‘But I don’t know any.’
‘So dream some up. Just give me five minutes.’
Judy nodded. But before she could turn away, Seth grabbed her by the arm and whispered, ‘Is this the right thing – am I doing the right thing? I’m scared.’
‘I know,’ she answered. ‘But that poor man shouldn’t have to suffer like that.’
‘But I swear if he isn’t conscious enough to give me his consent, I won’t do it. He’s got to give me his consent.’
Then they each walked off in a different direction.
At the nurses’ station, Seth picked up the medication prepared for Mr Gatkowicz for midnight and 3 A.M. He had an extra vial in the pocket of his white jacket.
He entered the sick man’s room. It was hard to tell whether Gatkowicz was awake or asleep, since he lived in a kind of drugged gray zone that offered the comforts of neither state.
Seth approached the bed. There were I.V.s attached to both of the patient’s arms, but his right hand was outside the covers. Seth took hold of it and whispered, ‘Mr Gatkowicz, if you can hear me, please squeeze my hand.’
Seth felt the man’s callused fingers close firmly on his.
‘Now, Mel, I’m going to ask you some simple questions. If the answer is yes, squeeze me once, and if the answer is no, twice. Do you understand, Mel?’
The man’s fingers tightened … once.
‘Mel,’ Seth continued his catechism, ‘have the doctors told you that you are going to die?’
One squeeze.
‘Are you afraid?’
Two squeezes. He was prepared for death.
‘Are you in great pain?’
The patient squeezed his hand with more force than ever … once.
‘Would you like me to help you? Would you like me to put you to sleep forever so you won’t feel any more pain?’
The sick man gripped Seth’s hand and would not let go. To Seth he seemed to be saying, ‘Take me from this earthly torture. In the name of God, let me go.’
‘I understand, Mel,’ Seth whispered. ‘Don’t worry, I’m going to help you.’
There was no problem about a hypodermic needle. Seth had merely to detach one of the I.V.s temporarily and insert the midnight morphine.
In a moment the patient was unconscious. Then Seth administered the three o’clock dose of morphine and finally the vial he had secreted. He pocketed the three empty ampoules, looked at the patient’s peaceful face, whispered, ‘God bless you, Mr Gatkowicz,’ and tiptoed out.
Later that night Mel Gatkowicz was discovered dead. The certificate, indicating cause of death as multiple carcinomas with attendant respiratory failure, was signed by Joel Fischer, M.D., and Seth Lazarus, M.D.
When informed by telephone, the widow broke into tears and cried, ‘Thank God, thank God.’
Once the inmates of the chronic ward were given their sleeping pills, Barney Livingston had relatively few problems on night duty. There were, of course, occasional calamities in the E.R., but these were mostly the result of Saturday night intoxication. Unable to sleep in such proximity to what he imagined were horrifically painful nightmares, he filled the empty hours by reading. And very soon by different activities.
First he began to telephone various classmates he knew were also on the graveyard shift. (Laura tried to synchronize her nights ‘on’ with his.) Barney could also call the West Coast where, because of the time difference, some people were actually going off day duty to get the now-mythical good night’s sleep.
During one of the latter types of conversation, Lance Mortimer casually remarked, ‘By the way, I’ve given your name to Lindsay Hudson.’
‘Who the hell is he or she?’
‘Well, in Lindsay’s case I don’t think he’s made up his mind yet. But anyway, the guy went to college with me and now he’s an editor of the Village Voice. He asked me if I knew any literate doctors, since they’re apparently rarer than benign tumors. So I suggested you.’
‘Hey, thanks, Lance,’ Barney replied, genuinely flattered. And then he joked, ‘How come you didn’t give him two names?’
‘Doctor Livingston, I honestly couldn’t come up with a second.’
True to Lance’s word, Hudson of the Village Voice called Barney two days later and asked if he would do a short piece on the psychodynamics of Albee’s Who’s Afraid of Virginia Woolf?
Barney enjoyed the task immensely and dropped heavy hints that he would be receptive to similar invitations.
