Friday, June 26, 2009


I'm heading on the road again, and owing to a laptop on the blink, I may not have reliable access. The blog may be off the air for ten days or so. Happy Independence Day.

Wednesday, June 24, 2009

Are You Happy Now?

In a New York Times blog philosopher Simon Critchley reflects on happiness, as a lot of people seem to be doing these days (the popular rumination on happiness does not bode well for the current prevalence of actual happiness, it seems to me). He disputes the notion that happiness is fundamentally an individualistic phenomenon achieved during life, suggesting instead that the happiness of a life is ultimately decided by those--family and a few friends in most cases, perhaps a wider public in more rare instances--who outlive the life in question.

This is something of an old-fashioned notion, akin to the age-old ideal of literary immortality. These days self-worth is more apt to be (questionably) self-defined, or measured in terms of how many other lives one is touching now, via audience share, sales figures, or blog or Twitter followers. The idea that the final arbiters of one's life prevail after one's death is discomfiting for the obvious reason that in that case they are beyond one's direct influence.

Something about this is intuitively appealing, although it threatens to make meaning suspiciously democratic, and therefore conformist. I recall once reading about a remark of W. H. Auden to the effect that "My purpose in life is to help other people; what their purpose is I have no idea." If one's life has no inherent meaning, apart from its effect upon others, what good does it do to influence other lives, that in themselves have no inherent meaning? Is altruism or influence something like a chain letter, good only if its recipient passes it along? What if one goes to a great deal of trouble to assist someone who turns out to be a great egoist?

I thought of Critchley's musing in relation to a favorite of mine, Emily Dickinson. Whatever her personal idiosyncrasies that arguably approached major mental illness, most would argue that her life was wondrously "happy" in the broad sense inasmuch as she expressed great genius in her poetry that has enraptured generations of readers. And yet had her sister, who discovered the great majority of her poems in her trunk after she died, chosen to burn them rather than preserve them for history, Dickinson would be unknown, a 19th-century footnote who published a handful of gnomic poems before dying obscurely. Dickinson obviously died without knowing exactly what would happen to her work. Would her life be any less "happy," considered within its own subjective confines, had her work not been preserved? This seems the biographical counterpart of the old chestnut "If a tree falls in a forest, does it make a sound if no one is there to hear it?"

The answer, of course, is that obviously the tree's fall causes atmospheric compression waves that would be interpreted as sound if there were a hearer. The harder question is what constitutes the corresponding "waves" of "happiness" or "worth" that await an appreciative audience that may or may not stand in witness.

Monday, June 22, 2009

My Fifteen for Today

Several lit blogs (including one I usually read, A Commonplace Blog) have been tossing around a challenge to decide, within 15 minutes, one's 15 most significantly "mind-forming" books. I take this to mean any kind of book, and the point is not to name those that are "the best" in any absolute sense (whatever that would mean), but those that happen to have been the most influential for a given person.

Why 15 I wonder? I suppose it is more generous than the conventional 10 and less cumbersome than 20. Obviously the list I come up with today may be different from that of a year ago or a year from now. And again, I claim these not as the best of their genres, only as those that stuck with me most tenaciously and that have beckoned me back again and again.

How revealing is a list like this? Given all the books out there, it seems doubtful that a million examples of such lists would be identical. Armed with no knowledge of a person beyond this list, how much could be deduced? At any rate, here's my list for today, in no particular order:

Nathanael West, "Miss Lonelyhearts"
Freud, Civilization and its Discontents
Thoreau, Walden
Loren Eiseley, Essays
Anton Chekhov, Stories
Tolkien, The Lord of the Rings
Richard Dawkins, The Selfish Gene
Peter Kramer, Listening to Prozac
Harold Bloom, The Western Canon
Emily Dickinson, Poetry
Wallace Stevens, Poetry
Nietzsche, The Geneaology of Morals
Kafka, Stories
Dostoevsky, The Brothers Karamazov

Several of these make the list not because of any towering literary merit, but because they exposed me to crucial ideas at particular times. And it is a shame that this kind of list excludes several favorites altogether--Proust, Blake, Dickens, Eliot, Hardy, Tolstoy.

Anyone else out there care to share?

