Contrary to popular belief, physicians do not hesitate to criticize each other’s work, at least in private. Thus, at the regular Monday-morning staff meeting, considerable doubt was expressed about whether a simple post-hypnotic suggestion (the whistle) would summon Robert from the depths of hell. One of my colleagues, Carl Thorstein, went so far as to call it a “nutty” idea (Carl has often been a thorn in my side, but he’s a good psychiatrist). On the other hand, it was generally agreed that little could be lost by doing the experiment, which had not been tried before.
Nor was there much enthusiasm for Giselle’s plan to get prot to talk to animals, though the broader suggestion of a zoo outing for the inmates was well received, and I was nominated a committee of one to look into the matter. Villers admonished me “to keep ze costs as low as possible.”
Some of the staff members were on vacation, so there was little further discussion of patients and their progress, if any. However, Virginia Goldfarb mentioned a remarkable improvement in one of her charges, the histrionic narcissistic dancer we call “Rudolph Nureyev.”
Rudolph was an only child who was reminded constantly that he was perfect in every way, and getting better. When he decided to take up ballet his parents responded with high praise and strong financial support. With that kind of encouragement (and considerable talent), he went on to become one of America’s finest dancers.
His only problem was one of attitude. He expected everyone, even music directors and choreographers, to defer to his impeccable taste and judgment. Eventually he became so important (in his own mind) that he began to voice other demands, and finally became so impossible to work with that he was fired by the management of his dance company. When this news spread, no one else in the world would take him in. He ended up a voluntary patient at MPI when his last and only friend encouraged him to seek professional help.
His sudden improvement came about following a single lengthy conversation with prot, who described to Rudolph the breathtaking beauty and grace of the performers in a balletlike dance he had seen on the planet J-MUT. He encouraged Rudolph to try some of the steps, but it required such fantastic speed, exquisite timing, and contortion of limb that Rudolph found the work impossible to execute. He suddenly realized that he was not the greatest dancer in the universe. Goldfarb reported that his supreme arrogance had vanished immediately, and she was thinking of moving him to Ward One. There was no objection.
Beamish, peering at me over his tiny glasses, joked that we should give prot an office and send all the patients to him. Ron Menninger (no relation to the famous clinic) remarked, a little less facetiously, that perhaps I ought to delay Robert’s treatment until prot had done whatever he could for the other inmates, a notion I had grappled with myself.
Villers reminded us that we were expecting three distinguished visitors over the next month or so, including the chair of our board of directors, one of the wealthiest men in America. Klaus wasted no words in emphasizing the importance of this visit, suggesting that we put our very best feet forward that day, funding efforts for the new wing having fallen below expectations.
After some other matters were disposed of, he announced that a major TV network had offered the hospital a healthy sum for an exclusive appearance by prot on one of its talk shows. Astonished by this ridiculous prospect, I asked how they even knew he had returned. Someone pointed out that it had already been picked up by the media, including one of the national news programs. I wondered whether Klaus himself had anything to do with that.
The discussion ended without resolution. Some, like me, thought it preposterous to let one of our patients be interviewed on television. Others, noting that prot was unique in all the world and that he would undoubtedly be able to hold his own with any interviewer, weren’t so sure. Though we could certainly use the money, I thought we were opening another can of worms. I pointed out that we had a lot of bizarre and interesting cases at the hospital, so why not a whole TV series based on their individual stories? Villers, missing the irony of my remark, seemed quite enthusiastic. I could almost see dollar signs in his eyes, which lit up like shooting stars as he contemplated the potential windfall.
Virginia caught me after the meeting. She wanted to know whether prot might be willing to schedule a look at a couple of her other patients. She wasn’t joking—Goldfarb never jokes. I assured her I would speak to him about the matter
If I have more than cottage cheese and crackers for lunch I have a hard time staying awake the rest of the afternoon. I watched in envy as Villers put away a huge plate of roast beef, various kinds of vegetables, buttered rolls, and pie. He said very little as he gobbled down his food, and left as soon as he was finished, dots of gravy and piecrust flecking his goatee. As I watched him go, I thought: I don’t know much about this man, who keeps his personal life to himself, but I’d know those drooping shoulders anywhere.
Klaus Villers is a paradox of the highest order. He exemplifies, I suppose, the public image of the typical psychiatrist—cold, decisive, analytical. Nothing appears to faze him. I have never seen the slightest hint of shock or amusement on his weather-beaten countenance, rarely sensed even the slightest emotion. Yet, for all his gruffness of character and outspoken opinions he can be soft as an oyster inside.
