After Lisa

Based on a true story

Chapter 1

October 1999

New York City

 

Glittering crystal chandeliers brightly illuminate the Plaza Hotel’s Grand Ballroom as the sound of Strauss’ Blue Danube Waltz sweeps through the room. Sipping cocktails, guests lightly applaud the  MacDonalds as they glide around the center of the ballroom, the floor to themselves.  Several dance partners stand at the edge, gathering courage to challenge the MacDonalds for the spotlight.  At the tables, gossip is cheerfully exchanged, as, here too, they check on the MacDonalds from time to time. Standing off not far from the bar, spicy singles in their 20’s flirt, their eyes searching through the crowd for the opportunity to find a still better partner.

Strauss has been a great choice for tonight.  Retro worked. It’s made the evening grand, not what the guests expected when they received their invitations.

Very high up in the vaulted ceiling, a sniper has positioned himself. He looks through his high-powered rifle, moving through the room, one table at a time.   While the women have spent weeks preparing for tonight; putting the perfect shoes, hair, and make-up together with the right dress, they didn’t expect to be examined through a rifle’s telescopic lens. At the head table, the assassin’s sight focuses on one after another of the guests.  He lingers on a matronly lady covered with serious jewelry, but tonight his goal is narrow. He settles on the MacDonalds as they return to the table. Mrs. Martin MacDonald is a stunning blonde in her thirties.  The assassin’s only interest is her dance partner, Martin MacDonald, a silver-haired man with a jutting chin, and a physique chiseled at his club.  Killing MacDonald is the whole purpose of the evening.       

The rifleman is perfectly positioned in a utility room above the ballroom.  Perched as high as he is, behind the glare of the chandeliers, his protruding telescopic rifle is a speck in the filigreed façade. Unnoticed, he will be able to proceed at a leisurely pace, carefully aiming without drawing the slightest attention.  His escape plan should also go smoothly.   He is dressed in a nicely tailored tuxedo. The sniper is confident that after he’s killed Macdonald his dapper appearance will allow him to easily disappear among the guests. He was born with good looks.  He enjoys using them.

Joe Tolley, from Channel 2 News, gently clears his throat into the microphone.  People’s eyes are drawn to the now lit up dais. This part of the evening is the reason they are here.  Everyone returns to their seats.  Tolley clowns a bit, gets some nice laughs.

“Our speaker tonight needs no introduction.  He is a man of our age, a captain of our decade…

Applause.  The clapping continues and continues. Tolley has prepared well.   Leaving little to chance, in front of the mirror he practiced the casual smile he is now presenting during the extended applause.  As it finally dies down he continues.

   “Martin MacDonald is the personification of who we are and have become.”

            Now actual cheers.

This brings a smile to MacDonald.  As he gets up from his chair, he bends forward over the table, and, whispering an imitation of Tolley’s voice, he captures his lisp perfectly.  The men seated nearby find this funny.   Not the women.  They draw back from MacDonald’s meanness, an effect that MacDonald seems to regularly elicit from the fairer sex.

MacDonald winks at his wife.  She returns an encouraging smile, which he doesn’t notice.  He long ago stopped seeing her. Jauntily he dashes for the stage.   Skipping up the steps he is soon at the lectern.  With his reading glasses low on his nose, patterned after an image of John Adams he saw on TV, he shuffles his papers, looks over the audience from far left to right.

MacDonald is hot.  Buoyed by increasing opportunities, at this point materializing daily, more than anyone he knows exactly what he has done to create his good fortune.   He is proud of it. He looks upward, to his Sicilian grandfather in heaven.  He wouldn’t be here today without him.

He smiles broadly at the audience, immersed in their adulation.  Who wouldn’t want in on MacDonald’s phenomenal profits?  Who wouldn’t want the wife he has, beneath the glittering chandeliers at the Plaza.

Business Week ran a feature on MacDonald in its May issue. His story is quintessential 90’s.  A startup in his garage, an office consisting of a file cabinet, desk, and telephone. MacDonald answered the phone himself.  He did the filing.  Later, as the business grew, he sweated through payrolls, wondering where he would find the money for his 12 employees.  Today he’s unfazed by billion dollar figures.  The one caveat?  He went into the health insurance business knowing  nothing about health insurance.  Like so many of the new wave of CEOs his expertise is with numbers. As long as they work he remains the golden boy.

 For CEO wannabes in the audience MacDonald offers magic.  For actual CEOs he offers lessons in how to hit the bottom line out of the ballpark.  He’s someone to study closely, figure out whether he’s doing what he claims to be doing.  In not very long they will be expected to replicate Cambridge Health’s profit.  If they don’t they’ll soon be gone, replaced by a CEO who will get the right numbers.  Anticipating platitudes they don’t expect to learn much tonight. But just in case, Martin MacDonald has their total attention

It’s been 25 years since his graduation from Macalester College, in St. Paul Minnesota.  He’s never lost his boy wonder quality. Probably it was the football.  Being a second team All-American linebacker did a lot to shore up his identity.  Thrown into the lion pit, he emerged a lion.  He has kept the momentum going.

Winning is the only acceptable result in his encounters.  He takes great pleasure smashing an adversary in his teeth. It has served him well. When the need to fight his adversaries temporarily abates, he has fun.  He is a wiz with numbers.  There is special satisfaction when the numbers are large.  Lately they have been huge.

Growing up he was greatly influenced by his mother’s scrappy Sicilian father and her two brothers, who lived nearby.  A Sicilian style wouldn’t ordinarily work in the insurance industry.  But MacDonald is also Scottish. To a casual observer he seems an all American regular guy, a team player, a boy scout, very unlike his ruffian uncles, an insurance man through and through.   Only savvy.

He saw his father, Robert MacDonald,  summers, but those summers  powerfully influenced his persona. His father’s cheerful Scotch veneer is what others knew him by and respected.  MacDonald’s adulation of his father made it possible to effortlessly emulate him. It also spiritually connected him to his father’s Scottish clan, one with a long tradition of money cleverness invariably bestowed on the eldest son. So his take no prisoners uncles from Sicily were well camouflaged by equally aggressive genes on his father’s side.

 He adjusts the mike, taps it with his finger a few times.  Then, with a strong voice he begins.

“My thanks to the American Insurance Association.  I am honored that you are having me here to tell you what you already know.  We need to stick together.  Stand as one.  Be strong.  We share the same mission, to put a stop to runaway medical spending, to deliver health care at a reasonable cost.”

Happily, the audience applauds.

Ever so slowly the rifleman scopes MacDonald between his eyes. A voice from inside him urges.

 “Now!”

 He can’t trust that voice, a hard lesson learned again and again when he made the mistake of trusting his impulses.

 The sight is fogging up.  He pulls his rifle back into the utility room, and wipes off the condensed vapor with his thumb.  All the while he keeps an eye on MacDonald. (an unobserved target can disappear.)  He double-checks that everything else is in order.  Nervously his tightly gloved index finger rubs over the filed off serial number. That was item one in his plan.  An identifier that had to be removed.  He pulls at the ends of his thin leather gloves to tighten them still further.   He cocks the trigger mechanism: cutting through the utility room’s silence, the sound of precision steel snapping into place with a bit of an echo. He repeats this a second time with military efficiency.  He takes a cartridge case from his pocket and loads.

Soon enough he again has MacDonald’s forehead perfectly centered.  Carefully, calmly–he can almost feel the bullet drilling in to the spot, into MacDonald’s skull.  He can  imagine the sweetness of that moment

There is a noise somewhere down the hall.  The sniper freezes. He  listens carefully for it to repeat.  He soon recognizes the scratching of a busy mouse.

 “Stay with this,” he commands himself.  He must follow a series of steps that have been practiced so often, that when his eyes and trigger-finger have the target in sight, what follows is automatic.   His finger tightens slowly.  Slowly.   He is almost there.

 MacDonald’s wit is knocking the audience out.  Laughter, cheers, happy shouts interrupt his talk.   This has seduced  MacDonald into letting it all  out.  The rhythm of a revivalist preacher rings out in the ballroom.

“Our fight is the good fight, our goal necessary…”

The audience’s enthusiasm pisses off the rifleman.   That stops him.

During training they drilled it in.  “Don’t act unless you’re emotionless.”     Focus requires brain silence.   The mind must disappear as the momentum of the plan closes in on the target.    Anger is the natural emotion before and during a kill, but not for a professional.  It undoes your skill.

 He learned the hard way.  In his first battle he got excited, terrified and furious at an adversary who had killed Arnie, his friend standing 3 feet away from him.  He shot wildly, like he had never learned a thing.   Fortunately, cool as a cucumber, one of his buddies shot the man dead.

It was the closest he came to getting killed.  He had no trouble picturing himself as rotting flesh six feet under. That image subsequently, kept him completely professional.

Twenty-six years ago, at army sharpshooter school, the basic method of training was simple and absolute.   Every  step was repeated again and again, again, and again until nothing else is possible other than the next step.   The final decision to kill doesn’t reside with the sniper.   It is muscle memory.

That’s not happening now.   The opposite.  Normally obstacles to a plan, which inevitably arise, are quickly absorbed as interesting new wrinkles to be patiently overcome.  Instead,  unexpected events, like the sound of the mouse, rattle him.  His concentration is shot. In the army, the sergeant sometimes fed the men greenies, amphetamines to improve their concentration.  Given their level of stress it helped them even more than kids with ADHD.

His chin tight, “Focus,” he says to himself in a nasty whisper.

He began so determined.  Righteous anger can move mountains.  Or drive you crazy until you act.  For months, unanswerable questions had wormed their way through his mind and exhausted him.  First grief, then blame,  endlessly assigning it to one person after another including himself.

Then that dissipated. His anguish completely disappeared once the specifics of his plan to kill MacDonald were thought out in detail. Setting it up took over.  He went from inactivity, practically in a coma,  to energy harnessed by having a purpose.

Getting  things done their way. The army had taught him how to stay organized.  Concentrate all efforts on the first step before going on to the next.   He needed a well-camouflaged spot with complete vision of the target.  As soon as he learned MacDonald was going to speak in the Plaza ballroom, he went through twelve utility rooms located in the ceiling before finding the perfect one.  The next thing on his check list-finding a MacMillan Tac 50 rifle was easier than he expected.  The Tac is extremely accurate and able to be broken down into a compact form. Fortunately, Marty, his pal at work knew exactly where to find one. It took only an hour and a half to find the guy.  And contrary to the image he had, based on Hollywood versions of gun salesmen, the guy who sold it to him was a character, an educated friendly enough black man with a wicked sense of humor.  Next he had to find the right size satchel.  The first one that he bought was too small so he had to return it and try out another size.

No problem. The view of the dais was so perfect, like a gift from God, it energized all the other steps.   Everything fell into place.  It may have taken two times on one of the items, or ten.  Didn’t matter.  It got done.

His smile returned.   At last justice would be done.

Except it isn’t happening tonight.

In truth, even in the army it got more complicated. At the beginning of his sniper training he had no difficulty pulling the trigger.  He carried out three missions successfully without a second thought. He killed whom he was assigned to kill and took pride in his accomplishment.

His fourth assignment brought that to an end.  He noticed his target’s red hair.   That did it.  His precision, so easily summoned a moment before, deserted him.   There was no flow.  His trigger-finger and eye were no longer one.

 It wasn’t a morality thing, at least not that he was aware of.  He had no specific thoughts about right and wrong.  He knew it was right to kill this particular bad guy, with or without his red hair.  There were no thoughts at all.  But the red hair kept coming into his mind.

A therapist taught him how to shut that off.  But it didn’t matter.   He’d still miss his target again and again.

When the time came he didn’t reenlist. His sergeant more or less made clear that was to be his plan.

 Once again the gunman pulls the rifle back into the utility room.  We get a better look at him.  He’s sweating.  His face is alive with emotion.   As opposed to our initial impression, he is anything but a professional.

“Take your time,” he commands himself.  That does nothing. Drifting thoughts grab his attention, one after another, without rhyme or reason.

He had imagined the exact instant in detail.    MacDonald, just after he’s made a clever observation, bathed in adulation, a split second before the applause erupts, the audience smiling, congratulating themselves for being there.

 Bang!

Blood is the perfect punctuation.

A single shot.

Sweet!

Bang.

It will put them on notice.  Someone’s watching.  Someone

sees what you’re doing.

 MacDonald ends his talk. Like a politician at a convention he waves to the audience.

As he returns to his table, the rifleman’s frantic.

He still has a good shot. Now!

He doesn’t pull the trigger.

The rifleman soon makes peace with the new facts. His fantasy about the precise moment of MacDonald’s death was self-indulgent.  The joy of catching him at a glorious moment in front of the audience isn’t all that important.  Reaching for a French fry, wiping off the ketchup from his lips, blowing his nose, trying to catch the eye of one of the attractive women at his table-any moment will be okay.  Shot and killed is the main point.  If the deed gets done, the meaning will be clear.   Dead is dead.

This last thought enables the rifleman to cool off.  MacDonald will remain in target range for at least an hour. Later will be fine.

 Michael wipes the sweat off his forehead. He’s hot and clammy, his shirt and underwear are sticking to him.  He takes off his tuxedo jacket, sits himself on the floor against a huge cable roll stored in the room. Trying to regain his composure, he closes his eyes and inhales deeply, filling his chest with air.

No luck.  His clammy shirt is bothering him.  He can’t seem to catch his breath. His mind is still all over the place. Doubts. More doubts.  He closes his eyes, drifts through his memories…

Chapter 2

Ten years earlier.

 

 Two tents have been pitched at a clearing high in the mountains.  It is a day to worship the fall foliage, sunny, , the air with a bite to it, crisp, clear, newly cold.

Far below, the farm fields form squares of contrasting green color, fall crops of lettuce and broccoli, waiting to be harvested.   Orange pumpkins are piled high near the corner of one of the squares. Another square is brown and orange, half picked and half unpicked.

Ten years younger Michael Russell is a devil with light green, deep-set eyes.  Calm and carefree, he hardly resembles the gunman.  At 30 Deborah Russell’s striking blonde, still thick, almost hippie curls are the first thing that catch people’s attention.  She is petite. She moves like a cat. The children are adorable. Six-year-old Richie is quiet and observant, seven-year-old Lisa feisty.  They are lucky. They have inherited Deborah’s hair and Michael’s luminescent green eyes, graceful like Deborah, with Michael’s energy propelling them.   

 Michael is eight feet up in a tree. He’s taped his brand new Nikon on a limb above him.  Seated on a lower branch, he looks through the eyepiece.  He is constructing a family portrait.   It’s going to be a great shot.

This shot was planned over a year ago. He told Deborah about it before they arrived.  It was hatched while they were making their first visit here and Michael sat on this exact tree trunk.  He saw an extraordinary view as he looked down at Richie, and wished he had his camera.  This time he is prepared.

He screws into his camera a cable he purchased for this picture.  The cable will invisibly run to the spot he has designated for himself in the portrait.  With the cable, his thumb will physically control the shutter.

 

 He moves them to their places, then plays with the shutter speed.   Deborah is beginning to lose her patience. Lisa also has done enough posing.

“Dad, how long do we have to stand here?”

That emboldens Deborah.  She gives Michael an “enough already” look.

“Good things come to those who wait.”

“Daaad!”

He saves fortune cookie advice for the children.  She is not amused This is the tenth time Lisa’s heard it.

“One more second.”

But he doesn’t mean it.  Once his stubbornness is aroused he can dig in. He will not be rushed.   As he looks through his eyepiece, he is fascinated by how he imagines it will look.   The four of them will seem surrealistically suspended in air, two thousand feet above the farmland in the valley. 

            Behind Michael, to the right, to the left, is the glory of autumn.  Maple trees, birches, and oaks prepare for winter, yellows, oranges and reds, intense pastels, intersected by strong brown tree branches and trunks. Michael likes the beauty of the surrounding foliage, but what he is even more drawn to the immense emptiness in front of him. It beckons him, pulls at him. Once before, on the top of the Empire State Building the same thing happened; again vast nothingness. 

He feels an urge to jump. He can feel it in his stomach which is poised to react to his leap.  Immediately after the impulse, dread.  Suicide is not at all on his mind. It never occurs to him.   Why that sensation? He read an article that claimed having a desire to jump from a great height is common. So is the quiver of anxiety when the thought registers. Freud took this phenomenon as evidence for one of his most radical speculations. He claimed we have an unconscious wish to die. Fully aware of how crazy it sounded, he ranked it with our sexual drive as one of the two fundamental forces shaping our motivation. Despite his anticipation of rejection Freud  wouldn’t back down.   He felt he had the evidence. 

Clearly, this is not a fitting background for a family picture. Why does Michael want to use it? It has nothing to do with his family. The explanation isn’t all that complicated. He’s still young, at an age when novelty can seem exciting, when “originality,” “creativity” are taken as a sign of serious talent.    His real talent is plain and simple, his attraction to beauty.  But he can’t help noticing the lilt in people’s voice when they describe someone as creative.  He would like his photography to be “cool” like that.  In fact he likes it a little too much. He has not reached a point where he appreciates how much this kind of vanity interferes with his artistic purposes.

        “Okay, everyone stay where you are. Look up.”

Richie breaks ranks.

A little too emphatically Lisa grabs Richie and returns him to his  place. 

“Ouch” he cries out angrily.

To deaf ears.  Lisa looks up at her father.  He smiles his ‘we are partners on a mission’ smile.  She loves that connection when it is offered. 

Still sitting on the limb, he positions Richie first to the right, then Lisa to the left.  Then he moves Richie left again.  Lisa pulls on her brother. “Richie! Over here,” she commands.

 “Look into the camera.  Deborah, Lift your chin… more…That’s it.”

Exasperated, Lisa admonishes him. “Daddy take the picture already.”

 They are very close to perfection. He likes the way Lisa’s arms are thrown around Harry, their mutt.  He likes the way Harry is smiling, half giddy, panting away, ready for the next bit of action.

“Just one more minute.  Richie, you could be up a little higher.”

  A look from Deborah warns him.  She has a temper.  She has complained many times to Michael about his fussiness taking pictures.  She’s asked him a thousand times.  Why does she have to get angry for it to register?

He hears her. Michael will have to settle for the picture he has now or get nothing at all.

“Nobody move.”

He hurriedly fiddles with the cable one last time, then swings down and hangs by the branch, imitating King Kong.

“Careful,” Deborah shouts.

He drops to the ground almost bouncing up as he lands. Score one for him against the nay-sayers.  Extending the cable he joins them. 

“Okay everyone, Look up… Cheese.”

They shout, “Carrot juice.”  “Carrot juice” has become a tradition since it made them laugh the first time. This time is no exception.  Smiling happy Russells-he likes what he sees.   Click click.

“Okay, one more”

It is the signal the kids have been waiting for.  They are outta there.

“Wait!” he yells

Lisa yells back ,“No way.”

Richie imitates Lisa.

“Yeah. No way.”

Happy noise: laughter, barking, Richie emits a wssssss, an airplane sound as he flies his miniature plane. Chin level he wsssses past Lisa.  She drops her coat to the ground and spreads her arms wide so that they resemble airplane wings.  She takes off with a wssssss.  She shouts to Richie.

“My plane is bigger.  Wsssssss.  Catch me.”

 He reverses course and runs with his airplane.  The two planes circle the campfire. Suddenly Richie trips and goes down.  He has scraped his knee.  He tries not to cry.

From the ground,  For one last second Richie tries to continue his  “Wsssss,” but it no longer is coming from a glorious airplane defying gravity.  He fights against his tears. 

 It is no use.  The dam breaks.  He hopelessly looks up at his daddy.  Michael lifts him and scolds the ground with a ditty.

“Oh what did you do to my Richie?

My Richie did nothing to you.

The next time you hurt my Richie.

I’ll caw-awl the policeman on you.”

 

Michael kicks at the ground twice with his heels as he shouts

“Boom.  Boom.”

His tears gone, Richie is put down and, imitating his father, he clumsily kicks the ground himself, twice with his toes.

“Boom-boom.”

  He again holds his plane in the air and starts running with it. Lisa turns around and with arms still held wide she makes  her wsssss sound louder, more powerful than Richie’s.  She is soon chasing Richie’s airplane with her own.  Harry comes into the picture.   They smile triumphantly,  join forces, two wissssers united, chasing Harry.  He gallops far away. Laughing, Lisa shouts for Harry to return. He barks at her from 20 yards away.. 

She once again runs around the fire.  Watching from the distance, Harry continues to bark.  Lisa calls to him.  He returns to chase her.  Finally catching her, he jumps on her back, a perfect tackle.   “Harry!” She screams happily as he brings her down.  Richie simply stands and watches them with a big fat grin.

The campfire is dying down.  The sun is low in the sky. The children are still whizzing around, but shortly exhaustion will take over.

 Deborah yells for them to come to her, which they do without  protest.  It has become a routine. Brushing their teeth.  Putting a dab of toothpaste on each toothbrush, she hands the yellow tipped one to Lisa and the green tipped to Richie. Lisa holds hers up and inspects hers to be sure she’s been given the right toothbrush. From a canteen Deborah pours water on her brush, then does the same for Richie.  They get to work. Richie hums as he goes.   Lisa is a more competent brusher.  Soon however, they are making more noise than actually brushing.

“Okay enough.” Deborah orders them.

            She hands Lisa the canteen for a swig of water.  Lisa gargles noisily then spits it out, aiming for the longest distance.  She enjoys the idea of spitting on the ground.

It’s Richie’s turn.  He gargles and spits not nearly as far as Lisa.  As compensation Richie sticks his toe on Lisa’s wet spot for good measure.

Deborah’s voice breaks through their procrastination. They know perfectly well what comes after brushing their teeth.  They deliver their toothbrushes to Deborah.    They love the absoluteness of the rules in this routine.  Like a game of Monopoly, “Go to Jail, Go directly to Jail. Do not pass Go.  Do not collect two hundred dollars.”

The excitement is only possible if you don’t ask why, why do I have to go to jail.  Why can’t I collect $200 dollars.  Why?  No whys are allowed.  No whys are needed.  The fun comes from totally living within Monopoly.

“Okay.  March to the tent.”

They march.  When they get to the entrance she calls to them.

“About face.” 

They do so with military precision.

“Wow. Do that again.  No wait.  Let me call Daddy.”

She shouts from some distance away, “Michael”

He shouts back, “What?”

“Watch this.”

Happy marionettes. They repeat their about-face.

He shouts to them. “You want to join the army like me?”

“Yeees.”

Deborah yells,  “I’ll be there soon.”

She turns to the kids, “Okay.  In your tent.  I’ll come in to kiss you good night in a minute.” 

No protest.  Sleeping in the tent is a treat.  Off they go.

Deborah washes their toothbrushes while listening to the crackling timbers in the fire.

She shouts to Michael.  He waves from the distance.  She inches her skirt little by little up her long legs.

He loves her legs. He’s told her many times that he married her for her legs.  She swims miles at the YMCA pool every other day to keep them  that way.

She enters the children’s tent, picks their clothes up and folds them. They are excited. This is a treat.  Normally they sleep alone in their rooms at home. They are sitting side by side with their legs in a shared sleeping bag.

 Lisa is wearing a ring that Deborah had found in her mother’s attic.. It belonged to her grandmother’s great aunt, a beauty who had never married. The ring had been given to her by a young man who was killed in a duel fought over her.  She remained true, wore the ring for the rest of her life, never marrying.  After she heard the story, Lisa asked for it.  Deborah had it sized.  Lisa wouldn’t take it off even when she took her bath.  Something about that story.

Lisa hands her ring to Richie, “Put it on tonight. It means we are married.”

Richie counters, “I can’t marry my sister.  Right Mommy?”

“Make believe,” Lisa argues.

The boss interrupts.

“Come on guys.”

Lisa ceremoniously puts the ring on his finger.  Richie lies back, enchanted with the thought of being Lisa’s husband. 

Deborah snaps him out of it.  She has him slide further into the bag so that she can zip him up on his side.  Next Lisa.  Deborah looks into her eyes. Her lips are parted.  She gives her a juicy kiss which makes her giggle. As Lisa brings her arms inside her bag and Deborah zippers her up they smile at each other, a devil in Lisa’s eyes.  Deborah gives Richie a kiss. As usual he gives her his yuck face.

  There is still a bit of light.  Not long after Deborah has left the tent, giggling excitedly, Richie and Lisa share a look of complicity.  Lisa unzips and flashes her hidden Hershey Bar.

 She puts her finger in front of her lips. “Shhh.”

 

 Their arms disappear inside the bags.  Richie pinches Lisa.

 From outside the tent Deborah warns them.

“Shh…”

They giggle again. Deborah sticks her head back in the tent.  They let out a startled scream.   Then more giggles.  Deborah pretends she hasn’t seen the chocolate bar.  After it disappears under the cover she points her finger at them, teasingly accusing them.  A high pitch tweet from them. She gives them their definitive goodnight, a “that’s enough” face.  They settle down quickly.  The fresh air has had its effect.  As their eyes close they are already half asleep.

Smiling, Deborah walks away and settles by the fire.  She listens to crackling twigs and sparks flying out from the fire.  She stares at a  brightly orange log framed by grey ash.  She is soon absorbed by the constancy of the flames and sparks.  She grew up with a fireplace.  She misses it in their New York apartment.  Every once in a while, she thinks she hears an animal stepping on a stick behind her.    A cougar jumps out of the dark woods!  A quick look in that direction.  It’s Harry settling down. She feels a chill. She puts on a sweatshirt and gets closer to the fire.   Sitting on a boulder, she lights a joint, unwinds, stares into space, finally calm with the darkness all around.

 After 10 minutes she reenters the children’s tent. They are sleeping peacefully.  Her eyes embrace them as she listens to their gentle breathing.  Lisa coughs. Deborah continues to listen. Her breathing is a bit nasal.  She finally convinces herself that it is nothing, as Michael invariably tells her.  As she parts the door flap of the tent to leave she can make out Michael sixty yards away.

He is seated where they took the picture, on the edge of the cliff thousands of feet above the valley. The ledge is tilted slightly downward. Deborah appears.  She is feeling the marijuana, grinning like a happy child. 

 Approaching carefully, she grips the rock with her strong fingernails for traction as she slides next to him.

 She slips anyway, but quickly recovers.

“Whoa.  That was close,” Michael says.

“I’m all right.”  She examines her finger.  “I broke a nail.” 

In the quiet she sits close to him, both of them looking straight out into the emptiness.

“How is your book going? How’s Cornelius?”

“Amazing- as always.  He refused to quit.”

“I still don’t get what’s so interesting about Vanderbilt?”

“He came from nothing and died the richest man in the world.  Believe me there is a story there.”

“But two years on this guy.  It’s like he’s part of our family. Truthfully I think he’s a macho schmuck.”

“You don’t know anything about him.”

“Is that what you really wanted to be, a macho guy who wins all the  time?  You know that means everyone else loses?”

“Yeah, but it must be nice to win all the time.”

“Don’t know how I landed up with someone like you… an ex army sharpshooter” she teases.  She loves his competitiveness.  She hates his competitiveness.

“You don’t want to win?”

“ Not really.”  She answers.  Yeah I hate to lose, but win.  I don’t think about it much.”  She hesitates, then continues, “Michael.  You have a bad case of it.”  She tells him with a superior tone, a tone bugs him  every time he hears it.

“Thanks,” he utters in a warning tenor. 

They both stop.  Time out.  They are quiet. She chews on her lip.   Both look straight ahead.

The quiet is at first a way to get away, to hide from the preceding moment. But it soon takes over. They came here hoping to be captured. It is happening.

            The sunset has begun.  Dreamily her eyes drift to the clouds, now painted with glowing colors.  Beyond she can make out the distant line where the sky touches the ground..  They listen to the soft whistling wind occasionally punctuated by ospreys screaming out dominance over the valley below.  Ca, Ca, Ca.  They don’t let up.

They both start to smile. 

“Nirvana.” He states sweetly.

 “Shush you’ll chase it away,” she whispers.  “No talking.”

She’s right.  He feels it in his fingers which seem light, in the air going in and out of his lungs, but mainly in what he sees, which excites both of them- the sky saturated with deepening colors.  No sunset is exactly the same.

 ” This is our fourth year.  Can’t remember how we found this place?”  

“Joe told me about it.”

“Well he’s good for something. Is he still giving you a hard time about your Exxon story?”

“Not as much.”

“Doesn’t surprise me.  It’s a good story.”

Again they are silent until Deborah laughs to herself.

“What?”

“Something Amy said.”

“What?”

“She said in a past life you must have been Japanese. Always trying to take it to the next level.”

“Do you think so?”

They both know it is true. Neither understands it.  He is forever on a quest for perfection.  “Live Now.  Live now.” the drugstore gurus urge.  Working towards tomorrow’s possibilities guarantees disappointment. You never quite get there.  Perfect is the enemy of the good.   Enjoy things for what they are.  Grab what you can while it can be had. The good, the good, the good is best.”

 But it’s simply not in him.  Perhaps you have to be born that way, able to live now.  Able to be satisfied with the moment.   Deborah complains that his quest makes him too critical.  She sees it in his expectations of the children.  Why can’t he see exactly how perfect they are?   Deborah’s sister complains about the same thing with her husband. They tell each other that it is just the way men are.  Michael should understand.  He’s always felt that he disappointed his father.  They never talked about it before his father died.  But he knew.  He could see it in his father’s eyes.

Wanting, expecting perfection makes him critical of what he has.  Living in the future means that when Michael gets where he wanted to go, even if it was very hard to get there, the satisfaction disappears and he soon dreams a new dream. A better one.  “Why not?” he asks.  “If you are alive why not want the best there is, just so that you know what that is like?”  Greed she calls it. Deprivation, he counters, but understanding will not change it.  It is simply a given. 

Except when it comes to a sunset.  It is not compared to other sunsets.   A sunset cannot be improved.  Just followed quietly.

 The sun is huge, the sky orange with hints of red.  Beyond the farms, high grasses define a creek that leads to an inlet.  Even without pot Michael is there with Deborah.  He thinks of Maine and the sea grasses.

 Off to the right, leaves dance in the fading orange light, which, ever so slowly, is changing to a reddish hue.   Very, very far away a tractor, looking like a toy, moves slowly along, leaving mounds of dirt looking like anthills.   Its driver is a tiny dot.

 Deborah’s body feels buoyant, like she is floating.    A cool crisp breeze blows across their foreheads, as a sliver of red sun shimmers at the very edge of the horizon.  Then it disappears. They exhale in appreciation.  He hands her a plastic cup of wine.  He is excited by a new thought.

“I can see why they used to worship the sun.”

“Who are they?” He is too easy a target.  She loves to tweak him when he becomes contemplative and speculative.  He is like a child.

“Ancient people. People who lived outside. Not knowing how things work, not learning about it in books, in school.  Just what’s in front of them, the sun, huge, hot.   Or cold on a winter day.   Completely gone on a cloudy day.  Can you imagine that?”

She is elsewhere.

“Sorry.”

 He doesn’t pause for a breath.

“For someone in that state of mind the sun is a mighty god.  If you’re trying to make sense of things, worshipping it makes perfect sense.  What else is a god if not something powerful, unworldly?”

She stays silent.

His voice raises, inspired by still another of his thoughts.  “Except you can see the sun!   It’s actually there.  That sure beats Jehovah.  I’d  worship it if I lived back then.”

She says nothing. He is stirred up, his voice loud.  Michael and God. Not the makings of a peaceful evening, but not always unpleasant.

            A Jew is not allowed to flirt with ancient gods.  Michael hasn’t been righteous since his teen years.  He’s long since blasted away at God in his mind and in conversations.    His heart is unmoved by the rituals his parents practiced.  But he’s close to blasphemy and he knows it. Blasphemy is blasphemy. Taunting Jehovah makes him giddy, which must be stopped.   His voice becomes quiet and respectful, almost humble.

“God’s done a pretty good job here,” he tells Deborah.

She smiles, acknowledging the thought.  Saying that calms him a bit.  He feels better when he is on better terms with Yahweh, the God he’s certain doesn’t exist.

 He holds up his cup. In a few weeks it will be Rosh Hashanah. 

“To the big guy in the sky.”

            He points his wine glass at Deborah” Shana Tova”

“Shana Tova” she repeats.

Deborah holds her cup up, points to where the sun has descended.  “To the Sun God.”

He gulps the wine.   She sips it. The` howling wind can be heard in the distance.  Leaves fly in the air in front of them. A moment later stillness returns.  They smile at each other contentedly, lucky to be a witness to “His” magic.

She points skyward straight above his head.  A sliver of the moon is already visible.  He turns around.

She whispers, “To the god who owns the night.   With a whisper.”

“Only one god allowed.”

            “If there is a sun god there is a moon god,”.

He smiles at her logic

She opens her arms.

“Come here Mr. Vanderbilt.”

Chapter 3

            Two hands slap at an overturned card, a jack. Lisa and Richie try to out shout each other.  Michael watches quietly.

“Slapjack!”

Richie, now eleven, is sitting on twelve-year-old Lisa’s hospital bed.   Both want to win badly. Happy rock n’ roll plays in the background.  Lisa has mastered her bubble gum, cracking it emphatically, rhythmically, repeatedly blowing small bubbles then sucking them in. With one hand behind her back, she draws the next card.

Richie fakes slapping the pack.  Lisa, just in time, freezes her hand.  He points at it.

“You moved your hand.”

She shakes her head, “No!”

“You did!”

They prepare for the next draw. Lisa sneaks a look at the covered card. Another jack! Keeping a poker face she uncovers it. She beats Richie’s slap, smiles triumphantly.

Richie is not happy.

“You cheated.  You snuck a look.”

“I did not.”

“You did. I saw you.”

“Daddy!

“Leave me out of it.”

She brings the back of her hand to her chest, swallows hard with a little too much theatre. Richie suspects this might be a ploy, but by the second swallow it looks like she is fighting nausea.  Concerned, he looks at his father for reassurance. Another tentative swallow.  She gags. This is clearly not under her control. Michael, who’s been reading the sports section of the newspaper, comes to life.

“You okay?”

She smiles at him a bit tearfully but then her discomfort passes as quickly as it came. In very short time, her mischievous grin takes over as  she prepares to turn over the next card. She imitates the sound of a drum roll. Richie not amused by her sound effects.

“Stop,” he orders.

Deborah noisily enters the room.  Lisa doesn’t look up. For a crucial moment she tries to stay with her game.  Finally she gives in.

As Deborah’s mother once did to her, Deborah moves the back of her hand across Lisa’s forehead, then puts her cheek on it, checking her temperature. “How’s the patient?” she asks cheerfully, as she deposits some bags of snacks on a chair.

 “Is the food any better in the cafeteria?  What they bring me here sucks.”

Deborah glares at Lisa. She doesn’t like that kind of talk.  Lisa’s eyes drop.  Michael  tosses a bag of potato chips to her.  Deborah tries to intercept it.

 “Doctor said only hospital food.”

Lisa throws it back to her father, “I wasn’t hungry anyway.”

Richie moves off to the corner of the room. He pretends to be busy, shuffling his deck of cards, but he is watching everything.

Deborah again touches Lisa’s brow with the back of her hand.

 “She definitely has a fever.”

“Again?”

“I’m pretty sure.  Here, feel her brow.”

Michael ignores her and plops into a different chair by the bedside.  He takes the TV remote and puts on the New York Jets.

Deborah strokes Lisa forehead.

“Are you okay?”

“The same.”

“Does anything hurt?”

“It’s the same Mom, the same.  Stop asking me. That’s the hundredth time you’ve asked today.”

“When did they bring your medicine?  Michael, check with the nurse.”

He reluctantly starts to get out of his chair. Lisa intervenes.

“Mom.  This is a big game.  Richie you go.”

Richie goes forward with his task.  He leaves the room and heads towards the nursing station.  The once grand hospital is showing its age. The corridors have been scrubbed and scrubbed, but the marble trim around passageways has passed the point of a pleasant ivory toned patina to simply looking brown and dingy.  The high ceilings seem to amplify the cold creepy institutional feeling.  Richie shuffles down the hall. He shoots a look in the first room he encounters.  A doctor and two assistants are busy preparing for a procedure.  He catches the eye of seven-year-old Billy sitting up on his bed.

“Hey Billy.”

      Billy, pale and clearly ill, points his index finger at him, pretending to shoot a gun. His thumb comes down as if it is the trigger, followed by an imitation  gun recoil. Richie returns the gesture calling out picccchhhhu as he shoots back. 

The door closes.  Richie moves on down the hall happily when suddenly Billy’s scream rips through the quiet. 

“OWWWWW”

     “It won’t hurt…It won’t hurt. I promise you. Stay still.”

          Then   another scream is heard all over the ward, this one the result of a local being administered so that a scalpel can cut through Billy’s flesh for a cut down to start the IV again.   In her room, Lisa looks at her father.  She squeezes her mother’s hand.

         Billy screams again. “You said it wouldn’t hurt. You said it wouldn’t hurt.  You promised.”

           Michael closes the door to their room.

  

  The doctor’s voice can still be heard.  “Hold him still. I can’t do this if he keeps moving.”

CHAPTER 4

 

As soon as they return from the hospital to their fifth floor West 70^th Street apartment Richie goes to his room.  Michael turns on the Jets game in the living room. Deborah settles by the window that looks out at the asphalt playground five stories below. It is late afternoon but the children’s energy has not let up. From up high their screams are soothing, like birds chirping in the countryside, each with a different call, talking back and forth to each other through the airwaves.  Laughter, anger, silliness, pleading, a little boy’s voice over and over in Spanish, “Mira! Mira,” then another and another, “Higher…” “Get away….”  “Stop that Joey…” Then a mother, “Get over here…    Now!”

 When she was playground age, Lisa used to call Deborah over to this window.  Within seconds their coats were on, and they were on their way out.  They both loved that about the apartment- the nicest view in all of Manhattan, the playground beneath them.

 Leaning against the windowsill, Deborah looks for little Maria and her mother. She’s been drawn to Maria ever since she watched her being introduced to the swing.  Frightened moans and complaints as her mother pushed her higher, laughter and shouting as she came swooping down.

Gradually that changed.  Her fear was replaced by excitement. “Higher, higher” she shouted, as she glided back to earth and her mother positioned herself to send her flying again.  Weeks later, quiet determination as, by herself, she kicked harder and harder, rhythmically pumping to swing to the highest possible point.  It reminded Deborah of Lisa: total abandonment, determination. Eventually, Maria started to do stunts like Lisa, standing on the swing, first on two legs then one, anything to revive her original fear and sweet conquest of it.

Except tonight Maria is not there. Deborah settles on a different child who is swinging calmly, ritualistically performing exactly the same kick every time.   It’s not enough distraction.  Billy’s cries from the hospital sneak back into her mind. 

She stands in front of Michael blocking his view of the Jets game.   

He tries to see around her. 

“Fourth quarter!” he says insistently.

Deborah glares at him.  He mutes the TV sound with his remote. She waits for his full attention.  She still doesn’t have it.  It’s her or the Jets.  And that is no contest. 

“It’s 7-7, 3 minutes left in the game.”

“Great!” she jabs at him as her glare builds towards rage.

“Debby, just tell me what you want.”

Lately, she’s been doing that a lot, starting badly.  Pissing him off. She can’t help it.  She’s pissed too. 

He’s the same as her father.  During a game he stopped being her father.  He was no longer her mother’s husband.  He was in another universe.  Except, it was the Giants not the Jets for her father.

 In the earliest years, when the current of Deborah and Michael’s love was powerful, there were no wrong moments, no good time or bad time to talk to him.  There was no right way or wrong way to say what she had to say. His attention was commanded effortlessly.   Anything she did, or said, put her on his stage. 

That is long gone.

“I want to take Lisa out of the hospital.”

      Instantaneously, fire comes out of Michaels’ eyes.  She returns to the window.   She breathes a sigh of relief. Maria’s arrived.

      Watching Maria in the playground is one of the few remaining ways Deborah can connect to another person without becoming agitated.  Her friend of 20 years, Anne has grown impatient with her.  “You have to get yourself together. You can’t let this get the best of you.”… It’s her way of saying “I don’t want to hear any more, shutting Deborah down so that she can chat about her own life.  At least, at cynical moments, that’s what Deborah thinks.

Laura’s the opposite.  She’s over solicitous, talking in a droopy “poor Deborah” voice, which has, on occasion escalated Deborah’s depression several notches. Once, after a visit from Laura, suicide popped into her mind.   She quickly dismissed the idea, but not without thinking, a sudden end to her life, if it were to happen by chance, would be a relief.  Only where would that leave Lisa?

Lana always competes with Deborah about who is more miserable.  Ten years ago, Lana’s brother and his wife were murdered in their bedroom by a stranger who had grown up in her brother’s house before he bought it.  Lana has never fully recovered.  Whatever misery she is presented with, the subject always comes back to her own misfortunes.  That she hasn’t totally recovered is understandable.  But she can talk 20 minutes straight about her misery, barely stopping to come up for air.  She is divorced and her children have grown up and moved out.  It always comes down to the same thing.  Deborah is lucky because she has Michael.

It isn’t just Anne, Laura and Lana.  Her relationships work no better with anyone;  cheap encouragement or, the opposite, dreary empathy.   Or some other variation which is equally a turn off. It’s no one’s fault.  What else can people do?   They mean well.   

But as a result, despite Deborah’s loneliness, she doesn’t feel she can be with anyone.  Not that her friends are beating down her door with social plans. If they are in a good mood, even a so-so mood, the last thing they want to do is be with Deborah.  Obligation demands a phone call every once in a while, but that’s about it. Seeing her can poison an entire day.

Deborah hadn’t quite realized her friendships weren’t good ones. How alone she is never occurred to her.  As the mood arose she saw her friends. They saw her.  They came in and out of her mornings and afternoons, visiting, phoning, shopping, in a natural flow that usually left pleasant feelings.  That was enough for her.  She liked them.  They liked her.  They were “friends.”

 True friends.  At first, everyone was duly concerned, and perhaps they still are, but by the third or fourth time that they’ve seen Deborah, time spent with her is usually tense.  While Lisa’s lymphoma gives Deborah a generous allowance of forgiveness for whatever less than cool behavior she shows, there are limits.  When her emotions break through, as they sometimes do, despite everyone’s best intentions, tension takes over the room.

Deborah has learned to give short answers when people ask about her.   “Fine.  Thank you for asking.”  That’s it.  Anything more and  Deborah’s desperation rears its ugly head.  It doesn’t take much.  A pleading look in her eyes- the slightest sign of anguish interrupts her partner’s small talk,  and quickly their own emptiness gathers momentum. The result is they feel trapped by Deborah.   The bottom line is that her visitors get fidgety. They wait for the right moment to exit politely.

She Initially believed that if her friends really tried they could get through to her, but she now thinks otherwise.  At least when she is alone she can feel whatever it is she feels without the added concern of whether being  morose is creepy.

 It is creepy. Her lack of interest in fun things, good gossip, a joke Johnny Carson told the night before, her lack of interest in any of it  irritates them.  

That would be okay if Deborah didn’t take it personally. At this point, it is rare for another person to find her interesting and want to spend time with her. That hurts.

 Going over unsuccessful conversations in her mind, too often takes over entire afternoons. She’s tried to apply soothing thoughts: It isn’t her they are rejecting.  Why would anyone want to hang out with the mother of a girl with cancer?  But she is only partially able to convince herself.  Her mother’s fierce efforts, years and years of battles with her and too many tears from her, all  aimed at teaching Deborah how to put on a mask.   The right hair, the right make-up, how to hide unpleasant feelings so they can’t gather ammunition against her. Everything she thought she hated most about her mother, especially the paranoia implicit in her lessons, she now treasures. She wishes she could regain her ability to follow her mother’s advice, be pleasant and never let down the veneer.

She just can’t pull it off.  She can’t imitate cheerfulness. When she was a teenager, she often practiced her smile in the mirror.  Eventually she got mostly comfortable with people.  No effort was involved.  Now she is back to step one.  Her best smile is pasty.

Sometimes it gets ugly.  Deborah’s “milking her misery,” “trying to get others to feel sorry for her.” She’s embarrassed as soon as she realizes that’s what she is doing.  She’s caught herself repeatedly, but she can’t help it.  An impulse to beg.  iIt takes over before she is aware that she is at it again.  Even Gail, who used to adore her, who gave her the most latitude can’t take too much of her now.  Losing her hurt more  than the others.  Perhaps Gail’s tolerance allowed Deborah to build up a head of steam that went way too far.

 Michael says times like these are how you find out who your real friends are. Yeah people love you when you are in your glory, but the test of friendship is how they are when you are down.

 Only he isn’t much better.  When he’s listened to her struggles about how it went with this friend or that for the umpteenth time (“What did they mean by this? By that?”)  especially, when  he’s at work,  he’s little different than her friends.  He finds an excuse to hang up.  He can do that easily at work, tell her he is busy, even when he isn’t, but not at home.

