sikh lady. Dr. Singh feared her sexual powers and hoped that I, or some other man, would be powerful enough to resist her charms. She might still have been hoping I'd rein her in, scold and advise her. By getting involved with a patient, she'd crossed a line and had committed the Great Psychiatric Crime. There was no doubt about what I was supposed to do: report her instantly to our professional College. The College would have tried to apply another version of instant solutions and fast cures, this time using disciplinary action. The College's diagnosis would have been that Leila had improperly wielded power over a patient. They would have been correct — except that in this case, it's also possible an ass-backwards diagnosis would have made the committee's deliberations more interesting. For the sake of therapeutic leverage, wouldn't it have been wiser for a committee to interpret this heartbreaking situation the other way around: that she feared her power rather than merely having wielded it, and perhaps had wanted assurance she could not seduce every man who came her way? If I'd reported Dr. Singh — and I was committing a professional offense if I didn't — I would have wrecked any possibility of helping her myself, because I would have betrayed her secrets. I might even have wrecked any hope of her getting help from someone else: how

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could she have trusted any future psychiatrist?

"That's fine, Dr. Singh," I told Leila. "Get your husband to give me a phone call. I'm not sure I can see him myself, but if I can't, I'll find someone for him. This is a tough situation you are in, all right. A bad mess. A big change in the smooth flow of life. Is there more about it you want to tell me?" "Oh, no, Dr. Warme," she said. "I just came because I didn't think I should talk to you about my husband over the phone. I'm grateful you will talk to him. Thanks a lot." And with that, she left. Her husband phoned a few days later, but he couldn't manage any of the times I offered him. He said his schedule would settle down in a week or so, and he would call again then. He didn't.

Leila's situation threw me into a frenzy of second-guessing: had I done the right thing? I'd seen that Leila was having trouble years ago, but liked it when she flirted with me and tried to make me jealous by straightening Jim Forster's necktie. If I'd seen it before she became a "sex-abuse case" — that's what the College calls such situations — should I have spoken to her at the time? If my greatest expertise is in human psychology, shouldn't I take note of what I see going on in my students, just as I might have taken note of it with Cathy Jones, Graham Copeland and later, with Christine Brydon? The irony is that, had I spoken to Leila a couple of years ago, or had I handled our interview differently, I would still have secondguessed what had happened. Had I done the opposite and stuck my nose into her affairs, would I have worried I was treating her as a child, thereby preventing her from observing herself or from designing her own response to what she observed? 328

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Labourers and the uneducated can make use of the Greek myths I tell them, and as intuitively as anyone else, listen to my intellectual interpretations. I, fancy-pants psychiatrist that I am, am just as versatile at negotiating the working-class world. It was a chilly November morning, and I was in Hudson Plumbing Supplies to buy a special washer for my wounded kitchen-sink faucet. Beside my elbow was a girlie calendar, something drought to be tacky in my world. But on that day, I was in a state of enlightenment. I realized this girl-caricature was beautiful — but I'd never say it out loud. Her plump breasts were dazzling, as was her silky skin. Her posture and her eyes celebrated life and womanliness and I'd be a deadbeat if I didn't admit this. Many men were already at work behind the counter, even though it was only 7:30 a.m. One was wearing a soiled team jacket, the others a potpourri of Indian sweaters and lumberjack shirts. Everyone seemed in a good mood. Four men worked the battery of telephones and, as another guy passed, one of them kicked him in the pants. "Oops," he said. "My foot just flew up all by itself." The kicker was black, but the receiver of the kick marched straight on, a good sign that racism is vanquished in this establishment. Too much jocularity in response to a kick from an African-Canadian might

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give away an overdone acceptance that all this was meant in fun. "Here it is," my server told me as he handed me my washer. He was wearing a baseball hat indoors and had knitted gloves without fingers, drawing attention to his nicotine-stained fingers. "Are you paying cash?" "Yes, unless it's more than a hundred bucks." He smiled and wrote out a bill. "Five hundred bucks," he said. "The deal's off," I replied. The miserable washer cost five dollars and I handed him three two-dollar coins. He handed me back a loonie and said, "There's your change, buddy." As I walked out into the cold, I was suffused with love of the world.

Dr. Long: savage fighter, scornful cynic, mother-hater. If such a man could give birth to a poet, the poet who lives within him, I guessed there was hope for me. In the past, I've done a good job of self-deception, forever thinking of myself as the ultimate democrat. Haven't I proved psychoanalysis can be offered to schizophrenics and niggers? I may not write poems, but I can quote Shakespeare and Nietzsche to my patients, can't I? Unfortunately, my pious liberalism and self-admiration take a beating when a great truth is revealed: I'm as evil as the next guy. As I accumulate experience, and become better acquainted with people like Socrates and Vladimir Nabokov, I become a better psychiatrist. Unfortunately, experience and the great minds of history also make me better at self-deception. Were I to tell a patient her behaviour was "ridiculous" as Jim Forster once did to Mrs. Paris, I'd know immediately something had gone awry. The truth is I'm so bloody slick at this game, nowadays my sadism with patients is subtle, clever and invisible. My colleagues see my belligerence when I get into academic

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fisticuffs at scientific meetings, but even there, I'm oblivious. To me, it's what academics are supposed to do. Dr. Long doesn't fight so much these days because he knows how the psychiatric game is played. When he visits Hudson's Plumbing Supplies, he knows how that game is played, too. Dr. Long isn't the same stubborn psychiatric student I first interviewed three-and-a-half years ago, yet in some ways, he's exactly the same. Then, he had paradoxical food interests: he liked sausage as long as it was Jewish or in a deli, and not Hungarian or German. He is still a paradox: he's a hardrock warrior on the athletic field, and quietly writes poetry. One day in therapy, he brought a typewritten sheet of paper that he handed to me. A young girl is standing beside me on the subway. She is a redhead with white transparent skin, and the tip of her poor little nose is red, her eyes puffy. She has a cold. She wears baggy bell-bottom trousers, which are exactly the right length for fashion, but six inches too long for safe walking, so her shoes are invisible. A delicate, delicious breast is snuggled against my left shoulder blade. She is a glorious nymphet, and I, being both glorious and evil, am fabulously hysterical: a pervert. Like everyone else on the packed subway car, the girl and I are silent and impassive. Despite the meeting of breast and scapula, and despite the stirrings of lust, everyone is silent, silent as a tomb. The world has turned strange for me. How can I be impassive when a nymphet sniffs and dabs at her nose, two inches from my ear? How can hundreds of us be silent, most looking off into some non-existent place, as though unaware of everyone else, packed together like collaborators in a mad orgy of group sex?

"While standing there on the subway," Dr. Long told me, "I thought of a story you once told about how you were lost in a reverie while you were looking at a painting of two young girls. I remembered how your mind wandered and suddenly, the other day, I realized that

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kind of reverie happens to me all the time, and I was doing it on the subway train at that very moment." Dr. Long was thinking of The Calmady Children, Laura Anne and Emily, painted by Sir Thomas Lawrence, a picture in an art book I'd wistfully looked at one evening when I was worrying about my sick granddaughter. Somebody must have told him the story because I'm sure he was working at St. Mike's at that time, so wasn't eligible to be in my seminar. The next year, some months after he had begun his analysis with me, he did start to attend. Once in a while, everyone wreaks magic on the world — transforming subways, cocktail parties or committee meetings into high drama, farce or caricature. Graham Greene once said writers must have a "splinter of ice" in their hearts so that they can stand back from horror and watch it dispassionately. Psychiatrists like Dave Long and me are in the same boat, duty-bound to mine life's moments for our professional use, for the awakening and refreshment of our mental instruments. Watching, listening and attending as scrupulously as a private eye are our stock-in-trade. Dr. Long is not just aping me. Nor would it be correct to say he is identifying or turning into another version of me. He's always had this proclivity in him, but his fighting style used to make it invisible. I identified with Dr. Long as well and noted associations that had come to mind as I read his typewritten page. I had flashbacks to other trains: the thrilling efficiency of modern German trains, the train to Cologne which, when I was a young man, led me into the heart of Germany, a Germany I had expected to be the heart of darkness. Other trains with packed boxcars that once traversed Germany; the train that brought my father home from an internment camp. And when my father was interned, I too had come home from camp on a train, except my camp was a summer camp, a pleasure island, courtesy of the Toronto Star Fresh Air Fund.

