I Know This Much Is True (35 page)

“Well, Mr. Birdsey, neuroleptic medications are mostly effective in lessening delusions and hallucinations,” Dr. Patel said. “They allow a reprieve from the
positive
symptoms which plague the patient. Unfortunately, the medication often enhances the
negative
symptoms: the flat affect, the Parkinson’s-like tremors we so often see in—”

“Turn off his voices by turning him into one of the body snatch-ers. Jesus Christ, I
know
all this! I know all about Stelazine and Prolixin and all the other fun stuff. You think you can have a brother in and out of the state hospital for twenty years and not already
know
about all this chemical voodoo?”

She said nothing. Waited.

“Look, he
hates
taking Haldol, okay? Even the smaller dose. It makes him feel like shit. I don’t want you guys turning him into a zombie just because he pitched a fit and turned over a table. Just because it’s convenient to the staff. Upping his dosage is unacceptable.”

“It’s unacceptable to me, too, Mr. Birdsey,” Dr. Patel said. “Please give me credit for some professional ethics. I am an
advocate
for your brother, not an enemy. Not a mad scientist.”

We sat there facing each other. Her eyes, young and mischievous, belied her salt-and-pepper hair. I opened my mouth to say something, then changed my mind.

“I told Dr. Chase that, in my opinion, increasing the dosage of your brother’s haloperidol—his Haldol—was probably ill advised.

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And certainly premature. And I’ll be glad to relay your concerns to the doctor as well.”

I let go a laugh. “As if
that
counts for anything. As if one of the divine gods of psychiatry would do anything except listen politely and then proceed the way they damn well wanted to, anyway.”

Her smile remained constant. “That’s quite a broad indictment, Mr. Birdsey,” she said. “You’re very angry. Aren’t you?”

“Hey, I’ve earned the right. Believe me. But what
I
am is irrelevant. All I’m saying is that if he—”

Smiling still, she reached across and covered my hand with her own small butterscotch-colored hand. Squeezed it. Relaxed the pressure. Squeezed again. The gesture was so unexpected, it disarmed me.

Shut me up for once. “Squeeze back,” she said. And I did.

“Drug treatment with schizophrenics is always a balancing act,”

Dr. Patel said. “As you said, a trade-off. But unless the patient is in danger of harming himself or other people, it’s always best to err on the side of caution. So you and I are in agreement. Isn’t that nice?

And in these days of American malpractice suits, it’s my guess that Dr. Chase will probably be inclined to agree as well. To listen more carefully than you’d think to the opinions of the patient’s family.”

She gave me that mischievous look again. “Ah,” she said. “The water is ready for our tea. Isn’t that lovely?”

She stood and went over to the hot plate. While I waited, I looked again at her smiling statue. What had she called him? Shiva?

She handed me a small yellow cup, hand-painted with monkeys.

Poured the tea from a matching monkey pot. It smelled delicious.

Warmed my hands.

“It’s ironic that I never drank tea when I was growing up in India,”

Dr. Patel said. “I acquired the habit later on when I was in my twenties. During my London days.”

I wasn’t sure why, exactly, but I was starting to like her in spite of myself. “Is that where you studied psychology?” I said. “In England?”

This was the kind of small talk I usually had no patience for.

“Oh, no, no. When I was in London, I was earning a degree in anthropology. I got my psychology degree later on at the University I Know[169-263] 7/24/02 12:37 PM Page 231

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of Chicago. I studied with Bettelheim. Do you know his work? Dr.

Bruno Bettelheim?”

I shrugged.

“Oh, you must read him!
The Uses of Enchantment, The Informed
Heart.
Splendid works.”

“So you’re both, then?” I said. “A psychologist
and
an anthropologist?”

She nodded. “Actually, my interest in the one field
led
to the other.

They’re quite interrelated, you know. The stories of the ages and the collective unconscious. Have you ever read Jung, Mr. Birdsey?”

“A long time ago. In college.”

