My name is Dr. Alan Forrester. I am a psychiatrist. In case you are unaware of the various credentials that exist among mental health professionals, I am the kind that went to medical school. I am a medical doctor, an M.D., graduated from Johns Hopkins University summa cum laude. I completed my residency at the New York–Presbyterian University Hospital of Columbia and Cornell. In my twenty-two years of practice, I have received numerous awards and distinctions, but I find no sanctuary in paper certificates, the kind you have undoubtedly seen hanging on the walls of your own doctors’ offices. Cream stock, Latin words written in calligraphy. Fine wooden frames. They remind me of the trophies my son used to collect after each sports season. Cheap and reflective of nothing more than the need to secure future enrollments. Nothing attracts customers like the promise of an award. They are advertisements, and those who display them publicly are nothing more than human billboards.
Mine is a profession of constant challenges. Whatever has been achieved is, by definition, in the past, and it will likely have no bearing on the successful treatment of the next patient who walks through my door. Yes, it is true that experience makes us better at our various trades, and mine is no different. I am certainly a more capable diagnostician now than I was at the start of my career. But I have found that the diagnosis is the easy part. It’s the treatment—the careful, balanced, meticulous management of pills and therapy—that poses the most significant challenges and requires as much humility as skill. Every brain is different. And so must be every course of therapy. I never presume to know what will work. And by “work” I mean help, because that is what we aim to achieve—the helping of a human being to escape the pain inflicted by his own mind.
You may conclude me a braggart, but I have been successful in helping every one of my patients with a single exception. This has been true in both my private practice at 85 Cherry Street in Fairview as well as my more gritty work at the men’s correctional facility in Somers.
I am the only practicing psychiatrist in Fairview. The doctor who administered the medication to Jenny Kramer, Dr. Markovitz, lives in Cranston and does not provide therapy in private practice. There are far more psychologists, social workers, therapists, and the like in our town, but none of them can prescribe drugs, and none of them is trained in psychopharmacology. That is the first reason the Kramers employed my services.
The second reason is my work in Somers. Once a week, I travel upstate to volunteer a full day (eight hours that would otherwise be billable at four hundred dollars each) to treat mentally ill criminals at Connecticut’s Northern Correctional Institution. This is a level five maximum security institution. So you are not confused, the men at Somers have been convicted of crimes and sentenced to prison. Some of them also happen to be mentally ill. Criminals who are found not guilty by reason of insanity are not sent to prison. They may face their own hell confined to state mental hospitals. Sometimes they are released after rather minimal and insufficient treatment. The irony is that there does not exist a perfect correlation between the degree of a criminal’s insanity and his ability to utilize an insanity defense. An otherwise “sane” man who slays his wife’s lover in the heat of the moment may be deemed temporarily insane and have a defense under the law, while a serial killer (all of whom, I would insist, are clinically sociopathic) will wind up on death row. Yes, yes, it’s all more complicated than this. If you are a criminal attorney, you are probably jumping up and down in protest of my oversimplified rantings. But consider this: Was Charles Manson not insane for ordering his cult to murder seven people? Was Susan Smith not insane to drown her children? Even Bernie Madoff—was he not insane to continue his Ponzi scheme after he had made more money than he could ever spend?
Insanity is just a word. The men I treat are violent offenders, and they have illnesses ranging from depression to severe psychosis. I provide them with traditional “talk” therapy, though not the amount that is needed, and with medication. The prison would prefer me to focus on the drugs. In fact, the prison workers would let me medicate the entire population living within its walls if such a thing were allowed. Sedated prisoners make for easy prisoners. But, of course, it is not allowed. You can understand, though, why they are eager to send me anyone who meets their criteria. Hour after hour, they come and they go from a line outside the guarded metal door. Sometimes the line grows throughout the day and I feel the urge to cut the sessions short so I can get to all of them. I’m sure I do, and this weighs on my conscience. I see their faces on the long drive home, the ones I can’t get to that week, and also the ones I sent away in haste with a few pills.
