The Thanatos Syndrome Read online

  I look into her eyes, which are dilated and dark with pupil. Again she reminds me of Degas girls, with their big black eye dots.

  “Are you taking any medicine, Donna?”

  She shakes her head quickly. How do I know, as certainly as if she were a four-year-old, that she is telling the truth?

  “Donna, make a circle with your thumb and forefinger like this and look at me through it, like so.”

  She does. She looks at me through the circle with her left eye. Ordinarily in a right-handed person, the right eye is dominant.

  I am musing but rouse myself. I’ll muse later.

  “Donna, is there anything I can do for you?” She shakes her head, almost merrily.

  “Donna, why did you come to see me? What do you want?” Although I had not yet got onto this peculiar business, I already knew—with her as well as with Mickey LaFaye—that I could ask her any question in any context.

  Her eyes are focused above me. She nods toward something. “That.”

  I turn around in my chair. There in the bookshelf, in a space between two bookends, squats a little pre-Columbian figurine, a mud-colored, sausage-shaped woman with a large abdomen. A patient with mystical expectations from a trip to Mexico and some Mayan ruins had given it to me. Her mystical Mexican expectations didn’t pan out. They seldom do.

  “You like that?” I ask Donna.

  She nods.

  “Would you like to have it?”

  She nods eagerly, the same quick assent of a four-year-old.

  “Why?” I am curious. Is it because it is fat and fertile? Because it is mine? Because it is Mexican? Does she have the Mexican itch?

  “Something I need.”

  “It is something you need?”

  “Yes, I need.”

  I need? A curious expression. I get up to get it to give it to her. Not hearing her chair scrape, I am startled when at the very moment I turn around, I run into her. She has come around my desk, barefoot and silent. She backs into me.

  “Oh, sorry,” I say automatically, moving sideways to my chair, but she has already reached behind her, seized my hands, brought them around her clasped in hers and against her. She presses the figurine in my hand against her body.

  “What’s this about, Donna?”

  By way of answer, she cranes her head back into my neck and begins turning to and fro. I begin to free my hands. She tightens her grip. “You know.”

  “Know what?”

  “Donna needs you.”

  “No, Donna doesn’t. We’ve been through all that, remember? First the hatred, then the love, neither of which had anything to do with me. We got past it, remember?”

  She’s turning to and fro. “I always liked to smell you. You in your seersuckers, not young not old, but like—?”

  “Like Atticus?”

  “Yeah.” She nods but is not heeding.

  She is engaging me, so to speak. To describe her backward embrace, I can only use the word primatologists use, presenting. She was presenting rearward. Enough of this. What probably saved me from the erotic power of her move was its suddenness and oddness.

  She reaches back for me, clasping her hands at the back of my neck.

  “You smell like—”

  “Like your father?”

  That did it. As suddenly as she started, she stops and goes stiff.

  “It’s okay,” I tell her, and turn her, not to face me, but to get her back to her chair with minimal embarrassment. She is not embarrassed. But her face is heavy and lengthened, mouth pulled down like a sulky child.

  “It’s okay, Donna.”

  “Okay.” She’s not badly put off.

  I look at her for a while. Something crosses my mind.

  “Donna, do you wish to come back next week?”

  “Yes.” An ordinary, perfunctory yes.

  “All right. You come back. Meet me at the hospital. Same time. I want to run a few tests on you. Okay?”

  “Okay.”

  She’s up and off, swinging her bag, as carelessly as she came.

  It is only after she’s left that I discover I’ve broken out in a sweat. There’s this business about seductive patients, known even to Hippocrates, and no credit to the physician—consider old funny-looking Hippocrates, who probably smelled stronger than I or Atticus Finch. But seductive is seductive, more or less, sometimes more than less. Ahem. What to do. One thing to do is open lower right desk drawer, remove fifth of Jack Daniel’s from where it’s been for two years, still half full and two years older, pour four fingers into a water glass, knock back. Ahem. That’s better.