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Dr. Long intruded on my reverie. He seemed to have lost his magic thinking and had reverted — as I used to do — to the earnest and rational. He was saying something he may have picked up from me, because once in a while I still slip into beating up on my listeners. He was delivering a sermon, too young to know sermons are boring even when they are interesting. "My daydream on the subway was an escape from life," he said, "and yet that's the only way of knowing about life. It was coolness, dreaming, and eternity-contemplation [this sounded like me]. How many people on the subway saw there was something odd about this scenario, and how many would have been baffled if asked about it? All of us were obeying a strict, constraining code of behaviour — I want to call it a ritual [ritual? For sure he'd picked up that word from me] — that made the world safe and manageable. I'd better not have violated die subway code, and responded sexually to the small, nymphatic eggbreast nestled against my ribs. The world knows we have to be realistic, which means . . . we're not supposed to be realistic." It was a good sermon, and I could have carried on with it without missing a heartbeat. But I liked Dr. Long's Lolita story better. If you don't behave yourself on the train, Dr. Long, there will be chaos; you'll be a sex fiend. It will be your turn to be the victim of a media feeding-frenzy. When you are in a silent passion over your nymphet, you're in the same frame of mind as teenagers are when they are in a froth over Mick Jagger, or Bill Clinton was when in a passion over Monica — and even as the moralists are when they're in a passion against the rest of us. The moralists are as blind as the rest of us when in the throes of one of our culture's rituals of indulgence or judgment. Ritual togetherness is everywhere. We're all singing in unison.

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Zeus, and his modern incarnation, Tony Soprano, love mortal women (like Europa). They are Dr. Long on the subway, living out a wonderful ritual of love. As they are chiefs, they have privileged access to women, especially virgins and nymphets. It's an archetypal story, a tribal enthusiasm, a law, and we alpha males practice it whether we are Mayans, Parisians or ancient Greeks. My enemies, those who gaily live life on the surface, are appalled when I say this and don't allow that they, too, are obeying a law as compelling as the law of love and sex: the law of propriety, decency and good sense. I'm forever caught in a tradition that is wonderful and delicious if a nymphet bewitches me — the way the sniffly-nosed redhead had bewitched Dr. Long on the subway train. It's just as wonderful and delicious if I judge, and find wicked, dirty-minded men like Dr. Long who lust after young girls. It's excitingly sexy; no matter which side I'm on, one version or another of Prince Charming and the fair young maiden: teacher and student, boss and secretary, doctor and nurse, and yes, even doctor and patient. On the other side are prudence, wise self-reflection and the Inquisition. Then there is the great sin between father and daughter, which must not even be named.

Dr. Kokott, a young doctor I'd been supervising for a few months, once reported me because I'd sat with my leg draped over the arm of my chair during her supervisory appointment. She had instantly read my secrets — my hysteria — and immediately invoked a stereotype more commonly used by men. Men of this unfortunate ilk are unsettled by joyous versions of womanhood — nervous Nellies, disconcerted by the sparkle of someone like Flaubert's Emma Bovary, who they'd label "hysterical" without realizing that so-called hysteria is merely documentation of womanhood prospering. A tight skirt (low-cut blouse, fragment of visible flesh) automatically means she's

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asking for it. "Asking for it," means fucking her, but also means beating or raping her. This kind of attitude amazes me. Why in the world are womanhood and manhood offensive, vulgar and terrifying? If Dr. Kokott had encountered Dr. Long's hysterical fugue on the subway train — they'd been student colleagues just a year before — would she have thought he was "asking for it?" Dr. Kokott had recognized the unspoken sexual content of our meetings, but opted to treat it explicitly rather than tacitly, as is usual. But her literalness embodied a judgment against our sexuality. I put my leg over the arm of the chair, she told the committee, to show off my sexuality. She was right, thank God, because it meant my sexuality was normal and intact. I may not reek of sweat and sperm like Dr. Long, but Dr. Kokott's keen nose had scented telltale traces of masculinity. Without knowing it, she'd acknowledged my sexuality — it's just that she did it according to a currently popular perversion of the truth. She'd rejected two other possibilities: the error of sexual involvement, and the option of quiet semi-awareness. Despite her apparent sexlessness, my young psychiatric resident was a fine but demure variant on womanliness, her sexuality easy to recognize, even as she goose-stepped to the tune of some modern fascists. When I told a friend this story, he said I was coming close to calling her a Fern-Nazi. Of course I was. Dr. Kokott's explicit aim was to do me professional harm for no reason other than my being a man. During our supervision hours, she didn't choose the chair in which most of my students sit. Instead, she chose a chair in which she didn't face me, at right angles to mine. If I use her way of thinking, I'm supposed to say she sat this way so I'd have a full-profile view of her tits. I never flirted with Dr. Kokott, which suggests I sensed something was amiss, even though I wasn't aware of what I sensed. I note that the world has finally woken up and made buggery legal but, in contrast, a new morality says I'm not allowed to flirt with my

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secretary. We flirt anyway, and enjoy imagining the reaction of those joyless deadbeats, just as I imagine homosexuals in years past enjoyed the reaction of anti-gay deadbeats to their styles of flirting — and fucking. I wonder what Dr. Kokott thinks of bum-fucking? But I'm not so tolerant of fathers. It would have mattered had the fathers — the committees that are at risk of taking strange complaints seriously — had failed, and had suggested impropriety on my part.

My colleagues don't like it: when I call everything a ritual, including styles of psychiatric illness, the behaviour of day-to-day life, and goosestepped complaints to education committees — but they are. I don't really want to be a ritualist, and like most people, prefer to think of myself as rational and sensible. I'm like my fact-collecting father, I say; I see it as good fortune that I've escaped my mother's excited mindlessness. When I was 10, I learned in school that light takes eight minutes to travel from the sun to the earth. When I told my mother this, she just scoffed. To her, this was nonsense: light is light and we see the sun directly. Her unscientific response allowed me to distance myself from her. I was scientific and sensible, not emotionally overwrought like her. But now I know we see the sun plainly, that the facts of science are true but boring, and my mother's vision had been poetic — even though she didn't know it and had therefore missed the fun. In those days, I didn't like Auden's definition: "Poetry is what makes nothing happen."

Since I'm happiest when I can judge what others do, I'm at risk of thinking it a silly ritual when other people do things. When I complain about a gossipy witch hunt concerning an errant colleague, I do so with the full conviction that I am having a rational response to a dangerous

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rumour-mill. And if I do the opposite and rage against my colleague's moral laxity, I'm not really doing the opposite at all; I've just changed my target. For today, I'm convinced of the need to speak out, and the rational necessity of moral outrage. I always think I'm the rational one, but my energy, the joyous enthusiasm and dexterous wit I employ when complaining about someone else, gives me away. In such instances, I'm a ritual celebrant, allied with a group I joyously support, feasting together on the carcasses of those we're sadistically denouncing. My individualism won't endure because it, too, is exposed as another currently popular ritual self-definition. Although it's clear to me that our era prizes individualism, I also know individualism is as ephemeral a truth as any other, that I am enslaved by forces greater than me, and that such forces can carry me along with hurricane energy. So when I'm thinking I'm immune to mass opinion, I sit quietly and smugly enjoy the idea that I belong to an elite that sees through the pettiness of the rabble. But despite my self-satisfaction, I can only know who I am by saying, "I am like so and so, or this group or that. They, like me, are rational and superior." When I announce I'm like no one else in the world, I end up being recognizable, despite myself. People are liable to say (and probably do), "Tsk, tsk, he's just an oddball, a cynic, a skeptic," all terms that peg me as a member of a recognizable sub-group. Even the dramatists who lose their identities in dissociative fugues, have identities after all: they're members of a well-known group of fugists, complete with typical behaviours and characteristics. Chronic fatigue syndrome, fibromyalgia sufferers and those merely allergic to the whole world have all figured out how to identify with their preferred reference group. But small or aberrant groups like these must be noisy, because there is hot debate about whether these disorders exist at all. They've got to prop themselves up with drama to nail down the reality of their existence.

