Authors: Michael Crichton
The resident explained the whole procedure. As students, we would each be assigned one patient to interview over six weeks. We would then make a report to the staff, and participate in the diagnosis. Other physicians would be interviewing the patients, too, but we would see them more often than anyone else, and our responsibilities were therefore to be taken seriously.
When we arrived on the floor, the patients were in the midst of a communal meeting. The resident couldn’t interrupt the meeting, but we stood outside the room while he pointed out our patients. Ellen’s patient was a heavyset woman in her fifties who wore garish clothes and makeup. This woman had had an affair with a doctor who gave her amphetamines, and she was now severely depressed. Bob was assigned a thin, scholarly-looking man of fifty who had been in Dachau and who now imagined cardiac problems. I was assigned a tall, strikingly beautiful girl of twenty with short blond hair and a miniskirt. She sat in a rocking chair, her long legs curled under her, looking very calm and composed. She looked like a college student.
“What’s her problem?” I said.
“Karen,” he said, “has successfully seduced every man she has ever met.”
During the psychiatry rotation, you saw your patient three times a week. You also saw a training analyst twice a week, to discuss your case and your feelings about it.
Robert Geller was my training analyst. Dr. Geller was a middle-aged man who had a beard and favored bright striped shirts. His manner was very quick and direct.
Dr. Geller asked me what I hoped to get out of my psychiatry rotation, and I said that I was very interested in psychiatry, that it was something I thought I might end up doing. He said that was fine. He seemed a neutral, balanced person.
“So, do you know anything about your patient?”
Yes, I did. I explained I hadn’t had a chance to talk to her yet, that I had only just seen her in the room, a twenty-year-old girl, sitting in the rocking chair.
“And?”
She seemed nice. Pretty. She certainly didn’t seem like a psychiatric case.
“Then what’s she doing there?”
Well, the resident told me that she had successfully seduced every man she had ever met.
“What did he mean by that?”
I hadn’t asked.
“Really?
I
would have asked,” Dr. Geller said.
I explained I just hadn’t thought to ask; I was trying to absorb everything, just seeing her and so on.
“And how do you feel about seeing her?”
“I don’t know,” I said.
“You don’t know?”
“No.”
“You said she was beautiful.…”
“Attractive, yes.”
“What did you think about having her as your patient?”
“I guess I wondered if I could handle her.”
“Handle her …”
This was a psychiatrist’s trick, repeating your last phrase to keep you talking.
“Yes,” I said. “I wondered if I would be able to handle her case.”
“Why shouldn’t you be able to handle her?”
“I don’t know.”
“Well, just say whatever comes to mind.”
This was another psychiatrist’s trick: I was immediately on my guard.
“Nothing comes to mind,” I said.
Dr. Geller gave me a funny look.
“Well,” he said, “are you afraid you won’t be bright enough to deal with her?”
“Oh no.”
“No problem there. With brightness.”
“No.”
“Are you afraid you don’t have enough knowledge to help her?”
“No …”
“Are you afraid you’re so busy you won’t be able to devote enough time to her?”
“No, no …”
“Then what?”
I shrugged. “I don’t know.”
There was a pause.
“Are you afraid you’re going to fuck her?”
I was profoundly shocked. The statement was so coarse and direct. I didn’t know how he could even imagine such a thing. My skull was ringing, as if I had been struck. I shook my head to clear it.
“Oh no, no, no, nothing like that.”
“You’re sure it’s not that?”
“Yes. Sure.”
“How do you know it’s not that?”
“Well, I mean, I’m married.”
“So?”
“And I’m a doctor.”
“A lot of doctors fuck their patients. Haven’t you heard?”
“I don’t believe in that,” I said.
“Why not?”
“I believe that when patients come to you, they are in a dependent state, they look up to a doctor, because they want help and they are frightened. And they deserve to be treated, and not have their dependencies exploited by the doctor. They deserve to get what they came for.”
I believed all this very strongly.
“Maybe she came to get fucked by her doctor.”
“Well,” I said.
“Maybe that’s what she needs to get better.”
I began to feel annoyed. I could see where this was heading. “Are you saying you think that I want to, uh, have sex with her?”
