The Rules of Dreaming (5 page)

Kreisleriana, Op. 16.  Completed in 1838, this series of episodic sketches was inspired by the eccentric fictional musician Johannes Kreisler, a character in various tales by the German Romantic writer E.T.A. Hoffmann (1776-1822).

“Hoffmann,” Nicole muttered, springing off the bed. She threw herself into her desk chair and touched a key on the computer.  The screen flared into action and she typed her way furiously into the very core of the internet.  “Déjà vu, déjà vu, déjà vu,” she said as the screens flashed by.  “All over again.”

After fifteen minutes she reached for her coffee mug and found it empty.  Déjà bu.  She laughed out loud at her own joke and turned back to the keyboard.
Forget the coffee. With or without caffeine, it was going to be a long night.

Chapter
5

Dr. Palmer returned from San Francisco on Friday, though I didn’t have a chance to speak with him until Saturday morning.  By that time Gottlieb had given him a characteristically poisonous account of everything that happened while he was gone, including the surprising piano performances and my
decision to lower Hunter’s dosages.  So naturally I spent most of a sleepless night rehearsing what I would say in my defense.  I don’t know why I felt so apprehensive.  My relationship with Miles Palmer had always been cordial, though of course when we were talking about a patient I deferred to his advice.  Yes, he was touchy on the subject of Peter Bartolli and his daughter Olympia, but at the time I wasn’t aware of any connection between that subject and my reduction of Hunter’s dosages.  And so I was prepared to stand my ground.

Later I came to understand that the Peter Bartolli issue colored everything that happened at the Institute.  When I began
my work there I’d been surprised—and more than a little disappointed—to learn that Dr. Bartolli was no longer in the picture.  Though I never mentioned it to anyone, I felt a secret kinship with Bartolli, owing to an incident that occurred while I was in my third year of medical school.  My interest in psychiatry had been first aroused when the two brothers came to the campus and put on a mock debate with the provocative title, ‘Has the brain lost its mind?’

This eagerly awaited event left a deep i
mpression on me.  The auditorium was filled to overflowing with anxious medical students, drowsy residents and combative faculty members.  The speakers arrived late, and after a few preliminaries the Chair of Psychiatry introduced them to enthusiastic applause.  Though they were brothers, they could hardly have looked less alike.  Miles Palmer was tall and athletic, handsome in a distinguished, gray-haired way, his every movement projecting solidity and authority.  Peter Bartolli looked like a character from a fairy tale—almost gnomelike in appearance, with exaggerated features and dark, deep-set eyes that never seemed to look in one direction for more than a fleeting moment.   By the time they spoke at my medical school, the Palmer Institute was famous but psychiatry itself had become schizophrenic, hopelessly at war with itself over the question of whether traditional approaches to therapy could hold their place in a world dominated by drugs and biological models of behavior.  “There’s been a revolution in the past twenty years,” Miles Palmer declared, towering over the podium authoritatively.  “A revolution in our understanding of the brain and what used to be called ‘mental illness.’”

“And like most revolutions,” Bartolli interrupted, crouching behind his lectern to peer impishly up at Palmer, “this one has left its share of mangled victims in the streets.”   He flashed a wide grin at the audience.  “I’m only his half brother,” he said, “in case you were wondering why I’m so short.”

We all laughed, nervously, uncomfortably.  None of us was prepared for Bartolli’s strange appearance or the irreverent tone he seemed to be setting.  “You talk about the brain,” he went on, turning again to face his brother, “but what I’d like to know is, whatever happened to the mind?  Isn’t that what we ought to be concerned about?”

“What you call the
mind,” Dr. Palmer scoffed, “is merely the brain as seen from the inside out.”

“And what you call the brain
is merely the physical mechanism the mind has evolved to perpetuate itself.”

More nervous laughter from the groundlings, myself included.  Could this impudent creature be the famous Peter Bartolli? we asked ourselves. What was he trying to prove?
 

Crouched behind his lectern, he gave us his answer in a hoarse aside:  “I’m here to play the id to my brother’s super-ego!”

Palmer cut off the laughter with a dismissive wave of his hand.  “If there were such a thing as an id,” he told the audience, “I could think of no one better qualified to play it than my brother.”

