K-Pax Omnibus Page 23

  And Bert. What a frustrating existence, an eternity of worry and sorrow. What was it about his brain that precluded his dealing with his undeterminable loss and moving on? Whatever it was, his easy solution to all his problems, like that of almost everyone else present, was a trip to K-PAX, where difficulties like his didn’t exist. In fact, Betty told me before lunch that the patients couldn’t hear enough about the place. “It’s like Lenny and the rabbits,” she said. (Betty has read all of Steinbeck’s novels more than once.)

  When we had finished eating, Milton stood up and rapped on the table. “Went to the doctor the other day,” he quipped. Some of the others were already tittering. “Told him I wanted somebody who knew what he was doing. He puffed out his chest and said, ‘I’ve been practicing medicine for more than thirty years.’ I said, ‘I’ll come back when you’ve got it right!’” Everyone was looking at me, giggling, waiting for my reaction. What else could I do but laugh, too?

  I was still thinking about possible strategies to get Robert to stay around for a while when prot marched in for our nineteenth session. “Why didn’t you tell me about the letters?” he inquired impishly as he reached for the fruit bowl.

  “I was going to,” I replied. “As soon as I thought you were ready to deal with them.”

  “Very interesting,” he replied, biting into a persimmon.

  “What—the letters?”

  The fruit made his mouth pucker up. “Don’t you find it amazing that so many beings want to get off this PLANET? Doesn’t that tell you something?”

  “It tells me we have our problems. But after all, the Earth has a population of six billion people, and only a few thousand called or wrote to you.” I remember feeling quite smug about this rejoinder.

  “Very likely because those are the only beings who read your book or Giselle’s article. Hardly anyone on your WORLD reads much, if at all.” He finished the persimmon and reached for another. “We don’t have anything like this on K-PAX. You should see what they look like in UV light!” He smacked his lips loudly and gazed thoughtfully at the fruit.

  “Do you plan to answer them?”

  “The persimmons?”

  “No, dammit. The letters.”

  “I’ll try. Most will be condolences, of course. I can only take a hundred beings with me when I go back, remember?”

  “How many have you lined up so far?”

  “Now, gene, if I gave you an obon, you’d take a jart.”

  “So you won’t tell me. Nor will you tell me when you’ll be leaving. I must confess, prot, I’m very disappointed that you still don’t trust me.”

  “As long as we’re being so honest and direct, doctor b, perhaps you could explain to me why human beings take everything so personally.”

  “I’ll tell you what: I’ll answer that if you’ll tell me how long you’re going to stay around.”

  “No way. But don’t worry—I won’t be leaving for a while yet. I’ve got the letters to consider and a few other things to take care of....” He swallowed the last of the fruit and sat back, still smacking his lips. “Ready, doc?”

  Sometimes I felt as though I were the patient and prot the doctor. “Just about. I’d like to speak to Robert first.”

  Without a word his eyes closed and his head slumped to his chest.

  “Robert?”

  No response.

  “Robert, can you hear me?”

  If he could, he didn’t let on. There was no need to waste any more time. Obviously he still wasn’t ready to cooperate, at least not without hypnosis. “All right, prot, you can come back out now.”

  “My tongue feels like cotton,” he declared.

  “That’s the persimmons. Okay, I think we’re ready now.”

  He gazed at the little white dot on the wall behind me. “Weird fruit. One-two-three-four—”

  I waited until I was sure he was in a trance. “You may leave your eyes closed for a while, prot.”

  “Whatever you say, gino.”

  “Good. Now I’d like Robert to come forward, please. Rob? Can you hear me?”

  His head dropped again.

  “Robert, if you can hear me, please nod.”

  He nodded almost imperceptibly.

  “Thank you. How are you feeling?”

  “Not very good,” he mumbled.

  “I’m sorry. I hope I can help you feel better soon. Please listen to me and trust me. Remember, this is your safe haven.”

  No response.

  “I thought we might talk a little about your childhood today. Your family. About growing up in Montana. Would that be all right?”