Sunday, June 21, 2009

Sunday School

We've been paying our respects to the Atlantic Ocean. There is something needful and reassuring about an entity that resists and curbs our destructiveness. Sure, we have been doing appalling things to the ocean for a long time now, but ultimately we can't destroy it without destroying ourselves. And along with the sky, it is the only vista routinely available that can take one back a billion years perhaps--the view is the same. I can't seem to locate the quote, but I remember coming across an observation by Lewis Thomas to the effect that, seen from space, the planet's true name ought to be, not Earth, but Ocean.

I don't even mind the shoreside kitsch like I used to, because it will always be overwhelmed by the sea's solemnity. We came from there, biology tells us--seawater runs in our arteries--yet it is a liquid desert to us now, not at all hospitable. There is a fascination with vast, deceptively simple things that are in reality infinitely complex--the ocean; deep space; death, perhaps. And unlike some other notions of plenitude, the ocean has the distinct advantage of indubitably existing. True, the water is implacable, caring nothing about us, but that can be a comfort. If an omnipotent being were to take a special interest in us, it may not be a good thing; there are worse fates than being ignored.

It's also the title of a wicked Led Zeppelin song, not to mention the subject of a sublime essay ("The Star Thrower") by Loren Eiseley.

This favorite Marianne Moore poem came to mind (with some formatting adjustments thanks to the annoying Blogger platform):

A Grave

Man looking into the sea,
taking the view from those who have as much right to it as you have to
it is human nature to stand in the middle of a thing,
but you cannot stand in the middle of this;
the sea has nothing to give but a well excavated grave.
The firs stand in a procession, each with an emerald turkey-foot at the
reserved as their contours, saying nothing;
repression, however, is not the most obvious characteristic of the sea;
the sea is a collector, quick to return a rapacious look.
There are others besides you who have worn that look--
whose expression is no longer a protest; the fish no longer investigate
for their bones have not lasted:
men lower nets, unconscious of the fact that they are desecrating a
and row quickly away--the blades of the oars
moving together like the feet of water-spiders as if there were no such
thing as death.
The wrinkles progress among themselves in a phalanx--beautiful under
networks of foam,
and fade breathlessly while the sea rustles in and out of the seaweed;
the birds swim through the air at top speed, emitting cat-calls as
the tortoise-shell scourges about the feet of the cliffs, in motion
beneath them;
and the ocean, under the pulsation of lighthouses and noise bell-
advances as usual, looking as if it were not that ocean in which dropped
things are bound to sink--
in which if they turn and twist, it is neither with volition nor

Thursday, June 18, 2009

The Bore

So [said the doctor]. Now vee may perhaps to begin. Yes?

Portnoy's Complaint

By way of Arts and Letters Daily, I enjoyed Mark Edmundson's reflections in The American Scholar on his great personal aversion to the bore, that dreaded figure who--oblivious to his hapless auditor--expatiates endlessly on his personal doings or philosophy of life. He memorably invokes the helpless frustration of having to listen to someone drone on for ten minutes about himself without even a polite inquiry in return.

Edmundson speculates about the psychology of the bore--about whether he is actually lonely and particularly needy for the adoration of others--without mentioning what should be obvious, that the bore and the narcissist, if not always the same creature, have a great deal in common. Describing the feeling one gets with the bore, he quotes Robert Greene: "There is no more infuriating feeling than having your individuality ignored, your own psychology unacknowleged. It makes you feel lifeless and resentful." That is exactly how one feels with a narcissist, who is by definition unable to fully acknowledge another's personhood.

Undergoing psychotherapy is such a peculiar experience because, among other things, it requires that one simulate being a bore, that is, to talk about oneself for fifty minutes without the inquiry of the other that non-bores take for granted in social exchange. Most people find this awkward at some level, and endure it only in the hope of eventual self-knowledge. However, some patients take to this so much like a fish to water that the therapist, feeling both talked at and ignored for an hour, may find the n-word come spontaneously to mind as diagnosis.

