“Neurosis is the inability to tolerate ambiguity.” ~Sigmund Freud
PROLOGUE — “The Bookend”
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Peering over her stylish brown Liz Claiborne frames, the doctor’s penetrating green eyes looked past the crying patient in front of her, who was currently going on ad nauseum about the same trauma she had already spoken of a thousand times before. [“And then the next thing I knew my father was gone…how could he just abandon me like that…my mother was broken.”] Her patient’s words had become like background noise to her, no different than the the ticking on the clock behind her, or the hum of the air conditioner that shot its icy cold breath from a vent in the hardwood floor near the window that overlooked the busy parking lot.
As the doctor looked past her patient, her eyes landed on a large bookend on the second lowest shelf of her mahogany bookcase. It was a bronze sculpture of a man pushing a boulder up a hill. According to Ancient Greek mythology there was a king named Sisyphus, who was punished by the gods for trying to cheat death; he was forced to push a boulder up a hill for all eternity. The punishment went on forever because every time Sisyphus would get near the top, the boulder would inevitably roll back down the hill. The story of Sisyphus is a lesson in futility, and the bespectacled, aloof, psychiatrist Dr. Linda Paper could really relate to such a story. To have to endlessly bear the burden of a heavy weight made a lot of sense to her. So she stared at her Sisyphus bookend while her patient kept praddling on and on. Occasionally, the doctor would interject a “And how did that make you feel?” which would keep the patient going. It is like winding a clock, she thought. Tick. Tick. Tick.
Another trick of the trade was to occasionally write in a leather bound notebook. Patients really “knew” you were listening to them then. Oftentimes the doctor was journaling her own feelings, recording what it felt like for her to have to listen to her patients’ never-ending problems. The fact of the matter was that it was hard for Dr. Paper to really hear her patients, because she had problems of her own with which to deal. She had her own tics, as it were.
“Okay, time’s up. Same time next week?” And just like that the patient’s tears would stop; they put away their tissues and Dr. Paper snapped her notebook shut. Click. Click. Pen down.
Every one of her patients walked away from their expensive sessions with the sense that their money was well spent. Dr. Paper was at the top of her field after all. Opposite her mahogany bookcase was the wall where her clock was hanging. Tick. Tick. It was flanked by an undergraduate diploma from Yale and a doctorate from Princeton. Below that was a picture of Sigmund Freud next to an award for the 2015 Psychoanalyst of the Year, which was slightly smaller than the plaque she received for the same award the previous year. The doctor would set herself against this backdrop, sitting in a leather-throne-of-a-chair in front of her large oak desk, which was topped with a layer of blue marble. “You know its real stone, because its cool to the touch,” she would tell anyone who would ask about it. She liked having nice things, but that didnt mean that they made her happy. Nothing really did. She carried the weight of a heavy burden, and it felt like it would never stop. Tick. Tick. Tick.
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PART I: SOUND — “Background Noise”
“Noise is the most impertinent of all forms of interruption. It is not only an interruption but also a disruption of thought.” ~ Arthur Schopenhauer
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RUFF! RUFF! RUFF! She could hear Charlie barking his little heart out as her mother pushed and pulled the vacuum over the carpet in the living room. Linda later discovered that the reason dogs always seem to act crazy around vacuums is the same reason that the sound of thunder upsets them so much. It is because many dogs suffer from canine noise aversion — it’s as if they can feel the rumbling sound reverberate through their body and as such it causes them to have a doggy panic attack.
Since a very early age, Linda showed a deep fascination for the scientific method, always trying out different experiments. She remembered learning in school of a scientist named Ivan Pavlov who did sound experiments on dogs. Every time Pavlov fed his dogs, he rang a bell, and over time the ringing sound became so connected with the act of eating that eventually all he would have to do was ring the bell, and the dogs would salivate whether food was present or not. Linda decided to try her own Pavlovian experiment on Charlie. What she did was every time she let the dog out in the yard to do his business, she would ring a bell when he came back in and give him a treat. This experiment worked so well that after a while, Linda would just ring the bell from the doorstep and Charlie would instantly come running back inside, treat or not. Needless to say, Linda won the science fair at school that year.
