On Psychiatrist

On Psychiatrist

 

I. Invocation 

It's crazy to think one could describe them— 

Calling on reason, fantasy, memory, eyes and ears— 

As though they were all alike any more 

 

Than sweeps, opticians, poets or masseurs.   

Moreover, they are for more than one reason   

Difficult to speak of seriously and freely, 

 

And I have never (even this is difficult to say   

Plainly, without foolishness or irony) 

Consulted one for professional help, though it happens 

 

Many or most of my friends have—and that,   

Perhaps, is why it seems urgent to try to speak   

Sensibly about them, about the psychiatrists. 

 

II. Some Terms

“Shrink” is a misnomer. The religious   

Analogy is all wrong, too, and the old,   

Half-forgotten jokes about Viennese accents 

 

And beards hardly apply to the good-looking woman   

In boots and a knit dress, or the man   

Seen buying the Sunday Times in mutton-chop 

 

Whiskers and expensive running shoes. 

In a way I suspect that even the terms “doctor”   

And “therapist” are misnomers; the patient 

 

Is not necessarily “sick.” And one assumes   

That no small part of the psychiatrist’s   

Role is just that: to point out misnomers. 

 

III. Proposition

These are the first citizens of contingency.   

Far from the doctrinaire past of the old ones,   

They think in their prudent meditations 

 

Not about ecstasy (the soul leaving the body)   

Nor enthusiasm (the god entering one’s person)   

Nor even about sanity (which means 

 

Health, an impossible perfection) 

But ponder instead relative truth and the warm   

Dusk of amelioration. The cautious 

 

Young augurs with their family-life, good books   

And records and foreign cars believe   

In amelioration—in that, and in suffering. 

 

IV. A Lakeside Identification

Yes, crazy to suppose one could describe them— 

And yet, there was this incident: at the local beach   

Clouds of professors and the husbands of professors 

 

Swam, dabbled, or stood to talk with arms folded 

Gazing at the lake ... and one of the few townsfolk there,   

With no faculty status—a matter-of-fact, competent, 

 

Catholic woman of twenty-seven with five children   

And a first-rate body—pointed her finger   

At the back of one certain man and asked me, 

 

“Is that guy a psychiatrist?” and by god he was! “Yes,”   

She said, “He looks like a psychiatrist.”   

Grown quiet, I looked at his pink back, and thought. 

 

V. Physical Comparison With Professors And Others

Pink and a bit soft-bodied, with a somewhat jazzy   

Middle-class bathing suit and sandy sideburns, to me   

He looked from the back like one more professor. 

 

And from the front, too—the boyish, unformed carriage   

Which foreigners always note in American men, combined   

As in a professor with that liberal, quizzical, 

 

Articulate gaze so unlike the more focused, more   

Tolerant expression worn by a man of action (surgeon, 

Salesman, athlete). On closer inspection was there, 

 

Perhaps, a self-satisfied benign air, a too studied   

Gentleness toward the child whose hand he held loosely?   

Absurd to speculate; but then—the woman saw something. 

 

VI. Their Seriousness, With Further Comparisons

In a certain sense, they are not serious. 

That is, they are serious—useful, deeply helpful,   

Concerned—only in the way that the pilots of huge 

 

Planes, radiologists, and master mechanics can,   

At their best, be serious. But however profound 

The psychiatrists may be, they are not serious the way 

 

A painter may be serious beyond pictures, or a businessman   

May be serious beyond property and cash—or even   

The way scholars and surgeons are serious, each rapt 

 

In his work’s final cause, contingent upon nothing:   

Beyond work; persons; recoveries. And this is fitting:   

Who would want to fly with a pilot who was serious 

 

About getting to the destination safely? Terrifying idea— 

That a pilot could over-extend, perhaps try to fly   

Too well, or suffer from Pilot’s Block; of course, 

 

It may be that (just as they must not drink liquor   

Before a flight) they undergo regular, required check-ups   

With a psychiatrist, to prevent such things from happening. 

 

VII. Historical (The Bacchae) 

Madness itself, as an idea, leaves us confused— 

Incredulous that it exists, or cruelly facetious,   

Or stricken with a superstitious awe as if bound 

 

By the lost cults of Trebizond and Pergamum ...   

The most profound study of madness is found   

In the Bacchae of Euripides, so deeply disturbing 

 

That in Cambridge, Massachusetts the players   

Evaded some of the strongest unsettling material 

By portraying poor sincere, fuddled, decent Pentheus 

 

As a sort of fascistic bureaucrat—but it is Dionysus   

Who holds rallies, instills exaltations of violence,   

With his leopards and atavistic troops above law, 

 

Reason and the good sense and reflective dignity 

Of Pentheus—Pentheus, humiliated, addled, made to suffer   

Atrocity as a minor jest of the smirking God. 