 Dr. Stern told Michael about Freud’s book, Totem and Taboo.  How in certain cultures, families in mourning are shunned.   It has nothing to do with social factors. The spirits of a dead person are said to hang over family members and possess them.  It’s believed that if a villager gets near a grieving person, the dead person’s spirit will infect the villager. So they stay away. 

That thought comforts Michael when he tunes Deborah out.  He doesn’t feel as trapped.  He can listen without a guilty conscience, which makes it easier when her eyes beseech him for answers. He has no answers.  Nor does anyone else.  But, being relieved of his guilt helps him to be patient, and that helps Deborah.  She senses when he is irritated, so when he isn’t, they are both ahead of the game.  If only Freud could supply him with some more theories.  On a more positive note, while theories help, in the end, when all is said and done, Michael possesses the most important quality. Like Deborah’s mother.  No matter what, he will be there. 

 

 

 

Chapter 5

 

Maria has bumped it up to still another level. Standing on the swing, she holds on to the ropes and momentarily lifts her body into the air. She repeats this several times trying to extend her time in the air.  Deborah erupted when Lisa made similar experiments.  She grabbed her and let her have it.

           That didn’t stop Lisa from trying to do it again.  Deborah blamed Michael for encouraging her wildness, which is fair enough.  Lisa’s stunts gave him a kick. He’s done the same thing with Richie, despite promising Deborah he would try to get them to be more careful. 

Deborah looks out the window as she speaks. Watching Maria on the swings enables her to stay calm. 

“Joanne cousin had a lymphoma. Everyone said nothing could be done… She took shark cartilage. They’ve used it in China for thousands of years. Joanne’s said it cured her.”

Michael’s face tightens. Joanne cuts Deborah’s hair so they get to talk at length. Joanne’s place now has an acupuncturist and a Yoga instructor. There is talk of a spa. She sells facial creams containing herbs. Deborah claims the creams work wonders. Still worse from Michael’s point of view, Joanne is mellow and soft spoken with a smile and an aura that hints at an understanding of the secrets of the universe. She truly believes what she believes. In style and tone she is the very opposite of Michael. He has looked over some of the brochures that Deborah’s brought home. They are nonsense.

Unfortunately, Deborah’s friend Laura is also into organic foods, and on the face of it, she doesn’t seem very crazy. No ax to grind.  Deborah has several other acquaintances who are in the same camp. Health food is no longer a cult, like Macrobiotics was in the 60’s. There are too many mainstream true believers. On the talk shows that Deborah watches similar information is repeated again and again by celebrity after celebrity, all with confidence that they know what they are talking about.   

Healthy foods, unprocessed food; at first pass that kind of makes sense. But the amount of misinformation being broadcast in the mainstream drives him nuts. Michael’s mother had her chicken soup as a remedy for sniffles, and honey and lemon juice for a cough. She knew however that these were bubameinsas that she got from her mother, and her mother got from her mother.  She knew that her children should drink plenty of milk, and eat their vegetables and fish was good for the brain. She also knew that she didn’t know very much about scientific subjects. Nothing in fact.  That doesn’t mean she adopted an I am a dodo persona. Not a hint of Lucy or Gracy Allen. She expected to be taken seriously but in science it would have been apt for her to be classified as stupid. His mother didn’t know how to change the channel on the TV nor did she care to learn.

“You want Lisa to take shark cartilage?”

“Michael, It’s natural.”

Michael erupts when he hears that word. He has gone over this subject in his mind again and again. Every time he reads or hears someone refer to “natural” as validation of a product, he comes up with a thousand counter arguments, which he marshals as what should be the end of the debate. It never is.   This is the perfect opportunity to unleash his full battery of thoughts..

“Deborah I love nature … I love the Grand Canyon. I love that river we go to upstate, untouched by people. I agree.  It is sacred.  That place in the mountains, clouds lit up by the sunset, the trees turning into a painting in fall. I love it.  I mean I truly  love it.  No one should mess around with it.  It’s sacred. But that doesn’t mean that everything natural is safe or good especially when it comes to medicines.”

“There is a balance in nature. Michael . We are always screwing it up. Throwing its equilibriums into chaos when we mess with it.”

“ Fine but those equilibriums are not sacrosanct. You know Manhattan was full of swamps. Living there in the summer meant being in a smelly, clammy, damp, rotting environment.  Yellow Fever could hit anytime. Washington DC was even worse. Guess what? They drained the swamps. They stood up to the wetlands. Fine some birds may have been displaced. Some may have died when they lost their swamps. Except we have New York City and Washington D.C.”

“ Yeah we have paved over nature with concrete.”

“We have two vibrant centers of human activity. I’ll take that over a swamp…Nature is just what it is. it is good, it is bad.  It can be very good.  It also can be very bad.

“Bubonic plague is natural. So is smallpox. That killed 300 million people.

“Michael-”

“They mine asbestos. It is a natural product buried under the earth. Poisonous mushrooms, mosquitos carrying malaria…”

“I get the point.” That doesn’t stop him

“Fungal diseases killing roses; black spot, aphids, mites. Nature’s gifts to us.”

With every point Michael gathers gusto. “Roses represent a victory over nature. Same for the Polio vaccine.”

MIchael interprets Deborah irritation with his lecture as a sign that she doesn’t yet grasp the essentials of what he is saying. His voice get louder  when he reads her irritation as skepticism or stubbornness.  That makes him pile on still more examples for his argument

“Cholesterol plaques build up in your arteries. If they get too clogged you die. That’s how nature arranged things.  Guess what. We’ve chosen to  defy nature. According to Joanne’s brochure, Lipitor is a nasty chemical. It’s synthetic.  It disturbs the balance in your body.

Yes Lipitor has some side effects. Yes it changes some of your body’s equilibriums. It is an unnatural chemical.  But it  happens to have saved the lives of hundreds of millions of people. This artificial chemical is a miracle as great as anything nature serves up.

When I was growing up, three of my friends’ dads died in their 40’s of a heart attack. Have you noticed that just isn’t happening any more. Lipitor!”

“Foods without preservatives are natural. Nature’s true purpose, spoiled food, once killed tens of thousands of people before they added those unnatural processed chemicals, the preservative that Joanne’s brochures carry on about.”

Okay Michael, Okay, Okay. This is just what I need, you ranting and raving. You’re like a bull dog.”

“You don’t want to hear it? Don’t get me started with that kind of bullshit. Natural.” He unsuccessfully hunts for one of the brochures she brought home. He finds it, but before he can open it, and read some silly quotes that he’s underlined, Deborah cuts him off

 “It’s not just the brochures. I’ve read articles, a lot of articles. Plenty of people believe in natural foods..”

“ I don’t care if 99% of people buy into it. Debbie. You’re not stupid. Use your brain instead of going along with everyone. What they are saying simply doesn’t make sense. What counts is whether something makes sense. Natural has nothing to do with it.

“You’re so narrow minded. If it’s not Western…”

“Deborah, think about what they’re saying. My mother would have never claimed she knew more than doctors, She knew her chicken soup worked and that was the end of it. He doesn’t like the look on her face.  “Oh right. My mother’s not liberated?”

“You said it. I didn’t”

“Thank God she isn’t.  Let me tell you. My mother had a good mind. Still does. She can sort out bullshit better than either one of us. She doesn’t buy into this women know better than men.

“Okay. Your mother’s not an idiot.”

“You’re not either but you are too taken by what other people say. I know Joanne is cool, and the people on Oprah are cool but they know shit about health and medical treatment. They’re like you, all liberal artsy in college. Science was for nerds. Those brochures you bring home? If you had ever taken a science course and taken it seriously, a course in anything, you would have read the first paragraph in that brochure and thrown it away.”

She raises her voice louder than him, “Can we stop? Michael we were talking about Lisa. Not politics. This is about Lisa. I know you need to talk about stuff you think about.  You need to get angry.  But-“

That silences him. She is right. He’s gotten carried away once again. Lately it has been more than ever. The room is quiet for the first time since they got home.

Remorsefully he takes her hand. “You want to give her shark cartilage, give her shark cartilage. But that’s it. It’s not going to replace real treatment.”          

 Pleased, Deborah drifts back to the window.   She’s thinking about where she can buy shark cartilage. 

Her eyes return to Maria in the park. She remembers when she was a pipsqueak.    She’s giving her mother a run for her money. 

Except Maria and her antics have stopped working as a distraction. Billy’s scream is again running through her mind.   Deborah returns from the window. 

“I’m not going to let them torture Lisa.”

 “Torture?” “Torture?” sarcasm dripping with each syllable.   He fumbles with the remote control, turns the sound back on, then turns it off.  The Jets are behind by two points.

 “Yes torture!”  He turns the TV off.  “They’re not going to torture Lisa.”

 “Come on,” he says with complete exasperation in his voice.

 “God only knows what they were doing to Billy today.  I swear.  They get off on it.”

She gets louder.  “The needles they stick into Lisa are nothing. Nothing compared to when they can’t find a vein.   They take out a scalpel and cut right into her arm, looking for one.”  She continues.  “They make her swallow awful tasting syrups.  It makes me gag when I watch her.”

He looks at her sympathetically.

 “Yesterday she had to swallow a plastic tube. She has trouble with pills. A plastic tube?  She almost vomited…  twice.” 

Deborah wipes away a tear.  Michael takes that hand.  He gently strokes it.

The tears continue to roll down her cheeks, but there is triumph in her voice, enough to stop her crying. Her finger touches a remaining tear.

 “You have a problem with Joanne? I want to know where doctors come up with their stuff? Tell me.  What stupid person dreams up the procedures they do to her?”

“Those stupid people are Harvard trained.”

“Oh Harvard.  Mr. Harvard.  There are fewer sadists at Harvard.  Right?  People are really nice there, soft spoken, nice, no bubermeisters.

She takes a breath then continues.  “Did it ever occur to you that maybe all that bookishness makes for better ways to torture children?  They finally get to do something besides read.”

He says nothing.  He knows where this is heading.

     “Leopold and Loeb.  Turned on by Dostoyevsky.  Brilliant.  The two of them bored out of their minds.   Wanting adventure.”

“I don’t want to talk about Leopold and Loeb again.”

 “The trick was finding someone weak enough to bully. They figured it out.  A baby!   A baby.  Those bastards killed a baby!”

She waits for a moment before continuing,  “I just wonder about child cancer doctors.  There has to be something wrong with someone who doesn’t mind seeing children in pain, someone who has no trouble doing those procedures.  Doing them year after year.”

“Jesus! Come on!  They’re trying to beat the cancer.”

“I’m telling you. They’re bored book people.  This is their form of excitement.”

       “Dr. Clark doesn’t have time to get bored.” 

            “You remember your cousin Ronnie?  He told me how exciting it was in medical school to do procedures on people.  He said it was so real, more exciting than Coney Island.”

        She continues.  “You think being smart makes people nicer.”  She looks him straight in the eye.  “It just makes for better bullshit.”

She’s said all of this before. Often. He’s always tolerated it..  At first it got to him. It doesn’t any longer. Repetition has dulled its sharp edges,  But you never know what Deborah might say.  He waits for what is coming next.

The phone rings.  It is Michael’s mother.  They both get on.

“How are the two of you holding up?”

“We’re okay.”

“Anything new?”

“Not really.”

She can hear from their voices that she is interrupting them.

“Is this a bad time?”

“Well…”

“Put Richie on.  His birthday is coming up isn’t it?  Any ideas?”

Both of them are miffed with themselves for forgetting his birthday.

“No real ideas.  …Maybe a video game?”

“Which one?”

“I don’t know?”

“Okay, just put him on.”

Michael screams down the hall to Richie.

          “Pick it up…It’s Grandma.”

“Hi Grandma.”

“Someone told me you have a birthday coming.  Are you going to have a party?”

“No.”

“Your Mom didn’t say anything?”

“No.”

“What video games are you playing now?”

“ Duke Nukem.”

“That’s your favorite?”

“I’m at level 3.”

“So you’re good at it?”

“Well…”

“Is there a new one coming out?”

“I’m not sure.”

“Find out. It’s getting harder to find presents for you.  Duke and Nukem?”

“ No just Duke Nukem.”

“Okay. I’ve written it down.  How’s school?”

“Okay.”

“Keeping up with your homework?”

“Yes.”

“Getting good grades?  You’ve got your father’s brains.  Don’t waste what God has given you.”

He doesn’t answer.

“You and Lisa getting along?”

“She’s still in the hospital?“

“I know honey.  Will you give her a kiss for me?”

“Yes…”

“Okay.  I’m getting off.  Duke and Nukem?

“No just Duke Nukem.”

They get off.  Deborah doesn’t waste a minute to get started again.

“You think Billy’s a cry baby don’t you?”

“I was wrong about Billy okay.  I admit it. Last week I saw him.   They barely touched him and he was screaming.”

“You called him a wuss.  Do you know what he’s been through?” 

“I was pissed, okay? I took it out on him. I’m not allowed to get pissed?”

“You said it loud enough for his mother to hear you.”

“You really think she could hear me?”

     “Are you kidding?”

 His face drops. “I’m sorry.  I didn’t know she was there.” 

Deborah knows Michael is telling the truth.  She believes Michael is sorry, but she can’t bring herself to forgive him.

 “I was wrong,” he repeats. “Okay?”

It is not okay and won’t be. She talks about Billy all the time.  The other patients on the ward and their families have become family to her.  They are the only ones that understand. 

 He knows that.  He knows how important they are to Deborah, but he has never felt part of it.  At that moment he couldn’t stand the whimpering.  No it wasn’t the whimpering.  It was when Billy began to scream.

She stares at him waiting. 

“What do you want me to say?  I was wrong. I know Billy’s been through hell.”

She continues to stare at him coldly.  He counters.

“We’re talking about a lymphoma. Dr. Clark knows what he is doing.”

“Lisa’s not going to end up like Billy.  Do you understand that?  “They’re not going to break her.”

“Lisa is not Billy.”

“It’s not whether she’s going to carry on, it is putting up with that pain.”

“They are not trying to break her.”

“Oh no?”

He stops for a moment and suddenly his voice is sympathetic, “Do you really believe that?” He is truly curious.

She begins in a measured tone.  “I’m sure they probably have to do most of what they do.  But some of it….  I swear!   One day they are going to do one thing, which they tell me is critical.  Then they change their mind and don’t do it.  Or they do something else instead.”

“There’s nothing wrong with that.  It means they are thinking things over, not just following a cookbook.”

Michael continues.  “I hated when they were following protocols. Everything preordained.  The doctor’s decision-making totally shut down.” 

“But they knew what they were doing.“

“They didn’t know anything.  They were just following a protocol.”

“Michael, the protocols meant they knew what they were doing.”

          “They knew all right.” He says with deep sarcasm.

         His tone shuts them both down.

         “The good old days,” he says morosely.

She speaks slowly.  “Lately they really don’t know what they are doing.  Half of it is just to do something.  Anything. And every one of those procedures hurt Lisa.”

“Maybe, but they’re trying.  It is better than nothing.”

“Not when what you are trying is to prove that you are a great doctor.”

“Deborah.  Come on… Maybe Dr. Fabian’s like that.  But not Clark.  He usually talks to me about what he’s planning.  He reads somewhere about a procedure.   He goes over it with me.  We both agree.  If it will help, why not?

“Why doesn’t he talk to me?  Is this a man thing?“

“There is no way you can hear him out when he’s talking about the pluses and minuses of a procedure.  You go bonkers.”

“Maybe it’s something else.  Have you looked at those bills?  Every time they do a procedure they get paid a fortune, what you earn in a month.”

“Deborah, the money goes to the school not them.” 

She is only half listening, which makes him speak louder.

“They’re doing their best.”

She won’t look at him.

            He glances at the TV hoping nothing has gone wrong for the Jets.

She shuts off the TV manually.  

He clicks it on with his remote.

“I hate that TV.”

“Deborah!”

“Fine.  You want to watch it. But while you are off in TV Land what about me?”

“Deborah it’s not about you.  I need to unwind.”

“Okay.  But less… okay?  Less.” 

Her anger softens.  Her eyes water “I can’t do this alone.”

  She sits down on the arm of his chair. Her tears continue. Soon his fingers begin kneading a knot at the back of her neck.

“Over here?”

“A little higher.  More to the left.  That’s it.  You got it.”

She continues,  “You’re not at the hospital during the week.”

His fingers stop. 

“I have to work.  We have bills.  You don’t look at them, but it is a disaster.”

“Still.”

           “I’m not going to apologize. I have a job.  We need money.”

“ Fine, but understand.  You miss half of what is going on.”

“Like what?”

 “What?  Everything!” 

He knows and she knows she is exaggerating.

 She takes his hand. “Okay, not everything.   But a lot.”

“What?  Really?”  At this  moment his anger is gone.

“Like what?” he repeats.

“Like Lisa’s spinal tap Tuesday.” Deborah smiles proudly like Lisa has done something big at school. 

 “Lisa was a trooper… She had that little scared smile.  Remember…at her third birthday party…?  The clown broke a balloon? She was startled but it was her “princess” party.   That’s what you called it. Those crinolines.  She looked like a princess. She knew she was a princess.    A princess doesn’t get scared.  So she scared or not  she smiled.”

Michael does remember.  It is on video.  At one point during the party, she has her hands on her hips, like she is about to sing out a verse from Oklahoma. Scared but not scared. Hamming it up.

Deborah continues. “It was like she was in one of her stories.  She still does that. Pictures herself as someone else.   I don’t know who she was playing, what story she was in.”

She continues.

“Maybe it wasn’t a story.  I don’t know what she was imagining, but during the spinal tap she did whatever the neurologist told her to do. No resistance…”

Deborah smiles again, “She’s a trooper…”  Her eyes water.  She whispers Lisa’s name through tightened lips.

“The neurologist asked her to lie down on her stomach.   She  did.  She did everything he asked.   Waited for the next direction.  She had it under control.  She was determined to go with the doctor.

 They told her to roll on her side. She did.  The nurses rubbed Betadyne on her back. They moved her higher up on the examining table. That’s when the trouble started.”

“What do you mean?”

 “Her hospital gown got pulled up. Her underpants were showing.  She tried to pull her gown down. 

 But, suddenly they were in a hurry. They had her pinned down and they weren’t going to let go.  The neurologist had had enough pussy footing around.  Getting it done was all he was thinking about.

 Her fingers kept moving, trying to catch her gown.  A nurse noticed.   She held her wrist even tighter.”

“So what did you do?”

 “I was whispering into her ear, kissing her.   I could see what was going on.” 

Her voice rises.  “I thought nurses are supposed to know about twelve year-olds.   About her underwear showing…I swear. They aren’t really nurses.  They’re doctor wannabes.”

“Some of the nurses are good.  Lisa loves Barbara.”

“Barbara wasn’t there. It was that tall one with the braids, and that

other short one. I wanted to shout: “Let go of her hand. Let go of her

hand.  Give her a minute.”  Deborah hesitates.  She’s again fighting her tears. 

“I said nothing.  Nothing.”

  Deborah’s rubbing her wrist. 

“They could have waited two seconds so she could cover up her underpants…She’s a twelve year-old girl.”

She rubs her wrist some more.

“I don’t understand why I said nothing.”

“You didn’t want to get them upset.  You wanted them to have a cool head. They were going to stick something in Lisa’s spine.”

Deborah’s face hardens.  “It’s not that.  It’s that they’re in charge.  What time we come, what time we go, what they feed her.  They are just automatically in charge.”

“It’s their hospital.”

“It’s our daughter.  Lisa’s ours. Michael she’s ours.”

“Okay fine. But Debby, Joanne’s health food stories are wacko.

 “Doctors are no better.”

“Dr. Clark studied for years, studied hard.  He’s not stupid.”

“Were back to that.  Good.  He’s not stupid. But you know what? It doesn’t matter… Sometimes the cancer calls the shots. I just want Clark to admit it if nothing is working.”

“He’s giving it everything he’s got.  Deborah.  Everything”

She looks out the window.

“If he’d slow down. Not just Clark.  All of them, … In and out of the room.  Dr. Clark should stop staring at Lisa’s chart and look into her eyes.”  Deborah’s eyes water again.  “Just once.” She wipes her eyes.

She pushes Michael’s hand away as he tries to stroke her.

She shouts angrily “He’s gotta tell me if he can’t do anything.  He has to stop torturing Lisa”

She looks imploringly at Michael.

“Am I asking too much?”

He doesn’t answer

“Am I?”

“No.”

“I’ve gone along with you all along, but now we’re done. Lisa’s staying in the hospital for us. She puts up with them for us.  For us!”

“Deborah, No more.  I can’t do this.”

Deborah ignores him.  She continues. “She’s waiting for me to say it. “Come on.  We’re out of here.  She’s waiting.”

“Deborah…”

“I’m going to take her home.”

“Deborah.  Please. We’ve been here.  Again and again”

“What did you expect?  I should have come home today and done my nails?”

 “No, but-“

“One more incident like this morning and we’re out of there.”

“Taking her home will make everything worse!”

She stops.  She knows that particular pitch and volume. Michael is about to blow.  She suddenly becomes very quiet, like she has heard thunder in the distance.  They’ve been here too many times. The argument has gone on way too long.  They’re both exhausted.

  She returns to the window.  The only person still in the park is a fourteen year-old girl, sitting on a bench.  She is fixing her hair, waiting for her boyfriend.

 He arrives.  They talk earnestly.  Biting her lip, Deborah watches. She gets lost in them, which calms her enough to continue.

“Remember the time I had that flat tire with them in the car?  Lisa was about six.”

“No.”

“AAA? I had a fight with you that night?”

“Right.”

“I never told you the whole story…” She has his attention. 

“I was screaming at Richie and Lisa to stop fighting, I got out.  Opened the trunk.  I couldn’t find the jack.  Meanwhile the back door opens. The traffic is buzzing by.  I screamed.  “Close the door.  Close the door.”  Lisa steps out anyway.   ”Get back in the car.  Get back in the car.”  She just looked at me and understood everything. I didn’t have to fake that I knew what I was doing.  I couldn’t fake it.   She knew that I didn’t.  But she also knew it was going to all turn out OK.  I wasn’t going to let anything bad happen.  Lisa and Richie used to get that from me.”

She smiles, “Lisa pushed her body against the car and slipped over near me at the back.  When she was close enough she stood next to me,  “Mom.  Call AAA.”  She ignored that I didn’t  know what to do because she did. Or thought she did. Either way it didn’t matter. She knew I wasn’t going to let anything bad happen.  Lisa and Richie knew that. That was my job.  I was good at it!” Again tears.

 “Sorry about AAA.” 

“It’s okay, Michael. We didn’t have much money back then.”

“Yeah but you were pissed about it and you were right.”

“Well you said no.  I wasn’t going to let you get away with that.”

She refocuses.  Her voice changes. “I understood.  We had to economize.”

“ So okay we agree?”

“Yes.”

“One more time like this morning and we are out of there.”

Her relentlessness!  “ No we are not agreed.  We’re going to do whatever Dr. Clark says.  We have to.”

She screams at him  “Clark doesn’t give a shit.  It’s just a job to him.”

 He shouts louder than her.  “You said that already.  Clark tries to do his job right. That’s enough.  That’s plenty.”

There is a trace of resignation in her voice. They are both exhausted, and saddened by their inability to get to the same page.   Lately that’s how it’s been. 

She trails off “If we’re not going anywhere, he better admit it.”  She mumbles,  “Fuckin’ Clark’s’ ego.”

            She pours scotch into a large glass, fills it half way up.  She sips a little, then downs it.  She stares down Michael’s disapproval.  She knows at this moment she has become a typical shiksa in his eyes.  She’s not sure she can forgive him for putting her in that box.

“You think your praying is any different?  You think you’re gonna get a miracle here?”

She downs another, then continues.

            “You think God listens to your mumbling? He’s old Michael. He needs a hearing aid and better glasses.  Because if he hears okay and sees okay he’s definitely a sadist.”

“Shut up. Debby”

 In his room Richie turns up the volume on his video game.   It fills the entire apartment with its pounding, its laser gun screeches, grunts from splattered monsters as they are gunned down

Despite his game’s battlefield noise he can still hear parts of his parent’s fight, the anger, the “shut ups”.  He turns up the volume of his game still more, to the point where it is now banging on everyone’s eardrums.  It pisses Michael off.  He says nothing.  The action gets more furious.  Deborah shouts from the foyer.

“Richie do your homework.” 

          Richie shoots a mutant alien. A loud groan.  Deborah listens more carefully.  There is no letup in the action.

        “Richie.  I mean it,” she shouts to him at the top of her lungs.

Michael goes to his computer.  He checks the football score.  The Jets lost.  He gets back to work on his novel about Cornelius Vanderbilt.  This man always won.  Always! Michael is blessedly absorbed within minutes.

 

Chapter 6

“Good news.”  Michael announces.

“You talked to the oncologist from Sloane Kettering?”

“The tests are in.  She’s a candidate for a bone marrow transplant.  There is a doctor in San Francisco, Dr. Berenson, who specializes in Lisa’s type of lymphoma. He’s had great results.  They’ll have to radiate her to kingdom come, but-”

“But?”

“But it will be worth it.”

“She’s not going to get sick from it?”

“She might, but this has a chance to make a big difference.”

“Cure?”

“Who knows?  It’ll give her years.”

“How many?”

“Years he said.  Not months.  Years.  He wasn’t promising but he thought the odds were better than average.

A week after she is discharged from the hospital, Deborah and Michael fly out to San Francisco with Lisa for her consultation with Dr. Berenson.  There is still a chance that he will decide Lisa isn’t a good candidate. 

In contrast to the hopelessness they have gotten used to in New York, Dr. Berenson has given an upbeat tone from the very first phone call. The message on his answering system is welcoming.  His secretary’s attitude is completely unlike the usual in New York.  Because she was busy she took their number and said she would call right back.  She did.  Five minutes later.  She wanted to know how everyone was doing.  She, like Berenson, is from Michael’s old neighborhood in Queens.  She wanted the latest gossip.  More of the same from Dr. Berenson. 

Dr. Berenson is from Queens Village, a mainly Jewish lower middle class garden apartment development that has produced many good doctors.  Carol, Dr. Berenson’s oldest brother’s wife, knew Michael in junior high.  They went together for two weeks.  That connection means everything to Deborah and Michael.     Lisa is finally  being treated as an actual person.  That’s the key thing.

They ask each other whether they are deluding themselves, grabbing at straws.  They don’t know. But the difference between him and the New York doctors is crucial. They can hand over the care of Lisa to someone they trust.  They had begun to believe that the medical profession had very few actual humans.

 The hurry up style of their doctors in New York has left its mark.  The quick answers expected of them, the frozen stares whenever Michael interrupted the doctors with a question; all the New York doctors seemed to have perfected their main message.  Their time is extremely valuable.  Don’t gum matters up with dumb questions when they could be using that time to take care of another patient with far greater need. Fair enough.  Except Deborah has seen Dr. Clark totally relaxed, gabbing in the cafeteria shortly after he’s given her his well-practiced ‘my time is valuable’ look.

“It pisses me off.”

“Debby.  You can’t expect hematologists to suffer along with their patients.  They couldn’t do what they do for very long if they got personally involved with every patient.  Two or three and it would be lights out for them.”

“I’m not asking for that.  Well maybe deep down I am. But maybe once in awhile, some sign that they care a little, a softening in their eyes, even if they fake it?  The fact that they are making an effort to do that would be plenty.   It would communicate something besides their impatience. I feel like I’m a chore to get out of the way.  The quicker they deal with me,  the better. 

If they questioned themselves closely they would realize a caring doctor is nice but it doesn’t improve Lisa’s outlook. That doesn’t occur to them. Merely having Dr. Berenson look out for Lisa changes everything. They don’t have to think over what their doctors are up to and whether it’s the best option.  That’s Dr. Berenson’s job.  If they have a thought about it they can ask Berenson.  And he will cheerfully take the time to explain. The difference is profound.

It means they can rest for a while. They don’t have to desperately search for answers.  It makes them less paranoid.  They don’t have to find villains everywhere that they can blame for their misfortune.

 Their eyes light up when they repeat conversations with Berenson.  About important things.  For instance all of Lisa’s knock-knock jokes have gone over well. She has some good ones.  New ones.  And Berenson appreciates them.  He’s delighted by them.  It affects the whole family

Lisa is quick to pick up on her parents’ good mood.  She’s like Harry. His tail starts wagging as soon as he senses someone in the family is cheerful.   He wants to play.  Deborah and Michael are suddenly smiling a lot and so is Lisa. Real smiles.  Not the pasted on variety that Deborah has perfected.   

Attempting to not burden Lisa with her own misery, Deborah acts cheerful with her.  She cracks jokes, unfunny jokes, which would be all right, boring but all right. Only on some days Deborah’s tries so hard to be cheery, that it becomes a strain on Lisa.  She can tell when her mother’s in trouble.  When she needs comforting.  And she’s stuck.  She can’t simply step out of the mood laid out by her.  She hates the whole charade, how screwy everything gets when her mother tries too hard.  Last week there was a lesson for all of them.

In the middle of one of those forced smiles, Lisa broke into tears.  She cried hard. Deborah hugged her, and kept holding on.  That brings tears to Deborah.

“You don’t have to try so hard.  Simply be the way you are.  If you feel bad you feel bad.”

  That make them cry still harder, but in a good way, a ‘we’re in this together’ cry.

 “I want you to always let me know what’s going on.  Be real with me.”

 Deborah holds her still more tightly.

  “Promise me.”

   “I promise.”

    “Mean it!”

     “I promise.  I promise”

    “You cry when you need to cry.  Promise me.”

     It felt like they had turned some kind of corner. For days after, the mood was a thousand times lighter between them.

 Until disaster struck.  Three day after the promise, Lisa cried per their agreement. But, Deborah’s emotions completely flew out of control. She choked. Inconsolable sobs took over.   She couldn’t stop.   She didn’t want to stop. Lisa had to find a way to comfort her.

One might think that was the last thing Lisa needed. But it actually was a good thing. Simply soothing her mother was easier than the exhausting convoluted behavior usually required.

The only problem was that neither Lisa nor Deborah’s pain dissipated as it might have after a good cry.  They both knew this was more.  Neither mattered, the strategies and stances they’ve instituted to try to control their side of the battle with the illness, or the straight forward behavior they were trying to adopt.  They had reached a point where strategy made no difference.  It was noise.  Michael’s pal at work, his managing editor Joe, told him the secret is learning to flow with life.  Acceptance.  Not winning.  “Go with the flow.” Joe’s not capable of actually practicing his Eastern philosophy.  He’s a go getter guy.  It certainly doesn’t help Michael.  Or Deborah.  They can do it for five minutes.  That’s it.  Neither silence and simplicity, nor their noisy determination to not give in, is better than the other. Lisa’s illness is progressing.

San Francisco gets them away.    The Bay area is where Deborah and Michael met and fell in love.  Somehow retracing those happy steps with Lisa means a lot to them.  They are bringing Lisa to visit their old stomping grounds in Berkeley.

Lisa drinks it up, soaks in their happiness. Her energy reappears. 

In San Francisco they take her on a cable car.  On a May afternoon, the light bright, almost white, the view of the bay below, the clanging bell, as they descend towards the bay, the cables grinding underneath the car.  So far, Lisa’s barometer for an amazing experience has been Disneyland. This is not Disneyland. It’s the real thing.  The wind blows on her face- a cold wind, but Lisa, bundled up in blankets, feels braced by its freshness. Her eyes sparkle.

 Michael is over the top.  The only way he can get to anything resembling cheerfulness is to push his way there, chase it with gags or his usual supply of animated ideas.  His psychiatrist calls it a touch of mania. The way you can tell is his mood is not contagious.  It comes across as what it is, desperate, not really connected to the other person.  Lisa can take it in small doses, which is all she gets, so it is fine with her.   But he irritates Deborah when he gets that way.  The acid test is their tried and true barometer of their moods. Harry doesn’t wag his tail when Michael is presenting himself as happy-happy.

When Deborah thinks over the reasons for Michael’s enthusiasm, she forgives him. But the love she experiences with that thought lasts as long as the thought lasts.  Which isn’t very long.   The majority of their time together, Deborah is again and again, irritated by Michael.

  “Too much noise.”  Deborah complains.  He has no choice. It’s the only thing that works for him.

 They go to Chinatown for lunch, settle into a restaurant halfway up a steep hill. The Russells sit at a table by the window.   Their bodies are below street level, while their heads and chest bask in the sun shining on them.  Lisa is chilled. Deborah takes Lisa’s hand and rolls her fingers in her palm.  Lisa’s teeth are chattering.

“Hot and sour soup.” She tells the waitress. “Could you bring tea right away?”

The tea arrives almost immediately, and the soup not far behind. Lisa puts her hands around the cup warming them.  She sips slowly.  Gradually she recovers.

However, when the food comes Lisa doesn’t eat much of it.  

“I’m not hungry.“

“Here let me put this on your plate.” 

Deborah  watches as Lisa pushes the food around, picks with her chopsticks, but puts nothing in her mouth. When she finally nibbles a few times, she puts her chopsticks down. She stares at the table. 

“Try the chicken.”  It’s got this sweet sauce.”…

Lisa doesn’t try the chicken.  But she drinks a lot of tea, which Deborah sees as a good sign.  For months she has tried to get Lisa to drink green tea.  And now she seems to be following her mother’s advice.

  Michael is skeptical of her effort.

“She’s just drinking the tea to keep warm.”  Michael has had three cups himself, something he never does at home. All of them can still feel the chill from the cable-car ride.  He’s not crazy about the taste of the tea, but the warmth feels good going down and radiates outward into his chest.   

Lisa keeps sipping. 

“I love this tea.”

“It’s sweetened by a flower, jasmine.   In London most Chinese restaurants serve jasmine tea.  Remember Michael?”

He doesn’t answer.  Deborah squeezes Lisa’s hand,  “We’re going to take you to London as soon as you’re better.”

She knows her mother’s promise is empty.  Her mother tells her about a lot of nice things, which don’t really register as actual promises,  but she is still pleased that her mother is wishing nice things for her, and tries to imagine them.

 “So you like green tea?” Deborah asks.

No answer.  She has to go to the bathroom.  Deborah gets up and helps her find it.  She returns to the table keeping an eye out for Lisa’s return.

Deborah smiles.  “She really loves the tea.”

“I still say it’s because she is cold,”.

“Lisa could have had hot chocolate.” 

“With Chinese food?”

The incongruity of chocolate and chow mein silences Michael.  She’s won this round.

 Since their troubles began to weigh hard on them, winning has become important to both of them. About stupid things.  They‘ve acknowledged to each other how silly it is. They’ve promised each other and themselves that it will end.

 But It doesn’t. They keep quibbling.  Some of the disagreements get carried over day to day.  When new evidence is found, for one or the other positions they have taken, it is brought up without a moment’s hesitation, Some times, a week after the original disagreement, new evidence is presented.

What difference does it make for Deborah to recognize that Michael was right all along?  What difference does it make for Michael to recognize that Deborah was right all along?

Theory 1.  Pitted against Lisa’s illness they are in a losing game, so winning at bickering is a satisfying contrast.  Even if the feeling doesn’t last more than a moment.  

Theory 2.  No theory 2.

 No Theory 3

Lisa is able to ignore their bickering.  Richie is ravaged by it.   Tail down, Harry slinks out of the room when things get tense.  Lisa’s ability to  tune out has always been one of her gifts.  Richie, on the other hand, goes into competitive mode.  He stays in the room rooting for Deborah. When she is upset from one of Michael’s arguments, he hates his father.

They wonder if it was a mistake to not bring Richie to San Francisco.  He would have liked the cable car.  And the moo goo gai pan they are eating would have been a big hit with Richie.  He would have given it a 10.  Moreover, for once It would have been nice to be in a good mood when they are around him.  There has been so little of that.  On the other hand, staying behind, he gets to have a needed vacation from Lisa’s illness and the effects it is having on the family.

Michael stuffs a dumpling into his mouth and gets up from the table, taking off while they remain eating.  The plan, after lunch, is to go driving. The rental car office is 2 blocks away.

“Are you tired?”  Deborah asks Lisa.

She shrugs.

“Are you tired?”  Deborah repeats, although she can see Lisa is. 

“Just sit here and watch for Daddy.  He’s coming back with a convertible.”

 “He is?”

“He told me!”  They smile at each other in anticipation.

 

Twenty minutes later, after Lisa has had 2 more cups of hot tea, a green Mustang convertible pulls up in front of the restaurant.  It’s still sunny and the temperature, now 61, is supposed to warm further.  Or, at least they hope it will.  With the heat blasting, and two blankets on Lisa they ride down Lombard Street.  An hour later they are walking through Muir Woods. 

Lisa has always loved the picture of Deborah and Michael in Yosemite, young and wildly in love, Deborah waving happily from the front seat as Michael drives his old black Ford Galaxie convertible through the center of a giant redwood.

“Try to see the top of this redwood.”

Lisa cranes her neck and looks straight up trying to see the top of a redwood next to her.  The top is so far away she is can barely make it out.

“See what I mean?” Michael says excitedly.

She smiles.  She decides to lie down on the ground to get a better view.  Deborah gets down on the ground with her.

Mission accomplished he extends his hand to both of them.  “Come on.” he says as he lifts them. He helps them brush off the leaves from each of their jackets..

They begin to walk again. Holding on to a tree trunk that had fallen, they climb up an incline, soon finding the path they had been on.

“Where’s that tree you drove through?” Lisa asks.

“Not here.  It’s in Yosemite, but these are redwoods just like the one in the picture.”

“I want to drive through that same tree.”

“That’s why we took you here.  To show you redwoods.”

 “They’re 2000 years old” Michael adds proudly.

“When you’re better we will come back to California and we’ll drive through that tree in Yosemite.”  Deborah tells her.

“In a convertible?” Lisa asks.

“With spoked wheels.” Michael adds.

Debby takes Michael’s and Lisa’s hand. She holds them to her bosom.  

“A promise.” Deborah declares in a tone suitable for a sacred prayer.

“A promise!” they say in unison, which is a new ritual they’ve created, somewhat like blowing out birthday candles. Get all the candles and you get your wish.  Say “promise” in perfect synchronization and…

They leave Muir Woods and head north on U.S. 1, high over the ocean, taking the curves.  Deborah drove with Michael on this road repeatedly during their courtship, driving to Stimson Beach and beyond, in that same black convertible.  Once they drove north all the way to the Russian forts.  It was thrilling.  In their memories it seems like yesterday.  Deborah was relaxed and young. 

No longer. Michael has been driving carefully.  He’s not even coming close to the edge of the road.  Yet she is more afraid than Lisa that they will go plunging thousands of feet below into the ocean. 

Lisa’s excitement puts off her afternoon somnolence. But then, as the sun has begun its decline, she falls asleep on the way back to San Francisco, her head cradled in Deborah’s neck in the exact spot she used to find years ago.

It has been a long time since she visited there.  As a little girl she cozied up often. When she stopped Deborah missed it but understood.  Lisa didn’t like to be crowded falling asleep. She was growing up.

Now she’s back. When Deborah nursed infant Lisa she was in heaven. Lisa hungry, then the satisfaction Deborah got from being able to satisfy her completely. As she got older, she had similar feelings whenever Lisa needed something and Deborah was able to give her what she needed.

“Having children is the most meaningful job I’ve ever had” she used to announce at parties, anticipating that some feminist might bully her for only being a mother.  She resented the pride this one woman, in particular,  had for having a career.  She suspected the job might have been motivated by a desire to score points at a party

Deborah has relished every minute of Lisa’s return to wanting physical contact.  Understanding her baby’s vulnerability and protecting her gave her satisfaction.  She derives similar satisfaction from their recent physical contact even though Lisa’s vulnerability comes from a very different place.  Although not completely different. Lisa was a healthy infant, but for at least a month or two after she was born, Deborah had a sixth sense that she was fighting to keep Lisa alive.  She feels blessed when she sees relief and appreciation in Lisa’s eyes, even if it is only for now.  Now is everything. 

Back in their hotel room they unwind.  Michael’s mother’s is staying at their apartment to take care of Richie.  They call home.    Richie’s in a very good mood, having just had milk and his grandmother’s brownies.

“You like her brownies?”  Michael asks Richie.

“Yup.  I ate the nuts.  Now I like nuts,” he says proudly.

“What about her stuffed cabbage?” 

“Now I like stuffed cabbage too.”

Michael smiles.  He knows his mother’s food very well.

“Really?”

“I like her stuffed cabbage.”

“With rye bread from Cake Box?  Did she buy you an éclair.”

“Yup.”

“Mommy will learn how to make stuffed cabbage from Grandma.  Then you can have it at home.”

“Is Lisa there?” Richie asks.

“Wait.  Let me put her on.  By the way, good news- the doctor said he can make Lisa alright again.”

Lisa grabs the phone.  She has a big smile. 

“You like stuffed cabbage? Yuk.”

“It’s good.”

“If Mom makes it…” She looks at her father.  “I’m not eating it.”

Michael puts his hand on the phone.

“Let Mom talk. “ He hands the phone to Deborah. She puts it on speaker phone

“Richie?”

“I like stuffed cabbage.  And grandma’s spaghetti.”

“What kind of spaghetti?”

“I don’t know.  From the night before.”

“Fried in butter?”  Michael says loudly.

“I think so,” he says tentatively.

“I know how to make that.” Deborah tells him.  “I’ll  make it for you.  Did you do your home work?”

“Yup.”

The mood carries over for weeks after they get home.  They untangle.   They find nothing to argue about.  No points to win. They are pleased about that.  Their new found cooperation continues even after bad news, a call from San Francisco.   Their insurance company considers bone marrow transplants experimental. 

“They won’t pay for it.  Berenson will discount his fee but we’ll still need $160,000.”

“One hundred and sixty thousand?”

“One hundred and sixty thousand.”  She looks him in the eye.  “We can sell the coop”

“Our coop is quadrupled mortgaged already.  We’ll get nothing.”

“I don’t want to discuss it.”  Deborah declares.  “If we have to be in hock for the next 10 years.  That’s what we’ll do.”

“20 years.”

“We have no choice.”

“I know.

There is still worse news awaiting them.  Richie’s bone marrow is the only match.   They will have to dig the marrow out of his bones.

There can be no worse martyr than Richie.  He goes nuts over a little needle when he gets his flu shot.  A couple of times, he couldn’t be found when it was time for his yearly shot.

At first he refuses to volunteer.  They will have to find someone else.

That doesn’t last. Michael doesn’t actually say anything when Richie refuses to volunteer but the look of contempt he gives him says it all.    When Deborah tries to cajole Richie the result is tears. 

In the end, however, Richie has the procedure done on him.  He makes hardly a peep, even as they scoop out his marrow.  He’s drugged enough to feel nothing. 

After the procedure, Michael is with him.

“You know Lisa lets out a few screams when they do things to her.”

“That’s not true,” Richie answers.  “I’ve never heard Lisa scream.”

“Maybe,”  Michael admits.  “But you could have, if you needed to.”

“I didn’t need to.”

For weeks after, Richie plays Duke Nukem on his computer louder than he has ever played it.  On the bright side, however, he automatically turns down the volume when Michael is home so they have fewer confrontations.  His defiance of his father has toned down, No reason for it.  Michael’s new found warmth for Richie, following his marrow transplant (it is the first time Richie has made a sacrifice) greatly lessens the tension between them. 

While his father is gone at work, however, Richie blasts the sound.  Deborah isn’t bothered at all.  She never has been. 

 

Chapter 7

Blood sprays all over the video screen, blood the manufacturer has gone out of his way to make look syrupy  and just the right red color.  Real blood flowing on the screen.  The alien dies.   Another one appears and is immediately out to kill Richie.

 Five years have passed and Richie Russell is still playing Duke Nukem.  More often than anyone else at his school.  He is a big, strong, sixteen year-old.  He is  on fire when he plays his game.  He loves the souped up version they have at Pizza Palace.  Pizza Palace has another lure. Marlene Schneider comes to the palace every day after school for a slice.  Marlene Schneider is unbelievably beautiful, a Natalie Portman look alike, but shy and soft like Natalie Wood was in Splendor in the Grass.  Michael played Splendor in the Grass for Richie.  Getting him to watch DVD’s has replaced watching the Mets as essentially the only thing Michael and Richie do together.  Even then, increasingly, Richie is finding excuses to not watch Michael’s latest serving of classical movies that he has aimed at improving Richie’s soul.

Richie decimates another mutant on the screen. On to the next screen. Duke Nukem’s death cries, part lizard, part bird screeching- Richie likes the sound of it.  He can imitate it. They play the game almost as loudly on the giant TV at Pizza Palace, as Michael plays it at home.  Michael rules Duke Nukem  not constantly, or it would get boring.   But often enough.   He bangs at the controls, killing and killing.