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The ancient Greeks make these questions easier for me. More honestly than most of us, they knew they were the dupes of the ritual interests of someone else, in their case, the gods. In keeping with modern preferences, I deny gods, and maintain it's me, the autonomous individual, who decides what I will do. Years of worry have made me recognize my eager participation in the agendas of my gods, the gods of group membership or social roles. I have a larger stake in our secular society than I sometimes like to admit. I acknowledge my rituals tentatively and at arm's length. I say that I don't believe in Valentine's Day or religious rituals, but I participate in them because my life is poorer if I don't. I'm a true believer in science, which I insist is rational, and deny that it's a form of ritual thinking. But it's that belief in the rationality of science that is the ritual. It's wonderful when science produces tangible results, just as it's wonderful that inspiring propaganda, or picking the right flowers on Valentine's Day produces tangible results. The rituals I believe in most ardently are precisely the ones I like to think of as rational. It's rational whether I'm a conservative, a social interventionist, a businessman or a union member. It seems that even though I know the world is ritualistic and truth is made, not found, I'm forever using the words ritual and magic for what others do. I'm hung up on Enlightenment rationalism — despite an appreciation of Schonberg, Freud, and quantum mechanics. The ancient Greeks were just as convinced of their rationality. They ate the flesh of the burned sacrifice, and the gods breathed the smoke into their nostrils. The gods needed no nourishment; they were immortal, and the ancient Greeks could therefore come to the rational conclusion that the gods needed only the non-nourishing pleasures of smoke, nectar and ambrosia.

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I risk being thought ridiculous if I say love is a ritual, and that acts of love have little to do with hormones. Love poems aren't speaking on behalf of testosterone, and like a mantra, they've got to be recited over and over again. The same goes for lovemaking. Because it's a ritual, it has to be urgently repeated, well beyond any reasonable physiological need or capacity. Like the cooing words of love, my lovemaking must be imaginative and adventuresome. Even elementary forms of love — the first date, the first holding of hands, the first kiss — are miracles of mutuality. Romeo knows his coffee invitation will be accepted, and holding hands and kissing happen romantically, with both he and Juliet attuned to the magical moment. Characters like Kramer on the television program Seinfeld, are the opposite — they are socially inept. When Kramer meets an angel on a subway train, he lives out a ritual of failure just as standardized as romantic perfection — not because he has two left feet, but because he has his own skills, a carefully calculated blueprint for failure. It is guaranteed ungainliness — he offers the kiss at exactly the wrong time, and his apparent attempt to hold hands is a grope and a disaster. When I interview a feminist of the silly breed, any signal that I know she is a woman and I, a man, is forbidden. In her preferred ritual, we are two pieces of lumber. In contrast, I am required by my preferred rituals to think of her as a life-denying fool. If I ask, she will tell me wit and wooing are sexual put-downs, fluttering eyelashes and attractive clothes are just crass seduction. If it has to do with the mind and body, innocent fun is not understood. When an angry feminist and I meet — I'm just as angry — things will be awkward, and she'll later discuss it (with ritual enthusiasm) with her like-minded friends, who will explain the events of the interview by saying, "You know that male shrinks are only interested in indulging their hormones and putting down women." As eagerly scornful as she, I will enthusiastically tell the story of the interview to

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my colleagues who, in response to my prompts, will give me the ritual reply I'm after: "You know that these women are ball-breakers."

Dr. Long had applied for psychoanalytic training but wasn't offered a place in the first year class. He'd been advised to apply again the following year. He'd been stubborn when I first interviewed him and I suspect he did some debating with the three senior analysts who'd done his screening interviews. I have privileged access to Dr. Long's inner world and know he'd be a good psychoanalyst, but application procedures, like hiring procedures, are impossibly weak and the interviewers couldn't pick up that, despite not having a diploma, Dr. Long was a psychoanalyst already. It's a state of mind, not a piece of paper; psychiatrists and psychoanalysts are born, not made. Another applicant, also in analysis with me, had sailed through the three industrial-grade interviews with ease. This young woman, to whom I also had privileged psychological access, was without psychological intuitions. She pushed drugs at patients and embarrassed her students by yelling at patients in the clinic. In her personal life, the woman was a shoplifter — no one knows except she and I — and had once harassed a tax auditor who disallowed certain deductions she had claimed. She'd found his home phone number and called in the middle of the night. For 20 years, my working assumption, and the working assumption of education committees, is that much can be learned in a well-conducted interview. I assume this to be true, but I also know that interviews don't always recognize natural-born analysts, nor do they recognize the bad-tempered bully. When first interviewed by me, no one would have believed Dr. Long could be a sensitive, artistically gifted psychologist. In the interviews conducted by the training committee, they would not have seen what I saw regularly. As Dr. Long

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denounced the corruption of the world, I insisted that he note that while these were facts, more importantly, they were an obsession and a fanaticism. Being Dave Long, what else could he do but argue? "It isn't, it wasn't, I'm not. . ." That much, Dr. Long's interviewers would have seen. But what they would not have seen were his next words, words he and I worked three years to unearth. "I saw my Dad's boss humiliate him," he said. "I told you I would tell you the story some day, but that's all I can say today. I want clear targets to battle against, but I know the problems of life are just life, and that really pisses me off. The enemy I have to fight can't be fought against, because it's unknown and unpredictable. It might strike me down and it may lift me up. I hate it that it's not a clean fight against a clear-cut enemy." Dr. Long had been cured, but I'm damned if I know of any disease of which I had cured him. It may be truer to say he cured me, because the man he'd become had taught me a lesson I ought to emblazon on my forehead: Don't try to adjust to the shit that life rains down on us, because adjusting means becoming one of the gray people. Do that, and we go to our graves horrified by the cowardly life we have lived. Dr. Long taught me to keep fighting, to see clearly that, while the ills of the world are here to stay, we must stand up to those ills just the same. That advice is as true for rascals as it is for honest citizens, because even rascals get more shit than they deserve. Isn't that what Achilles did, and the lesson all warriors teach? Never hide and never go along with the pathetic idea that for every problem, even trivial ones, we must enact a law, establish a grievance committee, give a pill, invent a new diet, and believe there is a solution. If we're real warriors, we'll shrug off slogans masquerading as guidelines for how to live. Our reward will be to suffer forever and die with honour. If we're Mttfwarriors, we'll also suffer forever, but die with dishonour. It's a lesson

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that must be learned again and again and, although I've learned it from Dr. Long, I've learned it plenty of times before, most eloquently from Victor Hugo: "If suffer we must, let's suffer on the heights." Psychiatry is not, and never has been, about chemicals, bad parents and trauma. It's about difficult realities like honour and loyalty, and about greed and vengeance. We witch doctors uphold the former and battle the latter.

Never once had Dr. Long commented on my collection of horse figurines. But as our work wound down he told me that, when he finished, he would give me a horse for my collection. On the last day, at the end of the appointment, he handed me a folder. "I told you I would give you a horse." When the door closed behind him, I opened the folder: THIS IS A HORSE This is a horse whose breath disintegrates beneath him in spring water he drinks, ice forming in the rivulets of spilled water and breath. This is a horse whose rider is not just the dumb cold afternoon. This is a shadow of a horse embarrassing the distilled light of this altitude, one thousand feet above the summer. Shadows are the broken bones of night that penetrate this day. This is the space between rider and horse,

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between the sky and ice that touch them on all sides, the space somehow reduced in their descent. The etiquette of evening allows shadows to reach ahead, man and horse to ride shadows. Let's call a spade a spade. This is not a horse. It is only my breath disintegrating beneath me; the empty in the hollow of the horse's back. It is the space between men.

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CHAPTER^EIGHtEEn

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The sky was darkening, my mind was atwitter and my ears and eyes were waking up. Robert Samson lay on my couch talking to me and, strangely, it was my story he was telling, about a series of women, his muses, marching through his life. When he'd been a child, his mother was a fanatical homemaker and sometimes kept Mr. Samson home from school to help her. She'd remove her clothes and, naked, frantically vacuum, dust and polish everything in the house. Mr. Samson hated those days because he'd been sexually aroused. Mr. Samson's wife was upset because they never made love anymore, but her husband had a secret. Two or three times a day, a black limousine picked him up, and a silent chauffeur drove him to an old house in the country. There, a butler took him to the mistress of the house, a young woman with large breasts and a very beautiful face. Around her neck she wore an iron cross. Mr. Samson was obliged to treat the woman with great respect, and when she insulted him, it was he who had to apologize. What happened was always the same. He submitted, kissed her boots and feet, then shrieked with horror as she approached him with the iron cross, intending to gouge out his eyes. At that moment, another woman entered the room.

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This ritual masturbation fantasy, repeated several times a day, was always constant: utterly predictable and boring — if you take repetition to be boring. My muses have also been repetitious, but they never seem boring to me either. The new woman who always entered the room was younger than the first, more beautiful, and her breasts were larger. She, too, wore the iron cross, with which she now gouged out the eyes of the first woman. Mr. Samson groveled before her, crawled to her feet, and offered his face as she moved toward his eyes with the cross. Mr. Samson had a second orgasm just as the door opened to reveal a third woman, younger, even more beautiful, with even larger breasts. This is why Mr. Samson and his wife no longer have a sex life. He was having four or five masturbatory orgasms a day.

