Already I have the urge to begin this history over again by insisting that it is a private one. And not only private but subject to my imagination as much as to the facts. It has taken me ten years to sort through my notes on this case, and through my thoughts as well; I confess I originally considered writing something about Robert Oliver for one of the psychiatric journals I most admire and where I've published before, but who can publish what might eventually prove to be professional compromise? We live in an era of talk shows and gargantuan indiscretion, but our profession is particularly rigid in its silences--careful, legal, responsible. At its best. Of course, there are cases when wisdom rather than rules must prevail; every doctor knows such emergencies. I've taken the precaution of changing all the names associated with this story, including my own, with the exception of one first name so common, but also so beautiful to me now, that I see no harm in retaining the original.
I wasn't raised around the medical profession: my parents were both ministers--in fact, my mother was the first female minister in their smallish sect, and I was eleven when she was ordained. We lived in the oldest structure in our town in Connecticut, a low-roofed maroon clapboard house with a front yard like an English cemetery, where arborvitae, yews, weeping willows, and other funereal trees competed for space around the slate walk to the front door.
Every afternoon at three fifteen, I walked up to that house from school, dragging my knapsack full of books and crumbs, baseballs
and colored pencils. My mother opened the door, usually in her blue skirt and sweater, later sometimes in her black suit and white dog collar if she'd been visiting the sick, the elderly, the shut-in, the newly penitent. I was a grumbling child, a child with bad posture and a chronic sense that life was disappointingly not what it had promised to be; she was a strict mother--strict, upright, cheerful, and affectionate. When she saw my early gift for drawing and sculpting, she encouraged it with quiet certainty day after day, never inflating her praise and yet never allowing me to doubt my own efforts. We could not have been more different, I think, from the moment I was born, and we loved each other fiercely.
It's odd, but although my mother died rather young, or perhaps because she did, I have found myself in middle age becoming more and more like her. For years, I was not so much single as unmarried, although I finally rectified that situation. The women I've loved are (or were) all something like I was as a child--moody, perverse, interesting. Around them, I have become more and more like my mother. My wife is not an exception to this pattern, but we suit each other.
Partly in response to those once-loved women and my wife, and partly, I have no doubt, in response to a profession that displays to me daily the underside of the mind--the misery of its environmental molding, its genetic vagaries--I've retrained myself since childhood into a kind of diligent goodwill toward life. Life and I became friends some years ago--not the sort of exciting friendship I longed for as a child, but a kindly truce, a pleasure in coming home every day to my apartment on Kalorama Road. I have a moment now and then--as I peel an orange and take it from kitchen counter to table--when I feel almost a pang of contentment, perhaps at that raw color.
I have achieved this only in adulthood. Children are assumed to enjoy little things, but actually I remember dreaming only big as a child, and then the narrowing of that dream from one interest to another, and then the channeling of all my dreams into biology and chemistry and the goal of medical school, and finally the revelation of the infinitesimal episodes of life, their neurons and helices and revolving atoms. I first learned to draw really well, in fact, from those tiniest shapes and shades in my biology labs, not from anything as large as mountains, people, or bowls of fruit.
Now when I dream big, it's for my patients, that they may eventually feel that ordinary cheerfulness of kitchen and orange, of putting their feet up in front of a television documentary, or the even bigger pleasures I imagine for them of holding down a job, coming home sane to their families, seeing the realities of a room instead of a terrible panorama of faces. For myself, I have learned to dream small--a leaf, a new paintbrush, the flesh of an orange, and the details of my wife's beauty, a glistening at the corners of her eyes, the soft hair of her arms in our living room's lamplight when she sits reading.
I said I wasn't raised around the medical profession, but perhaps it isn't so strange that I should have chosen the branch of it I did. My mother and father were not at all scientific, although their personal discipline, transmitted to me along with my oatmeal and clean socks with the intensity parents pour through an only child, stood me in good stead through the rigors of college biology and the worse rigors of med school--the rigor mortis of nights spent entirely in study and memorization, the relative relief of later sleepless nights hurrying around on hospital rotations.
I had dreamed of being an artist, too, but when the time came for me to select my life's work, I chose medicine, and I knew from the beginning it would be psychiatry, which for me was both a healing profession and the ultimate science of human experience; in fact, I'd also applied to art schools after college, and to my pleasure had been accepted at two rather good ones. I'd like to be able to say it was an agonized decision, that the artist in me rebelled against medicine. In reality, I felt that I could not make a serious enough social contribution as a painter, and I secretly dreaded the drift and struggle to make a living that that way of life might entail. Psychiatry would be a direct path to serving a suffering world while I would continue to paint on my own, and it would be enough, I thought, to know I could have been a career artist.
