Rachel Weeping for Her Children Redux

Twice last week I found myself in a dis­cus­sion focused on “tragedy.” Twice. Per­haps shop­ping to get a “bet­ter” answer? Per­haps to get any answer. I had sim­ply made the state­ment, “I strug­gle to grasp the nature of tragedy.” This began with what any clin­i­cal observer would term a day of a Verdi marathon of sorts, in eight sep­a­rate acts 1 ” ; and each act’s crescendo is a stream of “labil­ity”; a seem­ingly uncon­trol­lable swing in affect — fre­quently from laugh­ter to tears and back — seem­ingly con­trived, but in actu­al­ity, quite genuine.

Act One opened with a stun­ning onset of gasp­ing, body-wrenching sobs, induced by the seem­ingly benign ques­tion, “What is your date of birth?” I was so rocked & con­fused by the reac­tion that for a moment, I was par­a­lyzed; noth­ing in the form of an inter­ven­tion came to mind. And thus began the ram­bling, tan­gen­tial, psy­chotic pre­sen­ta­tion of a “bleed­ing out,” the other Triple A: aban­don­ment, adop­tion, and abuse. “I don’t know my real date of birth.” It is excep­tion­ally stress­ful, embar­rass­ing, and even dis­taste­ful to describe the expe­ri­ence of wit­ness­ing the human mind rav­aged by PCP, metham­phet­a­mine, and dis­ease. The inten­sity of the strug­gling thought process is, for me, sur­pris­ingly painful, while the con­tent, the expressed ver­bal “mad­ness,” is heart­break­ing. You are too young to be this sick! And if I accept the data by which we plot these mor­bid processes, this course is irrev­o­ca­ble. And now she is sob­bing at the cru­elty of the Dept. of Cor­rec­tions for not noti­fy­ing her “fans” (“And I just love each and every one of my fans”) that she had new hous­ing: “They were out­side my old win­dow, hold­ing signs, wav­ing to me and call­ing me to come to the win­dow. I could hear them, and I was cry­ing; I was help­less.” Exactly 31 days sep­a­rate her from her “fans,” her law & med­ical degrees, her singing career, and, of course, her chil­dren. Exactly 31 days before her fourth attempt to stay out of prison.

Act Two was a phe­nom­e­nal win­dow into what Dr. George Vail­lant has termed, “the wis­dom of the inte­grated adap­tive cen­tral ner­vous sys­tem.” The Ego. Freud analo­gized this inex­plic­a­ble “medi­a­tor” of the war­ring storms of the mind, the Id & the super-Ego, to Plato’s horse­man attempt­ing to “ride two horses at once.” But Valiant concludes:

Over time, Freud’s model of the ego has evolved. What is out­side of us is as threat­en­ing as what is within. Inter­per­sonal rela­tion­ships and exter­nal real­ity are now con­sid­ered just as impor­tant to uncon­scious con­flict as the Id and the Super-Ego. Thus, the ego must con­trol four horses: desire, con­science, peo­ple, and reality.

I believe myself to be a “benign,” friendly pres­ence, but approach­ing Act Two, she imme­di­ately stepped back­ward against the wall. Once my pur­pose was explained, she cau­tiously came into the office, seated her­self and slowly began the forward-to-back rock­ing that would con­tinue until she went home. Prob­a­bly med­ica­tion, prob­a­bly mind, but rock­ing always strikes me, as an observer, a com­fort­ing, even sooth­ing behav­iour; like the rock­ing motion of those at the Wail­ing Wall, while uncon­scious, it nev­er­the­less “feels” proper. And slowly unfolded what you would pre­dict in schiz­o­phre­nia: a flat, range­less affect; min­i­mal direct eye-contact; delayed thought pro­cess­ing; abrupt, con­crete answers. While the ego pro­vides the capac­ity to “syn­the­size ideas with feel­ings”, here, as with so many, the capac­ity appears absent. “I watched my mother mur­der my father when I was 10.” And while there are two pris­ons for women in SoCal, and Act Two has a long and rich his­tory of incar­cer­a­tion, it appears they are delib­er­ately sep­a­rated. Raped by an uncle, and later gang-raped on the streets. My mind reels with the inflic­tion of such trauma on a child, but she only rocks, with not an inkling of emo­tion, as if she had told me about today’s lunch. “The ego strug­gles to cope and reduce the forces that work on it”. My approx­i­mate fifth ques­tion, “Do you have chil­dren?” unleashes a flood of tears and sob­bing. Now, I sim­ply wait this out to hear, “My old­est told my youngest ‘Mama is a drunk and I won’t lis­ten to her any­more.’ It would seem fool­ish — and I sus­pect point­less — to attempt to “quan­tify” the psy­cho­log­i­cal impact of mur­der, rape, or the loss of the respect of your chil­dren. The por­tent of which, how­ever, is real­ized in front of me. From which horse has the rider fallen?