In his essay Edmundson wonders that while he is exquisitely sensitive to the bore in person, it may be puzzling that he himself is an indefatigable reader. For the book--and one may emphatically add, the blog--is the venue in which the writing bore is able to indulge his worst impulses. And yet in the deliciously available option of putting down the book in disgust, one is able to accomplish the otherwise impossible: to walk away from the bore in mid-sentence.

Inasmuch as I have long abhorred the prospect of the bore, I see in Edmundson a kindred spirit. I rarely attend lectures unless the subject is so interesting to me that it can hardly go wrong. Some professions, like academia and medicine, seem to attract more than their share of bores and narcissists. So over the years there have been a lot of talks to avoid.

Yet I am a passionate reader, because reading affords the ability to separate the wheat from the chaff, true authority from the pseudo-authority of the bore. Edmundson touches on the fact of our actual ambivalence with the bore, whether in person or in print--in his glib self-assurance, the bore evokes in us the hope that he may actually have access to a Truth that we crave. That is, the bore awakens an aspiration for the human prophet. Edmundson describes this experience wonderfully:

Perhaps my allergy to bores--along with an attraction to reading that can border on addiction (hell for me is being caught in a strange place with nothing to read)--is at the center of a paradox: we want to be told authoritatively, once and for all, what's what--and we want nothing of the kind. We love the character that therapists call the Subject Who Is Supposed to Know--he (and it almost always is a he) promises Truth. But we're sickened at the thought of taking our truth from another--it's belittling. And maybe we're dismayed, too, at the idea that the world, so rich in appearances, with its strangeness, beauty, horror, and the rest, should give way and open to one golden key. What a shrinking of the manifold! What a bringing down of the angels to dance minuets on the head of a pin.

In other words, as part of our normal, as opposed to pathological, narcissism, we feel a need to idealize an authoritative other, but an authority that also mirrors--and thereby accepts and validates--our own complicated imperfection. I remember reading somewhere in Harold Bloom's vast oeuvre that we do not read Shakespeare--he reads us. That is the experience one is always looking for in the next book: an experience of understanding in which one also feels understood.

The greatest reading experiences I have had have involved a kind of pleasurable paranoia--this writer, centuries before I was born perhaps, knew me. There is no escaping his or her gaze of recognition. But before the bore, I am invisible, as nothing.

The bore does not--cannot--understand his auditor or reader. That is why, as one grows older and time grows more precious, few things are more urgent than the need for real prophets--the wise--as opposed to the false prophets--the bores.

Wednesday, June 17, 2009

Henry Gets His

I found this to be a charming poem by William Heyen (already available online at The Atlantic here). Thoreau and DiMaggio: the names rhyme nicely with one another (and with Monroe, for that matter), but otherwise are the contrary extremes of American sensibility, perhaps of human experience. Which lived the better life? According to the tiresome contemporary preoccupation, which was more "happy?" Both and neither, I'm sure.


Henry Thoreau's last words: "Moose...Indian."
Joe DiMaggio's: "I'll finally get to see Marilyn."

Henry died never having gone to bed with a woman.
Joe enjoyed dozens, but in the end loved only one,

& believed that after he's signed his last ball or bat,
he'd find her waiting in Yankee Stadium in starlight.

Henry died younger, & wasn't sure about the out-there,
except it sounded transcendentally beautiful, whether

or not it was cognizant of him or was just a cowbell
thunking in the mind of the great Oversoul,

but if it at least proved amenable
to hounds, bay horses, turtledoves, what the hell.

Maybe Henry is in Joe's penthouse, Joe in Henry's cabin,
maybe Joe is writing books, Henry hugging Marilyn,

maybe Henry is hitting homers, & Joe is fishing Walden,
maybe Joe & Hank are pals, & Marilyn ecstatic with Emerson.

Monday, June 15, 2009

Bleak House

If you're interested in a different kind of beach reading, consider Alexander Waugh's The House of Wittgenstein: A Family at War (as thematic appetizer try Thomas Mann's "Death in Venice"). The book pithily traces the rise, ingenious apogee, and brilliant flameout of a clan that was simply different from you and me, and not just because they were rich beyond the dreams of avarice.