“Hey Richie!”

Dora and Elisa have been after Richie for months. 

In unison they cackle. “Richie!”  They smile at each other, pleased by the synchronization of their voices, the result of dozens of other nasty hellos they’ve thrown at him.  “Richie” they repeat, their voices louder and up an octave.   Fortunately he is easily able to ignore them.  The game has him.

He shoots wildly, recklessly, but often enough accurately.  Knocking out the aliens one by one is the most enjoyable part of his life.   The one place where he’s a force to be reckoned with.   On line, when he plays the game, his screen name is Yoko, a mysterious stranger, who could go loco at any time and kill his fellow game players.  He’s only done that once.  Usually he is a dependable ally, focused on the aliens. But there is a menacing quality about his on line presence, that his fellow gamers can’t entirely ignore.

Normally, once he beats a game he is bored by it. Not Duke Nukem The alien replacing the just killed alien is totally new, with new tricks...  Five years and the aliens have never stopped coming, never stopped screaming their death cries.  Since Lisa’s death “kill or be killed” in the form of this game has been the only thing that that seems real.  He’s not wholly engaged by anything else.  To a casual onlooker he walks and talks his way through lunches and dinners, the school bell and the locker room presentably enough, but he is not there.  Inside, where he is living, he is like a zombie.  Noting gets through to him.  Playing Duke Nukem is the only time he feels engaged  what is happening to him.     

In one sense he is no different than tens of millions of people watching TV. Adolescents everywhere need a steady supply of violent victory over a villain that scared them in the beginning of the program.  Good food, fed to a growing boy day after day, week after week, year after year is necessary to maintain the boy’s health.  Being fed stories in which the villain gets his comeuppance are just as essential. Particular heroes might change or the villains and the plot twists might be new, but the basic story doesn’t vary. Life is hard.  Invariably villains appear. Most human beings need victories in a greater supply then life serves them. Duke Nukem is merely one step beyond that.   TV shows ends with victory and you move on, feeling a measure of closure.   Duke Nukem  villains are constantly resurrected.  They keep appearing and never go away.  If you are Richie you are doing very weil indeed.

“Richie… Dick… Dickhead?  What’s the matter?  You don’t like girls?”

The two are now three.  Betty has joined Dora and Elisa.  They distract Richie long enough so that an alien mutant gets him.   The noise is horrific. YOU’RE DEAD   flashes on the screen.

Dan, his buddy since the third grade, moves alongside him.

“C’mon. Let’s get out of here.”

Richie and Dan leave the shop without looking back.  As Richie leaves, the girls stick out their chests triumphantly.

 Dan and Richie walk the sidewalks.  Dan struts as he passes Marlene Schneider. Richie’s eyes go straight to the ground.

 “You’re bringing that shit on yourself.  Richie. They’re giving it back to you.”

Richie only half hears him. Marlene Schneider’s image is still working its way through his brain.

“I’m just playing my game and suddenly they’re all over me…”

“That’s because you look angry. People think you don’t like them. When was the last time you actually smiled at someone?”

“I don’t want to hear this bullshit.”

“Well maybe you have to hear it.”

“What, that I hate everyone?

“You don’t hate everyone.  You hate a lot of people, but not everyone.”

“Thanks.”

“Well it’s true.”

 “You are a pain in the ass.  It’s not that complicated.  Most people don’t like me. This afternoon was typical.”

“Those three.  They’d like you in an instant if you gave them half a smile.  A quarter of one. You’re a good looking guy.  That’s all it would take.”

“I don’t want to fucking walk around with a smile.  You do it.” 

“Try it.”

“Fuck you.  I’ve tried it.  I can’t paste on a smile.  It’s bull shit.  Everyone can see right through that.”

“So fine.  Be a grouchy ass hole.”

“You think I like being grouchy?  You don’t think I like a few  laughs.  I’m just grouchy when I’m grouchy.”

“Which is most of the time.”

“And you think I like that?  Why can’t people leave me alone?”

“Everyone already leaves you alone.  I don’t see you exactly having a great time.”

“Fuck you man.” 

Dan grabs Richie’s arm and turns him towards him. 

“After Lisa died we all wanted to help you.  That was rough.  But it’s five years man. Five years” His voice goes up a notch.  “Get over it. Stop feeling sorry for yourself. Poor Richie. Poor Richie.”    His voice raises, “You enjoy being miserable.”   

“That’s bullshit.”

“I’m just telling you.  That’s what everyone says about you.  You’re Mr. Gloom and Doom.    The walking dead!  Move on.  Get on with it.”

Richie pulls his arm free.

“You can all fuck yourselves”

“Me too?”

“Especially you.”

Richie puts his hands in his pocket and walks away. Without  turning around he calls back:

“Just stay out of my business.”

As he gets a block away his mind returns to Marlene Schneider.  It bothers him that he is he so shy.  He’s afraid she’ll catch him stealing a glance.  Once, just once, 3 months ago he looked straight at her.  Hungrily.    He thought she looked back at him half interested, but he wasn’t sure.  At this point he’s replayed that moment again and again.  Only now what he wonders is if she caught how hard up he looked.  Did she notice? There is only a sliver of hope that she in fact liked being looked at that way.

 He can visualize the two of them passionately kissing each other.  He’s tried to imagine her naked.  He can’t do it.  First base.  It’s as far as he can take it, but that is plenty.

 

 

Chapter 8

H.R. removes his diplomas and awards from the wall of his Hartford Connecticut office and puts them in a box. He is 63, a man of his times, old school Dartmouth circa the 1950’s.  Making his final check of the room to see if he has missed anything, his eyes rest for a moment on a brass LIBERTY MUTUAL INSURANCE sign sitting on his desk. He picks it up and digs his fingernail into a discolored section. He takes out his handkerchief to polish it.  Not completely satisfied he puts it down.  He remembers the first day he arrived in this office. He felt on top of the world. He dials his wife.

“That just about does it. Twenty-three years in this room and…” he looks at his cleared off desk.  “In ten minutes it will be as if l I’ve never been here.”

Mrs. Rutherford speaks commandingly.  “H.R. I won’t hear that kind of talk.  You’ve given Liberty everything you have. They know that. Take a look at those awards. The insurance industry recognizes you as a giant.”

“Some giant. The merger had one purpose, clean house, get rid of the dead wood.  This giant is being put out to pasture, spend the rest of my years putting on greens.  I don’t even like golf.  And don’t tell me about ceramics.  I’d hate that even more than golf.”

“I won’t have you feeling sorry for yourself.  The same thing happened to Jack Elkins and you were the first one to tell him he hadn’t done anything wrong. I spoke to Linda.  They are the happiest they’ve ever been.  Jack has time for his grandchildren.  They play golf twice a week.”

“Sounds wonderful,” he says sarcastically.

“You’re going to make it twice as hard on yourself, if you become a sour puss.”  She has commanding tone.  Like the discussion is over.

     “Give me time. I’ve had a pretty long run.  I was lucky. It takes getting used to.”

    “I know.”  She says sympathetically.

     “ Listen I’m just about done here. I’ll be home in a half hour”

H.R. hangs up.  He walks over to the window and looks out at the skyscrapers.  The Travelers, Aetna, Connecticut General, The Hartford; insurance companies built this city.  And he was one of them.

Over the years, whenever things got stressful he would look out at the skyscrapers just as he is doing now.  It would calm him.  Even today, looking out at them brings half  of a smile.   Being head of one of the majors was far more than he had expected.  He’d come a long way from his parents’ grocery store in Minnesota.

When he graduated from Dartmouth with not the best grades, he felt lucky to find a job, any job, but what he lacked in college- he didn’t have a smidgen of curiosity about the deeper layers his professors liked to probe,  at Liberty that was a virtue.  He stuck with the obvious.  Nothing fancy.  After he got some momentum going, his practicality and hard work brought him to the top.  Joe Lempel, head of Sun Mutual was from Chicago, from the other side of the tracks.  He really deserves credit.  Tom Leyland was from a small town in Maine.   Actually only one of the heads of the majors was from Connecticut and he was from Waterbury, Bill Segur.   But they all belong to the same country club. Except for Joe Lempel, they go to the same church. The always impossible 2 iron has been mastered by none of them, as it should be.  It would strain the collegiality of the foursome to have one of them break out, and be ready for higher level partners and competitors.

No one  pushed too hard for the other’s business.  They existed in parallel fiefdoms, each governing their own territory, their own investments, culture, and their buildings.  If the policies varied little from one insurance company to the other, it was not because of lack of creativity.  It’s because they pretty much agreed that the identical policies they offered were the right policies.  It did the job for the insured, and if wisely priced, satisfied insurance companies’ need to receive adequate compensation for their work.

The industry he is leaving hardly resembles the one he knew.  Liberty has the same name, but it will not be the same company.  Most of H.R.’s senior associates, and a good portion of the juniors are being forced out along with him.

He keeps staring at the buildings.  He likes Hartford, or used to like it before it went the way of other American cities in the 70’s. He has learned to look past the street scene.  For him, even now, the real Hartford is the city he came to in the 50’s. It struck him right away.  Hartford people reminded him of the people he knew growing up, old time Minnesotans, orderly, soft spoken and hard as nails.  They went to Church and didn’t talk about it.  They weren’t that interested in how smart someone was. They simply knew what was right, and could identify fine upstanding people, doing what everyone, but the drunkards, considered the reason we were placed on earth.

H.R. had grown to love his version of Connecticut.  Even before he moved to Hartford he loved Katharine Hepburn. He would never admit that his schoolboy crush was a part of the reason that, as a young man, he came to Hartford in the first place.  He had a fantasy that he might meet her.  Now he can smile at his foolishness, but, like most men, when they are young, his fantasies kept him eager, gave him purpose. Excited him!

 Only recently did he admit to his wife that his crush on Hepburn was part of the reason they got a summer cottage in Old Saybrook.  He thought there was a chance that their paths might cross.  His wife got a chuckle from his admission when he told her.  They had recently been exchanging many of their secrets.

Katharine Hepburn was born and bred, shaped entirely by Hartford assumptions.  Strongly held beliefs, polished by private education-it was less about what other people have and more about what you have to do.   Los Angeles excited Ms. Hepburn, as did New York, and she was no saint, but she never questioned where she wanted to eventually be, where she felt she belonged. She never questioned the rules she lived by.  Like other show business people she might have broken too many rules, but she didn’t doubt them. The rules were the rules.  She was morally certain without a hint of self-righteousness.  No speeches, no political rant of any kind proclaiming the good and denouncing the bad.   It wasn’t her that was good.   It was her principles.  She might or might not live up to them. But they were a given, instilled at an early age, and silent. But everyone knew, and she knew, they were there and what they were. Their absoluteness was the secret of her toughness, the rod in her back, the steel certainty of her gaze.

  Mark Twain lived in Hartford for close to twenty years.  He lived next door to Harriet Beecher Stowe up on a hill, in a lavish home with many servants. Huck Finn and Tom Sawyer may have brought him fame, but Twain liked to act the part of a gentleman.  Some of the first insurance companies began here.  Not that Hartford was unique in that way.  There were companies all over America willing to gamble on the possibility of others’ misfortunes.  But Hartford’s companies flourished.

 There was a good reason.  To an outsider the abundance of prep schools in Connecticut is some snob waspy thing.  But it isn’t that simple.  Yes there is as much snobbery here as elsewhere, probably more, and a lot of it isn’t pretty, but the pride of the locals is not based on showboating. The opposite. Connecticut is about quiet values, never discussed beliefs.  No fancy rhetoric (the surest sign of someone trying to sell snake oil).  Everyone knew what was expected and lived by them.   And if, like everyone else, you occasionally broke the rules it was kept very private.  You didn’t mess around.  A scarlet letter could not easily be washed off. It is the very opposite of the South where evangelical rhetoric is so spectacular, where Clintonesque poets of God declare everyone saved on Sunday morning after a wild Saturday night. People from Connecticut aren’t good at convincingly stringing together words that leap out of the mouth and sound marvelous.  They can admire verbal dexterity as much as anyone else, but they don’t trust people who have that quality.  Their mayors and governors are not particularly articulate.

In the old days the prep schools ran a tight ship, showers at a prescribed time with the hard yellow soap they provided, specific times when letters home had to be written, study time, time for team practice, chapel, morning to night, rigorous character building.

Yes Sir.

 No Sir.

A thousand times a day.

 People in Connecticut are often described as unfriendly, but then again they have very little practice at being friendly.  Their homes are far apart compared to city people.  Before air conditioning, in the Bronx or Brooklyn, in Newark or Philadelphia, or Boston, where the immigrants live, you could stick your head out the window and in 2 minutes you were in the middle of a conversation.  In Connecticut people are more used to spending time alone with their own thoughts.  Good fences make good neighbors.

 New England was settled by people with religious convictions, by  Pilgrims forced to flee to America.  It’s a part of them.  Certain things are a given.  The rules don’t change. They can’t change. “What are we, if we are not guided by principles,” New Jersey’s Woodrow Wilson might have woven that into a speech.  Katharine Hepburn would not have given that speech at all.   It wasn’t up for discussion.  The less said the better.

So it wasn’t coincidence that Hartford was once America’s “insurance city.”  Its companies’ reputation as reliable insurers emerged after the calamitous New York City fires of 1835 and 1845, when Hartford companies fulfilled their payment promises, while many others didn’t.

H.R.’s buzzer goes off.  The temp. He gave his secretary the week off.  It is bad enough that he has to clean out.  She, at least, can be spared the grisly process.  Before he can respond to the buzzer there is a knock on the door.

“Come in.”

Martin MacDonald, the new CEO, and Leonard Birch, the new executive VP, enter.  MacDonald, fortyish, fit, a black shirt underneath a custom Italian suit, moves confidently forward. Birch lays low.

“It wasn’t necessary to see me out.”

“I know that sir. I just wanted to wish you good luck.  You’re a legend in the industry.”

H.R. stands up and busies himself organizing the things in his box.  He stands at an angle that allows MacDonald to offer his hand.  H.R. ignores it, turns his back more fully to them.  He continues to organize his things.

“Anything wrong?”  MacDonald asks.

H.R. remains with his back to them, still organizing his box.  He doesn’t answer.

 “I was just asking.”

 H.R. puts down his box and turns around.

“Look MacDonald.  We bought Cambridge Health and now you’re in charge. The board wanted that. Okay fine. But it doesn’t change anything.  You are not insurance people-never will be. “

MacDonald nonchalantly picks up the same brass Liberty sign that HR had said goodbye to.  He puts it down with no particular reaction to it.

H.R. isn’t finished, “It won’t be such easy going with the rest of our costs.  You’re going to pull the plug on the wrong person, piss the wrong person off.  You and those Germans that stole this company.”

“Hey just one minute. The Germans don’t own this company. And contrary to rumor, nor do the Arabs, and it’s not the Japanese. It’s not even the Mafia or the Jews. The people appointing the board are 100% American.”

“Whoever you are, you are 100% sons of bitches.”

 In his speculations, kept to himself, H.R. has gone pretty far.  He has heard MacDonald’s uncle is Mafia.  High up. H.R. has wondered more than once whether the Mafia had, in fact, bought into health care in a big way.  How could they not with a trillion dollars to steal?   Rumors, speculations.  No straight facts.  Not even a smoking gun.  But it would not be impossible.  They do well where there is confusion.

 It is not like the Gambino family could call up the board of the Aetna and offer to buy the company. If they were going to do it, however, with Wall Street laundering, all things are possible.  Wall Street allows enough layers of camouflage so that who owns what can be well hidden.

MacDonald can’t help himself. The chance to lecture HR is too good an opportunity to pass up.

“HR what you and your people never understood is, that in the end, it’s about the bottom line.  I can assure you this company is going to be the most profitable it has ever been.”

“I don’t doubt that.”

“That is the whole point of this operation. Isn’t it? Earning money?”

“I’ve always thought we are an insurance company.”

MacDonald amused countenance is forced as H.R. continues.

“You know it wasn’t always like this. We delivered insurance at a good price.  That was it.   That was the insurance business.”

“ The good old days, eh H.R? Except if it was so good how come it didn’t add up?”

 “You mean by the new math? H.R.’s voice rises, “ We didn’t have to squeeze every last dime we could out of the company.  We were going to be around for a while.  Our number crunchers, your buddies, you know what they did in this company?  The actuaries figured out what our rates should be based on paid claims.  That was it. We lived or died by our actuaries.  We did our books straight with actual real numbers. No spin. Just numbers.”

MacDonald’s smile switches from half polite to genuine.  The opportunity to watch H.R. rattled is the whole point of his visit.

H.R. continues. “Numbers…The bottom line… Every quarter, the bottom line? Wall Street will like this.  Wall Street won’t like that. Gamblers. Gamblers control half the companies in the United States.”

“Investing isn’t gambling.”

“Gamblers hire and fire whomever they want.   CEOs move from rubber companies, to auto companies, to insurance companies.  Don’t know squat about any of it. Doesn’t matter. They know how to massage numbers, how to make them good, how to keep the stock flying.”

“The owners of the company expect to make a decent return on their investment.  You think there’s something wrong with that?”

“Making money is one thing.  What you guys are doing on Wall Street is out of control.  Hundreds of billionaires appearing out of nowhere; just like that. Billions squeezed out of everyone else.”

“I don’t see you hurting.  Your retirement is going to leave you in pretty good shape”.

“I’m talking billions.”

 “Maybe you should become a politician, give speeches about what’s gone wrong.  Wicked Wall Street. People love that.

H.R. picks up his box. Trying to regain leverage he glares, but it is hopeless.   MacDonald stares back with a broad smile.

“You couldn’t wait 10 minutes until I was out of here, could you?”

“What do you mean?”  MacDonald continues, “You got something on your mind say it.”

H.R. shakes his head. “I used to think the problem was you weren’t raised as a gentleman.  I was wrong.  You are not fully human.”

“H.R.  We can do this two ways.  Either I call security, and they escort you out of the building or you be nice, and join the board.  You make it hard on me. I’ll make it hard on you. Believe it or not, we want the nice way. I mean that.  You’ll be great on the board…”

“Right. So Liberty can keep everyone believing this is still an insurance company…let me tell you…people are catching on.  Little by little.  Not just me, other people.”

“Look, as long as what you have to say stays in this room, fine.  Have fun.  But you won’t know what hit you if you break our termination agreement. I’ll have you working in the cafeteria. I mean it.”

H.R. tries to smile with a sense of irony, but fails. He has a pasty expression, barely covering his humiliation, which encourages MacDonald.

 “We want the nice way. You’re an honored part of our family, a permanent member on the board. We’ll send a limousine to bring you to the meetings.   If you move, the company jet will come and get you.

Or you don’t have to come at all.  Just shut the fuck up.  Be nice and we will be nice.”

H.R. walks to the door with his box.  Before he leaves MacDonald blurts out,

“Think about it.  We want you with us, not against us.”

H.R. closes the door    Martin and Lenny do a high five.  Then Martin MacDonald hesitates, sucks it in, stares triumphantly at the closed door,

“H.R. You old fart.  You got it right, watching you leave your office with that box in your hands.”

           “You’re having a good time, aren’t you?”

“Not bad.  What goes around comes around.  Fifteen years ago I walked through these doors for an interview.  Thought my Wharton degree had earned me a little swagger.  They smelled my Sicilian grandpa.  Saw the gutter.  Fuckin’ Ivy League pricks.  Gentlemen.  Mr. Dartmouth, Class of ’59.  Thought they ran the world.”

He hesitates for a breath.

“He’s lucky we let him keep his job the last 5 years.”

“Marty.  Calm down.  We won.”

“Yeah.  Well old H.R. and his buddies have been a pain in my ass every step of the way.  “We don’t do this, we don’t do that.” Well fuck you! We do do this and we do do that and we’re going to do more and more of it.

I swear he’s been working for the doctors all along.  Whatever they wanted, he handed them.  Our fuckin’ money.  Well that’s fixed now.  We pay the bills. We’re the boss.”

Birch cuts in.  “I brought some champagne. I’ll have them bring it in.”

“Later.  We got to get this place moving.  Plan A starts immediately. Call P.R. I want to see the press release they came up with for the Wall Street Journal.  Letting 5000 people go needs the right spin.” He takes a breath. “We’re there Lenny.  At the top of the list is the claims department. Those fuckers been giving away what belongs to us long enough. I don’t want a single claims person to keep her job. I only want people trained by us.”

“It’s sweet Marty.  Sweet.  Liberty is finally getting rid of the dead wood.”

“Yeah… well, get going.”

“

Deborah is lying on the sofa staring up at the ceiling, listening to Eric Clapton.  Michael returns home after a long day.  He hangs up his suit jacket and enters the living room without a word.  She doesn’t greet him. They have not made up after a fight the previous evening.

 He can smell the marijuana.  He goes to the ashtray, picks up what’s left of a joint.  He puts it back.  He goes to the kitchen, opens the refrigerator, and searches for something to eat. His eyes fix on a half eaten open tuna can with a plastic baggie loosely placed over it.

He hates when Deborah does that. He’s told her a hundred times. It will spoil and Richie might eat it.  Actually Richie won’t go near it.  But still…

“ What are we doing for supper?” he shouts.

She doesn’t answer.

He won’t be put off.  He returns to the living room.

“In case you didn’t notice you still have a son left. Lately, you’re stoned more than you’re straight.”

She will not answer when he assumes that tone of voice.

“Richie never comes out of his room.  I can’t get him to look at me let alone talk to me. The two of you feed off each other.”

“Bug off.”  She mumbles to herself.

“Deborah.  I’m talking to you.”

Finally she shouts back.  “Fine.  Everything’s my fault.  That’s what you want to hear?

“I didn’t say that.”

“But I know you think it.”

  Deborah, I remember when you used to be the strong one.  We counted on you to keep us going.”

“Things change.”

“How do we make it change back?”

Richie has put on a new CD in his room.  He’s blasting his music so loud they can’t hear each other.  So loud Michael can’t hear his own thoughts.

“That does it!”  He heads for Richie’s room and flings open the door. Richie turns down the volume on the music with his remote control.

“Yeah, what?”

Michael tries to calm himself.  He doesn’t entirely get there. His voice is still raised. But he is pleading rather than angry.

“I want you to get help.”

“What kind of help?”

“I want you to talk to someone, a doctor.”

“What’s that going to do?”

“After Lisa, I saw Dr. Stern. It made a big difference.”

“Yeah right.  Lisa came right back to be with us for Christmas.”

“Look I don’t want to talk if you’re not going to be serious.”

“I don’t want to talk period.”

“Richie. I-“

“Ya think there’s nothing wrong with you?”

Richie imitates Michael resolute but sour face.

“Fine sometimes I get in a bad mood.”

“Like maybe tonight?  Like maybe most nights?  You think you’re so easy to be around?”

“Okay fine. I’m a creep.”

“You’re just a bowl of joy.”

“Okay.  There’s plenty wrong with me. But I go to work.  Every day.  You’re failing every subject.  Your head’s always hanging down. Richie, you need to talk to someone.”

“I don’t want to talk to someone.”

“I want you to see the shrink I saw.  Dr. Stern. You’ll like him.”

“And what if I refuse?”

“You don’t get to refuse.”

Richie reaches for his remote control. Within a moment he’s again blasting his music. He falls on his bed with his back facing Michael.  Michael looks at him helplessly. Deborah’s usual refrain is in the back of his mind.  “You don’t get to be on the same level as Richie.  You’re his father.”  The 11^th Commandment, coming from  Deborah’s lips but sent from God. Michael must keep his head on straight.  Think of what he can do as a father.

He, in fact, can’t do anything.

“Fuck you Deborah.”  He thinks to himself.  “You read too many magazines.”

 “Be a Father?  Her tone of voice when she counsels him sounds like it comes from the Torah.   Behind her commandment a thousand rabbis, lined up, all  writing advice columns for her magazines.”

With a thinly layered imitation of fatherhood, he speaks like he imagines a father would lay it on the line. “You’re going and that’s the end of it.”

Chapter 10

Restlessly Michael thumbs through a magazine in Dr. Stern’s waiting room.  Richie sits slouched, low in his chair, legs spread, staring at the floor. Dr. Stern’s receptionist answers her intercom.  She turns to Michael.

“Dr. Stern’s free now. He’ll be right out.”

Dr. Stern approaches the two of them. He looks nothing like Sean Connery, but he has mastered his style when greeting new patients, a crisp, friendly, self assured professionalism.

“You’re Richie?”

”Yeah”

“Your Dad called me about you. We’re gonna’ see if I can help you.  Do you mind if I talk to your father first.  Just a minute or two?”

“No.”

Dr. Stern puts his hand on Michael’s shoulder as they enter his office.  At the height of Michael’s therapy they were close. They don’t close the door, but they speak softly so Richie can’t hear.

“You okay?” Stern asks in a fatherly way.

“Not the best. Richie’s got me worried.”

“What’s going on?”

“He’s depressed.”

“Given Lisa’s death, I’d be more surprised if he were cheerful.”

 “He’s very depressed.  There’s something more going on.”

“Like what?”

“I don’t know.  I have a million guesses, but I don’t know.”

“How long has he been down?”

“I can’t remember the last time he laughed.  I guess since Lisa, only lately it’s been getting worse.  He gets this look on his face.”

“What kind of look?”

“Sad.  Angry. Almost anything I say sets him off.  Except he says nothing. It’s just a look he gives me.

 “I think you are forgetting how you trained Richie to be a respectful son.  You were pretty forceful…Does he talk about Lisa?”

“Never.  Whatever’s going on with her is between him and her.”

“Nothing at all about LIsa?”

“He won’t mention her name.”

 Dr. Stern waits for Michael to continue.

 “I think he’s spooked.”

 “Spooked?”

 “Possessed.”

“Michael. You watch too many movies.”

“I don’t think he sees demons floating around like in a movie. He’s not spooked by a real ghost.  But whatever it is, it’s as real as any demon dreamt up in Hollywood.  Richie’s held on to Lisa so hard that he’s managed to keep her alive.”

“Does he talk to her?”

“Hallucinations?  Maybe.  I heard him talking to himself in his room.  I heard him say “Lisa.” He was mumbling but it was as if she were in the room with him.”

“How often does that happen?”

“I don’t think that often but I don’t know.  He’s in his room with the music blasting.”

“You understand it is not Lisa.” Stern interjects.  “From what you told me my guess is Lisa would have chased away any creepy spirits in any room she came into.”

  “I know.  She protected Michael.  She wouldn’t let anyone pick on him. Her mission was to protect her younger brother from the monsters.”

“After you heard him mumbling like he was talking to her, did you bring it up?”

            “I didn’t want him to think I was spying on him.”

            “Understood.”  He gives Michael’s neck a squeeze as he leads him back towards the waiting room…”I’ll see what I can do.”

That is not enough for Michael, but it will have to do.  No miracles promised. “I’ll see what I can do” is the most Michael’s going to get.  At least it’s honest.  Only half convincingly Michael tells himself, Stern has a way with patients.

“Did he agree to come today?” Stern asks still softly enough for Richie to be unable to hear.

Michael steps back in the office with him. “No.  But he’s here.  If Richie didn’t want to come he wouldn’t. I think he knows that what’s going on in his head is weird. My guess is that if he can trust you, he’d like to talk about it.  He’s made it clear that he is not going to open up with Debby or me.”

Dr. Stern steps back just inside the office.  The door is open.

“What about friends?  Does he have someone he talks to?”

Michael returns to the waiting room for a moment.  Before doing so he catches Richie’s attention.

“A few more minutes.”

 “He’s got one good friend, Dan. Since kindergarten they’ve been close.”

“They have serious conversations?”

“Yes but I don’t know how much he tells him.  My guess is he thinks that if Dan found out about his craziness, he’d drop him.”  Michael hesitates then continues  “What I’m hoping for is that he can talk to you like I did.  There’s something about not being judged that opens up everything.”

“Did you really believe I wasn’t judging you?”

“Not always, but I accepted that you were well trained, and thought certain rules were sacred.  That allowed me… ”

“We’ll see how it goes.” Stern repeats.  “If we have any luck, therapy will work for him too.”

“Hope so.”

“Send him in.”

Michael goes back to the reception area.  He stands over Richie, nervously.

“Remember. Give him a chance.”

“Sure Dad,” he says with a little too much sarcasm.

Richie goes into Dr. Stern’s office.   Michael looks around the reception room.  He opens an old New Yorker from 1991.  He turns the pages mindlessly, looking at the cartoons.  He is inert.  Every once in a while he looks up at the secretary.  She is occupied enough for him to have his privacy.  The New Yorker is the one magazine Michael pays for. He saves the stories for vacations but he devours the movie reviews immediately.  The habit is left over from the years that Pauline Kael was its movie critic.  At first he had great faith in her judgments, but he disagreed often enough so, in the end, his interest in her had nothing to do whether he agreed or disagreed with her review. He liked how passionately she felt about a movie she was writing about. Like he does.

He turns to the back of the magazine, and is happy to find her.   Probably one of her last.  She’s cutting up Disney’s Beauty and the Beast.  That sets off a memory from 10 years ago; Richie, Lisa and him watching Back to the Future, one bag of popcorn between them.  Delighted with the movie. The popcorn going back and froth between the three of them, it brought more family communion than dinner at home.

Lisa always made things fun.   It was her gift.  Her mood became Michael’s and Richie’s mood. She’d play music and Michael was soon asking for the name of the song.  When he was young he could lose himself in music.   He’d hear a song on the radio and was soon hearing it in his head; humming it or singing a phrase over and  over.  Somehow, it was one of many things he lost when he became an adult.  But Lisa enabled him to once again get into a song. He quietly hums, half sings “A Horse with No Name.”   He keeps losing the melody.  When they used to attack the song it made both of them goofy. Now, without Lisa, Michael remembers only fragments of the melody.

 He turns page after page of the magazine.   Not one of the cartoons gets a smile from him. He finds a story. No better luck.  He reads the first page over and over. With difficulty he finds the table of contents.  The New Yorker is a pain in the ass about that. He finds an Updike story. Occasionally he likes Updike. Not loves but likes.  The same thing happens.  He can’t leave his thoughts behind.  Time is moving very slowly.  Twelve minutes to go…

His reveries are interrupted by Richie.  He’s finished.

“The receptionist wants to talk to you.”

Michael goes to her desk.  He knows her from all the years he went to Stern.

Her teasing is friendly.“ I thought you were cured.  Here you are back again.”

 He shrugs, his eyes smiling sadly.

Michael enters the office.

Dr. Stern is on the phone. He waits until Dr. Stern hangs up.

“How did it go?”

“About how I expected.  He didn’t say that much.  It’ll take a while.  Unfortunately that’s now a problem. That was your insurance company on the phone. He’s only approved for 4 sessions.  Maybe we can get 5 or 6 more after that.  But then, they’ll probably force me to cut treatments to follow-up medication visits.  Once a month.

“What do you mean?”

“That’s the new model.  Everything’s a chemical imbalance.  I’ve put him on Prozac.  I have no problem with that.  Chances are it will help him feel better.  But he needs therapy and I doubt they will let him get much of that.”

“I still don’t understand.”

“We’ll speak soon.  Don’t worry. We will figure something out.”

He smiles, walks out with the doctor like an old buddy.  He tosses the keys to Richie.

“You can drive champ.”

He waits until they are on the open road before questioning him.

“So how did it go?”

“What do you mean how did it go?  I sat opposite this old guy and he asked all these personal questions.  Like I really want to tell him about my shit.”

“Do you want to see someone else?”

Richie floors the accelerator and passes a car.  They just miss an approaching van but Richie is able to pull it back to the right side of the road.

“Jesus! Take it easy. This isn’t a video game.  It’s the real thing. You could have gotten us killed.”

“Like I really give a shit.”

“What does that mean?”

“Just what it means.”

“You don’t care if you get killed?”

“Frankly, I don’t care but that’s another subject”

“No, that’s exactly the subject.”

“Look Dad. I don’t care if I live.  I don’t care if I die.  I don’t care if I see Dr. Stern, or if I see someone else, or if I see no one.  I don’t care.”

That evening Deborah is in the dark watching videos of the family.  Michael enters the house, throws down his coat. He smells the marijuana.

“Deborah, you gotta stop. You’re smoking too much dope.”

“It helps me get into things.”

“Except me. You’re so in to things I don’t even know you any more.  Where’s Richie?”

Deborah moves the images around on the screen with the remote control.  They both watch the video as she talks.

“God you were so handsome.  I wasn’t bad either… look at me.”

“Where’s Richie?”

“In his room.”

“Did he seem all right?”

The video continues.

“Remember that?  Look at you holding Richie.  He was gorgeous. Such a beautiful baby… Gorgeous! You were so proud…  Look.  Lisa’s off in the corner… Wait let me rewind…”

She rewinds.

“She doesn’t look so happy.  Look at her blonde hair.   It’s practically platinum.  God, it darkened.  She was almost a brunette…” The tape continues. “Oh there.  Now she’s smiling.  I love this part.  When we put Richie in her arms.”

The camera moves in for a close-up of Lisa.

“Look at her. Oh Lise…” The tears begin.   “You were such a good sister…”

Michael speaks loudly, “I can’t take this.  How can you look at that over and over again?”

“What?” she counters sharply. She feels betrayed.

“You heard me.”

“What do you want me to do?  Just tell me Michael.  What am I supposed to do?”

“She’s gone Deborah.”

“Maybe for you Michael.  Maybe for you.  You didn’t give a shit then and you still don’t.”

“Deborah.  This isn’t my problem. It’s yours. You won’t let her go.”

“Right. Okay Michael.”

Deborah pushes the eject button, waits for the tape then holds it up.

“Here’s the tape.  I’m going to dig a six foot deep hole and toss the tape in.  That’s what you want? You want her completely gone. You want her dead?”

“She is dead.”

“You don’t think I know that?”

“No I don’t. I don’t think you really know it.”

“Listen buddy. There is nothing I know more than that.  Nothing.”

“So then accept it.”

“I have, Michael.  I have.  I should have known I was going to get this shit tonight.  When you used to go to Dr. Stern… Every time you came home… You had the answers to everyone’s problems.  Got any new psychobabble for me?  Come on Michael.  Come on Mr. Fix-it.”

“You just want to fight don’t you?”

“You’re the one who came home with an attitude.  I got one thing to say.” She gives him the finger,  “Fuck you!”

“Actually I wouldn’t mind that occasionally.”

There is a suddenly a very loud s noise in the bathroom at the end of the hall.

They both freeze.  She shouts.

“Richie!”

Michael and Deborah immediately race there.

Michael shouts, “Richie!”

Deborah’s terrified.  She shakes the door.  Listens. Bangs the door.

“Richie. Richie!”

They hear a gasp.

The door is locked.  Michael, in two tries, breaks the door down.  Richie has tried to hang himself by jumping off the toilet.  He is semi-conscious. The pipe above the toilet, that he had tied a rope to, has bent.   Water is gushing out of a hole in the pipe soaking him and the room.  Michael embraces Richie around the waist and lifts him up to take the weight off his neck.  He struggles with the knot.

“Get a knife from the kitchen.”

Deborah returns with a big knife.   Michael cuts him down.  As he does they both fall clumsily to the floor.  In the process, Richie’s forehead is cut.  It is bleeding.  Struggling, desperately, Michael loosens the noose.

“Call 911”.

Michael is about to start CPR but then Richie begins choking and then breathes on his own, a raspy sound not yet steady.  Deborah returns.

“They’re on their way.”

 Both know Richie wasn’t playing around. This was the real thing. Deborah grabs a towel and puts it on Richie’s gash on his forehead.  She gets down on her knees on the floor and moves his head onto her lap. She watches him breath and begins to rock, holding his head to her breast.

“Oh baby. My baby.”

 Out of breath Michael quietly leans against the doorway watching them.  It is too much to bear.  He leaves.

Outside the Russell’s apartment complex an ambulance with flashing lights has attracted a crowd.  As they move Richie off the gurney and into the ambulance one of the workers stands with Michael and Deborah.

“He’s gonna be alright.  Mrs. Russell, you can come with us in the ambulance.  Sir, you follow in your car.  We’re going to Mt. Pleasant Hospital.”

Deborah gets in the ambulance with him.  They drive off, sirens blaring.  Michael is still holding the bloody towel.  He doesn’t move for a few moments as he stares at the ambulance driving away.   Then he walks back into the building, takes the elevator and returns to their apartment.  He looks for his coat. It is not in the front closet. He looks around some more.  There is utter silence except for the sound of his footsteps. He finds his car keys and leaves. Then comes back to the empty apartment, to shut off all the lights.

Chapter 11

It’s 3 AM in the Mount Pleasant Hospital Emergency Room. A well dressed 20-year-old woman paces back and forth with a young baby in her arms.  She does not have the burnt out look of a chronically ill person.  She’s very attractive, but she is obviously psychotic, talking to herself from time to time, laughing out loud, sometimes looking very distressed, sometimes erupting in anger. Leaning against a wall, a policeman indifferently watches her.  Occasionally his hand radio goes on.  Very loud, muddled staticky directives are issued by his sergeant at the police station.   A thin distressed young man, knees tightly together, looks down at the floor. Michael and Deborah sit together, taking it in.  Despite the time, they are wide awake, as are all the newly arrived patients, now waiting for what seems like forever.

 The policeman speaks into his hand radio, “I talked to the doc.  He’s saying I gotta’ stay here until he hears from the insurance company.  They’re short on security.  Says there’s been cut backs.”

“We’ve had someone there since 4 PM,” the sergeant barks back,  “Just leave.  We need you on your beat.”

As a nurse approaches him he shouts back,  “I’ll get back to you.”  He clicks the radio off not waiting for a reply.  He addresses the nurse.

“My sergeant’s getting pretty antsy.  I can’t stay here all night.”

 “The nurse, equally toughened by the ER’s usual barrage of chaos, gives him a look of indifference.  He follows her to the nurse’s station.

“There’s nothing we can do.  We can’t admit her without approval and so far they are not going along with us.”

“This lady’s nuts.  Did the doctor get the part about how there is a device hidden in her baby’s vagina?  She says she keeps looking for it.”

“He knows all about it.”

“So?”

“It’s not us.  Her insurance is giving us a hard time.”

“Meaning what?”

“They don’t think she’s a danger to anyone.  They want us to send her to a day hospital.”

“What about the baby?”

“They say that’s a problem for child welfare.”

“She’s not going to show up at no treatment program every day.”

“Exactly.  That’s why you are still here. Dr. Lurin agrees with you.  She needs to be in the hospital.  And by the way, our hospital isn’t contracted with her company for day hospital.  So, as of now, she’d be going to Beth Israel.”

“She lives on Amsterdam and 116^th.   Even if she could figure out how to get down there, it’s over an hour and a half each way, 3 changes on the subway.  She doesn’t even know where she is right now.”

“You got it.  We’re talking to people in Minnesota.  They don’t have a clue about New York City transportation. And they aren’t willing to listen.

“She should be in the hospital.”

“They have a million reason reasons why she can’t be admitted.”

“Like what?”

“Don’t ask?  It’s all crazy.”

She continues.  “We wouldn’t need you here except Dr. Lurin won’t give in. Right now we are waiting for one of their supervisors to get back to us.  We’ve called 4 times. No supervisor. They’re hoping we will give up and go away.  They do that a lot.”  She looks at her watch.  With mock astonishment she continues,  “We’re going on 8 hours.”

They get to the station.  She flips on the speaker phone.

“You want to hear something really special?  We are on hold now.”

Kenny G can be heard. A very airline cheerful voice speaks above the music.

“We are experiencing a temporary over load in volume. But please hold on.  Your call is very important to us.”

More Kenny G. Then the airline voice returns.

“Want to feel better?  Try laughter.  Having a sense of humor has been shown to increase self-esteem.  It even helps the immune system.”

The nurse smiles cynically as does the patrolman.  “They’re in charge?”

The nurse keeps smiling.

More Kenny G.

 Again that happy, happy voice.

“Do you want more respect?  Try treating your fellow workers with respect…Studies show it is the secret of every happy workplace.”

More Kenny G.

She flips the speakerphone off, “That’s where we are. Alice in Wonderland.”

.           She points the policeman to a chair.

“Better get comfortable.  With this on appeal, it’s going to be an all-nighter.”

Dr. Lurin walks out to the waiting area and approaches Michael and Deborah.  They recognize each other.  He takes Deborah’s hand.

“Aren’t you Laurie Lurin’s son? It must be 10 years.  The last time I saw you, you were four foot one.”

“I thought it was you when I saw your son’s chart.  It’s been a long time.”

She hugs him.  Her tears begin.

“Richie’s okay. No damage done. We’ve admitted him.”

“Can we talk to him?”

“We already sent him upstairs.  He’ll be okay.”

“Did he say anything?”

“Come back in the morning. You can see him then.”

The young crazy woman’s voice has gotten louder.  She is yelling at a fifty year old Hispanic man with a broken thumb, sitting with his 14 year-old son.

“You did it to my baby didn’t you?  You put that transmitter in her vagina.”

He tries to ignore her. His son is looking up at the ceiling.  They are both frightened.

Michael looks at Dr. Lurin.

“That woman with the baby—what’s going to happen to her?”

“I wish I knew. I have a situation like this almost every night, a stand off with the bastards.  Look, go home and get some sleep.  Things will look brighter in the morning.  Go home.”

They hesitate.

“Go.  There is nothing to do here.”

“Is there a diner around here?”

 Dr. Lurin can see how exhausted the Russells are.

“Listen to me. Save your energy.  Don’t stay up all night trying to figure things out.  It’ll get you nowhere.  Everything’s too complicated“  He watches them as they put their coats on.

 “Go home.  You have a long day tomorrow.”

Chapter 12

The morning after his suicide attempt Richie walks down the corridor of the ward nodding to other patients.  His neck shows scrape marks where the rope had been.  He catches the eye of another patient approximately his age.

“Hey man.”

“Yo.  What’s happening?”

An aide goes to the main heavy metal locked door of the ward and unlocks it with a giant key.  Michael and Deborah enter.  Michael is wearing a tie and sports jacket. Deborah has on a silk dress. They are shy in any new surroundings, but the inside of a psychiatric ward is completely foreign.  It isn’t something they ever imagined they would see.

They’re not sure what they are supposed to do.  They look around.  It’s dimly lit and gloomy, but the sight of a lot of teenagers, not that different from Richie, is a relief.  They thought it would be full of very strange people, like the woman last night in the ER.  Apparently not.  Apparently the very crazy people are sent somewhere else.

They spot Richie off to the side shyly trying not to eye a group of girls.  One of the girls, in particular, is petite and cute.  Deborah and Michael relax.  They wave to him. Smiling wanly Deborah mouths “I love you”.  They follow Dr. Rahmadi into his office.  After a perfunctory greeting, he points to two chairs, then wastes no time getting started, “How long has he been on Prozac?”

“He was supposed to begin it this morning.  He…”

Dr. Rahmadi cuts Michael off, “So he never got it.” He writes that on a form, and then looks up at them.

“How long did he see Dr. Stern?”

He just had one visit, yesterday.”

“Did Richard…”

Deborah intervenes, “Richie.  He likes to be called Richie.”

Dr. Rahmadi’s voice takes on an irritated tone. “Did Richie give any indications that he was thinking about suicide?”

Michael answers, “Not really.”

Deborah disagrees. “ Once, I think two years ago he talked about dying.  He wanted to know whether his sister Lisa—she died 5 years ago from a lymphoma- might be alive in heaven.  We talked about that.  I was surprised.  We’re not very religious.  But he believes in heaven.  Michael I guess he got that from you.  He really misses her.  We all do.  Immediately after Lisa died, Richie would bring things home from school that he said he was saving to show Lisa when he went to heaven. He’d speak about that a lot. And then he stopped talking to us about those kinds of things.  He stopped talking to us about much of anything.”

Dr. Rahmadi makes his impatience more unmistakable, “I mean actual suicide threats.”

“What do you mean actual?” Michael asks.

“Threatening to do it.”

“No nothing like that.  But you know…”

“Any family history of suicide?”

“No.”

“Dr. Stern told me he saw you for depression several years ago.  He kind of hinted that you also are depressed Mrs. Russell.  So there is a strong family history?”

“I don’t know. Not before Lisa’s illness.”

“Lisa?”

“My daughter.”

“Oh right, the one with the lymphoma.  What about his grandparents?  Did they get depressed?”

“They were okay.”

Michael cuts in, “What about your mom during menopause?  She was pretty crabby?”

“Well that was only a few months. I…”

“So the answer is yes.  There’s a strong family history.”

He marks it on his chart.

“Well I’m not sure.  I…”

“Listen, I have a patient scheduled in a few minutes. I’m all set.  I got what I need.”

“That’s it?”

“You’re supposed to see Mrs. Franklin next. She’ll answer your questions. She’s in charge of disposition…”

“What do you mean? Who are you disposing of?” Michael asks sarcastically.

