To Be a Psychiatrist at the Suburbs of Pittsburgh

“I don’t like strong people,” the patient muttered. “The ones who look perfect and seem as if they have a shield against all harm.” He looked at me to see if I would say anything. I didn’t. “You know, the ones who look as if they can never be hurt. As if happiness, or, at least, neutrality, always surrounds them, with no sad moments. Those who look like they don’t care about any blow of words, or vicious circumstances, or crippling pressures. Those with no tears. I hate them.” He was staring down, perusing my rug. Then his head jolted up, and he smiled.

“But I love those who are vulnerable. Not helpless, but vulnerable. The ones that I can help and support. Those who would appreciate a hug, or a pat on the back, and accept their need with a smile. The ones that would hug you back. I don’t know, maybe they satisfy that altruistic part of me that is hungry for the needy. Maybe, in a way, it’s even wicked. I like people who are hurt? I suppose that’s not a good sign.”

I answered, “But, maybe, everyone gets hurt, one way or another, and you just like those who accept it and show it more, because that’s a way to connect with them. You can reach them through their vulnerability, through their cry, or a simple muttering of angry words, and they can reach you through a touch of shoulders in a hug, or that simple reassurance you don’t even think about. And that makes a connection. A way to intimacy. To lasting friendship.”

“Or a momentary illusion of it,” he continued. I didn’t say anything.

“I’m one of those I hate, you see. Sure, I don’t look that strong; but I sure as hell hide every hurt part of me. I walk away, laugh it off, lie if I have to. That’s my most crucial mission when I’m hurt. To hide, and keep it hidden. And you know what? It works. It works so freakin’ well that no one even doubts. Or they think that I don’t need any help from anyone. That I can deal with it by myself. But I do need help. I do need that pat on the back too. I appreciate that hug more than anyone. I love a bit of tangible care, some physical show of concern. But I never receive it. Maybe I seem like I don’t need any outside help, or maybe I just never seem to be hurt. Maybe I just stand there and shovel all my smiles and jokes on it, making a pile, one shovelful after another, until even I can’t see it.”

“Why don’t you mess with that pile then?”

“Because I can’t.” He paused for a moment, and then continued. “But you know what? It’s always there, under that pile. Sometimes I feel it move, trying to come to surface, to breathe again. But I react with terror, quickly largening the pile, making it bigger and bigger, widening it, rising it, higher and higher. I throw all I have on it. And there’s always room for it to expand. And it does. It gets larger everyday. But, you see, I’m worried that one day, there won’t be any more room, and then, the pile won’t hold. It’ll collapse, and all that’s buried in it will burst outside, like a violent volcano, with its lava eating through all the shoveled smiles, and it’ll see the world, at last, and it’ll get colder and colder with regret.”

“Maybe then, you won’t hate yourself anymore,” I said.

“Maybe,” he said.

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