Perhaps the best example of this is the case of a former patient whom Klaus was powerless to help (a not infrequent situation at MPI). The man, a hopeless manic depressive from a poor family, was so fond of his doctor, for reasons of his own, that he carved several beautiful little birds for Klaus and his wife. When the man died, our “heartless” director, who barely found time or inclination to thank the man for his gifts, paid for his interment out of his own pocket, erecting a huge marker for “The Birdman of MPI.” No one knows why he did this, but I choose to believe that he simply felt sorry for a long-suffering patient he could do nothing for.
Klaus emigrated with his family to America from Austria more than fifty years ago. Born in 1930, he grew up during the years preceding World War II. His awareness of the atrocities going on around him may have been a factor in his decision to become a doctor, but this is pure speculation on my part. I don’t even know how he met his wife Emma.
For all his intelligence he still maintains a thick German accent and, unbelievably, his wife speaks almost no English at all. Extremely introverted, she virtually never leaves their secluded home on Long Island, tending to her garden and homemaking for herself and her husband. They rarely attend extramural functions or, even after he became director in 1990, invite anyone to their lovely home (I was there only once, years ago). Apparently they see no need for social contacts, finding everything they need in each other. As far as I know they have no children.
Their only hobby is hiking. They have walked the Appalachian Trail many times, once or twice with the late Supreme Court Justice William O. Douglas, who apparently didn’t have many friends either. As a result, Klaus knows every species of bird in eastern North America by sight or sound and, in fact, usually spends a part of his lunch hour each day on the lawn watching and listening. He remarked once that his wife does the same thing at exactly the same time so that, in a sense, they enjoy the experience together even though they are miles apart.
The reason I mention this now is that I had not seen him on the lawn with his field glasses for some time, or heard him whistle a bird call as he strode the corridors. In fact, he seemed to be acting a bit strangely in a number of ways, not the least of which was his plan to raise funds for the new wing (his legacy?) by getting prot to go on television. I suspected he was suffering from a mild case of depression, perhaps due to his having reached the standard retirement age of sixty-five. Or maybe he was just overworked—my own tenure as acting director was the most difficult period of my life.
I wanted to come right out and ask him if there was anything I could do to lighten his load, but I knew that would get nowhere. Besides, I had enough problems without adding him to my already overcrowded schedule.
When I returned to my office I found Giselle sitting in my chair, her feet resting on the stack of papers covering my desk, oblivious to her surroundings. “Giselle, you can’t have my desk. You’re only here because—”
“I think I know when he’s leaving.”
“You do? When?”
“About the middle of September.”
“How do you know that?”
“When I told him there may be a trip to the zoo in the next couple of weeks, he said, ‘I can just make it. Count me in.’”
“Okay. Good. Keep it up. Do you have any idea yet who he’s taking with him when he leaves?”
“He won’t say a word about that. Says he has to work out some details. But it could be anyone.”
“That’s what I was afraid of. Anything else?”
“I need a place to spread out.”
“C’mon. Let’s see if we can find you a desk somewhere.”
“All right,” I said, after watching prot devour a half-dozen oranges. “Let’s get to work.”
“You call this work? Sitting around chatting and eating fruit? It’s a picnic!”
“Yes, I know your thoughts about work. Now—is Robert there with you?”
“Yep, he’s right nearby.”
“Good. I’d like him to come out for a while.”
“What—without your hypnosis trick?”
“Robert? May I speak with you please?”
Prot sighed, set aside the ragged remains of an orange, and gazed dully at the ceiling.
“Robert? This is very important. Please come out for a moment. Everything will be all right. No harm will come to you or to anyone....”
But prot just sat there with his know-it-all smirk. “You’re wasting your time, gino. One, two—hey—where’s the dot?”
“I’m not going to hypnotize you just yet.”
“Why not?”
“I’ve got another idea.”
“Will wonders never cease!”
I reached into my shirt pocket and pulled out the whistle. Prot watched me with amusement as I put it to my lips and blew. At that moment the smirk vanished and a different person appeared, only I wasn’t sure who it was. He wasn’t slouched in the chair as Robert usually is. “Robert?”
“I’m here, Dr. Brewer. I’ve been waiting for you to call.” Though he seemed quite unhappy about it, he was nonetheless there, apparently ready to talk.
I stared at him, savoring the moment. It was the first time I had ever seen Robert when he wasn’t catatonic or under hypnosis (with rare exceptions—see K-PAX). But the triumph was undercut by a hint of suspicion. Something wasn’t right—it seemed too easy. On the other hand, he had been pondering his dilemma for years, and perhaps, as sometimes happens, he was simply getting bored with living in a figurative straitjacket. “How are you feeling?”
“Not so hot.” He looked much like prot, of course, but there were dissimilarities. For example, he was far more serious, not the least bit cocky. His voice was a little different. And he seemed exhausted.
