Treating With Silence Chapter 7

The only other person I met during that interview was Maya. She smiled at me, and I was grateful because she was the only one with a friendly look on her face. Most of the patients looked at me with a dull, distrustful gaze. I didn't blame them. They had been abused in various ways - physically, psychologically, S3xually, which meant that it took time to gain their trust. All the patients were women - most had rough features, with wrinkles and scars on their faces. They had had difficult life experiences and suffered all kinds of fears until they were forced into the no-man's land of mental illness; their experiences were written on their faces and could be seen at a glance.

But what about Ava Alicia? Where was she? I looked around the circle again, and still didn't see her. Then I realized it -- my eyes were on her. She was sitting across the circle, facing me.

I didn't notice her because she was so inconspicuous that she was almost invisible.

She sat in a chair, leaning forward, looking very calm. She was holding a paper cup of tea, her hands were shaking, and the tea was spilling on the floor like a trickle. I really wanted to go over and help her straighten the cup, but I controlled my impulse. She was completely unable to control herself, and I doubt she even noticed that I was watching her.

I had not expected her to be so pathetic. This once beautiful woman still had some of her charm: blue eyes, beautiful, well-proportioned features. But now she was not only skinny, but also filthy: her long reddish-brown hair was unkempt and shaggy around her shoulders; her nails were bitten and torn; and on both wrists, faded scars were clearly visible - similar wounds I had seen in the painting of Alcestis. Her fingers were shaking, no doubt a side effect of taking Risperdal and other high-dose antipsychotics. Her mouth was open, and a lot of white saliva accumulated in her mouth, and drool kept flowing down. This is another regrettable side effect of the drugs.

I noticed Nicholas was looking at me, so I briefly turned my attention from Alicia to him.

"Max, I think it would be better for you to introduce yourself than for me to do it," he said. "Why don't you say a few words, ok?"

"Thank you." I nodded. "I don't really have much to add. I just want to say that I'm glad to be here. I'm excited, nervous, and hopeful. I'm looking forward to getting to know all of you - especially my fellow patients. I---"

I was interrupted by the bang of the door. At first I thought it was an illusion. A large man rushed into the room, holding two jagged sticks high in his hands and throwing them at us like spears. One of the patients covered his eyes and screamed in fear.

I was afraid they would hurt us, but they just fell heavily to the ground in the middle of the circle. Then I saw clearly that they were not spears at all, but pool cues that had been broken in two. The patient was a large, dark-haired Turkish woman in her forties. She yelled, "I'm so mad. This pool cue has been broken for a week, and you haven't got a new one yet."

"Don't say bad words, Isabella," Nicholas said. "I'm not going to talk about the pool cue right now. You're so late, let's see if we can still let you attend the party." He turned around and slyly kicked the ball to me. "Max, what do you think?"

I blinked, and only later did I hear myself say, "I think it's important to be punctual and to be on time for group activities---"

"You mean, like you just did?" said a man sitting across the circle.

I turned around and saw that it was Ethan who was talking. He laughed, and seemed quite pleased with the joke he had just made. I forced a smile at him and then turned back to Isabella.

"He has a point. I was late for this morning's event as well. Maybe we should all learn from this."

"What the hell are you talking about?" Isabella said. "Who the hell are you?"

"Elifu, be polite," Nicholas said. "Don't make me shut you up. Sit down!"

Isabella still insisted: "What about the pool cue?"

She was asking Nicholas. But Nicholas was looking at me, waiting for my answer.

"I can see you're angry about the pool cue, Isabella," I said. "And I suspect the guy who broke it is angry too. That raises the question of how we should deal with anger in this clinic. How about we take a moment to talk about anger? Why don't you sit down first?"

Isabella rolled her eyes but still sat down.

Maya nodded, looking pleased. So Maya and I began to talk about anger, trying to get patients to discuss how they feel when they are angry. I felt that I was working very well with her.

I could sense Nicholas watching and assessing my performance. He seemed pleased.

I glanced at Alicia and was surprised to see that she was looking at me, too...at least in my direction. Her expression was inscrutable...as if she was trying hard to focus her eyes.

Everyone who knew her said she was radiant, full of life, and fascinating. I couldn't believe that this dowdy woman was Ava Alicia. At that moment, I knew that I had made the right decision to come here, to the Grove Clinic. All my doubts were gone. I was determined to spare no effort to make Alicia my patient. I would never give up until I achieved my goal.

There was no time to lose: Alicia was lost. She was lost. I wanted to find her.
Professor Nicholas' office was located in the most dilapidated part of the Edgwell Hospital. There were many cobwebs on the corners outside the door, and only one or two lights were on in the corridor. I knocked on the door and soon heard his voice coming from inside.