 

When Bacchus’s Chorus (who call him “most gentle”!) observe:   

“Ten thousand men have ten thousand hopes; some fail,   

Some come to fruit, but the happiest man is he 

 

Who gathers the good of life day by day”—as though 

Life itself were enough—does that mean, to leave ambition?   

And is it a kind of therapy, or truth? Or both? 

 

VIII. A Question

On the subject of madness the Bacchae seems,   

On the whole, more pro than contra. The Chorus 

Says of wine, “There is no other medicine for misery”; 

 

When the Queen in her ecstasy—or her enthusiasm?— 

Tears her terrified son’s arm from his body, or bears   

His head on her spear, she remains happy so long 

 

As she remains crazy; the God himself (who bound fawnskin   

To the women’s flesh, armed them with ivy arrows   

And his orgies’ livery) debases poor Pentheus first, 

 

Then leads him to mince capering towards female Death   

And dismemberment: flushed, grinning, the grave young   

King of Thebes pulls at a slipping bra-strap, simpers 

 

Down at his turned ankle. Pentheus: “Should I lift up   

Mount Cithæron—Bacchae, mother and all?”   

Dionysus: “Do what you want to do. Your mind 

 

Was unstable once, but now you sound more sane,   

You are on your way to great things.”   

The question is, Which is the psychiatrist: Pentheus, or Dionysus? 

 

IX. Pentheus As Psychiatrist 

With his reasonable questions Pentheus tries   

To throw light on the old customs of savagery.   

Like a brave doctor, he asks about it all, 

 

He hears everything, “Weird, fantastic things”   

The Messenger calls them: with their breasts   

Swollen, their new babies abandoned, mothers 

 

Among the Bacchantes nestled gazelles 

And young wolves in their arms, and suckled them;   

You might see a single one of them tear a fat calf 

 

In two, still bellowing with fright, while others   

Clawed heifers to pieces; ribs and hooves   

Were strewn everywhere; blood-smeared scraps 

 

Hung from the fir trees; furious bulls 

Charged and then fell stumbling, pulled down 

To be stripped of skin and flesh by screaming women ... 

 

And Pentheus listened. Flames burned in their hair,   

Unnoticed; thick honey spurted from their wands;   

And the snakes they wore like ribbons licked 

 

Hot blood from their flushed necks: Pentheus 

Was the man the people told ... “weird things,” like   

A middle-class fantasy of release; and when even 

 

The old men—bent Cadmus and Tiresias—dress up 

In fawnskin and ivy, beating their wands on the ground,   

Trying to carouse, it is Pentheus—down-to-earth, 

 

Sober—who raises his voice in the name of dignity. 

Being a psychiatrist, how could he attend to the Chorus’s warning   

Against “those who aspire” and “a tongue without reins”? 

 

X. Dionysus As Psychiatrist

In a more hostile view, the psychiatrists 

Are like Bacchus—the knowing smirk of his mask,   

His patients, his confident guidance of passion, 

 

And even his little jokes, as when the great palace   

Is hit by lightning which blazes and stays,   

Bouncing among the crumpled stone walls ... 

 

And through the burning rubble he comes,   

With his soft ways picking along lightly   

With a calm smile for the trembling Chorus 

 

Who have fallen to the ground, bowing 

In the un-Greek, Eastern way—What, Asian women,   

He asks, Were you disturbed just now when Bacchus 

 

Jostled the palace? He warns Pentheus to adjust,   

To learn the ordinary man’s humble sense of limits,   

Violent limits, to the rational world. He cures 

 

Pentheus of the grand delusion that the dark   

Urgencies can be governed simply by the mind, 

And the mind’s will. He teaches Queen Agave to look 

 

Up from her loom, up at the light, at her tall   

Son’s head impaled on the stiff spear clutched   

In her own hand soiled with dirt and blood. 

 

XI. Their Philistinism Considered 

“Greek Tragedy” of course is the sort of thing 

They like and like the idea of ... though not “tragedy” 

In the sense of newspapers. When a patient shot one of them, 

 

People phoned in, many upset as though a deep, 

Special rule had been abrogated, someone had gone too far.   

The poor doctor, as described by the evening Globe, 

 

Turned out to be a decent, conventional man (Doctors   

For Peace, B’Nai Brith, numerous articles), almost 

Carefully so, like Paul Valéry—or like Rex Morgan, M.D., who, 

 

In the same Globe, attends a concert with a longjawed woman.   

