“You were uncomfortable,” she said at last.
“Yes. I was, right from the start.”
“Why?”
I began to describe again those first moments, Gene’s obedient manner and appearance, his oval face, the off-center nose, my musings, about his being Eastern European.
Susan cut me off. “Kenny? You said his name was Kenny?”
“Yeah.”
“That sounds Irish. What’s his mother’s maiden name?”
I opened my briefcase and removed the preliminary interview taken by the NYU intern. “Shoen,” I said with a laugh.
“Sure doesn’t sound Eastern European,” Susan said. “Who did he remind you of? Who do you know who’s Eastern European?”
“Lots of people. My mother’s family, all my friends from Washington Heights. You. Harry.”
“And you,” Susan said. “You’re half — Eastern European.”
Harry appeared at the opening in the half-wall. His hair stood up in the air. He was in underpants and a T-shirt torn at the left armpit.
“Hello, darling,” Susan said.
Harry came over and kissed her sleepily. She slipped a finger into the tear to tickle him. He pulled away. “Not in front of the help,” he said. He studied me and then put a hand on my shoulder. “What’s wrong?” he said.
“Rafe had a session that worries him,” Susan said.
“Oh yeah?” Harry was a psychiatric social worker who worked with prisoners and their families, fighting a desperate battle against recidivism and the legacy of criminal behavior to their children. He tried to smooth down his hair. “I hope you really fucked up,” Harry said. “Sent the patient screaming to Bellevue.”
“Doesn’t sound serious at all,” Susan said. “In fact I think the patient likes him.”
Harry groaned. “Shit. I knew it. Want some coffee, Mr. Perfectionist?”
“Sure,” I said. The kitchen was open to the breakfast area so he could talk with us while measuring the coffee and filling a kettle.
“I saw him as me,” I said. “The pathetic me. The suicidal me.”
“Maybe,” Susan said. “Okay, so let’s go over it. You think he doesn’t want to move to the couch but he does it like a sullen little boy and you feel what?”
“I hated him.”
Harry laughed. Susan was skeptical. “Hated him?”
“It revolted me. There was something about the way he reacted, as if I were going to do something bad to him and he just resigned himself to it.”
“A perfect description of psychotherapy,” Harry said.
“Do something bad?” Susan asked wonderingly.
“I remember thinking at one point that he was worried I would hit him.”
“Possible abuse came up, didn’t it?” Susan asked. “About the father. When the mother made that—”
“That came from me. I said the law wouldn’t allow her to skip getting the father’s permission unless she was alleging abuse.”
“What?” Harry said. “Where did you get that gobbledy-gook?”
“The mother was trying to get Rafe to agree to keep the therapy secret from the boy’s father,” Susan explained.
“I needed to invoke the law or she would have kept after me forever.”
“We do require the parents’ permission,” Susan said. “That was appropriate.”
“A little hyperbolic,” Harry said.
“I can’t become part of whatever neurotic dynamic the mother has going with the father. And, besides, treating him in secret could easily become a legal issue,” I said. “You can’t treat minors without the knowledge of parents and I assume that means both parents.”
“Absolutely,” Harry said. “But it’s medical ethics. Why drag in the law?”
“You didn’t assert yourself,” Susan said.
Harry turned off the whistling kettle and shook his fist at me with mock outrage. “Be more phallic. You’re a goddamn M.D. You can sic the AMA on her.”
I covered my face. Despair, fatigue, disappointment in myself, the feeling that everything I had learned and worked for had been wasted overwhelmed me — and the knowledge that these reactions were excessive only made them worse.
“Rafe.” Susan said my name quietly, but it was a prompt. “Come on. Keep using your brain. Don’t indulge.”
These were key phrases from my therapy with her, Pavlovian in their effect. I uncovered, looked into her eyes and listed the reasons aloud. “I was angry at her, convinced I couldn’t stand up to her, so I grabbed for you first as a defense.”
“Help, Mommy,” Harry said.
“Shh,” Susan said.
“He’s right. Then I reached for the law—”
“Help, Daddy,” Harry said.
“And I was scared that if I was her only obstacle, she would talk me out of it and, typically irrational, I was scared if I stood my ground, she would use that as an excuse not to bring Gene in for therapy.”
“But that’s what you wanted, not to have him as a patient.”
“Me. I didn’t want to treat him. But I didn’t want to give her a way out of giving him treatment.”
“Sure is irrational,” Harry said. He put a cup of coffee in front of me. “She brought him in. She wanted him to be treated—”
Susan cut him off. “You didn’t believe her?”
“The school forced her to bring him in. No, I believe she wants her son to think of himself as sick. I don’t believe she wants him well.”
“Huh?” Harry said. “That’s quite a leap.”
“I know. I said I was out of control. Anyway, he needs treatment. I wasn’t confident that refusing to keep the therapy secret from his father was correct.”
“You were worried it was something you reached for to get out of being his doctor,” Susan said.
“Right,” I said. “So I wanted to leave the decision to you.”
“Bullshit,” Harry said mildly. “You were just being chicken.”
“No,” Susan said, equally mildly. “You let Felicia see you without telling her parents.”
I nodded.
“Felicia?” Harry asked.
Susan explained to Harry while he brought her a cup of coffee. “Felicia came in eight months ago. All by herself. She’s twelve. Her mother was a prostitute—”
“I remember,” Harry interrupted. “Your miracle cure. Twelve-year-old heroin addict turned into a ballerina. My wife, unfortunately, is right. You could have gotten into a shitload of trouble for seeing Felicia on the sly.”
“That’s the point. Why wasn’t I willing to take a very modest chance for Gene? It was a disgusting impulse.”
“No!” Susan slapped my hand, lightly, but it was still a slap. “Use your head. You were using it in the session. You’re not now.”
“I had a reason? A good reason?”
“Yes!”
I recalled the provocation: Carol lowered her voice, but not enough for Gene to be excluded…
“She was driving a wedge between Gene and his father,” I announced brightly, like an obnoxious A student in class. “The loss of the father-object is his central issue. I want the father to know his son is sick and I don’t want to strengthen the mother’s grip of guilt and shame about his need.”
Susan clapped. “And what’s more — you’re right. Don’t you think, Harry?”
“Yeah, yeah. He was right in theory, but in practice he was a chicken.”
“I was,” I admitted happily. “But it wasn’t just coming from my gook, I was still making a therapeutic choice.”
“You should have taken the responsibility yourself,” Harry said. “And not laid it on Susan or the fucking law.”
“You’re right. I had to be his father.”