The panic kit
[ fiction - november 03 ]
He was tall and handsome in addition to being a sharp dresser. He wore a blue cashmere blazer, pink shirt, rep tie, and highly polished penny loafers. Herbert was also energetic. He made a point of this by mentioning to me that the had walked three miles from Greenwich Village, where he lived, to my office on upper Park Avenue. This was our first meeting.
I liked the way he looked. I always wanted to be tall and handsome. Instead, I am medium height, a wee bit out of shape and late 50-something, like Herbert. I also wear loud colored shirts, like purple and orange, and contrasting ties. I am a very successful psychiatrist but my outfits are outrageous.
I knew that the new patient was comfortable with my looks. It was actually a source of esteem to him that he looked fifteen years younger than I. Therefore, even though he needed my help, he did not feel subordinate. In our society, we place a great deal of importance on looks. This is why I make it a point to keep my modest demeanor, resisting the proddings of my doctor and family to exercise. I want my patients to be comfortable with my looks. Herbert was. We talked easily from the start.
"About three week ago I fell into a funk. I probably had a small nervous breakdown. It came on when I was on Block Island. I had borrowed a friend's beach house for the week. Instead of bicycling and swimming, my usual recreation, I slept 18 hours a day. I developed a very bad cold, which is still not gone, and my body felt pained. I looked limp. My head hung down. I was desperate and could not function.
"Once back in town, I functioned better but had very little interest in life. In fact, I wanted to kill myself - and - for good reason."
"In today's economic environment," he pronounced like an economic reporter, "it may be too expensive for me to stay alive."
"I'm in a better frame of mind now. I want you to help me decide if suicide is appropriate for me. I've had a great life. I don't have to be the last guest to leave the party."
"You don't realize it, but you are still very depressed" I told him. I've been doing this for 30 years. Your facial muscles are tight, a sure sign, and you're manic-depressive. First you need medication to bolster your spirits. In about six weeks you should have therapy. What kind of work do you do?"
"I'm a writer."
Herbert continued, "I write silly poems and am also writing a coffee-table book about bankrupts in America. It's not a cheerless subject. Some of the best people are bankrupts. Thomas Jefferson, Debbie Reynolds. Over a million and a half people will file this year. So an individual who is broke is not alone in the world.
I tactfully asked, "Do you earn money from writing?"
"Not yet. In fact I have no money. I used to make my living in real estate. I sold office buildings. I was rich. Had a nice apartment on Fifth Avenue in the low eighties, Mercedes, Southampton and all of that. When the stick market went bad, everything, including my luck, turned sour. I lost the apartment and everything else. That's when I started writing about other unfortunates. Did you ever read Madame Bovary, a sublime fictional bankrupt?"
He continued enthusiastically.
"I have a special take on the suffering of the rich. So now that I write, doing business is distasteful. I can't be successful at it anymore. I'm virtually broke and it's hard to write without money. I'm trying."
A delicate moment had arrived. Here was someone in distress at my feet. I liked him. I could help him. He had no money.
"So, how can you afford psychotherapy? Something tells me you don't have insurance."
"True! It will be hard to come to you regularly without it. Yes, I have no health insurance." His wit had vanished.
After a moment's silence, I said, "Don't worry, I giving you these pills. It's important that you cooperate and take them as directed."
Then I handed Herbert a cardboard with 21 pills encapsulated on it and told Herbert to take one a day as directed. After a few weeks of this protocol Herbert would be lifted out of the crisis. As Herbert later wrote:
To take care of my snit
I was given
"for the treatment of Panic Disorder "
This story is about the 21 days when
Dinner was ready when he got home. Christopher, a composer, had been lover his for 16 years. He usually did not cook because Herbert ruled the kitchen. Tonight he wanted to surprise Herbert. Much to Christopher's surprise, Herbert was delighted. Since Herbert's breakdown, he had given special attentions to Herbert - nice small things, like holding his hand all night while they slept, a smile in the morning, and a little bit of cooking. He even composed some piano tunes for him. Tonight, he pulled out a bottle of Herbert's favorite red Bordeaux, Cheval Blanc, which they had been saving for a special event; this wine always turned the evening into a special occasion for both of them.