Muses assume many shapes. We all know them: masturbatory dominatrix, tidy mother — naked or clothed — the beloved, powerhouse grandmother, schizophrenic Cathy Jones, or twitchy-bottomed student. My mad mother, too, had been a neat freak. Many a Saturday I spent the morning cleaning the house under her supervision, working fast and finishing the vacuuming, mopping, and polishing in record time, before asking to go out to play with my friends. "You couldn't have done a good job so quickly," she'd say. "Do the mopping again." How could I turn into a man if I did housework? My mother wasn't naked when she did the housework; that happened at night when she and my aunt Dona wore negligees, satiny and transparent. If my amplified thinking alerts me when there's a muse in the neighbourhood, then Leila Singh must have been one. Earlier that year, the hospital began to buzz with the news she herself had told me about, that Leila had had an affair with a patient. In little fragments

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— I don't get to ask my patients for the details of the gossip they pass on — I heard that, not only was the affair public knowledge, but it had been Leila herself who'd broken the news. After a few weeks, the talk died down but, three months later, the story resurfaced with a new twist. Leila's brother, I heard, was paraplegic and — buzz, buzz — it was he, not a patient, with whom Leila had had the affair. Leila's fear of her power over men turned out to be an underestimation of the actual state of affairs: she'd gotten the whole hospital yearning for the juicy details of her private life. Oh, my. I hoped she'd be all right. My patient Cathy Jones was schizophrenic, but she was a safer muse than Mr. Samson's mother, my mother, or Leila Singh. I'll settle for a more modest muse and Cathy is just the ticket; she is never naked, her clothes are baggy and her skin dry and scaly. Just the same, she stirs me up in her own way and has made me rethink the notion of madness. My patronizing attitude toward her — wasn't she, like all crazy people, inferior to me, irrational, out of touch with reality, deluded? — showed me I was as intolerant of difference as everyone else, and convinced people like Cathy had to be transformed into normal people like me as fast as possible. When I was faced with Cathy, I completely forgot the craziness of socialist versus capitalist, Israeli versus Palestinian, Hindu versus Muslim. We can find a rationale for all those, but not for Cathy's madness — even when hers is only tragic and never harmful to others. The weirdness of committed schizophrenics doesn't cause the kind of damage done by committed Christians, Muslims, Jews, Hindus, socialists and capitalists. Muses stir me up.

As planned, Christine Brydon began working full-time at the Psychotherapy Centre in July of 1997. After her one-year stint, she would graduate from the psychiatric training program. When she began, I

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noted she was neither naked nor schizophrenic, nor — despite bearing the name of Christ — did she wear an iron cross. In her office, Christine set up a tiny statue of a ballet dancer, a conch shell, three small pots, and some books, literary rather than medical. Her previous experience as an English student and writer still defined how she presented herself. Looks as though I've got myself a gem for the next year, I thought to myself. Sure enough, as soon as she began work, Christine was brazen enough to believe she could have opinions about patients, opinions that, as all good citizens know, can only be held by senior staff. In other words, Christine was observant and perceptive, and she knew it. It wasn't long before I realized that, while she'd been quiet in my interviewing seminar, she wasn't just another shy student, overimpressed by my observations. Christine had plenty of opinions of her own. She'd been shy in the group but, alone with a man, she was bold as brass. Christine wrote up cases, and because she was a writer, formulated them with more wit and descriptive skill than any student I'd supervised previously. To stay ahead of her, I had to muster all my accumulated experience. I even cheated, keeping her off-balance with obfuscating psychiatric jargon. As she was my resident, it was my job to help her to learn something. She, it turned out, was equally determined she would teach me something. She had decided, I guess, that she was one of my muses; but everything got mixed up. I had previously thought there were two categories of women: women of life (hysterics) who were sexy, exciting, and full of display, and women of mind (obsessionals) who had plenty of rational intelligence. Somehow, a new configuration was revealing itself: the eros of mind and the intelligence of sensuality. Christine showed me the mind of the father and the ecstasy of the mother could be transposed and, it seemed, weren't legitimate divisions after all. Christine hated putting psychiatric labels on patients, and stub-

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bornly objected when I told her what she already knew perfectly well: that it was a medical and a hospital requirement that every patient have an official diagnosis. Christine was busy being a psychoanalyst before she actually was one or, more accurately, before she was one of those psychoanalysts who object to diagnosis. She'd told me three years before that she'd gone to medical school and specialized in psychiatry with the sole goal of becoming an analyst. Her argument with me was that psychiatric diagnosis was silly beyond belief, an idea that she would have figured out herself if she hadn't already heard me poking fun at my colleagues in the interviewing seminar. I remember something like this coming out of my mouth: "'Eureka,' they cry, 'phobias are caused by a phobic disorder! Anxiety is due to an anxiety disorder! Schizophrenic symptoms are due to a schizophrenic disorder! Depression is due to a depressive disorder!' Is it possible that psychiatrists who think this way might argue cheerfulness is due to a cheerfulness disorder? Any intellectual desperados who don't understand rny complaint should consider joining the infantry." The reality is actually worse than what I told the students. These arse-bandits — those who are currently hi-jacking, raping and pillaging our noble profession — are missing the thousand and one messages in the symptoms they hear about, statements of complaint in which patients encode the most precious parts of themselves. They are also missing out on the fun of psychiatry, which, I guess, is hard cheese for them. Drinking coffee, having three beers, and biting fingernails aren't diseases, but the bandits have made sure they've found a way of inserting them into the diagnostic manual. Despite the hoopla, there is no evidence nose-picking or nitpicking are bone fide diseases — and they invent new ones every day — any more than depression or schizophrenia. The idol is scientism, a stance that suggests poetry, love and wickedness are caused things. Modern psychiatric madmen believe patients

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are polluted by abnormal chemicals. When I call them on this ungrounded belief, they have two responses: "We're on die verge of discovering . . . [something]." "It's obvious they have a disease." Sure it's obvious. My German brother, Adolf Hitler, once said that he knew things that were obvious about Jews. I've been told that it's now forbidden to use the reductio ad hitlerum as an argument, but I'm a German so I figure I'm allowed. Am I supposed to pretend he didn't exist or that there's nothing to learn from him? The materialists, all too often by way of the press, are always telling us they've discovered the cause of dreams. It's always some brain centre diat's implicated. Such "discoveries" are no better than some more popular materialistic notions for example, that dreams are caused by an undigested bit of Camembert or by a blob of Skippy peanut butter. Our odd habits of thought are liable to make us forget it's a. person who dreams, and not some material stuff. The brain centre called the nucleus of Edinger-Westfahl and the fragment of Camembert cannot dream, nor can peanut butter, but a person certainly can. A psychiatrist true to his shamanic ancestry will always ground his thinking in dynamic persons, not static materials. My colleagues forget madness is just a variant on the weird behaviour of the rest of us, but when I say this, I'm being as outrageous as Christine. Unconventional behaviour invites us to concoct a label; the offender is a deviant, madman, criminal, revolutionary. The gods illustrate the ubiquity of unconventional behaviour. As far as I can see, any god worth his salt has a repertoire of weirdness at his disposal, as does every literary and mythological figure. It's what makes human conduct riveting. Christine was just as cranky as me. Both of us needed calming by someone like Thomas Mann: .. . [They] must be won over, so much is fact; and they are to be won,

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that must be a fact too, since they are not bad, but only a little stiffnecked and defiant. . . and prone to shuffle their feet.