“I don’t know. You tell me.”
“No,” I said. “I don’t.”
“Then what are you worried about?”
“I’m not worried about anything.”
“You just told me you weren’t sure you could handle her.”
“Well, I meant … in general, I wasn’t sure.”
“Listen, it’s okay with me if you want to fuck her. Just don’t do it.”
“I won’t.”
“Good. How old are you?”
“Twenty-four.”
“How long have you been married?”
“Two years.”
“Happy?”
“Sure.”
“Sex life okay?”
“Sure. Great.”
“So you wouldn’t be tempted in the first place.”
“How do you mean?”
“I mean, since your marriage is happy and your sex life is good, you wouldn’t be tempted by this girl in the first place.”
“Well, I mean … No, of course not.”
“She’s pretty?”
“Yes.”
“Sexy?”
“I guess.”
“I bet she knows how to maneuver men.”
“Probably.”
“I bet she knows just what to say and do, to wrap men around her little finger.”
“Well, I’m sure I can handle it,” I said.
“I’m glad to hear that,” Dr. Geller said. “Because that’s going to be your job.”
“How do you mean?”
“The only way this girl knows how to relate to men is sexually. She gets everything—friendship, warmth, comfort, reassurance—from the sexual act. That’s not a very good life strategy. She needs to learn there are other ways of relating to men, that she can get the warmth
and approval she wants from a man without having sex with him. She’s probably never had that experience before. You will be her first experience.”
“Yes.”
“As long as you don’t end up fucking her.”
“No. I won’t.”
“I hope not. Good luck with her. Let me know how things go.”
My conversation with Dr. Geller struck me as helpful. Although he obviously had some fixed idea I wanted to have sex with this girl, that didn’t worry me in the least. I was quite confident that I wouldn’t. I knew that, in becoming a doctor, I was assuming special responsibilities. This was the first of them.
In fact, far from worrying about sexual temptation, I was eager to see Karen, and begin our work together. I went immediately back to the floor and introduced myself to her.
She was very tall. She came up to my shoulder when we stood side by side. She had a lean, athletic body, and clear green eyes that looked at me steadily. “You’re my doctor?”
“Yes,” I said. “I’m Dr. Crichton.”
“You’re very tall.” She moved closer, until her forehead touched my shoulder.
“Yes.”
“I like tall guys.”
“That’s good.” I stepped back a little. That seemed to amuse her.
“Are you
really
my doctor?”
“Yes. Why are you smiling?”
“You look too young to be a doctor. Are you sure you’re not just a medical student or something?”
“I’m your doctor, believe me.”
“What kind of a name is Crichton?”
“It’s Scottish.”
“I’m Scottish, too. What’s your first name?”
“Michael.”
“Is that what they call you? Michael or Mike?”
“Michael.”
“Can I call you ‘Michael’?”
“ ‘Dr. Crichton’ would be better.”
She pouted. “Why? Why are you so formal?”
“We’re here to work together, Karen, and I think we should keep that relationship in mind.”
“What does that have to do with what I call you? ‘Dr. Crichton.’ Ugh. I hate ‘Dr. Crichton.’ ”
“I just think it’s better, is all.”
I found myself nervous, standing next to her this way. Her physical presence was very strong. It left me a little shaky. As part of the workup, I had to begin by drawing bloods for routine chemistries, so I took her into the little examining room. We were alone.
“Aren’t you going to close the door?”
“No.”
“Why not?”
“It’s fine the way it is.”
“Afraid to be alone with me?”
“What makes you say that?” I asked. I felt very clever and psychiatric, saying that. Giving her a question back.
“Do I have to take off my clothes?”
“That won’t be necessary.”
“Really? But don’t you have to examine me? My body and everything?”
“Just draw some blood.”
She ran her fingers across the examining couch. “Mind if I lie down on this bed?”
“Go ahead.”
Having finished my neurology rotation, I was more relaxed about drawing bloods. But right now my hands were shaking. She was sure to notice.
She lay back on the examining table and stretched like a cat. “You want me on my stomach or my back?”
“On your back is fine.”