“She’s in charge of discharge planning.  She’s an important part of the treatment team.”

“Why?  Are you thinking about discharge?  He just got here!”

“Hospital wards are not the proper place to treat patients.  It causes regression. Patients begin to like it here a little too much.”

“And you think that could happen to Richie?”

“I don’t know Richie, but yes, very possibly.  Let me talk to Richie some more and talk to his therapist…”

“Who is his therapist?”

“I already told you. Mrs. Franklin. She’ll meet with you later.  Let me see what time.”

The doctor picks up his phone and dials her extension. He mumbles something into the phone, and then looks up.

“In about an hour.  Why don’t you see if you can find Billy out there.”

“Billy?”

Dr. Rahmadi sneaks a look at his chart.

“Sorry…Richie.”

Dr. Rahmadi shows them the door.  They go into the corridor. Just around a bend, the patients, including Richie, are in a common room at a lecture. Michael and Deborah catch Richie’s eye.  They take a seat towards the back. A young woman, Ms. Allison, is in front of the screen where slides are being projected. A large picture of a nerve junction is depicted. Her pointer moves to what appears to be bubbles.

“This is serotonin. Depressed people don’t have enough of it. Who is on Prozac?”

Five patients raise their hand.  Richie doesn’t.  Michael signals him to do so. Richie ignores him.

“What about Celexa, Zoloft, Paxil, Effexor?”

Almost all of the rest of the patients raise their hand.

“Good.  These drugs fix your chemical imbalance.  They are miracle drugs like antibiotics.  If you take your medication you will feel much better.  Although sometimes they don’t work, we have other medicines and the chances are one of them will work. It’s very important that you take your medication… Religiously!”

A patient raises her hand.

“So our problems aren’t what’s bumming us out?”

“Well I’m sure you think they are, but it’s really that you have a chemical imbalance.  Well… that and one other thing…Anyone know what that is?”

No one raises their hand.

“Come on Connie. You’ve been here before.”

Connie gives her a look of disgust. Ms. Allison isn’t the least distracted.

“Negative attitudes.  I have this booklet for you that I want you to study about how to think more positively.”

A new person pipes in, “When do we meet with the doctor about our medication?  I’ve been here 5 days and I’ve only seen him once for 15 minutes.”

“ Well, he makes rounds every day and the staff reports to him. Exuding cheerfulness she continues, “He’s very, very busy.”

“Do we get to meet with him about medication problems?”

“Well, in special situations.  But we encourage you to bring up any medication problems in medication group.  For those of you who are new-you’ll meet together in a group once a day with the nurse. That’s where you are supposed to ask about any side effects that bother you.”

“I’m not going to talk about no side effects in front of every one else.”

“Sometimes you just have to find the courage.”

“Are you serious?  You know lady.  This serotonin thing.  It sounds like one size fits all.”

“Well you can look at it that way, but that is just negative thinking.” Very cheerfully she adds,  “You’ll see. Very soon you’ll feel fine.”

“How do you know that?”

“I know it because I used to get depressed. Just like you.  And now I am on medicine and… well…can’t you tell how positive I am? The medicine has a lot to do with that.”

“So now you have no problems?”

“I didn’t say that.  Now I look at my problems differently… with a positive attitude.”

“You is one drugged lady.”

She smiles as if nothing registered.  “Any other questions?”

Ms. Allison looks around the room.  No hands are raised.

“Very good.”   She holds up a booklet  For those who don’t have one of these come up to get your copy.  Seriously, there is a lot to learn about having a positive attitude. It works.”

Most of the patients do move forward to get the booklet.  Richie conspicuously moves in the opposite direction towards Michael and Deborah. He hugs his mother.

“You okay mom?”

“I’m good. I’m good.”

Michael addresses him,  “Are they treating you okay?”

“Well, no one’s coming at me with needles like they did last night.”

“You should get a copy of that booklet.”

“There’s so much bullshit up here.”

“I’m going to get a copy.  I’ll be right back.”  Michael leaves them.

 “Is dad pissed at me?” Richie asks his mother.

“No, he really isn’t.  Can’t you tell?”

“Not really.”

“Richie,  He’s here for you.”

Richie shrugs…

“You gave us a big scare.” She moves her fingers through his hair as she talks, “Are you okay?”

 Michael returns. Deborah and Richie greet him with an artificial smile.  Michael hands him the booklet.

“Read it over tonight.  What have you got to lose?”

“Yeah right, Dad.”

“Richie what do you want? Just tell me.”

Richie has a condescending look on his face.

 “We aren’t playing a game here.” Michael says with his voice raised.

“I want out of here.”

“You’d stay at a different place?”

“Like where?”

“I don’t know.  I’m seeing Dr. Stern.  He’ll have some ideas.”

“It’s got to be a place where they don’t take away your shoelaces.”

“Richie.  You seem to have forgotten why you are here.  Any place is going to do that.  Michael softens a bit, ”Look, let’s see what Dr. Stern has to say.” Michael looks at his watch, “I have to call in to the office; then I want to try to get in to see Dr. Stern.  He addresses Deborah.  “You want to see Dr. Stern with me?”

“I’m okay staying here.”

The awkwardness that both Michael and Richie feel as their anger dies down has become a ritual.  Richie’s voice is conciliatory.

“Dad. Could you check the ER? I’m missing my ring-the one Lisa gave me.”

 “Really?  That ring?”

Deborah and Michael exchange a glance.  They are both concerned that the ring has disappeared.

Richie leaves.

“That ring is very important to him.  Sometimes when he holds the ring he says he can feel Lisa there with him…You can make any face you want, that’s what he said.”

 “I’ll find the ring.”

Looking for the ring is what Michael does best, accomplish a concrete chore.  Throughout his life the bulk of his energy has gone to getting his to-do list done.  It takes priority.  He never decided this is the way he wants to be. He was raised that way and it has continued as an uninterrupted habit. HIs editor at the Sentinnel tells the other reporters, “Give something to Michael and it will get done.”

But Michael does not do this to garner praise. It operates by its own rules.  He has never put it in words but when he is doing what he is supposed to be doing, trying hard if necessary, he becomes a good person.  When he is not doing what is expected he is lazy.

He’s too smart to espouse these precepts.  Formulated, the degree to which he must act according to them would seem trite to him and any one else listening.  But it is nevertheless a given.

Moreover, there is a down side. Narrowing his focus narrows his perspective.  He’s a one track Charley. Deborah and Richie have gotten used to it.  That’s simply “Dad.”  The worst part is that, while he sees himself as a good person when he is busy at his chore, it is axiomatic that he sees procrastinating people, unfocused people as bad.  Once again this is unformulated.  It can be chased away with a moment’s reflection, but that doesn’t make it a less constant attitude. Both Deborah and Richie know Michael sees them as lazy.  He’s never said anything like that, but they understand the logic of his personality. Unbending determination is the main determinant of his self esteem. Achieving his goal determines the way the day is going.  When he hasn’t gotten done what he needs to get done he becomes irritable, annoyed by distractions that take him off task.

While Michael likes that Deborah is completely different  (She doesn’t operate according to his rules.)   there was a time when this difference was a breath of fresh air which he knew he desperately needed. Imprisoned by the dictums of his upbringing. Deborah was able to rescue him.    Nevertheless,  especially now, he has become  impatient with Deborah’s distractibility, her  lack of focus when she needs to get things done. Same for Richie.  He won’t designate them as lazy, not in words, but he cannot react in any other way.  He doesn’t wish to judge them, but his judgment cannot be changed.  When he is not doing what has to get done, he is lazy.  The same applies to them.

Speechless and awkward, Richie and Deborah stand together somewhat hurt by Michael’s abrupt disappearance.

“He’s so fucking out of it.”

“Don’t start.  He’s your father”

“You’re sure?”

“He can’t be a different person any more than you can.  This is it.  Put it in your pipe and smoke it.  He is who he is.”

“Still.  It bugs me.”

“Then get debugged.”

A psychiatric aide appears. He can’t be more than 23-24 but he has deepened his voice into a commanding staccato.

“Russell. You’re supposed to be at community meeting.”

“I’m with my mother.”

      “Doesn’t matter.  You have to attend community meetings.”

“And what if I don’t?”

“In our house, visitors go by house rules.  You have to go now!”

“Watta you going to do?  Give me an F in patient cooperation.”

 “We’ll be glad to give you an F.  A real good F.”

Deborah intervenes “On one of the bulletin boards there was a schedule for AA meetings at the hospital.  There’s supposed to be one today.” She looks at her watch,  “actually, in about 10 minutes. Richie.  Listen to this gentleman. Go to your meeting.  I want to go to that meeting.  It’s been a while.”

Chapter 13

Ten minutes later Deborah is in a large hospital conference room used by AA twice a week for meetings.  Several members surround a large coffee maker.  A tall angular man fusses over preparing his coffee.  He carefully pours a teaspoon of sugar, turns his spoon over, then repeats it for another teaspoon and a half.  Next comes the powdered creamer.  He studies the coffee as he stirs. Carefully he sips, smacks his gums; it is still too hot.

He studies the donuts.  He picks a circular cinnamon sugared one from the supermarket box.  He tears the donut in half.  He hasn’t looked at another person in the room.

There are clearly regulars, old friends, comfortable with the scene.   They squeeze each others’ hands, hug acquaintances; it is like church before the service is to begin.

Deborah is not paying attention to anyone.  She was not in decent shape before Richie’s attempt but the events of the last two days have overpowered her.     She waits her turn at the coffee maker, surrounded by strangers.  She feels awkward,   but nothing serious.   Although several of the younger divorced men, as always looking for a girlfriend, steal glances at her, she is doing pretty well ignoring them.

 Freshman year, high school cafeteria, she would turn scarlet, her face afire if someone sized her up.  Anyone!  Boy or girl.  That doesn’t happen anymore.  It was a major step in her development to be able to feel safe in this kind of situation.

How different people are. Her sister Beth relished every moment of attention she could get.  She still loves it.  She can’t get enough. She was born with  pzzazz. She keeps adding layers and layers of charm.    Her polish is a good part of how she earns her living as an agent.  Invited or uninvited she can enter any room and is soon welcome.  She looks people right in the eye, especially men. She’s been like that from the beginning.

  Deborah’s mother has always maintained they were born that way. Complete opposites. Deborah wears very little make up. She dresses updated 60’s.  Michael likes that look, and if he’s happy, it is one less problem for Deborah.   She’s always been as pretty as her sister, but her looks are noticeable only on second glance. She can send guys’ hormones into a summersault with  eye contact.  But she hasn’t given any men that look in a very long time.

Marriage rescued her.  Men stalking, even if they were polite about it,  made her heart flutter nervously.  No longer.   Her mightiest weapon has been her lack of interest in another partner.  It’s worked perfectly.

Like several other women at the meeting, she takes a seat away from the others.  Seated quietly, she is able to enter into a daze. She overhears small talk all around her, somewhat like the buzz you hear at the beach on a hot day, the sun burning as you fall asleep, a buzz without details, soft mumbled conversations fading in and out.  Except she isn’t sleep.  She has left the room and joined Lisa .  She enters one memory after another.

The very first time they went to their camping site in the mountains, a bright sunny day.  They are all excited to be there, excited to have discovered the spot. Michael grabs one-year-old Richie and swoops him into the air.  He catches him effortlessly, and then sets himself for another toss.  Michael throws him high, high into the air.  When he played baseball, he preferred a home run swing to a controlled bat.  Richie is terrified but just as quickly he lets out a happy squeal as Michael gently catches him. 

“Gaaan!”

“Again?” Deborah translates for him.

“Gaaan!”

Richie is pushing on Michael, waiting to be lifted.

“Again?” Michael asks.

He throws him up again, perhaps even higher. Richie squeals with laughter.

“Gaaan.”

 Lisa pulls at Michael’s leg.  He looks down at her.  She points straight up.  Michael hands Richie to Deborah and picks up Lisa who looks up at him excitedly.  She is a good deal heavier.  He throws her up, almost as high as he threw Richie, and catches her the same way. He’s delighted with himself.  She isn’t happy.

“No. As high as Richie!” she demands.

“That was as high!”

“It wasn’t. I saw. You threw Richie into the sky.”

            “You want to go into the sky?”

            “Higher than that!”

            “Okay.  I’m going to send you higher than the sky”.

            “To God.”

            “I’m not sure what kind of catcher he is.”

            “The best.”

            That memory does it every time.  A tear forms.  She dabs lightly with a Kleenex.

Another memory slips into her thoughts: earlier in their relationship; she and Michael still crazy in love.  They are dancing. They go to the punch bowl.  She is tipsy.  Michael finds her silliness thrilling, wonderful.  They dance and dance.

 

Deborah fingers the back of her neck, squeezing her muscles, trying to loosen them. She looks around the room.  A speaker is talking about his life when he drank.   Her memories continue.

 She opens up a book where she has hidden a joint.  Michael comes in to the room.  She tries to hide it.

Another: An anti-war demonstration; Deborah has a flower in her hair.  Michael has a beard and long hair. A hundred of them stand strong holding hands as policemen close in on their crowd.  Someone, not far from them, screams at the lined up policemen, “PIGS”   Suddenly the police charge.   Everyone scatters.  Fear, real physical fear, the first time she has ever felt it. She watches at a safe distance as one of the policemen throws Michael down to the ground.  He lifts his nightstick but then thinks better of it and chases another demonstrator.  It was at that moment, the moment she suddenly felt terrified for Michael, that she decided she wanted to spend her life with him.

A new speaker is before the group, a black man in his 50’s wearing a bow tie.

“ I want to say, right out, the bottom line.”

He hesitates for effect.  He is a skilled orator.

 “AA saved my life. AA saved my life.  That’s the truth.  AA saved my life.   You new people tonight.  I know you probably think that’s bull.  Probably everything here tonight sounds phony. Higher power?  Give me a break right?  Well you’re right.  It is bull.  Some people like to talk a lot of bull. AA lingo.  It’s annoying.  But you know what? The people that talk like that are right about all of it.”

 “All of it.” He repeats.

When I first came here I had to convince myself that there was something wrong with me.   Like, what is an alcoholic?  So what if I get drunk every once in a while?  What gives other people the right to tell me how much I should drink?  Fuck them.  It’s my life not theirs.  I will decide for myself.  People just luuuv to  be a judge .  They judge, and judge and judge.  They say they are trying to help. They care. Yeah right.  Fuck them. FUUCK them.”

 “Yeah man.”

He continues, “But you know what?  I’m here and you’re here because we know they’re right! Doesn’t matter what their reasons are. They’re right!

 First time I came here I waited for AA to do something for me, to prove it was going to work.

It didn’t work.  I screwed up for two more years.  Kept cheating.  Until I fucked up one too many times.  Lost my job.  My wife said she had had enough.  I knew she meant it.  That scared the shit out of me.  That’s what it took to get me serious, when I fuckin’ decided I was a goner.  When I was a goner.  Couldn’t stop myself before that.  I couldn’t stop drinking.”

He looks around the room.   “That’s when I stopped caring about you jerks at the meeting.  Didn’t matter what you said, didn’t matter who the fuck you are. I had to stop.  That’s all that mattered.

Took me a while but now I know.  Getting wasted is a wasted life.  Getting all cocked and telling off people who need telling off feels good.  Absolutely right on after you’ve had a couple.

Except for the next morning.  You wake up with this fear.  How you made a fool of yourself, how you made a new enemy.  How your wife’s feelings aren’t going to recover for weeks.  Maybe never.”

“Man. Okay maybe occasionally you have a good time just because you are high. And you can’t get that feeling any other way.  Partying is the best.  Telling people off is the best. Right?”

He hesitates.

“Feels good right?”

He hesitates again

“Wrong!”

“You need to get things fixed another way. You gotta keep half your brain.  Or you are going to be in deep shit. Because if you couldn’t do it while you are sober there’s gotta be a reason. There has to be a reason why you have to shut off your brain with booze in order to get there.

I know.  I remember the first time I got high.  It was amazing.  I didn’t have to do anything.  It was just there.  But later, later… it wasn’t. I started to chase it,.  And I only occasionally found it. Less and less and less.

Okay without a little help you are afraid to do much of anything.  You live in a prison.   Fear keeps you behind bars. I ain’t got no easy suggestions how to fix that.  See a shrink? Find out what is wrong?  Find out how to change. Learn how to have a good time without getting high. Take a medicine that helps you to enjoy yourself without having to be drunk.  I know. There isn’t one.  Well some tell me Prozac.  But others say no.  I’m not sure there is anything that is as good as getting high. Okay maybe the very best times you’ve ever had were when you were drunk.  I’m willing to say it is true.

There is a reason for that.  The devil always throws the best party in town. Nothing beats the devil.”

He hesitates for effect then continues. “ He also is the way to hell.

As high as you get from booze and marijuana, from heroine and cocaine, that’s how far you can fall.  You are here today, and you will come back here because your low has made all the highs you got, all of them together times ten thousand, all that great time you’ve had- it is worth shit now.  It is the shit.”

“AA is bullshit, a lot is bullshit.  But here’s the important point.  It saved me.  Because when you finally know that getting shit- faced is for shit that’s your only chance…

Knowing it and remembering it and living by it; that’s exactly what will save you.”

“Yes,” someone calls out in the audience.  Then a lot of “yeses” and “yeahs.”

  He stares out at his fans.  “Yeah you know it is good.  Real good. So what do you do?  Just in case you forget, you come here.”

 “Yeah some people have to come here again and again.  Start over.  And over.  And yeah some people here sound like robots.  So fuckin’ what if the real reason they repeat it, the reason they have to convince others so often is that they have to convince themselves.   They preach and preach to anyone who will listen but especially they preach to themselves. That is what I do.  Preach to myself.  Right now.”

His voice rises, “So fuckin’ what.  You do what you have to do.  If I don’t preach I’m going to be in trouble.

 I am Larry and I am an alcoholic.

I am Larry and I am an alcoholic. I am a father, a son, a husband.  I am the boss on my factory floor. When I am sober. And now I am sober.

 I am an alcoholic.  I almost blew it all and I still can.  Because, I want to get high.  I can almost taste it.  I am Larry and I am an alcoholic.”

“I need help from anything that makes even a little bit of sense.  Whether I say it or someone else says it; any phrase that I can repeat.  I need it.  It’s gold.

 Gold.   One day at a time. Hell. For me it’s one hour at a time.  Right now I want to have a drink.  This very second.  I am Larry and I am an alcoholic.  I haven’t had a drink in seven years.”

They cheer him on.

Deborah has left Lisa for a moment. She is listening.

Chapter 14

Michael’s back in the emergency room.  The insane twenty-year old woman is still there and still pacing.  A strapping black policewoman is watching her, carrying a loud hand radio that can be heard 25 feet away.  The static is constant.  You can barely make out the codes, so the messages are repeated and repeated until “over and out” communicates the message has been understood. The crazy woman seems to be competing with the hand radio to dominate the airwaves.

 Michael approaches a nurse.  She looks at him with the same tired cynicism as the earlier nurse.

“Can I speak to Dr. Lurin?”

“Who are you?”

“Michael Russell.  Dr. Lurin saw my son last night.”

The nurse says nothing.  She turns and walks down the hall.  Michael watches the insane woman.

 A speaker blares out.  “Code blue in 624, Code blue in 624.

The crazy woman’s mumbling gets very loud.  Then suddenly she shouts furiously at a nervous middle age balding man, who has been trying to avoid her gaze.

“First you take my baby. Now Code blue.  You think I don’t know what that means.  The spying machine you hid in my baby. I checked it eight times yesterday.” She shouts still louder.  “I knew you were hiding it there.”

Then she stops. “All units.  We have a 10-34  at 86^th and Amsterdam.  10-34 at 86^th and Amsterdam.  All units we have a 10-34 at 86^th and Amsterdam. The policewomen lowers her radio but the crazy woman listens intensely, and is soon focused on the static.

“Do you hear me?” the crazy women lets out to no one in particular.

Like a drunk in the street, she’s looking for someone to engage. She shoves a man’s shoulder as she walks past him on her way to the middle of the room.  No one is looking at her.  Her mumbling continues.  As best they can accomplish it, she is being ignored by everyone in the room.  Suddenly, she catches the eye of a woman at the end of a bench.  She goes over to her.  The woman is now staring across the room, regretting her curiosity.  Her panic emboldens the crazy woman.  She bends over and freezes into a furious stare four inches from the unfortunate woman’s face.   The policewoman slowly walks over.

“Helene!” she says in a commanding voice that leaves no room for misinterpretation.  That seems to do it.  The crazy woman moves on, shakes her head and starts conversing with herself again.

Dr. Lurin approaches Michael.  He cheerfully calls out to Helene.  “We’re trying.”  She looks at him bewildered by his affect. He might as well have been reasoning with a pinball machine.

Dr. Lurin turns to Michael.

“ A month ago I interviewed her at our crisis clinic.  She was very upset, scared of she didn’t know what, but she communicated the same as you and me.  Now she’s in outer space.

“Is that unusual?  Someone is sane and then suddenly they’re nuts?”

“I haven’t seen that much of it.  She’s probably manic-depressive.  Schizophrenics usually show signs years before, and slowly progress.  They aren’t necessarily insane at first but peculiarities start to grow.  Not manic depressives. They can flip out, and then in a month or two they can be totally normal again.  No one would know they have been psychotic.  Even in the middle of their craziness they can be normal for fifteen, twenty minutes before they’re nuts again.  Schizophrenic don’t look like Helene.”

“What do you mean?”

“She is attractive, stylish.  Look at her hair, the latest cut.  Mad woman isn’t the message you get from the way she looks.   It’s different with schizophrenics.  They’re pale, sickly looking, too out of it to have a hair style.  They’re not part of this world as you and I understand it. You don’t realize how extensive our persona is fine tuned until you see someone without one.  They’ve left the human world.   They are their own kind of animal.

Dr. Lurin signals for Michael to follow him down the hall.

“How’s Richie doing?” Dr. Lurin asks Michael.

“I wish I knew.”

“ I remember when I was 16.”

“So do I.”

“My bet is Richie will grow out of this.”

 “Agreed.  “If we can get Richie through this period, he’ll probably be all right.”

“ Being down  usually doesn’t last forever.  Sometimes it does, but I don’t think Richie is one of them.”

“He’s been down quite a while.”

“Probably an antidepressant will help.  You’d be amazed what they can do.”

“I hope so.  Richie could use something.”

 They both sigh.  Dr. Lurin pushes against Michael’s shoulder affectionately.

“We’ll find something.  He’ll be okay.”

 “I’m sure,” Michael responds sadly.

 “You wanted to talk to me?” Dr. Lurin asks in a business like manner.

 “I did.  Richie is missing a ring that his sister gave him.  Did you know Lisa?”

“No not really.  I knew someone who knew her.”

“ After she was gone,  it was like she had never been here.  The ring is one of the few things that remain from her.  She loved that ring.  She loved the story connected to it.

“What kind of story?”

Deborah found the ring in her grandmother’s attic after she died.  Her grandmother’s friend had never taken the ring off after it was placed on her finger by her lover the day before he died in a duel fought over her. She didn’t want it buried with her when she died.  Hence Deborah’s grandmother got it.  When Deborah told the story to Lisa, she  got all stirred up.  She put it on and vowed to never take the ring off.  She gave it to Richie a week before she died.

Richie has a whole thing about that ring”

“Like what?”

“Nothing. He’s a kid.  He’s got a lot of imagination.”

“Still what?”

“Nothing.  But I know he wants that ring back.  Real bad.”

“I haven’t seen it anywhere.  I’ll ask around.”

“Could you?”

“Things tend to get lost here.   A lot of people that they have working in the hospital are straight from New York’s rehab programs.  The hospital has to hire them or lose federal money. We’ve had some unsavory characters working here. Try admissions. They’re in charge of personal belongings.”

“Thanks.”

The crazy woman lets out a shriek.  Then another.  Then another.  In Michael’s state each shriek is like a stab in his gut. It makes him angry.

   “I can’t believe she’s still here.”

 He raises his  two fists in victory.  “She’s leaving today.”

“They agreed to hospitalization?”

“No. These new places are springing up. Kind of like surgi-centers. Basically boarding houses with uniformed guards.  A psychiatrist visits once or twice a week. It’s  a lot less money than the hospital.   Her insurance company will allow that, nothing more.”

“What do they do at these places?”

“Very little.  She’ll walk out in two days, and they couldn’t care less.  At least she’s out of here.”

There is irritation in the look Michael gives Dr. Lurin.

“Mr. Russell.  You don’t understand.  There’s nothing else I can do.  She can’t stay here. Administration has made it clear. This is an ER not a psych ward.”

Continuing his apology,  “What’s happening to psychiatry isn’t just here.  It’s everywhere.”

 “I admire the way you are handling it.”

 “  By the end of the day it gets to me.  But it used to be twenty times a day.  When you’re working with everyday you get used to it.”

“I don’t know if I could.  My job’s easy in comparison”

“No question it is a bummer.  I expected problems with patients, Plenty of them, but I didn’t really know about all of this other crap.“

.”

“When it started it was, “What the hell’s going on around here?” I went to school for four years, studying hard, day and night, learning from professors who taught us how to treat  patients properly.  A lot of it was subtle.  It took a lot of mental energies to get it right.  Now a clerk at an insurance company tells me to forget everything I’ve been taught.  His protocols tell me what is to be done.”

Dr. Lurin continues.  “At first it was mind boggling.  I was ready to quit.  But then I looked around and I asked around and eventually it sunk in.  This is it.   It isn’t just psychiatry.  It’s neurology and rheumatology, cardiology.  When I talk to my Dad he tells me it’s not just medicine.  You can’t find an occupation that doesn’t have something ridiculous like this. I taught school for two years in the South Bronx.   You want to talk about a broken system.   This is better than that.”

 Michael spots Dr. Stern down the hall approaching them.  He’s relieved to see him.

 “I was going to stop by at your office.”

“Had to come to the hospital… Lurin, Is there an open office?””

 “I don’t know, try the conference room.”

As Dr. Lurin leaves, Michael calls after him,   “Ben.  Say hello to your mother.”  Then,  “ You are making the right decision. See this through.”

Dr. Lurin calls back. “I will.”

Dr. Stern closes the conference room door.  They sit down at a large table.

“What’s the story with Richie?”

“He hates it here.  He wants out.”

“That’s not an option.  He has to be here until he is out of danger.”

“It’s a factory.  They don’t really connect to the patients.”

“That’s how it is at most places.”

“Dr. Lurin said the same thing.  Psychiatric care has taken a dive?”

“Don’t get me started.”

”Really?”

“You don’t want to hear it.”

“Actually I would like to get you started.  You forget what I do for a living.  Why not a story about this?  If Richie is getting screwed  I want to know about it.”

“I don’t know if it’s a good idea.  It might distract you. Richie needs his father, not some guy working on a story.”

“Maybe.”

“You get distracted too easily.”

 They are both quiet for a moment.  Michael knows Stern’s right.  He’d could easily forget about Richie and get all excited about the system.”  Michael starts to speak and then stops.

            “What?”

            Even if writing a story was my only reaction to Richie’s situation, at least it’s  something.  That’s better than I did with Lisa.  I don’t want to do that again.”

“Which is what?”

             “Completely tune out.”

“Michael You didn’t completely tune out.”

“ I wasn’t there for her.”

“Well, sometimes Prozac-“

“It was so crazy. I’d nod to everything the doctors said, right through ‘til the end. With the exception of this one time where I said what I was thinking, I was like a soldier standing at attention before a commanding officer.  Yes sir, no sir.”

 Later when I got home, I’d be thinking about what I had been told, trying to understand whether what they said made sense.  Sometimes it did.  Sometimes it didn’t.  When it didn’t, it freaked me out.  That one time I tried to get it clarified, asking what I thought were logical questions, the doctor got very short.  Like who was I to… Deborah said I was sarcastic …  I don’t think I was, but who knows? It’s in my personality, but really I wasn’t trying to show the doctor up.  I just wanted an answer.  The doctor looked at me like I was a prick.”

 “Who was the doctor?”

“I don’t remember his name, but it was just that one time…Deborah was more vocal, at least when the two of us talked, but when the doctors were there we both just shut up. After that first time I didn’t want to stir up trouble.  I was like a little boy.”

 Stern teases.  “You were such a good little boy.  I remember your fury any time you had to shut up.”

Stern can’t help himself. He is sliding into speaking to Michael like he is still in therapy.  Michael is partly there too.

 “It’s weird the things that stay with you.”

            “Like what?”

.           “It went beyond not speaking up. I worried about making a good impression.  Not just on the doctors, on nurses and everyone that kept coming into the room. And not just me.  All of us did it. Lisa and Richie even Deborah. Except for that one time when I questioned the doctor, we were Mr. and Mrs. Cheerful.  The kids too.  Showing other people what a nice family we were, that we were good sports about anything that happened.”

Stern smiles.  “Most people do that.”

“Maybe, but now it seems bizarre. Lisa’s dying and we’re worried about coming across as an All-American family.”

“You were no different than anyone else.”

“It pisses me off.”

“What?  What pisses you off?”

 “The numbness.”  Michael thinks further, “Maybe that’s bullshit.  Maybe I wanted to tune out.  Deborah’s accused me of that.”

“She has?”

“She’s not wrong.  It wasn’t just in front of other people. It was practically all the time.  Deborah was with Lisa.  I mean with her.   I wasn’t.”

“Well…-”

“I wasn’t.   That’s the bottom line. Deborah claims she forgives me but she still gets furious about it.  There are times she hates me.”

 “Michael, you did what most people do. What else could you do, think about how Lisa was dying from morning to night?  You had to go to work.  Be on time.  Get along with your boss.”

“It wasn’t just that.  Plenty of time I was having a good time.  I mean a really nice time.   If there was a Knicks game on, I’d get grouchy if Debby pulled at me for support.  She resented that.  She wanted me to be miserable when she was. Sometimes I was. But too many times I wasn’t, especially if I seemed to be enjoying myself.  She saw that as abandoning her.”

“Well…”

“I did.  But…”

He thinks to himself before continuing

“It wasn’t just Debby.  Lisa too.   I’d feel cooped up with her, especially if I knew half time was going to be over.“  Tears form.  “She knew it,”  “Daddy go watch the game.”  It really didn’t bother her.  That was Lisa.  She liked making other people happy.”  He dabs at his eyes.  “I had nothing to prove to her…She was special.”

He uses his sleeve to wipe his eyes.

“I was selfish.”

 “Michael.  The first day you came to see me you couldn’t stop crying.”

“I was feeling sorry for myself.  I’m telling you.  She was dying and all I thought about was how could the Knicks get more rebounds.  Was Allen Houston’s knee going to hold up?  That’s what I cared about.”

 “Michael just now you thought of how Lisa cared about you, wanted you to go and enjoy the game.  That brought a tear.  That tear wasn’t because  you were feeling sorry for yourself, you were remembering her.  Her love for you and your love for her brought that tear.  Those tears were for her.”

“Maybe.”

“Not maybe.  Definitely

Stern continues.  “What sucks about cancer is that it’s slow.   On and on.  Day after day.  People think they can be there all the way. Right up to death’s door.”

 “Debby didn’t stop at the door.  She jumped in to be with Lisa.  She’s remained there”  I know that’s nuts.  I’m talking about me looking after myself, making sure I was taken care of first while she was dying.

“The Knicks?  Look Michael if you enjoyed watching the Knicks that much, then you enjoyed it.  Period!  It doesn’t mean you didn’t care about Lisa.”

“Okay.  I cared.  But it wasn’t just Knick games.  It was-

“Okay, you cared about the  Knicks first.  So!  I’m sure you’d jump in front of an oncoming train to save Lisa.  But most of the time, the every day time,  thinking and feeling for Lisa wasn’t on your mind.  You were elsewhere.   People don’t admit it, but if you watch them it simply is the way it is.  Think about it.  It has to be that way.  If we spent all our time thinking about the dying we couldn’t function.  We have to function.

Michael is irritated.  Stern comes back at him.   “Okay most of the time you wanted to watch the Knicks more than be with Lisa.  You’re a selfish bastard.”

“Deborah was with her.  Holding her hand. Every step…”

 “That’s the point.  Look at her now.  Lisa took Deborah to hell.  While people are alive they aren’t supposed to go to hell.  They’re not supposed to be among the dead. “ Did you see Black Orpheus?”

Michael nods.  “He was a happy demigod. He sang in the morning to lure the sun into rising?  ”

“After he goes to Hades because he couldn’t be without Eurydice.  He doesn’t come back alive.  No longer can he sing to greet the sun, as it arises in the morning.  Hell cured him of that. All joy was gone.  In his heart there were death, not a single song to welcome the morning.”

Stern continues, “Deborah would have been a helluva lot better now if she hadn’t gone there with Lisa.”

“I know.”

  Like Richie she’s haunted..  Lisa’s ghost has a hold on her. Only it’s not  Lisa.  Not the one they knew.  The real Lisa, the very much alive Lisa.  The dead Lisa is a ghoul, killing everything before it.  At least you don’t have that ghoul to contend with.  You were able to bury her.”

  Stern stops for a breath.

“What you did is what you had to do. And I know you hate this word.  But it was “healthy.”

“Bullshit.  Let me tell you something.  I haven’t told you this before.”

He hesitates before continuing

 “I wanted her to die In the last few weeks I kept wishing it would be over.

“So?”

“I wasn’t thinking about Lisa.  It wasn’t for her, that she was suffering so much, that being dead was better.  It was for me. “

“Go on.”

“ I wanted to feel better.  I was miserable near the end.   I could feel myself being pulling down with her.  Not that she wanted me to go with hehad should want to.  I was getting away too easy.”

He interrupts himself.  “That doen’t come from Lisa. She was happy to leave me be, Happy if it made me happier to not be around her ..” Tears form.  “My happiness made her happy.  That’s just how she was.”

“Come on?”

“Okay.  I’m making it up.  There were times when she very much wanted me to stay, and let me know it.  Deborah would kill me for saying this, “But she was leechy sometimes.

“What else?”

“I’m sorry this really nice part of me wants her to be a saint  Sometimes I miss her. I remember times with her when our relationship was on a roll.

“Michael what happened is normal.  Cutting her off.   Normal.  Fifty, sixty, seventy percent of people start to react like you did.  No one talks about it and they quickly stop thinking about, but it’s normal. It’s healthy. You gotta know that Michael.”

“Loving the Knicks more than Lisa? That’s healthy?”

“Maybe. Not maybe. Loving the Knicks.  That’s what people do when they are alive.  Loving the Knicks.  Loving anything. That is the best we ever get.  Loving something.”

“You’re not hearing me.  I wanted her to die for me.”

 “Michael, in most cultures…”

Michael raises his voice.  “You’re not hearing me.  I wanted her to die.”

“In most cultures, most people disconnect from the dying.”

“I wanted her to die.  Can you understand that?”

“I understand. It’s subtle but any dying person will tell you.  What ever their intentions, people aren’t really there with them.  Lisa knew she was going to die alone.  She may have not liked it but she knew it.

In Alaska the Inuit leave their dying leaning against a tree and simply move on.  Why do you think we bury people 6 feet under the ground.  We want them away from us.  They stink.  I mean really stink.  It’s natural to get away from them.”

“Natural!” Hitler used the same argument.  It was the way of nature that the superior dominate, and the inferior are eradicated.  Sentimentality is a weapon of the weak.  The way it really is- wolves pick out the weakest among the herd and kill them first. Like they should.  You’re saying I just got to accept that.”

“Whether you accept it, or justify it ,or whatever you do with it.  It’s just there.  I’m not saying we should become that way, or its honky dory but people’s instincts are what they are.  You can spin an entire web of rationalizations, claim your innocence, try not to own this part of you.  But this is you.  This nasty creepy part of you has been woven by nature into who you are.  It can be contained but it is not going to go away…”

 “What does all this mean?   Let’s bring this back to where we were.”

“You have an instinct to stay away from the dead.”  Stern’s voice gets louder.  “And the dying.  It’s just there.”

“So that is why I wanted Lisa to die?”

Dr. Stern is paged. He squeezes Michael’s hand and goes to the hospital phone on the wall.

Chapter 15

Stern returns from his phone call.

 “I have time now.   No office hours on Wednesday afternoons.  You were talking about Lisa.”

 “I’m not going to do what I did with Lisa. After Richie tried to hang himself, I promised myself I’m going to be there every step of the way for him.“

“You didn’t hear a word I said, did you?”

“I did.”

“So?”

Okay, maybe there’s a part of me that’s saying “Fuck you Ritchie? Die. Die.  That’s what I am supposed to believe?”

“ Only if it is there.  If it’s there acknowledge it.”

“And do what?”

“I’m not going to tell you that.  You have to decide what you are going to do about it.  You want to be there every step of the way for Ritchie? Fine.  Only Richie’s not Lisa.  You and Richie have had a thing for a long time.”

“Not really.”

“Michael, even when Lisa was sick he was getting under your skin.  I’m sure he still is.”

“Maybe.”

“Maybe, or he is?”

“He is. I don’t know why. The loud music?  I don’t know.  The way he looks at me?  I want to smash him.”

“You told me that story.  He was three.  Deborah was sick and you were taking care of him.  You wanted Deborah to be able to nap and he kept waking her up. You got him away from her but then he had a tantrum.”

“He started screaming like crazy. I tried to outshout him.  Told him to stop That made him scream even louder.  In a rage I picked him up and threw him down into the couch.  It’s the only time I ever lost it with him.”

“What do you think happened?”

“I don’t know.”

“Really.”

“I really don’t know.  Sometimes you just lose it.”

“You must have thought about it.”

  “I have.”

  “And?”

  “I’m not sure, but remember I was raised to not push for what I wanted, to do for others.  Deborah was raising him the opposite of that.  Whatever he wanted she would give in to him.  I was from the “go to your room.  Think it over school”.  Not Richie.  He was entitled.  He deserved whatever he wanted.  That’s what Deborah got across to him.”

“You told me more than that.  You said Deborah would do anything for him.  She was not that way with you. Meaning, she loved Richie more than you.”

“Okay professor Freud.  The good old Oedipus complex.”

“Freud described what he saw over and over.  Only he focused on what the son felt like.  I’m taking about you, what a father feels like.  I just want you to remember what went on, what’s going on, and think about what you can do to help Richie now.”

“You think I should bring up that incident with him?  I already did that.”

“And?”

“And nothing.  He said he remembered, I apologized.  He could tell I meant it.  That was the end of it.”

“Okay, fine, Maybe that one incident wasn’t that harmful.”

“Only I think it was.  At that moment he probably thought I was going to kill him. I mean three years old and your father throws you down like that? I mean I really threw him down.  Angrily.  It had it’s impact.  Don’t think he saw me as some one to come for protection.  He saw me as someone who could kill him.

And it just spread out from there.  He’s afraid of too many things. Much too many. Things he shouldn’t be afraid of.  That’s my doing.  I made him like that.”

 “I don’t think so..  Believe me it is not all you.”

“I know so.”

“Michael.  You are leaving out all the fun you had with him.  How much you enjoyed your catches, watching the Mets together.”

“But even with the baseball, our catches there was tension.  I was grooming him to become a great baseball player.  It wasn’t just a relaxed fun .  Oh it was when he made a great catch, or fielded 30 grounders without an error.  I loved that.  So did he.  But it could easily deteriorate, into me being disappointed with him and grouchy. Especially if he threw the ball so I had to chase it.”

“Like a thousand other fathers with their sons.”

“His fear is my fault.  I don’t know how much of the rest of his bullshit is mine.  I’m not going to take credit for all of it.  But his fear… “

Michael’s expression changes,  “I just, hope revenge is not on his mind.”

“What do you mean?”

 “When he made the attempt.  My first thought was that it was aimed at me.  Killing himself to get at me.”

Stern takes a deep breath.  Michael has always tended to dramatize things.  As rational as he appears to be when he talks about his motivations, there is a wildness in him that is not in his control.

He squeezes Michael’s arm.

“You are way ahead of yourself.  You’re locked into this one narrative. Let’s drop this for now, talk about something else.

“Like what?”

 “Like the story you are going to do on the insurance companies- what’s happening there?”

“You don’t have to worry. I’m going to write it.  I want to fight back.”

“It can’t hurt Richie if you are involved like that.”

“No matter what I do, Richie thinks I’m a pain in the ass.”

“It doesn’t matter.  Write a good story for the paper. You obviously haven’t worked things out with Lisa.  So maybe this…”

Stern lowers his voice, “I have to admit something. For the last year or so, I’ve thought about every which way to phone you to get you on this story.“

“You have?”

“ I have…” They are both quiet then Dr. Stern continues.

“It’s been eating away at me.  It’s weird.  People know insurance companies are screwing them.  Anyone who’s had an illness lasting more than a week knows it.  But it never gets into the news.  The politicians and news people, the hot pundits, go on and on about gay rights, abortion rights—the same junk year after year.  Most people couldn’t care less.  They get hammered into the PC attitudes they are supposed to have and that’s that.  They’re finished with it.  They don’t have to hear about it a thousand times.

What’s screwy is those issues have very little to do with most people’s lives. But their health insurance?  It’s been slamming people over and over again.  People talk about the hassle they had with their mother, or their sister or a friend getting screwed by their insurance. Where is the media?  I thought they are always looking for stories. Where are the politicians?  What’s going on is screwing their constituents?

So why nothing about it?  It drives me crazy.  Not just me.  Whenever us shrinks get together, lately, managed care is all we talk about..  We can’t believe what’s happening. Without discussion, without warning, they put themselves in charge of us.  A silent coup and that was that.  Without a shot fired they took over our profession.

“So why didn’t you call me?”

“Because it’s not done.  Professional boundaries.  I can’t talk to my patients about personal matters.”

“Ex-patients”

 “Patients or ex-patients.”

“Even if you have strong feelings about something that needs to be fixed?”

“Especially if I have strong feelings.”

“Well put that away.  When it comes to this I’m not your patient.  If we’re doing this I need you to tell me everything you know.”

“Gladly, Michael, gladly.”

           Michael takes out his pocket dictation machine and turns it on.

          “The first time you saw Richie.  You said something about approved visits.  What did you mean?”

“Your HMO only approved med visits for him, and quickie therapy, meaning maybe 10 visits.  When I was trained we usually saw new patients 4 or 5 times just to evaluate them, figure out what we were going to do.  Even then, you could never be sure what was ahead, where your patient was going to take you.  The mind’s complicated. Look at you. The things you considered important, and I considered important in the beginning weren’t important at all.

 The insurance companies decided screw all that.  Now in one visit you are expected to evaluate patients, basically slap a diagnosis on them and start  treatment,  meaning  using a medicine that has been proven to help that diagnosis.  Meaning it works 60% of the times compared to placebo that maybe helps 30 or 40%.  Then I am expected to follow my diagnosed patient once a month for 15 minute med checks.

“The diagnosis doesn’t mean anything?”

“Sometimes it does but mostly it’s just what it is, a crude label.  Whenever I tried to do therapy they’d usually stop it after a month or two. Insurance companies don’t want psychiatrists doing therapy.  It’s too expensive.  So nowadays I send them to a therapist, which the insurance company can live with- at least for a while.  They hassle them too.  Usually, after a month or two, the most they’ll approve is a visit every other week.”

“I went home and read my policy. It says Richie can be seen as much as necessary.”

“They don’t think therapy is necessary, especially with a psychiatrist.  They think it’s bullshit.”

“What do you mean bullshit?”

“They are not going to pay for it.   The only therapy they’ll allow is therapy that is over quickly.”

“Which is what?”

“ Right now it is teaching patients how to think positively.  That’s supposed to do the trick.”

“Deborah sometimes puts positive sayings on the refrigerator door. Is that the idea?”

“Basically.  Remember Henry Higgins from My Fair Lady.  Kind of like that. Mind over matter.”

     “Henry Higgins?”

           “Henry Higgins, the same mind set.  There is a big emphasis on being rational.  Do that and you can will anything, take charge.   You just have to work at it.”

             “That’s pretty optimistic.”

   “They claim that when people’s emotions trouble them it’s because they have the wrong ideas, bad habits, like biting your nails, stuff like that.  With the right habits, the right ideas, your emotions can be anything you want them to be. Eliza Dolittle could become a baroness if she practiced often enough acting like a baroness.”

“ What about what’s inside?  What about what’s happened to get you that way?”

“What’s inside is bullshit to them. The rain In Spain falls mainly in the plain.  That’s what matters.  They send people home to do homework.  Think positive over and over.  Put up posters with positive messages. Catch yourself every time you have a negative thought.  You can learn how to get rid of it!”

“Just like that.”

“ Is the glass half empty or half full?  They love that ditty. The depressed person’s habits make him see the half empty glass.  That can be unlearned.”

“And what if in reality the glass is 99% percent empty and 1% full.”