Christine and I had made a bargain concerning diagnosis. If she put an official diagnosis in the body of the case history, I let her invent an imaginative designation and put it at the beginning of her report as a caption, perhaps something like: "Achilles, leader of armies, conqueror of cities, greatest of runners." She agreed, mostly because she thought the suggestion hilariously funny. Thereafter, her official hospital records started with captions like: "The Liar Who Says He Loves Women." "By the Skin of His Teeth." "The Rogue and Peasant Slave with the Mind of a Princess." This wasn't done for fun — Christine's titles were serious attempts to capture the essence of her patients' character styles. The "Rogue and Peasant Slave with the Mind of a Princess," for instance, was a depressed woman who presented herself as the world's biggest dud. She said she fully expected someday she would be a derelict, except she had spent her childhood as the sexiest, smartest, and best-behaved child in her family, and her young adult life as the most successful and desired woman wherever she went. Would the label, "depressive reaction," have better captured her essence? I remembered how Christine wiggled her bum the first time I interviewed her for her position, so I had a caption for her, too: "The Mind Who Wags Her Tail"

Christine enjoyed working with men, and whenever she was with them was enthusiastic, optimistic and insightful. Although smart, with wickedly shrewd insights into people, she couldn't always apply her intelligence to women. She found in them unattractive qualities;

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to her, most women were mindless flirts and bimbos. But doctors must treat everyone who comes their way, so against her will, and in accord with medical tradition, Christine was required to demonstrate competence widi men and women, young and old, and to work with them whether they smelled like perfume or reeked of the gutter. Christine hated being supervised; she didn't want to learn from me. She felt she could do her learning from books, although that doesn't explain why she'd chosen to work on my service. What Christine really wanted was to help me, and the supervisory situation made that hard for her. She admitted she'd had a history of stimulating men to do better work, to develop new ideas and, through her prompting, become stars, but didn't seem to think this noteworthy. It was just a fact about her and her abilities; in her mind, it was legitimate and natural to promote my development. In my case, it wasn't so easy for her to pull off. In addition to my official educational duties, I had a matching teaching demon, an iron, inner law that demanded I teach. But protocol, custom or my determination weren't going to stop Christine Brydon. Christine insisted that my position didn't leave room for the uniqueness of every situation, and was therefore just another example of the dumbing down of psychiatry. She scoffed when I said the question was whether or not she felt she was a student. She changed the subject to the problems of academia. "Has this profession no understanding of its history of scholarliness, its philosophical grounding?" she complained. "No one can do this work without at least some bits and pieces of a classical education. I sometimes get the feeling that, instead of trying to understand how the Greeks struggled with the problem of mind, people in this field struggle to ape Oprah Winfrey's understanding of mind." Christine was a pain in the neck, always on the attack. At first, I thought she was tilting at windmills, but it turned out hers was a well-

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reasoned system of skepticism — and I'm a sucker for skepticism. Christine's antics mirrored what I was always tempted to say, except I still wanted to be popular, so I (sometimes) held my tongue. The trouble with hold-your-tongue wisdom is that it's shallow. On automatic pilot, I'm inclined to question every truth; but I also know all-embracing disbelief is impossible. The problem arises when doubting becomes a system. Skepticism is really just one more possible mindset — a philosophical stance, if you like — that helps us play, make jokes and see the ironies of life, for starters, not to mention change our minds. But skepticism is just as seductive as the solid beliefs of Osman Awad, Leila Singh and Jim Forster — who Christine called "the drivel-king," the "pudding-realist" and "the lover boy," respectively.

Without me knowing it, Christine had persuaded my secretary to give her access to the computer, and extracted from it a book of mine that was in preparation. Chapter by chapter, she made copies until she had the whole thing. Then she told me. I was annoyed, but what could I do? Report her to the education committee? Pilfering my book out of the secretary's computer was enough to get her in big trouble, but Christine insisted her behaviour was legitimate and honourable. I called it a violation of my privacy, not to mention a corruption of my secretary. Christine didn't care what I said, and dared me to do something about it. Then there was Christine's contention that if she didn't want to work with women, why should she? In my supervisory meetings with her, she refused to tell me about her patients. She had other things she vitally wanted to talk about: me, my book, intellectual matters, the politics of the Institute, the stupidity of the world at large. Every day, Christine put a piece of my book in my mailbox, along with a sharp and exhaustive critique. Her big complaint was that I'd said I hadn't

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wanted to write a boring, standard textbook, but that I nevertheless kept making assertions and rational arguments and summoning lists of supportive facts and quotations. It wasn't the content to which she objected, it was the form and style: "Intensify!" "Make your point with stories." "These sermons bore me." tiC ' I" Stop it! Christine used her literary skill to challenge me and to critique what I'd written. Still, Christine was a student and a psychiatric greenhorn, and her behaviour, to say the least, was outrageous. And then there was me: how dare I comment on her arse, if only in my head or on the page? On the other hand, how dare she extract my book from the computer; she might as well have pulled out my dick. To top it off, I conspired with her in her rebelliousness. Since it would obviously feed into her defiance, suggesting to Christine that she should put captions on her case histories was pretty damn silly — even though it might have been harmless with a different resident. Didn't the medical records department complain, and wasn't there eventually a memo from the Clinical Director?

For me, the worst part was that Christine had stolen the role I cherished for myself. She scorned bureaucrats and I had to defend the system. How could I undo this, I wondered, without squelching Christine's imagination and without turning myself into one of those pale criminals — an official who tells people to "conform to the rules because it is a requirement." One day, as Christine complained yet again about some administrative requirement, I said, "Christine, you are a bloody thief. Here I am, a quiet rebel, trying to get away with being a nonconformist and

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hoping to pass on my gospel to a few students, and you come along and steal my thunder. If I told you we shrinks have to be careful not to fall into the trap of making our patients conform, turning them into 'nice' people, you one up me and give me a lecture about normalizing you, making you 'nice' by demanding you write regular assessment notes, or insisting that you tell me about your patients. I've arranged my life so that I can think of myself as a maverick, and here you come along and insist that you are the maverick while I am just another administrator. "But you know I'm not just joking around about this, Christine. Our conversations take only one form: you're the free spirit and I'm the rule-giver who tries to squelch you. How the hell did we get into this game? It's as though there are only two kinds of people, free spirits and enforcers. The worst is that I always end up being the enforcer. How did we get into this?" Christine was untouched by my jocularity. Her flashing eyes weren't the eyes of eroticism; she was infuriated by what I'd said. "You just want me to be a yes-man," she objected. "You can't fool me with your joking around. You remind me of that guy at the UN, Kofi Annan, always talking in his sweet, soft voice when you can see that he is boiling with rage underneath. You're furious at me and you just want me to knuckle under. I came to work on this service because I'd heard that you weren't like that, but I see you're like all political correctness freaks, pretending to be so moral and good-natured, but full of poison underneath, with your 'zero tolerance' and your campaigns to humiliate everyone who does something different — or something trivially stupid." Yes, I had noticed Kofi Annan's voice. Is mellifluent the right word? Dulcet tones? Yes, I knew about the false democracy of the modern world, leaders who avoid hard decisions, screen their decisions from view with a flood of surveys, all-staff meetings, retreats and question-

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naires, a modern version of bread and circuses that we permit because we fear the day when we ourselves will have to be the leaders. Christine was right. I was a coward like everyone else and didn't want her to hate me. I hadn't used the empathy ploy on her — its sugariness was too obvious for me — but my jokes were a version of the same ploy: I'm just a good natured guy, I know the world is stupid but you and I understand one another and we go along with it out of prudence, okay? To myself I was unwittingly saying, "Don't take a hard decision, don't insist on good work and don't become the leader/father too obviously." I watched and I learned. Christine would not be pigeonholed as a liberal, a socialist, or a reactionary. Like all people, she was composed of fragments of many things. There is no such thing as a rational world, plan or system; there are only bits of rationality, some good and some stupid. She left me reeling. "You damn politically correct conformists are systematic racists, even though you deny it," she railed. "You're intolerant of non-conformity and don't understand about 'good' bigotry, the bigotry against politicians and administrators, good because diese people need to be criticized to keep them on their toes — as long as it doesn't turn into a witch hunt. But that's what happens. Take Bill Clinton, for example. Philip Roth said that when Clinton was in trouble they should have put a sign on the White House that read, 'A human being lives here.' Why isn't there action against welfare bums, or psychiatric drug propagandists, to keep them on their toes? You, for example, don't flatly say the guys who push drugs are wrecking psychiatry, even though you slyly insinuate it all the time." Well, /thought I'd been braying like an ass about the drug idiocy, but . . . "The worst racism of all," Christine continued, "is the war that's been waged for 30 years against European men. All men are under

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attack, especially the scholars and the warriors. I hadn't really used the word 'warrior' until I heard you use it, Gordon, but it's a very good word. How the hell can the world survive without warriors? What joyful and admiring image of men can we have unless it's as people who protect the weak and the women?" "Gordon?" Since when was I "Gordon" to this young whippersnapper? Christine knew what the Spartans discovered 2500 years ago — that victors who seek the approval of other states, and who placate the conquered, are not thanked.