First Panel: “We’re a little early for the concert!   

There’s an art museum we can stroll through!” “I’d like 

 

That, Dr. Morgan!” Second Panel: “Outside the hospital,   

There’s no need for such formality, Karen! Call me   

By my first name!” “I’ll feel a little awkward!” 

 

Final Panel: “Meanwhile ...” a black car pulls up 

To City Hospital .... By the next day’s Globe, the real 

Doctor has died of gunshot wounds, while for smiling, wooden, 

 

Masklike Rex and his companion the concert has passed,   

Painlessly, offstage: “This was a beautiful experience, Rex!” 

“I’m glad you enjoyed it! I have season tickets 

 

And you’re welcome to use them! I don’t have   

The opportunity to go to many of the concerts!” 

Second Panel: “You must be famished!” And so Rex 

 

And Karen go off to smile over a meal which will pass   

Like music offstage, off to the mysterious pathos   

Of their exclamation marks, while in the final panel 

 

“Meanwhile, In The Lobby At City Hospital” 

A longjawed man paces furiously among 

The lamps, magazines, tables and tubular chairs. 

 

XII. Their Philistinism Dismissed

But after all—what “cultural life” and what   

Furniture, what set of the face, would seem adequate   

For those who supply medicine for misery? 

 

After all, what they do is in a way a kind of art, 

And what writers have to say about music, or painters’   

Views about poetry, musicians’ taste in pictures, all 

 

Often are similarly hoked-up, dutiful, vulgar. After all,   

They are not gods or heroes, nor even priests chosen   

Apart from their own powers, but like artists are mere 

 

Experts dependent on their own wisdom, their own arts:   

Pilgrims in the world, journeymen, bourgeois savants,   

Gallant seekers and persistent sons, doomed 

 

To their cruel furniture and their season tickets   

As to skimped meditations and waxen odes. 

At first, Rex Morgan seems a perfect Pentheus— 

 

But he smirks, he is imperturbable, he understates;   

Understatement is the privilege of a god, we must   

Choose, we must find out which way to see them: 

 

Either the bland arrogance of the abrupt mountain god   

Or the man of the town doing his best, we must not   

Complain both that they are inhuman and too human. 

 

XIII. Their Despair

I am quite sure that I have read somewhere   

That the rate of suicide among psychiatrists   

Is far higher than for any other profession. 

 

There are many myths to explain such things, things   

Which one reads and believes without believing   

Any one significance for them—as in this case, 

 

Which again reminds me of writers, who, I have read,   

Drink and become alcoholics and die of alcoholism   

In far greater numbers than other people. 

 

Symmetry suggests one myth, or significance: the drinking   

Of writers coming from too much concentration,   

In solitude, upon feelings expressed 

 

For or even about possibly indifferent people, people   

Who are absent or perhaps dead, or unborn; the suicide   

Of psychiatrists coming from too much attention, 

 

In most intimate contact, concentrated upon the feelings   

Of people toward whom one may feel indifferent,   

People who are certain, sooner or later, to die ... 

 

Or people about whom they care too much, after all?   

The significance of any life, of its misery and its end,   

Is not absolute—that is the despair which 

 

Underlies their good sense, recycling their garbage,   

Voting, attending town-meetings, synagogues, churches,   

Weddings, contingent gatherings of all kinds. 

 

XIV. Their Speech, Compared With Wisdom And Poetry

Terms of all kinds mellow with time, growing   

Arbitrary and rich as we call this man “neurotic” 

Or that man “a peacock.” The lore of psychiatrists— 

 

“Paranoid,” “Anal” and so on, if they still use 

Such terms—also passes into the status of old sayings:   

Water thinner than blood or under bridges; bridges 

 

Crossed in the future or burnt in the past. Or the terms   

Of myth, the phrases that well up in my mind:   

Two blind women and a blind little boy, running— 

 

Easier to cut thin air into planks with a saw   

And then drive nails into those planks of air,   

Than to evade those three, the blind harriers, 

 

The tireless blind women and the blind boy, pursuing   

For long years of my life, for long centuries of time.   

Concerning Justice, Fortune and Love I believe 

 

That there may be wisdom, but no science and few terms:   

Blind, and blinding, too. Hot in pursuit and flight,   

Justice, Fortune and Love demand the arts 

 

Of knowing and naming: and, yes, the psychiatrists, too,   

Patiently naming them. But all in pursuit and flight, two   

Blind women, tireless, and the blind little boy. 

