results from a violent and irreversible act. Had prot, in fact, killed someone, possibly on August 17, 1985? As a precaution, should I have him transferred to Ward Four?
I decided against the latter move, which might have driven him deeper into his seemingly impenetrable shell. Besides, all this was pure speculation at this point. And even if correct, he was unlikely to become violent unless we made substantial progress toward unraveling his past actions, the precipitants of his amnesia, a development I welcomed. Nevertheless, I would notify the staff and security office of the potential problem, have him watched more closely, and conduct subsequent interviews with greater caution. I decided also to notify the police department about a possible violent altercation some five years earlier, hoping it would help them to track him down, something our previous clues had failed to do.
But August seventeenth was fast approaching. I was frustrated and tired. Perhaps, I thought, I was getting too old for clinical work. Maybe I wasn't good enough any more. Maybe I never was.
I never wanted to be a psychiatrist. I wanted to be a singer.
As a pre-med student in college my only real interest was the annual 'Follies Brassiere,' a talent show for students and faculty, in which I shamelessly belted out Broadway tunes and opera arias, to loud and addictive applause. By the time I graduated, however, I was already married and it made no sense to pursue such a frivolous dream. I was no Don Quixote.
Thus, it wasn't until I got into medical school itself that I began to have serious doubts about my choice of profession. But just as I was about to confess to my new wife that I might rather try something else, Mother was diagnosed with liver cancer. Although the doctors decided to operate, it turned out to be far too late.
Mother was a courageous woman, though, and she put up a good front until the end. As she was being wheeled into surgery she talked about all the places she wanted to visit and all the things she wanted to take up: watercolors, French, the piano. But she must have known the truth. Her last words to me were, 'Be a good doctor, son.' She passed away on the operating table, never to see her first grandchild, who was born three months later.
There was only one other moment when I almost decided to chuck the whole thing. It was the afternoon I saw my first cadaver.
He was a forty-six-year-old white male, overweight, balding and unshaven. As we started to work on him his eyes popped open, and they seemed to be appealing to me for help. It wasn't that it made me feel faint or nauseated-I had been on too many hospital rounds as a boy-it was that the body looked exactly like. my father the night he died. I had to leave.
When I told Karen what had happened, that I couldn't cut into someone that looked like my own father, she said, 'Don't be silly.' So I went back and opened that man's arms and legs and chest and abdomen, all the time hearing my father, who considered himself something of a comedian, whispering in my ear, 'Ouch, that hurts.' But I was more certain than ever that I didn't want to be an internist or surgeon. Instead, I followed the example set by my friend Bill Siegel, and went into psychiatry. Not only because it seemed less sanguinary, but also because it appeared to be a great challenge-so very little seemed to be known about the subject. Unfortunately, that sad state of affairs is as true today as it was nearly thirty years ago.
THE afternoon that prot stalked out of my examining room I got a call from a freelance reporter who was planning to do a story on mental illness for a national magazine. She wanted to know whether she might be able to 'set up shop' at MPI for a few weeks to gather background material and 'pick our brains,' as she put it. That's a phrase I've never liked much, along with 'eat your heart out' and 'chew someone out'-I think of vultures. However, it was hardly a basis for rejecting her proposal, and I gave her tentative approval to do the article, hoping that the notoriety might get us some additional dollars. I transferred her call to Mrs. Trexler to arrange for an appointment at a time convenient for both of us. I laughed right into the phone when she said that 'now' was convenient for her.
A new patient of Dr. Goldfarb's arrived over the weekend. I'll call him 'Chuck' because, although that is not his name, that is what he wanted to be called. Chuck was a sixty-three-year-old New York City doorman-or doorperson, as Abby would have it-and a chronic cynic, hopeless pessimist, and classic curmudgeon. He was brought in because he was beginning to inform everyone who walked into his building that he or she 'stunk.' Everyone within fifty miles of him 'stunk.' Indeed, his first words, when he entered the hospital, were, 'This place stinks.' Bald as an eightball and somewhat cross-eyed, he might have made an almost comic figure had not his presence in Ward Two brought terror to the heart of Maria-he reminded her of her father.
Maria had been at MPI for three years and, in all that time, Russell was the only male who could get near her. At first she had numerous Sunday visitors, as befit her large family, including cousins of all ages. But the visitations soon dwindled to her mother and the odd aunt or uncle every month or two for the simple reason that when they came to see Maria they often found someone else-Maria suffered from multiple personality disorder.
MPD begins to manifest itself in early childhood, as an attempt to deal with a terrible physical or mental trauma from which there appears to be no escape. Maria wasn't beaten, Natalie was; Maria wasn't molested, it was Julia; Maria can't bear these attacks but Debra is strong. Many of the victims harbor scores of distinct personalities, depending on the number and severity of the -abuses, but the average is about a dozen, each of whom is able to 'take over' under certain circumstances. For reasons that are unclear, instances of a single alter ego are relatively rare.
Personality differences among the various alters are often astonishing. Some are much smarter than others, express widely discrepant talents, score uniquely on psychological tests, and even produce disparate EEG patterns! They might also visualize themselves as being very dissimilar in appearance, or even of a different sex, from that of the other identities. Whether these are true individuals is questionable, but, until integration occurs, many of the alters, including the 'primary' personality, are totally unaware of what the others are doing when in control of the body.
Maria was known to harbor more than a hundred separate and distinct personalities, most of whom rarely made an appearance. Otherwise her case is typical for this disorder. She had been raped innumerable times by her father, starting when she was barely three years old. Her devoutly religious mother, who cleaned a dozen large offices at night, never knew about these violations, and her older brothers had been threatened into silence until they were old enough to demand some of the 'action' for themselves. Under such circumstances life can become quite unbearable and the desire for escape overwhelming.
A pretty girl with long black hair that shines like the stars, Maria came to us after she, as Carmen, had nearly scratched a boy's eyes out when he tried to make advances. Until that incident she was thought of as 'quiet' and 'distant.' No one has touched her since, with the possible exception of Russell, who, of course, refers to her as 'Mother.'
But Maria herself is seldom in evidence. Most of the time one of the others is in charge, one of her 'defenders' or 'protectors.' Sometimes, when one of her 'persecutors' takes control, we see another facet of Maria, a darker side. One of these, who calls herself Carlotta, has tried to kill Maria, and therefore herself and all the others, on at least two occasions. It is this constant struggle for control among the various identities, often accompanied by anxiety, insomnia, and ceaseless headaches, that makes for the singular horror of the multiple personality sufferer.
Chuck thought all of Maria's alters stunk. Also Russell, Mrs. Archer, Ernie and Howie, and even harmless little Bess. The entire staff, including myself, stunk to high heaven. To his credit he admitted that he, himself, smelled worse than all the rest of us put together-'like a gutwagon,' as he put it. The only person in the entire hospital who did not stink, in his opinion, was prot.
Session Seven
BECAUSE of what had happened at the end of our previous encounter I asked Mr. Jensen and Mr. Kowalski to stand by during session seven. However, prot seemed in unusually good spirits as he chomped on a pineapple. 'How was your meeting?' he said with his familiar grin.
It took me a moment to figure out what this meant, but I finally remembered the 'important meeting' I had dismissed him with at the end of session six. I told him it had gone well. He seemed pleased to hear this. Or was it