As he approached the wine, Herbert, as he told me later, heard my voice. Only one glass of wine a night and get started immediately.
Herbert, however, was not one to follow orders. He never followed recipes or read directions on medication labels. So, it was in character that he would postpone starting the medication in favor of the wine.
The meal was great - broiled halibut, mashed potatoes, spinach, salad a lemon tart and Cheval Blanc. After dinner, Herbert called Sonia, one of my patients, to thank her for recommending me and in doing so indiscreetly told her of the business arrangements he had made with me. In spite of his hatred towards business these days, he managed to bargain with me. We agreed that Herbert would write me about his progress with the Zoloft, I would write back when appropriate and when finances permitted, he would have a paid office visit. As I came to realize later on, even when Herbert was flush with money, he always negotiated. It made sense to him. He liked it. Sonia greeted the news with enthusiasm. Perhaps she reckoned she could also work her own special deal. No good deed goes unpunished, as they say.
Then he compared notes.
"By the way, Sonia, you've taken Zoloft... I drank tonight, should I start the medication tomorrow or wait a day before taking my first pill?" queried Herbert. Sonia liked to play doctor.
"If everyone who took these drugs stopped drinking, the booze industry would be dead," Sonia assured him. "Start tomorrow morning. Then drink as you feel like it." Herbert took his first pill from the Panic Kit the very next morning. He did not suffer nausea as he had been warned. He had, instead, a very dry mouth and fatigue. At midday he had to sleep.
Now he was depressed. There was a fuzzy aura surrounding him. This annoyed him because he needed to work - not nap. So he wrote a poem, which he sent to me:
The wealthiest trader
Could he want more?
This need to nap suggested to Herbert that he suffered from depression and laziness. Only the rich, backward, sick and old can afford to sleep during the day. Nevertheless, he had a deep snooze and loved it. Later he tried to do some real estate work. This was the only career he had. It was the only way he knew to earn money. Could a book ever do it for him? In the end, I knew that the work on the book would stress him out as much as Real Estate? He needed a change, so, I never told him.
The night of Day One on the pill Herbert had another great dinner with Chris, which Herbert cooked himself, Chilean sea bass, root vegetables, green beans and strawberry shortcake. By inclination, he drank only one glass of wine.
Upon awakening, he thought that he had not slept. Christopher assured him that he had and wanted to know if he should make tapes of Herbert's snoring to prove this. He decided to write a letter to me as promised.
Day Two - Letter One
I remember that you asked me some questions, which I answered as honestly as I could. Today, only a few days later, I have very different responses to the same questions.
For example, " History of depression in your family?" I had told you "No." Now, I think maybe. Perhaps my father was depressed. He napped every day. So did his father. I remembered that as a child and into my late teens, People would see me on the street and ask, "Why do you look so unhappy? What's wrong?" A similar cloud occasionally comes over my 12-year-old nephew's face. I was a happy child. I enjoyed brooding. Russian novels and 19th century music were my best friends. I think that melancholia has a special beauty. I crave it. Will these inclinations become dangerously tragic with age? Of course, if I am not alive, these questions are, of course, academic.
Day Three - Letter Two
As you know, I am going to be 60 years old next month. I have no money - no provision for the future. My life has always had up and down financial cycles. Having made a lot of money when I was young, I presumed that everything would be OK when I was older. It's not. So why not kill myself before the sheriff catches up with me?
Let's ponder this some time if I can afford to visit you.
Day Five - Letter Three
Dear Doctor Himmilfarb,
I'll have to give you a call because I have a question about sex. I'm trying to remain cheerful. Perhaps I'll make a peach and plum tart. It goes well with organic whipped cream. Tonight's menu is simple. Now, your shape indicates that you are truly interested in food so that I think you will appreciate hearing some of our menus. Tonight's is cold bean salad on lemon rice, chocolate mousse and white wine. Will I stick to one glass? Probably, the medication might try to dictate. I hate the fact that a small pill is running my life like a computer chip. I am now very tired. I was much more normal when we first met.
