The Insane

WHAT ARE they teaching you now, son? said the old Doc brushing the crumbs from his vest.

Have one, Dad? Yeah. Throw it to me. I got matches.

I wish you wouldn’t do that, said his wife trying hard to scowl. It was the usual Saturday evening dinner, the young man, a senior in medical school, out for his regular weekend siesta in the suburbs.

I’m curious, said the old Doc glancing at his wife. Then to his son, Anything new? She placed an ash tray at his elbow.

I go on Medicine Monday, said the boy. We finished Pediatrics and Psychiatry today.

Psychiatry, eh? That’s one you won’t regret, said his father. Or do you like it, maybe?

Not particularly. But what can we learn in a few weeks? The cases we get are so advanced, just poor dumb clucks, there’s nothing to do for them anyway. I can see though that there must be a lot to it.

What are you two talking about? said his mother.

Insanity, Ma.

Oh.

Any new theories as to causes? said the older man. I mean, not the degenerative cases, with a somatic background, but the schizophrenics especially. Have they learned anything new about that in recent years?

Oh, Dad, there are all sorts of theories. It starts with birth in most cases, they tell us. Even before birth sometimes. That’s what we’re taught. Unwanted children, conflicts of one sort or another. You know.

No. I’m curious. What do they tell you about Freud?

Sex as the basis for everything? The boy’s mother looked up at him a moment and then down again.

It’s largely a reflection of his own personality, most likely. I mean it’s all right to look to sex as a cause, but that’s just the surface aspect of the thing. Not the thing itself. Don’t you think?

That’s what I’m asking you.

But everybody has a different theory. One thing I can understand though, even from my little experience, and that is why insanity is increasing so rapidly here today.

Really? said his mother.

I mean from my Pediatric work. He paused. Of the twenty-five children I saw in the clinic this week only two can be said to be really free from psychoneurotic symptoms. Two! Out of twenty-five. And maybe a more careful history would have found something even in those two.

Do you mean that those children all showed signs of beginning insanity? said his mother.

Potentially, yes.

Not a very reassuring comment on modern life, is it?

Go ahead, son, said his father.

Take a funny-faced little nine-year-old guy with big glasses I saw in the clinic this afternoon. His mother brought him in for stealing money.

How old a child, did you say?

Nine years. The history was he’d take money from her purse. Or if she sent him to the store to buy something, he’d come back without it and use the money for something he wanted himself.

Do you have to treat those cases too? asked his mother.

Anything that comes in. We have to get the history, do a physical, a complete physical—you know what that means, Dad—make a diagnosis and prescribe treatment.

What did you find?

The story is this. The lad’s father was a drunk who died two years ago when the boy was just seven. A typical drunk. The usual bust up. They took him to the hospital and he died.

But before that—to go back, this boy had been a caesarian birth. He has a brother, three years younger, an accident. After that the woman was sterilized. But I’ll tell you about him later.

Anyhow, when she came home, on the ninth day after her caesarian, she found her husband under the influence, dead drunk as usual and he started to take her over—that’s the story.

What’s that?

Oh, you know, Mother. Naturally she put up a fight and as a result he knocked her downstairs.

What! Nine days after her confinement?

Yes, nine days after the section. She had to return to the hospital for a check up. And naturally when she came out again she hated her husband and the baby too because it was his child.

Terrible.

And the little chap had to grow up in that atmosphere. They were always battling. The old man beat up his wife regularly and the child had to witness it for his entire existence up to two years ago.

As I say, she had a second child—three years old now, which, though she hated it, came between the older boy and his mother forcing them apart still further. That one has tuberculosis which doesn’t make things any easier.

Imagine such people!

They’re all around you, Mother, if you only knew it. Oh, I forgot to tell you the older kid was the dead spit of his dad who had always showered all kinds of attentions on him. His favorite. All the love the kid ever knew came from his old man.

So when the father died the only person the boy could look to for continued affection was his mother—who hated him.

Oh, no!

As a result the child doesn’t eat, has lost weight, doesn’t sleep, constipation and all the rest of it. And in school, whereas his marks had always been good—because he’s fairly bright—after his father died they went steadily down, down and down to complete failure.

Poor baby.

And then he began to steal—from his mother—because he couldn’t get the love he demanded of her. He began to steal from her to compensate for what he could not get otherwise, and which his father had given him formerly.

Interesting. Isn’t it, dear?

So young!

The child substitutes his own solution for the reality which he needs and cannot obtain. Unreality and reality become confused in him. Finally he loses track. He doesn’t know one from the other and we call him insane.

What will become of him in this case? asked the mother.

In this case, said her son, the outcome is supposed to be quite favorable. We’ll explain the mechanism to the woman—who by the way isn’t in such good condition herself—and if she follows up what she’s told to do the boy is likely to be cured.

Strange, isn’t it? said the old Doc.

But what gets me, said his son. Of course we’re checked up on all these cases; they’re all gone over by a member of the staff. And when we give a history like that, they say, Oh those are just the psychiatric findings. That gripes me. Why, it’s the child’s life.

Good boy, said his father. You’re all right. Stick to it.