The Thanatos Syndrome Read online

  It is hardly an ideal setting for an interview, but I know what I want and do not intend to waste time.

  It is a double room in the medical wing. Mickey LaFaye is in the bed next to the window. I stand at her bed but not touching it, facing the window. Behind me, not six feet away, is the curtained-off bed of the second patient. Lucy is attending the patient. I recognized her legs under the curtain, the same strong calves and laced-up oxfords I remember from when she was interning in pathology and I used to see her standing on tiptoe, calves bunched, to get at the cadaver.

  Lucy is doing some procedure, no doubt clearing an impaction. The old woman is making querulous sounds of protest. She is not cooperating. Lucy’s murmur is soothing, but there is in it a note of rising impatience.

  Directly opposite me, not thirty feet away, through the window, across a completely enclosed quadrangle of grass, beyond another window, stands Bob Comeaux in the glass box of the nurses’ station. I caught his eye. He is dressed in his riding clothes, turtleneck sweater, suede jacket. His office is not here at the hospital or close by but at the federal complex on the river. Dressed as he is, he is probably dropping by after his morning ride and before going to work. It is clear that he is doing just that, dropping by an ordinary small general hospital in his riding clothes, as much as to say that his real work as neurologist is elsewhere.

  Standing next to him is Sue Brown, the floor nurse, a pleasant woman and an excellent nurse, who was glad to see me and made me welcome. She cheerfully entered the test I ordered in Mickey’s chart, which is no doubt the chart Bob Comeaux is holding.

  “How do you feel, Mickey?”

  “Oh, fine! Fine!” Her legs move under the covers. Again she somehow gives the effect of straddling.

  “What are your plans when you leave here?”

  “Vermont!” she says in the same mild exclamatory voice.

  “You’re going back to your grandmother’s farm?”

  “Yes!”

  “Why are you going?”

  “Cool! Too hot here! Vandals and police and all!”

  “Where are the vandals?”

  “Out at the ranch!”

  “There has been some trouble out there?”

  “Oh yes! Terrible!”

  “I see. Who’s going to look after the ranch while you’re gone?”

  “Dr. Comeaux!”

  “Does going back to Vermont remind you of your dream?”

  “Dream?” It is not so much a question as the puzzled repetition of the word.

  “You remember. The dream you used to have about the cellar, the smell of winter apples, the expectation of something important about to happen which would tell you the secret of your life.”

  “Apples? Oh yes. In the hamper next to the chimney.”

  “That’s right. What are you going to do after you get to Vermont?” I am curious to know how she will answer a question which requires making a plan and telling of the plan in sentences.

  “So much better there! Not to worry. Dr. Comeaux—”

  “Dr. Comeaux says you’ll feel much better there?” Almost despite myself, I find myself repeating and filling out her utterances as one would with a child.

  She nods emphatically. “Right. Power of attorney!”

  “I see. Now, Mickey, I’ll tell you what we’re going to do. I’m going to do two quick little tests right now. All you have to do is follow along with me. Then I’m going to take you down to the PETscan room and they’re going to do another test. All you have to do is sit in a chair and they’ll put a funny cap on your head and let you listen to music and words—like a radio headset, okay?”

  She nods eagerly. Now you’re talking! This is what she’s good at. Taking directions, cooperating—not like that bad old woman in the next bed!—playing the game.

  “I’m going to crank you up straight. Now.”

  I sit on the bed, leaning almost athwart her, and, taking her face in both hands, turn her directly toward me. I cover her left eye.

  What do you see?”

  “You.”

  “Am I moving?”

  “No.”

  “Now.” With a forefinger I depress the fundus, the eyeball, of the open eye through the eyelid. “Am I moving now?”

  “Yes.”

  I take my hand away. “Now, with both eyes open, look back and forth as fast as you can.”

  She does it, then looks at me hopefully, to see if she has done well.

  “That’s fine. What happened?”

  “What—”

  “Did I move?”

  “Yes! You—everything—the room—”

  “That’s fine, Mickey.”

  She looks pleased.