Chris is still super kind. There is always that extra hug, smile and an attempt at optimism. This actually goes against the grain of his dark Irish pessimism. He loves me.
PS: I have not gotten nauseous yet. Should I?
Day Six - Letter Four
I have a strange kind of sleep. When I sleep, I feel that I am awake. Chris and I made love in this morning. I have never lost the urge for sex. I will call you later today and write more tomorrow. I feel free to do nothing.
Herbert was walking around the apartment in his boxer shorts and no shirt when he decided to call me about the sex question. When he went to pick up the phone he saw his reflection in the mirror and felt suddenly shy. He put on his blue jeans and a yellow sweater before calling.
"Will the medication ultimately interfere with my love life? People say that it does."
"It's a mixed blessing", I responded. "Some people thank me. It takes longer to reach orgasm and you don't cum as much. It is great for premature ejaculators." I like to be plain talking so that the patient understands.
"Are you sure that Zoloft is for depression? I am not a premature ejaculator. I was never one of those. I always want my partner to have a good time. You can ask anyone I've slept with."
"As a matter of fact, it is prescribed for premature ejaculation. Your dose, however, is light and the effects should therefore be slight, if at all. You'll adjust. Let me know if you have any problems. Don't be shy."
Day Nine - Letter Five
Thanks for the phone talk.
I have to confess that I was never very self-disciplined so it does not surprise me that I have skipped some days and I am now writing to you on Day 9 talking perhaps about Day 6 or 7 - not the day-to-day routine as I had planned. I am also writing a short story about these 21 days on the Panic Kit. I wrote a poem about missing days:
the lazy way
he'll play today
Do two tomorrow
better he work after play.
Missed two more days
never again to
MISS A DAY.
Thanks again for everything,
Day Eleven - Letter Six
Dear Doctor Himmilfarb,
Missing days: I think a lot about opportunities missed. I have a patter. I make a big deal, spend the money, give it away, loaf, have long lunches, wonderful lunches, go to museums, have lots of sex (sometimes in the museums) and run out of money. Then make a huge deal again, earn enough money to keep me going for three to five years and start all over again. This is when the stress sets in. It forces me to work. Unfortunately, my temperament is not to grind out big deal after big deal as less sensitive people do.
Our friends are all retired or semi-retired. Chris and I don't like money - that's why we haven't saved any. As a composer, Chris is expected to be poor. As a real estate person, I am presumed to be rich. As a couple, the world views us as very comfortable.
It is rough, but there is an upside. We live well. We eat like kings and go to great parties. There lingers a semblance of past prosperity. Friends have not forgotten us. We are invited to theater productions, musical events, and special art openings with dinner included. We do not know, however, from day to day where we will get next month's rent for our cozy and elegant rent-stabilized apartment in the Village. Nevertheless, we enjoy ourselves in spite of these circumstances, except when we get nervous.
Day Twelve - Letter Seven
Dear Dr Himmilfarb,
The Zoloft is rendering me calm. I neglect work and I don't care. I definitely have difficulty functioning in the world as it is. It is apparent to me that the world will not change, I must. The fastest track to becoming normal is, of course, medication. I hate it. It gives me diarrhea by the way.
Thanks a lot,
By the third week, Herbert began to feel better. Zoloft is not a quick fix like Valium or Xanax. It takes days to feel the benefits. He now becomes cockier the way everyone does when things get better. He buys Chris a present every day - using his credit card.
Day Fourteen - Letter Eight
People think that bankruptcy, the subject of my book, is depressing. I am writing about extraordinarily generous spendthrifts (not anal- retentives). My characters are the likes of Eli Whitney, Thomas Jefferson, Abe Lincoln, Pamela Harrington and many more. Over one and a half million people declared personal bankruptcy last year in the US, during our greatest period of prosperity. It's a great subject and the laws surrounding it today represent an element of forgiveness, which is absolutely necessary in this tough world. We all need fresh starts at one time or another.