Nonetheless, Linda has never forgiven herself for doing that experiment on Charlie. She could not get that image out of her head. And even worse than the sight of it all, was the sound. So what happened was this, one day when Charlie was out in the yard, a guy on a bike went riding by, and seeing the energetic beagle in the yard, gave him a friendly ring of his bell. At this point, mistaking the bike’s bell for Linda’s bell, Charlie (somehow) got out of the fenced-in yard and darted into the road. Two sharp, piercing, squeal sounds followed shortly thereafter. The Ford Escape slammed on its brakes. The screeching was like a noise covered with shards of glass. And the squeal that followed was even worse, sharper.
If you are familiar with the high-pitched, heartbreaking noise that a dog makes when you accidentally step on its tail, then the noise that Charlie expelled as he went rolling under the sport utility vehicle is easy to imagine, in that, that is how it sounded, except with Charlie it was magnified 1,000 percent. It was a sound one could feel. This is how thunder must feel to a dog, Linda thought, as the vibration of Charlie’s last yelp reverberated menacingly through her body. It was as if she could feel hair stand up on her spine. This feeling never went away.
Phonophobia is when someone has a fear of loud noises; Linda suffered from phonophobia, and whenever she heard a bell (as well as many other sharp sounds), it triggered something terrible inside of her — a doggy panic attack, if you will. The only remedy she could seem to find to quell the pain and fear of all the sound around her, was to surround herself with background noise. The hum of the air conditioner, the ceaseless droning of her patients, the ticking on the wall behind her. Tick. Tick. Tick. RUFF! RUFF! RUFF!
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PART II: SMELL — “The Stench of Failure”
“Smells are the fallen angels of the senses.” ~ Helen Keller
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Dr. Paper lived alone in a large brownstone on the East Side of Providence, near the Brown University football field. She would often thank whatever deity she believes in that she was able to afford such a place. She lived alone — less by choice and more by circumstance. In her early forties, Linda was a very attractive woman — well-accomplished, and well-dressed. If she ever put herself out there so to speak, she would have any number of successful men knocking down her proverbial door. She knew that single life, however, was probably better suited to her situation, her condition. She was extremely particular about things, and she didn’t want to subject anyone else to her “quirks.” That was the nice word she used to describe her (at times, debiltiating) neuroses. She learned long ago that her “idiosynchrasies” — another fancy word that she would use to describe her deep-rooted psychological issues — were not easy for others to deal with. Before she even knew it, she would be arguing with family, friends, or roommates over what, to them, seemed like no big deal.
Just after she got out of grad school, Linda was low on funds and in denial about how deep her issues actually were. She decided to move into an apartment with an old college friend. Prior to their living together, Linda got along with Susan swimmingly — on campus, nights out on the town, going to shows — they were “besties” as happier, less intellectually gifted young women might say. Linda had only spoken with Susan once since the latter had moved out abruptly. Susan said she had met someone, but Linda knew that Susan just got sick and tired of dealing with her “bullshit.” Out of all the words that Linda used to describe her issues, this was the one that she felt most accurately described them; and Susan would have agreed.
Their big falling out happened one day in early September when Susan, who was a very considerate roommate by any normal estimation, decided to clean the apartment while Linda was at work. Susan thought it would be a nice surprise for Linda, because she knew how clean Linda liked things to be. It was Susan’s way of trying to smooth over their increasingly strained relationship. When Linda came home, however, she was mortified. You would have thought by her reaction that Susan had set all her things on fire and thrown them out on the lawn.
When her quirks, or idiosyncrasies, or bullshit took over, Linda didn’t even realize what she was doing or saying. It was as if she had blacked out and some demon inside of her took over. When Susan saw this demon, she realized that her friendship with Linda was beyond repair; her friend needed some serious help — help that she just couldn’t give her.