  It is not fine. What is amazing is that with a normal eye and a normal brain, no matter how violent the movement of the eyes, the room—and I—will be perceived by you as what they are, stationary.

  “Okay, Mickey. Now let’s do this. I’m going to roll the bed table right up here, give you pencil and paper, okay? Now, what I want you to do is make X’s and O’s like this.” I show her and she makes some X’s and O’s and looks up for approval.

  “That’s fine, Mickey. Now here’s what I want you to do. Make an X and an O, then two X’s and O’s, then three X’s and three O’s and so on. Do you understand?”

  She nods eagerly and starts making X’s and O’s. She makes an X and an O, two X’s and an O, then a series of X’s with an occasional O.

  “That’s fine, Mickey. Now I want you to come along with me and we’ll—”

  Before I get any further, she has obediently folded back the covers and swung her legs out without, I notice, taking the universal woman’s precaution of minding her gown, which rides up her not thin thighs.

  “Just a moment, Mickey. I’ll get you a wheelchair.”

  I become aware of a silence behind me, a silence, I realize, which has gone on for some time.

  I turn. Lucy Lipscomb has come out of her curtained-off bed-room. I thought at first it was to give me a hand.

  “Hello, Tom.” She smiles, then hesitates, mouth open, as if she wanted to tell me something.

  “Lucy.”

  “Could I have a word with you?” She is not smiling. “Wait a minute.” She peels off her gloves and goes into the bathroom.

  I haven’t seen her for a year or so. She’s better-looking. Perhaps it’s the gleaming white coat, so starched that it rustles with every movement, against her dark skin. Perhaps she’s lost weight. Perhaps it’s the way her haircut doesn’t look butch anymore. She used to cut it herself, I thought. It was as rough-cut as a farmer’s—she is a farmer as well as a doctor. But instead of looking like a Buster Brown, it looks French, straight dark bangs come down her forehead at angles. No butch she. There is a reflex hammer and an ophthalmoscope in her breast pocket.

  “Sorry about the ward conditions, Tom.”

  “It didn’t matter.”

  “I noticed that. It seems you have an audience, or rather an onlooker.” She speaks in an easy but guarded voice, looking over my shoulder.

  “Who? Oh.” I turn around. Across the tiny quadrangle, still holding the steel chart in both hands, Bob Comeaux is looking straight at me.

  “Yeah. He’s waiting to see me when I finish.”

  “Hm. So it seems. Could I also?”

  “Also what?”

  “Have a word with you.”

  “Sure.”

  Mickey is thrashing impatiently. Lucy is spoiling her game.

  I’m out the door and down the hall, looking for a wheelchair for Mickey.

  “Doctor!” A sharp peremptory un-Southern man’s voice. “Just hold it right there.”

  It’s Bob Comeaux, with Sue Brown holding a chart. He’s angry, I see at once, so angry that he’s past prudence, to the point of showing his anger toward another doctor in the presence of a nurse—which for a doctor is angry indeed. He’s lost his temper. His nostrils flare and have actually whitened where they join the lip. Sue Brown gives m
e a frightened smile.

  Bob Comeaux is not smiling. His eyes are up in his eyebrows, mouth tight like a chief of surgery on grand rounds.

  “Doctor, would you mind stepping over here?” We walk back, past the open door of the room, presumably to get a little away from Sue Brown. We don’t want a nurse to see doctors fight. But Sue Brown has vanished into thin air. For a split second I am aware of Lucy through the doorway, standing still, her brown eyes rounded.

  Bob Comeaux and I find ourselves standing side by side, backed against the wall, hands in pockets, looking down at our toes in a studious exercise of control, of not facing each other, not confronting, not yelling, not fistfighting. We could be a couple of horsy docs discussing the hunter-jumper show. I notice that his field boots are muddy. He’s wearing short spurs. I remember wondering at that very moment if his coming to the hospital in riding clothes is simply a matter of convenience or whether it is more than that.

  “Doctor, what the fuck do you think you’re doing?” asks Bob Comeaux pleasantly, smiling—white around the mouth with rage—down at his boots.

  “I was doing the consultation on Mickey you asked for.”

  “I saw what you were doing.”