Now sometimes when I look in the mirror I see a young face. I imagine that I am young. I occasionally pass for 20 years younger than I am. I feel like a fraud. Funny, Chris, who is very good-looking, doesn't care how old, young or fabulous I look. On the other hand, I thank God every day that in spite of the huge amounts of food we eat and wine we drink, we are not fat. My family has always hated fat people.
This is my potpourri of thoughts for you today.
Day Fifteen - Letter Ten
The Zoloft has made me resilient. Every day I tackle many chores I could not normally confront.
How am I today? Finally the nausea has arrived. It does not have any beneficial side effects like curbing my appetite. I am still always hungry. A complete sleep has returned at night. I am livelier. I do small amounts of work on my book.
It's Sunday and a sunny afternoon on the 17th day. While Chris went to the Whitney Museum, Herbert went to Washington Square Park for sunshine and a suntan. There are people on the grass, sunning themselves: college students - he admires their youth; older people, he fears them and is afraid to become one of them; and there is, of course, the homeless. A very thin line separates him from them. He cries and goes home.
Day Seventeen - Letter Twelve
Dear Dr Himmilfarb,
You may be happy to know that I have started to socialize again. I didn't tell you. A few days ago I went to a swanky benefit for the neighborhood art school with Chris and my old friend Emily, an art historian. Emily has just returned from India bringing the traditional amoeba back with her. She always looks beautiful and healthful in that special American way. We took some private time in the courtyard during cocktail hour. I told her what has been happening to me. She in turn told me that nervous breakdowns are not reserved for the financially anxious. Her neighbor Clark ------, one of America's richest names, had a nervous breakdown while she was away. She gave me some of her wine, an excellent Medoc, a special treat. She herself confessed that she is tired of living on the edge. Throughout her life, she has contemplated suicide. I would have never guessed. She has a healthy sense of humor. I feel badly because I've been her friend for 20 years and had no clue. I needed to have some more of her wine listening to that story. God, you should keep some booze in your office.
Day Eighteen - Letter Twelve
For dinner tonight the main course was sautéed hake (it's like cod), russet potatoes, purple broccoli and tart apple pie. In a restaurant, this meal would cost us 75 dollars with tip tax and wine. At home (if we get good buys on wine), it costs fourteen.
Fortune is smiling on me now, I think.
I have an exclusive contract to lease a small downtown office building. Its owners are peculiar - a rich evangelical fellowship. I pitched it last week. It has been on the market through others for over a year so I suspect that since this desirable property is not leased, the fellowship is difficult. The long vacancy might soften them up and perhaps they'll lower the price. My timing may be right. By some miracle, I immediately got an offer at the asking price for the entire building. I want to close this deal in time for November's rent but the evangelist/preacher who handles these things is away salmon fishing. I am nervous but not edgy? No, I am dealing with this situation calmly. That is to say, I am a wreck but I don't feel it. I don't want this tenant to go elsewhere while the preacher is away.
I'll go to bed and get a good night sleep.
Day Nineteen - Letter Thirteen
I had been invited to escort Sonia, your patient, to her uncle's wedding party at the Kings Country Club. I know the place well. The membership is rich and loud. The late Myron Cohen would describe them as "the better class cheap junk."
I knew many of the guests. Some of them were my former neighbors. A few of the men and women have had plastic surgery since I had seen them last. Their voices didn't always match their taut young faces. I find this disconcerting, talking with someone with the voice of a 70-year-old and the face of a 40-year-old.
I know Sonia's uncle from business. He is a horrible businessperson. This marriage is his best move so far. The bride is a rich Canadian woman, widowed only nine months. I was ebullient, ate vigorously and drank. The party was a bit vulgar in its extravagance, however, I prefer these receptions to those with tiny cucumber sandwiches and cheap champagne. The days of one glass of wine are gone for me.
I looked rich again. I was wearing a $2,000.00 suit left over from the old days. It was part of my bankruptcy present to Bergdorf Goodman. It felt good to be uptown again. I splurged on a cab to take us downtown.
