Wednesday, October 22, 2003

Toast. Apples.

Why "Paula's House of Toast" ?

It's DK's phrase, his ironic name for my mythic toast restaurant. It reminds me, however, of a patient from my first internship way back when, 1977 probably. Back in the day, back when titans trod the earth.

I admitted some poor, elderly woman who'd been home subsisting on ice-cream cones sans ice cream for months and months. The tasteless, paper-and-air waffle kind, too: not tasty sugar cones. I wish I could remember what specific deficiency she'd been admitted with, but I can only remember being profoundly impressed by her diet of empty ice cream cones. What a strange asceticism !

We all have our secret fetishes. Some sexual, some oral.

I lived for months, once, in college, on apples and Special K. No milk.

The apples remind me of a book that impressed me in med school, in the days when I wanted to become a psychoanalyst. It was by a Swiss analyst, a woman; it was about schizophrenia, and her curing a female patient of it by feeding her apple slices, some kind of silly oral regression therapy.

That, in turn, takes me slightly farther back to the apple farm I stopped at during my first weeks at med school on my impulsive drive home to announce to my parents I was quitting medical school. I remember three green apples in my blue VW beetle. Sour apples. I remember my parents' horror. Quitting ? I'd barely begun ! Was I nuts ? Must be !

So they hauled me to a shrink. That very night, I think. Who in turn eventually referred me to The Alienist, who became apple of my eye for all those couchy years.

Still, I wonder. If they'd let me quit...

Those three green apples mark a real waystation in my life. They were witness to my remaining in medical school, my developing a transference-fueled wish to become a psychoanalyst, my ill-advised flight to the University of Chicago and a few miserable months of a psychiatry residency that, this time, I managed to actually quit, my quite accidental and unconsidered return to an internal medicine residency, my marriage to PMS, my accidental pregnancy, my long hiatus from the pregnancy-interrupted residency doing general practice in state prisons, divorce, remarriage, and, finally, the return to complete residency and become board certified: at the same teaching hospital where Alienist was still in the department of psychiatry. That's a twenty year circle.

I could say crop circle, but that's another story.

How do you like them apples ?

What I loved about psychoanalysis was how it honored language and image and metaphor. Arieti's book on schizophrenic language blew me away. A more recent book of a less academic genre but on the same topic is Lauren Slater's "Welcome to My Country." She's a therapist and wonderful writer who has, herself, struggled with bipolar illness. In this book she "reads" the verbal productions of the most difficult patients with loving attention, and deep, empathic understanding.

She's the sort of reader that all poets and all patients crave.

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