The bean counters come each quarter to scrutinize the spending on the prescriptions, but they can’t argue with my rate. As unpleasant as it is to pass a day with violent offenders, I believe I am serving a vital role. Our prisons are overflowing with the mentally ill. Whether the illness led them to commit their crimes, or the prison environment created their illness, is not always easily determined. And for my purposes, largely irrelevant. In any case, I understand the criminal mind.
The third reason I was chosen to become involved with Jenny Kramer has to do with a young man named Sean Logan. I will get to that shortly.
After slicing her wrists open, Jenny awoke in the middle of the night. Her father was in the room and had fallen asleep in a chair. From her description of this moment, there was never any doubt in my mind that she had fully intended to end her life.
My eyes were suddenly open and I was seeing the curtain again. It’s light blue and it hangs on metal rings from this bar that goes around the room in the ICU. They put me in the same room where I was the night they gave me the treatment. The night I was raped. I hate saying that. They tell me I should say it—and think it—because it will help me accept it and I guess get better. But it hasn’t, right?
Jenny lifted her bandaged wrists in the air.
Whatever they gave me to sleep was still sort of there, so I felt pretty good. Like I was high.
“Like when you take the pills from your friends’ houses?” I asked her.
Yeah. Then all these thoughts came at once, like a stream of bullets. I’m dead. I’m alive. This whole year never happened—it’s still the night of the rape. I felt relief that this year had been a bad dream. But then I felt horrible that I would have to live it all again. And that made me come back to the most obvious thing, which was that I had cut myself. And then more thoughts fired out at me. It was like this shock that I had done that, and even relief that it hadn’t worked, because I must have been crazy to want to do it. But then all the reasons that had made me do it rushed in, and I was like, oh yeah, I wasn’t crazy. I had reasons, really good reasons, and they’re all still here. The bad stuff that I feel every day, all the time, was still there. It was like swimming up from the bottom of the pool and popping out of the water to find yourself exactly where you started before you dove in. You know what I mean? I was exactly where I was before. I tried to move my arms onto my stomach because that’s what I do when I think about it, about the bad stuff I feel, but my arms were tied to the bed rails. Then I just thought how angry I was that it hadn’t worked.
Jenny cried then. It wasn’t the first time. But these were angry tears.
It wasn’t easy, you know. I was so scared. I sat in that bathroom and I was crying and crying. I thought about Lucas mostly, and about my dad and what this would do to them. And my mom, too, though she’s stronger than they are. I imagined she would be really mad at me. I almost stopped but then I told myself, just do it and get it over with! The blade was really sharp and it hurt way more than I thought. It wasn’t the cutting that hurt, but the air when it went into my veins. It was like this horrible stinging and burning. I did both of them. Do you know how hard that was? With the pain of the first one, knowing how bad it would hurt again? They say you shouldn’t look at the blood because it will make you try to save yourself out of instinct, but it was too hard not to look. And they were right. My heart started to pound like wild and “Stop it! Stop it!” was screaming in my head. I started looking around for ways to bandage myself, but I had removed everything before I started because of the instructions I read. I knew that would happen, that I would try to stop. I had to fight it so hard. You have no idea how hard it was. I had to close my eyes and lie down on the floor and focus on the dizzy feeling, which actually was kind of good. Like I was just letting go of everything. So I did. I just closed my eyes and ignored the voices that kept screaming at me and the burning pain. And I just let everything go. I did all of that. I went through all of that and it still didn’t work.
“Are you angry?” I asked her.
She nodded, the tears flooding her eyes and running down her face.
“With whom?”
She took a while to answer. And when she did, she avoided saying the name but rather alluded to the target of her rage. What was she doing there? Of all the places she could have been. The pool wasn’t even open yet. There was still some snow on the ground. After everything! I mean, come on! Why did she have to be there?
Jenny said none of this when she opened her eyes and saw her father. She kept her feelings to herself. But Tom Kramer had enough feelings to fill the entire hospital. He folded himself over her bed.