  A feeble shrug.

  “Good. Will you open your eyes, please?”

  They blinked open, but he avoided my gaze.

  “Why don’t you tell me something about your mother.”

  Softly but clearly: “What do you want to know?”

  “Anything you’d like to tell me. Is she a good cook?”

  He seemed to consider the question carefully, or maybe he was simply trying to decide whether to respond. “Pretty good,” he said.

  I couldn’t help feeling excited about this simple answer. It came in a lifeless monotone, but it represented a tremendous breakthrough, something I was afraid might take weeks of persistent cajoling. Robert was talking!

  The remainder of the session proceeded rather haltingly, but he seemed to become more at ease as we chatted about some of the basic elements of his childhood: his sisters, his friends, his early school years and favorite activities—books and puzzles and watching the animals in the fields behind the house. His pre-adolescent boyhood seemed to be a perfectly normal one, unusual only in that he lost his father when he was six (at which time prot made his first appearance), though I didn’t bring that up in this session. I merely wanted to gain Robert’s confidence, make him feel comfortable talking with me. The real work would come later.

  The discussion ended with Robert’s telling me about a memorable day he had spent, when he was nine, roaming the fields with Apple, his big, shaggy dog, and I hoped that finishing on this happy note might encourage him to come forward less reluctantly the next time. But before I recalled prot I tried something I was pretty sure wouldn’t work. I reached over, picked up a tiny whistle I had brought in for the occasion, and blew it loudly. “Do you hear that?”

  “Yes.”

  “Good. Whenever you hear that sound I want you to come forward, no matter where you are or what you are doing. Do you understand?”

  “Yes.”

  “Good. Now I’d like to speak with prot, if you don’t mind. Thanks for coming, Robert, and I’ll see you later. Please close your eyes.”

  They drooped shut.

  I waited a moment. “Prot? Please open your eyes.”

  “Hiya, gene. What’s up?”

  “The opposite of down?”

  “Dr. brewer! You do have a sense of humor!”

  “Thanks a lot. Now just relax. I’m going to count back from fi—”

  “Five-four-three-two—Hey! Are we finished already?”

  “Yes, we are. How did you know?”

  “Just a feeling I get sometimes. Like I’ve missed something.”

  “I know how it is.”

  He got up to leave. “Thanks for the interesting fruit. Maybe I could take a few seeds back with me when I go.”

  “Take a whole basketful if you like. By the way—I saw you talking with Lou yesterday. Do you have any suggestions on what we might do with him?”

  “I think it had better be a cesarean.”

  Our son Will spent his last vacation weekend at home with us—he would soon be moving into a dormitory at Columbia for the fall semester. A pre-med student, he was employed for the summer as an orderly at MPI.

  When he paid his first visit to the hospital five years ago and met Giselle, Will immediately announced that he wanted to be a reporter. That enthusiasm gradually faded over the years, as youthful interests tend to do, and after several return visits
he declared his intention to follow his old man’s footsteps right into psychiatry. I am very proud and happy that he made this choice, not just because he would be carrying on a family tradition, but also because he has a natural ability to get along with patients and they with him.

  In fact, it was Will who solved a bewildering problem for us earlier in the summer, an elderly man who was pretending to swallow his medication, devising various clever methods and schemes to fool the nurses. Will caught him at it, but, with an understanding beyond his years, did not try to force the man to take his pills or report him for not doing so. Instead, he spoke to him at length about the matter, discovering, finally, that the old boy was afraid to swallow anything red. When we had the medication repackaged in white capsules the patient was home with his family within two weeks.

  Will’s current self-imposed project, in addition to his regular duties, is to try to decipher the ramblings of a young schizophrenic patient who (Will thinks) is trying to communicate with us through some sort of code that no one can decipher. Most of his utterings seem to be pure gibberish. But occasionally, after one of his meaningless statements, he chomps a few times on an imaginary cigar and repeats the whole thing two or three times. Here is one of Dustin’s orations (a kind of poetry?), delivered with four chomps and four repeats, and carefully recorded by Will:

  Your life sure is fun when you like cabbage but be careful when you find a yellow box full of crabs or ostrich poop because then the world will stop and you can never really know if this is where someone says that you must comply because you’re not going there to learn how to be grateful or to make mistakes when you’re stepping out....