 

XV. A Footnote Concerning Psychiatry Itself

Having mentioned it, though it is not   

My subject here, I will say only that one   

Hopes it is good, and hopes that practicing it 

 

The psychiatrists who are my subject here   

Will respect the means, however pathetic, 

That precede them; that they respect the patient’s 

 

Own previous efforts, strategies, civilizations— 

Not only whatever it is that lets a man consciously   

Desire girls of sixteen (or less) on the street, 

 

And not embrace them, et cetera, but everything that was   

There already: the restraints, and the other lawful   

Old culture of wine, women, et cetera. 

 

XVI. Generalizing, Just And Unjust

As far as one can generalize, only a few 

Are not Jewish. Many, I have heard, grew up   

As an only child. Among many general charges 

 

Brought against them (smugness, obfuscation)   

Is a hard, venal quality. In truth, they do differ 

From most people in the special, tax-deductible status 

 

Of their services, an enviable privilege which brings   

Venality to the eye of the beholder, who feels   

With some justice that if to soothe misery 

 

Is a tax-deductible medical cost, then the lute-player,   

Waitress, and actor also deserve to offer   

Their services as tax-deductible; movies and TV 

 

Should be tax-deductible ... or nothing should;   

Such cash matters perhaps lead psychiatrists 

And others to buy what ought not to be sold: Seder 

 

Services at hotels; skill at games from paid lessons;   

Fast divorce; the winning side in a war seen 

On TV like cowboys or football—that is how much 

 

One can generalize: psychiatrists are as alike (and unlike)   

As cowboys. In fact, they are stock characters like cowboys:   

“Bette Davis, Claude Rains in Now, Voyager (1942), 

 

A sheltered spinster is brought out of her shell 

By her psychiatrist” and “Steven Boyd, Jack Hawkins   

In The Third Secret (1964), a psychoanalyst’s 

 

Daughter asks a patient to help her find her father’s   

Murderer.” Like a cowboy, the only child roams   

The lonely ranges and secret mesas of his genre. 

 

XVII. Their Patients

As a rule, the patients I know do not pace   

Furiously, nor scream, nor shoot doctors. For them,   

To be a patient seems not altogether different 

 

From one’s interest in Ann Landers and her clients:   

Her virtue of taking it all on, answering   

Any question (artificial insemination by grandpa; 

 

The barracuda of a girl who says that your glasses   

Make you look square) and her virtue of saying,   

Buster (or Dearie) stop complaining and do 

 

What you want ... and often that seems to be the point:   

After the glassware from Design Research, after   

A place on the Cape with Marimekko drapes, 

 

The superlative radio and shoes, comes 

The contingency tax—serious people, their capacity   

For mere hedonism fills up, one seems to need 

 

To perfect more complex ideas of desire, 

To overcome altruism in the technical sense,   

To learn to say no when you mean no and yes 

 

When you mean yes, a standard of cui bono, a standard   

Which, though it seems to be the inverse   

Of more Spartan or Christian codes, is no less 

 

Demanding in its call, inward in this case, to duty. 

It suggests a kind of league of men and women dedicated   

To their separate, inward duties, holding in common 

 

Only the most general standard, or no standard   

Other than valuing a sense of the conflict   

Among standards, a league recalling in its mutual 

 

Conflict and comfort the well-known fact that psychiatrists,   

Too, are the patients of other psychiatrists,   

Working dutifully—cui bono—at the inward standards. 

 

XVIII. The Mad

Other patients are ill otherwise, and do   

Scream and pace and kill or worse; and that   

Should be recalled. Kit Smart, Hitler, 

 

The contemporary poets of lunacy—none of them   

Helps me to think of the mad otherwise   

Than in clichés too broad, the maenads 

 

And wild-eyed killers of the movies ... 

But perhaps lunacy feels something like a cliché,   

A desperate or sweet yielding to some broad, 

 

Mechanical simplification, a dispersal 

Of the unbearable into its crude fragments,   

The distraction of a repeated gesture 

 

Or a compulsively hummed tune. Maybe   

It is not utterly different from chewing   

At one’s fingernails. For the psychiatrists 

 

It must come to seem ordinary, its causes   

And the causes of its relief, after all, 

No matter how remote and intricate, are no 

 

Stranger than life itself, which was born or caused   

Itself, once, as a kind of odor, a faint wreath   

Brewing where the radiant light from billions 

 

Of miles off strikes a faint broth from water   

Standing in rock; life born from the egg   

Of rock, and the egglike rock of death 

 

Are no more strange than this other life   

Which we name after the moon, lunatic   

Other-life ... housed, for the lucky ones, 

 

In McLean Hospital with its elegant,   

Prep-school atmosphere. When my friend   

Went in, we both tried to joke: “Karen,” I said, 

 

“You must be crazy to spend money and time   

In this place”—she gained weight,   

Made a chess-board, had a roommate 

 

Who introduced herself as the Virgin Mary,   

Referred to another patient: “Well, she must   

Be an interesting person, if she’s in here.” 