Offspring of the fabulously successful industrialist Karl Wittgenstein (1847-1913) and his clever, musical, but deeply neurotic wife Leopoldine (1850-1926), the eight Wittgenstein siblings who survived infancy included five boys and three girls. The book's subtitle might refer to war on three fronts: a general psychological war against the conditions of life (in which the Wittgensteins had a high casualty rate), longstanding strife among one another, and the chaos sown in the family by both World Wars, and particularly the efforts of the Nazi to appropriate the Wittgensteins' wealth. The latter machinations almost make one feel sorry for the exceedingly rich: there is so very much to lose, and so much toil needed to avoid doing so!

Of the five Wittgenstein sons, three apparently committed suicide (one by ingesting potassium cyanide in a restaurant, one by shooting himself in the course of military service in the last year of World War I, and the third by unknown means after his suspicious disappearance). Of the two remaining, Paul, the elder, became a successful left-handed concert pianist after his right arm was amputated in World War I, while Ludwig became the pre-eminent philosopher of the 20th century.

Carlin Romano in The Chronicle Review faults Waugh for slighting Ludwig's prominence in favor of attention to Paul's long and complicated career and personal life, but it seemed to me that Waugh, well aware that countless thousands of words have already been written on Ludwig, was determined to give a general account of the family that may also, secondarily, offer a different perspective on its most illustrious member. As the older brother and the one who attempted to manage the Wittgenstein millions amid the pandemonium engulfing central Europe, Paul was the family's more public representative.

Without indulging in any diagnostic speculation, I would just say that the Wittgensteins in general seem to have featured varying degrees of brilliance, extraordinary persistence, a sometimes astonishing lack of agreeability, and high neuroticism. They were both charismatic and objectionable to a prodigious degree. Waugh has this to say of Paul:

Paul was aware of his inability to get on easily with other people and it forced him, despite his charm, erudition and energy for life, to seek a solitary existence. He would never stay in other people's houses but insisted on booking himself and his valet, Franz Kalchschmidt, into a nearby hotel, having a piano brought in, and seeing his friends only when it suited him. When traveling by train, even with his family, he would insist on booking a private carriage for himself. One of his pupils, conductor Steve Portman, remembers Paul having "a shell around him, like a suit of armour that did not permit him to interact with other people--nobody would challenge him for he had an authority that very few people possess." Portman came from a poor and troubled New York background. His lessons with Paul were free. One Christmas he was given an expensive tie. "Oh I've never had anything like this!" Portman exclaimed. "I don't give rubbish!" Paul replied. "My memories of Paul Wittgenstein are absolutely positive," Portman recalls. "He could not have been more forthcoming or helpful."

Of Ludwig, who battled anguished self-doubt and depression for much of his life, and famously gave away his family fortune in favor of voluntary poverty, Waugh writes:

These were bad years for Ludwig. More than ever he was plagued by demons, unsettled by violent memories of war and grieving over the death of his closest friend. "Every day I think of Pinsent. He took half my life with him. The devil will take the other half." This bleak mental state can be observed through a series of confiding letters that he sent to an intellectual army friend, Paul Engelmann. "I have continually thought of taking my own life, and the idea still haunts me sometimes. I have sunk to the lowest point" and "I am in a state of mind that is terrible to me." He hoped and believed that teaching might save him from all of this, for he needed to be working every day "or else all the devils in hell will break loose inside me." As usual, he was consumed with self-loathing and described himself to Engelmann as "morally dead," "base," "stupied and rotten," and despite Tolstoy's injunction, he could not prevent himself from detesting most of the people around him. The Trattenbachers were "obnoxious, good-for-nothing and irresponsible," the Otterthalers "inhuman beings" and the people of Hassbach "repulsive grubs."

Yet this was the same man whose magnetic personality and massive intellect fascinated countless colleagues and students and whose last coherent words were "Tell them I've had a wonderful life!" Waugh's family chronicle is a fascinating collective psychological study, and a testament to paradoxical, inconsistent human nature.

Saturday, June 13, 2009

Psychiatry in a Slump

A brief commentary by Henry A. Nasrallah, M.D. in the, with all due respect, throwaway journal Current Psychiatry strikes a chord. Entitled "Is Psychiatry in a Recession?", the piece examines the field's setbacks, with respect both to publicity and to substance, in recent years.