Why did Linda flip out over Susan cleaning? It was the smell of bleach. The smell not only closed up Linda’s throat, but it sent her back in time to the most tragic day of her life (even more tragic than the day Charlie died).
Linda returned home from school one day to find her mother face down on the aquamarine tile with blood and broken pieces of sink all around her. Linda’s throat closed up. It was the smell of bleach that was responsible. Linda’s mother was cleaning the bathroom with the stuff, and the fumes made her dizzy enough to pass out. When she fell over, she whacked her head against the corner of the sink, breaking both, the porcelain basin and half a dozen cranial bones in the process. What was more, after that day Linda’s mother was never the same again. She was still a functioning adult, but just barely. Her mind was somewhere else and her intellectual capacity was severely diminished. The doctors described it as “a chronic brain fog.”
Within about a year and a half of the accident, Linda’s father moved away. He never even offered to take Linda with him. Linda always felt guilty for understanding why her father left, because deep down she wished she could get away too. It felt like she was living in a nightmare. Her mother looked the same, but there was an emptiness in her eyes that was like torture to look at.
Osmophobia is the fear of certain smells. Linda’s whole world was destroyed because of the smell of bleach. Linda choked up just thinking about it.
She blacked out…
… and lashed out at Susan like her friend was supposed to know not to use the most common (and most effective) household cleaner on the market. The truth was, Susan did know not to use bleach; it was one of the first things that Linda made Susan agree to before moving in. That day Susan used it, however, Susan thought that it wasn’t that big of a deal, and that when Linda saw what an excellent job she did cleaning, she would forgive her minor transgression.
Needless to say, Linda didn’t.
“It kills ALL bacteria! What do you think it does to the human body! That shit is toxic! I told you not to use it, and you agreed! I cannot believe this! I’m going to have to stay at a hotel now! This is ridiculous!”
“It certainly is,” Susan said under her breath as she watched her best friend descend into insanity. Susan saw an emptiness in Linda’s eyes. It was torture to look at.
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PART III: HEALTH — “Ladies and Germs”
“A sad soul can kill quicker than a germ.” ~ John Steinbeck
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The first book on Linda’s shelf, just beside the Sisyphus bookend, was Shakespeare’s timeless play Macbeth. Among other things, it is a story of pure psychological madness. So much so in fact, that Linda had written her doctoral dissertation at Princeton about it.
“Through his character Lady Macbeth,” Linda wrote, “Shakespeare demonstrates how psychological torment can manifest itself through obsessive tendencies. In this case, it is Lady Macbeth’s guilt for the part she played in the murder of the king that reveals itself as an obsession with getting clean. In an acute state of madness, Lady Machbeth becomes overly fixated on washing her hands — she subconsciously thinks that if she can clean her external self, she will (somehow) be able to wash away the guilt that plagues her internally as well.”
Linda was well aware of how strange it seemed to others for her to hate bleach as much as she did, while at the same time being such a massive germaphobe. After all, if you want to kill germs there is no better tool at one’s disposal than bleach. Nevertheless, Linda felt that her seeming incongruities made logical sense. Both had to do with staying healthy. She felt — and could scientifically prove (if anyone would ever take the time to hear her out) — that staying away from both bleach and germs was good for one’s health.
“Just soap and hot water is all I need,” she would often say. Much like Lady Macbeth, Linda, too, thought that she could somehow control her internal madness via external means. She never counted, but if she did, she would have realized that she typically washed her hands approximately two dozen times a day.
This leads us to the next big blowout that Linda had. One day, in preparation for winter, the owner of the brownstone she lived in, called in a plumber to reinforce the pipes. This required having the water shut off for some time. He told her, “On Wednesday, the water will be shut off from 12:00pm to 4:00pm.” This all sounded terrible to Linda; it was terrible not only for those four hours, but also for all of the time leading up to it as well. She found out on Saturday night that the plumber was coming on Wednesday. So, what seemed like a four hour inconvenience, for Linda, was more like a four day inconvenience. Being without water for four hours in the middle of the day was so horrifying to Linda that she worried about it practically every moment leading up to it.