“How about Joseph Campbell? Or Claude Lévi-Strauss? Or Heinrich Zimmer?”

“I’m a housepainter,” I said.

“But surely, Mr. Birdsey, you must read other things besides the side of a paint can.” Her smile, her soft, nasaly voice cut against the sarcasm. “Your brother says you’re an avid reader. That your house is filled with books. He was quite animated when he was telling me about you. He seems so proud of your mind.”

“Yeah, right,” I laughed.

“Oh, I’m serious, Mr. Birdsey. You think otherwise?”

“I think . . . I think Thomas doesn’t focus much on anything or anyone beyond Thomas.”

“Elaborate, please.”

“Because of his disease. He
can’t
think beyond himself. . . . Compared to, you know, the way he used to be.”

“How did he used to be?”

“Before the illness?”

She nodded.

“Well . . . when we were kids, he used to worry about me all the time. I used to get into things, you know? Take chances. Take risks.

And he’d get nervous about it. Try to talk me out of it. He was always worried about me.”

“What kinds of risks did you take?”

“Oh, you know. Climb ledges we weren’t supposed to climb. Jump I Know[169-263] 7/24/02 12:37 PM Page 232

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off the garage roof. Cut through people’s yards. Kid stuff. But Thomas would always hang back. Warn me I was going to get in trouble or get hurt or something. He was as big a worrywart as she was.”

“Your mother?”

“Yeah.”

“So when you look back, you would say that you were the more adventurous brother?”

“My mother used to call Thomas the bunny rabbit and me the spider monkey because . . . well, who cares, right? I’m going off on a tangent here.”

“No, no. Continue, please. You were the spider monkey because . . . ?”

“Because I was always getting into everything. I was Curious George.” She smiled. Waited. “He’s a . . . a character in a kid’s book. A little monkey who’s always getting into—”

“Indeed, he is, Mr. Birdsey. An inquisitive little fellow. My granddaughter would have me read her
Curious George
day and night if she had her way. But go on. You were the more curious brother and Thomas was more . . . ?”

“More mellow, I guess.”

“Excuse me, please. By that, do you mean more relaxed or more fearful of venturing forth?”

I looked up at her, impressed by her insight. “More fearful,” I said.

She jotted something down. “The little bunny rabbit,” she said.

“We were like that right from the beginning, I guess. That’s what Ma used to say. Thomas would sit there in the playpen and watch me escape.”

“Clarify something for me, Mr. Birdsey. Thomas was your mother’s bunny rabbit because . . . ?”

“Because he was . . . soft, I guess. More affectionate. They were pretty close.”

“Your mother and Thomas?”

“Yes.”

“Closer than your mother and you?”

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I looked away. Nodded. Watched my fingers lace and unlace themselves.

“And what about your father?”

“What about him?” I snapped back.

Dr. Patel waited.

“We never knew our father. . . . Do you mean Ray? Our
step
father?”

“Yes, your stepfather. Which of you was closer to him? Or were you equally close?”

I laughed one of those nothing’s-funny laughs. “We were equally distant.”

“Yes?”

“Well, not distant. You couldn’t
get
much distance from Ray. He was always in your face. . . . Cautious, I guess you’d say. We were equally cautious of Ray.”

“Go on.”

“He would . . . he used to pick on Thomas. I mean, he’d get on both our cases, but Thomas was the one who usually got it with both barrels. Thomas or Ma.”

“And not you?”

“Uh, not so much. No.”

“And how did that make you feel? To be the one of the three not getting it ‘with both of the barrels’?”

“What? I don’t know. . . . Good, in one way, I guess. Relieved.

But not so good, either.”

“Not good how?”

“It made me feel . . . it made me feel . . .”

“Yes?”

“Guilty, I guess. And, I don’t know . . .
responsible.
”

“I don’t understand. Responsible for . . . ?”

“For keeping them safe. They wouldn’t stand up for themselves.

Neither of them. So it was always me who—hey, look,
I’m
not the patient here. I thought we were talking about Thomas.”