  “You did?”

  “You ran a Tauber test, then some Luria X’s and O’s. I saw you.”

  “So?”

  “What the fuck for?”

  “I—”

  “And you were about to wheel her out.”

  “Yes.”

  “Where were you taking her?”

  “Down to get a PETscan. That’s the best I can do in this hospital. You must have seen the order on the chart.”

  “I sure as hell did. But to what end, for Christ’s sake?”—smiling, taking a deep breath, examining each muddy boot carefully. He’s getting it back, his lost temper. “Oh, I know you, old buddy!”—now smiling brilliantly, even nudging me. He has recovered himself and can wipe the smile and come close with a comradely seriousness. “God knows, I understand your intellectual curiosity, Tom—such is the stuff of great discoveries—but I’m just an ordinary clinician and must think first of my patient.”

  “I think she’s got a cortical deficit, probably prefrontal.”

  “Very interesting. Okay, okay. Let’s skip the metaphysics. You get into the prefrontal, you get into metaphysics. In any case it’s academic when it comes to managing her. That’s not why I asked you in on this.”

  “Why did you ask me in, Bob?”

  “I thought for one thing to do you a fucking favor. Believe it or not, I thought we were friends, and as a friend I wanted you back on your feet as a working physician—entirely apart from my role as one of your probationers. As such, I don’t mind telling you it was I who got the Board of Medical Examiners to move you from a Class Three to a Class Two offense.”

  “What is that?”

  “It means, Doctor, that your license is not revoked or suspended but that you are on probation. Do you think that happened by accident? We are hoping to get it down to Class One, reprimand. Tom, we want you doctoring here and not greens-keeping in Alabama. A good idea for all concerned, wouldn’t you say?”

  “Yes.”

  “Okay. Now as far as LaFaye is concerned, my point is that she is neurological and not psychiatric, which puts her on my turf, right? So all we need to commit her to my program over at NIMH is your co-signature as consultant.”

  “I see.”

  Things have eased between us. Hands in slant pockets, he’s pushing himself off the wall by nodding his head. His spurs clink against the terrazzo. We’ve fallen into our standard medical comradeship, having gone to the same medical school, years apart. We did not know each other there but we remember the old Columbia joke which has almost become a password, a greeting, between us:

  “Just keep in mind, Tom, the two most overrated things in the world.”

  “I will.”

  “Sexual intercourse and—”

  “Johns Hopkins University.”

  Bob Comeaux likes this because he knows I interned at Hopkins.

  The anger is gone, the threat withdrawn. Or did I imagine the threat? The threat: That if I don’t behave I could find myself back in the pine barrens of Alabama, driving the big John Deere.

  Bob Comeaux has always been skittish with me. The anger over Mickey LaFaye is something new and puzzling. The skittishness is old. It comes from something in his past which he is almost, but not absolutely, certain that I don’t know, can’t know. There is no reason why I should know, but the tiny possibility makes him skittish. Sometimes I catch him appraising me, wondering. It is a very small thing that I might know and it needn’t worry him, but it does. In fact I do know it, this curious little thing, and by the merest chance. It came from my reading the P & S Alumni News two years ago. You know a physician is not doing well when he has nothing better to do during office hours than read the alumni news. One’s eye skims down the listed names for someone familiar in “Necrology”—who died?—in reunions, newsy notes from alumni, honors. What my eye caught was not a name but a town, this town, in “Alumni Notes,” and opposite the name of the physician, a Dr. Robert D’Angelo Como, and the breezy note: “Bob doing yeoman work in the brain pharmacology of radioactive ions at NIH’s Feliciana Qualitarian Life Center—an appropriate name for a Qualitarian satellite, reports Bob, who describes himself as a converted Johnny Reb with his own hound dawgs, hosses, and ham hocks.” Hm. The familiar mixture here of professional seriousness and the always slightly deplorable tone of medical bonhomie. But Como? Not Comeaux? That’s what worries Bob. I can imagine what happened. It was his twenty-fifth class reunion and the secretary got his name not from his letter but from his class roster—yes, there he is on the reunion list, Dr. Robert D’Angelo Como. A small matter certainly, especially in Louisiana, where name changes were commonplace to accommodate whatever nation prevailed. German Zweig and Weiss often became La Branche and Le Blanc. Le Blanc and Weiss have been known to become White. No one cares. I know a man named Harry Threefoot whose family changed their name from Dreyfus. From French-Jewish to Choctaw. Why? Who knows? And in Louisiana who cares? Harry laughed about it. No, the little pique of interest comes from another small scrap of memory. A couple of years ago Mickey LaFaye, not then a horsewoman, lying on my couch, was going on in her old derisive tone about her husband, Durel, and his exclusive Feliciana Hunt Club, the old-line names and the old money it took to get in, the snobbery of it, the silliness and cruelty of fox hunting and so on, then less derisively about an attractive doctor she’d met at the Hunt Club, Dr. Robert Comeaux, newly arrived at Fedville but not one of your D.C. bureaucrats, no, he was old-line Delaware Huguenot stock. Voted into the club on the first ballot. Something occurred to me. Two years ago. My eyes went up to my bookshelves. My father subscribed to a yearly tome, the U.S. Medical Directory. I took down the most recent, ten years old. There he was: Dr. Robert D’Angelo Como, b. Long Island City, N.Y., C.C.N.Y., Columbia University’s College of Physicians & Surgeons …