When the day finally arrived, her schedule had been flipped upside down, and she was forced to take the day off of work. The property owner was a nice guy and said that he would gladly meet the plumber so she could keep her appointments that day. Linda, however, was much too distrustful and controlling to leave these two men alone in her house without being there to keep an eye on them.
During the four hours of water stoppage, Linda did her best to occupy herself. She read a book, did a crossword puzzle, and watched some television. When she was anxious like this, she would oftentimes clean. However, at that moment, without water, that was impossible. It wasn’t so much that water was needed to clean things around the house, it was more that the water was needed for Linda to wash her hands intermittently throughout the entire cleaning process. After dusting, wash. After using a hydrogen peroxide cleaner on the sink and counter, wash. After scrubbing the floor with Swiffer wet wipes, wash. So, if Linda couldn’t wash her hands after doing these dirty activities, then cleaning was definitely not an option.
Oftentimes, Linda would eat while she watched television. That day, however, that was not an option either — despite the fact that she was very hungry and it was lunch time. Her germaphobia was its most profound in regards to eating. She never (absolutely never) would eat without washing her hands first. And that didn’t change even if she were eating with utensils. “My hands still touch the utensils don’t they?” She remembered defensively explaining to Susan one time when she gave her a hard time about her pre-dinner ritualistic ablutions.
“Out damned spot! Out I say! What will these hands ne’er be clean!” Lady Macbeth said in her fit of madness.
Linda could feel her madness coming up. It was 5:15pm and the water had still not been turned back on.
These hands will never be clean, she thought to herself with anger and fear.
She was starving. Again this wasn’t just hours of inconvenience for Linda. It was days.
And those four days were just a spot on the hands-of-time that represented Linda’s life as a whole. She just couldn’t clean the spot from her mind; she felt fearfully unclean her whole life.
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PART IV: TASTE — “No Accounting for Taste”
“If life were predictable it would cease to be life, and be without flavor.” ~ Elenor Roosevelt
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Linda finally sat down in front of her television to eat at 7:30 that evening. The plumber had finished about an hour earlier. And about a half hour before that Linda threw a tantrum that made the one she threw in front of Susan seem like a nap. What Linda didn’t realize was that while she was going off [“How can you leave me without water this long! This is completely unacceptable! What kind of half-assed plumber did you hire? You cheap bastard!] the owner of the brownstone was going through every possible avenue in his head of how to evict this lunatic woman from the premises. He had seen so-called “Karens” flip out over silly little things on internet videos, but this was something else entirely.
As Linda continued to lose it in front of them, he began to feel deeply sorry for her, and wished that she would seek help. The irony was that the only psychiatrist that he knew was her.
He did his best to calm Linda down, and then he pulled the plumber aside, offered him more money, and said, “Do whatever you have to do to finish this up ASAP.”
Linda overheard her landlord’s words. It calmed her momentarily. All she wanted was for them to finish. She felt like her tantrum had paid off. The squeaky wheel gets the grease, she rationalized.
She just wanted to return to her very structured life. She hated these types of variables. She needed to eat something. But before that could happen, she needed the hot water to be turned back on. She felt so unclean. Altering the experiment (i.e., her life) in any way proved to alter the results dramatically. In other words, when too many variables were added to her life, out came the fear and subsequent drama.
So as she finally sat down in front of the television with an aromatic dish of pasta in front of her, she realized that even though she was extremly hungry, and she was finally getting exactly what she wanted, the food was tasteless. She could barely get it down. This was all very confusing. Linda didn’t understand why things were seemingly “back to normal,” but she still felt off. It was the guilt, shame, and regret that she felt because of her tantrum that was causing her food to be tasteless and unfulfilling. All her issues had blinded her to the fact that how one treats others effects one’s psychosis even more than allowing things to become disorderly.
The orderly…
stepped back into her room, and asked her if she was done with her tray.