"Come in."

I turned the knob and the door creaked open. The smell of the room startled me. His office was unlike the rest of the hospital. I didn't smell any preservatives or bleach. Instead, it was more like an orchestra pit, with the smell of wood, strings, bows, polish, and wax. It took a moment for my eyes to adjust to the dim light. I saw an upright piano against the wall, which seemed out of place in the hospital. In the dim light, I saw two dozen gleaming metal music stands. On one table, a pile of sheet music was piled high, like a shaky paper tower reaching to the sky. On another table, a violin sat, next to an oboe and a flute. Next to the table was a harp - a large one with a beautiful wooden frame and a cascade of strings.

I was so amazed at the sight of these instruments that I gaped in amazement. Nicholas laughed.

"You're curious about these instruments?" he said with a chuckle, then sat down in the chair behind his desk.

"Are they all yours?"

"Yes. Music is my hobby. No, I'm not saying that - music is my passion." His fingers slid triumphantly in the air. He was speaking in an animated manner, using lots of gestures to emphasize his words - as if he were conducting an invisible symphony orchestra.

"I have set up an informal music group, open to anyone who wishes to join," he said. "Staff and patients alike. I have found music to be a very effective therapeutic tool." After a pause, he added in a lilting, musical voice: "Music has a magical power to calm the beast... Would you agree?"

"You are certainly right."

"Hmm." Nicholas looked me over. "Do you play an instrument?"

"playing what?"

"Whatever. The triangle is the starting point."

I shook my head. "I don't have any musical talent. I played with the tape recorder in school when I was young, but that's it."

"Do you know music? That's a plus. OK, pick any instrument. I'll teach you."

I smiled and shook my head again: "I'm afraid I don't have enough patience."

"No? Well, patience is a virtue, and as a therapist, you have to cultivate it. You know, when I was young, I wasn't very focused, whether it was music, being a priest, or being a doctor." He laughed loudly. "Now I am all three."

"I think that's for sure."

"You know," he said, changing the subject quickly, "my words carried a lot of weight during that interview. Let's just say I tried to speak well of you when it came time to vote. Do you know why? I'll be honest - I'm very fond of you, Max. You remind me of myself... Who knows? Maybe in a few years, you might be running this place..." He said, then sighed, "If it still exists, of course."

"Do you think it's possible that it doesn't exist?"

"Who knows? There are too few patients and too many staff. We work closely with the Trust to find a 'economically viable' model. That is, we are constantly monitored and evaluated, or under surveillance. You might ask, how can we do any therapy under these circumstances? As Winnicott said, you can't do psychotherapy in a burning building." He shook his head, and suddenly he looked old - tired and bored. He lowered his voice and whispered mysteriously, "I think Director Stephanie Clark is in cahoots with them. After all, she is paid by the Trust. Just watch her and you will know what I mean."

I think Nicholas is a bit paranoid, but that's understandable. I don't want to say the wrong thing, so I'm always careful about what I say and what I do.

Then I said, "I want to ask you a question about Alicia."

"Ava Alicia?" Nicholas gave me a strange look. "What happened to her?"

"I would like to know what kind of psychological treatment she received. Was it individual therapy?"

"no."

"Why?"

"Tried -- but gave up."

"Why is that? Who was her doctor? Was it Maya?"

"No." He shook his head. "It was me, actually."

"I see. What's the situation?"

He shrugged. "She wouldn't come to my office, so I went to her room. During the treatment, she sat on the bed, looking out the window, and of course she didn't say a word, not even looking at me." He threw his hands up in despair. "I think all this effort is a waste of time."

I nodded. "I think... uh, I think we should change..."

"Change what?" He stared at me with curiosity. "Go on."

"You're an authority figure, and she might see your treatment as a potential punishment. It's a possibility, isn't it? I don't know what her relationship with her father is like, but..."

Hearing this, Nicholas smiled, as if he was listening to a joke and looking forward to the final words. "Do you think that if she were to be around someone younger, she might relax a little?" he said. "Let me guess... someone like you? Do you think you could help her, Max? You could save Alicia, make her talk?"

"I don't know how to save her, I just want to help her. I want to try."

He smiled, but still found the comment amusing. "You're not the first person to say that. I once believed I could succeed. My child, Alicia was a silent siren[1] who led us to the rocks and caused our wonderful treatment plan to crash into the water." He smiled. "She taught me a lesson about failure. Maybe you need to learn that lesson, too."