I had to focus more on Christine's uniqueness — her madness — than on the madness of her patients. She told me nothing about them anyway. But my way of talking to Christine also smacked of impropriety; psychiatric educators frown on anything that suggests a supervisor is acting like a therapist. It's not that Christine complained about me — on the contrary, she probably thought I was a wimp, beating around the bush instead of tackling her head-on. My answer to the concern about supervision turning into psychotherapy is to tell my colleagues they shouldn't be so earnest. Neither psychotherapy nor supervision are holy procedures; they're just good, serious talk about what's going on. I'm not saying talk isn't powerful, it's very powerful indeed, but the real issue is whether the power of talk is used for good or evil. The anxiety of my disapproving colleagues reminds me of the psychiatrists who fear straight talk with patients will cause regression and decompensation. They're the ones who'd disapprove of me working analytically with Mr. Allen because he ranks so high on the scale of unconventionality he has earned the label "schizophrenia." What nonsense. Psychotherapy is only talk, albeit serious and non-traditional talk. But it certainly doesn't damage patients. Nor is

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the study of a student's madness an impropriety. Supervisors and psychotherapists can be ignorant and ridiculous, of course, but that's true of the whole world. What was to be done? Should I have banished any discussion of the things foremost in Christine's mind, the things that most clearly expressed the workings of her soul, the only tool with which she could do her psychiatric work? And besides, despite her unorthodoxy, Christine did good work, and was a font of psychiatric knowledge. Unexpected behaviour is no problem when I'm with a patient because, unless he damages property or disrupts people in adjacent offices, to my mind he can do no wrong. Whatever he does — talk, read a magazine, stand on his head, skip appointments — is 100 per cent him, which is what he and I are trying to notice. As long as a patient pays for the time he's purchased from me, it's not my job to steer, guide, or persuade him to "try." What matters is whether I am smart enough to understand why this is the person he has designed himself to be today, and to understand how his actions fit into his wider life and his past. My job is to connect everything to everything else, to help him wise up about himself. Whatever he does is his most pressing expression of his immediate being. If I interfere with that, it would show I fear knowing certain things about him or, like an old-fashioned fascist, believe I know better than him what he ought to talk about. But what about Christine Brydon? Wasn't she just being who she was? Shouldn't I have demanded that she smarten up, get on the ball, and fill me in on her patients for whom, after all, I'd been responsible? When she said preposterous things, shouldn't I have taught her and showed her she was being preposterous, led her toward the true educational path? Or, if my most highly developed skill was helping people learn more about who they are, wasn't that the best thing I should have offered Christine? When she spoke of me and my foibles, might this have helped us to learn something worthwhile about her

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fear and her own foibles, her fear that I, her hero, might have been flawed? And her fear I might not be able to handle her? Christine lived as though haunted by a question: are women too powerful and potent, even for men who on the surface look heroic? In other words, I eventually realized Christine believed something after all, that she had a leak in her skeptical project of doubting everything. Maybe, if she was outrageous enough, I'd rear up, flex my muscles, and put her in her place. Actually, Christine's madness was perfectly designed to create such a scenario because, if I I'd gotten too nervous I might have reported her to the education committee, and they'd have stepped in and dealt with her. Wouldn't I then have been the powerhouse man who crushed her improper behaviour? To Christine, women were most safely thought of as boring, pathetic, and weak, so boring she wouldn't bother to work with them. It was a safety device; if she never got to know a woman well, she'd never have to find out that women are perfectly competent. Should Christine ever have unearthed that terrible truth about women's strength, wouldn't she become frightened that men were at risk? No, best to believe that all women (except her, and she'd see to it that men were given a leg up) are boring ciphers, while men are heroes. So I said things like: "What is this madness for male heroes who must be stimulated and awakened?" "Wouldn't it be awful if I were a really bad writer?" "I'll bet you were a nervous wreck when you read the first pages of my book." "You were determined to have a really good teacher this year." "Since you rarely end up alone in your office with a woman patient, there must be something about women you don't want to know." "I know women bore you, but since you and I are shamans, we also know about strange things like paradoxical truth, that every great

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truth has its opposite, and that boredom is the perfect cover-up for fascination. Actually, that's one of my rules for myself: if I ever start feeling bored with a patient, I wonder what it is I might be nervously fascinated by. Patients do it, too. "When they say, 'God, you must find me boring!' I always figure they must be worrying that I'm getting very interested in them. So I'm wondering if something like that is going on in you, that there are fascinating secrets in women you don't want to know about. Men are the opposite; they're always of high interest to you, even me and my book. I sometimes get the feeling that your male patients are all a mixture of Muhammad Ali, Achilles and Frederick the Great." Christine's reaction was to stay silent. She preferred controversy, but once in a while she could let herself be pensive. I didn't bring up her mother, her father, her husband or her brother, or dreams and sex — as I might have had she been my patient. My interpretive comments were psychotherapeutic, albeit cautiously so. But had Christine herself mentioned a parent, personal madness, or scandal, I wouldn't have backed off. For her part, Christine frenetically analyzed me, the hospital organization, and the culture at large. At first glance, it seemed like she also avoided all analysis of herself. Like Dave Long, Christine had a noisy exterior that belied her tender innards.

Recently, Christine told me, she'd talked to Osman Awad, now a staff psychiatrist at the Clarke, and he'd told her of his interest in cognitive behaviour therapy (CBT) and interpersonal therapy (IPT) — modern fads that will fade. The new terms are, of course, gobbledygook; could there be a psychological approach to patients that was not interpersonal, cognitive or behavioural? I don't much like the word psychotherapy, either, because therapy is imbedded in it, a word that

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conjures thoughts of illness and disease. For me, psychoanalysis is the best word, but I also like soul-talk, thymos-ta\!&. or /0gw-talk. Maybe my throwaway line is best: psychotherapy is talk between worried citizen and wizard. I frequently saw a harried Osman in the corridor rushing to the elevator, briefcase in hand. He had started wearing a necktie and jacket, as I did until recently, indicating he'd become one of us, the allimportant staff doctors. When he took up his new interests, Osman didn't understand he'd sold his soul and taken up a fad. Once upon a time, Osman's heart was in the right place, albeit a logical, theoretical place. I assumed the anatomical location of his heart was still in order, but at the time he hadn't calmed down enough to talk to people without a slogan, plan, or goal in mind. The new methods he was peddling were manual-based, in other words, perfect for research because they're predetermined by the manual, and therefore measurable. In my mind, I offered him free advice: Two-thirds of your patients will show improvement, Osman; I can tell you this without access to the data you are accumulating. And by the way, did you follow a manual when you wooed your wife? And would you make notes while making love to your mistress?

I pressed on with Christine's supervision, always a bit edgy because it so little resembled the supervision I usually do. Sometimes, she responded to my remarks scornfully, but once in a while she regarded me with a mixture of uneasiness, relief and thoughtfulness. Once or twice, she even confessed to being confused. I never responded to Christine's critiques of my book, but they affected me. Week after week, Christine dropped off her comments in my mailbox. Sometimes her ideas provoked in me those two predictors of change — restless sleep and unsettling dreams. Despite myself,

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I'd allowed Christine to become a muse. She insisted I face up to my fear of being literary and flamboyant, and scorned my addiction to facts and information. Her mad provocations made me pay attention, and helped me to let go of old hopes that there could ever be an accurate and logical science of mind. As Christine brought about this change in me, she couldn't know she was inviting me to let my father die away and to awaken my mother in me. For her part, she was keeping me, the father — that is to say, her father, all fathers — alive in her. My father had led me to good sense, arithmetic order, and facts. My mother was spit and venom, and perfumed, imaginative sighs. I had clung to the fraudulence of the psychiatric enterprise for a long time, but over the years it had begun to crumble. Christine pushed me into seeing just how sermonizing and intellectually vacuous I'd become. A Victorian Order nurse who'd fed me waffles in 1945, and my grandparents celebrating my arrival in Germany in 1958 also did their share. Christine fed and celebrated me, and helped me clear out what was left of the bigotry I'd honed into a psychiatric style.

Once I'd regained my composure, Christine began to look different. Like my Oma and Cathy Jones, Christine turned into a spectacle of sumptuous femininity. Her eyes and teeth shone more brightly, her nails lengthened and her bottom seemed svelte and sturdily alive. As always, it was most obvious in her fingers and lips. Christine was furious I wouldn't acknowledge her as my muse, and hinted she would take her revenge by having an affair with one of my patients, or a previous supervisor. Christine didn't change me on her own; I was already well along that road. But she helped me to tell stories as personally and specifically as I could. The uniqueness of events had become more central to me, and generalizations about the nature of man started to stick more

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than ever in my craw. My muses had corrupted me, and brought me to life. Most important of all, I finally figured out that, if the worlds of sex and intelligence can be transposed, so could the worlds of madness and sanity.