Looking forward to more good times,
Day Twenty - Letter Fourteen
This was a crucial day. In the morning, Harvey, the evangelist/preacher returned and went right to work on my deal. He wanted to visit the model agency that is the perspective tenant for his building. He liked the way they kept their offices and they assured him that they would care for his building in the same way. They bill $25,000,000pa. They are financially solid. He wants to make the deal. All he needs is the approval of his congregation. He will try to push it through. Can he? Will the congregation want leggy models in their building? Harvey is an amazing man, he writes Lieder à la Schubert instead of the hymns that are sung in his church. Also, he knows the name of almost every model on the wall. I hope he can get approval. I doubt it, but I can bear it if he can't.
With warmest personal regards,
Day Twenty-One - Letter Fifteen
Last day on the Panic Kit
Here is a variety of news, thoughts and greetings for you. Time to sum up. Bad news! The church doesn't have an interest in leggy models. I thought that we are all God's children. But, instead of a big commission, Harvey is going to pay me a small consulting fee because the deal was a go and the church backed out. Made the rent again. Can you imagine me being saved by evangelists? Harvey is very ethical.
Herbert took a break from the letter, goes over to his piano and plays a couple of the compositions that Chris wrote for him. He likes them. They are cheery pieces in three quarter time like waltzes. He then played a bittersweet E Minor Nocturne by Chopin, savored it, and returned to the letter.
Good news! After losing my deal, I went to the family doctor. My blood pressure is under control. My doctor talks to people more than you do. He wanted to know everything about my reaction to the Zoloft so that he can relate my response to that of his other patients who are taking it. He thinks, by the way, that my situation might not be as catastrophic as you think. The abilities to play the piano, have sex and maintain a good appetite are all located in the same part of the brain. If these things are intact, the patient (that's me) is basically healthy. I respect his opinions as well as yours. In the end, I will follow my own.
Will I continue on the Zoloft? Please note: since I started taking the Zoloft I do not grab my pillow inside of a tight fist when I sleep as I have always done. My facial muscles are more relaxed and so are my hands. It is the hands that have produced the greatest joy during the last three weeks.
My piano playing has gotten sharper without much practice. Chris says to concert-hall level. Concentration better. Emotions freer. I change moods faster, highlight phrases better, dip into emotions easier, produce a wonderful variety of sounds. In addition, the touches are sublime. I could practically live for that half-hour a day when I play. So pleased am I with this that the thought of a financial disaster, which might force me to sell my Steinway almost never enters my mind.
The process of cure for distress via medication occupies my thoughts. I think that we should take a more positive attitude towards depression. We should perhaps see it as a sign that a healthy person might be reacting to a rotten world. We could then blame the world instead of ourselves. Intolerable circumstances do exist. Should they change or should we? This does not mean I may not want to ride out my life in a padded Cadillac called Zoloft. On the other hand, I might prefer a rougher sports car ride and feel every bump in the road. I still have the prescription you wrote for more Zoloft when The Panic Kit is finished but have not filled it.
Business news: I have a new space for the model agency and a different tenant for the church - a publishing company. These two deals might work out. Then I can go on to really big ones - like the old days.
Nevertheless, I still have a certain cynicism about the business world. It is no wonder to me that people who are not depressed are, instead, bitter and angry. I am neither. I know that I never want to turn 60 again. If God forbid I live, what will 70 be like? Chris and I had better save some money just in case we're around.
I have a new title for my book. It is Beautiful Bankrupts from Emma Bovary to Debbie Reynolds. Do you like it? It could be a sell out.
The timing for ending this letter is perfect. The battery in my laptop is going down and will run out any minute. Soon I will take the last Zoloft in the sample pack you gave me. I'll call you next week to let you know if I have filled the prescription or if I have stopped taking it. I will also mail you the short story.
Here is one more poem for you.
Thank you again.
Before the battery runs out
have to spout
a minute left to go
too much to say
can't get it out
Did I want to really use "spout"
Should I have written "shout"?
30 seconds left
machine and I are getting weak
any moment is when
should consider g e t ting a
p e N.
And so should we all. It's easier to listen to patients when one reads.