“Yes, this food has no taste. I can barely get it down.”
“Sorry, Linda, I can bring you some salt and pepper packets next time if you want.”
“That’s Doctor Paper to you, young man.”
“Yes, of course, Doctor. I am so sorry,” the orderly replied dutifully, playing along.
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PART V: ORGANIZATION — “Organized Crime”
“For every minute spent in organizing, an hour is earned.” ~ Benjamin Franklin
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“Are you listening to me?” Hey!”
When Linda would get home from work, the first thing she would do was turn on the television. It’s not that she watched a lot of tv or anything, it was more for peace of mind. She would put on a familar show, and let it play in the background. It felt as if Chandler, Joey, and Monica were actually there with her. She found the sound of people talking in the background very comforting. It made her not feel so alone, as if she actually had friends, as it were.
“Hey! Are you listening to me?”
She would often be doing things around the house — dishes, laundry, vacuuming — while the shows played one after the other. Her life was a steady stream of dialogue and fictional drama.
“Are you listening to me? Hey! Doctor!”
Linda looked up from her leather bound pad, startled. “And how did that make you feel?” she said instinctually, trying to save face.
“Were you even listening to me?” Her patient’s sorrow turned to anger very quickly.
As if snapping out of a fog, Linda began to look around. She stared down into her leather journal at the notes she was taking. She looked over to the window that overlooked the busy parking lot. She could hear the air conditioner humming from the vent in the floor. She saw the Yale and Princeton degrees on the wall. She began to look at them more closely. Who is Margaret McCaffrey? That was the name to which the degrees had been awarded. Am I Margaret McCaffrey? she thought to herself with a paralyzing mix of confusion and fear. She shut her leather bound pad and snapped it closed. Click. There was that name again, on the cover: Dr. Margaret McCaffrey.
Linda’s face looked to be on the verge of tears, at which point her “patient” said to her, “Are you okay, Linda? I mean, are you okay, Doctor?”
She wasn’t sure how to answer that.
With tears in her eyes, Linda said, “Why did he have to leave me with her? If he had just taken me with her I could have been who I was supposed to be. I could have been something really great. But instead I’m here in this wretched place!”
This had been the breakthrough moment that Dr. McCaffrey had been waiting for. When Linda was admitted to the hospital a few years back, Dr. McCaffrey recognized quite quickly that Linda was suffering from the distinct personality states often associated with dissociative identity disorder (DID). And after they spent some time discussing Linda’s severe childhood traumas, as well as her crippling obsessive tendencies, the doctor’s initial diagnosis was confirmed.
What Dr. McCaffrey believed, and espoused in her research to the great acclaim of her peers, was that Linda, who had already been severely traumatized by the tragic death of her dog (for which she blamed herself), was then irreversibly scarred by the accident involving her mother’s brain injury. Then follow all of this by the abandonment of her father, and ironically, the delusions were all Linda had to keep herself from going completely crazy (in a manner of speaking).
As a mental defense mechanism against the tragic world in which she had found herself, Linda’s mind had created an alternate reality consisting of a second persona — the Linda who had left with her father. That Linda was a successful psychiatrist who had figured out how to cure the world of their neuroses and mental handicaps. Over time, Dr. McCaffrey began to notice that many of her own accolades (degrees from Yale and Princeton, Freud Awards, etc.) began to color Linda’s picture of her other self. This helped to make it much more vivid, and thus more real, in Linda’s mind.
Dr. McCaffrey proposed a plan of treatment where everyone in the hospital was to treat Linda as the doctor that she thought she was, and in so doing, that confirmation and affirmation of Linda’s delusions would convince her that she wasn’t crazy after all.
At this moment of jarring lucidity, where Linda started to question everything around her, it appeared that the doctor’s plan was finally working. This approach seemed to have shaken loose the proverbial monkey wrench in the circuits of Linda’s brain.