  4. IS THERE A COMMONALITY between these two cases? Have I been away so long and lived so strangely that everyone else seems strange? No, there’s something wrong with these women. And with Frank Macon. Two cases are too few even to suggest a syndrome, but I am struck by certain likenesses … In each there has occurred a sloughing away of the old terrors, worries, rages, a shedding of guilt like last year’s snakeskin, and in its place is a mild fond vacancy, a species of unfocused animal good spirits. Then are they, my patients, not better rather than worse? The answer is unclear. They’re not on medication. They are not hurting, they are not worrying the same old bone, but there is something missing, not merely the old terrors, but a sense in each of her—her what? her self? The main objective clue so far is language. Neither needs a context to talk or answer. They utter short two-word sentences. They remind me of the chimp Lana, who would happily answer any question any time with a sign or two to get her banana. Both women will answer a question like Where is Chicago? agreeably and instantly and by consulting, so to speak, their own built-in computer readouts. You wouldn’t. You’d want to know why I wanted to know. You’d want to relate the question to your—self.

  I’m sitting on the porch again, not sailing airplanes but musing and keeping one eye on my watch—I have to meet Max and Bob, my “parole officers,” at two—when suddenly I get a flash. Well, not quite a flash, but a notion. Could it be that—

  Could it be that there has occurred in both Mickey and Donna some odd suppression of cortical function?

  I am thinking of my sole contribution to medical science, a paper I wrote some years ago after an explosion in the physics lab at Tulane on the effect of a heavy-sodium fallout on the inhibitory function of the cerebral cortex on sexual behavior, which earned me a write-up in Time and some small local fame. I did in fact make a contribution toward the development of the present-day CORTscan, a scanning device for measuring localized cerebral functions. But there’s no reason to suspect a heavy-sodium factor in these cases. There’s been no explosion. It is true that the nuclear facility at Grand Mer has a sodium reactor, but there’s been no accident—or even an “occurrence,” as they call it.

  But accident or not, are there not signs of a suppression of cortical function in Mickey and Donna? I’m thinking particularly of the posterior speech center, Wernicke’s area, Brodmann 39 and 40, in the left brain of right-handed people. It is not only the major speech center but, according to neurologists, the locus of self-consciousness, the “I,” the utterer, the “self”—whatever one chooses to call that peculiar trait of humans by which they utter sentences and which makes them curious about how they look in a mirror—when a chimp will look behind the mirror for another chimp.

  Yes, I’ve been away, and yes, I’ve not been so well myself. But there’s an advantage in absence and return. One notices changes which other people don’t. Tommy has grown six inches, hadn’t you noticed? Betty looks ill. Mickey and Donna? Maybe they, my patients, are not crazy, but something’s going on here. What I need is objective evidence, more cases …

  But first I must convince Max and Bob that I am not crazy myself, or at least no crazier than most doctors.

  5. MEET BOB COMEAUX and Max in Bob’s splendid office in Fedville, the federal complex housing the qualitarian center, communicable diseases control, and the AIDS quarantine. He’s at the top now, director of something or other—Quali
ty of Life Division, or something like—in the penthouse of the monolith with a splendid panoramic view of the river in its great sweep from the haze of Baton Rouge to the south to the wooded loess hills of St. Francisville to the north. Except for the cooling tower of Grand Mer looming directly opposite and flying its plume of steam like Mt. St. Helens, it could be the same quaint lordly river of Mark Twain, its foul waters all gold and rose in the sunset. There’s even a stern-wheeler, the new Robert E. Lee, huffing upstream, hauling tourists to the plantations.

  Max and Bob are cordial and uneasy, having no stomach for this chore, riding herd on a colleague—what doctor would? Ordinarily we get along with standard medical jokes and doctors’ horsing around, but this business is official, legal, and awkward.

  Accordingly, they go out of their way to be easy, yawn and stretch a lot, sit anywhere but in chairs. Bob is dressed for riding, in flared stretch pants, field boots, and suede jacket, as if he had dropped in from the stables. There’s a connection between us. We went to the same medical school in the East and so we talk about Murray’s Bar and Grill on upper Broadway and old Doc So-and-so at Columbia-Presbyterian, as if we were classmates. In fact, we didn’t even know each other. He was some years after me. He’s from Long Island, but is very much the Southern horseman now, as handsome as Blake Carrington, with his steel-gray eyes and steel-gray sideburns brushed straight back like the rest of his hair, and his easy way of half sitting on his desk, swinging one leg and leaning over, hands in pockets. There is not a single wrinkle on his smooth tanned face except for a fold of skin at the corner of each eye, which gives him a slightly Oriental look.