“If a dedicated cognitive behavior therapist arrived in hell he would find that 1%.  With enough practice, hell could be turned into Shangri-La. At least in his mind.“

“I can see Richie really getting into it, rushing home to put up a poster where it really matters, on the top of the wall where he keeps his feet when he lies in bed.  The positive sayings of Darth Vader, looking at it through his toes will be good practice at getting his attitude right.”

Stern smiles warmly and helplessly.  He and Michael have been here before.  You can’t change what you can’t change.  At moments like this Stern wishes he could simply laugh like his brother, Sammy.  Growing up, when he used to compare himself to Sammy, Stern used to take pride in his own intelligence.  His brother was a wise guy, a jokester.  You could never get him to be serious. Lately he thinks his brother may have had it right.   Most things are a joke.  You got to learn how to laugh at it.

Except Stern has never been good at laughing.  The idea is one thing.  For a while acknowledging and appreciating the absurd had a certain cache. “Ionesco, Beckett, it was an acceptable overview of life. However, at best it offered him a lick of irony, moments at the theatre that seemed to incorporate a meaningful perspective.   He’s tried to savor that, appreciate the absurdity all around him. He was quite pleased with a college essay he wrote  for freshman English, but now thinking about it.  None of it compared to Sammy’s laughter.. His reactions are pure.  Something’s funny or it’s not.  It makes you laugh or it doesn’t. Sammy understands absurdity in his bones, which is the only real way to understand it.”

 “On the ward they had the patients together for an educational seminar. There was this woman talking to them about being positive.  She was very determined. Do you know who I mean?”

Stern answers in a monotonous tone, “Yeah Ms. Allison.”

“You are saying it is total bullshit?”

“It is bullshit, but maybe not total.”

“Why not total?”

“Sometimes it works.  I mean someone is drowning.  You throw a life preserver.  It’s going to help if it gets the person back on the boat.  Look, religion works for some people.  It turns some people completely around.  Great idea.  God’s your friend, your parent, watching over you. Ultimately everything is fair because he loves you.  And in the end there is heaven.  Or hell.  Essentially cures those who buy into it-sometimes for life. I can understand that kind of positive thinking.  Only plenty of religious people get into trouble.  They lose their faith.  But I will grant that it is a legitimate positive way to handle troubles.  Long before there were shrinks there was God.”

 Stern continues, “ When I was a kid, and I got down, my mother always had a good positive line ready for me. “Whistle a happy tune,”  “Stick and stones will break your bones.”  “Every cloud has a silver lining.”  “The sun will come out tomorrow.  Was that one of hers?  No that’s from Annie. Anyway, you name it and she comforted me with it at one time or another.  Sometimes it was from a show, sometimes she read it somewhere, sometimes it was her own zinger.   Mrs. Buddha Stern.”

         “So positive is good.”

“Yeah.  Sometimes.  Some people are amazing. They bounce back no matter what.  They will not let any hardship get in their way.  Sometimes people have this goal in life.  They’re ambitious.   Nothing is going to deter them.  They just know that with enough persistence and effort they are going to get to place where their dream is going to happen.   So setbacks along the way are just that, temporary obstacles.  Being like that has amazing effects on your ability to be positive. Well until you lose your dream.  It turns out not to be what you  wanted.  Or they don’t get there.  Then watch out.  Then they come to see me.

 Still, I’ve met people that I wish I could bottle whatever it is they have.  For them it has nothing to do with ambition.  They just think positive thoughts.  Sometimes thinking that way is a good habit.  Or maybe it’s chemical.  I just don’t like the part where they try to dress it up. “Cognitive Behavioral”  It sounds so scientific, the wonders of science, polio vaccines, cognitive behavior cures for depression and anything else that ails you.”

              Stern and Michael are two peas in a pod.  Idea junkies. They get lost in tangents.  It drives Deborah crazy.

            “Theories,”  she mocks him when he carries on. That supposed to slow him down or shut him up. But it doesn’t matter.  Ideas comfort Michael.  Always have.  A new way to look at things calms Michael.  He didn’t design himself that way but it is in fact what he lives for. From the first time Michael and Stern got together they both knew it was a match.  For both of them insight is a nectar.  It’s penicillin.

Stern continues, “Here’s the mean part.  It’s how you get there.  Insurance companies push positive thinking very hard.   Cognitive behavioral therapy, 12 session cures.  Serotonin reuptake inhibitors. The language of science sounds so terrific.  So legitimate! “Evidence based treatments” How can you doubt something like that?”

Michael smiles at Stern’s mental gymnastics.  He’s not about to interrupt Stern on a roll.

“Of course you want to get to a place where you are feeling positive.  The question is whether you can get there the same way you train a dog to salivate to a bell. That’s behaviorism. For some people it works.” But for others it’s nonsense. The insurance companies won’t allow alternatives.

        Anyway, behaviorist conditioning is not going to help Ritchie.  He needs real therapy.   He’s got to make sense of things.  Get some kind of grip. Not everyone can get there, but a lot of people…”

“So then why not positive thinking?  Isn’t that a grip?”

“It is for certain people.  Get a therapist who is a true believer and some of his patients are going to get something out of it. Only it’s not going help Richie’s.”

“You know before I saw you I tried self-help books.  A lot of positive talk.  I don’t know what I would have done without the therapy I got from you.  Understanding myself, what was going on.  That made the difference.

“What insurance people don’t get about talk therapy, about remembering things is how powerful it can be.  I once had this woman who was constantly miserable.  She cried and cried.  She was grouchy with her children and her husband.  Sometimes she got nasty which upset her.  She was mostly disappointed in her husband who didn’t pay attention to her, didn’t seem to love her.  She married him because he seemed to be a loving guy.  After a year or two  she was sure he didn’t love her.  He was like her father who wasn’t very interested in her.  Then she had this memory. Before she would leave for classes at Brooklyn College, while she was having breakfast, on freezing cold mornings her father would go down to the car and start it so it would be warm for her.  He came back with his teeth chattering.  He never said I love you, never hugged her, but tears poured out of her as she recalled how cold he was when he returned to the apartment.

That memory made all the difference.  Suddenly she was not being hurt by her husband.  She was no longer depressed.” Dr. Stern  tears a bit.  “All that from a memory.”

“It would  be nice if something like that could help Richie.”

“I It would be.”

 “But if my insurance won’t pay part of it, how am I going to pay for therapy? I’m broke.”

“You were broke when I treated you.   We will work something out.  Anyway that isn’t the problem now.  We have a more immediate issue.  We have to make sure they keep Richie in the hospital until it’s safe for him to leave.  Chances are they will discharge him in a few days. It is very important that we not let that happen”

“Dr. Rahmadi was saying that, but if he has to stay…”

“Doesn’t matter.  Your insurance company will make sure he’s discharged quickly.  Insurance companies don’t like talk therapy but that is nothing, absolutely nothing compared to what they think of hospitalization.  They consider hospitalization complete bullshit.  It’s public enemy number one.”

“But if it’s not safe for Richie to leave how could they discharge him?”

“They will find a reason.”

“Come on…”

“Trust me.  It’s a sure thing.  They will find a reason.”

“They can’t just…”

“They will.  That’s the way it is.”

“How can they do that?”

“Guidelines.  Their guidelines tell doctors whether Richie can stay or goes.”

“But…”

“ Even if the doctor manages to answer yes to all of the guidelines that they specify, they come back the next day, “Well that was yesterday.  How about today? “

“So what can we do?”

“I’ve been thinking about that.  Don’t know if this will work but maybe if you let them know you are going to publish a story about what is going on they will get nervous enough to leave Richie alone.”

“It’s worth a try.”

Neither of them is sure they believe it.  They are both getting antsy.

“Let’s get out of here.”  Stern says.   “I need a smoke.  Central Park’s a block away.”

Chapter 16

Richie is playing pool by himself.  Melissa comes over and watches him for a while.  He misses several shots.

“You got to be smooth.”

“You think you can do better?”

Melissa reaches for a pool stick.  She is a thin, attractive high strung 16 year-old little lady, an energy package.

“May I?”

Richie nods.  She chalks the pool stick, then knocks several balls down.

“Where’d you learn to do that?”

“My father.”

“Oh yeah?”

“Yeah. My dad’s neat. Ever go to any girl’s basketball games?”

“No.”

“You should.  I’m the starting point guard. My Dad taught me all my moves. We went to the state championships last year.  This year we’re going all the way.”

“Melissa…”

“So you know my name?”

“You know I do.  We were lab partners in 7th grade Mrs. Mor…  Mrs. Moravy? No. Mrs. Morton?”

He cracks his first smile in a while.

“Mrs. Moron.”

“I like when you smile. You have a great smile.”

“Yeah, well.  What was her name?”

“Mrs. Motown”

“Come on.”

“That was it. I’m telling you.”

“No that’s a record label.”

“Mrs. Morky.  That was it.  Morky…like Dorky.”

He smiles again.

“So how come you’re here?” he asks her.

“I took some pills.  It was stupid.  I got pissed at my mom and took  a bunch of Tylenol.  I told her 5 minutes later, but she made me come to the hospital anyway.  They admitted me to the medical ward. And then they put me in this stupid place.   I almost did real damage to my liver.  I’m out of here tomorrow. Never going to do that again. Those tubes they put in my nose were disgusting.”

He’s only half listening.  She’s had a crush on him for years.

 “How come you’re here?” she asks with practiced toughness.

 Don’t want to go there. But I’m also going to be out of here too.”

“How do you know”?

“Real soon.”

“They told you that?”

““I just have to “contract for safety.”  Sign this piece of paper saying I’m not going to kill myself.  Then they’ll let me go.”  That’s what my therapist ibasically told me.”

“She actually said that?”

“Well.  Not exactly, but you could tell that was the main thing she wanted.   Me to contract.”

“You don’t have to sign nothing. No one stays here for very long.  I mean I signed it but they didn’t make a big deal out of it.  They know I’m not going to do it.”

“I don’t know. Mrs. Franklin definitely had it on her to do list.  I may not sign it.”

“You like to be difficult.  Don’t you?”

“I just don’t like to be pushed around.”

“You get pushed around a lot?”

He hesitates.  My dad.  Not directly but he gets across what he wants.  When I “disappoint” him he gets grouchy.”

“That bothers you?”

“It makes me angry.   Then if I show it, I feel like a jerk for getting angry.”

“You is a fucked up dude.”

“You’re not Jewish so you wouldn’t understand.”

“No I get it.  He pushes you around.”

Melissa looks at her watch.

“I have an appointment with my therapist.”

“Which one?”

“Mrs. Taylor”

“Is she nice?”

“I’ve seen her all of one time.  Told her it was a gigantic mistake and that’s all she wanted to hear.  It was the ticket out of here.”

“Let’s face it, we are a pain in the ass to them. That’s why they hide. Three nurses sitting up there behind that locked door at the nursing station.  Talking away and ordering food out.  Like some time they ought to show up here among the patients.”

“Yeah and share their pizza. Or at least let us order out.”

 She looks at her watch again.

“I got two minutes.”  She holds out her hand.   “If I don’t see you again, hope you get out soon.  And listen.  When we’re around school sometime, how about saying hello to me?  Or are you too stuck up for that?”

“It has nothing to do with stuck up.”

“Yeah right.”

“It doesn’t. I just have things on my mind.”

“Well I’m more important then any stupid thing you are thinking about.  So it’s going to be hello from now on.  Right?”

No answer from Richie

“Right?”

“Right.”

She walks away sliding her slippers along the floor like a little girl in her mother’s shoes, like Lisa used to do.  She looks back.   She’s not Marlene Schneider but Richie is feeling something.  For once he’s connecting.

“You take care Richie Russell.  And when you get out we’re going to get together.”

No answer from Richie.

She turns around again.  She can’t tell if he’s listening.

“You’re going to come watch me play basketball …Just once…  Okay?”

Richie catches a glimpse of Dan down the corridor.  He shouts to him.  Dan has a kid’s rubber football in his hand.  He flies a perfect pass to Richie who  makes a neat one handed grab.  Richie throws it back. Melissa watches them.  Dan throws the ball to Melissa. Another patient turns up the CD player.  A couple of other patients get involved.  A psych aide starts to move to the music.  They are having a grand old time until an older nurse enters the picture.

“Knock it off.”

Everyone but the psych aide ignores her.

“I said quit it…. Now!”

Their pleasure increases the more aggravated the nurse becomes.  She signals two burly staff members.  Suddenly there is silence.  You don’t want to mess with them.  One of them is built like a bouncer and has that mean face that tolerates no bullshit.  Melissa has the ball.  She looks at the nurse who is staring straight into her eyes, commanding obedience, daring her.

“Throw that and it’s seclusion.”

Melissa throws a perfect spiral right into the nurse’s gut. Dan grabs his ball as it bounces on the floor.

Although she hardly feels physical pain, the nurse pronounces the sentence.  “Two hours seclusion.”

The group watches as Melissa is led away.   Dan comes over to Richie.

“Great place.”

“Yeah, we have good times here.”

“What is seclusion?”

“Remember “time out?”  This is a jazzed up professional version. They lock you up in this padded cell like in the movies, only it’s real. You should see some of the patients.  They really get into it.  Bang their heads against the wall, scream like wild coyotes.  It’s great times here.”

“You deserve it. You were supposed call me if it ever got that bad. Why didn’t you?”

“Dunno.”

“Richie, come on.  Why?”

“Why.  Why. There is no why.  I had these feelings.  No! They had me.  That never happened to you?”

Dan doesn’t answer.  Richie continues.

“I felt this sadness. Bad bad sadness. No not just that.    Fear.  I don’t know why I’m afraid.  It can last for hours.  The nurse calls it anxiety.  Like it is some kind of body thing.”

“It’s not anxiety?”

“It is.  I’d rather call it fear.”

“You get that a lot?”

“Did that day.  Didn’t really know where it was coming from.  Heard my parents yelling.  But they do that all the time.  Don’t know what it was. First time it was that bad.  I couldn’t take it. I had this feeling that it was going to go on and on.  Never stop.  I can’t take that.  I had to end it.”

“Your parents were yelling?  They always seem like they are in a good mood when I’m around.”

“They are when you are around.”

“Why’s that?”

“Look Dan.  Things are the way they are and that’s that.”

“Bullshit”

“Things are the way they are. You don’t understand that?”

“Bullshit.”

“It’s not bullshit. Oh fuck. I can’t explain this stuff to you?”

“Explain what asshole?”

“Me. I gotta explain me.  Used to be you just understood me.  You were there before it happened with Lisa and you stuck around.  The only one.  So why can’t you understand what I’m talking about?”

“This is all bullshit.  You know things just aren’t that complicated unless you make it that way.”

“Another one! It’s thinking negative thoughts that’s the problem- so I should just stop, right? That’s all we hear on the ward. They drill it into our heads.  Talk happy talk. Be positive.  Be positive.  This happy, happy, horseshit.”

“Yeah but Richie you take bad karma to new heights.  You’re the champ of gloom and doom. You’ve perfected it.”

“What can I say?  If you are going to do something, do it right.”

“You got to stop yourself.  I mean it. Just stop.”

Dan continues

 “I don’t know if you want to stop.”

“Oh, here we go.”

“No, you know it. Admit it asshole.”

“Admit what?”

“You don’t want to stop.”

“I don’t want to stop.  Happy?”

 “Sometimes I get this feeling that what you really want is to pull me in with you. See things like you see them.  Maybe have everyone see it that way.”

“Look I can’t stop. Period.  I can’t.  And okay sometimes I want company where I am.  I’ll admit it.”

“But when I try to cheer you up…”

“That doesn’t work.  Believe me when people are kidding around at school, even good jokes, the best I can do is fake a smile.  That’s the worst, watching everyone else kidding around, having a good time.  It just isn’t in me. It’s not there.  Nothing’s funny.”

“What about TV?”

“Not any more.”

“There’s no programs?”

“I used to spend hours in front of the TV..  It got me away from it?”

“It?”

“Feeling shitty.  It doesn’t work any more?”

“Why don’t you talk to your psychiatrist?”

“That’s a joke.”

“What about this guy Stern that you saw?”

“I was thinking about that, but he is not allowed to see me while I’m here.”

“Why not?”

“I don’t know.  The rules.”

 “You should talk to your father.”

“Right.”

“Your father isn’t that bad.”

“He pisses me off!”

“Why?”

“I don’t know.”

Dan signals Richie to run down the corridor for a pass.  He takes off.  Dan throws a perfect spiral, which Richie again catches neatly over his shoulder with one hand.  He brings back the ball and flips it underhand back to Dan.  They are both silent for a while. Dan fidgets with a zipper on his jacket.

“Richie?”

“Yeah?”

“You know I really would like to help you.”

“I know Dan, but you can’t.  No one can.  It’s okay.  I still like you.”

Chapter 17

Melissa paces back and forth in the padded cell. She screams.

“Let me out of here.”   As she lets loose, her pain is written across the face of several of the newer patients, who are not used to screaming of this magnitude.  She is really going at it.

“This is America you Fascist fucks.”

 Melissa drops to the ground. Leaning against the door she begins to sob in earnest. Richie comes over to the locked door.  He whispers to her.”

“Melissa?”

Melissa continues to sob. Richie raises his voice.

“Melissa.”

“Go away.”

“Come on.”

“Go away.”

“I’ll talk to them.  I should be in there as much as you.”

“It’s not just being locked up.  It’s everything.”

“What do you mean everything?”

“Everything! It’s all bullshit. I’m just a big bullshitter.”

“What do you mean?”

“I lie all the time.”

“So what.  Sometimes you got to do that.  Especially if something hurts, If it’s  getting to you…”

“I just lie, hurting or not hurting. You know that stuff about my father?

“Yeah?”

“It’s a lie.  I never met my father.  My mother isn’t even sure who he is.”

“It doesn’t matter.  I like him.  I like him a lot.”

“What does that mean?”

“It means lying is good sometimes.”

Melissa is quiet.

“My sister Lisa used to make up stories.”

“About what?”

“Everything.  You name it.  She had these two characters.  Shirley and Eddy the talking cockroaches.  Lisa and me discovered Shirley and Eddy in the forest.  I was 5. Lisa was 6.  They became famous. Us too. We became famous. We went on TV with them.  We used to talk about that when she was stuck in bed.  She reminded me how we went all over the world with Shirley and Eddy performing.  We met Queen Elizabeth and Barbra Streisand and the Earl of Zebra Land.”

“Who was that?”

“No one. She just always said it because it made me laugh.  Make believe memories. Only after a while I was making up the laughs.  It got harder and harder to talk about the great time we had the sicker she got.  But she’d tell the stories anyway and I’d pretend to laugh. She knew I was pretending. We did a lot of that.”

“You love her, don’t you?”

“You mean then?”

“Now!”

His eyes drop. “We both knew it was a makeup game but we talked about it like it really happened. I’ve never been as close to anyone as when we would do that.”

“You should give someone else a chance.”

 “Maybe.” He says barely loud enough to be heard.

But she hears him and through the heavy glass in the door, searches for his eyes.  They are not to be had.

 “It’s cool that you can make stuff up about your father like that.  You’re father teaching you all your basketball moves.  That man is a fine man in your head.  And now he’s in my head too.”

“You’re a nut.”

“I know. I guess we are where we belong.”

Chapter 18

Michael and Dr. Stern cross Fifth Avenue at 79th Street and head north to reach a path along the edge of a pond.  Stern has a cigarette hanging from his lips, an affectation, in his youth, that he originally patterned after Jean Paul Belmondo in Breathless.  Closing in on 60, it has become part of his look, at least in the way he sees himself.  Others from his generation might have placed him, with his raincoat, as more Columbo than Belmondo.   He picked that up in his forties.  Either way, while his appearance might have originally been derivative, over the years it has also become completely his own.  In truth, he looks nothing like Columbo or Belmondo. Like other sixty year olds, whatever might have been his original effort in the looking cool department is now irrelevant.  Cool isn’t possible.  Once handsome enough to get his share of looks-he still has a good chin, nice eyes, and an expressive upper lip, but his jowls and tummy confer invisibility. People passing him on the street wouldn’t notice him one way or another.  Fortunately, his motivation to present a distinctive image is mostly gone.  For better or worse, he is what he is, vintage Dr. Stern.

Which is okay.  While he has an assortment of mannerisms left over from his young glory aspiring days, his ambition now is to fit in comfortably.  For the most part, he is able to do that without much effort.

    Joggers run by them.  A swan, in the middle of the pond, flaps its wings.  Stern nods back to it nonchalantly as if they are good friends.  Michael is turned on.   He may swoon at a sunset, he still takes nice photographs some of them beautiful,  but he is usually oblivious to what is in front of him.  It takes something like a swan to catch his attention. That, or a beautiful woman wake up his eyes.  The rest of the time he is in his head.  So the swan catching his attention nets out as a good thing.   It cools his overworked brain.

Silently they continue to walk along the pond.  When Michael was in therapy they occasionally went for walks.  The advantage was they could be quiet for long stretches without the awkwardness that sometimes occurred when Michael had nothing to say.  Therapy is like being on the telephone.  You have to keep the conversation going.  Otherwise, sitting there and staring at each other can get weird.  Stern and Michael have in common, Perhaps it is Jewish.  Both feel they should talk when they are with people. No Randolph Scott for them, no John Wayne with his laconic spin.  Walking, instead of sitting, allows them to not have to talk.

 Fifty yards beyond the pond they are surrounded by trees.  They are not ceremoniously planted or cared for, just trees, basically weeds that were never pulled.  Dr. Stern ends the quiet.

“I’ve read a lot of your stories Michael.  They’re good… Believable, totally believable.”

“I try to stick to the facts.”

“That’s what comes through.  In this story the truth is pretty straight-forward. The facts speak for themselves.  The insurance industry makes every penny of its profits by limiting care. Pay out too much, they lose money. Pay too little they’re on easy street. In the last 10 years they have gotten to do what they choose to do.  It started as refusing to pay for experimental treatments.  Like Lisa’s bone marrow transplant.  That might have been your last hope.  Saving Lisa  was all that mattered.  From their point of view they were not going to pay for a very expensive treatment that a family grabbing at straws is bound to come up with.  Bone marrow advocates pointed to miracles using it.  Insurance companies pointed to how infrequently that happened.

From there they went on to eliminate or limit ordinary procedures and practices.”

“Like keeping a suicidal patient in the hospital?”

“Exactly.  No one stopped them.  No one.  They just started refusing to pay for patients remaining in the hospital and no one stopped them.”

Michael says nothing.

 “Even more amazing is how quickly a change like that simply becomes the way things are.  And everyone adjusts to it.”

“But what kept them from doing this kind of thing before? Or have insurance companies always done this?”

“No.  Before HMOs existed, doctors treated patients the best they knew how and insurance companies paid for the treatment. What was considered an effective treatment was decided in learned journals.  Insurance companies were not part of the discussion.

The insurance business was simple.  They paid out a percentage of whatever medical treatment cost.  Their actuaries had to figure out what that cost might be for the people they had insured.  Once they had that, they needed to figure out how much profit to bake in to the premium.  It wasn’t a lucrative business, but it was dependable.

In the past the insurance companies’ main job was  to convince their customers that they weren’t going to go under. No matter what.  You know. Prudential with its rock of Gibraltar.   But that was it.

  Maybe sometimes an insurance company would pay less than expected, claiming the doctor’s fees were too high.  That was regular practice in Manhattan if you chose to see the best doctors.  I saw a top neurologist at Presbyterian.  My insurance company paid 80% of what they considered a usual and customary fee, meaning they decided it was one third of what the actual charge was.  So they reimbursed me $64 dollars on a $240 dollar bill. I wasn’t too thrilled. I was paying good money for what I thought was good insurance.

 They essentially were saying.  “You want a top doctor you pay for it.  I don’t know if that was fair or not.  It was simply the way things were.   It’s what happened  after that.

Everything changed.  Very large sums of money was going to medical care.  A trillion dollars worth of care   The insurance companies wanted a piece of that action.  Which meant that they took it upon themselves to make the important decisions. Not doctors, insurance companies decided they knew what was, and was not, acceptable treatment.”

“Really.”

“You have to remember there were a lot of people who hated psychiatric hospitals.  “One Flew over the Cuckoo’s Nest” pretty much was the nail in the coffin. ACLU types had been screaming for years, that keeping a patient in a hospital against his will was a form of imprisonment without a crime being committed..  That movie just about did ended the legitimacy of inpatient care.

 “But weren’t certain doctors abusing the insurance companies, tacking on unnecessary charges?

“I’m sure there were doctors who took advantage of the system, and other doctors here and there who pilfered, stretched their charges a bit.  Billing an institution is very different than billing an actual person. I’m sure there was some padding.  But plenty of doctors were completely honest.  Their concern was taking care of their patients, not gaming the system.

What is happening now is that insurance companies tell even the 100%   honest doctors what they can and can’t do. It’s not like they went to top doctors and asked them what is reasonable.  It didn’t take a medical degree to decide what the treatment should be.  Just a good calculator.”

“That’s crazy.”

“No kidding.”

 They walk on quietly.  After thirty or forty feet, Michael breaks the silence.  “I keep thinking there is something I’m missing about what you are telling me. I don’t really get it. You’re saying that even if it is clear that Richie should remain in the hospital, the doctors, on orders from the insurance company will push him out of the hospital? “

“ He’s a thousand dollars a day that the HMO has to pay out. End of mystery.”

“A thousand dollars?”

“That’s a whole other story.  The thousand bucks. Three people could stay at the Plaza for what it costs to stay overnight in an institution with cinder block walls and lousy food.”

“Why does it cost so much?”

“Because everything they do now follows protocols.  You have no idea how much staff it takes to keep up with the paperwork. The day of doctors doing what they think is necessary to properly treat a patient are completely over.   Treatment is now regulated, documented up the kazoo.  You know, when I worked at a clinic years ago, we used to provide coverage for a group home run by the New York State. They had maybe eight or ten people that lived in a house, watched over by dozens of staff.  When I’d go there to see a patient the staff would hand me a chart that was practically the size of a phone book.  Sometimes there were two or three other clipboards with papers I was expected to fill out. I essentially had to duplicate what I had already written in the chart, three times on other forms.  Turns out that is what the staff did all day, filled out forms and notes.

You had to fill out a triplicate form for a fart. Anyway that’s what they did, mastered the expected lingo and repeated it in writing again and again.

What was really crazy is I that when I’d ask a staff member about a patient, they were clueless.  They knew practically nothing about them. Following a protocol with documentation was 90% of their job.  Not getting to know the patients, good paperwork defined whether a worker was doing a good job.

Now private hospitals operate by exactly the same principles as the state agencies.  Tons of paperwork, created by bureaucrats who have been advised by lawyers, that any deficiencies in the paperwork is akin to malpractice. Again! Not how the patients were treated, how adequate their paperwork is was the standard of care.  That cover your ass mentality is very expensive.  It has driven costs through the roof.

And everyone knows this is going on. The bureaucrats that make the rules, know very well they are accomplishing nothing at their jobs.  But in order for their boss to think they are productive, they create  more checklists more forms.  New forms prove they are working hard.  If it weren’t so crazy and destructive it would make an interesting study.  How people tangle themselves up in regulations for no apparent reason (other than to make believe they are working at their job.)

“Aren’t the insurance companies afraid of lawsuits?

“Not the least bit.  They have this perfect setup.  The doctors can claim the insurance company wouldn’t approve treatment they had recommended.   So they are pretty safe.  The insurance companies are completely fearless. The issue in a nutshell is you can’t sue a health insurance company!  No matter what they do they’re protected by federal law.  They are untouchable. Nothing.  No law suits.  Period.

As they walk Stern, worried that he’s throwing more at Michael than he can take, several times grabs hold of his upper arm and gives him an affectionate squeeze. “I’ve painted a pretty bleak picture of what is ahead for Richie.”

“You have.”

“But, given what you do for a living I had to fill you in on this.”

  “I understand.  Look I’m practically irrelevant up on the ward anyway.  What else can you tell me?”

I’m going to give you this folder.  Go through it.  Google Linda Peeno.  She’s an insider.  She was the medical director at Humana and a couple of other insurance companies.  What she reveals about how it all operates is amazing. She thought maybe she was with an unethical company when she resigned from the first insurance company.  But it was the same with the second and third companies.  Finally when she couldn’t stomach it any more she quit the industry.  Became an ethics professor at Louisville University.   Read it.  You can get an insider’s view.”

As they walk on Stern continues, “It’s amazing that what’s going on hasn’t had any publicity.  Being screwed by an insurance company is so common.”

“I know.”

 Most of the time people think someone made a mistake when their insurance company doesn’t pay.  It’s no mistake, every mistake made by their processor is money in their company’s pocket. If patients’ families challenge them the families may win. But most people give up.  After being put on hold for a half an hour, or not getting an answer to an appeal letter, or a voice mail, or talking to a moron intentionally hired by the company to be obtuse, the average person figures they are wasting their time.

This is one of the few industries where ineptitude is a treasured commodity.  They know exactly what they are doing, by being so incompetent when it comes time to pay your claims

Because every once in a while they make a mistake and pay too much.    When that happens all of a sudden you are dealing with a different company. You get a registered letter demanding that you immediately call them.  When you do they answer on the first ring.  No music, no recordings.   A competent person lays out the facts to you.

Insurance executives are not stupid. The people they ordinarily throw at you, the chaos awaiting you when you try to straighten out something is by design.  Not only do they not have an incentive to fix something that is broken, their profits depend on it remaining broken.  The incompetence of the claim payers, and the people they hire to answer your calls are very carefully chosen ”

“The profit motive can take strange forms.”

  “Here’s another part of the business. They hire doctors whose full time job is to dream up innocent sounding rules in the small print that gets their company out of paying.  That’s what Linda Peeno writes about.  It was a big part of her job.   She’s a good place to start.”

Stern hands his folder to Michael.

“Study it.”

Chapter 19

Returning from his walk with Dr. Stern, Michael finds Deborah and Richie standing together in the day room, a common room that serves as a public meeting place for patients and visitors.  Michael and Richie greet each other with an uncomfortable hug.  Michael tries to hold on.

“Dad I gotta go.?”

Awkwardly, Michael is still holding him.  “We‘re going to get through this.  You are going to be all right.”

Richie extricates himself.  He hugs Deborah.  She takes a deep breath to maintain self control.   As they look into each other’s eyes Deborah tears up.  Richie wishes he could explain, but he doesn’t know how to.  He walks away quickly without looking back.  He turns a corner and is out of view.

Michael gently runs his finger under Deborah’s eyes wiping away a tear.  She also moves away from him.

“What did Stern say?”

“He said the whole system has turned to crap. HMO’s have targeted hospitalizations.  They think the time spent in the hospital is unnecessary.  So they won’t pay for it”

“What do you mean? How can they do that?”

“Apparently they’ve done it, not just our company, all over the country, and no one has stopped them.”

Deborah is quiet.

“Psychiatrists, have complained, but no one’s interested.  Reporters think they are just looking out for themselves.“

“Stern thought I could write a story that might help Richie.  Maybe threatening Dr. Rahmadi and the hospital might give us leverage to let Richie stay here until he is ready to leave.

The other possibility is finding a better hospital.  He gave me the name of one.   Golden Hills. Said it used to be pretty good. It’s not just a ward. It has grounds.  It has basketball rims, tennis courts, things like that.  Makes sense. Being locked up in a place like this has gotta make you feel worse.”

“Sounds almost like a summer camp.”

It started out as a place for rich alcoholics to dry out.  It still attracts movie stars. But they also have a psych unit.

That’s encouraging.

“Only. Stern wasn’t sure what managed care has done to them.  They had to fire a lot of their staff. No more art therapists, dance therapist, people like that  They shut down two thirds of their wards.   They are bare boned.  Still. It’s gotta beat here.  Do you have a quarter?  I want to call them.”

Deborah finds a quarter in her purse and gives it to him.  She hands him Lisa’s ring with the quarter.

“They found it.  I think you should bring it to him.”

Michael takes the ring and heads for the phone.  Deborah approaches Melissa, who has just come from the direction Richie went.  “Do you know where Richie Russell went?”

“His room is right around that bend.  Try there.  Are you his mom?”

“Yeah hi.”

“I’m Melissa.   I was just talking to  him.”

“Oh, so you know each other?”

“We’ve become sort of buddies.   Which is funny. We’ve seen each other around school since the third grade, but we never said a word to each other. That’s the one good thing about this place you connect to people real fast”

  She smiles.   “Those eyes.”  She’s lit up as she says it.

Which brings a smile to Deborah

“I know.  He got that from his father.”

“A lot of girls at school have a crush on Richie. Only he doesn’t seem to notice them.  People say that he acts like he’s too good for everyone.”

“I guarantee you that isn’t going on.  To defend himself he may have learned how to make believe he’s better but that’s not him. It’s an act.

“Now I know that. But-

I’m sure most people at school are like him trying to act like they are better than everyone else. I remember being 16. Trust me.  Whatever act he’s been putting on, he doesn’t feel that way.  Particularly the last 6 months.  He doesn’t seem to notice much of anything.”

“Now I know that, but I didn’t really know him before.”

 Melissa hesitates.   “He must have felt pretty bad to try to hang himself.”

Deborah takes Melissa’s hand.

“Mrs. Russell I don’t think he would really do it.  I wanted to kill myself, but after I tried it in 10 seconds I knew I didn’t want to die.”

“So you think it’s the same for Richie?

Melissa doesn’t answer

 “I wish that were true. Did he tell you that?”

“We didn’t talk about it.”

“What did you talk about?”

“Mostly Lisa.  Boy she must have been something.”

“Richie was very close to her.”

“He’s very upset that he doesn’t have her ring.  He said he felt weird without it.”

“They found it.  His father has it.”

“Oh good.”

 “You know about the ring?  You really have gotten close to Richie?”

“We only talked a couple of times. But they were long talks.  I feel close to him.”

“I’m happy to hear that.  During the last year he hasn’t really talked to anyone.  Not even me.”

Michael returns which immediately causes Melissa to want to leave.

 Deborah puts out her hand to Melissa, who takes it.

“Maybe we can talk again sometime.”

“Definitely.”

Before leaving, Melissa looks Michael’s way.  He gives her a polite glimpse, but just that.  He is a man on a mission. Melissa was avoiding looking in his direction anyway.  She walks out of hearing range to the other side of the day room.

“Golden Hills said the insurance company won’t approve transfers unless there is a compelling reason.”

“You’re saying we can’t choose where we want Richie to be treated?”

“Correct. Golden Hill said getting a transfer approved by Liberty, is difficult   They’ll accept him as a private pay.  That means a cashier’s check for $25,000 dollars before admission, then another one every 3 weeks.”

“So we’re stuck here?  We can’t find the money somewhere?

“Not even close.  Our second mortgage and home finance loan, not to mention our maxed out credit cards pretty much takes care of the budget.  We knew this would happen when we went ahead with Lisa.   We can’t come up with $25,000 unless we talk to your aunt.”

“Last year I borrowed another $12,000 to pay off some bills.    We still owe her on that.”

“Still…”

“I can’t.  I just can’t.”

“It could be Richie’s life on the line.”

“Fine.  I’ll try.  I’ll call but I don’t know what I’m going to say.  Don’t count on it.”

“That’s okay.  I’ll tell Richie that we’re going to have to make the best of it here.  You want to come with me?”

“Nowadays whenever we’re a three-some, the two of you don’t get along.”

“We’re too busy trying to score on each other.”

“That’s because I’m a great prize.”

“You’re in a good mood.”

“Believe it or not, I am. While you were gone, I went to an AA meeting in the hospital.”

“It’s been a while.”

“It isn’t only AA.  I just have this good feeling. I don’t know why.  Richie’s made a new friend here.  It’s been a long time since that happened.  Maybe Richie’s suicide attempt wasn’t all bad.  Before that we were in a routine. Everything was just moving along silently The scare is making us rethink everything.  Maybe the same thing is happening to Richie.”

“You think so?”

“I don’t know.  Bring the ring to Richie. Talk to him. Tell him things are looking up.  I’ll see you tonight, meet you in your favorite spot.”

“Is that a promise?”

“It’s a certainty.”

Michael enters Richie’s room.  The lights are off.  It’s dimly lit

“Rich-you asleep?”

Silence

“Rich?”

Once again, silence.

 Finally, “Yeah?”

“How come you have the lights out?”

“I like it this way.”

“Listen they found Lisa’s ring.”

As he gives the ring to  Richie, for a moment he shows an emotion other than defiance, the first time Michael has seen that in a while..

Richie has long had a habit of fingering the ring whenever he gets tense. Very quickly he is doing that.  Several years ago, when he was around ten, he had a dream.  He told Deborah that in the dream Lisa’s spirit had entered inside her ring.  Literally.  A Geni left her body and got absorbed into the ring. She was alive in the ring. He woke up tightly gripping the ring.  He wore it on a metal necklace like GIs wear their nametag.  On more than one occasion, when he took it off his neck, he felt weird unless he continually slipped the ring off and on the end of his finger.

Deborah and Michael weren’t going to challenge him on this habit . Although Michael, sometimes couldn’t  help a quick glimpse in which he looked  at Richie like he was crazy.   Richie had caught it.  So he adapted a blank face around Michael when he had the ring in his hands.

 Deborah had told Michael about the geni. From Michael’s point of view Deborah seemed too okay with it.   She was encouraging nonsense.  Richie had no intention of telling Dr. Stern about all of this, perhaps later on, but maybe not.  In theory Michael could respect  the ring’s importance just not the craziness surrounding it

  Richie puts the ring back on the chain.

“That means a lot to you, doesn’t it.”

“Yes.”

“ Do you know the story about it?”

 “Which one?”

 “Grandma Ann had a great aunt, who was supposed to be very beautiful. She lived in the Van Buren Hotel downtown.  You know that extremely fancy hotel on 5^th Avenue.  We took you and Lisa there for ice cream once.  Remember it?”

“The one with the garden behind it?”

“Yes.  You do remember it?”

“I think so.”

“Well when she was 17 this young man fell in love with her at the ball that followed the presentation of debutantes.  He gave her the ring.  Her father was the manager of the hotel.  The uppity ups complained that the daughter of someone who worked at the hotel, and who wasn’t presented, was allowed to dance in the ballroom.  Actually, they were angry because she completely stole the evening. She was so beautiful that all eyes were drawn to her instead of the debutantes being presented. That night a fight broke out  after someone tried to shame her for being there.  The young man she had fallen for was shot and killed.

She never married. She still wore the ring at 90.   She gave it to Grandma Ann when she got sick and was dying.  Your grandma liked this woman.”

“What was her name?”

“I don’t know. Your Mom does.”

“She does?”

“ Mom found it in Grandma’s attic.  Lisa always liked that story.”

There is a very long pause, until Michael speaks.

“It’s been a long time since we talked.”

“I know.”

They are both quiet for what seems like an eternity.  Finally Michael cannot control himself any longer.

“Richie, why did you do it?”

“I wanted to.”

“And now?”

The answer is written on his face.

“Why? Why do you want to die?”

“Dad. This is going to go nowhere.  I appreciate the effort, but it’s not something you can understand. We’re coming from two different places.”

“Not as much as you think.”

“You’re wrong.”

“No I’m not.  You jump all over the ways we’re different… for instance because I like Spyro Gyra.  What is it with you and your friends with music?  I used to hear you and Dan putting everyone down. It’s like you’d categorize this one or that one as a creep or cool according to the music they like.”

“Music says a lot about who you really are.”

“Maybe, but some of it is bullshit “us” and “them” stuff.  People always find a way to do that.  People fight about religion.  They still do, hate people with a different religion. In this country it’s almost disappeared.  At least the people I know and you know.   So what do you and your friends do?  You invent something new, to make people the enemy. Music does just as good a job.”

“Oh fuck this. That’s what you want to talk about?   Show me how fucking smart you are?  I don’t want to hear your lectures.  It turns me off.”

Michael puts his hand on Richie’s shoulder.

“Sorry.”

Richie doesn’t respond.

 “You’re right to be pissed.”

“Do you understand?  When you get one of your ideas, I can see you’re excited but you’re not talking to me.  It may be someone in your head, but it isn’t me.”

 “It’s automatic… it’s this dad thing, I keep thinking I can teach you something.”

“Yeah, well, that’s one of the things that turns me off. I don’t want you to teach me anything.  You try to force it on me.  I stopped listening years ago.”

“I am sorry.  I really am. I want to understand, because the truth is I really don’t understand what you mean, why we’re so different.”

“You just react to things differently… You always have some kind of cause..  Some great idea that gets you all excited.  Stuff at work, fixin’ something at home.”

“So?”

“I don’t. For me there’s no point. Whatever I’m doing I’m not really doing.  I’m going through the motions. …  After a while, I don’t see the point of going through the motions.”

“Things change Richie.  They change.    When I was your age I was tall and skinny, a geek.  I kept trying, making jokes, doing favors for people, anything, kissing ass all over the place just to get people to like me. It didn’t work.  Only losers, I mean real losers called. And there was always someone who couldn’t resist the temptation.  He had to let me and everyone else know what a nothing I was.  Really rub it in… ‘After a while I wanted to stop everything. I thought about dying… a lot of times.”

“You did?”

“Almost every day.  Maybe. I don’t know…Maybe I would have tried something if it continued… Only it didn’t…That’s how it is…Talk to your Uncle Dave.  Talk to Aunt Barbara. Talk to anyone who’s been around for a while. Practically everyone’s been there.  Your Aunt Barbara was down when she was around twelve or thirteen.   I can still remember it… She had bad acne.  She had put on a lot of weight.  ”

“Aunt Barbara?  She’s practically a tooth pick now.”

“Those two years we used to call her Big Barbara.  She started developing earlier than the other girls.  All she talked about was how fat she was…

Whatever happens to people… when it’s going on you can’t imagine things could be different. It’s like the end of the road.  There is nowhere else to go. Kaput. Finished.  Time to wave good-bye,” he adds with a Borsht belt flourish.

It pisses off Richie. Michael notices. He immediately settles down but it is too late.

“Why do you fuckin’ do that?”

“I’m sorry.  I guess I thought being lighthearted could help the situation here.”

“You think this is a joke?”

“It’s not a joke, but Richie, it is exactly what I am trying to say to you. Look I know, and you know, that we don’t communicate too well with each other.”

Richie doesn’t answer.

“I’m trying okay? I’m trying.”

“Trying?  You love the sound of your voice. I don’t.”

“So you want to kill yourself and I am supposed to do nothing?”

“No.  But you can’t do anything if I want to do it.”

“Fine, but, at least, think about what I am telling you.”

“Which is what?”

     “It changes.  It just does.  Five years, ten years later you can hardly remember the bad times. It’s ridiculous.  You’re being tortured, and then you can’t really remember what that was like. Or why. It’s like a tooth-ache. You can’t remember how bad it felt.  Yet when you have one, it is the most pain you’ve ever had.”

“That’s you not me.  This isn’t something that is going to pass.   I haven’t been right for a long time…”

“Since Lisa?”

“Richie doesn’t answer “We’re different. I remember how you cried.  I didn’t. I kept thinking about how she was afraid.  The day she died she was afraid.”

“You don’t know that.”

 “Dad. I know. I saw.  I was there right ‘til the end.  She was afraid. Until the last second.  She was scared out of her mind.”

“No.  You can’t know that.”

”Dad.  She told me. She gave me the ring thinking it might help, and I was holding it.  She was squeezing my hand right up until the end.   Dad she was scared. I could feel the way she was squeezing. I can’t forget that.”

“Well, you have to.  You just have to.  Your mom.”  He fumbles “What about your mom?  She couldn’t take losing you.  That would be it.  You’re all she has left.  You can’t do that to her. You gotta’ stay around for her.”

“You don’t get it, Dad.” Tears start to stream down his face.  “Mom’s already gone.  She wants me to end it so she can finally be finished. She wants to totally let go.”  More tears.  “Just look at her, listen to her.  She wants it over.  I’m not doing her no favor sticking around.”  Through his tears, “She wants it over.”

   “Richie. I swear to you.  Right before I came in here your mother was saying things are looking up. She had this feeling.”

“Dad.  Come on!  I’ve heard that a hundred times.  She was probably on something.”

“You’re wrong.”

Richie’s tears keep coming, “No, Dad.  She’s probably been taking my Prozac.”

“Even if that were true, so what if she is? That’s what you need too.”

“You think I’m going to drug myself out of this?”

“It’s not the same thing as taking illegal drugs.  It’s from a doctor.”

“Oh, okay.  It’s not the same.  Except I see some of the patients around here and they’re in la-la land.”

“You know that woman in the group may be right.  Your negativity…  Where do you get it from?  How do you see things that way?”

“What do you mean?  Where have you been?  Where are you? I just want to tell it like it is.  Even if I could, I don’t know how to bullshit.  I’m not in love with bullshit.”