Suf­fice it to say that next five acts, to lit­tle vary­ing degree, were sim­i­lar. And I say this to empha­size the impact of this day, not to sug­gest trite occur­rence. But the day ended as far too many end, with the tragic and con­clud­ing act. Act Eight was far too young to have the his­tory of devel­op­men­tal dis­abil­ity, psy­chopathol­ogy, lengthy state hos­pi­tal­iza­tions, court-ordered med­ica­tion, and vio­lent “inci­dents” that com­prised her story. She was loud, unkempt, eat­ing crack­ers with her mouth open & spilling onto her shirt as we spoke, and yawn­ing, yawn­ing, yawn­ing. She had a baby exactly 32 days prior to our “visit.” She was zooted to the max on med­ica­tions (Haloperi­dol, Risperi­done, VPA, Lithium Car­bon­ate, Diphen­hy­dramine, & Tra­zodone!), required an expla­na­tion of each and every detail, and I finally ended up writ­ing out, step-by-step, from the gate to home, what she needed to do in order to meet parole require­ments, arrange post-natal care, and find a “dual-diagnosis” drug treat­ment pro­gram. But she is a doc­u­mented pain-in-the-ass and manip­u­la­tor, so they want her to “do things for her­self.” Schizoaf­fec­tive, Bipo­lar Type, with the high­est level of devel­op­men­tal dis­abil­ity the CDC can deter­mine, Poly­sub­stance Abuse, and in 19 days will walk off a com­mer­cial bus into Comp­ton (You know, “God bless the mem­ory of Easy E,” Comp­ton”) to take cus­tody of her new­born. And before she left, she exer­cized the “time-honored” prison tra­di­tion of “play-you-as-a-sucker-until-proven-otherwise” by mildly ask­ing if she could use the phone to call her mother. With­out look­ing up from my paper­work, “Nope.” She started with the atti­tude, head bob­bing, hands and arms in that gangsta thing. “You won’t lose those papers I gave you, right? Should I put a copy in your mail­box?” “Nah, I’m cool.” And she was gone.

I did not write this with the inten­tion of exam­in­ing the why’s, the source or inher­ent responsibility/liability for “out­comes.” In fact, as some­one sim­ply con­fronted with peo­ple set before me, the why’s are of no prac­ti­cal sig­nif­i­cance. My ques­tion is how to under­stand the wreck­age, the waste, the tragedy that is before me. My pride, like a Job with­out right­eous­ness, ques­tions that this is, for now, “beyond my under­stand­ing,” and in fact, has a cos­mic sig­nif­i­cance. All tragedy — be it inno­cent chil­dren who wit­ness hor­ror beyond their com­pre­hen­sion, or those I wit­ness as grossly abused in every aspect of their exis­tence — is present for a rea­son I can­not com­pre­hend, but will ulti­mately be revealed as sen­si­ble, as part of an essen­tial plan, later.

My pride, like Job with­out right­eous­ness, is impa­tient. My pride, like Job with­out right­eous­ness, strug­gles to com­pre­hend why the opera will begin again in the morn­ing. My pride, like Job with­out right­eous­ness, seeks jus­ti­fi­ca­tion and com­fort for mak­ing eye-contact with empti­ness and chaos. Fr. John Breck, in the con­fi­dence of his heart and in the com­fort­ing soft­ness of his voice, once told me that, the greater the tragedy, the more inti­mately drawn is the pres­ence and hand of God. My pride, like Job with­out right­eous­ness, needs to believe.


Down­load Rachel Weep­ing for Her Chil­dren Redux as a PDF file


Notes:

  1. Note that, while I describe actual patients, on an actual day in clinic, I have been care­ful in con­ceal­ing their actual iden­ti­ties.

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