“And so we are, Mr. Birdsey. You were saying that, before his illness began to manifest itself, he used to worry about you and that since its onset—”

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“It’s like . . . there’s nobody home at Thomas’s anymore, you know?

I look at him sometimes and he’s like . . . this abandoned building. No one’s been home at Thomas’s for years.”

I watched her thinking. Waited. “This just occurred to me,” she said. “When your brother expresses pride in your intellect, pleasure about all the books in your house,” she said, “he may be celebrating the achievements of his mirror image—the part of himself that is free of the burden of his disease. Do you think that’s plausible?”

I shrugged. “Couldn’t tell you.”

“In a sense, as your identical twin, he is you and you are he. More than most siblings, you are each other. No?”

My old fear: that I was as weak as Thomas. That one day, I’d look in the mirror and see a crazy man: my brother, the scary guy on the city bus that day. . . . When I tuned back to Dr. Patel, she was talking about anthropology.

“And, oh, my goodness, the myths of the world are
laden
with twins,” she said. “
Think
about it, Mr. Birdsey. Castor and Pollux, Romulus and Remus. It’s a fascinating aspect of the collective unconscious, really. The ultimate solution to human alienation. I assure you, Mr. Birdsey, whatever burdens you bear as a twin, the untwinned world is quite envious. Your own and Thomas’s duality is something we might wish to play with later on as we try to help your brother. But, as usual, I am getting ahead of myself. Going sixty-five miles per hour when I should be going forty.”

Laughing at her own little joke, she pushed the tape recorder’s

“rewind” button and set it whirring. “This is a cassette recording of my session with your brother from this afternoon,” she said. “The one I told you about. I thought it might be useful to play it for you and to hear your reactions. And perhaps, if you are willing, you can share some of
your
observations?”

I nodded. “Is this fair, though?”

“Fair? How do you mean?”

“In terms of—what do you call it? Patient confidentiality?”

The cassette clicked to an abrupt stop; the “rewind” button popped back up. “Ah, Mr. Birdsey, there you go again, worrying I Know[169-263] 7/24/02 12:37 PM Page 235

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about my ethical intent. Listen.” She depressed “play.” Smiled down at the machine.

“
Session with Thomas Birdsey, 2:30 P.M., 23 October 1990
,” Dr.

Patel’s voice said. “
Mr. Birdsey, you are aware I am taping our session
today, are you not?
”

A muffled grunt, but unmistakably Thomas’s.

“
Would you speak up, please? Are you aware this is being taped?
”

“ Yes, I’m aware
.
I’m aware of
plenty.” He sounded put out. Put upon. But it was a relief to hear his voice.

“
And I have your permission to replay the tape to the people we talked
about? Your brother, Ms. Sheffer, Dr. Chase?
”

There was a pause. “
Not Dr. Chase. I changed my mind about him.
”

“
Why is that?
”

“
Because it’s too risky. How do I know he’s not working for the Iraqis?

In my line of work, you can’t afford to take chances.
”

“
Your line of work, Mr. Birdsey? What line of work is that?
”

“
No comment.
”

“
I’m just trying to understand, Mr. Birdsey. Do you mean your coffee
and newspaper business or something else?
”

“
Curiosity killed the cat, didn’t it? Raid kills bugs dead. Don’t check
into the Roach Motel just yet, Dr. Earwig.
”

Another pause. “
Mr. Birdsey . . . I’m wondering if I may call you
Thomas?
”

“
No, you may not.
”

“
No?
”

“
I’m Simon Peter.
”

“
Simon Peter? The apostle?
”

“
I-eleven. Under the G-fourteen. Bingo, Mrs. Gandhi!
”

There was a pause.
“Why do you refer to me as Mrs. Gandhi, Mr.

Birdsey?
”

“
Why? Because you dress the part.
”

“
I do? Do you mean my sari?
”

No answer.

“
When you say you are Simon Peter, Mr. Birdsey, do you mean by that
that you emulate him or that you feel you are his physical embodiment?
”

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