“And how does that make you feel,” Linda said again out of instinct. She felt like a fraud. She was no psychiatrist. Her patients all knew it. Come to think of it, her patients weren’t patients at all — they were Dr. McCaffrey and her colleagues.
Many ticks on the clock passed. The orderly came back in, “It’s time to wash up before dinner, Doctor.”
“I’m no doctor, you can drop the facade, young man. What’s for dinner tonight?”
“Your choice of chicken breast or fish filet.”
“So its food I can eat with utensils?”
The orderly smiled and said, “You could eat them with your hands if you wanted. But, yes, most people eat them with utensils.”
“Okay,” Linda said, “I don’t need to wash my hands then.”
“Are you sure,” the orderly asked, tilting his head in confusion.
“Yes, I’m sure… And oh, can you give this to Dr. McCaffrey and tell her I’m finished with it.”
“Sure thing, Linda” the orderly said, happy to be of service. He then turned and left her room, looking down at the worn out copy of Shakespeare’s Macbeth in his hand.
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EPILOGUE — “The Bookend”
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Deep in thought, Linda sat back down on the end of her bed. It felt as if the world had stopped spinning for a moment.
Her leather bound journal with Dr. McCaffrey’s name on the front, caught the corner of her eye. She reached across her bed to the side table. She unsnapped the journal and opened it up to a random page in the middle.
It read: “I see my Sisyphus bookend lost in his never ending struggle. I wonder if, while he is pushing the boulder up the hill and getting closer to the top, that ancient epic king ever considers the progress he is making as a small sign of his success, even though in the end he always fails”
Linda remembered which patient she was seeing at the time she wrote this. It was a wealthy woman in stylish Liz Claiborne frames who lived in a nice brownstone in Providence; she was going on and on about some relationship-ending argument she had recently had with her best friend Susan.
On the other side of the hospital, Dr. McCaffrey slid the old copy of Macbeth back onto her shelf. She wore a very satisfied air about her as she did this. She rolled the Sisyphus bookend to the side, and into that vacancy Shakespeare’s tragedy went. And then the bookend was slid back over, closing the void.
Maggie was very proud of the strides she had made that day. The awareness shown by Linda was a sign of her progress. The doctor knew, however, that with someone as traumatized as Linda, her mental disorder was far from cured. Today was just a small step forward on a long road to understanding.
Linda was sitting on her bed, flipping vacantly through the pages in her journal, recalling how each patient she saw made her feel. (This was something that Dr. McCaffrey had told her to do). When things got too heavy for Linda to bear any longer, that is to say, when the boulder felt like it was about to roll back down the hill — tick tick tick — Linda would say, “Okay, time’s up.” It was then that her patience had left.
Flipping all the way to the last page in her journal, Linda found writing that seemed different from the rest. It was the most recent thing she had written. It read: It’s all about the small moments of lucidity, those tiny glimpses into true reality from the dreamworld we construct to protect our selves from harm. Or to put it another way, life is just a fiction we invent in order to hide from the truth we are too scared to see.
Sisyphus once again lost his grip on the boulder and down the hill it came crashing.
The orderly came rushing in at the sound of the noise.
“What was that?” He barely finished asking the question before he saw Linda’s dinner tray smashed on the floor — the fish filet and utensils spoke volumes.
“I can’t eat this! You know I need to wash my hands before I eat!” Linda barked. RUFF!
“But you said that you didn’t need to wash tonight because of the utensils,” the orderly explained, vainly attempting to remind Linda of a moment that her brain refused to recall.
“My hands touch the utensils don’t they! Why do I have to keep repeating myself.”
“Sorry, Linda.”
“That’s Doctor Paper to you, young man.”
“Sorry Doctor, I didn’t mean to make you mad.”
“Don’t worry, I was mad long before you got here.”
Ain’t that the truth? The orderly said under his breath as he cleaned up the mess.
With her hand on the Sisyphus bookend, the doctor understood the long road before her; now was not the time to get complacent. She thought of the heavy burden that Linda carried and reminded herself that Everyday in this place is an uphill battle.
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