“And I am?”

Richie smiles triumphantly.

“That’s what you think?”

“Some people sing in the shower.  You’re singing bullshit all the time.  You love the sound of your voice,”

“So what?”

“I don’t want to be around it.”

“So, in two years you’ll go to college.  Get a life of your own.  You don’t have to listen to my bullshit.  You can’t make two more years?

Richie’s smile isn’t as triumphant as it was a minute ago, but he is still smiling, secure in whatever that smile means.  It’s beginning to sink in. Michael sits quietly, considering his next move.

“I want you to promise me that you won’t hurt yourself.”

“Why?”

“Because that’s what I’m asking…  Because no matter how sure you are of the way things are, there are always surprises.  Things change.”

“Yeah. Like how, when I gave her my bone marrow, that was supposed to change things.  Probably made her worse.  My blood is no good.  It probably killed her”

“Jesus Richie.  That’s nuts. Your blood is good.  Your blood is good.  For a while there, after they gave her your marrow, her blood count went up. She felt much better.  For at least a week or two she was the old Lisa.  And she was good beyond that for 2 more weeks.  You gave that to her.”

“That’s great.  One whole month!”

“Richie you returned her to life.  Five minutes. One month. It doesn’t matter.  What you gave her was real.  Feeling alive rather than sick and dying, you gave that to her.”

“I can’t stand when you do this lying thing with me.  Bullshit about how everything is going to be good. That’s what you did to convince me to give my bone marrow.”

Michael’s voice becomes more determined.  “ Richie.  There is something you have to realize…”

“What?” He shoots back.

The contempt in his voice throws Michael back.  He waits for it to pass.

“What!” Richie shouts nastily but not quite as bad as the first time,

Michael speaks softly.

“What you gave to Lisa was a gift.  The most important gift you can give to anyone.  You gave her life.”

“Oh here we go, philosopher Russell.  Save it for one of your columns.”

“What you gave her is precious.  You don’t  think Lisa saw it that way?  You were her knight in shining armor.  Every minute she had, you gave that to her. She was alive again. If it were for a minute, it would have been a miracle. You gave her a month! “

Richie rolls his eyes.

 “You just remember the end.  Lisa would have told you what I’m saying..  There wasn’t a moment when she doubted that life is precious.  3 minutes gives you a song. Two hours gives you a movie, a game of Scrabble.

And Richie it’s not just that you gave it to her.  You possess it.  You’re alive.”

“Yeah all that fun. I love every minute.”

 Why didn’t you learn that from her?  If she were here she would kill you for wanting to throw it away.”

Richie says nothing. Michael continues

 “It’s full of surprises.”

“What kind of surprises?”

“How do you know you won’t fall in love?”

“You think the secret is falling in love don’t you?”

“You want to know the truth? Yes, I do. Except for Lisa, I haven’t really been depressed since I met Mom.”

“Well she has.”

“You know you’re scaring me Richard.  You really are.  You’re scaring me.”

“Welcome to the club.”

“Meaning what?”

“Meaning just that.  Welcome to the scared out of your fuckin’ mind club.”

“You’re trying to scare me aren’t you?”

“I’m trying to do nothing.  You asked.  I am telling you how it is.  Your son is losing the war.  Got that? I’m a loser.  And I’m not just talking about not being  a winner at school.   It has nothing to do with anyone else.  My fucking life has worn me down, beaten the shit out of me.  The one way I can take charge is to end it when I choose to end it.”

Michael looks at him in silence

“Let it sink in.  I’m a loser.  The son of Michael Russell is a loser. Be honest. That’s what really bothers you isn’t it?”

“You are so wrong. I’m way beyond that.   This isn’t my vanity Richie.  I don’t care what anyone else thinks.  This is about you…

Michael continues,  “Listen.  You just started this medicine.  Maybe they’re right.  Maybe this is all a chemical imbalance.  Give Prozac some time.”

“Yeah.  It’s a chemical imbalance.  Right Dad.”

“Maybe it is”

“Prozac is going to cause me more problems.”

“What kind of problems?”

“Do I really have to get into that?”

“What?”

“I didn’t tell you the real reason I tried to hang myself.”

“Well tell me, Richie. Tell me. I want to know.”

“I don’t know.”

“Please. Richie. I can’t stand trying to figure you out anymore. It gets me nowhere. I can’t do it. Just tell me.  Okay?”

“I did it because that day at school a couple of girls were teasing me, calling me a faggot.”

“You’re not gay.”

“I’m not so sure.  Lately I’m not interested in girls.”

“Did you talk to Dr. Stern about that?”

“Yeah.  He said it’s because I’m depressed.  He said I’m not gay because I’m not attracted to guys.  He asked me about whacking off.  It’s true. My fantasies are about girls.”

“So then what is the problem?”

“I don’t know. That day they were teasing me.   It went right through me.” He takes a breath.  “It wasn’t just teasing.  Last week this girl, Marlene Schneider… I finally met her.  It was awful. I could see that she thought I was pathetic.  She had a great time putting me down.  I felt like shit.  I couldn’t shake it.  Especially, after one of my tormentors—There are these girls who always tease me.  They egg each other on.  Show off to each other how mean they can be.  One of them invited me to her house.   I couldn’t get it up.  And then the teasing from her and her girlfriends got really bad… I just didn’t want to do it any more.”

Michael’s panic dies down.  ”I know this is going to sound crazy.  But I’m relieved.  If this is about sex I’m relieved…  Because that is going to fix itself. That I’m sure of.”

 “You are such a fuckin’ asshole.  Do you ever listen to yourself.  You said that like you just scored a point.  You having a good time talking to me? Are you  Dad?  Fucking point one for you. Or was it three points, a field goal.  Or was it a touchdown?”

“Rip me to shreds. Doesn’t matter I’m not going to let you die.”

“You don’t hear anything I say, do you?”

Michael puts on the light. Richie covers his eyes.

“Oh man.”

“I heard every word and you are not going anywhere. Mom and I are going to be there at your college graduation. I’m going to dance with your wife at your wedding.  It’s as simple as that. I won’t let you die.”

Richie is back to his cocky ironic smile. But then their eyes meet for a very brief moment.  It looks as if Michael might be registering with him. Richie gets up and walks out of the room without a word, “fuck you” the message on his face.

Michael is left in the room alone. One moment he looks lost, the next determined.    The image of Lisa near the end has flashed into his mind from time to time, but it has always disappeared before he could focus on it.  This time it stays.  He can see her face.  She is afraid.  She’s terrified! He whispers,

”God. Help me…Please!”

Chapter 20

   Sitting on the edge of his desk, at Cambridge’s New York office, MacDonald is on the phone.  Lenny is nearby.

“Get me John Parker…  Thanks.”

       He impatiently taps on the phone.  He signals Lenny to bring him his scotch.  Lenny pours twelve year old Chivas Regal straight over ice.  MacDonald downs it. “I don’t care if he is at a meeting.  This is Martin MacDonald.  Tell his secretary I have to speak to him now.”

He taps impatiently as he waits for her to return to the phone.

“John?”

“Yeah.”

“John.  I want to make sure you are putting the proper spin on the bottom line numbers coming out of this round of layoffs.  The street has so far looked at the dollars we saved from laying off 5000.  I want them to understand there is more to this story.  A lot more. The employees that are leaving are from the old regime.  They were approving unnecessary treatment.  That’s over.  Cambridge Health has now taken total control of Liberty.   Their people were asleep at the wheel.  The efficiencies coming out of our new claims processors will be enormous.”

“I understand that.”

“Also try to squelch those stories about us taking over Beneficial Bank.  If you can get rumors going that it is not going to happen, the shorts might hand us a present.”

Marty gives the thumbs up sign to Lenny as he continues on the phone.

“Perfect.  You’r.  You’re my man, John.  Send my regards to Elaine.”

He gets off, slaps Lenny’s hand like he’s just made a pinpoint pass for a touchdown through heavy traffic.  He had wanted to be a quarterback before his coach made him a linebacker.

“He’s lining it all up?” Lenny  asks

‘Exactly according to plan. Parker’s got it down to a routine at this point.  The other two times worked great.  This’ll go through without a hitch. Options have made me a very rich man. ”

“I got to say, you have balls.”

“You’ll see, when I’m out of here you’ll be able to do the same thing.”
”It’s brilliant, but I’m not sure it’s my style.”

“When you head up Liberty you’ll understand.  To the victors go the spoils.”

Lenny smiles lamely, which is noted by MacDonald.

“Or you won’t be in charge?

Fifteen minutes later, MacDonald enters Lenny’s office with a giddy look. “It’s done.”

“Congratulations.”

“Without a hitch.  No one batted an eyelash. 94 million is now in the plus column.”

“Not bad for a couple of minutes work.”

“I’m just warming up.”

“Come on.  You do this too many times – some one’s bound to catch on.”

“Not necessarily. You just have to add new wrinkles.”

“Marty.  You already have 100 million in that account.  You don’t need it.  What are you going to do with it?”

MacDonald corrects him, “a hundred and ninety four million.”

“Sorry.”

 “I don’t want to rub this in.  But thinking like that is why you are where you are. Something presents itself. You grab it while the getting is good.”

“Well, you just got a whole lot of good.”

Truth is, compared to his original conquests, MacDonald is no longer as excited when he’s made a huge profit.  94 million is not huge enough. “I’m tasting the appetizers.”  He often says to his wife.  “Wait ‘til we get to the main meal.”

Leonie shakes his head admiringly.

“Tonight we celebrate… Joey’s”

“You really like the other side of town don’t you?”

“ My mother and uncles were from Palermo.   So is Joey.  So yeah Joey’s like home.”

That night the two of them arrive in the company’s newly leased limousine. As they enter the restaurant MacDonald sticks his head into a room on the side where Tommy Luciano, a consigliore, holds court.  Joey and Tommy go way back when Joey’s was a small neighborhood restaurant.   Luciano is said to have been the money behind Joey’s elevation to the kind of place it is now. Marty nods to Luciano who hold up his glass to MacDonald.

Attracted by the electricity, show biz celebrities and New York professional athletes frequently hang out here. It’s a place for winners.  Good drinks, good looking women, good food, good service, good vibes, contagious energy.

Marty and Lenny order a drink at the bar while they wait to be seated.  Blondes and dark secretarial beauties, in tight skirts are gathered there, waiting to be asked to a table.  Marty eyes a stacked, 19 year-old cocktail waitress.  She comes over to take their order.

Marty is feeling a little too good.  He moves right up to her. Holding a fifty between his index and middle finger he pushes the money into her cleavage.

“For you beautiful.”

She is not amused.  This is her first day at the job.  She knew Joeys had a lot of action but she didn’t realize It was that kind of place.

He takes out four twenties and starts to push them in with the fifty.

She pulls his hand away, answers snappily.

 “We haven’t been introduced.”

He doesn’t let go of her hand.  He cozies up to her, speaks softly in her ear .  “Sorry I misunderstood. Find your boss and tell him Martin MacDonald is here.”

 She disengages and abruptly turns around.  Her stride is street cocky but she is actually wondering if she came across a little too strong.  Eighty dollars, half way to the bassinette she wants.  She finds Joey.

“You said I should come to you if anyone is bothering me.”

“Some one is giving you a hard time?”

“This guy’s got fast hands.  He said he wants to talk to you.  He acts like he’s someone.”
“What’s his name?”

“McDougal, something like that.  He’s an ass hole.”

“Well, bring me to this McDougal.  I’ll straighten him out.”

He follows her around a corner.  Recognizing MacDonald, he’s reoriented in a flash.

“Hey Mr. MacDonald”

“ Joey.  How’s the wife?”

“She just had a third one.”

“Hey.  Congratulations.”

“You need a table?  Marty, any time you come here ask for me.”

“I did.  Your young lady,”  He turns to her. “I’m sorry, what’s your name?”

“Vivian.”

“Glad to make your acquaintance Vivian.  I’m Martin MacDonald.”

 She relaxes.  “I’m new here” she explains

Joey walks off with her. As they turn the bend he speaks sharply.

“Vivian, You’re going to have to learn fast, very fast, who’s who around here.”

“Sorry.  I didn’t know.”

“Fine, but now you do.  It turned out okay, but don’t forget.  Treat MacDonald right.  You won’t be sorry.  He’ll treat you right.”

“What does that mean? He was sticking money in my cleavage, like this is a strip joint.  What is treating him right?

“Right.”

“Give him a blow job?”

Amused- Joey likes women who talk dirty.  He smiles  “Nothing like that here.   All I want is for guys to come here looking for you. Hoping they can get lucky.  That’s why I hired you. Guys coming here because you’re here.”

“That’s fine.  Only they got to keep their hands to themselves.”

 Agreed.  When they come on too strong give ‘em hell.”

“I will.”

Except for Martin MacDonald.  Just don’t make ‘eany of our customers feel like an ass hole. Be nice.  Be their friend.  Capeesh?  You want to be very nice.  That’s your own business.  But be nice to everyone.”

“I get it.”

“Good.  Tell Vince to find these guys a good table.”

He’s hit a grand slammer.  Basking in the glory is best part of the experience.  MacDonald spends the meal looking around.  He sends over a bottle of Campari to Billy Martin.  Martin salutes him, raises his glass from his table. As does MacDonald.   A very good looking red-head who had been throwing looks at MacDonald all night, now, with his encouragement is becoming increasingly open about it.

The ya re near the end of their meal.  Martin and Lenny are finishing off their coffee.  The original cocktail waitress comes over to their table.

“Listen Mr. MacDonald.  I’m sorry if I was a little short with you.”

“My fault.  It’s those uniforms.  I just misread the situation.  You were right to set me straight.”

“Thanks Mr. MacDonald.”

“Listen, here is the money you turned down before.”  He hands her the four twenties.  “No strings attached. You are a good kid.”

Smiling flirtatiously, she takes the money and leaves.

“I can never figure you out, Marty.”

“What can’t you figure out?  I have a daughter her age.”

“I know.”

 “My wife and kids mean everything to me. Everything important I ever learned came from my mother’s family. Everything.”

“ What about your MBA at Wharton” Lenny asks

“I went there because my father went there.  It gave me some polish and a few accounting tricks. I didn’t grow up with my father.

My uncles and grandfather taught me what’s what.  They can’t even spell Wharton. Never heard of it.  Anyway, when I was in school I used to tell my grandpa what they were teaching me at Wharton and he’d crack up.  Thought it was funny, the idea of a professor teaching business.  He said they were teaching me how to go out of business.  They should be giving sermons in churches.  The last thing you need is business professors.  It makes everything complicated.”

“He didn’t like teachers?”

“No.  He liked teachers.  To teach kids.”

“Some of them do pretty well as businessmen.”

“Maybe.”

 “ What about Joe Rankin?  He has his head on straight.”

“But only after he threw away his books.  I’m not saying professors are stupid.    It’s just they get all caught up proving they are always doing the right thing.  Stuff that they can proudly present to their 8 year-old as the right thing. Nothing wrong about it.  It comes from a good place. But it’s not exactly the kind of guy you want with you when you go to war.”

“My brother in-law teaches at Columbia.  I respect him.”

“Would you want to be in a trench with him?  My guess is he wouldn’t go to war and he’d be proud of that.  He might even think he was better than you for thinking about things like war.”

“He’s not stuck up about that bullshit, he’s a good guy.”

“I’m sure he is but you want him teaching nice guy attitudes in a business school.  That’s fucked up.”

MacDonald’s voice has become a little loud.  A guy at the next table is irritated by it. MacDonald speaks more softly.

“Look, some of them figure out what’s what. But most of them, it’s like having to carry 200 pounds on your back every where you go.  Not a lot of energy left for doing anything else.”

 “They cripple their children with that goody-good crap.  Now I see how lucky I was that my parents split up. My uncles set me straight from the beginning.  Never contradicted my mother but I knew they thought the way she looked at things was for children. Nice, sweet attitudes, but total bullshit.    Lenny. You need another drink.”

He signals his now loyal waitress.  She comes quickly.

“Bring the bottle.”

She returns with a bottle of Chivas.  They down 2 shots straight up.  Then another two.  They are beginning to be very loose.

           “The things that matter are simple. You don’t have to be smart; just stay focused on what is going to work.”

“Such as?”

“Timing.  Everything is timing.  The right time.  The right place. That’s it.”

“That’s it?”

“Most of the time business possibilities are so-so. You have to be patient until the time is right.   But you have to be ready.”

“Is this the time?”

 “You gotta be kidding me.  Is it?  We’re in heaven.  My grandfather loved the Wild West. Cowboys, not a dude left among them.”

“He was connected right?”

MacDonald doesn’t answer

“You once told me he was.”

“Doubt that.”

“So what did he say about the wild west?”

“It was paradise.   No bullshit laws from fancy politicians back East.  You did what you needed to do, and they left you alone.”

“The wild west,” he repeats softly, dreamily.

As a toast Marty bangs his drinking partner’s glass hard with his own.”

He speaks loudly enough to be heard 2 tables away

“We are in the promised land.  The health insurance business.  Everything in place.  The old rules are gone.  Everything’s brand new.  We get to make the rules“

“So we’re in the wild west?”

“Exactly. Heaven. A trillion dollars falling out of the sky.. A trillion dollars which we get to decide how to spend it.”

“A trillion… The Wild West?” Leonard repeats with half drunk irony.

  MacDonald mumbles a cowboy whoop.  A smiling drunk at the next table lifts his wine glass in a salute.

Michael is in front of his computer.  He can’t find the name of the medical director that Dr. Stern mentioned.  She was the medical director of three different insurance companies.  She quit the first and found out the second and third companies were exactly the same.   She couldn’t stomach it any longer and turned against them.  He speeds through his tape recording of their conversation.  Finally he finds it. He types Linda Peeno and US News and World Report in a search engine and within a half a second he finds the article.  He registers with the US News and World Report site and is soon reading an article by her,  “What is the Value of a Voice”

The staff of our medical department had attached questions as the letter passed through its maze to me, the HMO doctor at the end of the decision-making line. If something has to do with medical necessity, I am the final word. Our nurses could make denials if something was a benefit decision. Cosmetic surgery, for example, would be excluded in the certificate of coverage. The number of notes on the letter signals that this request falls in the gray area between outright necessity and clear-cut exclusion–the danger zone for the patient.

The decision is now mine, and I feel the pressure to find a way to say no. If I cannot pronounce it medically unnecessary, then I have to find a different way to interpret our medical guidelines or the contract language in order to deny the request.

A bright-blue square catches my attention. It is from a particularly cost-conscious staffer and contains a handwritten warning to me: “Approve this, and it will be your last!” It is common practice to use removable stickies. After we have finished passing any document around, we can remove all the comments. Official records will reflect only the final decisions and not the process by which we made them.”

Michael reads further on

 

“A doctor had called to tell me that his patient was almost 80, lived alone, and could not handle the preparations he would need to make for bowel surgery. Besides, we had already told the doctor that the surgery would have to be done in a hospital over 60 miles away from the man’s home. There was one in his town but they weren’t affiliated with the company.  The local hospital had not yet learned to buckle under.

Without the pre-op admission the night before surgery, this frail man would have to drive himself to the hospital almost in the middle of the night, after hours of laxatives and withholding of fluids. When I approved the request, I got a call from my physician supervisor, angrily telling me that we did not pay for creature comforts.  I told him I had already done it, but in the future…

 

CHAPTER 21

 

Relentlessly, Michael has been reading everything he can about what is going on in psychiatry.  The further he’s gone the less happy he is about what he’s found out. He’s started writing his article.  It is combative. He enters Dr. Rahmadi’s office with an umbrella and drenched raincoat. Dr. Rahmadi points to a doctor’s scale where his own raincoat has been hung.  Michael puts his raincoat on the other end of the scale

“It’s really coming down out there isn’t it?  When I got here at 8 it was like a hurricane”

 “How is Richie doing?” Michael asks him.

Dr. Rahmadi answers with practiced professional calm. “We think he’s coming along.  We’re going to discharge him on Thursday.”

“Aren’t you rushing things? You just met him four days ago.  You’ve seen him twice for 15 minutes each.”

 “We can only keep him if he’s suicidal.  We don’t think he is.”

“How did you come to that conclusion?”

“For one thing we’re not sure his attempt was that serious.  He had some drinks to get up the courage and had smoked marijuana.  From what we understand the pipe that he tied the rope to was pretty flimsy. He knew it would break.”

“I think he meant to succeed and miscalculated. He still has rope burns on his neck.”

“Look Mr. Russell.  We see kids like your son every day.  Mainly, they want to get something across to their parents. He knew you were home.  I’ve seen Richie on the ward gabbing with the other patients.  Laughing away.  We don’t think he is depressed at all.”

“What’s with the “we?”  Who is we?”

“The treatment team.”

“Which is who?”

“Richie’s team consists of six professionals.  Plus we have 23 other people who see patients.  The staff’s on duty 24 hours a day.  There are three shifts.  Every staff member comes into contact with Richie every day.  All are professionally trained social workers, nurses and aides.  They report any unusual findings to me.”

“And what have they reported?”

“ Richie hasn’t come up once.  No incidents. No talking about dying.  They don’t even think he looks sad.  Every patient is rated by staff on a depression scale. Every staff member must speak to every patient at least once a day. Before they go home they have to score each patient.  They can’t leave until they get that done.  We add up the scores.  It’s a pretty good predictor. Richie’s barely in the depressed range.”

  “All those people talking to every patient every day.  That sounds like a lot of contact.  You must have a very committed staff.”

Michael raises his voice:   “If Richie is willing to talk to more than one or two people in a day it’s a miracle.  So how do they get their assignment done?   What is your secret?”

“Look Mr. Russell-”

“Here’s the facts.  It sometimes takes months before Richie opens up to someone.  He has to get to know you.  You can’t just give a try demanded by your boss, and expect to be his best friend.”

“Our scales are evidence based. Almost 100% inter-rater reliability has been demonstrated over and over.”

“ Which means every body agrees with each other.  Why doesn’t that surprise me?”

  “These scales have been validated again and again.  People agree.  All twenty-nine can’t be wrong.”

“So there are 29 of you against 1.  Me.   Only you know zero about Richie.    29 times zero equals zero.”

  “Mr. Russell.  We are following a protocol that the country’s best psychiatrists have agreed upon.”

“The expert consensus protocol?”

“So you’ve been reading the literature?”

       “Who are these experts?”

“They are on the faculties of the finest medial schools.”

“And just happen to be paid undercover by pharmaceutical companies.”

“You read too much on the internet.  Look let’s cut to the quick. Richie has a diagnosis which the experts…”  Doctor Rahmadi stares Michael down. “experts” he repeats. “The experts have reached a consensus about the right treatment for someone with your son’s condition. Our treatment team follows expert advice.  We don’t plan treatment on a hunch.”

“We!”

“Yes WE.”

“Where does medical judgment enter into this?  What about getting to know your patient and thinking for yourself?  Do you know that he can pal with his buddy Dan and walk out of a room with him and seem fine?  Like he doesn’t have a care in the world.  Five minutes after Dan’s gone, he can look like it’s the end of the world, that is, if he does come out.  Sometimes he is in his room for days.  He stays up ‘til all hours.  He can’t settle down. This has been going on for years.”

“He’s slept fine at the hospital.”

“You mean you give him meds to make sure he sleeps”

 “It’s not just his sleep.  He scored 7 on the Hamilton Scale. In my book, a 7 on the Hamilton is not serious depression.”

            “You’re not listening.  He could be a 7 and three minutes later he could be off the charts for depression.”

            “You mean he has mood swings?”

            “He is like a volcano.”

            “Does he ever get high on his own?  He was positive for marijuana on our drug screening.”

Michael is silent.  He has often wondered if Richie steals some of Deborah’s pot.

“Does he get high when he hasn’t smoked pot?”

“I don’t know.  His moods can swing a lot in a day.”

Rahmadi’s eyes light up.

            “Richie is bipolar.  I’m convinced of it.  I’m putting him on a mood stabilizer.”

            “That was quick.  Just like that he’s bipolar.”

 “He has mood swings and he’s depressed a lot.  That’s bipolar disorder.”

            “What’s a mood stabilizer?”

            “What it sounds like. It’ll level his moods out.  It’s also neuro-protective.”

            “You just decided he was bipolar this second?”

“I didn’t know about his mood swings.“

            “But a lot of kids his age have moods that change quickly.  They’re bipolar too?”

            “There’s a good chance.”

            “Isn’t that something that is genetic, that you are that way for life?”

            “Yes.”

            “But I was that way when I was his age.  So was my brother.  So were practically all of my cousins.”

            “It runs in families.”

            “So you think we are all crazy?”

“I think this conversation is going nowhere.”

            “So everything is decided?”

            “Yes.  It’s decided.  And since he is not depressed now we will discharge him soon.”

“Fine.  He’s not depressed.  He’s a happy kid who just happened to miscalculate during one of his moods.  And since he gets caught up in his moods the best thing is to do is medicate his moods away.”

“Exactly. “

“Only he tried to kill himself.  Do you know anything about him?  Do you know what led up to him trying to end his life?”

“You mean your daughter’s lymphoma?  Not that much, but it doesn’t matter. Psychiatrists used to think that they had to search in their patient’s minds in order to understand what their problems were.  Find their demons. They were wrong.  You don’t.  You just have to know how to diagnose mental illness and follow the right protocol. We have statistics now, real numbers, evidence for what we are doing. We can calculate risks”

“And what is my son?”

 “Bipolar disorder type II 296.89 Cannabis dependency 304.30”

“Got any other numbers?”

“I suspect borderline personality 301.83.  All of you.”

“Meaning what?”

“The way you find villains.  Everything is black and white.  Your anger Mr.   Russell.”

“You don’t think there is anything to get angry about here?”

“You’ve had your share of hard times, but no I don’t.”

“I shouldn’t be angry that you know nothing about Richie and don’t want to know anything. I shouldn’t be angry that you think you have this science here which tells you the scientific thing to do for the particular DSM IV diagnosis that you have assigned to my son…who you may or may not know the name of.- who you spent all of a half an hour in toto meeting with him?  And that, as I’ve read, you follow something called an expert consensus protocol.”

“Exactly.  I’m glad you have been reading about how we…”  Once again his voice rises,  “We, not me, make decisions in modern psychiatry.  We’ve come a long way.”

Tell me, what exactly is an expert?”

“Exactly what it sounds like.”

            “That’s the favorite word people use whenever not enough is known about a subject.  When something is understood there are no experts.  There is just information.  When people are guessing a lot, that’s when experts appear.”

            “It’s not as simple as that.”

 “What I want to know is if it’s true most of your experts derive a considerable part of their income from drug companies?”

Exasperation  is written on Rahmadi face. “That’s gossip.  I’ve read some of the things they post on these anti-psychiatry sites.  Scientologists pay big money trying to make psychiatrists into idiots.  You really believe this is one big conspiracy created by drug companies?”

I don’t think it is a conspiracy.  I think it goes something like this.

 There is this guy at Harvard, Dr. Biederman.  Supposedly the leading expert on ADD.  The American Psychiatric Association gave him the Ittelson Award for Excellence in Child Psychiatric Research. He got 1.6 million from drug companies which he hid from Harvard.”  Dr. Stern told me that for years he would get  mailings from a whole assortment of organizations, invariably quoting this guy implying he and most of his colleagues too often were missing the diagnosis of adult ADHD.

 Dr. Stern told me that on some level, most psychiatrists are very aware that they don’t always know what they are doing. This expert is a famous doc at Harvard.  A reasonable person would assume he may know better.  The result? The shrink listens to the expert and puts his patient on amphetamines.  Tells him he has been diagnosed adult ADHD, and he needs treatment.   He’s given amphetamines better known as speed.  The patient takes the speed.  He gets back to the psychiatrist after trying it out  Tells him he has hit the nail on the head.  As “Tony the Tiger” might put it.  “I feel greaaaaat.  Do I think that is going on?”

“What’s your point?”

“I’m asking you to make sure that you know what you are doing.”

“Look.  I have thirty patients on this ward.  And they constantly change.  You’re right I don’t know everybody’s name.  Look Mr. Russell This is it. Used to be your own doctor took care of you when you needed hospitalization.  No more.  This is it.  This is the way things are done now.”

He waits for Michael to come back with something, but he doesn’t.  Dr. Rahmadi continues, “And this is the final point. Richie signed a contract, which means he no longer matches our criterion for medical necessity.”

“A contract?  What kind of contract?”

“Here, read it.”

Dr. Rahmadi takes the contract out from Richie’s chart and hands it to Michael who looks over the piece of paper.

“He’s signed a statement that he is not going to kill himself. He’s contracted for safety.”

 “You think this means something?” Michael counters.

“It’s a promise.  Most people keep their word.”  99% percent of people who say they won’t kill themselves don’t.”

“This “contract” means nothing, absolutely nothing.  He signed this so he can get out of here and finish the job.”

“The staff disagrees with you.   Not just me.  The entire team agrees.  We all agree”

“All 29.  None of who know my son. I just don’t get it.  How can you believe this crap?”

“It isn’t crap.  It’s science.  We have a valid system.”

“It is basically a system to save money.”

 “ Yes money is involved.  We have to be accountable to people paying for all of this.  And what that means is we can’t keep someone who is not a risk to themselves or others. He signed that contract.  That means your insurance company will not give further authorization.  That’s that.  That’s the rules.”

“Did my insurance company insist on getting Richie to sign the contract?”

“They expect patients to be contracted as part of our treatment approach.”

“So you can be objective in evaluating him?”

“You can be as sarcastic as you want but the bottom line is that since Richie signed it he no longer fulfills criteria for continued stay.”

“And you just go along with all of this?”

“No, they actually wanted him discharged tomorrow, but Dr. Stern refused to see him tomorrow.  So we will need an extra day to find a different psychiatrist.  They weren’t too happy about that.”

“Why wouldn’t Dr. Stern see him?”

“You’ll have to ask Dr. Stern.”

“I’m asking you.”

“There’s no reason to raise your voice.  Dr. Stern is not with the program.  He’s from the old school.  They used to keep people in the hospital for weeks, sometimes months.”

“You mean to be cautious?”

“They just did it. They didn’t have the same kind of medications we have today.”

“It’s only been four days.  Richie’s Prozac hasn’t kicked in yet.”

“It could take a couple of more weeks, but that’s beside the point.”

“What is the point?”

“I explained all of this to you before.”

“Explain it again.”

“ The hospital isn’t good for him.  It could make him worse.  It’s too comfortable here.”

“You think this is comfortable?”

“Not having to go to school. Not having to face his classmates.  Not having to take exams.  Not functioning is comfortable.  In a hospital you don’t have to face your life.”

“He has a better way planned. Look.  It’s not just me.  I’ll give you the phone number of his best friend Dan.  We’ve talked.  He’s as worried as me that Richie means business.”

Dr. Rahmadi rises from his desk.

“We’ve made up our mind.”

“You can’t expect me to go along with this.”

“It isn’t up to you.”

“Dr. Rahmadi.   At least wait until the medicine has time to work.”

“That will take weeks.  We don’t have weeks.  We have days.”

“Why days?”

“We’re going around in circles.”

“Okay. A few more days.  Give me time to get another plan lined up.”

“I don’t know how to make this any clearer.  We are only allowed to keep people when it is medically indicated.  He doesn’t match our criteria for continued stay.”

“Until Monday.  Please. I’m asking you. Give me the benefit of the doubt. You could be wrong. Be fair.  What if it was your boy?”

“This isn’t a question of right or wrong. We have rules. You’re asking me to break the rules, to make an exception for your son.  There is nothing I can do.  He doesn’t match our guidelines for continued stay.   Period.”

“What if you had a gut feeling about a patient that he just might do it?  Would you go by that?”

Dr. Rahmadi is having difficulty controlling himself.  Seething with frustration he pronounces his words one by one.

“Not if the patient did not meet our guidelines.”  His voice rises.  “Mr. Russell.  There are rules for everything you do.   I don’t make the rules. You don’t make the rules.  But they are there and both of us have to follow them.”

“You’re saying rules outweigh your professional judgment? You’re telling me that if you told some one at the insurance company that you know the situation better than they do, they would ignore you.”

“Mr. Russell, we’re getting nowhere.   This is pointless. You are in some 1950’s head about doctors.  This is the way it is now.  Now.  You can’t accept the way things are, and I can’t change it, so this all adds up to a waste of my time and your time.”

Michael heads for the door.  He turns around before leaving the room.

“Just one last thing, I’m a reporter. This is going to be part of a story.”  Dr. Rahmadi blinks, he emits a barely perceptible sigh, but then almost instantaneously his professional detachment returns.  He looks at his watch.  He looks at Michael as he silently counts to ten.

 “You are not going to look good in this story.  I have records of  every conversation I have had with each and every one of you.   I’m not going to let you do this.”

 “Right, Mr. Russell.”  He repeats, “Right.”

Dr. Rahmadi is thinking of the six phone calls he has to return… “Fine.”  He repeats.  He had ten, no, now nine minutes to make the calls.  He says to no one in particular.  “I’ll see you.”  And closes the door.

Which jars Michael awake.  He leans against the wall, hesitating, thinking,

He heads for the community room.  Richie is in a group led by Mrs. Allison. She stops the patient who is speaking and looks up at Michael.

“Can I help you?”

“I’m Richie Russell’s father.  I have to speak to him”

“Well you’ll have to wait ‘til the educational seminar is over.”

“I need to talk to him now.”

“You’ll have to wait.”

 “He’s my son, God damn it.”

“If you don’t go to the visitor’s area I’m going to call security.”

“Richie get over here.”

Richie is embarrassed.  “I don’t know this man” is written on his face.  But he does as he’s told.  Michael grabs his arm and marches him to his room.  Richie laughs self-consciously.

“This isn’t funny Richie.  Why did you sign that contract?”

 “You think you can just grab me in front of everyone.   I don’t count?”

“You count, but..”

  “But.”  He disengages himself.  “There’s nothing you can do.  That’s what I needed to get out of here. Did Dr. Rahmadi have you cosign it?  I’m a minor and it really should be cosigned.”

“I’m not going to let you do this. Get it out of your mind.”

Richie starts back to the meeting.  Michael again ries to grab him by the arm. Like a basketball player with a rebound, swinging his elbows wildly around, Richie gets his father in the jaw.  Michael goes into a fury.  He brings Richie down just as Dr. Rahmadi and two security guards arrive at the door.

    Rahmadi mumbles to one of the guards. “A borderline.  Thirty other patients here but everything has to be the Russell’s way.”

Rahmadi stares right into Michael’s eyes, “ I’m calling the police. They will arrest you for assault.  Then I’m calling the department of child welfare.  There are three witnesses to child abuse.  Truth is you belong here not your son.”

 He lets that sink in for a moment then speaks firmly,  “The other option is for you to leave Mr. Russell.  It’s your choice.”

Two beefy aides, the one on his left maybe 20 or 22, the other closer to 45, move very close to Michael.  They will not budge from their position six inches from him. Each one takes an arm.  He pulls his arms away from them. But they remain up against him. They move him towards the heavy metal door that separates the ward from the rest of the hospital.  One of them pushes him forward after they open it.

 “Okay, I’m going..”

Michael turns around and as best he can he shouts loudly enough for Richie to hear him. “I told you. It’s not going to happen.”

Dr. Rahmadi who has been in the background steps forward, “Mr. Russell.  You ‘re not to come back here unless we give you permission.  No visitor’s passes until we tell you to come here to pick up your son.  Do you understand that?”

He walks away.  One of the aides, a young man, looking like a college student accompanies  Michael through the door.  Before closing the door he hands Michael a piece of paper.

Richie sits on his bed. He’s been holding a tennis ball in his pocket.  He stands up and throws it against the wall as hard as he can.  He catches it on the fly. He sits down on his bed and looks up at the ceiling.  He punches himself in the back of his head hard, very hard.

“Calm down” he viciously whispers to himself.

He waits a moment. Then another moment. He can feel his heart beating,  “Calm down!” he says a little louder and more insistently. He punches himself still harder and again whispers  “Okay.  You got it,”.  He takes a deep breath.  Then another one. He straightens up and walks back to his meeting, very taut but back in control.

 

Chapter 22

The same night Michael is in front of his computer.  It is 1 AM.  He stops for a moment and rubs his eyes.   Deborah comes up behind him, drapes her hands over his chest.   “Its late.  Get some sleep.”

“ I can’t.  I have to finish this piece.  It’s our best shot. It’s our only shot.”

“I still don’t know why Dr. Stern refused to see Richie.”

“He said he would see Richie, but not under these circumstances.   It’s too dangerous. The hospital wanted him to see Richie tomorrow.  Stern said that was so they could get him off their books and on Stern’s.”

“What do you mean?”

“If he sees him he has legal liability.”

“That’s what they are thinking about?”

“Probably, but I don’t blame them for that.  How would you like to have lawyers ready to haul you into court for every mistake?  And not even mistakes.  Bad outcomes.  Stern explained it to me. If they are calling to make sure Richie is seen by someone the day after he leaves the hospital, they know he is not ready to be discharged. Stern said half the patients are simply sent home after they promise they will call someone for follow up.  Most call no one.  And no one really cares.  Because they are not worried about suicide.   This is different. When the hospital staff gets involved this way, you know they’re calling about someone who shouldn’t really be leaving.  They document that they have made a follow up call, everything said in the conversation. They know Richie is in danger.”

“Still.  Stern seeing him would be better than nothing.”

“He made a big point about that.  He said penicillin is a great drug.  But it is not going to do anything for a heart attack. With luck Stern can help Richie.  Eventually.  But that has nothing to do with what Richie has to have right now.  He has to be kept in a safe place. Period.  Even if Stern saw him every day, every hour, Richie still could hurt himself at any time.  He needs to be kept safe in a hospital until this passes.

“Yeah but…”

“He told me a story about another patient…  Same situation. The hospital called.  They wanted the patient seen immediately. It was at the beginning of HMO’s.  He had no idea why the social worker at the hospital seemed so aggressive in getting the patient seen immediately.  She was desperate.  He agreed to try to help…”

He hesitates.

“Go on.”

“The patient taught second grade at P.S. 24 in Riverdale. Her son was the starting shortstop at the high school.  She had a daughter in the fifth grade…”

Michael hesitates for a moment deciding whether to continue, but only a moment.

“Let me play for you this part of my interview with Stern.  He’s telling me about this patient.”  Michael fast forwards and rewinds his pocket dictation machine until he finds the part of the tape he wants.

Deborah stares at Michael impatiently.

“Wait.  I got it.”  He starts playing the tape.  It’s Stern’s voice.

            “She came to her appointment but when I went out to get her she wouldn’t leave the waiting room. She looked like a deer caught in the headlights, terrified.  I gave her some time but then later I went out to get her again.  “C’mon.   Come into the office.”  No luck.  So I tried to talk to her in the waiting room.   My secretary understood the situation and went into my office. It took the patient a long time to get started but eventually she began. She told me she had destroyed her family.  Nothing would ever be the same.

Unfortunately, not long after she began, my next patient came into the waiting room. The patient seemed more frightened by the new person than me, so she agreed to come into my office for the remaining time.  More of the same.  Everything was her fault. Her hospitalization had ruined her family.  Not to mention the embarrassment.

I tried to reason with her.  “I’m sure things aren’t that bad.”.  “I see people all the time.  You wouldn’t believe how bad it gets for some people and somehow…somehow everything works out.  Eventually.  No matter what it is.”

“You don’t get it,” she said.    “I’ve ruined my life. There’s no way out of this.”

Michael notices Deborah’s impatience.  He switches off the recorder.

 “Michael.  I’m tired.  Tell me about this in the morning”

He turns the recorder back on. Stern’s voice again.

“ We were now over her appointment time.  The next patient was waiting. I addressed my secretary.

“I want you to find a time tomorrow for Mrs. Z.”

“Tomorrow you don’t have anything open.”

“Start my day at 8 AM.  Put her in as my first patient .

The appointment was made. Mrs. Z still looked very afraid but I hoped something got across to her.

 I’ll see you tomorrow. We have a lot to talk about.”

She left reluctantly.  Her son had returned to take her home.  Later that day my secretary told me that Mrs. Z was talking to herself, probably hearing voices the whole time she was in the waiting room.”

The tape continues.

“Mrs. Z  didn’t show up for her appointment the next morning.   After waiting 15 minutes, I called her.  Her husband answered. She had blown out her brains with a shotgun the night before.”

Deborah’s eyes water up.

“Same as Richie.  She had signed a contract for safety and out she went.. They can go to court and say the patient swore she wouldn’t do anything to harm herself. They have it in writing.”

Deborah sighs.  “How can they live with themselves?”

Facing the computer screen Michael moves his document to a new part of his story.

“Here look at this…He reads through it, paraphrasing as he goes, Stern told me the chief of their psych department, Dr. Pollack, quit 8 months ago. They had pushed the hospital down to 6.8 ALS. That stands for average length of stay.  They threatened to terminate the hospital’s contract if he didn’t get it down to 6.4.  He couldn’t take the pressure. “You can’t squeeze blood from a stone,” Pollock told them.”

Deborah is overwhelmed, exhausted.

“I’m tired.  I’m going to bed Michael.”

She lies in bed half listening to Michael as he shouts from the adjoining room.

“Stern told me that at the monthly psychiatry department meeting everyone was joking about Dr. Pollack, the old chief. And all the old guys, Stern included.  They cut them to shreds. Pollack was the last Jew left on paid staff.  Years ago the department was all Jewish.

Stern sees himself as next on the list, still psychoanalytic, when it is clear to everyone else that Freud has been totally discredited.  Although he has no power in the department, he merely attends meetings, most of the hospital staff would be more than happy if Stern joined Pollack and resigned, if, for no other reason, than having more pleasant departmental meetings. Invariably, Stern stirs things up.   The younger doctors see nothing wrong with the way things are.  It’s all they have known. It doesn’t seem so bad.  The mystery to them is why he doesn’t get with the program, why old people adjust so poorly to changes.”

Deborah closes her eyes.  At this point hearing Stern’s name is a turnoff. Michael continues to shout from the next room.

“Stern says it’s automatic.  People adjust to anything.  Whatever is just is.  It’s “Reality.”   If you focus on what’s wrong, it makes you a malcontent, a complainer. You are supposed to adjust to whatever is.  How did people live under Ivan the Terrible.  They just did.  How did they live under Stalin? Most people will talk themselves into whatever it is they have to believe. Anything. It’s too uncomfortable not to be in line with expected beliefs.”

            Deborah is still.  Very still.  She stares sadly off into the darkness.  Sad for Michael, that more and more he is going on and on.  At this moment sad for herself, expected to listen.

“He says that’s part of what happened with the Nazi’s.  You could see it at the Nuremberg Trials.”

“Michael don’t get started with the Nazis.  It’ll ruin your story.”

“I know. I won’t.  It’s just I don’t get it. Guys like Dr. Rahmadi.  Why would he go to school all those years just so he can be a prick?  He looked me straight in the eyes, acted like ”what’s your problem?”

“Maybe for him being a doctor is not the same as it is for Dr. Stern.” Deborah is lying on her side, head on the pillow, exhausted.  Her eyes remain open, staring, staring at nothing.

“I have to go to sleep.”

She hates his rants.  She hates him.  She wonders why she married him.  His good looks, certainly not his charm, not at this point.  Have they passed a point where there is no going back? She can’t listen to anything he is shouting.

“Stern says on some level people know they’re wrong but if it is unsafe to admit it, they go with whatever they are told is right.”

She’s not listening.

 “They will pick survival.  And comfort!  Since they aren’t going to be very comfortable knowing they are wrong they will find a way to convince themselves of whatever it is they need to believe.  I’m not talking about knowing something is all screwed up and saying nothing because it is too dangerous to say it out loud. I’m talking about believing whatever it is they have to believe.

Innocence is an attribute, but feeling innocent comes from not being out of step with everyone else.    Something like that.  Not that people can fool themselves all the time.   When you have to lie to yourself constantly you become very brittle, snappy, mean.  In other words they get angry at you because you are making them uncomfortable. The average German could either hate Jews or hate the Nazis.  For their peace of mind it was no contest.  Even if they were not much of an anti-Semite to start with, they hated their victims way beyond discomfort with whatever anti-Semitism they had.”

Deborah lifts her head

“Michael.  Stop it.  We’re talking about Richie, not about Nazi’s.”

He shouts back.  “I can’t help it.  I can’t understand any of it. I can’t.”

He starts to type.  He stops. He reads over his last paragraph then out loud to Deborah.

“Stern told me that Rahmadi will be gone in a year or two.  They’ve had one psychiatrist after another.  They begin like him and then after a couple of suicides, they can’t bullshit themselves anymore.”

Deborah lies in bed very still.  Her eyes are closed.

Michael is like a man possessed.