He was obviously a natural to appraise John Huston’s cinematic biography of Freud, a film that Barney concluded was ‘probably the Master’s two least successful fifty-minute hours.’
This piece caught the eye of an editor from the recently launched New York Review of Books, who invited Barney to lunch at Four Seasons, an honor so staggering that Vera agreed to cover for him.
The next day, a copy of Pasternak’s Doctor Zhivago was messengered to him, with the request for a ‘think piece’ about physicians in literature, using Zhivago as a springboard.
‘I must have been crazy to take on the assignment, Castellano,’ he reported that evening. ‘It’s tantamount to intellectual hubris.’
‘Come on, Barn, from what little I’ve read that’s what the whole Review is based on. Besides, I know you can do a terrific job.’
Just as he was about to end the conversation, she suddenly added, ‘Hey, this is a first, Livingston.’
‘What do you mean?’
‘It’s the first time I’ve had to bolster your confidence.’
Vera Mihalic was becoming less and less able to maintain platonic – or for that matter professional – distance from the literary colleague with whom she shared a sink and shower and, occasionally, even toothpaste.
Sex had long figured prominently in her analysis – which, of course, is as superfluous as saying that a whale plays a role in Moby-Dick. Vera’s particular problem had been a fear of men. As she epitomized it to impress her doctor: ‘They’re either too phallic or too encephalic’ – i.e., beneath contempt or above reproach. It was, she theorized, the feminine version of the so-called ‘dual imago’ complex, which separates men’s views of women into antithetical categories.
The doctor had evinced considerable interest in this concept – both when Vera had articulated the notion, and again when she inquired if it seemed worthy of writing up for one of the journals. She even felt she could be daring enough to posit a paradigm of normalcy based on the qualities she perceived in Barney Livingston.
So, for the sake of research, curiosity, as well as the hope of not turning thirty still a virgin, she decided to give herself to Barney body and soul (reserving her psyche for the couch).
Naturally, she could not violate the entente cordiale in the apartment, and so she decided to offer herself when Barney was on night duty.
Her roommate Peggy was curious when she saw Vera preparing to go out just as the eleven o’clock news was beginning.
‘I thought you were off tonight, Vera,’ she said.
‘There’s a lunatic in the Chronic Ward,’ she replied, dabbing Joy behind her ears.
‘Aren’t they all lunatics? Isn’t that why they’re there?’
‘This is a special case,’ Vera replied.
‘What’s the problem?’ Peggy asked with interest.
‘Dual imago,’ Vera replied.
‘I’ve never heard of it.’
‘It’s very new,’ she explained. ‘In fact, I’m thinking of writing an article about it.’
‘Oh Christ, Mihalic, can’t you ever think of anything but work? Why don’t you seduce one of those cute young doctors? They’re supposed to be starving for sex.’
‘How do you know?’
‘Barney mentioned it.’
‘He did?’ Vera asked suspiciously. ‘When was this?’
‘This morning. At breakfast. Over corn flakes,’ Peggy replied.
‘Oh,’ said Vera. ‘Corn flakes, that’s fine. See you later.’
/> ‘Will you be gone long?’
‘I don’t know. It’s my first experience with a case like this.’
Barney was bushed. One of the chronics had a paradoxical reaction to the sedation and had gone so wild that he needed his hands and feet tied while they administered a massive dose of Thorazine.
Since he was the first on the scene, Barney had to wrestle with the guy till security arrived. By the time he got back to the on call room he was too tired to type any further. So he lay down on the bed, picked up the phone and asked the operator to get him Children’s Hospital in Boston.
Strictly speaking, of course, it was quite unethical for him to be making a personal call. But weren’t these doctor-to-doctor conversations?
‘This is Doctor Castellano,’ came a weary voice.
‘Hey,’ Barney replied, ‘you sound as tired as I feel.’
‘Oh, Barney, you can’t believe what this evening’s been like. Why do kids always seem to spike their fevers at midnight?’
‘Who knows,’ he remarked, ‘maybe they get lower rates like the telephone.’