  There is a manila file on the desk next to his thigh.

  Max doesn’t do as good a job at acting casual. He’s dressed too carefully in suit and vest, like a local doctor summoned before a congressional committee. He’s concerned about me and seems at a loss—Max of all people—not knowing what to say except to express his concern. “You’re okay, Tom?” he asks softly, keeping hold of my hand after the handshake. “Sure.” “Are you sure?” he asks. “Sure.”

  For some reason I become aware of my seedy suit. Ellen is not around much and I pay no attention to what I wear. I haven’t got around to buying clothes since my return. My cousin Lucy calls it my Bruno Hauptmann suit, a ten-year-old double-breasted broad-stripe seersucker, which I wasn’t even aware I was wearing until suddenly it feels dank and heavy.

  “Let’s get this over with, guys,” says Bob Comeaux briskly, leaning over his hands and swinging his leg. “So we can have a drink or something. I got to muck out a stall.” This, we understand, is in a manner of speaking.

  “Right,” says Max. Max and I are now sitting like patients in two chairs facing Bob Comeaux’s splendid desk.

  “Oh, say, Tom,” says Bob Comeaux.

  “Yes?”

  “Thanks for looking in on Mrs. LaFaye this morning. I appreciate it.”

  “Glad to. As a matter of fact, I’d like to speak to you, to both of you, about the clinical changes in her. I have an idea that—”

  “Yeah, sure,” says Bob, looking at his watch. “We’ll do that.”

  “I’m also a bit confused about the consultation. It was never made clear to me who requested it.”

  “We’ll get into that too. Right now, what say if we do the boiler plate and get the official crud out of the way.”

  “Fine,” I say.

  “Yes,” says Max. “Here’s what I suggest—”

  “Let’s do it by the book, guys,” says Bob Comeaux, removing his hands from his pockets and clapping one softly into the other. “What I’m proposing is that, at least for the time being, Tom come aboard here in my division. It’s not just a matter of my making room for him—hell, I’ve been after him for years and he can write his own ticket—and he won’t need a license.”

  “Wait,” says Max. “Hold it, Doctor.” Max holds up a hand like the Tulane professor that he is, flagging down an errant intern on grand rounds. “Let’s just hold it a second.”

  “Very well, Doctor,” says Bob Comeaux gravely. “What’s the problem?”

  “No problem. Possibly a misunderstanding. My understanding is that Dr. More wants to return to private practice. Has, in fact. Isn’t that so, Tom?”

  “That’s so,” I say, thinking for some reason about an expression in Mickey LaFaye’s eyes, in Donna’s eyes. There was something about her, them—There was something like—

  “I understand! I read you, Doctor! And believe me, there is nothing I admire more about us old-time clinicians, ha, than our concern for the traditional one-on-one doctor-patient relationship. But we got a little problem here.”

  “What’s the problem?” says Max in his old ironic style. Max is upset about something. I am noting that for some reason Bob Comeaux is striving for standard medical heartiness and not succeeding; is, in fact, doing very badly.

  “The problem, fellows,” says Bob Comeaux, looking up for the first time and smiling his rueful attractive smile, “is that Tom’s license to practice is in bureaucratic limbo. Theoretically he has a probationary license, but that leaves him open to malpractice suits and any cop who wants to lean on him. What I’m saying is that I can take him aboard here and he can do what he pleases, licensed or not.”

  “That’s ridiculous,” says Max to me. “That’s wrong!”

  “What’s ridiculous?” asks Bob Comeaux, puzzled.

  “That he has to report to us on his practice.”

  Bob Comeaux leans forward over his pocketed hands, frowning but not unpleasantly. “I’m not clear, Max. Do you mean that we both agree that Tom should be practicing any kind of medicine he pleases? Or do you mean that he was wrongfully deprived of his license?”

