Samuel Shem
Black Swan, £7.99, pp 480
ISBN 0 5529 9813 3
This is an edited extract from Samuel Shem’s new book, his sequel to House of God
“After lunch, Errol let me sit in on his private practice. His office was on the top floor with a fantastic view unrolling to the north, where the line of white smudges on the horizon was maybe snow on the mountaintops, maybe clouds. The office was a kind of museum of the drug trade: everything “Courtesy of” somebody. From the leather couch and chairs courtesy of Ciba-Geigy/Brazil; through the immense rosewood desk courtesy of Smith-Kline/Thailand; to a tiny working model of the blood supply to the human brain, bubbling bright red cartoon blood through the arteries and draining sludgy blue venous blood out through the veins, with a flashing sign that said, “Zoloft Keeps You Aloft.”
A series of well-heeled patients marched in. Errol spent at most ten minutes with each and treated each exactly the same way: asking about their drugs—usually they were on three to six drugs—and then adding or subtracting drugs before saying good-bye. He asked a question or two about their symptoms. He asked nothing about their psychological state. The patients were treated with a courteous benevolence, like good dogs.
It was astonishing to see how, being treated with total authoritarian objectivity, they responded with total submissive gratitude. Errol gave the impression of being absolutely sure. While he was sure about everything, he addressed but one thing: drugs. If his patients wanted to talk diagnosis, he talked drugs. If they wanted to talk symptoms, he talked drugs. Stress? Drugs. Suffering? Drugs. Family problems? Drugs. Job? Drugs. The love his patients felt for Errol was palpable. How could they love him? They could love him because not only did he convey to them that he was sure about their drugs, and by implication about all the other things they mentioned, but in addition he always said to each patient at the end of the ten-minute interview: “This will make you feel wonderful and make you better.”
Most patients loved hearing this and thanked him. A rare patient might ask “Are you sure?”
“Absolutely. This will make you feel wonderful and make you better.”
Finished with his private practice, Errol shot to his feet and bolted for the parking lot. Trying to keep up with him, I screamed out, “But a lot of them come back from their last visit with you not better.”
“And then I give ‘em a new drug and it makes ‘em feel wonderful and better.”
“But what if it doesn’t make them better?”
“I try a newer drug. Let’s go!”
“Don’t you ever run out of drugs?”
“You never run out of mixtures. Principle of ‘the Drug Cocktail’ - c’mon!”
The gull wings of his red Ferrari spread up and out as if just dying to catch the alluring spring breeze. A bumper sticker read:
RESEARCH TAKES BRAINS,
DONATE YOURS. CALL
1-900-BRAINBANK
“Nice car,” I said.
“Ferrari Mondial. Sterling/Italia cut me a deal. Only 197 K.”
“Still a lot.”
“Not if you maximise your billability. Everything you saw, I bill for. Ten minutes, a hundred bucks. Ten bucks a billable minute.”
“It’s mind boggling.”
“No, it’s modern psychiatry.””