‘No,’ she replied, ‘they get me. And I’m afraid I’m the best resident on my shift. I mean, I’m not joking. It’s just that the other guys are real dorks.’
Laura was in the midst of telling him how much he had risen in Palmer’s esteem since he had begun to publish in The New York Review of Books when Vera Mihalic stepped off the elevator at Barney’s floor.
‘Typical of that schmuck,’ twitted Barney, ‘always impressed by the externals. Why don’t you come back to New York where you’re really appreciated? In fact, why don’t you come down on your next free weekend? I can put you up.’
Vera stopped out of sight, but not out of earshot.
‘I thought you lived with someone,’ Laura said.
‘Oh, but that’s a strictly business arrangement,’ he replied. ‘I mean, Vera Mihalic is to sex what ants are to a picnic.’
Vera’s eyes were moist as she hastened toward the elevators. Hence she did not hear Barney’s mitigating compliments.
‘But she’s a real good person, Laura. I mean, looks aren’t the only thing.’
‘Now that’s a revolutionary statement, coming from you, Barney.’
‘Listen, Castellano, I’m starting my Training Analysis soon and I want to clean up my act so the guy will get me through it quickly. I’m working on temporarily moderating my libido.’
Laura laughed.
‘What’s so funny, Castellano?’
‘Your libido will wane when pigs fly, Doctor Livingston.’
‘Is that a compliment or a criticism?’
‘It’s a fact, Barney. Hey, listen, my light just went on. They need me in the E.R. Call me after midnight on Thursday.’
‘Okay. Give my love to Palmer.’
‘Why not,’ she said wistfully. ‘He doesn’t seem to want any of mine.’
Barney hung up and shook his head in consternation. Why the hell does she stay with that cold preppie nerd?
When he was finally relieved at 7 A.M., Barney walked the half mile to the apartment just to get some air in his lungs and blood in his legs.
The place was empty when he arrived, and he went to the bathroom to brush his teeth before going to bed.
There was broken glass everywhere. All of his toiletries – especially the aphrodisiacs like Old Spice aftershave, deodorant, etc. – were either broken or shattered all over the floor. Written in shaving cream on the mirror was ‘Drop dead’.
He took it to be an unprovoked expression of hostility from Vera.
Just as he had swept up every shard of glass (he hoped) and put some order to the chaos in the bathroom, the phone rang.
Christ, he thought to himself, I hope it’s the Violent Ward to tell me they’ve got Mihalic in a straitjacket.
‘Hello,’ he barked, ‘this is Doctor Livingston.’
‘Barney, can you tell me why all psychiatrists are crazy?’
It was Laura. And there was irritation in her voice.
‘Castellano, can you tell me who the hell broke all my bottles?’
‘What are you talking about? Now I know you’re as crazy as the rest of them.’
‘Hey, Laura, I’ve been up for nearly two days straight. The atom bomb’s just hit my bathroom and I’m so freaked out I’m gonna grab my stuff and move to the nearest “Y”.’
‘Livingston, before you go I’d like you to hear the letter I just received from Grete Andersen.’
‘Can I pass on that? I’m really not in the mood.’
‘No,’ she replied sternly. ‘Shut up and listen to this.’
Dear Laura,
Hope you’re well. I’m certainly as high as a flag on the Fourth of July, having conquered my phobias and joined the human race as a fully-fledged woman –
‘Laura, for God’s sake,’ Barney protested, ‘do I have to hear her gush about how the earth moved?’
‘Just listen to the rest of this.’ She read on:
What’s more, I’ve really lucked out. It’s true love. Andy says he’s never known anyone as wonderful as me –
‘Who the hell is Andy?’ Barney asked.
‘Andrew Himmerman.’ Laura replied flatly.
‘The Andrew Himmerman? You mean the guy who wrote that great book on ego development in teenagers?’
‘The very same. Apparently he’s been working on Grete’s ego – from the knees up.’
‘What?’ Barney said in righteous indignation. ‘That’s absolutely unprofessional and just what I’d expect from a hysteric like Grete Andersen. Laura, you had a psychiatry round in Med School. Haven’t you ever heard of transference?’