Psychiatry may have suffered more than other disciplines from the medical and cultural backlash against the marketing tactics, the profitability, and the faulty products of pharmaceutical companies. The uniquely malleable nature of psychiatric diagnosis has invited therapeutic creep (or perhaps therapeutic rush is more like it), whereby antidepressants and antipsychotics are used for an increasingly broad array of mental ailments. And psychiatrists, perhaps owing to their perennially modest stature and income among medical specialists, have arguably shown an unseemly eagernesss to ally themselves with drug companies.

We constantly hear about breathtaking advances in neuroscience, but as yet none of these have led to major consensus, either philosophically or scientifically, with respect to the nature and boundaries of mental disorders. So as the field looks forward to (perhaps braces for would be more apt) the DSM-V within a few years, there seems to be no more agreement than ever about such fundamental entities as ADHD or bipolar disorder. For those invested in psychiatry becoming a twin of neurology, this is bad news; for those drawn to psychiatry precisely because of its ambiguous and eclectic nature, this may be strangely reassuring.

As Nasrallah mentions in general terms, on a practical level psychiatry has met with disappointment over the past decade. The SSRI's, once seen as the vanguard of future generations of increasingly effective and well-tolerated antidepressants, have stalled out, plagued by concerns over sexual and suicidal side effects (yes, an odd pairing) and limited efficacy. Atypical antipsychotics, while arguably better tolerated in a subjective sense than older drugs, have their own major problems of expense and metabolic side effects. Once seemingly cutting edge treatments such as vagus nerve stimulation and transcranial magnetic stimulation, while still potentially helpful for individual patients, have not transformed the treatment of depression as once hoped. It speaks volumes that the single most effective treatment for acute depression remains electroconvulsive therapy, which is 70 years old.

This concern over morale in psychiatry speaks to the unique cultural valence of the field. It's hard to imagine nephrologists, for instance, fretting over the status of their discipline (kidney failure is kidney failure, period). The best antidote for abstract debates is to remain focused on patients, to realize that beneath academic considerations of the socially constructed nature of social anxiety or whatever, there really is a vast pool of suffering and psychopathology out there. Like the ocean, it is exhaustively documented, yet arguably our ignorance of it still dwarfs our knowledge. It may seem like I refer to it as a good thing; it's not--if it ever dried up, I could finally justify going back to graduate school.

Wednesday, June 10, 2009

Non-physician, Heal Thyself

I'm not sure that a word exists for the practice of obtaining prescription medications from friends, acquaintances, or (for whatever price the market will bear) from vending strangers. "Med-seeking" we designate the practice of sending health care providers to an early grave with endless and inappropriate pleas for pharmacological relief. "Self-medication" is the hypothesized use of alcohol, most classically, but also illicit drugs in an effort to treat some supposed mental disorder. "Substance abuse" is, well, substance abuse.

But the word I'm looking for involves co-opting the tools of doctors without having to resort to the doctors themselves in the same way that an autodidact bypasses educators or a vigilante bypasses law enforcement. It is surprisingly common for folks, lacking access to a doctor for reasons of money or transportation, to obtain meds from whatever source they can find. To be sure, these are often opioids or benzodiazepines, but by no means always. I saw a woman recently with bipolar disorder who had been obtaining Seroquel samples from her sister, who is a nurse. And if someone is going to run out of Effexor a week before he can get in with a doctor, who could blame him for scrounging up seven doses wherever he can? After all, it's not as if the medical system is flexible and easy to work with.

If someone has been prescribed Xanax for anxiety symptoms with positive results in the past, and finds himself between doctors for whatever logistical reasons, is it wrong for him to obtain Xanax in unconventional ways if he never exceeds a typically prescribed dose? The Drug Enforcement Agency would say yes, presumably, and certainly this isn't a practice one should condone, but does it constitute substance abuse? I don't think so, if he has a legitimate anxiety disorder and no substance abuse history. In this case it would be no different from someone using a friend's unused antibiotics for a (self-diagnosed) sinus infection. And consider that, because doctors are often understandably hypervigilant and restrictive as regards controlled substances, it may be hard even for patients who quite appropriately need and use them to gain access.