  A small thing, but puzzling. Why would anybody want to change Como to Comeaux nowadays? Why would anyone prefer to be thought Huguenot and not Italian? I’ve known plenty of both, and frankly—

  A small thing, but enough to make him skittish with me. But he’s very much at his ease now, clicking his spurs against the terrazzo and pushing off the wall by ducking his dark head just graying at the temples, neither Sicilian nor Huguenot now but very much the English gent in his muddy field boots. He smiles his new, brilliant smile.

  “Bob, what’s this about a fire and vandalism out at Mickey’s ranch? Did something happen out there? Something about a groom?”

  “Oh boy.” Bob’s face goes grave, showing white around the eyes inside the tan. With his deep tan and flashing white smile suddenly going grave, Bob is as handsome as a young George Hamilton. “Oh boy, it was more than that. The fire was the least of it. Tom, Mickey took it into her head one day last week to remove her husband’s .45 automatic from the clo
set shelf, drive out to the ranch, and begin shooting her thoroughbreds, beginning with the least valuable, fortunately—you know, she’s got over two million in horseflesh out there—until she was stopped and disarmed by a groom. Those horses weren’t burned. She shot them. Then she deceived the groom by pretending contrition, talked him out of the gun, headed back to the house. Tom, I’m afraid she intended harm to herself or her children or both.”

  “How do you know that?”

  “She told me.”

  “How did she tell you? In her present state I can’t see her telling a story, relating an event.”

  “You noticed that.” Bob Comeaux gives me a keen-eyed look. “You would. You’re quite right. You get it out of her by questioning her like a child. But she’ll tell you!”

  “What’s this about some sort of sexual business between her and the groom? Did the groom attack her?”

  Bob looks grave. “I fear not, Tom.” He stands quite close, facing me, head down, talking so low that not even Sue Brown, who’s back, now six feet away, can hear. “She was coming on to him, Tom.”

  “That’s the groom’s story?”

  “Yes, and I didn’t believe it at first. But she told me herself, quite openly.”

  We fall silent, pondering. Now Bob is back against the wall, speaking in our old offhand style.

  “Tom, you asked me earlier, with your typical Freudian skepticism, just how did I propose to modify her behavior and what sort of behavior I wanted from her.” Actually I didn’t ask him any such question. “Well, you’ve seen for yourself. Wouldn’t you say that such behavior needs modifying—entirely apart from whatever is going on in her subconscious mind, as I believe you call it.”

  “Yes.”

  “You know, Doctor, you and I might just be the ones to achieve a meeting of minds over the old mind-body problem, that ancient senseless quarrel. What do you think?”

  “Our minds might.”

  “Ha ha. Never quit, do you?” By way of leave-taking he gives me a warm, horse-smelling, shoulder jostle. “Oh, Tom—”