‘Excuse me, Barney, this is a little more than transference. It’s more like transportation. Apparently they’ve just spent a weekend in South Carolina.’
‘Do you believe that idiotic fantasy?’
‘She wrote me on Hilton Head stationery.’
‘So she went there on her own to fantasize.’
‘And I suppose the Polaroid picture of the two of them by the pool is also a figment of her imagination.’
‘So it might have been a conference.’
‘Then why are they twisted around each other like a pretzel?’
‘Jesus, that’s terrible. I’ve heard this sort of thing sometimes happens. I mean, he’s not the first to violate the Hippocratic Oath.’
‘No. But he’s the first to violate Grete and that’s a whole lot worse.’
‘Castellano, if this is true, Himmerman deserves to be bounced. But I also think that you’re yelling at me because you wanted a good reason to scold somebody else for wronging another woman.’
Laura thought for a minute.
‘I guess you’re right, Barn,’ she answered quietly.
‘Is Palmer screwing around?’
‘Well, let’s just say at the moment he’s dabbling in promiscuity.’
‘You don’t deserve that, Laura,’ he said softly.
‘Forget it, Barney. I called to talk about Grete.’
‘I’m sorry, Andersen can take care of herself. She’s a big girl.’
‘I’m a big girl too, Barn.’
‘No, you’re not,’ he said affectionately. ‘You need someone to take care of you.’
There was a sudden silence at her end.
‘It’s okay, Laura. It’s okay to cry. That’s what pals are for.’
‘Oh God, Barney,’ she said. ‘What did I ever do to get a friend like you?’
‘Moved to Brooklyn,’ he answered cheerfully. ‘Now go to sleep and we’ll speak again tonight.’
31
Psychoanalysis differs from all other medical disciplines in one major respect. While fledgling cardiologists, for example, do not have to lie on the table and have their chests cut open in order to qualify for their specialty, a psychoanalyst must learn what it feels like to be on both sides of the couch. Again, as opposed to the surgeon, he will be dealing not with a passive patient etherized upo
n a table, but with an active individual, agonizing with him.
At its best, psychoanalysis can be the most exciting and humane specialty of medicine. At its worst, it is unquestionably the most destructive.
Barney was accepted as a candidate for the Psychiatric Institute and began a Training Analysis with its president, Fritz Baumann, internationally renowned for his incisive writings and respected by his patients as a wise and caring therapist.
But Barney quickly discovered that analysis itself is far from enjoyable.
Freudian analysis, Dr Baumann explained, is like a repertory company of two actors, with the patient playing himself at various ages and the analyst playing all the other characters in his psychological development (or lack of it). By analyzing the scenes he recreates, the patient is then able to understand how long-ago incidents might have influenced the behavior patterns of the rest of his life.
In the abstract this sounded like fun to Barney. But all too soon it became clear that repressed thoughts are painful. And there is no way that the analysis, even of an ostensibly ‘well-balanced’ candidate, as he considered himself, can be anything other than brain surgery without knives.
Barney arrived for the first session jaunty and high-spirited, certain he would impress Dr Baumann as the best adjusted patient he had ever had. He was determined to transform what is traditionally a marathon into a hundred-yard dash.
He had, in a sense, been studying for this exam from the first moment he had taken Freud’s Interpretation of Dreams from the Brooklyn Library to read during the summer nights at Camp Hiawatha. From then on he had consciously tried to analyze the motivations for significant actions in his life. And he was determined to show Dr Baumann that he really knew what made him tick.
He entered the brown-carpeted, wood-paneled office with the narrow leather couch against the far wall, eager to dispense with the preliminaries and get down to the business of inner exploration.
Dr Baumann asked the usual questions – family history, siblings, childhood diseases, etc. He went on to explain that the bill (at a special discount for candidates) would be rendered monthly. Finally, he inquired if Barney understood the procedure.
‘Yes, sir,’ he answered. ‘I’ve got to say anything and everything that comes to my mind, to repress nothing and get down to the primary material.’