“The stories Stern told me, insurance stories about his patients. Dozens of them!  The amazing thing was that every one of them happened.  Every detail. He saw it with his own eyes.  And he had dozens more.  And he’s only one

psychiatrist.  There must be thousands and thousands of patients treated like this all over the country.”

Overwhelmed, hearing none of it, Deborah is on the very edge of sleep, there but then startled awake, then there again.

“He blamed One Flew Over the Cuckoo Nest?”  People went crazy about mental hospitals. I asked him if conditions in the hospitals were like they showed in the movie.

“Yes some hospitals had been that way, many state hospitals were.  There was also this chain of psych hospitals, the Charter Hospital chain.  Ninety  of them  all over the country.  Traded on the NY stock exchange.  We are talking about big money.  The hospitals had to be kept full for the stock price to stay up.  At one time Charter and stocks like that were a growth industry.  Stern was willing to bet the care in those 90 hospitals wasn’t too great but get this.  You won’t believe this.”  Michael’s voice gets loud.  “The largest behavioral HMO in the United States is Magellan Behavioral.  They are what’s called a carve out for a lot of insurance companies. They just handle mental health for them. They are hired to keep mental health costs down for insurance companies.

 Magellan is made up of the same people that ran the 90 hospital Charter chain.  Those hospitals are gone but these guys are true businessmen.  They saw there was a fortune to be made hospitalizing psych patients. Churned out formidable profits.  These same people had absolutely no problem adapting to the new wave, the eradication of their industry.  The fortune was now to be made keeping people out of the hospital.  So Magellan has become not only the largest but the most aggressive enemy of psychiatric treatment.  Makes no difference to them which side they are on.  Money is money.”  He was hoping his louder voice would catch her attention.  It hasn’t. She is more deeply asleep, a troubled sleep, but alseep

“Deborah?”

Michael gets up from the computer and goes to the bedroom.

“Deborah?”

He lies down next to her in bed.

“Sorry.”

“I just wish you wouldn’t go on like that.  It upsets me.”

“But what I’m saying is true.”

“I’m sure it is, but there’s something about you when you get going. I can’t listen to it.”

She’s told him this before, many times, especially lately.  She knows he can’t help himself.    She knows figuring out what’s behind things soothes him.   That doesn’t work for her.  Maybe it is, as he claims, a Jewish thing, this not knowing but needing to know.

 He was brought up with religion, went through a religious phase after he got out of the army.  He went to India, briefly thought he had incorporated what he had  learned in India into Judaism.  For a while he felt inspired by a guru.   It gave him great strength, a new confidence, even his mother noticed and was grateful he had found something that seemed to work.  From there he went to Berkeley.

His new Judaism?  It was not like it was back in Queens growing up  There was now a link up with Tao, although as the years passed he couldn’t recall what that linkup was.  Richie had a bar mitzvah. Michael liked the unconventional party, a steak and hamburger and hot dog barbecue in Central Park with horseshoes and basketball as the afternoon’s entertainment.

But otherwise his Judaism has stayed out of his way. Is all that questioning, as he claims a Jewish thing, regardless of whether the subject is Jewish. He saw this documentary, Arguing the World.  These CCNY Trotskyites in the 30’s eventually became Neoconservatives.  They never forgave the Stalinists on the left for staying with Communism, when it was clear it was evil.

 The passion that both sides have is the way Jews used to argue the Torah.  Every day in school, they tried to divine what God was telling them in the Torah about the world, what was right and what was wrong. There was no subject more important to them that what God expected of them as revealed in the Torah.  They eliminated the Torah, but the importance of their discussion about what is moral and not moral has remained as passionate. Deborah has come to understand that his arguing about the world has as deep a hold on him as she does.

Restlessly he returns to the computer.  Tries to focus. He notices the piece of paper handed to him by the aide on Richie’s ward.  Scratched in big letters it says, John Newcomb 718-224-8647 . Scribbled in red. Call me.  Any time.

It’s 1:45 in the morning.  Michael reaches for the phone hesitates, then decides to go ahead with it.  He calls the aide.

At first confusion.  The aide is wide awake watching TV, but he doesn’t immediately recognize Michael’s name.

“I’m Richie Russell’s father, Michael Russell”

“The one we kicked off the ward?”

“Right.”

“That paper I gave to you, I had it in my pocket all week.   I heard you’re doing a story. . .”

“Yeah.”

“Well I just want you to know that it is about time someone gave them a hard time.  We need an article about this shit.”

“I am doing a story about the kind of things that are happening with HMOs.”

“Well.  It is not just them.  It’s the whole system.  Someone’s got to tell people what is going on around here.  It used to be nice. You’re a friend of Dr Stern?

“He was my doctor.”

 “He was one of the better doctors that used to come here.  Been 5 years since I quit college. I wanted to work in a place like this.  I used to help a lot of patients.  Got to know them. That meant a lot to them. After being stuck alone in their rooms, or trying to lie to everyone around them.  it was  like they were finally going to a place where they could let down their guard and make a new friend,  a real friend, for some of them, the first in 20 years.  Just knowing that they could make a friend… Boy.  How things change.  They used to have encounter groups for the patients and the staff.  People telling each other secrets about themselves, letting each other know what they liked and didn’t like about each other.  Sometimes it got really hot in there.  People losing it.  Including the doctors. But it worked.  We were family, real people to each other.  And the patients were people.  We really got to know them. Sometimes they were there for months. It was good.”

“So what is it like now?”

He laughs   “Now none of the staff doctors come here.  Dr. Rahmadi works for the hospital.  He sees all the patients.”

“Do you still have those meetings?”

“You gotta be kidding.  Rahmadi  doesn’t have the time for that, nor the interest”

“Why?”

“Patients constantly coming and going.  Paperwork.  They have to document everything.  In case they have to go to court.  Or the JCAH comes sniffing around.  Got to document how they are improving quality.  That was the mantra from Japan which JCAH made a requirement, continuous quality improvement.

“Is the quality improving?”

He laughs.  “You see what’s going on.”

 “What’s wrong with it?  How did it get like that?”

“I once worked at Creedmore, a state hospital.  It was the same as this. Paperwork.  then more paperwork. Then more.   Not just the doctors.  Aides like me.  That’s why Rahmadi’s predecessor quit after 3 months….Can’t remember his name.  There’s been so many.”

“How’s Dr. Rahmadi stack up?”

“Who knows?  He’s not stupid, and he’s practical but basically all he cares about is keeping his job, covering his ass, getting his work done. Well I guess just like me.  But at least I care enough about what is going on to want to talk to you.   If they find out that I talked to you, by the way, I ‘d be out of a job.”

“I’ll be careful.”

“I’m glad you called.  I wanted you to know how bad things are. Stinks to high hell.  All the good people have left.  The other guys on the ward knew I slipped the note to you.    Told me it was my funeral.  But they could fill your ears with plenty of other examples.”

“You want to give me their phone numbers?”

“One other guy may be calling you. I don’t know, maybe not.  I got your number on my caller ID.  I’ll give it to him.

Anyway, you are right about Richie.”

“Why?  What have you seen?”

“Nothing specific.  I don’t know.  It is a certain look he has.  Not that often.  But all of a sudden you look in his direction and you think he could definitely do it.”

“Do you report that kind of thing?”

There’s no room on the form.”

           “Just get my phone number to the other guy that wanted to talk to me.”

Chapter 23

Feet on his desk, Joe Dyer, managing editor at the Sentinnel takes a drag from his Marlboro.  He’s frustrated with Michael’s story.  He doesn’t know what he’s going to do with it. He turns to the last page, then throws it down on his desk. He takes another drag.  He goes to his open office door, lifts his hand and signals Michael as if he is hailing a cab. Michael’s soon heading for Joe’s office trying to build up a head of steam. Seated, facing the open door, Joe takes another drag on his cigarette before beginning.

“What do you want me to do with this Michael?”

“Look I know it steps on a lot of feet.”

“Feet?  I’d call it several knees to the groin.  You’re naming names, making accusations on every page. You know I can’t do a story like this.”

“Why not?”

“Oh Jeez.  How long have you worked here?  Don’t play dumb with me.  You know just what you are doing.  You’re going to get people just a little excited.”

Michael’s eyes go to the ground

 “They are going to kick your mother fucking ass.  How the hell do you think you can take on this whole fucking industry?”

“Look, I know.”

“You know? Let me tell you something.  Leaving aside our legal department, which will not be too happy, the people behind the HMOs are heavy hitters. And it isn’t only the insurance companies.  Try most of the Fortune 500.  Hell the Fortune 20,000.  Every businessman in America is screaming bloody murder about the money they are spending on health care.    And you know what is number one on their list of things that’s got to go?… Mental Health.

 To them it is people bitching and moaning to their shrinks. And they have to pay for it. Great. You want to see a shrink?  Talk about what’s bothering you.  Go for it.  You want to go for Yoga?  What ever you want. Do it.  Only don’t make us pay for it.”

 “It wasn’t just bitching and moaning. Dr. Stern helped me a lot.”

“How do you know?   You didn’t get better any faster than any other father I know who has lost his 12 year-old daughter.”

“But that’s not it.  There were a lot of other things going wrong.  Debby and I weren’t getting along.  No one was.  We were always angry at something. Sometimes I was out of control.  It was scary.  Someone would cut me off on the highway.  I’d explode.  Completely lose it.  I could have gotten us in an accident.”  He is quiet for a moment then continues.

“It was worse when I was quiet.   I kept thinking maybe dying wasn’t so bad.  Had those thoughts for years… Richie was growing up listening to all of this shit.  Watching Deborah and me half the time hating each other.”

“I remember.  We all stayed out of your way.”

“Well that’s the point.   Dr. Stern got me out of that.  He helped clear things up in my mind.  You may think it is bullshit but he saved me from some  deeper shit, much deeper.”

Joe suddenly has a sheepish smile.  “Saved you? You seemed to be just as much a pain in the ass as you always were.  Okay it was worse.  We all heard the ange.  I still hear you in my office when you’re on the  telephone and you get put on hold.”

 “I was always like that”

“Exactly.”

“Maybe you can’t see it- Look Stern and I are not done yet. We’re not done with Lisa.  With a lot of other issues.  Richie’s attempt has set off all kinds of things I thought had been put to rest.  He looks Joe in the eyes.  “Richie’s got  to get that kind of help.  It helped me, Still is, and it can help him.”

“Okay fine. It’s helped you to understand your shit.  He was helpful. Granted but…”

“But what?”

“Why couldn’t you get that from a friend, from someone in your family?”

“No one’s going to listen to that.  Not for very long.  Besides there is stuff that I have on my mind that I don’t want anyone to know about.”

Michael.  I’m just not sure about this issue.  I know HMO’s are as bad as you say, but everyone knows that.  I mean where’s the news?  Anyone who has been to a doctor.  Anyone who has had to get a question answered by their insurance company.  Everyone knows they are big bureaucracies treating their customers like numbers.  If I ran your story it would like running a story on the Motor Vehicle Bureau.”

“Come on. Health insurance companies aren’t looked at like that.”

“Oh no.“

“No.  When people get sick.  I mean really sick.  That’s why they’ve had  insurance in the first place, to protect against something serious.”

“Granted

“Insurance isn’t like anything else people buy.  Actually most people don’t shop for their health insurance.  Their boss decides what they are going to get.  And usually, especially nowadays, your boss is deciding by price.  Whatever’s cheapest.  That’s just the way the industry works. How well an insurance company is treating their customers is low on the list of your company’s purchasing manager.  He’s mainly searching for next year’s contract, how much cheaper other companies are going to offer the services.”

“I get it.”

“Great you understand the mechanics, but I left the main point out.”

“What’s that?”

“Insurance companies are making fortunes.   The system is perverse.  The worse they deliver care to their patients, the better they do.”

“Granted they are making a lot of money.  Right now they are darlings on Wall Street, . There are a lot of business stories about how great this industry is doing.”

 Michael’s voice raises. “You don’t think there is something wrong with that? They are taking money out of the mouths of babes.  People who are sick.”

 “Fine.  People who are sick.   I still don’t know that it is news. That’s life, not news.”

Michael doesn’t answer.  He knows Joe simply being argumentative.  He knows he is wrong.

“Let me change the subject. Michael.  Where are you getting all of this?”

“From a lot of places.  It doesn’t matter.  It’s real.”

“If you tell me it’s real I’m sure it is real.   It better be.  The publisher doesn’t like big legal bills.  Truthfully.  What bothers me is all the victim/villain hissy fits you have.  Trust me there isn’t a villain. You say it here:  “Almost all of the managed care companies are the same.  They compete on price.  They have to beat the other companies and get the price down.”

“So?”

“No villain.  No laws broken.  No story… Executives don’t get a kick out of screwing patients?  They don’t even think about it. They are doing their job.   If they can get the cost of office supplies down, legal costs, you name it.  Health care is a cost of doing business like anything else.”

“Okay there’s no intentional evil.  It’s just good old capitalism at work.  But they’ve taken a meat cleaver to fix things. They don’t care how they do it.  It doesn’t even register. You cut health care?  It affects people.  When people get sick there is nothing more important to them than getting well again.  They’re scared.  For good reason.  They are willing to do whatever it takes. Along comes an insurance company and they decide what kind of care they can have and how much of it.  Sometimes the bad news they get is as bad as the illness.  You know how people toast to good health.  They should add a toast to “good insurance.”

“Michael, like it or not health costs have skyrocketed. Insurance companies provide an important function.  You carry on a lot in the article that  number-people have grabbed control of medical decisions.   Leaving aside whether doctors are corrupt.  Almost all of them are softeys.  Leave it to them and they’d ask for whatever their patients want, cost be damned.”

“You mean whatever they need.”

“Yes… yes… yes… yes. That is not how the world works.”

Michael begins to counter but then says nothing.

“Soft hearted people are great, I hope we always have a lot of them.  But hard headed, tough people serve just as important a function.  You need people who can say no. The world would very quickly fall apart if softees ran everything.  They’d bankrupt the country.  Think about what’s happening in France.”

“What’s happening?”

“Too many yeses.”

“What does that mean?”

“You can’t say yes all the time or you will wreck things.”

“Forget France.  America.  Not enough people are saying no.”

Michael is listening

“Insurance  executives aren’t trying to kill anyone.  It’s their job to save  money.  You need someone to say no.  Sure yes is great.  Whenever I hear about someone having a bad time, through no fault of their own, I’m a yes person just as m much as you are.  How can you be against people who genuinely need help?  We all want to help people who need help.  I am, you are, all for giving what people need.  But…Now try to wrap your head around this one. It can get out of hand. People are going to feel entitled to what ever they need, whether they can afford it or not.  Whether their employer can afford it.  Someone has to say no, at some point

“You know Hitler used to pull down the shades in his train cabin when he passed scenes of destruction.  He had visions of  a fantastic Germany.  He didn’t want to get upset, see Germany as it was.  If health insurance people don’t see what they are doing it’s because they refuse to take a look.”

“Maybe.”

 “Specially at the top. These guys are pigs.  If they weren’t  making fortunes I could see the logic of what you’re saying.  But they are literally taking care away from patients, care they need and putting it in their own pockets. It’s mindboggling.   And its isn’t  just psychiatry- any time the results of treatment are not fast and clean. People with multiple sclerosis, people with strokes—after a few weeks no more physical therapy. Physical therapy is what gives them a fighting chance.

Dr. Stern told me about this one patient who was using colostomy bags, For 20 years because of an operation that saved her life.   iI was  part of her usual routine..  All of a sudden the insurance company wouldn’t pay for The bags.  They were expensive.  She was just getting by.   It made her desperate.   Believe me she didn’t sell her Lexus.  She couldn’t get new tires for her 13 year old Chevy, the tread worn down to the point that sheer luck had so far kept her from a blowout and a serious accident   She fed her kids more and more spaghetti.  Meat  became a rarity.  She stopped taking one of her medications, one with a large copay.”

“Granted, things like that happen, but they’re mistakes…”

“No.  They know what they are doing.  The head of Oxford Health paid himself 28 million dollars a year.  And that’s a small local company. When US Health Care was bought by Aetna for 8.8 billion, the CEO walked away with 900 million dollars in his pocket.  900 million.  US Health Care was a garage startup. Let us at least tell the story that there is a fortune being made denying care. Squeezing patients’ benefits is very profitable.  Taking away their colostomy bags.”  Michael can’t resist repeating the Magellan story.

“Magellan Behavioral Health was formed out of the remains of this huge chain of hospitals. I think 90 of them Their stock was a Wall Street darling.  Billions of dollars involved.  Well guess what?  Several of their top executive went to jail for padding bills, making up diagnoses that got them higher pay from Medicare then they were entitled to get  We are talking about hundreds of millions of dollars.  Anyway.  This is the amazing part.  These people closed down their chain of hospitals and simply switched to where the money now was. Managing care, denying care! “

“So you are admitting that hospitals were charging insurance companies and Medicare for phony services.  They needed to be watched.”

“ I don’t doubt there are many crooks in a 1 trillion dollar industry that is not carefully policed.  A trillion dollars is going to attract sharks not to mention pilfers picking away wherever they can.

But you’re not hearing my main point.  The very people who were ripping off the insurance companies for phony care were put in charge by the insurance companies of limiting care.  The same bastards, only now they are telling everyone else that they can’t have the care they need.”

  “That’s not hard to understand. They are businessmen. Do you understand what that means?  To them it makes no difference which side they are on.  Business is business. These people can steal colostomy bags from people who need them, because they are not thinking about the effect they are having on patients .  Their feeling up because they thought of an angle that allows them to do it.  It allowed them to cut costs.  It’s their job. To cut costs. That is all that matters.”

Yeah they probably claimed the bags are “creature comforts”  which their policies exclude.s Joe I hear you.   But you’ve got to read Linda Peeno’s articles .  Undoubtedly, whoever thought of that was congratulated by their company for coming up with that angle.”

  “  Again.  They’re businessmen.” Joe raises his voice, “Businessmen.”

            .   “It’s not just the small guys, The State of Ohio gave one company, American Biodyne 14 million dollars to give mental health care to its state employees The company had said it would spend $4.5 million of the $7 million it received from the state annually for patient care. But the auditors concluded that the firm had actually spent $2.1 million on treatment claims in 1991 and $2.6 million in 1992. The rest of the $14 million over two years went straight into American Biodyne pockets.”

 “Okay.  Fine there are some people in this business who play it close to the legal edge.  But the concept is clean.  Companies are entitled to restrict benefits.  Companies say this is my budget.  This is all I’ll spend for my employees’ mental health.  They say to the insurance company,  “You make it happen.”

They do what’s demanded or they are out of business.  You know Michael I don’t think you have ever really understood what global competition means, how it forces you to be lean and mean.  I don’t think you understand that if you don’t  do the things you gotta do, some one else will.  Everyone is up against, In other countries, that companies don’t pay for their employees’ health care”

“I understand that.”

“, Lean and mean is what saved American business in the 80’s.”

“Oh fuck you Joe.  I’m telling you about evil and somehow it turns into good.”

“Fuck you Michael.  Communism is dead.  You want to go after corporations?Granted,  they can use some criticism, plenty of it, but try an easy angle, the environmental movement, try global warming, protecting rain forests, or go after genetic engineering.  How about endangered species?”

“Joe.  You don’t get it.  Everyone got excited about “corporate greed” with Michael Milken, when they lost money in the stock market, when Salamon Brothers’ secrets came out.  Well this has not been a secret.  People are getting fucked right out there in the open. When they run into a problem with their insurance they figure someone is making a mistake.  They don’t understand there is no mistake.  This is carefully thought out policy.”

“I agree with you.  My point is everyone already knows about this. Companies have to take a stand.  They can afford the stupid environmental issues.  It’s a pain in the ass but its peanuts compared to health care.  This is big big money.”

“Well fuck these people.  If I can slow it down a little.  At least not make it so easy.”

Michael.  You are not hearing me.  This is big money.  Big money!

 “Nothing can be done?  Is that what you want me to say?”

Joe lights a cigarette.  Then he continues.  “Right now you don’t have a story.  You haven’t found an angle.  Heath insurance means nothing to most people.  Oh yeah.  Their mother in her 70’s had some bills.  It was a hassle dealing with them.  But that’s it.  There’s no story because everyone knows the insurance company is going to be a pain in the ass. That’s not news.”

“Unless you get sick.”

 “Yeah, but most people go to the doctor, get their antibiotic and they’re done. “

“You are overlooking a lot of other things.”

 “No I ‘m not.  Think about it this way. How many people want to read about the deficiencies of their home owners policy? Not unless they get screwed royally by an insurance company. But a story about it?  Homeowner policies?  How about electricity companies?  I’m sure you could dig a little and write a story about how electricity companies fuck up all the time?   How about paper manufacturers?  That would excite people. Michael.  Maybe, there’s nothing here.”

He is quiet.

“Michael.  I understand about Richie.  I don’t have answers. Only what my dad used to tell me. You have to look after your own.  That’s the bottom line. Maybe a story isn’t the way to do it.” He blows out a stream of smoke.

Chapter 24

Three hours later Michael returns home.  He throws his coat down on the couch.  Deborah scoops it up and gives it back to him.  “Hang it up.”

Michael walks around the room noticing that everything is spiffed up.

“You’ve been busy.  The place looks great.  What’s the occasion?”

“I just felt like it. Any new ideas from Stern about what we should do?”

            “He thought I should talk to the new head of the department.  Maybe call the insurance company. He thinks that could help us more than anything.”

“Do you think it could help?”

“Truthfully, I don’t know.  Stern wants this story badly.  Whether it’s to help Richie or he just wants this story I can’t tell.  He’s really pissed about what’s going on, so I can’t blame him, but I’m not really sure it can make a difference.  Rahmadi wasn’t exactly shaking in his boots when I mentioned a story.”

“No?”

“Not really, but at this point I want to do it.  People should know what’s going on.  Right now, the main thing is convincing Joe that we have a story.  So far he doesn’t think so.  He wasn’t too encouraging.”

“He never likes your first draft.  You’ll think of an angle.  You always do.”

          “What gets me is Dr. Rahmadi not being intimidated. He couldn’t care less.”

“Maybe he thinks you were just talking.  You ought to show your actual story notes to him.”

“It’s not really challenging him directly.”

            “Still.”

“I guess it’s worth a try. We don’t have a better plan.”

Michael pours himself a drink.

            “Do you mind?”

            “No. I’m good.  I’m under control.”

            “You’re sure?” He loosens his tie. “You know it could all be so nice. If we can get Richie straightened out and you too…  The house looks wonderful.”

Deborah moves next to Michael, puts her hand on his cheek.

            “What?”

            “The way you’ve been.  This is the person I love. I know you’re going to get this fixed with Richie.”

            He says nothing.  She continues.

            “Maybe we can send Richie to Golden Hills. My aunt said she will loan us another $10,000.  And I called your Mom. She can give us $5000.”

“That’s her retirement money.  She’s got to live on that.  I can’t take that.”

“Okay, fine. So all you have to do is get $15,000 from the bank and we are in business.”

“Don’t know if I can get it but I’ll try.”

            “I have the name of someone at First Union, my aunt’s banker.”

            “You’ve been busy.”

            “Also someone else told me that they have a friend at Child Welfare who might be able to help. I called the friend. She told me that we could legally abandon Richie. That would force the hospital to keep him.”

“You know I think somehow this is going to come out okay.  We have so many angles. One’s got to work.”

            “Here’s the name of the guy at the bank.  Go. Get that loan.”

Michael takes a look at his watch.  I ‘m supposed to see Dr. Sturbridge at the hospital.”  He says a hurried goodbye.

Chapter 25

            Michael’s foot is tapping ever so slightly as he sits on the other side of the loan officer’s desk while he reviews the loan application.  Michael has not listed the money they owe to Deborah’s aunt.  There’s no record of it.  He, nevertheless, feels dishonest doing this.  His tapping has been silent, but the officer senses the motion and it irritates him.

“Your application says you want to borrow money to pay for hospital costs for your son?”

“That’s right.  Our insurance is limiting care.  We want to pay for it ourselves”.

“You’d be surprised how many people are doing that.  Only problem is I’m not sure that you have enough assets. How did you ever get so deep in the hole?”

“It wasn’t hard.  My daughter was ill for a couple of years. That just about did us in. We haven’t been able to get back on our feet. Look. It’s only 15,000 dollars.  If I were applying for a car loan for a lot more than  you’d approve wouldn’t you?

“But the car would serve as security.”

He studies the application. Your monthly payments on your apartment alone practically eat up all your salary.  Why did you take out the home finance loans?”

“It wasn’t really a choice at the time.  We had heard about a treatment in San Francisco and we went for it.  Our insurance company considered it experimental and that pretty much is the whole story, $165,000 in the red.  We’ve been slowly paying it off since.”

“Did the treatment help your daughter?”

“Not much.”

“And you want to do the same thing with your son?”

“I really didn’t come here for your medical advice. You think because we’re broke that entitles you…”

“Sorry.  I didn’t mean anything.  Do you have someone to cosign?”

“Not really.”

“Not really or no?”

“Look, just get to the bottom line. Yes or no. I’ve an appointment to see a doctor at the hospital…”

Michael looks at a clock on the wall, which says 12:35. Dr. Sturbridge said he won’t see Michael if he’s not at his office by one.”

“Well. You can leave the application but quite frankly…”

Michael grabs the application and crumples it up as he runs out the front of the bank.

Moments later at a parking garage Michael races up a ramp to the parking space and gets to his car.  The front door won’t unlock.  It’s been fussy for months but he hasn’t had the money to fix it.  He bangs it.  No luck.  He tries the other front door.  It opens.  He hurriedly gets in.  He climbs across the seat to get behind the driving wheel.  After several tries he gets the car started and like a teenager  he burns rubber making his way to the exit.  He rolls down his window and hands the attendant the ticket and money.. The attendant talks to himself, “I don’t have quarters.  Wait a minute.”

Michael takes a quick look at his watch. “Open the fucking gate. Keep the change.”

The attendant opens the gate.  Michael tears out on to the street, swerving to miss a Ford pickup truck.  He is soon behind a red light.  He looks at his watch.  He looks in every direction.  He goes through the red light.  After several other delays he makes his way to the hospital parking lot.  There is a long line of cars waiting to enter.  A miracle.  He finds a space a block from the hospital.

 He gets out and starts to run. When he gets through the main door he continues to run to the elevator. The welcome woman at the entrance shouts for him to slow down.  He ignores her.  On the 11^th floor he spots a nurse in the hall and asks her for directions.  It’s the wrong wing.  He reads his original directions again.  Then another time.  He can’t really absorb the information.  He sees another nurse and asks her.  She points in a direction and he jogs that way, making the second right as she has told him to do.  He can feel his heart banging in his chest.

He finds another hospital worker, who points him back where he came from.  Again Michael runs down a hall.  At the end the hospital library.  He goes in. This time he listens very carefully to the directions. The librarian walks out into the hall with Michael and points to where he has to turn.  Michael goes running off.

At last he finds the office.  On the door is written Dr. Sturbridge, Chief of Psychiatry.  Trying not to seem like a madman, Michael straightens his hair, and takes a deep breath.  He opens the door, walks in softly. He can hear himself gasping for air amidst the beeps of electronic instruments.  He opens another door.  Dr. Sturbridge looks up from his desk.

“You could knock.”

“Sorry.

Dr. Sturbridge scrutinizes him.

I’m Michael Russell. My son…”

“Richie Russell’s father.  You wanted to talk to me?

“I’m willing to sign papers legally abandoning my son.  I was told that you can’t discharge him if he has nowhere to go.”

“You were told wrong.  That’s been tried before.  If we have to we’ll send him to a shelter.  Look Mr. Russell, you’ve been stirring things up throughout the hospital.  They had to ban you from the ward. What is it that you want?”

            “I want to know my son is safe.  I want him to stay here until he’s no longer in danger.”

            “Dr. Rahmadi feels he isn’t in danger.”

“Dr. Rahmadi doesn’t know his ass from his elbow.”

“Dr. Rahmadi graduated from Harvard Medical School.  He did his residency at Yale.”

“He doesn’t know my son at all.”

            “Your son signed a contract.  Maybe Dr. Rahmadi knows what’s going on more than you think.  Did it ever occur to you, that you are too close to the situation?”

            “You mean I know my son?  He is going to hurt himself if he is let out of here.”

            “What makes you so sure?”

            “ He’s my son.  I know him. His best friend knows him.  He’s sure Richie is going to do it.   Dr. Rahmadi doesn’t know him.”

            “Our patients say things everyday that they don’t mean.”

            “It’s not just what he’s said.”

            “Your son fits a very well studied profile.  He’s part of a group that we have numbers for.  People in that group have a small chance of committing suicide.”

“That chance is too high.”

“You think he’s different than everyone else, completely unique. Statistics don’t apply to him.  You’re wrong.  He isn’t unique.  Everyone thinks they are unique but they aren’t.”

“No, You’re wrong.  My son is unique.  So is every single patient on that ward.  Can I speak bluntly?”

“Go on.”

“Your profession has gone off the deep end.  You say you have become scientific.   Only real scientists are exactly the opposite of you.  They know they’re in the dark.  Maybe, just maybe, they can get a glimpse into something they don’t understand.  You’re in the same situation. You operate, out here in the real world, where no one exactly knows what they are doing.”

“I wouldn’t…”

 “It’s fine. That’s the way it is.  You can’t know what you don’t know.  But you act like you do. You think by putting people into a slot, giving them a diagnosis, then following protocols for those diagnoses, you aren’t guessing.”

“We have statistics.”

   I’m sure you do.  But you are guessing.  Only somehow you think those protocols do away with the guessing.  Knowing what you don’t know is the beginning of knowledge.   Dr. Stern explained to me how doctors used to use common sense.  They made their decisions after found out whatever they could about their patients. They took a few weeks, and if they didn’t know then they took another few weeks. We’re talking about life or death.  Eventually, they were forced to take their best shot…”

            “What you are asking is impossible.  I can’t undermine my staff by overruling them.  No doctor is going to stand for that.”

            “Well, just evaluate my boy independently.  I’ll pay for it.”

            “I have to tell you straight out.  Even if I agree with you, your insurance company won’t allow it.  I have very little influence with them.”

“Well who does have influence?”

“No one.  They have criteria. The contract that Richie signed more or less made discharge automatic.”

“ Dr. Rahmadi doesn’t know Richie.”

“It doesn’t matter.  That is how things work.”

 “Do you have children?”  Michael asks, for the first time not combatively.

  Dr. Sturbridge’s  tone softens.  Their eyes meet his for the first time.

            “I’ll see your son this afternoon.  If I disagree with Dr. Rahmadi I’ll talk to him and we’ll put in an appeal.  Then it is out of our hands.”

            “How long will that take you?”

            “If we’re lucky 2, maybe 3 hours.”

            “ I’ll be at Dr. Stern’s office between 2 and 3 hours. Call me there.”

Chapter 26

“We’re doing better than I thought we would,” Dr. Stern tells Michael.

“Dr. Sturbridge wasn’t that bad. I got the impression he might lean in our direction.”

“If you hit the right buttons Sturbridge can be a good guy.”

            ‘You know, we never talk about the other option. What if I simply take Richie home, and between Deborah and me, we don’t let him out of our sight?”

            “You couldn’t keep it up for very long. Are you going to go into the bathroom with him, get rid of all the scissors and razors?”

            “That’s not impossible.”

            “I just don’t think it’s a good idea, ‘specially with hanging. Plus, from the sounds of what’s going on lately, Richie and you are getting each other going.  You could have one little skirmish, and, just like that, you’d be in trouble.”

The phone rings.  Dr. Stern picks up.  “It’s Dr. Sturbridge.”

            “Hey Lonnie, How’ve you been?… He’s with me now… Do you think he can be discharged safely?  Uh huh..”  Stern listens some more   Uh-huh.”

Stern gives Michael a thumbs down.

            “Yeah. No I understand.”

            Stern continues, “That Dr. Day is a pisser isn’t he?  You’re right…I agree… Okay, take care. I’ll talk to Mr. Russell.”

He hangs up.

“Bad?”

“Dr. Sturbridge said he agreed with Dr. Rahmadi, but he called Dr. Day from your insurance company anyway to make an appeal.  It was denied. Richie’s apparently made you sound like a nut.”

“Do you think that?”

            “No.  But I think you’re upset.  You’ve been pretty pissed with everyone.  I don’t think that is helping.”

            “Wouldn’t you be?”

            “I’ve been pissed about all kinds of things for years, but I’m not confrontational.  You seem to like that…  I mean the hospital knows how I feel  but you, they are ready to kill.”

            “Fuck em.”

            “I don’t blame you.  Even if you were Prince Charming we’d still be where we are now.  It’s not a good sign that Richie is so serious about getting out, that he’s actively pursuing his options.  It worries me.”

”I know.”

“I hope he’s not in this place where he’s found the answer.

If he is, it would explain what they say they are seeing, why all of a sudden he doesn’t look all that unhappy.  Depression is weird.  A lot of it is feeling  helpless, not knowing what to do, or feeling unable to do what has to be done.  They can’t imagine that anything can change.  That all goes away if you realize  there is something you can do.”

            “You mean?”

            “Hopelessness disappears once he’s gone to the next step.”

            “Killing himself?”

            Michael searches Stern’s face.   “You think he is there?

            “It’s a gut feeling.”

            “How good are your gut feelings?”

            “More than half the time my gut is right.”

            “Great.”

            Michael’s head is spinning.  Stern sees how distraught he is.

            “Look Michael , maybe I’m being an alarmist.  I am guessing.”

“Yeah but you always said.  “Plan for the worst.” Michael completes it,

“Hope for the best.”

 “Who is Dr. Day?”

            “He’s chief of psychiatry at St Anne’s in the Bronx.  He’s in charge of your insurance company’s behavioral management. He’s not an easy guy.”

“I’m gonna call him.”

“Don’t bother.   You’ll get his voice mail.  He’ll call you back in 5 weeks minimum. If he calls at all. Calls from people like you are the reason they invented call screening.”

            Michael takes out his car keys.

“You have an internet connection here?  I need directions to St. Annes “

“My computer is in that room over there.”

It turns out Michael knows exactly where St Anne’s is. He hasn’t been to this area  in 15 years. His grandmother lived on the Grand Concourse. After she died he had little reason to return.  It was already going bad 30 years ago, but he is not completely prepared for the scenes of devastation surrounding him. Stores are  boarded up.  The bakery where she used to go on Sunday morning for fresh rye bread, and bagels.  None of the stores are familiar.  There are three liquor stores in a two block stretch.  Automobiles are double and triple parked.  Some have multiple tickets that have not been removed from the windshields. .   Broken glass is everywhere. Drunks sit on tossed out furniture.  Rusting cars  are without wheels, completely stripped of all useful parts.  On the side streets drug dealers guard their spot on the sidewalk. Cars pull up to them.

A 10 year-old boy runs out into the street without looking.  Michael screeches to a stop.  The boy’s two friends start banging on the hood. Michael gets out and yells at them.  They move on after giving him the finger.

 He parks in the guarded hospital parking lot.  After he takes the keys out of the ignition, he simply sits still for a minute, takes a deep breath, and waits for his courage to gather.

            The psychiatry ward has the same kind of heavy metal door as Mt. Pleasant. He rings a buzzer and an aide lets him in.  A huge black male patient wearing mascara and a wig approaches him.

            An aide with a commanding voice, speaks from behind him, “Margaret.  Go back to community meeting.”

  Margaret doesn’t obey but he keeps his distance and stares at Michael.

            “Don’t worry about Margaret.  She’s more scared than you are.  How can I help you?”

“Dr. Day’s office.”

The aide points down the hall.  Michael comes to a locked metal door with a heavy glass window at face level.  He stands in front of it so he can be seen.  A buzzer lets him in. He faces a receptionist.

“I’d like to see Dr. Day.”

“Who shall I say is calling?”

“Mr. Russell. Michael Russell.”

The receptionist picks up her phone and pushes a button.  She speaks softly into it.  She puts down the phone and looks up at Michael.

“He said he won’t see anyone without an appointment.”

“Tell him he spoke to Dr. Sturbridge this morning about an appeal for my son, Richie Russell”

“He knows who you are. He won’t see you.”

“Well I’ll just have to see him.”

The receptionist blocks his path.  “You can’t go in there.”

            “I don’t really want to have to shove a lady. But I will if I have to.”

She steps aside.  Michael enters.

 Dr. Day is a tattered man in his 50’s, balding on top but with long hair along the sides.  There is a big sign on his wall.

TALK IS CHEAP

            “Isn’t that an unusual sign to put up in a psychiatrist’s office?”

            “Yeah.  It’s the opposite.  Talking to a shrink is very expensive.”

            “Dr. Day, my son can’t be discharged from the hospital.  I think, and his best friend thinks and his psychiatrist thinks, he is serious about killing himself.”

            “You’re totally out of line coming here.”

            “I had no choice.”

            “He’s been evaluated by two psychiatrists and a treatment team at the hospital.”

            “Their decision is wrong.”

            “It’s not negotiable.”

            “I don’t think you heard me.  My son is serious about hurting himself.”

            “Look Mr. Russell.  You think you can come in here from the other side of the world and demand special treatment.  Why should your son get it and not someone else?”

            “This has nothing to do with special treatment.”

            “The answer is no. Your son’s doctors agreed with our decision.”

            “But they have no choice.”

“They can choose to keep anybody they want.  You know that does happen sometimes.  More to the point. If you are sure, why don’t you pay for uninsured care?”

“I don’t have the money.  The hospital wants payment up front.”

            “My guess is your son just needs a whippin’ to get him to open his eyes.   Kids like him have been whining to their mommies since they’re two years old.  The worst punishment they get is “a good talk”.  We’re not going to pay for talks.  He’s had enough of them already.”

“This has nothing to do with my son.”

“ Look I get it.  Your son’s upset.  Tell him he’s got to get a life.”

            “ Fine, but give him time to get a life.” He’s a little more than upset. He-”

            “I don’t want to hear the details.  When you were driving over here did you take a look outside? Take a good look going home.  These kids are watching their friends shoot up every day.  Hell their parents, that is, when they have parents.  People are dying of AIDs all around them. Every night they hear gunfire.  The next morning they find out who was killed.  I don’t want to hear about your son.  He’s leading a fucking privileged life and if he can’t deal with that…”

“I brought something for you to read.  I’m a reporter.  Our conversation is being recorded.”

Dr. Day  skims  Michael’s story. He hands it back.

            “So what else is new?”

“That‘s all you’ve got to say?”

“You think that I give a damn that this guy made 900 million?  Look around you.  You want a cut of my millions. Your story has nothing to do with me. I probably make less money than you.”

            “I’m going to stop this, one way or another.”

“I hope you enjoy your drive home.”

“I’m not leaving until you agree to let my son stay in the hospital.”

“Listen hot shot. Get out of here.”

“What do you have to lose if a boy stays in the hospital for a week or two.

“This conversation is finished.”

Michael moves towards Dr. Day.  He shoves Michael. Michael swings at him. Michael isn’t a good fighter and doesn’t land a clean blow.  Dr. Day grabs Michael and pulls him down to the ground.

Five hours later Joe and Deborah greet Michael as he is given back his possessions at the jail.

            Deborah touches his brow soothingly.  She looks him over for any signs of bruises.  There are none. “How was it?” she asks.

“It was worth it.”

They go to Deborah’s car.  She hands him the car keys.  Deborah and Michael sit in the front, Joe in back. Michael hands notes for his story to Joe.

“I had time to work on it some more. Read it.”

“Now?”

            “Now.”

Joe looks over what he’s written.

“Did you see Richie?” Michael asks Deborah.

            “This afternoon.”

            “And?”

            “And you are doing the right thing.  I don’t know what we are going to do.”

            “What do you mean?  He said something?”

            “It was just the way he was acting.  I just know he’s going to try again

“Why?  What did he say?”

            “Nothing.  He said nothing.  But I can feel it.”

Joe finishes Michael’s piece.

            “What do you want me to do with this?”

            “I need a story now.  Right now.”

            “Did showing these notes work with Dr. Day?”

“No.”

            “So what makes you think it will work with anyone else?”

            “I don’t know.  I can’t think straight any more.  I’m out of ideas.  Take a chance. Put it in this week?”

            “Michael, it’s not ready.  You know that.  We’d need a very careful fact check by our legal people.  And even then why should that matter?”

            “I don’t know.   It might make them feel like they are being watched.  Just get their adrenaline going.  Put them on notice.”

            “Well you definitely got Dr. Day’s adrenaline going.  Look I have one idea. I’ll get the personal fax number of Martin MacDonald.  He’s head of your insurance company.   I’ll fax him your notes asking for a response.  That will get their attention.  Maybe you got a shot that way.  But I’ll be honest with you.  He’s supposed to be an absolute son of a bitch.  If anything, once he sees this he’ll probably try to get your son kicked out right on the spot.”

            “You’re serious?”

            “MacDonald isn’t a hide your head person.  He’s a macho guy.  Just on principle the bastard could go harder on your son.”

            “Really?”

            Joe shrugs, “Probably not.  When it comes to bad publicity, even people like MacDonald get circumspect.”

            “Honey, you’ve worked really hard on this, but I don’t think it’s going to move things quickly enough.  We may have to take him home and watch him like a hawk.”

            “If we have to, but Dr. Stern thought that wouldn’t work.”

“Well what else can we do?”

            “I’ll send the fax.  You never know.”

            “Joe.  Do you think you could loan us  $15,000?”

There is a sudden chill.  They are all quiet for a moment.  The tension mounts.

“Michael I can’t help you.  I really am sorry but I can’t. Except for my daughter’s college fund I don’t have that kind of money.  Maybe a thousand or two.”

“I have Dr. Stern’s emergency number.  Maybe he has a new angle.

Michael borrows Joe’s cell phone. He dials.

“Can the doctor talk?”

He watches the road like a hawk, one hand on the wheel.  They stop for a red light.

“Come on.  Come on.”

“Where are you racing to?” Deborah tells him.  “There is nowhere to rush to.”

“You don’t think I know that?”

“Hold it.”  He puts his hand over the phone mouthpiece, refocuses then continues,  “Go on… Right… So do you think that is good?  Okay.  Talk to you tomorrow.”

“What did he say,” Deborah asks.

            “There is some kind of plan.  They are not discharging him tomorrow.  I’m to meet with Dr. Rahmadi in the morning.”

Martin MacDonald’s 17 year-old daughter Barbara sends a backhand, hit with authority, along the side line out of her father’s reach.  She has won the set.  He meets her in the center of the court.

“Great shot Babs.  It looks like those lessons are paying off.”

“Thanks Dad.”

Lenny Birch, dressed in a suit, walks out of to MacDonald’s mansion to the tennis court with Michael’s article and hands it to him.  They are out of Barbara’s hearing range.

“It was just faxed.  A story from that reporter that Dr. Day called you about.”

Marty reads it over.

“Who the fuck does this Michael Russell think he is?”

“What do you want me to do?”

A malicious smile forms on his lips as he thinks about it, “Absolutely nothing.  Nothing at all.  These things come out all the time. That Dr. Peeno testified in front of congress in “96. She was an insider.  Knew health insurance backwards and forward.  I thought we might be in trouble then.  She wrote an article that every one read.  Hell it almost made me cry.”  He says sarcastically.  “That poor patient! But that was years ago. Nobody gave a shit.  People are bored by this subject.”

            “Russell mentions Dr. Peeno.  They’ll be interviewing her.”

            “The best thing that ever happened to America was how many exposé shows are on TV. You know 20/20, 48 hours, Frontline, 60 Minutes  I’ve lost count.

So has everyone else. It’s almost funny.  They’re pumping out so much of this junk that all they get nowadays is: “Oh well.” Probably because everyone’s on Prozac.”

“You sure we can relax about this?  You don’t want me to check up on this guy?”

“Do what you want. Just make sure you send a copy of these notes to P.R. But I don’t even think they need to do anything.  Russell is just getting off on being a bad boy.”

“I’m gonna check up on him anyway.”

“Lenny really.  Don’t bother.  I have a more pressing problem.”

“What’s that?”

“Beating Barbara for the second set.”

Chapter 27

With trepidation Michael enters Dr. Rahmadi’s office the next morning.

“I’ll be frank with you Mr. Russell.  I’m not surprised you landed up in jail.  You’re out of control. Next time they’ll give you real jail time.”

“Look, just get to the point.”

            “We’ve arranged for your son to be accepted at Second Chance.  It’s not a hospital, but it’s a good place, a drug treatment center, good reputation, good staff.  His pot smoking was certainly part of the problem.”

“You really believe that?”

            “Not entirely, but it’s a good compromise.  It was Dr. Day’s idea.”

            “Dr. Day can fuck himself.  He’s going to pay. One way or another.”

“Meaning what?”

            “While I was in jail, I met this Mafia guy.”

            “The Mafia?”  he asks amused.

            “The Mafia.” Michael repeats looking Rahmadi straight in the eye.