To be sure, medicine has a procedure for enabling this practice in cases where it's considered safe: it's called making a drug available over the counter. And doctors have a way of frowning on any circumvention of their alleged wisdom. Indeed, patients who engage in this practice (for which I can't think of a name) may simply have below average respect for authority in general (but perhaps above average resourcefulness). This practice has family resemblances both with people who decide on a medication for themselves based on television commercials and with physicians who liberally prescribe themselves medications (not recommended). All of these undertakings stem from the natural assumption that if you want something done right, you'd better do it yourself. "Self-doctoring" may be the term, but I wish there were something more felicitous...

Tuesday, June 9, 2009


I haven't communed with Emily here for a while, yet this is her time of year. After all, themes of death and endless self-consciousness weren't the whole story, even for her.


My Garden -- like the Beach --
Denotes there be -- a Sea --
That's Summer --
Such as These -- the Pearls
She fetches -- such as Me


Partake as doth the Bee,
The Rose is an Estate --
In Sicily.


There is a Zone whose even Years
No Solstice interrupt --
Whose Sun constructs perpetual Noon
Whose perfect Seasons wait --

Whose Summer set in Summer, till
The Centuries of June
And Centuries of August cease
And Consciousness -- is Noon.


Between the form of Life and Life
The difference is as big
As Liquor at the Lip between
And Liquor in the Jug
The latter -- excellent to keep --
But for ecstatic need
The corkless is superior --
I know for I have tried

Sunday, June 7, 2009

That Teenage Feeling

And nothing comforts me the same
As my brave friend who says,
"I don't care if forever never comes
'Cause I'm holding out for that teenage feeling"

Neko Case

"O Edward, Edward, wherefore art thou a vampire?" So seventeen-year-old Bella, already an old maid next to fourteen-year-old Juliet, should have exclaimed in Stephanie Meyer's Twilight. I am usually pretty insensitive to literary fads (I have yet to encounter Harry Potter on page or screen, and no Da Vinci Code graces my shelves), but this time a friend of mine had recommended it to me, which I am sensitive to, and then my daughter asked to read it. As she is, alas, not usually a bibliophile, but is approaching that most peculiar phenomenon of female adolescence, I thought it worth looking into. And whatever its literary merits, any book that sells over 50 million copies is of anthropological interest if nothing else. I have not had the pleasure of the sequels or the movie.

I do have the consolation of at least one other adult heterosexual male who has at least willingly made his way through the book, as Brad Meltzer acknowledges in his "Guilty Pleasures" entry at NPR. And Caitlin Flanagan took Twilight both quite seriously and favorably in her review in The Atlantic Monthly. Flanagan unsurprisingly views the latent menace of Edward's vampirism as symbolic of the sexuality that threatens to overwhelm adolescent affection. This may be (vampires have had strong sexual overtones at least since Bram Stoker), but I don't know that it accounts for the book's popularity any more than the carnal undercurrents of "Little Red Riding Hood" account for that fairy tale's enduring interest. There is a risk, in literary criticism as in psychology, of explaining phenomena by appeal to other, supposedly more fundamental factors. But sometimes what you see is what you get.

What I see in Twilight is a contemporary fairy tale, combining a well-paced plot, the clever use of a mythological entity, and an intense love story. Bella is something of a young Everywoman, the girl next door: sensible, down-to-earth, self-doubting but capable, awkward but winning (a nerd's perfect date, in other words). Her appeal is left deliberately ambiguous--in Phoenix, where she grew up, she was apparently something of an outsider, and yet when she moves to the small town of Forks, she is embraced by male and female peers alike. So she manages to be in the group and yet not of the group, which is every teenager's (perhaps every adult's) fantasy.

One does not look to Twilight for stylistic artistry; even in a book apparently intended for the young adult market, its prose seems almost willfully flat. Even the editing leaves something to be desired, as shown by this sample that, believe it or not, my eyes landed on the first time I re-opened it at random to look for a representative passage:

I ate breakfast cheerily, watching the dust moats (sic) stirring in the sunlight that streamed in the back window...By dint of much elbow grease, I was able to get both windows in the truck almost completely rolled down.