“I can understand that. I hope we can help you feel better soon.”
“That would be nice.”
“Let me ask you first: Should I call you Robert or Rob?”
“My family calls me Robin. My friends call me Rob.”
“May I call you Rob?”
“If you like.”
“Thank you. Care for some fruit?”
“No, thanks. I’m not hungry.”
There were so many questions I wanted to ask him that I didn’t know where to begin. “Do you know where you are?”
“Yes.”
“How do you know that?”
“Prot told me.”
“Where is prot right now?”
“He’s waiting.”
“Can you speak with him?”
“Yes.”
“Good. Now—do you know where you’ve been for the past five years?”
“In my room.”
“But you couldn’t move and you couldn’t speak to us—do you remember?”
“Yes.”
“Yes. I heard everything.”
“Can you tell me why you couldn’t speak or respond in some way?”
“I wanted to. But I just couldn’t.”
“Do you know why?”
“I was afraid to.”
“Why were you afraid?”
“I was afraid...” He gazed off into some inner space. “I was afraid of what might happen.”
“All right. We’ll get back to that later. Let me just ask you this: You seem to be less fearful now than you were then—can you tell me why?”
He started to answer, then hesitated.
“Take your time.”
“There are a couple of reasons.”
“I would like very much to hear them, Rob, if you feel like telling me.”
“Well, all of you have been so kind to me since I came here that I guess I felt like I owed you something.”
“Thank you. I’m glad you feel that way. And the other reason?”
“He said I can trust you.”
“Prot? Why now, and not before?”
“Because he’s leaving soon, and I think he’s becoming impatient with me.”
“How soon? Do you know?”
“No.”
“All right. But you were in the same situation five years ago. How is it different this time?”
“Last time I knew he would be coming back. This time he’s not.”
“He’s not coming back? How do you know that?”
“I know, but—”
“He told me you would take his place. That you would help me when he’s gone.”
He was appealing to me with such intensity that I went over and placed my hand on his shoulder. “I will, Rob. Believe me, I’ll help you in every way I can.”
With that he slowly puckered his face and began to cry. “I’m so tired of feeling bad. You don’t know how bad it is.” His head dropped.
“No one who’s not in your shoes can understand what you’ve been through, Rob. But we’ve helped a lot of people in similar situations and I think you’re going to feel better very soon.”
His head lifted and he looked at me. He was no longer crying. “Thanks, dr. b. I feel better already.”
“Prot? Where’s Robert?”
“He’s kind of tired. But if you play a nice tune on your whistle he might be back later.”
“Uh—prot?”
“Hmmmmmmm?”
“Thank you.”
“For what?”
“For giving him the confidence to come out.”
“Did he tell you that?”
“Yes. And he also told me this might be your last visit to Earth. Is that true?”
“It is if you get Robert back on his feet. Then there wouldn’t be any need for me to come, would there?”
“No, there wouldn’t. In fact, it might be better if you didn’t.”
“Don’t worry—I know when I’m not wanted. Besides, there are a lot of other interesting places to go.”
“Yep. Billions and billions of them in this GALAXY alone. You’d be surprised.”
“Can you give us a little time before you go back? Can you give us six more weeks?”
“I can only give you what I’ve got.”
“Will you at least tell me how much you’ve got?”
“Nope.”
“But prot—Robert’s life is at stake. Which is why you’re here, isn’t it?”
“I told you before: I’ll give you some warning. It won’t come as a complete surprise.”
“I’m happy to hear that,” I said glumly. “All right. Well, as long as you’re here, I’d like to ask you one more thing about Rob.”
“Is that a promise?”
“Not exactly. Now—is there some other reason he’s suddenly speaking to me? Anything I don’t know?”
“There doesn’t seem to be any limit to what you don’t know, my human friend. But I will tell you this: Don’t be fooled by his cheery disposition. It was all he could do to come forward today. He still has a long way to go and he could retreat at a moment’s notice. Be gentle with him.”
“I’ll do my very best, prot.”
“In spite of your primitive methods? Lotsa luck.” He picked up the fragment of orange and stuffed it into his mouth.
“How are you doing with the letters, by the way?” Through orange teeth: “I’ve read most of them.”
“Any decisions yet?”
“Too soon for that.”
“Will you tell me when you’ve decided who’s going back with you?”
“I might. Or maybe I’ll save it for the tv show.”
“What? Who told you about that?”
“Everyone knows about that.”
“I see. And I suppose everyone knows about the trip to the zoo? And about all the people who want to talk to you?”
“Of course.”
“Prot?”
“Yeah, coach?”
“You’re driving me crazy.”
“Tell me about it,” he sighed.