“This couch is too short; I have to put my legs up.” Her miniskirt slid around her hips.
“Whatever’s comfortable,” I said.
“Is it going to hurt?” she asked, wide-eyed.
“No, not at all.”
“Why are you shaking, Dr. Crichton?”
“I’m not.”
“Yes, you are. Do I make you nervous?”
“No.”
“Not even a little?” She was smiling, laughing at me.
“You’re a beautiful girl, Karen; you’d make anybody nervous.”
She smiled with pleasure. “You think so?”
“Of course.”
She seemed reassured by this, and I felt calmer as well. It didn’t hurt anything, I thought, to tell her she was attractive.
I started drawing the bloods. She watched the needle, watched the tubes fill. She had a calm gaze, a steady way of looking at things.
“Are you single?”
“No, I’m married.”
“You tell your wife everything you do?”
“No.”
“Men never do,” she said, laughing. It was a sarcastic, knowing laugh.
“My wife is in graduate school,” I said. “I sometimes don’t see her for days at a time.”
“Are you going to tell her about me?”
“What goes on between you and me is confidential,” I said.
“So you won’t tell her?”
“No.”
“
Good
.” She licked her lips.
I lived in an apartment on Maple Avenue in Cambridge. I had known my wife since high school. She was studying child psychology at Brandeis. One block away, my wife’s college roommate lived with her husband; they were both graduate students at Harvard. A block beyond that lived another friend and her husband, with whom I used to play basketball in high school. The six of us, all stable, all married, all in school, all connected in the past, spent a lot of time together. The relationships went way back. It was a small, complete world.
My wife liked to cook. She was cooking while we talked. “Is this girl in school?”
“Yes. Junior at BU. Says she wants to be a lawyer.”
“Smart?”
“Seems to be.”
“And she’s your patient?”
“Yes.”
“What’s her problem?”
“She has trouble relating to men.”
“And what are you supposed to do?”
“Interview her. Find out what’s wrong. Write a paper at the end.”
“Long paper?”
“Five pages.”
“That’s not too bad,” my wife said.
The resident told me I could meet with my patient twice a week, or three times a week, if I felt that was necessary. I felt three times a week would be required. There was an interview room that you booked.
I asked Karen how she had come to be admitted to the hospital. She told me she had had a bad trip on LSD in her school dorm; the campus police had brought her in. “But I don’t know why they made me stay here. I mean, it was no big deal, just a bad trip.”
I made a mental note to check with the BU campus authorities, and then asked her about her background, before college.
Karen spoke freely. She had grown up in a small coastal town in Maine. Her father was a salesman; he fooled around with a lot of women; he had always ignored her. Her father didn’t like it when she took up with Ed, just because he was a Hell’s Angel. Her father was very angry when she became pregnant by Ed at fourteen. He made her have the baby. She gave the baby up for adoption. Her father never liked her other boyfriends, either. For example, he didn’t like Tod, the rich kid who made her pregnant when she was sixteen. He wanted her to have that baby, too, but instead she had a miscarriage. She laughed. “In Puerto Rico,” she said.
“You had an abortion?”
“Tod’s rich. And he didn’t want
his
father to find out.” She laughed. “You probably think I’m crazy.”
“Not at all.”
“You smoke so much when we’re together.”
“Do I?”
“Yes. You’re chain-smoking. Am I making you nervous?”
“Not that I’m aware.”
“That’s good. I don’t want to make you nervous. I appreciate your helping me.”
She wore miniskirts all the time. She liked to curl herself in chairs. She would wait for just the right moment, then curl her body and show me her pink underwear. I had to quickly look away, but when my eyes met hers again, I saw that she was laughing at me.
“So? Did you make her pregnant yet?”
“No,” I said to Dr. Geller.
“Tell me how it’s going.”
I told him what I knew so far. Her story sounded terrible. I interpreted it as a cry from a young girl for the attention of her father, a man who obviously wasn’t capable of giving her the love and care she required. Instead he was harsh and punitive. Two pregnancies, then dismissed, sent off to various foster homes … It was amazing, I felt, that Karen had done as well as she had—had gotten into college and so forth.