            “Look Mr. Russsell. I need to know now if you’ll go along with our plan. Second Chance has approved a transfer for tomorrow morning.”

            “I can’t tell you now.  I want to discuss this with my wife.  I have to talk with Richie.”

An hour later Deborah and Michael are in a diner a block from the hospital.

“I don’t know Michael. His problem isn’t drugs.”

            “We don’t have any other choice. I called Dr. Stern. He’s heard good things about Second Chance.”

            She stirs her coffee, lifts her spoon and watches the coffee fall back into the cup.  She does that several times,  “I wish we had the money.”

            “You know in jail… for the first time I understood those guys. Everything  stacked against you. You have no chance. It makes you willing to do anything. Rules- they’re bullshit.  You just want to get even.  I started having these thoughts like how the Mafia is okay. Dr. Rahmadi laughed at me.”

 “My Phi Beta Kappa boy.  You’re going to trade in your pin for a gun.  Don’t you know the pen is mightier than the sword?”

“That was written by a writer.  Truth is I want to kill someone.”

            “Like who?”

            “A lot of people; Dr. Day for one.”

“Better watch it or you’ll land up in jail with those guys.”

“Maybe.  Because I’m seeing things the way they see it. I am ready to blow.”

            “But someone like Dr. Day.  He’s just doing his job”

            “You sound like Joe.  He kept saying that to me after he read my notes.  It’s not news.  Everyone knows about HMOs.”

            “You knew about this?”

“No.  I mean everyone knows insurance companies stink but I didn’t know it was this bad.”

         “Dr. Stern told me about this case that they wouldn’t let him give psychotherapy after ten visits.  It was the story of Job, a woman with breast cancer in both breasts.  She had had two heart attacks before the age of 40.  Her very handsome son had lost 3 jobs and she thought he was becoming a drunk.  Her husband was tired of listening to her complaints and was totally tuned out.  Her daughter had recently walked out of her marriage, for reasons she couldn’t understand.  Her daughter’s new boyfriend was a bum.   She needed to talk, to talk real bad.  The insurance company wouldn’t let her get therapy.  When the therapy was denied Stern kept at it.  He went through level after level of appeals.  That was years ago before he knew the ropes.  Anyway he got to the top.  He got to talk to Dr. Day.  Dr. Day refused the therapy.  “She needs hospice not psychotherapy,”  he said.  Stern tried to explain that she was not terminally ill. She was still going to work.  The family needed the money.  In fact, they deducted a significant amount of her pay every week for the insurance. When Stern kept pushing, Dr. Day told him if he wasn’t happy with his decisions no one was forcing him to remain as one of their doctors.  Then he simply hung up.  What I want to know is why can’t that kind of thing be part of a news story?”

 “I don’t know.”

“Stern’s theory is that people really do know all about depressing things like that from their own life.  That’s why they want to read about something else.    He told me he has patients who are living a nightmare.  All kinds of unimaginable stories.  And they don’t want to talk about it.  Yet they watch horror movies.  One after another.  That gives them the release they need.   Like with Hitler….”

“I told you.  No Hitler.”

            “Well this is the same principle.  People don’t want to hear too much about bad things when they are real.  Maybe after the fact, but not during it.  Not if they can’t change it.  Stern may be right.  That will never change.”

            Late in the afternoon Deborah and Michael tell Richie what the plans are.

Deborah sits next to him on his bed and strokes his hair.

“I’m not going to no drug program.”

““This is the best we can do.  This is it.”

            “Why do I have to be locked up?”

              Deborah continues to runs her fingers through his hair.

He pushes her hand away.

“Am I going to have to go through all this bullshit checking up on me every two seconds?”

“I don’t know,” Deborah answers.

            “I’m not putting up with that.  I’ll tell you right now.”

Michael’s voice toughens. “You’re going to go along with whatever the rules are.”

“And what if I don’t?”

“Don’t go there Richie.”

            Dr. Rahmadi enters the room.  Richie doesn’t look up.

            “What have you guys decided?”

“We’re going to do it,”  Deborah answers. “ But Richie has a question. “

“What is it Richie?”

“Nothing.  I’m good.”

“You’re sure?”

Richie doesn’t answer.  Dr. Rahmadi stops at the door.

“Actually it’s a nice drive. In the country.  Kent, Connecticut.  About two hours away.  It’s supposed to be nice weather tomorrow morning.”

Dr. Rahmadi leaves.  Richie picks up a vase and throws it against the wall.  It smashes into a thousand pieces.  Dr. Rahmadi returns.

            “You’re going into seclusion.”

Richie gives him the finger.  Michael and Deborah sit passively on the bed as the aides come into the room and escort Richie away.  Michael’s proud of Richie’s defiance.   Michael picks up a piece of broken ceramics and aims it for the waste basket.  It goes in. At that moment he remembers an incident only a few months before.

They were playing basketball at the playground.  Michael drove towards the basket.  He missed. He went up hard for the rebound. His elbow accidentally hit Richie in the chin.  As a reflex, Richie shoved his father. He was screaming,   “Always have to win don’t you?”

Michael spit back at him, “Is that all you got?  Come on.”  Richie punched his father in the nose.  Michael was more surprised than physically hurt.  He had a bit of blood at the tip of his nose.  Richie saw the blood and was upset.  He walked away, as did Michael.  Ten yards away Michael turned around.  Richie  was punching himself in the head.  Michael turned back and walked away.  He said nothing.

It is 7PM. Melissa is at the door of the seclusion room.  “You okay?’ she asks.

“I’ m good.”

            “You sound too good.  Someone slip you a funny pill?”

            “No, I’m just real good.  I’m finally getting out of here.”

            “Richie you sound funny.”

            “Tomorrow is a big day.”

            “What do you mean?”

            “I finally have things straight in my head.”

            “About Lise?”

            “Yes.”

“What did you figure out?”

            “I want to be with Lisa.”

            “Richie come on. That’s no answer.  You want to die? Wait until it’s your time.”

Richie doesn’t answer her.

            “You have so much here.  Don’t give up on us.  You got Dan and you got me.  You don’t know me, but I get better the better you know me.  I make great lasagna. I mean totally the real thing.  My grandmother taught me.  Rich come  on.  You have to taste my lasagna.”

Silence.

“Besides Lisa can wait for you.  Believe me she’s not lonely.  I heard she’s got a boyfriend.”

Silence.

            “You didn’t know that did you?  I’ve got psychic powers.  The minute you told me about Lisa I visited her.  She told me how she misses you but she’s all right.   You’re the only person she worries about.”

            “Can you really talk to her?”

            “I absolutely can.  I didn’t make that up about how she told me she can wait.  I didn’t make it up.   Lisa said it.  Said you shouldn’t do anything. That’s what she said.  She said she’s good and wants to see how you turn out.  She wants to see you grow up.”

Silence.

It’s making Melissa anxious.

More silence.

Melissa’s erupts.

“Richie you’re a jerk. Just like my father.”

            “I thought you never knew your father.”

“I lied. He used to beat up on my mother.”  She hesitates before continuing.   “He killed himself.   An idiot.  I hate him. Richie it’s stupid.  Everyone’s going to hate you.”

Richie knows that is not true.

            “I’m not going to do it.  I think about it a lot.  But no. Lisa’s not there so I’m not going to do it.”

            “Good.  But you’re wrong.  Lisa is there.  And I did talk to her.  And she said I should tell you to stick around.”

            “I said I will.”

            “Promise?”

            “You want me to sign a contract?  God what assholes they are in this place.”

“I want you to promise.”

Silence

            “Richie?  Richie?”

More silence. She starts to cry.  “Come on Richie.”

“Okay. stop”  he says with a sweet voice.  Melissa I told you this, but I want you to really know that I appreciate your ability to make up your stories.  Like Lisa and me with our talking cockroaches. Nice people make nice lies.”

“What I said about Lisa isn’t a lie.”

“Either way,”  he says with a smile, “You do good lying.”

“Richie.  I don’t like this bullshit.  Dan called me.  You got him scared too.  He said you sounded like you were saying final goodbyes.  Now I’m hearing it.  I don’t need no final goodbye.  I want to see you at one of my basketball games.”

She waits for him to answer, but he doesn’t.

  Richie, promise me you’re not going to do anything.”

Richie is sitting on the floor near the door, his back leaning against the padded walls.  He has left Melissa.  He is smiling to an inner voice.

It is 11 PM.   Melissa is at the nurses station.  She bangs on the locked door.

            “Open up.  I gotta talk to somebody.”

Melissa hits the door again.  Finally it opens.  The aide licks her fingers.  She has been called away from her Kentucky Fried Chicken.

            “Now what can be that important?”

Melissa hesitates.

            “Girl.  I’m talking to you.”

            “You have to promise me something.  When Dr. Rahmadi comes in.  Someone’s gotta tell him that Richard Russell is going to kill himself when he gets out.”

“He told you that?  He said he’s going to kill himself?”

            “Well…”

            “What were his exact words?”

“He said he wouldn’t.  But he wouldn’t promise.  He’s gonna do it.”

“Yeah I heard about you and how you think you are a psychic.  Let me tell you something girl.  The sooner you get back on this earth the better.  You’re a pretty girl.  You don’t need to be in no psychiatric hospital.”

            It is 11:15.   Michael and Deborah have just finished making love.  They are lying calmly in bed.  They are in a good place.  Periodically they stroke each other.

            “Michael I’m going to get a job.”

            “Really.  Why?”

            “First of all and second of all we need the money.”

            “We can manage.”

            “Michael enough.  You’ve been real sweet letting me get away with not helping.  You could have demanded that I put my head on straight and get the hell out of bed.   You’ve been good all along but let’s face facts. Our situation now might be different if we had some savings.”

            “Maybe.”

            “It’s not just that. I don’t like the way I’ve been since Lisa.  Doing nothing. I should have been able to get over Lisa.  I should have.  It didn’t do nothing for her and’s been bad for everyone else.”

            “It wasn’t stupid. You did what you had to do. You weren’t ready.  Now you are.”

            “I was never going to be ready. It messed up Richie seeing me like that for so long.”

            “Coulda, woulda, shoulda, it doesn’t matter.”

            “It’s not just Richie.”  Tears silently run down her cheeks,  “I’m glad we have something again.”

Michael keeps stroking Deborah’s hair.  He looks into her eyes searchingly.

            “What is it?” she asks

            “I don’t know.  It’s been so long.  You really have been like a stranger to me.  For years.  I’d try or you’d try and it never worked.  I don’t understand it.”

            “It just happened.” Deborah answers.

            “We can’t let it happen again.”

            “I hope we can do that.”

            Her fingers dig in, slowly massaging her neck.  She continues.

“It’s been lonely. Truthfully, I thought we would never be close again. “

“I was beginning to believe that too.

“ Don’t let me go back there okay?  No matter what.  Just don’t let me do it.”

            “How do I do that?”

            “I don’t know, but you can.  I’m sure you can.  Keep me with you.  I’m happy there.”

Michael gets out of bed. He goes to the bathroom, and then returns.  He studies Deborah for a moment before speaking.

            “Are you going to come with us tomorrow?

            She wipes her eyes.

“No, I don’t think we’re ready yet.  It shouldn’t be but we work better as a family one on one. I’ll call Richie and explain.  I’ll visit him on his second day  there.”

Deborah notices how down Michael is.

            “It will work out.  We’ll get through this.  And whatever comes after that.   Things are going to be better.”

”They can’t get worse,” he says half distracted.

The phone rings.  Michael looks at his watch.  It is close to midnight.  Deborah is frightened. No one calls them this late.  She answers, listens, hangs up.

            “That was Melissa.”

Chapter 28

 

Michael is in Dr. Rahmadi’s office early in the morning to pick Richard up to take him to Second Chance.  Dr. Rahmadi is not in the mood for another round.

            “Mr. Russell, Melissa is a pathological liar.”

            “You think Melissa would make up something like that?”

            “Yes.  She constantly lies.  She’s a patient on a psychiatric ward.”

            “Come on.  Have you ever talked to Melissa?”

            “Have you?”

            Michael’s expression gives him away.

            “Doesn’t matter. I spoke to her on the phone.  She wasn’t making this up.”

Dr. Rahmadi presses on.  “Mr. Russell, you won’t let up.  You keep going and going.  You’ve tried every angle. Now this. The answer is no.  Richie’s being discharged this morning.  He doesn’t fit our criteria for continued stay.”

“You mean the insurance company’s criteria?”

            “ You remind me of Geraldo Rivera or who’s that other guy?…

            “Don’t know who you mean?”

            “You bang away and bang away.  I heard you the first time.”

            “This is not about me.  It’s about my son.”

            “You’re like my daughter.  Jailhouse lawyer, since she’s four. Keeps at it until she gets what she wants.  She’s 16.  I’ll say to you what I say to her  ‘Shut up.’”

            Michael raises his voice.  “This is about my son.” He repeats.

“You know, somehow you missed out on what everyone else seems to know. I mean…”

He pauses, not sure how blunt he can be.  Rahmadi’s father was lucky.  He could say what he had to say and go right back to work the next day.  Doctors cannot say what they think,   “Fuckin’ kike, fuckin’ faggot.”  That would have been the end of it. Later at dinner his father would have justified it to the family.  Who appointed them?  God’s chosen people? Chosen for what?  To sit in judgment.    Dr. Rahmadi doesn’t know if it is because Michael is Jewish.  But he knows what he would still love to say anyway.   “Get the hell out of here you kike!”

            A doctor can’t talk like that.  It would end his career.

“I’m waiting.” Michael says insistently  “What did I miss out on?”

“You think you’ve earned special rights because you’re good with words. Do you really think Jesus cares whether you are smart or not smart?  Do you think you can debate your way into heaven?”

Michael is stung.  But then relieved.  Knowing what he is up against is better than not knowing.

 “Maybe Richie is going to try again. Maybe he will. What you don’t get is that we see people like your son all the time.  All the time.  We have people here right now who have tried 5 or 6 times.  One woman in there has tried 9 times. Just like Richie they give plenty of warning. But they’re still here, alive, breathing, back for more.  Some have been doing this for years.  What should we do?  Keep someone in the hospital for ten years.  You want to keep Richie here ten years?”

“No but how about until the medicine works.  How about getting to know my son so you can make a better guess about when he should or should not leave.  Dr. Stern told me that used to be standard.”

“Dr. Stern is a dinosaur.  That was before we had DSM IV, before we could make accurate predictions about a patient’s illness.”

“You really think you understand someone when you give them a diagnosis?”

“We’ve been over this.  If I kept everyone like Richie here, we’d keep half the ward here months at a time.  Who pays for that?   Sure it can happen. Richie could kill himself.  Yes we are gambling, but so are you every time you step off a street corner.”

“This is higher odds than that.”

“Mr. Russell, how come I make these decisions all the time and other parents aren’t climbing all over me?”

“I can’t answer that.  I’m not them.”

“But you are asking not to be treated like them.  You want an exception made for you.”

Silenced Michael tries to look defiant as he stares straight into .adi’s eyes

“I am not going to make an exception.  Richie is going to leave here like everyone else.  You can’t pay for it and the hospital can’t afford to give it away for free.  So it is what it is.

“You don’t have to do this.”

 “Fine.  You are a great parent.  You care.  More than any other parent.  You’re the greatest Mr. Russell.  And I don’t give a damn about Richie.  I don’t give a damn about any of our patients. What does that do for you, when you put us bad guys down?”

“You think psychiatrists categorize? It’s nothing compared to people like you.  Everyone is either good or bad.”

 Dr. Rahmadi continues,  “Look Mr. Russell I feel bad for you. If my daughter died of cancer at twelve I wouldn’t be in great shape.  But that doesn’t change a thing.   You’re a pain in the neck.  Maybe well intentioned.  Maybe.  But  definitely you’re a trouble maker.”

“ What do you want me to tell you?”

            “Tell me?  Not a thing.  Go talk to Dr. Stern and whine to him.   Leave me out of it.   He’s your therapist, not me.”

              He puts out his hand and hands Lisa’s ring to him. “ They took it away from Richie when they put him in isolation.” Michael accepts it. Dr. Rahmadi puts out his hand for a handshake.  His voice is half friendly.

            “Your son is waiting for you.  Be smart.  Spend some good time with him.  Then drive him to Second Chance.  It’s a decent place.  Then get out of the picture.  You’re stirring up a lot of dust.  It’s not good for him.  Or anyone else.”

Chapter 29

Two hours later Michael and Richie drive through the countryside.  Michael’s has decided on a detour north of Second Chance. Morricone is playing on the stereo.

“Do you remember Cinema Paradisio?”

“I think so.”

“We saw the DVD together. This is the music from it.”

 As in the movie, the music bathes the sweet sad memories that are passing through Michael’s mind:

Richie at three Lisa at four having a catch, neither very good- it cracked him up.

“You were very cute. Ritchie.  Very cute.”

“Like I am now.  Right”

“No you are not cute, but I feel connected to you.  And I was just remembering how cute you were.  Mom’s told me that when you and Lisa were two, three years old it was the happiest time of her life.  Richie I know it’s strange  but the way you were in the past carries over til now.  I see you like  you are now but I also see you at two and three and four. At ten and fourteen.  They are all you.  What is happening to you now is only a small part of you.  And maybe you can’t see the future, but I can.  It’s going to get better.”

“Yeah right” Richie says sarcastically.

“Yeah right” Michael tells him emphatically.

The music continues.  Pretty soon Richie has left again.  He is in his own world.  It’s a sunny fall day in New England.  They go up and down hills, pass a meadow, then through a covered bridge.  From time to time Michael steals a glance at Richie and vice-versa.  The scenery is beginning to look familiar to both of them.  At one point Richie looks up at his father, fondly.  Michael pretends he isn’t noticing.  Richie’s eyes water.  Michael stares straight ahead at the road.

“Do you have that Nancy Griffith CD you used to play?” Richie asks.

            “You remember that?”

            “Yeah, play it.”

Nancy Griffith sings “Across the Great Divide.” As he listens, Richie smiles in a strangely contented way.

The finest hour that I have seen

             Is the one that comes between

The edge of night and the break of day

It’s when the darkness rolls away

 “I want to play the yodeling song.”

Richie hits the skip button, until he gets to song 6.  He still remembers that it is 6. Nancy Griffith’s Night Rider Lament

But she’s never seen the Northern Lights

Never seen a hawk on the wing

Never seen Spring hit the Great Divide

And never heard Ol’ Camp Cookie sing

They both start yodeling imitating the high pitched yodeling on the CD.   Yode le he hoo.   Yode le he hoo.”  Both crack up

It is the first light moment between them.  It is  like sunshine entering the room.

“I haven’t listened to music with you in a long time.”

“I know,” Richie answers.

 This is followed by silence.

“Sorry.  I can’t help it.”

“Why do you want to die?” he blurts out..

Richie scowls, “Not going to talk about it.”

That is all it takes, the nastiness in Richie’s voice pisses off Michael. He doesn’t know why he is set off so easily but he is.  And very quickly, Deborah jabbing at him.

“You’re supposed to be the grown-up.”  That would get him angry at her for taking Richie’s side

Stern pointed out that’s how it was between Michael and his father.  They often hated each other.  So he shouldn’t be surprised.

But then the anger goes away. Richie’s earlier openness is bothering him.  It’s not Richie.  Being in a good mood is not Richie.  Being even a little bit friendly with Michael is not Richie.

He takes this as evidence that Richie is planning to go forward with his plan.  They arrive at the spot Michael wants to revisit.

              Richey almost instantly recognizes where they are.

            “I wanted to bring you here before I dropped you off. Remember? Mom and I used to camp out here every year when the leaves were just like this.

“I remember.”

“The four of us.  We promised each other that we’d come here every year. It was our  version of Rosh Hashanah. Reconnecting to God.  That did the trick better than getting all dressed up and  reading prayers synagogue That didn’t work.   This did.”

They get out of the car and start climbing a rocky path.

“Why’d we stop coming here?”

“I don’t know.  After Lisa…  We shouldn’t have. We just stopped. You want us to start coming here again? You get your head straight and we’ll come here every year…”

Richie doesn’t answer.  Michael isn’t sure if he’s listening.

“Every year. You’ll bring your children, and then they’ll bring their children. That’s how it’s supposed to be. You keep going and going…

They arrive at the vista.  Richie looks far out into the distance.

  “Do you believe in God?” he asks.

             “Yes.”

              “You really do?  All the time?  You’re sure?“

“Yes.” Michael lies.

“And heaven.  You think we are going to see Lisa again?”

             “We are going to be together. But Richie first we have a lot of years here.  I know you think it’s bullshit, but Mom’s better. Everything is going to be better.  You get better and we are going to be, okay.  It’s that simple.”

As they move closer to the drop off Richie has to raise his voice to be heard.

            “I remember every year you’d take a picture of us right over there.”

            “You remember that?”

“I remember everything dad.  Everything.”

“I’m going to start taking pictures again.”

            “I remember Lisa hiding behind that tree. Harry found her.”

            “Do you still feel connected to Harry?  Would you like a puppy?”

Michael half whispers, “The new Russell family.”

“Right”  There’s a hint of sarcasm in his tone.

Richie walks over to the edge of the cliff.  Looking down he clutches Lisa’s ring. Above and below the two of them, the wind, high pitched, like it’s blowing into an enormous cave, the size of a valley…   Below, the wind answers itself  with deeper tones, humming, almost singing.  Between the gusts there is silence, until it starts again.  Michael shouts to Richie.

            “Don’t get too close.”

            “Don’t worry dad.”

Richie sits down with his legs dangling over the edge.

            “Come here. It’s nice.” He tell his father.

Michael does as he’s told.

“It is nice. I love this spot.”

They sit silently.  They watch an osprey in flight, soaring, soaring.  A few beats of its wings then it glides free in a giant circle.    Down below leaves swirl in bursts as the wind recedes and returns.  The vastness before them, and their smallness in the scheme of things, creates a kind of calm.

Richie and Michael say their goodbyes outside the admissions building at Second Chance.  They hug.  Strangely Richie wants the contact as much as Michael, which initially Michael finds encouraging.  Only after he returns to the car do darker implications enter his mind. He once again listens to Morricone.  He pulls out on to the road.  He drives very slowly, quietly.  He’s flooded with memories…which the music soothes and makes his sadness wonderful  a poetic melancholy that is simultaneously frightening .

  Home movies.  Michael and Deborah each making clown faces for the camera.  Michael throwing infant Richie into the air and catching him.  Lisa pulls at his leg.  He hands Richie to Deborah.  He picks up Lisa and throws her up. 

Michael arrives at the spot where he got out with Richie earlier that morning.  He walks up the path.  He goes behind the tree.  He can almost hear the sound of their giggles… 6-year-old Richie, 7-year-old Lisa running around in circles.  There Deborah, young Deborah, radiant Deborah offering him a canteen filled with cold water.  He is sweaty from putting their tents up. He had done a good job.  Deborah rarely saw him doing physical work.  The look in her eyes as she handed him the water.  The way Richie hugged him as they said goodbye comes back into his mind.  It bothers him still more. He considers turning around and simply taking him home but doesn’t.

 He is almost in a dream as he arrives at their apartment house.  He pushes the button in the elevator to the 5^th floor.  The elevator stops with a jolt.  The elevator door opens.  He’s greeted by the aroma of Mrs. Murphy in 5F making her cabbage soup.

Michael puts his key into the lock but it opens before he can turn it. Deborah stands before him. She has been waiting for him.  Waiting to collapse in his arms. Tears are not enough.  She needs to collapse. Needs to sob. Needs him to hold her.  Michael doesn’t say a word.    He’s thinking about what Debby needs, what he can do for her.

“Ten minutes after he got there.” She speaks slowly almost as if she is trying to comprehend what she is saying.  She stops after each sentence,   “He found a necktie.  He was holding Lisa’s ring in his hand.”

Chapter 30

For days Deborah has been trembling.  She has a chill that layer after layer of sweaters can’t relieve.  It began after she touched Richie’s hand when they went to identify his body.  His ice cold fingers chilled her own. And they have remained that way.  The thermostat has been turned to 80 but her fingers are  like icicles.  Lisa’s death  summoned her, but never this physically.

United by their emptiness Deborah and Michael hold on for dear life. Because they are incapable of giving each other what they need the harder they try the more exacerbated their separation.  It makes them all too aware that they can no longer comfort each other. Moreover they aren’t entirely successful in keeping their disappointment with each other from becoming rancorous.

11 AM, three days after Richie’s death.  Deborah is curled in their giant black leather chair by the giant window that she often goes to.  She’s looking down at the playground. She and Harry have often cuddled here.  Petting, scratching, finding that place behind his ear-  when she found the spot they were in heaven.

It is not happening this morning.  She pushes Harry off of her.  She moves her hand across her shoulder gently, then strokes her face as if rubbing cold crème on to her cheeks and under her eyes. She is reminding herself what that feels like, reminding herself that her face is intact.  She searches through the playground hoping to find Maria, but Maria is five years older and doesn’t any longer come to the park.

Deborah is still beautiful.  Michael watches her.  She’s like a cat licking its paws, stretching, finding its way into comfort. Only Deborah cannot find that place, any better than when Harry was on her lap.  Searching for comfort she keeps reshaping herself into a new position, hoping to find it, but she doesn’t succeed for long in any position.  Michael still finds grace in Deborah her movements, like a  dance, gentle, languorous, smooth. As she strokes herself she is so familiar that she seems a part of him, but just as often she isn’t.  He is unconnected as often as he is with her, extraneous, more like pepper on mashed potatoes, than milk or butter.

Michael’s family didn’t touch much.  What hugging there was functioned more like a greeting handshake than true affection  There was  never cuddling.  Never. Watching her, wanted her capacity, he cannot wish it for himself. It is not a quality that can be reached for, or practiced until perfect.  It is Deborah.  Not Michael.

Having tender thoughts, when they come, is the best he can do. Even the, they seem like a mirage.  His pain is too deep for his affection to last very long.  She cannot supply what he needs to soothe his conscience.  And he can’t cuddle.  The love they started with was extraordinary.  But neither can be who they can’t be.

For Deborah, sleep would be so nice, so nice.  But sleep, like she used to sleep, is cruelly unavailable.   “Gai shluffen” Michael sweetly whispered in her ear late one evening like his mother often did when he was tired.

“I’m not tired.” She said.  She is exhausted, particularly becaue she is not able to rest.  Nightmares keep interrupting any brief composure she can find.   She craves deep, deep sleep, the kind of sleep where consciousness totally disappears. Nothingness. Only drugs can get her close to there.

People keep dropping in.   Hour after hour Mike and Deborah are besieged by well meaning friends, coworkers from the office, cousins who they haven’t seen in years.  With the exception of Joe, Michael can take it for no more than five minutes.   It isn’t just now that he his having difficulty. Behavior meant for company is not something Michael is capable of sticking with very long. Fortunately, Deborah is not having a better time. She knows how to hint.   Their guests get the message.  They don’ want to chit- chit either. They are more than happy to keep it short,

He needs time to be alone, to be swept up in his fury.  Except begun, he doesn’t know how to stop it.  Doesn’t want to.  Can’t anyway. The anger, swirls through gulleys in his consciousness.  Good or bad, invited or not , they grab hold of him, sweep him every which way. He prefers that to maintaining a persona when other people are around. Being social hasn’t been his thing since he turned thirty, since he realized his childhood friends, and those who followed  weren’t for forever.

 In the weeks that follow Michael is busy, busy trying to figure out what happened. Busy sorting it all out, who to blame, busy trying to anticipate what will come next, only each possibility might become worse than the next. He can numb up for work.  Come hell or high water he functions. For years after Lisa died, work was his most reliable friend. He was lucky.   The angrier he got the stronger his writing became. Going to the office got him out among people.  While he’s not crazy about anyone at the office and they are not crazy about him, they all like each other. Which helps.  Being around Joe, forces him to deliver what the paper needs.

It doesn’t bring him anywhere near his soul, but acting professionally is exactly what he has always done.  His mother used to put out their clothes the night before the family was going to an event.  Not just the clothes, getting, being prepared was a holy ritual.  After that, proceeding forward is deeply embedded in his character.  It bulldozes every distraction to the side. That, and his perpetually striving to be better.   Now more than ever, Michael’s effort at high functioning is down to routine.

Debbie returns to her former drug behavior.  She’s no longer watching videos of Lisa.  She doesn’t think about her that often.  Can’t.  Before Richie’s suicide there was a painful, but still sweet melancholy when she connected to Lisa in her memories.  It was a visit.  Now a visit means unbearable sadness.  Unbearable.  She tried it once.  Once was enough.

Instead she hangs out.  Like she did in high school.   Some are old friends.  Her original high school drug crowd never stopped hanging out together.  Several of the originals have been lost to overdoses.  Some are new, but someone high is someone high.   Glazed consciousness.  It is the only way she can be.  There is something about Don’s looks, his demeanor when he is high.  He seems to have it all together. Several women in the group  court him.

 Sensing that something might happen between Don and her gives Deborah a sliver of hope. There is great danger in having an affair.  She hasn’t acted yet, and may never, but the fantasy of her with Don gives her what little life remains in her. Right or wrong, a glimmer of hope is better than nothing at all.

Michael senses something might be going on. That’s fine with him.  After Richie died, his expectations from Deborah, his efforts to keep courting her, his thinking about her, ceased to be the core of his existence.  It was a relief.

When he was young he was too often desperate trying to win over young ladies. That didn’t materialize with Deborah.  It went comfortably from the very beginning.  Later it got complicated and too often exhausting, but still there was this undying hope that they were going to reconnect and have the wonderful ease they began with.  He had lived with her still believing the evil spell that surrounded her after Lisa’s death would come to an end.  Eventually, maybe not soon, but eventually.

After Richie’s death he accepted there would be no return.  For her, or for him.  He would never have back the Deborah he loved when they met, the magic, the fascination both had for the new things they learned about each other.

Actually, that particular excitement was gone years before Lisa death  Honeymoons come to an end. But the hope that they could return to something approximating their early love, remained.  Even if it seemed unlikely, hope held them together.

 After Richie that was gone.  You can’t go home again. Getting through the day. Then the following day.  Then the next.  Hope is what keeps life from being Sisyphean. That was gone.

The tragedy when young people die is that neither they, nor their parents, will find out which of their dreams will come true. There will be no opportunity for them to play it out.  The half formed persons Deborah and Michael knew as children and nurtured weren’t always terrific.  Far from it, but there were nice things about each of them, Lisa’s smile, Richie’s intensity, many, many qualities. It was always based on the knowledge that these half formed persons would become a fully formed version, one way or another their dream actualized, or at least approximated.  It would play out.  When they were alive Richie and Lisa’s dreams might be fulfilled. Now that would never be. Their death stripped of all hope.

 When Deborah’s not around, Michael sometimes blames her for what happened.  The same thing happens to Deborah.  She blames him.  They know that it’s not fair or smart to do that.  There is nevertheless no way around it.  Wise ideas are a weak bulwark against the emotional tsunamis that tear away at them.   Defenses are feeble.  Michael retained the power of epiphanies throughout his life, a sudden cleansing realization that he understands and is clear about what to do next.  In his youth epiphanies were good for months, sometimes years, later maybe a day.  Now, even the best ones dissolve in a matter of minutes.

Chapter 30

Looking through the scope at MacDonald, Michael begins to tremble.  He is not a born killer.   He doesn’t have ice water in his veins. He wants ice.  But it was not given to him. With all his theories, with all his hatred, all that chatter is not even close to delivering ice.  He takes several deep breaths trying to steady himself. No luck.  He stands up and walks around the room a bit. His fingers feel stiff. He opens his hands, stretches his fingers as far as he can. Closes them.  Opens them. Then he shakes them.  No better. Pins and needles from his finger tips to his wrists.  His left hand begins to ache.  He’s read about that symptom.  He could be having a heart attack.  If it is a heart attack he has little time to spare. He focuses on MacDonald in his sight.  MacDonald is cutting his prime rib.   His shoulders are as straight as a soldier.  He’s cutting big pieces of red meat, tearing at the flesh with gusto.

Michael has broken into a cold sweat.  He feels like he could pass out. The trembling has now become spasms. He is going to fail unless he can get calm.  The words go through his mind as an order.  He begins to mouth them.  Then out loud:

“Calm.”

“Calm.”  He repeats it like his sergeant used to, begging then demanding it threateningly.

 “Calm!”

He counts to 10.  He does a multiplication problem mentally.   47 times 213.  It is no use. He can’t concentrate.  The numbers won’t stay still in the columns.   Dull aching numbness has replaced the pins and needles in his fingers.

  Perhaps he is having a stroke.  What he has to do is clear, completely clear. If he doesn’t act soon he will fail.  It has to be done now. No choice other than to go ahead.  He aims.  MacDonald has cut his meat and is now talking to a woman to his right.  She is a little too close to him.  He can’t risk an innocent person.  Suddenly Michael’s line of vision is clear but the rifle is trembling too much.  He takes his left hand and pushes down hard, trying to steady it. No better.  The line of fire remains clear. He pulls the trigger, shoots the shot.

 It misses by a mile.  The bullet goes slamming into a portrait on the wall    ripping across the cheek of the man in the portrait.   Michael’s first reaction is not disappointment.  It is terror.  Complete terror.  He is terrified for his own safety.

There is bedlam below, women screaming and men shouting directions to get under the table.  Security people, with guns drawn, search the ceiling trying to identify where the shot came from.  He pulls the gun back and lays it on the floor.  He feels the same thing as everyone else in the room.  Fear.  Terrible, terrible fear. Terror.  He is terrified.   His only thought is the same as every one else in the room.  He wants to get away safely.   Having never taken off his gloves there will be no fingerprints.  So, as planned, he leaves the gun on the floor.  He gets out of the room and starts down a tunnel that connects to a number of the rooms like the one he was in.  They could be racing to get there before he makes it out.  His heart is pounding.  Pounding.  He has to get out of the tunnel.  He can see the entrance to the back stairs.  Thirty more yards. He can hear them running towards the tunnel.   No sign of them, but he can hear them getting closer.  The steel door to the back stairs.  It is stuck. He throws himself at the door. It opens a bit.  He wedges himself through, pushes it closed, leaps down the stairs as quietly as possible.  He is down two flights.  He hears the door he came through open, hears their shouting.  But then the door closes.  Finally, silence.

At the next landing he realizes his best hope is mingling, so he switches to the regular stairs.  He slows down. Then he realizes the elevator will be even better.  He takes off his gloves, puts them in his pocket, slightly lumpy but nothing that will draw attention.  He simply stops and waits for the elevator. The elevator light goes on.  The door opens. As he enters there is a family of three dressed very casually.  The four year old little girl stares at him, critically.  How is it that dogs and young children know?  They have their instincts.  But the mother and father do not look his way.  They look in every direction but his.  So they must be sensing something.

“Nice evening” he says with a trembling voice.  They nod then continue to look away.  He realizes he is soaked.  He’s been perspiring buckets. It was hot in that room.  His shirt is wet. The elevator door opens.  He is a short distance from the lobby. He feels cold in the air conditioning.  Finally he finds people looking as afraid as he is, people in tuxedos and gowns who had left the ballroom and are making their way out of the lobby.  He walks with them trying to seem calm.  No luck.  He smiles once at someone whose face is familiar, a pasty smile.  He finds a cab a block away. On the ride home he is again shaking.  He had done something crazy. His anger had turned to terror.  He misses the anger.  It is more comfortable than fear.

Deborah is watching the news on TV as Michael comes into the room.

“Someone tried to shoot Martin MacDonald.”

“I hope they got him.”

 He tries to act as if nothing has happened.  She knows him too well to be fooled.  She should be shocked, but isn’t.  She thought it might be Michael as she watched it on the news

Michael undresses, puts on his pajamas.

Deborah looks him in the eye.  Her voice is scolding.

“Michael.”

“I had to do something.  I had to.”

“Maybe, but that isn’t it.  It’s got to stop.”

He tries not to react.  She continues.

 “ I should have seen it coming.  When you watch the news.”

He listens quietly.

“Your anger.  I can’t take it.  I know you’re not angry at me, but to see and hear your hatred.   Can’t help myself.  You make me hate you. You’ve got to stop. I can’t live with it Michael. I can’t.”

The next day Michael is back in Harlem, carrying a satchel.  He checks the address.  He enters the building, knocks at 4E.

“Back for another one?  What did you do with the first rifle?”

 He is shown an assortment of rifles and revolvers.  He chooses one much like the one in the utility room.  He disassembles the parts and puts it his satchel.

He returns home.

Michael is looking through a drawer in the dining room.  He lifts several objects for inspection before returning them.  Finally, he has what he is looking for, his bar mitzvah tallis.  He holds it up.  Then he wraps the gun parts with his tallis and puts them in the satchel.  As he is finishing Deborah enters the room.

“What are you doing?”

“Nothing.  Listen, I’m going to that place in the mountains.  Come with me, okay?”

“That’s a long drive.  It’s pretty late to start for there. We’ll have to drive back in the dark.”

 She is trying to understand what he is up to.  She is frightened, confused.

“Okay.  I’ll go for the ride, but I don’t want to go up there.”

During the hours in the car, they talk very little.  They are lost in their thoughts.  When they arrive Michael gets out.

“I won’t be long.”

Michael grabs his satchel.  He looks at his watch.  He gives her a kiss.  A thought flashes into her mind.  This might be goodbye.  She starts to get out of the car.

“I want you to wait for me here.”

He sees her fear.  “Really.  I’m going to be alright.”

 She watches him climb the incline not knowing what to do.

It is almost time for the sunset.  When he arrives at their spot he looks out at the horizon, searching, searching.

Deborah stares out of the car window becoming more and more frightened.

Suddenly Deborah hears a gunshot. In a panic, she climbs to reach him.

Michael has his rifle in position, aimed at the descending sun.  He shoots again, screaming like a mad man.

“Fuck you God. Fuck you.”

He shoots again.

Deborah stops and watches quietly.

“Fuck you.  Fuck you.”

He throws the rifle over the cliff. He goes back to the satchel.  He takes out his tallis. He kisses the fringes. Rhythms he had seen again and again as a child take over.  A soft echoing moan, the identical melody can be discerned. He prays, chanting as his father had chanted, and as his grandfather and great grandfathers had chanted. Dovening in exactly the same way, the same voice, the same beat, the hum- -in this process the voices of father and grandfathers are returned to their sons. Like his uncle, like his father, his grandfather, his great grandfather, and great great grandfather, a melody repeated, a certain sway that has been repeated for 500 years.  Though he has never seen or heard them doven, they all are there in his doven.  The departed are reincarnated. They live in the rhythm that has taken over his body, in his voice as he mutters the ancient chant of his tribe.

“Yis’ga’dal v’yis’kadash sh’may ra’bbo, b’olmo dee’vro chir’usay

 v’yamlich malchu’say,

b’chayaychon

uv’yomay’chon

uv’chayay d’chol bais Yisroel,

ba’agolo u’viz’man koriv;

 v’imru Omein.

Y’hay shmay rabbo m’vorach l’olam ul’olmay olmayo.

translation: May his great name be blessed, forever and ever.  Blessed, praised, glorified, exalted, extolled, honored, elevated and lauded be the Name of the holy one, Blessed is he-above and beyond any blessings and hymns,
May his great name be blessed, forever and ever.)

 1Deborah approaches him.  He sees her.

“I never said Kaddish…For either of them.”

He drops to his knees. He begins to cry. Sobs soon replace his tears.  Years of tears, centuries of Jewish tears.  He is united with his father and grandfather, and great grandfather all who said the Kaddish in their moment of grief. Gathering from his fingers, his lungs, his bowels, his lips, a flood of tears, an ocean.  He begins to shake.  He can’t stop himself.  Deborah holds him in her arms.

“Shhhhhhhhhh…Shhhhhhhhh. It’s over.”

She strokes him slowly, lovingly. He closes his eyes.  He’s becoming calm, released. It’s been a long time.

“It’s over.” She whispers again as she holds him.

The End

.

Following the usual disclaimer that this is a work of fiction, any resemblance etc…

Then: ” Although the characters and situations are completely fictional After Lisa was inspired by a real story.  Stewart Moscovitch (not a reporter but a factory worker) filed suit against his insurance company PHS, Danbury Hospital and Vitam Center Inc. after his 16-year-old son committed suicide in July 1995.  According to the suit, Nitai Moscovitch was hospitalized at Danbury after twice attempting to kill himself. His 12 year-old sister had died of cancer several years before his suicide attempt.  Eight days after admission, PHS had Moscovitch transferred to Vitam, a drug treatment center in southern Connecticut. He hung himself shortly after his arrival.  Mr. Muscovitch had begged the doctors not to discharge his son. He had been advised by a friend to claim he would abandon his son.  He was told his son would be sent to a shelter. Vitam was a compromise worked out with the doctors and the insurance company.  The Moscovitchs eventually divorced.

Federal Judge Chrisopher Droney on October 23, 1998 ruled that due to a legal technicality (the transfer of Nitai from one health facility to another) PHS was not automatically exempt from a lawsuit.  It was the first time that there was a ruling of this type.

Dr. Linda Peeno, a physician who worked for 3 managed care companies before she could no longer stomach it, testified before a Congressional subcommittee on Health and the Environment on May 30, 1996.  She had no apparent impact.  Her testimony and many articles by her can be found on the internet.  Showtime produced a film Damaged Care that tells her story.

In June of 2001 (see June 21^st 2001 Congressional record) the Senate debated and passed the McCain Kennedy Bill that would have allowed lawsuits against HMOs by a vote of 59-36.  Changes were made in the House and then the bill essentially disappeared from the political landscape.  Subsequently, several states passed legislation allowing suits against insurance companies. But, on June 23, 2004, the United States Supreme Court unanimously decided that while congress could pass legislation allowing lawsuits against health insurance companies, states could not do so.   There are also claims that the unusual 9-0 vote was an indication that this issue was too important, the pressure was too great for the justices to allow controversy.

The success of insurance company lobbying to not only defeat this bill, but successfully end all discussion of lawsuits is a mystery that I do not fully understand.

This is truly a work of fiction. Insurance executives may or may not be indulging in illegal trading, Aetna and Cigna were each sued in Federal Court by several state medical societies for racketeering under the  Racketeer Influenced and Corrupt Organizations Act.  The Wall Street Journal ran an expose, “Health Care Gold Mines.” It was reported that William McGuire, CEO of one of the larger health insurance companies, United Health Care, had unrealized gains on stock options worth 1.8 billion dollars.  He had been given the right to “time” his stock option grants.  His timing was so extraordinary that questions have been raised that he backdated his purchases.  His associates call him “brilliant.”  Very brilliant. The Wall Street Journal’s analysts concluded that if the options were granted to him blindly, the chance of his guessing as well as he did, was 1 in 200 million.

Practically any family who has faced chronic illness can attest to the heartless practices of their insurance companies. They are very bitter, especially those who paid for their health coverage themselves over many years, all the while assuming insurance would be there when they needed it.  Even if they  hardly used it, it was assumed the money was well spent.  Only when a member of their family got sick did they learn that they had been feeding rip off artists.

            The specific practices of the insurance companies depicted in this book are totally factual. Most of the stories are from cases I have treated. The story about the second grade teacher who was prematurely discharged from the hospital and killed herself without ever making it out of the waiting room and into the psychiatrist’s office is factual.  She was my patient.  Or more accurately, she sat in my waiting room that one time.  ( I had agree to see her a day after discharge after a desperate call from a social worker at Danbury Hospital who very clearly understood how insane the discharge was.)

            So is the story of the patient with cancer in both breasts and several heart attacks.  Other aspects of Dr. Day are fictional but Robert Dailey MD head of PHS psychiatry, from Bridgeport Hospital told me that I could not have more sessions with this patient when I appealed PHS’ denial of care.  As stated in the book  he would not give in to my requests.  He said “she should be sent to hospice.”  This was  a woman still working and very much in the battle to keep her family afloat.  This was explained to Dr. Dailey to no avail.

All of the other stories about HMOs are based on actual clinical cases, including the insane woman in the emergency room who kept checking her baby’s vagina for a spying device.  I spent hours in the emergency room of New Milford Hospital trying to get approval from Oxford, her insurance company for her to be admitted for inpatient care.  They wouldn’t allow it.  Later Oxford called New Milford Hospital’s administration to complain about my persistence.  It was at a time when HMO’s were able to scare hospitals that they could lose their status as an in-network facility.  I have many, many other actual stories to report.  So do hundreds of thousands, perhaps millions of patients throughout the United States.  It has not been newsworthy.  Certainly not enough for politicians to rally around this cause.  Not a single one, despite the pleading from members of my profession.

The recent passage of mental health parity in ObamaCare is irrelevant to the issue at hand.  Connecticut, in the cases reported here, already had mental health parity.  If anything, it made insurance companies more scrupulous in denying what they considered unnecessary care.”