Thank God! I kept saying that over and over again. I tried to hold her, but she was so fragile, her delicate arms with layers and layers of bandages, tied to the bed rails. I pressed my cheek against hers, smelled her hair and her skin. It wasn’t enough just to see her awake. I needed to feel her and smell her.… Christ, her face was so pale. It was different from the night of the attack. That night she looked lifeless. On this early morning, she looked dead. I never knew there could be a difference. But there is. There really is. Her eyes were open and she was looking at me and at the ceiling. But she wasn’t there. My beautiful daughter wasn’t there anymore. Dr. Baird came in with Dr. Markovitz. It was surreal, being back in the hospital with those two doctors again. I guess I had started to believe what my wife had been saying, that Jenny was better. That she would keep getting better, and that this dark moment in our lives was finally passing. I must have believed that. Thinking about it now, I must have started to take all my doubts and put them on myself. Like I was the one in the family who couldn’t get past it. Like maybe I was projecting my despair onto my daughter and that she really was okay. I was the one who couldn’t accept that this monster would never be found. And, God I can’t believe I’m going to say this out loud. I think I was mad at her, at Jenny, for not remembering. For not being able to help the police find him and punish him for what he’d done. Is that crazy? To be so obsessed with vengeance?
“No,” I assured him. “You are her father. It’s instinct.” I meant those words. And I fully intended to alleviate his guilt. I did so at the risk of encouraging his search for Jenny’s rapist, and for this, I have some regret that I did not direct him away from embracing his instincts without reservation. An instinct may explain a reaction. But that does not mean the reaction is the best course to pursue. In any event, Tom was relieved.
That sounds right! Like I couldn’t help myself! I found myself watching the news all day and every evening. I flipped between CNN, CNBC, Fox, waiting to hear about another attack. I had “rape” on a Google alert. Can you believe that? Part of me actually wanted this monster to strike again so there would be a chance to catch him. I’m a horrible person. I don’t even give a shit anymore, you know? It feels good to admit it to someone, let it do whatever it’s gonna do. Send me straight to hell. Send me to jail. Whatever. Being back in the hospital with those same doctors and my daughter again in the fucking ICU! Fuck it. Fuck me. I should have known she wasn’t okay. I’m her father, for Christ’s sake. But I know now from the shock I felt in that hospital that I had let myself believe it.
* * *
What Tom didn’t say on that day, but what he did finally admit to me weeks later, was that he also vowed to stop deferring to his wife. The first fault line had given way. The fracturing of their marriage, their family, had begun. And so it was, on that morning after Jenny cut herself open, that Charlotte became the new villain—both to Jenny and her father.
This was not a surprise to me. But the art of therapy is to allow a patient to come to his own conclusions. It must be this way, and as a therapist, it requires great patience to nurture this process without corrupting it. How easy it would have been for me to lead Tom to this conclusion, that he was angry at his wife for making him believe their daughter was recovering. A few carefully placed words. A sentence here and there. Reminders of the facts that would make this case against his wife. It was, after all, Charlotte who insisted Jenny have the treatment. And Charlotte who demanded they forgo therapy and remove her to Block Island, where she would be in relative seclusion. Charlotte who insisted and persisted in mimicking normalcy in spite of Jenny’s loss of interest in her life. Charlotte who reprimanded her husband whenever he brought up the subject of their daughter’s rape. I said nothing of the sort. I was very careful. A therapist has tremendous powers of suggestion. Tremendous powers, period.
I will not say whether or not Tom was justified in his feelings. Feelings do not require justification. On the one hand, Charlotte had been adamant in her version of the truth. The rape had been erased from her daughter’s mind. And so it never happened. It is obvious now to see that she was wrong. But she was not without the very best of intentions. Nor was she entirely delusional. Dr. Markovitz had administered the drugs, and Jenny’s memory had been compromised. She didn’t remember the rape. Charlotte cannot be blamed for not understanding the human mind and the devastating aftereffects of the treatment. Those were just beginning to surface. And that brings us back to Sean Logan.