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CHAPTERJlillEfEEn

Finis QpERis

On an autumn evening, a Friday, a telephone message from Cathy awaited me when I got home. In a matter-of-fact voice, she said, "Hi Warmie, could you call me when you get in? I have good news and bad news." There had been no hints in Cathy's letters or in her occasional phone calls that gave away what she meant, nor had there been any troubling news that I knew. I phoned back at 9:00, and again at 10:30. No answer. I called on Saturday morning; no answer. At noon on Saturday, Cathy's aunt phoned and told me she had died. The doctor said she'd had an attack of asthma during the night and had stopped breathing. I phoned the doctor, explained who I was, and hinted that I knew more than I'd mentioned, but he courteously explained that she had stopped breathing. Finis opens. Oh my God, I thought. What a pain. I was supposed to go to the ballet on Tuesday and now I'll have to go to a funeral. As I thought this, I noticed the tears in my eyes and had flashes of Cathy's face, dead, and tear-stained like mine. But I am a doctor; I know how to turn into ice. After my initial bizarre reaction, I grieved, but only in a muted way. Cathy's life had come to an end, which meant her suffering was over. Hadn't her telephone message said, "I've

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got good news and bad news"? The good news was the end of the goddamn misery, suffering, and loneliness. But it was also good that death wasn't Cathy's whole story. There was also honour, worth and struggle. The doctor in me resolved to be sensible. I didn't excitedly phone Cathy's family, spilling the beans that her death had been a suicide, nor did I pressure the family doctor to investigate further. In my mind, I also gave Cathy a gift. "Finis opens,''I'd said aloud, a glamorous Latin epitaph for her, a final, dramatic flourish, and my little tribute to her. No, I didn't grieve in the usual sense, but for a week or two I shook my head a lot — sort of amazed, stunned, and relieved. It's only now, as I write these words, that I can weep. What an astonishing ordeal, labour and trial she and I had been through. Dare I think of it as something else; dare I think of it as an adventure? Cathy would have liked chat idea, but would the world approve? Cathy's death condemned me to another life sentence, condemned me to be ordinary and human, the same penalty imposed on me by Graham's death. I'll always be haunted by the idea that there are things I ought to have said to Cathy, although I'll be damned if I know what they are. After her death I round two quotations in Cathy's file I'd put away years ago — two more epitaphs — copied by me onto a scrap of paper. The first was from Thomas Mann, the second, Miguel Cervantes. . . . they and the whole audience espoused the view that rejection is a destiny like any other, with a dignity of its own. Every condition is a condition of honour . . . We cannot all be friars, and many are the ways by which God leads his own to eternal life.

Finally, there was this poem by W. B. Yeats. It could only have been written on behalf of Cathy.

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Had I the heavens' embroidered cloths, Enwrought with golden and silver light, The blue and the dim and the dark cloths Of night and light and the half-light, I would spread the cloths under your feet: But I, being poor, have only my dreams; I have spread my dreams under your feet; Tread softly because you tread on my dreams.

I'd learned from Cathy, and she inspired this book. I'd set out to mother her and she gave birth to me, I miss her, and swear she is my final muse.

We can't as an act of will decide on our myths. The culture and the unconscious have minds of their own; they pick our myths for us. I used to think we were entitled to live by any myths we wished, but I'm not so broad-minded anymore. Now, I stick with stories that have withstood the test of time. The Greek myths are my favourites, and that's why Cathy is my final muse, because after all, she was my first. And, yet, secretly and potently, my mother may turn out to have been the first, though all the same the last. Thank God there are only nine Muses because I couldn't handle one more. In a crazy way, I've mixed Cathy up with Carol, a foster child who lived with my family after my father was released from the internment camp. A series of children had lived with us in 1942 and 1943 (most of the internees stayed until the war ended in 1945, but through the intervention of friends, my father was released late in 1942). But in 1943, Carol, a newborn, came to live with us. She was Jewish and her mother was unmarried. To me, it's still astonishing that Jews, in the middle of World War n, would have boarded their child with a German family. Although her mother visited weekly with her married

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boyfriend, Carol was treated as our very own child. No one said so, but in my mind, she was being raised as a nice German girl. We loved her and when, at age two, she left, we were devastated. We'd assumed she would stay forever. On the day I got the news that Cathy was dead, I remembered Carol, who I thought I'd forgotten. She'd been my baby sister, and I last saw her 58 years ago. I was acutely aware that Carol's parents were Jewish. To me, they even looked Jewish, though I had no image in my mind of what a Jew should look like. We lived in a WASP neighbourhood and the only Jew I'd ever met was the boy who, despite the sign that said, "Gentiles Only," was on the beach at Lake Wilcox. To my amazement, Carol's father occasionally brought me gifts. He had noticed I liked building model planes and he brought models larger and better than I could afford. He also noticed I used old, safety-razor blades to shape the balsa wood, and had the inevitable nicks and cuts on my fingers. So he bought me an X-Acto knife I treasured for many years.

The patients who I assess in the interviewing seminar meet with me and, after 30 minutes, disappear into history. Like Cadiy and Carol, they come and then they are gone, like my students — but none are forgotten. I blunder into old students in the corridors of the hospital from time to time, and am embarrassed when I don't remember their names. Worse, I was recently shocked when I did not recognize my exwife at a wedding. Absolutely gone, I guess — except as a piece of history. Captain Ahab, intent on finding Moby Dick, puts it all into perspective for me when he hoists his tot of rum and, with the crew of the Pequod, drinks a toast: "Like life, gulped and gone." As I've said earlier, I regularly see Osman Awad striding toward the elevator carrying his briefcase. He is well thought of in the department

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of psychiatry, and students enjoy his teaching. When we bump into one another, his eyes light up enthusiastically and he greets me warmly. But I've got the goods on him — he still thinks I'm a villain. A student once snitched on him, reporting to me that Osman had told him to avoid me as a supervisor. Dave Long also shows up in my corridor now and then, as does Christine Brydon. Dave's inner poetry remains concealed from the casual observer, but on my wall, alongside portraits of Mann, Shakespeare and Wittgenstein, I've hung his poem. Klimpt's luscious portrait of Danae is there, too, as is my old grandmother — and Zeus's golden net. Christine has gotten plump but she still wiggles. A few days after the World Trade Center bombings, she cornered me, and as though we'd never stopped our meetings, carried on with her diatribe: "We'll see what happens now, whether the Yanks decide to act like warriors or whether they'll have to smother their actions with consultations, alliances, explanations — bloody excuse-making, I call it — instead of doing the right thing." I've heard that Leila Singh and Jim Forster are now in private practice, and recently I saw them going into the auditorium together. They were part of an enthusiastic crowd of people attending a conference on some psychiatric public relations triumph, something important like "sleep hygiene," masterful advice bequeathed to us by years of research: don't drink coffee for a few hours before bed, have a quiet room, develop regular sleep habits, etc. This advice, when offered by a psychiatrist, earns him more than $100 an hour. As he walked into the auditorium, I noted that, like Lewis Caroll's white rabbit, Jim was still rushing. Leila smiled her sweet smile and wore Western clothes. Was it my imagination, or did she look bruised and tender? If she was now less sure of herself, had Leila become wiser? I've heard no further gossip about her, but I expect she's still licking her wounds. Am I different because I've had my own analysis, or is it life events

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that have shaped me? Could it really be true that it's all in my genes, or is it just luck? Perhaps it was the nine Muses, my Muses, who unsetded and woke me to life. They're mine — the many people I've loved, inspiring and passionate, both consumed by the bright sexuality of mind and body, and, since love is folly, broken by loneliness and despair. A few weeks ago, I had lunch with my difficult mother, now 92 years old. She looked across the table with a twinkle in her eye and remarked: "It's hard living without a woman." She paused, and twinkled a bit more. Was it Zeus's golden web glittering in her eye, the net that redeems me from my years of exasperation with her? "But with a woman it gets crowded

A noose has choked off my old way of life. I've long abandoned professional politics, stopped reading psychiatric journals, and have written no new articles for journals. The referees who screen such articles, more than anything else, have become censors and protectors of the faith. Anything that deviates from the faith is screened out — and as I've said, I'm no longer a believer. The noose around the neck of my past tightens further, the heat increases, and the threatening clouds signal the incoming storm. In 1998,1 asked my mother about the events of 1939: "What exactly happened when the RCMP came that night? How many of them were there? Was it really four in the morning? Did they search the house, and use crowbars on something?" My memories were pretty much right. And then, 25 years after the traumatic ending of my analysis, I asked the long-delayed question: "When they took Pappa away, was I very upset?" "No, you weren't," said my mother. "You were a very good boy. But