My parents reflected deeply on my choice of specialty, as I could tell when I mentioned it to them in one of our weekend telephone conversations. There was a pause on their end while they digested what I had laid out for myself and why I might have selected it. Then my mother observed calmly that everyone needs someone to talk to, which was her way of quite rightly connecting their ministry and mine, and my father observed that there are many ways to drive out demons.
Actually, my father does not believe in demons; they don't figure in his modern and progressive calling. He likes to refer sarcastically to them, even now in his very old age, and to read about them, shaking his head, in the works of early New England preachers such as Jonathan Edwards, or in those of the medieval theologians who also fascinate him. He is like a reader of horror fiction: he reads them because they upset him. When he refers to "demons" and "hellfire" and "sin," he means these things ironically, with a disgusted fascination; the parishioners who still come to his study in our old house (he will never fully retire) receive instead a profoundly forgiving picture of their own torments. He concedes that although he deals in souls and I deal in diagnoses, environmental factors, behavioral outcomes, DNA, we are striving for the same end: the end of misery.
After my mother became a minister as well, our household was a busy one, and I found plenty of time to escape on my own, shaking off my occasional malaise with the distraction of books and explorations in the park at the end of our street, where I sat reading under a tree, or sketching scenes of mountains and deserts I had certainly never seen myself. The books I liked best were either adventures at sea or adventures in invention and research. I found as many children's biographies as I could--on Thomas Edison, Alexander Graham Bell, Eli Whitney, and others -- and later discovered the adventure of medical research: that of Jonas Salk and polio, for example. I was not an energetic child, but I dreamed about doing something courageous. I dreamed of saving lives, of stepping forward at the right moment with some lifesaving revelation. Even now, I never read an article in a scientific journal without a version of that feeling: the thrill of vicarious discovery and the twinge of envy for the discoverer.
I can't say that this desire to be a saver of lives was the great theme of my childhood, although, as it turns out, that would make a neat story. In fact, I had no vocation, and those biographies for children had become a memory by the time I was in high school, where I did my homework well but without unusual enthusiasm, read extra Dickens and Melville with considerably more pleasure, took art classes, ran cross-country with no distinction, and lost my virginity with a sigh of relief my junior year to a more experienced girl, a senior, who told me she'd always liked the back of my head in class.
My parents did rise to some distinction themselves in our town, defending and successfully rehabilitating a homeless man who'd wandered in from Boston to take up shelter in our parks. They traveled to the local prison to give talks together, and they prevented a house nearly as old as ours (1691 -- ours was 1686) from being torn down for a supermarket lot. They came to my track meets and chaperoned my proms and invited my friends for ecumenical pizza parties and officiated at the memorial services of their friends who died young. There were no funerals in their creed, no propped-open coffins, no bodies to pray over, so that I didn't touch a cadaver until medical school and I didn't see a dead person I knew personally until I was holding my mother's hand-- her perfectly limp, still-warm hand.
But years before my mother died, and while I was still in school, I made the friend I mentioned before, who gave me the greatest case of my career, if we're going to relent and put it that way. John Garcia was one of several male friends from my twenties--college friends with whom I studied for biology quizzes and history exams or threw a football around on Saturday afternoons, and who are now balding, other men I knew in medical school by their quick steps and flying white jackets in labs and lectures or later in the throes of awkward patient interactions. We were all getting a little gray by the time of John's phone call, a little sloped around the middle or else valiantly leaner in our attempts to combat sloping--I was already grateful to myself for my lifelong running habit, which had kept me more or less lean, even strong. And to fate for the fact that my hair was still thick and as much brown as silver, and that women still glanced my way on the street. But I was indisputably one of them, my cohort of middle-aged friends.
So when John called to ask me his favor that Tuesday, of course I said yes. When he told me about Robert Oliver, I was interested, but I was also interested in my lunch, my chance to stretch my legs and shake off the morning. We are never really alert to our destinies, are we? That's how my father would put it, in his study in Connecticut. And by the end of the day, when my meeting was over and the hail had changed to a fine drizzle and the squirrels were running along the backyard wall and leaping over the urns, I had almost stopped thinking about John's call.
Later, after I'd walked quickly home from my office and shaken out my coat in my own foyer--this was before I was married, so no one greeted me at the door and there was no sweet-smelling blouse from the workday slung over the foot of the bed--after I'd left the streaming umbrella to dry and washed my hands and made a salmon sandwich on toast and gone into my studio to pick up the paintbrush--then, with the thin, smooth wood between my fingers, I remembered my patient-to-be, a painter who had brandished a knife instead. I put on my favorite music, the Franck Violin Sonata in A Major, and forgot about him on purpose. The day had been long and a little empty, until I began to fill it with color. But the next day always comes, unless we actually die, and the next day I met Robert Oliver.