They continued in this vein for nearly an hour, and it was the most exciting hour of my medical education.  Of course it was all an act, a dramatization of the struggle tearing at the heart of psychiatry—or so I assumed at the time.  Not until later, when I’d finished my residency and signed on for a full-time job at the Palmer Institute, did I realize that the hostility I’d witnessed between the brothers was not only real but of mythic proportions.  “The mind, un
like the brain, is infinite!” Bartolli had shouted in an impassioned moment toward the end of the debate.  And after the presentation had ended, he leaped back on the stage and had the last word.  “I leave you with a challenge,” he told the medical students.  “No matter where your career takes you, remember that the human psyche must be viewed with the naked eye.  Not through a telescope from light years away, nor through a microscope that can focus only on synapses and neuroreceptors.  You have to look at it from a human distance, the distance between one person and another.  And that’s the hardest part of this profession.  To enter it, you must be a scientist—but to succeed, you must be a human being.”

Now this unlikely champion of humanism was gone from the Institute, even before I’d been able to meet him, his place as Associate Director usurped by the egregious Gottlieb, and here I stood in Miles Palmer’s office trying to explain why I
had lowered Hunter Morgan’s dosages based on the way he played the piano.  Of course there was more to it than that: the current dosages were much higher than recommended, and the piano playing might have represented Hunter’s attempt to break through his drug-induced isolation and wrestle with some long-forgotten part of his unconscious.  As always, Dr. Palmer was courteous and respectful.  He did not pull rank.  Instead he listened attentively and explained why he disagreed with my approach.  He seemed fascinated by my account of Olympia’s strange dance on the lawn and asked repeatedly whether I thought it was linked to Hunter’s piano playing, which had begun the next afternoon. 

“It’s possible,” I allowed.  “Although it wasn’t the same music.  I don’t know what she was dancing to, but it wasn’t piano music.  It sounded like a whole orchestra.”

“With singing?  Was it an opera?”

“I don’t know.  Possibly.  I don’t know much about opera.”

“No, neither do I.  I don’t care for it, do you?”

“No.  I never did.”

Dr. Palmer offered me a seat and we both sat down, he behind his enormous desk and I in the deep leather wing chair that was usually reserved for wealthy donors and relatives of patients.  “You see,” he explained, “Olympia is my niece—she has my eyes, have you ever noticed?  And, I like to think, a little of my intellect and common sense, at least more than she could have inherited from my brother.  She practically grew up here, and I’ve tried to care for her and make her feel welcome even after Peter’s departure.  In my opinion, the more time she spends here and away from him, the better off she’ll be.”

He stared as if expecting me to agree, but I turned away uncomfortably.  “I don’t know your brother.”

“Peter’s a strange bird,” Dr. Palmer said, shaking his head.  “I love him, of course, as a brother.  But he’s done a horrible job of bringing up Olympia—there’s something missing in her, something essential that’s not quite there.  And as if to compensate for that, he’s infected her with all his New Age nonsense—aromatherapy, past life regression, performance therapy.  It’s all a bad joke.  But I hope I can be a good influence on her, and you can too, Ned.  Please show an interest in her, if you can.”

“Sure,” I nodded.  “I’ll try to do what I can.”

On the subject of reducing the twins’ medications, Dr. Palmer was less tolerant.  In his view, there was no scientific or ethical basis for the “humanistic” approach his brother advocated.   I admitted I was troubled by the shift from psychotherapy to chemical intervention because of what it implied for the human spirit. 

“You start out in psychiatry because you want to help people discover their unique individuality,” he said
with an understanding smile.  “But the longer you practice, the more you wonder whether anyone, yourself included, has any unique individuality to discover.” 

“I can’t accept that kind of psychological determinism.”

“Of course you can, or you wouldn’t be a psychiatrist.  The whole premise of psychiatry is that you can influence causes and effects.”

“Shouldn’t we at least acknowledge the power of the unconscious?”  I realized that I was challenging him, and it gave me an unexpected thrill.   “Instead of making the patient wrestle with his
demons, aren’t we just helping him avoid them?  Aren’t all these medications just another form of repression?”

Dr. Palmer forced a smile and leaned toward me with his head tilted in an imitation of fatherly indulgence.  “
You’re a mechanic, not a priest, Ned.  Try to keep that in mind.”   In a habitual gesture of control, he stood up and waited for me to do the same.  “But forget about lowering those dosages.  Put them back up where they were.”