  Did Dustin have some sort of cabbage fetish, or had he had an unfortunate run-in with a crab or an ostrich? And was the cigar a phallic symbol? We stared at this nonsense for an hour after dinner until Karen sent us outside to shoot a few baskets and chase after the dogs and forget about work for a while. But Will wanted to know more about some of the other schizophrenics and the nature of the affliction in general, which he referred to as “split personality.”

  “The first thing you should know about schizophrenia is that although it literally means ‘split brain,’ it is not the same thing as multiple personality disorder. It’s more of a malfunction of sense and logic, not a ‘split’ personality. The patient might hear voices, for example, or believe things that are patently false. Others suffer from delusions of grandiosity. In the paranoid type, feelings of persecution predominate. Many speak ‘word salad,’ but this can happen with certain other maladies, too.”

  “You’re lecturing again, Dad.”

  “Sorry. I guess I still find it hard to believe you’re following in the old man’s footsteps.”

  “It’s a dirty job, but somebody’s got to do it.”

  “Anyway, with schizophrenia, you’ve got to be careful with your diagnosis. Nice shot.”

  “What’s the etiology?”

  “Schizophrenia usually develops early in life. Recent evidence suggests a genetic origin, or possibly fetal damage by a virus. It often responds almost miraculously to antipsychotic drugs, but sometimes doesn’t, and there’s no way to predict which cases—Oxie, come back here with that!”

  “What about Dustin?”

  “In Dustin’s case, none of the neuroleptics has alleviated his symptoms in the slightest, not even a gram of Clozapine a day. But he’s an unusual case anyway. I’m sure you’ve noticed that he plays chess and other games without any problem. He never says much, but he seems perfectly focused and logical during these encounters. In fact, he almost always wins.”

  “Do you think his problem has anything to do with the games he plays?”

  “Who knows?”

  “Maybe his parents. They visit him almost every evening. Would it be all right if I talk with them sometime?”

  “Now, Will, I admire your enthusiasm, but that’s something you shouldn’t get involved with at this point.”

  “Well, I’m not giving up on him. The key to the whole thing is in that cigar routine, I think.”

  I was very proud of him for his perseverance, which is one of the most important attributes a psychiatrist can have. He spends part of his lunch hours and every spare minute of his time with Dustin. Of course he is quite taken with prot, too, as is everyone, but he gets little chance to talk with him because the line is so long. It’s only when everyone else goes off to bed that our alien friend gets any time to himself. I only wished I knew what he was thinking about during those long, dark hours of the night.

  Session Twenty

  Contrary to popular belief, physicians do not hesitate to criticize each other’s work, at least in private. Thus, at the regular Monday-morning staff meeting, considerable doubt was expressed about whether a simple post-hypnotic suggestion (the whistle) would summon Robert from the depths of hell. One of my colleagues, Carl Thorstein, went so far as to call it a “nutty” idea (Carl has often been a thorn in my side, but he’s a good psychiatrist). On the other hand, it was generally agreed that little could be lost by doing the experiment, which had not been tried before.

  Nor was there much enthusiasm for Giselle’s plan to get prot to talk to animals, though the broader suggestion of a zoo outing for the inmates was well received, and I was nominated a committee of one to look into the matter. Villers admonished me “to keep ze costs as low as possible.”

  Some of the staff members were on vacation, so there was little further discussion of patients and their progress, if any. However, Virginia Goldfarb mentioned a remarkable improvement in one of her charges, the histrionic narcissistic dancer we call “Rudolph Nureyev.”

  Rudolph was an only child who was reminded constantly that he was perfect in every way, and getting better. When he decided to take up ballet his parents responded with high praise and strong financial support. With that kind of encouragement (and considerable talent), he went on to become one of America’s finest dancers.