Thinking he was joking, I chuckled a little. But he seemed to be quite serious. I glanced at the clock on the wall behind him—we still had a few minutes left. I stood up. “All right. You take my place and I’ll take yours.”
Without a moment’s hesitation he jumped up and ran over to my chair. He plopped into it, squeezed the vinyl arms several times, and whirled around in a complete circle. Obviously enjoying himself, he grabbed a yellow pad and began to scribble furiously as he stroked an imaginary beard.
I took his chair. “You’re supposed to ask me some questions,” I prodded.
“That won’t be necessary,” he mumbled.
“Why not?”
“Because I already know what’s bugging you.”
“I’d love to hear what it is.”
“Alimentary, my dear canal. You were born on a mean, cruel PLANET from which you see no way to escape. You’re trapped here at the mercy of your fellow humans. That would drive any being crazy.” Suddenly he banged his fist on the arm of my chair. “Time’s up!” He scooted over, grabbed another orange, and bit into it. Then he whirled again and flung his feet onto my desk. “And I’ve got work to do,” he concluded with a dismissive wave. “Pay the cashier on your way out.”
I gave him a poor imitation of a Cheshire-cat grin. He screeched and bolted for the door.
It wasn’t until later that I happened to glance at the yellow pad he had scribbled on. In a messy but legible scrawl he had written, over and over again, 17:18/9/20. It took me a moment to figure it out, but finally I realized: He’s leaving on the twentieth at 5:18 P.M.!
Not having been in Ward Three since before my “vacation,” I decided to take a brief tour. I found Michael in 3B perusing a book called The Right to Die, a work he has read dozens of times, as Russell reads and rereads the New Testament.
A naked woman streaked by. Michael ignored her. He wanted to know when he was going to get to talk with prot. Unforgivably, his request had slipped my mind, but I told him I would see to it immediately. He said, jokingly, I hoped, “I could be dead by the time he gets here.” I slapped him on the shoulder and continued my rounds, stopping to chat with various social and sexual deviates, tortured souls preoccupied with specific bodily functions. I watched in never-ending amazement as one of them, a Japanese-American male, undressed himself, smelled the crotch of his underwear, then dressed again, and undressed, over and over again. Another man kept trying to kiss my hand. Others performed their own endless rituals and compulsions. Yet none of these miserable creatures were more tragic than the inhabitants of 3A, the severely autistic ward.
Autism was once blamed principally on unfeeling and uncaring parents, especially the mother. It is now known that autists suffer some sort of brain defect, whether genetic or induced by organic disease, and no amount of nurturing will alter the progress of this debilitating affliction.
Stated simply, autists are missing the part of brain function that makes a person a soulful human being, someone who can relate to other people. Although often able to perform extraordinary feats, they appear to do so entirely mechanically without any “feel” for what they have accomplished. The ability of the autist to concentrate on whatever it is that occupies his or her thoughts is astonishing, and typically to the exclusion of everything else. There are exceptions, of course, and some are able to hold jobs and learn to function to some extent in society. Most, however, live in worlds of their own.
I found our twenty-one-year-old engineering wizard, whom I’ll call Jerry, working on a matchstick recreation of the Golden Gate Bridge. It was almost finished. On display nearby were replicas of the Capitol Building, the Eiffel Tower, the Taj Mahal. I watched him for a while. He worked deftly and rapidly, yet seemed to pay little attention to his project. His eyes darted all over the room, his mind apparently somewhere else. He used no notes or models, but worked from memory of photographs he had glanced at only briefly.
To Jerry, who may not even have noticed me, I said, “That’s beautiful. How long before it’s finished?”
“Before it’s finished,” he replied, without changing his pace.
“What’s next on the agenda?”
“Agenda. Agenda. Agenda. Agenda. Agenda. Agenda—”
“Well, I’ve got to go now.”
“Go now. Go now. Go now.”
“Bye, Jer.”
And so it was with the others, most of whom were wandering around or staring intently at their fingertips or studying the blemishes on the walls. Sometimes someone would let out a bark or start clapping his hands, but not one of them paid the slightest attention to me or glanced in my direction. It is as if autists actively practice a kind of desperate avoidance. Nevertheless, we continue to try to find some way to relate to them, to enter their worlds, to bring them into ours.
One feels sorry for such individuals, to pity their lack of contact with other human beings. Yet, for all we know, they may be quite happy within the confines of their private realms, which might, in fact, encompass gigantic universes filled with an incredible variety of shapes and relationships, with interesting and satisfying visions, and tastes and sounds and smells that the rest of us cannot even imagine. It would be fascinating to enter such a world for one glorious moment. Whether we would choose to stay there, however, is another matter.