Despite the frankness of our discussion, there was something I couldn’t bring myself to say to Dr. Palmer about Hunter and Antonia.  Everyone at the Institute referred to them as “schizophrenic” because that was the official diagnosis, carried forward on t
heir charts over a seven-year period.  But in fact their illnesses bore almost no resemblance to classic schizophrenia or any other recognized form of mental disturbance.  Whatever they had, it was unrecognizable, unique, defying classification.  This troubled me because it went against all my training and experience up to that time.  Patients, I’d been taught, can always be diagnosed—that is, categorized—because they’re not like you and me. They are not normal, healthy individuals with unique personalities that can express themselves in an infinite number of ways.  They have illnesses with certain symptoms; there are only a limited number of possibilities.  In other words, even if the rest of us are unique, mental patients are not.  But here were Hunter and Antonia, who defied medical classification.  The lexicon of modern medicine was useless in the face of their individuality.  The only thing you could say about them was that they were crazy.  Mad.  That’s what they were, I told myself privately: Mad. 

And yet I did not agree with Dr. Palmer’s insistence that their medications be kept at such extreme levels.  That was only cutting them off from themselves and their demons.  But I lacked the courage to defy him and order that the dosages be reduced.  In any case, as we realized when it was too late, Hunter found
a way to do that for himself.

*   *   *

Dubin sat at the bar sipping a Grey Goose martini at the end of a long, empty day.  It was the kind of day he liked.  He still had Susan Morgan’s $5,000 check in his wallet and he wouldn’t start spending it until he’d earned it.  If he never found anything worth paying for, he’d return her money.  If the case played out as he hoped it would, he might earn enough to retire on.  In the meantime he had to live.  Did blackmailers have expenses? she’d wanted to know.  Of course they have expenses.  They have expenses no one else can imagine, and a couple of Grey Goose martinis at the end of a long empty day is the least of them.  Not the kind of expenses most men have: wives, kids, mortgages and the like—Dubin had learned that the hard way.  Sandy, his ex-wife, stood by him through scandal and investigation, scapegoating, breakdown and recovery, on the unspoken assumption that when all was said and done he would be his old self again.  That could never be, he told her the day he brought home his first fee as a blackmailer, an incredible $50,000 from a wealthy aficionado of kiddie porn.  She left him the next day.  It was ironic: Sandy always wanted a nice apartment with a balcony and trees and an outdoor pool and now that was exactly where he lived.  She coveted a sports car and now he drove a BMW convertible that one of his clients had given him in lieu of a fee.  Were there expenses?  Of course but they had been paid in advance.  The sense of betrayal, the complicity, the realization that exposing evil will not make it disappear—they were already entered on the ledger and they could never be recovered or written off.

Everyone knew him in the bar, and they knew enough about him not to talk to him.  He liked the mute TV screens, the secondhand smoke, the subdued frenzy of the place.  Familiar faces—some smooth, some wrinkled, all of them as gray as the goose in his martini.  They all had their success stories, their tragedies, their farces.  Nobody cared.  The bartenders, the regulars, the cocktail waitresses—they knew who he was, but they didn’t care.  Just the way he liked it.  Nothing to hide and nothing to
declare. 

He took a sip of his martini and wondered why Susan Morgan had given him a check for $5,000.  Not blackmail exactly, though she was very astute in sensing his purpose—he had no information, only suspicion, and her instruction had been to keep looking, not go away.  If Avery Morgan was a wife-killer, she would naturally want to know it.  And maybe she intended to blackmail Morgan herself with the information she got from Dubin; it would make for an interesting divorce.  In that case Dubin was a bargain.  He could never extract as much money from Susan Morgan as she could squeeze out of her husband.

The barflies were working themselves into a lather about something on the TV.  A new scandal involving the President.  New accusations, new denials, new outpourings of contrived emotion.  Dubin looked away from the screen and concentrated on his martini, which was unfortunately nearing its end.  The news didn’t interest him anymore.  Back when he was a reporter, he’d follow every detail of every scandal, every crime, every political twist and turn, trying to calculate how he could contribute to the hysteria.  Now he listened only to the sports and the weather, and even those he found wearily predictable.  But he was sympathetic to the President and his mistresses and co-conspirators.  He knew what it was like to have a secret, lots of secrets, to dread their exposure but never really to expect it.  The dull panic that hits you when it finally happens.  A sense of déjà vu, the perverse satisfaction of justice.  If someone had blackmailed him, he wondered, would he have paid?  They say it never works for long, but how do they know?  It might have worked for him.