  His only problem was one of attitude. He expected everyone, even music directors and choreographers, to defer to his impeccable taste and judgment. Eventually he became so important (in his own mind) that he began to voice other demands, and finally became so impossible to work with that he was fired by the management of his dance company. When this news spread, no one else in the world would take him in. He ended up a voluntary patient at MPI when his last and only friend encouraged him to seek professional help.

  His sudden improvement came about following a single lengthy conversation with prot, who described to Rudolph the breathtaking beauty and grace of the performers in a balletlike dance he had seen on the planet J-MUT. He encouraged Rudolph to try some of the steps, but it required such fantastic speed, exquisite timing, and contortion of limb that Rudolph found the work impossible to execute. He suddenly realized that he was not the greatest dancer in the universe. Goldfarb reported that his supreme arrogance had vanished immediately, and she was thinking of moving him to Ward One. There was no objection.

  Beamish, peering at me over his tiny glasses, joked that we should give prot an office and send all the patients to him. Ron Menninger (no relation to the famous clinic) remarked, a little less facetiously, that perhaps I ought to delay Robert’s treatment until prot had done whatever he could for the other inmates, a notion I had grappled with myself.

  Villers reminded us that we were expecting three distinguished visitors over the next month or so, including the chair of our board of directors, one of the wealthiest men in America. Klaus wasted no words in emphasizing the importance of this visit, suggesting that we put our very best feet forward that day, funding efforts for the new wing having fallen below expectations.

  After some other matters were disposed of, he announced that a major TV network had offered the hospital a healthy sum for an exclusive appearance by prot on one of its talk shows. Astonished by this ridiculous prospect, I asked how they even knew he had returned. Someone pointed out that it had already been picked up by the media, incl
uding one of the national news programs. I wondered whether Klaus himself had anything to do with that.

  The discussion ended without resolution. Some, like me, thought it preposterous to let one of our patients be interviewed on television. Others, noting that prot was unique in all the world and that he would undoubtedly be able to hold his own with any interviewer, weren’t so sure. Though we could certainly use the money, I thought we were opening another can of worms. I pointed out that we had a lot of bizarre and interesting cases at the hospital, so why not a whole TV series based on their individual stories? Villers, missing the irony of my remark, seemed quite enthusiastic. I could almost see dollar signs in his eyes, which lit up like shooting stars as he contemplated the potential windfall.

  Virginia caught me after the meeting. She wanted to know whether prot might be willing to schedule a look at a couple of her other patients. She wasn’t joking—Goldfarb never jokes. I assured her I would speak to him about the matter

  If I have more than cottage cheese and crackers for lunch I have a hard time staying awake the rest of the afternoon. I watched in envy as Villers put away a huge plate of roast beef, various kinds of vegetables, buttered rolls, and pie. He said very little as he gobbled down his food, and left as soon as he was finished, dots of gravy and piecrust flecking his goatee. As I watched him go, I thought: I don’t know much about this man, who keeps his personal life to himself, but I’d know those drooping shoulders anywhere.

  Klaus Villers is a paradox of the highest order. He exemplifies, I suppose, the public image of the typical psychiatrist—cold, decisive, analytical. Nothing appears to faze him. I have never seen the slightest hint of shock or amusement on his weather-beaten countenance, rarely sensed even the slightest emotion. Yet, for all his gruffness of character and outspoken opinions he can be soft as an oyster inside.

  Perhaps the best example of this is the case of a former patient whom Klaus was powerless to help (a not infrequent situation at MPI). The man, a hopeless manic depressive from a poor family, was so fond of his doctor, for reasons of his own, that he carved several beautiful little birds for Klaus and his wife. When the man died, our “heartless” director, who barely found time or inclination to thank the man for his gifts, paid for his interment out of his own pocket, erecting a huge marker for “The Birdman of MPI.” No one knows why he did this, but I choose to believe that he simply felt sorry for a long-suffering patient he could do nothing for.