  “I mean it’s wrong! The whole damn thing.”

  We fall silent. Max’s defense of me is loud and lame.

  I am thinking that I should be experiencing a sinking of heart at Max’s lame defense of me, but that I’m not. Instead, I find myself watching Bob Comeaux curiously. There is a new assurance about him. I observe that when he leans over, and now when he takes his hands out of his pockets and folds them across his chest, grasping his suede-clad arms, at the same time sitting-leaning gracefully, one haunch on the desk, he is doing so consciously and well. There is a space between what he is and what he is doing. He is graceful and conscious of his gracefulness, like an actor.

  Max is nothing of the sort. He is upset and at a loss. Max suddenly looks tired and old. No longer the bright young Jesus among the elders, planes of his temples flashing light, amazing the older staff physicians with his knowledge, he sounds more like a Jewish mother. He moralizes: This is wrong, this isn’t the way it’s supposed to be.

  But Max revives, perks up, sits erect. “Excuse me, Bob, but this is all a lot of humbug. The fact is that is why we are here: to review Dr. More’s competence and integrity, which I’m assuming is not in question here, and as members of the ethics committee of the medical society to recommend to the state board that his license be reinstated in full, which will then occur as a matter of course, right?”

  “Right. Except for one annoying little glitch like I told you,” says Bob Comeaux patiently. He looks both genial and doleful.

  “What glitch?”—Max, cocking his head.

  “You know as well as I do, Max,” says Bob Comeaux wearily. “In the case of a felony count, even with our recommendation, a license can only be reinstated after a year’s probationary service under our supervision—which is exactly what I’m offering him, except that he’ll be free and won’t have to report to us.”

  “Felony?” Max spreads his hands, beseeches the four walls, the Mississippi River. “What felony?”

  “Oh boy,” says Bob Comeaux softly, shaking his head. He flips open the file next to his thigh on the desk where he’s still lounging at ease, reads in a neutral clerk’s voice, sighting past his folded arms. “These are the minutes of the first hearing before the State Medical Board. Dr. Thomas More cha
rged by Agent Marcus Harris of the ATFA—let me see, blah blah—with the sale of one hundred prescriptions of Desoxyn tablets and two hundred prescriptions of Dalmane capsules at one dollar per dose for the purpose of resale at the Union 76 truck stop of I-12 near Hammond, Louisiana—blah, blah—look, guys, there is no need to go back over this stuff.” He closes the file.

  “That’s entrapment!” Max cries, again to the world at large. “That narc guy was posing as a trucker.”

  “Right,” says Bob Comeaux glumly. “A sting operation. Could I ask you something, Tom—something I’ve never understood?”

  “Sure.”

  “I’ve never understood why you didn’t just charge those guys a medical fee. Why sell the damn prescriptions wholesale through a goddamn truck stop?”

  “I needed the money. I knew the owner of the truck stop and had confidence in him, that he would only deal with truckers who needed them. You will note that the dosages were minimal, twenty-five milligrams of Desoxyn and thirty milligrams of Dalmane, just enough to get them up enough to keep awake and then down so they could sleep. You know those guys push those big double and triple tandems over crumbling interstates for up to eighteen hours a day. Then they’re so tired they can’t sleep.”

  “Oh boy,” says Bob Comeaux.

  Max opens his hands again but says nothing. Doesn’t have to. Tom, that was dumb, was what he would say.

  “Okay,” says Bob gently. “Here’s our little problem. Desoxyn is an amphetamine, isn’t it, Tom?”

  “Yes.”

  “Dalmane is a hypnotic, right?”

  “Yes.”

  “We’re talking controlled substances, fellows, schedule three. We’re talking a felony count under new state and federal statutes.”

  “So what’s the big deal?” asks Max, asking the space between me and Bob Comeaux. “So it was a dumb thing to do. Not dangerous, but dumb. As a matter of fact, he probably saved lives by keeping those poor bastards awake. Dumb, yes. But he’s paid for his mistake. The feds are not interested in him. As far as we are concerned, the ethics committee, I don’t see the problem. I’m sure Tom doesn’t mind my saying that he was not at all himself at the time. I know because I was treating him.”