Enough said (as a rejection letter of an adolescent story of mine read, "Read The Elements of Style, over and over." Eventually, I did). But the heart of the story for me is the extraordinarily close tie between Bella and Edward, which conveys fairly convincingly the experience of erotic love: the blind adoration of the other, who for a time seems to have no faults; the feeling of an arbitrary yet unique bond; the sheer pleasure of the other's company; the agonizing insecurity should the attachment seem threatened. It is the ecstasy of first love, the echoes of which we can only hope to faintly recapture later in life; it may be inane and stupid, but if so, intelligence may be overrated.

If Twilight's audience is predominantly female, it may be less because it is chick-lit than because the figure of Edward is nauseatingly familiar to some male readers, thanks to the rather different experience of male adolescence. Ironically given Edward's famous actual restraint with Bella, to the male gaze he is the ultimate player: he has the perfect looks, the preternatural power, the money, the smarts, the smug superiority, the ineffable cool. He even drives slick cars (fast) and has a great sound system in his room. He is a brief for evolutionary psychological accounts of female attraction: he is the alpha male.

What I would like to ask perfect Edward is why, as a 105-year-old vampire, he is angling for a 17-year-old girl (okay, I know the answer: evolutionary psychology). And yet the ambiguity of Bella's attraction for him may make the story particularly powerful for female readers, for every girl or woman who reads the book can see herself as Bella. After all, while Bella's character is appealing enough, she exhibits neither spectacular wit nor stupendous beauty so far as we know, and her background is ordinary enough. Edward himself is puzzled by her pull (which seems related to his inability to read her mind as he does most humans'). The encounter with the virtuous vampire is much like the quasi-supernatural experience of love, the thunderclap on a calm day that comes unbidden and unexplained.

Thursday, June 4, 2009

Straight Shooter

Some clinical anecdotes are irresistible.

A 55-year-old gentleman with a vague history of schizophrenia was brought in by a community support worker for a new evaluation, apparently at the behest of a family member, although there was no report of specific symptoms or dangerous behavior. But he had recently moved back to the area, so maybe the family just assumed he ought to get an evaluation for regular treatment.

He presented as somewhat disheveled, with a glazed look in his eyes; he was calm and pleasant enough, albeit quite flat and concrete, answering questions minimally. He couldn't or wouldn't say much about his psychiatric history other than to acknowledge the diagnosis of schizophrenia, multiple previous hospitalizations, and the experience of monthly injections at some point in the past. "What brought you back here from Texas?" "Greyhound bus." For a fleeting moment I thought he was wryly joking (for which his manner otherwise certainly would not have prepared me), but no such luck. So I settled myself uncomfortably into the plane of the literal for the duration.

When I asked him how much alcohol he drank, though (I long ago stopped asking people whether they drink, and now go straight to how much), he answered, "As much as I can." For a second again I wondered about some sly humor on his part, but he was deadpan. Yet his response had the kind of upbeat, slightly dutiful tone one might use to answer a question like "Do you get regular exercise?" But he wouldn't quantify.

So I moved on to marijuana (for which I have also recently moved directly to asking how much)--the complacent yet somewhat eager reply was, "As often as I can get it." "How often is that?" He just shrugged. On to cocaine, for which I still ask whether rather than how much. "Crack," he assented, nodding with an attitude somewhere between satisfaction and gusto. "Do you think any of those drugs could be a problem?" Incomprehension. "Has anyone told you these substances could be bad for you?" "No, nobody ever told me that!" he countered, baffled yet dismissive.

The interview unwound from there. As we returned to his diagnosis, I learned that he had actually "gotten over" his schizophrenia. "Would you consider taking medication again?" "No." (There was more to it, but this was the gist).

In a world of duplicity and innuendo, particularly surrounding substance use and treatment compliance, this was actually refreshing. There was no need to dance around the facts, as it was abundantly clear that he had no use for me, and our relationship at this point could blissfully and neatly come to an end. No hard feelings.

The community support worker, driving him home with a couple of other patients from the same area, stopped at a store to pick up something. The fellow went in and emerged with a beer; upon being told that he couldn't bring the beer in the car, he proceeded to chug it in the parking lot.

One more thing: he does receive Social Security disability payments monthly. Tax dollars hard at work.