 

XIX. Peroration, Defining Happiness

“I know not how it is, but certainly I 

Have never been more tired with any reading   

Than with dissertations upon happiness, 

 

Which seems not only to elude inquiry,   

But to cast unmerciful loads of clay   

And sand and husks and stubble 

 

Along the high-road of the inquirer. 

Even sound writers talk mostly in a drawling   

And dreaming way about it. He, 

 

Who hath given the best definition 

Of most things, hath given but an imperfect one,   

Here, informing us that a happy life 

 

Is one without impediment to virtue .... 

In fact, hardly anything which we receive   

For truth is really and entirely so, 

 

Let it appear plain as it may, and let 

Its appeal be not only to the understanding,   

But to the senses; for our words do not follow 

 

The senses exactly; and it is by words   

We receive truth and express it.” 

So says Walter Savage Landor in his Imaginary 

 

Conversation between Sir Philip Sidney   

And Fulke Greville, Lord Brooke, all three,   

In a sense, my own psychiatrists, shrinking 

 

The sense of contingency and confusion   

Itself to a few terms I can quote, ponder   

Or type: the idea of wisdom, itself, shrinks. 

 

XX. Peroration, Concerning Genius 

As to my own concerns, it seems odd, given   

The ideas many of us have about art,   

That so many writers, makers of films, 

 

Artists, all suitors of excellence and their own   

Genius, should consult psychiatrists, willing   

To risk that the doctor in curing 

 

The sickness should smooth away the cicatrice   

Of genius, too. But it is all bosh, the false   

Link between genius and sickness, 

 

Except perhaps as they were linked   

By the Old Man, addressing his class 

On the first day: “I know why you are here. 

 

You are here to laugh. You have heard of a crazy   

Old man who believes that Robert Bridges   

Was a good poet; who believes that Fulke 

 

Greville was a great poet, greater than Philip   

Sidney; who believes that Shakespeare’s Sonnets 

Are not all that they are cracked up to be .... Well, 

 

I will tell you something: I will tell you 

What this course is about. Sometime in the middle   

Of the Eighteenth Century, along with the rise 

 

Of capitalism and scientific method, the logical   

Foundations of Western thought decayed and fell apart.   

When they fell apart, poets were left 

 

With emotions and experiences, and with no way   

To examine them. At this time, poets and men 

Of genius began to go mad. Gray went mad. Collins 

 

Went mad. Kit Smart was mad. William Blake surely   

Was a madman. Coleridge was a drug addict, with severe   

Depression. My friend Hart Crane died mad. My friend 

 

Ezra Pound is mad. But you will not go mad; you will grow up   

To become happy, sentimental old college professors,   

Because they were men of genius, and you 

 

Are not; and the ideas which were vital 

To them are mere amusement to you. I will not 

Go mad, because I have understood those ideas ....” 

 

He drank wine and smoked his pipe more than he should;   

In the end his doctors in order to prolong life   

Were forced to cut away most of his tongue. 

 

That was their business. As far as he was concerned   

Suffering was life’s penalty; wisdom armed one 

Against madness; speech was temporary; poetry was truth. 

 

XXI. Conclusion

Essaying to distinguish these men and women,   

Who try to give medicine for misery,   

From the rest of us, I find I have failed 

 

To discover what essential statement could be made   

About psychiatrists that would not apply   

To all human beings, or what statement 

 

About all human beings would not apply   

Equally to psychiatrists. They, too,   

Consult psychiatrists. They try tentatively 

 

To understand, to find healing speech. They work   

For truth and for money. They are contingent ...   

They talk and talk ... they are, in the words 

 

Of a lute-player I met once who despised them,   

“Into machines” ... all true of all, so that it seems   

That “psychiatrist” is a synonym for “human being,” 

 

Even in their prosperity which is perhaps 

Like their contingency merely more vivid than that   

Of lutanists, opticians, poets—all into 

 

Truth, into music, into yearning, suffering, 

Into elegant machines and luxuries, with caroling   

And kisses, with soft rich cloth and polished 

 

Substances, with cash, tennis and fine electronics,   

Liberty of lush and reverend places—goods   

And money in their contingency and spiritual 

 

Grace evoke the way we are all psychiatrists,   

All fumbling at so many millions of miles   

Per minute and so many dollars per hour 

 

Through the exploding or collapsing spaces   

Between stars, saying what we can.


By Robert Pinsky

Photography by Sam Taylor-Johnson