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/was very upset. I used to go into the bedroom and cry, I had panic attacks, and couldn't sleep for almost a year." "When you went into the bedroom, did you cry into the mattress?" "I did. You remember that?" I knew it because I had lived it out in myself when I lost my own analyst-father in 1968. Phil Holzman and I had thought it was me lying on his couch for four years. Little did we know it was my mother, the mother I never wanted to be. I was thunderstruck that I had so dramatically identified with my mother — especially since I had assured myself that I would never be like her. The identification was profound and detailed, the absorption of an injury that was in someone else, and relocated in me. My mixedup reactions to my analyst, Phil Holzman, and to my teachers, Herb Schlesinger and Bob Wallerstein, were samples of the same psychological trick. At first I thought they were German. Then they, the Jews of the world, were no longer injured; they were German like me, and therefore okay. It's the guilt of the survivor, whether it's the young generation of Jews who were spared the Holocaust, or the young generation of Germans who are now spared the blame. While this story revealed a vital and eternal truth about me, it was also a defensive falsehood — I was thrilled to be thunderstruck by rny mother's information. It meant that I could indulge my preferred madness: it wasn't me who had a bad separation reaction to loss, after all. I could cling to my belief I was immune to the loss of fathers, since it was her, not me who'd been upset. To lock in my immunity idea, and to illustrate the power of identification, I frequently told my students this amazing story of a perplexity of deaths.

When I was a child, my fainting and panic attacks had proved to me I was a sissy and a girl, my greatest fear come true. And yet I also

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feared being a boy. I was more rough-and-tumble than most, but a fear of boyishness made me hide it from adults — with them, I was very well behaved. I still maintain that goodbyes and losses don't bother me. As a result, I'm extra vigilant about my patients' reactions to my absences, because I'm liable to underestimate how much it might affect them. I can't fear losses; I'd be a sissy — like my mother who reacted so strongly to my father's internment. But I hate being alone and, old bachelor that I've become, the absence of a woman in my life makes me feel like a social misfit. If I invite a woman to dinner, I'm liable to suffer little hints of anxiety, fearing that the whole anticipation of the evening is a stupid illusion, the universal illusion of togetherness: "You're no one till somebody loves you . . ."

Greek mythology saves all of us from die grim realities of madness. It also teaches us how we might defang, reframe, and refresh the grim realities we all seem to face. The greatest of teachers was Zeus himself, that silly, impulsive philanderer. How did the old fool pull off such a trick? By way of two heroic deeds: the creation of the world of the Olympians and the conception of Helen of Troy. I've told you the first of these stories, how Zeus swallowed the universe, then vomited it out again, transformed, to our eternal benefit. That act created the world of the Olympians, the world diat sparkles, remembers and speaks. Zeus's second heroic deed was to force Nemesis — "necessity" — to give birth to beauty. Zeus was attracted to mortal women and had no interest in tampering with the Fates. The Fates were all women, all right, but they were also ancient, disturbing, and hostile. Zeus preferred to dabble with those ancient Spice Girls, die beribboned maidens who played in the fields with the beautiful white bulls. But one day, Zeus changed. He became enamored of the Fate we

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know as Nemesis. He'd grown up by this point, and was ready to love an adult woman, rather than always falling in love with giddy young girls. At first, Nemesis tried to elude Zeus by fleeing, and changing herself into many slippery shapes. When the mad flapping came to an end, with Zeus as swan, and Nemesis as goose, the two were joined. He had forced her to yield. The way of the world has been fundamentally altered by this event. Nemesis — necessity — was forced to yield. Ordinarily, we're all inclined to yield to necessity, but these days, strangely, it's the other way around, and grim reality, just slightly, seems a little less grim. The Olympians have been obliged to open a window to hope, although we should not allow ourselves to think of great hopes, high hopes. Like the hope that emerges from Pandora's box, this hope is delicate and tiny. From her "box," Pandora's femininity, emerges the same yielding good Nemesis has surrendered to us. Important stories are always repeated; that's why myths are ever present in opera, cartoons, art — even in the names of automobiles. Zeus therefore continues in his disguise as a swan, and repeats his seduction with Leda. From Nemesis' womb, a white egg appears, and is transported by Hermes into Leda's womb. From that egg emerges a perfectly formed, tiny Helen, the most beautiful woman who ever lived. Zeus has forced necessity to yield up beauty. This is the second of the great stories in which Zeus teaches psychiatrists how to do their work. The tragic schizophrenic man or woman, are they fated to be forever mad? Is schizophrenia a dreadful chemical destiny, a fate brought upon its victims by Nemesis? Or can we, like Zeus, struggle against the inevitable, wrench from it a small victory, a fragment of beauty in the midst of suffering? Are we grownup enough to love the mature and adult woman, Nemesis, and seduce her into yielding up her beauty? In truth, psychiatrists have no choice. Mature or not, we also must

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fulfill our destinies, which is to change destiny. Like the ancient Greeks, we must make a shift, give up power as our raison d'etre, and shift our interest toward beauty. We will never be able to bathe the whole world in light, as Zeus did, but much will be gained if we can splash droplets of light on the world, and into the lives of the mad. Stern reality never ends, of course, but before Zeus brought forth his era of the Olympians, grim reality was just plain grim. Now something is different; grimness has taken on a new, barely perceptible glitter. When armed with this new perspective, the ironies of life become visible to us, as does the silliness, the humour, and the realization that everything that's been thought can be thought over more than once. We can smile at our own foibles and at the stupidity of the world, and, once in a while, avoid the unwarranted and grim conclusion that madness is an incurable disease. It's not that; it's a way of life for some people with whom psychiatrists sometimes talk. This is the model of the world I choose. If I'm smart, I'll see mental illness for what it is, just life twisting and turning before my eyes. With the benefit of Zeus's inspiration, I can grit my teeth and emulate him, knowing Nemesis, the Fates and Cronus will always resist my caresses at first. I'll respond to their resistance by increasing my ardour, and by perfecting my skills of seduction. Like Zeus, I'll find scraps of beauty in every evil or madness that afflicts my patients. Zeus overcame his fear of the Fates, as incarnated in Nemesis. Her maturity was no longer an obstacle, or an eternal biological impediment. Zeus lost interest in the pretty Spice Girls who played with the bulls, and if I ever become a grown-up, I'll do the same. I'll lose my fear of destiny, and once and for all, stop believing my patients are somehow chemically and biologically unfit.

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My mother, my first and last Muse, gets confused these days, but she's still herself. At lunch, she recently asked me my name. "I'm Gordon." "Oh, yes, Gordon. How old are you?" t( o« • » Sixty-nine. "Sixty-nine? . . . " She giggled mischievously into her hand. "It's time to get married!" It's quiet and neither of us speak, but I smile ruefully at her confused alertness. "The girls that work in the home are so well trained. They are very good housekeepers. You ought to marry someone like that." I smiled and shook my head, but suddenly she corrected herself. "Maybe you shouldn't marry a good housekeeper. Maybe you should marry a sexy housekeeper." My mother's native instinct, her life-long passion, has been to be unrelentingly critical and mean. So I have to give credit to Zeus for giving a befuddled old woman that hilarious, glittering line.

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AFTERWORD

The names of the patients and students have been changed in this book, as have the names of some of my friends. Graham Copeland had a distinguished musical career, but did not discover the secret of Bach's Musical Offering. That discovery was actually made by the musicologist Ursula Kirkendale, who I have heard of but never met. I have used her story to disguise Graham's identity. My colleague Robert Maunder wrote the poem, "This is a Horse," not Dr. Dave Long. Another colleague, Jack Lieber, wrote the untitled poem about the shaman sitting in his cave. You will have noticed a skew in the way I have presented the cases: I have recorded a lot of my talk, and little of what the patients said. In the consulting room it's the opposite; the psychiatrist is quiet, and his moments of talking are only very occasionally long-winded. What patients say to their doctors is easy to report. But how the psychiatrist responds and enters into the dialogue is harder. With-out knowing about the psychiatrist's own life, his private musings and how he speaks to his patients, how can the psychiatric story come to life? I hope I've allowed for that. Robin Roger and Jack David read and criticized several versions of

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this book. More than I like to admit, their advice led to improvements, especially because they insisted I should reveal things about which I'm usually circumspect. My editor, Kevin Connolly, frequently unsettled me by understanding my intent too well; when I read his critiques, I wondered if I'd violated my Hippocratic oath by revealing medical secrets improperly. Despite my stubborness, he got me to improve my petrified medical language and prodded me into making this a much better book.

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